A Rare Case of Wolfram Syndrome

A 15-year-old boy was referred because of bilateral hydroureteronephrosis. He had poorly controlled diabetes mellitus since he was 4 years old. He had polyuria and polydipsia. On water deprivation test, he developed hypernatremia along with increased levels of BUN and creatinine. He also had hypertension that was effectively managed with losartan. Bilateral optic atrophy was detected on ophthalmoscopic examination. It seems that this boy is a rare case of Wolfram syndrome.Keywords: Diabetes Insipidus; Diabetes Mellitus; Wolfram Syndrome; DIDMOAD; Deafness; Optic Atrophy

Comparison of the Incidence of Postoperative Hyponatremia after Infusion of Hypotonic Versus Isotonic Intravenous Solutions in Children

Introduction: Hyponatremia is the most common electrolyte disorder in patients following surgical interventions (19-50%). Hospital acquired hyponatremia is often due to using hypotonic solution s and can be lethal.Materials and Methods:Between January and December 2014, 190 children (1 month to 12 years) who were admitted in the urology department of Children’s Hospital Medical Center for elective surgical procedures were enrolled in the study. The patients were randomly divided into two groups: group I received 50 mEq/L sodium and 20 mEq/L potassium in D/W 5% and group II received 154 mEq/l sodium and 20 mEq/L potassium in D/W 5% at the maintenance dose for a period of 6 hours following the operation. The patients did not have any oral fluid intake 6 hours postoperatively. The incidence of hyponatremia before and after maintenance IV fluid therapy was analyzed. Other characteristics of the patients such as age, gender, duration of hospitalization, other concomitant electrolyte disturbances, and symptoms of hypervolemia were also evaluated. The incidence of fluid-IV therapy-induced hyponatremia was investigated and analyzed in different categories of patients.  Results: One hundred and ninety patients were enrolled. The mean age was 3.75 years (ranging from 1 month to 12years).  One hundred and thirty-three patients (70%) were boys. The incidence of hyponatremia before and after maintenance IV fluid therapy was 9.5% and 36%, respectively. After the therapy, the incidence of hyponatremia was 54% and 17% in hypotonic and isotonic groups, respectively. Final multivariate logistic analysis showed that hyponatremia was common in patients that received hypotonic solution after surgery.Conclusions: Hyponatremia was markedly induced in patients receiving hypotonic solution after surgery. It seems isotonic fluid therapy after surgery protects the patients from hyponatremia.Keywords: Hyponatremia; Isotonic solutions; Hypotonic solutions; Child

Rectal adenocarcinoma in an 9 year old girl. A case report

Rectal adenocarcinoma is rare in children. The patient described here is a 9-year-old girl who presented with rectorrhagia. Her problem started 3 months ago and she had been treated for infectious diarrhea. A colonoscopy was performed 3 months after the onset of symptoms and a non-pedunculated polyp in the rectum was noted and resected. After the colonoscopy signs and symptoms of peritonitis developed and in laparotomy a rectal perforation was noted and a biopsy from rectal mucosa was taken. The result of biopsy was adenocarcinoma. Then a low anterior resection of rectum with protective ileostomy followed by adjuvant chemotherapy was performed. During a 15 month follow-up the patient had no problems and no clinical, radiological or laboratory signs or symptoms of recurrence was found. However rectal adenocarcinoma is rare but it should be considered in the differentialdiagnosis of intestinal problems

Efficacy of 153Sm-EDTMP on Bone Pain Palliation in Metastatic Patients: Breast and Prostate Cancers

Purpose: This study aimed to evaluate the effect of samarium-153-EDTMP (153Sm-EDTMP) on pain relief bone metastases of Breast Cancer (BC) and Prostate Cancer (PC) patients. Materials and Methods: Thirty patients aged 40-77 years (62.6±10.2 years) with intractable metastatic bone pain were included in the current study. A checklist of patient information and a standard questionnaire for the assessment of pain and quality of life were completed before and after four and eight week’s palliative treatment with 37 MBq/kg of 153Sm-EDTMP. To analyse the data, parametric and non-parametric tests were used in SPSS software. Results: Twelve females with BC (40%) and 18 males with PC (60%) were included. Four and eight weeks after palliative treatment of 153Sm-EDTMP, the mean pain score reduction and quality of life were statistically increased compared to before the intervention (P-value 0.05). Conclusion: The injection of 153Sm-EDTMP had therapeutic efficacy for bone pain palliation in patients with diffuse bone metastases at the end of the 4th and 8th week post-infusion

Purcell Enhancement and Wavelength Shift of Emitted Light by CsPbI3 Perovskite Nanocrystals Coupled to Hyperbolic Metamaterials

Manipulation of the exciton emission rate in nanocrystals of lead halide perovskites (LHPs) was demonstrated by means of coupling of excitons with a hyperbolic metamaterial (HMM) consisting of alternating thin metal (Ag) and dielectric (LiF) layers. Such a coupling is found to induce an increase of the exciton radiative recombination rate by more than a factor of three due to the Purcell effect when the distance between the quantum emitter and HMM is nominally as small as 10 nm, which coincides well with the results of our theoretical analysis. Besides, an effect of the coupling-induced long wavelength shift of the exciton emission spectrum is detected and modeled. These results can be of interest for quantum information applications of single emitters on the basis of perovskite nanocrystals with high photon emission rates

Seismic fragility assessment of reinforced concrete moment frames retrofitted with strongback braced system

This study focused on analysing the seismic fragility and retrofitting of reinforced concrete flexural frames using strongback braced system. Using the steel strongback braced system as a means of seismically strengthening and retrofitting reinforced concrete moment frames (RCMFs), this research aims to enhance the effectiveness of RCMFs. In this study, RCMFs of 5-, 10-, and 15-stories are designed according to the first and fourth editions of the Iran Earthquake Standard 2800. The RCMFs designed according to the first edition are strengthened and reinforced using the SB system. The studied structures were analyzed under incremental static loading and time history analysis. The results show that the yield force and maximum base shear for the structures designed with the fourth edition, compared to the structures designed with the first edition, have increased by 1.28–1.42. This demonstrates the necessity of improving structures constructed according to the first edition. Meanwhile, the results of the retrofitted structures with strongback braces show the same or better performance than newly designed structures. The results of the fragility analysis show that the addition of the strong bracing system significantly improves the performance of the structures and brings them closer to the 4th edition standards. The retrofitting system reduces drift ratio between floors and reduces structural damage

Assessment of cyclic behavior and performance of hybrid linked-column steel plate shear wall system

An innovative hybrid linked columns steel plate shear wall (HLCS) system provided, and its cyclic behavior and energy absorption are investigated by finite element method in this study. The objective of the designed HLCS system was to reduce or possibly prevent damage to the SPSW at low and medium seismic levels by focusing the seismic damage to interchangeable link beams (the energy dissipation components of the presented HLCS system). In this study, the cyclic behavior and energy dissipation of HLCS systems were investigated using numerical methods. To evaluate the hysteresis behavior and energy absorption of the proposed HLCS system, parametric studies were performed. Also, the accuracy of finite element models was evaluated by comparing test results that showed the good accuracy of finite element models in predicting the specimens' hysteresis behavior and failure modes. Due to the failure mechanisms, the coupling ratio amounts meaningfully affect the onset of the first surrender mechanism between the infill steel plate and link beams. In general, by increasing the number of link beams in the floor, the ultimate shear force to the weight ratio of the structure was increased. Also, the type of beam in terms of flexural and shear behavior did not significantly affect the ratio of base shear force to the structure weight. The proposed HLCS system has increased the ratio of base shear force to the weight by an average of 4%–27%, indicating that this system is economically comparable to the SPSW systems. Moreover, the energy dissipation in the HLCS system exhibited a 14%–91% enhancement compared to the SPSW system

Frequency of iron deficiency anemia and its related factors in adult patients referred to the internal clinic of Shohada Ashayer from 6 March to 6 July 2011

Background : Anemia is one of the most common health problems in Iran and the world. Moreover, iron deficiency anemia is the most prevalent nutritional anemia in the world. Considering the high prevalence of iron deficiency anemia and the relationship between their severity and cultural-economic condition in an area, this study was conducted to obtain the prevalence and plan the treatment of diseases. Materials and Methods: This cross-sectional study was conducted using a census method. All the adult patients with anemia signs and symptoms referred to the internal clinic of Shohada Ashayer were examined for CBC and RBC indices. The patients whose hemoglobin amounts fell in the anemia definition range were included. Iron level, serum ferritin, and TIBC assessments were performed and a questionnaire was completed for each patient. Then data were analyzed statistically. Results: Out of all the anemic patients, 44.4% suffered from iron deficiency anemia. The prevalence of iron deficiency anemia was 52.3% in women and 22.6% of the men. 60.9% of the patients in 15-49 age group and 24.5% of those aged over 49 had iron deficiency anemia. A significant relationship was found between age, sex, and iron deficiency anemia. No significant relationship was found between history of NSAIDs consumption and the incidence of iron deficiency anemia. Conclusion: Since the prevalence of iron deficiency anemia in the studied population is high, considering improving and preventive interventions and comprehensive training programs in this regard seem to be necessary