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Background: Acute kidney injury (AKI) requires continuous renal replacement therapy (CRRT), which is one of the most important problems in medical and surgical patients. Therefore, it is very important to identify the influencing factors to reduce the dimensions of the problem. This study was conducted to investigate the mortality rate in medical and surgical patients with AKI requiring CRRT treatment.

Materials and methods: In this observational study, which was conducted as a cross- sectional analytical study, 100 patients with AKI requiring CRRT treatment, including medical and surgical patients, were selected from 2018 to 2021 at Masih Daneshvari Hospital. The mortality rate was estimated. Also, the effective factors were investigated and compared between the dead and surviving patients.

Results: 85 cases (85%) of the patients died. Most underlying and demographic variables had no statistically significant difference between the dead and surviving patients (P>0.05). However, in the cases of primary calcium (P=0.001), primary leukocyte (P=0.037), bicarbonate during hospitalization (P=0.025), bicarbonate during AKI (P=0.028), magnesium during hospitalization (P=0.038), and magnesium at the end of CRRT (P=0.019), the differences were statistically significant.

Conclusion: In conclusion, mortality is observed in 5 out of 6 patients with acute kidney failure who need CRRT treatment, which is related to risk factors such as bicarbonate, magnesium, leukocyte, and calcium levels. Therefore, multifaceted planning is needed to reduce its dimensions to improve the prognosis of this group of patients.

Background: Recently, genetic mutations in surfactant protein C (SFTPC) have been linked to diffuse parenchymal lung diseases (DPLD). The present study investigated SFTPC mutations among Iranian patients with DPLD for the first time.

Materials and methods: In this study, we examined 28 patients diagnosed with DPLD. Patients were divided into two groups: 23 cases (82.1%) had interstitial lung disease (ILD), 7 (30.4%) of which were categorized as familial ILD, and 5 cases (17.9%) had pulmonary alveolar proteinosis (PAP). Genetic variations in the SFTPC gene were detected by direct DNA sequencing.

Results: The mean (±SD) age of patients was 21.8 (± 17.1) years and 60.7% of the patients were male. Overall, 11 different mutations were detected in the SFTPC gene. Two novel mutations, c.202-43 G>A and c.416 G>C, were detected among patients. The c.201+49 C>T mutation showed a significant difference with the minor allele frequency (MAF) data. There was no significant difference between the most frequent mutations in Iranian patients and those of the general population in the world. The proximity analysis showed similarity between Iranian patients and patients of the African race. We did not find any correlation between SFTPC mutations and DPLD in the patients.

Conclusion: It seems that the rs2070684 (c.201+49 C>T) mutation could be used as a specific genetic marker for distinguishing the Iranian population from other human races in the world. There was a correlation between some intronic variations and the development of disease. A new missense mutation, c.416 G>C that encodes Arg139Thr, could probably damage the protein structure and/or function and cause the signs and symptoms of DPLD.

Background: Primary cardiac tumors (PCT), such as myxoma, are rare and predominantly benign. Angiofibroma tumors are an extremely rare subtype of PCT, reported in less than ten cases. In this study, we presented a mixed tumor of myxoma and angiofibroma for the first time in the human heart.

Case presentation: This case report describes a 30-year old man with a positive cerebrovascular accident (CVA) history who presented with syncope, aphasia, and right-side hemiparesis to the emergency department. The imaging assessment, including echocardiography and magnetic resonance imaging, revealed a suspected cardiac tumor in his left atrium extended to the interatrial septum. Therefore, during tumor resection surgery, the mass was removed entirely. Microscopical pathology and desmin immunohistochemical and trichrome staining findings confirmed the angiofibroma diagnosis with myxoma components.

Conclusion: According to our presentation, angiofibroma can be accompanied by myxoma and result in neurological symptoms. The best treatment for this dual component tumor is surgical resection of the tumor and the affected margin.

Background: SARS-CoV-2 is a member of the coronavirus family that has caused infections in humans. Iran, as one of the countries in West Asia, is facing a high prevalence of this virus. In this study, we aimed to investigate the association between smoking and COVID-19 outcomes during the pandemic and sociodemographic characteristics.

Materials and methods: This cross-sectional survey was done to assess the frequency of tobacco smoking in COVID-19 patients hospitalized at Masih Daneshvari Hospital, Tehran, Iran. All patients' basic and clinical characteristics, smoking status, and outcomes (ICU admission) were recorded.

Results: A total of 254 participants, of whom 206 (81.10%) provided complete data on variables included in the present analyses. In the present study, 137 (66.5%) of all patients were men and 69 (33.5%) were women. Also, 63 (30.4%) of the study population had a family member with a current disease or history of COVID-19. Fourteen patients (6.79%) were ex-smokers and 34 (16.50%) were current smokers. We found significant relationships between Ex-smoking and ICU admission in COVID-19 patients.

Conclusion: Ex-smoker inpatients with COVID-19 require special attention since they are a vulnerable population with a much higher morbidity rate.

Background: Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder associated with multisystem organ involvement. The STOP-BANG questionnaire is a short and valid questionnaire used to screen OSA. This study aimed to investigate the ability of the STOP-BANG questionnaire to predict postoperative OSA- related respiratory complications in patients undergoing bariatric surgery.

Materials and methods: In this cross-sectional study, all the eligible patients were evaluated in preoperative visits using a predetermined checklist including demographic and clinical information related to OSA and the STOP-BANG questionnaire. After bariatric surgery, patients were assessed for postoperative OSA-related complications. The receiver operating characteristic (ROC) curve was used to determine the cut-off point of the STOP-BANG checklist score based on the patient's postoperative outcomes.

Results: In total, 115 subjects were included in the study. There were significant associations in terms of gender, age, body mass index (BMI), patient's neck circumference, diabetes, heart diseases, and the mask ventilation grade variables between the two groups of patients with high risk and low risk according to the STOP-BANG questionnaire (P < 0.05 for all comparisons). In addition, ai rway obstruction and hypoxia (mild and moderate) were more prevalent in the high-risk group than in the low-risk one (P < 0.05 for all comparisons). A significant difference was reported with a cut-off score of 2 in the STOP-BANG questionnaire for those with and without airway obstruction. Moreover, the cut-off point of 4 in the STOP-BANG questionnaire was determined as a predictor for both airway obstruction and mild-to-moderate hypoxia.

Conclusion: STOP- BANG scores may be used as a preoperative risk stratification tool to predict the risk of intraoperative adverse events and postoperative complications in bariatric surgery.

Background: Rhinoviruses are known as the leading pathogens of respiratory diseases. Determining the prevalence and phylogeny of rhinoviruses plays a pivotal role in producing vaccines and medications and preventing virus complications. This study investigated the frequency, and genetic variation of rhinoviruses detected in patients referred to Masih Daneshvari Hospital.

Materials and methods: It was a descriptive cross-sectional study. The samples were from all ages whose information was recorded in 2017 according to a clinical diagnosis of acute respiratory infection (ARI) and in 2015 based on a clinical diagnosis of community-acquired pneumonia (CAP) within the HIS system of Masih Daneshvari Hospital. Using a random number table, 202 patients diagnosed with ARI and 51 patients diagnosed with CAP were selected. The real-time PCR method was used for primary screening; nested PCR was performed in the VP2/VP4 gene region for phylogenetic investigations, and MEGA software drew a phylogenetic tree.

Results: The highest level of rhinovirus infection was seen in subjects under 18 years of age, males, and during the spring season. In this study, the genotypes of HRV-A (including A15, A29, A40, A47, A58, A67, and A80) and HRV-C (including C39 and C44) and two samples of enterovirus D68 were found.

Conclusion: Like other studies conducted in Asia, the most detected genotypes were HRV-A and HRV-C. Conducting further studies with a larger sample size and in different geographical regions of Iran will provide us with more comprehensive information about the frequency of rhinoviruses and common genotypes.

Background: Due to the high prevalence of COVID-19 and the prevention and control of adverse fetal and neonatal outcomes in pregnant women, including vertical transmission, this study was performed to describe the fetal and neonatal outcomes of pregnancy with a spectrum of COVID-19 disease during pregnancy in Iran.

Materials and methods: In this cross-sectional study, we analyzed the medical records of 258 pregnant women admitted to the Forghani Hospital, Qom, Iran, from 18 February 2020, to May 10, 2021. PCR-RT or respiratory compromise in the presence of marked radiographic changes of COVID-19 in the lungs, or both COVID-19 disease confirmed COVID-19 disease. Then, we collected the disease spectrum of COVID-19 and fetal and neonatal outcomes from patient records.

Results: The findings of our study showed that out of 258 pregnant women who were hospitalized due to COVID-19, 79.8% had mild to moderate disease, 16.7% had severe COVID-19, and 3.5% were in the critical stage. After adjusting for the confounding variables, the severity of the disease was significantly associated with adverse fetal and neonatal outcomes such as fetal distress, Intra Uterine Growth Restriction (IUGR), preterm delivery, and Low Birth Weight (LBW), and low first minute Apgar score. However, the severity of COVID-19 was not a predictor of spontaneous preterm delivery, admission to NICU, low Apgar scores at 5 minutes, vertical transmission, stillbirth, and neonatal death.

Conclusion: Neonates of mothers with the severe and critical stage of COVID-19 are exposed to higher potential risks such as fetal distress, IUGR, preterm delivery, LBW, and low Apgar scores at 1 minute than women with mild to moderate disease.

Background: This study aims to investigate the clinical and demographic features of underlying medical conditions and the potential relationship between underlying diseases and the increased rate of morbidity and mortality due to COVID-19.

Materials and methods: This study was conducted on 350 COVID-19 patients hospitalized at the Masih Daneshvari Hospital from February-July 2021. All participants had confirmed COVID-19 diagnosis based on symptoms and/or positive PCR test or chest X-ray results. Data was collected from medical records on demographics, disease severity, symptoms, underlying conditions like diabetes, hypertension, coronary heart disease, obesity, renal disease/transplantation, and outcomes like hospital stay, ICU admission, and mortality. Relationships between age, underlying diseases, and mortality were analyzed using chi-square and Fisher's exact tests."

Results: A total of 350 patients diagnosed with COVID-19 were included in the study, with an average estimated age of (60.8±15.4). The age group of 56 and above had the highest morbidity rate, which accounted for 50% of the total participants. Among the COVID-19 patients, diabetes was the most common underlying medical condition, accounting for 31.4% of the cases. High blood pressure was present in 27.1% of the patients, and 17.1% of the total participants had coronary heart disease (CHD). Additionally, 10.9% of the participants were overweight, and 30 of them had previously experienced kidney failure or transplantation. Moreover, the study found that 40% of patients with diabetes died, while the mortality rate was 38.3% in patients with CHD and 47.4% in overweight participants. High blood pressure patients had a mortality rate of 43.2%, and patients with renal failure or kidney transplantation had a significantly increased risk of mortality at 83.3%. The research also revealed a significant and direct relationship between mortality rate, age group, and underlying disease among the patients (P<0.05).

Conclusion: The findings of the present study hold significant implications for preventive interventions and policy adoption, particularly in relation to the use of calendar age as the key criterion for risk evaluation. These results underscore the need for a more precise and focused approach to prioritizing patients with identified risk factors.