Motor polyradiculoneuropathy as an unusual presentation of neurobrucellosis: a case report and literature review.

Brucellosis, a zoonotic disease caused by Brucella species, poses a significant global health concern. Among its diverse clinical manifestations, neurobrucellosis remains an infrequent yet debilitating complication. Here, we present a rare case of neurobrucellosis with unusual presentations in a 45-year-old woman. The patient's clinical course included progressive lower extremity weakness, muscle wasting, and double vision, prompting a comprehensive diagnostic evaluation. Notable findings included polyneuropathy, elevated brucella agglutination titers in both cerebrospinal fluid and blood, abnormal EMG-NCV tests, and resolving symptoms with antibiotic therapy. The clinical presentation, diagnostic challenges, and differentiation from other neurological conditions are discussed. This case underscores the importance of considering neurobrucellosis in regions where brucellosis is prevalent and highlights this rare neurological complication's distinctive clinical and radiological features. Early recognition and appropriate treatment are crucial to mitigate the significant morbidity associated with neurobrucellosis.

Comparing the Efficacy of Diluted Lidocaine Solution and Placebo in Reducing Pain Perception During Burn Wound Dressing Change.

The aim of this study was to evaluate the effectiveness of 0.08% diluted lidocaine solution during and after wound dressing procedures for patients with burn injuries. Fifty burn patients aged 18-60 years, with burns ranging from 30% to 60%, were divided into intervention and control groups. The intervention group received dressings diluted with 0.08% lidocaine solution, while the control group received a placebo. Vital signs were continuously monitored before, during, and after the application of new dressings. Pain was assessed using the Visual Analog Scale (VAS) checklist before and after the dressing change in both groups. The study included 25 participants in the intervention group with a mean age of 40.2 ± 6.5 and 25 participants in the control group with a mean age of 39.1 ± 6.8. The groups were comparable in terms of baseline characteristics, including gender, age, weight, height, body mass index, percentage and degree of burns, as well as average morphine intake. No significant differences were observed in vital signs or pain scores before and after dressing changes between the 2 groups. However, the intervention group reported significantly lower pain scores during the dressing change compared to the control group (P < .001). Diluted lidocaine solution during wound dressing procedures can reduce pain in burn patients. Further research with larger sample sizes is needed to establish the safety and efficacy of this technique. This study suggests that lidocaine can be a useful tool in the management of pain during dressing changes for burn patients.

Overcoming diagnostic challenges in desmoplastic fibroma of the scapula: a rare case report.

Desmoplastic fibroma (DF) is an aggressive benign tumor that commonly affects long tubular bones. Also, the skull, mandible, pelvis and spine involvement have been reported. However, its occurrence in the scapula is extremely rare. In this case report, we present the challenging diagnosis and successful treatment of DF in a 27-year-old woman who had been experiencing worsening pain in her right shoulder for 5 years. Plain radiographs and magnetic resonance imaging revealed a lucent, trabeculated and expansile infiltrative lesion, disrupting the posterior cortex and extended to the posterior soft tissue. After ruling out malignancy through a core needle biopsy, the patient underwent wide surgical resection of the tumor, which involved a hemi-scapulectomy. And histologic diagnosis consistent with DF, no postoperative radiation was administered. Remarkably, the patient became pain-free just 2 weeks after surgery. Follow-up examinations, X-rays and computed tomography scans conducted 6 weeks, 6 months and 18 months after surgery revealed no signs of recurrence.

Potential Adverse Effects of COVID-19 Vaccines on Iranian Healthcare Workers: Comparison of Four Available Vaccines in Tehran: A Retrospective Cross-sectional Study.

Objectives: This study aimed to compare four COVID-19 vaccines for their potential extensive side effects and the relationship between the side effects and age, body mass index (BMI), and history of COVID-19 infection. Methods: This cross-sectional study was conducted from June to August 2021 among 1474 healthcare workers of seven selected hospitals in Tehran, Iran. All the subjects were vaccinated (91.7% received two doses and 8.3% received one dose) with one of four vaccines, Sputnik, Covaxin, AstraZeneca, and Sinopharm, at least 10 days before the study. The incidence of 47 side effects was measured after vaccination. Results: Over half of the participants (59.4%; n = 876) were 20-29 years of age, with the mean and average BMI being 26.1±9.0 and 23.5±3.4, respectively; 36.0% (n = 530) were previously diagnosed with COVID-19. There was no significant relationship between age and the incidence of side effects for AstraZeneca, Sputnik, and Covaxin; however, the occurrence of side effects of Sinopharm was significantly higher (p < 0.001) among younger healthcare workers. There was no significant relationship between BMI and the incidence of side effects for all four vaccines. However, in the group with a history of COVID-19 disease, health care workers vaccinated with the Sinopharm vaccine showed significantly (p < 0.001) more complications. The occurrence rate of at least one adverse effect and referral to medical centers for AstraZeneca, Sputnik, Covaxin, and Sinopharm vaccines were 24.9-93.9%, 18.2-86.0%, 14.8-77.0%, and 3.5-37.2%, respectively. The highest and lowest rates were found for AstraZeneca and Sinopharm showing a significant (p < 0.001) difference. The most commonly observed side effects for the AstraZeneca vaccine included fever (64.4%), fatigue (62.5%), and muscle pain (59.9%); for Sputnik muscle pain (59.8%), fever (49.5%), and fatigue (49.5%); for Covaxin fever (49.2%), topical reaction (41.0), and fatigue (34.4%); and for Sinopharm fever (18.7%), topical reaction (17.9%), and fatigue (16.6%). Inactivated virus vaccines (Sinopharm and Covaxin) showed a lower (39.7%) occurrence rate of side effects compared to viral vector vaccines (AstraZeneca and Sputnik; 90.6%). The most likely time for the vaccines to exert side effects was the first 24 hours after vaccination. Conclusions: We found no significant relationship between age, BMI, history of COVID-19 disease, and the incidence of side effects in healthcare workers vaccinated with any of the four vaccines. All four vaccines are safe and have controlled side effects.

Comparison of Side Effects of COVID-19 Vaccines: Sinopharm, AstraZeneca, Sputnik V, and Covaxin in Women in Terms of Menstruation Disturbances, Hirsutism, and Metrorrhagia: A Descriptive-Analytical Cross-Sectional Study.

BACKGROUND: Present study assessed whether Sinopharm, AstraZeneca, Sputnik V, and Covaxin's vaccinated women
reveal a distinct incidence of menstruation disturbances, hirsutism, and metrorrhagia.
Materials and Methods: Data collection was performed from June to August 2021, and 427 women working in seven
selected hospitals in Tehran were studied in this descriptive-analytical cross-sectional study. All of these women had
received one or both doses of the vaccines with one of the assessed vaccines. Required data was collected via questionnaire
and imported to SPSS 16 for further assessment and analysis. Fisher's Exact Test and Chi-Squared test were
main statistical tests used to understand whether any significant relation exists or not.
Results: The participant's mean age and body mass index (BMI) were 29.78 ± 10.55 and 23.27 ± 3.82, respectively.
Three hundred ninety-five cases (92.4%) had received both doses of the vaccines. Also, 154 cases (36.1%) had a history
of COVID-19. A total of 38 cases (8.8%) of menstruation disturbances, 20 cases (4.6%) of metrorrhagia, and 7
cases (1.6%) of hirsutism were reported after receiving the vaccines. There was a significant difference among the
vaccinated groups with the vaccines as mentioned earlier in terms of menstruation disturbances (hypermenorrhea,
dysmenorrhea, Amenorrhea) (P=0.01). The highest and the lowest incidence of menstruation disturbances were recorded
in the group vaccinated with Covaxin (17.6%) and Sputnik V (5%), respectively. There was also no significant
difference amongst the vaccinated groups with the four vaccines regarding the incidence of metrorrhagia and
hirsutism (P=0.10 and P=0.12, respectively). There was no significant relationship between all three complications
incidence with the previous infection concerning all vaccines (coefficient=0.46, 1.27, -0.15 respectively for menstruation
disturbances, metrorrhagia, and, hirsutism).
Conclusion: Seemingly, Covaxin revealed the most side effects in terms of menstruation disturbances. As a result, professionals
must carry out several studies with reasonable samples to recommend the vaccine to those women confidently.