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Background: Asthma is a common inflammatory disease of the airways which is characterized by variable and recurrent symptomes. The disease causes airway inflamtion and hyperresponsiveness, reversible airway obstruction and airway deformity, and accomponied with symptoms including shortness of breath, cough and wheezing in patients. Environmental and genetic factor ssuch as gene polymorphisms are involved in the development of asthma. Gene polymorphisms alter the function of genes, hence they involve in disease progression. Studies have shown genetic polymorphism in ADAM33 and TBX21 genes are associated with the risk of asthma. Materials and Methods: In present study, the polymorphism rs2787094 of ADAM33 and rs11650354 of TBX21 genes was assessed for the first time in Iranian patients with asthma and healthy individuals. For this purpose, 30 blood samples from patients with asthma and 30 samples from healthy donors were collected. Then their DNA was extracted, and subsequently ARMS-PCR technique was used, applying specific designed primers for normal and mutant allels for each polymorphism of candidate genes. Then the results were analysed. Results: The results indicated rs2787094 polymorphism in ADAM33 was significantly associated with the risk of asthma, while there was no significant relationship between rs11650354 in TBX21 and asthma risk. Conclusion: It appears that rs2787094 polymorphism in ADAM33 and different genotypes in this locus play a siginificant role in asthma risk in Iranian patients. [ABSTRACT FROM AUTHOR]

Background and Objectives Antihistamine drugs for acute upper respiratory tract infection treatment in children have many side effects. In this study, a anti-cough syrup was prepared from Cordia (Sepestan in Persian) extract and its effect was compared to that of diphenhydramine syrup on cough relief of children with upper respiratory tract infection. Subjects and Methods This double-blind randomized clinical trial was conducted on 124 children with upper respiratory tract infection aged 6-12 years referred to Abouzar Hospital in Ahvaz, Iran during 2019- 2021 in two treatment groups. The first group was given Sepestan syrup at a dose of 20 mg/kg/day and the second group received diphenhydramine syrup at a dose of 5 mg/kg/day in four dosages. For three days, the number and severity of day-time and night-time coughs were examined and the data were analyzed with independent t-test and chi-square test in SPSS software, version 24. Results The number and severity of day-time and night-time coughs in the group received Sepestan syrup significantly decreased compared to the diphenhydramine group, without any side effects (P<0.001). Conclusion High polysaccharides, strong antioxidants, and anti-inflammatory compounds of Sepestan can reduce throat irritation and soften the chest. The mucilage in the Sepestan extract can dissolve in water and produce a viscous substance such as gelatin that cause softening of the breast and expectoration. [ABSTRACT FROM AUTHOR]

Background & Aims: Influenza is one of the leading causes of respiratory illness in children and adults with underlying disease and the elderly. The virus kills large numbers of people annually, and dangerous types of the virus are associated with pneumonia and complications. Muscle pain is one of the most common findings in this disease, which is associated with myoglobinuria and increased levels of creatine phosphokinase (CPK). Patients with high CPK levels are associated with more complications and a higher risk of hospitalization. There has been a lot of research on the high levels of CPK in these patients, but the association of this enzyme in the blood of hospitalized patients with influenza has not been done and it is important to pay attention to the levels of this enzyme in hospitalized people. Serum CPK levels in the flu can be used as a diagnostic marker and predict the effects of the flu. Therefore, the aim of this study was to evaluate the level of CPK in patients with influenza and its differences in different ages. Methods: In this descriptive-analytical study, 264 patients with influenza resulting in hospitalization with an age range of one month to 90 years who were referred to Hazrat Ali Asghar and Hazrat Rasoul Akram Hospital in Tehran in autumn and winter of 1398, were Were examined. The clinical signs of influenza were evaluated in these patients and the frequency of lymphopenia, thrombocytopenia, neutropenia, myoglobinuria, positive blood culture and blood CPK level were measured in vitro. The relationship between influential variables such as myalgia and myoglobinuria and platelet status with high CPK levels was investigated. The obtained data were analyzed by SPSS software version 23. Results: The mean age of patients was 24.99 years. 54.2% were male. Prevalence of clinical symptoms of patients based on age groups showed that 176 (66.7%) had chills, 179 (67.8%) had myalgia, 115 (43.5%) had pharyngitis, 242 (98.4%) Cough, 119 patients (45%) had sputum, 58 patients (22%) had headache, 66 patients (25%) had shortness of breath and 68 patients (25.6%) had diarrhea. Among these, the highest and lowest prevalence of myalgia were in the age group of 21-40 years and children under 5 years, respectively, which was statistically significant (P = 0.027). There was also a significant difference in the prevalence of pharyngitis (P ˂0.001), sputum (P = 0.004) and shortness of breath (P ˂0.001) in patients. CPK levels were about 50% higher than normal and did not differ between age groups and sexes. Lymphopenia, thrombocytopenia and neutropenia had a prevalence of 41%, 25% and 20%, respectively. Myoglobinuria had a prevalence of 82%, which was more common in the under-5 age group. In the group with normal CPK, the prevalence of myoglobinuria was nearly 30% higher. Also, the prevalence of high CPK in the group with myoglobinuria was almost 35% higher than the group without it, which indicates the relationship between the prevalence of high CPK and myoglobinuria (P = 0.02). There was a significant relationship between patients' blood platelet status and high or normal CPK (P = 0.01). The prevalence of myalgia in the group with high CPK was 52% higher than the group without myalgia and in the group with myalgia, the prevalence of high CPK was 16% higher and the prevalence of myalgia symptom was statistically significant (P = 0.004). Positive blood cultures were higher in adults and the elderly than in youth and children, and among the clinical signs, CPK was associated only with myalgia. Conclusion: High levels of CPK were observed in half of the patients and our findings showed that high levels of CPK were significantly associated with myalgia and myoglobinuria and platelet status. This indicates that the increase and decrease of this enzyme can affect the fate of the disease. It is suggested that future studies investigate the association of CPK levels with lymphopenia and leukopenia and immune cells. Examination of CPK levels in future patients can be effective in identifying the risk factor for disease severity and help in better treatment and reduction of disease complications. [ABSTRACT FROM AUTHOR]

Background and purpose: Cough, hoarseness, and sore throat are complications of intubation. The aim of this study was to evaluate the effect of gargling with honey and lemon water on cough, sore throat, and hoarseness after extubation of endotracheal tube following surgery. Materials and methods: A clinical trial was carried out in 110 patients undergoing surgery in Neyshabur 22 Bahman Hospital, Iran 2020. They were selected using convenience sampling and randomly allocated to experimental or control group. In experimental group, 6 hours after surgery, 30 cc of honey lemon water was gargled, three times, every two hours and then swallowed. The control group received routine care. Postoperative sore throat, cough, and hoarseness were assessed before the intervention, and 12 and 24 hours after extubation of endotracheal tube. Data were analyzed by independent t-test and repeated measures analysis of variance. Results: Findings showed no significant difference between the two groups in cough and sore throat 12 hours after extubation, but the score for hoarseness was lower in experimental group (P= 0.05). Twenty-four hours after extubation, cough (P= 0.001), hoarseness (P= 0.006), and sore throat (P= 0.023) were significantly lower in experimental group. The passage of time was found to significantly affect all three variables (P<0.001). Conclusion: Considering the positive effects of gargling with honey and lemon water in reducing the complications of endotracheal tube and no side effects, it is recommended to be used after extubation. [ABSTRACT FROM AUTHOR]

Background and Aims: Coronavirus disease 2019 (COVID-19) is an emerging disease, whose first case was reported in December 2019, and rapidly affected the world. Therefore, the present study was conducted to investigate the frequency and factors associated with morbidity and mortality due to COVID -19 in Ghaen, Iran. Materials and Methods: This retrospective descriptive-analytical study used the information sources of the portal of Shohada Ghaen Hospital, Gaen, Iran, from March 2020 to December 2021, which was collected from 1,124 patients with suspected respiratory infection referring to the hospital. Data using Chi-square and Fisher's exact test for univariate relationships. Moreover, two-way logistic regression was used to investigate the causal relationships, and P<0.05 was considered statistically significant. Results: In this study, the mean age of participants (n=1,124) was obtained at 51.6±24.5 years, and 546 (48.6%) subjects had a positive COVID-19 test by reverse transcription polymerase chain reaction, among whom 65 (11.9%) cases passed away. Clinical symptoms of body aches, coughs, diarrhea, and shortness of breath were associated with a positive COVID-19 test. It was also revealed that habitat, diabetes, cardiovascular and lung diseases, age, and job were risk factors of COVID-19 infection, and hospitalization in the ICU and age were identified as risk factors for COVID-19-caused death (P<0.05). Conclusion: In the present study, cough and shortness of breath were found to be the most frequent symptoms among patients and deceased individuals. Since these symptoms may be associated with a worse prognosis, they require the special attention of medical staff. The findings of this study also showed that the elderly were more at risk of death from this disease than other age groups, which increased the need for more education and attention to this group of society. [ABSTRACT FROM AUTHOR]

Background Considering the high prevalence of Coronavirus Disease 2019 (COVID-19) and the medical resource constraints, a better understanding of the characteristics of the disease and identifying the factors indicating the severity of the disease can help decide on the allocation of important and limited resources. The current study aimed to investigate the demographic, clinical, laboratory characteristics, and imaging features of critically-ill patients with COVID-19 who were admitted to the Intensive Care Unit )ICU) of 3 hospitals in Rash City, Iran. Objective This retrospective study was performed on 138 patients with COVID-19 who were admitted to the ICU. The study patients’ data, including demographic characteristics, underlying disease, laboratory, imaging findings, and disease outcome were extracted from their records. Methods This retrospective study was performed on 138 patients with COVID-19 who were admitted to ICU. Patient data, including demographic characteristics, underlying disease, laboratory and imaging findings, and disease outcomes, were extracted from patient records. Results In this study, the majority of patients were male and in the age range of 55-69 years. Diabetes mellitus, hypertension, and chronic heart disease were the most common underlying diseases; shortness of breath, fever, and cough were the most common symptoms. Ground glass opacities were the most common sign in lung Computer Tomography (CT) scan and an increase in the level of LDH, ESR, CRP, neutrophil percentage, and lymphopenia were the most common laboratory findings in the study subjects. The mortality rate was equal to 90.58%. Conclusion This study revealed that most patients with severe manifestations of the disease were older, had a history of underlying disease, symptoms of shortness of breath, cough, and fever, and extensive lung involvement in imaging and changes in laboratory results. Mortality remained high despite medical therapy and mechanical ventilation. [ABSTRACT FROM AUTHOR]

Background and Aim Inferior turbinate hypertrophy is one of the most common causes of nasal obstruction after nasal septal deviation. Enlargement of the turbinate is the result of the position of turbinate bone or swelling of turbinate submucosal. This study aimed to evaluate the effectiveness of the Sub- Mucosal Resection (SMR) method with electrocautery method in the treatment of inferior turbinate hypertrophy. Methods and Materials A total of 140 patients with inferior turbinate hypertrophy complicated with nasal congestion and rhinorrhea and candidate of surgery were randomly divided into two groups. In the first group, after induction of anesthesia, we performed SMR of inferior turbinate hypertrophy. In the second group, after induction of anesthesia, we performed monopolar cauterization with 20-gauge angiocath in three anterior, middle, and posterior regions and crests of the inferior turbinate. Ethical Considerations This study was approved by the Ethics Committee of Arak University of Medical Sciences (Code: 91.133.3). Results In the electrocautery group, a significant improvement was observed in nasal congestion after 6 months (P=0.017). In the SMR group, a satisfactory headache improvement was reported (P=0.034), one month after the operation. Also, the electrocautery group reported less pain and burning in the site of surgery, sneezing, coughing, and itching (P=0.013). Conclusion Electrocautery can be superior over SMR because of its less bleeding, shorter time of surgery, the availability of primary equipment, and relative improvement in decreasing the rhinorrhea. However, if the patient suffers from isolated inferior turbinate hypertrophy, SMR as a suitable method is recommended. [ABSTRACT FROM AUTHOR]

Aims: After tracheal extubation, following the patient' waking up from general anesthesia, respiratory physiological responses are with symptoms such as cough, laryngospasm, and stridor. Different medications are used to prevent these complications. The aim of this study was to compare the effects of intravenous hydrocortisone and dexamethasone on the respiratory side-effects before tracheal extubation. Materials & Methods: In this two-blinded clinical trial, 108 patients candidate for orthopedic surgery, general surgery, and urology by general anesthesia hospitalized in Shahid Hashemi Nezhad and Bidaxt 15th Khordad hospitals were studied in Mashhad, Iran, in 2015. The subjects were selected via available sampling method. Randomized assignment was done by BBR. The first and the second groups received 100mg hydrocortisone and 8mg dexamethasone 30 minutes before tracheal extubation as one intravenous dosing, respectively. Individual information and clinical status were recorded based on the diagnoses by an anesthesiologist. Data was analyzed by SPSS 13 software using Chi-square, independent T, and Mann-Whitney tests. Findings: There was no significant difference between dexamethasone and hydrocortisone groups in the frequencies of cough, laryngospasm, and stridor (p>0.05). There were significant differences between the mean weights of patients with laryngospasm (p=0.03), cough (p=0.002), and stridor (p=0.001) and the patients without such symptoms. There was no significant difference in gender between patients with stridor and laryngospasm and other patients without such symptoms (p>0.05), excluding patients with cough (p=0.003). Conclusion: The effects of hydrocortisone and dexamethasone are similar on laryngospasm, cough, and stridor after tracheal extubation. [ABSTRACT FROM AUTHOR]

Background and purpose: Sore throat is one of the most common complications of general anesthesia. The source of pain perhaps is from the pharyngeal, laryngeal or tracheal and maybe is the cause of unpleasantness, discomfort and a bad memory after general anesthesia. This study evaluated the effectiveness of lubricating lidocaine gel on the sore throat; cough and scratching of throat after laryngeal mask airway (LMA) insertion. Materials and methods: Sixty patients -who scheduled for elective eye surgery- underwent general anesthesia and with the inclusive criteria and were randomly divided into two groups of intervention and control in a double-blinded study. The posterior surface of LMAs was lubricated with lidocaine gel 2% in the intervention group and non-medical lubricant gel in the control group. After induction of anesthesia that was similar in two groups, the LMA was inserted using classical method by an anesthesiologist who was unaware of the used gel, and after ensuring adequate ventilation LMAs were fixed in site. Twenty-four hours after the operation the patient's sore throat, coughing and itchy throat were checked. Results: Results showed that the two groups had no statistically significant differences regarding age and gender (P > 0.05). Furthermore, there was no statistically significant difference between the two groups regarding the amount of blood staining on LMA cuff after removal. The severity of sore throat in 24 hours after the surgery, the incidence of cough and itchy throat were similar as well. Conclusion: The gel used to facilitate placement of LMA has no impact on the postoperative sore throat, cough, and blood staining on LMA, and throat itching. [ABSTRACT FROM AUTHOR]

Background and Objective: Viral upper respiratory tract infection and cold drugs consumption is prevalent among children. These drugs have no effect on disease improvement, but it may also have accompanied with many side effects. This study was conducted to compare the effect of honey and diphehydramine on the alleviation of cough in 2-5-year-old children with viral upper respiratory tract infection. Materials and Methods: This double-blind clinical trial study was carried out on 170 children (60 boys and 66 girls) aged 2-5 years old with viral upper respiratory tract infection who were taken to the pediatric clinic of Shariatee hospital in Bandar Abbas, Iran during 2010. Children demographic charactrastics were including age, gender, period of illness, vaccination history, weight, growth, overall health, and cardiopulmonary examinations. Patients were randomly divided into two groups of 63 children receiving honey (three times a day and the last dose an hour before bed) and diphehydramine syrup (5mg/kg/BW). Two days later, subjects were examined again for the severity and frequency of coughs during day and night. Data were analyzed using SPSS-19, independent t-test and chi-square test. Results: Mean±SD of the age of children was 45.21±11.39 and 43.98±11.95 months in honey and diphenhydramine groups, respectively. The frequency and severity of night coughs was lower in the honey group (97.4%) as compared to the diphenhydramine group (58.7%) (P<0.02). The frequency and severity of daily coughs was lower in the honey group (84.1%) while it was lower in 58.7% of the diphenhydramine group (P<0.01). Conclusion: This study showed that honey is more effective than diphenhydramine in the alleviation of cough caused by viral URTI in 2-5-year-old children. [ABSTRACT FROM AUTHOR]

Background: Patients commonly ask pharmacists for the over-the-counter medications when they get different ailments. Assessment of how a pharmacist evaluates a patient's signs and symptoms and his or her approach to treating the patient using over-the-counter medications were the main goals of this study. Methods: In this cross-sectional study, the scenarios on cough, diarrhea and Obesity were selected from questionnaires that had been responded by 61 pharmacists. The scenarios were then designed by determining important questions including the key question using appropriate references and the opinions of a panel of experts. Subsequently, a list of all pharmacies in Isfahan (Iran) was obtained and 210 pharmacies were randomly selected. Final analysis was made on 151 visits to 127 community pharmacies. Performance of pharmacists, i.e. the number and type of questions used to come up with a recommendation and the appropriateness of the decision, was assessed both strictly and leniently. Moreover, the length of time spent for counseling and influence of gender and ownership of pharmacists were analyzed. Findings: The mean counseling time was 130.2 ± 86.1 and 98.6 ± 72.4 seconds for female and male pharmacists, respectively (P = 0.01). The key questions for cough, diarrhea, and Obesity scenarios were asked by 29 (55%), 45 (87%), and 0 (0%) of pharmacists, respectively. The questions led to 25 (47%), 10 (19%), and 8 (17%) appropriate recommendations according to a lenient evaluation. Conclusion: Despite asking the key questions, the majority of pharmacists do not make appropriate recommendations for cough, diarrhea, and especially Obesity. Incorporating relevant courses in the pharmacy curricula and devoting continuing education seminars to over-the-counter medication usage are suggested to improve pharmacists' performance. [ABSTRACT FROM AUTHOR]

Background and purpose: After marked reduction of pertussis during recent two decades the incidence of disease is increasing, particularly in early infancy. The main sources of infection in this age group are mother and other household close contacts. Our purpose was to examine whether administrating prepregnancy pertussis booster dose can induce long-term protection enough to provide higher maternal antibodies levels to their offsprings compared with prebooster titers. Materials and methods: Totally 114 healthy 18-35 year-old childbearing age women planning to become pregnant were boosted with one dose of adult type pertussis vaccine. Blood samples were obtained before, four weeks, and one year after boosting. Sera were tested for IgG antipertussis-antibodies using ELISA method. Descriptive statistical method and paired t-test were used to compare the data before and after vaccination. Results: Seroprevalence rate and mean concentration of antibodies at before vaccination were 69.3% and 68.19 (SD 38.46) Eu/mL, respectively which significantly increased to 93.8% and 152.82 (SD 70.31) EU/mL, respectively. One year after vaccination these rates were significantly higher than before vaccination (82.4%, and 107.0 (SD44.75) EU/mL, respectively). Serologically recent pertussis infection was detected in 3.5% of the women. Conclusion: Pertussis booster immunization was safe, well tolerated and highly immunogenic and resulted in immunity which was preserved for more than one year. Further investigations with larger sample size and longer duration are recommended. According to these findings and review of literature, targeted prepregnancy pertussis vaccine boosting may be an alternative strategy to protect young infants. [ABSTRACT FROM AUTHOR]

Background and purpose: Bordetella pertussis is a gram negative and obligate aerobic bacteria that is cause of whooping cough and is exclusively a human pathogen. In the last decade increasing rate of pertussis was observed. Despite the importance of pertussis as a contagious disease enough information does not exist regarding its incidence rate in Iran. In this research pertussis suspicious specimens were collected from different provinces of Iran in 2009-2010 and then were studied. Materials and methods: A total of 1084 sample from nasopharyngeal secretion or nasal of patients with coughing more than two weeks were collected from different provinces of Iran and were sent to microbiology unit of pertussis reference laboratory in Pasteur institute of Iran. The isolation was done through culturing method. All samples were inoculated through swab on pertussis charcoal agar and Bordet-Gengou plates containing (40 μg/ml) cephalexin antibiotic and once without it. Then the suspected colonies were gram stained and complementary tests was done if colonies were identified as B. pertussis, B. parapertussis. Results: From the total of 1084 samples 12 inoculated samples were positive (1.1%) of which 11 samples were B. pertussis and one sample was B. parapertussis. Among positive cultures, three cases were the patients who were below 2 months, six cases related to individuals from two months to two years of age, two cases related to those aged between two and 10 years old and one patient was over 10 years of age. Nine cases of positive culture specimens were vaccinated and seven cases were the patients who used antibiotics. Conclusion: Results of this study indicated that most isolated strains in Iran were related to those aged between two months to two years old. According to clinical and paraclinical problems regarding whooping cough in Iran and also low sensitivity of culturing method to diagnose Bordotella, complementary methods such as Real-Time PCR should be used. [ABSTRACT FROM AUTHOR]

Background and purpose: Severe, tormenting and long-term coughing in patients suffering from pertussis causes disturbances in their and their families' daily activity. The aim of this study was to evaluate the effect of Tramadol on alleviating coughing and severity of symptoms in pertussis patients. Materials and methods: Sixty cases of adult pertussis patients based on WHO and CDC guidelines were included in the study. Based on the severity of their clinical symptoms, they were divided into moderate and severe groups. The case group received Azithromycine, Cetirizine and Tramadol but the control group received only Azithromycine and Cetirizine. Results: The case group consisted of 13 male (43.33%) and 17 female (56.66%) patients: sixteen cases had severe and 14 cases moderate symptoms. The control group consisted of 14 male (46.66%) and 16 female (53.33%) patients: 17 cases had severe and 13 cases moderate symptoms. After one week of treatment in the case group, 7 cases were severe (22.33%) and 6 cases were moderate (20%) (p<0.05) but in the control group 43.33% were severe and 33.33% were moderate (p<0.05). Conclusion: A faster and more suitable reduction in clinical symptoms, especially coughing, using tramadol with an appropriate dose, can result in an improvement in patients' quality of life. [ABSTRACT FROM AUTHOR]

Background: Cough is one of the most common symptoms for which outpatient care is sought. Since, a few research evaluated efficacy and therapeutic effect of baclofen in remedy of cough (especially chronic cough), In this study we compared the efficacy of oral Baclofen 20 mg with Dextromethorphan to improvement of cough in two groups. Methods: In this double blind randomized clinical trial, 120 patients with chronic cough (up to three weeks) that were referred to respiratory diseases clinic of Ali Ebn-e Abitaleb (AS) hospital in Zahedan, Iran at 2007 were randomly devided to two groups. 60 peoples in each, (baclofen recipient group with mean age 32.32±6.51 and dextromethorphan recipient group with mean age 31.54±5.06 year) were evaluated for qualitative decline of severity, period and duration of cough for 14 days. Results: In baclofen recipient group 73.3% and in dextromethorphan recipient group 65% all patients had decline of severity, period and duration of the cough. Statistically, there were no significant differences between two groups in regard to qualitative decline of severity, period and duration of cough (p>0.05). Also, there were no drug related side effects in the patients. Conclusions: Baclofen decreased severity, period and duration of cough more than dextromethorphan. Because there were no significant differences between two groups, we needed to do more quantitative researches to compare them. [ABSTRACT FROM AUTHOR]