Investigating the Relationship between Carotid Intima-Media Thickness (CIMT), Opium Addiction, and Components of the Metabolic Syndrome.

Background: Atherosclerosis has an essential role in causing cardiovascular diseases. Various factors affect the risk of coronary artery atherosclerosis, and the increase in the carotid intima-media thickness (CIMT) is a primary marker for detecting atherosclerotic changes in the artery wall. Since opioid use is one of the leading social and health problems in many countries, this study aimed to detect the factors influencing the increase in CIMT in opium consumers. Methods: This cross-sectional study was conducted on 350 participants of the phase 2 of the KERCADRS cohort study who visited Besat clinic in Kerman and were divided into addicted and non-addicted groups. The participants in both groups underwent carotid artery ultrasound, and the Philips IU22 ultrasound machine was used to measure the CIMT. Findings: The mean age of the participants was 42.28±12.58 in the addicted group and 35.99±15.38 in the non-addicted group (P=0.001). CIMT was similar in the two groups (P=0.170). Moreover, CIMT had a significant positive correlation with age, waist circumference, systolic blood pressure (SBP), body mass index (BMI), fasting plasma glucose (FPG), and triglyceride in both addicted and non-addicted groups. Age, weight, waist circumference, SBP, and BMI in the multivariate model were significant determinants of CIMT in the addicted group. Conclusion: The results revealed that age, weight, waist circumference, SBP, and BMI were the factors influencing intima thickness in opium consumers, and no significant relationship was observed between addiction to opium and CIMT.

The relationship between vitamin D and short-term blood pressure variability.

OBJECTIVES: This study aimed to evaluate the relationships between serum levels of 25-hydroxyvitamin D (25(OH)D) and short-term blood pressure variability (BPV) in newly diagnosed hypertensive patients. METHODS: One hundred newly diagnosed patients with stage one essential hypertension were included and divided into two groups, the deficient and non-deficient groups, according to their 25(OH)D level. The blood pressure was recorded automatically by a portable ambulatory blood pressure monitor for 24 h. RESULTS: In the present study, there was no significant relationship between vitamin D levels and short-term BPV or other parameters derived from ambulatory blood pressure monitoring (ABPM) (P > 0.05). Age (r = 0.260, P = 0.009), serum phosphorus (r = 0.271, P = 0.007), and cholesterol levels (r = 0.310, P = 0.011) were positively correlated with 25(OH)D levels, while glomerular filtration rate (r = -0.232, P = 0.021) negatively correlated with vitamin D levels. There was no crude or adjusted relationship between the levels of 25(OH)D and any parameters of ABPM in multiple linear regression analysis. CONCLUSION: Although the relationship between vitamin D levels and cardiovascular diseases has been confirmed, vitamin D deficiency does not cause an increase in cardiovascular risk by influencing the short-term BPV or other parameters derived from ABPM.

Co-infection of coronavirus disease 19 and cytomegalovirus in a kidney transplant recipient.

It has been suggested that severe SARS-CoV-2 infection could be a risk factor for Herpesviridae reactivation due to the state of sepsis-associated immunosuppression. We presented the case of co-infection of CMV and COVID-19 infection in a 43-year-old woman with end-stage renal disease.

Streptococcus-related acute suppurative thyroiditis in a COVID-19-positive child: A rare case report.

In this case report, we present a 10-year-old girl with acute suppurative thyroiditis (AST) symptoms, such as fever, sore throat, and swelling in the suprasternal region, who had a positive PCR test for COVID-19. The result of the secretions culture obtained from the abscess drainage was positive for nonhemolytic Streptococcus.

Investigating the relationship between haematological parameters and metabolic syndrome: A population-based study.

BACKGROUND: Metabolic syndrome (MetS) is a global public health concern. Chronic inflammation plays a role in MetS; haematological inflammatory parameters can be used as MetS predicting factors. OBJECTIVE: Hereditary and environmental factors play an important role in the development of MetS. This study aimed to determine the relationship between haematological parameters and MetS in the adult population of southeastern Iran, Kerman. METHODS: This cross-sectional study was a sub-analysis of 1033 subjects who participated in the second phase of the Kerman Coronary Artery Disease Risk Factor Study (KERCADRS). Metabolic syndrome was diagnosed according to Adult Treatment Panel III (ATP III) definition. Pearson correlation coefficient was used to investigate the relationship between haematological parameters with age and components of metabolic syndrome. The role of WBC, neutrophil, lymphocyte and monocyte in predicting metabolic syndrome was evaluated using the receiver operating characteristic (ROC) curve. RESULTS: White blood cell (WBC) and its subcomponent cells count, red cell distribution width (RDW), monocyte to HDL ratio (MHR) and Neutrophil to HDL ratio (NHR) had a significant positive correlation with the severity of MetS. The cut-off value of WBC was 6.1 (×103 /µL), the sensitivity was 70%, the specificity was 52.9% for females, the cut-off value of WBC was 6.3 (×103 /µL), the sensitivity was 68.2% and the specificity was 46.7%, for males. CONCLUSION: WBC and its subcomponent count, RDW, MHR and NHR parameters are valuable biomarkers for further risk appraisal of MetS in adults. These markers are helpful in early diagnoses of individuals with MetS.

To evaluate the relationship between serum magnesium and parathyroid hormone levels in peritoneal dialysis and hemodialysis patients.

OBJECTS: This study aimed to determine the relationship between magnesium and PTH levels in peritoneal dialysis (PD) and hemodialysis (HD) patients. METHODS: This cross-sectional study was performed on HD and PD patients in Kerman, Iran. After recording demographic and clinical data, the pre-dialysis levels of hemoglobin, 25-hydroxy vitamin D, ferritin, creatinine, calcium, phosphorus, albumin, PTH, and magnesium were measured for all patients. The P value of less than 0.05 was considered statistically significant. RESULTS: Magnesium levels in PD patients were significantly higher than in HD patients (P < 0.001). The median PTH level in PD patients was significantly lower than in HD patients (P = 0.046). The correlation between PTH and serum magnesium levels was not significant in PD or HD patients. In the regression model, dialysis modality (PD or HD) was the only significant variable in determining serum magnesium levels (P = 0.005). CONCLUSION: Magnesium is a neglected ion in peritoneal dialysis and hemodialysis patients. In dialysis centers that use a dialysate with standard magnesium concentration (0.5 mmol/L in HD and 0.75 mmol/L in PD), special attention is necessary to hypomagnesia and its complications because magnesium levels in PD patients were significantly higher than in HD patients. As the correlation between magnesium and PTH levels in both PD and HD patients were not significant, the association of high magnesium levels with low PTH in PD patients should be considered in terms of increasing the potential for adynamic bone disease. It seems that ordering serum magnesium in the routine tests of dialysis patients is necessary.

Hyperuricaemia and its association with other risk factors for cardiovascular diseases: A population-based study.

INTRODUCTION: Cardiovascular diseases are very common in the general population, and several factors play a role in their development. The purpose of this study was to investigate the relationship between hyperuricaemia and other cardiovascular disease risk factors. METHODS: This cross-sectional study was conducted on 1008 people over the 15-year-old general population in Kerman, Iran. The blood samples of all patients were analysed for the uric acid serum level, and they completed a checklist including physical activity, previous history of hypertension and diabetes, smoking and opium. RESULTS: A number of 1008 cases of people were entered into the study. According to the results of this study, 254 patients had uric acid levels above the 75th percentile (6 mg/dl in males, and 5 mg/dl in females). No significant difference was observed between gender (p = .249) and age groups (p = .125) of people with and without hyperuricaemia. The prevalence of overweight/obesity (p < .001), hypertension (p = .004) and low physical activity (p = .033) was significantly higher in patients with hyperuricaemia. The duration of hypertension was significantly higher in hyperuricaemic individuals (p = .022). Overweight/obesity (OR = 2.67; 95% CI = 1.87-3.82) and hypertension (OR = 1.40; 95% CI = 1.02-1.93) were two significant independent factors that contributed to the increased risk of hyperuricaemia in the subjects. CONCLUSION: The uric acid serum level is higher in people with hypertension and overweight/obesity. Hyperuricaemia increases the risk of cardiovascular events, which can be prevented by determining the appropriate strategy for the early diagnosis and treatment of this metabolic disorder.

Investigating the relationship between serum uric acid to high-density lipoprotein ratio and metabolic syndrome.

AIMS: This study aimed to determine a parameter to more easily diagnose metabolic syndrome and predict its probability of occurrence in high-risk individuals. METHODS: In this cross-sectional study, data related to the study population in the Kerman Coronary Artery Disease Risk Factor Study (KERCADRS) were examined. Subjects were divided into two groups with and without metabolic syndrome, and the relevant factors such as the ratios of uric acid to high-density lipoprotein (HDL) (UHR) in these two groups were compared, and the best cut-off point was determined. RESULTS: Data related to 817 people including 96 people with metabolic syndrome and 721 people without metabolic syndrome were analysed. The mean UHR was significantly higher in patients with metabolic syndrome (14.76 ± 6.33%) compared with those without metabolic syndrome (10.0 ± 3.10%) (p < .001). People with high UHR are 2.9 times more at risk of metabolic syndrome and the best cut-off point was 9.50% with 86% sensitivity and 55% specificity. CONCLUSIONS: According to our study, UHR is also helpful in diagnosing metabolic syndrome and can also be used to screen people at risk for metabolic syndrome.

Bone Loss Correlated with Parathyroid Hormone Levels in Adult Celiac Patients.

BACKGROUND: Celiac disease (CD) is a gluten-sensitive enteropathy with intestinal and extra-intestinal presentations in genetically predisposed cases. Musculoskeletal problems are one of the most common extra-intestinal manifestations in adult patients with CD. In the present study, we evaluated parathyroid hormone (PTH) levels in men and premenopausal women with CD who had osteoporosis and osteopenia. METHODS: This was a cross-sectional study of 387adult patients with CD who were referred to the Mashhad Celiac Disease Center between 2014 and 2019. We excluded bone loss confounding factors, including cases with endocrine disorders, corticosteroid consumption, smoking, and age of more than 55 years. Factors such as intestinal pathology, bone mineral density (BMD), serum level of anti-tTG, serum vitamin D, and PTH levels were also assessed at the time of diagnosis. RESULTS: Femoral osteopenia was found in 140 (36.2%) patients, and osteoporosis was observed in 55 (14%) patients. Spinal osteopenia and osteoporosis were observed in 127 (33%) and 63 (16.4%) patients, respectively. High levels of PTH were detected in 72/193 (27.2%) of the patients with CD. There was a significant difference between PTH levels in patients with osteopenia, osteoporosis, and normal BMD (P=0.0001). CONCLUSION: This study showed a correlation between low BMD and PTH levels in patients with CD, which suggests autoimmune endocrine disorder as a cause of osteopenia and osteoporosis.

The first presentation of Wolcott-Rallison syndrome in a four-month-old infant with diabetic ketoacidosis (DKA) precipitating by COVID-19: A case report.

Monogenic diabetes mellitus (eg, Wolcott-Rallison syndrome) is a rare condition. It associates with neonatal or early-infancy insulin-dependent diabetes. We reported DKA in the four-month infant as the first presentation of monogenic diabetes that has accelerated by COVID-19 infection. Therefore, considering the concurrency of COVID-19 and DKA is crucial.

Addison's disease in antiphospholipid syndrome: A rare complication.

The association of APS and AI is rare, but it is very important, and in cases where there is an evidence in favor of the association of these two diseases, due to the importance of early treatment of both diseases, further evaluation is necessary.

Effect of hydro-alcoholic extract of Rosa damascena on cardiovascular responses in normotensive rat.

OBJECTIVE: Rosa damascena mill L. (R. damascena) is a well-known plant with fragrant effects. Several therapeutic effects of this plant on respiratory, gastrointestinal and nervous systems have been reported. It is also suggested to have beneficial effect on cardiovascular system especially blood pressure regulation. The present study was carried out to evaluate acute cardiovascular effect of hydro-alcoholic extract of R. damascena. MATERIALS AND METHODS: Thirty-two male Wistar rats were randomly divided into four groups (n= 8 for each group). After anesthesia, a catheter was inserted into the femoral artery and blood pressure and heart rate (HR) were continuously recorded by a power lab system. Animals received three doses of hydro-alcoholic extract (250, 500, and 1000 mg/kg) via peritoneal (i.p). After 30 min, systolic blood pressure (SBP), mean arterial pressure (MAP) and HR were recorded and maximal changes were compared to control group. RESULTS: Injection of all doses of the extract did not significantly change HR compare to control group. The SBP, dose dependently, was decreased by all doses of the extract and the maximal response was significant compared to saline group (p<0.01 to p<0.001). Different doses of the extract also dose-dependently decreased maximal changes of MAP responses compared to control group. The effect of higher doses of the extract on SBP and MAP was significant compared to lower doses (p<0.05 to p<0.01). CONCLUSION: This study provides evidence of a hypotensive effect of hydro-alcoholic extract of R. damascena with no significant effect on HR. Therefore, R. damascena is suggested to have beneficial effect to control blood pressure. However, it needs to be more investigated.