No abstract

Background. Lipid profile and its related ratios such as total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), triglyceride (TG), high-density lipoprotein-cholesterol (HDL-C), TG/HDL-C ratio, TC/HDL-C ratio, LDL-C/HDL-C ratio, white blood cell (WBC)/HDL-C ratio, and fasting blood glucose (FBG)/HDL-C ratio are valuable indicators that have been studied in various disorders to predict mortality. The present study was conducted with the aim of investigating the role of lipid profile ratios in predicting mortality in COVID-19 patients. Methods. At the beginning of hospitalization, laboratory tests were taken from all patients ( n = 300 ). The ability of lipid profile ratios to determine the COVID-19 severity was evaluated using receiver-operating characteristic (ROC). In addition, survival probability was determined with the average of Kaplan-Meier curves, so that the end point was death. Results. In deceased patients, TG, TC, LDL-C, HDL-C, TC/HDL-C, TG/HDL-C, and LDL-C/HDL-C parameters were significantly lower than those of surviving patients, while WBC/HDL-C and FBG/HDL-C were significantly higher. TC ( HR = 3.178 , 95 % CI = 1.064 to 9.491, P < 0.05 ), TG ( HR = 3.276 , 95 % CI = 1.111 to 9.655, P < 0.05 ), LDL-C ( HR = 3.207 , 95 % CI = 1.104 to 9.316, P < 0.05 ), and HDL-C ( HR = 3.690 , 95 % CI = 1.290 to 10.554, P < 0.05 ), as well as TC/HDL-C ( HR = 3.860 , 95 % CI = 1.289 to 11.558, P < 0.05 ), TG/HDL-C ( HR = 3.860 , 95 % CI = 1.289 to 11.558, P < 0.05 ), LDL-C/HDL-C ( HR = 3.915 , 95 % CI = 1.305 to 11.739, P < 0.05 ), WBC/HDL-C ( HR = 3.232 , 95 % CI = 1.176 to 8.885, P < 0.05 ), and FBG/HDL-C ratios ( HR = 4.474 , 95 % CI = 1.567 to 12.777, P < 0.01 ), were detectably related to survival. The multivariate Cox regression models showed that only FBG/HDL-C ratio ( HR = 5.477 , 95 % CI = 1.488 to 20.153, P < 0.01 ) was significantly related to survival. Conclusion. The results suggested that FBG/HDL-C ratio in hospital-admitted COVID-19 patients was a reliable predictor of mortality.

Tuberculosis (TB) is a major global health problem. Awareness of liver injury due to anti-TB therapy is vital because fulminant hepatic failure is a devastating and often fatal condition without liver transplantation. Here, we report for the first time, two patients of fatal liver injury due to anti-TB drugs in the presence of alpha-1 antitrypsin deficiency. Based on the triad of rapid loss in hepatocyte function, the onset of hepatic encephalopathy, and absence of a prior history of liver disease, the diagnosis of acute liver failure was established. Both patients had low levels of serum alpha-1 antitrypsin, consistent with alpha-1 antitrypsin deficiency. Despite aggressive medical therapy and supportive care, patients developed multi-organ failure and died. It seems measuring the serum levels of alpha 1-antitrypsin before beginning anti-TB therapies is necessary, especially when there is emphysema or bronchiectasis.

Background: Acinetobacte is the leading cause of pneumonia and sepsis in the ICU ward. Accordingly, in the present study, the antibiotic susceptibility pattern, presence, and dissemination of different classes of integrons and fluoroquinolone resistance genes were investigated among A. baumannii isolates. Methods: In this descriptive, cross-sectional study, during a period of 24 months (2018-2020), 100 isolates of A. baumannii were isolated from different clinical specimens of patients admitted to the two teaching hospital in Ardabil province in the northwest of Iran. Kirby -Bauer disk diffusion, PCR, and sequencing methods were used for antimicrobial susceptibility testing and gene and mutation verification. Results: The resistance rates to all tested antibiotics were found to be between 78% and 100%. No isolate was resistant to polymyxin B. Multidrug-resistant (MDR) rate among tested clinical isolates was about 99%. The prevalence of class 1, 2, and 3 integrons was found to be 70%, 21%, and 0%, respectively. The aadA1 cassette gene was detected in all class 1 integron-carrying strains. Conclusions: High-level antibiotic resistance and a high prevalence of integrons were observed among these clinical isolates. Our findings highlighted the need for continuous monitoring of resistant isolates.