Objectives COVID-19 continues to cause devastation throughout the world. Various factors influence the perioperative course and prognosis of COVID-19. This study aims to collate the independent prognostic factors among hospitalised COVID-19 patients in east Iran. Study design In this cohort study, all patients with a confirmed diagnosis of COVID-19 between 19 February 2020 and 1 August 2020 who were admitted to nine public hospitals of South Khorasan province, Iran, were enrolled. Methods Univariate analysis (chi-square [χ 2 ], and Mann–Whitney U test) and multiple logistic regression was performed. Results This study included 1290 participants; 676 patients (52.4%) were male. A total of 1189 (92.2%) recovered and 101 (7.8%) died. The results show that in-hospital mortality increases with advanced age (the optimal cut-off point = 62 years). The following three variables were shown to have the most significant role in in-hospital mortality: age >60 years (odds ratio [OR] = 8.01, 95% CI [confidence interval] 4.8-13.35), shortness of breath (OR = 2.65, 95% CI 1.4-69.17) and atypical radiological manifestations in a chest X-ray on admission (OR = 2.16, 95% CI 1.3-28.64). In the univariate analysis, associated comorbidities, such as cardiovascular diseases, influenced the in-hospital mortality rate, while the same could not be replicated in the multiple variable analysis. Conclusions This study revealed the potential predictors of COVID-19 and highlighted the need to be cautious with advanced age and heightened clinical symptoms at the time of admission.

Background: Emergence delirium (ED) is a complication after surgeries due to general anesthesia. Objectives: This study aimed to evaluate the efficacy of melatonin and clonidine, which are hypothesized to have a curative effect on ED. Methods: This randomized, placebo-controlled, double-blind, three-way parallel clinical trial was performed in Imam Reza Hospital in Birjand, Iran in 2019 - 2020 who were selected using convenience sampling. The inclusion criteria were age > 65 years and preoperative Abbreviated Mental Test (AMT) score ≥ 8. The exclusion criteria were suffering from any chronic diseases. Participants were divided into 3 groups: Placebo, clonidine, and melatonin groups who received placebo, 100 μg clonidine, and 5 mg melatonin, respectively. A first dose was administered at bedtime before surgery, a second dose 90 minutes before the procedure. An AMT and Mini-mental State Examination (MMSE) were administered to determine ED. Results: This study included 150 patients with a mean and standard deviation of 74.6 ± 6.8 years. According to AMT and MMSE, there was no significant difference in the level of ED between groups on the first, second, and third days after surgery (P > 0.05). Emergence delirium levels in the clonidine and melatonin groups were lower than in the placebo group. According to AMT and MMSE, ED was not significantly correlated gender, age, and type of surgery. Emergence delirium was significantly associated with postoperative bleeding and electrolyte disturbance (P < 0.05). Conclusions: Melatonin and clonidine did not affect the occurrence of ED in the elderly undergoing surgery, but these medications could slightly reduce their occurrence.

Diabetes is a chronic metabolic disorder that leads to the dysfunction of various tissues and organs, including eyes, kidneys, and cardiovascular system. According to the World Health Organization, diabetes prevalence is 8.8% globally among whom about 90% of cases are type 2 diabetes. There are not any significant clinical manifestations in the primary stages of diabetes. Therefore, screening can be an efficient way to reduce the diabetic complications. Over the recent decades, the prevalence of diabetes has increased alarmingly among the Middle East population, which has imposed exorbitant costs on the health care system in this region. Given that the genetic changes are among the important risk factors associated with predisposing people to diabetes, we examined the role of single-nucleotide polymorphisms (SNPs) in the pathogenesis of diabetes among Middle East population. In the present review, we assessed the molecular pathology of diabetes in the Middle East population that paves the way for introducing an efficient SNP-based diagnostic panel for diabetes screening among the Middle East population. Since, the Middle East has a population of 370 million people; the current review can be a reliable model for the introduction of SNP-based diagnostic panels in other populations and countries around the world.

Background: Chronic diseases confront the patient with questions about the meaning and the purpose of life, and many patients recognize spiritual health as a factor in creating meaning and purpose in life and improving the quality of life. Objectives: The aim of this study was to determine the relationship between spiritual health and stress, depression, and anxiety in hemodialysis patients of Birjand Special Diseases Center in 2019. Methods: In this descriptive-analytical cross-sectional study, using the census method, all the dialysis patients visiting Birjand Special Diseases Center, Iran, were examined. A three-part questionnaire was used to collect information in this study. The first part deals with patient demographic information (i.e., age, gender, marital status, degree, occupation, duration of dialysis per week, and medical history), the second part includes the DASS21 standard questionnaire, and the third part comprises the Ellison-Palutzian spiritual health standard questionnaire. Data analysis was performed by the Mann-Whitney, ANOVA, and Pearson correlation coefficient. Results: In this study, 119 hemodialysis patients were studied, of which 77 (64.7%) were male. The mean depression, anxiety, and stress scores of the participants in the study were 18.8 ± 7.52, 16.43 ± 7.13, and 19.36 ± 8.31, respectively. The mean spiritual health of the patients studied was 82.37 ± 12.12. The results showed a significant (P < 0.05) inverse relationship between spiritual health and depression, anxiety, and stress in the patients studied. Conclusions: The findings showed that patients with higher spiritual health scores experienced less anxiety, stress, and depression. Thus, more focus should be on improving the spiritual health of hemodialysis patients by medical staff in the process of admitting and dealing with them in hospitals and medical centers.

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