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The newest virus from the SARS family of viruses called acute syndrome-coronavirus-2 (SARS-CoV-2), which causes COVID-19 disease, was identified in China at the end of 2019. In March 2020, after it spread to 29 additional countries, it was declared a pandemic by the World Health Organization (WHO). SARS-CoV-2 infection mainly starts through the respiratory tract and causes a wide spectrum of symptoms from asymptomatic infections to acute respiratory distress syndrome with multi-organ failure and vasoplegic shock. Among the many immunomodulatory and antiviral drugs that have been studied for the treatment of COVID-19, methylene blue (MB) may play an influential role. This article reviews the history of MB applications, the antiviral effects of MB against SARS-CoV-2, and the results of in vivo and in vitro studies of the use of MB in COVID-19. Based on studies, MB can simultaneously affect most of the host’s harmful responses caused by SARS-CoV-2 infection due to its multiple properties, including anti-hypoxemia, anti-oxidant, immune system modulator, and antiviral. The use of MB is associated with a reduction in the possibility of getting infection, and mortality, and can be used as a safe, effective, cheap, and available treatment option with minimal side effects for the clinical management of COVID-19. [ABSTRACT FROM AUTHOR]

The ear is a very important facial feature and enhances the overall look of the face. Usually, patients with entire ear burns also have large areas of burn in their bodies. To save the patient, skin grafting to reduce the injured body surface area is prioritized and the treatment of the ears may be inevitably delayed, which results in minor to very severe cosmetic deformity. This has a deep effect on the life quality of a patient who survives a burn injury. Therefore, any step that decreases ear deformity or loss is very crucial for the patient. There are different challenging procedures for ear reconstruction which are very tedious works. In this study, for one patient, repairing gel–platelet-rich plasma-fibrin glue was applied for the treatment of a deep dermal burned ear as a novel, non-invasive, and simple approach to give a normal shape to the ear to prevent extensive morbidity during the acute phase and deformities later as a consequence of burns. No keloid is observed after treatment. [ABSTRACT FROM AUTHOR]

Introduction: In multiple sclerosis (MS), oxidative stress (OS) plays a vital role in the neurodegeneration process. Cholesterol and lipids in the myelin sheath supplied by low-density lipoprotein (LDL) are also vital for nerve cells. In OS, lipid peroxidation occurs in LDL. To investigate the OS biomarker such as prooxidant-antioxidant balance (PAB), malondialdehyde (MDA) and their correlation with LDL and oxidized LDL (Oxi-LDL) in patients with relapsing-remitting MS. Methods: Blood samples from 18 patients with relapsing-remitting MS and 18 healthy subjects were collected to measure the OS biomarkers. Results: In the patients' group in comparison to the control group: PAB, white blood cells (WBC), and neutrophils significantly increased (P<0.05), but there was no difference between the relapsing and remitting phase; MDA significantly increased in the relapsing phase (P=0.013) but was marginally significant in the remitting phase (P=0.068). There was no significant difference in LDL and Oxi-LDL between the two groups. Only the lymphocytes were different between the relapse and remission phases. Conclusion: The importance of OS in the process of MS disease was confirmed and a PAB assay can be used to determine OS levels. [ABSTRACT FROM AUTHOR]

Aim: The current study purposed to evaluate the autologous platelet-rich plasma (PRP), and platelet-rich fibrin glue (PRFG) effect on the treatment of complex, and recalcitrant anal fistula (AF) which was not cured by several surgeries. Background: AF has remained one of difficult challenges for centuries. Surgery is the common treatment method for it, but the risk of fecal incontinence and recurrence is still a distressing complication for patients and surgeons. New procedures were published in the scientific literature, each with advantages and disadvantages. According to reports, an effective therapy option is the autologous fibrin glue that is rich in platelets. Methods: Autologous PRP and PRFG were prepared from 10 patients' own blood. The surgeon curetted the tract of anal fistula for the deepithelialisation till hemorrhage occurred; PRP was injected around the fistula into the tissue, and PRFG was interpositioned in the tract. Age, number of previous surgeries, complications, number of PRP and PRFG administrations, and duration of halting the discharge were among the information gathered. Patients were followed up between 10 months to 84 months after treatment. Results: No complications were observed during and after the injection. During the period of follow-up, AF leakage was stopped for 6 patients, but not for 4 patients. Conclusion: Since autologous PRP injection, and PRFG interposition is a safe, effective, and minimally invasive procedure for resistant AF to surgeries; it can be used, along with surgery to increase the healing rate of complex anal fistula. [ABSTRACT FROM AUTHOR]

Introduction: Many ongoing challenges have been applied to reduce the considerable postoperative pain and increase wound healing after tonsillectomy, but they are still not optimally managed. This study applied autologous platelet-rich plasma (PRP) & platelet-rich fibrin glue (PRFG) to reduce pain and increase wound healing. Materials and Methods: PRP & PRFG were prepared from 26 patients' blood. At the end of the tonsillectomy, one tonsillar bed was selected randomly, PRP was injected, PRFG was applied topically on the bed wound, and the other sites were left untreated. The treated and untreated tonsillar beds were compared for pain and wound healing the next day, 3rd day, 6th day, 9th day, and 15th day. Results: There were no complications during and after the injection. The mean age was 24.76 ±5.54 years. In the treated beds in comparison to untreated beds, pain decreased marginally in 1st day (intervention:4.5±2.54, control:5.53±2.94, P-value=0.18) and 3rd day (intervention:3.92±2.96, control:4.8±2.82, P-value=0.276), and significantly in 6th day (intervention:2.3±2.46, control:3.92±2.6, P-value=0.026), 9th day (intervention:1.26±1.48, control:2.76±2.4, P-value=0.009) and 15th day (intervention:0.73±1.07, control:1.84±2.36, P-value=0.08) after surgery. Healing did not change in 1st day (P-value=1), changed marginally in 3rd day (P-value=0.2), and increased significantly in 6th day (P-value=0.001), 9th day (P-value=0.006), and 15th day (P-value=0.004) after surgery. Conclusions: Autologous PRP injection & PRFG application offer an effective, safe, and non-invasive method for reducing pain and increasing wound healing after tonsillectomy. [ABSTRACT FROM AUTHOR]

Background. Oxidative balance and inflammatory processes affect wound healing phases, and their disruption is connected with delayed wound healing. The present study aimed to assess the association between serum hs-CRP, prooxidant-antioxidant Balance (PAB), and vitamin D with anthropometric and biochemical parameters in patients with diabetic foot ulcers (DFU). Methods. Thirty-two patients with DFU were included in this study. The Spearman correlation coefficient was used to evaluate the bivariate relationship between serum hs-CRP, PAB, and vitamin D with anthropometric characteristics, glycemic status, lipid profiles, homocysteine level, liver, and kidney function tests. Results. Our data showed a significant positive association between serum hs-CRP and insulin (r = 0.417, P = 0.027), uric acid (r = 0.629, P = 0.001), creatinine (r = 0.431, P = 0.022), erythema (r = 0.36, P = 0.049), and ESR (r = 0.560, P = 0.002). Moreover, hs-CRP negatively correlated with FBS (r = --0.427, P = 0.023), total bilirubin (r = --0.639, P = 0.001), direct bilirubin (r = --0.445, P = 0.033), lDl-cholesterol (r = --0.405, P = --0.032), BMI (r = --0.398, P = 0.033) and HTN (r = --0.450, P = 0.014). Serum PAB value negatively correlated with patients age (r = --0.460, P = 0.027), and BMI (r = --0.442, P = 0.035), and positively associated with insulin level (r = 0.431, P = 0.040). A significant positive association between serum vitamin D with patient sex (r = 0.379, P = 0.047), and QUICKI (r = 0.456, P = 0.029), and negative correlation with HbA1c (r = -0.381, P = 0.045) were also determined. Conclusions. This study demonstrated that serum hs-CRP, PAB, and vitamin D are significantly associated with some anthropometric and biochemical parameters with important clinical value in patients with DFU. low levels of vitamin D and high levels of hs-CRP and PAB may have an important role in the pathogenesis of DFU. [ABSTRACT FROM AUTHOR]

Introduction:Gastric bypass surgery is an intervention used to treat class III obesity and its complications. Evidence is scarce regarding its benefits among the Iranian population, especially its role in resolving obesity-related complaints and comorbidities. The present study aimed to investigate the impact of gastric bypass surgery on the improvement of obesity-related complaints and comorbidities in morbid obesity. Methods:This study was conducted on 35 morbidly obese patients who volunteered to undergo gastric bypass surgery. Anthropometric data, comorbidity status, and dietary habits were collected at baseline and six months postoperatively. Data analysis was performed in SPSS version 16.0. Results: The majority of the patients were female (80%). A significant difference was observed in the frequency distribution of normal dietary habits (five regular meals per day) before and after surgery (P = 0.01). In comparison, the distribution was not significant for snacking and three large meals per day (P > 0.05). All complaints of eating disorders according to self-reports (e.g., overeating and night eating syndrome) significantly improved (P < 0.05). Moreover, the dose of the medications prescribed for the comorbidities associated with obesity reduced significantly (P = 0.001). The frequency of several obesity-related complaints (e.g., knee pain, hirsutism, acanthosis nigricans, and sleep apnea) also decreased significantly (P < 0.05). However, no significant improvement was observed in hair loss, brittle nails, and menstrual dysfunction (P > 0.05). Conclusion: Accordingly, gastric bypass surgery could improve obesity-related complaints six months postoperatively. Also, according to the patients' self-declaration, patients' adherence to "normal eating habits" increased during this period, and their eating disorders like night eating syndrome (NES) and overeating behaviors decreased compared to before the surgery. [ABSTRACT FROM AUTHOR]

OBJECTIVES Open in new tab Download slide Open in new tab Download slide The postoperative persistence of chylothorax is a fatal complication of paediatric cardiac surgery. There is an urgent need for an effective treatment of chylothorax. This study reports the application of allogenic platelet-rich plasma fibrin glue (PRP-FG) as a conservative therapy before reoperation. METHODS Over a 9-year period, from 2010 to 2019, 27 patients with persistent chylothorax following a cavopulmonary connection, with a mean latency period of 11 days (range 10–15 days), were treated with PRP-FG. These patients were selected because they had not responded positively to initial conservative management plans. The patients were followed up for 9 years. RESULTS Twenty-five patients (92%) responded positively to treatment with PRP-FG; 2 patients did not respond to the treatment and died after reoperation. All of the successfully treated patients in follow-up continued to live a healthy life without further complications. CONCLUSIONS Recalcitrant chylothorax that persists after paediatric cardiac surgery responded positively to treatment with PRP-FG. This technique precluded the need for another operation and significantly decreased the morbidity and mortality rates. [ABSTRACT FROM AUTHOR]

Background: Until recently, a gene polymorphism in the promoter region of endothelial nitric oxide synthase has been suggested as a risk factor for thromboangiitis obliterans (TAO) development. The aim of this study was to compare the metabolites of nitric oxide (NO) and its backup, heme-oxygenase-1 (HMOX1), between TAO patients and those of a smoking control group matched by race, age, sex, and smoking habits. Methods: Twenty-four male Caucasian TAO patients and 20 male Caucasian controls enrolled in the study. Their smoking habits were matched based on the serum cotinine levels of 17 of the TAO patients and the 20 controls. A colorimetric kit was used to measure NO, and an enzyme-linked immunosorbent assay kit was used to measure cotinine and HMOX1 levels. Results: The mean serum level of NO metabolites in the TAO group was significantly less than in the controls (p = 0.03) and also significantly less in the patients with below-knee amputations than in non-amputees (p= 0.018). Also, HMOX1 was significantly greater in the TAO patients than in the controls (p= 0.01). No significant correlation was found between NO and HMOX1 (p = 0.054). Conclusions: Nitric oxide may play a pivotal role in TAO development and its outcome. However, the intact HMOX1 pathway may demonstrate the unique role of NO, which cannot be compensated for by HMOX1 and whose absence may make patients susceptible to developing TAO. In addition, another pathway besides NO, with influence on vascular tone and hemostasis, might be involved in TAO development, such as the autonomic nervous system. Further studies are suggested regarding these issues. [ABSTRACT FROM AUTHOR]

Purpose: Evaluation of preliminary cosmetic and functional outcomes of biodegradable scaffolds covered with platelet-rich plasma in penile girth augmentation. Materials and Methods: Between June 2016 and June 2018, 36 males who had a mean age of 28.91 years (range 20 - 48 years) with micropenis underwent this procedure. A mixture of platelets-fibrin glue and mesenchymal cells obtained from dermal fat tissue were prepared. Then the mixture was seeded on the pretreated tube-shaped poly lactic-co-glycolic acid scaffold and underwent a whole day of incubation. Following penile degloving, scaffolds were surgically implanted within the interface region of dartos and Buck's fascia. The 5-point Likert scoring scale was used to evaluate the patients' satisfaction with surgery. Results: Patients followed up for 6-12 (8 ± 2.86) months. The penile length in an erected state before surgery was 6.5 - 12.5 cm (9.08 ± 1.6) which enhanced to 7 - 14 cm (10.59 ± 1.71) after surgery (P < .0001). The penile girth before and after surgery were 8.49 ± 1.53 and 10.91 ± 1.96 cm, respectively (P < .0001). An augment in penile length and girth of 1.5 and 2.6 cm were achieved, respectively. Patients appraised surgical intervention on a rating of one to five. The highest possible score (5) was assigned by 27 %, 33 % expressed a very good mark (4), and 19 % gave a good mark (3). Conclusion: Covering the scaffold with a mixture of Platelets-Fibrin glue and mesenchymal cells seems a safe and feasible method for penile reconstruction surgery. More studies should be done to determine the effect of platelets-fibrin glue and mesenchymal cells for treating micropenis. [ABSTRACT FROM AUTHOR]

Objective: Sulfur mustard (SM) is a strong alkylating agent that primarily targets the skin, eye and lung. The current study evaluated the pro-oxidant–antioxidant balance (PAB) assay in human serum of SM-exposed patients.Design and methods:sera of 35 SM-exposed patients and 19 healthy volunteers were recruited. Both groups had nonsmoker and nonalcoholic people with no diseases such as diabetes, heart disease and other pulmonary diseases (COPD because of smoking, asthma and so on). All patients haddocumented exposure to SM. The PAB was measured.Results:SM-exposed patients with normal values for pulmonary function test and severe obstructive pulmonary disease demonstrated a significant increase in PAB value in compared with healthy volunteers (the PAB values in healthy volunteers, normal and severe patients were 48.74 ± 21.07 HK, 101.45 ± 32.68 HK and 120.23 ± 31.55 HK, respectively). However, the level of oxidation is not related to the severity of disease defined by spirometry findings. A significant negative correlation was established between the PAB value and FEV1. Conclusions:The increased PAB value in chemical casualties showed that these patients are exposed to oxidative stress. [ABSTRACT FROM AUTHOR]