Ocular Penetrating Injury as a Complication of Blepharoplasty: A Case Report

Purpose: To report a rare case of ocular penetrating injury after blepharoplasty procedure.Case report: Blepharoplasty is a frequent oculoplastic surgery with relatively infrequent complications. Penetrating injury of the eye due to blepharoplasty has been reported in few previousstudies. Here we report a 35-year-old woman presenting with visual loss in her left eye as a complication of blepharoplasty. In funduscopic examination, prominent retinal folds were found and optical coherence tomography (OCT) findings were compatible with macular hypotony caused by a neglected penetrating injury during oculoplastic surgery. She was admitted and underwent the primary repair of the scleral and limbal laceration. Her visual acuity and other symptoms improved significantly one week after surgery. After six months, her visual acuity for the injured eye was 20/20 without any other complications.Conclusion: Hypotonic maculopathy, disproportionate pain, and visual loss can be alarming signs after cosmetic blepharoplasty pointing to a probable penetrating eye injury

Severe COVID-19 in a Postpartum Woman: A Three-Month Challenge with Convalescent Plasma and Corticosteroid

Introduction: Management of seriously ill patients infected with new corona virus (SARS-CoV-2) is challenging especially in pregnancy and postpartum state. Case presentation: A 39- year-old primigravid critically ill woman with acute respiratory distress (ARDS) due to confirmed SARS-CoV-2 infection underwent urgent cesarean delivery (a healthy neonate) at 33 weeks and 5/7 of pregnancy. She received treatments including hydroxychloroquine, antivirals and broad-spectrum antibiotics while she was intubated for mechanical ventilation. In spite of all treatments, she developed a critical course after the mild primary clinical improvement. Convalescent plasma transfusion as a rescue treatment was performed and led to an improvement in her general condition and delayed gradual recovery in respiratory function after two months. Conclusion: The promising role of early treatment with convalescent plasma transfusion in seriously ill pregnant women infected with SARS-CoV-2, needs to be elucidated by further randomized studies.&nbsp

Ocular Brucellosis: A Brief Update

Brucellosis is a zoonotic disease of important health significance in endemic areas such as Iran. Brucellosis can affect any organ or system in the human body. Ocular involvement is rare and can lead to poor visual prognosis if not treated early. The most common ocular manifestation of brucellosis is uveitis, although any ocular structure can be involved. The diagnosis of ocular brucellosis is based on clinical examination as well as culture and serological tests. The classical treatment regimen includes doxycycline and rifampin. Early diagnosis and prompt treatment are effective in preventing blindness. Here we breifly review the manifestations, diagnostic tools, and treatment of ocular brucellosis

Occurrence of Bacillus cereus in beef burger marketed in Tehran, capital of Iran

Introduction: Beef burgers made in Iran contain various compounds such as meat, cereals flour, as well as some spices which can be contaminated with Bacillus cereus, causing gastroenteritis in the consumer. This study is focused on occurrence of B.cereus in beef burgers marketed in Tehran, capital of Iran. Methods and Results: In this cross-sectional study, a total of 80 samples of different types of beef burgers marketed in Tehran, Iran were randomly collected based on their percentage of meat content, including 30% (n=25), 60% (n=40) as well as 90% (n=15). The samples were analyzed microbiologically by routine culture assay and biochemical tests to find B.cereus. Data were analyzed statistically by Microsoft Office Excel 2010.  Twenty-five out of 80 (31.25%) beef burger samples were contaminated by B. cereus. Based on the percentage of meat content in the samples, the beef burger with 90% meat were significantly (p<0.05) more contaminated than the others. Also, the contamination rate was significantly (p<0.05) higher in summer compared to winter. Conclusion: This survey showed that the beef burgers supplied in Iran markets is main source of B.cereus that can cause disease in Iranian consumers. More attempts must be focused on cold-chain maintenance in production, distribution, and storage of the meat products

Understanding the impact of COVID-19 pandemic on health-related quality of life amongst Iranian patients with beta thalassemia major: a grounded theory

Background:The coronavirus disease 2019 (COVID-19) pandemic and the resulting measures can impact daily life and healthcare management amongst patients with beta thalassemia major.Methods:The Corbin and Strauss method of grounded theory was used to explore the impact of the COVID-19 pandemic on health-related quality of life (HRQoL) amongst Iranian patients with beta thalassemia major. Semi-structured interviews with 16 patients with thalassemia major in the eastern of Iran were performed. Data collection was conducted from 19 September through 18 November 2020. Collected data were recorded, transcribed, and coded to develop themes and subthemes. Paradigm components were sought to find out what happened to these patients and explore the process and events.Results:Insights from these interviews led to five major themes: ‘changing physical health’, ‘emotional and psychological reactions’, ‘changing the nature of relationships and the scope of social support’, ‘metamorphosis of ongoing healthcare, and ‘functionality and adaptation to new realities.’ The emerging core concept was labelled: ‘maintaining well-being balance.’ The COVID-19 pandemic disturbed the balance of life and health of the patients. Multiple strategies to maintain balance and reduce the negative effects of the COVID-19 pandemic on HRQoL were used by the patients, the healthcare team, and support systems.Conclusions:Due to the fear of COVID-19, the patients with beta thalassemia were less likely to contact healthcare professionals. They considered postponing blood transfusion and abandoned evaluating disease complications. Reduced access to the healthcare system and shifting resources from existing programmes to COVID-19 by the healthcare system were incompatible policies. These policies and strategies had strong and negative effects on the physical domain of HRQoL. The patients experienced a deterioration of emotional functioning. They reported a strong reduction in social functioning and felt lonely. Online interventions supporting mental health and social interactions and telemedicine can help during the times of social distancing and lockdowns

The effect of oral royal jelly on clinical disease activity index (CDAI) and morning stiffness in patients with rheumatoid arthritis (RA); A randomized double-blind, placebo-controlled trial

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease which can cause articular destruction and disability in patients. Current therapies are relatively effective and sometimes harmful. Royal Jelly with anti-inflammatory and anti-oxidative properties may be used as an adjunct therapy. The aim of this study was to assess the effect of Royal Jelly on Clinical Disease Activity Index (CDAI) and morning stiffness in patients with rheumatoid arthritis. Methods: According to American College of Rheumatology (ACR) 1987 classification criteria, 80 patients with RA, who had active disease (CDAI > 2.8), were randomly assigned to receive Royal Jelly or placebo beside background treatment for 3 months. Morning stiffness, tender joint count (TJC), swollen joint count (SJC), evaluator global assessment (EGA) and patient's global assessment (PGA) based on visual analogue scale (VAS) were determined before and after 3 months of intervention. The changes in aforementioned indexes were analyzed by SPSS software. Findings: 65 patients completed the study (35 in Royal Jelly and 30 in placebo group). The sex, age, residence, disease duration and drug consumption had no significant changes (P > 0.050). In the first group, CDAI (P = 0.012), SJC (P = 0.024), TJC (P = 0.027), and morning stiffness (P = 0.004) had significant statistical changes; but only changes in morning stiffness were statistically different between the two groups (P < 0.05). Conclusion: Royal Jelly has good effect on morning stiffness but not on CDAI and may be a suitable adjunct therapy. Further studies may demonstrate more significant results

The relationship between the serum levels of copper and zinc and brucellosis disease

Background: Brucellosis is a zoonotic disease in humans and animals and a public health problem throughout the world. Given that measuring changes in the levels of trace elements is a good marker for the diagnosis of infectious diseases from non-infectious ones, the aim of this study was to examine the relationship between the serum levels of copper and zinc and brucellosis. Materials and Methods: This cross-sectional study was conducted on 100 patients with the brucellosis disease and the subjects were divided into two groups of case and control (n=50 in each group). The serum levels of copper and zinc were measured using the automatic absorptive spectrophotometer. Results: From a total of 100 patients, 31 patients (31) were females and 69 (69) were males. The mean age of the patients in the case group was 32.74&plusmn;13.7 years and in the control group was 33.44&plusmn;13.6 years. The results showed that the serum copper level was significantly increased and the zink level significantly decreased in the patients with brucellosis (P&lt;0.001). Conclusion: It seems that the serum levels of copper and zinc can be used as a valid marker for the diagnosis of brucellosis

Anti-mutated citrullinatedvimentin antibody for predicting the activity of rheumatoid arthritis

Background: Anti-citrullinated protein/peptide antibodies (ACPAs) are a heterogeneous family of autoantibodies, targeting citrullinated proteins. We investigated the relationship between serum levels of anti-mutated citrullinatedvimentin antibody (anti-MCV) and rheumatoid arthritis (RA) activity. Method: A total of 271 consecutive female patients with diagnosis of RA who met the ACR/EULAR criteria were enrolled. The disease activity was measured by the Disease Activity Score in 28 joints-erythrocyte sedimentation rate (DAS28-ESR). Anti-MCV was measured by enzyme-linked immunosorbent assay using a commercial kit with a cut-off value for positivity >20 U/mL. Results: Anti-MCV was positive in 153 (56.5%) patients. Disease in anti-MCV positive patients was significantly more active. A new composite index for predicting disease activity was constructed by replacing ESR with anti-MCV in the DAS28 model. There was a correlation between the absolute scores of DAS28-anti-MCV and DAS28-ESR scores. The new composite index best cut-off values corresponding to DAS28-ESR values of 2.6, 3.2, and 5.1 were 2.94, 3.17, and 4.87, respectively. The patients were re-categorized based on the new threshold values calculated by ROC curve analysis. There was agreement between the DAS28-anti-MCV categories and DAS28-ESR disease activity categories. Conclusions: Based on the correlation between anti-MCV levels with RA disease activity index, we conclude that anti-MCV may be a useful test to determine disease activity in RA

Effect of anti-cyclic citrullinated peptide and HLA-DRB1 subtypes on clinical disease activity index in rheumatoid arthritis patients

Rheumatoid arthritis (RA) is a crippling disease with a global prevalence of approximately 0.5%-1% in adults. Genetic, environmental and immunologic factors contribute importantly to pathogenesis of RA. American College of Rheumatology (ACR) assists in early diagnosis of the disease. Aim: The aim of this study was to investigate the effects of HLA- DRB1 gene and anti-Cyclic Citrullinated Peptide (CCP) antibody on Clinical Disease Activity Index (CDAI) and to determine the frequency of HLA-DRB1 alleles in the patients with RA. Materials and Methods: In this descriptive-analytical study, 64 patients with RA referring rheumatology clinic of Hajar Hospital, Shahr-e-Kord, Iran were enrolled based on ACR criteria (1987) by convenience sampling. All patients were examined to assess primary CDAI and referred to laboratory for serologic tests [Rheumatoid Factor (RF) and anti-CCP]. After the patients’ DNA was extracted, HLA-DRB1 was determined per single specific primer-polymerase chain reaction by inno-train kits. The patients were re-examined six months later. Results: The most prevalent type of HLA-DRB1 in the studied patients was 04. In patients with HLA-DRB1 (04), HLA-DRB1 (01), and HLA-DRB1 (15), CDAI decreased pronouncedly after six months, but in other patients it did not (p<0.05). Of the patients, 81.3% had high titers of anti-CCP, but no association between anti-CCP and CDAI was found. Conclusion: RA could be a multifactorial disease. The patients with HLA-DRB1 (04), HLA-DRB1 (01) and HLA-DRB1 (15) showed a good response to routine treatments. The patients with HLA- DRB1 (04) are likely to have no decrease in secondary CDAI. High titers of anti-CCP in patients may indicate the severity of RA in the studied region and perhaps environmental, genetic and unknown or idiopathic factors are aetiologically crucia