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The effect of body mass index on estimated glomerular filtration rate in patients with iga nephropathy; a systematic review and meta-analysis of the cohort studies
No full textIntroduction: The study is motivated by the growing concern surrounding chronic kidney disease worldwide and the need for early identification and effective management to slow or prevent kidney disease progression. To achieve this goal, we evaluated the correlation between body mass index (BMI) and estimated glomerular filtration rate (eGFR) in patients with IgA nephropathy through a systematic review and meta-analysis. Materials and Methods: The data were acquired after conducting a comprehensive exploration of the international databases of PubMed, Scopus, Web of Science, Cochrane, and the Google Scholar search engine until June 2024. The study heterogeneity was evaluated utilizing the I2 index. The data were scrutinized employing STATA 14, and a P value < 0.05 was considered significant. Results: Seven studies with a sample size of 1354 normal BMI people and 1020 obese or overweight patients were included in this meta-analysis. Based on the findings of the weighted mean difference (WMD), individuals who are overweight or obese had a lower eGFR (WMD = -7.34 CI; -9.62, -5.05, P<0.001). Conclusion: The results demonstrated that the eGFR was significantly lower in obese or overweight people compared to individuals with normal BMI; therefore, we conclude that being overweight or obese may hurt kidney function. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (CRD42023417633) and Research Registry (UIN: Reviewregistry1665) websites. © 2025, Society of Diabetic Nephropathy Prevention. All rights reserved
Modeling the Consequences of Fire and Leakage of Toxic Substances of Methyldiethanolamine Tank with PHAST Software (A Case Study in Phase 14 of the South Pars Refinery, Iran)
No full textBackground: Due to the high volume of the substance in the methyldiethanolamine (MDEA) tanks and the chemical properties, inflammability, and toxicity of the substance as well as the presence of hydrogen sulfide gas in the equipment around this tank, it is important to model its accidents. In this study, the rupture scenario of the MDEA tank in two seasons, cold and hot, with the presence of a protective wall and the absence of a protective wall, was modeled. Methods: At first, the dimensional data of the volume of the tank, the chemical and thermodynamic information of the substance, and the geographic maps of the desired area were defined for the software. Besides, the average weather conditions were inquired from reliable authorities and given to the software so that after performing the calculations, the results of the reservoir rupture scenario would be stated. In this study, the PHAST software was used for calculating the information. Findings: The area under the pool fire radiation in the hot season was 96.5 meters in the wind direction, which was 93 meters in the cold season. Besides, the minimum distance from the center of the fire, where the probability of death is 99, was 35 meters in the direction of the wind. The concentration of toxic substances up to a distance of 1825 meters in the direction of the wind had a 99 probability of death, and after that it decreased and reached about zero up to a distance of 1865 meters. In the hot season, the pool evaporation rate increased from 1.3 kg/s to 1.6 kg/s. In the cold season, the evaporation rate of substance was 0.3 kg/s. In the absence of a protective wall for a pool fire, the maximum heat radiation was at a distance of 124 meters; this amount of radiation was about 10 meters in the case of the presence of the protective wall. Conclusion: According to the obtained results, during the occurrence of any of the consequences, which will be in the worst case of these results, the safe distance of the tank can be determined by warning signs. Moreover, in case of accidents, how far the rescue team can approach the danger center and what measures they will have to control the crisis is of great importance. © 2025, Isfahan University of Medical Sciences(IUMS). All rights reserved
Supranuclear Vertical Gaze Palsy in Movement Disorders
No full textVertical gaze palsy, a neurological impairment affecting the upward and downward movement of the eyes, can be caused by various disorders. Understanding this phenomenon is essential for accurate diagnosis and effective management. This review aims to present a practical overview of vertical gaze palsy, its manifestation in various movement disorders, and the clinical relevance of such impairments. We did a thorough non-systematic search of the literature in PubMed with various keywords such as ‘gaze palsy’, ‘vertical gaze palsy’, ‘gaze abnormality’, and ‘eye movement disorder’. Vertical gaze palsy can manifest in various disorders such as Parkinson’s disease, atypical Parkinsonian syndromes, Niemann-Pick disease type C, Wilson’s disease, Whipple’s disease, prion disease, and several others. This comprehensive review elucidates the spectrum of movement disorders linked to vertical gaze palsy, exploring the specific ways it manifests and the complexities in diagnosing the condition. The list of movement disorders causing vertical gaze palsy is extremely wide, encompassing neurodegenerative, metabolic, infectious, autoimmune disorders, and intoxication with certain substances and specific medications. The differential diagnosis consists of various etiologies with heterogeneous presentations that may overlap and mimic each other. We hope that this paper will assist practitioners in managing the complex process of diagnosing a patient with vertical gaze palsy. © 2024 Taylor & Francis Group, LLC
Beyond the richter scale: a fuzzy inference system approach for measuring objective earthquake risk
No full textEarthquakes pose significant natural hazards and impact populations worldwide. Iran is among the most susceptible countries to seismic activity, making comprehensive earthquake risk assessment crucial. This study employs geospatial methods, including integrating satellite, ground-based, and auxiliary data to model earthquake risk across this country. A Fuzzy Inference System (FIS) is used to generate earthquake hazard probability and vulnerability layers, considering factors such as slope, elevation, fault density, building density, proximity to main roads, proximity to buildings, population density, and earthquake epicenter, magnitude, proximity to the epicenter, depth density, peak ground acceleration (PGA). The results highlight high-risk areas in the Alborz and Zagros Mountain ranges and coastal regions. Moreover, the findings indicate that 39.7 (approximately 31.7 million people) of Iran’s population resides in high-risk zones, with 9.6 (approximately 7.7 million) located in coastal areas vulnerable to earthquakes. These findings offer valuable insights for crisis management and urban planning initiatives. © The Author(s) 2024
A systematic review and meta-analysis of the association between selenium and osteoarthritis
No full textIntroduction: Osteoarthritis is an inflammatory disorder and the most common human joint disease. Considering the anti-inflammatory properties of selenium, we aimed to investigate the relationship between selenium and the risk of osteoarthritis in this study. Materials and Methods: The present study was a systematic review and meta-analysis based on the PRISMA guidelines, conducted in databases including Web of Science, Cochrane, ProQuest, PubMed, and Google Scholar Search Engine for articles published until December 12, 2023. Data was analyzed using STATA 14 software, and tests with p-values lower than 0.05 were considered statistically significant. Results: Seven cross-sectional studies with 412998 participants were combined, and results indicated thatselenium intake increased the risk of osteoarthritis (OR: 1.26; 95 CI: 1.06, 1.49). However, the risk of osteoarthritis in individuals with low, moderate, and high serum selenium levels was (OR: 1.03; 95 CI: 0.81, 1.31), (OR: 0.97; 95 CI: 0.83, 1.13), and (OR: 0.99; 95 CI: 0.99, 1), respectively. The relationship between serum selenium level and the risk of osteoarthritis in male and female patients were also (OR: 0.99; 95 CI: 0.98, 0.99) and (OR: 0.99; 95 CI: 0.98, 0.99), respectively. Findings showed the relationship between serum selenium level and knee (OR: 1.11; 95 CI: 0.89, 1.38) and hip (OR: 1.23; 95 CI: 0.86, 1.77) osteoarthritis. Conclusion: Selenium intake increased the risk of osteoarthritis by 26. However, there was no statistically significant relationship between the serum selenium level and the risk of osteoarthritis. Considering the limited number of reviewed studies, further studies in this field are required. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (ID: CRD42023494294) and Research Registry (UIN: reviewregistry1762) website
Enhancing clinical risk assessment in pediatric blunt abdominal trauma: A novel scoring system using ultrasound and laboratory data
No full textBackgroundGiven the importance of diagnosing intra-abdominal injury (IAI) in children with blunt abdominal trauma (BAT) and preventing radiation exposure to children by avoiding CT scans, this study aimed to evaluate a scoring criterion based on ultrasound (US) findings and laboratory data in assessing the clinical risk of IAI in children with BAT. Materials and methodsIn this retrospective study, baseline and clinical information of 180 children (under 18 years of age) with BAT including physical examination, hemodynamic parameters, and laboratory data, were extracted from medical records. US findings were considered abnormal if any report of mild free fluid or solid organ injury was noted. The presence or absence of IAI was assessed through medical records or telephone interviews to inquire about the patients' outcome within the two-week period post-discharge. The primary outcome was the identification of IAI, assessed through a combination of US findings, physical examination (abdominal tenderness), and laboratory parameters (WBC count and hematuria). The measurement methods included Chi-squared tests, Fisher's exact test, independent samples t-test, logistic regression, and ROC analysis. ResultsThe current study showed that 153 (85) and 27 (15) patients were without and with IAI, respectively. The positive US finding with sensitivity and specificity of 92.59 and 44.44, respectively, abdominal tenderness with sensitivity and specificity of 81.48 and 87.58, respectively, hematuria with sensitivity and specificity of 62.96 and 50.33, respectively, and high WBC level with sensitivity and specificity of 85.19 and 76.47, had a significant diagnostic value in detecting the presence of IAI (P value = 2 from the sum of the scores of these four criteria can predict the presence of IAI with a sensitivity of 81.48 and a specificity of 94.12 (AUC = 0.94; P value < 0.001). ConclusionThis study shows that a scoring system based on positive US findings, abdominal tenderness, hematuria, and high WBC levels effectively diagnoses IAI in BAT children. A score of 2 or more strongly indicates the presence of IAI, improving decision-making for further imaging and treatment. Implementing this system can reduce unnecessary CT scans and radiation exposure, enhancing pediatric trauma care
Macular vessel density in patients with refractory diabetic macular edema in different stages of nonproliferative diabetic retinopathy
No full textBackground: Macular vessel density can play a significant role in the prognosis of diabetic macular edema (DME). The aims of this study were to investigate macular vessel density using optical coherence tomography angiography (OCTA) in patients with refractory DME across different stages of nonproliferative diabetic retinopathy (NPDR) and explore its relationship with clinical parameters. Material and Methods: This was a cross sectional descriptive analytical study. Diabetic patients diagnosed with NPDR and refractory DME were included. OCTA imaging was performed to quantify vessel densities. Foveal avascular zone (FAZ), central macular thickness (CMT), and best corrected visual acuity (BCVA) were also measured. Results: Eighty nine eyes from 89 patients, including 53 males (59.6), with a mean age of 60.17 +/- 9.95 years were enrolled. The results revealed no significant differences in vessel densities and FAZ between different DR severity groups (P > 0.05). In addition, no significant correlations were observed between vessel density and CMT or most clinical variables, except for a negative correlation between deep capillary plexus (DCP) vessel density in the foveal region and BCVA (r = -0.246, P = 0.019). Conclusion: In patients with refractory DME, foveal DCP density was negatively correlated with visual acuity, suggesting its potential as a biomarker for visual prognosis and follow up of patients
A Diagnostic and Therapeutic Approach to Retained Anchoring Sutures: Color Doppler Ultrasound for Diagnosing and the Retract-and-Cut Technique for Minimizing Invasive Interventions
No full textBackground: Retained sutures following catheterization procedures are rare but can present significant diagnostic and therapeutic challenges. This case highlights a novel approach to diagnosing and managing a retained anchoring suture following catheter removal for abdominal fluid drainage in a patient with pancreatic adenocarcinoma and metastatic ascites. The use of color Doppler ultrasound to identify the suture's path and the application of the retract-and-cut technique minimized invasive interventions, demonstrating a safe and effective alternative to surgical removal.Case Presentation: A 68-year-old male with pancreatic adenocarcinoma and metastatic ascites underwent subhepatic fluid drainage using an 8Fr pigtail catheter. After successful drainage and catheter removal, the patient presented with localized pain and tenderness at the catheter insertion site. Ultrasound revealed a hyperechoic linear structure in the subcutaneous tissue suggestive of a retained suture. Real-time visualization using color Doppler ultrasound confirmed the suture's path as a linear Doppler signal was observed during manipulation. Given the adhesion of the suture to deeper tissues, the retract-and-cut technique was employed. The suture was gently pulled taut at the skin surface, cut, and allowed to retract along its original track, avoiding unnecessary trauma. The patient experienced no recurrence of symptoms, fluid collection, or infection during long-term follow-up.Conclusions: This case underscores the importance of timely diagnosis using color Doppler ultrasound, which provided real-time visualization of the retained suture and its relationship with surrounding tissues. In addition, the retract-and-cut technique offers a minimally invasive and effective approach for managing retained sutures, avoiding the need for surgical intervention. This method ensures patient comfort and safety, particularly in palliative care settings where nonsurgical options are prioritized
Dairy consumption and premature coronary artery disease onset: Iran premature coronary artery disease (IPAD) study insights
No full textEvidence has argued about the association between dairy intake and premature coronary artery disease (PCAD) development aimed to be discussed in this study. This case-control study was conducted on 813 individuals with PCAD and 471 healthy controls. The dairy intake of participants was assessed by a validated semi-quantitative food frequency questionnaire. Binary and ordinal logistic regression was applied to determine the association of dairy intake with PCAD and its severity, respectively. Compared to the first quartile, the highest quartile of total dairy consumption was associated with an increased risk of PCAD Odds ratio (OR):1.56; 95% confidence interval (95%CI): 1.13, 2.14; P = 0.008 in the crude model. It was strengthened after full adjustment OR: 2.44, 95% CI; 1.50,3.97; P < 0.001. Both low-fat and high-fat dairy intake revealed no association with the risk of PCAD in the crude model. However, in the fully adjusted model, respectively highest quartile of high-fat and low-fat dairy intake had a relationship with a higher risk of SCAD. (OR:1.68; 95%CI: 1.05,2.69; P-value for trend = 0.011) and (OR:1.99; 95%CI: 1.20,3.27; P-value for trend = 0.005). After adjustment for potential confounders, the highest amount of intake of high-fat dairy was related to increased severity of PCAD (OR:1.84; 95%CI: 1.27,2.68), but not for total and low-fat dairy intake (OR:0.98; 95%CI: 0.67,1.44 and OR: 0.74; 0.51,1.07; respectively). Dairy consumption regardless of its fat content was associated with increased risk for PCAD. The severe atherosclerotic manifestations in the coronary arteries were only associated with higher intake of high-fat dairy
Investigating the results of transcatheter aortic valve implantation (TAVI) in non-diabetic and diabetic patients: a systematic review and meta-analysis
No full textBackgroundTranscatheter aortic valve implantation (TAVI) has emerged as an effective treatment option for patients with severe aortic stenosis, particularly in those who are not suitable candidates for open-heart surgery. While diabetes is known to be associated with a higher risk of cardiovascular diseases, the impact of diabetes on the outcomes of TAVI remains controversial.MethodsA systematic literature search was conducted across major databases, including PubMed, Web of Science (WOS), and Google Scholar, for studies published in English over the past 20 years, up until July 2024.ResultsA total of 10 observational studies were analyzed, revealing that diabetic patients were generally younger than non-diabetic patients. The 30-day mortality rate was lower in non-diabetics (0.03 0.02-0.04) compared to diabetics (0.04 0.03-0.05). However, the hazard ratio for death beyond 30 days in diabetics was 2.05 (95% CI: 0.91-4.60, p = 0.08), and at one year, it was 1.04 (95% CI: 0.78-1.39, p = 0.77), with neither result reaching statistical significance. Meta-regression analysis showed that non-insulin-treated diabetes was significantly associated with an increased risk of acute kidney injury (AKI) compared to non-diabetics, with a log odds ratio (LogOR) of 0.3393 (p = 0.035) in one analysis and 0.3166 (p = 0.028) in another, confirming a statistically significant increase in AKI risk.ConclusionsThis review highlights that while diabetes slightly increases short-term mortality after TAVI, long-term survival remains comparable to non-diabetic patients. However, non-insulin-treated diabetes significantly raises the risk of acute kidney injury (AKI), emphasizing the need for enhanced renal protection and perioperative management.Clinical trial numberNot applicable