Effects of COVID-19 pandemics on urinary metabolites in kidney stone patients: our kidney stone prevention clinic experience

BACKGROUND@#The dietary habits and lifestyle changes during the COVID-19 pandemic could affect the urinary risk factors in kidney stone formers. In this study, we investigated the effects of the COVID-19 pandemic on 24-h urine metabolites, as a surrogate for dietary intake, in patients with kidney stones, in Tehran, Iran.@*METHODS@#We evaluated the medical records of all patients with urolithiasis who visited in our stone prevention clinic from the beginning of COVID-19 in Iran to 1 year later (Feb 2020-Feb 2021) and compared it with the patients' medical records in the same period a year before COVID-19 (Feb 2019-Feb 2020).@*RESULTS@#The results of our stone prevention clinic showed a decrease in the number of visits during COVID-19. Twenty-four-hour urine urea, sodium, and potassium were significantly lower, and 24-h urine magnesium was significantly higher during COVID-19. Higher 24-h urine oxalate was only shown in patients with the first-time visit, whereas lower 24-h urine uric acid and citrate were only shown in patients with the follow-up visits.@*CONCLUSIONS@#COVID-19 pandemics may change some of the dietary habits of the patients, including lower salt, protein, and fruit and vegetable intake. Although economic issues, restricted access, or sanitation issues may be the reason for the undesirable dietary changes, the importance of a quality diet should be discussed with all patients, as possible. Since the number of patients visited in the stone clinic was lower during COVID-19, virtual visits could be an excellent alternative to motivate patients with kidney stones.

effect of pomegranate extract on survival and peritoneal bacterial load in cecal ligation and perforation model of sepsis in rats

Sepsis is one of the major causes of death in intensive care units. Oxidative stress and hyper-inflammation has been shown to be major cause of mortality and morbidity in septic cases. Pomegranate is a fruit considered for its antioxidant and anti-inflammatory properties. The aim of this study is to evaluate the effect of a standard pomegranate fruit liquid extract[POMx], on mortality and peritoneal bacterial load in cecal ligation and perforation [CLP] sepsis model. Male wistar rats were divided into four groups of 24 each: sham; CLP; prevention [consumed POMx [250 mg of polyphenols/kg/day] for 4 weeks before CLP]; treatment [received a single drink of POMx [250 mg of polyphenols/kg] after CLP]. Each group was divided into three subgroups, each containing eight animals, for bacterial load and survival [with and without antibiotics] studies. Sepsis was induced by CLP surgery. Ten day survival rate was recorded. Peritoneal bacterial load was also assessed. Data were analyzed using Log-rank and Kruskal-Wallis tests. There was no significant difference in survival rate of CLP, prevention and treatment groups, in subgroups without antibiotics. However, in subgroups with antibiotics, the prevention group had significantly lower survival rate than sham group [P 0.05]. Conversely, the bacterial load of prevention and treatment groups were significantly higher than sham group [P< 0.01]. Our study demonstrates for the first time that pomegranate extract could increase mortality rate via increasing peritoneal cavity bacterial load, in CLP sepsis model. More studies to assess mechanisms of this effect are warranted

Dietary intakes in asthmatic and non-asthmatic female pupils of Tehran

Dietary factors are suggested to be involved in recent increases in the prevalence of asthma. The differences in dietary intake of 23 asthmatic and 317 non-asthmatic students were investigated, who were chosen by multistage stratified cluster sampling. The dietary data were assessed by food frequency questionnaire and a 24-h recall form. Total calorie and fat intake were similar. Daily intake of Saturated and poly-unsaturated fatty acids, and calcium and sodium were significantly higher in asthmatics. There was no significant difference between dietary antioxidant intake of asthmatic and non asthmatics. It seems that in this age, the type of consumed fat may be more important than the amount of fat intake in inducing asthma. For accurate results, n-6 and n-3 fatty acid intake must be assessed. Higher sodium and calcium intake may also be associated with asthma. Randomized controlled trials with restricting diets can help to elucidate the results

Factors affecting patients' compliance to metered-dose inhaler drugs in two asthma clinics in Tehran, Iran

Asthma affects an estimated 300 million people worlwide. Poor compliance with the prescribed medication leads to increased morality and morbidity. Various determinants of compliance have been described. The purpose of this study was to determine factors that can influence patients' compliance with prescribed Metered Dose Inhaler drugs. 179 patients with diagnosis of asthma were selected from two asthma clinics in Tehran. 160 of them met the inclusion criteria. Collected data consisted of patients' demographic data, asthma symptoms and severity, medical history of patients and their attitude towards asthma control and using drugs. Compliance was assessed by four questions regarding using metered Dose Inhaler drugs. There was a significant correlation between compliance and patient's literacy level, attitude about using drugs, and their knowledge about asthma [p=0.012, p=0.0001, p=0.001 respectively]. However there was significant negative correlation between symptom control score and compliance [r=-0.270, p=0.004]. Other factors including sex, patients' attitude about asthma control and severity of asthma did not show any significant relation. There are four major factors influencing the patients' compliance: level of literacy, attitude towards asthma management, knowledge about asthma, and symptom control. The negative relation between compliance and symptom control may be caused by patients' inadequate knowledge towards continuing treatment after improvement in their conditions. The study emphasizes on the importance of enhancing the patients' compliance. This could be done by providing patients with adequate information about their disease and treatment

Association between asthma severity and obesity in two asthma clinics in Tehran

The prevalence of both obesity and asthma has increased in recent years. Thus we decided to investigate the relation between obesity and asthma severity. We undertook a cross-sectional study in outpatient asthma clinics of 2 tertiary hospitals in Tehran. Obesity was defined as a body mass index greater than 30. Asthma severity was defined by using the Guide for Asthma Management and Prevention 2004 guidelines, according to patients' clinical and/or spirometerical parameters. Active cigarette smoking patients and patients with a history of other lung diseases were excluded. A total of 116 individuals, aged 16-83 years with a mean age of 46.57 +/- 15.05 years, met the entry criteria. There were 73 females and 43 males. The prevalence of obesity in our study population was 29.3%. The Spearman correlation coefficient between asthma severity and body mass index was r= 0.275 [p= 0.001]. Mean body mass index of females and males were 28.95 +/- 5.41 and 25.17 +/- 4.17, respectively. Mean body mass index of females with asthma was significantly higher than males [p< 0.0001]. The odds ratios for obesity were 8.650, 8.746, and 22.491 for mild, moderate and severe persistent asthma, respectively, compared to patients with mild intermittent asthma. With increasing asthma severity, we observed higher occurrence of obesity in adults. The association of asthma severity with obesity suggests that obesity may be a potentially modifiable risk factor for asthma or asthma exacerbation