دکتر فاطمه خاجوی مایوان

It is believed that anthracosis is one of the most important occupational diseases, mainly seen in the residents of industrial areas and coal mine workers. This bronchial disease is more common in Asia's rural areas, particularly in the Middle East. In this study, we examined the epidemiology and genetic factors affecting this disease and its relationship with different types of cancer.

In this review article, we searched four databases (Pubmed, the Cochrane Database of Systematic Reviews, Embase and Scopus) up to June 3, 2022, for published articles on anthracosis, epidemiology, gene, and cancer. Non-published studies, studies not published in indexed journals or without peer review, and studies not available in English were all excluded.

The relationship between this disease and tobacco, smoking, air pollution, mycobacterium tuberculosis, gender, and indoor smoke was researched, and its prevalence was cited. Mutations in tumour suppressor genes such as P16 and P53 and expression levels of P16, CDH1, LUNX and RASSF1A genes were researched. Finally, this article discussed the relationship between anthracosis and cancers.

According to the studied literature, antracotic people are more susceptible to pulmonary adenocarcinoma, hepatic nodules, renal cell carcinoma, and esophageal cancer.

 The thyroid gland, a small butterfly-shaped organ in the neck, regulates the body’s metabolism. Disruptions in its function can lead to various health issues, including fatigue, weight changes, and cardiovascular problems. In hemodialysis patients, thyroid function is even more crucial. Hemodialysis, a treatment for kidney failure, filters waste and excess fluid from the blood, potentially affecting various bodily systems, including the endocrine system. This study examines the effect of thyroid function on hemodialysis.

In this descriptive-analytical study, dialysis patients were classified into three groups: hypothyroid, hyperthyroid, and euthyroid. The levels of thyroid and parathyroid hormones, serum electrolytes, clinical symptoms, laboratory results, and blood pressure of the patients in these groups were compared.

There was no significant difference between the number of dialysis sessions and thyroid function. The serum calcium level was significantly higher in hypothyroid patients than in euthyroid and hyperthyroid patients. There were no significant differences in weight changes before and after dialysis considering the participants’ sex and age (P = 0.227 and P = 0.457). Moreover, there were no significant differences in the number of dialysis sessions (P = 0.508), systolic (P = 0.419), and diastolic blood pressure (P = 0.559), or in the serum level of parathormone in patients with different thyroid functions (P = 0.103). However, the serum level of phosphorus was significantly higher in hyperthyroid patients than in normal patients and lower than in hypothyroid patients (P = 0.049). The hemoglobin concentration was higher in hyperthyroid patients than in other groups (P = 0.021).

The changes in calcium, hemoglobin, and parathormone levels in hemodialysis patients with different thyroid function statuses showed significant differences. These differences are believed to be caused by high bone metabolism in dialysis patients. Evaluating these parameters in dialysis patients is recommended, highlighting the need for regular thyroid function screening among these patients.

 Epidural hematoma (EDH) and subdural hematoma (SDH) are common complications after traumatic brain injury. Intracranial hematomas can be without complications or associated with life-threatening conditions, including midline shift, cerebral edema, intracerebral ischemia, and increased intracranial pressure. This study aimed to investigate the prevalence of EDH and SDH in patients with head trauma attending the emergency department.

 This descriptive cross-sectional study included 146 patients with head trauma referred to the Emergency Department of Shahid Mohammadi Hospital, Bandar Abbas, in 2021. Patients’ data, including age, gender, Glasgow Coma Scale (GCS) on admission, mechanism of trauma, type of hematoma, length of intensive care unit (ICU) stay, outcome (recovery/death), and neurosurgery requirements were extracted from their medical files.

 The mean age of the participants was 20.97±15.05 years, of whom 114 (78.1%) were male. EDH and SDH were observed in 7.5% and 11% of patients, respectively. The most common mechanism of trauma was traffic accidents (39%), followed by falls (28.1%) and assaults (13%). Moreover, 11% of the patients needed neurosurgical intervention. Most patients recovered (95.9%), and 4.1% died. The mean GCS on admission was 13.47±2.34. Furthermore, SDH was significantly higher in the patients who died (P=0.001) and those aged≥18 years (P=0.028).

 The results of the current study showed a higher prevalence of SDH compared to that of EDH. Both hematoma types appeared to correlate with the mechanism of trauma, ICU admission, GCS on admission, and neurosurgery requirement, while SDH was associated with age and death.

SARS-CoV-2 is a new coronavirus type that first appeared in Wuhan, China, and caused a pandemic of respiratory diseases from the end of 2019. Severe infections of this virus can cause incorrect adjustments of cytokine and chemokine responses, which ultimately causes damage to the lung tissue. Corticosteroids are a class of drugs that reduce inflammation and immune system activities in the body. For this reason, many doctors and researchers thought of using corticosteroid treatments to control the cytokine storm.

In this retrospective descriptive cross-sectional study, the files of Covid-19 patients who were admitted to Shahid Mohammadi Hospital, Bandar Abbas, Iran, were examined. On the basis of the severity, the patients were grouped into two groups of moderate and severe patients. Patients in each group were then sub-categorized into high dose and low dose, according to the received dose of corticosteroids. Then we investigated the effect of different doses of corticosteroids on the course of recovery of Covid-19 cases.

In the severe group, the patients who received high-dose of corticosteroids had a higher mortality rate as compared to the low-dose group. In both the severe and moderate groups, the LDH level of the patients who received low doses of corticosteroids at the time of discharge were significantly less compared to those who received high doses. In the moderate group, the percentage of lymphocytes in the low-dose corticosteroid group was considerably higher compared to the high-dose corticosteroid group at the time of discharge.

According to the results, in the case of patients with moderate clinical severity, a low dose of corticosteroids improved the disease, but in the case of patients with severe clinical severity, the results were contradictory, which may be caused by interference of other factors such as underlying diseases, the severity of the illness, etc. in the severe group.

Coronary artery disease (CAD) is the most common type of cardiovascular disease (CVD) and has a high mortality and morbidity rate. Smoking is one of its important risk factors. The time perspective is the basic cognitive process by which individuals perceive, interpret, and interact with their environment and describes the impact of attention on the past, present, and future. It was hypothesized that this cognitive process can have an effect on decisions to use or quit smoking. Thus, this study evaluated the relationship between smoking cessation and time perspective.

Overall, 170 patients who were hospitalized with the diagnosis of CAD in Bandar Abbas Shahid Mohammadi hospital were selected for inclusion in this cross-sectional descriptive study. They all had a history of smoking. The subjects were divided into two groups of smokers and previous smokers (smoking cessation at least 3 months ago). Finally, Zimbardo Time Perspective Inventory was used to evaluate the time perspective.

In general, 170 patients were surveyed, including 151 males and 19 females. Based on the results, 140 people were smokers and 30 had quit smoking. Those quitting smoking received higher scores on past-positive and future time perspectives (P < 0.05). Patients who were smokers had higher scores in the present-hedonistic, present-fatalistic, and future transcendent perspectives, but they were not statistically significant.

Although previous evidence confirmed a positive relationship between present time perspective and risky behaviors, our findings failed to prove it. However, people with future time perspectives had less tendency to drug addiction and smoking. 

Today, various drugs have been investigated as the primary or complementary treatment for coronavirus disease 2019 (COVID-19). N-acetylcysteine (NAC) has been used as a mucolytic in pulmonary diseases. This drug apparently contributes to the retrieval of the intracellular antioxidant system.

This study aimed to determine the efficacy of NAC in severe COVID-19 patients admitted to the intensive care unit (ICU).

This single-blinded randomized controlled phase III clinical trial included 40 patients with confirmed COVID-19 (based on polymerase chain reaction) admitted to the Shahid Mohammadi Hospital’s ICU, Bandar Abbas, Iran, in 2020. All cases had severe COVID-19. They were allocated randomly to two equal groups. Patients in the control group received standard drug therapy based on the treatment protocol of the national COVID-19 committee, while those in the NAC group received a single dose of intravenous NAC (300 mg/kg) upon admission to the ICU in addition to standard drug treatment. Clinical status and laboratory tests were done on admission to the ICU and then 14 days later or at discharge without knowing the patient grouping.

The two groups were comparable regarding age, gender, and other baseline laboratory and clinical parameters. At the final evaluation, respiratory rate (21.25 ± 4.67 vs. 27.37 ± 6.99 /min) and D-dimer (186.37 ± 410.23 vs. 1339.04 ± 2183.87 ng/mL) were significantly lower in the NAC group (P = 0.004 and P = 0.030, respectively). Also, a lower percentage of patients in the NAC group had lactate dehydrogenase (LDH) ≤ 245 U/L (0% vs. 25%, P = 0.047). Although the length of ward and ICU stay was shorter in the NAC group than in controls, the difference was statistically insignificant (P = 0.598 and P = 0.629, respectively). Mortality, on the other hand, was 75% in the control group and 50% in the NAC group, with no statistically significant difference (P = 0.102). Concerning the change in the study parameters, only the decrease in diastolic blood pressure (DBP) was significantly higher with NAC (P = 0.042). The intubation and mechanical ventilation rates were higher, while oxygen with mask and nasal oxygen rates were lower with NAC, but the difference was statistically insignificant.

Based on the current research, NAC is related to a significant decrease in RR, D-dimer, and DBP in severe COVID-19. Also, LDH was significantly lower in the NAC group than in the controls. More research with larger sample sizes is needed to validate the current study results.