The Effectiveness of Laboratory Parameters in Predicting the in-Hospital Mortality of Iranian Patients with Coronavirus Disease 2019 (COVID-19).

Background: The novel coronavirus 2019-nCoV (now SARS-CoV-2) has spread globally and affected healthcare systems worldwide. Due to lack of long-term immunization and effective specific treatments for the COVID-19 disease, there is a need of identifying the patients who are at the risk of a fatal outcome, according to the available epidemiological data and laboratory parameters. Objective: Thus, we aimed to evaluate the prognostic value of epidemiological data and laboratory para-meters for in-hospital case fatality in patients with COVID-19. Materials and Methods: A retrospective cohort of patients with COVID-19 admitted to the Shahid Mostafa Khomeini Hospital of Ilam University of Medical Sciences from February 29 until March 29, 2020 was performed. Epidemiologic data and laboratory results were collected. Univariate and multivariate logistic regression models were performed to evaluate the prognostic value of the laboratory parameters for in-hospital death. Results: A total of 256 Iranian COVID-19 patients were included in the evaluation; 38 of them died, resulting in a in-hospital case-fatality rate of 14.8%. The univariate analysis showed that advanced age [OR=1.04, 95% CI: 1.02, 1.06, P=0.001], smoking [OR=4.041, 95% CI: 1.546-10.563, P=0.004], white blood cells [OR=0.941, 95% CI: 0.904-0.980, P =0.003] and hematocrit [OR=1.060, 95% CI: 1.009-1.113, P=0.020] were positively associated with the risk of a fatal outcome. Multivariate logistic regression analysis revealed that COVID-19 patients with an elevated white blood cell count and elevated hemoglobin level had 1% and 9% greater risk of an in-hospital death for each elevated unit [OR=1.07; 95 %CI: 1.024-1.088, P =0.002 and OR=1.379; 95% CI 0.064-1.788, P =0.015, respectively]. Conclusions: An increase in white blood cell count and an increase in hemoglobin level might be indepen-dent risk factors for in-hospital death in Iranian patients with COVID-19. Further studies are necessary in order to conferm the prognostic value of the variables discussed.

The frequency of arrhythmias in COVID-19 patients, a study in the Shahid Mostafa Khomeini Hospital of Ilam from March to August 2020.

Cardiac arrhythmias are important causes of death among populations and are always responsible for a high percentage of mortality in hospitalized patients. The aim of this descriptive analytical study was to evaluate the frequency of arrhythmias in patients with coronavirus disease 2019 (COVID-19) in the Shahid Mostafa Khomeini Hospital of Ilam from March to August 2020. All the COVID-19 patients with a cardiac condition admitted to the intensive care unit were enrolled in the study by census. Electrocardiography (ECG) and Holter monitoring were used to diagnose arrhythmias. Data analysis was performed in Microsoft Excel using descriptive statistics (frequency and percentage). The total number of eligible patients was 45, of whom 26 (57.8%) were men and 19 (42.2%) were women. The mortality rate of arrhythmias among COVID-19 patients was 17.77% (8 out of 45 patients), and the recovery rate was 82.13% (37 out of 45 patients). Tachycardia and a lack of response to heart-rate-reducing drugs were observed in patients with COVID-19. Owing to an overlap between these symptoms and those of heart diseases, there is a need to further evaluate patients with arrhythmias. Although arrhythmias are not common in COVID-19 patients, they can be fatal and have a high mortality rate, which can be prevented by early detection.

Delayed gastric emptying in diabetic rats caused by decreased expression of cystathionine gamma lyase and H2 S synthesis: in vitro and in vivo studies.

BACKGROUND: This study aimed to evaluate the role of H2 S on gastric emptying rate (GER) and also to determine the effect of gastric distention on mRNA and protein expression of cystathionine ß-lyase (CBS) and cystathionine γ-synthase (CSE) in diabetic-gastroparetic and normal rats. METHODS: Adult normal rats intraperitoneally received either propargylglycine (PAG), L-cysteine or NaHS 30 min prior to GER marker (acetaminophen) to investigate H2 S involvement in GER and the same protocols were performed in diabetes-induced gastroparesis rats. The role of calcitonin gene related peptide (CGRP) neurons in the prokinetic effect of endogenous H2 S on GER was determined. The level of CBS and CSE expressions in response to gastric distention were also determined. The effect of H2 S on frequency and tension of spontaneous contractions of gastric smooth muscle strips was investigated. KEY RESULTS: Our results showed that: (i) H2 S and L-cysteine increased GER in gastroparetic and normal rats. (ii) The increased levels of CSE expression in response to gastric distention in diabetic rats were lower than in normal rats. (iii) PAG inhibited the excitatory effect of capsaicin on GER and on tension of spontaneous contractions of strips. (iv) Hydrogen sulphide increased the frequency and tension of spontaneous contractions of gastric strip muscles in normal and diabetic rats. CONCLUSIONS & INFERENCES: The results showed that delayed GER in diabetic rats can be due to down-regulation of H2 S biosynthesis enzyme, CSE and suggested that a potential prokinetic role for H2 S to treat the delayed gastric emptying in diabetic patients.

Antisperm antibodies and human infertility.

In a trial to evaluate the role of antisperm antibodies in human infertility, 120 couples (30 normal controls and 90 suffering from various types of infertility) were examined for the presence of agglutinating antibodies (by the Kibrick and Franklin-Dukes methods) and immobilizing antibodies in the serum, cervical mucus, and seminal plasma. In the male partners the highest and most significant incidence was found in the serum and seminal plasma of the group with poor sperm motility. In the female partners the highest and most significant incidence was found in the serum and cervical mucus of the group with unexplained infertility. It was concluded that it is greatly advisable to test for antisperm antibodies in selected groups of infertile couples.