bluuebunny/crossref_metadata_2025 huggingface dataset:
L’esperienza della consulenza di etica clinica presso la Terapia Intensiva Neonatale della Fondazione Policlinico Universitario “A. Gemelli”, IRCCS
Authors: Corsano Barbara , Masilla Simone S. , Vento Giovanni , Papacci Patrizia , Costa Simonetta , Mallardi Maria , Sacchini Dario , Spagnolo Antonio G.
Published: October 2023

Introduzione: Negli ultimi decenni la Consulenza di Etica Clinica (CEC) ha assunto un ruolo importante in ambito clinico-assistenziale, non solo come supporto nell’identificare le questioni etiche implicate nella storia clinica del paziente, ma anche per facilitare il processo decisionale. La Terapia Intensiva Neonatale (TIN) è un ambito peculiare nel quale i valori in gioco necessitano di opportuna considerazione al fine di garantire il perseguimento del bene del neonato nella presa in carico della sua condizione clinica e della famiglia. Obiettivo: Presentazione dell’esperienza del servizio di CEC all’interno della TIN del Servizio di Consulenza di Etica clinica della Fondazione Policlinico Universitario “A. Gemelli” IRCCS di Roma (Italia). Metodi: Attraverso un’indagine retrospettiva abbiamo analizzato: 1. il numero di CEC richieste ed elaborate dal servizio CEC in TIN dal 2016 ad oggi, incluse le consulenze effettuate per i neonati provenienti dal percorso “Hospice Perinatale”; 2. la forma in cui è stata elaborata la consulenza (consulenza “standard” oppure Documento Condiviso di orientamento etico-assistenziale); 3. i quesiti etici alla base delle richieste. Risultati: Il numero di CEC è aumentato progressivamente nel tempo passando da 3 nel 2016 a 19 nel 2022. La CEC si è rivelata un prezioso supporto per l’équipe neonatologica e per i genitori. Infatti, i dati emersi dall’analisi documentano come la CEC, attraverso valutazioni interdisciplinari, abbia facilitato l’identificazione dei problemi etici emergenti, contribuito al processo comunicativo e decisionale al fine di orientare verso l’opzione terapeutica eticamente adeguata, promosso le cure palliative e, laddove possibile, l’elaborazione di una pianificazione condivisa dei trattamenti, con la finalità condivisa con l’équipe curante e la famiglia di perseguire il maggior bene possibile per il neonato. Infine, il carattere “dinamico” della CEC ha consentito di riformulare, in alcuni casi, il piano di cura del neonato. Conclusioni: Negli ultimi anni il numero crescente delle richieste CEC analizzate sottolinea il ruolo sempre più rilevante che la consulenza etica ha all’interno di un contesto così peculiare e delicato come quello della TIN, dove inizio vita e fine vita spesso coesistono, generando dilemmi etici all’interno dell’équipe curante e nella famiglia.
29th AICC Annual Conference | L'Aquila, Italy, 23-25 November 2016
Authors: Zazzeroni Francesca , Alesse Edoardo , AICC board For the
Published: October 2023

This issue contains the abstracts presented at the 29th AICC Annual Conference | L'Aquila, Italy, 23-25 November 2016.
Predicting central incisor length from the incisive papilla in a multiethnic Northern Nigerian population
Authors: Ikusika Oluwafeyisayo Francis , Adeyemi Tope Emmanuel , Sotunde Olawale Akeem , Igweagu Chibuzor Emmanuel , Oguchi Chikaodi Odinaka , Alalade Olusegun , Akeredolu Patricia Adetokunbo
Published: October 2023

Background:

Personalization of complete dentures (CDs) may improve their acceptance by patients. This study sought to develop an individualized predictive model for central incisor length in CDs based on the relationship of the incisive papilla with central incisors.

Methods:

Seventy-three adult participants were included in the study. The vertical distance (VD) and horizontal distance (HD) from the incisive papilla to the central incisor margins and the mean crown heights (CHs) of both central incisors were determined and recorded along with potential confounders. Bivariate and multivariate analyses were performed to develop a best-fit model equation for predicting the CH from the VD and HD.

Results:

Thirty-seven males and 36 females (mean age: 33.4 ± 7.8 years) participated in the study. The ovoid arch form (61.6%) was the most common, whereas the square-shaped arch form (4.1%) was the least common. The mean CH, HD, and VD were 10.12 ± 1.02 mm, 10.64 ± 1.36 mm, and 8.00 ± 1.19 mm, respectively. Further, 49% of CH variability (Model 1) was explained by HD (β = 0.61, t = 7.02, P < 0.001) and VD (β = 0.29, t = 3.29, P = 0.002). Participant sex (Model 2) explained another 3% CH variability (β =0.18, t = 2.09, P = 0.04). The predictive equation from Model 2 was CH (mm) = 3.28+ (0.46 × HD) + (0.22 × VD) +0.37 × participant sex.

Conclusion:

The central incisor CH can be predicted with 52% accuracy using the equation CH (mm) =3.28 + (0.46 × HD) + (0.22 × VD) + 0.37 × participant sex. This finding may aid the fabrication of more individualized dentures.
Effects of Teriparatide on Clinical and Radiologic Long-Term Outcomes after Fixation of Pertrochanteric hip Fractures
Authors: Hosseini Khameneh Mehdi , Gorji Mona , Jafari Kafi-Ababdi Meisam , Biglari Farsad , Gholipour Morteza , Asadi Keivan , Sabbaghzadeh Amir
Published: October 2023

Background:

Pertrochanteric hip fractures are common and among serious injuries of the old population with considerable mortality and morbidity. The aim of this study was to evaluate long-term effects of recombinant human parathyroid hormone on postoperative clinical and radiologic outcomes in elderly patients with pertrochanteric hip fractures.

Materials and Methods:

Between 2016 and 2019, we prospectively assessed 80 patients with pertrochanteric hip fractures who underwent reduction and internal fixation with a dynamic hip screw. Patients were divided randomly into two groups. About 40 patients in the control group who received supplementary calcium (1000 mg/day) and vitamin D (800 UI/day), and 40 others who were treated additionally with 20–28 mg daily teriparatide for three months post-operatively. The functional and radiologic assessment was done using visual analog scale (VAS), Harris hip score (HSS), and standard radiographs of the hip.

Results:

At the final follow-up, there was a significant difference between the two groups regarding average HSS (68.38 in the control group versus 74.12 in the treatment group, P-value <0.001). VAS score was also significantly lower in the treatment group (P-value <0.001). Regarding radiographic evidence of union, the results were not statistically different between the two groups.

Conclusions:

The current study illustrated that short-term daily administration of teriparatide improves long-term functional outcome after pertrochanteric hip fracture fixation and can reduce the pain but does not affect union and callus formation.
Evaluation of Tenascin Expression in Ameloblastoma, Odontogenic Keratocyst, and Dentigerous Cyst by Immunohistochemistry
Authors: Ghazi Narges , Saghravanian Nasrollah , Mirhashemi Majid , Abedini Ardakani Abolfazl
Published: October 2023

Background:

The aim of this study was to evaluate the expression pattern of tenascin in ameloblastoma, odontogenic keratocyst, and dentigerous cyst.

Materials and Methods:

The expression of tenascin was evaluated in microscopic slides of 42 paraffin blocks including 12 ameloblastomas, 15 odontogenic keratocysts, and 15 dentigerous cysts by immunohistochemistry. The expression of tenascin was examined in stroma, epithelium-connective tissue interface, and epithelium of the lesions by two pathologists semiquantitatively.

Results:

Stromal expression of tenascin was higher in ameloblastomas than other groups. All the paired groups showed significant differences except comparison of odontogenic keratocysts and dentigerous cysts. Epithelial-mesenchymal interface expression of tenascin was significantly higher in ameloblastomas and odontogenic keratocysts than dentigerous cysts. All the paired groups showed significant differences except comparison of odontogenic keratocysts and ameloblastomas. Expression of tenascin in epithelial cells of ameloblastomas was focal whereas in odontogenic keratocysts and dentigerous cysts negative immunoreactivity was reported.

Conclusions:

Expression of tenascin in these lesions suggests that it could play a role in epithelial-mesenchymal interaction. Higher expression of tenascin in ameloblastoma, can explain immaturity of its stroma and aggressive nature of this lesion compared with other studied groups. Moreover, higher expression of tenascin in epithelial-mesenchymal interface of odontogenic keratocyst compared with dentigerous cyst reveals its more immature and aggressive nature and high rate of recurrence.
Remission of Prurigo Pigmentosa after Breaking Ketogenic Diet and Resuming Regular Diet
Authors: Daneshpazhooh Maryam , Nikyar Zahra , Kamyab Hesari Kambiz , Rostami Ehsan , Taraz Jamshidi Shirin , Mohaghegh Fatemeh
Published: October 2023

Prurigo pigmentosa (PP) is a rare skin disorder presenting as erythematous urticarial papules on the chest and leaving reticulated pigmentation. Although the etiology of PP is unknown, conditions associated with ketosis such as diabetes mellitus, ketogenic diet (KD), and anorexia nervosa are implicated. Herein, we report a 21-year-old woman who developed PP after adhering to a KD and responded to resuming a regular diet.
A Rare Case of Spinocerebellar Ataxia Autosomal Recessive 21 Presented with Liver Disease
Authors: Zare Narges , Saneian Hosein , Khademian Majid
Published: October 2023

Spinocerebellar ataxia autosomal recessive 21 is known as a very rare disease. It is caused by a homozygous mutation in the SCYL1 gene on chromosome 11q13 and presented in early childhood. The common presentations of this disease are recurrent episodes of liver failure, chronic liver fibrosis, cerebellar atrophy in early childhood, late onset of learning disabilities, and peripheral neuropathy. Diagnosis of spinocerebellar ataxia autosomal recessive 21 is challenging, especially due to the variety of clinical presentations. In the current study, we present an 11-year-old girl diagnosed with spinocerebellar ataxia autosomal recessive 21. She had multiple episodes of acute hepatic failure with later presentations of neurological dysfunctions. The diagnosis of spinocerebellar ataxia autosomal recessive 21 was made by genetic testing.
The Role of Hematological Parameters in Predicting the Death of Hospitalized Patients with COVID-19
Authors: Mobinikhaledi Mahya , Mousavi Zahra S. , Falahati Vahid , Ghasemi Ali , Almasi-Hashiani Amir , Ghaffari Kazem
Published: October 2023

Background:

The role of the hematologic indicators in the identification of severe or critical patients requires further investigation. In this study, we focused on predicting Covid-19 patients at risk of progression using blood parameters.

Materials and Methods:

We performed a retrospective study including 444 patients with confirmed Covid-19. Hematological parameters were evaluated. The logistic regression analysis was performed with step-wise method with dependent variables such as intensive care units admission, partial pressure of oxygen saturation, and mortality. Also, independent variables such as hematological parameters, age and sex to assess variables that are likely to predict patients at risk of progression.

Results:

Patients in intensive care units had significantly higher mean absolute neutrophil count than outpatients (P < 0.001). There was a statistically significant difference in the mean absolute lymphocyte count between dead and survived patients (P = 0.015). Multivariate analysis confirmed the positive association of the white blood cells (P < 0.001), absolute neutrophil count (P < 0.004), red cell distribution width (P < 0.001), and lactate dehydrogenase (P = 0.007) to be positively associated with the admission of Covid-19 patients in the intensive care units and the absolute monocyte count (P = 0.012, Odds ratios = 0.100, CI95% = 0.066-0.605) to be negatively associated with mortality.

Conclusion:

Based on the results of our study, it is recommended to use hematological data to make clinical decisions and evaluate the patient's prognosis.
In Vitro Study of the Leishmanicidal Activity of Perovskia Abrotanoides Terpenoid-Rich Fractions Against Leishmania Major (MRHO/IR/75/ER)
Authors: Sadeghi Dinani Masoud , Emarati Noushabadi Seyed A. , Namdar Fatemeh , Hassani Abharian Parastoo , Hejazi S. H. , Sebghatollahi Zahra
Published: October 2023

Background:

Cutaneous leishmaniasis (CL) is an ulcerative skin disease caused by some species of the genusLeishmania. Evidence shows thatPerovskia abrotanoidesis an important herbal medicine againstLeishmania.This study was conducted to investigate the killing effect of terpenoid-rich fractions on promastigotes ofL. major(MRHO/IR/75/ER).

Material and Method:

The eluates of reverse phased medium pressure liquid chromatography (RP-MPLC) of the extract were subjected to thin-layer chromatography (TLC) and categorized into six final fractions. Primary proton nuclear magnetic resonance (H-NMR) spectroscopy confirmed fractions' nature. Fractions 4, 5, and 6 (F4, F5, F6) were identified as terpenoid-rich content. Two concentrations of 50 and 100 μg/ml were prepared to test leishmanicidal activity. Followed by treating promastigotes ofL. majorby the fractions in incubation times of 12, 24, and 48 hours, their viability was determined using a cell proliferation MTS ((3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium) assay.

Result:

F4, F5, and F6 showed significant killing activity on promastigotes ofL. majorin a concentration-dependent manner. The viability of promastigotes was significantly reduced at a concentration of 100 μg/ml compared to 50 μg/ml (P-value <0.05). Also, over time a significant decreasing trend in the viability of promastigotes confirmed the time-dependent manner of the fractions (P-value <0.01). Furthermore, F5 had the highest leishmanicidal activity at the first incubation time compared with other fractions.

Conclusion:

Terpenoid-rich fractions of theP. abrotanoideshave a leishmanicidal activity that depends on time and concentration. Among them, F5 has the highest potency that may contain potent terpenoid constituents.
Investigating the Effect of Home-based Physical Activity Schedule on the Quality of Life, Sleep Quality, and Mood of the Elderly at Risk of Depression as Compared to the Control Group
Authors: Motamedi Narges , Mostajabodaavati Seyede Roxana
Published: October 2023

Background:

This study aimed at investigating the effect of home-based physical activity schedule on the quality of life (QOL), sleep quality, and mood of the elderly at risk of depression as compared to the control group.

Materials and Methods:

The open-label randomized controlled trial was performed on 61 elderly people at risk of depression who were divided into two groups. In addition to routine care provided by the health-care center (relaxation techniques), the elderly in the intervention group were given a home-based physical activity booklet. The control group only received the routine care of the health-care center. Moreover, before and after the intervention, the results of the QOL questionnaire, petersburg sleep quality questionnaire index (PSQI), and depression questionnaire were assessed and recorded.

Results:

The depression scores in the 1st and 3rd months during the intervention and 1 month after the intervention were significantly lower in the intervention group with the means of 3.60 ± 3.91, 2.03 ± 2.43, and 2.66 ± 3.37 as compared with the control group with the means of 5.39 ± 2.88, 4.96 ± 2.77, and 5.13 ± 3.14, respectively (P < 0.05). Furthermore, the QOL and total PSQI scores in the physical and mental dimensions in the 3rd months during and 1 month after the intervention were higher in the intervention group as compared with the control group (P < 0.05).

Conclusion:

According to the findings of the study, the addition of home-based physical activity schedule to the routine care of the elderly can play a significant role in reducing the severity of their depression and improving their physical–psychological quality and sleep quality.
Predictive Value of Blood Markers in Nonfunctional Pituitary Adenomas Using Artificial Neural Network
Authors: Sayyadi Shahram , Kashani Hamid Reza Khayat , Jafari Rozita , Azhari Shirzad , Salimi Sohrab , Komlakh Khalil , Alesaadi Morteza , Alizade Pooyan , Solomon Habtemariam , Khayatkashani Maryam
Published: October 2023

Background:

Nonfunctioning pituitary adenomas (NFPAs) are the most common pituitary tumors and although they do not secrete hormones, they can have systemic effects. These tumors affect the function of other organs in the body by exerting pressure on the pituitary gland. There are differences between biomarkers NFPAs compared to healthy people. This study was conducted to show blood marker changes in adenomas compared to healthy people.

Materials and Methods:

This article compared the blood markers of NFPAs with healthy individuals retrospectively. The difference between blood markers in the two groups was statistically investigated where the predictive value of blood markers in the differentiation of the two groups was determined. An artificial neural network was also designed using the blood markers with its accuracy and predictive value determined.

Results:

A total of 96 NFPAs (nonfunctional pituitary adenoma) and 96 healthy individuals were evaluated. There was statistically a significant difference and positive correlation in platelet to lymphocyte ratio, neutrophil to lymphocyte ratio, and derived neutrophil to lymphocyte ratio between NFPAs and healthy individuals. There was a significant and negative correlation between red blood cell (RBC), lymphocyte, and monocyte between the two groups. RBC as an independent factor was associated with NFPAs. In this study, the artificial neural network was able to differentiate between NFPTs cases and healthy individuals with an accuracy of 81.2%.

Conclusion:

There are differences between blood markers in NFPAs relative to healthy people and the artificial neural network can accurately differentiate between them.
Evaluating the Clinicopathologic Parameters of Tongue Squamous Cell Carcinoma Based on Its Local Distribution
Authors: Khalesi Saeedeh , Abbasi Arash , Razavi Sayed Mohammad
Published: October 2023

Background:

Oral squamous cell carcinoma (OSCC) is one of the most common oral lesions and the tongue is one of the most common areas involved. The aim of this study was to evaluate the clinicopathologic feature of tongue SCCs based on its local distribution.

Materials and Methods:

In this cross-sectional study, clinical data such as age, gender, location, and clinical appearance were extracted from the archives of the Oral Pathology Department, Isfahan Dental School, registered with a definitive diagnosis of tongue SCC during 2005-2019. Then, 34 specimens were selected for histopathological evaluation in a simple random way. The histopathologic slides were examined to determine the grade of tumor malignancy. The data were entered into SPSS23 software and analyzed by Chi-square, Fisher exact, One-way ANOVA, and Non-parametric tests. P value <0.05 was considered significant.

Results:

Of the 275 OSCCs, 68 samples were tongue SCC. The mean age of patients was 61.7 ± 15 and 61.8% were women. The most common clinical manifestations were exophytic lesions (42.6%) and the most common site was the lateral border of the tongue (36.8%). The results did not show a significant relationship between the clinicopathologic feature including mean age (p = 0.766), gender (p = 0.338), clinical presentation (p = 0.434), grade of malignancy (p = 0.763) and location. But, among the histopathological parameters, the pattern of invasion (p = 0.047) was significantly associated with the local distribution.

Conclusion:

Given that most OSCCs had moderate differentiation of malignancy, identification of clinical features is needed. Attention to the pattern of invasion and location on the tongue can be effective in determining the therapeutic approach.
The Effect of Vitamin D Supplement on the Relapsing Incidence of Rhinosinusitis with Nasal Polyposis after Fuctional Endoscpoic Sinus Surgery
Authors: Ghazavi Hossein , Hashemi Sayed Mostafa , Jafari Samaneh
Published: October 2023

Background:

Nasal polyp (NP) is the most common benign tumor that can cause nasal obstruction and more annoying problems in patients. Recently, investigators have been focusing on complementary therapies alone or in conjunction with endoscopic nasal and sinus surgery. However, given the association of Vitamin D (VD) deficiency and chronic rhinosinusitis with nasal polyposis (CRSwNP) in previous studies, it may be possible to prevent the recurrence of NP and the development of rhinosinusitis by controlling serum levels of VD and maintaining it at a normal level. The current study aimed to investigate the efficacy of VD supplementation in preventing CRSwNP recurrence after endoscopic surgery.

Materials and Methods:

This clinical trial composed of vitamin D deficient patients with CRSwNP who were candidates for endoscopic sinus surgery in two groups of cases and controls. After endoscopic sinus surgery for all patients, we administered VD supplementation (50,000 IU) once a week for 8 weeks for cases and no further intervention for controls. The severity of symptoms was assessed using Sino-nasal outcome test (SNOT-22) and NP recurrence and recorded pre- and postintervention.

Results:

The findings indicated a higher mean change of SNOT-22 in the case group compared to that of the control group (36.03 ± 10.71 vs. 29.90 ± 11.99; P = 0.041). Moreover, the percentage of NP recurrence in cases was lower than controls; so that receiving VD supplementation has significantly reduced the chance of NP recurrence (odd ratio [95% confidence interval]: 0.298 [0.099–0.900]; P = 0.032).

Conclusion:

According to the result of the study, the administration of VD supplementation after endoscopic sinus surgery can reduce the severity of CRSwNP symptoms and NP recurrence significantly.
The Effect of Ipratropium Bromide with Violet Flower Extract, Ipratropium Bromide with Budesonide, and Ipratropium Bromide Alone on the Cuff-Leak of the Endotracheal Tube in Intubated ICU Patients
Authors: Hashemi Seyed Taghi , Alikiaii Babak , Mohkamkar Niloofar
Published: October 2023

Background:

The aim of the present study was to evaluate the effect of ipratropium bromide with violet flower extract, ipratropium bromide with budesonide, and ipratropium bromide alone on the cuff-leak of the endotracheal tube and changes in hemodynamic parameters in intubated patients admitted to the intensive care unit.

Materials and Methods:

The present randomized clinical trial study was performed on 195 intubated patients in three groups of 65 patients. The first group received nebulized ipratropium bromide with budesonide (I + B group), the second group in addition to ipratropium bromide, received one tablespoon of the violet flower extract syrup every 8 hours (I + V group), and the third group received nebulized ipratropium bromide alone (I group). Hemodynamic parameters and the cuff-leak ratio (CLR) of patients were evaluated up to 72 hours after intubation.

Results:

The results of the present study revealed that 12 hours after intubation, the mean of CLR was significantly lower in group I (with a mean of 0.14 ± 0.02) as compared with that of the I + V and I + B groups (with the means of 0.16 ± 0.05 and 0.23 ± 0.05, respectively) (P < 0.001). In addition, 24 hours after intubation, the mean of CLR in group I + V was higher than that of I + B and I groups (P < 0.05).

Conclusion:

According to the results of this study, the use of violet extract syrup in patients under intubation can significantly improve patients' ratio of cuff-leak and SpO2. It seems that the use of violet extract syrup is effective to prevent unwanted complications during intubation and to facilitate patients' breathing.
Report of a Case with Intraventricular Cardiac Hydatid Cyst with Coronary Artery Disease and Multiple Hepatic Hydatid Cysts
Authors: Mirmohammadsadeghi Mohsen , Hosseini Alireza
Published: October 2023

Despite the prevalence of hydatid cyst in humans, its occurrence in the heart is rare. The clinical signs of the mentioned cyst in the heart are diverse, which makes its diagnosis challenging. In addition, the cardiac hydatidosis is diagnosed late as this disease progresses gradually. In this report, the cases discussed of a case with intraventricular cardiac hydatid cyst with coronary artery disease and multiple hepatic hydatid cysts. After diagnosis, the patient underwent coronary artery bypass graft surgery, and the cyst was successfully removed. Considering the probability of heart involvement in endemic regions, devoting due attention to the disease as well as performing faster diagnosis of the disease can play a significant role in reducing its complications.
Latent Class Analysis of knowledge, Attitude, and Practice of a Population-Based Sample of Iranian Pregnant Women toward COVID-19
Authors: Yazdi Maryam , Bemanalizadeh Maryam , Mohebpour Fatemeh , Goli Parvin , Daniali Seyede Shahrbanoo , Kelishadi Roya
Published: October 2023

Background:

The aim of the study is to identify latent class (LC)-derived patterns of women’s knowledge, attitude, and practice (KAP) toward coronavirus disease 2019 (COVID-19) in Iran.

Materials and Methods:

This cross-sectional survey of 2029 women, who participated in the PERSIAN Birth Cohort, was conducted in Isfahan, Iran. KAP was assessed by shortened and validated form of a recently used questionnaire in Iran. LC analysis was used to discover underlying response patterns of KAP toward COVID-19 using Mplus 8.0 software.

Results:

Three classes were identified: Class 1 (n = 514, 25.33%) “Low knowledge and poor practice, Class 2 (n = 423, 22.08%) “Moderate knowledge and proper practice,” and Class 3 (n = 1092, 53.82%) “Low knowledge and proper practice.” The lowest rate of positive attitude was seen in Class 3. Women living in rural areas, as well as those with lower education, were more likely to member classes with improper practice.

Conclusion:

The findings suggest that the LCA approach can provide important information reflecting different levels of adoption of protection toward COVID-19 infection. The results may be useful to conducting health-care programs during the outbreaks.
A Comparative Study of the Effect of Intravenous Morphine and Ketorolac on Pain Control in Patients with Renal Colic
Authors: Pourafzali Seyed Mehdi , Sanei Abdolrahim , Abdolrazaghnejad Ali , Poursadra Elahe
Published: October 2023

Background:

The present study aimed at comparing the effect of ketorolac and morphine on the pain control in patients with renal colic.

Materials and Methods:

The present clinical trial was performed on 272 patients with renal colic that were divided into two groups. Patients in the first and second groups intravenously received morphine at a dose of 1.0 mg/kg and ketorolac at a dose of 30 mg, respectively. Then, systolic blood pressure, diastolic blood pressure, heart rate, respiration rate (RR), and oxygen saturation percentage (SpO2) as well as patients' pain scores before and 5, 15, 30, 60, and 90 min after the intervention were recorded and evaluated.

Results:

The results of this study revealed that the mean pain scores of patients before and after the intervention were not significantly different between the two groups (P > 0.05). However, patients' pain significantly relieved over time in both groups (reduce: Morphine group = 9.4 and ketorolac group = 9.09; P < 0.001). In addition, nausea, dizziness, and a decreased SpO2 in the morphine group were 5.1%, 2.9%, and 1.5%, respectively, and in the ketorolac group only dizziness was 2.2% (P > 0.05).

Conclusion:

According to the results of this study, the efficacy of ketorolac in reducing patients' pain was not significantly different from that of morphine. Therefore, considering that the occurrence of complications in the ketorolac group was lower than that of the morphine group, it can be stated that ketorolac is a safer and more reliable drug than morphine in relieving pain in patients with renal colic.
Ultra-Widefield Fundus Fluorescein Angiography Findings in Patients with Fuchs’ Uveitis Syndrome
Authors: Nasrollahi Kobra , Fazel Farhad , Mirjani Taha , Kianersi Farzan , Fazel Mohammadreza , Pourazizi Mohsen
Published: October 2023

Background:

The aim of this study was to evaluate ultra-widefield (UWF) fundus fluorescein angiography (FFA) findings in patients with Fuchs’ uveitis syndrome (FUS).

Materials and Methods:

This cross-sectional study was conducted in patients with FUS. All the patients underwent a complete ophthalmologic examination, and FFA was carried out with Optos UWF retinal imaging. Standard FFA and image acquisition consisted of early phase (15–45 s) images, and late-phase (5–10 min) images were also obtained for both eyes.

Results:

Forty eyes from twenty unilateral FUS patients, including 11 females (55%), who had a mean age of 38.50 ± 6.97 years, were enrolled. Eighty-five percent of the FUS eyes had optic disc hyperfluorescence (ODH) in the FFA. A significant relationship was observed between ODH and iris heterochromia (P= 0.004). ODH was seen in all the patients with iris heterochromia (n= 16). Peripheral vascular leakage (PVL), capillary nonperfusion, chorioretinal scar, and vascular sheathing were observed in 3, 3, 2, and 8 of the patients’ eyes, respectively.

Conclusion:

UWF FFA imaging seemed to be mandatory for evaluating the prognosis of the FUS patients, and another investigation may require to be conducted to evaluate the effect of antivascular endothelial growth factor agents for the management of PVL in these patients.
CT Characteristics of Coronavirus Disease 2019 Pneumonia and Its Association with C-Reactive Protein, Erythrocyte Sedimentation Rate and Gender
Authors: Eftekhari Moghadam Ali Reza , Fazelinejad Zahra , Nashibi Roohangiz , Pour Mohsen Bouri
Published: October 2023

Background:

This research intended to investigate the characteristics of COVID-19, accurately evaluate radiological findings, and compare it with laboratory evidence of coronavirus.

Materials and Methods:

A retrospective study of 120 consecutive cases with a mean age of 55.9 ± 15.82 years and laboratory-confirmed COVID-19 pneumonia was performed. On admission, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels were tested. Computed tomography (CT) findings and scored pulmonary involvement were evaluated.

Results:

An elevated level of CRP and mildly raised ESR was seen in all patients. ESR showed a meaningful difference between both genders (P < 0.05). Ninety-four (78.3%) patients showed peripheral pulmonary lesions and 119 patients had ground-glass opacity (99.2%), 110 (92.4%) had consolidation, and 9 patients (7.5%) had linear opacities. Of 120 cases, 25 (20%) had bronchial changes, 25 (20%) had air bronchogram, 11 (9.2%) had bronchial distortion, and 2 had mediastinal lymphadenopathy. The CT scores in males and females were 17.41 ± 4.86 and 14.65 ± 4.96, respectively with a significant difference between both genders (P = 0.001). CT score difference was significant between both genders (P = 0.01). The largest lung lesion diameter in both sexes (male: 46.0725.75 and female: 57.9131.14) showed a meaningful difference. CRP (r = 0.10; P < 0.05) and ESR (r = 0.15; P < 0.05) were correlated with the CT scores.

Conclusion:

the results indicated that the infection involved lung parenchyma and interstitium. CRP and ESR levels were correlated with lung lesions and showed positive performance in predicting severity and disease monitoring.
Does COVID-19 Escalate Aging Process? A Possible Concern
Authors: Tayeri Katayoun , Asadollahi Kiarash , Madani Navid , Haghjooy Javanmard Shaghayegh
Published: October 2023

A key challenge after the COVID-19 pandemic will be managing the long-term sequelae for the millions of individuals who recover from the disease. Based on the available evidence, our hypothesis is that the SARS-CoV-2 pandemic and its long-term complications will lead to premature aging (in terms of health) of many people in the world. Obviously, to maintain appropriate public health and prevent poor health-care services, countries should think and plan about the health problems and the long-term consequences of SARS-CoV-2 after controlling the COVID-19 pandemic.
Characteristics of Hospitalized COVID-19 Patients in a Major Referral Center in Shiraz, Iran
Authors: Dowran Razieh , Edalat Fahime , Fardi Majid , Hashemi Seyed Mohammad Ali , Moattari Afagh
Published: October 2023

Background:

Several countries, including Iran, have been affected by the novel Coronavirus Disease 2019 (COVID-19) pandemic since December 2019. The aim of this study was to provide a comprehensive report on COVID-19 patients in Shiraz, Southern Iran.

Materials and Methods:

This study was performed on 311 hospitalized patients with COVID-19. The data on demographic, clinical, and paraclinical features were analyzed.

Results:

The median age of the patients was 58 years, with 42.1% of the patients being above 60 years of age. Upon admission, fever was detected in 28.2% of critically ill patients. At least one underlying disease or risk factor was also present in 75.6% of the patients. Shortness of breath was the most common clinical symptom (66.2%), dry cough (53.7%), and muscle pain (40.5%) was the second and third. Sneezing (0.3%), rhinorrhea (0.7%), and sore throat (3.09%) were observed only in non-critically ill patients. In addition, 26.9% of all patients had lymphocytopenia, 25.8% had raised C-reactive protein, and 79.9% had abnormal creatinine levels. Finally, death occurred in 39 patients (12.5%).

Conclusions:

Noncritically ill patients were younger than critically ill patients. The most common risk factors for getting critically ill were surgery, hypertension, diabetes mellitus, chronic heart disease, asthma, and chronic renal disease.
Identification of Cancer/Testis Antigens Related to Gastric Cancer Prognosis Based on Co-Expression Network and Integrated Transcriptome Analyses
Authors: Ansari Sara , Nikpour Parvaneh
Published: October 2023

Background:

Gastric cancer is a worldwide life-threatening cancer. The underlying cause of it is still unknown. We have noticed that some cancer/testis antigens (CTAs) are up-regulated in gastric cancer. The role of these genes in gastric cancer development is not fully understood. The main aim of the current study was to comprehensively investigate CTAs' expression and function in stomach adenocarcinoma (STAD).

Materials and Methods:

A comprehensive list of CTA genes was compiled from different databases. Transcriptome profiles of STAD were downloaded from the cancer genome atlas (TCGA) database and analyzed. Differentially-expressed CTAs were identified. Pathway enrichment analysis, weighted gene correlation network analysis (WGCNA), and overall survival (OS) analysis were performed on differentially-expressed CTA genes.

Results:

Pathway enrichment analysis indicates that CTA genes are involved in protein binding, ribonucleic acid processing, and reproductive tissues. WGCNA showed that six differentially-expressed CTA genes, namely Melanoma antigen gene (MAGE) family member A3, A6, A12 and chondrosarcoma associated gene (CSAG) 1, 2, and 3, were correlated. Up-regulation of MAGEA11, MAGEC3, Per ARNT SIM domain containing 1 (PASD1), placenta-specific protein 1 (PLAC1) and sperm protein associated with the nucleus X-linked family member (SPANXB1) were significantly associated with lower OS of patients.

Conclusion:

MAGEA11, MAGEC3, PASD1, PLAC1, and SPANXB1 can be investigated as prognostic biomarkers in basic and clinical studies. Further functional experiments are needed to understand the exact interaction mechanisms of these genes.
Genotypic Patterns of Multidrug-Resistant Acinetobacter Baumannii: A Systematic Review
Authors: Rahimzadeh Golnar , Rezai Mohammad S. , Farshidi Fereshteh
Published: October 2023

Acinetobacter baumannii (A. baumannii) is one of the most common bacteria in nosocomial infections. Inappropriate usage of antibiotics has led to expanding emergence resistance to A. baumannii as a multidrug-resistant (MDR) strain. Empirical antibiotic therapy is necessary to evaluate the resistant gene pattern of MDR A. baumannii. For this purpose, the present study evaluated the resistance genes pattern of MDR A. baumannii collected from hospitalized patients using a genotypic diagnostic technique. To find evidence related to the study objectives, databases were searched such as Google Scholar, Web of Science, Science Direct, PubMed, and Scopus from 2000 to 2022, with specified keywords in the title and text of the articles. Articles were included based on inclusion and exclusion criteria. The mentioned database displayed 284 articles. After screening, 65 eligible articles were included. The results showed that various b-lactamases genes, aminoglycoside-modifying enzymes (AMEs) genes, and pump-expressing genes are resistance gene patterns in MDR A. baumannii isolates. MDR A. baumannii has significantly become resistant to b-lactams, carbapenems, and aminoglycosides.
Mycobacterium Indicus Pranii (MIP) Vaccine: Pharmacology, Indication, Dosing Schedules, Administration, and Side Effects in Clinical Practice
Authors: Dogra Sunil , Jain Sejal , Sharma Ayush , Chhabra Seema , Narang Tarun
Published: October 2023

Mycobacterium indicus pranii (MIP), previously called Mw vaccine, is a one-of-a-kind immunomodulatory vaccine. It was indigenously developed in India for use in leprosy. MIP is heat-killed Mycobacterium w, which is a non-pathogenic atypical mycobacterium belonging to Class IV of Runyon classification. It shares epitopes with Mycobacterium leprae and Mycobacterium tuberculosis, which forms the rationale behind its use in leprosy and tuberculosis. MIP activates both innate and acquired immunity. It induces a Th1 and Th17 immune response along with downregulation of Th2 pathway and activates macrophages and dendritic cells. MIP vaccine is safe with adverse effects such as local site erythema, swelling, and rarely fever and other systemic reactions. Apart from leprosy, MIP has been used in dermatological diseases such as warts and psoriasis. Clinical trials have evaluated the efficacy of MIP in a plenitude of non-dermatological conditions such as category II tuberculosis, Gram-negative sepsis, non-small cell lung cancer, human immunodeficiency virus (HIV), muscle-invasive bladder cancer, and very recently, coronavirus 2019 (COVID-19). In vitro and animal studies have also demonstrated its utility in leishmaniasis, melanoma, and as a vaccine for the prevention of pregnancy. The PubMed database was searched using “Mycobacterium indicus pranii, MIP, Mycobacterium w” as the keyword in title. This comprehensive review provides useful information for healthcare professionals about immunotherapeutic potential of MIP vaccine, its composition, dosing schedule, administration, and side effects besides its efficacy in various indications other than leprosy.
Childhood Leprosy in Postelimination Era: A Clinico-Epidemiological Prospective Observational Study from India
Authors: Joy Nirma , Patnaik Sayadarshi , Nayak Surajit , Rout Arpita N.
Published: October 2023

Background:

Although India has achieved national level elimination of leprosy in December 2005, it reports highest number of leprosy cases in the world. Incidence of leprosy amongst young children indicates active foci of transmission in the community, making it a robust epidemiological indicator to assess the progress of leprosy control programs.

Aim and Objectives:

To study prevalence, clinical spectrum, patterns of extracutaneous involvement, reactions, relapse, demographic profile, anthropometric characteristics of children with leprosy.

Materials and Methods:

A prospective observational study of children younger than 14 years old with clinical signs and symptoms of leprosy, including cases diagnosed from October 2018 through September 2020 at a tertiary hospital in Eastern India.

Results:

Childhood leprosy constituted of 10.4% of total new leprosy cases. Mean age observed was 11.14 ± 1.5 years. 30.4% were females and 69.6% were males. The mean average duration was 9.95 ± 12.3 months. 82.1% of children belong to below poverty line (BPL) status. 19.6% of children had malnourishment/stunting/thinness, and 55.4% had anemia. 84.1% presented with skin discoloration. The most common site affected was upper limb (57.1%). 29.2% had contact history. A single case of relapse (1.7%) was reported. Most common peripheral nerve involved was ulnar nerve (67.8%). 8.9% of children had type 1 lepra reaction, and 1.7% had type 2 lepra reaction. 73.21% presented with borderline tuberculoid clinical type of leprosy. 19.6% showed slit skin smear positivity.

Conclusion:

Pockets of high endemicity of childhood leprosy as detected in the current study point toward the unmet need of better healthcare facilities along with increased awareness, campaigns, and school surveys for early diagnosis and treatment for the prevention of complications and spread in community.
Subcorneal Pustular Dermatosis Occuring in Association with Pyoderma Gangrenosum and Rheumatoid Arthritis: A Triple Whammy!
Authors: Khurana Ananta , Sachdeva Soumya , Paliwal Purnima , Gogate Siddharth
Published: October 2023

Neutrophilic dermatoses are a wide group of disorders encompassing indolent to severely disabling conditions. A co-existence of two such conditions, pyoderma gangrenosum (PG) and subcorneal pustular dermatosis, necessitates a thorough investigation for IgA dysglobulinemia. We report a middle-aged woman who developed PG following 18 years of (undiagnosed) subcorneal pustular dermatosis, along with rheumatoid arthritis, a known association of PG.
Spontaneous bile duct perforation causing biliary peritonitis in chronic pancreatitis
Authors: Kumar Mukesh , Prasad Sanjit , Roy Vivek Kumar , Mahesh Lavudya , Gopal Krishna
Published: October 2023

Spontaneous perforation of the extrahepatic biliary system is a rare presentation of chronic pancreatitis. Very few cases of bile duct perforation have been reported in adults. It is rarely correctly diagnosed preoperatively in an emergency. A 25-year-old male presented at the surgical emergency with a long history of abdominal pain and repeated episodes of vomiting, after 4 days of duration, he came with pain abdomen, and distension with evidence of generalized peritonitis. The diagnosis made was perforative peritonitis for which he underwent an exploratory laparotomy with cholecystectomy. A single perforation was presented on the anterolateral surface of the supraduodenal part of the common bile duct (CBD) which was repaired with the help of T-tube. On the 10th post-operative day, T-tube cholangiogram shows two radio-opaque dense shadows in the main pancreatic duct which shows chronic pancreatitis and lower CBD stricture. Spontaneous perforation of the extrahepatic bile duct is a rare but important presentation of chronic pancreatitis in adults causing biliary peritonitis. Therefore, awareness of the clinical presentation, expert ultrasound examination, and surgery are important aspects of the management.
A threat to patient safety due to drug labelling error in the postanaesthesia care unit during the COVID-19 pandemic
Authors: Ahmad Sarfaraz , Kumar Neeraj , Lenin Dharani , Kumar Amarjeet
Published: October 2023

A postanaesthesia care unit (PACU) is vital to hospital surgical suites and ambulatory care centres. The COVID-19 pandemic has led to a shortage of trained staff in PACU which lead to opioid drug labelling errors. We report a case of a patient who underwent a loop colostomy for carcinoma rectum under general anaesthesia and then was shifted to PACU for the management of postoperative pain. She received an inadvertently increased dose of injection fentanyl intravenously due to a hand-written labelling error by a junior nurse. But the patient was managed successfully following basic life support protocol.
Pulmonary nodular ossification: A rare and incidental autopsy finding
Authors: Saraf Pallavi , Bharti Jyotsna Naresh
Published: October 2023

Pulmonary ossification is also known as metaplastic bone formation. It is a rare and incidental post-mortem finding. Dendriform and nodular pulmonary ossification are the two forms which are recognized, and they are usually associated with systemic or primary lung pathology. Its awareness is necessary to correctly diagnose and differentiate them from other lung pathologies. Histopathology aids in the accurate diagnosis of this dormant entity. Herein, we present an autopsy case of a 37-year-old male with pulmonary ossification discovered incidentally during an autopsy.
Extravasation of Non-Cytotoxic Drugs in Older People
Authors: Montague T’yanna , Weaver Salome Bwayo , Wingate La’Marcus T.
Published: October 2023

Objective To describe the risk factors of extravasation, its impact on the pharmacokinetics of non-cytotoxic drugs, and management of extravasation in older individuals. Extravasation occurs when vesicants leak from blood vessels into surrounding tissue causing severe injury
such as tissue necrosis while infiltration is caused by leakage of an irritant that causes injury but does not lead to tissue necrosis. Extravasation occurs in approximately 0.01% to 6% of patients, particularly with cytotoxic agents. However, there is limited documentation about extravasation
of non-cytotoxic agents, particularly in older people. Data Sources A literature search of Pubmed and Medline was performed using the following search items: “extravasation,” “infiltration,” “elderly,” and “non-cytotoxic drugs,”
as well as a combination of these terms. Conclusion It is important to recognize, identify, and manage extravasation early since it can have deleterious consequences for older people. It is more important to prevent extravasation than manage it using standardized evidence-based
protocols, and this can be implemented in the nursing facility and acute care setting.
The Frobenius semiradical, generic stabilizers, and Poisson center for nilradicals
Authors: Panyushev Dmitri I.
Published: October 2023

Let
${\mathfrak g}$
be a complex simple Lie algebra and
${\mathfrak n}$
the nilradical of a parabolic subalgebra of
${\mathfrak g}$
. We consider some properties of the coadjoint representation of
${\mathfrak n}$
and related algebras of invariants. This includes (i) the problem of existence of generic stabilizers, (ii) a description of the Frobenius semiradical of
${\mathfrak n}$
and the Poisson center of the symmetric algebra , (iii) the structure of as -module, and (iv) the description of square integrable (= quasi-reductive) nilradicals. Our main technical tools are the Kostant cascade in the set of positive roots of
${\mathfrak g}$
and the notion of optimization of
${\mathfrak n}$
.