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Author(s): Seyed Mostafa Mirakbari (corresponding author) [1]; Amir Mohammad Kazemifar [1]; Peyman Namdar [2]; Mahyar Seddighi [3]; Abbas Allami [4]; Ameneh Barikani [5] INTRODUCTION Acute poisonings are increasingly exerting a [...], Background and Aims: To date, different methods have been invented to risk-stratify critically ill patients, however, there is a paucity of information regarding assessing the severity of poisonings. This study was designed to determine the comparative efficacy of Simplified Acute Physiology Score-II (SAPS-II) and Acute Physiology and Chronic Health Evaluation-II (APACHE-II)score with cardiac troponin I (cTnI) in predicting severe intoxication outcomes. Methods: This was a prospective study conducted on patients who fulfilled defined severe intoxication criteria necessitating intensive care unit (ICU) admission over a period of 6 months. SAPS-II and APACHE-II scores were calculated and cTnI concentrations were measured. These indicators were compared to determine which has the better ability to prognosticate mortality and complications. Results: A total of 55 cases (median age, 35 [24-49] years) were enroled. Eight patients (14.5) died. Mean SAPS-II, median APACHE-II score and median cTnI concentrations were 32.05 ± 11.24, 13 [10-17] and 0.008 [0.002-0.300] ng/ml, respectively, which were significantly different between the survivors and non-survivors. Receiver operating characteristics curve results of SAPS-II, APACHE-II score and cTnI concentrations in predicting mortality were 0.945, 0.932 and 0.763 and in predicting complications were 0.779, 0.739 and 0.727, respectively. High cTnI concentration (>0.37 ng/ml) correlated with soft clinical outcomes, including length of ventilatory support, length of ICU stay and length of hospital stay (LOS) (r: 0.928, 0.881 and 0.735 respectively; all P < 0.001). Conclusion: SAPS-II scores were superior in predicting death and complications, while cTnI correlated more closely with soft clinical outcomes, such as the length of ventilator support, length of ICU stay or LOS. Keywords: APACHE, mortality, poisoning, simplified acute physiology score, troponin

Background: Coronavirus disease 2019 (COVID-19) is a global pandemic that has spread worldwide. The high rates of morbidity and mortality associated with the disease are notable, causing significant socioeconomic damage in many parts of the world. Objectives: This study investigates the epidemiological status of COVID-19 in patients admitted to 15 hospitals between 2020 and 2021. Methods: In this multicenter cross-sectional study, we analyzed 18,653 patients with COVID-19 who were treated in hospitals. Demographic characteristics, symptoms, and comorbidities were also assessed. Additionally, the duration of hospitalization and the outcomes of the disease (recovery or death) were recorded. Data were extracted from the National Registry System of the Medical Care Monitoring Center (MCMC) and analyzed using SPSS software version 18. Chi-square and Fisher's exact tests were used to analyze categorical data. A P-value of less than 0.05 was considered statistically significant. Results: From February 4, 2020, to February 3, 2021, 18,653 patients were hospitalized in hospitals in Qazvin province with COVID-19 symptoms. A total of 2,678 patients died. Approximately 14.7% (2,614) of the patients required intubation, and 9.2% (1,635) required oxygen therapy. Cardiovascular diseases, hypertension, and diabetes mellitus were the most common comorbidities. Conclusions: The present study indicates that advanced age, underlying diseases, and intubation are associated with an increased risk of death in patients with COVID-19. Given the various strains of coronavirus, epidemiological studies are essential for the prevention, control, and understanding of this disease. [ABSTRACT FROM AUTHOR]

Background and objectives: High blood pressure increases the probability of insulin resistance and hyperinsulinemia. Also, insulin resistance can be defined as a risk factor for hypertension. The present study investigated the relationship between hypertension and insulin resistance in non-diabetic participants who were referred to Qazvin Metabolic Diseases Center. Material and methods: In this cross sectional study, 1103 participants (111 non-diabetic with newly diagnosed hypertension and 992 normotensive subjects aged = 20 years) were enrolled from September 2014 to April 2016 in Qazvin (Iran). Systolic and diastolic blood pressure, insulin resistance, waist circumference, body mass index, triglycerides, cholesterol, LDL-cholesterol, fasting blood glucose (FBG) were measured. Fasting triglyceride to highdensity lipoprotein cholesterol ratio (TG/HDL-C) was used as a surrogate of insulin resistance. Data were analyzed using SPSS software and p < 0.05 was assumed as significant level. Results: Ten percent of all participants had hypertension. TG/HDL-C was 3.78 ± 3.28 in non-HTN and 5.76 ± 5.35 in HTN participants (p < 0.001). The frequency of all cardio-metabolic risk factors (except HDL cholesterol level) was higher in hypertensive group, after adjusting for age and gender (p < 0.001). Conclusion: Based on these results, essential hypertension is associated with a higher prevalence of hyperinsulinemia and insulin resistance in the non-diabetic community in Iran. [ABSTRACT FROM AUTHOR]

The use of corticosteroids is one of the methods put forward for the strengthening and speeding up the process of labor. After identification of glucocorticoid receptors in human amnion, the role of corticosteroids in starting the process of labor has been studied in numerous studies. The purpose of this study was to determine the effect of intravenous Dexamethasone on preparing the cervix and on labor induction. A randomized, clinical, and double - blind trial was conducted on 172 women divided into a control and an experimental group. The inclusion criteria were that they had to be primparous, in or before the 40th week of pregnancy, and with Bishop scores (B.S.s) of 4 or lower. The exclusion criteria were diabetes, preeclampsia, macrosomia, twin pregnancy, rupture of the membrane (ROM), breech, and women suffering from background diseases. The B.S.s of the women was measured in charge of the study, and each woman was intravenously injected with eight milligrams of Dexamethasone or eight milligrams of distilled water. Four hours after the injections, the B.S.s of the participants was measured, and they were put under the conditions of labor induction using oxytocin. Information was collected in checklists A and B. The patients were compared with respect to B.S., the time the induction started, the average interval between the start of induction and the beginning of the active phase of childbirth, and the average length of time between the start of the active phase and the second stage of childbirth. The first and five minutes Apgar scores of the two groups of women were compared. The frequencies, the means, and the standard deviations were calculated using the SPSS - 16 software, and analysis of the results was performed with the Student's t- test and the chi-square test with P<0.05. There were no statistically significant differences between the two groups in terms of their age, period of pregnancy, and B.S. at the start of the study. The average B.S. of women four hours after the injections with Dexamethasone was 5.9 ± 1.57, and the corresponding figure for women in the control group was 4.6 ± 1.72. These figures were significantly different at P<0.001. The average interval between labor induction and the start of the active phase in the group injected with Dexamethasone was significantly less than that of the control group (2.87±0.93 versus 3.80± 0.93 at P<0.001). The average duration of the active phase of the second stage of childbirth was 3.47±1.10 hours in the experimental group and 3.6 ± 0.99 hours in the control group at P<0.49. These two figures were not significantly different. The Apgar scores of the first and fifth minutes after the birth of the children of the two groups of women were not significantly different. It was found that intravenous Dexamethasone improves the Bishop score of the cervix and thus causes softening of the cervix and reduces the length of time between labor induction and the start of the active phase of childbirth. [ABSTRACT FROM AUTHOR]

Orientation of public and physicians to the complementary and alternative medicine (CAM) is one of the most prominent symbols of structural changes in the health service system. The aim of his study was a determination of knowledge, attitude, and practice of general practitioners in complementary and alternative medicine. This cross- sectional study was conducted in Qazvin, Iran in 2013. A self-administered questionnaire was used for collecting data including four information parts: population information, physicians' attitude and knowledge, methods of getting information and their function. A total of 228 physicians in Qazvin comprised the population of study according to the deputy of treatment's report of Qazvin University of Medical Sciences. A total of 150 physicians were selected randomly, and SPSS Statistical program was used to enter questionnaires' data. Results were analyzed as descriptive statistics and statistical analysis. Sixty percent of all responders were male. About sixty (59.4) percent of participating practitioners had worked less than 10 years. 96.4 percent had a positive attitude towards complementary and alternative medicine. Knowledge of practitioners about traditional medicine in 11 percent was good, 36.3% and 52.7% had average and little information, respectively. 17.9% of practitioners offered their patients complementary and alternative medicine for treatment. Although there was little knowledge among practitioners about traditional medicine and complementary approaches, a significant percentage of them had attitude higher than the lower limit. [ABSTRACT FROM AUTHOR]

The ophthalmologic outcomes of diabetes were important. This research is conducted to assess the relation between diabetes and intraocular pressure changes in the patients of Avicenna Hospital, compared with healthy persons referring to the facility. With cross-sectional research, 400 persons including 200 diabetics and non-diabetics were selected on a random basis over one year in 2012. Research data were collected by examination and checklists, and then analyzed by SPSS 16 statistical software. Descriptive results were extracted, and the relation between the variables were analyzed by Chi2 test, t-test, Fisher's exact test, Pearson's correlation coefficient, with P. value less than 0.05 (P<0.05). In the group of diabetics, 37% and 63%were male and female respectively, while in non-diabetics group 47% and 53% were male and female. The mean age of diabetics patients were 54.17 ± 8.25 and non-diabetics 49.06 ± 7.26 years. Mean vision acuity of the right eye was 9.035 in the diabetics and 9.56 in the witness group. Mean intraocular pressure was 16.71 ± 1.96 mm/Hg in diabetics, and 12.86 ± 1.45 mm/Hg in non-diabetics, which showed a significant difference (t = 22.337, P=0.001). It is advisable that the intraocular pressure of diabetics be measured and recorded on a regular basis. [ABSTRACT FROM AUTHOR]

Vitiligo Vulgaris is a pigment disorder as the lack of skin pigmentation which its most prevalent cause is autoimmune. Vitamin D has various effects on the natural and acquired immune of the body because of its effectiveness on the T cells and B cells, macrophages and dendritic cells.The object of this study was assessment of the Vitamin D in patients with vitiligo vulgaris in dermatologic clinics in Qazvin in 2012. The 100 patients with Vitiligo were studied through a cross-sectional study. The required data were collectedby the questionnaire (age, gender, job, family background, consumption of the dairies and vitamin D supplements), examination (type of skin) and para clinical test (measurement of the serum 25-hydroxyvitamin D level). The 42 (42%) and 58 (58%) people of the population under study were respectively male and female. The mean age of the population under study was 28.7±1.17. The mean serum of 25-hydroxyvitamin D level was 42±24.14 which had a significance difference with a normal level (p<0.04). The mean serum 25-hydroxyvitamin D level among patients with Vitiligo had a significance difference with a normal level. [ABSTRACT FROM AUTHOR]

Background: 5TCoronary Artery Bypass Graft surgery (CABG) is one of the most common surgery procedures performed annually in worldwide. The objective of this study is to determine the prevalence and risk factors of the early neurologic complications emerged after CABG surgery. Materials and Methods: In a cross-sectional study we have investigated 160 consecutive patients undergoing CABG between July 2008 and April 2011 in cardiac surgery ward. Risk factors that evaluated in our analysis consist of hypertension (HTN), diabetes, age, sex, perioperative Myocardial Infarction (MI), postoperative atrial fibrillation, duration of aortic clamp, severity of carotid artery stenosis and addiction. Our dependent variables were delirium, CVA and seizure. The data were analyzed by SPSS-16 with Chi-square test and p<0.05. Results: In our analysis, of total 160 patients, 58 (36.2%) were female. Mean age of patients was 62.7±9.6 years. Of total patients, 71 (44.4%) were found to have HTN, 35.6% had diabetes, 18.8% had atrial fibrillation, 30.6% had a history of preoperative MI and 10.6% had addiction. Mean time of aorta clamp time was 78.5±8.9 min. The incidence rate of delirium after CABG was 12 out of 160 patients (7.5%) and for CVA were 2 (1.2%). There was not any seizure among our population. Of total patients, 7% of diabetic patients, 8.5% of patients with HTN, 16.7% with atrial fibrillation and 8.2% of patients with a history of preoperative MI affected with delirium after the CABG surgery. In our analysis, no significant correlation observed between delirium and these risk factors. In present study, duration of aortic clamp had a significant relation with CVA after CABG (p=0.0001). Conclusion: According to this analysis, duration of aorta clamp time is one of the most important risk factors of CVA after CABG. [ABSTRACT FROM AUTHOR]