Healing of a diabetic foot wound through surgical debridement using med-honey, maggot therapy, and human amniotic membrane: A case study.

INTRODUCTION AND IMPORTANCE: Diabetic foot ulcers (DFUs) are a common and challenging issue for individuals with diabetes, creating difficulties in effective wound healing and requiring novel treatment methods. CASE PRESENTATION: The individual, a 46-year-old man, arrived at our clinic with a pressure wound concern. The wound had progressed to where necrotic tissue removal was necessary, accomplished through four sessions of maggot therapy. Following this initial treatment, Med-honey dressing and human amniotic membrane application were used in eight subsequent sessions, resulting in the successful closure of the wound. DISCUSSION: Treating DFUs presents a significant hurdle in medical practice due to their intricate nature and potential complications. Recent years have seen an increase in the exploration of unconventional and innovative therapies to enhance wound healing outcomes and tackle the multifaceted challenges linked with DFUs. CONCLUSION: The effective management of the pressure wound in this 46-year-old male patient with a combination of maggot therapy, Med-honey dressing, and human amniotic membrane application highlights the significance of a personalized and interdisciplinary approach in DFUs care.

Surgical debridement and maggot debridement therapy can survive patient with diabetic foot ulcer after foot trauma: A case report.

INTRODUCTION AND IMPORTANCE: Diabetic foot ulcers, a common issue associated with diabetes, can pose challenges in treatment, especially when they do not respond to traditional therapies. Maggot therapy, known as larval therapy, has surfaced as a substitute approach for managing stubborn wounds. CASE PRESENTATION: A 42-year-old male with a history of type 2 diabetes and peripheral neuropathy presents at the clinic with a long-lasting sore on the bottom of his right foot. The individual reveals that the ulcer has persisted for multiple months and has shown no improvement despite trying different remedies like creams and dressings. CLINICAL DISCUSSION: Diabetic foot ulcers are significant complications associated with diabetes, commonly triggered by neuropathy, peripheral artery disease, and impaired wound healing mechanisms. These ulcers can result in severe infections, amputations, and reduced quality of life for those affected. CONCLUSION: Maggot therapy arises as a valuable additional option for chronic ulcers in diabetic patients, providing a secure and efficient method for cleaning wounds and promoting healing.

Comparison of the effect of telephone follow-up with social network follow-up program on self-efficacy and depression in patients undergoing coronary artery bypass graft surgery: A randomized controlled trial.

Introduction: Coronary artery bypass graft (CABG) surgery is a common procedure to improve blood flow to the heart muscles, but patients often face challenges during the recovery period. Self-efficacy and depression play crucial roles in patient outcomes. Telephone follow-up and social network follow-up have been introduced as interventions to enhance self-efficacy. This study aims to compare the effectiveness of telephone follow-up and social network follow-up on self-efficacy and depression in CABG patients. Method: The study is a single-blinded, randomized controlled trial conducted at Shahid Rajaee Heart Hospital in Tehran, Iran. The sample size was determined to be 99 patients who met the inclusion criteria. Data were collected using a demographic questionnaire, Sullivan's cardiac self-efficacy questionnaire, and the Beck Depression Inventory (BDI). Participants were assigned to three groups: control, telephone follow-up, and WhatsApp follow-up using randomization. Data were analyzed using IBM SPSS Statistics for Windows, version 25 (IBM Corp., Armonk, N.Y., USA). Results: The results revealed significant improvements in self-efficacy and reductions in depression scores for both the telephone and WhatsApp follow-up groups compared to the control group following the intervention (p < 0.001). Additionally, the mean self-efficacy score was higher and the mean depression score was lower in the WhatsApp follow-up group than in the telephone follow-up group after the intervention (p < 0.001). Discussion: The findings provide valuable insights for healthcare professionals in choosing appropriate interventions to enhance patients' self-efficacy levels and improve mental health outcomes. Both telephone follow-up and social network follow-up interventions have their own advantages and can be effective in supporting patients' recovery after CABG surgery.

Comparing the Efficacy of Acupressure and Foot Reflexology on Sleep Quality in Patients With Leukemia: A Comparative Clinical Trial.

BACKGROUND: Among leukemia patients, sleep disruptions are prevalent and can profoundly affect their overall quality of life. Acupressure and foot reflexology, modalities rooted in traditional Chinese medicine, have garnered attention for their potential to address sleep disturbances and mitigate associated symptoms. METHODS: This research utilized a randomized controlled trial with a pretest-posttest design involving 102 leukemia patients admitted to Imam Khomeini Hospital in Urmia. Participants were randomly allocated to 3 groups: acupressure (n = 34), reflexology (n = 34), or control (n = 34). Prior to the intervention, patients completed a demographic survey and the Pittsburgh Sleep Quality Index (PSQI) for baseline assessments. Acupressure involved stimulation of the SP6 point twice daily for 10 minutes over 4 weeks, while reflexology entailed daily 10-minute sessions with sweet almond oil on the soles for the same duration. The control group received standard care without additional interventions. Following the 4-week intervention period, post-intervention evaluations were conducted using identical measurement tools. RESULTS: The findings underscored the efficacy of both acupressure and foot reflexology in significantly improving sleep quality within the intervention groups (P < .001). Initially, there were no notable differences in sleep quality among the 3 groups (P > .05). Subsequently, pairwise comparisons adjusted with Bonferroni corrections revealed significant disparities in sleep quality between the acupressure and reflexology groups compared to the control group (P < .001). However, post-intervention analysis indicated no statistically significant variance in enhancing sleep quality between the acupressure and foot reflexology groups (P < .05). CONCLUSION: This study demonstrates that acupressure and foot reflexology interventions can enhance sleep quality in individuals with leukemia. These findings support the effectiveness of these complementary modalities, offering targeted relief and relaxation. While these non-invasive therapies show promise in improving well-being, further research is needed to confirm and expand upon these results due to study limitations.

Traditional cheese consumption leading to hemodialysis induced by rifampin treatment: A case report.

This case report details the journey of a 51-year-old man residing in a remote Iranian village, involved in livestock rearing, who was hospitalized due to Brucellosis contracted from consuming traditional cheese and dairy products. Initially treated with doxycycline and rifampin, complications arose during antituberculosis therapy, with the patient developing symptoms of nausea, vomiting, and edema alongside renal function deterioration necessitating medication cessation. Subsequent manifestations of proteinuria, toxic hepatitis, and nephrotic syndrome prompted renal biopsy, revealing drug-induced glomerular and tubular damage. Swift cessation of rifampicin, combined with prednisolone therapy, led to symptom amelioration, resulting in the cessation of dialysis and the patient's discharge within three weeks. This case underscores the intricate relationship between traditional cheese consumption, medication-induced renal complications, and the importance of timely intervention and appropriate management in achieving a successful patient outcome.

The devastating impact of unresectable infectious undifferentiated pleomorphic sarcoma in the gluteal region: A case report.

INTRODUCTION AND IMPORTANCE: Undifferentiated pleomorphic sarcoma (UPS), previously known as malignant fibrous histiocytoma (MFH), is a highly aggressive soft tissue sarcoma characterized by its pleomorphic histology and lack of differentiation. CASE PRESENTATION: A 35-year-old man visited our oncology department with a complaint of a growing mass in his left buttock area. The mass had been increasing in size for the past six months, affected by local and systemic infection. While it was initially painless, the patient started feeling discomfort during sitting and physical activities a few weeks, but later the complication of tumor became more aggressive. CLINICAL DISCUSSION: UPS can arise in various anatomical sites, including the extremities, trunk, retroperitoneum, and head and neck region. Clinically, UPS may present as a rapidly growing mass, often with pain and limited range of motion. However, the presentation may vary depending on the site of origin. Treatment for UPS typically involves surgical resection, aiming to remove the tumor completely. Depending on the size, location, and aggressiveness of the tumor, additional treatments such as radiation therapy or chemotherapy may be recommended. CONCLUSION: Undifferentiated pleomorphic sarcoma (UPS) represents a rare and aggressive soft tissue sarcoma requiring prompt and accurate diagnosis for appropriate management. With its non-specific clinical presentation and histological features, UPS can be challenging to differentiate from other soft tissue tumors.

Comparing the impact of acupressure and reflexology on fatigue in chronic lymphocytic leukemia patients: A randomized controlled trial with three arms.

PURPOSE: This study aimed to evaluate the effects of acupressure and reflexology on fatigue in chronic lymphocytic leukemia patients. METHOD: In this randomized controlled trial with three arms and a pretest-posttest design, 102 CLL patients were randomly allocated to acupressure (n = 34), reflexology (n = 34), or control (n = 34) groups. Pre-intervention assessments were conducted using a demographic questionnaire and a fatigue scale for cancer patients. The acupressure group received routine care with acupressure targeting the SP6 point for 10 min twice daily over four weeks. The reflexology group received daily 10-minute reflexology sessions over four consecutive weeks following the preparation and lubrication of the soles of their feet with sweet almond oil. Post-intervention assessments were administered to all groups using the same instruments. RESULTS: Results showed both acupressure and reflexology significantly reduced fatigue compared to the control group (P < 0.001). While differences were noted between acupressure, reflexology, and control groups initially, the post-intervention analysis revealed no significant variance between acupressure and reflexology in reducing fatigue (P < 0.05), suggesting similar improvement between acupressure and reflexology. CONCLUSIONS: Acupressure and reflexology are recommended as cost-effective and low risk complementary approaches for managing fatigue in chronic lymphocytic leukemia patients. These therapies offer promise in alleviating fatigue and enhancing the quality of life for cancer patients.

Effect of spiritual care on the quality of life in patients who underwent intracranial hemorrhage surgery: a randomized controlled trial.

INTRODUCTION: One of the most important complications of stroke after intracranial haemorrhage surgery is impaired quality of life. This study was conducted to determine the impact of spiritual care on the quality of life of stroke patients. METHODS: This single-blind clinical trial with a pre-test and post-test design was conducted on 100 stroke patients. Participants were recruited and randomly assigned to a control group and an intervention group. The stroke-specific quality of life (SS -QoL) scale was used to assess the quality of life of stroke patients. The intervention group received four sessions of spiritual care. RESULTS: The independent t -test showed no significant difference between the two groups in the mean quality of life score ( t =-0.120, P =0.281) and its dimensions before the intervention. However, after the intervention, the results showed a significant difference between the two groups in terms of the mean quality of life score ( t =1.984, P <0.001) and its dimensions. In addition, the results of the paired t -test showed that in the intervention group, the mean score of quality of life ( t =5.161, P <0.001) and its dimensions were significantly different before and after the intervention. Furthermore, the results showed that before and after the intervention in the control group, the mean score of quality of life ( t =1.109, P =0.614) and its dimensions were not significantly different. CONCLUSIONS: Based on this results, the authors strongly recommend the use of spiritual care as a holistic care and complementary method to improve the symptoms and quality of life of stroke patients.

Self-esteem and optimism in patients with major depression disorder: a cross-sectional study.

Background: Depressive disorders are common mental illnesses characterized by persistent feelings of sadness, hopelessness, and loss of interest in activities. Self-esteem refers to the appraisal of one's worth and personality, whereas optimism reflects a positive attitude and the expectation of positive outcomes. Therefore, the present study aims to determine the average self-esteem and optimism of patients with depression in 2022. Methods: The present study is a single center and prospective descriptive-analytical study in which 121 patients out of 154 participants with major depression using convenience sampling were studied. Recruitment started on 10 June 2022 and ended on 12 July 2022. Data were collected using a demographic questionnaire, the Rosenberg Self-Esteem Scale (RSES), and the Revised Life Orientation Test (LOT -R). Data analysis was performed using statistical tests and the Pearson correlation coefficient with SPSS software version 21. Results: The mean and SD of patients' self-esteem scores were 14.68±1.30, and the mean and SD for optimism scores were 9.90±1.68. Pearson correlation analysis showed that educational level had a significant inverse relationship with patients' self-esteem scores (r=-0.009, P=0.03), and sex had a significant relationship with patients' optimism scores (r=0.175, P=0.008). Conclusion: Considering the importance of self-esteem and optimism in the recovery and return to society of patients with major depression, it is necessary to take measures to strengthen and increase self-esteem and optimism in these patients.

Fighting diabetic foot ulcer by combination therapy, including larva therapy, Medi honey ointment, and silver alginate dressings: A case report.

INTRODUCTION AND IMPORTANCE: Diabetic foot ulcers (DFUs) are a common complication of diabetes and can be challenging to manage. A combined approach can lead to faster healing and better outcomes for individuals with DFUs. CASE PRESENTATION: This case report presents a 70-year-old man with a 15-year history of diabetes who developed a diabetic foot ulcer. The patient was undergoing treatment with routine therapy. Despite the severity of the ulcer, a combination therapy approach, including larva therapy, Medi honey ointment, and silver alginate dressings, was implemented, leading to successful healing. CLINICAL DISCUSSION: By combining these three treatment modalities, we may be able to achieve a synergistic effect and maximize wound healing and infection control benefits. CONCLUSION: The combined use a honey-based Media Honey ointment and silver alginate larva therapy can be an effective treatment option for diabetic foot ulcers.

Maggot therapy, alginate dressing, and surgical sharp debridement: Unique path to save unresponsive diabetic foot ulcer.

INTRODUCTION AND IMPORTANCE: Diabetic foot ulcers are a severe complication of diabetes mellitus, affecting a significant proportion of the diabetic population. In some cases, ulcer progression and infection can lead to the need for amputation. CASE PRESENTATION: An 84-year-old male with a history of poorly controlled type 2 DM and HTN presented with an infected DFU on the plantar aspect of his right foot. This case report illustrates the successful management of an 84-year-old patient with a DFU amputation candidate, emphasizing the effectiveness of a combined treatment approach. CLINICAL DISCUSSION: Conventional treatment options, including antibiotic therapy, often fail to provide adequate healing in these high-risk patients. Alternative approaches, such as maggot therapy, which involves the application of sterile maggots to the wound bed, have shown promising results. CONCLUSION: This case highlights the potential therapeutic benefits and clinical efficacy of such a combined treatment approach, particularly in challenging cases with limited response to conventional therapies. Further studies and randomized trials may be warranted to support the incorporation of this therapy combination into clinical practice guidelines for DFU management.

Pyknodysostosis: A case report of an 8-year-old male with a rare genetic disorder.

INTRODUCTION AND IMPORTANCE: Pyknodysostosis is a rare genetic disorder characterized by skeletal and craniofacial abnormalities. It is an autosomal recessive disorder caused by mutations in the gene encoding cathepsin K. Pyknodysostosis is associated with short stature, brittle bones, and distinctive facial features. CASE PRESENTATION: This case report presents the clinical manifestations, diagnostic challenges, and management strategies of an 8-year-old male with pyknodysostosis, an extremely rare genetic disorder characterized by skeletal and craniofacial abnormalities. The patient's clinical presentation, radiographic findings, genetic testing results, and treatment approach are discussed. Additionally, the importance of genetic counseling and multidisciplinary care in managing this condition is emphasized. CLINICAL DISCUSSION: A multidisciplinary approach involving orthopedics, genetics, dentistry, and psychological support is crucial for managing patients with pyknodysostosis. Regular follow-up visits, careful monitoring of fractures, and appropriate interventions can improve the patient's quality of life and reduce complications. CONCLUSION: The importance of early recognition, genetic testing, and multidisciplinary care is emphasized for effective treatment and support. Further research is needed to enhance our understanding of this rare genetic disorder and develop targeted therapies.

The effects of coadministration of curcumin and vitamin E on the reproductive system of diabetic male rats; An experimental study.

Introduction: Diabetes causes testicular damage due to oxidative stress. Nowadays, the use of vitamins and antioxidants is one of the common methods to treat this disease. Therefore, the aim of this study is to investigate the effect of single and combined administration of these two substances on the reproductive system of male diabetic rats. Method and materials: In this study, 48 adult male Wistar rats weighing 250-270 grammes were divided into 6 groups: Control group, diabetic group, vehicle group, vitamin E, curcumin group, and vitamin E and curcumin group. The control group was the healthy group, and in the other groups, the rats were made diabetic by streptozotocin (60 mg/kg/ip). The vehicle group received 1 ml of olive oil, the vitamin E group (100 mg/kg/ip) received Vit.E, and the curcumin group (50 mg/kg/ip) received Cu. The group of rats received vitamin E and curcumin. At the end of the sixth week after treatment, blood was taken from the rats and biochemical analysis was performed to check the amount of malondialdehyde (MDA), LH hormones and serum testosterone, then the rats were killed and their testes and epididymides were removed. The weight of the testes and sperm parameters, the maturity of sperm nuclei and the integrity of their DNA were checked. The number of spermatogenic cells was determined by histological examination. Results: This study showed that diabetes caused a decrease in testicular weight, sperm count, motility, and viability, an increased percentage of sperm with immature nuclei, and an increased percentage of sperm with denatured DNA. In addition, diabetes decreased the average number of matogenic sperm, and biochemical results showed that diabetes increased the level of MDA and decreased the level of the hormones LH and testosterone. Treatment with vitamin E, curcumin and their combination improved all these parameters, and this improvement was significant in the Toam group. Conclusion: Combined administration of vitamin E and curcumin in diabetic rats significantly improves sperm parameters, matogenic sperm count, and improves MDA levels, LH, and serum testosterone compared with separate treatment.

Surgical management on a rare type of vertical liner fracture of tibia: A case report study.

INTRODUCTION AND IMPORTANCE: The vertical liner fracture of the tibia is an infrequent and intricate injury that presents considerable difficulties in terms of its diagnosis, treatment, and long-term consequences. This particular fracture pattern is distinguished by a vertical line of fracture along the length of the tibial shaft, spanning from the proximal to the distal end. CASE PRESENTATION: The 31-year-old female patient, who had no prior medical conditions, presented to the emergency department with complaints of intense pain and impaired ambulation in her right lower limb. She reported an accidental fall while descending a staircase, resulting in substantial impact and pressure on her right leg. CLINICAL DISCUSSION: While fractures of the tibia are frequently encountered, there exist exceptional instances of vertical liner fractures within this category. A vertical long liner fracture of the tibia denotes a distinct fracture type in the elongated bone of the lower limb, characterized by a vertical fracture line that extends along the length of the bone. CONCLUSION: Vertical liner fractures of the tibia, although rare, are distinct from more common tibial fracture patterns. Accurate diagnosis and thorough evaluation using various imaging methods are crucial for assessing the extent of the fracture and any associated injuries.

Gigantic undifferentiated pleomorphic sarcoma (UPS) of breast in a woman: A rare case report.

INTRODUCTION AND IMPORTANCE: Undifferentiated pleomorphic sarcoma (UPS), also known as malignant fibrous histiocytoma, is a rare mesenchymal tumor that occurs mostly in the soft tissue of the limbs and retroperitoneum. UPS of the breast is extremely rare, with less than 20 cases reported in the literature. CASE PRESENTATION: We present a case of UPS of the right breast in a 56-year-old female. The growth of tumor could not be impeded by chemotherapy and radiotherapy. Then, she underwent right modified radical mastectomy with axillary lymph node dissection. The patient died eventually due to severe respiratory failure. UPS of the breast is a rare and aggressive tumor that presents with a rapidly growing mass. It can be difficult to diagnose as it shows no specific histological features and can mimic other spindle cell tumors of the breast. CLINICAL DISCUSSION: Breast sarcomas are categorized in very rare malignancies, and the mortality of this type of cancers are significantly high as they often are not diagnosed in early stages. CONCLUSION: The treatment of UPS of the breast is mostly surgical, with adjuvant radiotherapy and chemotherapy depending on the tumor characteristics and response to neoadjuvant chemotherapy. Long-term follow-up is necessary as these tumors have a high rate of local recurrence and distant metastasis.

Diabetic foot ulcer: Successful healing with combination therapy, including surgical debridement, maggot therapy, and negative pressure wound therapy.

INTRODUCTION AND IMPORTANCE: Diabetic foot ulcers (DFUs) are a common and serious complication of diabetes. A variety of treatments available to help heal diabetic foot ulcers, including sharp debridement, maggot therapy, and negative pressure wound therapy. CASE PRESENTATION: This case report presents the case study of a male patient with an 8-year history of diabetes who developed a diabetic foot ulcer. The patient was undergoing treatment with metformin and insulin. Despite the severity of the ulcer, a combination therapy approach, including surgical debridement, maggot therapy, and negative pressure wound therapy, was implemented, leading to successful healing. CLINICAL DISCUSSION: DFUs are caused by various pathological mechanisms, the single therapy would lead to a very low level of recovery. Therefore, DFU management requires multimodal care and interdisciplinary treatment. CONCLUSION: This case study highlights the effectiveness of a multimodal treatment strategy for diabetic foot ulcers, emphasizing the importance of individualized care and combining evidence-based practices.

Surgical excision for gigantic bilateral pulmonary hydatid cyst in a 14-year-old adolescent: A case report study.

INTRODUCTION AND IMPORTANCE: Bilateral pulmonary hydatid cysts in adolescents are rare and present unique diagnostic and treatment challenges. Adolescents with pulmonary hydatid disease often present with nonspecific symptoms such as cough, abdominal pain, nausea, vomiting, and hepatosplenomegaly. CASE PRESENTATION: This case is about 14-year-old adolescent who reported feeling a mass in his chest and experienced a loss of appetite. Imaging studies were performed which showed the presence of bilateral hydatid cyst in the lung. The cyst contents were sent for histopathological analysis, which confirmed the diagnosis of hydatid cysts. CLINICAL DISCUSSION: The clinical presentation of hydatid cysts varies depending on the organs involved. Bilateral hydatid cysts may occur in various organs such as liver, lung, brain, spleen, kidney, bone and other sites. Diagnosis of bilateral hydatid cysts in adolescents is difficult because symptoms may be nonspecific and the cysts may not be apparent until they reach a sufficient size. The type of surgical approach depends on the location, size, and number of cysts. CONCLUSION: Bilateral pulmonary hydatid cysts have become an increasingly important diagnosis in adolescent patients. Imaging plays a critical role in prompt diagnosis, and surgical intervention remains the mainstay of management. There are limited studies regarding the management of such rare cases, but through a multidisciplinary approach, improved outcomes can be achieved.

A cruel invasion of Ewing's sarcoma of the skull: A rare case report.

INTRODUCTION AND IMPORTANCE: Ewing's sarcoma, a highly malignant bone tumor, typically affects the pelvis and long bones of the lower extremities in children and young adults; primary involvement of the skull is rare. Primary Ewing's sarcoma arising from the skull is very rare. In most cases, this disease is fatal, although the prognosis of Ewing sarcoma improves with radiation and chemotherapy after surgery. CASE PRESENTATION: This case is about 25-year-old woman who was referred to Omid Hospital in Urmia because of frequent headaches, where a tumor mass was found according to the results of CT scan. Biopsy confirmed small round cell sarcoma as the diagnosis. Chemotherapy was ineffective and tumor growth was unstoppable, causing the patient to die after 3 months. CLINICAL DISCUSSION: Ewing's sarcoma can affect various parts of the human body, including bone and soft tissue, but rarely the skull. Ewing's sarcoma typically grows extradural and often reaches a very large size before invading the skull or being detected clinically. CONCLUSION: In most cases, Ewing's sarcoma is fatal, although the prognosis of this disease improves with radiation and chemotherapy after surgery.

Ectopia cordis with multiple ventricular septal defect and sternal cleft in a newborn: a case report.

Ectopia cordis is a rare type of malformation where the heart is not located normally. It may be partially or completely located outside the thoracic cavity and can be associated with other congenital abnormalities. Case presentation: This case report is of a 34-week- and 6-day-old female fetus with a birth weight of 2040 g, a height of 41 cm, and a head circumference of 32 cm. The initial physical examination revealed a responsive newborn with an externalized heart outside the chest, with pericardium protection. In addition, a thoracic wall defect was detected suggesting incomplete formation of the septum bone. Moreover, in this case, the echocardiography report showed a multiple ventricular septal defect. Conclusion: The management of ectopia cordis is a challenge for any obstetrician and pediatric surgeon due to its rarity. It causes mental agony and anxiety to the parents. With an early diagnosis, termination of pregnancy can be one of the options. Once it is diagnosed late, it needs a multidisciplinary approach, and the services of a very experienced pediatric surgeon to improve the prognosis.