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Introduction: Left atrial appendage aneurysm is an infrequent abnormality presenting as atrial tachyarrhythmia, progressive dyspnea, atypical chest pain, and systemic thromboembolism. Surgical excision is considered to prevent fatal complications, even in asymptomatic cases. The present study aimed to report a 20-year-old male who presented with sudden onset palpitation and dyspnea. Case Presentation: The case was really novel, because congenital left atrial appendage aneurysm was accompanied by dilated cardiomyopathy and Left Ventricular (LV) non-compaction. Electrocardiography (ECG) showed atrial fibrillation with Rapid Ventricular Response (RVR) secondary to a massive congenital left atrial appendage aneurysm. At first, left-sided weakness was diagnosed. In the next Computed Tomography (CT) scan performed in the hospital, right temporoparietal hypodensity was detected, which was in favor of right Middle Cerebral Artery (MCA) territory infarction that progressed with hemorrhagic transformation. Conclusion: The patient did not accept surgical treatment and was discharged with medical therapy (oral anticoagulants and antiarrhythmic medications). He was expired as a result of multiple strokes. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate the demographic features in patients with Coronavirus Disease-2019 (COVID-19) and to determine the relationship between Computerized Tomography (CT) and mortality. Objectives: This study aims to evaluate the characteristics for diagnosis and severity of involvement in primary imaging, their adaptation to the course of the disease, and their relationship with mortality. Methods: This retrospective study was conducted on the medical records of 212 patients with suspected COVID-19 admitted to the teaching hospitals of Shiraz University of Medical Sciences from February 20, 2009 to August 2020. The patients' CT images were also assessed and the frequency of abnormalities was determined. Results: The Reverse Transcription-Polymerase Chain Reaction (RT-PCR) test was positive in 204 patients (99%). Consolidation was observed in all the 206 patients. The highest degree of lung involvement (90%) was observed in 69 patients (33.5%). Atoll sign was also diagnosed in 121 cases (58.7%). Besides, crazy-paving reticular lines, subpleural sparing, and bronchial distortion were observed in 129 (62.6%), 88 (42.7%), and 124 patients (60.2%), respectively. In addition, multi-segment was detected in the CT scan results of 194 cases (94.2%), which was higher compared to the single segment seen in 12 patients (5.8%). Conclusion: CT scan is a relatively sensitive technique for diagnosing COVID-19. The study results revealed a significant relationship between CT scan and death. The disease severity was also accurate using this method. [ABSTRACT FROM AUTHOR]

Background: Oral contraceptive (OCP) use is a significant risk factor for cerebral venous thrombosis (CVT). There is limited research on its association with CVT development in Islamic countries. Therefore, our study aimed to assess the risk of different OCPs in developing CVT and their prognosis. Methods: This is an observational retrospective single-center cohort study that included CVT patients between March 2018 and March 2021. All CVT participants were registered in the organized registry system (CVT registry code: 9001013381) at the Neurology Research Center of Shiraz University of Medical Science. Univariate analysis and multivariable binary logistic regression modeling were applied to determine the associated factors leading to poor outcome. Results: A total of 204 patients (139 women, 65 men) were enrolled in the study. Seventy-four females (53.25% of total female patients) used OCPs, with second-generation OCPs being the most commonly used type (70%). OCP consumption was associated with a lower mortality rate (P=0.004, aOR=11.732) and a better 3-month follow-up outcome (p=0.001, aOR=9.882) than their female counterparts who did not use OCPs. The duration and generation of OCPs did not affect the follow-up outcome (P=0.148, P=0.428, respectively) or mortality (P=0.555, P=0.569, respectively). In multivariable analysis, the use of OCPs was a predictor of a favorable 3-month follow-up outcome in females (aOR =4.423, 95% CI: 0.423-46.248). Conclusion: These results suggest that OCPs may have a positive impact on the prognosis of CVT in women. However, further research is required to understand the underlying mechanisms and validate these findings. [ABSTRACT FROM AUTHOR]

Introduction: There have been some reports of the association between SARS-CoV-2 infection and mucormycosis. This study aims to compare the hospitalization rates and clinical characteristics of mucormycosis before and during the COVID-19 pandemic. Methodology: In this retrospective study, we compared the hospitalization rate of mucormycosis patients in Namazi hospital in Southern Iran for two periods of 40 months. We defined July 1st, 2018 to February 17th, 2020, as the pre-COVID-19 period and February 18th, 2020, to September 30th, 2021, as the COVID- 19 period. In addition, a quadrupled group of hospitalized patients with age and sex-matched SARS-COV-2 infection without any sign of mucormycosis was selected as the control group for COVID-associated mucormycosis. Result: In the total of 72 mucormycosis patients in the COVID period, 54 patients had a clinical history and a positive RT-PCR, which confirms the diagnosis of SARS-COV2 infection. The hospitalization rate of mucormycosis showed an increase of + 306% (95% CI: + 259%, + 353%) from a monthly average value of 0.26 (95% confidence interval (CI): 0.14, 0.38) in the pre-COVID period to 1.06 in the COVID period. The use of corticosteroids prior to the initiation of hospitalization (p ≤ 0.01), diabetes (DM) (p = 0.04), brain involvement (p = 0.03), orbit involvement (p = 0.04), and sphenoid sinus invasion (p ≤ 0.01) were more common in patients with mucormycosis during the COVID period. Conclusions: In high-risk patients, especially diabetics, special care to avoid the development of mucormycosis must be taken into account in patients with SARS-COV-2 infection considered for treatment with corticosteroids. [ABSTRACT FROM AUTHOR]

Background: While ventriculo-extracranial shunting procedures have been the standard treatment option for hydrocephalus for a long time, their long-term morbidity, including the development of post-shunt de Novo seizures, should be taken into account. This study aimed to investigate the rate and risk factors of the occurrence of de Novo post-shunt seizures in patients with hydrocephalus., Methods: In this retrospective longitudinal study, all patients with hydrocephalus who had ventriculo-peritoneal shunt insertion from 2014 to 2017 at Namazi Hospital, (Shiraz, Iran) were studied. Phone calls were made to all patients to obtain their postoperative seizure outcome and other data (e.g., sex, age at surgery, shunt insertion location, history of seizures before surgery, history of seizures after surgery, any other type of brain surgery, and the etiology of their hydrocephalus). The Pearson Chi Square was used for the analysis of binary variable (e.g., sex) differences, and the t test for the analysis of differences in the means of numerical variables (e.g., age). Bonferroni correction tests were also utilized. P values less than 0.05 were considered significant., Results: A total of 114 patients were included in the study. Overall, 68 (60%) patients had a frontal location of shunt insertion and 46 (40%) had a parietal site. Twenty-four (21%) patients reported experiencing de Novo post-shunt seizures, 15 of which had a frontal location and nine a parietal location for shunt insertion (P=0.824)., Conclusion: De Novo post-shunt seizures are common occurrences. However, shunt location is not a significant risk factor for the development of de Novo post-shunt seizures., (Copyright: © Iranian Journal of Medical Sciences.)