Argon Plasma Coagulation in Treatment of Post Intubation Tracheal Stenosis

INTRODUCTION: Acquired tracheal stenosis can be created by various malignant or benign causes. The most common cause of acquired non-malignant tracheal stenosis is endotracheal intubation, even for a short period. Argon plasma coagulation is a non-contact method of thermal hemostasis. Argon plasma coagulation can be used easily and fast and has low depth of penetration. METHODS: This study is single blinded. Subjects are patients with tracheal stenosis after endotracheal intubation who were selected by non-probability sampling and were studied from March 2007 to November 2009 in bronchoscopy and laser center of Masih Daneshvari Hospital, Tehran. First, for each patient, a diagnostic flexible bronchoscopy was performed to identify the type, location, and severity of the stenosis. Then, under general anesthesia, patients underwent rigid bronchoscopy. Then, with Argon plasma coagulation device (ERBE VIO 200D) the stenosis was removed as possible. After two weeks, a new PFT (pulmonary function test) was done for checking the obstructive signs.RESULTS: Of these 34 patients, 24 were asymptomatic for more than 1 year and responded to treatment(70/6%), 5 were asymptomatic for more than 10 months and less than 12 months (14/7%) and 5 did not have asymptomatic periods more than 10 months, and did not respond to treatment. In PFT follow-ups, FEV1 in all patients who were asymptomatic for more than 10 months had a significant progress; therefore, in 27 out of 29 patients at the end of the study, FEV1 was more than 90% and 2 patients had FEV1 of 70-90%.CONCLUSION: In fact, although the surgical treatment remains the main treatment of tracheal stenosis after intubation (PITS), if this method is not possible for any reason, APC is very useful as a safe and effective method

Evaluation of the Effects of Low Level Laser Therapy on the Healing Process After Skin Graft Surgery in Burned Patients (A Randomized Clinical Trial)

Background: Skin graft is standard therapeutic technique in patients with deep ulcers but as every surgical procedure has complications. Although several modern dressings are available to enhance comfort of donor site, using techniques that accelerate wound healing may enhance patient’s satisfaction.Low Level Laser Therapy (LLLT) has been used in several medical fields, especially for wound healing but for treating large ulcers, it may last several months to heal completely.Materials and Methods: The protocols and informed consent were reviewed according to Medical Ethics Board of Shahid Beheshti University of Medical Sciences (IR.SBMU.REC.1394.363) and Iranian Registry of Clinical Trials (IRCT2016020226069N2). Nine patients with bilateral similar grade 3 burn ulcer in both hands or both feet, candidate for Split Thickness Skin Graft (STSG) were selected. One side was selected for laser irradiation and the other side as control, randomly. Laser area was irradiated by red, 655 nm laser light, 150 mW, 2 J/Cm2 for the bed of the ulcer and infra red 808 nm laser light, 200 mW for the margins, every day for 7 days.Results: The rate of wound dehiscence after skin graft surgery was significantly lower in laser treated group in comparison to control group which received only classic dressing (P=0.019).Discussion: In the present study for the first time we evaluate the effects of LLLT on the healing process of skin grafted area in burn patients. The results showed LLLT is a safe effective method which improves graft survival and wound healing process and decreases the rate of wound dehiscence in patients with deep burn ulcer

Investigating the effectiveness of emotional regulation techniques along with drug therapy on reducing blood pressure, anxiety symptoms, depression and hostility in patients with hypertension compared to drug therapy alone

Objective: Blood pressure-related diseases are the most influenced by psychological factors. The present study was done with the aim of investigating the effectiveness of emotional regulation techniques along with drug therapy on blood pressure reduction, anxiety symptoms, depression and hostility in patients with hypertension compared to drug therapy alone. Materials and Methods: The present study is a quasi-experimental study with pre-test design, post-test design and control group. The population of this study was men and women between the age of 20 to 70 years with hypertension and resident in Tehran province in 2019. Among patients with hypertension referred to Ayatollah Taleghani Training Center Clinic, 30 persons were selected accessibly and were randomly assigned to experimental and control groups. The intervention program of cognitive emotion regulation techniques training was done during 8 sessions in the experimental group. The instruments used in this research were Hospital Anxiety and Depression Scale (HADS) and Spielberger's State-Trait Anger Expression inventory (STAXI). Results: Analysis of covariance showed that there was a significant difference between the experimental and control groups after the intervention in the level of blood pressure, anxiety, depression and total anger expression index at p <0.05 level. Effect size was 0.39, 0.26, 0.21, and 0.21 in depression, anxiety, blood pressure, and total anger expression index, respectively. Conclusion: Specialists in cardiovascular diseases and health psychology area can employ cognitive emotion regulation techniques to improve the physical and psychological problems of individuals with hypertension including blood pressure, anxiety, depression and ange

First insight into the drug resistance pattern of Mycobacterium tuberculosis in Dohuk, Iraq: Using spoligotyping and MIRU-VNTR to characterize multidrug resistant strains

SummaryThe objectives of this study were to determine drug resistance pattern in new and previously treated tuberculosis (TB) patients, to assess function of TB control program, and to characterize multidrug resistant TB (MDR-TB) by molecular fingerprinting methods. Anti-micorbial susceptibility testing (AST) to the first line anti-TB drugs was performed on Löwenstein–Jensen (middlebrook 7H10) medium according to the proportion method. Molecular fingerprinting of all MDR strains was performed by spoligotyping and MIRU-VNTR. Mycobacterium tuberculosis strains were isolated from 53 Iraqi patients with pulmonary TB. Thirty eight patients (71.7%) tested cases, and 15 (28.3%) were previously treated. Four of the 38 new cases (10.5%) had resistant, of which 3 (7.9%) were MDR. Eight (53.3%) of the 15 previously treated patients had resistant strains, of which 7 (46.7%) were MDR. Spoligotyping of MDR strains showed CAS family (40%) as the predominant genotype. Using MIRU-VNTR typing, all isolates had a unique profile. MDR-TB prevalence is higher among previously treated patients than among the new cases. The many drug resistant strains, in absence of evidence of recent transmission and in combination with the many previously treated cases, highlight the need for an improved control program, coupled with a need to improve detection rate and early diagnosis of MDR-TB

Correlation between the muscle, blood and heart level of Irisin in exercise-trained rats with Nano selenium supplementation: A rat model of COPD

The aim of this study was to considering the correlation between the muscle fibronectin type III domain-containing protein 5 (FNDC5), blood and heart level of Irisin in exercise-trained rats with Nano selenium supplementation after intraperitoneal injection of cigarette smoke extract induced chronic obstructive pulmonary disease (COPD). To this end, 49 male Wistar rats (8 weeks old) were divided into seven groups: control, SeNPs (2.5 mg/kg b.w by oral gavage, 3 days/week, 6 weeks), AIT (49 min/day, 5 days/week for 6 weeks, interval), SeNPs+AIT, CSE (150 µL by IP injection, 1 day/week for 6 weeks), CSE+AIT, and CSE+SeNPs+AIT. The results of the present study showed that CSE injection caused inflammation and damage to lung tissue, especially alveoli, compared to the healthy group. In other words, based on the histological examination of cigarette smoke extract, it was able to cause lung tissue damage similar to COPD, and doing exercise and taking nanoselenium antioxidant supplement could control these lung tissue damage. Pearson's correlation method was used to investigate the relationship between muscle FNDC5, serum and heart Irisin, and the results of this correlation were not significant in different groups (p>0.05). It seems that exercising and taking nanoselenium supplements can increase Irisin levels in serum and heart tissue by expanding muscle contraction and increasing muscle FNDC5. However, the relationship of this factor in muscle and heart crosstalk should be investigated more closely

Changes in glycosylated haemoglobin and treatment outcomes in patients with tuberculosis in Iran: a cohort study.

BACKGROUND: Diabetes mellitus (DM) affects tuberculosis (TB) treatment outcomes, mostly by increasing recurrence, mortality and treatment failure. The objectives were to determine the pattern of change in glycosylated haemoglobin (HbA1c) level in new TB patients admitted to hospital at the start and 3-months after TB treatment, and to relate the measurements at these two time intervals to whether patients successfully completed treatment. METHODS: A prospective cohort study was conducted on hospitalized new TB patients at Masih Daneshvari Hospital from 2012 to 2013. All patients were tested for HbA1c at the beginning and 3 months after initiation of TB treatment. Changes in HbA1c were compared to TB treatment outcome. RESULTS: There were 317 new TB cases admitted to hospital of which 158 had HbA1c at baseline and 3-months. Of these, 67 (42%) had normal values, 54 had an elevated HbA1c at either base-line or 3-months (uncertain diabetes status) and 37 (24%) had elevated HbA1c (≥6.5%) at both time points (DM). There were differences between the groups: those with DM were older, had a known history of DM and a higher prevalence of cavities on chest x-ray. There were 150 (95%) patients who successfully completed treatment with no significant differences between the groups. CONCLUSION: There were changes in HbA1c during the first three-months of anti-TB treatment, but these were not associated with differences in TB treatment outcomes. Transient hyperglycemia should be considered in TB patients and needs to be taken into account in planning care and management

3D Printing of Dental Prostheses: Current and Emerging Applications

Revolutionary fabrication technologies such as three-dimensional (3D) printing to develop dental structures are expected to replace traditional methods due to their ability to establish constructs with the required mechanical properties and detailed structures. Three-dimensional printing, as an additive manufacturing approach, has the potential to rapidly fabricate complex dental prostheses by employing a bottom-up strategy in a layer-by-layer fashion. This new technology allows dentists to extend their degree of freedom in selecting, creating, and performing the required treatments. Three-dimensional printing has been narrowly employed in the fabrication of various kinds of prostheses and implants. There is still an on-demand production procedure that offers a reasonable method with superior efficiency to engineer multifaceted dental constructs. This review article aims to cover the most recent applications of 3D printing techniques in the manufacturing of dental prosthetics. More specifically, after describing various 3D printing techniques and their advantages/disadvantages, the applications of 3D printing in dental prostheses are elaborated in various examples in the literature. Different 3D printing techniques have the capability to use different materials, including thermoplastic polymers, ceramics, and metals with distinctive suitability for dental applications, which are discussed in this article. The relevant limitations and challenges that currently limit the efficacy of 3D printing in this field are also reviewed. This review article has employed five major scientific databases, including Google Scholar, PubMed, ScienceDirect, Web of Science, and Scopus, with appropriate keywords to find the most relevant literature in the subject of dental prostheses 3D printing

Estimation of Effective Doses and Lifetime Risk of Exposure-induced Cancer Death in Pediatric CT Scans

Background: The increasing frequency of computed tomography (CT) scans for a range of purposes, particularly pediatrics, has raised concerns regarding the population's radiation exposure and subsequent chances of cancers. This study aimed to estimate the effective doses of pediatrics radiation and induced cancer risks from five most common CT scan procedures in Yazd Province, Iran.Methods: Data of pediatric patients from four age groups of ≤1, 1-5, 5-10, and 10-15 years old were retrospectively collected from 6 educational institutions located in diverse areas of Yazd Province. For each participant, the effective doses and REID (risk of exposure-induced death) rate were estimated by Impact Dose and PCXMC software, respectively. Then, the findings were reported by categorizing the patients regarding their effective diameter.Results: The effective doses and REID values did not show any significant differences among the studied age groups. The highest mean of effective dose was recorded for the scan of abdomen-pelvis (average ± standard deviation, 5.24±3.19 mSv) followed by chest (3.76±2.28 mSv), brain (1.25±1.07 mSv), and sinus (0.65±0.4 mSv) examinations. The highest REID was documented for chest scan (490±314 excess deaths in one million scans) followed by abdomen-pelvis procedure (404±280).Conclusion: The radiation doses delivered to the pediatric patients and the associated fatal cancer risk with common CT procedures were comparably in the same range of the previous studies. Our findings can represent an estimation of the radiation-induced risks of CT scans and can be used for extending the knowledge of clinicians and researchers

Churg-Strauss syndrome following cessation of allergic desensitization vaccination: a case report

<p>Abstract</p> <p>Introduction</p> <p>Churg-Strauss syndrome is a vasculitis of medium to small sized vessels. Diagnosis is mainly clinical with findings of asthma, eosinophilia, rhinosinusitis and signs of vasculitis in major organs.</p> <p>Case presentation</p> <p>We present a case of a 19-year-old Persian male who developed signs and symptoms of this syndrome related to hyposensitization treatments for allergy control.</p> <p>Conclusions</p> <p>No unifying etiology for the disease can be presented as it is found associated with environmental factors, medications, infections and is even considered a variant of asthma with predisposition to vasculitic involvement. Therefore, it is important to recognize this disease and be aware of underdiagnosis because of emphasis on pathologic evidence. Here, we present a case of allergic desensitization causing Churg-Strauss syndrome in the absence of other known factors.</p