javad boskabadi

The coronavirus disease 2019 (COVID-19) is highly contagious and has turned into a global health problem.  In this study, we investigated the role of clinical and laboratory characteristics along with administered therapeutic agents in patients with COVID-19, and identified some effective factors on the mortality of these individuals. 

In this retrospective study, we evaluated the data from all the hospitalized patients who had been diagnosed with COVID-19 between February 23 and May 23, 2020. The data were obtained from medical records. Additionally, a checklist was used to record demographic, clinical, laboratory, imaging, and treatment data for each patient. 

Totally, 478 patients were involved in this study, and their median age was 58.5 years. Of these, 53.3% patients were male. The most common pre-existing underlying disease was hypertension (37.9%), and the mortality group had significantly more comorbidities (85.4%).  Higher neutrophil lymphocyte ratio (NLR), lymphopenia, and reduced hemoglobin were more frequent in the mortality group (p < 0.001).  Similarly, the need to be admitted to the intensive care unit was significantly greater in the mortality group (p<0.001). The most frequently administered therapeutic regimens included hydroxychloroquine and lopinavir/ritonavir, which did not have any correlation with survival outcome. 

Older age, opioid addiction, cardiovascular disease, kidney disease, baseline NLR and hemoglobin, and ICU admission were independently associated with COVID-19 mortality. On the other hand, hydroxychloroquine and lopinavir/ritonavir indicated no beneficial effects on patients’ outcome.

Supracondylar fractures of the humerus are common elbow fractures in children. Supracondylar fractures have two subtypes: flexion, which makes up less than 2% of all such fractures, and extension, which makes up more than 98% of supracondylar fracture of the humerus. Supracondylar fractures of the humerus can develop vascular and neurological complications, either following the fracture itself due to the detached pieces of bone or after reduction or K-wire fixation therapy. The most common complication is damage to the brachial artery. 

Our patient is a healthy 7-year-old right dominant boy who sustained a Gartland type III fracture following a fall and was admitted to the Emergency Ward. At first, a weak pulse was detected in the distal part of the right upper extremity. After the reduction using 2 K-wires, the distal pulse of the limb became undetectable. Vascular examination revealed that the adventitia of the brachial artery was trapped between the condyle parts. The artery was then released, and the distal pulse returned.

This case shows that although entrapment and pulling of the adventitia of the brachial artery between the condyles of the humerus following a supracondylar fracture is a rare occurrence, it can happen in this type of fracture. After reduction using K-wires percutaneously, a neurovascular examination in all cases of supracondylar fractures is necessary. In supracondylar fractures with pink pulseless limbs, immediate arterial exploration can achieve a markedly better outcome than simply monitoring.

The Coronavirus Disease 2019 (COVID-19) was first observed in December 2019 and caused a global pandemic. The aim of this study was to evaluate the clinical features and paraclinical findings in patients who died of COVID-19 in Sari Imam Khomeini Hospital, February 2020- May 2020.

A cross-sectional descriptive and retrospective study was done by reviewing the medical records of 149 patients who died of Covid-19 whose diagnosis was confirmed by chest CT scan or PCR-RT. Independent sample t test was used to compare quantitative variables and Chi-square test was used for analyzing qualitative variables.

The mean age of death from Covid-19 was 63.36±15.26 years and 58.1% were male. The most common clinical complaints were cough, fever, and dyspnea. The most common manifestation of chest CT scan was bilateral involvement. Among the dead cases of COVID-19, 13.5% had myocarditis and 4.7% developed respiratory complications (such as pneumothorax). According to findings, 54.1% died of cardiac arrest and 44.6% died due to respiratory arrest.

Many ambiguities of SARS-CoV-2 still remain that require extensive studies and research in various aspects. Evaluation of demographic, radiological, clinical complications, and laboratory features can help physicians in finding ways to reduce mortality, perform more effective treatments, and use predictive tools.

This study was conducted to evaluate the possible mechanisms of the relaxant effects of hydroalcoholic extract of Plantago major (P. major) on tracheal smooth muscle (TSM) in rats. The effects of cumulative concentrations of P. major (5, 10, 20 and 40 mg/mL) and theophylline (0.2, 0.4, 0.6 and 0.8 mM) were evaluated on pre-contracted TSM with 10 μΜ methacholine or 60 mM KCl. To determine the possible mechanisms, the relaxant effect of the plant was also examined on incubated TSM with atropine, indomethacin, chlorpheniramine, glibenclamide, diltiazem, papaverine, and propranolol. The results indicated concentration-dependent relaxant effects for P. major in non-incubated TSM contracted by methacholine or KCl. There was no statistically significant difference in the relaxant effects of P. major between non-incubated and incubated tissues with indomethacin, papaverine, and propranolol. However, the relaxant effects of P. major in incubated tissues with atropine (p<0.01 to p<0.001), chlorpheniramine (p<0.05 to p<0.001), glibenclamide (p<0.05), or diltiazem (p<0.01) were significantly lower than non-incubated TSM. P. major indicated relatively potent relaxant effects which were lower than those of theophylline. Muscarinic and histamine (H1) receptors inhibition, as well as calcium channel blocking and potassium channel opening effects are suggested to contribute to the TSM relaxant effect of the plant.

Baicalein, a compound extracted from a variety of herbs, showed various pharmacological effects. This study evaluated the relaxant effects of baicalein and its underlying molecular mechanisms of action on rat’s isolated tracheal smooth muscle. Tracheal smooth muscle were contracted by 10 μM methacholine or 60 mM KCl and the effects of cumulative concentrations of baicalein (5, 10, 20 and 40 mg/ml) and theophylline (0.2, 0.4, 0.6 and 0.8 mM) were evaluated. To examine the possible mechanism(s) of the relaxant effect of baicalein, its effect was also evaluated on incubated tissues with atropine, indomethacin, diltiazem, N(G)-Nitro-L-arginine methyl ester (L-NAME), glibenclamide, propranolol and chlorpheniramine. A concentration-dependent and significant relaxant effect was seen for baicalein in non-incubated tissues contracted by KCl or methacholine (P A potent relaxant effect comparable to the effect of theophylline was shown for baicalein, which was probably mediated via inhibition of histamine (H1) receptors, stimulation of beta2-adrenergic receptors and potassium channels activation.