Faezeh Badkoubeh

Background: Coronary artery disease (CAD) is a major cause of morbidity and mortality worldwide. Inflammation plays a central role in the pathogenesis of atherosclerosis, with neutrophils and high‐density lipoprotein cholesterol (HDL‐C) being key components. The neutrophil‐to‐HDL‐C ratio (NHR) has recently been proposed as a potential biomarker of CAD. This study is aimed at evaluating the association of NHR with the presence and angiographic severity of CAD. Methods: This retrospective, cross‐sectional study was conducted on 250 patients who were referred for suspected CAD and underwent coronary angiography at Afshar Hospital, Yazd, Iran. Demographic, clinical, and laboratory data were collected, and the severity of CAD was assessed using the Gensini score. NHR was calculated as the neutrophil count (×10 ³ / μ L) divided by HDL‐C (mmol/L). Multivariable logistic regression and receiver operating characteristic (ROC) analyses were performed; the model adjusted for age, sex, smoking, body mass index, and blood pressure (Model III) was designated as the primary model, and a fully adjusted model (Model IV) served as a sensitivity analysis. Results: The findings showed that patients with CAD had a significantly higher NHR than patients without CAD (3.9 ± 1.8 vs. 3.1 ± 1.28, p = 0.001). NHR increased across Gensini score tertiles ( p = 0.04). In the primary adjusted model, each 1‐SD increase in NHR was independently associated with CAD (OR = 2.01, 95% CI 1.28–3.14; p = 0.002) and a high Gensini score (OR = 1.56, 95% CI 1.14–2.12; p = 0.005). Bootstrap resampling (1000 replicates) confirmed the stability of these estimates. These findings were consistent in the fully adjusted model (OR = 2.31 and 1.62, respectively). NHR showed only modest discriminative ability for CAD (AUC = 0.638) and a high Gensini score (AUC = 0.620). Conclusion: NHR was independently associated with the presence and severity of CAD in patients referred for coronary angiography. However, its discriminative ability was modest, and its incremental value and prognostic utility require validation in independent prospective cohorts.

Background: The coronavirus disease 2019 (COVID-19) dramatically impacts healthcare delivery. Pulmonary diagnostic procedures have had frequent disruptions during this pandemic. Objectives: This study aimed to discover how the COVID-19 pandemic affected pediatric flexible fiberoptic bronchoscopy. Methods: This retrospective cross-sectional study was carried out on pediatric patients who underwent fiberoptic bronchoscopy at a tertiary pediatric hospital affiliated to Tehran University of Medical Sciences. Procedural analysis was done from 20 March 2019 to 20 February 2020 (the pre-pandemic period) and 20 March 2020 to 20 February 2021 (during the pandemic period). The two groups were compared with regard to bronchoscopic indications and findings. Results: Our results from the data registry showed that within (group 1), 290 patients vs. 241 patients from 20 March 2020 till 20 February 2021 (group 2) were admitted to the operation room at least once for bronchoscopy procedures. Although the findings of foreign body aspiration in bronchoscopy were more frequent in group 2, this difference was not significant in the two groups (P = 0.055). The number of cases without abnormality in group 2 was significantly less than in group 1 (P = 0.006). The prevalence of Laryngomalacia was also significantly higher in group 2 (P = 0.000). Conclusions: Our results confirmed the reduction of bronchoscopy in children after the COVID-19 epidemic. However, there was no change in the immediate indications for bronchoscopy, and this pandemic had the most significant impact on elective bronchoscopy.