مجله طب جنوب
شماره 0 (آذر و دی 1402)

The effect of Tocilizumab and high dose of corticosteroid on COVID-19 mortality and out-comes is equivocal. This study was designed to compare the effect of tocilizumab and Methylpredniso-lone pulse dose on mortality, outcomes and duration of hospitalization in severe COVID-19 patients.

The above research was a retrospective study conducted on 131 patients with severe COVID-19 admitted to the acute respiratory ward of Shohadaye Khalije Fars Hospital in Bushehr, Iran, from March to October 2021. Of these patients, 66 were assigned to the methylprednisolone pulse group and 65 to the tocilizumab group and the two groups were then compared in terms of clinical out-comes, laboratory test results, and lung imaging findings.

The results of the study showed that the percentage of mortality, the mean duration of hospitali-zation, and the rate of requirement for intubation were not signiciantly different between the methylpred-nisolone pulse and the tocilizumab groups (P>0.05). The improvement in CRP and arterial oxygen satura-tion was significantly different between the two groups after treatment (P<0.01). 

High dose of methylprednisolone in severely ill patients was associated with faster recovery of the patients in terms of arterial oxygenation and the inflammatory marker CRP. Nevertheless, there was no difference between the two drugs in terms of mortality rate and prognosis. Therefore methylprednisolone pulse dose can be a good alternative to tocilizumab in severe COVID-19.

Microplastics are persistent environmental pollutants. Their presence in water resources, air and food chains is a growing concern all over the world. Since air is a strong environmental substrate, the release and effects of airborne microplastics can remain localized or go far beyond the point of release. In this study, the indoor and outdoor air pollution of residential houses in Kermanshah, Iran, was investigated.

In order to collect samples, different parts of the houses, including bedroom, living room, kitchen, corridor, yard and roof, were selected as the sampling points. Ten stations were selected as the sampling points. After washing with distilled water, the samples were transferred to the laboratory through a fiberglass filter (diameter 47 mm, 1.1 μm pore size) and filtered using a vacuum pump. After preparing and extracting the above samples, the visual method was used for the quantitative and qualitative detection of the microplastics.

The results of the study confirmed the presence of microplastics in all the samples. The frequency of microplastics was minimum 158 and maximum 4480 per square meter. The indoor samples were significantly more polluted than the outdoor samples. The highest frequency was related to black fiber, which can be attributed to a textile origin. Also, more than 78% of the samples were determined to be less than 500 micrometers in size.

Exposure to microplastic-contaminated air is inevitable, and currently, our knowledge about the release of microplastics in indoor air as well as the factors affecting microplastic transmission is lacking. There is a need for more studies focusing on these issues, because they are of great importance in assessing the potential risk of microplastics on human health.

The ectopic presence of helminths and their eggs in the appendix tube can directly and indirectly lead to the hyperplasia of lymphatic follicles in the walls of the tube by antigenic stimulation and thereby cause obstruction and subsequently acute appendicitis. The present study was designed to determine the extent of this role as well as the frequency of appendectomy samples with E. vermicularis during the last ten years in Bushehr.

A total of 3210 slides related to appendiceal samples of appendectomy patients were collected in Bushehr over ten years (2012-2022) and examined in terms of microanatomy. The microscopic evaluation of the samples as well as the information contained in the patient health records were summarized and the collected data were analyzed in SPSS-16 software using the Chi-square test.

The frequency of appendicitis caused by E. vermicularis in the studied samples was 0.8%, showing a decreasing trend over the last years. There was a significant relationship between appendicitis caused by E. vermicularis and the gender and age of the patients, but there was no significant relationship with their place of residence.

Considering the decreasing trend of appendicitis caused by Enterobius over the last few years in Bushehr, a role can be attributed to the COVID pandemic in this outcome. It is suggested to carry out preliminary evaluations for the early diagnosis of this parasitic infection, especially in infected areas, in order to eliminate unnecessary surgical interventions.

Congenital toxoplasmosis during early pregnancy may lead to fetal death or cause irreversible complications in the fetus. In the present research, the prevalence of anti-Toxoplasma IgG and IgM antibodies was determined in pregnant women with a history of spontaneous abortion in comparison with women of normal pregnancy course referring to Bushehr medical centers.

In this descriptive cross-sectional study, 150 blood samples were collected from pregnant women with a history of spontaneous abortion and normal pregnancy course referred to Bushehr medical centers from May 2020 to May 2021. Sera were tested for anti-Toxoplasma IgG and IgM antibodies using the ELISA method. The test results along with the questionnaire information were analyzed using SPSS-16 software and Chi-square test.

A total of 18.7% were seropositive and 81.3% were seronegative for anti-Toxoplasma IgG/IgM antibodies. The comparison of the two groups of women showed that there was a significant relationship between the prevalence of anti-Toxoplasma IgG antibody and spontaneous abortion and also education level, place of residence and method of washing vegetables; however, there was no statistically significant relationship between infection and some of the analyzed variables, such as history of contact with cats, number of pregnancies, deliveries and abortions, and some nutritional behaviors.

Chronic form of toxoplasmosis can be considered a factor for recurrent miscarriage in pregnant women. Due to the emphasis of some researchers on the non-significance of this relationship, the subject is debatable and needs further studies.

In the process of treating children with primary monosymptomatic nocturnal enuresis (PMNE), the relapse of PMNE after stopping the medicine causes the child to take the medicine for a prolonged time. The purpose of this study is to compare the rate of disease relapse in two groups of PMNE treatment with a combination of desmopressin + tolterodine and desmopressin alone.

One hundred twenty-three patients of both genders, suffering from nocturnal enuresis, 5-16 years old, were examined in a randomized, single-blind, single-center clinical trial. The first group was given one puff of desmopressin nasal spray and the second group was given one puff of desmopressin nasal spray + 1 mg tolterodine one hour before going to sleep. Data were analyzed using SPSS 21 software and Chi-Square and student t-test (P<0.05).

The positive response of the patients to the treatment in the desmopressin treatment group was 100% and the relapse rate after stopping the treatment was 47.1%. In the desmopressin + tolterodine group, 96.4% responded positively to the treatment, and relapse after stopping the treatment was observed in 34.5% of them. There was no significant difference between the two groups in terms of response rate to treatment (P=0.11) and relapse after stopping the treatment (P=0.16).

Treatment with desmopressin and desmopressin + tolterodine was effective in reducing PMNE relapse after the initial treatment process in children. Considering that there was no statistically significant difference between the desmopressin and desmopressin + tolterodine treatment groups, there is no need to add tolterodine to the treatment regimen of nocturnal enuresis.