Evaluation of chest CT scan finding in the patients with acute respiratory symptoms following positive results of RT-PCR-COVID19.

BACKGROUND: Reverse transcription-polymerase chain reaction (RT-PCR) is a standard technique for diagnosing coronavirus disease 2019 (COVID-19). The parameters for the diagnosis of COVID-19 included the history of exposure to positive COVID-19 patients, clinical signs and symptoms related to the disease, inflammation factors in the blood test or positive antigen-antibody test, and chest computed tomography (CT) findings. The current study evaluated the chest CT scan findings in patients with respiratory problems following positive RT-PCR of COVID 19. MATERIALS AND METHODS: This cross-sectional study was performed on 120 patients referred to Ali Ibn-Abi Talib Hospital in Rafsanjan, Kerman Province, Iran, with respiratory symptoms between Dec-2019 to Dec-2020. Two radiologists reviewed the chest CT scans of these patients using the checklist that included parameters such as the types of involvement (consolidation/grand-glass/crazy paving, etc.) and the patterns of involvement (central/peripheral), and the pleural findings. RESULTS: The CT scan was conducted in 107 patients with a typical condition and 11 patients with an atypical form of the disease. The frequency of the typical CT image of COVID-19 in the male group was significantly higher than that in the female group (P=0.004). The frequency of reverse halo sign, septal thickening, cardiomegaly, and crazy paving was significantly higher in males than in females (P≤0.05). Also, there was a significant difference between age groups based on the number of involved lobes (P=0.04). CONCLUSION: Chest CT scan is an important diagnostic method for COVID 19 with high sensitivity. The parameters in the CT scan are beneficial for the diagnosis of COVID 19. In addition, some characters in CT scans in the male gender are more specific.

Evaluating Pancreatic index in Patients with and without Metabolic Syndrome.

BACKGROUND Metabolic syndrome can be considered as a combination of metabolic disorders that may led to an increased risk of some diseases such type II diabetes, cardiovascular diseases, myocardial infarction, and is the cause of mortality from coronary artery disease. Its prevalence is particularly high in women. There is evidence that pancreatic fat, as a key factor in non-alcoholic fatty liver and metabolic syndrome, numerates as an early indicator of abnormal fat deposition. METHODS In this study, we enrolled 262 patients, who were admitted to Ali Ibn Abi Talib Hospital in Rafsanjan city, using the non-random-sequential method. Data collection tools were a questionnaire containing demographic characteristics (age, sex, history of diseases, etc.) and a checklist including MetS (based on NCEP/ATP III criteria and Diabetes Committee), pancreatic density (P), and spleen (S) and pancreatic index (P/S). One-way ANOVA and Post-Hoc and Chi-square tests were used for statically analyses. RESULTS The prevalence of metabolic syndrome was 34.8%, index of pancreas in the group without and with metabolic syndrome were 0.85 ± 0.11 and 0.74 ± 0.29 Hounsfield Units, respectively. CONCLUSION Compared with the group with at least one criterion and the group with the complete criteria (p = 0.013), pancreas index was higher in the group without metabolic syndrome.

Brain magnetic resonance imaging without contrast significantly increased serum levels of IL-6, but not IL-10, IL-17A and TGF-ß.

Introduction: Magnetic Resonance Imaging (MRI) is a non-invasive imaging modality. However, the effects of MRI on the immune system in the in vivo conditions are yet to be clarified. In this study we explored the effects of routine brain MRI on the protein and mRNA peripheral blood levels of interleukin-6 (IL-6), IL-10, IL-17A and transforming growth factor-beta (TGF-ß).Material and methods: 40 subjects, who referred for brain MRI, were entered for evaluating effects of routine brain MRI on the protein and mRNA peripheral blood levels of IL-6, IL-10, IL-17A and TGF-ß. Accordingly, peripheral blood were collected before and 3 hours after MRI from the participants. Protein levels of the cytokines were evaluated using ELISA. Also, mRNA levels were analyzed using Real-Time PCR techniques.Results: Brain MRI without contrast led to an increase in protein levels of IL-6 in the peripheral serum, but did not change protein and mRNA levels of IL-10, IL-17A and TGF-ß. IL-6 mRNA levels after MRI were higher in the participants with mild anxiety compared to those without anxiety.Conclusion: brain MRI without contrast can induce secretion of IL-6 and may be associated with its functions, such as development of plasma cells or induction of inflammation.

Achillea millefolium is beneficial as an add-on therapy in patients with multiple sclerosis: A randomized placebo-controlled clinical trial.

BACKGROUND: Multiple sclerosis (MS) is a neurological disease for which to date there is no cure and the existing disease-modifying drugs just slow down the disease progression. PURPOSE: In this clinical trial we evaluated the efficacy of Achillea millefolium (A. millefolium) aqueous extract in MS patients. METHODS: A triple-blind randomized placebo-controlled parallel group trial was conducted on 75 MS patients. The patients were randomized into three groups including placebo and two groups receiving A. millefolium with two different doses, i.e. 250  mg/day and 500  mg/day, for 1 year. The primary outcome was the annualized relapse rate. Also, number and volume of lesions were obtained from magnetic resonance imaging (MRI) scans. Furthermore, we performed a comprehensive neurological and cognitive tests as follows: changes in the expanded disability status scale (EDSS), the multiple sclerosis functional composite (MSFC), fatigue severity scale (FSS), Ashworth spasticity assessment, Beck depression test, State-trait anxiety inventory (STAI), mini-mental status examination (MMSE), Wisconsin card sorting test (WCST), tower of London test (TOL), word-pair learning, paced auditory serial addition task (PASAT) and standard laboratory tests. RESULTS: This study showed one year administration of A. millefolium (both doses) decreased the annual relapse rate in MS patients. The mean volume change of lesions significantly decreased in the 500 mg A. millefolium group. The add-on therapy also increased time to first relapse and the MSFC z-score; it decreased the EDSS score and improved performance in word-pair learning, PASAT, and WCST. CONCLUSION: We found beneficial effects of A. millefolium aqueous extract as an add-on therapy in MS patients.

Creutzfeldt-Jakob Disease Presenting with Dementia and Mimic a Stroke During One Year: Case Report and Review of Literatures.

BACKGROUND: Creutzfeldt-Jakob disease (CJD) is a progressive and fatal prion disease in human and its annual incidence is estimated one per million. Sporadic form of CJD is the most common form of the disease that involved 85% of cases. CASE REPORT: We presented two cases of CJD with the different clinical presentation; a 58-year-old woman who referred with amnesia, depression and a 59-year-old woman with ataxia as her chief complaint. Based on the findings and roled-out the other differential diagnosis, the CJD was confirmed. Both of them died before 12 months after diagnosis. CONCLUSION: Although CJD is a rare disease with different clinical manifestation, it is considered as one the differential diagnosis of progressive dementia.

Large vessel atherosclerotic infarction and lacunar lesions.

BACKGROUND AND PURPOSE: Lacunar infarcts are small deep infarcts resulting from an occlusion of a perforating artery, and account for about a quarter of all ischemic strokes. Some new investigations indicate that subcortical lacunar lesions may have a greater chance of causing a progressive cerebral stroke than deep lacunar lesions in future. The goal of this study was to determine the frequency of subcortical and deep lacunar lesions and its association with large vessel atherosclerotic infarction at the Ali-Ibne-Abi Taleb Hospital, Rafsanjan. MATERIALS AND METHODS: In a cross-sectional study with consecutive sampling of patients with clinical suspicion of cerebral strokes that were assessed with magnetic resonance imaging (MRI), patients with ischemic strokes were selected. Diagnosis of large vessel atherosclerotic infarction was confirmed with carotid Duplex/Trancranial Doppler sonography. Then patients with lacunar lesions on MRI were assessed about their locations. One hundred and eighty patients were studied. The data were analyzed by SPSS software. RESULTS: 57.8% of patients were women and 42.2% were men. 58.6% of patients were older than 60 years. 67.8% of patients had deep lacunar lesions, 28.3% had subcortical lacunar lesions, and 3.9% had both. 56.11% had a history of hypertension. In patients with a history of hyperlipidemia, 80.1% had deep lacunar lesions. Frequencies of hypertension and hyperlipidemia were significantly higher among the patients with deep lacunar lesion (p < 0.01). CONCLUSIONS: There is no association between large vessel atherosclerotic infarction and the site of lacunar lesions. Both hyperlipidemia and hypertension are risk factors for deep lacunar lesions.