A PARAMETRIC STUDY ON SEISMIC CHARACTERISTICS OF COLD-FORMED STEEL SHEAR WALLS BY FINITE ELEMENT MODELING

Shear wall panels, including cold-formed steel frames and its attached sheathing, are common lateral load resisting systems of cold-formed steel structures. In this paper, the finite element method is used to study the lateral performance of shear wall panels. The finite element model is validated against experimental results of other researchers. Using the validated model, a parametric study is described to determine strength, drift and seismic behavior of the shear wall panels. Based on the results, it is concluded that the initial stiffness and ultimate lateral strength are dramatically affected by the thickness of the frame members, type of sheathing material, edge screw spacing, height of the frame, while some parameters such as field screw spacing have a minor effect on the initial stiffness and the ultimate lateral strength. In addition, this study looks into the earthquake performance of the shear wall panels and presents the corresponding ductility factor and force reduction factor (R-factor) of shear wall panels

Dermatologists Communication Skills and Performance From Point of View of Patients

Introduction: Effective communication is an important issue in patient-doctor interaction which is even more important regarding chronic disorders which need a strong relationship between patient and clinician for better compliance and optimal control disease. Objectives: This study was aimed to develop the best cultural adapted Persian version of the 28-item Calgary- Cambridge Observation Guide (CCOG) questionnaire. Methods: In this descriptive‑analytic study, data collected from 400 patients attending the outpatient dermatology clinics of 3 major hospitals in Tehran using the modified Persian version of CCOG questionnaire, both before and after being visited by dermatologists. Results: The difference of CCG scores for all of questions, except for questions number 1,16 and 22, was statistically significant. The highest score, both before and after visiting, attained by question regarding being respectful. The lowest scores for necessary behavior and the adequate amount of execution were related to questions number 3 (Introducing self) and 4 (Introducing role), respectively. Age and educational level of patients were significantly correlated with their expectations regarding communication skills of clinician. Conclusions: This study showed the acceptable validity of modified Persian version of CCOG-24 item questionnaire. Our findings also demonstrated that there was a significant difference between what patients expected from a dermatologist and the manner they actually were treated regarding physician communication skills

The Immune Response of Hepatitis B Vaccination in Hemodialysis Patients Referring to the Dialysis Centers of Shomal Health Center in Tehran in 2016

Background and objectives: Hepatitis B virus infection is a major health problem in the worldwide. The prevalence of occult and chronic HBV in hemodialysis patients is higher than standard in developing countries. The aim of this study was to determine the immune response of hepatitis B vaccination in hemodialysis patients referring to the dialysis centers in North Health Center inTehran in 2016. Materials and Methods: This descriptive-correlational study was conducted among all hemodialysis patients referring to the dialysis centers of North Health Center inTehran in 2016. A total of 304 people participated in this study. Data were collected using a checklist including age, sex, weight, frequency of vaccine injections, duration of vaccination completion, number of dialysis, per week, duration of dialysis, diabetes, high blood pressure and cigarette smoking. In these patients, the level of HBs Ab was evaluated by ELISA method. Data was entered in the SPSS-21 software and analyzed by the independents t-test and Chi-Square. Results: In this study, 211 (69.4%) of the participants were male and 93 (30.6%) were female. The mean (SD) of serum HBsAb level in the study period was 105.7 (100) in women and 90.4 (97.5%) in men. The mean (SD) of the time elapsed from the last vaccination in immune person against hepatitis B was 21.1 (19.3) months and in nonimmune was 44 (22) months (P<0.001). However, there was no signifiant relation between the rate of response to hepatitis B vaccine in patients with hemodialysis with gender, age, weight, number of injections of vaccine, number of dialysis per week and patient’s blood group. Conclusion: The study showed that with the increase in the duration of the last injection of the hepatitis B vaccination in hemodialysis patients, the immune response is reduced. It seems that with the periodic control of the antibody titre, a dose of booster can be done before it is reduced

Kaposi's sarcoma in a patient with pemphigus vulgaris mimicking exacerbation of pemphigus

Abstract Background Kaposi's sarcoma (KS) is a rare multifocal angiogenic tumor often seen in immunocompromised setting such as acquired immunodeficiency syndrome (AIDS) or organ transplantation recipients. Pemphigus vulgaris (PV) is a rare blistering disorder with mucocutaneous involvement for which immunosuppressive therapy has long been the core of treatment. Iatrogenic form of KS has been reported infrequently in pemphigus patients as a result of long‐term immunosuppressive therapy. Case We describe a 39‐year‐old male patient with confirmed diagnosis of PV who developed KS after receiving immunosuppressive agents for his pemphigus. KS was initially localized to the oral cavity with features mimicking exacerbation of his pemphigus. Conclusion This interesting case of KS suggests that dermatologists visiting patients with pemphigus with discomfort in the oral cavity should have a high degree of awareness and consider other differential diagnoses along with merely an exacerbation of PV

A case report of esophageal cancer in a patient with pemphigus vulgaris: A coincidence or something beyond that?

Abstract Background Pemphigus is a group of rare but serious autoimmune blistering disorders, affecting skin and mucus membrane. Different reports have been published in respect to the coexistence of pemphigus with neoplasms, especially lympho‐proliferative ones. Case Here, we have reported a patient previously diagnosed with pemphigus vulgaris (PV) who developed esophageal squamous cell carcinoma (SCC). Conclusion Dyspepsia and dysphagia in patients with PV might not be merely due to pemphigus erosions or simply an adverse effect of systemic corticosteroid such as irritant or candidal esophagitis and should raise the suspicion of more serious conditions in case of resistant symptoms without appropriate response to treatment

Two cases of neglected leishmaniasis with marked facial disfigurement: A diagnostic conundrum

Key Clinical Message There is a need to pay more attention to cutaneous leishmaniasis in endemic regions which may mimic other dermatoses and treatment should be initiated with a strong clinical suspicion even without any histopathologic or PCR confirmation to avoid disfigurement or development of secondary malignancy. Abstract Leishmaniasis is a vector‐borne disease with a variety of Clinical manifestations. Cutaneous leishmaniasis (CL) is the most common form of disease and can mimic other dermatoses. We describe two unusual cases of chronic leishmaniasis that remained undiagnosed for many years and led to superimposition of squamous cell carcinoma (SCC) on lesions of one patient. These reports showed that the leishmaniasis should be borne in mind by clinicians when encountering any infiltrated lesion in patients from endemic regions and treatment should be initiated with a strong clinical suspicion even without any histopathologic or PCR confirmation to avoid disfigurement or development of secondary malignancy

PSORIASIS AND INCREASED PREVALENCE OF HYPERTENSION AND DIABETES MELLITUS

Background: Psoriasis is an autoimmune skin disease and associated with other diseases such as cardiovascular, hypertension, and diabetes mellitus. Aim: Our aim was to explore the prevalence of diabetes mellitus and hypertension in psoriatic patients. Materials and Methods: Between April 2008 and May 2010, a total of 304 psoriatic and 300 nonpsoriatic patients were enrolled in this cross sectional study. Data were obtained on age, sex, weight, heights, etc; documented medical history of diabetes mellitus and hypertension; family history of diabetes mellitus and hypertension in first relatives, history of smoking. Results: There was no significant difference in age and gender distribution between two groups. There was also no difference in body mass index between two groups. Within psoriatic group, 79.3% of patients present with plaque type of the disease and 20.7% present with other types. The results showed that within psoriatic patients, the prevalence of diabetes in women is significantly higher than in men (OR=1.93, CI95%: 1.1-3.6, P=0.004) but this difference is not present in nonpsoriatic patients. The results also showed that the prevalence of diabetes in psoriatic patients is significantly higher than nonpsoriatic patients (OR=1.76, CI95%: 1.11-2.8, P=0.015). The data showed that psoriatic patients were more likely to develop hypertension compared with nonpsoriatic patients (OR=2.2, CI95%: 1.2-4.6, P=0.003). According to results, although smoking rate within psoriatic patients is higher than the other group but the difference was not significant. Conclusion: Psoriatic patients have an increased risk of developing metabolic syndrome and hypertension in comparison to nonpsoriatic patients

Unmasking sarcoidosis following SARS‐CoV‐2 vaccination: A case report

Abstract Sarcoidosis is an inflammatory and granulomatous disorder, developed due to dysregulation between immune response and certain environmental antigens. We hereby report an interesting case of sarcoidosis following COVID‐19 vaccination (COVIran Barekat), which presented with inflammation of previous tattoo sites as well as the development of erythema nodosum and systemic lymphadenopathy, suggested a possible link between the COVID vaccination and dysregulation of the inflammatory process and served as a reminder for clinicians to have enough vigilance before proposing a vaccine booster to these patients