Aim: The aim of this study was to compare the different phases of chronic Hepatitis B virus (HBV)... more Aim: The aim of this study was to compare the different phases of chronic Hepatitis B virus (HBV) infection with different values for normal ALT. Background: For many years, the upper limit of 40 IU was considered normal for ALT for both sexes, but in recent years this value is challenged and some guidelines have lowered their limit. Methods: In this cross-sectional study, 2000 HBsAg positive patients who were referred to Taleghani Hospital, Tehran, Iran, from 2011 through 2018 were classified in four groups according to American Association of the study of the liver disease (AASLD), European Association of the study of the liver (EASL) /Asian-Pacific Association of the study of the liver (APASL) and American Collage of Gastroenterology (ACG) guidelines. The frequency of each group based on 3 different guidelines was compared. Results: In HBeAg positive patients (n=100), the percentage of immune tolerance phase was 43% according to AASLD cutoff for normal ALT (35 IU for men, 25 IU for women), while it was 68% and 28% with regard to EASL/APASL and ACG (30 IU for men, 19 IU for women) cutoffs respectively. In HBeAg negative patients (n=1900), 66.68% were inactive carriers according to AASLD, but the percentage changed to 82.89% and 52.42% considering EASL/APASL and ACG values, respectively. Conclusion: Using ACG and to a lesser extent AASLD cutoff for ALT, many patients shift from immune tolerance and inactive carrier state into the immune active phase. Thus, more patients are candidates for treatment or intensive workup to determine the extent of liver damage.
Introduction: The estimated prevalence of functional bowel disorders and its subtypes varies enor... more Introduction: The estimated prevalence of functional bowel disorders and its subtypes varies enormously depending on the diagnostic criteria employed. This study aimed at estimating the prevalence and risk factors of functional bowel disorders in an Iranian community. Methods: This study was a cross-sectional household survey conducted from May 2006 to December 2007 in Tehran province, including 18,180 participants who were randomly selected and interviewed face-to-face using a validated questionnaire based on Rome III.
International journal of travel medicine and global health, Dec 8, 2020
Introduction Coronavirus disease 2019 (COVID-19) caused by a new coronavirus is called severe acu... more Introduction Coronavirus disease 2019 (COVID-19) caused by a new coronavirus is called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), detected in Wuhan city, China on December 31, 2019, and then the World Health Organization (WHO) declared the outbreak a global health emergency on January 30, 2020, and a global pandemic on March 11, 2020. 1 The global pandemic of COVID-19 infection has emerged as a highly pathological and widespread virus in humans and as a serious disease in the field of public health and global concern with high morbidity and mortality rates. 2 According to the study by Jin et al, 3 about 13% of the patients with confirmed COVID-19 infection reported severe respiratory symptoms, among which 2% died. As of 29 November 2020, a total of 62 634 553 confirmed cases of COVID-19 have been reported, including, 1 459 325 deaths and 43 241 504 have been reported as recovered from COVID-19 worldwide. 4 Given the prevalence and mortality rate of the COVID-19 pandemic, it has affected economic, political, social, and even military sectors in all the countries around the world. Therefore, this pandemic is not just a medical phenomenon; it especially affects the mental health of individuals, which raising worries of widespread panic and growing anxiety in individuals exposed to the hazard of the virus or among certain groups in particular, older adults, care providers and people with underlying health conditions. 5,6 Thus, it is highly http://ijtmgh.com
DOAJ (DOAJ: Directory of Open Access Journals), Dec 1, 2021
Background and aims the role of serum neutrophil gelatinase-associated lipocalin (NGAL) in predic... more Background and aims the role of serum neutrophil gelatinase-associated lipocalin (NGAL) in predicting delayed graft function (DGF) after kidney transplantation is poorly de ned. The objective of this study was to evaluate the serum NGAL expression in the early postoperative phase after kidney transplantation and compare it with serum creatinine (Cr). Methods We studied 32 patients who received kidney transplantation from deceased (n=24) and live
Asia-pacific Journal of Clinical Oncology, Jan 24, 2022
In spite of decreasing the overall incidence of gastric cancer (GC), it remains one of the most c... more In spite of decreasing the overall incidence of gastric cancer (GC), it remains one of the most common and deadly cancers worldwide. The incidence and mortality rate of GC is very different in the world. Geographical differentiation is one of the most distinctive characteristics of GC. Effective prevention and early diagnostic strategies are the most important public health interventions in GC, as a common malignancy worldwide. Notably, the preventive strategies require understanding the risk factors associated with GC for identifying high‐risk groups that may require screening for prevention. Therefore, up‐to‐date statistics on GC occurrence and outcome are essential for the primary prevention of the disease. We conducted this review based on the current epidemiology knowledge of GC to provide an update perspective of GC in Asia‐Pacific region. Based on the findings of this study, incidence and mortality rate of GC in Asia‐Pacific region shows a great heterogeneity. Gastric carcinogenesis arises as a consequence of a complex interaction between host and environmental factors. In addition to screening and eradication of Helicobacter pylori (H. pylori) infection, it seems that the main cause of GC is an undesirable lifestyle in this region. Therefore, it is necessary to improve the lifestyle and the community awareness about GC risk factors and healthy lifestyle education.
Upper gastrointestinal bleeding (UGIB) remains a common medical problem worldwide. It is an emerg... more Upper gastrointestinal bleeding (UGIB) remains a common medical problem worldwide. It is an emergency medical condition, which may require hospital admission. UGIB also increases the risk of morbidity, and mortality and uses health care resources. The aim of this study was to determine the endoscopic findings and their frequencies in patients with UGIB with regard to age in Tehran's Taleghani Hospital. Materials and Methods: The medical records and endoscopy reports of 990 patients, who underwent endoscopy for UGIB in Tehran's Taleghani Hospital over a period of 2 years from 2010 to 2012, were retrospectively analyzed. Results: A total of 990 patients consisted of 594 (60%) men and 396 (40%) women had endoscopy for UGIB. Mean (±SD) age of the patients was 54 (±17.2) years. The commonest (45.5%) cause of UGIB was peptic ulcer disease, which included; duodenal ulcer (26.4%), gastric ulcer (19.1%), followed by esophageal and gastric varices (19.5%). Malignant conditions (cancers) contributed to 14.7%, which included gastric cancer (7.2%), esophageal cancer (5.5%), and duodenal cancer (2%). Other less frequent causes of UGIB were esophageal ulcer (6.7%), erosive gastritis (6.3%), Mallory-Weiss syndrome (5.4%), and Dieulafoy's lesion (1.2%). Normal endoscopic findings were recorded in 0.7% of the patients with UGIB. Conclusion: Peptic ulcer diseases are the commonest cause of UGIB followed by esophageal and gastric varices.
Aim: The objective of this study was to determine the epidemiologic characteristics of patients w... more Aim: The objective of this study was to determine the epidemiologic characteristics of patients with liver cirrhosis. Background: Liver cirrhosis is an end-stage condition of chronic liver disease. Liver disease is an important cause of morbidity and mortality worldwide. Methods: In this cross-sectional study, demographic and epidemiologic characteristics of 203 patients with liver cirrhosis who were admitted in Taleghani Hospital over a period of two years were determined. Results: A total of 203 patients with liver cirrhosis consisted of 136 (67%) males and 67 (33%) females and the mean age was 53.7±15.2 years. No etiology were found in (59.6%) cirrhotic patients; therefore, they were labeled as cryptogenic cirrhosis, but according to clinical evidence and ultrasonography findings, (29.7%) of these patients were probable NAFLD. The other causes of liver cirrhosis in this study were HBV (20.2%), HCV (11.8%) and autoimmune hepatitis (AIH) (8.4%), respectively. Esophageal varices were present in (41.9%), ascites in (36.5%), variceal bleeding in (8.9%), encephalopathy in (7.4%) and spontaneous bacterial peritonitis (SBP) in (5.4%) of patients. When cirrhotic patients were grouped according to Child-Pugh classification, 26.1%, 54.7% and 19.2% were in classes A, B and C respectively. The mean MELD score was 16.16±7.7. Conclusion: In this study we found that the leading etiology of cirrhosis is cryptogenic cirrhosis 59.6% (in all age groups) and followed by HBV. Noteworthy, according to the clinical and ultrasonography findings, 29.7% of patients who were labeled as cryptogenic cirrhosis were consistent with NAFLD.
Background: Despite advances in the treatment of abdominal injuries in patients with trauma, it r... more Background: Despite advances in the treatment of abdominal injuries in patients with trauma, it remains a major public health problem worldwide. Evaluation of hazard ratio (HR) of 90-day mortality in intensive care unit (ICU) patients with abdominal injuries compare with head injuries in trauma patients and non-trauma surgical ICU patients. Methods: This single-center, prospective cohort study was conducted on 400 patients admitted to the ICU between 2018 and 2019 due to trauma or surgery in Hamadan, Iran. The main outcome was mortality at 90-day after ICU admission. Cox proportional hazards models were used to determine the HR and 95% confidence interval (CI) for 90-day mortality. Results: The 90-day mortality was 21.9% in abdominal injuries patients. According to multivariate Cox regression, the expected hazard mortality was 2.758 times higher in patients with abdominal injuries compared to non-trauma patients (HR: 2.758, 95% CI: 1.077-7.063, P = 0.034). About more than 50% of all deaths in the abdominal and head trauma groups occurred within 20 days after admission. Mean time to death was 27.85 ± 20.1, 30.27 ± 18.22 and 31.43 ± 26.24 days for abdominal-trauma, surgical-ICU, and head-trauma groups, respectively. Conclusion: Difficulty in accurate diagnosis due to the complex physiological variability of abdominal trauma, less obvious clinical symptoms in blunt abdominal injuries, multi-organ dysfunction in abdominal injuries, failure to provide timely acute care, as well as different treatment methods all account for the high 90-day mortality rate in abdominal-trauma patients. Therefore, these patients need a multidisciplinary team to care for them both in the ICU and afterwards in the general ward.
Clinical, Biological and Molecular Aspects of COVID-19, 2021
AIM We aimed to describe the epidemiological and clinical characteristics of Iranian patients wit... more AIM We aimed to describe the epidemiological and clinical characteristics of Iranian patients with COVID-19. METHODS In this single-center and retrospective study, patients with confirmed COVID-19 infections were enrolled. Univariate and multivariate logistic regression methods were used to explore the risk factors associated with outcomes. RESULTS Of 179 patients with confirmed COVID-19 infection, 12 remained hospitalized at the end of the study and 167 were included in the final analysis. Of these, 153 (91.6%) were discharged and 14 (8.38%) died in hospital. Approximately half (50.9%) of patients suffered from a comorbidity, with diabetes or coronary heart disease being the most common in 20 patients. The most common symptoms on admission were fever, dyspnea, and cough. The mean durations from first symptoms to hospital admission was 8.64 ± 4.14 days, whereas the mean hospitalization time to discharge or death was 5.19 ± 2.42 and 4.35 ± 2.70 days, respectively. There was a significantly higher age in non-survivor patients compared with survivor patients. Multivariate regression showed increasing odds ratio (OR) of in-hospital death associated with respiratory rates >20 breaths/min (OR: 5.14, 95% CI: 1.19-22.15, p = 0.028) and blood urea nitrogen (BUN) >19 mg/dL (OR: 4.54, 95% CI: 1.30-15.85, p = 0.017) on admission. In addition, higher respiratory rate was associated with continuous fever (OR: 4.08, 95% CI: 1.18-14.08, p = 0.026) and other clinical symptoms (OR: 3.52, 95% CI: 1.05-11.87, p = 0.04). CONCLUSION The potential risk factors including high respiratory rate and BUN levels could help to identify COVID-19 patients with poor prognosis at an early stage in the Iranian population.
Background: To address whether in intensive care unit (ICU) patients, which factors correlate wit... more Background: To address whether in intensive care unit (ICU) patients, which factors correlate with development of delirium (primary outcome), as well as more rapid delirium onset and recurrence (secondary outcomes).Methods: A retrospective secondary analysis of 4,200 patients was collected from two academic medical centers. Delirium was assessed with the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) in all patients. Univariate and multivariate Cox models, logistic regression analysis, and Chi-square Automatic Interaction Detector (CHAID) decision tree modeling were used to explore delirium risk factors.Results: Increased delirium risk as associated with exposed only to artificial light (AL) hazard ratio (HR) 1.84 (95% CI: 1.66-2.044, P<0.001), physical restraint application 1.11 (95% CI: 1.001-1.226, P=0.049), and high nursing care requirements (>8 hours per 8-hour shift) 1.18 (95% CI: 1.048-1.338, P=0.007). Delirium incidence was inversely associated with ...
A retrospective secondary analysis of 4,200 patients was collected from two academic medical cent... more A retrospective secondary analysis of 4,200 patients was collected from two academic medical centers. Delirium was assessed using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) in all patients. Univariate and multivariate Cox models, logistic regression analysis, and Chi-square Automatic Interaction Detector (CHAID) decision tree modeling were used to explore delirium risk factors. Increased delirium risk was associated with exposed only to artificial light (AL) hazard ratio (HR) 1.84 (95 % CI: 1.66-2.044, P<0.001), physical restraint application 1.11 (95 % CI: 1.001-1.226, P=0.049), and high nursing care requirements (>8 hours per 8-hour shift) 1.18 (95 % CI: 1.048-1.338, P=0.007). Delirium incidence was inversely associated with greater family engagement 0.092 (95 % CI: 0.014-0.596, P=0.012), low staff burnout and anticipated turnover scores 0.093 (95 % CI: 0.014-0.600, P=0.013), non-ICU length-of-stay (LOS)<15 days 0.725 (95 % CI: 0.655-0.804, P<...
In spite of decreasing the overall incidence of gastric cancer (GC), it remains one of the most c... more In spite of decreasing the overall incidence of gastric cancer (GC), it remains one of the most common and deadly cancers worldwide. The incidence and mortality rate of GC is very different in the world. Geographical differentiation is one of the most distinctive characteristics of GC. Effective prevention and early diagnostic strategies are the most important public health interventions in GC, as a common malignancy worldwide. Notably, the preventive strategies require understanding the risk factors associated with GC for identifying high‐risk groups that may require screening for prevention. Therefore, up‐to‐date statistics on GC occurrence and outcome are essential for the primary prevention of the disease. We conducted this review based on the current epidemiology knowledge of GC to provide an update perspective of GC in Asia‐Pacific region. Based on the findings of this study, incidence and mortality rate of GC in Asia‐Pacific region shows a great heterogeneity. Gastric carcino...
Background: The role of chest computed tomographic (CT) to diagnosis coronavirus disease-2019 (CO... more Background: The role of chest computed tomographic (CT) to diagnosis coronavirus disease-2019 (COVID-19) is still an open field to be explored. The aim of this study is to use non-contrast chest computed tomography (CT) scan as a helpful tool in diagnosis quantification and follow-up of patients with COVID-19. Method: This study was performed on patients with COVID-19 who underwent chest CT scan at Baqiyatallah Hospital, Tehran, Iran. The age, gender, types of lesions, other specific signs of high-resolution computed tomography (HRCT), presence of diffuse opacity, underlying diseases, number of involved lobe and total opacity score of 1078 patients were evaluated. Decision tree (DT) model was used to analyze and establish a risk assessment model of critical and non-critical situation. Results: The bilateral distribution and multifocal lung involvement were 165 (97.6%) and 766 (84.3%) in critical patients, respectively. According to DT model, total opacity score, age, lesion types an...
Gastroenterology and Hepatology From Bed to Bench, 2012
Aim This study compared PR and NB in predicting HCV patient costs. The objective of this study wa... more Aim This study compared PR and NB in predicting HCV patient costs. The objective of this study was to predict the direct cost of the HCV patient in Iran. Background Hepatitis C virus (HCV) is a common and expensive infectious disease in Iran. Cost associated with HCV and its complications has not been well characterized. Analysis of cost data is important in providing consistent information to aid budgeting decisions and certain statistical regression models need for prediction mean costs. Poisson regression (PR) and negative binomial regression (NB) are more common in cost prediction study. Patients and methods This study designed as a cross-sectional clinic base from 2001 to 2010. First treatment period of each patient bring in study. We evaluated the doctor visiting, drugs, and hospitalization and laboratory tests of patients. Cost per person per one treatment period estimated in purchasing power parity dollars (PPP$). The PR is one of the models from general linear models (GLM) ...
Gastroenterology and Hepatology From Bed to Bench, 2018
Cancers of the gastrointestinal (GI) track are a serious global health problem. The human GI trac... more Cancers of the gastrointestinal (GI) track are a serious global health problem. The human GI tract is home to trillions of microorganisms that known as gut microbiota and have established a symbiotic relationship with the host. The human intestinal microbiota plays an important role in the development of the gut immune system, metabolism, nutrition absorption, production of short-chain fatty acids and essential vitamins, resistance to pathogenic microorganisms, and modulates a normal immunological response. Microbiota imbalance has been involved in many disorders including inflammatory bowel disease, obesity, asthma, psychiatric illnesses, and cancers. Oral administration of probiotics seems to play a protective role against cancer development as a kind of functional foods. Moreover, clinical application of probiotics has shown that some probiotic strains can reduce the incidence of post-operative inflammation in cancer patients. In the present narrative review, we carried out updat...
Aim: The aim of this study was to compare the different phases of chronic Hepatitis B virus (HBV)... more Aim: The aim of this study was to compare the different phases of chronic Hepatitis B virus (HBV) infection with different values for normal ALT. Background: For many years, the upper limit of 40 IU was considered normal for ALT for both sexes, but in recent years this value is challenged and some guidelines have lowered their limit. Methods: In this cross-sectional study, 2000 HBsAg positive patients who were referred to Taleghani Hospital, Tehran, Iran, from 2011 through 2018 were classified in four groups according to American Association of the study of the liver disease (AASLD), European Association of the study of the liver (EASL) /Asian-Pacific Association of the study of the liver (APASL) and American Collage of Gastroenterology (ACG) guidelines. The frequency of each group based on 3 different guidelines was compared. Results: In HBeAg positive patients (n=100), the percentage of immune tolerance phase was 43% according to AASLD cutoff for normal ALT (35 IU for men, 25 IU for women), while it was 68% and 28% with regard to EASL/APASL and ACG (30 IU for men, 19 IU for women) cutoffs respectively. In HBeAg negative patients (n=1900), 66.68% were inactive carriers according to AASLD, but the percentage changed to 82.89% and 52.42% considering EASL/APASL and ACG values, respectively. Conclusion: Using ACG and to a lesser extent AASLD cutoff for ALT, many patients shift from immune tolerance and inactive carrier state into the immune active phase. Thus, more patients are candidates for treatment or intensive workup to determine the extent of liver damage.
Introduction: The estimated prevalence of functional bowel disorders and its subtypes varies enor... more Introduction: The estimated prevalence of functional bowel disorders and its subtypes varies enormously depending on the diagnostic criteria employed. This study aimed at estimating the prevalence and risk factors of functional bowel disorders in an Iranian community. Methods: This study was a cross-sectional household survey conducted from May 2006 to December 2007 in Tehran province, including 18,180 participants who were randomly selected and interviewed face-to-face using a validated questionnaire based on Rome III.
International journal of travel medicine and global health, Dec 8, 2020
Introduction Coronavirus disease 2019 (COVID-19) caused by a new coronavirus is called severe acu... more Introduction Coronavirus disease 2019 (COVID-19) caused by a new coronavirus is called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), detected in Wuhan city, China on December 31, 2019, and then the World Health Organization (WHO) declared the outbreak a global health emergency on January 30, 2020, and a global pandemic on March 11, 2020. 1 The global pandemic of COVID-19 infection has emerged as a highly pathological and widespread virus in humans and as a serious disease in the field of public health and global concern with high morbidity and mortality rates. 2 According to the study by Jin et al, 3 about 13% of the patients with confirmed COVID-19 infection reported severe respiratory symptoms, among which 2% died. As of 29 November 2020, a total of 62 634 553 confirmed cases of COVID-19 have been reported, including, 1 459 325 deaths and 43 241 504 have been reported as recovered from COVID-19 worldwide. 4 Given the prevalence and mortality rate of the COVID-19 pandemic, it has affected economic, political, social, and even military sectors in all the countries around the world. Therefore, this pandemic is not just a medical phenomenon; it especially affects the mental health of individuals, which raising worries of widespread panic and growing anxiety in individuals exposed to the hazard of the virus or among certain groups in particular, older adults, care providers and people with underlying health conditions. 5,6 Thus, it is highly http://ijtmgh.com
DOAJ (DOAJ: Directory of Open Access Journals), Dec 1, 2021
Background and aims the role of serum neutrophil gelatinase-associated lipocalin (NGAL) in predic... more Background and aims the role of serum neutrophil gelatinase-associated lipocalin (NGAL) in predicting delayed graft function (DGF) after kidney transplantation is poorly de ned. The objective of this study was to evaluate the serum NGAL expression in the early postoperative phase after kidney transplantation and compare it with serum creatinine (Cr). Methods We studied 32 patients who received kidney transplantation from deceased (n=24) and live
Asia-pacific Journal of Clinical Oncology, Jan 24, 2022
In spite of decreasing the overall incidence of gastric cancer (GC), it remains one of the most c... more In spite of decreasing the overall incidence of gastric cancer (GC), it remains one of the most common and deadly cancers worldwide. The incidence and mortality rate of GC is very different in the world. Geographical differentiation is one of the most distinctive characteristics of GC. Effective prevention and early diagnostic strategies are the most important public health interventions in GC, as a common malignancy worldwide. Notably, the preventive strategies require understanding the risk factors associated with GC for identifying high‐risk groups that may require screening for prevention. Therefore, up‐to‐date statistics on GC occurrence and outcome are essential for the primary prevention of the disease. We conducted this review based on the current epidemiology knowledge of GC to provide an update perspective of GC in Asia‐Pacific region. Based on the findings of this study, incidence and mortality rate of GC in Asia‐Pacific region shows a great heterogeneity. Gastric carcinogenesis arises as a consequence of a complex interaction between host and environmental factors. In addition to screening and eradication of Helicobacter pylori (H. pylori) infection, it seems that the main cause of GC is an undesirable lifestyle in this region. Therefore, it is necessary to improve the lifestyle and the community awareness about GC risk factors and healthy lifestyle education.
Upper gastrointestinal bleeding (UGIB) remains a common medical problem worldwide. It is an emerg... more Upper gastrointestinal bleeding (UGIB) remains a common medical problem worldwide. It is an emergency medical condition, which may require hospital admission. UGIB also increases the risk of morbidity, and mortality and uses health care resources. The aim of this study was to determine the endoscopic findings and their frequencies in patients with UGIB with regard to age in Tehran's Taleghani Hospital. Materials and Methods: The medical records and endoscopy reports of 990 patients, who underwent endoscopy for UGIB in Tehran's Taleghani Hospital over a period of 2 years from 2010 to 2012, were retrospectively analyzed. Results: A total of 990 patients consisted of 594 (60%) men and 396 (40%) women had endoscopy for UGIB. Mean (±SD) age of the patients was 54 (±17.2) years. The commonest (45.5%) cause of UGIB was peptic ulcer disease, which included; duodenal ulcer (26.4%), gastric ulcer (19.1%), followed by esophageal and gastric varices (19.5%). Malignant conditions (cancers) contributed to 14.7%, which included gastric cancer (7.2%), esophageal cancer (5.5%), and duodenal cancer (2%). Other less frequent causes of UGIB were esophageal ulcer (6.7%), erosive gastritis (6.3%), Mallory-Weiss syndrome (5.4%), and Dieulafoy's lesion (1.2%). Normal endoscopic findings were recorded in 0.7% of the patients with UGIB. Conclusion: Peptic ulcer diseases are the commonest cause of UGIB followed by esophageal and gastric varices.
Aim: The objective of this study was to determine the epidemiologic characteristics of patients w... more Aim: The objective of this study was to determine the epidemiologic characteristics of patients with liver cirrhosis. Background: Liver cirrhosis is an end-stage condition of chronic liver disease. Liver disease is an important cause of morbidity and mortality worldwide. Methods: In this cross-sectional study, demographic and epidemiologic characteristics of 203 patients with liver cirrhosis who were admitted in Taleghani Hospital over a period of two years were determined. Results: A total of 203 patients with liver cirrhosis consisted of 136 (67%) males and 67 (33%) females and the mean age was 53.7±15.2 years. No etiology were found in (59.6%) cirrhotic patients; therefore, they were labeled as cryptogenic cirrhosis, but according to clinical evidence and ultrasonography findings, (29.7%) of these patients were probable NAFLD. The other causes of liver cirrhosis in this study were HBV (20.2%), HCV (11.8%) and autoimmune hepatitis (AIH) (8.4%), respectively. Esophageal varices were present in (41.9%), ascites in (36.5%), variceal bleeding in (8.9%), encephalopathy in (7.4%) and spontaneous bacterial peritonitis (SBP) in (5.4%) of patients. When cirrhotic patients were grouped according to Child-Pugh classification, 26.1%, 54.7% and 19.2% were in classes A, B and C respectively. The mean MELD score was 16.16±7.7. Conclusion: In this study we found that the leading etiology of cirrhosis is cryptogenic cirrhosis 59.6% (in all age groups) and followed by HBV. Noteworthy, according to the clinical and ultrasonography findings, 29.7% of patients who were labeled as cryptogenic cirrhosis were consistent with NAFLD.
Background: Despite advances in the treatment of abdominal injuries in patients with trauma, it r... more Background: Despite advances in the treatment of abdominal injuries in patients with trauma, it remains a major public health problem worldwide. Evaluation of hazard ratio (HR) of 90-day mortality in intensive care unit (ICU) patients with abdominal injuries compare with head injuries in trauma patients and non-trauma surgical ICU patients. Methods: This single-center, prospective cohort study was conducted on 400 patients admitted to the ICU between 2018 and 2019 due to trauma or surgery in Hamadan, Iran. The main outcome was mortality at 90-day after ICU admission. Cox proportional hazards models were used to determine the HR and 95% confidence interval (CI) for 90-day mortality. Results: The 90-day mortality was 21.9% in abdominal injuries patients. According to multivariate Cox regression, the expected hazard mortality was 2.758 times higher in patients with abdominal injuries compared to non-trauma patients (HR: 2.758, 95% CI: 1.077-7.063, P = 0.034). About more than 50% of all deaths in the abdominal and head trauma groups occurred within 20 days after admission. Mean time to death was 27.85 ± 20.1, 30.27 ± 18.22 and 31.43 ± 26.24 days for abdominal-trauma, surgical-ICU, and head-trauma groups, respectively. Conclusion: Difficulty in accurate diagnosis due to the complex physiological variability of abdominal trauma, less obvious clinical symptoms in blunt abdominal injuries, multi-organ dysfunction in abdominal injuries, failure to provide timely acute care, as well as different treatment methods all account for the high 90-day mortality rate in abdominal-trauma patients. Therefore, these patients need a multidisciplinary team to care for them both in the ICU and afterwards in the general ward.
Clinical, Biological and Molecular Aspects of COVID-19, 2021
AIM We aimed to describe the epidemiological and clinical characteristics of Iranian patients wit... more AIM We aimed to describe the epidemiological and clinical characteristics of Iranian patients with COVID-19. METHODS In this single-center and retrospective study, patients with confirmed COVID-19 infections were enrolled. Univariate and multivariate logistic regression methods were used to explore the risk factors associated with outcomes. RESULTS Of 179 patients with confirmed COVID-19 infection, 12 remained hospitalized at the end of the study and 167 were included in the final analysis. Of these, 153 (91.6%) were discharged and 14 (8.38%) died in hospital. Approximately half (50.9%) of patients suffered from a comorbidity, with diabetes or coronary heart disease being the most common in 20 patients. The most common symptoms on admission were fever, dyspnea, and cough. The mean durations from first symptoms to hospital admission was 8.64 ± 4.14 days, whereas the mean hospitalization time to discharge or death was 5.19 ± 2.42 and 4.35 ± 2.70 days, respectively. There was a significantly higher age in non-survivor patients compared with survivor patients. Multivariate regression showed increasing odds ratio (OR) of in-hospital death associated with respiratory rates >20 breaths/min (OR: 5.14, 95% CI: 1.19-22.15, p = 0.028) and blood urea nitrogen (BUN) >19 mg/dL (OR: 4.54, 95% CI: 1.30-15.85, p = 0.017) on admission. In addition, higher respiratory rate was associated with continuous fever (OR: 4.08, 95% CI: 1.18-14.08, p = 0.026) and other clinical symptoms (OR: 3.52, 95% CI: 1.05-11.87, p = 0.04). CONCLUSION The potential risk factors including high respiratory rate and BUN levels could help to identify COVID-19 patients with poor prognosis at an early stage in the Iranian population.
Background: To address whether in intensive care unit (ICU) patients, which factors correlate wit... more Background: To address whether in intensive care unit (ICU) patients, which factors correlate with development of delirium (primary outcome), as well as more rapid delirium onset and recurrence (secondary outcomes).Methods: A retrospective secondary analysis of 4,200 patients was collected from two academic medical centers. Delirium was assessed with the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) in all patients. Univariate and multivariate Cox models, logistic regression analysis, and Chi-square Automatic Interaction Detector (CHAID) decision tree modeling were used to explore delirium risk factors.Results: Increased delirium risk as associated with exposed only to artificial light (AL) hazard ratio (HR) 1.84 (95% CI: 1.66-2.044, P<0.001), physical restraint application 1.11 (95% CI: 1.001-1.226, P=0.049), and high nursing care requirements (>8 hours per 8-hour shift) 1.18 (95% CI: 1.048-1.338, P=0.007). Delirium incidence was inversely associated with ...
A retrospective secondary analysis of 4,200 patients was collected from two academic medical cent... more A retrospective secondary analysis of 4,200 patients was collected from two academic medical centers. Delirium was assessed using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) in all patients. Univariate and multivariate Cox models, logistic regression analysis, and Chi-square Automatic Interaction Detector (CHAID) decision tree modeling were used to explore delirium risk factors. Increased delirium risk was associated with exposed only to artificial light (AL) hazard ratio (HR) 1.84 (95 % CI: 1.66-2.044, P<0.001), physical restraint application 1.11 (95 % CI: 1.001-1.226, P=0.049), and high nursing care requirements (>8 hours per 8-hour shift) 1.18 (95 % CI: 1.048-1.338, P=0.007). Delirium incidence was inversely associated with greater family engagement 0.092 (95 % CI: 0.014-0.596, P=0.012), low staff burnout and anticipated turnover scores 0.093 (95 % CI: 0.014-0.600, P=0.013), non-ICU length-of-stay (LOS)<15 days 0.725 (95 % CI: 0.655-0.804, P<...
In spite of decreasing the overall incidence of gastric cancer (GC), it remains one of the most c... more In spite of decreasing the overall incidence of gastric cancer (GC), it remains one of the most common and deadly cancers worldwide. The incidence and mortality rate of GC is very different in the world. Geographical differentiation is one of the most distinctive characteristics of GC. Effective prevention and early diagnostic strategies are the most important public health interventions in GC, as a common malignancy worldwide. Notably, the preventive strategies require understanding the risk factors associated with GC for identifying high‐risk groups that may require screening for prevention. Therefore, up‐to‐date statistics on GC occurrence and outcome are essential for the primary prevention of the disease. We conducted this review based on the current epidemiology knowledge of GC to provide an update perspective of GC in Asia‐Pacific region. Based on the findings of this study, incidence and mortality rate of GC in Asia‐Pacific region shows a great heterogeneity. Gastric carcino...
Background: The role of chest computed tomographic (CT) to diagnosis coronavirus disease-2019 (CO... more Background: The role of chest computed tomographic (CT) to diagnosis coronavirus disease-2019 (COVID-19) is still an open field to be explored. The aim of this study is to use non-contrast chest computed tomography (CT) scan as a helpful tool in diagnosis quantification and follow-up of patients with COVID-19. Method: This study was performed on patients with COVID-19 who underwent chest CT scan at Baqiyatallah Hospital, Tehran, Iran. The age, gender, types of lesions, other specific signs of high-resolution computed tomography (HRCT), presence of diffuse opacity, underlying diseases, number of involved lobe and total opacity score of 1078 patients were evaluated. Decision tree (DT) model was used to analyze and establish a risk assessment model of critical and non-critical situation. Results: The bilateral distribution and multifocal lung involvement were 165 (97.6%) and 766 (84.3%) in critical patients, respectively. According to DT model, total opacity score, age, lesion types an...
Gastroenterology and Hepatology From Bed to Bench, 2012
Aim This study compared PR and NB in predicting HCV patient costs. The objective of this study wa... more Aim This study compared PR and NB in predicting HCV patient costs. The objective of this study was to predict the direct cost of the HCV patient in Iran. Background Hepatitis C virus (HCV) is a common and expensive infectious disease in Iran. Cost associated with HCV and its complications has not been well characterized. Analysis of cost data is important in providing consistent information to aid budgeting decisions and certain statistical regression models need for prediction mean costs. Poisson regression (PR) and negative binomial regression (NB) are more common in cost prediction study. Patients and methods This study designed as a cross-sectional clinic base from 2001 to 2010. First treatment period of each patient bring in study. We evaluated the doctor visiting, drugs, and hospitalization and laboratory tests of patients. Cost per person per one treatment period estimated in purchasing power parity dollars (PPP$). The PR is one of the models from general linear models (GLM) ...
Gastroenterology and Hepatology From Bed to Bench, 2018
Cancers of the gastrointestinal (GI) track are a serious global health problem. The human GI trac... more Cancers of the gastrointestinal (GI) track are a serious global health problem. The human GI tract is home to trillions of microorganisms that known as gut microbiota and have established a symbiotic relationship with the host. The human intestinal microbiota plays an important role in the development of the gut immune system, metabolism, nutrition absorption, production of short-chain fatty acids and essential vitamins, resistance to pathogenic microorganisms, and modulates a normal immunological response. Microbiota imbalance has been involved in many disorders including inflammatory bowel disease, obesity, asthma, psychiatric illnesses, and cancers. Oral administration of probiotics seems to play a protective role against cancer development as a kind of functional foods. Moreover, clinical application of probiotics has shown that some probiotic strains can reduce the incidence of post-operative inflammation in cancer patients. In the present narrative review, we carried out updat...
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Papers by Sara Ashtari