Review Article

A Review on Fungal Myocarditis: The Agents, Predisposing Factors and Treatments

Mehrnaz Amiri, Mahdis Cheraghi, Ensieh Lotfali

Novelty in Biomedicine, Vol. 11 No. 4 (2023), 20 November 2023,

Background and Aim: Myocarditis is an inflammatory disease of the heart muscle. It has many symptoms, from mild chest tenderness to cardiogenic alarm. Fungal myocarditis is a disseminated infection that mostly occurs in immunocompromised patients, especially in the intensive care unit (ICU). It has similar symptoms to coronary disease. The exact diagnosis of fungal myocarditis is complex and may be caused by different fungal agents.
Materials and Methods: A review of the literature on fungal myocarditis using PubMed and Google Scholar was conducted. This review collected case reports of fungal myocarditis from 2010 to 2023 worldwide to provide current prevalence in different sex categories and ages. Case reports were reported from North America, Asia, and Europe.
Results: According to results, Aspergillus myocarditis was more commonly reported in men (71.4 %) and had the highest mortality rate among the other fungi (close to 57%). Generally, there are no case reports from South America, Africa, and Australia. Amphotericin B is the first drug choice for Aspergillus myocarditis. Despite qualifying voriconazole treatment, voriconazole use is still under research and has not been confirmed for childcare. Fungal myocarditis mainly occurs in immunocompromised patients who have been hospitalized in ICU.
Conclusion: Regarding morbidity and mortality rate, myocarditis is an alarming disease. Misinterpreting signs and symptoms with other diseases often make diagnosing this disease complex. Delayed diagnosis often leads to failure of the multiple organs and can directly affect the treatment protocol.

Original Article

Early Effects of Hypertonic Dextrose versus Corticosteroid on Pain and Activity, in Knee Osteoarthritis; A Randomized Clinical Trial

Mahshid Ghasemi, Mehrdad Taheri, Ziba Bagherian, Alireza Amanollahi, saeed hashemi

Novelty in Biomedicine, Vol. 11 No. 4 (2023), 20 November 2023,

Background: Knee osteoarthritis is highly prevalent and causes debilitating pain, progressive movement limitation, and significant socio-economic costs. Intra-articular corticosteroids are widely used to control it, but only short-term effects have been proven for them. Also, they have shown many local and systemic side effects, including cartilage destruction and infection susceptibility. Knee prolotherapy in various forms of hypertonic dextrose injection has shown significant restorative effects, long-lasting pain and activity improvement, negligible side effects, and low cost. The objective is to compare the early effectiveness of intra-articular dextrose with corticosteroids regarding pain and activity changes in knee osteoarthritis.
Materials and Methods: In this short-term blinded randomized clinical trial, 70 participants (knees) with primary osteoarthritis grade II or more were divided (1=1) into two random groups that received a single injection of triamcinolone 40 mg or hypertonic dextrose 20% five cc. Visual analog score (VAS) for pain and the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score for activity were assessed before, one week after, and one month after injection. The data was analyzed using independent t-test, chi-square, Fisher's exact tests, Repeated measure test, and the linear mixed model regression.
Results: The rest and activity VAS score and WOMAC score were reduced in both groups one week and one month after injection, and the difference between the two groups was non-significant for the VAS score but significant for the WOMAC score in favor of the dextrose group.
Conclusion: The early analgesic and activity-improvement effects after hypertonic dextrose injection in the arthritic knee are significant and comparable to corticosteroids.

Synergistic Effect of Colistin with Selected Antibiotic on Colistin Resistant Pseudomonas aeruginosa Strains Isolated from Clinical Samples

Zahra Keramati, Leila Asadpour, Hadi Habibollahi

Novelty in Biomedicine, Vol. 11 No. 4 (2023), 20 November 2023,

Background: The spread of antibiotic resistance and the emergence of MDR strains, especially in gram-negative bacteria, has led to combining antibiotics to treat infections caused by these bacteria. The study aimed to evaluate some antibiotics' synergistic effect on multidrug-resistant Pseudomonas aeruginosa isolates isolated from clinical samples between thyroid dysfunction and asymptomatic bacteriuria in women of reproductive and postmenopausal age.
Materials and Methods: P. aeruginosa was isolated from Rasht city hospitals (North of Iran) clinical specimens with multiple antibiotic resistance. The antibiotic resistance of isolates was determined by the disk diffusion method. The screening checklist evaluated the synergistic effects of ciprofloxacin, colistin, meropenem, and gentamicin.
Results: The combination of meropenem and colistin in four isolates was additive, and in two isolates was indifferent. The combined effect of ciprofloxacin and colistin was also incremental in 4 isolates and indifferent in 2 isolates. The combined effect of gentamicin and colistin was indifferent in all selected strains.
Conclusion: Results of this study showed that combinations of colistin with ciprofloxacin and colistin with meropenem were successful against resistant isolates, while a combination of gentamicin and colistin showed no synergistic effect. Since the characteristics of each clinical isolate differ from the other isolates, more study with more isolates is recommended to make any precise and definite recommendation.

Impact of an Antimicrobial Stewardship Program on the Frequency of Drug resistant Bacteria in an Intensive Care Unit

Davood Yadegarynia, Shabnam Tehrani, Amirreza Keyvanfar, Somayeh Rashidinejad

Novelty in Biomedicine, Vol. 11 No. 4 (2023), 20 November 2023,

Background: One of the major health problems in the intensive care unit (ICU) is the nosocomial infection caused by multidrug-resistant (MDR) pathogens. The antimicrobial stewardship program (ASP) is a solution to prevent antibiotic resistance. This study aimed to determine the impact of an antimicrobial stewardship program on the frequency of drug-resistant bacteria in an ICU.
Materials and Methods: This quasi-experimental study was conducted between 2019 and 2021 in Labbafinejad Hospital, Tehran, Iran. This study consisted of two time periods: 1) one year with no restriction of antibiotic prescription (before ASP), and 2) one year with restriction of antibiotic prescription based on the stewardship program (after ASP). We obtained demographic and clinical characteristics of patients from their medical records. Standard disk diffusion and broth microdilution were used to determine the antibiotic susceptibility of bacterial pathogens isolated from the patients.
Results: A total of 300 ICU-admitted patients were included in the study (150 for each period). We found out that the total length of hospitalization, length of hospitalization in ICU, and treatment duration were lower after ASP (P=0.022, P=0.383, and P<0.001, respectively). Also, the frequency of antibiotic resistance, including MDR and Vancomycin-Resistant Enterococci (VRE) strains, decreased significantly after performing ASP (P=0.013). However, in terms of mortality, there was no significant difference between the two periods (P=0.236).
Conclusion: The results of our study highlight the implementation of the antibiotic Stewardship program and the rational use of antibiotics in the ICU setting to inhibit the spread of antibiotic-resistant bacteria.

Investigation of the Potential Presence of Porphyromonas gingivalis in Esophageal Squamous Cell Carcinoma (ESCC) Paraffin Embedded Tissue Samples

Afsoon Taghavi, Masoud Dadashi, Saeideh Khaleghnejad, Somayeh Delfani, Parisa Abedi Elkhichi, Parto Nasri, Bahareh Hajikhani

Novelty in Biomedicine, Vol. 11 No. 4 (2023), 20 November 2023,

Background and Aim: Esophageal cancer is the eighth most common cancer and the sixth leading cause of cancer death worldwide Evidence suggests that there is a link between bacterial infection and malignancy. There are few studies on the prevalence of Porphyromonas gingivalis in esophageal squamous cell carcinoma (ESCC), so this study aimed to investigate the possible presence of this bacterium in ESCC tissue samples.
Materials and Methods: In this study, 34 esophageal squamous cell carcinoma samples were collected to evaluate the potential presence of Porphyromonas gingivalis. After extracting the DNA, the polymerase chain reaction (PCR) technique was used to detect the presence of the bacterium molecularly.
Results: The age range of the study population was 26 to 90 years, with a mean age of 63 years. Most tissue samples come from stage I cancer (73.5%). Based on the molecular analysis, no P. gingivalis was detected in any biopsy specimens
Conclusion: P. gingivalis infection and ESCC were not correlated based on the current in this study. Likely, the use of fresh samples, more accurate diagnostic methods, geographic differences, and larger sample sizes all contribute to the differences in results between related research, which can be clarified through large-scale studies.