Pneumomediastinum, pneumopericardium pneumothorax and subcutaneous emphysema in Iranian COVID-19 patients

Recently, spontaneous pneumomediastinum (PM), pneumopericardium (PP), pneumothorax (PT), and subcutaneous emphysema (SE) were reported as infrequent complications in coronavirus disease 2019 (COVID-19) patients in intensive care (ICU). Here we report these complications in nine Iranian patients of COVID-19. Nine patients with reported PM, PP, PT, and SE in COVID-19 who were hospitalized in Arya hospital, Rasht, Iran, for three months, were followed to record demographic data and clinical characteristics of these patients. In nine PM-developed patients, six cases represented PT, one patient with PP, and four patients with PT and SE. Four patents expired and only five patients survived. PM, PP, PT, and SE are uncommon complications in COVID-19 patients and were reported frequently in male patients. Early diagnosis and treatment could save the patients since these complications are related to poor prognosis and prolonged hospitalization. Patients with mild COVID-19 and mild pulmonary damage have a favorable outcome.

Frequency of using complementary herbal medicines among Helicobacter pylori-infected patients in the North of Iran

Helicobacter pylori is a prevalent infection and one of the most critical factors that result in gastric cancer. Besides antibiotic therapy, some plants are suitable as an alternative treatment against H. pylori infection due to their role in protecting the gastric mucosa. This study investigated the frequency of using complementary herbal medicines among H. pylori-infected patients in the North of Iran. This cross-sectional study was conducted on 390 patients with H. pylori infection undergoing treatment in Rasht, Iran, 2022. The demographic data, clinical characteristics, and consumption of complementary herbals were recorded. The mean age of the patients was 40 years, and 63.6% were female. The majority of the patients were educated. About 55.9% of patients consumed at least one herbal product, and the most consumed herbal product was mint extract. Most patients purchased herbal products from the grocery (93.1%); none referred to the pharmacy. About 89.2% of the patients recovered completely, and 10.8% had a disease recurrence. No particular complications were observed in most patients (97.7%). However, no significant association between the consumption of herbal products and patients' recovery was reported (P0.05). According to our results, consuming herbal products results in no specific improvement in patients with H. pylori infection

The Effect of Aromatherapy with Lavender on Pain of Needle Insertion and Severity of Restless Legs Syndrome in Hemodialysis Patients; a Systematic Review and Meta-analysis

Introduction: Pain experienced during the insertion of a catheter into the arteriovenous fistula (AVF) and restless legs syndrome (RLS) are prevalent issues among Hemodialysis (HD) patients. The primary objective of this systematic review and meta-analysis was to consolidate the findings from randomized clinical trial (RCT) studies examining the impact of aromatherapy with lavender on the pain associated with AVF catheter insertion and RLS in HD patients. Methods: A systematic search was conducted on PubMed, Web of Science, Scopus, Cochrane, Embase, ClinicalTrials.gov, and Google Scholar search engine from inception to August 1, 2022, using keywords extracted from Medical Subject Headings, such as “Aromatherapy”, “Lavender”, “Arteriovenous fistula”, “Pain”, “Restless legs syndrome”, and “Hemodialysis”. Results: Finally, eleven articles were included in this systematic review and meta-analysis. The results showed that aromatherapy reduced the average pain of catheter insertion in AVF compared to the control group (Standard Mean Difference: -1.60, 95% Confidence Interval: -2.32 to -0.87, Z=4.32, I2:90.3%, P<0.001). Also, aromatherapy massage reduced the average severity of RLS compared to the control group, which was statistically significant (Weighted Mean Difference: -13.21, 95% Confidence Interval: -17.50 to -8.91, Z=6.03, I2:93.0%, P<0.001). Also, the subgroup analysis showed that lavender in the intervention group significantly decreased the pain intensity compared to the "no intervention" group (P<0.001), yet it was not significant compared to the placebo group (P=0.12). Conclusion: In summary, the findings indicate a notable reduction in catheter insertion pain in AVF and relief from RLS among HD patients through the use of lavender essential oil. As a result, future research is encouraged to include a comparison of lavender's effects with those of a placebo group

Evaluation of the Relationship Between Primary Spontaneous Pneumothorax and Exercise and Return to Previous Activities in Patients Referring to Hospitals of Rasht during 2015-2017

BACKGROUND: The most common cause of primary spontaneous pneumothorax (PSP) is subpleural bleb apical rupture. Little is known about the relationship between PSP and exercise and return to exercise the time. In this study, we tend to investigate the relationship between training and PSP and time of return to exercise and previous activities.METHOD: This study was designed as a case series and the sample size included all patients diagnosed with PSP in Razi and Poursina and Aria hospitals of Rasht during 2015-2017 based on inclusion criteria. Variables were analyzed using Fisher's exact test, Chi-square, Mann Whitney U and t-test (p&lt;0.05).RESULTS: The most common treatment type in patients was transaxillary thoracotomy with pleurodesis with iodine (TTP) in 58.2% and tube thoracostomy and pleurodesis in 41.7%, which was not statistically significant between athletes and non-athletes (p=0.806). Athletes who underwent TTP after four weeks and those treated with tube thoracostomy and pleurodesis after 8-12 weeks were advised to return to their previous activity. Of athletes, 9.5% had a recurrence; of non-athletes, 9.8% had a recurrence. Of athletes, 4.8% did not tolerate returning to their last activity; of non-athletes, 7.3% did not tolerate returning to their previous activity regardless of treatment, and this difference was not significant.CONCLUSION: Our study showed no significant difference between clinical manifestations and image findings and the frequency of treatment and complications in both athlete and non-athlete patients. There is no increase in recurrence and intolerance at the time recommended for return to previous activity

The association between the volume of the gallbladder based on sonographic findings and demographical data in the PERSIAN Guilan cohort study (PGCS)

Abstract Background Ultrasound is an important method to determine the volume of the gallbladder and check its structure. Considering the variation in the size and volume of the gallbladder in disease and physiological conditions, determining the volume of the gallbladder is clinically valuable. This study was carried out to evaluate the gallbladder volume and its association with patients’ demographic data in the Prospective Epidemiological Research Studies of Iranian Adults (PERSIAN) Guilan cohort study (PGCS) population. Methods In this cross-sectional study, 957 individuals aged 35–70 participated in determining the gallbladder volume by a radiologist based on the ultrasound method. The demographical data were collected using a questionnaire. After fasting for 12 h, the ultrasound was performed with an Ultrasonic device (Sonix SP series) with a 3.5 to 5 MHz probe. Results The total frequency of gallbladder lesions was 2.2%. The results showed a significant association between marriage and gender with the presence or absence of lesions in the studied participants (P  0.05). Conclusion According to our results, gender, BMI, MET, and CVD were significantly associated with gallbladder volume

Family history of cancer as a potential risk factor for colorectal cancer in EMRO countries: a systematic review and meta-analysis

Abstract The current meta-analysis aims to investigate the existing articles that evaluated the implications of a positive family history of cancer on the risk of colorectal cancer (CRC) within the EMRO countries. We employed PubMed, Scopus, and Web of Science as search databases for this study. To assess the quality of the selected articles, we utilized the Newcastle–Ottawa (NCO) checklist. In comparing the impact of a family history of cancer between the case and control groups, we computed the odds ratio (OR) along with its corresponding 95% confidence interval (CI). Finally, 27 articles were selected for meta-analysis. The result of the meta-analysis showed a significant association between the presence of a family history of CRC or any cancers and CRC (OR 2.21; 95% CI 1.54–3.17; P < 0.001, OR 1.76; 95% CI 1.27–2.42; P = 0.001, respectively). Our findings underscore the critical importance of timely screening and early identification for individuals with a family history of cancer. By fostering close coordination among healthcare facilities and actively promoting the adoption of screening methods for early detection, we have the potential to significantly reduce both mortality rates and financial burdens of CRC on the general public, ultimately leading to enhanced patient outcomes

Epigenetic profiling of MUTYH, KLF6, WNT1 and KLF4 genes in carcinogenesis and tumorigenesis of colorectal cancer

Colorectal cancer (CRC) is distinguished by epigenetic elements like DNA methylation, histone modification, histone acetylation and RNA remodeling which is related with genomic instability and tumor initiation. Correspondingly, as a main epigenetic regulation, DNA methylation has an impressive ability in order to be used in CRC targeted therapy. Meaningly, DNA methylation is identified as one of most important epigenetic regulators in gene expression and is considered as a notable potential driver in tumorigenesis and carcinogenesis through gene-silencing of tumor suppressors genes. Abnormal methylation situation, even in the level of promoter regions, does not essentially change the gene expression levels, particularly if the gene was become silenced, leaving the mechanisms of methylation without any response. According to the methylation situation which has a strong eagerness to be highly altered on CpG islands in carcinogenesis and tumorigenesis, considering its epigenetic fluctuations in finding new biomarkers is of great importance. Modifications in DNA methylation pattern and also enrichment of methylated histone signs in the promoter regions of some certain genes like MUTYH, KLF4/6 and WNT1 in different signaling pathways could be a notable key contributors to the upregulation of tumor initiation in CRC. These epigenetic alterations could be employed as a practical diagnostic biomarkers for colorectal cancer. In this review, we will be discuss these fluctuations of MUTYH, KLF4/6 and WNT1 genes in CRC