A study of professional radiation hazards in CT scan and nuclear medicine workers using GTG-banding and solid stain

Background: CT scan and nuclear medicine exams deliver a great part of medical exposures. This study examined professional radiation hazards in CT scan and nuclear medicine workers. Methods: In a cross sectional study 30 occupationally exposed workers and 7 controls (all from personnel of a laboratory) were selected. Physical dosimetry was performed for exposed workers. Blood samples were obtained from the experimental and control groups. Three culture mediums for each one were prepared in due to routine chromosome analysis using G-banding and solid stain. Results: There were significant increased incidence of chromatid gap (ctg) and chromatid break (ctb) with mean±SD frequencies of 3±0.84 and 3.1±1.40 per 100 cells respectively in the nuclear medicine workers versus controls with mean±SD frequencies of 1.9±0.69 and 1.3±0.84 for ctg and ctb, respectively. Chromosome gaps (chrg) were higher significantly in the nuclear medicine population (2.47±0.91) than in controls (1.4±0.9) (p< 0.05). In CT scan group the ctg and ctb were increased with a mean±SD frequency of 2.7±0.79 and 2.6±0.91 per 100 cells respectively compared with control group. The mean±SD frequencies of the chrb were 2.0±0.75 and 0.86±0.690 per 100 cells for exposed workers and control group, respectively. Conclusion: This study showed chromosome aberrations in peripheral lymphocytes using solid stain method are reasonable biomarker reflecting personnel radiation damage

Study on nursery growth performance of Pacific white shrimp (Litopenaeus vannamei Boone, 1931) under different feeding levels in zero water exchange system

Effect of different feeding levels on water quality, growth performance, survival rate and body composition of Pacific white shrimp Litopenaeus vannamei post larvae were studied in zero water exchange system. Shrimp post larvae with mean weight of 74.46± 6.17 mg were fed for 32 days in 300L fiberglass tanks containing 130L water at density of 1 post larvae L^-1. There were five treatments including control and four biofloc treatments with different feeding levels of 15%, 15%, 12%, 9%, 0% of body weight per day, respectively. The results showed that there were no significant differences in water parameters such as dissolved oxygen and pH between different treatments (p>0.05). There were significant differences in water ammonia level between different treatments (p<0.05). The maximum (0.39 mg/L) and minimum (0.12 mg/L) levels of ammonia were observed in control and biofloc treatment with minimum feeding level (9%BW/day), respectively. The highest body weight gain (1.55g), growth rate (48.50 mg per day), specific growth rate (9.64%/day), biomass gain (182.1g) and body length increase (33.62mm) were observed in biofloc treatment with maximum feeding level. The highest feed conversion ratio and the lowest feed efficiency were obtained in control (p<0.05). The proximate body composition analysis revealed an increase in lipid, protein and ash in biofloc treatments. Results showed that using biofloc technology can decrease water exchange amount and improve feed utilization in nursery culture of Pacific white shrimp. Moreover, presence of biofloc improved the water quality which led to the enhancement in growth performance in nursery stage of shrimp

Evaluation of egg vitamins A and E content in rainbow trout (Oncorhynchus mykiss Walbaum, 1792) broodstock affected by different levels of synthetic and natural (Heamatococcus pluvialis) astaxanthin

In present research, effect of dietary astaxanthin levels in sources of synthetic and algal on vitamins A and E content of egg rainbow trout broodstock was investigated, totally for 120 days. It was considered seven groups consisting six treatments (T1-T6) in two different astaxanthin sources and control (C). According to experiment design, treatments were arranged as algal astaxanthin (Haematococcus pluvialis) in the three levels of 2.67, 3.55 and 8gr/kg food (T1, T2, T3); and synthetic astaxanthin in three levels of 40, 80 and 120mg/kg food (T4, T5, T6). Egg vitamins A and E content in obtained eggs from all treatments during spawning season was measured. The highest (280.88± 22.51 ng) and the lowest (147.82± 12.71ng) amount of vitamin A were observed in T2 and control group, respectively. The highest (19.71± 2.92µg) and the lowest (5.27± 0.51µg) amount of vitamin E were obtained in T3 and control group, respectively. By increasing level of astaxanthin in both sources of algal and synthetic, content of vitamin E in egg increased but the effect of algal source on these indices was more perfect. In general present study show that, feeding broodstock affected on quality content of egg, It also concluded that natural astaxanthin (Haematococcus pluvialis) for the reason that contains supplementary nutritious, is extraordinary preferable than synthetic astaxanthin to improve vitamins content of egg in rainbow trout

How can patient journey in surgical wards of a referral hospital be improved?

Background: We studied the patient journey in surgical wards in order to find an effective and efficient way of scheduling in surgical wards.Methods: We applied Root cause analysis (RCA) model within three months in a referral hospital. After understanding root causes of the events occurred through a focus discussion group, required interventions were proposed according to literatures, experiences, and preference of the stakeholders. Possible interventions were also analyzed based on its ability to reduce contributing factors in the events and the belief of process-owner that if interventions can be implemented.Results: The results were provided for five main steps: 1) the most important root cause was “not prioritizing patients and pre-scheduling the number of surgical procedures in the days before”. 2) Constraints indicated that workforce weren't allocated proportionally to the number of surgical operations in varying shift lengths, increased numbers of on-calls physicians increased related costs, the admission of patients in VIP wards have been getting a high priority, and surgeon compensation based on fee for service method was challenging. 3) The current situation of allocating three rooms on average for each physician can be changed depending on numbers of surgeries. 4) Proposed interventions are establishing a computer registration system, reforming payment methods, setting up an electronic waiting list, development of scheduling guidelines, and Applying MIP model.Conclusions: Implementing of scheduling reforms requires a comprehensive action plan system and predefined functional indicators. These should be achieved with considering comments of all clinical and technical groups to ensure the feasibility of an operating room schedule.Keywords: patient journey, surgery, scheduling, Root cause analysis (RCA), patient transfe

Short view of leukemia diagnosis and treatment in Iran

Background: Early diagnosis and treatment of leukemia patients remains a fundamental aim in clinical oncology, especially in developing country. Present study highlights the basic requirements of these patients in Iran. Better understanding of these issues may lead to improve the healthcare standards toward leukemia diagnosis and treatment. Methods: This descriptive study included 101 specialists in hematology-oncology and pathology serving in oncology centers. The participants were then asked to fill out a standard questionnaire on the issues around diagnosis and treatment of blood malignancies. Results: According to specialists, unfair distribution of facilities across the country, delayed diagnosis of disease, absence of psychological support for patients, and insufficient financial support were the main reasons of inappropriate diagnosis and treatment in leukemia patients. Conclusions: Our results show that making an amendment to health policies by preparing well-equipped medical centers in all provinces, improving the morale of patients through consultation during the process of treatment, and above all, subsiding leukemia patients' financial problems will promote the health standard regarding the leukemia diagnosis and treatment in Iran. © 2015, Tehran University of Medical Sciences (TUMS). All rights reserved

A comparison between dextranomer/ hyaluronic acid and polyacrylate polyalcohol copolymer as bulking agents for treating primary vesicoureteral reflux

Purpose: In recent years, endoscopic subureteral injection has gained popularity as a therapeutic alternative to open surgery because of its high success rates and low morbidity. We compared the success and complication rates of Polyacrylate polyalcohol copolymer (PPC) and Dextranomer/Hyaluronic acid (Dx/HA) in the endoscopic treatment of VUR. Materials & Methods: We retrospectively reviewed the patients who underwent endoscopic correction of their VUR by subureteric injection of PPC or Dx/HA from Jan 2010 to April 2016. The injection technique was STING (subureteric), distal HIT (intraureteric), and double HIT according the hydrodistention (HD) grade. The success rate, injection technique, injection volume, VUR grade, and obstruction rate were evaluated and compared between two groups. Results: 107 renal refluxing units (RRU) with a mean age 55.23 ± 36.58 months and 64 RRU with a mean age 52.13 ± 31.66 months were treated in Dx/HA and PPC groups, respectively. The PPC group showed a more successful outcome in comparison to the Dx/HA group (92.2 versus 75.7 of the RRU with P < .001) at 3 months follow up. The injection technique was not significantly different between two groups. In PPC group the success rate was decreased significantly with increasing reflux grade but this reduction was not statistically significant in Dx/HA group. The injected volume was significantly more in PPC group; in addition, there was statistically significant correlation between injected volume of the bulking agent and obstruction rate. However, the obstruction rate did not establish significant difference between the two groups (P = .83), however it was earlier in Vantris (4 months versus 22 months). Conclusion: Our investigation approved PPC as a more effective material, regardless of other confounding variables such as reflux grade, learning cure, and technique of injection, in endoscopic treatment of VUR. In addition, the other remarkable point is this effectiveness is not accompanied by more post-operation obstruction. © 2019, Urology and Nephrology Research Centre

Effect of different feeding levels on water quality, growth performance and survival of western white shrimp (Litopenaeus vannamei Boone, 1931) post larvae with application of biofloc technology

In this study, effect of different feeding levels on water quality, growth performance and survival of western white shrimp Litopenaeus vannamei post larvae were studied in biofloc rearing system. Shrimp postlarvae of PL10 with mean weight of 3±0.7 mg and mean length of 4.4± 0.93 mm were fed for three weeks in fiberglass containers with 200 liters volume of water and density of 10 post larvae per liter in four tretments including one control with water exchange and three biofloc treatments at different feeding levels of 25, 20 and 15% of body weight. According to the results, in the values of water quality parameters including salinity, dissolved oxygen, pH, nitrite and nitrate, no significant differences were observed among the groups (p>0.05). The highest increase in body weight (58.42 mg), growth rate (2.78 mg per day), specific growth rate (15.09 %/day), biomass (84020 mg) and survival rate (71.9%) were obtained in biofloc treatment at 25% feeding level. The highest feed conversion ratio (2.05) and the lowest feed efficiency (48.62%) were obtained in water exchange treatment without floc, showing significant difference compared to the other treatments (P< 0.05). The results from this study reveals that by using biofloc rearing technology can decrease the amount of water exchange and feed utilization compared to body weight in culture of western white shrimp post larvae. Moreover, the presence of biofloc improves growth performance and production of L. vannamei post larvae in biofloc rearing system

Latent atriofascicular pathway participating in a wide complex tachycardia: Differentiation from ventricular tachycardia

Accessory pathways with anterograde decremental conduction properties usually are characterized by presence of antegrade preexcitation during atrial pacing. We report a 38-year-old man with frequent episodes of palpitation. No evidence of ventricular preexcitation was seen during sinus rhythm or atrial pacing. All electrophysiologic maneuvers were compatible with an antidromic tachycardia using atriofascicular pathway as the antegrade limb and the atrioventricular nodal pathway as retrograde limb. Radiofrequency ablation at recording site of accessory pathway potential resulted in cure of tachycardia with no recurrence during 3-month follow-up. This report indicated that atriofascicular pathway-mediated tachycardia should be considered in differential diagnosis of all cases of wide complex tachycardia with left bundle branch morphology and left axis. © 2006, The Authors

Exploring the features of mobile phone application of anatomy in basic medical sciences: A qualitative study

Background: The importance of mobile phones has become one of the new research topics in health professions education due to the ease of access and flexibility. Although novel approaches to health professions education recommend the use of educational technologies, such as mobile applications, a limited number of studies have been conducted with regard to learning anatomy through mobile applications. Considering the increasing needs of medical students for mobile technology to meet their educational needs, wants and desires, we decided to explore the features of an anatomy mobile application. Methods: This qualitative study was conducted in two stages of holding focus groups, and an expert panel session. Students of basic Medical sciences, and faculty members of anatomy at Iran University of Medical Sciences formed the research participants. Semi-structured interviews and note-taking were used to collect the data. Moreover, Brown and Clark methods were used for thematic analysis. Finally, four criteria presented by Lincoln and Guba for qualitative studies were used to ensure the credibility, confirmability, trustworthiness and transferability of the data. Results: Based on the data analysis, 37 codes that could be used to design anatomy mobile content for medical students were extracted. These features were categorized into eight main themes of "visual richness", "scientific comprehensiveness", "auditory richness", "affordability", "user-friendliness", "self-assessment", "interactive content"and "user support". Conclusion: This study explored the features of an anatomy application that can be used by educational app developers. Anatomy departments at Medical Universities, policymakers, and curriculum planners in the field of medical education can also adopt the findings of the present study. © 2020 The Author(s)

Predictors of venous obstruction following pacemaker or implantable cardioverter-defibrillator implantation: A contrast venographic study on 100 patients admitted for generator change, lead revision, or device upgrade

Aim: Venous obstruction following transvenous device implantation rarely cause immediate clinical problems. When lead revision or device upgrade is indicated, venous obstruction become a significant challenge. The aim of this study was to determine the predictors of venous obstruction after transvenous device implantation, and to asess likely effects of antiplatelet/anticoagulant drugs in preventing venous thrombosis. Methods and results: Between March 2005 and July 2006, contrast venography was performed in 100 patients who were candidates for generator change, lead revision, or device upgrade. Vessel patency was graded as either completely obstructed, partially obstructed (>70), or patent. The incidence of venous obstruction was 26, with 9 of patients having total obstruction and 17 of patients exhibiting partial obstruction. No statistically significant differences between obstructed and non-obstructed patients were seen for age, sex, indication for device implantation, atrial fibrillation, cardiothoracic ratio, insulation material, operative technique, device type, and manufacturer (all Ps > 0.05). In a univariate analysis, multiple leads (P = 0.033), and presence of dilated cardiomyopathy (P = 0.036) were associated with higher risk of venous obstruction, whereas anticoagulant/ antiplatelet therapy (P = 0.047) significantly reduced incidence of venous obstruction. Multivariate logistic regression analysis showed that only number of the leads (P = 0.039, OR: 2.22, and 95 CI: 1.03-4.76) and antiplatelet/anticoagulant therapy (P = 0.044, OR: 2.79, and 95 CI: 0.98-7.96) were predictors of venous obstruction. Conclusion: Total or partial obstruction of the access veins occurs relatively frequently after pacemaker or ICD implantation. Multiple pacing or ICD leads are associated with an increased risk of venous obstruction, whereas antiplatelet/anticoagulant therapy appears to have a preventive effect on development of access vein thrombosis. © The European Society of Cardiology 2007. All rights reserved