Traumatic Central Retinal Vein Occlusion: A Case Report

Here we report a healthy 48-year-old man who experienced severe loss of vision in the left eye due to central retinal vein occlusion (CRVO) after head trauma. The patient was visited by us three days after the trauma. All systemic workups were normal. Anterior segment examination showed subconjunctival hemorrhage in the left eye. Anterior chamber was deep and clear and intraocular pressure was normal. Relative Afferent Pupillary Defect (RAPD) was negative. A dilated fundoscopic examination of the left eye revealed a moderately congested optic nerve with dilated and tortuous retinal veins scattered throughout the fundus with dot, blot, and flame-shaped hemorrhages. A few yellowish white cotton-wool spots were also seen. A fluorescein angiogram in the left eye confirmed a nonischemic CRVO.Although isolated CRVO following trauma is a rare condition, ophthalmologists should be aware of the potential for blunt head trauma causing CRVO

Focal Choroidal Excavation in a Case of Choroidal Osteoma Associated with Choroidal Neovascularization

Purpose: To report a case of choroidal osteoma associated with reactivation of choroidal neovascularization (CNV) and development of focal choroidal excavation (FCE). Case Report: A 34-year-old woman with choroidal osteoma complicated by CNV in the right eye for two years presented with deterioration of visual acuity in her right eye. A small retinal hemorrhage accompanied by subretinal fluid (SRF) was seen in the macular area of the right eye. Optical coherence tomography (OCT) showed that the inner retina was intact, and the outer retinal layers had outward displacement. SRF and a wedge-shaped choroidal depression were also seen. This choroidal excavation was not present on previous OCT images. The integrity of the inner retinal layers was maintained, and an optically clear space was present between the neurosensory retina and the retinal pigment epithelium. Conclusion: Choroidal osteoma can be complicated by CNV and FCE could occur as a consequence. Again, FCE can lead to CNV development. This cascade can deteriorate vision and sometime lead to permanent visual loss

Serum IL-23, IL-10, and TNF-α predict in-hospital mortality in COVID-19 patients

ObjectiveThe hyperinflammatory response, caused by severe acute respiratory syndrome-2 (SARS-CoV-2), is the most common cause of death in patients with coronavirus disease 2019 (COVID-19). The etiopathogenesis of this illness is not fully understood. Macrophages appear to play a key part in COVID-19’s pathogenic effects. Therefore, this study aims to examine serum inflammatory cytokines associated with the activation state of macrophages in COVID-19 patients and attempt to find accurate predictive markers for disease severity and mortality risk in hospital.Methods180 patients with COVID-19 and 90 healthy controls (HCs) participated in this study. Patients were divided into three different subgroups, mild (n=81), severe (n=60), and critical groups (n=39). Serum samples were collected and IL (Interleukin)-10, IL-23, tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ), IL-17, monocyte chemoattractant protein-1 (MCP-1) and chemokine ligand 3 (CCL3) were determined by ELISA. In parallel, myeloperoxidase (MPO) and C-reactive protein (CRP) were measured using colorimetric and electrochemiluminescence methods, respectively. Data were collected, and their associations with disease progression and mortality were assessed using regression models and receiver operating characteristic (ROC) curves.ResultsCompared to HCs, a significant increase in IL-23, IL-10, TNF-α, IFN-γ and MCP-1, were observed in COVID-19 patients. Serum levels of IL-23, IL-10, and TNF-α were significantly higher in COVID-19 patients with critical cases compared to mild and severe cases, and correlated positively with CRP level. However, non-significant changes were found in serum MPO and CCL3 among the studied groups. Moreover, significant positive association has been observed among increased IL-10, IL-23 and TNF-α in serum of COVID-19 patients. Furthermore, a binary logistic regression model was applied to predict death’s independent factors. Results showed that IL-10 alone or in combination with IL23 and TNF-α are strongly linked with non-survivors in COVID-19 patients. Finally, ROC curve results uncovered that IL-10, IL-23 and TNF-α were excellent predictors for prognosing COVID-19.ConclusionThe elevations of IL-10, IL-23, and TNF-α levels were seen in severe and critical cases of COVID-19 patients and their elevations were linked to the in-hospital mortality of the disease. A prediction model shows that the determination of these cytokines upon admission is important and should be done on COVID-19 patients as a way of evaluating the prognosis of the disease. COVID-19 Patients with high IL-10, IL-23, and TNF-α on admission are more likely to experience a severe form of the disease; therefore, those patients should be cautionary monitored and treated

Influenza vaccination coverage and obstacles in healthcare workers (HCWs) and the follow up of side effects: A multicenter investigation in Iran

Introduction. Influenza is a highly contagious acute respiratory illness. Due to the high exposure of hospital personnel, widespread vaccination of these high-risk groups seems to be a necessity in healthcare centers. To determine vaccination coverage in the personnel of four tertiary referral collegiate hospitals in 2019, and to further investigate individual obstacles for Influenza vaccination. Methods. In this cross-sectional descriptive study, 637 personnel were selected randomly from distinctive hospitals in a list-wised. Ones vaccinated filled the side effects questionnaire and who not vaccinated filled the vaccination obstacles questionnaire. Results. The mean vaccination coverage was 29.4% and the coverage difference among centers was not statistically significant (p=0.192). The following items had the most impact on personnel decision: confidence about one’s immune system (p<0.05), the experience of side effects from previous vaccinations (p=0.011), attitude about vaccination in colleagues (p=0.021) and work experience (p<0.05). About 23% of vaccinated individuals reported side effects following vaccination and the most common side effect was mild cold symptoms with 12.3% prevalence. Conclusion. The results of the current study revealed that influenza vaccination coverage among HCWs is not satisfactory in Iran. Hospital authorities and infection control units should plan to remove the obstacles of influenza vaccination

Correction to: Health risk assessment on human exposed to heavy metals in the ambient air PM10 in Ahvaz, southwest Iran

Heavy metals (HM) are one of the main components of urban air pollution. Today, megacities and industrial regions in southwest of Iran are frequently suffering from severe haze episodes, which essentially caused by PM10-bound heavy metals. The purpose of this study was to evaluate the health risk assessment on human exposed to heavy metals and Zn) in the ambient air PM10 in Ahvaz, southwest Iran. In this study, we estimated healthy people from the following scenarios: (S3) residential site; (S2) high-traffic site; (S1) industrial site in Ahvaz metropolitan during autumn and winter. In the current study, high-volume air samplers equipped with quartz fiber filters were used to sampling and measurements of heavy metal concentration. Inductively coupled plasma optical emission spectroscopy (ICP-OES) was utilized for detection of heavy metal concentration (ng m−3 ). Also, an estimate of the amount of health risk assessment (hazard index) of Cr, Ni, Pb, and Zn of heavy metal exposure to participants was used. Result of this study showed that the residential and industrial areas had the lowest and the highest level of heavy metal. Based on the result of this study, average levels of heavy metal in industrial, high-traffic, and residential areas in autumn and winter were 31.48, 30.89, and 23.21 μg m−3 and 42.60, 37.70, and 40.07 μg m−3 , respectively. Based on the result of this study, the highest and the lowest concentration of heavy metal had in the industrial and residential areas. Zn and Pb were the most abundant elements among the studied PM10-bound heavy metals, followed by Cr and Ni. The carcinogenic risks of Cr, Pb, and the integral HQ of metals in PM10 for children and adults via inhalation and dermal exposures exceeded 1 × 10−4 in three areas. Also, based on the result of this study, the values of hazard index (HI) of HM exposure in different areas were significantly higher than standard. The health risks attributed to HM should be further investigated from the perspective of the public health in metropolitans. The result of this study showed increasing exposure concentrations to heavy metal in the studied scenarios have a significant potential for generating different health endpoints, while environmental health management in ambient air can cause disorders in citizenship and causing more spiritual and material costs

Mortality and disability-adjusted life years in North Africa and Middle East attributed to kidney dysfunction : a systematic analysis for the Global Burden of Disease Study 2019

The authors would like to thank the hard work of the staff of the Institute for Health Metrics and Evaluation (IHME) for providing the best possible epidemiologic estimation of diseases in almost all regions and countries of the world, trying to reduce and eliminate poverty of knowledge and information about the diseases globally. Also, the core team authors sincerely thank all the collaborators of the GBD 2019 study who contributed to this study by providing data or a precise review of the manuscript. Publisher Copyright: © The Author(s) 2023. Published by Oxford University Press on behalf of the ERA. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.Peer reviewe

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed