The Effect of Bariatric Surgery on Polycystic Ovary Syndrome (PCOS) Symptoms and Related Hormones Improvement in Women with Morbid Obesity

Background: Obesity is associated with developing polycystic ovary syndrome (PCOS). The present study investigated whether weight loss after bariatric surgery could improve symptoms and related hormones in women with morbid obesity.Methods: In a retrospective observational study, 50 women aged 18-40 years with body mass index (BMI)=42.3 kg/m2 who underwent laparoscopic Roux-en-Y gastric bypass (RYGB) were enrolled. Evaluation of anthropometric data, serum testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin (PRL), fasting plasmaglucose (FPG), and lipid profile were measured preoperatively and at 1-year follow-upResults: Of 50 women, 32 (64%) women were diagnosed to have PCOS. The mean BMI at 1-year follow-up was 27.05 kg/m2. Hirsutism and irregular menstruation resolved entirely among 68.8% (11/16) and 100% (18/18) at 1-year follow-up. There was a significant decrease in total serum testosterone (2.1±0.2 to 0.9±0.1 ng/mL) and LH (8.5±3.36 to 5.02±2.4 mIU/mL) at 1-year follow-up, whether changes in levels of serum FSH, PRL were not significant.Conclusion: Bariatric surgery was effective in weight loss and improvement of PCOS symptoms and related hormones in women with morbid obesity. Thus, women with PCOS and morbid obesity should be eligible for bariatric surgery

Frequency and Geographic Distribution of CARD9 Mutations in Patients With Severe Fungal Infections

Autosomal recessive deficiency in the caspase recruitment domain containing protein 9 (CARD9) results in susceptibility to fungal infections. In the last decade, infections associated with CARD9 deficiency are more reported due to the advent of genome sequencing. The aim of this study was to evaluate the frequency, geographic distribution and nature of mutations in patients with CARD9 deficiency. We identified 60 patients with 24 mutations and different fungal infections. The presence of the homozygous (HMZ) p.Q295X (c.883C > T) and HMZ p.Q289X (c.865C > T) mutations were associated with an elevated risk of candidiasis (OR: 1.6; 95% CI: 1.18–2.15; p = 0.004) and dermatophytosis (OR: 1.85; 95% CI: 1.47–2.37; p < 0.001), respectively. The geographical distribution differed, showing that the main mutations in African patients were different Asian patients; HMZ p.Q289X (c.865C > T) and HMZ p.Q295X (c.865C > T) accounted for 75% and 37.9% of the African and Asian cases, respectively. The spectrum of CARD9 mutations in Asian patients was higher than in African. Asia is the most populous continent in the world and may have a greater genetic burden resulting in more patients with severe fungal infections. The presence of a high diversity of mutations revealing 24 distinct variations among 60 patients emphasize that the unique genetic alteration in CARD9 gene may be associated with certain geographical areas

Clinical and genomic evaluations of a persistent fatal SARS-CoV-2 infection in a goods syndrome patient: a case report

Abstract The coronavirus disease of 2019 (COVID-19) resulted from an infection by severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) which is the main cause of acute respiratory distress syndrome (ARDS) in global population from 2019 on. It may contribute to higher rate of death among the patients with immunodeficiency based on recent reports. In addition, Good syndrome (GS) as a result of thymoma removal might cause in some long-lasting microbial infections. We described clinical aspects and viral mutations on a case of GS suffering from COVID-19. A 46-year-old man with fever, common respiratory disease symptoms and positive COVID-19 polymerase chain reaction (PCR) test, with the history of thymoma removal surgery was admitted to Masih Daneshvari Hospital, Tehran, Iran. Lung radiographs and oxygen saturation measurement disclosed considerable implication resulted in application of several anti-microbial medication. The delta variant (B.1.617.2 (21 J Clade)) was the strain isolated from the patient by sequencing methods done by the COVID-19 National Reference Laboratory (CNRL), Pasteur Institute of Iran, while the dominant strain circulated mostly among population was Omicron (B.1.1.529) at the time of sampling. Unfortunately, the patient had passed away a month later by sudden respiratory failure progressed in refractory septic shock. Despite the fact that opportunistic infections may lead the GS patients to a major health problematic condition, unusual persistent of infections such as non-dominant variant of SARS-Cov-2 could be observed through the disease timeline. Therefore, a fully screening of thymoma plus intra-host evolution monitoring of SARS-CoV-2 is highly recommended in immunocompromised patients

Side Effects of COVID-19 Vaccination Among Healthcare Workers in Tehran, Iran: Side effects after COVID-19 vaccination

Background: Since the emergence of coronavirus disease 2019 (COVID-19), many people have been vaccinated worldwide. Despite the preventive role of vaccines, their side effects face disease management with challenges. This study aims to investigate the side effects of COVID-19 vaccination among healthcare workers in Tehran, Iran.Methods: This cross-sectional study was conducted from April to October 2022 on 377 healthcare workers in Tehran, Iran. Data collection was carried out through an interview by a researcher using a checklist assessing systemic and local side effects of COVID-19 vaccines.Results: The mean age of participants was 36.03±10.24 years, and 68.2% were female. Participants experienced significantly more local (26.5% vs. 14.3%, P<0.001) and systemic (52.0% vs. 31.8%, P<0.001) side effects after the first dose than after the second dose. After the first dose, AstraZeneca (45.9%) caused significantly more local reactions than Sputnik V (21.7%) and Sinopharm (14.5%). AstraZeneca (83.7%) caused significantly more systemic side effects than Sputnik V (50.7%) and Sinopharm (14.5%). The prevalence of local and systemic side effects after the first dose was significantly different in terms of vaccine types (P<0.001). After the second dose, AstraZeneca (20.4%) caused significantly more local reactions than Sputnik V (12.8%) and Sinopharm (10.5%) (P<0.001). Additionally, AstraZeneca (38.8%) and Sputnik V (37.4%) caused significantly more systemic side effects than Sinopharm (7.9%) (P<0.001).Conclusion: Most healthcare workers in Tehran experienced flu-like symptoms and local reactions at the injection site after vaccination against COVID-19, mainly after the first dose. They had more side effects after vaccination with AstraZeneca and Sputnik V, compared to Sinopharm

Co‐infection of Klebsiella pneumonia, Cytomegalovirus, Aspergillus and Zygomycete in a patient with SARS‐CoV‐2

Abstract Co‐infection between severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) and other pathogens has become a serious threat. There are the reports of fungal, bacterial, and viral co‐infections with SARS‐CoV‐2. We report the unusual case of concomitant aspergillosis, mucormycosis, cytomegalovirus pneumonia, and also klebsiella pneumoniae empyema as the complication of SARS‐CoV‐2