Introduction Pilonidal sinus disease (PSD) is a common skin and subcutaneous disease that is mainly seen in men (mean age, 30 years); its incidence rate is 26 cases per 100 000. PSD greatly affects quality of life. Ideally, a surgical procedure to treat PSD should involve a minimal hospital stay and require minimal time off work, discomfort, operative time, and cost; it should also limit recurrence. In this study, we present a new minimally invasive technique for pilonidal sinus surgery known as endoscopic pilonidal sinus treatment (EPSiT). Methods From February 2017 to April 2019, 100 patients diagnosed with PSD were treated with the EPSiT method at the Department of General Surgery, Imam Reza Hospital. Patient information was recorded prospectively. During the operation, the fistula cavity and tracts were ablated by an electrode that was introduced through the operative channel. All the epithelial and granulation tissues were removed by a brush inserted into the operative channel or by a Volkmann spoon. Results None of the patients had postoperative complications, such as hematoma, seroma, or wound infection, during the follow‐up period. Recurrence was seen four patients (4%). At 1 week postoperatively, the visual analog scale score was 3 for 37 patients (37%) and 2 for 28 patients (28%). The maximal cosmetic satisfaction rate was reported in 85 patients (85%). Conclusion As a minimally invasive procedure, EPSiT is effective for treating PSD. Compared with excision and primary closure techniques, EPSiT has a very low recurrence rate after the procedure and a short hospital stay.

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Introduction: Multiple sclerosis (MS) is a chronic and unpredictable demyelinating disease of the central nervous system (CNS). While MS is mostly known for muscle weakness, numbness, and pain, but fatigue is the most common complaint of this condition. Despite this fact, MS related fatigue is one of the most misunderstood symptoms. Methods: A non-interventional study of 100 individuals was conducted in the MS clinic, Tabriz University of Medical Sciences. Patients were divided into groups with and without complaints of fatigue. The course of the disease was determined for all patients. To quantify fatigue, the Modified Fatigue Impact Scale (MFIS) was used. Furthermore, mood disorders, pain, disability, nocturia, insomnia, and spasticity were evaluated among the patients. Results: Overall, fatigue was diagnosed in 61 through 100 patients. Depression was reported in 23 patients of whom 19 had fatigue (P=0.015). 40 patients showed anxiety 33 of which had fatigue (P>0.001). 53 patients of whom reported to have pain (76 patients) showed fatigue (P=0.001). Insomnia was reported in 27 patients, where 21 of them had fatigue (P=0.036). Nocturia was reported in 10 patients, of whom 9 had fatigue (P=0.047). Spasticity was detected in 9 patients, all of whom had fatigue (P=0.012). Conclusion: There are several factors directly and indirectly associated with fatigue that are either fatigue-induced, caused by fatigue, or showing a two-way relationship with it. Understanding these links and attempting to reduce them will improve the quality of life for these patients.

Severe Acute Respiratory Coronavirus Syndrome 2 (SARS-CoV-2) is a new human coronavirus family discovered during the highly communicable respiratory disease outbreak in Wuhan, China, in 2019. Various COVID-19 vaccines are up to 95% effective against symptomatic infections caused by the COVID-19. Whether people with PD or PS have an increased risk of COVID-19 and are associated with a higher risk of death is still uncertain. In this study, we report eleven cases of PD patients who died whitin 24 hours after vaccination with the Sinopharm. All patients were over 79 years old (84.64 ± 5.08). All patients were SARS-CoV2 PCR negative and took their first dose of the Sinopharm. All patients had a duration of more than 5 years with PD. All patients presented to the hospital less than 12 hours after vaccination. All patients died less than 24 hours after vaccination. In this study, All the patients were elderly and hypertension and diabetes were seen in 11 (100%) and 7 (63.6%) patients which could reinforce the hypothesis that older patients with PD should be vaccinated more cautiously and these patients should be discussed the vaccine with their physician especially in patients who have other comorbidities. Because our report was a case series study, we only identified patients, and the causality could not be assumed or proven.

Background:Colorectal cancer (CRC) is a leading cause of global mortality and presents a significant barrier to improving life expectancy. The primary objective of this study was to discern a unique differentially expressed gene (DEG) that exhibits a strong association with colorectal cancer. By achieving this goal, the research aims to contribute valuable insights to the field of translational medicine. Methods:We performed an analysis on four colorectal cancer microarray datasets obtained from the GEO database in order to identify differentially expressed genes (DEGs). In addition, we explored the TCGA colon adenoma carcinoma (COAD) dataset using GEPIA2, which provided high-throughput RNA-Seq data to identify DEGs associated with COAD. To further investigate, we conducted a comprehensive analysis using a pan-cancer model encompassing 33 different cancer types to identify common DEGs between the GEO datasets and the GEPIA2 COAD-TCGA data. We also performed gene set enrichment analysis using Enrichr to gain insights into the functional relevance of these DEGs. To uncover potential regulatory relationships, we constructed a co-expression network utilizing data from the STRING and LinkedOmics databases. Furthermore, we established a competing endogenous RNA (ceRNA) network by integrating information from the miRTarBase and circBank databases. Additionally, correlation between tumor-immune signatures in distinct tumor microenvironments was investigated using the TISIDB database. Finally, we investigated potential interactions between the identified gene and various drugs, providing valuable insights into therapeutic possibilities. Results:GUCA2A emerged as a significant DEG specific to colorectal cancer (|log2FC| > 1 and adjusted q-value < 0.05). Importantly, GUCA2A exhibited excellent diagnostic performance for COAD, with 98% sensitivity, 95% specificity, and a 99.6% area under the curve (AUC). Moreover, low expression of GUCA2A significantly impacted overall patient survival. Enrichment analysis highlighted the receptor guanylyl cyclase signaling pathway and guanylate cyclase activator activity as the most significant gene ontology terms. A ceRNA network consisting of 8 miRNAs targeting GUCA2A and 183 circRNAs acting as miRNA sponges was constructed. Significant correlations were observed between tumor-immune signatures and GUCA2A expression. Additionally, lactose anhydrous, Atropin, and Volanesorsen sodium were identified as drugs potentially interacting with GUCA2A. Conclusions:This study identifies GUCA2A as a promising prognostic and diagnostic biomarker for colorectal cancer. Further investigations are warranted to explore the potential of GUCA2A as a therapeutic biomarker.