Reviews in Clinical Medicine
Volume:8 Issue: 3, Summer 2021

Erythema nodosum (EN) is a condition in which the skin suffers from oval-shaped and tender erythematous patches, mostly on the anterior region of the leg and sometimes other parts of the body, including the arms and affects subcutaneous adipose tissue. These patches are self-limiting and usually heal on their own within one to two weeks. This is a case report of a patient who is a 14-year-old boy complained of oval-shaped tender erythematous lesions on the legs of both legs and referred and was hospitalized 5 days ago. The patient continued to complain of pain in both thighs when standing and sitting. The patient developed a high fever upon admission. There was no history of the disease while we were taking his history. All laboratory tests were performed and rheumatic diseases and possible malignancies were evaluated and rejected. The patient was treated with the anti- naproxen, an inflammatory drug, and then the patient’s pain and fever decreased. However, the patient suffered from multiple ulcerative lesions in the mouth on the final day of hospitalization. Infectious counseling was performed and he was discharged with a diagnosis of EN in the context of oral herpes. Two days after discharge, the patient suffered from hematochezia. Consequently, he was hospitalized and underwent colonoscopy, which showed multiple mucosal lesions in the esophagus and duodenum, and a sample was sent for pathology. The test result showed Crohn’s disease, and the patient was treated immediately.

The aim of this study was to determine the serum levels of ST2 protein and interleukin-33 in patients affected to tuberculosis and compare them with the control group. In the present study, at first 30 patients affected to TB were randomly selected and 52 healthy individuals, who were matched with respect to their age and gender, included in the study as the control group. After that, the serum levels of sST2 and IL33 were measured by ELISA sandwich method using commercial Quantikine Human ELISA kit (R&D Systems). The data were finally analyzed by SPSS software. IL-33 levels in the TB group were higher than the healthy controls and a statistically significant difference was observed in the IL-33 levels between the two groups (P = 0.021). Moreover, IL-33R (ST2) was slightly increased in the TB patients compared to the healthy controls, although statistical analysis showed no significant difference between the two groups (P = 0.083). Regarding the high normal variation of sST2 and the limitations of the present study, it is recommended that future studies of sST2 be performed in with higher number of TB patients.

The present study was conducted to evaluate the prevalence of trend and use of complementary and alternative medicine in patients referring to the Gastroenterology clinics in Mashhad.  

The present cross-sectional study was performed at Gastroenterology clinics affiliated with Mashhad University of Medical Sciences. The study began in December 2015 and ended in March 2017. The study subjects (n=751) were randomly selected from patients referring to Gastroenterology clinics in the city of Mashhad.  Patients responded to the questions through interviews. The collected data were analyzed by SPSS-16 statistical software.

This study was conducted on 751 patients referring to gastroenterologists; of whom, 274 (48.36%) were male and 476 (38.63) were female. According to the results, the most popular complementary and alternative medicine treatments were respectively herbal medicine, cupping therapy and acupuncture. A significant difference was observed in the means at is faction with complementary and alternative medicine between those who believed in it and those who did not (p=0.001); but, no significant difference was detected in mean satisfaction with complementary and alternative medicine between patients with different occupations (p=0.193). There was also a significant difference in the number of patients between the group of patients receiving chemical medication and the group of patients receiving complementary and alternative medicine therapies (p=0.005). No significant difference was found in the level of satisfaction with complementary and alternative medicine between participants referring to the Gastroenterology clinics for different causes (p=0.431); nonetheless, the highest satisfaction was observed in patients with malignancy, and the lowest satisfaction was detected in patients with esophageal disorders.

This study indicated the high prevalence of complementary and alternative medicine in Iran. The worldwide popularity of complementary and alternative medicine should not be overlooked, therefore; current medical treatment systems need to be revised and modified

Today, the use of new technologies has expanded in various fields. One of these cases is the use of smartphones and barcode reader software and two-dimensional barcodes. In this study, we tried to evaluate the influence of barcode utilization in the training of residents.

This was a descriptive cross-sectional study conducted in the emergency department of Ghaem Hospital, in which the effect of using educational barcodes on 30 medical residents of the emergency, internal medicine, and neurology was investigated. A questionnaire recording the performance of residents in medical emergency procedures was used. Also, demographic variables of residents were recorded. Data analysis was performed using descriptive and inferential statistics in SPSS software.

A total of 30 residents completed the study questionnaire before installing the poster, and 29 of them completed the post-test questionnaire. Of these, 10 (33.3%) were emergency medicine residents, 13 (43.3%) Internal medicine and 7 subjects (23.3%) were neurology residents. All of them (100%) found the use of QR codes practical and easy. Analysis of data related to pre-test and post-test scores of residents shows that their average scores in the pre-test, 7 ±2.39, and their average scores in the test post 10.86 ±2.431, which indicates a significant increase after using the QR code poster (P-value = 0.000)

The use of QR codes has been practical, easy, and user-friendly. Also, comparing the average scores of participants before and after the installation of these codes, shows that it has had a significant effect on training residents.

Bisphosphonates (BP) have recently been used in the treatment of bone diseases. The BP-related osteonecrosis of the jaw (BRONJ) is a severe complication of long-term usage of BP and can lead to serious consequences. This study aimed to evaluate the level of awareness and performance of dentists and senior dental students in Bandar Abbas, Iran, regarding the treatment of patients who take BP. In this cross-sectional study, a questionnaire, based on the standard guidelines, was handed out to dentists and senior dental students in Bandar Abbas city. Variables, such as gender, age, level of awareness, and performance when treating the aforementioned patients were taken into account. The collected data were analyzed using Kolmogorov-Smirnov, Levene, chi-squared, and independent t-test. The performance index was 11.8±2.82 in dentists and 14.29±5.8 in senior dental students which indicates a significant difference between them in terms of performance when treating BRONJ in patients taking BP. However, no significant difference was observed in terms of their knowledge.  The level of performance and knowledge in most dentists and dental students was intermediate and policies should be made to raise their abilities.

Stigma and disease have an ancient relation. Since disease is being considered as the curse of God and patients of contagious diseases is considered as disease spreader facing the social rejection. Wreak havoc of COVID-19 across the globe has desolated the mindset of common man, fear, anxiety and ignorance of community fuelling the social discrimination. The patient can recover the physical wound or diseases but stigma strikes the soul of victim that debilitates the will for survival. Stigma does not only affect the patients only but also the front line warriors excruciating the global emergency.  Psychological distress mitigation is still missing in COVID-19 coping strategies. This article is intended to provide an overview of social-stigmatization faced by different sets of population as well as to draw attention over mental health component assimilation in therapeutic measures of COVID-19. To ensure the physical, mental and social wellbeing of the individual, community and society as whole.

Gastrointestinal (GI) anastomosis is a usual procedure in the context of GI cancer surgeries. Performing an anastomosis may be complicated by infection, bleeding, anastomotic stricture, and anastomotic leakage. Anastomosis leakage is one of the devastating complications after performing an anastomosis which can be associated with several preoperative, intraoperative, and postoperative risk factors. Gender, body mass index, chemoradiotherapy, and underlying disease are preoperative risk factors for anastomosis leakage. In addition, surgical technique, operation time, tumor characteristics, blood loss, and blood transfusion are intraoperative risk factors. Diverting stoma and intestinal microbiota are assumed as post-operative risk factors for anastomosis leakage. In this comprehensive review, we aimed to describe risk factors of anastomosis leakage, especially blood transfusion. Blood transfusion can affect anastomotic healing by interfering with microcirculation, anastomotic healing phases, and the inflammatory phase of anastomosis healing. Compromised microcirculation caused by transfusion is one of the possible mechanisms for the failure of the anastomoses.

Recent clinical research studies evaluated metformin's potential effects as a weight-reducing drug in non-diabetic individuals despite its glucose-lowering effects. Metformin reduces weight by acting on the appetite regulatory pathways, peripheral fat metabolism, and averse unfavorable fat storage. Clinical recent findings indicated that individuals maintain weight with the help of lifestyle modifications and bariatric surgery. However, metformin's clinical efficacy on weight loss helped the individuals overcome overweight and obesity complications. Metformin alters the hypothalamic physiology, including insulin and leptin sensitivity. Furthermore, metformin regulates the circadian rhythm changes and gastrointestinal physiology by affecting food intake and regulating fat oxidation, storage fat in the liver, muscles, and adipose tissues. Research also indicated other appetite suppressing medications such as topiramate, lorcaserin, and phentermine along with metformin also seems logical but clinical data reported that their weight loss results are lacking. However, more detailed research on how metformin induces weight loss in non-diabetic individuals and the prescription of other pharmacological interventions is needed.