جستجوی مقالات مرتبط با کلیدواژه « clinical manifestations » در نشریات گروه « پزشکی »

The significance of HTLV-1 proviral load as a prognostic biomarker in HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) has been a subject of controversy. This study aims to assess the impact of HTLV-1 proviral load (PVL) on the clinical outcome in patients with HAM/TSP.

An absolute quantitative HTLV-1 PVL RT-qPCR, TaqMan method was developed with 100% sensitivity and specificity. Then, from 2005-2018, the HTLV-1 PVL of 90 eligible newly diagnosed HAM/TSP patients were assessed for demographic, clinical symptoms and their associations with HTLV-1-PVL.

The quality control of the designed RT-qPCR showed a sensitivity and specificity of 100%. Spasticity in lower limbs in 58.9% and urinary symptoms in 17.8% of HAM/TSPs were observed. Using this designed RT-qPCR, the HTLV-1-PVL strongly affected spasticity and sphincter disturbance (p=0.05). The multivariate logistic test showed that only the beginning of lower limb weakness along with tremor was associated with PVL (OR: 2.78. 95% CI (0.99-1.02) and p=0.05). Urinary incontinence was prevalent among these patients; however, no association was identified with the HTLV-1 proviral load (PVL).

The absolute RT-qPCR developed for measuring HTLV-1 proviral load (PVL) demonstrated reliable results. Despite a high prevalence of urinary incontinence in these patients, no association was observed with the PVL. Consequently, it appears that HTLV-1 proviral load is specifically associated with developing spasticity in HAM/TSP.

Exposure to phosgene, a colourless poisonous gas, can lead to various health issues including eye irritation, a dry and burning throat, vomiting, coughing, the production of foamy sputum, difficulty in breathing, and chest pain. This systematic review aims to provide a comprehensive overview of the clinical manifestations and treatment of phosgene toxicity by systematically analyzing available literature. The search was carried out on various scientific online databases to include related studies based on inclusion and exclusion criteria with the use of PRISMA guidelines. The quality of the studies was assessed using the Mixed Methods Appraisal Tool (MMAT). Thirteen articles were included in this study after the screening process. Inhalation was found to be the primary health problem of phosgene exposure with respiratory symptoms such as coughing and dyspnea. Chest pain and pulmonary oedema were also observed in some cases. Furthermore, pulmonary crackle was the most common reported physical examination. Beyond respiratory tract health issues, other organs involvements such as cardiac, skin, eye, and renal were also reported in some studies. The symptoms can occur within minutes to hours after exposure, and the severity of symptoms depends on the amount of inhaled phosgene. The findings showed that bronchodilators can alleviate symptoms of bronchoconstriction caused by phosgene. Oxygen therapy is essential for restoring oxygen levels and improving respiratory function in cases of hypoxemia. In severe cases, endotracheal intubation and invasive mechanical ventilation are used for artificial respiration, along with the removal of tracheal secretions and pulmonary oedema fluid through suctioning as crucial components of supportive therapy.

 The new coronavirus has been responsible for the recent pandemic. It mainly affects adults; however, children of all ages, including neonates, may also be affected. The disease has shown different manifestations and symptoms so far.

 The present study reported four neonates with COVID-19 admitted to the neonatal intensive care unit. All neonates had positive PCR results and suffered from pulmonary hemorrhage during hospitalization.

 The clinical symptoms, laboratory findings, and imaging findings were severe in neonates with COVID-19 and pulmonary hemorrhage, possibly related to surfactant damage and degradation.

SARS-CoV-2 primarily targets the respiratory system, resulting in pulmonary complications. However, recent research has indicated that COVID-19 can exert broader systemic effects on various organs. This comprehensive paper, which synthesizes studies up until now, centers on the clinical characteristics and symptoms of COVID-19. It furnishes a detailed overview of prevalent symptoms, highlighting fever, cough, and fatigue as the most frequently reported symptoms. Moreover, it delves into the diverse manifestations impacting not only the respiratory system but also the eyes, nervous system, musculoskeletal system, and skin. In addition to symptomatology, this study offers a succinct exploration of patients’ clinical presentations, potential complications, incubation period, and outcomes. This compilation of knowledge serves as an invaluable tool for medical practitioners, providing them with essential insights to enhance the accuracy of diagnosis and optimize the treatment strategies for COVID-19 patients. It bridges the gap between the pulmonary-centric focus of the virus and the broader multi-organ implications, thereby empowering healthcare professionals in their comprehensive care approach.

Up to this time, screening for people infected with coronavirus disease 2019 (COVID-19) relies on clinical symptoms. As a result, our study focused on establishing a relationship between clinical manifestations, risk factors, and the prognosis of COVID-19 for prompt intervention. This cross-sectional study was performed on patients with positive COVID-19 tests in Shiraz, Iran, from 2020 through 2021. Patients were randomly selected from those registered as COVID-19 positive in various family clinics affiliated with Shiraz University of Medical Sciences Health Centers. A telephone interview was conducted to gather necessary data about the clinical symptoms of 401 patients, their risk factors, and their prognosis of the disease in two weeks. Body pain, followed by fever, were the most reported symptoms. Except for dyspnea that was related to hospitalization, no relation was found between initial clinical symptoms and hospitalization or 2-week recovery. We observed a statistically significant difference between different blood groups of patients concerning their rate of hospitalization and recovery after two weeks. A significant relationship between hypertension and hospitalization was seen. Body pain, fever, certain demographic aspects (such as older age), and comorbidities like hypertension showed strong associations with the severity and prognosis of COVID-19. Our results add to the growing body of evidence suggesting blood type may play a role in the prognosis of COVID-19.

The objective of this research is to analyze influenza-induced complications, symptoms, and the interaction of morbidity and mortality rates in hospitalized influenza cases based on age-sex dispersion, influenza virus subtype, prescribed medications, and underlying conditions.
We performed this retrospective study using a dataset of 10,517 hospitalized individuals, including 3,101 laboratory-confirmed influenza cases from patients of all ages who had attended hospitals in the Northwest of Iran due to respiratory complications.
The most prevalent strain which circulated annually was influenza A/H3N2. In contrast to previous studies, our findings suggested that influenza A/H1N1 has the highest mortality rate and the most severe complications.
Regardless of virus type/subtype, the most susceptible age group for influenza was 0-9 years old in both males and females. Meanwhile the high-risk age group among males was 50-59 years old and among females were over 80 age group (mortality rate ≈ 20%). Chronic obstructive pulmonary disease (COPD) (32%) and cardiovascular disease (CVD) (30%) were the most prevalent active underlying diseases among the patients who died, with the latter being more prevalent in males over the age of 70. Patients with a history of chemotherapy had the highest mortality rate. Patients who were prescribed a combination of antibiotics and antivirals had better outcomes with lowest mortality rate.
Our findings demonstrated that annual influenza seasons are often marked by changes in influenza types and subtypes, with variations in the severity. Development of a standardized set of arrays that best correspond with infections, can be useful in guiding diagnostic and therapeutic decisions.

Portal hypertension (PH) refers to a clinical syndrome characterized by an elevation in the pressure gradient between the portal and hepatic veins. It is necessary to identify the underlying causes to manage this disorder effectively.

This study aimed to investigate the etiology, clinical manifestations, and endoscopic findings in children with PH.

This analytic cross - sectional study was performed on patients (< 18 years) with PH who were referred to the Pediatric Gastroenterology Clinic of Mofid Children’s Hospital in Tehran, Iran, within 2014 - 2020. The demographic details of the patients were collected from their medical records. Clinical manifestations, age at diagnosis, family history, and endoscopic findings were also recorded.

A total of 102 patients participated in this study. The subjects’ mean age was 6.81 ± 4.46 years. The results revealed that 50 (49.0%) and 46 (45%) cases had PHdue to extrahepatic and intrahepatic diseases, respectively. Autoimmune hepatitis and portal vein thrombosis were the most common etiology of intrahepatic and extrahepatic PH, respectively. Based on the endoscopic analysis, esophageal varices were the most common findings (95.8%) observed in patients with PH.

Extrahepatic diseases were the most prevalent PH etiology in children referred to the Pediatric Gastroenterology Clinic of Mofid Children’s Hospital.

 The emergence of the coronavirus disease 2019 (COVID-19) has become one of the greatest health problems of the 21st century. The current study was conducted to investigate COVID-19’s clinical manifestation, mortality factors, and their association with each other during the three devastating waves of the pandemic in Razavi-Khorasan province, Iran.

 This cross-sectional epidemiological population-based study was performed in Razavi-Khorasan province, Iran from January 21, 2020, to March 20, 2021. The data, including demographic characteristics and clinical presentations of the patients, were extracted from the Medical Care Monitoring System (MCMS), disease management portal in the Deputy of Health and hospital information system (HIS) of the medical universities/faculties of the province.

 Overall, 80499 patients were admitted to all hospitals of Khorasan-Razavi with the laboratory/ clinical COVID-19 confirmed disease. The male-to-female ratio and the mean age of our COVID-19 individuals were 1.10:1 and 55.67±23.27, respectively. The most frequently reported presenting symptoms in histories provided at the admission time were respiratory distress (58.2%), fever (36.7%), and cough (34.9%), while the less common ones were abdominal pain (2.7%) and alternation in smell/ taste (0.9%). Male gender (odds ratio [OR]=1.32, P<0.001), age over 60 (OR=2.59, P<0.001), and presence of at least one comorbidity (OR=1.32, P<0.001) were significantly associated with higher mortality rates.

 Healthcare providers and public health managers can benefit from the findings of this study to detect and emphasize patients with poor prognoses.

Snakebite is a medical emergency that frequently occurs in different countries. Considering the incidence of annual snakebite in Iran, this study deals with the epidemiology of snakebite in hospitalized patients. Epidemiological data of patients can improve proper and timely treatment of snakebite This retrospective descriptive-analytical study was performed using census sampling of snakebite patients. The statistical population included all patients referred to Afzalipour Hospital in Kerman from 2016 to 2018. After collecting data, the results were analyzed using chi-square and paired t-test. A total of 36 snake bites were reported, 28 males and 8 females. The highest frequency was in the age range of 21-40 years. Local complications included pain 55.5, swelling 36.9, erythema 36.1, skin ecchymosis 13.9, tenderness 8.3, and bleeding 1%. Systemic symptoms included nausea and vomiting 16.6, headache 2, drowsiness 2, and 72.4 without symptoms. Out of 36 patients, 8 had compartment syndrome and 4 patients required fasciotomy. Chi-square test showed a significant relationship between bite and sex, bite and season. Local and systemic symptoms of patients indicate that Viperidae snakes are more likely to cause bites in this province. Snakebites have been more commonplace among men and in the age group of socially active people and more in summer. The development of treatment protocol by experienced and eager physicians with Local and systemic manifestation of venom caused by venomous snakes in the region is essential.

 Conversion of glucose-6-phosphate to glucose is the final step in both glycogenolysis and gluconeogenesis. In glycogen storage disease type Ia (GSD type Ia), decreased activity of the enzyme glucose-6-phosphatase leads to an increased concentration of glucose-6-phosphate within the hepatocytes and shunting into alternative pathway with the following consequences: hyperlactatemia, hyperuricemia and hypertriglyceridemia. Patients develop hypoglycemia within 3 to 4 hours after a meal.

Case Report:

 We reported four patients with GSD type Ia with different clinical manifestations such as hypoglycemia, hepatomegaly, lactic acidosis, hyperchylomicronemia, and hyperuricemia and also described their prognosis.

 Previously, many children with GSD Ia died in infancy or early childhood. Recurrent severe hypoglycemia can cause brain damage, but the prognosis has improved dramatically with early diagnosis and long term maintenance of optimal metabolic control.

 The emergence of a novel coronavirus (COVID-19) in late December 2019 and its rapid global spread has led World Health Organization (WHO) to introduce it as a very dangerous pandemic. People with underlying disease and a history of organ transplantation are at higher risk for COVID-19 disease compared with healthy people.

 In the present study, clinical and laboratory manifestations in the patients with COVID-19 with a history of kidney transplantation has been investigated.

 This study conducted on 103 COVID-19-positive kidney transplant patients as a descriptive epidemiological study. Clinical and laboratory symptoms of hospitalized renal transplanted patients have been assessed. Statistical analysis of the collected data conducted using SPSS (Statistical Package for Social Sciences, version 22).

 This study consisted of 103 COVID-19 patients with a history of kidney transplant, of which 64 males (62.1%) and 39 females (37.9%) with an average age of 48.5 ± 13.1 years. The most common clinical manifestations were headache (67%) and shortness of breath (66%). Elevated lactate dehydrogenase (LDH) levels, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) has been observed in 100%, 98.1% and 93.2% of patients, respectively. In 12.6% and 41.7% of patients, the degree of lung involvement was above 75% and 50%-75%, respectively. Moreover, 79.6% of patients has been discharged after improved, while 20.4% of patients died.

 We found, kidney transplantation may increase COVID-19-related mortality when compared to COVID-19-related mortality in the general population.

Coronavirus, a common infectious disease in the 21st century, has not been studied enough in children. Therefore, this study aimed to investigate the clinical manifestations, laboratory findings, and outcomes of children with Covid-19 admitted to Shahid Beheshti Hospital in Kashan during 2020-2022.

In this retrospective cohort study, the medical records of children with covid-19 referred to Shahid Beheshti hospital in Kashan between February 2020 and March 2022 were reviewed. The information extracted from the patient's medical records included demographic variables, clinical characteristics, laboratory findings, and the outcome of covid-19. The collected data were analyzed through SPSS 16, using descriptive statistics (frequency distribution, mean and standard deviation) and inferential statistics (chi-square test and ANOVA).

The findings of 271 children (159 boys; 52% of the age group≤5 years) showed that fever (57.6%), cough (39.9%), nausea-vomiting (31.7%), and diarrhea were the most common clinical symptoms. Also, the majority of patients were in the abnormal range in terms of Monocyte (89.3%), PTT (84.7%), Lymphocyte (83.6%), Neutrophil (80.4%), and LDH (74.5%). Pulmonary involvement was present in 12.5% of children. Finally, four children (1.5%) died.

Severity of lung involvement and the outcome of the covid-19 disease (admission to the ICU and death) among children were at a low level, and in fact, it shows the better condition of children than adults in relation to this disease.

The recent pandemic is caused by the new coronavirus (COVID-19). The disease primarily affects adults but can also affect children of all ages, including infants. It is not known what the prevalence of this disease is in children, but it is evident that the severity of symptoms in children and infants is less than in adults.

Fifteen neonates with COVID-19 were reported in this paper who were hospitalized in neonatal intensive care units. Five of the neonates were preterm, and all of them tested positive for PCR. The most common symptom was respiratory distress. During their hospitalization, five neonates died.

The results of this study indicate that clinical manifestations, laboratory findings, and radiological findings are less severe in infants than in other ages. Consequently, it can be predicted that the prognosis for infants will generally be favorable.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a family of drugs that are among the most commonly prescribed drugs worldwide. Due to the ease of access and widespread use of these drugs, many cases of intentional and accidental poisoning of these compounds have been reported.The aim of this study was to determine the prevalence of the clinical signs of drug toxicity with aspirin and NSAIDs in patients referred to Razi Hospital in Ahwaz. In this study, patients suffering from aspirin and NSAIDs poisoning referred to Razi Hospital during 2013-2015 were included in the study. Information reviewed from their stored records includes clinical presentation, demographic information, reference data, and treatment options. In this study, 79.5% were female respondents and 20.5% were male, and Faye and Kramer coefficients confirmed the existence of a strongly separate relationship between the gender variable and the first clinical signs of poisoning. The results showed that Diclofenac with 27% had the highest toxicity and nausea was the most common symptom in all drug toxicity with aspirin and NSAIDs. Nausea is a common symptom of poisoning with these drugs. There was a significant relationship between laboratory changes with the type of drug and the need for ICU admission, and this relationship was not strong due to the index values. According to the results, most of the patients were aged between 14-24 years old. Nausea was the most common symptom in all drug toxicity with aspirin and NSAIDs.

The common variable immune deficiency (CVID) is known as the most prevalent symptomatic primary immune deficiency (PID) diseases, which is characterized by hypogammaglobulinemia with variable infectious and noninfectious manifestations. In this study, the researchers aimed to evaluate the frequency of cardiac disorders and investigate its association with other manifestations in CVID patients.

A total of 337 CVID patients registered in the Iranian Primary Immunodeficiency Registry were evaluated in this study. The questionnaire was completed for all patients to collect the participants’ demographic data, clinical manifestations and laboratory finding. The analysis was performed between the two groups of the study including CVID patients with cardiac manifestation and those without it.

The prevalence rate of cardiac manifestation was calculated to be 9.1%. pericardial and myocardial diseases and pulmonary hypertension were the most prevalent complications. CVID patients with a history of cardiac problem had significantly higher prevalence rates of otitis media, lymphoproliferative disorders, splenomegaly, hepatomegaly, failure to thrive and lower numbers of CD8+ T cells and CD19+ B cells compared to the patients without cardiac disorders. Notably, no significant differences were observed in immunoglobulins serum levels, CD3+ and CD4+ T cells between the patients with and without cardiac manifestation.

Regular echocardiographic evaluation and of CVID patients for cardiac complications especially for inflammatory cardiac disease, heart failure and pulmonary hypertension, is critical to reduce the risk of heart disease.

IgA deficiency (IgAD) is the most common primary immunodeficiency, which is caused by a defect in IgA antibody production. Most of the patients are asymptomatic. However, patients can present various manifestations. This study was designed to assess the clinical and laboratory manifestations of symptomatic patients with IgA deficiency.

A group of 123 patients with IgA deficiency referred from all over the country to the national immunodeficiency registration center were entered and followed in this study. The data including demographic characteristics, clinical manifestations and laboratory findings recorded at the registry and also the follow-up visits were extracted.

The mean age of studied patients was 17.1 years old. Regarding gender, 45 patients (36.5%) were female. The most common clinical presentations included upper respiratory tract infections in 22 (17.9%), enteropathy in 9 (7.9%), allergic rhinitis in 11 (8.9%), sepsis in 4 (3.3%) patients. Four cases of leukopenia with white blood cell (WBC) <4,000/μl and 21 cases of leukocytosis with WBC> 10,000/μl were observed based on the laboratory results. Moreover, IgG2 and IgG4 in 2 and 11 patients were less than normal rate for their age, respectively.

Although IgA deficient patients are almost always asymptomatic, clinical manifestations such as recurrent sinopulmonary infections, multiple autoimmune diseases, allergic respiratory and skin disorders, gastrointestinal diseases, and rarely severe life-threatening infections could occur.