ali ahmadzadeh amiri

All sporting events were halted due to the COVID-19 pandemic, and many athletes suffered from the infection.

This study aimed to evaluate the clinical characteristics and training days lost to COVID-19 in professional football.

This questionnaire-based report on COVID-19 symptoms was conducted during the 2019-20 Iranian men's premier league and second division football. Team members with positive PCR tests were enrolled in the study and were told to fill in the questionnaire after the resolution of the symptoms. The questionnaire was designed to measure the frequency, severity, and duration of COVID-19-related symptoms.

Out of 133 males, including 86 players and 47 team officials with a mean age of 30.81 ± 10.7 years, 63.2% reported experiencing no symptoms. The most frequent symptom was the loss of smell, while the least frequently reported symptom was gastrointestinal unrest. It was also revealed that our population missed an average of 12.89 days to return to the team training.

Since most of the infected individuals in our population were asymptomatic proper case identification using regular PCR testing could stop the transmission of the disease more effectively. Also, more attention is required to be paid to less severe symptoms such as the loss of smell and taste. Moreover, the days lost due to COVID-19 are almost comparable to the days lost by other injuries for the players, which highlights the importance of taking proper preventive measures.

Melanocytoma is a rare benign stationary tumor that usually appears as a pigmented lesion on the optic disk. Optic Disc Melanocytoma (ODM) can compress the optic nerve or undergo necrosis, leading to ischemic axonal loss and visual field defect, similar to those caused by glaucoma. Also, ODM often displays a clinical diagnostic dilemma due to its similarities with melanoma. Some patients have undergone enucleation because of uncertainty between both pathologies. Progressive growth and malignant transformation can be documented by close monitoring of the patient’s eyes. Fundus examination and ancillary imaging procedures such as fundus photo, autofluorescence, B-scan ultrasonography, fluorescein angiography, and spectral-domain optic coherence tomography are powerful tools for ODM diagnosis and management. 

A 19-year-old female presented with a decrease in vision in the left eye for about 3 months. Her visual acuity was 20/20 and 20/80 in her right and left eyes, respectively. Funduscopic examination of the left eye showed a well-defined deeply pigmented brownish-black, dome-shaped nodular mass covered the entire optic disc with the normal-appearing overlying vitreous, macula, and surrounding retina. Short-wave autofluorescence revealed hypo-autofluorescence on the pigmented mass lesion. The patient’s condition did not change significantly over 2 years of follow-up. The diagnosis was made as ODM.

Melanocytomas grow very slowly over several years or remains stable, in contrast to malignant melanoma. Although ODM tends to have benign behavior, it may adversely affect visual function. Yearly fundus examination is necessary for monitoring growth and detecting malignant transformation. Visual loss can result from optic neuropathy or retinal vascular obstruction. In suspicious cases, close follow-up with serial fundus photographs is essential, even though the malignant transformation is exceptional.

Non-graft-versus-host disease(non-GVHD) Ocular complications after hematopoietic cell transplantation(HCT) are uncommon. Although these side effects may consider it to be a minor side effect, however, for the patients, blurred vision, vision loss or other eye symptoms can be troublesome. This study was designed to review the non-GVHD ocular complications after bone marrow transplantation.
A search of the PubMed database in English language from 2004 to 2018 was used to search for published articles on ocular complications of hematopoietic stem cell transplantation with the following terms: hematopoietic stem cell transplantation, bone marrow transplantation, eye or ocular, side effects, eye and vision.
In this review, cataract was the most common ocular complication seen in more than 11% of adults and more than 4% of children. Glaucoma was observed in 0.4% to 1.7% of cases. Bacterial, fungal, protozoan, and viral infections have been seen in more than 2% of patients after hematopoietic stem cell transplantation. However, noninfectious eye involvement such as hemorrhage, ischemia, and retinal detachment has been observed in more than 3% of patients. Most studies have emphasized that awareness of non-GVHD ocular complications is essential for both transplant physicians and ophthalmologists provide comprehensive collaborative team care. 
Available evidences suggest that initial ocular evaluation before HCT should be considered in all patients undergoing hematopoietic stem cell transplantation. Follow-up assessments should be considered based on clinical presentations and risk factors. Preventive strategies and treatments for post-HCT ocular complications remain to be considered on individual case basis.

The experience of pre-operative anxiety in patients is a common and accepted issue; however, anxiety can potentially increase the patients' need for care, the level of post-operative pain, and ultimately patients' morbidity and mortality. The goal of this study was to determine the patients' pre-operative anxiety level right before they undergo surgery in the operating room. This study was conducted as a prospective cross-sectional study. Accordingly, completed State-Trait Anxiety Inventory questionnaires as well as demographic and contextual variables of 230 patients undergoing surgery were evaluated. Data analysis was taken out using SPSS v24. P of less than 0.05 was considered significant. 230 patients with an average age of 48.95 (14.68) years were enrolled. The frequency of mild, moderate, and severe anxiety among the patients was 50.8%, 37%, and 12.2%, respectively. The analysis revealed that the patients' age, gender, occupation, awareness about the type of anesthesia, and place of residence, as well as the type of anesthesia, had no significant correlation with the patients' pre-operative anxiety. However, a significant difference was found regarding patients’ pre-operative anxiety level and their educational, marital, awareness of post-operative complications, and trait anxiety status as well as their history of anesthesia. Therefore, to reduce post-operative complications, it is recommended that the patients with these characteristics be given priority for interventions aimed at reducing pre-operative anxiety.

Two major complications of surgeries are postoperative nausea and vomiting (PONV) and also postoperative pain (POP). Several studies have compared total intravenous anesthesia (TIVA) with inhalational anesthesia regarding these two complications. Some results have shown a better postoperative recovery conditions, but other contradictory results can also be found.This study was performed to evaluate and compare the effect of inhalational and intravenous anesthesia in patients undergoing elective laparoscopic surgery, on the incidence and the severity of PONV and POP.

This study was performed as a single-blinded prospective clinical trial. All patients aged 18-65, with ASA class I and II who underwent elective laparoscopy were included. Patients were divided into two groups of intravenous anesthesia and inhalational anesthesia. The incidence and the severity of PONV and POP were examined in 5 separated times after the surgery. The use of a rescue antiemetic and analgesic medication were also evaluated.

Overall, 67 patients received inhalational anesthesia and 55 patients received intravenous anesthesia. It was revealed that 47.8% of the patients in the inhalation group and 18.2% of the patients in the intravenous group developed PONV (P<0.001). The severity of PONV was significantly lower in the TIVA group (P<0.001), however, no statistically significant difference was found regarding the severity of abdominal pain (P=0.62).

The incidence of PONV and the need for administration of an antiemetic rescue drug are significantly lower in the TIVA group.

Life expectancy of people with immunodeficiency virus (HIV) has improved due to the emergence of antiretroviral therapy. As a result, these individuals may encounter a higher rate of non-specific malignancies for acquired immune deficiency syndrome. Previous studies have shown cancer-related survival in HIV patients to be worse, in part because of the advanced stage of cancer at diagnosis. The purpose of this review is to evaluate the prevalence and screening of non-non defining malignancies for acquired HIV deficiency syndrome. A search of the PubMed database in English from 1996 to 2018 was used to evaluate the prevalence and screening studies of HIV malignancies. Eligibility criteria include any study comparing the prevalence and screening for nonspecific malignancies in adult acquired immunodeficiency syndrome according to HIV status. Cases that only screened for malignancies in other groups were excluded. After reviewing the title and full text, the articles that met the eligibility criteria were translated into Persian. Of the 140 articles identified through the search, nine were studied. Although the most common type of cancer in HIV is lung cancer, which accounts for 20% of all cancers (versus 12.9% of normal population), a comparative screening study was not found. Therefore, only three studies were evaluated including breast cancer, 4 cases with colorectal cancer and 2 cases with prostate cancer (7%, 6%, 6% prevalence respectively). Five of the studies reviewed showed that people with a positive HIV test were less likely to receive cancer screening than the general population, while three articles showed that the screening ratio was higher in the HIV population than in the general population, and one of them showed that the screening ratio was equal to the general population. Most studies showed that people with positive HIV testing who had regular access to health care were more likely to be screened for cancer. The available evidence does not confirm that people with positive HIV testing in most countries with appropriate health care have a lower chance of cancer screening. Social health factors (insurance status, access to health care, education, income level) are associated with receiving appropriate cancer screening.

Pediatric optic neuritis can occur in isolation or association with neuroinflammatory disorders. We reviewed the abnormal orbital and cranial magnetic resonance imaging in literature diagnosed as pediatric optic neuritis, which was primarily presented with visual problems.

A PubMed literature search was accomplished using the following key terms: “Neuroimaging", “Pediatric", “Optic Neuritis", “Multiple Sclerosis", and “Magnetic Resonance Imaging".

Poorly demarcated changes in white and or gray matter, well-demarcated white matter changes, confluent lesions in white matter, and small nonspecific lesions or nothing in some areas of the brain are the most common patterns of children with optic neuritis. The thin, fat suppression imaging technique can reveal optic nerve lesions. Contrast-enhanced sequences, especially by short tau inversion recovery, allow differentiation of particular high-signal intensity foci in the optic nerve and newly formed active lesions from inactive lesions.

Brain imaging should be performed in all patients, if possible, during the two weeks after the initial diagnosis. The cranial neuroimaging can predict multiple sclerosis development in pediatric patients with demyelinating brain lesion

Ocular surface squamous cell neoplasia (OSSN) refers to a wide range of conjunctival and corneal epithelial tumors including: dysplasia, in situ carcinoma, and invasive cancer. The incidence of OSSN with human immunodeficiency virus (HIV) is increased due to its associated risk factors, such as human papillomavirus and exposure to sunlight. In this review, we discuss the epidemiology, clinical presentation, diagnosis, and treatment of OSSN associated with HIV infection. A search of the Google Scholar, Elsevier, Pubmed, ISI (Web of Science), Iran Medex, Scopus database in English from 1992 to 2018 was used to investigate the prevalence and prevalence of HIV positive squamous cell neoplasia. Eligibility criteria include any type of study that addresses the clinical manifestations of OSSN according to HIV status. Cases involving or screening for other types of malignancies in other groups were excluded. The 101 articles identified through the search were, in this review, OSSN reported as the first HIV / AIDS marker in 26 -86% of cases, and HIV positive testing in 38 -92% of patients with OSSN listed. The median age of onset of OSSN in HIV-infected patients in developing countries has dropped to the third to fourth decade. Those infected with HIV have shown larger invasive tumors, more severe malignancy, more invasive corneal, scleral and orbital invasion; more advanced stage tumors (T4), greater need for enucleation and wider exentration, and increased risk of tumor recurrence. It is noteworthy that current management of OSSN in HIV-positive people is based on the same standard treatment guidelines as described for OSSN in the general population. Most studies have shown that OSSN can occur at any time during the HIV / AIDS courses, and no significant association was found between CD4 count and severity of OSSN. In addition, the impact of antiretroviral treatment on OSSN is controversial. Based on the available evidence, HIV screening is recommended in all cases associated with OSSN to rule out HIV infection. The importance of the disease and the risk of relapse and its spread to patients should be counseled, with emphasis on regular follow-up and timely referral to the ophthalmologist for any unspecified ocular symptoms.

Introduction Macrophage activation syndrome (MAS) is a rare and life-threatening complication of Kawasaki Disease (KD) that is usually diagnosed at the same time or after KD. We report a case of MAS as the initial manifestation of KD. Case Report A previously healthy 3-year old girl was admitted to the pediatric infectious diseases ward of Bahrami Children’s Hospital, Tehran, Iran. She had a 3-day history of fever and lymphadenopathy which persisted despite antibiotic therapy. Patient's general condition gradually worsened and she developed loss of consciousness. After being diagnosed with MAS based on laboratory findings, she developed mucocutaneous manifestations of KD. She responded to methylprednisolone pulse therapy, intravenous immunoglobulin and dipyridamole. The follow-up at 2 weeks and 2 months showed no abnormal findings. Conclusion MAS may manifest even before the diagnosis of KD is made.  Early recognition of MAS associated with KD and prompt treatment with corticosteroids can improve the outcome.