Intravenous calcium Gluconate alleviates Lead-induced abdominal pain, a randomized clinical trial

Background: In 2016, in a lead poisoning outbreak in Iran, physicians reported thousands of opium users who presented to emergency departments (EDs) with intractable severe abdominal pain which did not respond to any narcotic medication. During the same period of time, we investigated the efficacy of intravenous calcium gluconate in alleviating lead-induced abdominal pain. Methods: In a single-center, single blinded, randomized controlled trial, a convenient sample of adult opium-addicted patients who presented to an academic ED with abdominal pain and had an initial diagnosis of lead poisoning were included and randomly subjected to two treatment groups receiving conventional treatment (morphine 0.1 mg/kg + normal saline; group 1) and conventional treatment plus 1 g of intravenous calcium gluconate (group 2) to alleviate their abdominal pain. The visual analogue scale (VAS) was determined by each patient (0 to 100 mm) before treatment, and 15, 30, and 60 min after intervention. Results: A total of 50 patients (25 in each group) were enrolled. Blood lead levels, VAS scores before treatment, and mean administered dose of morphine were similar between the two groups. After treatment, mean VAS score dropped to 64.7± 10.4 vs. 67.1± 10.9 at 15 min (P = 0.437), 64.6± 10.9 vs. 58.0 ± 11.2 at 30 min (P = 0.041), and 63.8± 10.7 vs. 53.6± 10.9 at 60 min (P = 0.002) in groups 1 and 2, respectively. Conclusion: Intravenous calcium gluconate administration along with morphine can improve abdominal pain in lead poisoning due to the ingestion of lead-contaminated opium. Further interventional studies are recommended to see if response to calcium salts in suspected lead-induced abdominal pain can rule in lead toxicity. Trial registration: IRCT20171009036661N2. Registered 27 May 2018-Retrospectively registered, © 2020 The Author(s)

Assessment of the Effect of Serum and Follicular Fluid Vitamin D and Glucose on Assisted Reproductive Technique Outcome: A Cross-sectional Study

Background: Vitamin D and glucose play an important role in the female reproductive system. Objective: The aim of this study was to assess the effect of serum and follicular fluid vitamin D on assisted reproductive technique (ART) outcomes. Materials and Methods: 102 infertile women were enrolled in the study. All cases received the routine in vitro fertilization protocol. On the oocyte retrieval day, a sample of their peripheral blood and follicular fluid was obtained to determine the level of vitamin D and glucose. We also evaluated ART outcomes including oocytes, 2 pronucleus and embryo number, implantation, chemical and clinical pregnancy, and abortion rate. Finally, the effect of serum and follicular fluid vitamin D and glucose on the ART outcomes was assessed. Results: There was no difference in the characteristics, serum vitamin D, follicular fluid vitamin D, Fasting blood sugar (FBS), or follicular fluid glucose between the women with vs. without a positive clinical pregnancy. There was no significant difference between the ART outcomes based on vitamin D level. The mean follicular fluid glucose levels in women who were deficient, insufficient and sufficient in vitamin D were 65.20 ± 14.65, 63.47 ± 14.90 and 55.97 ± 15.64, respectively. Follicular fluid glucose was lower in women with sufficient vitamin D levels and this difference was statistically significant (p = 0.01). There was no relationship between the three follicular fluid vitamin D levels and ART outcomes. In women with normal FBS levels, the level of follicular fluid vitamin D was significantly lower than in the women with pre-diabetic FBS status (p lt; 0.001). Conclusion: The present study showed that serum vitamin D level, follicular fluid vitamin D level, FBS, and follicular fluid sugar were not predictive parameters for ART outcomes. Key words: Vitamin D, Glucose, Follicular fluid, Pregnancy, Assisted reproductive techniques

Radiographic texture reproducibility: The impact of different materials, their arrangement, and focal spot size

Background: Feature reproducibility is a critical issue in quantitative radiomic studies. The aim of this study is to assess how radiographic radiomic textures behave against changes in phantom materials, their arrangements, and focal spot size. Method: A phantom with detachable parts was made using wood, sponge, Plexiglas, and rubber. Each material had 1 cm thickness and was imaged for consecutive time. The phantom also was imaged by change in the arrangement of its materials. Imaging was done with two focal spot sizes including 0.6 and 1.2 mm. All images were acquired with a digital radiography machine. Several texture features were extracted from the same size region of interest in all images. To assess reproducibility, coefficient of variation (COV), intraclass correlation coefficient (ICC), and Bland�Altman tests were used. Results: Results show that 59, 50, and 4.5 of all features are most reproducible (COV �5) against change in focal spot size, material arrangements, and phantom�s materials, respectively. Results on Bland�Altman analysis showed that there is just a nonreproducible feature against change in the focal spot size. On the ICC results, we observed that the ICCs for more features are >0.90 and there were few features with ICC lower than 0.90. Conclusion: We showed that radiomic textures are vulnerable against changes in materials, arrangement, and different focal spot sizes. These results suggest that a careful analysis of the effects of these parameters is essential before any radiomic clinical application. © 2020 Isfahan University of Medical Sciences(IUMS). All rights reserved