nooshin zaresharifi

Traumatic brain injury (TBI) is a leading cause of mortality and morbidity worldwide. COVID-19 can impact the central nervous system (CNS) and hematologic system and appears to affect clinical outcomes and the average cerebral hemorrhage volume (ACHV) in patients with TBI.

Our study focused on evaluating the effects of COVID-19 on clinical outcomes and the ACHV in TBI patients.

In this study, we included TBI patients presenting to an academic trauma center in the North of Iran and categorized them into two groups: infected with COVID-19 and non-infected. A total of 128 TBI patients were identified during 19 months of the COVID-19 pandemic.

Road accidents account for 92.2% of TBI. Among different types of brain lesions, subdural hematoma (SDH) had a significant relationship with COVID-19 (P=0.043). Among patients, 13 (10.2%) were on anticoagulants, with no significant differences between the two groups. Among the COVID-19 patients, those who were anticoagulant users experienced a higher ACHV than those who did not use this medication (P=0.015). The two groups had no significant difference in the ACHV and mortality (P=0.758, P=0.601, respectively). The regression analysis indicates no statistically significant relationship between COVID-19 and ACHV (P=0.983) or between COVID-19 and the mortality rate of TBI patients (P=0.695).

The study highlights that TBI patients with COVID-19 on anticoagulants show higher ACHV levels than those without, a pattern missing in non-COVID patients. This finding suggests a possible synergistic interaction between COVID-19 and anticoagulation, with COVID-19 potentially worsening coagulation disorders.

Changes in the body fluid and serum electrolyte status following major operations, such as brain tumor resection, are always expected. These changes can increase post-operation morbidity and mortality.

We aimed to evaluate the changes in serum electrolyte levels and renal function parameters in brain tumor patients after operation.

This cross-sectional study was performed on 168 patients with supratentorial tumors in Poursina Hospital, Rasht City, Iran, in 2020. The study parameters included patients’ demographics, hemodynamic stability, serum sodium, potassium, blood urea nitrogen (BUN) and creatinine levels, urine specific gravity, and urinary output, measured immediately and 12 hours after the operation.

This study revealed statistically significant increases in serum sodium level (from 139.70±5.60 meq/L to 140.34±6.23 meq/L, P=0.002), urinary output (from 1043.70±455.00 mL to 1967.50±661.10 mL, P=0.008), urine specific gravity (from 1.010±0.007 to 1.012±0.008, P=0.011), and in serum BUN level (from 17.46±6.92 to 18.41±6.40, P=0.001), but significant decrease in serum potassium level (from 3.88±0.49 meq/L to 3.78±0.28 meq/L, P=0.017) during the first 12 hours after operation. However, the change in serum creatinine level was not significant (from 1.18±2.08 mg/dL to 1.17±2.08 mg/dL, P=0.787).

Significant changes in serum electrolytes (sodium and potassium) and renal function indicators (urine output, specific gravity, and serum BUN) are expected within the first 12 hours after brain tumor operation.

B-cell lymphomas represent most non-Hodgkin lymphomas (NHLs) arising within lymph nodes, and about 27% of patients have extranodal involvement. Primary cutaneous lymphoma is defined as malignant lymphoma limited to the skin at diagnosis. Diffuse large B-cell lymphoma (DLBCL) is the most common form of NHL, accounting for over one-third of all lymphomas. Primary cutaneous diffuse large B-cell lymphoma (PCDLBCL) is a type of non-Hodgkin’s lymphoma with skin involvement as the first and only site of involvement. Primary cutaneous diffuse large B-cell lymphoma typically presents as a rapid-growing, red or bluish nodule or tumor on the legs, though around 10–15% of patients present with lesions elsewhere. This case report illustrates a rare manifestation of PCDLBCL presenting as a non-healing, rapidly progressive ulcer in the groin area diagnosed based on histopathology and immunohistochemical expression. The patient was treated successfully with systemic chemotherapy. This report could have implications for clinicians to consider the diagnosis of PCDLBCL in patients with unusual, non-healing, chronic ulcers, especially in the elderly, despite the anatomic site of the lesions.

 Oral lesions can affect people’s quality of life by interfering with chewing, swallowing, and speech. These lesions may originate from epithelial or mesenchymal tissues. Malignant oral lesions can be life-threatening. Epidemiological data of oral lesions in Iran is limited.

 This study aims to investigate the frequency of oral lesions in Rasht, Iran.

 In this cross-sectional study, histopathologic data of oral lesions reported by Razi laboratory in Rasht from 2015 to 2019 were evaluated. The data collected: Patients’ age and sex, histopathologic findings, and location, type and origin of lesions. Non-specific diagnoses and dental and bone lesions were excluded.

 A total of 259 pathologic reports were included. The mean age patients was 52.09±19 years, and 40.2% were male. Oral lesions in patients aged <40 years were mainly benign (64.2%), whereas half of lesions in patients ≥70 years were mostly malignant. Tongue was the most common location of the lesions (34.7%) and the main location for malignant lesions (46.7%). Benign lesions were significantly higher in females whereas malignant lesions were significantly higher in males (P=0.011). Epithelial tissues were the most common site of origin (49%) and salivary glands were the least common site of origin (11.6%) for oral lesions.

 Malignant oral lesions are more common in Iranian men aged >70 years, where the tongue is the most common site of involvement and epithelial tissue is the main site of origin.