Background: Cervical cancer, the most common gynecological cancer, is a matter of concern, especially in developing countries. The present study investigates survival rates, associated factors, and post-treatment follow-up status in cervical cancer patients. Study Design: A retrospective cohort study. Methods: This study was conducted on 187 patients referred to an academic referral cancer center in Iran from 2014-2020. Overall survival (OS) and event-free survival (EFS) were evaluated using Kaplan Meyer analysis. The event was defined as recurrence, metastasis, or death. Results: The patients came for post-treatment visits for a median of 36 months (interquartile range [IQR]: 18-51). The median OS and EFS were 24 and 18 months, respectively. The 1- and 3- year OS rates were 90% and 72%, respectively. The 1- and 3- year EFS rates were 76% and 61%, respectively. Stage≥III (hazard ratio [HR]: 3.1, 95% confidence interval [CI]: 1.5, 6.5, P<0.001) and tumor size>4 cm (HR: 2.5, 95% CI: 1.2, 4.9, P=0.006) predicted lower OS. The most common histopathology was squamous cell carcinoma (SCC) (71.1%) with non-significant higher 3- year OS (HR: 0.62, 95% CI: 0.33, 1.16, P=0.13). No significant difference in OS was found between adjuvant and definitive radiotherapy in both early and advance-staged patients (Log-rank=0.7 P=0.4, log-rank=1.6, P=0.2, respectively). Conclusion: As evidenced by the obtained results, the survival of patients was lower compared to that in developed countries. Higher stage and tumor size led to shorter survival. The histopathology and type of treatment in comparable stages did not have any significant impact on survival.
Objectives The purpose of this study was to investigate the analgesic effects of duloxetine, specifically on postoperative pain, opioid consumption, and related side effects following total hip or knee arthroplasty. Methods In this systematic review and meta-analysis, Medline, Cochrane, EMBASE, Scopus, and Web of Science were searched until November 2022 for studies which compared duloxetine with placebo when added to routine pain management protocols. Individual study risk of bias assessment was conducted based on Cochrane risk of bias tool 2. Random effect model meta-analysis was done on mean differences, to evaluate the outcomes. Results Nine randomized clinical trials (RCT) were included in the final analysis, totaling 806 patients. Duloxetine reduced opioid consumption (oral morphine milligram equivalents) on postoperative days (POD) two (mean difference (MD): - 14.35, p = 0.02), POD three (MD: -13.6, p < 0.001), POD seven (MD: -7.81, p < 0.001), and POD 14 (MD: -12.72, p < 0.001). Duloxetine decreased pain with activity on POD one, three, seven, 14, 90 (All p < 0.05), and pain at rest on POD two, three, seven, 14, and 90 (All p < 0.05). There was no significant difference in the prevalence of the side effects, except for increased risk of somnolence/drowsiness (risk ratio: 1.87, p = 0.007). Conclusion Current evidence shows low to moderate opioid sparing effects of perioperative duloxetine and a statistically but not clinically significant reduction in pain scores. Patients treated with duloxetine had an increased risk for somnolence and drowsiness.
Background: Based upon WHO (World Health Organization) Coronavirus Dashboard more than 5 million deaths worldwide have been attributed to the COVID-19 (Coronavirus Disease 2019) caused by the SARS-Cov-2 virus (Severe Acute Respiratory Syndrome Coronavirus) till November 2021. The annual flu vaccination has raised many questions about the vaccine's effects on Covid-19 outcomes. Several possible mechanisms including cross-reactivity and cross-protection have been reported to be responsible for the potential protective effect of the flu vaccine on the COVID-19 infection. This study was performed to evaluate the possible effect of the influenza vaccine on the disease severity, the mortality rate, and the length of hospitalization in COVID-19 patients. Methods: The data of 1300 patients were recorded from May 2020 to October 2020. Patients with a previous history of COVID-19, patients under 18 years old, and patients who did not have accurate information about their influenza vaccination history were excluded. 498 hospitalized unvaccinated COVID-19 patients with typical clinical manifestations and a positive PCR (Polymerase Chain Reaction) test for COVID-19 were included in this observational, cross-sectional study. The participants were divided into two groups (vaccinated and unvaccinated) based on the history of influenza vaccination at the time of admission. Results: The length of hospital stay was lower in the vaccinated compared to the unvaccinated group (p < 0.05). However, there was no significant difference between the mortality rate, the need for ICU (Intensive Care Unit) admission, and the severity of the disease between the two groups (p> 0.05). Conclusion: Since the patients studied in this article did not receive any of the Covid-19 vaccines; Therefore, the effect of influenza vaccination on the clinical course of Covid-19 can be evaluated using the results of this study. A longer length of hospital stay was observed in the unvaccinated patients in our study, which may suggest the possible protective effect of the influenza vaccine against COVID-19.
Soft tissue filler injection is the second most common nonsurgical cosmetic procedure. Despite the safety of fillers, as use has grown, so has the number of patients affected by adverse events. Ophthalmoplegia following cosmetic filler injection is a rare complication, mostly occurring after injection to the glabella, nasolabial fold, periorbital, and lateral nasal site. In all cases where ophthalmoplegia has been reported following fillers, patients have simultaneously experienced vision loss and other ocular symptoms. We report a case of isolated acute ophthalmoplegia following hyaluronic acid injection solely in the temple region. A 40-year-old woman, 3 hours after the procedure, presented to our hospital with left eye ophthalmoplegia, ptosis, and hypotropia. Treatment started with hyaluronidase, steroids, and anticoagulants. After 4 weeks, left eye ophthalmoplegia remained unchanged, and through a 10-week follow-up, all left ocular movements improved, and only mild hypotropia and ptosis persisted. This case report shows that ophthalmoplegia may also happen with temple region filler injections. We also review available prevention techniques and treatments to avoid such complications when performing soft tissue fillers for gaunt appearance correction.
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