Hospital Practices and Research

Abstract Background: The primary patency rate (PPR) is still controversial in angioplasty and heart bypass surgery for blood vessel repair and reconstruction in patients with femoropopliteal disease.
Objectives: This study aimed to investigate the prolonged PPR rate in patients with stenosis/occlusion of the femoropopliteal artery undergoing superficial femoral artery (SFA) and popliteal angioplasty.
Methods: A case series study population consisted of patients demonstrating femoropopliteal artery occlusion referred to Sina Hospital, Tehran, Iran for angiography during 2016-2018. After angiography, patients underwent either stent placement or balloon angioplasty in the case of stenosis/occlusion of femoropopliteal arteries. After angioplasty, patients were followed up in the 3rd, 12th, and 24th months for re-examination, and color Doppler ultrasonography of femoropopliteal arteries was also performed to measure the patency rate. The SPSS Statistics version 21.0 was used to analyze the data. The Kaplan–Meier method and a log-rank test were utilized to evaluate this rate.
Results: Sixty patients were included in the study, from which 44 were women (73.3%) and 16 were men (26.6%) with a mean age of 69.9 years. Fifty-two, 41, and 29 patients were examined at intervals of 3, 12, 24 months, with PPRs of 86%, 79%, and 68%, respectively. There was a significant relationship between claudication degree and procedure success (P = 0.02).
Conclusion: The prolonged PPR rate of patients after femoropopliteal artery angioplasty was acceptable and was a safe and effective treatment. For future studies, an increase in the number of study variables, a more comprehensive classification, and PPR-related variables are suggested.

Abstract Introduction: During the current worldwide pandemic of coronavirus disease 2019 (CPVID-19), this disease was first identified in Iran at the end of February. This study was conducted to examine patients with severe COVID-19 disease, who were treated with three medications, namely ReciGen, methylprednisolone, and Sovodak.
Case Presentation: We identified 10 patients (3 males and 7 females) with the mean (± SD) age of 55.70 ± 21.48 years, who were admitted to the only referral hospital in Rafsanjan County (Iran) from March to July 2020 with confirmed infections with severe COVID-19. They were treated with the combination therapy of subcutaneous ReciGen interferon every other day, methylprednisolone at a dose of 250 mg every 6 hours for 5 days, and one tablet of Sovodak daily.
Conclusion: In the series of cases investigated in this study, the general conditions of all patients improved in terms of their clinical parameters after receiving the combination therapy, and all patients were discharged with a blood oxygen level of ≥ 93% and in good general conditions.

Abstract Background: Japanese Encephalitis (JE) is a serious public health issue in an Asian region, causing high mortality and disability rates across all age groups.
Objectives: The current study aims to examine the clinical characteristics, laboratory findings, treatment patterns, and discharge outcomes of JE-admitted patients at a tertiary care neurology hospital in the Northeast state of India.
Methods: The medical records of diagnosed JE patients were reviewed retrospectively between January 2021 and December 2022. Demographic and clinical characteristics were analyzed. Characteristics of the disease severity were assessed based on the discharge status: routine discharge, Discharge Against Medical Advice (DAMA), and mortality during the hospital stay.
Results: A total of 28 JE patients were included; their average age was 40.7 (±20.2) years, males predominantly (60.7%), and the majority belonged to the lower socioeconomic level (85.6%). The most common clinical symptom was fever with altered sensorium (89.3%), with involved hyperintensities in the thalamus (25.0%). Twenty-six patients required Neurological Intensive Care Unit (Neuro-ICU) management with tracheostomy-assisted ventilation due to neurological deterioration. Symptomatic treatment was prescribed such as prophylactic antibiotics and osmotic diuretics. JE patients’ mortality (25.0%) during a hospital stay due to superadded septic shock and elevated intracranial pressure, 21.4% were routine discharge, and 53.6% underwent DAMA.
Conclusion: The prevalent reasons for JE patient mortality were superadded septic shock, increased intracranial pressure, and disease severity. Fever with altered sensorium and thalamus involvement were major findings. Many patients were DAMA because of their low socioeconomic level, which was a barrier to monitoring the progression of the disease.