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As statins decrease the progression of sepsis and its related mortality, this study aimed to evaluate the effect of atorvastatin on survival and symptom improvement in hospitalized patients with COVID-19. This randomized controlled trial was performed on 156 hospitalized patients with COVID-19 in Bojnourd city in 2021. Patients were randomly divided into comparison (standard therapy: hydroxychloroquine + Kaletra®) and intervention groups (atorvastatin 20 mg, SD, plus standard therapy). The main outcomes were the rate of symptom improvement, duration of hospitalization, need for intubation, and mortality rate. In this study, seven patients died, two patients (2.6%) in the comparison group and five (6.6%) in the intervention group. The mean hospitalization days (p = 0.001), the pulse rate (p = 0.004), and the frequency of hospitalization in the ICU ward (18.4% vs. 1.3%) were longer and greater in the intervention group. The remission probability in the comparison group was greater (p = 0.0001). The median hospitalization days in the intervention group was longer (p 0.001) and remission in the comparison group occurred 1.71 times sooner (hazard ratio = 1.70, 95% confidence interval = 1.22-2.38, p = 0.002). Totally, adding atorvastatin to the standard regime in this study increased hospitalization days and imposed negative effects on symptom improvement in hospitalized patients with COVID-19.

BackgroundAn epileptic appendix torsion is a rare event that can lead to acute abdominal pain and occurs at any age. Chiropractic is a type of complementary medicine that is performed explicitly by spinal manipulations. Specialists use spinal manipulation to treat many musculoskeletal disorders, usually mechanical back and neck pain, headaches, and spinal stiffness. Case presentationA 49-year-old man with a history of progressive diffuse abdominal pain predominately in the left lower quadrant started three days ago was referred to Ghaem Hospital, Mashhad, Iran. All laboratory tests were normal, and no abnormal findings were observed on ultrasound and X-rays, but the CT scan revealed a definite diagnosis of appendicular torsion. Gastrointestinal rest, antibiotics, analgesics, and fluid therapy were started for the patient. After 72 hours, the patient's general condition improved, and he was discharged from the hospital. In this report, we presented a case who developed acute abdominal pain after spinal manipulation. Chiropractic is not a completely safe treatment and can cause irreversible damage, so we should know this method's dangers and have enough experience to provide the best and safest medical services for patients.

We present a case of a 37-year-old woman referred to our hospital with a 1-week history of significant weakness, anorexia, and mild abdominal pain. According to laboratory and radiographic data, the patient was diagnosed with perforated appendicitis and gangrene.

Ovarian Cancer (OC), as the seventh most common cancer throughout the world, is one of the most lethal gynecologic malignancies in women. In addition to well-studied risk and prognostic factors of OC, such as age, obesity, stage, histology, etc., ABO blood groups associations with OC has been attracted the investigators’ focus in the recent decade. The objective of this study is to find any relationships between ABO blood groups and OC through a meta-analysis. The databases of PubMed, Embase, and Web of Science were systematically searched by available MeSh terms for “Ovarian Cancer”, and “ABO blood group” up to August 1, 2020. Hazard ratio (HR) or odds ratio (OR) were extracted and used from studies for outcome estimation whenever appropriate with 95% confident interval (CI). Data were analyzed using CMA v. 2.2.064. Fourteen papers, including 58,193 participants, entered in the systematic review. The meta-analysis indicated a substantially higher risk of developing OC in individuals with blood group A (OR 1.17, 95% CI 1.01–1.36) and AB (OR 1.27, 95% CI 1.02–1.59), but the subject was not significant in individuals with blood group B (OR 1.11, 95% CI 0.81–1.51). No associations were found between OC overall survival and blood group A (HR 1.14, 95% CI 0.79–1.64), AB (HR 1.00, 95% CI 0.69–1.45), and B (HR 0.88, 95% CI 0.58–1.33). Recurrence rates of OC for blood groups A, AB, B, and O were 30.8%, 34.3%, 33.6%, and 32.0%, respectively. Rates of mortality in different blood groups are as follows: A (31.8%), AB (31.1%), B (26.2%), and O (33.8%). This systematic review and meta-analysis revealed a considerably increased risk of developing OC among individuals with blood group A and AB. However, no substantial impacts were found for ABO blood groups on the overall survival of the OC patients.

BackgroundEvidence recommends that vitamin D might be a crucial supportive agent for the immune system, mainly in cytokine response regulation against COVID-19. Hence, we carried out a systematic review and meta-analysis in order to maximize the use of everything that exists about the role of vitamin D in the COVID-19.MethodsA systematic search was performed in PubMed, Scopus, Embase, and Web of Science up to December 18, 2020. Studies focused on the role of vitamin D in confirmed COVID-19 patients were entered into the systematic review.ResultsTwenty-three studies containing 11901participants entered into the meta-analysis. The meta-analysis indicated that 41% of COVID-19 patients were suffering from vitamin D deficiency (95% CI, 29%-55%), and in 42% of patients, levels of vitamin D were insufficient (95% CI, 24%-63%). The serum 25-hydroxyvitamin D concentration was 20.3 ng/mL among all COVID-19 patients (95% CI, 12.1-19.8). The odds of getting infected with SARS-CoV-2 is 3.3 times higher among individuals with vitamin D deficiency (95% CI, 2.5-4.3). The chance of developing severe COVID-19 is about five times higher in patients with vitamin D deficiency (OR: 5.1, 95% CI, 2.6-10.3). There is no significant association between vitamin D status and higher mortality rates (OR: 1.6, 95% CI, 0.5-4.4).ConclusionThis study found that most of the COVID-19 patients were suffering from vitamin D deficiency/insufficiency. Also, there is about three times higher chance of getting infected with SARS-CoV-2 among vitamin D deficient individuals and about 5 times higher probability of developing the severe disease in vitamin D deficient patients. Vitamin D deficiency showed no significant association with mortality rates in this population.

Pancreatic cancer has a high mortality rate due to the absence of early symptoms and subsequent late diagnosis; additionally, pancreatic cancer has a high resistance to radio- and chemotherapy. Multiple inflammatory pathways are involved in the pathophysiology of pancreatic cancer. Melatonin an indoleamine produced in the pineal gland mediated and receptor-independent action is the pancreas and other where has both receptors. Melatonin is a potent antioxidant and tissue protector against inflammation and oxidative stress. In vivo and in vitro studies have shown that melatonin supplementation is an appropriate therapeutic approach for pancreatic cancer. Melatonin may be an effective apoptosis inducer in cancer cells through regulation of a large number of molecular pathways including oxidative stress, heat shock proteins, and vascular endothelial growth factor. Limited clinical studies, however, have evaluated the role of melatonin in pancreatic cancer. This review summarizes what is known regarding the effects of melatonin on pancreatic cancer and the mechanisms involved.

Background The roots and leaves of Arctium lappa (burdock) have been used for different therapeutic purposes, especially for diseases linked to chronic inflammation. Objectives The present study was designed to evaluate and compare the immunomodulatory activities of root extract of burdock and leaves extract of burdock in vitro. Methods In this experimental study, PHA- or LPS-stimulated splenocytes were treated with different concentrations of root or leaves extract of burdock and proliferation of splenocytes measured by MTT assay. The levels of IFN-γ and IL4 in the supernatants of PHA-stimulated splenocytes determined using ELISA. We also studied the effects of root and leaves extract of burdock on Nitric Oxide production by LPS-stimulated macrophages using the Griess reagent. The data were analyzed by one-way ANOVA followed by Tukey’s post-test using GraphPad Prism software, version 5.0. Results Our findings showed that both root and leaves extract of burdock have suppressive effects on LPS-stimulated splenocytes proliferation, IL-4 secretion from PHA-stimulated splenocytes, and NO production from LPS-stimulated macrophage and stimulatory effects on PHA-stimulated splenocytes proliferation, and IFN-γ secretion from PHA-stimulated splenocytes. Although both root and leaves extract of burdock had similar immunomodulatory effects in vitro, stronger immunomodulatory effects seen in root extract of burdock. Conclusions According to our results, we suggest that root of burdock is better option than leaves of burdock in modulation immune responses and inflammations.