Background: Hypertension, the most common comorbidity among coronavirus disease 2019 (COVID-19) patients, is accompanied by worse clinical outcomes, but there is lack of evidence about prognostic factors among COVID-19 patients with hypertension. We have come up with some prognostic factors to predict the severity of COVID-19 among hypertensive patients. In addition, epidemiologic, clinical and laboratory differences among COVID-19 patients with and without underlying hypertension were evaluated.Methods: Medical profiles of 598 COVID-19 cases were analyzed. Patients were divided into two comparative groups according to their positive or negative history of hypertension. Then, epidemiologic, clinical, laboratory and radiological features and also clinical outcomes were compared.Results: 176 (29.4%) patients had underlying hypertension. Diabetes was significantly higher in hypertensive group [72 (40.9%) vs 76 (18%)] (P-value: 0.001). Cardiovascular and renal disorders were significantly higher in hypertensive patients. (P-value: 0.001 and 0.013 respectively). In COVID-19 patients with hypertension, severe/critical types were significantly higher. [42(23.8%) vs. 41(9.7%)], (P-value: 0.012). In the logistic regression model, Body mass index > 25 (OR_Adj: 1.8, 95% CI: 1.2 to 2.42;P-value: 0.027), age over 60 (OR_Adj: 1.26, 95% CI: 1.08 to 1.42;P-value: 0.021), increased hospitalization period (OR_Adj: 2.1, 95% CI: 1.24 to 2.97;P-value: 0.013), type 2 diabetes (OR_Adj: 2.22, 95% CI: 1.15 to 3.31; P-value: 0.001) and chronic kidney disease (OR_Adj: 1.83, 95% CI: 1.19 to 2.21; P-value: 0.013) were related with progression of COVID-19.Conclusion: Hypertensive patients with Age > 60-year-old, BMI > 25 Kg/m², CVD, diabetes and chronic kidney disease are associated with poor outcomes in those with COVID-19 infection.

Background: Gastric cancer (GC) has been considered as the 5th most common type of cancer and the third leading cause of cancer-associated death worldwide. The aim of this historical cohort study was to evaluate the survival predictors for all patients with GC using the Cox proportional hazards, extended Cox, and gamma-frailty models. Methods: This historical cohort study was performed according to documents of 1695 individuals having GC referred to three medical centers in Iran from 2001 to 2018. First, most significant prognostic risk factors on survival were selected, Cox proportional hazards, extended Cox, gamma-frailty models were applied to evaluate the effects of the risk factors, and then these models were compared with the Akaike information criterion. Results: The age of patients, body mass index (BMI), tumor size, type of treatment and grade of the tumor increased the hazard rate (HR) of GC patients in both the Cox and frailty models (P < 0.05). Also, the size of the tumor and BMI were considered as time-varying variables in the extended Cox model. Moreover, the frailty model showed that there is at least an unknown factor, genetic or environmental factors, in the model that is not measured (P < 0.05). Conclusions: Some prognostic factors, including age, tumor size, the grade of the tumor, type of treatment and BMI, were regarded as indispensable predictors in patients of GC. Frailty model revealed that there are unknown or latent factors, genetic and environmental factors, resulting in the biased estimates of the regression coefficients.

Background: Historically, Roux-en-Y gastric bypass (RYGB) has been considered the gold standard of bariatric surgery (BS). This procedure acts as a mixed restrictive and malabsorptive operation. Methods: This retrospective cohort study included 410 morbidly obese patients (BMI > 40 kg/m² or BMI > 35 kg/m² along with at least one major comorbidity) who underwent primary laparoscopic RYGB surgery from 2009 to 2015 by a single surgery team. The patients were 18 years and older with at least 12 months of follow-up. Total weight loss (%TWL) and comorbidity resolution were compared in short-term (12 months) and mid-term (12–60 months) follow-ups. The primary and secondary outcomes were evaluating the effect of Roux-en-Y on weight loss and control of comorbidities, respectively. Results: The mean ± SD age, weight, and BMI at surgery were 40.1 ± 10.58 years, 123.32 ± 19.88 kg, and 45.78 ± 5.54 kg/m², respectively, and 329 (80%) were female, and 62 (15%) had T2DM. %TWL was significantly higher in T2DM patients 9 months postoperatively and after that. Patients with lower BMI (< 50 kg/m²) at surgery and non-diabetic patients had a significantly lower %TWL over a short- and long-term follow-up (P < 0.001). Conclusions: BS remains the most efficacious and durable weight loss treatment. However, a proportion of patients will experience insufficient weight loss following BS.

Background: Owing to the direct impact of total hip arthroplasty (THA) on health-related quality of life (HRQOL) and the higher prevalence of THA in the elderly, this study aimed to compare HRQOL before, and after THA in the Iranian elderly. Methods: The present prospective cohort study was performed on 161 THA candidates. Demographic data were extracted from records of patients. Before, 6, and 12 months after THA, a Short Form 36 health survey (SF-36) was used to assess HRQOL. Before THA, 6 and 12 months after THA, Physical (PCS), and mental component scores (MCS) were obtained from a hundred separately for each subscale of the questionnaire. The Paired t-test was used to compare HRQOL before and after THA. Results: Both 6 and 12 months after THA, HRQOL was significantly increased compared to previous THA (P = 0.001). In the first half-year after THA, vitality and emotional state were not different from pre-surgery. However, 12 months after THA, these two subscales also were significantly improved. Although, 6 months after THA, the PCS has dramatically gone up compared to the previous THA (P = 0.012), despite MCS was remained steady. Nonetheless, by comparison with the before surgery, 12 months after THA, MSC notably improved (P = 0.048). Conclusion: HRQOL was appreciably improved by the THA in the elderly after 12 months. The improvement in HRQoL in the first 6 months after THA is related to the promotion in the physical aspect (PCS score), and in the second 6 months after THA is related to the promotion in the psychological aspect (MCS score).

Introduction: Currently breast (BC) cancer is a serious medical problem in all countries of the world. Survivaldepends on many factors. The present study focused on 5-year survival and its related factors in patients with BC inIran. Material and methods. The present analytical retrospective study was performed (from March 2010 until March2015) on patients with BC followed for at least 6 months. The main variables assessed were tumor size, grade of lymphnode involvement, metastasis, stage, history, human epidermal growth factor receptor expression, and tumor origin.Analysis of survival was accomplished using the Kaplan- Meier method. Results: Some 351 (80.2%) of the total of438 individuals had unilateral and 87(19.8%) had bilateral cancer, 28 (35.6%) of the latter being synchronous and56(64.4%) metachronous. Mean duration of follow-up was 47.44±28.19 months, during which 61 (17.3%) patientswith unilateral and 18 with bilateral cancer eventually died. The 5-year survival rate in patients with unilateral BC wassignificantly higher than those with bilateral BC (Log-rank Test chi2= 3.11, p=0.032). In addition, with metachronouscases, the survival rate was 64.2% in comparison with 51.6% for synchronous BCs. Survival rate was significantly(p value =0.038) higher with metachronous than with synchronous cancers (Log-rank Test chi2=3.54, p=0.038). Thehighest survival rate was reported for BCs originating from lobule tissue and the lowest rate examples of interstitialtissue origin (Log-rank Test chi2=11.54, p=0.0001). Patients with earl stage lesions (M1) survived longer than withother stages (Log-rank Test chi2= 9.55, p=0.001). Conclusion: In this study, most women with BC had a positivefamily history and were married. The 5-year survival rate was lower with advanced stages of cancer. According to ourfindings, survival rates might improve if patients undergo screening and diagnosis is made at an early stage of the disease.