Evaluating the impact of fractional flow reserve-guided percutaneous coronary intervention in intermediate coronary artery lesions on the mode of treatment and their outcomes: An Iranian experience.

BACKGROUND: Today, the fractional flow reserve (FFR) guides the physician to select suitable patients with intermediate severity coronary lesions in angiography that should be treated or not with stent. The aim of this study was to evaluate the impact of using FFR in the selection of appropriate treatment strategy in angiographic intermediate coronary lesions and their short-term outcome in a sample of Iranian population. METHODS: In a prospective cohort, 34 patients who had intermediate coronary artery lesion(s), defined as having a 40-70% diameter stenosis, as determined by visual estimation or quantitative coronary angiography were enrolled through a convenience sampling method. All patients underwent FFR measurement to decide whether percutaneous coronary intervention should be performed. The results of visual assessment, quantitative coronary angiography, and functional assessment of the severity of coronary stenosis were compared. Significant stenosis was defined as FFR < 0.80. All patients were followed for 6 months for the incidence of major advanced cardiac events. RESULTS: In this study, 34 patients (22 male and 12 female) with mean age of 57 ± 8 (range 45-70) were included. In 26.47% (9/34) of patients, FFR was 0.80 and stenting was done to the other vessels with significant coronary lesions. CONCLUSION: Measurement of FFR is a useful approach in making clinical decisions about revascularization procedures in patients with moderate coronary artery lesion severity, especially in LM and multivessel disease. This study showed that not only FFR can change treatment plan of the patients, but also it would improve clinical outcomes. KEYWORDS: Coronary Angiography; Coronary Stenosis; Fractional Flow Reserve Myocardia

Neurologic complications in percutaneous nephrolithotomy

Percutaneous nephrolithotomy (PCNL) has been the preferred procedure for the removal of large renal stones in Iran since 1990. Recently, we encountered a series of devastating neurologic complications during PCNL, including paraplegia and hemiplegia. There are several reports of neurologic complications following PCNL owing to paradoxical air emboli, but there are no reports of paraplegia following PCNL. Materials and Methods: We retrospectively reviewed the medical records of patients who had undergone PCNL in 13 different endourologic centers and retrieved data related to neurologic complications after PCNL, including coma, paraplegia, hemiplegia, and quadriplegia. Results: The total number of PCNL procedures in these 13 centers was 30,666. Among these procedures, 11 cases were complicated by neurologic events, and four of these cases experienced paraplegia. All events happened with the patient in the prone position with the use of general anesthesia and in the presence of air injection. There were no reports of neurologic complications in PCNL procedures performed with the patient under general anesthesia and in the prone position and with contrast injection. Conclusions: It can be assumed that using room air to opacify the collecting system played a major role in the occurrence of these complications. Likewise, the prone position and general anesthesia may predispose to these events in the presence of air injectio

Evaluation of Freezing Tolerance of Hexaploid Triticale Genotypes under Controlled Conditions

In order to evaluate freezing tolerance of different triticale (X Triticosecale Wittmack) genotypes, an experiment was carried out under controlled conditions in 2007 and 2008 at college of agriculture, Ferdowsi University of Mashhad. In this study seeven triticale genotypes (�Juanilo-92�, �ET-82-15�, �ET-82-8�, �ET-83-20�, �ET-83-19�, �ET-83-18� and �ET-79-17�), across six temperatures (0�C, -4�C, -8�C, -12�C, -16�C and -20�C) were evaluated within a factorial-completely randomized design with three replications. Plants were kept until 2 leaf stage in chamber with temperature of 20/15�C (day/night) and 12.5 h photoperiod. At the end of this stage, plants were under acclimation for three weeks. After exposing to acclimation freezing the cell membrane integrity was measured through electrolyte leakage (EL) and the lethal temperature (LT50) of samples was measured. After the exposure to freezing temperatures the samples were transferred to the greenhouse. Survival percentage, plant height, leaf area and number, chlorophyll content, and plant dry weight were determined after 3 weeks. Results showed that the effect of different freezing temperature and genotypes were significant on all plant characteristics. As temperature decreased, %EL of all genotypes was increased. Minimum and Maximum EL % in leaf and crown were observed at 0�C (21%) and -20�C (88.5%). �ET-79-17� and �Juanilo-92� genotypes showed the highest EL% (55.5% and 44.8%) and �ET-83-20� the lowest EL% (47.3% and 41.2%) in leaf and crown. Dry weight and leaf area decreased by 48% and 42% respectively compared to non frozen control plants. �ET-79-17� and �ET-82-15� genotypes showed the highest dry weight (83.8 mg) and highest leaf area (14.3 cm2) respectively and �ET-83-20� cultivar showed the lowest dry weight and leaf area (58.2 mg and 8.7 cm2)

Reconfigurable Dynamic Cellular Manufacturing System: A New Bi-Objective Mathematical Model

Dynamic Cell Formation Problem (DCFP) seeks to cope with variation in part mix and demands using machine relocation, replication, and removing; whilst from practical point of view it is too hard to move machines between cells or invest on machine replication. To cope with this deficiency, this paper addresses Reconfigurable Dynamic Cell Formation Problem (RDCFP) in which machine modification is conducted instead of their relocation or replication in order to enhance machine capabilities to process wider range of production tasks. In this regard, a mixed integer nonlinear mathematical model is proposed, which is NP-hard. To cope with the proposed model’s intractability, an Imperialist Competitive Algorithm (ICA) is developed, whose obtained results are compared with those of Genetic Algorithm’s (GA’s), showing superiority and outperformance of the developed ICA

Diagnostic value of color doppler ultrasonography in detecting stenosis and occlusion of central veins in patients with chronic kidney disease

Venography is an invasive diagnostic test that uses contrast material that provides a picture of the condition of the veins. But, complications, including adverse effects on the kidney, do occur. On the other hand, with the current technological development, application of ultrasound in the diagnosis of obstructive diseases of the veins is gaining popularity, being non-invasive, easy to perform and cost-effective. The aim of this study was to evaluate the diagnostic value of Doppler sonography in the diagnosis of central vein stenosis. In this descriptive-analytical study, 41 hemodialysis patients who had been referred for 50 upper limb venographies to the radiology department of Imam Reza (AS) were included. Patients with chronic kidney disease with a history of catheterization of the vein, jugular or subclavian, and who had established fistulas or synthetic vascular grafts were targeted. Central venous ultrasound was performed on both sides to evaluate stenosis or occlusion. Venography was performed by the radiologist the next day or the day before hemodialysis. Data on demographic characteristics, findings of clinical examination and findings of ultrasound as well as venography were recorded by using the SPSS software, Chi-square test and Spearman correlation, and Kappa agreement was calculated for sensitivity, specificity and predictive values. Twenty-three (56%) patients were male subjects and 18 patients (44%) were female. Twenty-three (56%) patients of the study population were aged 60 years. The overall sensitivity, specificity and positive predictive value and negative predictive value of Doppler sonography in the proximal veins in hemodialysis patients compared with venography were, respectively, 80.9%, 79.3%, 73.9% and 85.1%. Color Doppler sonography, as a non-invasive method, could be a good alternative for venography in the assessment of the upper limb with central vein stenosis and occlusion

Serum Phospholipase A2-IIA, hs-CRP, and Lipids in Women With Subclinical Hypothyroidism

BACKGROUND: Subclinical hypothyroidism (SCH) is a metabolic disorder characterized by elevated TSH level but normal T4 level. Some previous studies suggest that SCH is associated with inflammation. OBJECTIVES: The present study aimed to compare lipid serum levels in SCH patients and normal participants, also explore possible association between SCH and the two inflammatory markers hs-CRP and PLA2-IIA. PATIENTS AND METHODS: This study was performed on 77 women aged 20-45 (39 with SCH and 38 in the control group). TSH and T4 levels were measured by electrochemiluminescenceassay. Lipid profiles were analyzed using enzymatic-colorimetric methods. Hs-CRP and PLA2-IIA were determined using the ELISA method. IBM SPSS 19.0 was used for statistical analysis. RESULTS: Serum levels of TG, cholesterol, and LDL were higher in the SCH group than the control group. However, there was no significant difference between the two groups for HDL level. Likewise, no difference was observed for the serum level of hs-CRP. PLA2-IIA mean value was higher in the SCH group. CONCLUSIONS: SCH is associated with increased level of PLA2-IIA, which is independent of BMI. The stronger association of SCH with PLA2-IIA than with hs-CRP indicates that PLA2-IIA is an inducer of inflammation while hs-CRP is not

Comparison of Multiplex Quantitative Real-Time PCR and Culture Methods for the Diagnosis of Bacterial Meningitis in Patients with Suspected Meningitis

Background: This study aimed to compare the diagnostic efficacy of standard culture method with multiplex quantitative real-time polymerase chain reaction (qPCR) in examining cerebrospinal fluid (CSF) samples collected from patients with suspected meningitis. Materials & Methods: A retrospective evaluation was conducted on 166 patients with suspected meningitis, who were treated in Vali-Asr hospital in Birjand, Iran between 2011 and 2020. Diagnosis of bacterial meningitis was based on CSF culture and multiplex qPCR results. Findings: Among 166 patients, conventional methods identified causative pathogens in only 10.3% of cases, while multiplex qPCR detected pathogens in eight out of 25 culture-negative cases as well. The most common pathogens identified were enterovirus, Epstein-Barr virus, herpes simplex, Haemophilus influenzae, and Streptococcus pneumoniae. Conclusion: Multiplex qPCR appears to be a more effective method than conventional culture in identifying bacterial and viral pathogens that most commonly cause meningitis. The incorporation of qPCR as a routine diagnostic method for meningitis in clinical practice could significantly enhance clinical decision-making and patient care