seyed bashir mirtajani

Continuous monitoring of the cardiovascular system and control of the changes affecting it is a constant challenge for the surgical team. The need to control the condition of the heart and better understand its condition is raised in the topic of advanced hemodynamic monitoring, which is a set of different techniques for real-time monitoring of the cardiovascular condition and its influencing factors. Cardiac output, as the most important indicator of cardiac function, is an integral part of cardiac monitoring systems. The measurement of this index has witnessed extensive changes in the past few years, which clearly shows its importance. Cardiac surgery is one of the most serious cases that requires accurate assessment of cardiac output and advanced hemodynamic monitoring. Therefore, the present study examines the types of cardiac output in cardiac surgery.

The epidemic caused by the spread of the infectious agent called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has posed a huge challenge to various communities around the world. The high prevalence and widespread infectivity of this virus indicated that despite the relentless efforts of various biological scientists to provide appropriate treatment or control of the disease, no definitive treatment has been reported successfully. Since the source of infection of this virus is an entry into the host cell through the specific angiotensin-converting enzyme-2 (ACE2) receptor, in the present study, we reviewed the ACE2 receptor and its role in SARS-COV-2 infection.

 Healthcare workers must wear masks throughout their shifts, especially those in operating rooms for long periods.

 This study evaluated the effects of wearing N95 masks on blood and cerebral oxygen saturation levels for three hours.

 The present case-control study enrolled 20 operating room workers wearing N95 masks. Their blood oxygen saturation (SaO2), end-tidal carbon dioxide partial pressure (PETCO2), and right- and left-sided cerebral oxygenation (rSO2) were measured in the beginning (0 h) and after wearing N95 masks for one and three hours.

 Wearing a mask affected PETCO2, rSO2, and pulse rate and caused fatigue and lightheadedness in some cases. The participants' mean PETCO2 increased significantly, from 32 mmHg before putting on a mask to 38 mmHg after wearing it for three hours (P < 0.05). No significant change was observed in the participants' mean rSO2, though changes in their rSO2 levels were recorded (P > 0.05).

 We showed evidence of changes in different physiology parameters due to using masks for 1 to 3 h. Notably, wearing an N95 mask increased end-tidal carbon dioxide partial pressure and decreased cerebral oxygen saturation in individual cases, not all cases.

The activation of bradykinin B1 receptors on endothelial cells in the lung following inflammation is a major cause of the severity and mortality of COVID-19. It has already been shown that bromelain and montelukast as two anti-inflammatory agents can be effective in controlling this condition.

Patients with the novel coronavirus (COVID-19) referred to Masih Daneshvari hospital in Tehran were included in the study after providing full explanations and obtaining written consent. All 40 patients with moderate symptoms were randomly divided into the placebo (n = 20) and intervention (n = 20) groups. In the sample group, a dose of 200 mg oral bromelain was given to patients every 8 hours and one tablet of montelukast 10 mg 1 hour before or after dinner for 5 days. In the control group, placebo capsules were administered exactly at the above intervals. The results were evaluated using a t test and SPSS21 software.

After treatment, the sample (bromelain and montelukast) group represented significant improvements in C-reactive protein (CRP), lactate dehydrogenase (LDH), and lymphocyte count (P < 0.05), while the other factors did not have significant differences with the control group.

Bromelain and montelukast can improve the condition of hospitalized COVID-19 patients by the positive effect on oxygen saturation, lymphocytes, serum levels of CRP, and LDH.

Desmopressin is an analog of the antidiuretic hormone (vasopressin), which causes anticoagulant activity by increasing plasma factor 8. The use of desmopressin dates back to 1977, when this hormone was used to prevent bleeding during tooth extraction and surgery in patients with hemophilia A and von Willebrand disease. After that, this hormone was expanded to prevent bleeding in congenital defects and conditions such as chronic kidney and liver failure. Also, this hormone is used to prevent bleeding in major surgeries such as heart surgery, where the patient loses much blood and needs a blood transfusion. Considering the importance of desmopressin in bleeding control, the present study was conducted to investigate the possible effect of this hormone in heart surgery.

 The application of methylprednisolone in ARDS patients has led to a sustained reduction in inflammatory plasma cytokines and chemokines and has recently been used in the treatment of patients with SARS-CoV-2 infection.

 In this study, the effect of methylprednisolone on clinical symptoms and antioxidant changes of patients with COVID-19 has been investigated.

 In the present study, patients with moderate to severe COVID-19 who required hospitalization were entered into the study phase. Then, in addition to standard treatment, patients received methylprednisolone at a dose of 250 mg intravenously over three days. Necessary evaluations include analysis of arterial blood gases, pulse oximetry, monitoring of patient clinical signs, examination of inflammatory biomarkers, and also receiving 10 cc of peripheral blood samples to check for antioxidant changes, at the beginning of the study, after 24 hours, and 72 hours after receiving methylprednisolone was on the agenda.

 Changes in fever, superoxide dismutase (SOD, Glutathione-S-Transferase (GST, the ferric reducing ability of plasma (FRAP, malondialdehyde (MDA, Nitric oxide, Ferritin, and TNF-α before treatment and 72 hours after treatment were significantly different between the two stages (P < 0.05).

 The use of methylprednisolone improves the balance of antioxidants and immunological factors in patients with COVID-19 and thus improves some clinical indicators in these patients.

Organoids are a miniature, simplified version of a human organ that are produced in three dimensions in the laboratory and show the true anatomical array. These organelles originate from one or more cells - embryonic stem cells or induced multipotent stem cells - that can organize themselves in three-dimensional culture media. The use of stem cells due to the unlimited capacity of tissue division and regeneration is a great promise as a therapeutic tool. These three-dimensional models of human tissue can be used to test drugs before they are tested on humans. Lung organoids are one of the different types of organoids that, like other organoids, can be formed through a process of self-organizing stem cells or specific parts of an organ. These organoids can also be utilized as a useful tool for screening drugs and vaccines for infections such as the novel SARS-COV-2 infection. The aim of this study was to investigate the potential of lung organoids in the treatment of pulmonary diseases.

With the outbreak of the new coronavirus (SARS-COV-2), one of the challenges ahead has been to control the prevalence of the disease in the world. However, because the main way the virus enters the host is through the respiratory tract, the useof a mask is more necessary than in other cases. The medical staff who are in contact with these patients in closed environments in the operating room and other places are forced to use the mask continuously to prevent infection.

Considering the necessity of using a mask in the prevalence of COVID 19, especially in the medical staff and the possible effects of this use on tissue oxygen and exhaled carbon dioxide, the present study investigates the effect of using a mask on health care. the present study investigates the effect of using a mask on health care.

Twenty healthy members of the medical staff (staff working at Masih Daneshvari Hospital in Tehran) entered the study voluntarily according to the inclusion criteria. Everyone wore a maskfor 2 hours a day. Brain oxygen delivery percentage was measured using cerebral oximetry and petCO2with capnogram at 0, 60 and 180 minutes. Demographic information of participants about the age, sex and underlying diseases were also recorded in a pre-prepared questionnaire. Independent t-test, paired t-test and chi-square were used to compare the clinical features of the participants. P-value less than 0.05 was considered to show statistical significance.

The average of petCO2in time 2 was significantly higher than time 1 and zero (P=0.001). Likewise, the average petCO2factor at time one is significantly higher than at time zero. The relationship between BMI and changes in the studied indices shows that the left cerebral oxygenation factor, at times 0-60’ and 30’-60’ and also the right cerebral oxygenation factor at times 0’-60’, have a direct and significant relationship with BMI.

Based on the results of the present study, it can be said that the use of surgical masks has significantly increased petCO2in individuals, while the Pao2 index in some individuals has been associated with a downward trend.

Hesperidin is a secondary metabolite of the flavonoid group. Due to its antioxidant, anti-inflammatory and anti-viral properties, it can be helpful as a treatment option for patients with COVID 19. This study was conducted as a clinical trial in Masih Daneshvari Hospital in Tehran. After providing complete explanations and obtaining written consent, patients with new coronavirus (COVID-19) were included in the study if they met the inclusion criteria.  20 patients with the new coronavirus (COVID-19) were included in the study. Patients were then randomly divided into hesperidin and control groups. Patients in the hesperidin group received 1 mg of hesperidin orally intravenously every 6 hours for 5 days, whereas in the control group, they did not. Then, the desired variables were measured during the research period. Patients were monitored for adverse drug reactions based on clinical symptoms and signs. The results were evaluated with regard to the design of the questionnaire and its completion using t-test and SPSS16 software. Patients with equal gender ratio were studied and diabetes mellitus with a prevalence of 60% had the highest prevalence among patients. On the other hand, 85% of these patients presented with bilateral lung involvement. Using hesperidin decreased lymphocytes, CRP, ESR, LDH, D-dimer, and IL-6 and increased WBC, Hb and Plt. None of the mentioned changes were significant (p>0.05). Utilizing hesperidin could not cause significant changes in the level of immunological and inflammatory factors in patients with COVID 19.

In the last days of 2019, a novel strain of coronaviruses reported in Wuhan and spread rapidly all over the world which called 2019 novel coronavirus (2019- nCoV). Almost a few months later in the early 2020 (January 2020), the WHO declared the outbreak of COVID-19 a Public Health Emergency which Compared with the other SARS- CoV, has a stronger transmission capacity. Although respiratory problems are the main clinical symptoms of COVID-19, some patients also experience other conditions and injuries, such as severe vascular damage. Therefore, it can be said that understanding the damage caused by this infection to the vascular system and its underlying mechanisms is of great importance.

There are inconclusive data of Ven venous extracorporeal membrane oxygenation (VV‐ECMO) VV‐ECMO for a therapeutic strategy for acute respiratory distress syndrome (ARDS).

Totally 28 critically ill patients were included into the study between 23 September 2013 and 20 january 2020. Critically ill adult patients who were refractory to conventional therapeutic modalities were eligible for veno-venous ECMO and study inclusion.

Of a total of 28 patients, 15 patients (53.6%) survived and 13 (46.42%) died. Gender frequency had no significant difference between survivors and non-survivors (P=0.07). Mean of age and BMI had no significant differences between the mentioned groups also (P>0.05). It was the same for BSA and the two groups were in the same situation (1.82±0.37 vs. 1.79±0.29; P=0.81). There were no significant differences between survivors and non-survivors regarding ECMO time (114.49±91.05 vs. 162.62±100.17 minutes; P=0.20) and ICU stays (9.65±5.11 vs. 8.93±4.96; P=0.10). The average time of ICU stay was 9.29±5.16 days. The ejection fraction in survives was significantly higher than non-survivors (52.14±6.42 vs. 57.31±4.39; P=0.02). Those patients who were in the non-survivors group had lower blood pressure (MAP<65mmHg) during the study (P=0.049), however, did not find any significant differences between the groups regarding inotropes or vasoconstrictors.

In this study, the mortality rate was 46.42%. Bleeding, hypotension and dialysis were the risk factors for mortality among study participants.

Sustained inflammation has been observed in the majority of severe COVID-19 cases. The impact of choice of opioid on perioperative inflammatory processes has not been assessed in the clinical setting.
Patients with novel coronavirus (COVID-19) who referred to Masih Daneshvari and Noor-Afshar Hospitals in Tehran were included in the study after providing full explanations and obtaining written consent. Patients were then randomly divided into three groups: morphine, fentanyl and control. Patients in the morphine group received 3 mg of morphine intravenously every 6 hours for 5 days, whereas in the fentanyl group, 1.5 mcg / kg / h of fentanyl was infused for 2 hours on 5 consecutive days. The results were evaluated based on the design of the questionnaire and its completion using t-test and SPSS25 software.
A total of 127 participants responded to the survey between 20 April and 20 June 2020, of whom 90 (70.86%) with the average age 65.2 years, provided complete data on variables included in the present analyses. 53 (58.33%) of all individuals were men and 37 (41.12%) were women. Accordingly, 22 (24.4%) patients had a history of hypertension. However, diabetes with 16 (17.77%) cases and kidney diseases with 12 (13.33%), were the next most common underlying diseases. Evaluation of patients' clinical, laboratory and inflammatory conditions at different time intervals in both fentanyl and morphine groups did not show significant changes between these groups and the patients in the control one.
The results of this study did not show any significant change in the use of fentanyl and morphine compared to patients with COVID 19. This may be due to the use of these drugs in the viral phase of the disease. The use of morphine and fentanyl in the viral phase of COVID 19 disease do not show significant benefits.

Lactic acid bacteria interfere to improve the taste of food products and and to prevent the growth of food spoilage organisms and pathogens with producing antimicrobial substances called bacteriocin. To study the antagonistic effect of isolated Lactobacillus from soil where native yogurt is processed against pathogenic bacteria is the purpose of this study.
In this cross-sectional study, Lactobacillus isolated from the soil contaminated with native yogurt waste were identified with the help of biochemical methods. The antimicrobial quality of supernatant fluid was tested against five pathogenic bacteria using diffusion agar and disk diffusion agar methods. Each test was repeated three times to reduce error and inhibition zone diameter measured then their antimicrobial ability were compared.
According to the results, three species of Lactobacillus were identified. These bacteria included Lactobacillus casei, plantarum and delbrueckii. Also, these bacteria showed their good antimicrobial ability against pathogenic bacteria. The most antibacterial effect was abserved from Lactobacillus casei against Staphylococcus aureus in well diffusion agar method with inhibition zone diameter of 18.66 mm.
A great variety of bacteria producing bacteriocin with antibacterial activity against pathogenic bacteria exist in traditional dairy products, and it is recommended to use them in the production of industrial dairy products.