Depression, anxiety, and quality of life in patients with systemic lupus erythematosus.

Introduction: Systemic lupus erythematosus (SLE) is a multisystem disorder that can affect multiple organs; psychiatric manifestations including depression and anxiety are commonly seen in SLE. The aim of this study is to explore the prevalence of depression, anxiety, and stress, and assess the quality of life (QOL) in patients with SLE and also evaluate associated risk factors. Material and methods: In this cross-sectional study, adult patients with SLE were identified through our institution's SLE data registry. Participants were evaluated with three questionnaires: Depression, Anxiety, and Stress Scale (DASS-42), General Health Ouestionnaire-28 (GHQ-28), and World Health Organization quality of life instrument short form (WHO-QOL BREF). Results: A total of 222 patients were included in the study, 203 (91%) of whom were female and 19 were male (9%). Participants had a mean age of 35.6 ±9.5 years. According to DASS-42 questionnaire, 22.1%, 28.7% and 20.3% of patients had varying degrees of depression, anxiety, and stress, respectively. Based on GHQ-28 questionnaire, 137 (62%) of patients reported some degree of distress. Quality of life score was 12.8, 13, 14.3, and 13.9 in physical health, psychological health, social relationships, and environmental health, respectively. Conclusions: We found that depression, anxiety, and stress are common in patients with SLE, and quality of life is significantly affected. A high percentage of patients with SLE deal with some degree of distress. Routine evaluation of the quality of life and psychological disturbances is recommended in patients with SLE. Non-pharmacological interventions as well as specialist referral should be considered in patients with anxiety, depression, or stress.

Challenging diagnosis of Kimura disease in a child with nephrotic syndrome: A case report.

Kimura disease (KD) is a rare condition with a challenging diagnosis because it may be misdiagnosed and not differentiated from other disorders. We reported a 13-year-old patient who presented with growing neck masses and was hospitalized due to the nephrotic syndrome relapse but was eventually diagnosed with KD.

The effect of green tea (Camellia sinensis) on lipid profiles and renal function in people with type 2 diabetes and nephropathy: a randomized controlled clinical trial.

Introduction: Diabetic nephropathy is one of the most important microvascular complications of diabetes. Despite the modern treatments, herbs or medicinal plants have gained wide attention. One of these herbs is green tea (Camellia sinensis), which may have an impact on renal function, lipid profiles, and HbA1c. However, the evidence for this is unclear and limited. The present study aimed to evaluate the effect of different doses of green tea on these parameters in type 2 diabetes patients (T2DM) with nephropathy. Methods: Sixty-six individuals with T2DM nephropathy (aged 30-70 years) were randomly assigned to receive three cups of green tea/day (n = 22), two cups of green tea/day (n = 22), and the control group (n = 22) for 12 weeks. Lipid profiles, glycated hemoglobin A1c (HbA1c), and renal markers were measured before and after intervention. Data were analyzed using SPSS software version 23. One-way analysis of variance (ANOVA), least significant difference (LSD) post hoc, and analysis of covariance were used to compare quantitative variables. Results: In total, 64 participants completed the study. Consuming three cups of infusion green tea per day (7.5 gr) led to a significant reduction in serum levels of total cholesterol (p = 0.009) and HbA1c (p = 0.006) and increased in high-density lipoprotein cholesterol (HDL-C) (p = 0.02) compared with the control group who did not drink green tea. However, no significant differences were observed for other variables. Conclusion: In general, it was found that drinking three cups of green tea infusion (7.5 gr) per day produced beneficial effects on some lipid profiles and HbA1c without any adverse effects on renal function in patients with T2DM nephropathy. More studies are needed to fully elucidate these findings. Clinical trial registration: Iranian Registry of Clinical Trials (www.irct.ir) under registry number: IRCT2014020114538N2.

Urinary incontinence and related quality of life among elderly women in Tabas, South Khorasan, Iran.

BACKGROUND: Urinary incontinence (UI) is one of the most common problems in old age that is often seen in women, which causes not only physical problems but also psychological, social, economic problems and poor quality of life. The aim of the present study was to evaluate the UI and related quality of life (QoL) in elderly women. METHODS: This cross-sectional study enrolled 369 women over 60 years old and living in Tabas city, Iran who were selected by cluster random sampling method. The instruments included the International Consultation on Incontinence Questionnaire-Short Form, the International Consultation on Incontinence Questionnaire Urinary Incontinence Quality of Life Module, and a demographic questionnaire. Data analysis was carried out using independent t-test, chi-square, and logistic regression in SPSS software. RESULTS: The UI prevalence among participants was 24.9% and stress urinary incontinence was the most common type (40.2% of all elderly patients). The mean UI-related QoL score was 38.04 ± 11.67 from the score range of 22-76. There was a significant positive correlation between UI-related QoL score and UI score (r = 0.585, p < 0.001). Age, body mass index (BMI), constipation, history of cesarean section, hypertension, and the use of angiotensin receptor blockers are factors increasing the odds of having UI in this study population. CONCLUSION: Aging, some chronic diseases, high BMI, and the use of some drugs are related to UI prevalence. Also, it is associated with lower QOL among elderly women. Designing appropriate intervention programs, controlling chronic diseases, training in the proper use of drugs, and also some physical exercises can be effective in controlling and improving this common syndrome of old age and promoting their QoL.

Ascorbic acid effect on CIN incidence in diabetic patient after coronary angiography.

BACKGROUND: This study aims to investigate the antioxidant effect of vitamin C in preventing contrast-induced nephropathy (CIN) in diabetic patients after catheterization. MATERIALS AND METHODS: In a double blinded, randomized controlled trial, 90 diabetic patients who were referred for cardiac catheterization were randomly allocated into two arms of vitamin C (A) and placebo (B). The treatment arm (A) received 2 g of vitamin C orally 2 h before catheterization and the control group (B) received 2 g of oral placebo. Six hours before catheterization, patients received fluid resuscitation with normal saline (CIN was considered as a 25% rise in creatinine (Cr) level or an increase of 0.5 mg/dL in earlier creatinine). CIN was compared between groups. Before andthree days after catheterization. Serum Bun - Cr was measured and GFR were calculated. The results were compared between the two groups. Six hours before catheterization, patients received fluid resuscitation with normal saline CIN was compare between arms. RESULTS: Mean GFR in group (A) before procedure was respectively 69.82±19.26 and after the treatment was 81.51±27.40 (P=0.001). But in group (B) it was 74.18±24.41 and 75.20±29.65 (P=0.747). Contrast-induced nephropathy was observed in 10 patients (12.3%) including 3 patients (7.7%) in group (A) and (16.7%, 7 patients) in group (B) (P=0.315). CONCLUSION: Ascorbic acid intake in diabetic patients prior to use of contrast agents can be effective in maintaining GFR, but the incidence of contrast-induced nephropathy is not associated with the consumption of ascorbic acid.

The Prevalence of Occult Hepatitis B Virus in the Hemodialysis Patients in Yazd, Iran.

Occult HBV infection of hemodialysis (HD) patients is informative in terms of virus transmission. It may be of clinical importance in HD patients. The aim of this study was to investigate the prevalence of anti-HBc in the HD Patients. Number of 126 patients undergoing hemodialysis were included in this study from main hemodialysis units in Yazd. Hepatitis B surface antigens (HBsAg), hepatitis B core antibody (anti-HBc) were examined in all subjects. Finally, stored serum samples from anti-HBcAb positive, HBsAg negative patients were anonymised and tested for HBV DNA by real time quantitative PCR assay. The age range of the patients was 17-88 years. Of the 126 patients, 123 patients (97.6%) were HBC-Ab negative and 3 (2.4%) were positive. Of 3 patients with Anti-HBC positive, HBV DNA was detected in 1 patient. This study showed a low rate of isolated anti-HBc (2.4%). HBV DNA was also detected in 1 patient.

Association of dialysis adequacy with nutritional and inflammatory status in patients with chronic kidney failure.

The number of patients with dialysis-dependent renal failure has increased in the past years worldwide. Several parameters have been introduced for the quantitative assessment of dialysis adequacy. The National Cooperative Dialysis Study results indicated that Kt/V and time-averaged concentration of urea (TAC) are predictors of mortality in patients who receive maintenance hemodialysis (HD). Also, the protein catabolic ratio (PCR), which is an indicator of nutritional status, can predict patients' mortality. Our aim was to assess the impact of parameters that show dialysis adequacy on indices of nutrition or inflammation. A total of 46 patients were included in the study; eight patients were excluded during the course of the study and 38 patients were enrolled in the final analysis. All patients were receiving HD for at least for three months. HD was administered three times per week and the study lasted for two months. Kt/V, TAC and PCR were assessed at the beginning of the study based on patients' urea and blood urea nitrogen in the first week of our study; these calculations were repeated at the end of the first and second months using the mean of the mentioned values in the month. Both adequacy indices significantly and positively correlated with changes in PCR (P <0.001). However, no significant correlation was detectable between Kt/V and TAC with either body mass index and albumin or C-reactive protein. Based on the Kt/V values, patients with adequate dialysis had slower decrease in the PCR (P <0.001). Our results indicate that adequacy of dialysis is correlated with patients' nutritional status. No correlation was observed between dialysis adequacy and inflammatory status.

Diagnosis and treatment of Sagliker syndrome: a case series from Iran.

Sagliker syndrome was introduced in 2004 in patients with end-stage renal disease and severe secondary hyperparathyroidism. This syndrome describes maxillary and mandibular deformities, dental abnormalities, benign soft tissue tumors in mouth, and various kinds of skeletal changes including short stature and fingertip abnormalities. There are a few reports from different regions of the world. The aim of this study is to report 5 cases of the Sagliker syndrome from Iran.

Dermatomyositis sine myositis with membranoproliferative glomerulonephritis.

Dermatomyositis (DM) is an autoimmune disease that is characterized by involvement of proximal musculature and skin. We report a 52-year-old woman with a 6-year history of dermatomyositis sine myositis, who developed lower extremity edema and proteinuria. Pathological examination of renal biopsy showed membranoproliferative glomerulonephritis. She received steroid, cyclophosphamide, and mycophenolate mofetil. Over the 9 to 10 months after the beginning of treatment, the proteinuria was improved.

Modified jejunoileal bypass surgery with biliary diversion for morbid obesity and changes in liver histology during follow-up.

BACKGROUND AND AIMS: Bariatric surgery is the most effective treatment for morbid obesity. The classic procedure, jejunoileal bypass, has many complications including rapid progress of liver disease. The senior author (I.F.) has developed a modification of jejunoileal bypass, which we believe overcomes many of the shortcomings of the classic procedure. METHODS: Consecutive patients referring for bariatric surgery were included. A modified jejunoileal bypass in which the defunctionalized limb is eliminated by anastomosing its ends to the gall bladder and cecum was performed. Liver biopsies were taken during operation and at a mean of 16 months later. The patients were followed for 5 years. RESULTS: Forty-three patients were enrolled. The mean value of weight and body mass index (BMI) fell from 128 kg and 46 kg/m(2) before operation to 85 kg and 31 kg/m(2) at 5 years, respectively (p < 0.001). There was no significant change in the degree of liver steatosis and necroinflammation. The mean liver fibrosis score increased from 0.1 to 0.9 (p = 0.015). No sign of advanced liver disease was observed during the 5-year follow-up. CONCLUSION: The modified jejunoileal bypass is very effective in inducing and maintaining weight loss for 5 years and does not lead to hepatic failure or rapid progression of liver disease.