SARS-CoV-2 Seroprevalence among Health-Care Workers in Isfahan, Iran.

Background: Health-care workers (HCWs) are in the frontline for fighting the coronavirus disease 2019 (COVID-19) pandemic and are at higher risk of acquiring the infection. Therefore, the defining immunity status among HCWs helps mitigate the exposure risk. In this study, we investigated the anti-SARS-CoV-2 immunoglobulin G (IgG) and immunoglobulin M (IgM) and also the associated risk factors in the HCWs working in Isfahan University of Medical Sciences COVID-19 referral hospitals. Materials and Methods: In a cross-sectional study, demographics, COVID-19 symptoms during the past 2 weeks, and health-care details were collected from 200 consenting health workers of COVID-center-hospitals of Isfahan University of Medical Sciences from 23 October to 21 December 2020. The recombinant SARS-CoV2 nucleocapsid protein enzyme-linked immunosorbent assay-based IgM, and IgG antibody tests were evaluated. Data were analyzed using Chi-square and independent-t-student tests, and P < 0.05 was considered significant. Results: One hundred and forty-one women and 59 men with a mean age of 36.4 ± 7.77 years participated in the study. IgG Ab and IgM Ab were positive in 77 (38.5%) and 12 (6%) of samples, respectively, and both antibodies were detected in 9 (4.5%). Higher ages, direct contact with the patients with COVID-19, muscle pain, loss of taste and smell, fever, and cough were the factors associated with antibody seropositivity against SARS-CoV2. Conclusion: This study demonstrated that the prevalence of HCWs with antibodies against SARS-CoV-2 is relatively high in Isfahan University referral hospitals. The development of safety protocols and screening and vaccination strategies in the frontline HCWs must be implemented to reduce the burden of infection.

A Process Evaluation of the Isfahan Antibiotic Awareness Campaign: Developing Engagement on Antimicrobial Resistance.

Background: One of the most prominent global health threats is antibiotic resistance, leading to infection treatment failure. The first Iranian antibiotic awareness week campaign was initiated to improve the prudent use and wise prescription of antibiotics. Materials and Methods: The Isfahan antibiotic awareness campaign was held from November 30 to December 6, 2019, among two targeted populations; the general population and health-care workers by Isfahan University of Medical Sciences. In this campaign held in the main squares, streets, and a city's referral hospital, various educational methods were used to aware and sensitize the general population and medical staff about antibiotics and microbial resistance. These methods include face-to-face training, brochures, advertisement posters and billboards around the city, educational videos, social media messages, retraining for medical doctors and medical specialists, and interviewing in the Islamic Republic of Iran Broadcast. Results: Two hundred and twenty general practitioners, medical specialists, and residents participated in two retraining educational conferences in Al-Zahra Hospital, Isfahan, Iran. The mean score satisfaction of the two conferences was three from four. Nearly 2000 of the general population were under face-to-face educational programs whom after that, 83.6% had the correct answer to the questions around antimicrobial awareness. Conclusions: This campaign was an excellent experience as a pilot study with appealing issues. Further, activities are required to improve engagement with the target population and determine the impact of this campaign on antibiotic consumption and prescription behavior among the public and health-care professionals.

Antioxidant and Bone; Protect Your Future: A Brief Review.

The global campaign of osteoporosis has been organized by the International Osteoporosis Foundation (IOF) and them introducing World Osteoporosis Day (WOD) in 1997. The day is celebrated on October 20th each year and aimed to improve the awareness of the population about disease prevention. We present some aspects of bone health and the prevention of osteoporosis related to the use of vitamins. The presenting mini-review covers a variety of sources including PubMed, Embase, Scopus, and directory of open access journals (DOAJ) from 10 years ago (Oct 2009 to Oct 2019) for recent developments in the prevention of bone loss. The search was performed by using combinations of the following keywords and or their equivalents; osteoporosis, bones health, bone loss, and vitamin to find related articles about the prevention of osteoporosis by nutritional factors. The factors affecting bone are various and could begin from fetal periods to the end of life. Some of them are not changeable including age, and genetic; however, it is possible to modify some others such as poor nutrition and vitamin deficiency. Beyond vitamin D deficiency, consumption of other vitamins also is beneficial to maintain bone health. By considering the nutritional factors especially vitamins that affect bones, it is possible to have stronger bones to enjoy life in the elderly and protect your future.

Current status of COVID-19 pandemic; characteristics, diagnosis, prevention, and treatment.

Humans have always been encountered to big infectious diseases outbreak throughout the history. In December 2019, novel coronavirus (COVID-19) was first noticed as an agent causing insidious pneumonia in Wuhan, China. COVID-19 was spread rapidly from Wuhan to the rest of the world. Until late June 2020, it infected more than 10,000,000 people and caused more than 500,000 deaths in almost all of countries in the world, creating a global crisis worse than all previous epidemics and pandemics. In the current review, we gathered and summarized the results of various studies on characteristics, diagnosis, treatment, and prevention of this pandemic crisis.

Medicinal Plants, Effective Plant Compounds (Compositions) and their Effects on Stomach Cancer.

Medicinal plants have special importance around the world. Further, they have been noticed for nutrition and illness treatment such as preparation of anticancer new drugs. Therefore, a wide range of studies have been done on different plants, and their anticancer effects have been investigated. Nowadays, cancer is the most important factor of death rate in the developed and developing countries. Among them, stomach cancer is one of the most common malignancies around the world. At present, it is recognized as the fourth common cancer and the second factor of death rate due to cancer. So far, there has been wide range of effort for cancer treatment; however, in most cases, the response to the treatment has been very weak and often accompanied improper subsidiary effects. The present problems as a consequence of chemical treatment and radiotherapy and many subsidiary problems created due to their use for patients, and also, the resistance to the current treatment has motivated researchers to apply new medicines with more effect and less toxicity. The secondary metabolisms existent in the plants have an important role in the treatment of several diseases such as cancer. This study was conducted to investigate and collect scientific results for stomach cancer and to clarify the role of medicinal plants and secondary plant compounds on its treatment.

Role of Oxidative Stress and Inflammatory Factors in Diabetic Kidney Disease.

Diabetic nephropathy (DN) is a serious complication of diabetes mellitus, and its prevalence has been increasing in developed countries. Diabetic nephropathy has become the most common single cause of end-stage renal disease worldwide. Oxidative stress and inflammation factors are hypothesized to play a role in the development of late diabetes complications. Chronic hyperglycemia increases oxidative stress, significantly modifies the structure and function of proteins and lipids, and induces glycoxidation and peroxidation. Therefore, hyperglycemia causes auto-oxidation of glucose, glycation of proteins, and activation of polyol mechanism. Overproduction of intracellular reactive oxygen species contributes to several microvascular and macrovascular complications of DN. On the other hand, reactive oxygen species modulates signaling cascade of immune factors. An increase in reactive oxygen species can increase the production of inflammatory cytokines, and likewise, an increase in inflammatory cytokines can stimulate the production of free radicals. Some studies have shown that kidney inflammation is serious in promoting the development and progression of DN. Inflammatory factors which are activated by the metabolic, biochemical, and hemodynamic derangements are known to exist in the diabetic kidney. This review discusses facts for oxidative stress and inflammatory factors in DN and encompasses the role of immune and inflammatory cells, inflammatory cytokines, and stress oxidative factors.

Ameliorative effect of green tea against contrast-induced renal tubular cell injury.

INTRODUCTION: Reactive oxygen species are a mediator of kidney damage by contrast media, and green tea is a potent-free radical scavenger. This study was designed to examine whether green tea could protect against the nephrotoxicity induced by contrast media. MATERIALS AND METHODS: Forty rats were randomly divided into 4 groups. Group 1 was control; group 2 received contrast medium (intravenous iodixanol, 10 mL/kg, as a single dose); group 3 received contrast medium and then green tea extract for 3 days (10 mg/kg/d, intraperitoneal); and group 4 first received green tea and then contrast medium. Histological changes (degeneration, vacuolization of tubular renal cells, dilatation of tubular lumen, and presence of debris in the lumens) were assessed and recorded as scores from zero to 4. The sum of scores were used as the overal renal injury level. RESULTS: Groups 3 and 4 with green tea treatment had significantly higher overall scores than the control group, but significantly lower scores than group 2 with contrast medium only. A similar trend was seen for dilatation and degeneration levels. Vacuolization level was not significantly lower in the green tea groups as compared to the contrast medium group. Debris level was not significantly lower in group 3 than group 2. The differences were not significant between groups 3 and 4.   Conclusions. We observed beneficial effect of green tea against nephrotoxicity of contrast media. Green tea extract may offer an inexpensive and nontoxic intervention strategy in patients with a risk for nephrotoxicity with contrast media.

Paradoxical effects of atorvastatin on renal tubular cells: an experimental investigation.

INTRODUCTION: Atorvastatin has antioxidant activity and has been reported to increase blood antioxidant capacity. This study aimed to evaluate the effect of different doses of atorvastatin on gentamicin-induced kidney injury. MATERIALS AND METHODS: In this experimental study, 30 male Wistar rats were designated into 6 equal groups for a 7-day period of intraperitoneal injections of gentamicin and atorvastatin. Group 1 received gentamicin, 80 mg/kg. Group 2 received phosphate buffer as the vehicle of atorvastatin. All rats in groups 3, 4, and 5 received gentamicin, 80 mg/kg/d, and then, after a 1-hour interval, atorvastatin was injected for 7 days as follow: group 3, 10 mg/kg/d; group 4, 50 mg/kg/d; and group 5, 150 mg/kg/d. Rats in group 6 received only 150 mg of atorvastatin. On the 8th day, blood samples were collected for evaluation of creatinine and blood urea nitrogen levels, and the animals' kidneys were dissected out for histopathological examinations. RESULTS: Morphological damages to the tubular cells in groups 3 and 4 were less than those in groups 1 and 5. Injuries to the renal tubular cells in the rats of group 5 (gentamicin and atorvastatin, 150 mg/kg/d) and in group 6 (atorvastatin 150 mg/kg/d alone) were more extensive than those in group 1. CONCLUSIONS: The none-dose-dependent effect of atorvastatin in inducing renal tubular cell protection and renal tubular toxicity of atorvastatin in higher dose suggest administration of low-dose atorvastatin in critical conditions associated with renal tubular cell protection.

Association of glomerular C4d deposition with various demographic data in IgA nephropathy patients; a preliminary study.

BACKGROUND: IgA nephropathy (IgAN) is the most prevalent primary chronic glomerulopathy worldwide. Thus, it is of vital importance to search for factors aggravating the disease progress, monitor disease activity and predict disease-specific therapy. C4d is a well-known biomarker of the complement cascade with a potential to meet the above needs. OBJECTIVES: The aim of our study was, therefore, to determine whether C4d staining at the time of kidney biopsy had any correlation with the demographic, clinical and biochemical variables in IgAN. PATIENTS AND METHODS: The definition of IgAN requires the presence of diffuse and global IgA deposits which were graded ≥2+ and weak C1q deposition. C4d immunohistochemical staining was conducted retrospectively on 29 renal biopsies of patients with IgAN, which were selected randomly from all biopsies. C4d immunohistochemical staining was performed on 3-µm deparaffinized and rehydrated sections of formaldehyde-fixed, paraffin-embedded renal tissues. RESULTS: Of 29 selected patients, 68% were male. In this study, 54.2±25 percent of glomeruli in all biopsies were positive for C4d. The mean and standard deviation (SD) of serum creatinine and the magnitude of proteinuria were 1.72±1.2 mg/dl and 1582±1214 mg/day, respectively. In this study, we observed statistically significant correlations of percent C4d positivity with the serum creatinine (r=0.61, p=0.0005), magnitude of proteinuria (r=0.72, p=0.0001), the proportion of globally sclerotic glomeruli (r=0.43, p=0.02) and the proportion of tubulointerstitial fibrosis (r=0.54, p=0.0023). CONCLUSIONS: The results from our investigation on C4d positivity in biopsy-proven cases of IgAN are in accord with some of the previous studies. These findings, however, require further validation in larger samples.

Adiponectin and chronic kidney disease; a review on recent findings.

Adiponectin is a multifunctional cytokine that has a role in regulating inflammation. In patients without chronic renal failure (CRF) and type 2 diabetics, decreased adiponectin levels are associated with insulin resistance. Lower serum plasma adiponectin values are link to larger tumor size and metastasis in clear-cell carcinoma of the kidney too. However, in patients with established chronic kidney disease (CKD), adiponectin levels are elevated and positively predict progression of disease. In addition, increased levels of serum adiponectin of hemodialysis patients were associated with decrease in bone mineral density in hemodialysis patients. Thus, depending on type of renal failure should be adjusted the adiponectin levels in patients. In CKD patients without diabetic, decreasing adiponectin levels by ARB drugs may be appropriate for inhibition of disease progression.

Efficacy of supplementary vitamin D on improvement of glycemic parameters in patients with type 2 diabetes mellitus; a randomized double blind clinical trial.

INTRODUCTION: Studies have revealed the association between vitamin D deficiency and changes in blood glucose and insulin levels as well as sensitivity of the target tissues to insulin. OBJECTIVE: In this study, we examined the effect of adding vitamin D (cholecalciferol ; 50,000 units) to therapeutic regimen of T2DM patients compared to placebo on regulating the blood glucose and glycemic parameters. PATIENTS AND METHODS: This study was a double blind clinical trial conducted on 60 type 2 diabetes mellitus (T2DM) patients. Exclusion criteria were taking calcium, vitamin D supplements or any drugs effecting calcium and vitamin D metabolism in the past 6 months. Serum 25-Hydroxy vitamin D [25(OH)D] level was measured with ELISA method. Patients were administered weekly vitamin D supplementation (50000 units) for 12 weeks. RESULTS: There was no significant relation between HbA1c and 25(OH)D level prior the study (p> 0.05). After intervention, 25(OH)D level in interventional group was significantly higher compared to that of control group. HbA1c in male interventional group was significantly less than that of control group (p= 0.0068). CONCLUSION: Weekly vitamin D supplementation had beneficial effect on glycemic parameters in male type 2 diabetic patients.

Association of serum lipids with level of blood pressure in type 2 diabetic patients.

INTRODUCTION: Dyslipidemia and high blood pressure in diabetic patients increase the risk of microvascular and macrovascular complications. OBJECTIVES: This study was conducted to investigate the association between serum lipids and level of blood pressure in type 2 diabetic patients (T2D). PATIENTS AND METHODS: A prospective analytical study was carried out in 60 patients with T2D of both genders. None of the patients had a history of hypertension, and none was treated with antihypertensive drugs. Resting systolic blood pressures and fifth phase diastolic blood pressures were measured three times while the subjects were seated, and the results were averaged second and third measurements. Sixty patients with T2D were enrolled to the study. None of the patients who had a history of gout, was treated with allopurinol or treated with antihypertensive drugs previously. RESULTS: Of 60 participants, mean of serum creatinine was 0.98±0.22 mg/dL. Mean of systolic and diastolic blood pressure was 133±13 mmHg and 84±7.4 mmHg respectively. In this study, a significant positive correlation of serum cholesterol with systolic (r=0.598, p=0.001) and diastolic blood pressure (r=0.584, p=0.001) was seen. Also the associations of serum LDL-C with systolic and diastolic blood pressure were as follow (r = 0.335, p<0.001) and (0.491, p<0.001) respectively. Associations of HDL-C with systolic and diastolic blood pressure were not significance as follow -0.05 and 0.04 respectively. CONCLUSION: The results of this study suggest that serum cholesterol has a strong association with levels of systolic and diastolic blood pressure in T2D patients. More attention to serum lipids and treatment of dyslipidemia could halt the progress of diabetic kidney disease.

A biochemical study on ameliorative effect of green tea (Camellia sinensis) extract against contrast media induced acute kidney injury.

INTRODUCTION: Reactive oxygen species have been shown to be mediators of kidney injury and green tea polyphenols are potent-free radical scavengers. OBJECTIVES: In this study we sought to examine whether green tea was able to protect renal toxicity induced by contrast media or not. MATERIALS AND METHODS: In this experimental study 40 rats were randomly divided into four groups including: 1) control group 2) contrast media group 3) contrast media plus green tea 4) Green tea pretreatment and contrast media group. Blood urea Nitrogen (BUN) and serum creatinine were assessed for severity of kidney injury. RESULTS: Serum creatinine level was higher in group II than in other groups (p<0.001). Treatment (group 3) or pretreatment (group 4) with green tea significantly reduced blood creatinine level when compared with contrast media group (group 2). CONCLUSION: In this study, beneficial property of green tea, against renal toxicity of contrast media was observed. Green tea extract is an inexpensive, nontoxic, and effective treatment modality in individuals with a risk for acute kidney injury of contrast media.

Clinicopathological correlations in lupus nephritis; a single center experience.

BACKGROUND: Renal biopsies play an important role in the diagnosis, management and prognosis of patients with lupus nephritis (LN). OBJECTIVES: To determine the correlation between the pathological features of LN and the demographic, clinical and laboratory parameters. PATIENTS AND METHODS: This retrospective study was conducted from 2008 to 2014 on all consecutive cases of biopsy-proven LN at a nephropathology laboratory in Iran. The demographic, clinical and laboratory data were obtained from patients(') files and the biopsy findings from the original biopsy request forms. RESULTS: Of the 84 patients enrolled, 69 (82.2%) were females and 15 (17.8%) males. The mean age was 32.7±12 years. The mean serum creatinine was 1.5±0.94 mg/dl and the mean 24-h proteinuria, 1.6±1.9 grams. The majority of cases belonged to classes III and IV. The extracapillary proliferation was found in 42.86% of biopsies and endocapillary proliferation in 66.67% of biopsies. Patients of class IV-LN had a higher mean serum value of creatinine in comparison to class III-LN (2.19±1.09 versus 1.2±0.56 mg/dl; p= 0.0001). There was no significant difference of 24-h proteinuria between the two classes (p= 0.882). A significant association of serum creatinine with 24-h proteinuria (p= 0.041) was seen. Serum creatinine had significant positive correlation with activity percent (p< 0.001), and chronicity percent (p= 0.006), and also with proportion of glomeruli with crescents (p < 0.001). While there was a significant relationship of proteinuria with chronicity percent (p= 0.001), this association for activity percent was not significant (p= 0.094). Furthermore, the association of proteinuria with totally sclerotic glomeruli and proportion of crescents was not statistically significant (p= 0.186 and p= 0.0145 respectively). CONCLUSIONS: In conclusion, the results from our study on biopsy-proven cases of LN largely concur with the previously reported studies from Iran and other parts of the world.

Association of helicobacter pylori infection with serum magnesium in kidney transplant patients.

INTRODUCTION: Few studies are available regarding the various promoting factors of H. pylori infection in kidney disease patients especially renal transplant individuals. OBJECTIVES: This study was therefore conducted to examine the association of serum magnesium with H. pylori infection among kidney transplant patients. This cross-sectional investigation was conducted on a group of stable kidney transplant patients. Peripheral venous blood samples were collected for biochemical analysis after an overnight fast, Also urea breath test (UBT) was conducted for patients. PATIENTS AND METHODS: A total of 50 cases was enrolled to the study. Mean serum magnesium value of the patients was 1.98 ± 0.62 mg/dl. Serum magnesium level in positive H. pylori patients was more than negative H. pylori patients (p=0.0005). In this study population, there was no significant difference in serum intact PTH, calcium, alkaline phosphatase, albumin levels and body mass index (BMI) between males and females or H. pylori positive and H. pylori negative subjects (p>0.5). CONCLUSION: It is possible that, magnesium aggravates H. pylori infection in kidney transplant patients through the mechanisms like hemodialysis, which we had reported previously. However, more studies are necessary to prove the association of magnesium with H. pylori infection in renal transplant patients and finding the clinical relevance of our findings.

Contrast induced nephropathy; recent findings.

Contrast induced nephropathy is one cause of acute renal failure. Contrast induced nephropathy is the third most common cause of hospital-acquired acute renal failure. The incidence of contrast induced nephropathy in the general population is 0.6% to 2.3%, but when focusing on specific high-risk patients the incidence can increase to more than 40%. Studies suggest that intravenous hydration is the most effective strategy to prevent contrast induced nephropathy. Hydration is inexpensive and is usually risk-free. Administration of optimal fluids before and after the contrast procedure allows for increased urine output and improved outcomes.

Serum cholesterol and LDL-C in association with level of diastolic blood pressure in type 2 diabetic patients.

INTRODUCTION: Elevated cholesterol and blood pressure are major risk factors for the development diabetic kidney disease. Possible interactions between these two parameters have not been studied in detail. OBJECTIVES: This investigation aims to study the values of blood serum cholesterol, blood pressure and possible correlations between them, in a group of type 2 diabetic (T2D) patients. PATIENTS AND METHODS: A total of 60 patients with T2D were enrolled to the study. Venous blood samples were obtained in the fasting state for determinations of serum creatinine, lipids and hemoglobin A1C (HbA1c). RESULTS: Of 60 participants, Mean of age was 57±8.3 years. Mean of systolic and diastolic blood pressure was 133±13 mmHg and 84±7.4 mmHg respectively. Mean of serum cholesterol and LDL-C was 182±34.5 mg/dl and 97.2 ±27.9 mg/dl respectively. In this study, a significant positive correlation of serum cholesterol with level of diastolic blood pressure (r= 0.286, p=0.030) was seen (adjusted for duration of diabetes and weight). Furthermore a significant positive correlation of serum LDL-C with level of diastolic blood pressure (r= 0.263, p= 0.044) was seen (adjusted for age). CONCLUSION: We found a significant inverse correlation of serum cholesterol and LDL-C with level of diastolic blood pressure. This study showed the influence of serum lipids on the development of hypertension and further support the control of dyslipidemia, to prevent diabetic kidney disease.