Publications by authors named "Ali Alavi Foumani"

12 Publications

  • Page 1 of 1

Association of Metabolic Syndrome and Asthma Status; A Prospective Study from Guilan Province-Iran.

Endocr Metab Immune Disord Drug Targets 2021 Mar 5. Epub 2021 Mar 5.

Inflammatory Lung Diseases Research Center, Department of Internal Medicine, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Introduction: Asthma is defined as a chronic inflammatory airway disease. Recent studies have shown the association between metabolic syndrome and deterioration of the lung functions in patients with asthma. The aim of this study was to evaluate the relation between metabolic syndrome and asthma status.

Methods: In this prospective cross-sectional study, 160 asthmatic patients attending Razi hospital in Guilan province, were divided equally into two groups of 80 patients. The case group was contained asthmatic patient with metabolic syndrome and the control group contain asthmatic patient without metabolic syndrome. Blood pressure, height, weight, waist circumferences, fasting blood glucose and lipid profiles were measured by standard methods. Asthma severity was determined based on clinical symptoms and GINA criteria. To evaluate pulmonary function parameters, spirometry was performed for the patients.

Results: Pulmonary function test including FEF, FVC and FEV1 were significantly lower in the case group compared to control group (P < 0.05). Also, a significant negative correlation was found between waist circumference, cardiovascular risk factors (including diabetes, hypertriglyceridemia, hypertension) with spirometric indices (P < 0.05).

Conclusion: Metabolic syndrome causes major declines of pulmonary parameters in asthma patients, thus controlling metabolic syndrome might improve symptoms of asthma.
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http://dx.doi.org/10.2174/1871530321666210305125059DOI Listing
March 2021

Incidence of symptomatic venous thromboembolism following hospitalization for coronavirus disease 2019: Prospective results from a multi-center study.

Thromb Res 2021 02 11;198:135-138. Epub 2020 Dec 11.

Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Background: Thrombosis and pulmonary embolism appear to be major causes of mortality in hospitalized coronavirus disease 2019 (COVID-19) patients. However, few studies have focused on the incidence of venous thromboembolism (VTE) after hospitalization for COVID-19.

Methods: In this multi-center study, we followed 1529 COVID-19 patients for at least 45 days after hospital discharge, who underwent routine telephone follow-up. In case of signs or symptoms of pulmonary embolism (PE) or deep vein thrombosis (DVT), they were invited for an in-hospital visit with a pulmonologist. The primary outcome was symptomatic VTE within 45 days of hospital discharge.

Results: Of 1529 COVID-19 patients discharged from hospital, a total of 228 (14.9%) reported potential signs or symptoms of PE or DVT and were seen for an in-hospital visit. Of these, 13 and 12 received Doppler ultrasounds or pulmonary CT angiography, respectively, of whom only one patient was diagnosed with symptomatic PE. Of 51 (3.3%) patients who died after discharge, two deaths were attributed to VTE corresponding to a 45-day cumulative rate of symptomatic VTE of 0.2% (95%CI 0.1%-0.6%; n = 3). There was no evidence of acute respiratory distress syndrome (ARDS) in these patients. Other deaths after hospital discharge included myocardial infarction (n = 13), heart failure (n = 9), and stroke (n = 9).

Conclusions: We did not observe a high rate of symptomatic VTE in COVID-19 patients after hospital discharge. Routine extended thromboprophylaxis after hospitalization for COVID-19 may not have a net clinical benefit. Randomized trials may be warranted.
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http://dx.doi.org/10.1016/j.thromres.2020.12.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7836837PMC
February 2021

The Role of Metallic Nanoparticles in Inhibition of Mycobacterium Tuberculosis and Enhances Phagosome Maturation into the Infected Macrophage.

Oman Med J 2020 Nov 12;35(6):e194. Epub 2020 Nov 12.

Institute for Tuberculosis Research, College of Pharmacy, University of Illinois at Chicago, Illinois, USA.

This review focuses on the role of gallium (Ga) nanoparticles (NPs) to enhance phagosome maturation into the -infected macrophage and the role of magnetic iron NPs as nanocarriers of antituberculosis drugs. The literature shows that silver (Ag) and zinc oxide (ZnO) NPs with dimensions less than 10 nm can penetrate directly through the macrophage bilayer membrane. Ag NPs increase the permeability membrane by motiving the aggregation of proteins in the periplasmic space and forming nano-sized pores. ZnO NPs can interact with the membrane of which leads to the formation of surface pores and the release of intracellular nucleotides. The colloidal Ag:ZnO mixture NPs with 1:1 ratio can eliminate and shows the lowest cytotoxicity effects on MCF-7 and THP-1 cell lines. Ag/ZnO nanocrystals are not able to kill alone ex-vivo. Hence, bimetallic gold (Au)/Ag NPs possessed high efficiency to inhibit in an ex-vivo THP-1 infection model. Co-delivery of mixed MeNPs into a polymeric carrier collaborated to selective uptake by macrophages through passive targeting, initial burst release of ions from the encapsulated metallic (Me) NPs, and eventually, reduction of MeNPs toxicity, and plays a pivotal role in increasing the antitubercular activity compared to use alone. In addition, Ga NPs can import drugs to the macrophage, inhibit growth, and reduce the inhibition of phagosome maturation. Magnetic encapsulated NPs exhibited good drug release properties and might be suitable as carriers of antituberculosis drugs.
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http://dx.doi.org/10.5001/omj.2020.78DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7658918PMC
November 2020

Epidemiology of Pseudomonas aeruginosa in cystic fibrosis patients in Iran: A systematic review and meta-analysis.

Infez Med 2020 Sep;28(3):314-321

Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

The present study aims to investigate the prevalence of Pseudomonas aeruginosa in Iranian Cystic Fibrosis (CF) patients. We conducted a systematic search on this topic in Web of Science, PubMed, Embase, Scopus, and Google Scholar electronic databases to the end of July 2019. Then, 14 articles with eligible criteria were selected for data extraction and analysis by Comprehensive Meta-Analysis Software. The pooled prevalence of P. aeruginosa was 40.6% (95% CI: 32.4%-49.4%) ranging from 32.4% to 49.4%. There was a significant heterogeneity among the studies (χ2 =21.02; p <0.001; I2 = 86.07%). The funnel plot for publication bias showed no evidence of asymmetry. Based on the results of Begg's and Egger's test no significant publication bias was observed. The study demonstrated a relative prevalence of P. aeruginosa among CF patients in Iran. Due to the rapid spread and infection severity of P. aeruginosa and other opportunistic pathogens, efforts are required to identify risk factors, reservoirs, transmission routes and source of infection.
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September 2020

Clinical characteristics and outcome of COVID-19 pneumonia in kidney transplant recipients in Razi hospital, Rasht, Iran.

Transpl Infect Dis 2020 Dec 2;22(6):e13420. Epub 2020 Aug 2.

Inflammatory Lung Diseases Research Center, Department of Internal Medicine, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Background: In late December 2019, a novel coronavirus SARS-CoV-2 started to spread around the world in different populations. Its clinical and laboratory characteristics and outcome in kidney transplant recipients are little known. Therefore, we describe 22 kidney transplant recipients with SARS-CoV-2-induced pneumonia.

Methods: All kidney transplant recipients who referred to the Razi Hospital of Rasht with a diagnosis of SARS-CoV-2 infection from February 20 to 19th of April 2020 have been included in this observational study.

Results: We present 22 cases of COVID-19 in kidney transplant recipients (median age 52 years [interquartile range 40.75-62.75 years]) and baseline eGFR 60 (mL/min/1.73 m ) (44.75-86.75). Patients complained of cough (72.7%), dyspnea (63.6%), fever (68.2%), and chill (72.7%) with greater prevalence. We decreased the dose of immunosuppression and started stress dose of intravenous hydrocortisone or equivalent oral prednisolone. Each patient received antiviral therapy based on the latest updated version of local protocol at the time of admission. CT scan findings in 90.9% of patients showed bilateral multifocal lesions. Acute kidney injury (AKI) was observed in 12 patients during hospitalization. Six patients died after a median of 12 days from admission (IQR, 1-21).

Conclusions: In this small observational study, we observed high AKI occurrence and mortality rate in kidney transplant recipients with COVID-19.
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http://dx.doi.org/10.1111/tid.13420DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7404381PMC
December 2020

Is latent tuberculosis infection challenging in Iranian health care workers? A systematic review and meta-analysis.

PLoS One 2019 3;14(10):e0223335. Epub 2019 Oct 3.

Inflammatory Lung Diseases Research Center, Department of Internal Medicine, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Background: The high chances of getting latent tuberculosis infection (LTBI) among health care workers (HCWs) will an enormous problem in low and upper-middle-income countries.

Method: Search strategies were done through both national and international databases include SID, Barakat knowledge network system, Irandoc, Magiran, Iranian national library, web of science, Scopus, PubMed/MEDLINE, OVID, EMBASE, the Cochrane library, and Google Scholar search engine. The Persian and the English languages were used as the filter in national and international databases, respectively. Medical Subject Headings (MeSH) terms was used to controlling comprehensive vocabulary. The search terms were conducted without time limitation till January 01, 2019.

Results: The prevalence of LTBI in Iranian's HCWs, based on the PPD test was 27.13% [CI95%: 18.64-37.7]. The highest prevalence of LTBI in Iranian's HCWs were estimated 41.4% [CI95%: 25.4-59.5] in the north, and 33.8% [CI95%: 21.1-49.3] in the west. The lowest prevalence of LTBI was evaluated 18.2% [CI95%: 3.4-58.2] in the south of Iran. The prevalence of LTBI in Iranian's HCWs who had work-experience more than 20 years old were estimated 20.49% [CI95%: 11-34.97]. In the PPD test, the prevalence of LTBI in Iranian's HCWs who had received the Bacille Calmette-Guérin (BCG) was estimated 15% [CI95%: 3.6-47.73]. While, in the QFT, the prevalence of LTBI in Iranian's HCWs in non-vaccinated was estimated 25.71% [CI95%: 13.96-42.49].

Conclusions: This meta-analysis shows the highest prevalence of LTBI in Iranian's HCWs in the north and the west probably due to neighboring countries like Azerbaijan and Iraq, respectively. It seems that Iranian's HCWs have not received the necessary training to prevent of TB. We also found that BCG was not able to protect Iranian's HCWs from TB infections, completely.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0223335PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6776393PMC
March 2020

Waist Circumference and Spirometric Measurements in Chronic Obstructive Pulmonary Disease.

Osong Public Health Res Perspect 2019 Aug;10(4):240-245

Inflammatory Lung Disease Research Center, Department of Internal Medicine, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Objectives: The aim of this study was to evaluate whether the waist circumference of patients with chronic obstructive pulmonary disease (COPD), had an impact on lung function.

Methods: There were 180 patients with COPD recruited into this prospective cross-sectional study. The age, weight, body mass index and waist circumference (WC) were measured. Spirometry parameters including forced vital capacity (FVC), and forced expiratory volume in the first second (FEV1), were measured and FEV1/FVC calculated.

Results: The mean FEV1/FVC in both normal weight and overweight patients, did not statistically significantly correlate with WC. The COPD assessment test, positively correlated with WC ( = 0.031). A positive correlation with body mass index ( < 0.001), smoking ( = 0.027), and global initiative for chronic obstructive lung disease score ( = 0.009), were observed to positively associate with WC. WC, age, C-reactive protein, duration of disease, and gender (male), were observed to be statistically significant risk factors for the severity of COPD.

Conclusion: WC was not observed to impact upon lung function in this study but it was a predictive factor for COPD severity in patients.
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http://dx.doi.org/10.24171/j.phrp.2019.10.4.07DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6711712PMC
August 2019

Impact of vitamin D on spirometry findings and quality of life in patients with chronic obstructive pulmonary disease: a randomized, double-blinded, placebo-controlled clinical trial.

Int J Chron Obstruct Pulmon Dis 2019 8;14:1495-1501. Epub 2019 Jul 8.

Inflammatory Lung Diseases Research Center, Department of Internal Medicine, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

COPD is an irreversible chronic illness with airflow limitation. The aim of the current study was to assess the role of vitamin D on quality of life and pulmonary function in patients with COPD. A randomized, double-blinded clinical trial was conducted in 63 patients with COPD. Patients were placed into intervention and placebo groups. Each individual in the intervention group took 50,000 IU vitamin Donce a week for 8 weeks and then once a month for 4 months. There was no significant difference among FEV, FEV/FVC, and number of exacerbations in patients with COPD (>0.05). In the intervention group, a significant difference was observed in quality of life at 2 months (<0.001) and 6 months (<0.001). In addition, qualitative analysis showed that the status of exacerbation had not got worse six months after initiation in the intervention group. The current study shows that consumption of 50,000 IU vitamin D, as a convenient supplementation in a daily diet, is able to increase quality of life in patients with COPD.
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http://dx.doi.org/10.2147/COPD.S207400DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6625601PMC
February 2020

Add-on probiotics in patients with persistent allergic rhinitis: A randomized crossover clinical trial.

Laryngoscope 2019 08 22;129(8):1744-1750. Epub 2019 Feb 22.

Department of Otolaryngology, Guilan University of Medical Sciences, Rasht, Iran.

Objectives: Current medications for allergic rhinitis (AR) may have undesirable side effects that could affect quality of life (QoL). Probiotics could be an alternative in these patients. The aim of this study was to assess the impact of add-on probiotics on symptoms and QoL of patients.

Methods: In this randomized crossover clinical trial, patients with persistent AR were included. Each subject received budesonide with probiotic supplements (BP) or budesonide with placebo for 8 weeks (B), then vice versa for a further 8 weeks. There was an 8-week washout. The primary outcome was the change of the Short Form 36-Item Health Survey (SF-36) score. The secondary outcomes were assessed by the Sinonasal Outcome Test-22 (SNOT-22) and the Control of Allergic Rhinitis and Asthma Test (CARAT) questionnaires.

Results: A total of 152 subjects (30.1 ± 7.6 years) completed the study. The SF-36 score in both groups showed improvement compared with baseline values. Treatment BP was more effective than that of B. The Cohen's d and the number needed to treat for Physical Component Scales of SF-36 were 0.40 and 10.77, respectively. These values for Mental Component Scales were 0.33 and 12.61, respectively. Also, treatment BP showed more reduction in the score of SNOT-22 and CARAT.

Conclusion: This study showed that the addition of probiotics to budesonide significantly improved QoL in persistent AR patients. However, the clinical situation of these patients may be not very representative of AR patients in general population. Further studies are recommended.

Level Of Evidence: 1b Laryngoscope, 129:1744-1750, 2019.
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http://dx.doi.org/10.1002/lary.27858DOI Listing
August 2019

Sarcoidosis, a report from Guilan (an Iranian northen province) (2001-09).

Sarcoidosis Vasc Diffuse Lung Dis 2015 Jan 5;31(4):282-8. Epub 2015 Jan 5.

Guilan university of medical sciences.

Background: Sarcoidosis is a chronic multiorgan autoimmune disorder that affects all racial and ethnic groups and occurs at all ages.

Objective: The aim of this study was to assess the clinical and epidemiological features of sarcoidosis patients in a referral clinic of pulmonary disease in city of Rasht (Guilan-Iran).

Method: This retrospective study was done by reviewing sarcoidosis patient's records containing demographic, sign and symptom and clinical data in a pulmonary clinic in Rasht from 2001-09. All statistical analyses were achieved using SPSS.

Results: most common signs and symptoms were respiratory, systemic and musculoskeletal complaints. According to Chest X-Ray, 61.3% had bilateral hilar lymphadenopathy (BHL) alone (stage 1), and 24.2% had BHL plus parenchymal involvment (stage 2). The most common abnormal finding in spirometry was small airway disease (20.3%).The follow-up data showed that 178 patients (45.2%) had significant improvement clinically, radiologically or both.

Conclusion: It seems many clinical and radiological aspects of sarcoidosis in our patients are similar to other series. However, presentation with Lofgren's syndrome is a common feature and skin (n=48, 12.3%) and eye (n=19, 4.8%) involvement are less frequent. There is significant difference between west and east of Guilan in relation to referred patients (12.9 % vs 78.5% respectively).Of course this may be due to referral issues of patients and medical teamwork connections
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January 2015

Correlation of the Ratio of Upper Third to Lower Third Circumferences of the Chest with Obstructive Pattern in Spirometry.

Tanaffos 2015 ;14(4):222-6

Inflammatory Lung Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran.

Background: Obstructive Lung Diseases (OLDs), could lead to progressive hyperinflation of the lungs that cause increased work of breathing, impaired gas exchanges and functional limitations in patients. In this study, thoracic circumference of patients in upper and lower third were measured directly and the association of the upper to lower third width of chest with spirometric parameters was evaluated.

Materials And Methods: In this cross-sectional study, five hundred twenty nine consecutive patients, with obstructive pattern in spirometry (FEV1/FEVC<70% and FEV1<80%), and 143 controls with normal spirometry were entered. Demographic and clinical data including age, sex, smoking, type, duration and severity of disease and spirometric characteristics were recorded. Upper Third circumference of Chest (UTCC) at axillary level, and Lower Third circumference of Chest (LTCC) at lower rib edge, were measured with an ordinary tape meter. Asthma Control Test (ACT) questionnaire for asthmatic and COPD Assessment Test (CAT) questionnaire in COPD patients were completed.

Results: We found that in patients with UTCC/LTCC ratio > 0.8, UTCC had significant correlation with FEV1 and FEV1/FVC (R: 0.069, 0.055); Moreover significant correlation was found in UTCC, LTCC and UTCC/LTCC ratio with ACT score in this subgroup (R: -0.123, -0.092, -0.124)On the other hand in patients with UTCC/LTCC ratio > 0.9, UTCC and LTCC had significant correlation with FEV1 (R: 0.07, 0.051).

Conclusion: UTCC/LTCC ratio > 0.8, may be a predictor of obstructive pattern in patients. This is more important in some occations, for example during preoprative evaluation of a patient in an emergency conditions which there is no enough time for performing appropriate diagnostic tests such as spirometry to reveal the type and severity of obstructive pulmonary diseases.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4841987PMC
April 2016

Upper third to lower third width ratio on chest x-ray may predict severity of obstruction in obstructive lung disease.

Tanaffos 2014 ;13(1):15-9

Respiratory Diseases Research Center of Guilan University of Medical Sciences (GUMS), Rasht, Iran.

Background: The symptoms and functional limitations due to obstructive lung disease (OLD) are the direct results of airway and lung parenchymal destruction. In these conditions, airflow obstruction leads to increased work of breathing, and gas exchange abnormalities. Hyperinflation, which is inferred from a standard chest radiograph (CXR), may imply increased total lung capacity that can be seen in patients with OLD. Based on experimental observations in OLD patients, we proposed that upper third width in posterioranterior (PA) CXR could be used as a rapid screening method for suggestion of OLD.

Materials And Methods: In this cross-sectional study, 99 patients admitted to the Respiratory Ward of Razi Medical Center, a teaching referral hospital affiliated to Guilan University of Medical Sciences (GUMS), were entered in the study. The inclusion criteria were any FEV1 with FEV1/FVC <70% or FEV1/FVC>70% with MMEF 75/25 <65%. All cases with diagnostic possibilities other than OLD were excluded. The PA and lateral CXR were performed and 13 measurements - including previous well-known measurements and our proposed new ones- were made by an ordinary ruler on the films.

Results: There was no significant correlation between the upper third width and superior/inferior (sup/inf) ratio with spirometric indices in patients. When considering only patients with FEV1/FVC <70%, middle third proportion width had a significant correlation with FEV1/FVC. In subgroup analysis when considering sup/inf ratio > 0.8, superior and inferior third widths were correlated with FEV1/FVC and when considering sup/inf ratio > 0.9, sup/inf ratio was significantly correlated with FEV1/FVC and FEV1.

Conclusion: The sup/inf ratio >0.9 in PA CXR, may be a predictor of obstructive pattern in OLD patients. For better correlation determination, larger and more extensive studies are needed.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4153277PMC
September 2014