The effect of Phytopaj ) Ferula assa-foetida L. oleo gum resin and tragacanth( in patients with COVID-19: A randomized clinical trial.

Objective: Exogenous hydrogen sulfide (H2S) has a positive effect on respiratory diseases. Oleo-gum of Ferula assa-foetida contains this compound. This study assessed the effects of Ferula assa-foetida L. oleo gum resin and tragacanth (Phytopaj) on patients with COVID-19. Materials and Methods: A randomized, single-blinded, controlled trial (RCT) phase 2 was conducted in Mashhad on hospitalized COVID-19 patients. In this RCT, 122 patients were randomly assigned to either receive a 14-day oral phytopaj plus ordinary treatment or ordinary treatment only. Changes in peripheral blood lymphocyte count (LC) and blood oxygen saturation (PO2) were the endpoints. Results: Mean±SD of PO2 in Phytopaj comparison ordinary treatment before intervention was 91.86±4.62 and 91.41±9.18, after the intervention it was 93.22±4.26 and 91.91±5.92 mmHg; before intervention, mean±SD of peripheral blood lymphocyte count was 1015.90±500.55, and 1104.28±543.61, and after intervention, it was 1652.27±921.38 and 1326.12±719.28/µL respectively. Conclusion: Phyopaj is most useful in moderate stages of Covid19, and it is not recommended for elderly patients and patients with comorbidity until more insight is gained.

Acute invasive fungal rhinosinusitis: our experience with 18 cases.

Acute invasive fungal rhinosinusitis (AIFRS) is a rapidly progressive life threatening infection that is seen most commonly among immunocompromised patients. We present a case series of 18 patients clinically and histopathologically diagnosed with AIFRS with a mean follow-up of 9.11 ± 2.51 months (range 6-17). Demographic data, apparent symptoms and signs, underlying disorders, and outcomes are discussed. The mean age was 39.56 ± 20.66 years (range 2-75). The most common underlying diseases were diabetes mellitus (50 %) and leukemia (44.44 %). Mucosal biopsy confirmed fungal invasion of the nasal mucosa in all cases. The main fungi were Rhizopus oryzae (55.56 %), Absidia mucor (16.67 %), and Aspergillus fumigatus (27.78 %). Headache and facial pain (77.8 %), facial paresthesia (55.6 %), and ophthalmoplegia (33.3 %) were the most common symptoms and signs. Computed tomography and endoscopic findings showed various stages of sinonasal (100 %), pterygopalatine fossa (55.56 %), orbital (44.45 %), and cerebral (5.56 %) involvement. All patients underwent serial surgical debridement (3.78 ± 1.80 times; range 2-8) simultaneously with systemic antifungal therapy and proper management of the underlying disease. The most extreme case with brain involvement survived and recovered with no evidence of recurrent disease following treatment. All patients were considered cured after two endoscopic negative histopathologic evaluations. Three patients (16.67 %) died, one from uncontrolled leukemia and two due to renal failure. AIFRS is a potentially fatal condition, however, early diagnosis and management of the underlying disease accompanied with systemic antifungal and aggressive serial surgical intervention appears to be effective in reducing mortality in most patients.

Fatal nosocomial spread of Crimean-Congo hemorrhagic fever with very short incubation period.

Crimean-Congo hemorrhagic fever is a tick-borne viral zoonosis with the potential of human-to-human transmission with case fatality rates from 3% to 50%. The incubation period depends on host, route of infection, and viral dose. Herein, we report a nosocomial spread of the disease in a hospital at Mashhad, northeastern Iran, with a very short incubation period for one of the secondary cases. The patient was a medical student who had a negligible contact with a Crimean-Congo hemorrhagic fever patient during his admission to the hospital. The time interval between the contact and the onset of symptoms was merely 20 hours. Unfortunately, he died within 1 week of exposure.

Occupational exposure to blood and other body fluids among health care workers at a university hospital in Iran.

Occupational exposure to sharp items or body fluid splash is a hazard for health care personnel via transmission of blood-borne viruses through such exposures. To determine the occurrence of needlestick injuries and other high-risk exposures among health care workers at a hospital in Iran, data collected for 2 years were reviewed. During this period, 171 occupational exposures were self-reported. Approximately 20% of all exposed personnel were men and 80% were women. One hundred twenty-six (74%) of the exposed personnel had needlestick injuries, 13 (8%) had sharp instrument injuries, and 32 (19%) had mucosal contact with potentially infectious fluids. Thirty-two percent of injuries occurred during or after sharp instrument disposal and 67% during operative procedures. Appropriate blood tests were performed for 55 (32%) and postexposure prophylaxis was administered to 31 (18%) of the exposed personnel.

Brucellar psychosis.

Brucellosis is the most common worldwide zoonotic infection of which psychosis is a rare feature of this disease. Brucellar psychosis should be considered in a patient with unexplained, nonspecific psychological complaints. Its timely diagnosis relies on special attention to the epidemiologic profile of the patient for a possible exposure to the brucella species. This article has presented three cases of brucellar psychosis initially misdiagnosed because the risk factors which made them at risk for the disease were ignored.