The Effect of Body Relaxation Techniques on Pre-Eclampsia Syndrome.

Background: Hypertension in the second trimester of pregnancy is accompanied by proteinuria that is called Preeclampsia Syndrome (PES). Body relaxation is a technique which makes harmony between mind and body. The aim of this study was to investigate the effect of Body Relaxation Technique (BRT) on some symptoms of Preeclampsia Syndrome (PES). Materials and Methods: This clinical trial was conducted on 96 high-risk pregnant women who were selected by random sampling method from among women referring to community health centers of Isfahan city. The samples were divided into intervention and control groups by even and odd numbers. The intervention group members received BRT during 16 sessions. Blood pressure and proteinuria were measured and recorded before and after the intervention in both groups at the beginning and in the 36th week of pregnancy. The collected data were analyzed. Result: According to the Chi-square test, the frequency of PES was 11.10% and 23.50% in the intervention and control groups, respectively (χ2 = 3.95, df = 1, p = 0.046). After the intervention, there was no significant difference between the two groups in terms of the diastolic blood pressure and proteinuria. Systolic blood pressure and stress were also significantly reduced in the intervention group. However, proteinuria was not significantly different between the two groups. Conclusions: Based on the results, the relaxation technique, as an easy technique, is recommended for pregnant women who are susceptible to pregnancy hypertension and preeclampsia. Moreover, as a clinical complementary method, it can be recommended for preventing the symptoms of PES.

Familial Hypercholesterolemia (FH) in Iran: Findings from the Four-Year FH Registry.

BACKGROUND: Familial hypercholesterolemia (FH) is a common autosomal dominant disease. Its diagnosis in Iran was uncommon. Iran registry of FH (IRFH) has been started from 2017 from Isfahan. In this study, we report the four-year FH registry. METHODS: The Iran FH registry is an ongoing study which is followed by a dynamic cohort. It has been started from 2017. The patients are selected from laboratories due to high cholesterol level and who have history of premature cardiovascular disease. The Dutch Lipid Clinic Network (DLCN) criteria are used for the detection of FH. Cascade screening is performed for detection of first-degree relative of patients. RESULTS: Among the 997 individuals included in this registry, they were 522 (mean age 51.41 ± 12.91 year), 141 (mean age 51.66 ± 8.3 year), and 129 (mean age 41 ± 16.5 year) patients from laboratories, premature cardiovascular disease, and relatives, respectively. In total, 263 patients were diagnosed with probable or definite FH, and others were in the possible group. Low-density lipoprotein cholesterol (LDL) level was 141.42 ± 45.27 mg/dl in the laboratory group and 54.9% of patients were on LLT treatment. In patients with premature cardiovascular disease and FH, the LDL level was 91.93 ± 32.58 and was on LLT treatment. The LDL concentration in the first relative of FH patients was 152.88 ± 70.77 and 45.7% of them are on LLT therapy. CONCLUSIONS: Most of FH patients were underdiagnosed and undertreated before their inclusion in the IRFH. Cascade screening helps in the improvement of diagnosis.

Unusual gastrointestinal manifestations of COVID-19: two case reports.

As of December 2019, a new strain of coronavirus named severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was discovered in Wuhan, China, following an epidemic of a fast-spreading viral respiratory disease, later called Coronavirus Disease 2019 (COVID-19), which then lead to the present pandemic the world has come to know. Patients who tested positive for COVID-19 are mostly asymptomatic or present with mild self-limiting symptoms. While GI symptoms occur with less prevalence, they are increasingly being reported. A diagnosis of Covid-19 has increased dramatically in patients presenting with gastrointestinal symptoms suggesting that GI symptoms should be taken into serious consideration with patient diagnosis. Case 1: A 65-year-old man presented to the hospital emergency room with abdominal pain, Murphy's sign and chills without fever, subsequently diagnosed as acute acalculous cholecystitis with a positive COVID-19 rRT-PCR. Case 2: A 78-year-old woman presented to the hospital emergency room complaining of severe positional epigastric pain precipitated by lying supine, chills with no fever, being later diagnosed as acute pancreatitis and a positive COVID-19 rRT-PCR. It has become evident that the ACE2 receptor plays a significant role as the entry site into human cells for the virus. This receptor is generally expressed in respiratory cells, as well as the gastrointestinal tract, corresponding with extrapulmonary manifestations of COVID-19. Studies concluded that the origin of gastrointestinal symptoms could be caused by the interaction of the SARS-CoV-2 virus with cells through the ACE2 receptor. The findings of the present study support this theory, as both patients presented with symptoms regarding tissues with high ACE2 expression.

Axillary nerve block in comparison with intravenous midazolam/fentanyl for painless reduction of upper extremity fractures.

The painful nature of fractures has made it inevitable to use various anesthetic techniques to reduce or immobilize fractured parts. In the present study, axillary nerve block was compared with intravenous midazolam/fentanyl to induce anesthesia for Painless Reduction of Upper Extremity Fractures. The subjects in the present clinical trial consisted of 60 patients with upper extremity fractures. They were randomly divided into two equal groups of intravenous sedation (IVS) with midazolam/fentanyl and axillary nerve block (ANB). Rate of anesthesia induction, recovery time, and pain intensities at baseline, during the procedure and at the end of the procedure were recorded in both groups. Data was analyzed and compared between the two groups with SPSS 18 statistical software using appropriate tests. Demographic data, vital signs and means of pain intensities at the beginning of the procedure were equal in the two groups. In the IVS group, the overall duration of the procedure was shorter with more rapid onset of anesthesia (P<0.05). In contrast, the recovery time was much shorter in the ANB group (P<0.001). No life or organ threatening complications were observed in the two groups. Axillary nerve block can be considered an appropriate substitute for intravenous sedation in painful procedures of the upper extremity.

A fibrous histiocytoma of intermediate malignancy arisen from the parotid gland.

The light microscopic and immunohistochemical characteristics of a case of fibrous histiocytoma of intermediate malignancy arising from the parotid gland are presented. This neoplasm is rare in this site and must be distinguished from other spindle cell tumors of the parotid gland, particularly those of epithelial and myoepithelial origins. Histologic characteristics similar to those displayed by dermatofibroma and dermatofibrosarcoma protuberans help to differentiate this tumor from other spindle cell tumors. The absence of cytochemical epithelial markers is useful for establishing the diagnosis. This tumor appears to have arisen from mesenchymal elements within the gland.