Journal of Cardio -Thoracic Medicine
Volume:10 Issue: 2, Spring 2022

Vitamin D deficiency (VDD) affects more than one billion individuals globally. We aimed to review all the published papers on vitamin D deficiency in  in the country. 

PubMed, Google Scholar, Web of Science, Scopus, Science direct and scientific information databases were searched for papers related to the prevalence of vitamin D insufficiency for all age groups in Iran from 2000 to 2018. The Joanna Briggs Institute prevalence critical appraisal tool was applied for the assessment of the methodological quality of these studies. The Meta-analysis is based on the random effect model using Comprehensive Meta-analysis data analysis.

Eighty-seven original articles reported on participants with vitamin D insufficiency in Iran. According to the meta-analysis of the prevalence of moderately deficient of vitamin D in men and women as well as younger and older individuals (>18 years) using a cut-off point of 25(OH) D3<20 ng/mL was 39% and 51%, respectively. Vitamin D concentrations <30 ng/mL among Iranian populations in the cities of Tehran, Shiraz, Mashhad, and Zahedan were reported to be higher than 90%. The prevalence of vitamin D insufficiency in Iranian women was higher than in men in various age groups. The highest prevalence of vitamin D insufficiency in neonates, children, adults and pregnant women was observed in the Middle East. Most countries had a high prevalence of VDD in elderly people.

Vitamin D insufficiency is common in the Iranian population and is an important public health problem that should be considered seriously.

Diabetes mellitus is a chronic multisystem disease that lungs are also affected .However, there are conflicting evidence about the abnormal pulmonary function in diabetic patients. This study evaluated the difference between pulmonary function tests among patients with type 2 diabetes and healthy adults. This present descriptive cross sectional had been studied in Khorasan Razavi province of Iran from November 2016 to May 2017. The patients with type 2 diabetes which were older than 18 years without history of pulmonary diseases, heart failure, smoking, anemia, musculoskeletal, pulmonary or connective tissue disorders were included in the present study. A group of healthy volunteers participated as a control group with similar age, gender, height and weight to the diabetic participants. Both groups underwent spirometry and body box . Pulmonary function tests among study groups were compared. Total number of 40 diabetic patients as the case group and 40 healthy individuals as control group enrolled in this study. The control group had significantly higher force vital capacity (FVC), forced expiratory volume in 1 second (FEV1)  and lower FEV1/FVC (P=0.001, P=0.05 and P=0.001 respectively). Males in diabetic groups had significantly lower FVC and FEV1/FVC (P=0.01 and P=0.003) and diabetic females had significantly higher FVC, FEV1 and lower FEV1/FVC (P=0.001, P=0.05 and P=0.003 respectively). According to the linear regression model, by controlling the effect of gender, diabetes significantly affected both FEV1/FVC and FVC levels. The present study demonstrated that diabetic patients are more likely to develop abnormal pulmonary function and  gender can affect the pulmonary function of the diabetic patients.

Foreign body aspiration (FBA) is a life threatening medical condition and considered a surgical emergency in patients with acute symptoms. Eating disorders like pica may increase the rate of foreign body ingestion especially in toddlers with immature airway protective reflexes. Iron deficiency is the common cause of both pica and anemia in infancy and this article evaluates the incidence of anemia among patients with FBA. Medical records of 141 children with aspirated foreign body were reviewed. Control group consisted of patients who had been operated because of inguinal hernia considering the same exclusion criteria and age range and sex distribution. RBC indexes were assessed and incidence of anemia was evaluated and compared between FBA patients and control group. Anemia according to age matched Hemoglobin was observed in 34.8% of FBA cases and 15.6% in control group so anemia in FBA group was significantly more common than control group. Screening and early detection of IDA in childhood, especially in high risk group should be considered a public health care priority to prevent its direct or indirect life-threatening complications such as foreign body aspiration.

Bacterial endocarditis is one of the high mortality complications after the valve surgery. Despite the medical advancements, the mortality rate of Bacterial Endocarditis has not been decreased. We designed this study to determine the epidemiology of Bacterial Endocarditis following surgery.  This is retrospective study  from 2012 to 2016 in  Mashhad University of Medical Science. Patients with history of Cardiac Surgery with Implantation of Prosthetic valve .The diagnostic method of bacterial endocarditis was based on the Duke’s criteria, Transthoracic echocardiography, and culture lab. Among 2802 patients with cardiac valve surgery, 9 patients had developed Bacterial endocarditis. The common infectious valve was mitral (58.4%) and prosthetic valves were mostly used in general (77%). There was no relationship between gender (p=0.47), marital status (p=0.68), and type of surgery (p=0.29) and Bacterial endocarditis. But there was a significant relationship between the type of valve surgery and Bacterial endocarditis (p=0.01). Also, 3 patients with Bacterial endocarditis had a history of smoking and drugs. Three patients also died and were excluded. Bacterial endocarditis differ according to the different studies and our results were compatible with previous studies. Our study confirmed that the utilization rate of the prosthetic valve was higher than the homograft valve. The use of antibiotics should be evaluated prior to performing a culture test which could affect the test results and consequences of the study.

Mediastinal enteric cysts occurs rarely amongst adults and are encountered mostly in neonates and infants. In most cases they present as a right posterior mediastinal mass, often accompanied by vertebral defects. A case of a 69 years old female who had a mediastinal mass on chest X-ray as an incidental finding was reported to us. Computed Tomography (CT) scan was performed and found to have a cystic mass in the left anterior mediastinum with no associated vertebral anomalies. Posterolateral thoracotomy followed by cyst excision was performed. Histopathology report confirmed to be an enteric cyst.

Pulmonary mass lesions are very commonly encountered in our practice. Sometimes they present as homogenous opacity on a Chest Xray or CT scan and sometimes as a collapsed lung. Most of them are malignant and some are benign also. Lung infections rarely present as endobronchial mass. Only histopathology can aid us in diagnosing. One rare disease that can present as an invasive mass lesion is Pulmonary actinomycosis. We present a case of Lung actinomycosis coinfected with Mycobacterium tuberculosis that presented to us with the complaint of right lung collapse and effusion due to endobronchial growth mimicking lung malignancy.

In the present study, a 63-year-old patient with no history of immunodeficiency was described. Accordingly, he referred to our center with fever, sweating, shaking chills, cough, and retrosternal chest pain that started three weeks ago. Pre-operative CT scan revealed a cystic mass with peripheral enhancement in the anterior mediastinum. The patient underwent open thoracic surgery and as a result, an infected thymic cyst was seen which was confirmed by performing pathologic examinations after resection.