Publications by authors named "Pardis Ziaeefar"

10 Publications

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A cross-sectional multicenter linkage study of hospital admissions and mortality due to methanol poisoning in Iranian adults during the COVID-19 pandemic.

Sci Rep 2022 06 13;12(1):9741. Epub 2022 Jun 13.

Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

A methanol poisoning outbreak occurred in Iran during the initial months of coronavirus disease 2019 (COVID-19) pandemic. We aimed to evaluate the epidemiology of the outbreak in terms of hospitalizations and deaths. A cross-sectional linkage study was conducted based on the hospitalization data collected from thirteen referral toxicology centers throughout Iran as well as mortality data obtained from the Iranian Legal Medicine Organization (LMO). Patient data were extracted for all cases aged > 19 years with toxic alcohol poisoning during the study period from February until June 2020. A total of 795 patients were hospitalized due to methanol poisoning, of whom 84 died. Median [interquartile ratio; IQR] age was 32 [26, 40] years (range 19-91 years). Patients had generally ingested alcohol for recreational motives (653, 82.1%) while 3.1% (n = 25) had consumed alcohol-based hand sanitizers to prevent or cure COVID-19 infection. Age was significantly lower in survivors than in non-survivors (P < 0.001) and in patients without sequelae vs. with sequelae (P = 0.026). Twenty non-survivors presented with a Glasgow Coma Scale (GCS) score > 8, six of whom were completely alert on presentation to the emergency departments. The time from alcohol ingestion to hospital admission was not significantly different between provinces. In East Azerbaijan province, where hemodialysis was started within on average 60 min of admission, the rate of sequelae was 11.4% (compared to 19.6% average of other provinces)-equivalent to a reduction of the odds of sequelae by 2.1 times [95% CI 1.2, 3.7; p = 0.009]. Older patients were more prone to fatal outcome and sequelae, including visual disturbances. Early arrival at the hospital can facilitate timely diagnosis and treatment and may reduce long-term morbidity from methanol poisoning. Our data thus suggest the importance of raising public awareness of the risks and early symptoms of methanol intoxication.
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http://dx.doi.org/10.1038/s41598-022-14007-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9189800PMC
June 2022

Medium-Term Outcomes of COVID-19 Infection After Kidney Transplantation for Ongoing Living and Deceased Kidney Transplantations within the COVID-19 Pandemic.

Urol J 2022 Feb 8;19(2):126-130. Epub 2022 Feb 8.

Urology and Nephrology Research Center (UNRC), Shahid Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.

Objectives: To present the early to midterm experience of two referral kidney transplantation centers with living and deceased kidney transplantations that were performed within the COVID-19 pandemic.

Materials And Methods: All cases performed in two referral centers in Iran within the COVID-19 pandemic were investigated. Transplantations were performed from May 2020 to February 2021. The protocol for screening included nasopharyngeal RT-PCR with chest CT scan for living and deceased transplantations in center A and RTPCR for living transplantations and chest CT scan for deceased transplantations in center B. Patients were followed for 14-26 months after transplantation regarding COVID-19 infection and its outcomes in case of infection.

Results: 103 kidney transplantations were performed during the study period including 54 (52.4%) living and 49 (47.6%) deceased kidney transplantations. Twenty-four recipients (23.3%) and a living donor (1%) were infected with COVID-19. The severity of COVID-19 infection was mild, moderate, severe, and critical in 16 (66.6%), 4 (16.6%), 2 (8.4%), and 2 patients (8.4%), respectively. Two mortalities were observed within transplantation recipients with COVID-19 infection (1.9%). 87.5% (7/8) COVID-19 infections in center B were observed in recipients of deceased transplantations who were screened only by chest CT scan.

Conclusion: The results of this study indicate a low frequency of COVID-19 mortality (1.9% for the whole cohort and 8.3% within COVID-19 infected patients) for recipients of living and deceased kidney transplantation that were performed within the COVID-19 pandemic. The above findings highlight for the first time in a large study the probability of living kidney transplantation during the COVID-19 pandemic in case strict screening of donors and recipients and close supervision of operating rooms and wards are implemented. We further hypothesize the inadequacy of chest CT scan for screening of COVID-19 in kidney transplantation surgery candidates.
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http://dx.doi.org/10.22037/uj.v18i.6930DOI Listing
February 2022

Outcomes of Ongoing Living and Cadaveric Kidney Transplantations within the COVID-19 Pandemic in Two Referral Centers.

Urol J 2022 02 8. Epub 2022 Feb 8.

Urology and Nephrology Research Center (UNRC), Shahid Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran.

Purpose: To present the early to midterm experience of two referral kidney transplantation centers with living and deceased kidney transplantations that were performed within the COVID-19 pandemic.

Materials And Methods: All cases performed in two referral centers in Iran within the COVID-19 pandemic were investigated. Transplantations were performed from May 2020 to February 2021. The protocol for screening included nasopharyngeal RT-PCR with chest CT scan for living and deceased transplantations in center A and RT-PCR for living transplantations and chest CT scan for deceased transplantations in center B. Patients were followed for 14-26 months after transplantation regarding COVID-19 infection and its outcomes in case of infection.

Results: 103 kidney transplantations were performed during the study period including 54 (52.4%) living and 49 (47.6%) deceased kidney transplantations. Twenty-four recipients (23.3%) and a living donor (1%) were infected with COVID-19. The severity of COVID-19 infection was mild, moderate, severe, and critical in 16 (66.6%), 4 (16.6%), 2 (8.4%), and 2 patients (8.4%), respectively. Two mortalities were observed within transplantation recipients with COVID-19 infection (1.9%). 87.5% (7/8) COVID-19 infections in center B were observed in recipients of deceased transplantations who were screened only by chest CT scan.

Conclusion: The results of this study indicate a low frequency of COVID-19 mortality (1.9% for the whole cohort and 8.3% within COVID-19 infected patients) for recipients of living and deceased kidney transplantation that were performed within the COVID-19 pandemic. The above findings highlight for the first time in a large study the probability of living kidney transplantation during the COVID-19 pandemic in case strict screening of donors and recipients and close supervision of operating rooms and wards are implemented. We further hopothetize the inadequacy of chest CT scan for screening of COVID-19 in kidney transplantation surgery candidates.
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http://dx.doi.org/10.22037/uj.v18i.6930DOI Listing
February 2022

The controversial association of gut and urinary microbiota with kidney stone formation.

Microb Pathog 2021 Dec 20;161(Pt A):105257. Epub 2021 Oct 20.

-Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Electronic address:

Nephrolithiasis (kidney stones) is one of the most common chronic kidney diseases that are typically more common among adult men comparing to adult women. The prevalence of this disease is increasing which is influenced by genetic and environmental factors. Kidney stones are mainly composed of calcium oxalate and urinary oxalate which is considered a dangerous factor in their formation. Besides diverse leading reasons in the progression of nephrolithiasis, the gut and urinary microbiome has been recognized as a major player in the development or prevention of it. These microbes produce metabolites that have diverse effects on host biological functions. Therefore, Changes in the composition and structure of the microbiome (dysbiosis) have been implicated in various diseases. The present review focuses on the roles of gut and urinary in kidney stone formation.
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http://dx.doi.org/10.1016/j.micpath.2021.105257DOI Listing
December 2021

COVID-19 pandemic and methanol poisoning outbreak in Iranian children and adolescents: A data linkage study.

Alcohol Clin Exp Res 2021 09 6;45(9):1853-1863. Epub 2021 Sep 6.

Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: During the first wave of COVID-19, many Iranians were poisoned by ingesting hand sanitizers and/or alcoholic beverages to avoid viral infection. To assess whether the COVID-19 pandemic resulted in an increased prevalence of accidental hand sanitizer/alcoholic beverage exposure in children and adolescents, we compared pediatric hospitalization rates during COVID-19 and the previous year. For poisoning admissions during COVID-19, we also evaluated the cause by age and clinical outcomes.

Methods: This retrospective data linkage study evaluated data from the Legal Medicine Organization (reporting mortalities) and hospitalization data from nine toxicology referral centers for alcohol-poisoned patients (age 0 to 18 years) for the study period (February 23 to June 22, 2020) and the pre-COVID-19 reference period (same dates in 2019).

Results: Hospitalization rates due to ethanol and methanol exposure were significantly higher in 2020 (n = 375) than 2019 (n = 202; OR [95% CI] 1.9 [1.6, 2.2], p < 0.001). During COVID-19, in patients ≤15 years, the odds of intoxication from hand sanitizers were significantly higher than from alcoholic beverages, while in 15- to 18-year-olds, alcoholic beverage exposure was 6.7 times more common (95% CI 2.8, 16.1, p < 0.001). Of 375 children/adolescents hospitalized for alcoholic beverage and hand sanitizer exposure in 2020, six did not survive. The odds of fatal outcome were seven times higher in 15- to 18-year-olds (OR (95% CI) 7.0 (2.4, 20.1); p < 0.001).

Conclusion: The Iranian methanol poisoning outbreak during the first wave of COVID-19 was associated with significantly increased hospitalization rates among children and adolescents-including at least six pediatric in-hospital deaths from poisoning. Public awareness needs to be raised of the risks associated with ingesting alcoholic hand sanitizers.
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http://dx.doi.org/10.1111/acer.14680DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8653331PMC
September 2021

Rosai-Dorfman disease: A case report of asymptomatic isolated renal involvement.

Clin Case Rep 2021 Jul 10;9(7):e04132. Epub 2021 Jul 10.

Department of Radiology Shahid Labbafinejad hospital Shahid Beheshti University of Medical Sciences Tehran Iran.

A possible diagnosis of RDD should be kept in mind when encountering a patient with raised plasma creatinine levels and renal mass. Timely diagnosis and management of RDD will help prevent future kidney loss.
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http://dx.doi.org/10.1002/ccr3.4132DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8271259PMC
July 2021

Comparing the Clinical Characteristics, Laboratory Findings, and Outcomes between Epidemic and Episodic Methanol Poisoning Referrals; a Cross-sectional Study.

Arch Acad Emerg Med 2021 12;9(1):e46. Epub 2021 Jun 12.

Department of Clinical Toxicology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Introduction: Due to illegal manufacturing and sales of alcoholic beverages, epidemic outbreaks of methanol poisoning may occur. The aim of this study was to determine if there were differences in the severity, course of poisoning, and outcomes between methanol-poisoned patients admitted during an outbreak versus those who were admitted following episodic exposures.

Methods: The present retrospective study was performed in a single referral poisoning center between March 2018 and March 2019 in patients with confirmed methanol poisoning. During this time, in addition to episodic cases of methanol intoxication, there were three methanol poisoning outbreaks. Outbreaks were characterized by an unexpected increase in the number of methanol-poisoned patients in a short period of time, which impacted resources and decision-making. The two groups were compared regarding their severity of poisoning, sessions of hemodialysis, and clinical outcomes.

Results: Outbreak cases had a higher level of methanol than episodic cases. Odds of being dialyzed more than once was 5.4 times higher in the cases presenting during an outbreak (95% CI 2.1-14.0; p=0.001). Mean hospital stay, intubation/mechanical ventilation, and death were similar between the two groups. An evaluation of the alcoholic beverage samples available in the Iranian black market during the outbreak showed a 7-percent methanol concentration with no ethanol content.

Conclusions: Poisoning risk may be higher during methanol outbreaks due to the higher methanol concentrations, requiring more hemodialysis sessions for persistent metabolic acidosis. In addition to alcohol dehydrogenase blockade, careful risk assessment of all methanol poisonings can assist with stratifying the priority for, and duration of, hemodialysis to optimize outcomes.
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http://dx.doi.org/10.22037/aaem.v9i1.1278DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8221550PMC
June 2021

Correction to: Protective effect of flumazenil infusion in severe acute benzodiazepine toxicity: a pilot randomized trial.

Eur J Clin Pharmacol 2021 Apr;77(4):555-556

Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

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http://dx.doi.org/10.1007/s00228-021-03117-wDOI Listing
April 2021

EARLY AND LONG-TERM OUTCOME OF SURGICAL INTERVENTION IN CHILDREN WITH INFLAMMATORY BOWEL DISEASE.

Arq Bras Cir Dig 2020 20;33(2):e1518. Epub 2020 Nov 20.

Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Background: Long-term complication-free survival chart in children with IBD . Although children with inflammatory bowel disease (IBD), disease control is possible through medical procedures, but surgical intervention is indicated in some cases.

Aim: To evaluated long-term surgical outcomes in children with IBD.

Methods: This retrospective cohort study was done on 21 children suffering IBD with surgical indication admitted to a referral children hospital in Tehran in 2019. The baseline information was collected by reviewing the recorded files and children were followed-up to assess surgical outcome.

Results: The rate of early complications after surgery was 47.6%; they included intestinal perforation in 4.8%, peritonitis in 4.8%, wound infection in 23.8%, pelvic abscesses in 14.3%, deep vein thrombosis in 4.8%, intestinal obstruction in 9.5%, pancreatitis in 9.5% and anal fissure in 4.8%. The mean duration of follow-up for patients was 6.79±4.24 years. The rate of delayed complications during follow up was 28.6%. Accordingly, long-term free-complication survival rate during 5-10 years after surgery was 92.3% and 56.4%, respectively. Among the early features, lack of prior drug treatment and bleeding as indication for surgery, were two predictors of long-term surgical complications.

Conclusion: Standard surgery in the treatment of IBD in children with surgical indication is associated with favorable outcome, although short- and long-term surgical complications are also predictable.
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http://dx.doi.org/10.1590/0102-672020200002e1518DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7682153PMC
December 2020

Protective effect of flumazenil infusion in severe acute benzodiazepine toxicity: a pilot randomized trial.

Eur J Clin Pharmacol 2021 Apr 30;77(4):547-554. Epub 2020 Oct 30.

Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Objective: We aimed to investigate the efficacy of flumazenil infusion in the maintenance of arousal and prevention of development of complications in severe benzodiazepine poisoning.

Materials And Method: Sixty severely poisoned patients (intubated due to loss of consciousness) intoxicated by sole benzodiazepines referred to Loghman Hakim hospital between May 2018 and August 2019 were considered to be included in the current study. All were evaluated for possible contraindications of flumazenil administration. If there were no contraindications, we continued supportive care in one group and supportive care plus flumazenil infusion in the second group. Following response to the stat dose of flumazenil, complications, hospital stay, and outcome were compared between these two groups.

Results: A total of 60 benzodiazepine-poisoned patients aged between 16 and 84 years old (37 males and 23 females) were enrolled. There was no statistically significant difference between these two groups regarding the period of hospital stay. Need for intubation significantly decreased in the infusion group. None of the patients experienced seizure or dysrhythmia. One patient died in the control group which received only a stat dose of flumazenil.

Conclusions: Administration of flumazenil is safe in benzodiazepine-poisoned patients with appropriate indications. Flumazenil infusion can significantly decrease the need for intubation and subsequent ICU admission. Even though flumazenil is an expensive antidote, its administration may decrease the need for ICU beds in the setting of acute poisoning.
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http://dx.doi.org/10.1007/s00228-020-03031-7DOI Listing
April 2021
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