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Volume 61, Issue 3 (6-2003)
Essential hypertension is one of the risk factors of cardiovascular diseases. Hypertension etiology is not completely known, it seems that rennin-Angiotensin system has an important role in its etiology, Thus better recognition of this system and its activity changes or vascular reaction changes to different parts of this system during progressive hypertension can be more effective in better recognition of the disease progress and treatment.
Materials and Methods: In this study responsiveness of mesenteric vessels of Goldblatt two kidney- one clip (2k-lc) renovascular hypertensive rats to angiotensin / and II with and with out captopril during a time of two , four , six and eight weeks after hypertension induction was investigated and compared with control and surgical sham groups.
Results: This study shows that vascular responsiveness to angiotensin // in animals that passed four weeks of their hypertension , (p< 0.05) and in the sixth and eight week of post induction hypertension (p< 0.01 and p< 0.001) has a significant different with both sham and control groups. Also it has been observed that an increased reaction to angiotensin II with an increased significant rate of arterial hypertension in hypertensive group. In the other hand in spite of inhibition of angiotensin converting enzyme by captopril in animals that have been eight weeks hypertension , on the contrary to other groups reactive to angiotensin /.
Conclusion: Results of this study show that vessels reaction to angiotensin /and II increased due to six to eight weeks post induction renal hypertension. Captopril does not inhibite mesenteric vessels reaction to Angiotensin / in hypertensive Rats after eight weeks. Try to completely inhibit production of angiotensin II maybe a hopful way in controlling essential hypertension.
Volume 64, Issue 6 (8-2006)
Background: Hypertention and diabetes are important risk factors for cardiovascular disease. studies have shown that microalbuminuria is a strong predictor of cardiov-ascular disease in different population.In this study the relation of microalbuminuria with diabetes and hypertention as risk factors of atherosclerosis disease were investi-gated.
Methods: Two hundered twenty eight patients with angiographically confirmed coronary atherosclerotic lesions, (mean age 60 ± 0.5 SD) referred to Madani Hospital, Tabriz, Iran were studied .This patients according to the number of diseased vessels were classified in two groups. The levels of glucose and creatinine and that of post parandial glucose were determined in venous blood samples by standard methods. Immunoturbidimetric method was employed in the measurement of microalbuminuria. The results were analysed by statistical tests.
Results: The increased albumin/creatinine ratio was markedly correlated with fasting blood sugar, systolic and diastolic blood pressure (P < 0.05 in all cases). Significant correlation was noticed between microalbuminuria, diabetes according to the extension of the disease lesions (P < 0.05). No relationship was observed between microalbumin-uria, high levels of blood pressure according to the number of diseased vessels (P > 0.05). Conclusion: The relationship between diabetes and microalbuminuria was meaningful. According to atherosclerotic lesions a marked correlation was also noticed between microalbuminuria and diabetes. These facts may contribute to the higher cardiovascular risk in diabetic patients. An associated between hypertension and microalbuminuria was noticed. The result suggests that although risk factors such as hypertension and diabetes are known to cause cardiovascular disease, microalbuminuria may in fact be a better indicator of established microvascular damage and better predictor of cardiov-ascular events.
Volume 64, Issue 10 (10-2006)
Background: Microalbuminuria (MA) is associated with increased cardiovascular risk in hypertensive patients, but not many studies have specifically examined the effects of MA-lowering on regression of left ventricular hypertrophy (LVH) among pediatric patients with hypertension.
Methods: Fifty-five patients with essential hypertension, 11 to 19 years old were prospectively studied. All patients received concomitant therapy of hydrochlorothiazide and angiotensin-converting-enzyme inhibitor. Five patients also required angiotensin-receptor blocker to achieve the blood pressure goal. Baseline and 12-month follow-up measures of left ventricular mass index (LVMI) determined by echocardiography and urine microalbumin/creatinine ratio (MA/Cr) were collected. MA was defined as MA/Cr>30. LVH was defined as LVMI>38.6 g/m2. The primary end points were 25% or more reductions in MA and the LVMI.
Results: Weight (r=0.83), body surface area (r=0.85), body mass index (BMI) (r=0.86), systolic blood pressure (SBP) (r=0.57), diastolic blood pressure (DBP) (r=0.49), mean arterial pressure (r=0.53) and MA (r=0.87) were all univariate correlates of LVMI. In a multiple regression analysis, MA, BMI and SBP were significant correlates of LVMI. MA alone explained 76% of the variance of LVMI, whereas BMI and SBP explained only 1.6% and 0.4% of the variance, respectively. MA was the most significant correlate of follow-up LVMI after BMI and SBP were included in the overall multiple regression models.
Conclusion: MA is a strong predictor of LVH in hypertensive children and adolescents. MA-lowering halts the progression of LVH or induces its regression.
Volume 64, Issue 12 (11-2006)
Background: Abdominal compartment syndrome (ACS) is a clinical entity that develops from progressive, acute increases in intra-abdominal pressure (IAP) and adversely affects all vital organ systems In this study, the development of intra-abdominal hypertension (IAH) and ACS in a surgical ICU population is described and examined.
Methods: Over a one-year period (2004), urinary bladder pressure (UBP) was measured prospectively in all surgical patients with abdominal problems admitted to the ICU of the Imam Hospital complex. UBP of >20 cm H2O indicated IAH. ACS was defined as the development of multiple organ dysfunction including peak airway pressure (PAP) >50 cm H2O, Horowitz quotient <150 torr or urine output <0.5 ml/kg/hr in the setting of IAH. Data were gathered on all patients with IAH and ACS.
Results: We evaluated some 353 patients, consisting of 165 elective laparatomies and 188 emergency cases, including 28 trauma patients. The incidence of IAH and ACS was 2 and 1 per cent (7 and 3 patients, respectively). The mean IAP of these seven patients was 29.8 cm H2O. No elevated IAP was observed after elective laparotomy (165 patients), nor in emergency cases with temporary abdominal wall closure (29 patients). APACHE II score, PAP and worst base deficit were significantly higher in patients with elevated IAP. None of the three patients with ACS underwent decompressive laparotomy. The mortality rate for patients with elevated IAP was 85%, significantly higher than the total study population.
Conclusion: IAH is a rare disease of the rarity of IAH, routine measurement of IAP is necessary only in high-risk patients. Prophylactic temporary abdominal wall closure may prevent IAH and ACS in high-risk patients. Patients with elevated IAP have dismal outcomes. Critical care practitioners should become familiar with different aspects of IAH and ACS, including decompressive laparotomy.
Volume 65, Issue 12 (3-2008)
Background: Exposure to low levels of lead increases blood pressure in humans and animals. Although there are controversial reports about the exact mechanisms of lead-induced hypertension, many factors such as alteration in the cardiovascular responsiveness to endogenous substances including catecholamines could be one of the mechanisms involved. In the present study, the effect of lead acetate on the systolic blood pressure and responsiveness to β-adrenergics was investigated in rats.
Methods: Through their drinking water, three groups of rats were exposed to 100 ppm lead acetate for periods of 4, 8 or 12 weeks. The blood pressures of the rats were monitored throughout the study. The rat hearts were isolated and perfused with Krebs-Henseleit solution (pH=7.4) at 37˚C and gassed with 95% O2 + 5% CO2. The heart rate (chronotropic) and contractile (inotropic) responses were recorded before and after adding isoproterenol at multiple concentrations to the perfusion solution.
Results: The mean blood pressures in the 8 and 12-week lead-treated groups were significantly higher than that of the control group (P<0.01). The chronotropic response to many doses of isoproterenol was significantly increased in the 12-week lead-treated group compared to that of the control group (P<0.05). The inotropic response to this drug was significantly increased in both the 8- and 12-week lead-treated rats (P<0.05 and P<0.01, respectively).
Conclusions: Our results indicate that low-levels of lead increase systolic blood pressure as well as both chronotropic and inotropic effects of β-adrenergics, which could imply an important role in the pathogenesis of lead-induced hypertension.
Volume 66, Issue 2 (5-2008)
Background: Hypertension is a very common and important disease. There are conflicting reports about mercury, a trace element, in the genesis of hypertension.
Methods: In this study we examined the relationship between blood mercury levels and hypertension prevalence in a population-based sample of hypertensive and normotensive patients at the Shariati Hospital and the Tehran Heart Center in Tehran, Iran. A cross sectional sampling of 224 patients, aged 40-80 years, who participated in physical examinations conducted in 2006 were included in this study. The population that participated in this study were sample of hypertensive (n=112) which had essential hypertension and normotensive (n=112) patients which had no history of essential hypertension at the Shariati Hospital and the Tehran Heart Center in Tehran. The consent of all the patients were taken in the written form before the experiments. After selecting the patients the range of blood mercury levels were measured with Flame atomic absorption.
Results: The range of blood mercury levels was 0 to 39.55 µg/dL. The mean blood mercury level of hypertensive patients (10.75 +1.23 µg/dL) was higher than that of normotensive patients (1.6 +1.02 µg/dL). There was a significant difference in the mean blood mercury level of normotensive men (1.74 +1.56 µg/dL) versus that of hypertensive men (11.9 +1.38 µg/dL). The mean blood mercury level of normotensive women (1.5 µg/dL) was also significantly different from that of hypertensive women (9.65 +0.53 µg/dL) (p<0.001).
Conclusions: In this population, there is a positive relationship between the concentration of blood mercury levels and the presence of hypertension.
Volume 66, Issue 6 (9-2008)
Background: Identification of the best screening measure for the risk of chronic disease is essential. This study aims to comparatively assess the ability of waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHpR) and waist-to-height ratio (WHtR) to predict hypertension among women in Tehran.
Methods: In this population-based cross-sectional study, a representative sample of 926 adult women aged 40-60 years were selected using a multi-stage cluster random sampling method. Demographic data were collected and anthropometric measures including weight, height, WC and hip circumference were assessed according to a standard protocol. BMI was calculated as weight in kilograms divided by the square of the height in meters. Cut-off points of 80 cm for waist circumference, 25kg/m2 for BMI, 0.87 for WHpR and 0.5 for WHtR were used. Blood pressure was measured and hypertension defined according to the sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 6).
Results: In this study, the mean age of women is 48.7±5.6 years. Mean WC, BMI, WHpR and WHtR are 85.1±9.9cm, 29.4±4.6kg/m2, 0.82±0.06 and 0.55±0.06, respectively. Although all anthropometric indicators have a significant association to hypertension, WC has the highest sensitivity, specificity and accuracy in predicting hypertension in both age groups of 40-50 and 50-60 years. This measure also has the greatest area under the ROC curve compared to other anthropometric measures: 0.70(0.69-0.71) for WC, 0.65(0.62-0.67) for BMI, 0.62(0.60-0.64) for WHpR and 0.65(0.63-0.67) for WHtR.
Conclusions: Among this group of women in Tehran, waist circumference is the best screening measure for hypertension. However, no data are available regarding similar patients who have emigrated thus similar studies on Iranian women who have emigrated are recommended.
Volume 69, Issue 12 (3-2012)
Background: Epidemiological studies have reported positive, negative, U-shaped or J-shaped association between high blood pressure and cognitive function as well as dementia whereas other studies have not reported any significant association. The aim of this study was to examine the association between hypertension and cognitive impairment in the elderly residents of Kahrizak Charity Foundation (KCF).
Methods: This cross sectional study was done in Kahrizak Charity Foundation in suburban areas of Tehran, Iran during 2008. The data were collected over one week. Among the 850 elderly residents of the Foundation who were ≥ 65 years old, 185 individuals were chosen randomly. The Mini-Mental State Examination (MMSE) was completed for all. Mean of all blood pressure readings were recorded while anthropometric and biochemical measurements were performed.
Results: The findings indicated that in participants with cognitive impairment, systolic blood pressure, diastolic and mean blood pressures were higher than people with normal cognitive function but the differences were not significant statistically. The odds ratio of cognitive impairment in patients with and without hypertension was 1.52 and 1.58, respectively (P>0.05).
Conclusion: This study did not show any significant association between hypertension and cognitive impairment in the elderly residents of Kahrizak Charity Foundation.
Volume 70, Issue 7 (10-2012)
Background: There are conflicting reports about zinc, a trace element, in the pathogenesis of hypertension and other cardiovascular diseases. The aim of this study was to evaluate the role of zinc in high blood pressure.
Methods: We conducted this study on 80 patients with primary (idiopathic) hypertension and 80 normotensive people with similar age who attended to Tehran Heart Center between 2007 and 2008. We examined the effect of zinc concentration on blood pressure in both sexes in four age groups (41-50, 51-60, 61-70 and 71-80 years old). We measured plasma zinc concentration by atomic absorption.
Results: The mean plasma zinc concentrations were 0.456±0.04 µg/ml and 0.551±0.055 µg/ml in patients with hypertension and in normotensive people, respectively, (P≤0.05). Nevertheless, the mean plasma zinc concentrations were 0.494 µg/ml and 0.486 µg/ml in men with and without hypertension, respectively. The mean plasma zinc concentrations of women with and without hypertension, respectively were 0.415 µg/ml and 0.596 µg/ml, showing a significant difference between two groups (P≤0.001). Moreover, there was a significant difference in plasma zinc concentration between hypertensive and normotensive people in 51 to 60 years age group (P≤0.05), but difference were not significant between other age groups.
Conclusion: The results of this study revealed the relationship between the decrease in plasma zinc concentration and increase in blood pressure in women and in the men aged 51 to 60 years.
Volume 73, Issue 11 (2-2016)
Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorders in reproductive age women. These women confer with complications of pregnancy such as gestational diabetes, pregnancy-induced hypertension, preeclampsia and neonatal complications such as small for gestational diabetes (SGA) are more prevalence in women with PCOS. The aim of this study was to evaluate the incidence of complications associated with PCOS in pregnant women.
Methods: This was an observational and prospective study which recruited 205 pregnant women with PCOS from Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences (AJUMS) between 2013 and 2014. Inclusion criteria were women with PCOS and gestational age over 20 weeks. The demographic and clinical variables including mother's age, body mass index (BMI) and conditions of pregnancy including pregnancy-induced hypertension, preeclampsia, gestational diabetes and overt diabetes and neonatal complications such as preterm labor (PTL), SGA and intrauterine fetal death (IUFD) were recorded.
Results: The prevalence of hypertension disorders, preeclampsia, gestational diabetes and overt diabetes were observed in 44 (21.5%), 18 (8.8%), 29 (14%) and 22 (11%) patients, respectively. The history of familial diabetes was shown in 28 patients (13.6%). In addition, the history of pregnancy induced hypertension was reported in 25 patients (12.1%). Only 6 patients (2.9%) had history of gestational diabetes. Among neonatal complications due to PCOS, SGA with 15.3% and then PTL with 12.6% had highest prevalence. IUFD was shown only in 2 patients.
Conclusion: Pregnant women with PCOS are at the higher risk for pregnancy and neonatal complications. Specifically, these women should be evaluated for pregnancy induced hypertension during pregnancy than others.
Volume 75, Issue 6 (9-2017)
Methods: In this case-control study, the required data were collected from outpatient cases referring to Taleghani Hospital and Sina Hospital related to Tabriz University of Medical Sciences in Tabriz city, Iran. Data needed for the control group included patients accompanying patients who had no symptoms of urinary tract infection and with no history of blood pressure.
| Results: 60 patients with urinary tract infections were examined: 57 (47.5%) of the subjects were men and 63 (52.5%) women. There was a significant relationship between the rate of red blood cell deposition in the first hour and systolic blood pressure. There was no significant correlation between the numerical value of white blood cell count and systolic or diastolic blood pressure in the studied patients. |
Volume 75, Issue 10 (1-2018)
Methods: This cross-section study was done in April 2016. The study population was 95 patients, more than 30 year old with hypertension and chronic renal failure. Patients were selected from clinics of two private and university hospitals affiliated to Qom University of Medical Sciences Shahid Beheshti Hospital and Vali-e-Asr Hospital, Iran. Checklist containing data such as age, sex, duration of renal failure and cause of renal failure were filled. Serum creatinine and serum urea levels were measured and entered in the checklist. The circadian rhythm of blood pressure in all patients was assessed by Holter monitoring. patients who had less than 10% decrease in blood pressure overnight were considered non-dipper and those who had 10% or more decrease in blood pressure overnight were considered dipper.
Results: Average (SD) 24-hour ambulatory systolic and diastolic of blood pressure was 136.56 (16.66) and 84.84 (10.86) mmHg, respectively. 70 patients (73.7%) had non-dipper blood pressure pattern and 25 patients (26.3%) had dipper blood pressure pattern. There was no significant difference between two groups (dipper and non-dipper) based on distribution of gender (P=0.744), age (P=0.407), serum creatinine (P=0.569), serum urea (P=0.689) and renal failure duration (P=0.812). Mean of glomerular filtration rate in dipper group was 68.64±4.13 and in non-dipper group was 65.09±16.27 (P=0.337).
Conclusion: The results of this study did not show a significant relationship between circadian rhythm of blood pressure and renal failure severity. In addition, patients with chronic renal failure showed higher rates of non-dipping pattern of blood pressure.
Volume 77, Issue 4 (7-2019)
Methods: In this cross-sectional study, we used the results of 2015 census in Mashhad City, a population based survey of people over the age of 30 (n=300745) to determine the proportion of self-reported hypertension. In this study, the data of the studied population was extracted from the databank of Sina Electronic Health Record System (SinaEHR®) and patients with ICD10 codes including I10 and I11 approved by doctors as a reference. Finally using SPSS software, version 20 (SPSS Inc., Chicago, IL, USA) and MedCalc (https://www.medcalc.org/calc/odds_ratio.php), sensitivity, specificity, positive predictive value, negative predictive value were calculated with 95% confidence interval.
Results: Sensitivity of self-reported hypertension was 23.92% (CI95%: 23.43-24.41), specificity 97.03% (CI95%: 96.97-97.09), Positive Linkelihood Ratio 8.06% (CI95%: 7.82-8.30), Negative Linkelihood Ratio 0.78% (CI95%: 0.78-0.79), Positive Predictive Value 46.34% (CI95%: 45.60-47.08), Negative Predictive Value 92.25% (CI95%: 92.20-92.29). The self-reported sensitivity to hypertension in males, Iranian individuals, single, aged 60 and over, body mass index lower 18.5 individual with university education was higher, which was 24.67%, 31.09%, 30.07%, 32.43% and 26.03% respectively.
Conclusion: Although the sensitivity of self-reported hypertension was poor in this study, but specificity and positive and negative predictive values were fairly good.
Volume 77, Issue 9 (12-2019)
Methods: In an analytical study, fifty women aged 20-50 years old candidate to cholecystectomy under general anesthesia and tracheal intubation were entered randomly to this study in two groups (no. 25) at Imam Khomeini Hospital, Urmia, Iran, and under support of Urmia University of Medical Sciences Urmia, Iran, from May 2017 to May 2018. Ten minutes before end of surgery, 0.8 µg/kg dexmedetomidine in the study group and for the other patients in control group normal saline as placebo were infused over ten minutes. During the emergence phase, blood pressure, heart rate and oxygen saturation were recorded at 0,1,2,3 and 5 minutes after extubation. Also, sedation index was evaluated via the Ramsay sedation score and recorded at recovery room.
Results: Heart rate, systolic blood pressure and diastolic blood pressure in patient with infusion of dexmedetomidine were lower significantly at 1,2,3 and 5 minutes after extubation than control group. Data for heart rate, systolic and diastolic pressure, at min 1 after extubation were 81±6 vs. 88±9, 120.64±13.21 vs. 137.52±11.06, 72.84±8.32 vs. 81.36±9.26 in dexmedetomidine and control groups respectively. Data for heart rate, systolic and diastolic pressure, at min 5 after extubation were 73±6 vs. 80±8, 110.64±10.68 vs. 119.88±10.01, 69.84±8.32 vs. 73.48±5.13 in study and control groups, respectively. As well as 80% of the patients in dexmedetomidine group had satisfactory sedation and cooperation in compare to the 28% in control group (P=0.001).
Conclusion: Intravenous infusion of 0.8 µg/kg dexmedetomidine 10 minutes before extubation of endotracheal tube and during emergence, facilitate extubation and lead to hemodynamic stability and satisfactory sedation.
Volume 78, Issue 2 (5-2020)
Case Presentation: A 59 years old man, known case of diabetic nephropathy with a serum creatinine level of 1.2 mg/dL and proteinuria of about 3300 mg in 24 hours referred to Hypertension Clinic of Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, for evaluation of resistant hypertension. The patient was under treatment by losar-H, diltiazem, and furosemide, which are not appropriate combinations of antihypertensive agents. The ambulatory blood pressure monitoring (ABPM) of the patient revealed daytime and nighttime hypertension and also the non-dipping status of blood pressure. Dihydropyridine CCB was prescribed in combination with RAS blocker (Exforge 50 mg/ 160 mg) and the diuretic was changed to thiazide-like agents. In the next step, spironolactone and carvedilol were added for better control of blood pressure. The patient referred to the sleep clinic for polysomnography and evaluation of obstructive sleep apnea. Following three months prescription of these medications, ABPM revealed relatively appropriate control of blood pressure, so the average 24-hour blood pressure decreased from 157/91 mm Hg to 136/83 mm Hg.
Conclusion: The complications and mortality of hypertension would be increased dramatically in patients with resistant hypertension. So, an appropriate diagnostic and therapeutic approaches should be considered for these patients. Choosing appropriate diuretic agents would be important in the management of resistant hypertension.
Volume 78, Issue 5 (8-2020)
Methods: The present study was conducted experimentally randomized, placebo-controlled and double‑blind on 24 men with hypertension and coronary heart disease after angioplasty aged 40-60 since years May to August 2019 at the Exercise Physiology department of Sport Sciences Faculty, Shahid Rajaee Teacher Training University, Tehran, Iran. The subjects were randomly divided into two groups of HIIT+quercetin (n=12) and HIIT+placebo (n=12) and were followed during 8 weeks of high-intensity interval training (30 seconds of activity and 30 seconds of rest) and quercetin consumption (250 mgr of quercetin supplement or placebo pills daily). Echocardiography was used to investigate morphological factors such as posterior wall dimension (PWd) and left ventricular end diastolic diameter (LVEDd). Plasma total antioxidant capacity (TAC) and malondialdehyde (MDA) were measured by colorimetric method.
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Results: The results showed that MDA and The relative wall thickness (RWT) decreased after 8 weeks in HIIT+ supplement and HIIT+placebo groups and TAC level and LVEDd increased significantly (P<0.05). PWd decreased significantly only in the exercise+supplement group (P<0.05). No significant difference between groups in any other variables was detected (P>0.05).
Conclusion: Eight weeks of high-intensity interval training alone or with quercetin by reducing oxidative stress(increasing total antioxidant capacity (TAC) and reducing malondialdehyde (MDA) reduces level of concentric pathologic hypertrophy in men with hypertension and coronary heart disease after angioplasty. So that high-intensity interval training with quercetin supplementation has relatively more effects. |
Volume 79, Issue 8 (11-2021)
Methods: This was a descriptive cross-sectional study. It was performed on 276 patients with cholangiocarcinoma who had been referred to Firoozgar Hospital affiliated with the Iran University of Medical Sciences in Tehran from March 2020 to February 2021. Demographic information, family and personal history, social history (tobacco or drug use) and blood group of patients were extracted from their files. SPSS version 16 was used for data analysis. A P-value below 0.05 was considered statistically significant.
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Results: The mean±SD age of patients was 65.97±13.07 years, of whom 65.6% were male and 34.4% were females. The most common site of cholangiocarcinoma was the distal part of the bile ducts and the most common blood group was O+. The main manifestations were jaundice and pruritus. Among the risk factors, the most common ones were smoking, high blood pressure, history of gallstones, opium use, history of cancer of other systems in the family, history of cholecystectomy and diabetes mellitus. While, the lowest prevalence of risk factors was related to heroin use, IBD, Gallbladder polyps, pancreatitis and alcohol consumption. None of the patients in our study had a history of viral hepatitis or PSC.
Conclusion: This was a cross-sectional study and only in the group of cholangiocarcinoma patients, therefore, larger prospective studies are recommended to examine underlying mechanisms of malignant transformation in the biliary tree. |
Volume 80, Issue 1 (4-2022)
Methods: This retrospective study was conducted as a cross-sectional descriptive and analytical study to evaluate the frequency of CKD and associated factors in psoriatic patients admitted to the Razi Hospital whose last time of admission was from June 2018 to January 2019. According to the K/DOQI guideline, CKD is defined as the GFR<60 mL/min/1.73 m² during at least a period of three months. GFR was calculated based on the MDRD formula. The sample size was equal to 265. The hospital documents of inpatients who have been admitted to Razi Hospital wards or follow-up clinics during 2017-2019 were used for collecting information and data. This information has been extracted based on the initial checklist for data collection. Collected data has been analyzed and performed by using SPSS 25 software.
Results: The study found that 18 (6.8%) of psoriasis patients had CKD. Patients were in the age range of 3.5-92 years, the majority of them were in the age range of 18.65–79.7 years. 171 (64.5%) patients were male and 94 (35.5%) were female. 41 (15.5%) patients had diabetes, 94 (35.5%) had hyperlipidemia and 41 (15.5%) had hypertension. History of NSAID, Methotrexate, Cyclosporine, Acitretin, Infliximab, and Adalimumab medication use among 9 (3.4%), 205 (77.4%), 56 (21.1%), 147 (55.5%), 30 (11.3%), and 28 (10.6%) patients were observed, respectively. Also, 54 (20.4%) had a history of phototherapy. 217 (81.9%) of the psoriatic patients had CPP (Chronic Plaque Psoriasis) and 48 (18.1%) had PP (pustular Psoriasis) and finally, 21 (7.9%) of the patients had psoriatic arthritis.
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Conclusion: The prevalence of CKD was shown to increase by age. The other correlated factors are diabetes, hypertension, and hyperlipidemia. On the other hand, there was not found any significant correlation between drugs (NSAIDs, Methotrexate, Cyclosporine, Acitretin, Infliximab, Adalimumab) and CKD prevalence. There was also no significant correlation between phototherapy, psoriasis type and psoriatic arthritis, duration of psoriasis and CKD prevalence.
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Volume 80, Issue 3 (6-2022)
Methods: In this descriptive cross-sectional study all the non-toxic children under 18 who were referred to the neurology clinic of Loghman Hospital of Tehran from October 2017 to October 2018 with increased intracerebral pressure symptoms were studied. The increased intracerebral pressure symptoms were headache or vomiting or blurred vision or 6th nerve palsy and they had papillary edema. Also, if their diagnostic brain imaging measures were normal such as: Magnetic Resonance Imaging (MRI), Computed Tomography scan (CT scan) and in some cases Magnetic Resonance Venography (MRV), they were suspected to Idiopathic intracranial hypertension and were entered into the study consecutively. Their complete medical history and comorbidities and biographical information were recorded in the file. All patients were candidates for a lumbar puncture to measure cerebrospinal fluid pressure. After full explanation to the parents and obtaining written consent from them before performing a lumbar puncture, patients in coordination with the ultrasound unit without delay in performing a lumbar puncture, first underwent trans orbital ultrasound in supine position and were awakened with closed eyes. Opticians were implanted in both eyes by a skilled sonographer. And then sedated with sedatives (ketamine or midazolam) prescribed by an anesthesiologist. It was placed in a sterile position in a supine semi-flexion position and with lateral decubitus aligned with the body. Cerebrospinal fluid pressure to cm of water was recorded using a serum set in the lumber intervertebral space 4-5. Then a sample was sent for analysis and smear.
Results: Out of 10 patients (age 2.5–14 year, mean 9 years) 10% were girls, 90% were boys, and mean BMI was 22.5 kg/m2. Their symptoms included: 80% Headache, 40% Vomiting, 40% Diplopia, 20% Blurred vision, 10% 6th nerve palsy, and 10% Tinnitus when being reffered. In All patients, CSF pressure was more than 25 cm H2o (mean 40 cm H2o), right and left eyes optic nerve sheath diameter (ONSD) was more than the cutoff point (ONSD≤4.5 mm), the mean right ONSD was 6.31 mm and left eye was 6.64 mm.
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Conclusion: According to the findings of this study, the measuring of optic nerve sheath diameter in patients suspected of increasing the pressure of idiopathic intracranial hypertension can be helpful as a non–invasive diagnosis method.
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Volume 83, Issue 2 (5-2025)
Methods: A retrospective analysis was conducted on 217 patients hospitalized at Ayatollah Rouhani Hospital in Babol (2019-2021). Eligible participants were aged ≥18 years and had received HCTZ for at least seven consecutive days. Patients with baseline hyponatremia, concurrent use of drugs independently causing hyponatremia, or incomplete laboratory data were excluded. Demographic, clinical, medication, and biochemical variables were abstracted from medical records. Hyponatremia was defined as serum sodium <135 mmol/L and categorized as mild (130-134), moderate (125-129), or severe (<125). Predictors of occurrence were estimated with multivariable logistic regression; onset timing was assessed using a Cox proportional hazards model; and severity determinants were examined through multinomial logistic regression. Statistical significance was set at P<0.05.
Results: Hyponatremia occurred in 32.7% (71.217) of patients, most frequently within the early weeks of HCTZ treatment. Among affected individuals, 49.3% had mild, 31.0% moderate, and 19.7% severe hyponatremia. Adjusted analyses showed that older age, concurrent nonsteroidal anti-inflammatory drug (NSAID) use, shorter HCTZ duration, and lower serum potassium and uric acid independently increased hyponatremia risk, while HCTZ dose and sex were nonsignificant. In the Cox model, older age and lower potassium and uric acid predicted earlier onset. Patients with hyponatremia more often presented with weakness, headache, altered consciousness, and seizures. Baseline glucose, creatinine, and most comorbidities were not independently associated with risk or timing.
Conclusion: HCTZ-related hyponatremia was common and typically emerged soon after initiation. Advanced age, NSAID co-administration, brief exposure, and reduced potassium and uric acid were practical, readily measurable markers associated with both occurrence and earlier onset. Routine early and repeated electrolyte monitoring particularly in older adults and patients receiving NSAIDs- together with patient education on warning symptoms is recommended. These findings highlight key predictors for targeted surveillance and prevention in similar clinical contexts.
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