Pharyngeal Aspiration of Complete Upper Denture in 90-Year-Old Man; a Case Report

Foreign body aspiration is unusual in adults, except those who are debilitated or have neuropsychiatric disorders. It can be a life-threatening situation and it often requires a high index of suspicion, because the diagnosis can be obscure. Prompt diagnosis and intervention through foreign body retrieval are critical to prevent significant morbidity and mortality. We present a case of denture aspiration by a debilitated 90 years old man. He had aspirated his complete upper denture to pharynx causing incomplete obstruction with pleasure whistling respiratory sound, dyspnea, dysphagia and dysphonia. He underwent successful retrieval of the dental plate manually by fingers with complete resolution of symptoms.

Assessment of Thyroid Dysfunction as a Predisposing Factor for Asymptomatic Bacteriuria in Women of Reproductive and Postmenopausal age

Background: Infectious diseases are associated with thyroid autoimmune disorders, mainly. Meanwhile, thyroid gland function as a risk factor for infectious diseases is a challenging debate topic that needs more evaluation. Considering the high burden of hypo and hyperthyroidism in many regions of the world and the consequences of these disorders on different aspects of human health, evaluating and screening high-risk populations and treating patients is of great importance. In the present research, we investigated any association between thyroid dysfunction and asymptomatic bacteriuria in women of reproductive and postmenopausal age. Materials and Methods: The study was performed for six years (between 2015-2021) in Tehran, Iran. Our study enrolled 188 women of reproductive and postmenopausal age with and without asymptomatic bacteriuria. All participants' thyroid stimulating hormone (TSH) and free T4 levels were evaluated. The association between thyroid dysfunction and asymptomatic bacteriuria was assessed. Results: The mean level of TSH in all culture-positive samples was 2.39, while it was 3.11 in culture-negative samples (P value < 0.05). The mean TSH level was 2.4 and 2.3 in Escherichia coli and Non- E. coli positive urine cultures, respectively (P value= 0.67). Asymptomatic bacteriuria was significantly more common in patients with lower TSH levels. The mean level of free T4 in all participants was 8.21, with maximum and minimum levels of 12.3 and 4, respectively. Also, the mean level of free T4 in all culture-positive samples was 9.53, while 7.13 in culture-negative samples (P value=0.09). The mean free T4 level was 9.36 and 10.03 in E. coli and Non-E. coli positive urine culture respectively (P value= 0.35). Conclusion: Our study revealed a significant correlation between the population's TSH level and asymptomatic bacteriuria. Also, it showed no significant association between TSH level and any specific uropathogenic

Epidemiological, Clinical and Paraclinical Study of Hydatid Cysts in Three Educational Medical Centers in 10 Years

Background: Echinococcosis or hydatidosis, caused by the larval stage of Echinococcus granulosus (E. granulosus), is an important public health problem in many areas of the world  and  Iran is a country of endemic situation for hydatidosis In the present study, we evaluated epidemiological, complications and clinical characteristics of hydatidosis at three University Medical Centers in Tehran over a 10-year period.Materials and Methods: This is a descriptive cross-sectional study performed in patients with hydatid cysts. Information about age, gender, number of cysts, organ involvement, morbidity and mortality and relapse were collected from medical records of hydatid patients. Paraclinic information such as CT Scan, MRI, ultrasound, complete blood count, pathological diagnosis and complication of disease were collected.Results: Overall, 81 patients, 35 (43.2%) male and 46 (56.8%) female, who were diagnosed as having hydatid cyst by clinical and radiological findings, with pathologic documentation were studied in three university medical center registries over a 10-year period (2003- 2012) in Tehran. Fourteen patients (17% of cases) had complications resulting from this disease. Patients' age ranged from 5 to 86 years, and the peak prevalence of the disease was between 20 and 40 (34% of cases).Conclusion: Iran  is a country of endemic situation for hydatidosis. Prevalence rate of hydatidosis in Iran was reported to be 0.61-2 in 100000 populations. The highest  rate of infection and complications were in patients of 20-40 years age. Clinical examination revealed that abdominal pain was the most common complaint and was present in 51.7% of the cases. Other most common complain were cough, abdominal mass, dyspnea, icterus, chest pain, dyspepsia, back pain and seizure; and it was result of occupying effect of cysts in organs. This is similar with previous studies in Ira

Large-vessel stenosis in the patients with ischemic stroke in Iran: Prevalence, pattern, and risk factors

Background—Large artery disease (LAD) is a common cause of stroke, but a little is known regarding its role in Iranian stroke patients. The current study investigates the prevalence and risk factors for cervicocephalic arterial stenosis in the patients with ischemic stroke using digital subtraction angiography (DSA). Methods—This was a prospective cross-sectional study performed in hospitals affiliated to Shiraz University of Medical Sciences from March 2011 to March 2013. Patients with ischemic stroke underwent noninvasive vascular and cardiac investigations to find the etiology of the stroke. Patients suspected of having large artery stenosis underwent DSA. The severity of the stenosis was calculated according to the North American Symptomatic Carotid Endarterectomy (NASCET) and Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) Trial criteria. The presence of cigarette smoking, hyperlipidemia, hypertension, and diabetes mellitus were documented for all subjects. Results—A total of 3703 stroke patients were identified. Of them, 342 patients (62.3%, male) underwent DSA for LAD. The mean age at the time of angiography was 66.7±10.3 years. Extracranial and intracranial arteries were involved in 305 (89.2%) and 162 (47.4%), respectively. And 301 patients (88%) had anterior circulation and 128 patients (37.4%) had posterior circulation involvement. Diabetes mellitus but not age, sex, hypertension, hyperlipidemia, or smoking was significantly associated with intracranial involvement. (P = 0.002) Conclusion—It can be concluded that the distribution of the large arterial atherosclerotic disease in Iran is similar to that seen in North America and Europe. Intracranial stenosis was more prevalent in diabetic patient

پیشگیری از تشنج ناشی از تروما در بیماران مراجعه کننده به بخش اورژانس

Head trauma is a known cause of seizure and about 10% of patients with severe or moderate head trauma are affected with seizure. Preventing and controlling seizure after head trauma is of great importance for minimizing secondary brain injuries. Depending on their time of occurrence, post-trauma seizures are divided into 3 types, namely immediate seizures, early seizures, and late seizures. Immediate seizures occur within less than 24 hours after the trauma, while early seizures happen in less than a week and late seizures happen more than a week after trauma. Phenytoin is an antiepileptic drug that is widely prescribed for preventing seizure in trauma patients. This drug has nonlinear pharmacokinetics even in therapeutic doses and its prescription requires cardiac monitoring, continuous monitoring of the drug’s plasma levels and dose adjustment. Studies have shown that phenytoin prevents early seizures but is not effective in decreasing late seizures. On the other hand, in most cases, due to pharmacokinetic changes in patients with head trauma, blood concentration of phenytoin is outside the therapeutic range and determining its serum levels cannot always be done. Therefore, finding replacement treatments for preventing seizure in these patients is necessary. Sodium valproate is an antiepileptic drug that is usually used along with other drugs for treating different types of epilepsy. This drug decreases electric discharges in the brain. Sodium valproate is also used for prevention of seizure attacks. The side effects of this drug are rare and mostly unimportant. The authors of this letter randomly divided 70 patients presenting to emergency department with severe head trauma (consciousness level of 8 or less on Glasgow coma scale) with the mean age of 36.41 ± 14.81 years (18 – 64) into 2 groups of 35 and prescribed phenytoin for 1 group and sodium valproate for the other as antiepileptic drugs and monitored them for 6 hours (91.4% male). The 2 groups were not significantly different regarding baseline characteristics. The results of this study showed that out of the 5 patients who had seizure during the first 6 hours, all 5 were in the group receiving phenytoin. It seems that before reaching a conclusion in this regard, studies with larger sample sizes and longer follow-up periods are required for comparing the efficiency and side effects of the mentioned drugs in prevention of seizure due to trauma. ترومای سر يكي از علل شناخته شده تشنج است و حدود 10% بيماران با تروماي شديد و متوسط سر دچار تشنج مي شوند. پیشگیری و كنترل تشنج پس از ضربه به سر جهت محدود كردن آسيب هاي ثانويه مغزي بسیار حائز اهمیت است. تشنج هاي پس از تروما برحسب زمان وقوع آسيب به انواع تشنج هاي اوليه، تشنج هاي زودرس و تشنج هاي ديررس تقسيم مي شوند .تشنج هاي اوليه در كم تر از 24 ساعت پس از ضربه اتفاق مي افتند در حالي كه تشنج هاي زودرس در كم تر از يك هفته و تشنج هاي ديررس در بيش از يك هفته بعد از تروما روي مي دهند. فني توئين يك داروي ضد تشنج است كه به طور گسترده براي پيشگيري از تشنج در بيماران ترومايي تجويز مي گردد. اين دارو حتي در غلظت هاي درماني نيز داراي فارموكينيتيك غير خطی  بوده و تجويز آن نيازمند مانیتورینگ قلبی، پايش مداوم سطح پلاسمايي دارو و تنظيم دوز است. بررسي ها نشان داده اند كه فني توئين از تشنج هاي اوليه جلوگيري می کند اما در كاهش تشنج هاي ديررس مؤثر نمي باشد. از طرفی در اكثر موارد به دليل تغييرات فارماكوكينتيكي در بيماران با تروماي سر، غلظت خوني فني توئين خارج از محدوده درماني بوده و تعیین سطح سرمی فنی توئین همیشه مقدور نمی باشد. لذا یافتن درمان های جایگزین جهت پیشگیری از بروز تشنج در این بیماران ضروری است. سدیم والپروات یک داروی ضد تشنج است که اغلب همراه با داروهای دیگر برای درمان انواع مختلف صرع به کار می رود. این دارو تخلیه های الکتریکی را در مغز کاهش می دهد. از سدیم والپروات در پیشگیری از حملات تشنج نیز استفاده می شود. عوارض جانبی سدیم والپرات نادر و معمولا کم اهمیت هستند. نویسندگان این نامه 70 بیمار مراجعه کننده به بخش اورژانس با ترومای شدید سر (سطح هوشیاری کمتر یا مساوی 8 در مقیاس کمای گلاسکو) و با میانگین سنی 81/14 ± 41/36 سال (64 – 18) را به صورت تصادفی به دو گروه 35 نفری تقسیم کردند و به یک گروه فنی تویین و به گروه دیگر سدیم والپروات به عنوان داروی پیشگیری از تشنج دادند و آنها را به مدت 6 ساعت تحت نظر قرار گرفتند (4/91 درصد مرد). دو گروه از نظر ویژگی های زمینه ای با یکدیگر تفاوت معنی داری نداشتند. نتایج این مطالعه نشان داد که از پنج نفری که در طی شش ساعت اول دچار تشنج شدند هر 5 نفر در گروه دریافت کننده فنی تویین قرار داشتند. به نظر می رسد قبل از اظهار نظر نهایی در خصوص مذکور، نیاز به انجام مطالعاتی با حجم نمونه و دوره پیگیری مناسب برای مقایسه اثرات و عوارض دو داروی مذکور در پیشگیری از تشنج ناشی از تروما داریم

Assessment of Thyroid Dysfunction as a Predisposing Factor for Asymptomatic Bacteriuria in Women of Reproductive and Postmenopausal age

Background: Infectious diseases are associated with thyroid autoimmune disorders, mainly. Meanwhile, thyroid gland function as a risk factor for infectious diseases is a challenging debate topic that needs more evaluation. Considering the high burden of hypo and hyperthyroidism in many regions of the world and the consequences of these disorders on different aspects of human health, evaluating and screening high-risk populations and treating patients is of great importance. In the present research, we investigated any association between thyroid dysfunction and asymptomatic bacteriuria in women of reproductive and postmenopausal age. Materials and Methods: The study was performed for six years (between 2015-2021) in Tehran, Iran. Our study enrolled 188 women of reproductive and postmenopausal age with and without asymptomatic bacteriuria. All participants' thyroid stimulating hormone (TSH) and free T4 levels were evaluated. The association between thyroid dysfunction and asymptomatic bacteriuria was assessed. Results: The mean level of TSH in all culture-positive samples was 2.39, while it was 3.11 in culture-negative samples (P value < 0.05). The mean TSH level was 2.4 and 2.3 in Escherichia coli and Non- E. coli positive urine cultures, respectively (P value= 0.67). Asymptomatic bacteriuria was significantly more common in patients with lower TSH levels. The mean level of free T4 in all participants was 8.21, with maximum and minimum levels of 12.3 and 4, respectively. Also, the mean level of free T4 in all culture-positive samples was 9.53, while 7.13 in culture-negative samples (P value=0.09). The mean free T4 level was 9.36 and 10.03 in E. coli and Non-E. coli positive urine culture respectively (P value= 0.35). Conclusion: Our study revealed a significant correlation between the population's TSH level and asymptomatic bacteriuria. Also, it showed no significant association between TSH level and any specific uropathogenic

Accelerating stereo image simulation for automotive applications using neural stereo super resolution

Camera image simulation is integral to the virtual validation of autonomous vehicles and robots that use visual perception to understand their environment. It also has applications in creating image datasets for training learning-based vision models. As camera image simulation takes into account a wide variety of external and internal parameters, achieving a high-fidelity simulation is a computationally expensive process. Recently, several neural network-based techniques have been proposed to reduce the computational complexity of image rendering, a critical element of the camera simulation pipeline. However, the existing methods are tailored for monocular camera images and are not optimised for stereo images, which are widely used in autonomous driving applications. To address this, we propose a technique based on Stereo Super Resolution (SSR) to speed up the simulation of stereo images. The proposed method first simulates stereo images at a lower resolution, then super-resolves them to their original resolution using our introduced SSR model, ETSSR. We evaluated the performance of our technique using the CARLA driving simulator and created our own synthetic dataset for training ETSSR. The evaluations indicate that our approach can speed up stereo image simulation by a factor of up to 2.57 over various resolutions. Moreover, it shows that our ETSSR achieves on-par or superior performance compared to the state-of-the-art models, using significantly fewer parameters and FLOPs. We have made our source code and dataset available at https://github.com/hamedhaghighi/ETSSR

Efficacy and safety of sofosbuvir in the treatment of SARS-CoV-2: an open label phase II trial

Objective:&nbsp;Despite the worldwide spread of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), an effective specific antiviral treatment for coronavirus disease of 2019 (COVID-19) is yet to be identified .We did this study to investigate the safety and efficacy of sofosbuvir as antiviral therapy among hospitalized adult patients with SARS-CoV-2.&nbsp;Methods:&nbsp;Patients were randomized into intervention arm receiving sofosbuvir or comparison arm receiving usual antiviral agents in addition to standard of care. The primary end point of the study was clinical recovery as defined by normal body temperature and normal oxygen saturation. The main secondary outcome was all-cause mortality during the admission in hospital or within 14 days after discharge if applicable. Reports of severe adverse events were observed in the intervention arm.&nbsp;Results:&nbsp;Fifty-seven patients enrolled into either the clinical trial arm (n=27) or the comparison arm (n=30). Primary outcome was achieved by 24 (88.9%) and 10 (33.3%) in the intervention and comparison arms, respectively. Median hospital length of stay was significantly shorter in the intervention arm (10 days [IQR: 5-12] vs. 11.5 days [IQR: 8.5-17.75], P = 0.016).&nbsp;All-cause mortality was two and thirteen in intervention and comparison groups, respectively. No serious adverse events were reported by the patients receiving sofosbuvir during the study.&nbsp;Conclusion:&nbsp;Among patients hospitalized with SARS-CoV-2, those who received sofosbuvir had more clinical recovery rate and had a shorter hospital length of stay than those who received usual antiviral agents in the study and these differences were statistically significant

Estimation of pyrolysis product of LDPE degradation using different process parameters in a stirred reactor

Pyrolysis of low density polyethylene (LDPE) by equilibrium fluid catalytic cracking (FCC) was studied in a stirred reactor under different process parameters. In this work, the effect of process parameters such as degradation temperature (420-510°C), catalyst/polymer ratio (0-60%), carrier gas type (H2, N2, ethylene, propylene, Ar and He), residence time and agitator speed (0-300 rpm) on the condensate yield (liquid, gas and coke) and product composition were considered. Reaction products were determined by GC analysis and shown to contain naphthenes (cycloalkanes), paraffins (alkanes), olefins (alkenes) and aromatics. Higher temperature and more catalyst amount enhanced LDPE cracking. The maximum “fuel like” condensed product yield was attained at 450°C and 10% catalyst, respectively and gaseous products increased with increases in temperature. Hydrogen as a reactive carrier gas increased the condensed and paraffinic product yield. Appropriate heat transfer (by stirring) increased the catalyst efficiency in a stirred reactor