Volume 3, Issue 4, Autumn 2021


Pulmonary Embolism, the Only Demonstration of Covid-19 in a 53-year-old Patient

Sina Imanizadeh; Mohammad Rezapour; Hoorolnesa Ameli; Farzaneh Bolouki Moghaddam

Canadian Journal of Medicine, 2021, Volume 3, Issue 4, Pages 162-166
DOI: 10.33844/cjm.2021.60601

On March 30, 2021, a 53-year-old man was hospitalized, complaining of breath shortness, chest pain, and pain in his right leg from 2 weeks ago when he went mountain climbing. His symptoms did not improve, and his shortness of breath worsened. Therefore, he went to a hospital and was hospitalized to investigate the possibility of Deep Vein Thrombosis (DVT) and Pulmonary Thromboembolism (PTE) further. At admission, O2 sat was 91, followed by Respiratory Rate (RR) of 18 and White Blood Cell (WBC) of 9.6. The patient was admitted to Coronary Care Unite (CCU), and color Doppler sonography, echocardiography, and pulmonary angiography were conducted.

Letter to Editor

Autophagy and Coronavirus Interaction: Its Significance for COVID-19 Treatment

Pallab Chakraborty

Canadian Journal of Medicine, 2021, Volume 3, Issue 4, Pages 167-170
DOI: 10.33844/cjm.2021.60596

In December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, Hubei province, China [1, 2]. According to the literature, the coronavirus was found to interact with autophagy pathways [3–6]. The autophagy process (recycling pathway) is very important for the degradation of cytosolic compounds and the creation of building blocks in cells [7]. During starvation conditions, this process can be activated. It delivers the cytosolic components, including the damaged cellular organelles and mis-folded proteins, into lysosomes by establishing autophagosomes, where the degradation takes place [3, 8]. It is reported to have a paradoxical role in protecting cells from viral and bacterial infections, depending on the types of pathogens and the host cells [3, 9]. Commonly known processes are xenophagy (viral particle degraded) and virophagy (degradation of neosynthesized components from virus), and innate- adaptive immune induction, by which autophagy contributes to the antiviral response [8, 10, 11].

Review Article

Evaluating and Mitigating the Challenges of International Students Amidst the COVID-19 Pandemic: An Overview

Daivat Bhavsar; Peter Anto Johnson; John Christy Johnson; Jasrita Singh; Austin Albert Mardon

Canadian Journal of Medicine, 2021, Volume 3, Issue 4, Pages 171-175
DOI: 10.33844/cjm.2021.60597

International students are one of the most vulnerable social groups during the COVID-19 pandemic, ignored by social and financial welfare programs. The use of statistics, governmental statements, and academic literature outline the additional hardships faced by post-secondary international students to propose interventions to reduce precarity. The hospitality of educational institutions and response programs towards international students would be crucial for upholding commitments to social justice during these challenging times. This paper can contribute to understanding the role of social work in serving groups most vulnerable to COVID-19.

Letter to Editor

Pitfalls in Interpretation of SARS-CoV-2 Infection-related Neurological Complications

Seraph Shi Kei Wu; Sunny Chi Lik Au

Canadian Journal of Medicine, 2021, Volume 3, Issue 4, Pages 176-178
DOI: 10.33844/cjm.2021.60602

Coronavirus disease (COVID-19) is an ongoing global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Many systematic reviews and meta-analyses discussed the correlation of COVID-19 with a different disease. Given the urgent need for data, some meta-analyses containing datasets included many manuscripts, but their providence was not clearly reported. The possible overlap between some of the studies included in the analyses is a significant issue for conducting systematic reviews during the COVID-19 pandemic.

Review Article

How will the COVID-19 Pandemic Change Dermatology Services over the next Five Years?

Immanuel Sani; Damilola Agboluaje

Canadian Journal of Medicine, 2021, Volume 3, Issue 4, Pages 179-181
DOI: 10.33844/cjm.2021.60605

The advent of COVID-19 has radically transformed conventional affairs in numerous facets of life across the world. The reverberation of such alterations has presented a myriad of challenges to dermatology services worldwide. Dermatology services have attempted to suppress the dissemination of COVID-19 by reducing in-person consultations and non-essential procedures. Teledermatology has been utilised to mediate patient triage to ensure patients are promptly referred to the appropriate service. Additionally, a plethora of cutaneous sequelae of COVID-19 have been identified and exhibit considerable heterogeneity in skin inflammatory findings compared to viral infections with known cutaneous effects. There has been a longstanding demand to efficiently capitalise on limited expertise allied to dermatology services. The COVID-19 pandemic has illuminated the urgent need to extend the dermatological competence of several primary care clinicians. Ultimately, the developing COVID-19 pandemic may provide the impetus to revolutionise dermatology services in the next five years to transcend current challenges in clinical practice. 

Oncogenic Role of Cancer Stem Cell LGR5 in Colorectal Cancer Progression

Sourena Ghorbani Kalkhajeh; Alireza Parsanezhad; Mahdieh Banoei; Maryam Vahidi; Maziar Malekzadeh Kebria; Zahra Pezeshkian; Noshad Peyravian

Canadian Journal of Medicine, 2021, Volume 3, Issue 4, Pages 182-190
DOI: 10.33844/cjm.2021.60609

Colorectal Cancer (CRC) is the second most common cancer in women and the third most common cancer in men. There is strong evidence for the role of Cancer Stem Cells (CSCs) in cancer progression. The identification and understanding CSCs genes such as LGR5 involved in the induction of cancer development is crucial in the prognosis of CRC. LGR5 is a membrane protein involved in several molecular signaling pathways, such as the Wnt signaling and NOTCH pathways. It has been shown that the LGR5 gene was overexpressed in CRC and is associated with the worst outcomes in patients with CRC, but molecular mechanisms of LGR5 in CRC development have been poorly identified. This review has summarized current studies about the role of stem cell marker of LGR5 in CRC progression. Future research in this area may improve the early detection of CRC, new therapies, and monitoring of CRC.

Case Report

Presentation of Varicella-Zoster Virus Infection with Bladder Mass and Gross Hematuria

Mosa Asadi; Mohammad Reza Fattahi; Somayeh Mohammadi

Canadian Journal of Medicine, 2021, Volume 3, Issue 4, Pages 191-194
DOI: 10.33844/cjm.2022.60610

Varicella-zoster virus reactivation can cause painful and vesicular rashes involving some dermatomes, which is defined as herpes zoster. We reported a 68 years old man who had come to the clinic with a complaint of hematuria. In the examination, varicella-zoster lesions were visible on the left buttock. After beginning valacyclovir for the patient, cystoscopy was done due to the existing polypoid mass in sonography. Red patches, fragile and bleeding places were seen in the cystoscopy on the left bladder wall without any evidence of any mass. This patient was managed conservatively. One week after the first ultrasonography, new sonography by the same radiologist showed no evidence of bladder mass.

Cerebral Methanol Intoxication: A Case Report with Literature Review

Mehdi Mesri; Mohammad Javad Behzadnia; Mohammad Nikpoor; Ali Ghazvini

Canadian Journal of Medicine, 2021, Volume 3, Issue 4, Pages 195-201
DOI: 10.33844/cjm.2022.60611

We report the case of a 24-year-old man admitted to the emergency room with a history of headache exacerbated. At the emergency room, he was unresponsive to drug or alcohol consumption. At this time, computed tomography (CT) did not detect the brain and abdomen lesions. At the intensive care unit (ICU), 6h later, he suddenly developed shallow respirations, followed by loss of consciousness, hypotension, and blurred vision. He was intubated immediately and underwent mechanical ventilation. Arterial blood gases and biochemical analyses indicated intense metabolic acidosis (Day1: pH 7.25, PCO2 49 mmHg, PO2 65 mmHg, HCO3 15 mmol/L and day 2, pH 7.32, PCO2 45 mmHg, PO2 60 mmHg, and HCO3=19 mmol/L) and elevated liver enzymes. The clinical diagnosis of toxic alcohol ingestion was based on the history, arterial blood gases results, and significant biochemical changes. In ICU, the patient underwent ethanol infusion and hemodialysis and the impression of methanol intoxication. He underwent redialysis with a minimal dose of heparin (5000 IU/mL). A second CT scan revealed basal ganglia ischemia, and an MRI scan exhibited clear abrasion and basal ganglia necrosis. Finally, he died  due to severe methanol intoxication, but the probability of cerebral hemorrhage may be the cause of the patient death associated with heparin.

Correspondence

Myocarditis Associated with Covid-19 Pneumonia

Alireza Soleymanitabar; Fakhri Allahyari; Somayeh Mohammadi; Sina Imanizadeh

Canadian Journal of Medicine, 2021, Volume 3, Issue 4, Pages 202-204
DOI: 10.33844/cjm.2022.60612

The covid-19 pandemic is one of the most serious worldwide concerns, which has created many problems in health, economics, and other aspects of human life around the world. Coronavirus has shown to have a lot of manifestations during the infection, among which some of them are more critical. Cardiac complications can be considered one of the major and serious problems caused by coronavirus infection… .

Original Article

The Health of Companions: Evaluation of Care Burden, Psychological Distress and Psychiatric Disorders of the Companions of Patients in the Medical Ward of a University Hospital

Elif Duman Acar; Melahat Akdeniz; Ethem Kavukcu; Esma Eseroglu; Hasan Hüseyin Avcı

Canadian Journal of Medicine, 2021, Volume 3, Issue 4, Pages 205-219
DOI: 10.33844/cjm.2021.60613

The aim of this study was to evaluate the care burden, psychological distress, and psychiatric disorders of the companions of adult patients in the hospital. This study is a cross-sectional descriptive study. The study questionnaire included a sociodemographic information form, the Zarit Caregiver Burden Scale (ZCBS), and the Brief Symptom Inventory (BSI) were administered to the companions. Simple descriptive and inferential statistics were performed. The Mann-Whitney U test was used when there was no normal distribution. Correlation coefficients and statistical significance were calculated by using the Spearman test for at least one non-normal distributed relationship. A multiple linear regression analysis was performed for determining factors associated with BSI scores. The type 1 error level was used as 5% for statistical significance. All p-values of less than .05 were considered significant. Three hundred companions were included in the study. An emotional commitment was the leading cause of companionship. The mean values of the companions’ ZCBS and BSI scores were 20.2 and 34.4, respectively. There was a moderately positive correlation (r = .50) between the ZCBS and BSI scores, and it was found to be statistically significant. ZCBS scores were positively associated with BSI scores. Psychological distress increases as the care burden of companions increases. Companions need more assistance from health care institutions, family members, and the community. The support of health workers and family members reduced the companions’ care burden and psychological distress. Physicians working in the hospital should take into account that companions may be hidden patients.