Journal of Kermanshah University of Medical Sciences
Volume:24 Issue: 4, Dec 2020

Context:

 Radiofrequency ablation is a highly effective and safe therapy for the management of patients with symptomatic Wolff-Parkinson-White (WPW) syndrome. However, the management of asymptomatic patients with radiofrequency ablation is controversial. This review aimed to investigate whether prophylactic ablation could improve the long-term outcomes of asymptomatic patients with WPW.

 A systematic literature search was performed in databases such as PubMed, Google Scholar, and Cochrane Library for the relevant articles published during 2000 - 2020. Only original studies, cohorts, and randomized controlled trials (RCTs) performed on the WPW patients undergoing radiofrequency ablation were selected.

 In total, six studies were reviewed, some of which suggested that the patients undergoing radiofrequency ablation had a high incidence of atrial fibrillation even after ablation. On the other hand, some of the findings indicated that ablation could reduce the mortality rate of WPW patients. In addition, two RCTs suggested that prophylactic ablation may reduce arrhythmic events in high-risk pediatric and adult patients, while one clinical trial showed no significant risk reduction for arrhythmias in the patients undergoing the prophylactic radiofrequency catheter ablation of the accessory pathways.

 Available evidence suggests that prophylactic ablation is effective in the prevention of arrhythmic events and sudden cardiac death in asymptomatic patients with WPW. However, the risk of asymptomatic patients becoming symptomatic or sudden cardiac death has been reported to be low. Therefore, only high-risk patients are recommended to undergo prophylactic ablation.

 The neonatal mortality rate remains high in developing countries despite the significant reduction in under-five mortality globally. Therefore, periodic evaluations on the causes of mortality are an aspect of health status, which could be performed to improve the neonatal mortality rate.

 The present study aimed to determine the pattern and causes of neonatal mortality in the Federal Medical Center in Owo, Ondo State, Southwest Nigeria.

 This retrospective study was conducted using the hospital records of the neonates admitted over a five-year period from 1st of January 2015 to 31st of December 2019.

 In total, 2,065 neonates were admitted, including 208 cases of neonatal deaths. Mortality occurred in 127 males (61.1%) and 81 females (38.9%), with the male-to-female ratio of 1.6:1. Among the recorded deaths, 114 cases (54.8%) occurred within the first 24 hours of admission, while 94 neonates (45.2%) died after 24 hours of admission. In addition, the mortality rate was higher among outborn neonates (n = 120; 57.7%) compared to inborn neonates (n = 88; 42.3%). The major causes of neonatal deaths included birth asphyxia (46.6%), prematurity (23.1%), and sepsis (17.8%). The overall mortality rate over the five-year period was 10.1%, which is equivalent to 19 deaths per 1,000 live births.

 According to the results, preventable diseases such as birth asphyxia, prematurity, and sepsis remain the major causes of neonatal mortality, of which neonatal deaths occur mostly within 24 hours of admission.

 Nosocomial infections are important medical concerns in developed and developing countries. Pseudomonas aeruginosa is considered the third leading cause of nosocomial infections following Staphylococcus aureus and Escherichia coli.

 The present study aimed to determine the antibiotic resistance of isolated P. aeruginosa strains in the patients admitted to Imam Reza Hospital in Kermanshah, Iran.

 This descriptive, cross-sectional study was conducted on 900 patients with positive P. aeruginosa cultures who were admitted to Imam Reza Hospital in Kermanshah, Iran during 2016-2018. Bacterial isolates were separated using laboratory tests, and the standard disc-diffusion method was used to assess antibiotic susceptibility based on the CLSI protocol. Data analysis was performed in SPSS version 24.

 The majority of the P. aeruginosa-positive cases were isolated from the emergency ward (44.3%), intensive care unit (21.9%), blood samples (40.4%), and urine samples (18.7%). The highest antibiotic resistance was observed against cotrimoxazole, ceftriaxone, ampicillin, ampicillin-sulbactam, nitrofurantoin, nalidixic acid, cefazolin, and cefixime. In addition, ciprofloxacin and imipenem were the most effective antibiotics against P. aeruginosa with the sensitivity of 68.1% and 57.2%, respectively.

 According to the results, P. aeruginosa had high resistance against antibiotics such as cotrimoxazole and ceftriaxone. Therefore, these antibiotics should be used correctly and reasonably, and epidemiological studies in this regard should be focused on proposing national programs to prevent the further spread of antibiotic resistance.

 Colorectal cancer (CRC) has no significant clinical symptoms at the early stages, and the molecular differences in the serum of the patients and healthy subjects could be assessed to identify the biological markers that indicate the detection of this cancer at the levels of the biological system.

 The present study aimed to assess the concentrations of the alpha-(1, 3)-fucosyltransferase IV (FUT4) enzyme and copper (Cu) and zinc (Zn) as biological elements.

 This case-control study was conducted on 40 patients with CRC, including 20 men and 20 women. A metal-free sterile tube was used to collect five milliliters of venous blood. The enzyme-linked immunosorbent assay (ELISA) based on the Biotin double-antibody sandwich technology was used to measure the human FUT4 in the sera. In addition, plasma zinc and copper values were determined using Zist Chem Diagnostics kits.

 The mean FUT4 levels in the CRC patients was slightly higher than the control group (P = 0.17), and the mean serum copper and zinc levels of these patients were lower than the control group with a significance difference in this regard (P < 0.001). In addition, the AUC of FUT4, copper, and zinc was 0.58, 0.80, and 0.77, respectively.

 According to the results, the altered levels of FUT4, copper, and zinc in the serum of the CRC patients compared to the healthy controls could be an indicator associated with the CRC disease course. Furthermore, the unusual changes in the FUT4, copper, and zinc levels may signify CRC development, which plays a key role in the diagnosis and monitoring of this cancer.

 Dysfunctional attitudes are biased assumptions and beliefs that the subject has toward himself, his surroundings, and the future world.

 The present study aimed to predict COVID-19 preventive healthy behaviors based on dysfunctional attitudes in five countries.

 This was a descriptive, correlational study, and the statistical population of the study included all individuals over the age of 18 years residing in Iran, Australia, England, Sweden, and Canada. Subjects were selected by the voluntary sampling method in the Spring of 2020. In total, 498 electronic questionnaires encompassing three sections of demographic characteristics, dysfunctional attitude scale (1987), and COVID-19 preventive health behaviors questionnaire (2020) were completed online. In addition, data analysis was performed in SPSS version 21 using Pearson’s correlation coefficient and stepwise multiple regression.

 In this study, there was a significant negative relationship between dysfunctional attitudes and COVID-19 preventive healthy behaviors (P < 0.001). In addition, perfectionism, gender, and age predicted healthy behaviors (P < 0/001). The results of the comparison of Iran with other countries also demonstrated a significant reverse correlation between dysfunctional attitudes and healthy behaviors (P < 0.001). Moreover, there was a significant association between marital status, age, level of education, gender (P < 0.001), and economic status (P < 0.05) with healthy behaviors in Iran while no significant relationship was observed in other countries studied in this regard.

 It is suggested that workshops on changing dysfunctional attitudes and strengthening positive attitudes in community members be held in-person or via cyberspace before or during the occurrence of crises such as the COVID-19 outbreak.

 Coronaviruses are a large family of RNA viruses, which range from the common cold virus to the causative agent of more severe diseases. Coronavirus was declared a pandemic in December 2019 in Wuhan, China. Iran has been an endemic zone for the spread of the coronavirus since the outset of this global epidemic and has remained among the countries largely affected by high rates of the disease.

 The present study aimed to investigate the range of the chest computed tomography (CT) scan findings among the hospitalized patients with COVID-19 in Kermanshah, Iran during March-April 2020 to contribute to the accurate diagnosis of the infected patients.

 The sample population consisted of 286 hospitalized patients diagnosed with or suspected of the coronavirus disease. Chest CT-scan images and clinical data were reviewed, and their correlation was analyzed.

 In total, 176 patients (61.53%) were male, and 110 (38.47%) were female. The mean age of the patients was 56 years. Polymerase chain reaction (PCR) results showed that 35.31% of the cases had coronavirus, while the results were negative in 64.69% of the cases. In addition, the CT-scan findings indicated 77.27% abnormal and 22.73% normal chest CT-scans. Among the patients, 75.87% recovered completely, and 18.53% died. The major CT abnormalities were diffuse ground-glass opacification (35.66%), peripheral ground-glass opacification (bilateral; 21.33%), and a combination of diffuse and peripheral ground-glass lesions (18.88%). The consolidation lesion of one lobe was detected in 16 patients, and the consolidation lesion of more than one lobe was observed in 40 patients.

 According to the results, the most common chest CT-scan findings in COVID-19 include diffuse ground-glass opacification, peripheral ground-glass opacification (bilateral), central ground-glass opacification (bilateral), a combination of diffuse and peripheral ground-glass opacification, a combination of central and peripheral ground-glass opacification, the consolidation lesion of one lobe, and the consolidation lesion of more than one lobe. Furthermore, significant correlations were observed between the CT-scans and the main clinical symptoms, while no significant correlations were denoted between the chest CT-scan and PCR results.

The conversion disorder (CD) or functional neurological symptom disorder is a diagnostic category used in some psychiatric classification systems, which often refers to the patients presenting with neurological symptoms. Parkinson’s disease (PD) essentially affects non-motor and motor functions. The chronic use of levodopa, which is the primary treatment in this regard, has been reported to cause complications such as the wearing-off phenomenon. This problem may also increase the disease symptoms, as well as the patients’ need to receive higher doses of the drug to remain symptom-free for a longer period. This case study aimed to describe a 47-year-old male patient with PD and psychotic features, the symptoms of which had progressed in a conversional setup relating to particular visitation times. According to the examinations, CD was the main problem, which simulated the features of PD.

 Coronavirus disease (COVID-19) causes a severe acute respiratory syndrome and is known as coronavirus 2 (SARS-CoV-2), which was first discovered in December, 2019 in Wuhan, China. The question of whether the COVID-19 patients that recover from the disease acquire immunity or are still susceptible to reinfection remains unanswered.

 In this study, we presented the case of a 46-year-old male who recovered from the first round of COVID-19 infection. After symptom resolution, two consecutives negative real-time reverse transcription-polymerase chain reaction (RT-PCR) tests confirmed the negativity of the patient. Seven weeks after the first infection, the patient presented with fever and dry cough, and the infection was confirmed using real-time RT-PCR. The reinfection was associated with more severe symptoms, which required antiviral treatment.

 Our study indicated the possibility of COVID-19 reinfection. If the occurrence of reinfections is confirmed, it may implicate changes in the vaccine and community-based disease prevention strategies. Further studies are required to confirm the possibility of COVID-19 reinfection.