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Background: Traumatic brain injury (TBI) is one of the most common neurological disorders worldwide. We aimed to investigate the efficacy of high-dose vitamin D3 on inflammatory biomarkers in patients with moderate to severe TBI. Methods: Thirty-five moderate to severe TBI patients were randomly assigned to intervention and control groups. Patients in the intervention group received a single intramuscular (IM) dose of 300,000 IU vitamin D. The primary endpoints were interleukin levels (IL-1β and IL-6), and the secondary endpoints were changes in neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), Glasgow Coma scale (GCS), and Glasgow Outcome Scale-Extended (GOS-E) scores compared between intervention and control arms of the study. The linear Generalized Estimating Equations were used for trend analysis and evaluating the association of independent factors to each outcome. Results: The results revealed a significant decrease in IL-1β levels (-2.71±3.02, in the intervention group: P=0.001 vs. -0.14±3.70, in the control group: P=0.876) and IL-6 (-88.05±148.45, in the intervention group: P=0.0001 vs. -35.54±175.79, in the control group: P=0.325) 3 days after the intervention. The improvement in the GCS score (P=0.001), reduction in NLR (P=0.001) and PLR (P=0.002), and improvement in the GOS-E score (P=0.039) was found to be greater in the vitamin D3 arm of the study than the control group. Conclusion: Administration of high-dose vitamin D3 in the acute phase of TBI could be effective in lowering the inflammatory markers and improving the level of consciousness and long-term performance outcomes. Trial registration number: IRCT20180522039777N2. [ABSTRACT FROM AUTHOR]

In recent decades, the number of cases developing drug-induced esophagitis (DIE) has reportedly been growing, which indicates the significance of detecting medicines capable of causing this adverse reaction. This study aims to provide an updated review on recent case reports of DIE, to evaluate the possible mechanism of this side effect, and to provide helpful management. Data was gathered through searches of three databases, namely PubMed, Medline, and Cochrane. Seven drug categories were evaluated: antibiotics, bisphosphonates, cardiovascular medicines, chemotherapeutic agents, non-steroidal anti-inflammatory drugs (NSAIDs), other medications, and supplements. According to the findings, retrosternal pain, heartburn, odynophagia, and dysphagia are typical symptoms of DIE, and in most cases, DIE is a self-limiting side effect which can be resolved by removing the causative agent and providing supportive therapy. [ABSTRACT FROM AUTHOR]

This research aimed to evaluate the clinical features and computed tomography (CT) scans associated with poor outcomes in COVID-19 patients with acute kidney injury (AKI). A total of 351 COVID-19 patients (100 AKI, 251 non-AKI) hospitalized at Imam Hossein Teaching Hospital affiliated to Shahid Beheshti University of Medical Sciences were included. To investigate the factors associated with in-hospital mortality in COVID-19 patients developing AKI, COX univariate and multivariate regression models were applied after controlling other confounding variables. C-reactive protein CRP, lactate, and procalcitonin levels were significantly higher in AKI patients than in non-AKI patients (P < .05). In addition, AKI patients had higher frequencies of lymphopenia and leukocytosis (P < .05). The troponin levels and WBC were the most significant factors for predicting mortality in patients with AKI. Our findings showed that AKI per se is much more important than any other prognostic factor affecting non-AKI patients. However, AKI patients with higher CRP, PCT, and lactate levels had a poor prognosis. [ABSTRACT FROM AUTHOR]