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Introduction: bite affects about 2 million people every year, with more than 100000 mortalities annually. A person bitten by a snake represents a variety of symptoms. Snake bite might be asymptomatic or with mild local symptoms or even could lead to tissue damage and rapid death. This study aimed to investigate characteristics of snake bite in Northwest Iran. Methods: In this retrospective study, medical records of all patients with final diagnosis of snake bite who were admitted to Sina Clinical-Educational Center, the referral center for envenomation in Northwest Iran were investigated from 2002 to 2012. Demographic information and laboratory findings were collected using a checklist. Results: During a 10 year period, 160 individuals with snake bite were admitted, of which 128 (77.6%) were male. With regard to occupation, farmers accounted for the largest portion (n = 57, 34.6%). The most prevalent sites bitten by snakes were right hand (25.5%) and left leg (24.8%). Fifty-seven patients (34.5%) had leukocytosis and four (2.4%) had coagulopathy. Pain and swelling were two main complaints, with vomiting, dizziness, and tingling in extremities coming afterwards. Conclusion: Because snake bite is one of the most important emergencies presenting to emergency department and Iran's geographic status bears wide spectrum of poisonous snakes, this study was performed to further explore the clinical and epidemiologic details of snake bite.

Community acquired Pneumonia (CAP) is a common respiratory disease and a common health problem that causes many deaths annually and has burden of costs on health care system. Prognostic factors can be used for assessing and treating patients with CAP. The aim of the present study was to evaluate prognostic factors and outcome of patients hospitalized with CAP in infectious diseases centers. In a retrospective-descriptive study, 236 patients with CAP who referred to Imam-Reza and Sina hospitals of Tabriz University of Medical Sciences, Tabriz, Iran, during 2011-2013, were studied. Age, sex, comorbidities, rate of mortality, and laboratory results of patients were evaluated. P value considered statistically significant when ≤ 0.05 for statistical analysis. The mean age of patients was 68.7 ± 18.9 years, and male to female ratio was 1 to 1.02. The mean duration of hospitalization was 8.0 ± 4.6 days and mortality rate of patients was 11.9%. Increase in heart rate (r = 0.406, P = 0.001), and respiratory rate of patients (r = 0.154, P = 0.018), pleural effusion (r = 0.313, P = 0.001), increase in blood urea level (r = 0.271, P = 0.001), and increase in creatinine level (r = 0.226, P = 0.001), had significant correlation with mortality rate of patients. Based on the findings of the present study, heart rate, respiratory rate, pleural effusion, blood urea level, and creatinine level had significant correlation with mortality rate of patients with CAP. Lung disease, heart disease, and diabetes were the most common comorbid conditions in these patients.

Introduction: The aim of the study is to evaluate the effect of metformin in complication improvement of hospitalized patients with COVID-19. Methods: This was a randomized clinical trial that involved 189 patients with confirmed COVID-19 infection. Patients in the intervention group received metformin-500 mg twice daily. Patients who received metformin before admission were excluded from the control group. Patients who were discharged before taking at least 2000 mg of metformin were excluded from the study. Primary outcomes were vital signs, need for ICU admission, need for intubation, and mortality. Results: Data showed that patients with diabetes with previous metformin in their regimen had lower percentages of ICU admission and death in comparison with patients without diabetes (11.3% vs. 26.1% (p=0.014) and 4.9% vs. 23.9% (p=<0.001), respectively). Admission time characteristics were the same for both groups except for diabetes and hyperlipidemia, which were significantly different between the two groups. Observations of naproxen consumption on endpoints, duration of hospitalization, and the levels of spO2 did not show any significant differences between the intervention and the control group. The adjusted OR for intubation in the intervention group versus the control group was 0.21 [95%CI, 0.04-0.99 (p=0.047)]. Conclusions: In this trial, metformin consumption had no effect on mortality and ICU admission rates in non-diabetic patients. However, metformin improved COVID-19 complications in diabetic patients who had been receiving metformin prior to COVID-19 infection, and it significantly lowered the intubation rates.

Background: Interleukin 8 increases in various types of meningitis, specifically acute bacterial meningitis inflammation, and it is important in the distinction between types of meningitis. The present paper aims at evaluation of the level of interleukin 8 in cerebrospinal fluid in acute adult bacterial meningitis. Methods: All adult patients’ with diagnosis of suspected meningitis with symptoms of fever, headache, neck stiffness, and consciousness disorder. Lumbar puncture was taken in between the third and fourth vertebra by a specialist physician for all patients suspected with meningitis. To determine the level of consciousness, the GCS of the patients was determined and the cerebrospinal fluid was cultured and sent to the laboratory for the analyses of cell count, diffraction, CSF fluid glucose, CSF fluid protein, LDH, or lactate dehydrogenase, and the level of interleukin 8. Results: The mean of IL-8 protein was 296.17±48.57Pg/ml in patients with aseptic meningitis and 1088.96±526.55Pg/ml in the group of patients with septic meningitis. There was a significant difference between the two groups in terms of the amount of interleukin 8 (p = 0.009). Cutoff was 297.6 Pg/ml for the detection of positive bacterial meningitis with a sensitivity of 92% and the specificity of 83.1% was 297.6 pg/ml. Conclusion: Interleukin 8 has a high sensitivity and specificity in the diagnosis of bacterial meningitis from aseptic meningitis, and along with the measurement of cerebrospinal fluid protein, it can be a good criterion for differentiation of bacterial from aseptic meningitis.