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Background: Researchers have already reported a high level of interleukin (IL)-6 in patients affected by Coronavirus Disease 2019 (COVID-19). In this study, we investigated the surge of IL-6 level and its association with the clinical and paraclinical markers in these patients. Materials and Methods: The study sample comprised 205 confirmed hospitalized patients with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and 70 healthy volunteer individuals. Routine laboratory examinations, including hematology, biochemistry, and hormone analysis, as well as IL-6 level measurement, were conducted. The patients grouped into 5 based on their IL-6 levels. Then, they were compared with regard to their need for mechanical ventilator and clinical laboratory routine tests. Results: IL-6 levels were significantly higher in hospitalized patients compared with healthy individuals (P

Kidney involvement is a major cause of death and disability in patients with systemic lupus erythematosus (SLE). Early andaccurate determination of the type of involvement is essential in choosing the appropriate treatment for these patients. Thecurrent study aimed to determine whether laboratory findings are consistent with kidney biopsy for biopsy classification.This descriptive analytic cross-sectional study was performed on 17 patients with SLE admitted to rheumatology and nephrologydepartments. All patients underwent renal biopsy and received appropriate treatment according to the reported pathology. Dataanalysis was performed using SPSS software version 25. The participants comprised 14 females and 3 males with a mean ageof 32.23±11.12 years. The findings of this study showed that mean serum C3 and 24-hour urine protein concentrations weresignificantly different between the four studied groups according to the type of kidney pathology (p =0.042, p =0.041;respectively). No significant relationship was found between pathological findings and clinical signs, demographic information,and other laboratory findings (p >0.05). Based on the findings of the present study, it can be concluded that renal biopsy is themost accurate method available for the diagnosis and classification of lupus nephritis. Nonetheless, renal biopsy has limitationsincluding side effects, the need for an experienced pathologist, and suboptimality in some cases; renal biopsy was suboptimalin three cases of the current study. Therefore, noninvasive faster methods with high efficacy should be sought.

Background and objective: Vasculitis is a rare disease and its prevalence varies according to age, race, time and geographical location. Due to the fact that no study has been conducted in Iran to investigate the frequency, clinical and laboratory symptoms of vasculitis in a considerable population of vasculitis patients, so the need for this study is felt. The aim of this study was to evaluate the frequency and clinical signs of granulomatosis with polyangitis (GP) patients who admited in rheumatology ward of Valiasr hospital in the last 10 years.Methods and material: In this study, all patients with a possible diagnosis of vasculitis in the rheumatology ward of Valiasr Hospital during the past 10 years were evaluated. Then the GP patients were evaluated for clinical, laboratory, radiological, pathological findins, outcome, mortality, and major complications. Results: During the last 10 years, 223 vasculitis patients have been admitted to Valiasr hospital. Of these, 87 % were primary vasculitis and 13% were secondary vasculitis. The highest frequncy was related to GP (21.52 %) followed by Behcet's disease. Women and men were included 52.08 % and 47.91 % of GP patients, respectively. Upper and lower airway involvement and totally ear, nose and throat (ENT) involvement were the most common clinical symptoms in GP patients.Conclusion: According to the finding of this study, GP vasculitis was the most common type of vasculitis that ENT involvements were the most common clinical symptoms in this patients. However, more studies are required to confirm these data in Iran.

Background and objectiveRheumatoid arthritis (RA) is a chronic, inflammatory autoimmune disease characterized by inflammatory arthritis, rheumatoid factor (RF) and anti-cyclic citrullinated peptide (Anti-CCP) autoantibodies. In the present study, the aim was to register RA patients in Tehran Imam Khomeini Hospital.Methods and materialThe study population was RA patients referred to the rheumatology clinic of Imam Khomeini Hospital in Tehran, who were visited at this clinic in 1398 and were diagnosed during the 5 years ago. Demographic, clinical, and laboratory information of patients at the beginning of referral, 3 months, 1, 2, 3, and 4 years after referral were carefully recorded in each patients’ questionnaire.ResultsIn the first visit, 79 RA patients were examined and in the other 5 visits, 73, 52, 33, 20, 13 patients and all of 270 visits were examined, respectively. RF and Anti-CCP were positive in 58.22% and 62.02% of patients, respectively.The mean age of patients was 52.5±11.25 years. The results of the present study showed that the mean morning stiffness, DAS, arthritis, arthralgia, ESR and CRP decreased from the second visit to the five visits, which indicates disease control.ConclusionClinical and laboratory data showed considarable disease control, however, relapse of disease was seen due to drug discontinuation. Disease registry make it possible to recording the necessary information of each patient, including demographic, clinical, paraclinical findings and consultations, also gives the physician accurate access to patient information and unnecessary duplication of paraclinical examinations.

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with an unknown aetiology. Although there is no definite treatment for this disease using proper prescribed medications, mortality and morbidity ratios could be decreased. The present study attempted to investigate adherence to medical treatment in patients suffering from SLE and to evaluate the related factors which influence adherence in order to improve patients’ prognoses. In this cross-sectional study, 132 patients with SLE who referred to the rheumatology clinic of Imam Khomeini Hospital (Tehran, Iran) over the period of 2012-2013 wereexamined using a questionnaire. The applied questionnaire included two parts; the first part pertained to adherence to medication treatments (CQR: compliance questionnaire rheumatology), and the second part was related to the factors involved in adherence to medication treatments. The obtained data were analyzed using the Chi-Square test and processed by SPSS16.0 software.In this research, the mean adherence to drug treatment was calculated to be 72.48%. Among the variables of age, marital status, salary, education, distance from the clinic (accessibility), disease duration, level of patient activity, main medications consumed, and side effects, the only significant association was found between adherence level and lack of side effects due to SLE (p

Background: There are controversies regarding the diagnosis of lupus nephritis. Also, its clinical manifestations and severity are different from one patient to another. Objectives: The current study aimed to interpret clinical and laboratory features of lupus nephritis according to the results of the biopsy. Methods: Following a retrospective design, 30 patients with lupus, who were candidates for renal biopsy and undergoing kidney biopsy, were studied. Clinical findings (blood pressure and limb edema) and laboratory findings (Cr, ESR, CRP, BUN, C3, C4, CH50, Anti-ds DNA, and hematuria) were gathered. Finally, the diagnostic value of clinical and laboratory findings was interpreted according to the biopsies and the staging of samples in the pathology. Data were analyzed using SPSS. Quantitative variables are displayed using mean and quartiles. Fisher’s exact test was used to compare study groups. Also, independent samples t-test and Levene’s test were used to evaluate variances of quantitative variables. Results: Of 30 cases, 5 had a biopsy of 3 and FSGN. Also, 8 cases were on stages 3 and 4, 9 had a stage of 4 biopsy, and 8 cases were on stage 4 - 5, 5, and 5 - 6. The association between age, Limp edema, ESR, and biopsy was statistically significant (P < 0.05). Conclusions: This study demonstrated the usefulness of clinical and laboratory findings to determine the severity of the disease in the shortest time, mainly due to its easy, non-invasive access and early preparation of the results, which will facilitate the initiation of treatment.

Dermatomyositis (DM) and polymyositis (PM) are known as two major types of idiopathic inflammatory myopathies (IMMs). During the past years, growing data strongly suggest the clinical significance of myositis-associated autoantibodies (MAAs) and myositis-specific autoantibodies (MSAs). The present study aimed to determine the profile of MSAs and MAAs, subsequently to address the clinical significance of these autoantibodies in Iranian myositis patients.In this cross-sectional study, 28 DM and 24 PM patients were entered. Demographic and clinical characteristics were collected by direct examination and patients' medical record. The existence of MSAs and MAAs was assessed by indirect immunofluorescence then using immunoblotting (FA 1510-1005-1, DL 1530-1601-4 G; Euroimmun, Germany). Data were analyzed using the SPSS software (v22; SPSS Inc. Chicago, IL, USA).The mean age of the patients was 46.18 ± 12.95 years and male/female ratio was 28.8/71.2. Autoantibodies were positive in 63.46% of myositis patients. Interestingly, anti-TIF1γ and anti-PL7 were significantly associated with malignancy (P 0.001, P = 0.008; respectively). The existence of autoantibody and anti-Jo1 had significant relation with interstitial lung disease (ILD) (P = 0.034, P = 0.006; respectively). Joint involvements including arthritis and arthralgia were significantly associated with anti-Ro52 and anti-Jo1 (P = 0.04, P = 0.02; respectively).Taken together, it can be concluded that certain myositis autoantibodies present clinical significance which is in line with the literature. The use of these autoantibodies as biomarkers by line blotting along with indirect immunofluorescence facilitates diagnosis of inflammatory myopathies and makes it more accurate as well as better management of myositis patients if used based on a science-based manner. Key Points • Identification of MSAs and MAAs facilitates the diagnosis of inflammatory myopathies and provides better myositis patient's management if used according to a science-based manner. • Anti-rod and ring antibody was detected in a patient with ovarian cancer-induced dermatomyositis. • Malignancy and ILD are integrated parts of myositis which can be associated with MSAs and MAAs.

Rheumatoid arthritis (RA) is an autoimmune disease that is characterized by inflammation of the articular tissue. This study aims to evaluate the expression of microRNA (miR)-146a-5p, miR-24-3p, and miR-125a-5p in the plasma of RA patients and compare them with those of healthy controls to obtain a specific expression profile for earlier diagnosis and assistance in treating patients. This study was performed on 50 RA patients and 50 healthy controls. Five microliters of blood were taken from each patient/control. Plasma RNA was extracted using the Trisol solution. cDNAs were synthesized; using moloney murine leukemia virus (MMLV) and deoxynucleoside triphosphate (dNTP). Real-time PCR was performed using SYBR green kit. The mean expression of miR-146a-5p, miR-24-3p, and miR-125a-5p in the RA group were 8.1±1.9, 6.5±1.2, and 6.8±2.2 and in the healthy group were 4.8±1.6, 3.6±2.2, and 3.4±1.7, respectively. Significant differences were also observed in the mean expression of these three miRNAs in four subgroups of RA patients with different disease activity based on disease activity score 28 (DAS28) (p

The severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) spread rapidly all over the world in late 2019 and caused critical illness and death in some infected patients. This study aimed at examining several laboratory factors, especially inflammatory and immunological mediators, to identify severity and mortality associated biomarkers. Ninety-three hospitalized patients with confirmed coronavirus disease 2019 (COVID-19) were classified based on disease severity. The levels of biochemical, hematological, immunological, and inflammatory mediators were assessed, and their association with severity and mortality were evaluated. Hospitalized patients were mostly men (77.4%) with an average (standard deviation) age of 59.14 (14.81) years. The mortality rate was significantly higher in critical patients (85.7%). Increased serum levels of blood sugar, urea, creatinine, uric acid, phosphorus, total bilirubin, serum glutamic-oxaloacetic transaminase, serum glutamic-oxaloacetic transaminase, lactic dehydrogenase, C-reactive protein, ferritin, and procalcitonin were significantly prevalent (p=0.002, p

Introduction There are no determined treatment agents for severe COVID-19. It is suggested that methylprednisolone, as an immunosuppressive treatment, can reduce the inflammation of the respiratory system in COVID-19 patients. Methods We conducted a single-blind, randomised controlled clinical trial involving severe hospitalised patients with confirmed COVID-19 at the early pulmonary phase of the illness in Iran. The patients were randomly allocated in a 1:1 ratio by the block randomisation method to receive standard care with methylprednisolone pulse (intravenous injection, 250 mg·day−1 for 3 days) or standard care alone. The study end-point was the time of clinical improvement or death, whichever came first. Primary and safety analysis was done in the intention-to-treat (ITT) population. Results 68 eligible patients underwent randomisation (34 patients in each group) from April 20, 2020 to June 20, 2020. In the standard care group, six patients received corticosteroids by the attending physician before the treatment and were excluded from the overall analysis. The percentage of improved patients was higher in the methylprednisolone group than in the standard care group (94.1% versus 57.1%) and the mortality rate was significantly lower in the methylprednisolone group (5.9% versus 42.9%; p, This study showed that methylprednisolone pulse administration at the beginning of the early pulmonary phase of illness decreased the mortality rate and improved pulmonary involvement, oxygen saturation and inflammatory markers in COVID-19 patients https://bit.ly/3hik4JB

Background: Researchers have already reported a high level of interleukin (IL)-6 in patients affected by coronavirus disease 2019 (COVID-19). In this study, we investigated the surge of IL-6 level and its association with the critical health factors in these patients. Methods: The study sample comprised 111 confirmed hospitalized patients with SARS-CoV-2 and 70 healthy volunteer individuals. Routine laboratory examinations, including hematology, biochemistry, and hormone analysis, as well as IL-6 level measurement, were conducted. Findings: IL-6 levels were significantly high in hospitalized patients compared with healthy individuals (P < 0.001). The IL-6 level was approximately ten-fold of the normal range in 23.7% of the patients and more than 50% of them signify IL-6 over three-fold of normal range. The levels of BS, LDL, VLDL, ALP, TSH, CRP, platelets, neutrophils, and monocytes were significantly different between patients with diverse levels of IL-6. The values of triglyceride, LDL, VLDL, red blood cells and platelets showed an indirect linear trend and the levels of lactate dehydrogenase, serum glutamic oxaloacetic transaminase, creatine phosphokinase, dehydroepiandrosterone sulfate, and CRP demonstrated a direct linear trend with elevating rate of IL-6. Furthermore, IL-6 levels had a significant and direct correlation with troponin I, CRP, ferritin and pro-calcitonin while it had a significant and indirect correlation with VLDL.Interpretation: A hazardous level of IL-6 probably threatening the critical health factors and has a crucial role in immune-mediated acute lung injury in CIOVID-19 patients. Funding Statement: Immunoregulation Research Center of Shahed University Ministry of Health, Treatment and Medical Training of Iran. Declaration of Interests: The authors declare no conflicting of interests. Ethics Approval Statement: The study was approved by the National Ethics Committee on Research in Medical Sciences affiliated to the Iranian Ministry of Health (Ethical Code: IR.NIMAD.REC.1398.411).

Background: Rheumatoid arthritis (RA) is the most prevalent chronic infl ammatory disease of the joints. It is correlated with periodontal disease due to similar factors that exist in both diseases. The present study assessed the relationship of periodontal disease with RA and juvenile idiopathic arthritis (JIA). Materials and Methods: In this case-control study, 30 RA and 30 JIA patients along with similar number of matched controls were selected among patients referred to Imam Khomeini Hospital, Tehran, Iran. Periodontal parameters including pocket depth (PD), clinical attachment level (CAL), O’Leary and Bay plaque index (PI) and bleeding on probing (BOP) were determined in cases and controls. Erythrocyte sedimentation rate, number of painful and infl amed joints and severity of disease were evaluated in RA and JIA patients. Mann-Whitney U-test nonparametric, Spearman and Pearson’s correlation coeffi cients, and Chi-square tests were used as statistical analysis (α = 0.05). Results: PD (4.17 vs. 3.6 mm; P 4 mm (58.83% vs. 44.33%; P 3 mm (74.13% vs. 64.4%; P < 0.001), percentage of sites with BOP (9.67% vs. 6.87%; P < 0.0001) and PI index (85.73% vs. 80.63%; P < 0.0001) were signifi cantly higher in RA patients than controls. In this group, direct and signifi cant correlations were found between serologic fi ndings, disease severity and number of painful and infl amed joints with periodontal factors. In JIA patients, no signifi cant relationships were found between JIA fi ndings and periodontal parameters. Conclusion: Considering the limitations of this study, there was a relationship between RA and periodontal disease. Severity of periodontal disease increases in patients with RA, while no increased risk of periodontal disease or its severity was observed among JIA patients. Key Words: Juvenile, rheumatoid arthritis, periodontitis, case-control studies

The development of alternative approaches to prevent and/or treat osteoporosis, as a chronic progressive bone disease, is being considered currently. Among dietary supplements, probiotics may have favorable effects on bone metabolism. Therefore, the aim of this study was to evaluate the effects of a multispecies probiotic supplementation on bone biomarkers and bone density in osteopenic postmenopausal women.This randomized double-blind placebo-controlled clinical trial was performed on 50 patients with osteopenia aged 50-72 years. Participants were randomly assigned to take either a multispecies probiotic supplement (GeriLact; n = 25) or placebo (n = 25) for 6 months. GeriLact contains 7 probiotic bacteria species. Participants received 500 mg Ca plus 200 IU vitamin D daily. Bone mineral density (BMD) of lumbar spine and total hip and blood biomarkers including bone-specific alkaline phosphatase (BALP), osteocalcin (OC), collagen type 1 cross-linked C-telopeptide (CTX), deoxypyridinoline (DPD), parathyroid hormone (PTH), 25-OH vitamin D, and serum pro-inflammatory cytokines (tumor necrosis factor [TNF]-α and interleukin [IL]-1β) were assessed at baseline and at the end of the study.The multispecies probiotic significantly decreased BALP (p = 0.03) and CTX (p = 0.04) levels in comparison with the control group but had no effect on BMD of the spine and total hip. Moreover, there was a statistically significant decrease in serum PTH (p = 0.01) and TNF-α (p = 0.02) in the intervention group compared to the placebo group.These results may suggest the favorable effects of the multispecies probiotic supplementation for 6 months on bone health in postmenopausal women due to slowing down the rate of bone turnover.

The present study was conducted to determine the prevalence of T-score discordance and its risk factors in a group of patients with spinal cord injury in a university teaching hospital in the Iranian capital of Tehran.This cross-sectional study was conducted on paraplegic men undergoing bone density testing in an outpatient clinic at a hospital in the Iranian capital, Tehran, between March 2011 and 2012. A questionnaire on demographic and anthropometric characteristics, including age, height, weight, engagement in physical activity and personal smoking habits, was filled out for each subject. All the subjects underwent bone mineral density measurement and blood samples were sent for laboratory testing.Major T-score discordance between two sites was noted in 54 (41.22%) patients. Multivariate logistic regression revealed that every unit increase in serum calcium levels, as the only factor influencing T-score discordance, was associated with a 2.49-fold increased risk in T-score discordance in the area. As for the spine and radius, BMI was the only influencing factor as every unit increase in BMI was associated with a 14% lower risk for T-score discordance in these regions. Body mass index was the only factor, based on the multivariate model, affecting the risk of developing T-score discordance between two sites.Our study revealed the high prevalence of T-score discordance in patients with spinal cord injury. Physicians should therefore be encouraged to perform BMD at three sites when visiting patients with such injuries.

Background: Treatment of gastrointestinal symptoms in patients with systemic sclerosis has been a challenge for years. Drugs, immunosuppressive or anti-fibrotic have always been associated with complications. The effectiveness of probiotics as live microorganisms of nonpathogenic always was to treat the symptoms.Methods:In this clinical trial, 37 patients with systemic sclerosis with mild to severe symptoms in the intervention and control groups were studied. Inventory (UCLA SCTC GIT 2.0) was used for rating the severity of the gastrointestinal tract. Collected data was analysed by statistical methods using SPSS.19.Results: Improvement was seen in total score after the use of probiotics in gastrointestinal reflux condition ((P=0.001), gastric distention (P =0.001), emotional function ((P=0.001), social.Conclusions:This study showed that probiotics were significantly effective in treatment of gastrointestinal symptoms in patients with systemic sclerosis.