The Outcomes of Accidental Ingestion of Hand Sanitizer

Background: children are exposed to numerous chemicals, such as hand sanitizers and their associated poisoning. Awareness of such poisoning symptoms and their management is critical for healthcare providers, as it can induce dangerous conditions. This study evaluated the clinical and paraclinical parameters of children who ingested hand sanitizers.Methods: In the first 6 months of 2020, the cases of children who accidentally ingested hand sanitizer and were referred to Akbar Hospital in Mashhad City, Iran (Referral pediatric poisoning center) were evaluated in this cross-sectional study. The relevant medical information and laboratory parameters were recorded.Results: In total, 20 patients were evaluated; of whom, 80% were male. The Mean±SD age of the study subjects was 4.9±4.2 years (2-15y). The ingestion was accidental in the study participants. The amount of ingestion approximately equaled a sip (3-7cc). All clinical and laboratory parameters were normal according to their age. Only 1(5%) case presented metabolic acidosis. No study subject manifested hypoglycemia or the loss of consciousness. Thus, they only received supportive care and were observed for ≥12 hours.Conclusion: Based on the present study results and absence of symptoms in the explored cases of hand sanitizer ingestion, the suitability of hand sanitizer solutions. Therefore, the formulation of these products should be carefully evaluated

Validation of Hepascore as a Predictor of Liver Fibrosis in Patients with Chronic Hepatitis C Infection

Introduction. Liver biopsy is an invasive determinator for hepatic fibrosis. Serum biomarkers can probably be used as an alternative to liver biopsy in assessment of the degree of fibrosis in patients with chronic Hepatitis C. Method. Eighty patients with chronic Hepatitis C were included in the study using simple nonrandom sampeling metod. After fulfillment of liver biopsy, the patients were categorized according to the METAVIR Scoring system. The Hepascore algorithm is computed based on age, sex, and the serum levels of total bilirubin, δ-glutamyl transferase, α2-Macroglobulin, and hyaluronic acid. The spearman and ROC tests were used. Results. According to the liver biopsy results, 12, 25, 20, 7 and 16 patients had F0, F1, F2, F3, and F4, respectively. With regard to the 0.34 cut-off point Hepascore had 67%, 56%, 64%, and 56% sensitivity, specificity, respectively, positive prediction value (PPV), and negative prediction value (NPV), respectively, for diagnosis of significant fibrosis. For a Hepascore cut-off point 0.61, sensitivity, specificity, respectively, PPV and NPB 82%, 86%, 70%, and 92% in diagnosis of severe fibrosis. For a Hepascore cut-off point 0.84, sensitivity, specificity, PPV and NPB were respectively 100%, 97%, 89%, and 100% for diagnosis of cirrhosis. Conclusion. Hepascore has a high value in diagnosis of the level of fibrosis, particularly cirrhosis. Therefore, it can be used for primary screening of patients to determine the need for liver biopsy

Flexible Ureterorenoscopy Versus Extracorporeal Shock Wave Lithotripsy for the Treatment of Renal Pelvis Stones of 10–20 mm in Obese Patients

Introduction: To compare outcomes of retrograde intrarenal surgery (RIRS) with extracorporeal shock wave lithotripsy (ESWL) as treatment of choice.Methods: A total number of 46 patients with renal pelvic stones 10-20 mm and body mass index (BMI) >30 randomized in two groups underwent RIRS and ESWL from 2011 to 2014 and followed for 3 months.Results: The patients mean ± SD age was 36.1 ± 13.1 years in ESWL and 33.2 ± 11.4 years in RIRS groups (P = .1) with comparable BMI in both groups (36.2 vs 38.1). In ESWL and RIRS groups, the operation time was 72.2 ± 21 vs 66.5 ± 19 minutes (P = .061), respectively. Stone free rate (SFR) at 3 months was 68% in ESWL group vs 90.4% in RIRS group (P = .019). The complication rate was 20% in ESWL group vs 14.2% in RIRS group (P = .211) but all of them were minor and managed conservatively.Conclusion: According to our study, RIRS procedure in comparison with ESWL is a safe and successful option of treatment for renal pelvis stone of 10-20 mm in obese people

Direct Vision Internal Urethrotomy with Application of Holmium: YAG Laser

INTRODUCTION: Male urethral stricture is a complicated urologic disease that could be successfully treated using internal urethrotomy. Laser internal urethrotomy has been used in many cases with favorable outcome in many studies. Holmium: YAG laser with its incisional properties on tissue is one of the laser types applied for internal urethrotomy.METHODS: We present a 19 year-old male with history of aortic valve stenosis and metallic aortic valvoplasty on prescription of oral anti-coagulant therapy (Warfarin) who was a candidate for internal urethrotomy due to bulbar urethral stricture. Holmium laser core-through urethrotomy was performed for him.RESULTS: Internal urethrotomy was done using the ablative 50-watt Holmium: YAG laser 2140 nm (manufactured by the Atomic Energy Organization of Iran [AEOI]). No complication was observed intra- and post-operatively. After 6 months of followup no evidence of urethral stricture was observed.CONCLUSION: According to our study, Ho-YAG laser core through urethrotomy is a safe and effective procedure. It is a less invasive alternative to more complex urethroplasty procedures for patients with post-traumatic urethral stricture with high risk of urethral bleeding due to anti-coagulant therap

Radiopharmaceutical transport in solid tumors via a 3-dimensional image-based spatiotemporal model

Peer reviewe

The Effect of Propofol on the Success Rate of Transurethral Lithotripsy by Holmium Laser: A Randomized Clinical Trial

Introduction: Urinary stone disease is the third most common affliction of the urinary tract that has been associated with an increasing incidence. Over decades, great advances have been made in the minimally invasive treatment of urinary stones. Recently, transurethral lithotripsy (TUL) by holmium laser was introduced as a possible therapeutic option. This study evaluated the effect of propofol on the success rate of TUL by holmium laser.Methods: A double-blind randomized controlled trial was conducted on 180 patients to investigate the effect of propofol on the success and complication rate of TUL by holmium laser. The enrolled patients were divided into two groups: the first group received sodium thiopental (n = 89) while the second group received propofol (n = 91). The two groups were compared in terms of the fluctuations of systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), operation time, future stone-free rate (SFR), stone migration, post-operative fever, and ureteral complications such as perforation and mucosal damage. Other developed complications were also recorded. After data gathering, statistical analysis was performed with SPSS version 21.Results: the patients’ data such as age, sex, stone diameter, stone laterality, duration of stone impaction, primary SBP, DBP and HR were not significantly different between the two groups (P > 0.05). TUL and anesthesia duration, first-minute and fifth-minute SBP and DBP, and also changes of HR were significantly lower in the propofol group compared with the sodium thiopental group (P < 0.001). Moreover, SFR of TUL was more evident in the propofol group. Ureteral mucosal damage was significantly less in the propofol group.Conclusion: Propofol was associated with a higher reduction in SBP and DBP, decreased duration of TUL, fewer fluctuations in HR, and an increased success rate of stone removal by TUL with holmium laser

A Model for Supply Chain Performance of Electronics Industry in Malaysia

Abstract-During the last decades supply chain issues have attracted researchers and industrialists' attention especially in manufacturing-based industries. Enhancing supply chain performance can significantly affect firm's competitive position within competitive markets and provide the enterprise with competitive advantage over its rivals. Based on the existing literature in the context of supply chain, this study tries to present a model for supply chain performance. The conceptual model presented in this study consists of supply chain design, information sharing, flexibility, delivery and supply chain performance and the electronics industry in Malaysia is selected as the population of this study in order to test the model by using the data collected from the industry. The model is investigated through path analysis and then by using factor analysis, Friedman test and paired sign test the variables are identified and the priority of each variable is investigated. The model presented by this study can be employed as a platform by Malaysian electronics manufacturing companies in order to improve their supply chain performance and obtain competitive advantage within local and foreign markets

Characteristics of Traumatic Urogenital Injuries in Emergency Department; a 10-year Cross-sectional Study

Introduction: Urogenital system injuries (UGIs) are seen in 10% of adult cases with multiple trauma. Although UGIs are rarely life threatening, they can cause major long-term morbidities. This study aimed to evaluate the characteristics of traumatic UGIs in patients who were referred to emergency department following multiple traumas.  Methods: This retrospective cross-sectional study was conducted on multiple trauma patients who were presented to emergency department during a 10-year period (2008-2017). All patients with kidney, ureter, bladder, urethra, or external genitalia injuries were studied. The patients’ data were extracted from their clinical profiles. Results: Out of the 13598 admitted patients in our trauma center, UGIs were seen in 267 (1.9%) cases. The mean age of patients with UGIs was 27.3 ± 6.1 years (74.15% male).  The highest incidence of UGI was seen in those aged between 21 and 30 years (39.7%) and motorcycle accidents (49%) was the most frequent cause of trauma. 221 patients had an unstable situation and were emergently transferred to operation room (13.57% with traumatic kidney injury). The most common injured sites of urogenital system were kidney with 155 (58%) cases, followed by external genitalia with 91 (34.1%) cases. 77.5% of cases were managed conservatively and the rest (22.5%) underwent surgical procedures. Conclusion: UGIs comprise a low percentage (2%) of traumatic injuries, which are mostly caused by blunt trauma due to road traffic accidents. Kidney is the most common injured organ and UGIs mostly happen in young ages