Parameters of lower extremities alignment view in Iranian adult population

Normal axial alignment restoration in lower extremities is crucial for surgeons performing reconstructive surgeries. Since reference normal values of axial alignment are affected by age, sex, and ethical issues, we tried to scrutinize these parameters in Iranian adults and compare them with normal values in literatures. Through a cross-sectional design, standing axial alignment views of lower extremities were surveyed from 100 volunteers (50 males and 50 females) aged between 15-32 years. The lower extremities alignment variables were evaluated during two separate measurements. Total average values were used for comparison among genders. Tibiofemoral mechanical angle depicted mean varus of 1.5 degrees in an Iranian population that was significantly higher in male participants. The Mean angle between anatomical and mechanical axes of the femur was 5.7 ± 1.2º. The Knee joint was shown to be medially inclined 3.6 ± 1.7º in men comparing 2 ± 2º of women with a significant difference. Joint line congruence angle was medially inclined in all of the study participants with a mean of 1 ± 1.6º. To compare with anthropometric studies of western populations, Iranian participants had more varus lower limb alignment. It seemed mainly because of larger medially inclined knee joint (knee-joint obliquity). This finding along with more compensatory ankle valgus is similar to results of other Asian studies. Such racial variation should be considered in designing appropriate systems in reconstructive surgery. © 2015 Tehran University of Medical Sciences. All rights reserved

Parameters of lower extremities alignment view in Iranian adult population

Normal axial alignment restoration in lower extremities is crucial for surgeons performing reconstructive surgeries. Since reference normal values of axial alignment are affected by age, sex, and ethical issues, we tried to scrutinize these parameters in Iranian adults and compare them with normal values in literatures. Through a cross-sectional design, standing axial alignment views of lower extremities were surveyed from 100 volunteers (50 males and 50 females) aged between 15-32 years. The lower extremities alignment variables were evaluated during two separate measurements. Total average values were used for comparison among genders. Tibiofemoral mechanical angle depicted mean varus of 1.5 degrees in an Iranian population that was significantly higher in male participants. The Mean angle between anatomical and mechanical axes of the femur was 5.7 ± 1.2º. The Knee joint was shown to be medially inclined 3.6 ± 1.7º in men comparing 2 ± 2º of women with a significant difference. Joint line congruence angle was medially inclined in all of the study participants with a mean of 1 ± 1.6º. To compare with anthropometric studies of western populations, Iranian participants had more varus lower limb alignment. It seemed mainly because of larger medially inclined knee joint (knee-joint obliquity). This finding along with more compensatory ankle valgus is similar to results of other Asian studies. Such racial variation should be considered in designing appropriate systems in reconstructive surgery

A Simulated Annealing method to solve a generalized maximal covering location problem

The maximal covering location problem (MCLP) seeks to locate a predefined number of facilities in order to maximize the number of covered demand points. In a classical sense, MCLP has three main implicit assumptions: all or nothing coverage, individual coverage, and fixed coverage radius. By relaxing these assumptions, three classes of modelling formulations are extended: the gradual cover models, the cooperative cover models, and the variable radius models. In this paper, we develop a special form of MCLP which combines the characteristics of gradual cover models, cooperative cover models, and variable radius models. The proposed problem has many applications such as locating cell phone towers. The model is formulated as a mixed integer non-linear programming (MINLP). In addition, a simulated annealing algorithm is used to solve the resulted problem and the performance of the proposed method is evaluated with a set of randomly generated problems

Stage IE primary bone lymphoma: Limb salvage for local recurrence

Background: Primary bone lymphoma or non-Hodgkin lymphoma of bone is a rare disease. There are only a few case series of stage IE of this condition in medical literature. The aim of this study is to determine the rate of survival for stage IE after combined modality treatment, the rate of local recurrence, and the results of limb salvage in cases of local recurrence. Methods: We collected data from 61 patients with histologically confirmed PBL treated at the Musculoskeletal Oncology Department of our hospital from 2000 to 2010. Retrospective evaluation included demographics, symptoms, tumor locations, outcomes of surgical treatment for local recurrence and survival rates. Results: All patients received Combined Modality Therapy. Overall, five year survival was 89 and five year disease free survival rate was 78. Local recurrence occurred in 6 patients during follow up period, which was treated surgically by wide excision and reconstruction. The mean follow-up for the local recurrence group was 36(24-54) months and mortality rate in this group was 17. Conclusions: Combined Modality Therapy for stage IE primary bone lymphomaresults in good survival rate. In case of local recurrence, wide excision and reconstruction improves the outcomes. © 2015 BY THE ARCHIVES OF BONE AND JOINT SURGERY

Quantifying environmental risk factors for multiple sclerosis in discordant monozygotic twins: a case report

Relative contribution of genetic and environmental risk factors in complex disorders is widely explored through discordant identical twins. Multiple sclerosis is a demyelinating disease of the central nervous system in which the interplay of genetic and environmental risk factors define the disease pathogenicity. Robust epidemiological studies in different populations suggested that active levels of serum vitamin D and viral load implicate in MS pathogenicity and severity. In order to refine non-shared components of susceptibility factors in MS, we investigated the role of serum 25-hydroxyvitamin D and viral infection in a pair of identical twins remained discordant for MS during the course of 5 years follow up. Here we report serological finding regarding the viral load and serum 25-hydroxyvitamin D level in a pair of discordant monozygotic twins. Based on our observation, lower levels of serum 25-hydroxyvitamin D and higher anti-viral IgG titre was consistent with the disease statues in the affected sib

Improving the efficiency of term weighting in set of dynamic documents

In real information systems, there are few static documents. On the other hand, there are too many documents that their content change during the time that could be considered as signals to improve the quality of information retrieval. Unfortunately, considering all these changes could be time-consuming. In this paper, a method has been proposed that the time of analyzing these changes could be reduced significantly. The main idea of this method is choosing a special part of changes that do not make effective changes in the quality of information retrieval; but it could be possible to reduce the analyzing time. To evaluate the proposed method, three different datasets selected from Wikipedia. Different factors have been assessed in term weighting and the effect of the proposed method investigated on these factors. The results of empirical experiments showed that the proposed method could keep the quality of retrieved information in an acceptable rate and reduce the documents\u2018 analysis time as a result

Prevalence of high-level gentamicin-resistant Enterococcus faecalis and Enterococcus faecium in an Iranian hospital

This study was designed to determine the molecular characteristics and antimicrobial resistance of enterococcal strains isolated from patients admitted to an Iranian Hospital. Enterococcal strains were isolated from the burn patients. All strains were screened for genes encoding resistance to aminoglycoside aac(6')-Ie-aph(2'')-Ia, aph (3'), ant (4'), resistance to vancomycin (vanA, vanB), resistance to tetracycline (tetK, tetL, tetM, tetO), and resistance to erythromycin (ermA, ermB, ermC) by PCR and multiplex PCR-based methods. Genetic diversity was evaluated via Random Amplified Polymorphic DNA (RAPD)-PCR. All enterococcal isolates showed complete sensitivity to vancomycin with MIC � 0.5μg/ml. Resistance to gentamicin, tetracycline, erythromycin, ciprofloxacin or quinopristin-dalfopristin was detected, whilst more than 96.2% of isolates were high-level gentamicinresistant (HLGR) and multiple drug resistant. The most prevalent aminoglycoside resistance gene was aac(6')-Ie-aph(2'')-Ia, that was found in 96.2% (26/27) of the isolates. The most prevalent tetracycline resistance genes were tetM, found in 85.1% (23/27) followed by tetL and tetO found in 7.4% (2/27) of the isolates. The ermA and ermB genes were detected in 33.3% (9/27) and 44.4% (12/27) of the isolates respectively. RAPD-PCR analysis yielded 17 distinct profiles among 27 investigated isolates. One cluster of isolates shared the same RAPD pattern, while 16 isolates had unique RAPD pattern. Our study showed that during the examination time period one RAPD genotype was the common type and was disseminated among patients in the burn unit. Interestingly, most of these strains had an identical or very similar antibiotic and gene resistance pattern

The results of biplanar distal femoral osteotomy; a case series study

Background: Distal femur wedge osteotomies for varus or valgus alignment of the lower extremity could be done in either uniplanar or biplanar fashion. Union time and stability of the osteotomy site has been considered important in this anatomic region. In this study, clinical and radiographic findings of biplane distal femur osteotomy were reported. Methods: Clinical, functional, and radiological findings of eight patients (10 knees) underwent biplane distal femur osteotomy were evaluated. Visual analogue score (VAS) and Lysholm-Tegner knee score were used for the assessment of pain and function before and three months after surgery. Results: In this study, eight patients were included. All patients were female. The mean age was 28±6.3. The mean pre-operative mechanical angle was 8.7±2.2° and the post-operative angle was 1.4±0.53° in patients with valgus alignment whileit was 7.0±1.0°preoperatively and 0.66±1.2° postoperatively in patients with varus alignment. The mean lateral distal femoral angle (LDFA) was 85±8.0° before surgery and was 88±1.3° after surgery. According to Lysholm-Tegner knee score, in the post-operative visit, six knees were good and four were excellent. The mean union time was 9.2±2.3 weeks. Conclusions: Biplane distal femur osteotomy is a reliable technique that creates larger surfaces and more stability at the osteotomy site with further rapid union. © 2015 BY THE ARCHIVES OF BONE AND JOINT SURGERY

Substance abuse and the risk of severe COVID-19: Mendelian randomization confirms the causal role of opioids but hints a negative causal effect for cannabinoids

Since the start of the COVID-19 global pandemic, our understanding of the underlying disease mechanism and factors associated with the disease severity has dramatically increased. A recent study investigated the relationship between substance use disorders (SUD) and the risk of severe COVID-19 in the United States and concluded that the risk of hospitalization and death due to COVID-19 is directly correlated with substance abuse, including opioid use disorder (OUD) and cannabis use disorder (CUD). While we found this analysis fascinating, we believe this observation may be biased due to comorbidities (such as hypertension, diabetes, and cardiovascular disease) confounding the direct effect of SUD on severe COVID-19 illness. To answer this question, we sought to investigate the causal relationship between substance abuse and medication-taking history (as a proxy trait for comorbidities) with the risk of COVID-19 adverse outcomes. Our Mendelian randomization analysis confirms the causal relationship between OUD and severe COVID-19 illness but suggests an inverse causal effect for cannabinoids. Considering that COVID-19 mortality is largely attributed to disturbed immune regulation, the possible modulatory impact of cannabinoids in alleviating cytokine storms merits further investigation

Efficacy of 16S rRNA variable regions high-resolution melt analysis for bacterial pathogens identification in periprosthetic joint infections

Background: Accurate and rapid identification of microorganisms causing periprosthetic joint infections (PJIs) are necessary for choosing an appropriate antibiotic therapy. Therefore, molecular techniques are suggested for diagnosis in suspected PJIs. The Broad-range PCR and High-Resolution Melt Analysis (HRMA) were evaluated for the identification of causative organisms of PJIs in this study. Results: For 47 of 63 specimens, both the culture and broad-range PCR were positive. The culture was found to be able of organism�s detection in 74.6 (47/63) of patients. Of 47 positive cultures, 11 (23.4) were polymicrobial and 36 (76.59) were monomicrobial cultures, in which 34 (91.89) cases were detected by HRM assay. The sensitivity, specificity of HRMA vs monomicrobial culture were 91.89, 93.75, respectively. The sensitivity, specificity of total HRMA (mono + poly) vs culture were 82.92, 93.75. Conclusions: HRM assay coupled with broad-range PCR are effective screening, rapid, and relatively cost-effective methods for discrimination of PJIs especially in aiding culture method. Using computer programs such as the Matlab-2018b program for HRM data analysis is also valuable and helpful in diagnosis. © 2021, The Author(s)