jamal akhavan moghaddam

The persistent disease 2019 (COVID-19) presents prodigious challenges for research and medical practice, mainly due to its specific epidemiological and clinical characteristics. Patients with COVID-19 pneumonia may have conditions ranging from asymptomatic to death due to respiratory failure. COVID-19 pneumonia may be associated with pleural complications such as pneumothorax (PT), pneumomediastinum (PM), pleural effusion, and empyema. This study investigates primary Pleural and Mediastinal Complications (PPMCs) and their treatment in patients with COVID-19. In this cross-sectional study, 10,000 patients with COVID-19 were investigated for the incidence of mediastinal and pleural effusions between the beginning of the second half of 2019 and the end of the first half of 2020. The average age of patients with PPMCs was 54.29 ± 14.69 years. 62% (124 patients) were male and 38% (76 patients) were female. Among 10,000 patients with COVID-19, 600 patients (6%) had pleural effusion, of which 456 (4.56%) had mild pleural effusion, and 144 (1.44%) had moderate to severe pleural effusion. The frequency of PPMCs in COVID-19 patients was as follows: 0.53% (53 cases) PT, 0.09% (9 cases) hemothorax, 0.06% (6 cases) empyema, 0.96% (96 cases) PM, 0.12% (12 cases) pericardial effusion, 0.17% (17 cases) atelectasis, and 0.04% (4 cases) emphysema. The most frequent pleural complication was pleural effusion, with a frequency of 6%, and the second most common complication was PM, with a prevalence of 0.96%. Being elderly was strongly associated with the rate of intubation and mortality in the hospital (P<0.05). No significant relationship existed between patients’ age and PPMCs (p>0.05). There was no significant difference in PPMCs between men and women (p>0.05). The results of our study show that PPMCs in patients with COVID-19 have a low prevalence, and if they do occur, the most frequent are related to pleural effusion and PM.

Cystic echinococcosis (CE) is a worldwide zoonotic helminthic disease caused by the larval stage of Echinococcus granulosus. The infection is particularly important in terms of economic and medico-veterinary aspects in endemic areas including Iran. Considering the possibility of organ-tropism in E. granulosus strains, the present study was aimed to identify the genotypes of E. granulosus in different organs involved in patients, undergone surgery in Baqiyatallah Hospital, Tehran, Iran from 2005-2015.

Overall, 29 formalin-fixed paraffin-embedded tissues (FFPT) from patients with histologically confirmed CE including liver (N: 14) lungs (N: 6) abdomen (N: 2), pancreas (N: 2) and each of spleen, gallbladder and, muscles (N: 1) plus unknown organs (N: 2) were used and genetically characterized using polymerase chain reaction, followed by partial sequencing of mitochondrial cytochrome c oxidase gene subunit 1(cox1) and analyzed.

Nineteen out of 29 isolates including liver (N: 6) lungs (N: 4) abdomen (N: 2), pancreas (N: 2) and each of spleen, gallbladder, and muscle (N: 1), unknown organs (N: 2) obtained from paraffin-embedded blocks of human CE created an acceptable sequence in two directions. All 19 isolates regardless of the organ involved were recognized as E. granulosus sensu stricto (G1).

The sequence alignments of the isolates displayed two profiles. All sequenced samples showed E. granulosus sensu stricto (G1) with no organ-related genotype.

''Lichtenstein'' tension-free mesh repair is the most common surgical techniques used for inguinal hernia repair." Read-Rives" method is tension-free, too, but here prosthesis is placed just over the peritoneum, and there is no weak area. The aim of this study was to compare the results of "Read-Rives" and Lichtenstein method in the hernioplasty. Methods and Materials: In this prospective randomized clinical trial 126 patients who had unilateral inguinal hernia were examined: 64 patients operated with Lichtenstein and 62 patients operated with Rives method. They evaluated for early post-operative complications, duration of surgery and hospital stay, return to normal activity, and then they followed for recurrence of hernia.

Postoperative pain was significantly lower and the return to normal activity was shorter in Rives group. Duration of surgery and hospital stay and recurrence rate was equal, lower postoperative wound infection was found within Rives method.

Although the ''Read-Rives'' method is not technically as simple as ''Lichtenstein'' method, but this procedure is easy to learn, so it is recommended because of its better final outcome in comparison with Lichtenstein repair.