The Potential of Cannabidiol for Acute Respiratory Distress Syndrome in COVID-19.

COVID-19 disease manifests itself in a wide range of signs and symptoms, beginning with mild symptoms, such as fever, cough, and dyspnea, progressing to acute respiratory distress syndrome (ARDS) and death in some cases. The cytokine storm, or an excess of cytokines released locally, is assumed to be the primary cause of ARDS and mortality in COVID-19 patients. To enhance the survival rate of COVID-19 patients, early management of the cytokine storm with immunomodulators is crucial. Although the effectiveness of some immunosuppressants, such as corticosteroids and tocilizumab, has been studied in clinical trials, the administration of these drugs should be exercised cautiously. Cannabidiol (CBD) is a non-psychotropic phytocannabinoid from Cannabis sativa extracts with anti-inflammatory properties. This review is intended to discuss the possible utility of CBD for the management of COVID-19 patients, particularly those with ARDS.

The effects of oral pregabalin on post-Lichtenstein herniorrhaphic pain: a randomized clinical trial.

Background Pregabalin is a gamma-aminobutyric acid analog which seems to be effective in different neuropathic pains, as well as in incisional and inflammatory injuries. This study evaluated the effectiveness and safety of pregabalin on pain relief post herniorrhaphy. Methods In this randomized clinical trial, 60 men were chosen for unilateral inguinal herniorrhaphy under spinal anesthesia. The participants were randomly divided into two groups. The investigation (pregabalin) group received 300 mg of oral pregabalin 2 h before and 150 mg of pregabalin 12 and 24 h after surgery in addition to routine postoperative medication and 1 mg/kg of pethidine as needed. The control (placebo) group received placebo capsules similar to the investigation group, as well as routine medication and 1 mg/kg of pethidine as needed. All surgeries were done with the same technique. Post-surgery pain was evaluated in the walking and lying positions with a visual analog scale at 12 and 24 h and at 3 and 7 days after the surgery. Pethidine consumption and adverse effects of pregabalin were also assessed. Results The investigation group had less pain and lower visual analog scale scores at 12 and 24 h and also at 3 days after surgery and consumed less pethidine compared to the control group (p<0.05). Conclusions Pregabalin reduces pain and opioid consumption in the first 3 days after surgery. The adverse effects of pregabalin are limited to the first 12 h after surgery. Pregabalin can be suggested for pain relief, but it should be used with caution in the elderly.

Comparison of the Application of Allogeneic Fibroblast and Autologous Mesh Grafting With the Conventional Method in the Treatment of Third-Degree Burns.

Wound healing is a multipart process involving different cell types and growth factors. Third-degree burns are usually treated by early excision and skin grafting. Tissue engineering has been developed in this field in response to limitations associated with autografts. Allogeneic fibroblasts on meshed split thickness skin grafts (STSGs) are known to have useful properties in wound healing and can be used to construct a new model of living skin substitute. Fourteen patients were chosen from June 2009 until December 2010 as the sample for this study. After debridement and wound excision, meshed STSG was used to cover the entire wound. Alloskin (allofibroblasts cultured on a combination of silicone and glycosaminoglycan) was applied on one side and petroleum jelly-impregnated gauze (Iran Polymer and Petrochemical Institute) was applied on the other. The healing time, scar formation, and pigmentation score were assessed for the patients. All analyses were undertaken with SPSS 17 software. Alloskin demonstrated good properties compared to petroleum jelly-impregnated gauze. The average healing time and hypertrophic scar formation were significantly different between the two groups. In addition, the skin pigmentation score in the alloskin group was closer to normal. Alloskin grafting, including fibroblasts on meshed STSG, may be a useful method to reduce healing time and scar size and may require less autologous STSG in extensive burns where a high percentage of skin is burned and there is a lack of available donor sites.

Delay in diagnosis and treatment of gastric cancer: from the beginning of symptoms to surgery--an Iranian study.

BACKGROUND/AIMS: In developed countries, diagnosis of gastric cancer is performed in early stages through screening, and the five-year survival rate has risen to 86%. Although patients in developing countries have digestive symptoms for some time, they do not undergo early endoscopy. The patients refer to physicians in developed stages. This research was conducted to determine the median time of delay from the beginning of symptoms to surgery. METHODS: In this research, 63 patients suffering from gastric cancer were investigated during 2004-2005. A research questionnaire was completed from patient's admission to endoscopy until surgery through patient interview. Mann-Whitney statistical test and SPSS software were used for data analysis. RESULTS: Out of 63 patients, 48 (76.2%) were male and 43 (68.3%) were rural residents. The most common cancer area was cardia (31 patients) and the most common symptom was abdominal pain (28 patients). The results showed that the median total delay from the beginning of symptoms until surgery was 96 days. Median patient delay [from first symptom to presentation to general practitioner] was determined as 8 days, general practitioner delay (from the first referral to endoscopy) as 57 days, pathologist delay (from endoscopy to pathology confirmation) as 12 days, and surgeon delay (from pathology confirmation to surgery) as 7 days. Factors such as place of residence, education, income and gender had no significant effect on time of delay. CONCLUSIONS: Delays from referral to endoscopy performance and from performance of endoscopy to pathologic confirmation were higher than expected. A screening plan for timely referral of patients and performance of endoscopy seems essential. To reduce the time of delay, efforts such as physician education, cooperation between hospital units and pathologists and provision of necessary hospital equipment are highly recommended.