Anesthesia in a pediatric patient with Xeroderma pigmentousoma: A case report

Xeroderma pigmentosum (XP) is an autosomal recessive genetic disorder with the following conditions: neurologic disorders that gradually progress and skin hypersensitivity to ultraviolet (UV). Inhalational anesthetic drugs should be avoided in these patients since they may induce DNA damage, also use of muscle relaxants should be kept to a minimum. Thus for XP patients, total intravenous anesthesia (TIVA) is more appropriate for inducing general anesthesia and airway manipulation must be kept to a minimum. We report a 6 year old boy with XP and its airway management and anesthesia during surger

Intraorbital Steroid Injection for Active Thyroid Ophthalmopathy

Purpose: To evaluate the effect of orbital steroid injections in patients with active thyroid ophthalmopathy resistant to or dependent on systemic steroids, or with complications related to systemic steroid use. Methods: This prospective non-comparative case series includes 31 eyes of 17 patients with active thyroid ophthalmopathy and clinical activity score (CAS) of 3 or more, without compressive optic neuropathy or overt exposure keratopathy. All subjects had a history of previous systemic steroid use (with steroid resistance or dependence) or had developed complications related to steroids. A combination of steroids including triamcinolone acetonide 20 mg and dexamethasone 4 mg was injected in the upper and lower retroseptal orbital spaces three or four times at one-month intervals. The patients were examined periodically after each injection and at least three months after the last injection. Results: Mean pre-injection CAS was 5.2 ± 1.3 which was improved to 1.6 ± 1 after the fourth injection (P < 0.001). Upper and lower lid retraction improved in 100% and 68.2% of the affected eyes, respectively. Strabismus completely resolved in one of five affected patients and the most significant improvement was observed in supraduction. Mean improvement in exophthalmos was 1.2 ± 1.1 mm. Visual acuity did not significantly change after the injections. Eyelid ecchymosis and/or subconjunctival hemorrhage was observed in 7.1% and intraocular pressure rise occurred in 8.8% of eyes. Conclusion: Orbital steroid injections can be used for the treatment of active thyroid ophthalmopathy when the patient is resistant to or dependent on systemic steroids or has developed complications of systemic steroids

Distribution and monitoring of power and mechanisms to increase the efficiency of power in Shiite political thought

The results of this study, due to the many ambiguities in the field of power in Islam, can be considered by government organizations such as the Guardian Council and researchers in the fields of jurisprudence and law, natural and legal persons who somehow deal with sources of power, and students and professors of political science. And rights to be placed. Depending on the subject of the research, the method of collecting materials in an analytical and descriptive manner and by studying valid sources in the library and, if possible, the interview method will be on the agenda so that first the desired sources are studied and after analysis, In the end, this research aims to achieve results and make suggestions for improving the current situation; Therefore, first the required resources from various sources of presence in the library, digital libraries, existing software such as comprehensive Ahl al-Bayt and Shiite history and existing articles, treatises and dissertations, selected and after studying and separating the required materials, receipts Necessary from the required resources and then as a complete research, its compilation will be completed. The present study will have a new approach to all aspects of power in Shiite political thought and the author will try to have a comprehensive look at the jurisprudential principles of this issue based on Quranic arguments, narration, sayings of jurists and rational arguments

Bladder Tumor in Women with Microscopic Hematuria: An Iranian Experience and a Review of the Literature

Aim. In this study we report our experience with microhematuria and its relation with bladder tumors in Iranian women. Materials and Methods. Overall 249 women were evaluated. Microscopic hematuria was defined as three or more red blood cells per high-power field on at least two different occasions. Patients with a history of gross hematuria or coagulation disorders, having organic diseases, urinary stones, urinary tract infections, nephrological diseases, and local lesions such as urethral caruncle were excluded from the study population. Final diagnosis of malignant tumors was done with cystoscopy and biopsy specimen pathological assessment in all cases. Results. Age for the study population was 49.7 ± 11.8 years. 95 (38%) of patients were identified during routine check up and presenting symptoms in other patients were frequency, dysuria, stress urge incontinence, urge incontinence, feeling of incomplete urine emptying, and flunk pain, respectively. Finally, 7 (2.8%) of study subjects were confirmed as having bladder tumors. One of tumor cases was diagnosed 24 months after initial assessments. Patients with bladder tumor were significantly older; more frequently had diverticulum in their bladder wall (P < .05). Conclusion. Female microscopic hematuria is relevant and deserves evaluations, especially in elderly patients. Patients whose reason for microhematuria would not be diagnosed at the initial evaluations should be followed

Linear scanning ATR-FTIR for chemical mapping and high-throughput studies of Pseudomonas sp. biofilms in microfluidic channels

A fully automated linear scanning attenuated total reflection (ATR) accessory is presented for Fourier transform infrared (FTIR) spectroscopy. The approach is based on the accurate displacement of a multi-bounce ATR crystal relative to a stationary infrared beam. To ensure accurate positioning and to provide a second sample characterization mode, a custom-built microscope was integrated into the system and the computerized work flow. Custom software includes automated control and measurement routines with a straightforward user interface for selecting parameters and monitoring experimental progress. This cost-effective modular system can be implemented on any research-grade spectrometer with a standard sample compartment for new bioanalytical chemistry studies. The system was validated and optimized for use with microfluidic flow cells containing growing Pseudomonas sp. bacterial biofilms. The complementarity among the scan positioning accuracy, measurement spatial resolution and the microchannel dimensions paves the way for parallel biological assays with real-time control over environmental parameters and minimal manual labor. By rotating the channel orientation relative to the beam path, the system could also be used for acquisition of linear biochemical maps and stitched microscope images along the channel length.Comment: 9 pages, 6 figure

Prioritizing social determinants of health in East Azerbaijan: a qualitative research

Background: In order to improve health-centered decision making and planning to reduce inequalities in health, it is important to identify, classify, and prioritize social determinants of health. This study aimed to identify and rank three major social determinants of health in East Azerbaijan. Methods: This research was conducted using a qualitative approach in grounded theory. Through purposeful sampling, 40 key informants from East Azerbaijan, North West of Iran, were selected and in-depth interviews were performed. The collected data was analyzed with a three-step coding method including open, axial, and selective coding using Corbin and Strauss’s systemic approach. Also, Interpretive Structural Modeling and “Matrice d'Impacts Croisés Multiplication Appliquée&nbsp;à&nbsp;un Classement” (MICMAC) analysis were used to identify and rank social determinants of health in East Azerbaijan. Results: Of the 40 participants, 27 (68%) were male and 13 (32%) were female. The mean age was 39.28± 12.46 years. 63% had a doctoral degree. According to the result of MICMAC analysis, social harm, social capital, and good governance were identified as three major social determinants of health in East Azerbaijan province. Conclusion: Social determinants of health have a significant and crucial role in human welfare and by identifying and prioritizing social determinants of health at a local level and/or national level, the first step can be taken toward social welfare

Evaluating the effects of ERP systems on performance and management accounting in organizations

Coordination of operation and information in order to elevate the efficiency is one of the processes in organizations and often has been accompanied with resorting to IT in a large scale. Organizations have implemented Enterprise Resource Planning (ERP) systems due to problems posed by separated systems. The aim of this research is to study whether ERP systems cause increasing performance efficiency and changing management practices in organization. In addition, the role of management accountants have been examined to find out that whether they are gaining new roles within organization and whether their work content has changed after the ERP implementation. The research is conducted with a survey questionnaire. The sample consists of 50 knowledgeable persons in organizations that have implemented ERP systems. Results indicated that ERP systems have had an impact on organization performance, accountants and management accounting. These systems provide more real-time and accurate information to budgets and techniques, and organizations have also introduced advanced management accounting techniques after the implementation. As regards the time use of accountants, the results exhibit that the respondents have used less time on their routine work after the ERP implementation. This extra time is devoted on interpreting data and performance evaluation and other tasks. Finally, accountants in the study consider that the implementation of ERP systems has made skills such as, IT skills and knowledge of other functional areas more important

Evaluating the effects of ERP systems on performance and management accounting in organizations

Coordination of operation and information in order to elevate the efficiency is one of the processes in organizations and often has been accompanied with resorting to IT in a large scale. Organizations have implemented Enterprise Resource Planning (ERP) systems due to problems posed by separated systems. The aim of this research is to study whether ERP systems cause increasing performance efficiency and changing management practices in organization. In addition, the role of management accountants have been examined to find out that whether they are gaining new roles within organization and whether their work content has changed after the ERP implementation. The research is conducted with a survey questionnaire. The sample consists of 50 knowledgeable persons in organizations that have implemented ERP systems. Results indicated that ERP systems have had an impact on organization performance, accountants and management accounting. These systems provide more real-time and accurate information to budgets and techniques, and organizations have also introduced advanced management accounting techniques after the implementation. As regards the time use of accountants, the results exhibit that the respondents have used less time on their routine work after the ERP implementation. This extra time is devoted on interpreting data and performance evaluation and other tasks. Finally, accountants in the study consider that the implementation of ERP systems has made skills such as, IT skills and knowledge of other functional areas more important

Priorities of the Nurse Schedule by using MODM Approach: A case Study

El efecto bienestar de una migración internacional es habitualmente calculado como la variación del ingreso per capita de quienes quedan atrás luego de la migración. En este trabajo se presenta una crítica de dicho criterio que toma en cuenta que el efecto bienestar es opuesto para asalariados y capitalistas en el caso en que la migración modifique la relación K/L de la economía. Se propone un criterio alternativo que descubra de manera adecuada los efectos que la migración tiene para cada uno de los grupos mencionados.The welfare effect of an international migration is usually calculated as the per capita income variation of those left behind after the migration. A critique of this criterion and a proposal of an alternative one is presented in this paper, considering the fact that in the case in which the overall K/L ratio changes, the welfare effect of wage earners is the opposite of the welfare effect of capital owners.Instituto de Investigaciones Económica