Case report: Actinomyces in Hand: An Unusual Cause of OsteomyelitisAlireza Khosravi 1, Alireza Ghanadan2, Alireza Hadizadeh 3, Mohammadsadegh Talebi Kahdouei 4, Fatemeh Aghaei5, Faezeh Salahshour6, Zahra Saffarian7*1. Mycology Research Center, Faculty of Veterinary Medicine, University of Tehran, Tehran, [email protected]. Professor of pathology department of dermatopathology, Razi hospital, department of pathology, cancer institute, Imam Khomeini Hospital Complex, Tehran University of Medical Science, Tehran, [email protected]. Female Pelvic Medicine and Reconstructive Surgery (FPMRS), Division of Urogynecology, University of Chicago, Northshore University HealthSystem, Skokie, IL, USA4. Medical School, Tehran University of Medical Science, Tehran, [email protected]. Medical School, Tehran University of Medical Science, Tehran, [email protected].  Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences and Liver Transplantation Research Center, Imam Khomeini Hospital complex, Tehran University of Medical Sciences (TUMS), Tehran, [email protected] [email protected] [email protected]. Assistant professor of dermatology, Dermatology Department of Imam Khomeini Hospital Complex, Tehran University of Medical Science, Tehran, [email protected]*Co-responder author:Assistant professor of dermatology, Dermatology Department of Imam Khomeini Hospital Complex, Tehran University of Medical Science, Tehran, [email protected]

Premature ovarian failure and Asherman syndrome are leading causes of infertility. This case is a woman who after cesarian scar pregnancy and uterine artery embolization developed premature ovarian failure and Asherman syndrome. she underwent hysteroscopic adhesiolysis. she became pregnant with low AMH levels and delivered the newborn without any complications.

This study reports a patient developing TEN after the first dose of (BBIBP-CorV). He developed numerous purpuric and dusky patches with flaccid bullae and areas of epidermal detachment covered more than 30% of the body area within 6 days. After treatment with dexamethasone and cyclosporin, he recovered within 14 days.

Introduction Mitral valve diseases affect 18.1 million people every year, and the increased life expectancy has led to increased disability-adjusted life-years. Depending on the type of valve that is used to replace mitral valves, the type of complications differs. While a bioprosthetic valve has a lower bleeding risk than a mechanical valve, the overall durability is generally lower. However, the novel generations of valves are suggested to have better durability. This study was conducted to assess the durability and complications of either type of valve. Materials and methods This study is a retrospective cohort study that assesses the risk factors, complications, performance and durability of valves in short and long follow up. The cases of this study included all patients who had undergone valvuloplasty from 2004 to 2014. Results The results show that the mortality rate and admission duration is not significantly different between the two types of valves. However, reoperation rates are higher among bioprosthetic valves by three times. Cardiac tamponade, pleural effusion, and valvular thrombosis rates are higher among mechanical valves in the short term, while GI bleeding, valvular thrombosis, valvular thrombectomy rates are more prevalent with mechanical valves in the long term. Conclusion While bioprosthetic valves inflict more minor complications their overall durability is less than mechanical valves.

Metastatic ovarian cancers could originate from the gastrointestinal tract, and the origin is diagnosed with pathologic and immunohistochemistry evaluation. This case was a woman who was presented with bilateral abdominal masses which were adenocarcinomas originating from GIT. A mass was found in colonoscopy and total colectomy was performed.

Background and objectives:Exosomes therapy is a promising technique that can decrease the concern related to the fate of transplanted stem cells to the fistula location. The unique properties of mesenchymal stem cells (MSCs)-derived exosomes can improve fistula healing because of their high ability to regulate and modify immune responses. This project aims to examine the safety and efficacy of implementing MSCs-exosomes in treating refractory fistulas in inflammatory bowel disease (IBD) patients.Methods:The exosomes were isolated from umbilical cord-derived MSCs and characterized using flow cytometry, western blotting, and transmittance electron microscope (TEM). Five patients (three men and two women) with refractory perianal Crohn's disease with an average age of 35.4 years old were included. The patients did not match the exclusion criteria, and the presence of refractory fistulas was the main inclusion criteria. These patients have their exosomes injections in the operation room. The therapy responses of patients were assessed using physical examination, face-to-face interviews, computerized tomography (CT) scan, and magnetic resonance imaging (MRI) six months later.Result:The Following injection, patients reported a 70% improvement on average. Two patients claimed complete healing after exosome injections, while one patient reported no improvement and active discharge from the fistula site. In addition, five patients reported no adverse effects, both systemic or on the injection site.Conclusion: Injection of exosomes extracted from MSCs shows total safety and a satisfactory therapeutic impact, as shown in this and other research, and could play a significant role in the treatment of gastrointestinal fistulas in the future.

Introduction: Coronary artery disease is high-risk comorbidity of COVID-19 infection. Non-elective coronary artery revascularization in COVID-19 patients carries substantial risk. Therefore, it is essential to understand the risk factors and outcomes fully. This study aims to evaluate the prognosis of Coronary Artery Bypass Grafting (CABG) Surgery in patients with COVID-19. Materials and methods: This retrospective cohort study assesses 171 patients who underwent urgent and emergent CABG in Tehran Heart Center from March 2020 to September 2021. The patients were allocated to cases and controls based on COVID-19 infection status. Demographic and clinical features, alongside the complications and outcomes, were compared between the two groups. Results: According to diagnostic criteria, 62 patients were diagnosed with COVID 19 (Case), and 109 patients had no COVID diagnosis (Control). Regarding the demographics and risk factors, hypertension was more prevalent among patients with COVID 19 (64.5% compared to 43.1% p-value= 0.007). Length of hospital stay, ventilation time, and ICU stay time were significantly higher in patients infected with COVID 19. Post Operative complications, including stroke, atrial fibrillation, pleural effusion, blood transfusion, and Inotrope use, were significantly higher in the case group. Mortality rates were also higher in COVID-19 patients with an Odds ratio of 1.53; however, this difference is not statistically significant (p-value 0.44, 95%CI= 0.50-4.01). Conclusion: COVID-19 is associated with a significantly higher hospital stay, ventilation time, and ICU stay. Mortality rates are also higher, albeit insignificantly. Various postoperative complications are also higher with COVID-19.

intrauterine rarely fail which results in pregnancy. Meanwhile, these devices can perforate uterine and migrate through abdomen. Our case experienced IUD failure and perforation simultaneously and the device was embedded in omentum and shifted rapidly which made it hard to localize and could only be removed using ultrasonography guidance

In this article, we report a 34-year-old man who presented with a buccal progressive ulcerated lesion which through histopathologic and IHC findings diagnosed as Peripheral T-cell lymphoma.

Our patient had previously been diagnosed with Ulcerative colitis. the clinical manifestations of the patient along with laboratory tests such as anti-dsDNA and proteinuria were also positive. Therefore, the clinical manifestation was consistent with SLE. in the following work up monoclonal gammopathy in serum electrophoresis was also detected.

In this article, we report a 34-year-old man who presented with progressive hip pain and osteolytic bone lesions . Primary workup included Core needle biopsies manifested as osteomyelitis; however as no sign of remission was observed, an open biopsy considered which revealed primary bone lymphoma.