Paraclinical Characteristics Of Patients Research Articles

Chronic meningitis in adults: a comparison between neurotuberculosis and neurobrucellosis

BackgroundIn regions endemic for tuberculosis and brucellosis, distinguishing between tuberculous meningitis (TBM) and brucella meningitis (BM) poses a substantial challenge. This study investigates the clinical and paraclinical characteristics of patients with TBM and BM.MethodsAdult patients diagnosed with either TBM or BM who were admitted to two referral hospitals between March 2015 and October 2022, were included, and the characteristics of the patients were analyzed.ResultsSeventy patients formed the study group, 28 with TBM and 42 with BM, were included. TBM patients had a 2.06-fold (95% CI: 1.26 to 3.37, P-value: 0.003) higher risk of altered consciousness and a 4.80-fold (95% CI: 1.98 to 11.61, P-value: < 0.001) higher risk of extra-neural involvement as compared to BM patients. Cerebrospinal fluid (CSF) analysis revealed a significantly higher percentage of polymorphonuclear leukocytes (PMN) in TBM compared to BM (Standardized mean difference: 0.69, 95% CI: 0.18 to 1.20, P-value: 0.008). Neuroimaging findings indicated higher risks of hydrocephalus (P-value: 0.002), infarction (P-value: 0.029), and meningeal enhancement (P-value: 0.012) in TBM compared to BM. Moreover, TBM patients had a 67% (95% CI: 21% to 131%, P-value:0.002) longer median length of hospital stay and a significantly higher risk of unfavorable outcomes (Risk ratio: 6.96, 95% CI: 2.65 to 18.26, p < 0.001).ConclusionsOur study emphasizes that TBM patients displayed increased frequencies of altered consciousness, PMN dominance in CSF, extra-neural involvement, hydrocephalus, meningeal enhancement, and brain infarction. The findings emphasize the diagnostic difficulties and underscore the importance of cautious differentiation between these two conditions to guide appropriate treatment strategies.

Clinical Characteristics of Patients with Hematologic Malignancies and Invasive Aspergillosis: A Cross-sectional Clinical Report from Iran

Background: The incidence of invasive aspergillosis (IA) has significantly increased in recent decades. In patients with hematologic malignancies (HM), IA is associated with higher mortality rates. Objectives: This study aimed to assess the clinical features of IA in patients with HM. Methods: In this retrospective study, we used the hospital information system (HIS) database to extract clinical and paraclinical characteristics of patients with various HMs who received a diagnosis of probable or proven IA during their hospitalization at Imam Khomeini Hospital Complex in Tehran, Iran, between March 2018 and March 2022. Results: After evaluating 350 patients with HM, 51 patients with IA (14.6%) were identified, of whom 40 cases (78.4%) were probable and 11 (21.6%) were proven. Among these, 34 individuals (66.7%) were male. The most common symptoms were fever (n = 23, 62.7%), cough (n = 20, 39.2%), and fever that did not respond to antibiotic therapy (n = 16, 31.4%). The most prevalent malignancies were AML (n = 28, 54.9%), ALL (n = 16, 31.4%), and lymphoma (n = 7, 13.7%). Out of the 51 patients with HM and IA, 48 (94.1%) had abnormal findings on chest CT scans, with the majority (n = 31, 72.1%) showing a nodule with a halo sign. Aspergillus flavus (n = 19/24, 79.2%) was the most commonly isolated species. Initially, patients received liposomal amphotericin B or caspofungin as empiric antifungal therapy, which was then switched to voriconazole once the diagnosis of IA was probable or proven. Eight patients (15.6%) died. Conclusions: Patients with HM presenting with fever and cough should undergo close monitoring for IA. A higher incidence of IA is observed in AML patients, and voriconazole could be considered as antifungal prophylaxis in HM patients. A. flavus is likely the most frequent cause of IA in Iranian patients with HM.

Serum levels of neuregulin-1 in patients with coronary artery disease: clinical and pathogenetic aspects

Aim. To determine the relationship between the serum level of neu-regulin-1 (NRG-1) and the severity of coronary artery (CA) atherosclerosis and clinical and paraclinical characteristics of patients with coronary artery disease (CAD).Material and methods. The study included 264 people, of which 220 were patients diagnosed with coronary CAD. The patients underwent coronary angiography using the Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery (SYNTAX) score and echocardiography. The patients were divided into groups according to SYNTAX score: group 1 — with moderate CA atherosclerosis (≤22 (n=124); group 2 — with severe CA atherosclerosis (23-32) (n=53); group 3 — with extremely severe CA atherosclerosis (≥33) (n=43). Group 4 was represented by healthy volunteers (n=44). All subjects underwent a study of the serum NRG-1 (ng/ml) level. Statistical processing of the results was carried out using Statistica 10.0 software. Differences were considered significant at p&lt;0,05.Results. Significantly higher NRG-1 values were obtained in the control group compared to patients with CAD (p&lt;0,001). An inverse correlation was found between the NRG-1 concentration and the severity of CA atherosclerosis (p&lt;0,001). A decrease in NRG-1 concentration is associated with a high functional class of = heart failure (p&lt;0,01) and low left ventricular ejection fraction (p&lt;0,001). The significance of NRG-1 differences between groups of patients with a history of myocardial infarction (p&lt;0,001), angina pectoris (p&lt;0,01), permanent atrial fibrillation (p&lt;0,01), chronic left ventricular aneurysm (p&lt;0,01) and repeated myocardial infarction (p&lt;0,05) in comparison with patients without these pathologies.Conclusion. The identified correlations between the NRG-1 concentration and CAD, as well as the clinical and paraclinical characteristics of patients, makes it possible to consider NRG-1 as a reliable biomarker of CA and heart failure severity and may form the basis for the development of novel diagnostic approaches.

Gut microbiota at different stages of cardiovascular disease continuum

Aim. To study the relationship of gut microbiota (GM) composition with clinical and paraclinical characteristics of patients with coronary artery disease (CAD) and heart failure with reduced ejection fraction (HFrEF).Material and methods. The study included 64 patients (men, 71,9%) with CAD, 33 (men, 87,9%) with HFrEF and 38 (men, 63,2%) with various cardiovascular risk factors (control group). GM composition was assessed using real-time polymerase chain reaction and next- generation sequencing. To identify correlations of GM composition with clinical and paraclinical characteristics, the Spearman rank correlation coefficient (ρ) was calculated. Generalized linear models (QuasiPoisson, overdispersion) with covariates (age, body mass index) were used to compare groups by phylotype.Results. The relative abundance of Bacillota phylotypes is significantly higher in patients with CAD and HFrEF compared to controls (p&lt;0,001). The Bacillota/Bacteroidota dysbiosis ratio was also significantly higher in patients with CAD and HFrEF than in the control group (p&lt;0,001). According to correlation analysis, the relative representation of methanogenic archaea Methanomassiliicoccaceae, Methanomethylophilaceae (ρ=0,49, p&lt;0,0003) directly correlated with ventricular arrhythmias in patients with HFrEF.Conclusion. Patients with CAD and HFrEF differ significantly from the control group in GM composition at the phylotype level. In the study groups, Bacillota/Bacteroidota dysbiosis ratio was also significantly higher than in the control group. The relative abundance of the archaea Methanomassiliicoccaceae and Methanomethylophilaceae is associated with episodes of ventricular tachycardia/ventricular fibrillation.

Relationship between apoptosis markers and the severity of coronary atherosclerosis and clinical and paraclinical characteristics of patients with coronary artery disease

Aim. To assess markers of serum apoptosis markers depending on the severity of coronary atherosclerosis, as well as to study their relationship with clinical and paraclinical characteristics of patients with coronary artery disease (CAD).Material and methods. The study included 176 people (105 men and 71 women), of which 150 were patients with an established diagnosis of CAD, 26 — healthy volunteers (control group). The patients were divided into the following groups: group 1 — with coronary atherosclerosis without stenosis (n=17); group 2 — with hemodynamically insignificant (stenosis &lt;50%) coronary atherosclerosis (n=21); group 3 — with hemodynamically significant (stenosis &gt;50%) coronary atherosclerosis (n=112). Group 4 was represented by healthy volunteers (n=26). Patients underwent coronary angiography using the SYNTAX score, echocardiography, extracranial artery duplex ultrasound. All subjects were studied for the serum level of apoptosis markers Bcl-2, Bax, Bcl-2/Bax, TRAIL and p53. Statistical processing was carried out using the Statistica 10.0 software. Differences were considered significant at p&lt;0,05.Results. There was a very high correlation between the Bcl-2 (r=-0,84; p&lt;0,001), Bax (r=0,83; p&lt;0,001), Bcl-2/Bax (r=-0,86; p&lt;0,001), p53 (r=0,80; p&lt;0,001), TRAIL (r=-0,78; p&lt;0,001) and the severity of coronary atherosclerosis. A correlation of varying strength and significance was revealed between the values of these apoptosis markers and a number of clinical and paraclinical characteristics of patients. In addition, there were significant differences (p&lt;0,001) in Bcl-2, Bax, Bcl2/Bax, p53 and TRAIL between groups of patients with multifocal atherosclerosis, restenosis after previous revascularization and a history of myocardial infarction in comparison with patients without these signs.Conclusion. The correlations we have identified between laboratory signs of apoptosis and coronary lesions, clinical and paraclinical characteristics of patients, as well as the detected reliability of differences between groups with multifocal atherosclerosis, coronary artery restenosis and myocardial infarction in history, make it possible to consider these biomarkers as indicators of atherosclerosis severity. This can also be the basis for the development of novel treatment and diagnostic strategies.

Experience with Creutzfeldt-Jakob disease in a single referral center in Mexico. Case series.

Creutzfeldt-Jakob disease (CJD) is a rapidly progressive and fatal central nervous system disease caused by prions. To present the main clinical and paraclinical characteristics of patients with probable CJD in a referral center of Latin America. Retrospective study of patients diagnosed with rapidly progressive dementia between 2014 and 2019. Clinical, demographic, electroencephalogram, magnetic resonance imaging, and 14-3-3 protein characteristics were included, as well as positron-emission tomography (PET) data when available. Twenty-four patients met the criteria for sporadic CJD (75% were women). Mean age was 59.29 ± 11.67 years, while mean disease duration from symptom onset to hospital admission was 7.41 ± 6.54 months. The most common first symptom was behavioral changes (41.7%). Delta wave complexes prevailed (54.2%) on electroencephalogram, cortical hyperintensity (83.3%) on magnetic resonance and frontal hypometabolism (37.5%) on PET. Seven cases showed positive total Tau; five, positive 14-3-3 protein; and three, positive phosphorylated tau on cerebrospinal fluid analysis. There is significant clinical heterogeneity regarding initial symptoms. Auxiliary test findings were consistent with those of other series.

Evaluation of Biochemical Tests in Patients with Severe SARS-CoV 2 Infection and Need for Oxygen Therapy

Abstract Introduction: Since December 2019, when a cluster of pneumonia cases due to SARS-CoV-2 first appeared in China and then rapidly spread worldwide, the need for data on clinical but also paraclinical characteristics of patients with COVID-19 has been highlighted. Method: Between April 15, 2022, and July 31, 2022, 2583 RT-PCR tests were performed in the Emergency Clinical County Hospital Saint Andrei Constanta. Of these 463 were positive, 223 patients were hospitalized in different wards and 70 had severe forms requiring oxygen therapy. The present study aimed to evaluate laboratory data of patients diagnosed with severe SARS-COV2 infection requiring oxygen therapy to detect any parameters associated with more severe forms and reserved prognosis according to previous published research. Results: The patients in the study group were mostly from urban areas, had a mean age of 69.9 years (24-94), 59% were women, and 95.7% of them had associated comorbidities, (38.5% of them had 2 comorbidities and 30% even 3 comorbidities) the most common being hypertension (70%), diabetes mellitus (24.2%) and cardiovascular diseases (31.4%). In the group of patients analyzed showed increases in leukocyte count (48.5%), neutrophil count (52.9%) and decreases in lymphocyte count (72.8%), as well as a degree of anemia in 52.9% of patients. Increased values of inflammatory tests were also recorded: ESR (68.7%), CRP (77.6%), LDH (84%), Fibrinogen (59.3%). D dimers and ferritin were also detected with increased values in 85.7% and 84.2% of patients who had these parameters measured. Increases in urea (57.6%), creatinine (51.6%) and AST (51.6%) were detected but not in ALT. No notable changes in K, Na, AR were detected. Out of the total of 70 patients 45 patients received nasal tube oxygen therapy and the remaining 25 received bilevel positive airway pressure (BiPAP) ventilation. The death rate was 4.3% (3 patients died). CONCLUSIONS: the majority of patients with severe COVID 19 who required hospitalization and oxygen therapy were elderly, had at least one associated comorbidity, high levels of inflammatory tests and D-dimer and ferritin, and tests showing hepatic, renal or pulmonary damage.

INDICATIONS FOR THYROID SURGERYEXPERIENCE OF THE ENT DEPARTMENTOF MOULAY ISMAÏL MILITARY HOSPITAL IN MEKNES (ABOUT 103 CASES)

Introduction: The indications for thyroid surgery are currently well defined and specified in the consensus recommendations for the management of thyroid nodules, which would allow on the one hand to reduce the excessive number of thyroidectomies, and on the other hand would not allow a malignant lesion to evolve. Objectives: Our study aims to evaluate the epidemiological, clinical and paraclinical characteristics of patients who have undergone thyroidectomy and to discuss the different surgical indications. Patients and methods: This is a retrospective study spread over one year, from January to December 2019, involving 103 patients hospitalized for thyroid surgery, in the ENT (ear nose throat) department of Moulay Ismail military hospital in Meknes. Results: The average age of our population was 50.68 years and the sex ratio W/M was 5.86. The time to consultation was more than 2 years in half of the patients. The reason for consultation was cervical swelling in 88 cases, signs of hyperthyroidism in 27 cases and compression in 15 cases. All our patients have benefited preoperatively from a TSH assay and a cervical ultrasound. A cervico-thoracic scan was performed in all patients with plunging and/or compressive goiter. Cytopuncture could only be performed in 10 cases.Surgical indications were retained in case of suspected malignancy (56.31%) hyperthyroidism (26.22%), compressive goiter (14.56%), aesthetic discomfort (1.94%) and recurrent thyroid cyst (0.97%)The surgical procedure consisted of a total thyroidectomy in 81.5% of cases, a lobo isthmectomy in 8.7% of cases and secondary totalization in 9.7% of cases. The pathological study revealed thyroid cancer in 11.65% of cases. Postoperative follow-up was marked by the occurrence of a compressive hematoma in one patient, transient unilateral recurrent paralysis in 2 patients, transient hypoparathyroidism in 6 patients, and tumor recurrence in one case Discussion: Surgical indications have been proposed, primarily in case of suspected thyroid neoplasia, mainly based on clinical and ultrasound criteria. The cancer/benign tumor ratio was 13.2%. It was therefore important to develop the cytopuncture.Autonomous goiters/nodules and compressive and/or plunging goiters were the main other indications for surgery with low morbidity, but at the cost of permanent hypothyroidism. Conclusion: Surgery is the gold standard treatment for symptomatic thyroid goiters/nodules. However, its contribution must be constantly reassessed according to the evolution of new diagnostic procedures and alternative techniques.

CLINICAL, PARACLINICAL FEATURES OF PATIENTS WITH CYTOMEGALOVIRUS DISEASE AT THE NATIONAL HOSPITAL FOR TROPICAL DISEASES 2020 - 2022

Objectives: To describe the clinical and paraclinical characteristics of patients with CMV disease at the National Hospital for Tropical Diseases.Subjects and methods: Retrospective combined with a prospective cohort study on 58 patients diagnosed with CMV disease treated at the National Hospital of Tropical Diseases in 2 years from January 2020 to June 2022.Results: In a total of 58 patients with CMV disease, 56.9% of patients were male and the mean age was 45.57 ± 15.7 years. HIV (55.17%), history of prolonged corticoid therapy (20.7%), diabetes (10.34%), alcoholism (3.45%), transplantation (1.72%) were major comorbidities. Common clinical symptoms were:fever (74.13%), low visual acuity (37.93%), weight loss (31.03%), productive cough (31.03%), headache(27.59%), lymphadenopathy (24.14%), dry cough (22.41%). 43.1% had monocytosis status, most patientshad normal white blood cell (WBC) count, and slightly increased inflammation markers (ESR, CRP, PCT).The interquartile range of T-CD4 was48 (11.75 - 215), and 60% of patients had T-CD4 countless than 100cells/µL. There was no difference between two groups of HIV and non-HIV patients in sex ratio. The HIVgroup had higher mean age than non-HIV. Low visual acuity, lymphadenopathy, and weight loss were more frequent in the HIV group, and liver damage was only seen in the non-HIV group.Conclusion: The study showed that the clinical and paraclinical signs of CMV disease are diverse, nonspecific and need to be considered for screening in patients with suspected symptoms with a history of HIV, prolonged corticoid, diabetes, alcoholism, or transplantation.

Clinical and paraclinical profile of neuromyelitis optic spectrum disorder in a peruvian cohort

BackgroundNeuromyelitis Optica Spectrum Disorders (NMOSD) is an autoimmune, inflammatory disorder of the Central Nervous System that typically involves the spinal cord and the optic nerves. Recently, the clinical and radiological spectrum of NMOSD has been increasing in Latin America. In Peru, there have only been a few clinical reports on NMOSD published. For this reason, we aimed to assess the clinical and paraclinical characteristics of patients with NMOSD from a tertiary-level neurological center in Lima-Peru. MethodsThis is a descriptive study. We assessed medical reports of patients with NMOSD based on the 2015 diagnostic criteria attended in a goverment institute (Instituto Nacional de Ciencias Neurologicas) from Peru between 2013-2019. Those patients who met diagnostic criteria were selected and analyzed. We analyzed continuous data among groups (AQP4-IgG seropositive and AQP4-IgG seronegative/unknow). ResultsWe identified 58 clinical records that met the selection criteria and were included in the study. The highest percentage of patients (53%) were born in the north of Peru (from parallel 0°01’48’’S – 6°56’38’’S). NMOSD were more prevalent in women (86%), the male:female ratio was 1:6, the mean age at diagnosis was 50 years. AQP4-IgG antibodies were tested in (63.8%), 62% of whom were seropositive and 38% seronegative. The frequency of EO-NMO and LO-NMO was 34.8% and 65.2% in AQP4-IgG seropositive patients, respectively. Unknown AQP4-IgG was found 21 patients. In LO-NMOSD group, AQP4-IgG seropositive was found in a higher percentage. Optic neuritis was the first clinical event at 40% . In the patients who presented myelitis as the first clinical event, 18.2% were AQP4-IgG seropositive, while only 4.8% was found in the rest of the patients. 17% had other associated autoimmune diseases and 16% had anti-nuclear antibodies. 79% of patients had low vitamin D-25(OH) levels (<30ng/ml). Orbit MRI showed unilateral optic neuritis in 46.6%. Spinal cord MRIs showed extensive longitudinal myelitis in 52% of patients and the thoracic segment was the most frequently affected (47%). ConclusionsIn the present study of a peruvian NMOSD cohort, we found a higher frequency of unilateral optic neuritis cases, and a higher percentage of AQP4-IgG seropositive patients among those older than 50.

Level and correlations of soluble suppression of tumorigenicity 2 protein in heart failure and its relationship with clinical and paraclinical characteristics of patients

Aim. To establish the correlations of the soluble suppression of tumorigenicity 2 protein (sST2) and N-terminal pro-brain natriuretic peptide (NT-proBNP) with some clinical and paraclinical characteristics of patients with heart failure (HF).Material and methods. The study included 130 patients with HF (men — 54, women — 76, mean age, 64,3±8,3 years) from the regional registry of HF patients in the Voronezh Oblast. All patients underwent echocardiography and general clinical investigations. In addition, the serum levels of sST2 and NT-proBNP were determined and their correlations with other parameters were studied.Results. The blood level of sST2 in HF patients was 339,8 [266;405] pg/ml. In the study sample of patients with HF, sST2 levels correlated with right atrial (r=0,49) and right ventricular (r=0,32) sizes, left ventricular end-diastolic dimension (r=0,34) and volume (r=0,33), left ventricular early diastolic filling rate (r=-0,35), blood calcium level (r=-0,55) and functional class of exertional angina (r=-0,37).Conclusion. The data obtained may indicate a pathogenetic relationship between sST2 and systolic and diastolic dysfunction of the left ventricle and right heart.

Clinical and Paraclinical Characteristics of Patients With Coronary Artery Anomalies

Abstract Introduction Coronary artery anomalies are rare congenital abnormalities often found incidentally on conventional coronary angio-gram or coronary computed tomography angiography. They may result in various clinical outcomes. The objective of this study was to investigate the prevalence of coronary artery anomalies, the clinical and laboratory characteristics of patients with coronary artery anomalies, and the outcomes at five-year follow-up of these patients in a high-volume coronary interventional center in Romania. Materials and Methods To define the study population we reviewed all coronary angiograms performed between 01.01.2014 and 31.12.2014. A total number of 5832 coronary angiograms were analyzed, and we identified 31 patients with coronary artery anomalies. Results The prevalence of coronary artery anomalies was 0.53%. Eighty-seven point four percent of the patients had origin and distribution anomalies, and twelve point nine percent of the patients had a coronary artery fistula. The most common coronary artery anomalies were the anomalous origin of the right coronary artery and the anomalous origin of the left circumflex artery from the initial segment of the right coronary artery. Sixty-one point three percent of the patients underwent coronary angiogram due to atypical chest pain. Twenty-nine percent of the patients had significant coronary artery disease. No death or significant complication were recorded in the 31 patients during the 5 years follow-up. Conclusions The prevalence of coronary artery anomalies in this study was slightly lower but still like that of previous studies. The majority of patients presented with atypical symptoms, and only a minority had coronary artery disease. In the context of no death or significant complication at 5-year follow-up highlights the benign prognosis of most coronary artery anomalies.

Evaluation of clinical, epidemiological and paraclinical characteristics of patients diagnosed with COVID-19 and its relationship with disease severity in Amir Al-Momenin Hospital in Tehran

Evaluation of clinical, epidemiological and paraclinical characteristics of patients diagnosed with COVID-19 and its relationship with disease severity in Amir Al-Momenin Hospital in Tehran

Frequency, clinical, and paraclinical characteristics of patients with Bickerstaff brainstem encephalitis in a tertiary-referral neurological center

Frequency, clinical, and paraclinical characteristics of patients with Bickerstaff brainstem encephalitis in a tertiary-referral neurological center

Demographic and Clinical Characteristics of Patients Who Died of Methanol Toxicity During COVID 19 Period in Loghman-e Hakim Hospital in Tehran

Background: Outbreaks of methanol poisoning were observed during the COVID-19 pandemic. Acute methanol poisoning is a global crisis. Methanol can cause acute and fatal toxicity through metabolic acidosis. In the present study, we evaluated demographic, clinical, and paraclinical characteristics of patients who died in the recent outbreak of methanol poisoning in Tehran from March to April 2020. Methods: This cross-sectional study was accomplished at the Loghman-Hakim Hospital in Tehran on 80 patients who died of methanol toxicity. Demographic, clinical, and laboratory data were collected retrospectively from the patient’s files and analyzed with appropriate statistical tests. Results: Men were significantly more involved than women (%85 vs. %15). There were no significant differences between other characteristics of male and female patients, including the time between consumption to arrive hospital, dialysis sessions, pulse rate, respiratory rate, loss of consciousness, seizure, acute kidney injury, brain CT, and Intracerebral Hemorrhage ( ICH). Blood sugar, serum potassium, and liver function tests were higher than average in most of the patients. Conclusion: Our study showed that this outbreak of methanol poisoning was due to the use of alcoholic drinks that contain methanol. Men were primarily affected that could be because of the cultural and social status of our country. The greater seizure probability in females could be because of enhancing the NMDA receptor by estrogen. Abnormalities in Alanine aminotransferase (ALT), Aspartate Aminotransferase (AST), and Prothrombin Time (PT) were seen in most patients, indicating liver damage. Misbeliefs about the protective effects of alcohol consumption against COVID-19 may lead many to consume poorly made alcohols that contain methanol and outbreaks of methanol intoxication.

Inhibition of Renin-angiotensin System and Clinical Outcomes of COVID-19

Background and Aim: COVID-19 is an acute respiratory illness caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A few studies with conflicting results have been performed to evaluate the relationship between the use of angiotensin system inhibitors and COVID-19 outcomes. Therefore, this study was performed to compare the clinical and paraclinical characteristics of patients with COVID-19 in two groups of patients treated with angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) and the control group (no history of ACEIs/ARBs) in Kamkar and Shahid Beheshti hospitals in Qom City, Iran from March 14, 2019, to the end of September 21, 2020. Materials and Methods: This retrospective descriptive study was performed by reviewing the medical record of 359 patients with COVID-19, which was confirmed by a physician via lung scan or reverse transcription polymerase chain reaction (RT-PCR). We used the independent t test to compare quantitative variables and the Chi-square test to analyze qualitative variables. Results: The common clinical symptoms, number of hospitalization days, oxygen saturation, and lung involvement were not significantly different between the two groups. Weakness, nausea, and sweating were significantly reduced in the control group compared to the ACEIs/ARBs group (P&lt;0.05). Regarding the biochemical study, the patients’ hemoglobin levels and lymphocyte count on the first day of hospitalization in the ACEIs/ARBs group were significantly lower than the control (P&lt;0.05) Conclusion: These findings do not provide evidence of adverse or beneficial effects of angiotensin system inhibitors, so we require more detailed studies with a larger sample size.

Demographic and Clinical Characteristics of Patients Who Died of Methanol Toxicity During COVID 19 Period in Loghman-e Hakim Hospital in Tehran

Background: Outbreaks of methanol poisoning were observed during the Covid 19 pandemic. Acute methanol poisoning is a global crisis. Methanol can cause acute and fatal toxicity through metabolic acidosis. In the present study, we evaluate demographic, clinical, and paraclinical characteristics of patients who died in the recent outbreak of methanol poisoning in Tehran in March and April 2020. Methods: This is a cross-sectional study that was accomplished at the Loghman-Hakim Hospital in Tehran that performed on 80 patients who died of methanol toxicity; demographic, clinical, and laboratory data were collected retrospectively from the patient’s files and analyzed with appropriate statistical tests. Results: Men were significantly more involved than women %85 vs. %15. There were no significant differences between other characteristics of male and female patients, including time between consumption to arrive hospital, dialysis sessions, pulse rate, respiratory rate, loss of consciousness, seizure, acute kidney injury, brain C.T. and ICH (intracerebral hemorrhage). BS (blood sugar) and liver function tests and serum potassium were higher than average in most of the patients. Discussion and conclusion: Our study shows this outbreak of methanol poisoning was due to the use of alcoholic drinks that contain methanol. Men were primarily affected that could be because of the cultural and social status of our country. The greater seizure probability in females could be because of enhancing the NMDA receptor by estrogen. Abnormality in ALT (alanine aminotransferase), AST (aspartate aminotransferase), and PT (prothrombin time) was seen in most patients, indicating liver damage. Misbeliefs about the protective effects of alcohol consumption against COVID-19 may lead many to consume poorly made alcohols that contain methanol and outbreaks of methanol intoxication.

Clinical and anamnestic characteristics of patients with non-ST elevation myocardial infarction after COVID-19

Aim. To study clinical, medical history and paraclinical characteristics of patients with non-ST elevation myocardial infarction (NSTEMI) after coronavirus disease 2019 (COVID-19).Material and methods. The study included 209 patients with NSTEMI who were admitted to the Demikhov City Clinical Hospital (Moscow). The patients were divided into 2 groups: the experimental one (n=104) — those after COVID-19, the control one (n=105) — those without history of COVID-19. All patients underwent routine diagnostic investigations in accordance with current standards and clinical guidelines.Results. The mean age of patients in the experimental group was 61,8±12,2 years, while in the control one — 69,0±13,0 years (p&lt;0,0001). Myocardial infarction developed 49 days [34.0; 82.0] after COVID-19. Prior exertional angina was observed in 76,9% of patients in the experimental group and in 88,6% in the control one (χ2 =4,97; p=0,0258). The level of C-reactive protein in the experimental group was 19,2 mg/l [4,9; 53,0], and in the control one — 5,6 mg/l [0,4; 21,8] (p=0,0007). The average troponin I level in the experimental group was 2,7 ng/ml [1,3; 8,0], while in the control one — 1,8 ng/ml [0,8; 3,5] (p=0,0091).Conclusion. Patients with NSTEMI after COVID-19 were significantly younger compared to patients without a history of COVID-19. They had less common exertional angina prior to MI, while C-reactive protein and troponin I levels were significantly higher than in the control group. In addition, in NSTEMI patients after COVID-19, the estimated pulmonary artery systolic pressure was significantly higher compared to patients without a history of COVID-19.

Salvation to Hearts in Distress under Shells of Stress: Subtotal Pericardiectomy in a Series of 9 Patients with Constrictive Pericarditis

Objective: Chronic constrictive pericarditis (CCP) is a rare entity responsible of diastolic heart failure. The true prevalence is yet to be defined. The purpose of this study was to describe the clinical and para-clinical characteristics of patients with CCP, the therapeutic management, the outcomes and impacting factors. Materials and Methods: We conducted a retrospective descriptive study from 2017 to 2020 including 9 patients hospitalized for CCP in our cardiovascular surgery department. Results: The mean age was of 32.6 years. Majority were men (n=7). Dyspnea was the most common sign. Peripheral signs were dominated by signs of right heart failure. Cardiac ultrasonography showed pericardial thickening and calcifications with Doppler adiastolic signs in 90% of cases. Thoracic CT was performed in 7 patients, cardiac MRI in one patient, showing calcifications and measuring the pericardial thickening. Cardiac catheterization performed in 6 patients showed the aspect of Dip plateau. Tuberculosis etiology was retained in 55.6%; post-radiation origin in one patient and 33.4 % of cases were idiopathic. All of patients benefited from subtotal pericardiectomy with good results in the medium and long term. Two deaths occurred, the first patient died following multi-visceral failure, the second died 3 years later from neoplasia. Conclusion: The CCP is a rare condition with poor prognosis. The diagnosis should be raised when there are signs of right heart failure associated with signs of hemodynamic adiastolia. The echocardiography, with computed tomography or cardiac MRI and especially cardiac catheterization confirm the diagnosis and also etiological orientation. Tuberculosis and idiopathic etiologies were the most common at our country. Medical treatment options are limited. Pericardiectomy remains the only radical treatment with good results in immediate, medium and long term.

Clinical and paraclinical characteristics of patients undergoing hemodialysis

Introduction: End-stage renal disease (ESRD) is an irreversible decrease in kidney function with severe consequences. Objectives: The aim of this study was to investigate clinical and paraclinical characteristics of hemodialysis patients. Patients and Methods: This study was a descriptive-analytical performed on 105 patients undergoing hemodialysis referred to Bou Ali and Velayat hospitals in Qazvin. The data were included age, gender, duration of dialysis, kind of vascular access, kind of catheter, site of catheters, weight, height, systolic and diastolic blood pressure, kind of flux, use of midodrine, kind of dialysis solution, number of dialysis per week, calcium (Ca), iron, total iron binding capacity (TIBC), ferritin, parathyroid hormone (PTH), Kt/V, blood urea nitrogen (BUN) and creatinine (Cr). The data were analyzed using SPSS version 21. Results: The mean age of the patients was 60.97±15.13 years and 44.8% of the patients were females. The mean number of dialysis per week was 2.84 times with a mean duration of 3.90 years. The mean Cr level was 8.89±3.14 mg/dL. Males had higher level of BUN (55.91±16.06 mg/dL versus 65.24±17.53 mg/ dL, P=0.006) and Cr (8.09±2.43 mg/dL versus 9.59±3.47 mg/dL, P=0.010). Arteriovenous fistula/AVF was the most common vascular access (76.2% of cases). With increasing BUN, number of dialysis per week and weight, the level of Cr increases significantly (P&lt;0.05). In the younger patients, Cr showed low level compared to the older patients. Conclusion: The number of dialysis per week, weight and BUN level is factors to predict the level of Cr and with increasing these factors, the level of Cr increases. The mean Cr level was high which showed inadequacy of hemodialysis in these patients. The level of Cr and BUN is higher in men.