1
|
Bunting N, Martynoga R, Crayton H, Pandita A. Recovery from acute haemorrhagic leucoencephalitis secondary to COVID-19. BMJ Case Rep 2024; 17:e256640. [PMID: 39122379 DOI: 10.1136/bcr-2023-256640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2024] Open
Abstract
A man in his 50s presented with sudden onset expressive aphasia and right-sided facial droop after experiencing coryzal symptoms and malaise for 7 days prior to admission. A brain MRI showed a rapidly progressive mass effect across both hemispheres and cerebrospinal fluid analysis revealed neutrophil predominance with raised protein levels. Acute disseminated encephalomyelitis was provisionally diagnosed, and high-dose methylprednisone was initiated.On admission to the high dependency unit, the patient tested positive for COVID-19 and was treated with appropriate therapeutic agents for severe COVID-19. A subsequent brain biopsy confirmed a demyelinating process, strongly indicating a diagnosis of acute haemorrhagic leucoencephalitis when correlated with the presence of severe oedema on imaging. Nine sessions of plasma exchange were provided over 18 days.At the time of writing, the patient has made an excellent recovery. We urge clinicians to consider this diagnosis and these treatment options for an otherwise devastating condition.
Collapse
Affiliation(s)
- Nicholas Bunting
- Coffs Harbour Base Hospital, Coffs Harbour, New South Wales, Australia
| | | | - Henry Crayton
- Westmead Hospital, Westmead, New South Wales, Australia
| | | |
Collapse
|
2
|
Lam CM, Sanderson M, Vu DT, Sayed D, Latif U, Chadwick AL, Staats P, York A, Smith G, Velagapudi V, Khan TW. Musculoskeletal and Neuropathic Pain in COVID-19. Diagnostics (Basel) 2024; 14:332. [PMID: 38337848 PMCID: PMC10855145 DOI: 10.3390/diagnostics14030332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
Chronic pain constitutes a significant disease burden globally and accounts for a substantial portion of healthcare spending. The COVID-19 pandemic contributed to an increase in this burden as patients presented with musculoskeletal or neuropathic pain after contracting COVID-19 or had their chronic pain symptoms exacerbated by the virus. This extensive literature review analyzes the epidemiology of pain pre-pandemic, the costs associated with the COVID-19 pandemic, the impact of the virus on the body, mechanisms of pain, management of chronic pain post-pandemic, and potential treatment options available for people living with chronic pain who have had or are currently infected with COVID-19.
Collapse
Affiliation(s)
- Christopher M. Lam
- Department of Anesthesiology, Pain, and Perioperative Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA; (C.M.L.); (M.S.); (D.T.V.); (D.S.); (U.L.); (A.L.C.); (A.Y.)
| | - Miles Sanderson
- Department of Anesthesiology, Pain, and Perioperative Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA; (C.M.L.); (M.S.); (D.T.V.); (D.S.); (U.L.); (A.L.C.); (A.Y.)
| | - Dan T. Vu
- Department of Anesthesiology, Pain, and Perioperative Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA; (C.M.L.); (M.S.); (D.T.V.); (D.S.); (U.L.); (A.L.C.); (A.Y.)
| | - Dawood Sayed
- Department of Anesthesiology, Pain, and Perioperative Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA; (C.M.L.); (M.S.); (D.T.V.); (D.S.); (U.L.); (A.L.C.); (A.Y.)
| | - Usman Latif
- Department of Anesthesiology, Pain, and Perioperative Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA; (C.M.L.); (M.S.); (D.T.V.); (D.S.); (U.L.); (A.L.C.); (A.Y.)
| | - Andrea L. Chadwick
- Department of Anesthesiology, Pain, and Perioperative Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA; (C.M.L.); (M.S.); (D.T.V.); (D.S.); (U.L.); (A.L.C.); (A.Y.)
| | - Peter Staats
- National Spine and Pain Centers, Frederick, MD 21702, USA;
| | - Abigail York
- Department of Anesthesiology, Pain, and Perioperative Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA; (C.M.L.); (M.S.); (D.T.V.); (D.S.); (U.L.); (A.L.C.); (A.Y.)
| | - Gabriella Smith
- School of Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA; (G.S.); (V.V.)
| | - Vivek Velagapudi
- School of Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA; (G.S.); (V.V.)
| | - Talal W. Khan
- Department of Anesthesiology, Pain, and Perioperative Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA; (C.M.L.); (M.S.); (D.T.V.); (D.S.); (U.L.); (A.L.C.); (A.Y.)
| |
Collapse
|
3
|
Aryafar M, Gholami F, Bozorgmehr R. Vitamin D status and blood group among severe COVID-19 patients. Ann Med Surg (Lond) 2023; 85:4262-4267. [PMID: 37663733 PMCID: PMC10473361 DOI: 10.1097/ms9.0000000000000955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 06/04/2023] [Indexed: 09/05/2023] Open
Abstract
Objective Prognosis of COVID-19 infection has been indicated to be associated with vitamin D status and ABO blood group. However, owing to discrepancies and an increased number of cases globally, the findings remain unclear. This study aimed to evaluate the association between vitamin D and ABO blood group systems in patients with severe COVID-19. Methods In this cross-sectional study, COVID-19 patients referred to two hospitals in the capital of Iran, Tehran, admitted to the ICU ward due to the severity of COVID-19 were evaluated. Serum vitamin D and ABO levels were evaluated in these patients. The data obtained were statistically analyzed using SPSSv24. Results Of 305 patients, 33.1% patients had O+ blood type, 27.8% had A+ blood type and 22.4% had B+ blood type. Vitamin D deficiency was significantly associated with a mortality rate among these patients, P<0.05. The blood group of the patients was not correlated with mortality. Thirty-seven percent of the patients in the study died because of COVID-19. Conclusion In our study population, mortality due to COVID-19 was significantly associated with vitamin D deficiency but not the ABO blood group. We recommend further studies in this regard that include more variable and detailed biochemical analysis.
Collapse
Affiliation(s)
- Mohamad Aryafar
- Department of Anesthesiology, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University
| | - Farshid Gholami
- Department of Anesthesiology, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University
| | - Rama Bozorgmehr
- Clinical Research Development Unit, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
4
|
Copley M, Kozminski B, Gentile N, Geyer R, Friedly J. Postacute Sequelae of SARS-CoV-2: Musculoskeletal Conditions and Pain. Phys Med Rehabil Clin N Am 2023; 34:585-605. [PMID: 37419534 DOI: 10.1016/j.pmr.2023.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2023]
Abstract
Musculoskeletal and pain sequelae of COVID-19 are common in both the acute infection and patients experiencing longer term symptoms associated with recovery, known as postacute sequelae of COVID-19 (PASC). Patients with PASC may experience multiple manifestations of pain and other concurrent symptoms that complicate their experience of pain. In this review, the authors explore what is currently known about PASC-related pain and its pathophysiology as well as strategies for diagnosis and management.
Collapse
Affiliation(s)
- Michelle Copley
- Department of Rehabilitation Medicine, University of Washington, 325 Ninth Avenue, Seattle, WA 98104, USA
| | - Barbara Kozminski
- Department of Rehabilitation Medicine, University of Washington, 325 Ninth Avenue, Seattle, WA 98104, USA
| | - Nicole Gentile
- Department of Family Medicine, University of Washington, 1959 Northeast Pacific Street, Box 356390, Seattle, WA 98195-6390, USA; Department of Laboratory Medicine and Pathology, University of Washington, 1959 Northeast Pacific Street Seattle, WA 98195-6390, USA
| | - Rachel Geyer
- Department of Family Medicine, University of Washington, 1959 Northeast Pacific Street, Box 356390, Seattle, WA 98195-6390, USA
| | - Janna Friedly
- Department of Rehabilitation Medicine, University of Washington, 325 Ninth Avenue, Seattle, WA 98104, USA.
| |
Collapse
|
5
|
Wang Z, Le TT. The COVID-19 pandemic's effects on SMEs and travel agencies: The critical role of corporate social responsibility. ECONOMIC ANALYSIS AND POLICY 2022; 76:46-58. [PMID: 35919271 PMCID: PMC9334160 DOI: 10.1016/j.eap.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 07/22/2022] [Accepted: 07/22/2022] [Indexed: 06/15/2023]
Abstract
This study is based on the system resilience framework, which outlines the aspects of community behavior, employees, the environment, history, and corporate social responsibility. We used a partial least squares structural equation model to evaluate a sample of 300 Vietnamese SMEs and travel agencies. We discovered that SMEs' strategies positively influence performance and are co-created with corporate social responsibility. The dependability of internal integrity was then determined. The empirical results showed that the overall confidence index for all facilities ranged from 0.70 to 0.95, with values ranging from 0.809 to 0.931. Furthermore, the A and Cronbach's alpha reliability values ranged from 0.70 to 0.90. As a result, the reliability of internal consistency was established. The convergence validity of the configurations was assessed by comparing the extracted mean values of variance (AVE), which, for all configurations, exceeded the limit of 0.50. This approach emphasizes the impact of corporate social responsibility practices on communities, the environment, and heritage.
Collapse
Affiliation(s)
| | - Thanh Tiep Le
- Ho Chi Minh City University of Economics and Finance, Viet Nam
| |
Collapse
|
6
|
Kim N, Kim J, Yang BR, Hahm BJ. Associations of unspecified pain, idiopathic pain and COVID-19 in South Korea: a nationwide cohort study. Korean J Pain 2022; 35:458-467. [PMID: 36175345 PMCID: PMC9530679 DOI: 10.3344/kjp.2022.35.4.458] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/18/2022] [Accepted: 06/30/2022] [Indexed: 12/02/2022] Open
Abstract
Background Few studies have investigated unspecified or idiopathic pain associated with COIVD-19. This study aimed to provide the incidence rates of unspecified pain and idiopathic pain in patients with COVID-19 for 90 days after COVID-19 diagnosis. Methods A propensity score matched cohort was used, including all patients with COVID-19 in South Korea, and analyzed their electronic medical records. The control group consisted of those who had not had tests for COVID-19 at all. Unspecified pain diagnoses consisted of diagnoses related to pain included in the ICD-10 Chapter XVIII. Idiopathic pain disorders included fibromyalgia, temporomandibular joint disorders, headaches, chronic prostatitis, complex regional pain syndrome, atypical facial pain, irritable bowel syndrome, and interstitial cystitis. Results After matching, the number of participants in each group was 7,911. For most unspecified pain, the incidences were higher in the COVID-19 group (11.7%; 95% confidence interval [CI], 11.0–12.5) than in the control group (6.5%; 95% CI, 6.0–7.1). For idiopathic pain, only the headaches had a significantly higher incidence in the COVID-19 group (6.6%; 95% CI, 6.1–7.2) than in the control group (3.7%; 95% CI, 3.3–4.1). However, using a different control group that included only patients who visited a hospital at least once for any reasons, the incidences of most unspecified and idiopathic pain were higher in the control group than in the COVID-19 group. Conclusions Patients with COVID-19 might be at a higher risk of experiencing unspecified pain in the acute phase or after recovery compared with individuals who had not had tests for COVID-19.
Collapse
Affiliation(s)
- Namwoo Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea.,Department of Clinical Medical Sciences, Seoul National University College of Medicine, Seoul, Korea
| | - Jeewuan Kim
- Department of Statistics and Data Science, Yonsei University, Seoul, Korea
| | - Bo Ram Yang
- College of Pharmacy, Chungnam National University, Daejeon, Korea
| | - Bong-Jin Hahm
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea.,Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
7
|
Khalighi E, Marzban-Rad S, Taheri HR. Acute Progressive retro-peritoneal hematoma in COVID19 patients with sub cutaneous ecchymosis. Ann Med Surg (Lond) 2022; 79:104107. [PMID: 35784949 PMCID: PMC9238019 DOI: 10.1016/j.amsu.2022.104107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/26/2022] [Accepted: 06/26/2022] [Indexed: 01/08/2023] Open
Abstract
Introduction and importance: COVID19 is a multifunction disease where hematological disorders are reported. Coagulopathy is seen in these patients, indicated by thromboembolic events. Case presentation We present case of 11 COVID19 who were presented with localized skin ecchymosis lesions in different areas of the body and retroperitoneal hematoma in the posterior wall of the abdomen and chest. Clinical discussion Increased INR and bleeding and ecchymosis in Corona patients require discontinuation of anticoagulants and, FFP, essential and tri amino injections are needed. Conclusions Diagnosis and management of hematoma is important to avoid fatality. Global upsurge in COVID19 cases has been marked with systemic manifestations. We present case of 11 COVID19 who were presented with localized skin ecchymosis lesions. We present COVID19 patients who were treated with anticoagulants and were seen to be presented with retroperitoneal hematoma.
Collapse
Affiliation(s)
- Ebrahim Khalighi
- Department of Anesthesiology, School of Allied Medical Sciences, Shahid Mostafa Khomaeini Hospital, Ilam University of Medical sciences, Ilam, Iran
| | - Saeid Marzban-Rad
- Department of Surgery, Imam-Reza Hospital, Aja University of Medical Sciences, Tehran, Iran
- Corresponding author.
| | - Hamid Reza Taheri
- Department of Surgery, School of Medicine, Shahed University, Tehran, Iran
- Corresponding author.
| |
Collapse
|
8
|
Marzban-Rad S, Bahmani S, Kazemi A, Taheri HR. Acute retroperitoneal hematoma following severe Covid-19 and the use of anticoagulants. Ann Med Surg (Lond) 2022; 78:103909. [PMID: 35693103 PMCID: PMC9173825 DOI: 10.1016/j.amsu.2022.103909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/27/2022] [Accepted: 06/02/2022] [Indexed: 01/08/2023] Open
Abstract
Introduction and Importance: Severe COVID19 patients under anticoagulant therapy are at the risk of developing hematoma. Case presentation We present case of 11 COVID19 who were presented with localized skin ecchymosis lesions in different areas of the body and retroperitoneal hematoma in the posterior wall of the abdomen and chest. Clinical discussion Cases of hematoma with severe COVID19 patients under anticoagulant therapy are reported in several case studies, particularly in geriatric population with the previous history of blood and/or cardiac disorders. Conclusion These patients should be carefully monitored for hematomas by skilled nurse and practitioner and timely treated and monitored. - Global upsurge in COVID19 cases has been marked with systemic manifestations. Clinical studies have indicated thromboembolic events and vascular injuries in COVID19 patients. We present case of 11 COVID19 who were presented with localized skin ecchymosis lesions in different areas of the body. Alterations in biochemical parameters should also be monitored closely.
Collapse
Affiliation(s)
- Saeid Marzban-Rad
- Department of Surgery, Imam-Reza Hospital, Aja University of Tehran Medical Sciences, Tehran, Iran
| | - Sahar Bahmani
- Zist Takhmir Pharmaceutical Company, Tehran University of Medical Sciences, Tehran, Iran
| | - Amenehsadat Kazemi
- Department of Psychology, Faculty of Medical, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Hamid Reza Taheri
- Department of Surgery, School of Medicine, Shahed University, Tehran, Iran
- Corresponding author.
| |
Collapse
|
9
|
Zendehdel A, Bidkhori M, Ansari M, Jamalimoghaddamsiyahkali S, Asoodeh A. Efficacy of oseltamivir in the treatment of patients infected with Covid-19. Ann Med Surg (Lond) 2022; 77:103679. [PMID: 35531426 PMCID: PMC9054703 DOI: 10.1016/j.amsu.2022.103679] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/20/2022] [Accepted: 04/25/2022] [Indexed: 12/26/2022] Open
Abstract
Objective The recent unprecedented pandemic caused by Sars-Cov-2 (the new coronavirus 2019), is threatening public health around the world. Although several studies have been performed, there is no identified treatment for Covid-19 patients. Here we assessed the efficacy of oseltamivir in combination therapy, by comparing two different therapeutic regimens in hospitalized patients, in improving outcomes and find better treatment for Covid-19 patients. Methods This is a single-center retrospective cohort study of 285 confirmed Covid-19 in patients at (XXX). Depending on the date of admission, the patients were divided into two groups; group 1 (oseltamivir group) from February 20, 2020 to March 15, 2020 received Oseltamivir with routine regimen and group 2 (control group) from March 20, 2020 to April 20, 2020 received routine regimen alone that included Azithromycin 500 mg/day and Hydroxychloroquine 200 mg/12 h. Endpoints including duration of hospitalization, requirement to admission to intensive care unit (ICU) and mechanical ventilation, outcome and mortality rate. Results A total of 285 patients were enrolled in the two months, 120 patients for group 1 and 165 for group 2. The median time from admission to discharge was significantly shorter in the oseltamivir group compared to the control group (4.9 vs 6.6 days, p < 0.001). Additionally, the mortality rate was found to be lower in the oseltamivir group than in the control group (1.7% vs 6,7%, p = 0.06) which was statistically significant by multivariate analysis (p = 0.03). The incidence of admission to the ICU (6.7% vs 11.5%, p = 0.1) and mechanical ventilation (2.5% vs 4.8%, p = 0.3) were also decreased in the oseltamivir group, but was not statistically significant. Conclusions This study showed that administration of oseltamivir was associated with shorter length of hospital stay and earlier recovery and discharge of hospital, and a lower mortality rate. The recent unprecedented pandemic caused by Sars-Cov-2, is threatening public health over the world. Although several studies have been performed there is no identified treatment for Covid-19 patients. This study showed that administration of oseltamivir was associated with shorter length of hospital stay.
Collapse
Affiliation(s)
- Abolfazl Zendehdel
- Geriatrics Department, Associate Professor of Internal Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Family Medicine Department, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Bidkhori
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Ansari
- Radiology Department, Amir al-Momenin Hospital, Islamic Azad University of Medical Sciences, Tehran, Iran
| | | | - Azadeh Asoodeh
- Family Medicine Department, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding author. Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
10
|
Marzban-Rad S, Ghafarzadeh M, Bahmani S, Kazemi A. The use of remdesivir among pregnant women and associated clinical outcomes in mother and the child. Ann Med Surg (Lond) 2022; 77:103681. [PMID: 35506126 PMCID: PMC9047404 DOI: 10.1016/j.amsu.2022.103681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/20/2022] [Accepted: 04/25/2022] [Indexed: 11/17/2022] Open
|
11
|
Acute disseminated encephalitis (ADEM) as the first presentation of COVID-19; a case report. Ann Med Surg (Lond) 2022; 77:103511. [PMID: 35369575 PMCID: PMC8958253 DOI: 10.1016/j.amsu.2022.103511] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/08/2022] [Accepted: 03/26/2022] [Indexed: 01/02/2023] Open
Abstract
Introduction and importance: Neurological ailments are reported during and after SARS-COV-2 infection. Case presentation We report a 67-year-old Iranian man with COVID-19 infection and Acute Disseminated Encephalomyelitis (ADEM) whose neurological symptoms appeared before clinical and radiological pulmonary manifestations. Clinical discussion COVID-19 can cause neurological complication without entering the CNS via para infectious inflammatory mechanisms. Conclusions This report shows that ADEM might be among primary presentations of COVID-19.
Collapse
|
12
|
Karimpour-razkenari E, Naderi-Behdani F, Salahshoor A, Heydari F, Alipour A, Baradari AG. Melatonin as adjunctive therapy in patients admitted to the Covid-19. Ann Med Surg (Lond) 2022; 76:103492. [PMID: 35287296 PMCID: PMC8908573 DOI: 10.1016/j.amsu.2022.103492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/03/2022] [Accepted: 03/06/2022] [Indexed: 11/24/2022] Open
Abstract
Objective Coronavirus has disrupted the natural order of the world since September 2019 with no specific medication. The beneficial effects of melatonin on sepsis and viral influenza were demonstrated previously, but its effects on covid-19, especially COVID -19 ICU, is unclear. Therefore, our aim was to determine the effects of melatonin in COVID-19 ICU patients. Methods This is a retrospective cohort study in which the records of patients admitted to COVID -19 ICU of (XXX) during March to June 2020 were reviewed. According to inclusion criteria, patients who received 15 mg of melatonin daily were called MRG and the rest were called NMRG. Results Thirty-one patients were included and analyzed, of which twelve patients were in MRG. Demographic and clinical characteristics, and laboratory data were similar between two groups at ICU admission. Melatonin had no significant effect on ICU duration, CRP and ESR, also the trend of changes was in favor of melatonin. Nevertheless, melatonin significantly reduced the NLR (OR = −9.81, p = 0.003), and also declined mortality marginally (p = 0.09). Melatonin was well tolerated with no major adverse effects, moreover the thrombocytopenia occurrence was significantly lower in MRG (p = 0.005). In MRG, survival increased and mortality risk decreased, although the difference between groups wasn't significant (p = 0.37), which might be related to the small sample-size. Conclusion Our study showed that melatonin is unlikely to reduce mortality among COVID19 patients and with no significant effect on disease-specific biochemical parameters. Coronavirus has disrupted the natural order of the world since September 2019 with no specific medication. The beneficial effects of melatonin on sepsis and viral influenza were demonstrated previously. Our survey showed melatonin had a beneficial effect on survival and mortality risk. As well as platelets and lymphocytes without life-threatening complications. Melatonin was an essential adjuvant therapy in patients admitted to covid-19 ICU.
Collapse
|
13
|
Araiana S, Hosseini MS, Khademi M, Kazemi SN, Ghaffari E, Falahatie M, Shahmirzadi SA, Hosseini A. A case-control study on the severity postpartum depression among COVID19 positive mother. Ann Med Surg (Lond) 2022; 73:103223. [PMID: 35003731 PMCID: PMC8719917 DOI: 10.1016/j.amsu.2021.103223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/24/2021] [Accepted: 12/24/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND COVID19 pandemic has caused a variety of psychological problems including panic disorder, anxiety and depression. It is also associated with adverse psychological outcomes in pregnant women. The aim of this study was to compare the severity of postpartum depression in pregnant women with and without COVID-19 during the coronavirus epidemic. METHODS This case-control study was performed on 102 pregnant women referred to the hospitals of (XXX). Using questionnaire, consisting of demographic and maternal data (age, number of pregnancies, type of delivery, history of any disease, history of drug use, breastfeeding experience, separation of mother from infant due to coronavirus) and score from Edinburgh postnatal depression scale (EPDS) score data from all the participants obtained and analyzed statistically using SPSSv23. RESULTS The results showed that the mean EPDS score in COVID-positive mothers was 26.64 and in COVID-negative mothers was 24.76, which was statistically significant, p < 0.001. The score did not vary among the two group with respect to age group and type of delivery method. The score was significantly higher among the women with 3-4 pregnancies. CONCLUSION COVID-positive status is associated with increased postnatal depression among women. Perinatal and postnatal psychological consultancy is required in such patients along with monitoring of maternal and neonate physical and mental health.
Collapse
Affiliation(s)
- Shideh Araiana
- Department of Obstetrics and Gynecology, Fellowship of Perinatology Division, School of Medicine, Imam Hossein Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam sadat Hosseini
- Department of Obstetrics and Gynecology, School of Medicine, Preventative Gynecology Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mojgan Khademi
- Department of Psychiatry, School of Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyedeh Neda Kazemi
- Department of Obstetrics and Gynecology, School of Medicine, Preventative Gynecology Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elnaz Ghaffari
- Clinical Research Development Center, Imam Hossein Educational Hospital, Shahid Beheshti University Of Medical Sciences, Tehran, Iran
| | - Masoome Falahatie
- Clinical Research Development Center, Imam Hossein Educational Hospital, Shahid Beheshti University Of Medical Sciences, Tehran, Iran
| | | | - Afsaneh Hosseini
- Clinical Research Development Center, Imam Hossein Educational Hospital, Shahid Beheshti University Of Medical Sciences, Tehran, Iran
- Corresponding author. Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
14
|
Vaziri-Harami R, Delkash P. Can l-carnitine reduce post-COVID-19 fatigue? Ann Med Surg (Lond) 2021; 73:103145. [PMID: 34925826 PMCID: PMC8667465 DOI: 10.1016/j.amsu.2021.103145] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 12/16/2022] Open
Abstract
A significant number of patients infected with the new coronavirus suffer from chronic fatigue syndrome after COVID-19, and their symptoms may persist for months after the infection. Nevertheless, no particular treatment for post-disease fatigue has been found. At the same time, many clinical trials have shown the effectiveness of l-carnitine in relieving fatigue caused by the treatment of diseases such as cancer, MS, and many other diseases. Therefore, it can be considered as a potential option to eliminate the effects of fatigue caused by COVID-19, and its consumption is recommended in future clinical trials to evaluate its effectiveness and safety. The coronavirus disease is a viral infection that could induce different respiratory. A significant number of patients infected with the new coronavirus suffer from chronic fatigue. Clinical trials have shown the effectiveness of L-carnitine in relieving fatigue.
Collapse
Affiliation(s)
- Roya Vaziri-Harami
- Department of Psychiatry, School of Medicine, Behavioural Sciences Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parisa Delkash
- Department of Adult Rheumatology, School of Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
15
|
Prevalence and risk factors of musculoskeletal pain symptoms as long-term post-COVID sequelae in hospitalized COVID-19 survivors: a multicenter study. Pain 2021; 163:e989-e996. [PMID: 34913880 DOI: 10.1097/j.pain.0000000000002564] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 12/01/2021] [Indexed: 10/19/2022]
Abstract
This study investigated the prevalence of long-term musculoskeletal post-COVID pain and their risk factors in a large cohort of COVID-19 survivors. A multicenter cohort study including patients hospitalised due to COVID-19 in five hospitals of Madrid (Spain) during the first wave of the pandemic was conducted. Hospitalisation and clinical data were collected from medical records. Patients were scheduled for a telephone interview after hospital discharge for collecting data about the musculoskeletal post-COVID pain. Anxiety/depressive levels and sleep quality were likewise assessed. From 2,000 patients recruited, a total of 1,969 (46.4% women, age: 61, SD: 16 years) were assessed on average at 8.4 (SD 1.5) months after discharge. At the time of the study, 887 (45% women) reported musculoskeletal post-COVID pain. According to the presence of previous pain symptoms, the prevalence of "de novo" (new-onset) musculoskeletal post-COVID pain was 74.9%, whereas 25.1% experienced an increase of previous symptoms (exacerbated COVID-related pain). Female gender (OR1.349, 95%CI 1.059-1.720), previous history of musculoskeletal pain (OR1.553, 95%CI 1.271-1.898), the presence of myalgia (OR1.546, 95%CI 1.155-2.070) and headache (1.866, 95%CI 1.349-2.580) as COVID-19 associated onset symptoms, and days at hospital (OR1.013, 95%CI 1.004-1.022) were risk factors associated musculoskeletal post-COVID pain. In conclusion, musculoskeletal post-COVID pain is present in 45.1% of COVID-19 survivors at eight months after hospital discharge with most patients developing "de novo" post-COVID pain. Female gender, history of musculoskeletal pain, presence of myalgias and headache as COVID-19 symptoms at the acute phase, and days at hospital were risk factors associated with musculoskeletal post-COVID pain.
Collapse
|
16
|
Marzban-Rad S, Bozorgmehr R, Sattari P, Azimi G, Azimi A. Radical extrapleural pneumonectomy with bronchial fistula by pulmonary function test evaluation technique. Ann Med Surg (Lond) 2021; 72:103071. [PMID: 34840777 PMCID: PMC8605380 DOI: 10.1016/j.amsu.2021.103071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/14/2021] [Accepted: 11/15/2021] [Indexed: 10/24/2022] Open
Abstract
INTRODUCTION and importance: Pulmonary Function Tests (PFTS) is an important tool in the assessment of pulmonary pathologies and preoperative evaluation. Case presentation: A 54-year-old man with history of massive pleurisy in the left thorax, treated by placing chest tube and drainage of bloody effusion, was readmitted for epithelioid mesothelioma. He was then presented with pneumothorax due by a refractory bronchial fistula while having a plural catheter. Based on the consultation, the whole-body bone scan was conducted, and findings demonstrated epithelioid mesothelioma (stage 1) with the refractory fistula for which the patient was candidate for thoracic surgery. Decreased lung capacity was seen by Pulmonary Function Testing - PFTS. CLINICAL DISCUSSION The novel PFTS Evaluation Technique was designed to measure the true pulmonary capacities in order to evaluate the pulmonary post-operative tolerance. In this technique the chest tube was placed for 4 weeks until the patient reaches mediastinal fixation then the measurements by PFTS were carried out in two steps. First, using an open chest tube and second, using a clamped chest tube. In both steps, the pulmonary capacities were measured and provided to the pulmonologist for consultation. CONCLUSION In this case, after acquiring the approval of the specialist depended on PFTS after PFTS Evaluation Technique, the radical extra pleural pneumonectomy surgery was conducted, and the patient was discharged with a good general appearance and treated fistula.
Collapse
Affiliation(s)
- Saeid Marzban-Rad
- Department of Thoracic Surgery, Imam-Reza Hospital, Aja University of Medical Sciences, Tehran, Iran
| | - Rama Bozorgmehr
- Clinical Research Development Unit, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parastesh Sattari
- General Practitioner, Institute of Health Education and Research, Chamran Hospital, Tehran, Iran
| | - Ghasem Azimi
- Department of Internal Medicine, School of Medicine, Shahed University, Tehran, Iran
| | - Ali Azimi
- Student of Research Committee, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| |
Collapse
|
17
|
Marzban-Rad S, Marzban-Rad Z, Khanbanan A, Bahmani S, Kazemi A. Early percutaneous tracheostomy in COVID19 patients with failed intubation: A case series. Ann Med Surg (Lond) 2021; 72:103030. [PMID: 34777796 PMCID: PMC8576056 DOI: 10.1016/j.amsu.2021.103030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 11/07/2021] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION COVID19 and pulmonary dysfunction leading to acute respiratory distress syndrome (ARDS). CASE STUDY PRESENTATION Herein we presented the cases of failed intubation that was replaced by early percutaneous dilational tracheostomy. The procedure is safe for the patients, doctors and clinical staff. CONCLUSION Additionally, we report mucormycosis after COVID19 treatment that was potentially due to immunosuppressive drugs.
Collapse
Affiliation(s)
- Saeid Marzban-Rad
- Department of Surgery, Imam-Reza Hospital, Aja University of Medical Sciences, Tehran, Iran
| | - Zahra Marzban-Rad
- Department of Obstetrics and Gynecology, School of Medicine, Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Khanbanan
- General Practitioner, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Sahar Bahmani
- Zist Takhmir Pharmaceutical Company, Tehran University of Medical Sciences, Tehran, Iran
| | - Amenehsadat Kazemi
- Department of Psychology, Faculty of Medical, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| |
Collapse
|
18
|
Astaraki P, Hadian B. Coronavirus case presentation in a patient with loss of consciousness due to dyspnea. Ann Med Surg (Lond) 2021; 71:102994. [PMID: 34745604 PMCID: PMC8556678 DOI: 10.1016/j.amsu.2021.102994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/18/2021] [Accepted: 10/28/2021] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION AND IMPORTANCE Severity of corona virus disease 2019 (COVID19) is presented with respiratory distress. CASE PRESENTATION We present a case of a 29-year-old male who was not presented with typical symptoms of COVID19 at the time of referral but loss of consciousness. CLINICAL DISCUSSION The importance of testing patients without typical symptoms for coronavirus infection and multi-system manifestation of the virus is presented in this case. CONCLUSION Severe drop in oxygen saturation in asymptomatic patients can lead to encephalopathy.
Collapse
Affiliation(s)
- Peyman Astaraki
- Department of Internal Medicine, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Babak Hadian
- Department of Internal Medicine, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| |
Collapse
|
19
|
Ahmadinejad M, Ahmadinejad I, Soltanian A, Mardasi KG, Taherzade N. Using new technicque in sigmoid volvulus surgery in patients affected by COVID19. Ann Med Surg (Lond) 2021; 70:102789. [PMID: 34512969 PMCID: PMC8416359 DOI: 10.1016/j.amsu.2021.102789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 08/25/2021] [Accepted: 09/02/2021] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Coronavirus pandemic-initiated Wuhan city, Hubei Province, China. It mainly involves respiratory system and cause fever, cough. However, it has other manifestations such as GI system, CNS and skin involvement. It is transmitted mostly through respiratory system, but some researchers claim that in can potentially spread by oral, fecal or intestinal gas. During colorectal surgeries such as volvulus sigmoid, surgeons are at risk of exposure to intestinal gas. CASE PRESENTATION A 57-year-old mentally retarded man came to our emergency department with complain of abdominal pain, constipation, obstipation, nausea, vomiting and abdominal distention. His vital sign was stable and his laboratory data revealed no abnormality. His abdominal x-ray showed intestinal obstruction with suspicious of sigmoid volvulus. His PCR for COVID 19 was positive and his chest CT scan has manifestations of lung involvement. He was proceeded for surgery. CONCLUSION Owing to odds of spread of coronavirus through intestinal gas, in this case, sigmoid colon was removed without evacuation of intestinal gas.
Collapse
Affiliation(s)
- Mojtaba Ahmadinejad
- Department of Surgery, School of Medicine, Shahid Madani Hostpital, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Ali Soltanian
- Department of Surgery, School of Medicine, Shahid Madani Hostpital, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Noshin Taherzade
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| |
Collapse
|
20
|
Farzan N, Vahabi S, Farzan B, Madani S. Evaluation of invasive ventilation rate and comorbidities, clinical signs and lab findings among COVID-19 patients. New Microbes New Infect 2021; 43:100925. [PMID: 34336225 PMCID: PMC8302482 DOI: 10.1016/j.nmni.2021.100925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The severity of COVID-19 has been to be associated with comorbidities. It is defined as the presentation of severe respiratory dysfunction or failure, leading to the need for ventilation and mortality. The aim of this study is the evaluate the factors predicting the rate of invasive ventilation among these patients. This retrospective study involved 317 COVID-19 patients referred to (XXX) Hospital in Qom, Iran. The following data were obtained for all the patients: demographic parameters, comorbidities, need for mechanical ventilation, signs and symptoms and lab findings. The results from the demographic data of the study indicated that the need for mechanical ventilation is significantly associated with advanced age, p = 0.001. Additionally, hypertension, leukopenia and blood urea nitrogen to creatinine ratio p = 0.008. p = 0.042 and p < 0.001, respectively, are significantly associated with an increased need for mechanical ventilation. Malignancy, diabetes, asthma, chronic obstructive pulmonary disease, headache, fever, platelet count, prothrombin time, c-reactive protein, erythrocyte sedimentation rate and creatinine phosphatase were not significantly different in the two groups, p > 0.05. Prediction of the extent of severity among COVID-19 patients using clinical parameters and comorbidities prepare medical practitioners and health care centres to take immediate measurements and reduce the burden of the scarcity of health supplies and care.
Collapse
Affiliation(s)
- N. Farzan
- Department of Emergency Medicine, Clinical Research Development Centre, Qom University of Medical Sciences, Qom, Iran
| | - S. Vahabi
- Department of Anesthesiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - B. Farzan
- Department of Anesthesiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - S.S.H. Madani
- Emergency Medicine Department, Student Research Development Centre, Qom University of Medical Sciences, Qom, Iran
| |
Collapse
|
21
|
Farzan N, Vahabi S, Hashemi Madani SS, Farzan B. Evaluating characteristics associated with the mortality among invasive ventilation COIVD -19 patients. Ann Med Surg (Lond) 2021; 69:102832. [PMID: 34512967 PMCID: PMC8423777 DOI: 10.1016/j.amsu.2021.102832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/05/2021] [Accepted: 09/05/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is associated acute respiratory distress syndrome that leads to intensive care unit admission and subsequent need of invasive ventilation. The aim of this study is to evaluate mortality rate and associated parameters among COVID 19 patients under invasive ventilation. METHODS In this retrospective studies, COVID 19 patients referred to our center we evaluated. The data regarding demographic characteristics, comorbidities, biochemical and radiographic findings, need of invasive ventilation and mortality were collected and recorded for all the patients. Statistical analysis was performed to evaluate the risk of mortality in invasive ventilation patients relative to each risk factor or paraclinical or clinical feature. RESULTS Among patients included in the study, 63 patients underwent invasive ventilation where 53 (84%) of these died. The mortality rate among invasive ventilation was significantly associated with advanced age, p = 0.006 whereas it was not significantly associated with smoking, gender, c-reactive protein, platelet count, hypertension, lymphopenia, leukopenia, creatinine kinase, addiction, blood urea nitrogen to creatinine ratio, malignancy, cough, fever, nausea, chronic obstructive pulmonary disease and erythrocyte sedimentation rate. CONCLUSIONS The findings of our study indicate that advanced age can increase the risk of mortality in COVID 19 patients under invasive ventilation whereas, mortality among invasive ventilation patients is high, irrespective of their characteristic. Guidelines are therefore, required regarding the use of invasive ventilation among these patients.
Collapse
Affiliation(s)
- Nina Farzan
- Department of Emergency Medicine, Clinical Research Development Center, Qom University of Medical Sciences, Qom, Iran
| | - Sepideh Vahabi
- Department of Anesthesiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Shima Sadat Hashemi Madani
- Emergency Medicine Department, Student Research Development Center, Qom University of Medical Sciences, Qom, Iran
| | - Behrooz Farzan
- Department of Anesthesiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| |
Collapse
|
22
|
Kiabi FH, Emadi SA, Jamkhaneh AE, Aezzi G, Ahmadi NS. Effects of preoperative melatonin on postoperative pain following cesarean section: A randomized clinical trial. Ann Med Surg (Lond) 2021; 66:102345. [PMID: 34040762 PMCID: PMC8141662 DOI: 10.1016/j.amsu.2021.102345] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/19/2021] [Accepted: 04/25/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Data regarding the analgesic effects of melatonin after the surgery is scare. So far, only one study has investigated the analgesic effect of melatonin during cesarean section. Objective: The present study was performed to investigate the effect of preoperative oral melatonin on pain intensity after cesarean section during spinal anesthesia. METHODS In a double-blind randomized controlled clinical trial study, 204 patients undergoing elective cesarean section with class 1 and 2 anesthesia (ASA) were enrolled. Patients were randomly divided into 3 groups of 68 patients. Patients in group A were given 5 mg melatonin tablets, patients in group B were given 10 mg melatonin tablets, and group C was given placebo. All patients underwent spinal anesthesia with the same anesthesia protocol. Pain intensity, nausea, vomiting, pruritus and headache were assessed and recorded 2, 6, 12 and 24 h after surgery. The time of first dose of analgesia, the amount of opioid consumed within 24 h, and the time to resume physical activity was also recorded. Statistical analysis of data was performed using SPSS 20 software. RESULTS Repeated measurements of pain intensity during the study showed that in all 3 groups pain intensity was significantly reduced during the study, p < 0.001, respectively. The intensity of pain was significantly different in groups B and C, groups B and A and groups A and C, P < 0.001, respectively. The pain reduction was greatest in group B, followed by group A and group C, respectively. The time interval between the end of surgery and the patient's need for analgesia was significant in group B compared to group A (P = 0.035) and C (P < 0.001) and also in group A compared to group C (P = 0.011). The mean dose of opioid was significantly least in group B, p < 0.001. The mean time to resume physical activity was also shortest in group B, p < 0.001 Headache and nausea/vomiting were observed in 7 patients (10.7%) group A and 7 patients (10.7%) in group C. None of the patients in group B developed complications. CONCLUSION The results of the present study showed that the use of 10 mg of melatonin before cesarean section with spinal anesthesia is not only safe, but also reduces the severity of patients' pain, increases the duration of postoperative analgesia, reduces the need for analgesics after surgery and resumption of physical activity.
Collapse
Affiliation(s)
- Farshad Hassanzadeh Kiabi
- Department of Anesthesiology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Abdollah Emadi
- Department of Anesthesiology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Aghdas Ebadi Jamkhaneh
- Department of Obstetrics and Gynecology., School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Goli Aezzi
- Department of Anesthesiology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | | |
Collapse
|
23
|
Kiabi FH, Emadi SA, Shafizad M, Jelodar AG, Deylami H. The effect of preoperative sublingual buprenorphine on postoperative pain after lumbar discectomy: A randomized controlled trial. Ann Med Surg (Lond) 2021; 65:102347. [PMID: 34026096 PMCID: PMC8121872 DOI: 10.1016/j.amsu.2021.102347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/19/2021] [Accepted: 04/25/2021] [Indexed: 12/20/2022] Open
Abstract
Background Lumbar discectomy is one of the most common surgical procedures performed to manage pain caused by the protrusion of an intervertebral disc. Postoperative pain management can be challenging and might lead to increased intake of opioids. Objective: The aim of this study was to determine the effect of preoperative sublingual buprenorphine on severity of pain after lumbar disc surgery and postoperative intake of morphine. Methods This Randomized clinical trial study was performed on 78 patients who were selected for lumbar discectomy surgery. Patients were randomly divided into two groups of 39 patients, each. Patients in the buprenorphine and placebo group received 2 mg buprenorphine sublingual, and placebo 1 h before surgery. Severity of pain, nausea, vomiting and pruritus and intake of opioids in the two groups were evaluated and recorded 1, 6, 12 and 24 h after surgery. Data were analyzed using SPSSv21. Results There was a significant difference in pain score in buprenorphine group at 1, 6, 12, and compared with placebo (P < 0.005). In the control group, the use of analgesics was more than the buprenorphine group. In the first hours after surgery (1–6 h), the incidence of nausea in the buprenorphine group was significantly lower than of the control group (P < 0.05). However, at 12 and 24 h, this difference was not observed, p > 0.05. There was no significant difference in incidence of side effects (nausea, vomiting, pruritus) in the two groups (P > 0.05). Conclusion Sublingual buprenorphine in postoperative pain management is an effective and low dose drug. Due to its simpler administration, it is recommended to relief postoperative pain after lumbar disc surgery. Lumbar discectomy is one of the most common surgical procedures performed to manage pain. Postoperative pain management can be challenging and might lead to increased intake of opioids. Sublingual buprenorphine in postoperative pain management is an effective and low dose drug. It is recommended to relief postoperative pain after lumbar disc surgery.
Collapse
Affiliation(s)
- Farshad Hassanzadeh Kiabi
- Department of Anesthesiology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Abdollah Emadi
- Department of Anesthesiology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Misagh Shafizad
- Department of Neurosurgery, School of Medicine, Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Hojat Deylami
- Student of Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| |
Collapse
|
24
|
Farzan N, Vahabi S, Hashemi Madani SS, Farzan B. Invasive mechanical ventilation and clinical parameters in COVID19 patient: Can age be a factor? INTERNATIONAL JOURNAL OF SURGERY OPEN 2021; 32:100344. [PMID: 34568620 PMCID: PMC8045425 DOI: 10.1016/j.ijso.2021.100344] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Severity of corona virus disease 2019 (COVID19) is presented with respiratory distress and requires mechanical ventilation. Advanced age is one of the significant risk factors of the worst prognosis and mortality in this disease. The aim of this study is to investigate the clinical parameter among COVID19 patients under mechanical ventilation in regard to the age groups. METHOD In this retrospective study, COVID19 patients under invasive mechanical ventilation at Shahid Beheshti Hospital in Qom were included. The patients were divided in two age groups, those aged ≥50 years and <50 years. Clinical parameter of these patients like blood pressure, heart rate, respiratory rate, oxygen saturation and body temperature were recorded at the time of mechanical ventilation and 24, 48 and 72 h under the mechanical ventilation. RESULT A total of 317 patients were included in the study where 214 patients were over the age of 50 years and 98 were under 50 years. The mean age of patients was 59.71 ± 16.46 year. At the start of mechanical ventilation and 24, 48 and 72 h during the ventilation, blood pressure, pulse rate, rate of respiration, oxygen saturation, Glasgow coma scale and temperature were not significantly different at among the two age groups, p > 0.05, respectively. CONCLUSIONS The findings of the study indicated that prognosis of COVID19 patients under invasive mechanical ventilation in terms of changes in clinical parameters might not be associated with the age.
Collapse
Affiliation(s)
- Nina Farzan
- Department of Emergency Medicine, Clinical Research Development Center, Qom University of Medical Sciences, Qom, Iran
| | - Sepideh Vahabi
- Department of Anesthesiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Shima Sadat Hashemi Madani
- Emergency Medicine Department, Student Research Development Center, Qom University of Medical Sciences, Qom, Iran
| | - Behrooz Farzan
- Department of Anesthesiology, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| |
Collapse
|
25
|
Marzban‐Rad S, Sattari P, Taheri HR. Unilateral repair of tracheoesophageal fistula with dilatation of incomplete subglottic stenosis. Clin Case Rep 2021; 9:2036-2039. [PMID: 33936636 PMCID: PMC8077439 DOI: 10.1002/ccr3.3937] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 01/08/2021] [Accepted: 02/02/2021] [Indexed: 11/11/2022] Open
Abstract
A case of TEF along with subglottic stenosis in a patient as a result of prolong intubation. We performed left unilateral tracheal repair to avoid injury to left recurrent laryngeal nerve followed by endoscopic balloon repair of stenosis. Due to critical condition of the patient and COVID-19 infection, she expired.
Collapse
Affiliation(s)
- Saeid Marzban‐Rad
- Department of SurgeryImam‐Reza HospitalAja University of Tehran Medical SciencesTehranIran
| | - Parastesh Sattari
- General PractitionerChamran HospitalInstitute of Health Education and ResearchTehranIran
| | | |
Collapse
|
26
|
Kazem Shahmoradi M, Khoshdani Farahani P, Sharifian M. Evaluating outcomes of primary anastomosis versus Hartmann's procedure in sigmoid volvulus: A retrospective-cohort study. Ann Med Surg (Lond) 2021; 62:160-163. [PMID: 33520215 PMCID: PMC7820798 DOI: 10.1016/j.amsu.2021.01.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 01/10/2021] [Accepted: 01/10/2021] [Indexed: 02/07/2023] Open
Abstract
Background The aim of this study is to compare the short outcomes of two methods of sigmoid resection and primary anastomosis with sigmoid resection and end colostomy (Hartmann's procedure) for sigmoid volvulus. Methods This retrospective study included 102, of which 56 patients underwent end colostomy (Hartmann's procedure) and 46 patients underwent resection and primary anastomosis for sigmoid volvulus. The medical records of the patients were reviewed to evaluate the patients' characteristics, operative data, short-term postoperative outcomes and mortality. Results The mean age of patients in the groups of Hartmann's procedure and primary anastomosis were 68.23 ± 13.42 and 70.10 ± 12.71, respectively. From the 46 patients who had primary colorectal anastomosis, 2 patients (4.3%) suffered from anastomosis leakage, which was not significantly different. This study showed that anastomosis leakage, prolonged ileus, bleeding, surgical site infection and fascial dehiscence were not different between Hartmann's procedure and primary anastomosis, significantly, p < 0.05. Hospital stay in the Hartmann group was less than primary anastomosis group in the same admission, p = 0.04. The mortality rate was not statistically different among the two groups, p = 0.549. Conclusions Postoperative complications and mortality rate do not different among the two groups however, the duration of hospitalization was lesser in Hartmann's procedure group.
Collapse
Affiliation(s)
- Mohammad Kazem Shahmoradi
- Department of General Surgery, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Parham Khoshdani Farahani
- Department of General Surgery, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Masoud Sharifian
- Department of General Surgery, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| |
Collapse
|