First Iranian Experience of the Minimally Invasive Nuss Procedure for Pectus Excavatum Repair: A Case Series and Literature Review

Pectus excavatum is the most common congenital deformity of the chest wall. The most frequently used techniques include Ravitch (costochondral resection) and Nuss (minimally invasive pectus repair of pectus excavatum [MIRPE]). The Nuss technique includes using temporary metallic bars without costochondral resection to correct the chest wall deformity. Modified MIRPE can be learned easily and performed safely with few complications. There are no reports of successful MIRPE in Iran, although the Ravitch technique is well known. In the present study, we report the first Iranian experience with the modified Nuss procedure in 5 patients with pectus excavatum (age range=13–48 y). All the patients suffered from low self-esteem, and one of them complained of low exercise capacity and occasional chest pain. With single-lung ventilation and sternal elevation, an introducer was entered into the right thoracic cavity and retrosternal tunneling was performed under thoracoscopic vision. The introducer was passed to the left thoracic cavity and exited on the left thoracic wall. A titanium plate bar was implanted and fixed with stabilizers. There were no cases of mortality, and all the patients were discharged in good conditions within 2 weeks. Postoperative complications consisted of 1 case of pneumothorax and 2 cases of fixed bar protrusion. The present case series indicated that a skilled thoracoscopic surgeon is able to do the Nuss procedure in Iranian patients with symmetrical pectus excavatum with few complications. However, mixed or redo cases require more expertise

A Collect of Recommendations and Guidelines for Management and Treatment of Underlying Malignancies During the COVID-19 Pandemic

The coronavirus disease 2019 (COVID-19) pandemic is the main challenges to public health systems worldwide now. Cancer patients are considered as a high risk group during the COVID-19 pandemic. Considering the evidence so far, cancer as underlying comorbidities might increase the risk of death in patients with COVID-19. Many cancer patients with increased risk of contracting COVID-19 than the general population regularly visit health facilities for treatment and disease surveillance. Thus, the COVID-19 pandemic has a profound impact on cancer care and treatment. Here, we attempted to summarize the current suggestions for handling of cancer patients during COVID-19 pandemic. We carried out a integrative literature review using several online bibliographies. A total of 113 papers were accessed for the time frame between October 05 2020 and October 10 2020. After screening of titles and full-texts, 10 publications were selected in this study. In this work some recommendations and guidelines that would help for management and treatment of cancer for the purpose of address the challenges during COVID-19 pandemic were collected. We hope that this collection recommendations and guidelines assist health care providers in management of individuals with underlying malignancy during the COVID-19 pandemic

Optimal design of adaptive and proportional integral derivative controllers using a novel hybrid particle swarm optimization algorithm

Controlling of a rotational inverted pendulum is considered as a challenging problem, mainly due to the system’s inherent nonlinear and unstable dynamics. In fact, the goal of this control is to maintain the pendulum vertically upward regardless of external disturbances. This paper aims to optimally design a model reference adaptive proportional integral derivative (PID) control for rotary inverted pendulum system based on a novel hybrid particle swarm optimization algorithm, combining sine cosine algorithm and levy flight distribution. Evaluation of the performance quality of the proposed adaptive controller is accomplished based on the stabilization and tracking control of rotary inverted pendulum system. In addition, two other PID controllers are designed to get a better understanding of the performance and robustness of the proposed controller. To make a complete comparison, the performance of the hybrid particle swarm optimization algorithm is examined against two other optimization techniques known as simple particle swarm optimization and whale optimization algorithm. Finally, the obtained simulation results demonstrate that the proposed optimal adaptive controller is superior to the other controllers, especially in terms of the transient response characteristics and the magnitude of control output signal