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Background: COVID-19 has led to the demand for finding effective antiviral agents. Preliminary experiments showed Umifenovir inhibit replication in vivo. There is limited data on the clinical efficacy of COVID-19-infected pneumonia. Therefore, we aimed to evaluate this medication based on clinical findings. Methods: The present study was designed to investigate the advantages and disadvantages of Umifenovir and compared to empirical treatments. For this purpose, multi-stage sampling was considered. 56 people who had mild-to-moderate symptoms without signs of pneumonia, were selected by accidental non-random sampling method and divided into two groups [(group A with Hydroxychloroquine (HCQ) and group B in combination with Umifenovir] by randomized block sampling (1:1). During the study, three patients left the case group. Their clinical signs and symptoms were evaluated on 3rd, 7th, and 14th day after taking these medicines in the disease course. The SPSS software was used for data analysis and the significance level was considered to be p

Background:: Tuberculosis considered as a chronic infectious disease caused by Mycobacterium tuberculosis, may invade all organs but mainly affects the lungs. Overall, disseminated TB is rare in immunocompetent patients and its association with seborrheic keratosis has never been reported. Case Presentation: We reported a 54-year-old man with a complaint prolonged fever, abdominal pain, weight loss and lymphadenopathy without any immunosuppression who was eventually treated based on the diagnosis of diffuse tuberculosis.

Background: The outbreak of COVID-19has led to a high demand for finding effective antiviral agents. Preliminary experiments showed that Umifenovir could inhibit coronavirus replication in vivo. There is limited data on the clinical efficacy of COVID-19-infected pneumonia. Therefore, we aimed to evaluate this medication based on clinical findings.Methods: The present study was designed as a clinical trial to investigate the advantages and disadvantages of this medicine compared to empirical treatment. For this purpose, multi-stage sampling was considered. 56 people who have mild to moderate symptoms without signs of sever pneumonia , were selected by accidental non-random sampling method. This sample size was subsequently divided into two groups (group A threated with hydroxycloroquine and group B who threated with combination hydroxycloroquine and Umifenovir) by randomized block sampling (1:1). During the study, three patients left the case group. Their clinical sighns and symptoms were evaluated on 3 th and 7 th and 14 th days after oncet illness while taking these medicines in the disease course. The SPSS software was used for data analysis and the significance level was considered to be PResults: On the seventh days after visit patients , there were statistically significant differences in recuperation dry cough(p = 0.001), weakness(p = 0.004), gastrointestinal symptoms(p = 0.043) and shortness of breath (p = 0.001) between the two groups, so that in patients who under orescription combination HCQ and Umifenovir group had a faster recovery.Generally during illness , there were statistically significantly faster melioratation myalgia(p = 0.03), gastrointestinal symptoms(p = 0.047), and weakness(p = 0.007)in patients who threated with both HCQ and Umifenovir .Conclusion: Evaluation clinical findings in mild to moderate COVID-19 patients symptoms and sighns recuperation faster in group who under orescription combination HCQ and Umifenovir .regimen. In other words, adding Umifenovir to the empirical treatment accelerated the recovery process of patients’ clinical symptoms.Registration: IR.TUMS.VCR.REC.1399.204, 04.13.2020 , http://ethics.research.ac.ir/IR.TUMS.VCR.REC.1399.204

BackgroundMore than one year of emerging COVID 19 infection, no signs of the pandemic remission appear. Returning of symptomatic patients who had a history of recovered COVID-19 disease with a new positive SARS Cov-2 PCR test after several weeks to months of a negative PCR result is one of the novels challenging phenomena during the pandemic. In this study, we determined the clinical and laboratory characteristics of these Iranian patients and discussed possible reasons.METHODWe retrospectively investigated the SARS Cov-2 PCR tests performed in the three referral hospitals six months after the pandemic onset. All patients who had the following criteria were included in the study: two SARS COV2 PCR positive tests three months apart, have no symptoms, and a negative PCR between the two positive tests, access to the patient and his medical information. Then, retrospectively recorded the clinical and laboratory characteristics of the eligible patients. We also compare clinical and laboratory features of the second episode to the first.RESULTA total of 32,567 tests were performed, of which 1899 patients. Finally, 37 cases were eligible in the study based on our criteria. The majority of patients were male and nurses. The mean body mass index was 25.84±3.25. The mean age was 37.54 ±15.16 years old. Weakness, myalgia, and fever were the most clinical presentation symptoms in both episodes. Chest Computed Tomography (CT) scan showed pneumonia in 56.8% and 43.2% of cases in the first and second episodes, respectively. The mean duration between the discharge and second presentation was 117±61.42 days. Seven (18.9%) patients hospitalized in the second episode compared to 2 (5.4%) cases in the first. The clinical, radiological, and laboratory characteristics were not significantly different between the two episodes except for significantly more dexamethasone usage in the second one (p= 0.03).CONCLSIONAlthough we could not perform the phylogenic sequencing of SARS-CoV-2 and viral culture in the re-presenting symptomatic patients with positive RT-PCR, prolonged duration between two episodes suggest probably reinfection in our cases. Finally, this clinical phenomenon may be more common in healthcare providers without a significant consequence.

Background: Fever of unknown origin (FUO) remains a clinical challenge in both emergency and infectious diseases departments. Being clinically updated on probable etiologies helps physicians to narrow their diagnostic and treatment approach. Objectives: This study aimed to assess the causes of FUO in an academic setting in the recent 5 years to update the clinicians. Methods: In a cross-sectional study, the files all patients with the primary diagnosis of FUO were extracted and evaluated. The records were assessed with regard to patients & rsquo; age, gender, days of fever before admission, time of admission and discharge, clinical course of the disease, laboratory and other para-clinical findings were documented. The patients were then classified based on the etiology of the disease and the type of test utilized for the diagnosis. Median and frequencies were used for descriptive variables; chi-square test was performed for correlation analysis. Results: From March 2009 to April 2014, 101 patients were admitted and their files were recruited for the purpose of this study. The median age of our patient population was 39. Infections (23.1%) and non-infectious inflammatory diseases (21.1%) constituted the most common known causes of fever in our patient population. Invasive tests had been documented for 41.1% while non-diagnostic in 20%. Non-invasive tests leading to final diagnoses were performed for 48.4%. There was a significant association between the type of the utilized test for diagnosis and different etiologies of FUO (P = 0.001). Conclusions: Similar to global trends, non-infectious inflammatory diseases comprised an increasing share of the causes of FUO. However, tuberculosis remains an important infectious cause that may present with FUO or simply be overlooked in primary patient visits. Updating a local database for the causes of FUO in hospitals at certain time intervals may facilitate the diagnostic approach.

The nicotinic cholinergic receptors have been reported to be involved in several actions of cannabinoids (e.g., bradycardia, hypothermia). However, the influence of central cholinergic system on cannabinoids antinociceptive effect has not been reported. This study investigated the possible part played by nicotinic cholinergic modulator drugs on the antinociceptive effect of central administration of arachidonylcyclopropylamide (ACPA) in mice. The antinociceptive effects of intracerebroventricular (i.c.v.) administration of ACPA using the formalin test have been studied in mice. The effects of nicotine or mecamylamine (a nicotinic cholinergic antagonist) on ACPA analgesia are also studied. i.c.v. administration of ACPA (0.004-1 microg/mice) induced antinociceptive effect in mice. i.c.v. administration of nicotine (0.1 or 0.5 microg/mice) or mecamylamine (2 microg/mice) potentiated or antagonized ACPA antinociceptive effects, respectively. It is concluded that ACPA-induced analgesia is influenced by central nicotinic cholinergic activity.

Introduction: Tuberculosis of the foot is an unusual type of skeletal tuberculosis. Case Presentation: We report on an eighty-six-year-old woman, who presented pain and purulent discharge from the right foot for 10 months. The final diagnosis was confirmed with a culture of Mycobacterium tuberculosis. Discussion: Diagnosis of this form of tuberculosis is established with some delay due to the uncommon site of involvement, lack of awareness about the condition and its ability to mimic other disorders. Diagnosis and appropriate treatment can often be delayed, which may lead to significant consequences for the patient. Our case was treated with anti-tuberculin medications for nine months and conservative management of the bony lesions resulting complete resolution of symptoms.