Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), is a new virus that emerged in China and immediately spread around the world. Evidence has been documented that the immune system is impressively involved in the pathogenesis of this disease, especially in causing inflammation. One of the important components of the immune system is the complement system whose increased activity has been shown in inflammatory diseases and consequently damage caused by the activity of its components. In the present study, serum levels of C3 and C4 factors as well as the activity level of complement system in the classical pathway were measured by CH50 test in patients with SARS-CoV-2. Participants in the study consisted of 53 hospitalized patients whose real-time PCR test was positive for SARS-CoV-2. The mean age of these patients was 42.06 ± 18.7 years, including 40% women and 60% men. The most common symptoms in these patients were cough (70%), fever (59%), dyspnea (53%) and chills (53%), respectively. Analysis of biochemical and hematological test results revealed that 26 (49%) patients had lymphopenia, 34 (64%) patients were positive for C-reactive protein (CRP) and 26 (49%) patients had ESR and LDH levels significantly higher than normal. In addition, 27 patients (51%) had vitamin D deficiency. The mean CH50 activity level in COVID-19 patients was significantly reduced compared to healthy individuals (84.9 versus 169.9 U/ml, p = < 0.0001). Comparison of the mean CH50 activity levels between different subgroups of patients indicated that COVID-19 patients with decreased peripheral blood lymphocyte count and positive CRP had a significant increase in activity compared to the other groups ( p = 0.0002). The serum levels of C3 and C4 factors had no significant change between patients and healthy individuals. Conclusion: The activity level of complement system in the classical pathway decreases in COVID-19 patients compared to healthy individuals, due to increased activity of complement system factors in these patients.
A BSTRACT Aim: The aim of the present study was to compare the pain intensity due to intravenous injection of sodium thiopental, propofol, diazepam, and etomidate during the induction of general anesthesia. Methods: This was a non-controlled quasi-experimental double-blinded study performed on eligible patients referred to the operating room of Shahid Beheshti Hospital in Yasouj. A total of 200 patients were randomly selected by convenience sampling and based on a table of random numbers generated on a computer. They were then randomly divided into four intervention groups based on random blocks (sodium thiopental, propofol, etomidate, and diazepam). Finally, the collected data were analyzed using descriptive as well as analytical statistical tests such as Chi-square, analysis of covariance (ANCOVA), and Bonferroni post hoc test were analyzed in SPSS ver. 24. Results: The results of the present study showed that the diazepam group experienced the highest pain intensity (8.42) compared to other groups, which was statistically significant ( P = 0.001). Also, the sodium thiopental group experienced the highest pain (6.92) after the diazepam group, which was also statistically significant as compared to the other remaining two groups ( P = 0.001). Propofol and etomidate groups experienced the lowest pain intensity (3.30 and 3.26, respectively). Conclusion: The present study revealed that the use of diazepam and sodium thiopental as anesthetic drugs was generally associated with greater pain intensity during injection and less hemodynamic stability. The results of the present study indicated that propofol and etomidate are preferred over diazepam and sodium thiopental in abdominal and gastrointestinal surgeries, considering their less pain intensity and fewer hemodynamic changes.
It is widely accepted that any interventional treatment, such as surgery, requires a precise and predetermined treatment plan. Moreover, conventional images do not allow for the presentation of all canal dimensions, and patients concepts of beauty and their expectations are greater for the premaxilla region. Therefore, the use of three-dimensional images is essential in surgical procedures, such as pathological lesions or implant placement surgeries. In cone-beam computed-tomography images, the nasopalatine canal was examined in sagittal, coronal, and axial planes. The diameters of nasopalatine and incisive foramina were separately measured, and the length of the nasopalatine canal was found by measuring the distance between the mid-levels of the nasopalatine foramen and incisive foramen. The shape of the canal was assessed in the sagittal and coronal planes in the mid-level of the canal. In addition, the shape of the canal and posterior borders were examined in the mid-level of the canal in the axial plane. The nasopalatine angle was measured as an anterior angle between the long axis of the canal and the hard palate. The number of canals in the midline and openings in each plane was also counted. The nasopalatine canal in the sagittal plane was classified into six groups: conical (33.2%), cylindrical (25.6%), hourglass (24.7%), funnel-shaped (9.8%), reverse-cone (4.3%), and spindle (2.4%). In the coronal plane, the shape of the canal was assigned to three categories: single channel (59.2%), Y-shaped (31.2%), and dual-channel (9.6%), and the posterior border of the nasopalatine canal was classified into four groups: U-shaped (42.5%), V-shaped (37.2%), reverse-V-shaped (154%), and Y-shaped (4.9%). Finally, in the axial plane, the canal shape was classified into four groups: round (40.5%), oval (31.1%), heart-shaped (21.3%), and triangle-shaped (7%). The use of three-dimensional images should be strongly considered in all surgical interventions involving the nasopalatine canal, such as dental implant placement since any error in surgical interventions will bring about serious consequences due to higher aesthetic expectations for the anterior maxillary region. Due to the lack of correct diagnosis of canal morphology in conventional images, such as periapical and panoramic radiography, it seems necessary to use three-dimensional radiography when performing surgical interventions in this region.
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