The Prevalence and Risk Factors of Metabolic Syndrome in Patients with Hemodialysis.

Introduction: Metabolic syndrome is a common disorder that puts patients at high risk for cardiovascular disease (CVD) and mortality. To our knowledge, there is no published study in Pub Med which evaluated both lifestyle and metabolic syndrome in hemodialysis patients. This study aimed to estimate the prevalence of metabolic syndrome and investigate the potential risk factors in hemodialysis patients. Methods: This was a cross-sectional study conducted on 204 patients enrolled conveniently. National Cholesterol Education Program Adult Treatment Panel III criteria considered for Metabolic Syndrome. Demographics, lifestyle, and disease characteristics were gathered. The relationship between metabolic syndrome and its severity with independent variables was investigated through multivariable multivariate logistic and linear regressions. Results: The mean (SD) age was 55 (14) years and 42% were women. 42.6% had metabolic syndrome. Low high-density lipoprotein (HDL), high fasting blood sugar, high blood pressure (BP), increased waist circumference (WC), and high triglyceride were observed in decreasing order of frequency in 54.4%, 44.1%, 38.7%, 33.3% 28.9% of patients, respectively. The logistic regression model revealed significant associations between metabolic syndrome and physical activity (OR=0.85, 95% CI : 0.74-0.97), mood (OR=1.04, 95% CI : 1.002-1.078), age (OR=1.023, 95% CI : 1.001-1.046), and missed work (OR=0.86, 95% CI : 0.76-0.97). The linear regression model revealed significant associations between metabolic syndrome severity score and physical activity (B=-0.12, 95% CI : -0.21-0.02) and sleep quality (B=0.017, 95% CI : 0.001-0.033). Conclusion: Poorer sleep quality, lower physical activity, lower mood status, and older age were associated with higher odds of metabolic syndrome/metabolic syndrome severity score in hemodialysis patients.

Prevalence of contrast-induced nephropathy after primary percutaneous coronary intervention at a tertiary referral hospital.

Objective: This study aimed to quantify the incidence of Contrast-induced nephropathy (CIN) in patients undergoing primary percutaneous coronary intervention (PPCI) due to acute ST-elevation myocardial infarction (STEMI). Methods: From April 2019 to March 2022, a prospective, observational study enrolled 213 consecutive STEMI patients referred to a tertiary hospital for PPCI. Participants were divided into tow groups based on the presence or absence of contrast-induced nephropathy. The chi-square test (χ2) and Student's t-test evaluated the data, with logistic regression identifying CIN's independent predictors. Results: Results: In this study, the incidence of contrast-induced nephropathy was observed at 13.1% (N = 28). Several factors were more prevalent among patients exhibiting contrast-induced nephropathy. These factors encompassed: radial access for coronary angiography over the femoral method (P = 0.021), elevated contrast volume (P = 0.003), smoking (P = 0.009), diabetes (P = 0.04), heart failure (P = 0.049), a history of coronary artery bypass graft (P = 0.006), diminished left ventricular ejection fraction indicating systolic dysfunction (P = 0.012), cardiogenic shock (P = 0.046), increased BUN at the time of admission (P = 0.043), decreased initial GFR (P = 0.004), and prior consumption of medications such as aspirin (P = 0.002), diuretics (P = 0.046), beta blockers (P = 0.04), angiotensin-converting enzyme inhibitors (P = 0.033), angiotensin receptor blockers (P = 0.02). Other relevant conditions included anemia (P = 0.012), leukocytosis (P = 0.011), hypercholesterolemia (P = 0.034), and reduced HDL levels (P = 0.004).Through logistic regression, key predictors for the onset of contrast-induced nephropathy were determined, which included heart failure (OR: 5.52; 95% CI: 1.08-28.24), radial access (OR: 12.71; 95% CI: 1.45-110.9), hypercholesterolemia (OR: 1.02; 95% CI: 1.004-1.04), increased BUN upon admission (OR: 1.11; 95% CI: 1.006-1.24), and leukocytosis (OR: 2.03; 95% CI: 1.18-3.49). Conclusions: While heart failure, radial access, hypercholesterolemia, elevated BUN at admission, and leukocytosis significantly influenced renal filtration deterioration post-PPCI, it's evident that CIN is multifactorial. Further studies are crucial to elucidate the underlying factors.

Evaluation of venom diversity and antivenom quality from the venom of long-term captive vs recently wild captured Pseudocerastes persicus snake: An In vitro and In vivo study.

Snakebite envenomation is a life-threatening condition and antivenoms are used as the most effective treatment. Venom obtained from snakes in long-term captivity showed some variations in comparison to the venom of the wild snakes. The objective of this study is to compare the venom of the Pseudocerastes persicus under long-term captivity and wild conditions as well as the antivenom obtained from these venoms. We have analyzed venom samples and produced trivalent antivenoms using the venom of long-term captive (LTC) or recently wild-captured (RWC) Pseudocerastes persicus, and RWC Macrovipera lebetina, and Echis carinatus. The HPLC analysis revealed that the RWC snakes' venom had three peaks that were not present in the LTC snake's venom. Further analysis using MALDI-TOF and MS/MS showed that the fraction with a retention time (RT) of 14 min contained a toxin from the Kunitz-type serine protease inhibitor (KUT) class, while the fraction with RT 21 a peptide identified within the snake venom metalloproteinase (SVMP) class. The third peak was identified as a sphingolipid. Interestingly, the in vivo preclinical tests showed no significant differences in the effectiveness of the antivenoms. which could be due to the cross-immunogenicity or cross-reactivity between different toxins in the venom. According to our results, small variations in the venom composition of a species do not lead to a decrease in the efficacy of the polyvalent antivenom.

ZnO/metal/ZnO (metal = Ag, Pt, Au) films for energy-saving in windows application.

In this paper, the impact of different metals (Ag, Pt and Au) on the ZnO/metal/ZnO samples, being coated on a Glass substrate via RF/DC magnetron sputtering system, is investigated. The structural, optical, and thermal properties of the as-prepared samples were systematically studied for the purpose of storage and production of energy in industry. Our results show that these layers can be used as suitable coatings on building windows for energy storage applications. In the same experimental conditions, the case of Au as the intermediate layer has shown to have better optical and electrical conditions. Then the Pt layer also led to further improvement of the properties of the samples rather than those of the Ag. Moreover, the ZnO/Au/ZnO sample has shown the highest transmittance at the visible region (68.95%) and the highest FOM (5.1 × 10-4 Ω-1). Therefore, it can be considered as relatively the optimum sample in order for the building windows to save energy because of its low U-value (2.16 W/cm2 K) and low emissivity (0.45). Finally, by applying the equivalent voltage of 12 V at the ends of the sample, the surface temperature of sample has risen from 24 to 120 °C.

Changes in 4-year antimicrobial resistance pattern of gram-positive bacteria at the main referral teaching hospital, Tehran, Iran.

Infectious diseases are one of the most common causes of morbidity and mortality and the spread of resistant microorganisms is playing a significant role in this regard. The purpose of this study was to assess the trend in antimicrobial resistance of gram-positive bacteria at the main referral teaching hospital in Tehran during a 4-year period. All patients' biological isolates such as blood, urine, wound drainage, synovial fluid, sputum, and cerebrospinal fluid sent to the central laboratory of the hospital from 2007 to 2010 for identification and subsequently, antimicrobial susceptibility testing by Kirby-Bauer disc diffusion method were considered. All isolates (100%) of S. aureus were sensitive to vancomycin and linezolid and resistant to amoxicillin. The rate of S. aureus resistance to oxacillin increased from 60.78% in 2007 to 72% in 2010. All isolates of Streptococci in 2007 and 2008 were sensitive to vancomycin; while, 3.33% and 4.76% of Streptococci isolates were reported to be vancomycin-resistant in 2009 and 2010, respectively. Enterococci isolated from the entire specimens were identified to be sensitive to teicoplanin and linezolid and resistant to cloxacillin and oxacillin. The rates of Enterococci sensitivity to vancomycin were 90.91%, 81.25%, 86.67%, and 93.3% in 2007, 2008, 2009, and 2010, respectively. Changes of antibiotics sensitivity against g positive pathogens were significant during four years in this study. To minimize the spread of resistant gram positive pathogens, periodic and regular surveillance of antimicrobial resistance pattern is highly recommended.

Changes in gram negative microorganisms' resistance pattern during 4 years period in a referral teaching hospital; a surveillance study.

BACKGROUND AND PURPOSE: Surveillance studies evaluating antimicrobial susceptibilities are of great value in preventing the spread of resistant pathogens by elucidating the trend of resistance in commonly used antibiotics and as a consequence providing information for prescribing the most appropriate agent. This study is a longitudinal antimicrobial resistance surveillance study designed to evaluate the trend in antimicrobial resistance to gram negative microorganisms from 2007 to 2010. METHOD: During a four-year period (2007-2010) isolates derived from all patients admitted to infectious diseases ward of Imam Khomeini Hospital, the major referral center for infectious disease in Iran with the highest admission rates, were evaluated. Based on disk diffusion method and zone of inhibition size, the microorganism was regarded as to be sensitive, resistant or has intermediate susceptibility to the antimicrobial agents. RESULTS: The widest spread Gram-negative microorganism in all of isolates taken together in our study was E.coli (30%) followed by Stenotrophomonas maltophilia in 28.6% and Enterobacter spp. in 11.9%, respectively. The susceptibility to amikacin, imipenem, piperacillin/tazobactam, and nitrofurantoin was equal or above 50% for all microorganisms over four years. However, the susceptibility to ampicillin, ampicillin/sulbactam, cefotaxim, and ceftriaxone was less than 50% in derived isolates during the study period. CONCLUSION: In conclusion, the finding of the present study revealed that resistance rate to common antimicrobial agents in Iran is growing and isolates were susceptible mostly to broad-spectrum antibiotics including imipenem and piperacillin/tazobactam.

Combination of aspiration and non-aspiration fine needle biopsy for cytological diagnosis of thyroid nodules.

BACKGROUND: Good cytological sample is very important for the cytological diagnosis of thyroid nodules. The aim of this study was to evaluate the adequacy of prepared samples by the combination of aspiration and non- aspiration fine needle biopsy. METHODS: In this descriptive - analytical study, sampling was done simultaneously for each patient in fine needle aspiration and non-aspiration biopsy. The sufficiency of samples was studied using Mair Scoring System. Wilcoxon Signed Rank test was used for the data analysis. RESULTS: Three hundred two cases (289 females, 13 males) with the mean age of 43.83±12.9 years were evaluated. Inadequate samples were 31 (10.3%) in fine needle aspiration, 40 (13.2%) in non-aspiration and 13 cases (4.3%) by using two methods together (p=0.0001). The average total score was 6.00±2.17 in fine needle aspiration and 5.76±2.26 in non-aspiration method (p=0.08), and 6.6±1.98 in the combination of the two methods (p<0001 comparing with one method alone). CONCLUSION: The results show that using both methods simultaneously in each nodule considerably increases the efficiency of samples for cytological diagnosis.