complications

There are few reports related to the possible side effects of injected vaccines, and evaluating the frequency and severity of the complications of COVID-19 vaccines can increase the knowledge, safety and importance of vaccines and reduce mistrust towards them. Therefore, we assessed the frequency and severity of the complications of COVID-19 vaccines in the medical staff of Khatam Al-Anbia and Ali Ibn Abi Talib hospitals in Zahedan.

In this cross-sectional study, 200 medical staff working in two hospitals, Khatam Al Anbia and Ali Bin Abitalib Zahedan were studied. The frequency of side effects after COVID-19 vaccination was recorded in the questionnaire.

The distribution of the frequency of the type of vaccine received in the studied treatment group is equal to 83 people (41.5%) AstraZeneca vaccine, 82 people (41%) Sinopharm vaccine, 22 people (11%) Sputnik vaccine and 13 people (6.5 %) had received Barekat vaccine. The frequency distribution of side effects in the first dose and the second dose after receiving the COVID-19 vaccine was equal to 135 people (67.5%) and 96 people (48%), respectively. Distribution of the percentage of the type of side effect that occurred after receiving the first dose of COVID-19, according to fever (80.7%), headache (46.7%), weakness (40%), disorder Sleep (33.3%), myalgia (n19.2%), sweating (10.3%), dizziness (9.6%), tachycardia (18.8%), sore throat (6.7%), chest pain (5.2%), arthralgia (5.2%), rhinorrhea (3.7%), diarrhea (2.9%) and loss of appetite (2.9%).

It can be stated that the COVID-19 vaccine did not show severe side effects and with timely management and supportive treatment and control of side effects, patients were encouraged to get vaccinated and as a result, the collective immunity level of the society improved.

Continuous ambulatory peritoneal dialysis (CAPD) is a conventional treatment for children with end-stage kidney disease. All infectious and non-infectious complications should be detected early and managed because they may cause ultrafiltration, or Soult failure, or catheter failure. This study aims to investigate infectious and noninfectious complications of CAPD, such as mechanical and metabolic issues, at a children’s medical center between 2020 and 2022.

A retrospective cross-sectional study was performed on pediatric patients with end-stage renal disease (ESRD) undergoing peritoneal dialysis at Children’s Medical Center in 2020-2022. Data were collected from the medical records and files and entered into SPSS software, version 26 for analysis.

The study included 30 participants with an average age of 5.89±1.2 years. Twothirds of the participants were boys. Among the girls, 70% (7 of 10) and 80% of the boys (16 of 20) developed peritonitis. Bacterial infections were mostly observed in girls more than 2 times. Tunnel infections were observed in 10% of patients, three girls and one boy. Exit-site infection occurred in eight boys and one girl. Non-infectious complications, such as seizures, were observed in approximately 40% of patients. An inguinal hernia was observed in all male patients.

In our experience, the most common infectious complication observed in CAPD patients was bacterial peritonitis caused predominantly by staphylococcus aureus. Tunnel infection and exit site infection were also common, while the predominant non-infectious complication was hernia.

Studies on diabetes and its associated oral complications indicate that diabetic individuals are more prone to cardiovascular, renal, neurological, eye, and, particularly, oral health issues. Vascular problems, oxidative stress, immune system imbalances, and deficiencies create favorable conditions for the growth of gram-positive and harmful bacteria, as well as various fungi, especially Candida albicans , in the mouth and gums.

This study was designed and conducted to assess the incidence of periodontal disease in diabetic patients admitted to Imam Khomeini Hospital (RA).

This cross-sectional study was conducted at Imam Khomeini Teaching Hospital in Urmia, Iran, and included patients admitted to the endocrinology department with glycemic disorders and diabetes. The demographic information of the patients, including age, gender, disease duration, fasting blood sugar, glycosylated hemoglobin (HbA1c), Body Mass Index (BMI), and systolic and diastolic blood pressure, was recorded.To assess periodontal health, the oral symptoms of the patients were evaluated and recorded, including dry mouth, unpleasant taste in the mouth, bad breath, loose teeth, swollen gums, sensitive teeth, gum bleeding, burning mouth and tongue, and a burning sensation in the gums. Additionally, oral and dental hygiene practices were assessed based on the use of a toothbrush, toothpick, dental floss, and mouthwash. Patients were also examined for chronic periodontitis, with the severity classified as mild, moderate, or severe.

This retrospective cross-sectional study included 400 diabetic patients admitted to Imam Khomeini Hospital in Urmia, Iran. Among them, 214 patients (53.5%) were male, and 186 (46.5%) were female. The average age of the patients was 51.49 ± 5.73 years, with a minimum age of 37 years and a maximum of 61 years. The frequency of periodontitis among the studied patients was 88.25%.Regarding oral symptoms, the most common symptom was dry mouth, reported by 57.75% of patients, followed by an unpleasant taste in the mouth (22.25%). The least common symptom was a burning sensation in the gums, with a frequency of 11.25%.

The results of this study indicate that the incidence of periodontal disease in diabetic patients at Imam Khomeini Hospital in Urmia is 88.25%. Furthermore, in diabetic patients, there is a direct and significant relationship between glycemic control and the severity of periodontal disease.

A 59-year-old male patient with stage five chronic kidney disease presented to the nephrologist to discuss long-term renal replacement therapy.

Nipple sparing mastectomy has become a preferred method in breast cancer patients but safety of this procedure in large ptotic breasts needs to be documented to broaden its application. We aimed to assess complication rates of patients undergoing NSM and immediate implant-based reconstruction with skin reduction to determine the safety of reduction in this patient group.

Patient with breast cancer and ptotic breasts whom received nipple sparing mastectomy and immediate implant-based breast reconstructions were analyzed, operated between April 2020 to last month of 2023 in Shiraz, Iran. Post-operative complications were recorded and analyzed.

The mean age and BMI of patients were 40.76 ± 5.0 and 23.72 ± 3.27 year, respectively. The median post-operative24 months (min 14, max 34). None of patients had disease recurrence. The most common complication was the flap full thickness necrosis, occurring in a total of 7 (20%) breasts. The incidence of full thickness necrosis was just seen in patients with ptosis grade III, and the most common site for the necrosis was the suture line [4/7 (12%)]. The other 3 patients had full thickness partial necrosis of NAC. We did not have any complete NAC necrosis.

Nipple sparing mastectomy and immediate implant insertion in ptotic breasts, is a valuable method of reconstruction with acceptable rate of complications.

The re-revision of anterior cruciate ligament reconstruction (ACLR) can be contemplated a secure and efficacious surgical technique with good results, whether it is performed in one -stage or two-stages or is performed with autograft or allograft. With reg ard to the surgical technique, there is no evidence that performing ACLR in one stage is superior to performing it in two stages. With respect to graft choice, allograft is the most chosen, and the allograft most frequently utilized is the Achilles tendon. However, the best graft to use for re-revision is not yet known. For revision ACLR orthopedic surgeons have to contemplate the amendment of an outrageous posterior tibial slope, especially after having failed two or more consecutive interventions. The potential benefit of combining ACLR with an anterolateral ligament reconstruction is to achieve greater rotational stability. It will diminish both the elevated failure percentages observed specifically in young individuals and increasing osteoarthritic chang es encountered following sole ACLR. Level of evidence: III

Delirium is a common challenge in pediatric open heart surgery intensive care units (OH-ICU). It is believed that emergence of delirium can lead to extended hospitalization periods. Therefore, we decided to investigate the association between delirium and its inciting factors in OH-ICU. This was a cross-sectional study on 92 pediatric patients admitted to OH-ICU of “Children’s Medical Center” in Tehran, Iran, for more than 48 hours. To screen for delirium, the Cornell Assessment of Pediatric Delirium (CAPD ≥ 9) was utilized. Demographics, length of stay, development of complications, delirium, and factors associated with delirium were recorded. We observed 34 (37%) cases of delirium in patients in OH-ICU. We had 51% male patients and 49% female ones, with a median age of 8 (0.2-144) months. The median length of mechanical ventilation was 11.5 hours (2-405) and they stayed in the hospital for a median of 4 days (2-31). The most common cardiac abnormality was ventricular septal defect (18%), associated with tetralogy of Fallot (TOF) (10%). Most of the patients (71%) experienced no adverse events during their stay; however, among those who did, vomiting and post-operation chorea were the most prevalent. Among the patients in our study, age [adjusted odds ratio (AOR) = 0.91], weight (AOR = 1.34), and sex (AOR = 0.31 for boys vs. girls) were significantly associated with delirium. We observed delirium in 37% of the patients. Development of delirium in patients admitted to pediatric intensive care unit (PICU) was associated with younger age, female sex, and higher weight.

Fournier gangrene is a rare but severe complication of ulcerative colitis, characterized by necrotizing fasciitis affecting the genital and perineal regions. We present a case of a 53-year-old man with a history of ulcerative colitis and cytomegalovirus (CMV) colitis who developed Fournier gangrene, an exceptionally uncommon occurrence in this patient population. The patient initially presented with intense pain, swelling, and skin discoloration in the genital area, accompanied by systemic symptoms, including fever. Prompt recognition and intervention are critical due to the aggressive nature of Fournier gangrene, which often results in significant morbidity and mortality. This case underscores the importance of vigilance for unusual presentations of necrotizing infections in patients with inflammatory bowel disease (IBD), particularly those with complicating factors such as immunosuppression and concurrent infections.

Recently, the relationship between clinical outcomes and postoperative complications in diabetic patients who underwent arthroscopic rotator cuff repair has been reported. However, based on knowledge, very limited studies have focused on the association between preoperative hemoglobin levels and postoperative complications. Therefore, considering the importance of the subject, the aim of this study was to evaluate the association between complications 6 months after surgery and the average level of hemoglobin 3 months before and 3 months after surgery in diabetic patients.

This retrospective study was conducted on 61 patients with diabetes who underwent arthroscopic surgery for rotator cuff repair between 2019 and 2021 in rasoul-e-akram and Mohib mehr hospitals in Tehran, affiliated to Iran University of Medical Sciences. The hemoglobin HbA1c (HbA1c) level was evaluated for all patients three months before and after surgery. All patients were followed up 6 months after surgery, in terms of tissue infection, need for revision, wound dehiscence and postoperative stiffness.

Sixteen patients (26.2%) had stiffness after surgery. There were no cases of wound dehiscence, tissue infection, or the need for revision 6 months after surgery. The results of multivariate logistic regression analysis showed that the age (odds ratio(OR): 1.13, 95% confidence interval (95% CI): 1.03, 1.27, p: 0.041), male gender (OR: 1.88, 95% CI: 1.11, 2.75, p: 0.001) and HbA1c after (OR: 1.23, 95% CI: 1.03, 1.48, p: 0.011) and HbA1c before the operation of patients (OR: 1.11, 95% CI: 1.02, 1.26, p: 0.023) were associated with a higher risk of Stiffness after surgery.

Our study showed that the mean level of HbA1c before and after the surgery was significantly associated with an increase in the incidence of stiffness after arthroscopic rotator cuff repair surgery.

This study investigated complications and 30-day readmission rates following lobectomy for lung cancer in a pre-enhanced recovery after surgery (ERAS) program setting at the University Medical Center Ho Chi Minh City, aiming to identify key areas for improvement.

A retrospective analysis was conducted on 99 patients who underwent lobectomy for lung cancer. Data on patient demographics, surgical details, and postoperative outcomes were collected. Complications were categorized using the Clavien-Dindo classification system, and statistical analyses were performed using STATA software.

Among the 99 surveyed patients, 53.5% were male, and 46.5% were female, with the majority being over 60 years old. The postoperative complication rate was 19.2% (30.9% reduction with multimodal pain relief, P = 0.001), and the 30-day readmission rate was 13.1% (19.4% reduction with physical therapy before surgery, P = 0.008). High-risk complication factors included open surgery (42.9%) compared to video-assisted thoracoscopic surgery (VATS) (11.8%) (P = 0.026) and vomiting after surgery (46.7%, P = 0.008).

The findings underscore the necessity of integrating ERAS principles to enhance postoperative care and outcomes in lung cancer surgery. Implementing ERAS protocols could potentially reduce complications and readmissions, improving patient experiences and surgical efficacy. Future research will focus on applying these insights within the ERAS framework to optimize lobectomy outcomes.

Drug addiction constitutes a global issue associated with severe personal, economic, social, and health problems. Saffron, an herbal medicine, has demonstrated potential therapeutic applications for mental and physical symptoms. This review assesses the efficacy of saffron crocin in managing the clinical and psychological complications of opioid substance withdrawal syndrome(OWS).

The research methodology entailed a comprehensive literature review spanning from 2010 to 2023, utilizing databases such as Scopus, PubMed, Embase, and Web of Science. The search focused on the impact of saffron crocin on clinical and psychological complications of opioid substance withdrawal syndrome. Human randomized controlled trials (RCTs) and animal studies published in English were included for data synthesis. Subsequently, information was collated based on the following parameters: study author, number of studies, dosage, control group, duration, outcome criteria, and primary outcomes.

Eight articles were analyzed, demonstrating the efficacy of saffron and crocin in treating opioid withdrawal syndrome (OWS) by ameliorating withdrawal symptoms and improving laboratory indicators.

While several RCTs support the effectiveness of saffron crocin in alleviating opioid withdrawal symptoms, further rigorous studies are warranted to corroborate these findings.

There has been significant interest in using Cotoneaster for treating jaundice or elevated bilirubin levels in newborns, and it has, in many cases, replaced phototherapy in herbal medicine. However, using these compounds to treat hyperbilirubinemia can lead to complications in neonates, potentially resulting in morbidity and even death.

This study examined the side effects of Cotoneaster consumption in jaundiced neonates admitted to the Children’s Medical Center between 2021 and 2022.

We conducted a cross-sectional study involving healthy neonates who consumed Cotoneaster following treatment for neonatal jaundice and subsequently experienced complications. The data were recorded using pre-prepared questionnaire forms.

The most common complications following Cotoneaster derivatives were exaggerated hyperbilirubinemia, dehydration, and poor feeding.

Given the sensitivity of neonates, the treatment of jaundice in babies should be approached with caution and supported by extensive studies. The use of herbal medicines in neonates remains questionable due to associated complications.

Subcutaneous emphysema (SE) is defined as localized tissue swelling caused by gas entering subcutaneous tissue through a tissue gap. Although SE is usually a nonfatal and self-limiting disease, in severe cases, the gas may spread to the neck, mediastinum, and chest, leading to mediastinal emphysema and other serious complications. This article aims to explore the etiology, pathogenesis, clinical manifestations, diagnosis, differential diagnosis, and treatment strategy of SE related to dental therapy, to provide some reference for dentists.

By increasing trend of cesarean sections (c-section) has raised the rate of health implications after c-section analogously. This study aimed to identify the factors influencing the choice of cesarean birth from obstetrician' perspective. Present study was a descriptive-analytical cross-sectional study at three medical centers dependent on Tehran University of Medical Sciences in 2022. The questionnaire included parents' demographic and economic factors, parents 'previous experiences and insistence of relatives, environmental and facilities, cultural and religious, the doctor's personal opinion, and the mother's clinical and psychological factors. In general, 67 gynecologists participated in the study. The average (SD) age and work experience of doctors was 42.95 (7.68), and 11.49 (8.35) years respectively. The most determining factors in the choice of cesarean delivery from the doctor's point of view were the maternal clinical and psychological factors. Other important factors were the culture and personal beliefs of the parents. The factor of fear of litigation and court in case of birth problems and complications was one of the other essential factors in choosing cesarean delivery. In the current study, the age and experience of the specialist doctor showed a positive correlation with the personal opinion of the gynecologists. Obstetricians and gynecologists are the final decision makers in choosing the type of delivery. To select the correct method, there is a need for a specific protocol for choosing the kind of delivery, and providing a suitable platform to resolve legal concerns and lawsuits.

The persistent disease 2019 (COVID-19) presents prodigious challenges for research and medical practice, mainly due to its specific epidemiological and clinical characteristics. Patients with COVID-19 pneumonia may have conditions ranging from asymptomatic to death due to respiratory failure. COVID-19 pneumonia may be associated with pleural complications such as pneumothorax (PT), pneumomediastinum (PM), pleural effusion, and empyema. This study investigates primary Pleural and Mediastinal Complications (PPMCs) and their treatment in patients with COVID-19. In this cross-sectional study, 10,000 patients with COVID-19 were investigated for the incidence of mediastinal and pleural effusions between the beginning of the second half of 2019 and the end of the first half of 2020. The average age of patients with PPMCs was 54.29 ± 14.69 years. 62% (124 patients) were male and 38% (76 patients) were female. Among 10,000 patients with COVID-19, 600 patients (6%) had pleural effusion, of which 456 (4.56%) had mild pleural effusion, and 144 (1.44%) had moderate to severe pleural effusion. The frequency of PPMCs in COVID-19 patients was as follows: 0.53% (53 cases) PT, 0.09% (9 cases) hemothorax, 0.06% (6 cases) empyema, 0.96% (96 cases) PM, 0.12% (12 cases) pericardial effusion, 0.17% (17 cases) atelectasis, and 0.04% (4 cases) emphysema. The most frequent pleural complication was pleural effusion, with a frequency of 6%, and the second most common complication was PM, with a prevalence of 0.96%. Being elderly was strongly associated with the rate of intubation and mortality in the hospital (P<0.05). No significant relationship existed between patients’ age and PPMCs (p>0.05). There was no significant difference in PPMCs between men and women (p>0.05). The results of our study show that PPMCs in patients with COVID-19 have a low prevalence, and if they do occur, the most frequent are related to pleural effusion and PM.

The COVID-19 pandemic has posed significant challenges to health systems and the global economy. As a result, effective vaccines against Coronavirus disease 2019 (COVID-19) are necessary to reduce the enormous burden of SARS-CoV-2 deaths. However, vaccination may cause side effects (SE) that threaten individuals’ lives.

This study aimed to evaluate the vaccination status and factors associated with COVID-19 vaccine complications among healthcare workers (HCWs) in Chaharmahal and Bakhtiari province, Iran.

This cross-sectional study was conducted in 2022 on 739 HCWs in Chaharmahal and Bakhtiari province. Healthcare workers were selected by cluster sampling, and their information was collected using a demographic questionnaire and disease history. The data were analyzed using binary logistic regression analysis.

Most HCWs (712, 96.3%) were vaccinated. About half of them reported complications after vaccination. More complications were reported in those vaccinated with the Oxford/AstraZeneca vaccine. Male gender, contact with suspected or confirmed COVID-19 patients, COVID-19 history, and type of vaccine were risk factors significantly associated with COVID-19 vaccine complications (P < 0.05).

This study aimed to investigate vaccination status and factors associated with COVID-19 vaccine complications among HCWs. The Oxford/AstraZeneca vaccine had the most SE, while the BIVI-Cove-Iran vaccine had the fewest SE after the first dose. Additionally, men experienced fewer vaccine SE than women. Healthcare workers have a higher likelihood of facing complications from the COVID-19 vaccine if they have been exposed to infected individuals and have previously contracted the virus.

Gallstone disease, traditionally associated with older, overweight females, is increasingly being observed in younger individuals. This shift necessitates a closer examination of the unique characteristics and risk factors associated with gallstone development in this demographic. While conventional risk factors such as gender, age, and genetic predispositions continue to play a role, emerging trends suggest that modifiable factors, including dietary habits, lifestyle choices, and medical conditions, are also influential.

In this observational study conducted at Al Wahda Teaching Hospital in Derna, Libya, between January 2021 and January 2022, we retrospectively collected data from 182 patients diagnosed with gallbladder disease. The study focused on recording demographic information and assessing modifiable risk factors, including dietary habits, reproductive history, smoking, and associated chronic illnesses.

The majority of patients were female (92.3%), with the most commonly affected age group being 26 - 30 years. The average weight of the population was also notably high. Assessment of modifiable risk factors revealed a high prevalence of a high-fat diet (75.8%) and a sedentary lifestyle (73.6%), while surprisingly, 69.2% maintained a high-fiber diet. A range of chronic illnesses contributed to a small proportion of cases, including hemolytic anemia (13.2%), diabetes mellitus (5.5%), and liver disease (4.4%). The predominance of laparoscopic cholecystectomy (54.9%) indicates a shift in treatment approach. Complications were absent in the majority of cases (81.3%), suggesting a generally favorable outcome in gallstone disease management within this cohort.

The evolving nature of gallstone disease in younger populations calls for a reassessment of understanding and management strategies. The observed trends highlight the need for further research to better understand the changing landscape of gallstone disease and to develop targeted preventive measures for this demographic.