Early administration of thrombolytic agents is standard for patients presenting with acute myocardial infarction (MI). Also, prolonged QT intervals indicate a higher risk for sudden death in patients with MI. This study was conducted to evaluate the door to needle time of streptokinase administration and the incidence of life-threatening arrhythmia in patients with anterior MI. This study was a prospective, single-center study on participants with anterior MI, who were divided into streptokinase and non-streptokinase groups. After administration of streptokinase, QTc was measured in hyper-acute, acute, and recent phases of anterior MI in the group and compared with acute and recent phases in the non-streptokinase group. The incidence of life-threatening arrhythmia was measured and compared in two groups. The data were analyzed by descriptive statistics method and variance analysis in the SPSS software, version 22. The level of significance was considered to be 0.05. Among 87 participants, there was a significant relationship between the door to needle time of 30 minutes and QTc interval in the hyperacute phase (P=0.005). Also, QTc in the streptokinase group was significantly lower than the non-streptokinase group in the acute phase (P=0.003 vs. P=0.205) and recent phase (P=0.007 vs. P=0.228). The incidence of fatal arrhythmias in the streptokinase group was lower than in the others. The relationship between the incidence of VT/VF and TIMI flow grade was insignificant (P=0.089). Reduction of the door to needle time after anterior MI has significant effects on QTc and incidence of threatening arrhythmia.

Ever since the new coronavirus has become the cause of the COVID-19 pandemic; it has manifested with unknown and new presentations. In this report, we are presenting a 46-year-old female infected with COVID-19 (confirmed by Reverse transcription polymerase chain reaction (RT-PCR) nasal swab test) and a known case of Diabetes mellitus type 2 who had a history of Intensive care units (ICU)admission due to COVID-19 with uncontrolled diabetes mellitus. In the second admission after recovery, she had blurred vision. Fundus examination revealed multiple yellow-white well-demarcated nonpigmented masses. Diagnosis of the multiple subretinal abscesses was confirmed. KOH-Calcofluor staining of vitreous fluid was negative for fungal infections of the eye. No polymorphonuclear leukocytes (PMN), epithelial cells, nor any organisms were detected. The patient was treated with an injection of the intravitreal Amphotericin B 10 µg/0.1 cc. To our knowledge, the presented case is the first case of the subretinal abscess after COVID-19 infection.

The article's abstract is not available.

Cardiovascular disease (CVD) mortality has increased in the Iranian population. Word Health Organization (WHO) risk score was recently used in Iranian prevention and control of non-communicable disease programs for risk assessment. The purpose of the study was to compare the 10-year cardiovascular risk using atherosclerotic cardiovascular disease (ASCVD) and WHO risk score. In a cross-sectional study, data from patients with cardiac symptoms without any documents related to CVD were collected from the outpatient clinic. The proportion of subjects with high CVD risk according to ASCVD and WHO risk score and also agreement between two scores was presented. The sensitivity and specificity of ASCVD according to the WHO risk score as a national risk assessment tool were calculated. The study included 284 subjects with a mean age of 53.80 (8.78) years and 68 % of women. The frequency of subjects with high CVD risk based on ASCVD and WHO was 35% and 6%, respectively. The agreement between the two scores was moderate (κ=0.45), with the most agreement in identifying low-risk subjects. The sensitivity and specificity of ASCVD according to the WHO risk score was 95.3% and 75.1%, respectively. The present finding showed that Agreement between two risk scores was moderated, especially in stratifying low-risk subjects. But, the ASCVD risk score categorized more people as a high risk rather than the WHO tool. Assessment of the accuracy of the WHO risk score with comparing predicted risk with observed risk in a cohort study for the Iranian population is necessary.

Obesity and associated chronic inflammation lead to insulin resistance. The aim of this study was to evaluate the effect of varying intensity circuit resistance training on metabolic and inflammatory markers in obese men. In a semi-experimental trial, 44 obese men were selected and randomly divided into four groups, including 1) Control (n=11), 2) Low-intensity circuit resistance training (n=11), 3) Moderate-intensity circuit resistance training (n=11), and 4) High-intensity circuit resistance training (n=11). Resistance training was performed at different intensities, including 1) High-intensity circuit resistance training (80% 1RM), 2) Moderate-intensity circuit resistance (60% 1RM), and 3) Low-intensity circuit resistance training (40% 1RM), three sessions per week for 12 weeks. Serum levels of Dectin-1, TLR2, TLR4, MyD88 were measured using an ELISA kit. Data were analyzed with covariance analysis at P<0.05. Twelve weeks of moderate and high-intensity circuit resistance training significantly reduced weight, body mass index, serum levels of Dectin-1, TLR2, TLR4, MyD88, and HOMA-IR (P=0.001). The reduction of weight, body mass index, serum levels of Dectin-1, TLR2, TLR4, MyD88, and HOMA-IR were significant in obese men in the high-intensity training group compared to low-intensity training (P=0.001). It seems that circuit resistance training, especially high-intensity circuit resistance training, can be used as an option to reduce the inflammatory and metabolic complications associated with obesity.

Diverticulosis of the appendix, as a rare and incident disorder, mimics acute or chronic appendicitis and is characterized by herniation of the appendiceal mucosa through the muscular wall. Symptom and laboratory data of diverticular disease usually represent chronic inflammation. In this study, a 43-year-old female with a history of right lower quadrant pain and anorexia represented abdominal tenderness and rebound tenderness in the physical examination and normal laboratory tests. Abdominal sonography did not show any evidence of acute appendicitis. The removed appendix was 12 cm in length and had multiple diverticular protrusions along with it. The histologic examination showed diverticulosis without evidence of inflammation. The patient was discharged two days later in optimal clinical condition. Diverticulosis of the appendix often is confused with acute or chronic appendicitis based on similar presenting symptoms and imaging studies. Although surgery is the definitive treatment of both conditions, an appropriate diagnosis of diverticular disease before surgery is very important because of the association of appendiceal diverticular disease with neoplasm and other complications.

Inflammation, and remodeling in airways are the two crucial characteristics of asthma, a common respiratory disease. In asthma pathophysiology, the recruitment of granulocytes finally results in inflammation, leading to lung damage. In this regard, failure to clear inflammatory cells by programmed cell death, apoptosis will cause the prolongation of inflammation. On the other hand, in airway epithelial cells, apoptosis may occur, resulting in airway remodeling. Hence, dysregulation of apoptosis has been suggested to contribute to the development of asthma. Importantly, knowledge of the factors related to apoptotic cascade seems vital to explore various pharmacological interventions for the treatment of asthma. In this review, we highlight several important apoptotic and anti-apoptotic factors contributing either to inflammatory cells or airway epithelial cells involved in asthma pathogenesis.

The aim of this study is to evaluate the response to endoscopic treatment and treatment outcomes in patients with rhino-orbito-sinusal mucormycosis. In this descriptive cross-sectional study, 19 patients with rhino-orbito-sinusal mucormycosis were involved. Data such as age, gender, the 6-month survival rate of the patients, type of underlying disease, site of involvement, number of endoscopic procedures, history of exenterating of the eye, type of received systemic treatments, and the time interval between the onset of symptoms and the start of treatment were recorded and analyzed. The 6-month outcome analysis showed that 10 out of 19 patients (58.8%) survived. The results also revealed no significant difference in the 6-month survival rate according to parameters such as gender, underlying disease (57.9% of the patients had diabetes and 42.1% had cancer), age, delay in surgery, site of involvement, and the number of surgeries (P>0.05). However, there was a significant difference in the 6-month survival rates of patients with respect to exenterating of the eye (P<0.05). According to our results, uncontrolled diabetes is the most common underlying cause of rhino-orbito-sinusal mucormycosis. It also seems that exenterating of the eye affects the survival rate of patients. This study suggests that timely and early diagnosis as well as correct treatment, endoscopic procedure, if possible, play an important role in the prognosis of the disease and can greatly reduce the mortality rate.

Strongyloides stercoralis is a common cause of gastrointestinal infection. Symptoms are usually mild, but in the setting of impaired host immunity, severe and disseminated illnesses may occur. The present report describes a male patient with a history of asthma and corticosteroid therapy, now presented with dyspnea and abdominal pain. Examinations show Strongyloides stercoralis larvae in Bronchoalveolar lavage fluid specimens. The patients who have undergone immunosuppressive therapy are highly indicated for Strongyloides stercoralis screening which prevents hyperinflation in endemic areas.

This study was attempted to investigate the prevalence of BRAF gene mutation (V600E) in aspiration cytology of patients with suspected papillary thyroid carcinoma (PTC). Seventy-six patients suspected of having PTC who were referred for fine-needle aspiration (FNA) biopsy were included in this cross-sectional study. Ultrasound-guided FNA was taken from the thyroid masses, and samples were sent for cytologic evaluation. Simultaneously, the samples were sent to a genetic laboratory to check the status of BRAFV600E mutation. Patients with FNA positive for PTC were assigned in one group, and those with FNA negative for PTC were assigned to another group. Cytological and molecular results were compared with those of histopathology and sonography. The results showed that the prevalence of the BRAF gene (V600E) mutation in our study was 21.1% (16 out of 76 patients). In addition, the results showed a significant relationship between gene mutation and pathologic findings so that the highest gene mutation was significantly detected in patients with FNA positive for PTC (P=0.001). Also, our results showed a significant relationship between gene mutation and some sonographic findings (calcification, P=0.004) and no significant relation in the other sonographic findings (hypoechoic changes, P=1.12 and regular changes, P=0.194). According to the results of the present study, BRAF mutation (V600E) can be an effective indicator for definitive diagnosis and primary treatment of PTC in suspected cases.