Background and Aim: Wasp stings can cause life-threatening conditions if not promptly managed. Symptoms can vary from local reactions to severe multi-Organ Dysfunction, such as acute kidney injury (AKI), acute liver failure (ALF), rhabdomyolysis, pulmonary edema, respiratory failure, hematological and neurological involvement, and even death. Emergency interventions are often needed. The purpose of this report was to increase awareness among clinicians about possible complications of wasp stings in order to provide early detection and proper management. Case Presentation: A six-year-old girl had been suffering from Multiple wasp stings. She was diagnosed with Multiple Organ Dysfunction syndrome (MODS), including hemolysis, AKI, liver injury, and respiratory failure. She was managed with renal replacement therapy and was ultimately discharged with normal renal function. Conclusion: Children with Multiple wasp stings should be referred earlier for the initiation of proper management to improve the outcomes.

Introduction: Observing the effects of high-volume hemofiltration (HVHF) treatment on the monocytes apoptosis, antigen presentation, and secretion function, this study investigated the mechanism of HVHF effect on immunity homeostasis in Multiple Organ Dysfunction syndrome (MODS) in an animal model.Materials and Methods: Lipopolysaccharides were administered in 12 Beagle dogs in order to induce MODS. Six dogs were randomly assigned to receive HVHF treatment for 12 hours (HVHF group) and the rest did not receive any treatment (the MODS group).The expression of DLA-DR, apoptosis, and cytokine levels were measured at 7 time points: normal condition (T1), after operation (T2), and zero, 3, 6, 9, and 12 hours after endotoxin injection (T3 to T7, respectively).Results:Apoptosis of CD14+mononuclear cell increased in early and late stages gradually in the MODS group and began to decline gradually after the HVHF treatment. There was a significant difference between the two groups at time points T2 to T7 (P<.01).After HVHF, the impaired expression of dog leukocyte antigen-DR showed an improvement trend in the HVHF group, which was significant better at T5 and T7 than that in the MODS group (P<.05). Interleukin-4 secretion increased significantly with HVHF and was significantly higher at time points T4 to T7 as compared with the MODS group (P<.01).Conclusions: High-volume hemofiltration can alleviate the mononuclear cell apoptosis, improve antigen-presenting function and secretion function, inhibit the release of inflammatory factors, and maintain immune homeostasis, and consequently alleviate symptoms of MODS effectively.

High levels of hormones secreted by the adrenal cortex lead to hypercortisolism, among whose complications is Cushing's syndrome. Thyroid carcinoma is one of the malignant neoplasms of the thyroid gland, the most common type of which is Papillary thyroid carcinoma (PTC), which is more common in women in the age group of 30-50 years. The course of the patient's symptoms ranges from asymptomatic to foreign body sensation, dysphagia, neck swelling, and voice change. The prognosis of patients with surgical procedures is good, and the five-year survival of patients is 90%. The concurrentincidence of several diseases in one person is a rare phenomenon. The reported article is the first very rare case of Cushing's syndrome, papillary thyroid carcinoma, and renal cysts.

Background and purpose: Intensive care unit is a subspecialty ward that manages critically ill patients. Scoring systems have been developed in intensive care medicine to predict the outcomes of patients admitted with severe illnesses resulting in significant mortality rates as well as to improve resource allocation and to assist in clinical decision-making. This study was conducted to determine how Multiple Organ Dysfunction score (MODS) would predict outcome and mortality of critically ill patients. Materials and methods: This was a prospective, observational and cohort study. One hundred patients who underwent mechanical ventilation in 2004 in the general ICU of Imam Khomeini hospital center were induded in the study. Each component score provides a quantitative measure of physiologic function over 24 hours, such that zero represents normal function, and 1,2,3, and 4 represent increasing physiologic derangement. Data were collected prospectively using forms and analyzed. Results: The mean age of the patients was 48.63 years. The mean age of patients were 41.66±16 in discharge patients and 55.6 ± 17 in dead patients. Mean discharge scores have been less than mean dead scores. Mean change scores have been reduced in comparison with baseline score (P<0.05). Conclusion: Our study showed that MODS have significant correlation with prediction of mortality. A significant correlation between age and mortality was also noted. It means that the mortality increases with age as mean change scores have been reduced in comparison with baseline (P<0.05). The results indicate that therapeutic measurement was effective in correlation with indicidual score.    

Background: Interleukin 6 (IL-6) functions as both a pro-inflammatory cytokine and an anti-inflammatory cytokine. Objective: To evaluate the levels of IL-6 in patients with Multiple Organ Dysfunction syndrome (MODS). Methods: Level of IL-6 was assessed and recorded for 14 days subsequent to the injury in 161 Multiple trauma patients. MODS were diagnosed using Marshal Score. Injury Severity Scoring (ISS) was measured for all patients. Results: The results of this study indicated that there was a significant relationship between the level of IL-6 and ISS on the post trauma days number one and two (P=0. 0001). The high level of IL-6 on the post trauma day number 2 was associated with high mortality rate. Conclusion: Our study suggests the second day as the golden time for measuring the serum levels of IL-6. These findings warn us to take more health care actions in patients with higher serum levels of IL-6 on the second day.