Vitamin B12 effectiveness in the management of hospitalized COVID-19 and its clinical outcomes and complications: A randomized clinical trial.

Background and Aims: Since 2019, severe acute respiratory syndrome coronavirus 2, has spread and challenged the health care system for treatment which is mainly limited to supportive care. It is well-established that malnutrition impedes the immunity in human bodies, and makes it vulnerable to microorganisms. Vitamin B12 is one of the agents that has critical roles in body systems. Thus, the following clinical trial was conducted to assess its possible therapeutic value in COVID-19 patients. Method: The present randomized clinical trial was carried out in Baharlou Hospital, and patients with confirmed COVID-19 infection within 24 h of admission were included. We used quadruple blocks randomization to divide patients into groups of case and control. The case group received 1000 mg of vitamin B12, daily for 7 day while the patients in control group were administered distilled water as placebo. The studied outcomes were duration of hospitalization, need for intensive care unit (ICU), mechanical ventilation, mortality rate and laboratory findings. The statistical analysis was done via SPSS version 22. Results: After implementing inclusion and exclusion criteria, 34 participants were included in the study, 20 of which were male. Serum levels of creatinine, LDH (Lactate dehydrogenase), Ferritin, and CRP (C-reactive protein) had decreased in both groups. The improving changes of CRP, LDH, ferritin and creatinine was higher in case group. The increase of Alanine Transaminase and D-dimer was higher in control group. however there was no statistically significant difference. More patients were admitted to ICU in the control group but the difference was not statistically significant. Duration of hospitalization did not differ statistically between the groups. No in hospital mortality has been recorded. Conclusion: Our study suggests that vitamin B12 supplementation seem to have curative effect in COVID-19. Nutritious diet is necessary for proper functioning of the immune system. Since malnutrition is associated with poor prognosis in COVID-19 patients, and limited number of participants in this study, we suggest performing meta-analysis on similar studies to reach reliable result.

Scrotal wall leiomyosarcoma: a case report and review of the literature.

BACKGROUND: Up to 30% of all scrotal masses are sarcomas. Leiomyosarcoma of the scrotal wall is rare, and its clinical significance and prognosis have not been well defined, since the most reported cases have little or no follow-up. CASE PRESENTATION: We report a 45-year-old Caucasian man who was admitted with a firm, nontender, mobile scrotal wall mass from 15 months ago. Laboratory data including testicular tumor markers were within normal range, and transscrotal ultrasonography revealed an oval-shaped, hypoechogenic, solid mass with blood flow and well-defined border. Histopathologic examination and immunohistochemistry staining, following surgical excision, were in favor of malignant leiomyosarcoma. CONCLUSION: Here we describe the morphological features and immunohistochemical presentations of the tumor and the patient's relatively long-term follow-up.

Life stressors, coping strategies, and social supports in patients with irritable bowel syndrome.

BACKGROUND: The frequency and the perceived intensity of life stressors, coping strategies, and social supports are very important in everybody's well-being. This study intended to estimate the relation of irritable bowel syndrome (IBS) and these factors. MATERIALS AND METHODS: This was a cross-sectional study carried out in Isfahan on 2013. Data were extracted from the framework of the study on the epidemiology of psychological, alimentary health, and nutrition. Symptoms of IBS were evaluated by Talley bowel disease questionnaire. Stressful life event, modified COPE scale, and Multidimensional Scale of Perceived Social Support were also used. About 4763 subjects were completed questionnaires. Analyzing data were done by t-test and multivariate logistic regression. RESULTS: Of all returned questionnaire, 1024 (21.5%) were diagnosed with IBS. IBS and clinically-significant IBS (IBS-S) groups have significantly experienced a higher level of perceived intensity of stressors and had a higher frequency of stressors. The mean score of social supports and the mean scores of three coping strategies (problem engagement, support seeking, and positive reinterpretation and growth) were significantly lower in subjects with either IBS-S or IBS than in those with no IBS. Multivariate logistic regression revealed a significant association between frequency of stressors and perceived intensity of stressors with IBS (odds ratio [OR] =1.09 and OR = 1.02, respectively) or IBS-S (OR = 1.09 and OR = 1.03, respectively). CONCLUSIONS: People with IBS had higher numbers of stressors, higher perception of the intensity of stressors, less adaptive coping strategies, and less social supports which should be focused in psychosocial interventions.