The Effect of Bromelain Combined With Montelukast in Hospitalized COVID-19 Patients

Introduction: The activation of bradykinin B1 receptors on endothelial cells in the lung following inflammation is a major cause of the severity and mortality of COVID-19. It has already been shown that bromelain and montelukast as two anti-inflammatory agents can be effective in controlling this condition. Methods: Patients with the novel coronavirus (COVID-19) referred to Masih Daneshvari hospital in Tehran were included in the study after providing full explanations and obtaining written consent. All 40 patients with moderate symptoms were randomly divided into the placebo (n=20) and intervention (n=20) groups. In the sample group, a dose of 200 mg oral bromelain was given to patients every 8 hours and one tablet of montelukast 10 mg 1 hour before or after dinner for 5 days. In the control group, placebo capsules were administered exactly at the above intervals. The results were evaluated using a t test and SPSS21 software. Results: After treatment, the sample (bromelain and montelukast) group represented significant improvements in C-reactive protein (CRP), lactate dehydrogenase (LDH), and lymphocyte count (P<0.05), while the other factors did not have significant differences with the control group. Conclusion: Bromelain and montelukast can improve the condition of hospitalized COVID-19 patients by the positive effect on oxygen saturation, lymphocytes, serum levels of CRP, and LDH

Seizure following removal of Swan Ganz Catheter

Venous air embolism (VAE) is an infrequent incident with fatal consequences during insertion or removal of central venous catheters. It is befalling when air or gas arrives at the vascular system. In this case report, we present a case of a 38-year-old female patient with an air embolism after removal of the Swan Ganz catheter that caused the seizure and cardiac arrest. There is an overview of the causes and ways to prevent VAE in the patien

Thiamine can decrease Lactate and Creatinine level after Coronary Artery Bypass Surgery in Patients with Mild Systolic Dysfunction

Introduction: During cardiopulmonary bypass, oxidative stress happens in the patient's cells due to blood contact with various levels of synthetic materials. It can activate inflammatory process and release factors such as IL-6, CRP, and Neutrophils witch may hurt different organs. In recent years, many efforts have been made to prevent this type of damage, however, no single treatment has been proposed to reduce this risk. Antioxidant substances such as Thiamine is important in cell defense against free oxygen radicals. Regarding this issue, in this study, the effect of thiamine on lactate levels in patients undergoing coronary artery bypass graft surgery has been investigated.Materials and methods: In this study, 140 patients from 25 to 65 years old with mild systolic dysfunction (EF = 45-55%) who were candidates for elective CABG surgery in two groups: control and purpose (patients receiving Thiamine) were examined. All of these patients were anesthetized in an identical manner, and were subjected to a heart-lung pump. Serum lactate levels were measured before, during and 6, 12, 18, and 24 hours after surgery. All data collected in a questionnaire were recorded and evaluated using spss statistical software.Results: Study groups showed no significant differences regarding demographics and underlying diseases. Serum lactate was significantly lower in thiamine group during the first 24 hours after surgery (except before operation and 2 hours later) (p &lt;0.05).Creatinine level in two groups before surgery was not significantly different ,However, it was significantly lower in case group 24 hours after surgery(1.54±0.14 vs. 1.24±0.19; p: 0.001).Also, dose of Inotropes in  patients who received thiamine, was significantly lower than the control group (p= 0.001). Extubation was longer in control group (15.4±4.9 vs. 13.15±4.1; p=0.003) while ICU stay was not different.Conclusion: It seems that thiamine administration before cardiopulmonary bypass, in patient with decreased left ventricular function, can decrease serum lactate as tissue perfusion marker and also improve kidney function

Geographical distribution of cystic fibrosis; The past 70 years of data analyzis

Cystic fibrosis (CF) has been generally well defined throughout the world although its prevalence is very difficult to ascertain for a number of reasons, including the fact that the medical/scientific literature and patient registries vary in quality in different countries. In the present review literature (1938–2017), we found out the higher frequency of registered CF patients in the European Union. This could be due to strong clinical awareness and greater health facilities. In contrast, we found a very irregular report from Asian and African countries. In these countries, the national CF registration system is mostly lacking or it is individualized-based research. In this situation, the estimation of various risk factors such as ethnicity and/or races is remained to be resolved. Overall, this review outlines the urgent need for revitalization of national and global CF registration, worldwide

The Effect of Using the Surgical Mask on the Status of Cerebral Oxygen Saturation and End-Tidal Carbon Dioxide in Health Care Workers

Background: With the outbreak of the new coronavirus (SARS-COV-2), one of the challenges ahead has been to control the prevalence of the disease in the world. However, because the main way the virus enters the host is through the respiratory tract, the use of a mask is more necessary than in other cases. The medical staff who are in contact with these patients in closed environments in the operating room and other places are forced to use the mask continuously to prevent infection. Aim: Considering the necessity of using a mask in the prevalence of COVID 19, especially in the medical staff and the possible effects of this use on tissue oxygen and exhaled carbon dioxide, the present study investigates the effect of using a mask on health care. the present study investigates the effect of using a mask on health care. Methods: Twenty healthy members of the medical staff (staff working at Masih Daneshvari Hospital in Tehran) entered the study voluntarily according to the inclusion criteria. Everyone wore a mask for 2 hours a day. Brain oxygen delivery percentage was measured using cerebral oximetry and petCO2 with capnogram at 0, 60 and 180 minutes. Demographic information of participants about the age, sex and underlying diseases were also recorded in a pre-prepared questionnaire. Independent t-test, paired t-test and chi-square were used to compare the clinical features of the participants. P-value less than 0.05 was considered to show statistical significance. Results: The average of petCO2 in time 2 was significantly higher than time 1 and zero (P=0.001). Likewise, the average petCO2 factor at time one is significantly higher than at time zero. The relationship between BMI and changes in the studied indices shows that the left cerebral oxygenation factor, at times 0-60’ and 30’-60’ and also the right cerebral oxygenation factor at times 0’-60’, have a direct and significant relationship with BMI. Conclusion: Based on the results of the present study, it can be said that the use of surgical masks has significantly increased petCO2 in individuals, while the Pao2 index in some individuals has been associated with a downward trend

Beyond prediction: unveiling the prognostic power of μ-opioid and cannabinoid receptors, alongside immune mediators, in assessing the severity of SARS-CoV-2 infection

Abstract Background This study aims to explore the potential of utilizing the expression levels of cannabinoid receptor 2 (CB2), μ-opioid receptor (MOR), MCP-1, IL-17, IFN-γ, and osteopontin as predictors for the severity of SARS-CoV-2 infection. The overarching goal is to delineate the pathogenic mechanisms associated with SARS-CoV-2. Methods Using quantitative Real-time PCR, we analyzed the gene expression levels of CB2 and MOR in nasopharynx specimens obtained from patients diagnosed with SARS-CoV-2 infection, with 46 individuals classified as having severe symptoms and 46 as non-severe. Additionally, we measured the circulating levels of MCP-1, IL-17, IFN-γ, and osteopontin using an ELISA assay. We examined the predictive capabilities of these variables and explored their correlations across all patient groups. Results Our results demonstrated a significant increase in MOR gene expression in the epithelium of patients with severe infection. The expression of CB2 receptor was also elevated in both male and female patients with severe symptoms. Furthermore, we observed concurrent rises in MCP-1, IL-17, IFN-γ, and osteopontin levels in patients, which were linked to disease severity. CB2, MOR, MCP-1, IL-17, IFN-γ, and osteopontin showed strong predictive abilities in distinguishing between patients with varying degrees of SARS-CoV-2 severity. Moreover, we identified a significant correlation between CB2 expression and the levels of MOR, MCP-1, osteopontin, and IFN-γ. Conclusions These results underline the interconnected nature of molecular mediators in a sequential manner, suggesting that their overexpression may play a role in the development of SARS-CoV-2 infections. Graphical Abstrac