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Background: There have been safety concerns regarding the COVID-19 vaccines because of their unprecedented speed of development. Therefore, systematic reviews are necessary to address these concerns and reduce public hesitancy regarding COVID-19 vaccines. This study aims to systematically review the reported adverse events related to viral vector COVID-19 vaccines.

Materials and methods: We performed a systematic search in the databases of PubMed, Scopus, Web of Science, and Cochrane on September 15^th, 2021. This study adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. The records underwent two-step title/abstract and full-text screenings, and the eligible records were included in the data extraction process. We used the Newcastle-Ottawa Scale (NOS) for the Bias Assessment of included articles.

Results: The adenovirus vector-based COVID-19 vaccines, including the Janssen COVID-19 vaccine, the AstraZeneca COVID-19 vaccine, and the Sputnik V vaccine were included in this review. Among these vaccines, the AstraZeneca has presented enormous side effects with most being systemic and a few sporadic cases of life-threatening events such as thrombosis and capillary leak syndrome and even death in a few cases. Prominent systemic side effects of the adenovirus vaccines include fever, fatigue, malaise, arthralgia, myalgia, sweating, and dizziness. Erythema, swelling, tenderness, itching, and numbness at the injection site are the most common local reactions.

Conclusion: It appeared that the frequency of serious adverse events is negligible, and vaccination to prevent severe COVID-19 and mortality has greater benefits than adverse events in the general population.

Background: Safe airway management during anesthesia induction is a challenging issue. Airway-related morbidity can be prevented by carefully evaluating patients and formulating a difficult airway management strategy. The purpose of this study is to investigate and compare two indices, AASI, and HMDR, in predicting difficult laryngoscopic visualization.

Materials and methods: Six hundred and twenty-two patients, who entered the operating room for any type of elective surgery and were candidates for general anesthesia, underwent AASI and HMDR measurements after filling out a questionnaire containing personal information, oral examinations, and history of illness or surgery before anesthesia prescription. The Cormack grade was recorded during laryngoscopy, and finally, the predictive value of the two methods was compared.

Results: Based on analysis, AASI has a higher specificity than HDMR (87.5% vs. 76.1%) and the positive predictive value of AASI is 97%. Therefore, both HMDR and AASI are valid and significant indicators for predicting difficult laryngoscopy.

Conclusion: AASI has a better diagnostic profile than HMDR regarding sensitivity and positive predictive value, Additionally, AASI is more convenient to use because it is simpler and visually predictable, making it a reliable clinical predictor.

Background: The halo sign and reverse halo sign are two computerized tomography scan views based on the placement of ground glass opacity. These two views have various differential diagnoses, but infections are known to be the most important differential diagnosis in both views. Lung adenocarcinoma, one of the deadliest tumors of both genders, can be included in the differential diagnosis. Nevertheless, we decided to report this case since both of these features were present in the same patient.

Case presentation: A 51-year-old man presented with gradual symptoms such as shortness of breath and myalgia, with a history of smoking and coronavirus disease 2019. In his computerized tomography scan, two views of the halo sign and the reverse halo sign were seen along with other lesions. In further investigations, due to his lack of recovery, a biopsy was prepared. Finally, with a definitive diagnosis of lung adenocarcinoma, we treated the patient appropriately.

Conclusion: When a patient presents with a halo sign and reverse halo sign on a computerized tomography scan and has a smoking history, it is necessary to take a biopsy of the observed lesions to rule out primary lung carcinoma.

Background: The physical basis of ventilator-induced lung injury has been explored extensively in the last decades. The three mechanisms named volutrauma (overdistension of alveoli), barotrauma (high airway pressure), and atelectrauma (cyclic opening and closing of alveoli) have been known as the main mechanisms of lung injury. Lowering tidal volume and applying positive end-expiratory pressure have been suggested to minimize these mechanisms. Besides, some researchers believe that elevated airflow-related shear stress on the epithelial cell layer could cause an inflammatory response.

Materials and method: In this study, a simplified 0-D model for air flow in human lungs has computed the airflow-related shear stress. The airway resistance, compliance, and inertance have been calculated using Womersley analysis and included in this model. Considering a constant flow, volume-controlled mechanical ventilation, the effect of ventilation parameters including tidal volume, respiratory rate, and inspiratory/expiratory ratio on the magnitude of shear stress has been investigated.

Results: The results show that high tidal volume, high respiratory rate, and low inspiratory/expiratory ratio, increase the magnitude of wall shear stress but still in the safety range.

Conclusion: This result suggests that airflow-related shear stress is not the primary cause of mechanical damage. So far, it has been assumed that wall shear stress plays a critical role in ventilator-induced lung injury. This paper enhances our understanding of wall shear stress magnitude, indicating that the shear stress from airflow in mechanical ventilation is not high enough to inflict mechanical damage on pulmonary epithelial cells.

Background: This study aimed to summarize the baseline and radiological characteristics of patients with COVID-19 and investigate the correlation between clinical outcomes and radiological findings in the first week after admission.

Materials and methods: A single-center retrospective study was carried out on confirmed cases of COVID-19 based on RT-PCR and chest CT scan findings according to Iran's National Guidelines for defining COVID-19 in patients admitted to Imam Hossein Hospital, Tehran, Iran. Baseline and chest CT scan characteristics of patients were investigated, and their correlation with the change in clinical outcome was reported.

Results: 72 patients (50%) with a mean age of 54.65±16.2 years were in two periods of time including the first day of diagnosis and 6.0±3.4 days later. Based on CT scan Severity Score (CTSS) changes (decrease/no change or increase) during the study, patients were divided into two groups of CTSS progression (n=47) and CTSS no-progression (n=25). Diabetes mellitus (20%) and hypertension (19.1%) were the most frequent comorbidities among the patients in the non-progression and progression groups, respectively. There was no significant difference in demographic features including age and gender, and comorbidities (P>0.05). On the first day of diagnosis, there was no significant difference in blood tests and radiological findings and the number of patients who managed out-patients or in-patients in both groups. However, on the second evaluation day, patients in the progression group had significantly higher CTSS in comparison with the non-progression group (13.11±4.7 vs. 9.48±4.2, P=0.003), and the clinical situation in 15 patients in progression changed from out-patient to in-patient (p=0.033). Only chest CT imaging score was a potential parameter associated with the change in clinical progression (P=0.030, RR=10.18, 95, CI=1.25-89.72).

Conclusion: Increasing CTSS is a strong predictor of worsening clinical outcomes during hospitalization in COVID-19 patients.

Background: we aimed to investigate the physiological impact of facemasks use during a graded treadmill exercise test in male adolescents and young adults.

Materials and methods: Twenty-one males aged 15 to 28 volunteered. Participants completed four sessions with a 72-hour gap between each session. They completed four visits: 1 rest and 3 graded treadmill exercise test sessions no mask, surgical mask, and FFP2/N95 mask. Pre- and post-graded treadmill exercise test, heart rate, systolic blood pressure, diastolic blood pressure, and blood oxygen saturation were measured. Repeated measures analysis of variance determined statistical differences (p<0.05).

Results: There were no differences in exercise performance (e.g., time to termination, estimated VO2max) nor heart rate, systolic blood pressure, and diastolic blood pressure between conditions. FFP2/N95 mask resulted in lower blood oxygen saturation compared to no mask and surgical mask, and the surgical mask was lower than no mask at exhaustion.

Conclusion: Participants could safely complete the graded treadmill exercise test without detriment to exercise performance even though blood oxygen saturation decreased with facemask use.

Background: Adult community-acquired pneumonia is the most common cause of hospitalization and a leading cause of death. Identification of microorganisms causing community-acquired pneumonia.

Materials and methods: A cross-sectional design was used. Information on adults hospitalized due to pneumonia in the cold seasons of 2018 and 2019 was collected. Results of microbiologic tests, other than serology and urinary antigen, were reviewed.

Results: 205 patients had eligible criteria. The mean age was 52.4 and 62% were male. Microorganisms were identified in 117 (57%) patients. The most common etiologic agents were Influenza H1N1 2009 (n=39, 33.4%), Tuberculosis (n=21, 17.9%), Non-Albicans Candida Yeast (n=9, 7.8%), Methicillin Resistant Staphylococcus Epidermis (n=7, 6%) and Klebsiella Pneumonia (n=5, 4.3%). Streptococcus Pneumoniae had the 6^th rank (n=3, 2.6%). A higher body mass index was associated with superimposed infections. 10 of 18 (56%) patients who died in hospital, got definite microbiologic diagnoses. The maximum mortality was due to staphylococci, with methicillin-resistant strains of Staphylococcus aureus (n=2, 66%) and Staphylococcus epidermis (n=2, 29%).

Conclusion: H1N1 2009 was the first cause. Tuberculosis with rising incidence could cause acute pneumonia. Pneumococcal incidence had declined. Community-acquired staphylococcal pneumonia is the most dangerous; hence, specific protocol-based treatments should be applied promptly. Community-acquired Staphylococcus epidermis and Tuberculosis must be included in differential diagnosis of the disease. Antibiotics need to be individualized in managing the obese patients. A special focus on the epidemiology of virulence factors of Klebsiella pneumoniae is needed as it is common, severe, and lethal.

Background: Cryptogenic organizing pneumonia (COP) is a rare lung condition affecting the bronchioles and alveoli. This study aimed to determine the course of the disease and response to treatment in a group of COP patients.

Materials and methods: In a cohort study, patients' data including demographic features, chest imaging, spirometry, and blood tests, were recorded. Inclusion criteria were radiological features compatible with COP, confirmed tissue biopsy, and the absence of underlying diseases at the time of presentation. All patients received the same steroid-based regimen (oral prednisolone with a dosage of 1 mg/kg tapered to none within 6 months). They were followed for 3 years.

Results: Sixteen patients were included, 43.75% were male. The mean age was 56 ± 15 years. Nobody experienced recurrence. Reversed halo sign and ground-glass opacity were the most common radiological findings. ESR decreased significantly after treatment (P<0.005). Forced vital capacity increased significantly after treatment (P<0.005), the same was true for oxygen saturation (P<0.005). On three years of follow up, 5 patients developed signs and symptoms of connective tissue diseases and malignancy. There was no significant association between the final diagnosis and radiological findings at presentation (P>0.05).

Conclusion: Standard treatment in patients with early diagnosis of COP was associated with an appropriate therapeutic response and no recurrence of pulmonary symptoms. Proper treatment can lead to optimized oxygenation parameters and a decreased inflammatory index. Lower response to treatment among corticosteroid-treated COP patients may suggest secondary causes of organizing pneumonia.

Coagulation disorder is common among COVID-19 patients, particularly those afflicted with the severe form of the disease. Manifestations of thrombotic complications such as pulmonary embolism, deep vein thrombosis (DVT), ischemic stroke, cardiac infarction and arterial embolism is high in COVID-19 patients which have been assessed in various studies (5).It seems that COVID-19-related coagulopathy is a combination of low-grade DIC and pulmonary thrombotic microangiopathy which can have a significant effect on organ dysfunction in patients with severe COVID-19 (6). Numerous complications have been reported following COVID-19 disease. Although the disease often improves after going through various clinical phases, some people have short-term or long-term complications including coagulationdisorders. This case report presents an unusual instance of extensive left ventricular thrombosis in a patient who had recently recovered from COVID-19, despite being on anticoagulant prophylaxis.

Background: Cancer is a disease caused by manifestation and abnormal gene expression. Many of the genes that inhibit cancer by the microRNAs. The aim of this study was to investigate the Expression of miR155 gene and CEA and VEGF proteins as Diagnostic Markers in Early Stages of Non-Small Cell Lung Cancer (NSCLC).

Materials and methods: Fifty pairs of non-small lung cancer specimens of patients from healthy and tumors were collected based on physical examination and diagnosis of an expert, that, in Masih Daneshvari Hospital. 50 healthy volunteers as a control group were volunteered by the physician after examination and filled out the consent form in this study. From all subjects, 6 ml of peripheral blood were taken and examined by Real-Time PCR (RT-PCR) and ELISA.

Results: The expression level of miR-155 in patients was significantly increased compared to the control group (p<0.001). VEGF protein was positive in 34 of the 50 patients and in healthy subjects, 3 persons were positive. The statistical comparison of the amount of positive biomarker was performed in two groups and it was shown that there is a statistically significant difference between these two groups (P<0.001). CEA protein was positive in 38 of the 50 patients and 5 in healthy subjects were positive. The statistical comparison of the amount of positive biomarker was performed in two groups and it was shown that there is a statistically significant difference between these two groups (P<0.001).

Conclusion: This study showed that miR155 gene and CEA and VEGF proteins are relatively good markers for the diagnosis of non-small cell lung cancer patients in Iranian population.