Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 7 2022 08 14 387 397 Gözde Özsezer Department of Public Health Nursing, Faculty of Health Sciences, Çanakkale Onsekiz Mart University, Çanakkale, Turkey Gülengül Mermer Department of Public Health Nursing, Faculty of Nursing, Ege University, İzmir, Turkey 2021 05 25 2021 09 08 Artificial intelligence applications are known to facilitate the diagnosis and the treatment of COVID-19 infection. This research was conducted to investigate and systematically review the studies published on the use of artificial intelligence in the COVID-19 pandemic. The study was conducted between April 25 and May 6, 2020 by scanning national and international studies accessed in "Web of Science, Google Scholar, Pubmed and Scopus" databases with the keywords ("Coronavirus” or “COVID-19") and ("artificial intelligence" or “deep learning” or “machine learning”). As a result of the scanning process, 1495 (Google Scholar: 1400, Pubmed: 58, Scopus: 30, WOS: 7) studies were accessed. The studies were first examined according to their titles, and 1385 studies, which were not related to the research topic, were not included in the scope of the research. 50 articles, which did not meet the inclusion criteria, were excluded. The abstract and complete texts of the remaining 60 studies were scanned for the study's inclusion and exclusion criteria. A total of 10 studies, consisting of reviews, letters to the editor, meta-analysis studies, animal studies, conference presentations, studies not related to COVID-19, and incomplete studying protocols, were excluded. There were 50 studies left. 9 articles with duplication were identified and excluded. The remaining 41 studies were examined in detail. A total of 26 researches were found to meet the criteria for the systematic review study. In this systematic review, AI applications were found the be effective in COVID-19 diagnosis, classification, epidemiological estimates, mode of transmission, distribution and density of lesions, case increase estimation, mortality/mortality risk and early scans. https://acta.tums.ac.ir/index.php/acta/article/view/9422

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 7 2022 08 14 398 398 Omar Ajaj Department of Pediatric Surgery, University of Anbar, College of Medicine, Anbar, Iraq 2021 07 29 2021 12 26 Clinical Case    A 5-year-old female child, who consulted for pigmented patches involving the posterior surface of the trunk, buttocks and upper one third of both legs. There were hairy surface, dark, black colour and a sharply bordered measuring 29×39.5 cm (Figure 1).    The physical  examination of child was normal. There was no history of other congenital anomaly or neurological deficit . No abnormality(bleeding or ulceration )was detected in the lesions. She was a product of non- consanguineous marriage. Both parents were healthy and none of the close family members had similar skin lesions.    A clinical diagnosis of Giant congenital melanocytic nevus (GCMN) was made. The patient was advised frequent follow-up visits and the performed screening procedures, including ultrasound and CT scan of lumbosacral region, did not reveal any abnormalities. https://acta.tums.ac.ir/index.php/acta/article/view/9568

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 7 2022 08 14 399 406 Maryam Moradi chaleshtori Department of Pathology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Parvin Kheradmand Department of Pathology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Nastaran Ranjbari Department of Pathology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Mahin Taheri-Moghadam Department of Anatomical Sciences, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 2021 08 04 2021 12 27 Colorectal cancer (CRC) is common cancer with a high mortality rate worldwide. Cyclin D1 is a gene that regulates cell cycle passage from stage G1 to S (G1/S checkpoint) and has recently been linked to the prognosis of a variety of cancers. Therefore, the aim of this study was to investigate the expression of cyclin D1 in colorectal cancers and its relationship with clinicopathologic factors. In this retrospective study, paraffin blocks of tumors of consecutive CRC patients registered in the histopathology laboratory of hospitals affiliated with Ahvaz Jundishapur University of Medical Sciences were used. Patients' clinicopathologic findings were extracted from their files, and using paraffin blocks, specific staining for cyclin D1 was performed using the immunohistochemistry method. Data were analyzed by SPSS software. In terms of staining, 11 samples (28.9%) scored 4, 11 samples (28.9%) scored 3, 8 samples (1/21%) scored 2, 3 samples (7.9%) scored 1, and 5 samples (2/13٪) scored zero. Staining intensity was severe in 10 cases (26.3%), moderate in 14 cases (36.8%), mild in 8 cases (21.1%), and negative in 6 cases (15.8%). The severity and extent of staining had no significant relationship with sex, age, tumor location, degree of differentiation (grade), depth of invasion, tumor size, lymph node involvement, and vascular and perineural invasion (P>0.05). Despite the high expression of cyclin D1 in colorectal carcinoma, no significant relationship was observed between its expression and prognostic factors, which is probably due to the small sample size. https://acta.tums.ac.ir/index.php/acta/article/view/9582

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 7 2022 08 16 407 412 Azar Hadadi Research Center for Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran Ali Ajam Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran. Mahnaz Montazeri Department of Infectious Diseases, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Samira Kafan Department of Pulmonary Diseases, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Abdolazim Veisizadeh Department of Infectious Diseases, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Morteza Ghoghaei Department of Internal Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Sina Kazemian Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran Arezoo Ahmadi Department of Anesthesiology and Critical Care Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Fazeleh Majidi Research Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Maryam Moghadasi Rheumatology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Mehdi Kashani Research Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Faezeh Ghasemi Research Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Marzieh Pazoki Department of Pulmonary Diseases, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran 2021 08 15 2021 12 28 Remdesivir, an antiviral medication, became an early promising therapeutic candidate for coronavirus disease 2019 (COVID-19) due to its ability to inhibit the virus in vitro. Current evidence about remdesivir treatment has been very controversial, so we aim to evaluate remdesivir to improve our knowledge about COVID-19 management and its long-term effects. In this retrospective cohort study using registered data derived from the Sina Hospital COVID-19 Registry with a 9-month follow-up, we enrolled patients receiving remdesivir and then matched a "control group" which did not receive remdesivir based on age, gender, and severity using propensity score matching. We used multivariant Cox regression to evaluate the remdesivir effect on patients' 9-month and in-hospital survival. We enrolled 227 patients, 116 in remdesivir and 111 in the control group. 213(93.8%) patients developed the severe disease, 88(38.8%) died during the 9-month follow-up, and 84(37.0%) died during hospitalization. In multivariate analysis, remdesivir did not affect the 9-month all-cause mortality and in-hospital mortality. Remdesivir was associated with increased in-hospital survival only in severe patients with diabetes (HR: 0.32; 95% CI: 0.14-0.75; P:0.008), and there was a trend for better 9-month survival in severe patients with diabetes (HR: 0.47; 95% CI: 0.20-1.09; P:0.080). We concluded that remdesivir treatment did not increase the 9-month survival rate either in patients with COVID-19 or patients with severe disease and underlying diseases. On the other hand, we found that remdesivir treatment could increase in-hospital survival only in patients with severe COVID-19 and a history of diabetes mellitus. https://acta.tums.ac.ir/index.php/acta/article/view/9595

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 7 2022 08 16 413 417 Mahnaz Montazeri Department of Infectious Diseases, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Marzieh Pazoki Department of Pulmonary Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Azar Hadadi Department of Infectious Diseases, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Melika Shafeghat Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran Abdolazim Veisizadeh Department of Infectious Diseases, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Mohammad Reza Khajavi Department of Anesthesiology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran Farhad Najmeddin Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Samira Kafan Department of Pulmonary Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran 2022 02 02 2022 06 29 During the coronavirus disease-2019 (COVID-19) pandemic, which was caused by the novel coronavirus, there is an ongoing controversy about the use of corticosteroids. This study aims to investigate the association between Dexamethasone treatment and clinical outcomes in patients with severe COVID-19. In this single-center retrospective cohort study, patients with COVID-19 were enrolled from February 16, 2020, to November 1, 2020. After performing propensity score matching with age, sex, and disease severity. The independent effect of Dexamethasone treatment on in-hospital mortality was evaluated by multivariate proportional hazards regression models. Of 1413 patients with COVID-19 diagnosis, 1172 patients entered the final analysis. 473(40.4%) patients received dexamethasone treatment with a median duration of 6.0[4.0-9.0] days. After matching and adjustment with possible confounders in the multivariate model, administration of dexamethasone significantly increased the survival in severe patients (hazard ratio: 0.25, 95 confidence intervals: 0.16-0.38, P<0.001), but there was no difference in non-severe patients (P:0.888). The administering of dexamethasone was associated with an increased in-hospital survival rate (HR: 0.25 [0.16-0.38]) in severe COVID-19 patients. The survival rate was more significant in severe patients with diabetes mellitus or hypertension after receiving dexamethasone treatment (HR:0.19). On the other hand, patients without severe disease did not benefit from dexamethasone administration. https://acta.tums.ac.ir/index.php/acta/article/view/9967

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 7 2022 08 20 418 421 Nader Ali Nazemian Yazdi Department of Anesthesiology and Pain, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran Seyed Khalil Pestehei Department of Anesthesiology and Pain, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Mehdi Sanatkar Department of Anesthesiology and Pain, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran 2022 04 02 2022 05 11 - Postoperative pain is one of the most important factors in the recovery process after surgery. The incision site of tympano-mastoidectomy is related to the innervation of the superficial cervical plexus. The aim of this study is to evaluate the effect of superficial cervical plexus block on reducing post-tympano-mastoidectomy pain. This is a prospective, double-blind clinical trial study, and patients aged 20-61 years who were candidates for tympano-mastoidectomy were included in the study and were randomly divided into two groups. Before induction of general anesthesia, the subjects underwent superficial cervical plexus block with ultrasound guidance, injection of ropivacaine 0.2% in the treatment group, and normal saline in the control group, respectively. Hemodynamic parameters, intraoperative remifentanil used to maintain hemodynamic stability, the severity of perioperative pain, nausea and vomiting, and perioperative analgesic use were compared between the two groups. Pain intensity in the recovery phase, 2, 6, 12, and 24 hours after surgery in the treatment was 2.6, 1.8, 1.4, 0.5, and 0.4 and in the control, group was 3.7, 2.5, 2.1, 1.5, and 0.9, respectively (P<0.05). Intraoperative use of remifentanil was 410±622.2 µg in the block group and 1340±448.4 µg in the control group, respectively. The need for opioid administration was 8.2±10.4 mg in the block group and 13±13.2 mg in the control group, respectively (P=0.046). The need for administration of diclofenac in the first 24 hours after surgery was 8±27.4 mg in the treatment group and 54±50 mg in the control group, respectively (P<0.001). Superficial cervical plexus block can significantly reduce pain and the need for opioid administration after the tympano-mastoidectomy operation. https://acta.tums.ac.ir/index.php/acta/article/view/10075

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 60 7 2022 08 16 422 428 Ali Zare Dehnavi Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran Maryam Daicle> Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 10 2021 11 10 610 616 Elaheh Yaghoubvand Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Rokhsareh Aghili Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran Alireza Khajavi Student Research Committee, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Mohammad Ebrahim Khamseh Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran 2020 06 09 2021 09 10 The aim of this study was to assess the performance of the Framingham, UK Prospective Diabetes Study (UKPDS), and the Action in Diabetes and Vascular disease: Preterax and Diamicron-MR Controlled Evaluation (ADVANCE) risk equations in the prediction of 4-year cardiovascular disease CVD) in Iranian people with type 2 diabetes. The 4-year risks of CVD were estimated using the three equations in a community of 557 patients with type 2 diabetes and free of CVD at baseline. A trained physician evaluated all of the participants regarding the occurrence of CVD events during follow-up. CVD was defined as major events including fatal/non-fatal myocardial infarction as well as fatal/non-fatal stroke, minor events including treated coronary heart disease (CHD), and established peripheral arterial disease (PAD). During four years of follow-up, 64 CVD events were observed (66% minor CVD events). Despite having a good calibration (estimated to observed ratio ranging from 91.37 to 98.2 percent, Hosmer–Lemeshow χ2 (HLχ2) values <15), both general (Framingham) and diabetes-specific (UKPDS and ADVANCE) equations did not have adequate discriminative ability (Area Under the Curve (AUC) ranging from 0.48 to 0.56). Framingham, UKPDS, and ADVANCE risk equations, regardless of being general or diabetes-specific, could not precisely predict 4-year risk of CVD in Iranian individuals with type 2 diabetes. https://acta.tums.ac.ir/index.php/acta/article/view/8535

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 10 2021 11 10 617 620 Mohsen Yaghubi Department of Extra-Corporeal Circulation (ECC), Razavi Hospital, Imam Reza International University, Mashhad, Iran Morteza Valaei Department of Internal Medicine, Razavi Hospital, Imam Reza International University, Mashhad, Iran Reza Ghasemi Department of Cardiology, 9 Dey Educational Hospital, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran. Mahmood Hosseinzadeh Maleki Department of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Sara Rezaei Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Samaneh Kakhki Department of Clinical Biochemistry, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran 2020 12 12 2021 08 10 Chlorine-containing bleach, as a common disinfectant, can cause mild to severe symptoms from nasal irritation to life-threatening conditions such as acute respiratory distress syndrome (ARDS). However, the toxicity level of chlorine gas depends on the duration and concentration of exposure. Herein, we describe the case of a 44-year-old man admitted to the emergency department with a chief complaint of severe shortness of breathing and hemoptysis following accidental, short-time exposure to chlorine-containing bleach. Because of the life-threatening condition, he was transferred to the Intensive Care Unit (ICU) and received mechanical ventilation along with a corticosteroid agent and antibiotic therapy. Despite limited data on management of the severe complications of the exposure, the patient successfully recovered after four days. https://acta.tums.ac.ir/index.php/acta/article/view/9015

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 10 2021 11 10 621 624 Goli Golpayegani Otorhinolaryngology research center, Imam Khomeini hospital complex, Tehran University of Medical Sciences Mehrdad Jafari Otorhinolaryngology Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Anita Karimi Shahid Beheshti Medical University, Tehran, Iran 2021 03 26 2021 08 10 Arhinia is an extremely rare condition reported in less than 100 cases so far. We report a case of arhinia with bilateral anophthalmia. In physical examination, only alar portions of the nose were partially formed. No septal, lower, upper lateral cartilages or nasal bones were detectable. Both nostrils were atretic. The orbital area was covered with skin and eyebrows were partially formed. Bilateral complete cleft lip and palate was evident. Surgical interventions should be considered not only for reconstruction of the external nose, but for timely creation of a lacrimal passage and repair of the accompanying cleft lip and palate. https://acta.tums.ac.ir/index.php/acta/article/view/9262

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 10 2021 11 10 625 628 Reza Bayat Department of Pediatrics, Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran Shahin Koohmanaee Department of Pediatrics, Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran Nejat Mahdie Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran Fatemeh Kharaee Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran Maryam Shahrokhi Department of Clinical Pharmacy, Faculty of Pharmacy, Guilan University of Medical Sciences, Rasht, Iran Afagh Hassanzadeh Rad Department of Pediatrics, Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran Saber Najafi Chakoosari