A multicenter study of severity and prognosis of symptomatic COVID-19 in end-stage renal disease and non-dialysis patients in East of Iran.

OBJECTIVES: This study aimed to assess the severity and related factors of symptomatic COVID-19 in end-stage renal disease (ESRD) patients from several centers in Eastern Iran. METHODS: In this retrospective cohort study, after obtaining ethical approval, 410 patients diagnosed with COVID-19 were included for analysis. Patients were categorized into two groups based on their dialysis status: the dialysis group (ESRD patients undergoing hemodialysis) and the non-dialysis group (those without chronic dialysis). Demographic information, clinical symptoms, laboratory tests at admission, length of hospitalization, ICU admission, need for mechanical ventilation, and mortality data were extracted from their medical records and entered into researcher-developed checklists. RESULTS: In this multicenter study, 104 dialysis patients with a mean age of 64.81 ± 16.04 were compared to 316 non-dialysis patients with a mean age of 60.92 ± 17.89. Patients were similar in terms of age and gender, but a higher percentage of the dialysis group was aged over 65 years (p = .008). Altered consciousness, dyspnea, headache, myalgia, anorexia, and cough were statistically significantly more common in the dialysis group when evaluating clinical symptoms (p < .05). The dialysis group had significantly higher levels of white blood cell (WBC), potassium, calcium, urea, creatinine, blood pH, INR, ALT, ESR, and CRP, and lower levels of red blood cell, Hb, platelets, sodium, and LDH compared to the non-dialysis group. Profoundly altered consciousness was more common among deceased patients (p < .001), and this group had higher WBC counts, urea levels, AST, ALT (p < .05), and lower blood pH (p = .001). CONCLUSION: Based on the results of this study, it is plausible to suggest a hypothesis of greater severity and worse prognosis of COVID-19 in ESRD patients. Underlying comorbidities, such as liver disorders or more severe clinical symptoms like altered consciousness, may also be indicative of a worse prognosis in dialysis patients with COVID-19.

The effect of scaling and root planning on the periodontal condition in hemodialysis patients: A clinical trial study.

Background and Aims: Periodontitis is very common in kidney patients undergoing hemodialysis. The two diseases interact with each other so that kidney failure exacerbates periodontal disease and periodontal disease increases the severity of the renal failure. This study aimed to compare the effect of scaling and root planning on the periodontal status of hemodialysis patients and the healthy control group. Methods: A clinical trial study of 60 subjects, 30 subjects in the dialysis group with chronic periodontitis, and 30 with chronic periodontitis who were systemically healthy was conducted. After a health education session, gingival pocket depth (PD) measurement, and clinical attachment level (CAL), scaling was performed for both groups. Then, the mentioned indices were measured consequently, at 4 and 8 weeks of treatment. Improvement in both groups was analyzed by Mann-Whitney and paired sample t-test at the significance level of 0.05 by SPSS software. Results: In both groups, the decrease in PD and CAL was steadily observed from the first to the third time and the changes from the first to the second and the first to the third time were significant however it was not significant between the second and third time. Mean PD and CAL in the dialysis group were higher than in the nondialysis group, which was significant (p < 0.001) for the mean PD. The mean improvement of PD and CAL in dialysis patients was 14.31 ± 10.48 and 17.60 ± 7.83%, respectively, and the mean improvement of PD in the nondialysis group was significantly higher than in the dialysis group (p = 0.008). Conclusion: Periodontal treatment (scaling) causes more improvement in periodontal clinical parameters in healthy people with periodontitis than in dialysis patients.

Effect of Magnesium Status on Microalbuminuria in Type 2 Diabetic Patients.

BACKGROUND: There are several controversies regarding the association between serum magnesium depletion and microalbuminuria in type 2 diabetic patients. OBJECTIVE: Therefore, this study aimed to assess serum magnesium concentrations in Type 2 diabetic patients with microalbuminuria and normoalbuminuria in Birjand, Iran, in 2019. METHODS: In this cross-sectional study, 25 type 2 diabetes patients with microalbuminuria were enrolled as the case group and 25 type 2 diabetes patients with normoalbuminuria as the control group. Both groups were matched for age, sex, hypertension, and dyslipidemia. Blood samples were obtained for serum magnesium measurement. RESULTS: Our findings showed no significant difference between serum magnesium concentration in the case and control groups (mean serum magnesium concentration for case group: 2.34 ± 0.35 mg/dl and control group: 2.27 ± 0.33 mg/dl). Pearson correlation coefficient analysis did not show any correlation between serum magnesium levels and urine albumin levels in patients with microalbuminuria versus patients with normoalbuminuria (r = 0.06, p = 0.67). CONCLUSION: This study did not indicate a correlation between serum magnesium concentrations and microalbuminuria in Type 2 diabetic patients.

Comparison of serum levels of vitamin D in periodontitis patients with and without type 2 diabetes and healthy subjects.

OBJECTIVE: The purpose of this study is to find out the levels of serum vitamin D in periodontitis patients with and without type 2 diabetes and to compare them with healthy subjects. METHODS: In this study, 48 periodontitis patients with type 2 diabetes mellitus (PDM), 53 periodontitis patients (P), and 42 controls who were in the age ranges of 30-50 years and had the entry requirements were selected. Plaque index, calculus index, modified gingival index, pocket depth, clinical attachment loss (CAL), and tooth loss were measured. Serum 25(OH)D level was estimated by electrochemiluminescence immunoassay, and fasting blood sugar and glycosylated hemoglobin were estimated by biochemical colorimetric assays. RESULTS: The mean serum 25(OH)D level was 17.06 ± 10.73, 15.12 ± 7.74, and 14.17 ± 11.04 ηg/ml for PDM, P, and control groups, respectively, showing no statistical difference. The mean CAL was significantly high in diabetic patients as compared to other groups. Prediabetes prevalence was significantly high in periodontitis patients as compared to controls. CONCLUSIONS: The prevalence of vitamin D insufficiency was high in the population studied. Serum levels of 25(OH)D showed no significant difference between groups. Periodontitis patients showed an elevated risk for diabetes.

Evaluation the Effects of Alpha-tocopherol in Comparison with N-acetylcystein for Prevention of Contrast Induced Nephropathy (CIN) in CKD Patients.

INTRODUCTION: Contrast induced nephropathy (CIN), a well-known complication of using radio contrast media, dramatically increases the likelihood of patient morbidity and mortality following coronary angiography. As there is no specific treatment for CIN, prevention could be the best strategy to address this issue. Since now, the only approved preventing strategy was hydration with normal saline while antioxidant agents as a new yet unapproved remedy for this purpose could be applied .The present study was conducted to examine the effect of alpha tocopherol in CIN prevention. METHODS: This prospective controlled trial was carried out on 201 patients with chronic kidney disease (eGFR < 60 cc/min) underwent coronary angiography. We assigned three groups of CKD patients: 72 patients who received prophylaxis administration with isotonic saline (Group A), 66 patients with isotonic saline plus N-acetylcysteine (1200mg twice a day) for 2 days (Group B) and 63 patients who received isotonic saline plus daily alpha tocopherol (600 IU once daily from one day before till 2 days after angiography) for 4 days (Group C). The contrast media in all three groups was nonionic iso-osmolal agent, Visipaque. RESULTS: Even though CIN didn't developed in any of the three aforementioned groups but there was statistically significant reduction in eGFR from baseline in all three groups (P < .001). Moreover, We found no statistically significant difference in GFR reduction between three studied groups. CONCLUSION: Administration of alpha tocopherol has no additive beneficial effect over isotonic saline in CIN prevention in CKD patients.

Evaluation of General Dentists' and Dental Specialists' Knowledge about Oral Cancer in South Khorasan-Iran 2014.

BACKGROUND: Oral cancer is one of the most prevalent cancers and one of the top ten causes of death in the whole world. Most oral cancers are diagnosed at late stages. Since dentists play a critical role in early detection of oral cancer, they should be knowledgeable and skillful in oral cancer diagnosis. The aim of this study was to survey dentist knowledge about oral cancer in Southern Khorasan Province. MATERIALS AND METHODS: This descriptive, cross-sectional study was conducted with dentists who participated in an in-service educational program at the Faculty of Dentistry of Birjand University of Medical Sciences in spring 2014. A questionnaire including demographic information with 11 questions regarding oral cancer was prepared. The participants were required to be complete the questionnaires within a specific time span. The data were analyzed using SPSS 15 software by t-test and one-way ANOVA at 0.05 confidence level. RESULTS: A total of 73 dentists out of 80 answered the questionnaires - 36 (49.3%) were females and 37 (50.7%) were males. Total mean score of knowledge was 7.91 ± 1 of 11. Mean scores of knowledge of male and female participants were 7.70 ± 1.83 and 8.13 ± 1.94 respectively. Mean knowledge score of general dentists was 7.41 ± 1.79 and of dental specialists was 9.44 ± 1.0 In spite of higher knowledge score of women compared to men and general dentists compared to dental specialists, these differences were not statistically significant (p=0.09). Tukey testing showed a significant difference between groups with 1-4 years of experience (8.74) and over twenty years of experience (6.50) ( p=0.001). CONCLUSIONS: Considering the good knowledge level of young dentists and the specialists and the importance of early diagnosis of oral cancer, it seems necessary to pay more attention to academic education for dentistry students, as well as holding retraining courses for experienced dentists, so that their knowledge not be reduced over time.