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Purpose: To assess the efficacy of interferon-beta1b (INF-beta1b) in combination with favipiravir in early treatment of patients with COVD-19 pneumonia. Methods: This prospective non-controlled study was performed on admitted patients with moderate to severe COVID-19 disease to Amir-Alam hospital. The diagnosis of COVID-19 pneumonia was based on positive RT-PCR test from nasopharyngeal samples and typical spiral chest CT scan findings. At the time of this study, there was the shortage of efficient anti-COVID drugs especially “Remdesivir” due to sanction of Iran. All the patients received subcutaneous IFN-beta1b plus favipiravir. The patients with severe infection received intravenous dexamethasone. Those who underwent invasive or noninvasive mechanical ventilation, at the admission onset, were excluded from the study. Results: One hundred and eighty-two patients with moderate to severe COVID-19 pneumonia were included in this study. Among182 patients, 90 cases had moderate and 92 had severe pneumonia. Twenty-one cases with severe pneumonia and 14 cases with moderate pneumonia were transferred to ICU to receive invasive or non-invasive mechanical ventilation. The mean duration of hospital ward admission and ICU stay was 10.69±7.54 and 5.45±2.72 days, respectively. One hundred and seventy-four patients (80.7 %) recovered completely and discharged without need to ICU admission. The response rate was the same in patients with moderate and severe pneumonia. Nine cases (4.9 %) were passed away. Diabetic patients had higher mortality rates. Conclusion: This study showed the efficacy of IFN-beta1b plus favipiravir in early treatment of patients with moderate to severe COVID-19 pneumonia who did not need to mechanical ventilation.

Characteristics of parathyroid glands usually determined by ultrasonography such as its total weight or volume might be a good indicator for the induction or suppression of parathyroid hormone (PTH) secretion from these glands. In the present study, we investigated the relationship between the volume and blood supply grade of the parathyroid glands, and its PTH secretion. Study subjects included 52 consecutive patients with the secondary hyperparathyroidism undergoing maintenance hemodialysis therapy referred to dialysis wards of the Imam Khomeini and Amiralam University Hospitals in Tehran. Serum intact PTH (i-PTH) was measured by an ELISA assay. The parathyroid glands characteristics were identified by ultrasonography that was performed simultaneously with blood collection. Parathyroid blood flows were evaluated by power-Doppler color imaging. There was no significant correlation between the total mass of the glands and serum concentration of i-PTH. No significant correlations were also observed between both total central and peripheral parathyroid glands blood flow and serum i-PTH level. Dialysis duration and serum alkaline phosphatase were significantly correlated in a positive manner with i-PTH level. Furthermore, serum level of i-PTH was not correlated with the total signals of glands blood flow in a multivariable linear regression analysis. Serum secreted i-PTH level might not be predictable by a total mass of parathyroid glands as well as their blood supply.

Leptin is the protein product of the obesity gene, which is produced in fat tissue. It was originally thought to be involved only in the regulation of food intake and energy balance. We aimed to investigate the relationship of serum leptin levels with bone mineral density (BMD) and biochemical markers of bone turnover in patients on hemodialysis (HD). This study included 72 patients (43 males and 29 females), whose mean age was 55.1 ± 11.4 years, mean body mass index was 23.13 ± 2.75 kg/m 2 and mean duration on HD was 5 ± 3.4 years. The BMD values were calculated using dual-energy X-ray absorptiometry (DEXA) at the femoral neck and lumbar spine. Blood samples were taken for leptin, intact parathyroid hormone (I-PTH), bone alkaline phosphatase (BAP), calcium (Ca), phosphate (P) and albumin. The leptin levels were higher in females than in males (22.3 ± 19.6 vs 20.8 ± 23), but this difference was not significant. The serum leptin level had a strong positive correlation with Ca levels in the female patients (r = 0.659 and P = 0.01) and a negative correlation with albumin levels (r = -0.461 and P = 0.01). No correlation was found with age, BMI, duration on dialysis, BMD and serum levels of PTH, BAP and P for the entire patient group or either gender separately. The serum leptin level was significantly lower in females with PTH >300 pg/mL when compared with patients with PTH = 100-300 pg/mL (86 ± 85 vs 47 ± 48) (P = 0.011).Women with BAP