Congenital Antithrombin Deficiency in a Pregnant Woman with Right Atrium Thrombosis

BACKGROUND: One of the rare causes of venous thromboembolism in pregnancy is antithrombin III deficiency. Antithrombin III deficiency is estimated to carry a 30% risk of venous thrombotic  complication during each pregnancy and postpartum.CASE DETAILS: We present thea case of a A 21-year-old pregnant woman (Para 1+) with a history of  large atrial septal defect repair at our hospital (Imam Ali Hospital, 2 May 2014). The patient, with  unknown history of antithrombin III deficiency, was admitted at our emergency center with dyspnea and chest pain for the rule out of tamponade. She presented with a right atrial thrombosis in the second  trimester of pregnancy despite the use of therapeutic doses of heparin and warfarin in the postoperative  period as thromboembolic prophylaxis. The risk of warfarin emberyopaty led to termination of pregnancy, and successful redo-cardiac surgery outcome was achieved with the combined use of therapeutic  anticoagulation and regular plasma-derived antithrombin concentrate infusions to normalize her  antithrombin levels.CONCLUSSION: She recovered from the operation uneventfully, and wad discharged in the 12th postoperative day. In the 6th month of follow-up, antithrombin III increased to 70% in more stable level  and transethoracic echocardiography showed no recurrence of right atrial thrombus formation. This case  leads to further debate regarding whether full anticoagulation should be a worthy preventive measure for  venous thromboembolic prophylaxis after an open heart surgery complicated by pregnancy in a women  with inherited antithrombin III deficiency. This point may become more relevant as further experience is  gained with the use of recombinant human antithrombin in known cases during open cardiac surgery.KEYWORDS: pregnancy, antithrombin ш deficiency, cardiac surger

EFFECT OF ULTRAVIOLET RADIATION ON THE FORMATION OF ERGOCALCIFEROL (VITAMIN D2) IN Pleurotus ostreatus

Naturally the content of ergocalciferol (vitamin D2) in mushrooms is small, but they are rich of ergosterol which is known as its precursor. Ergosterol converted to vitamin D2 by UV light irradiation following by heat reaction. The aim of the study is to observe formation of ergocalciferol from its precursor in the Pleurotus ostreatus using UV radiation at 254 and 366 nm. Crude samples were irradiated for 15, 30, 60, 90, and 120 minutes. The samples were then extracted using reflux for one hour. Ergocalciferol content was determined using spectrophotodensitometer. The results show that the content of ergocalciferol after 15, 30, 60, 90, 120 mins radiation under UV 254 nm are 24.12 ± 3.46; 28.15 ± 1.43; 38.22 ± 2.11; 48.19 ± 3.68; and 14.81 ± 3.41 μg/g respectively, whereas under UV 366 nm in similar duration the content are 9.59 ± 5.35; 20.6 ± 5.58; 27.67 ± 4.5; 10.62 ± 2.81; 8.76 ± 0.32 μg/g, respectively. No ergocalciferol is found in the control. It is concluded that the ergocalciferol was formed in mushroom after irradiating with ultraviolet light. The highest ergocalciferol content was found in sample irradiated under UV light 254 nm for 90 minutes.Keywords: Ergocalciferol, ergosterol, duration, irradiated, Pleurotus ostreatus spectrophotodensitometer, ultraviolet ligh

The Largest Reported Dissecting Aneurysm of Ascending Aorta Following Aortic Valve Replacement Accompanied by Superior Vena Cava Syndrome

BACKGROUND: Ascending aortic dissection (AAD) is a rare and serious complication of aortic valve replacement. Multiple risk factors such as connective tissue disease, aortic wall thinning, aortic diameter, calcification of wall, structural features of aortic wall and associated diseases have been considered as a predisposing factor for the occurrences of AAD. Preoperative recognition of these variables with proper intra intra operative logic judgment may decrease tehe incidence of this complication.CASE DETAILS: We herein present a huge ascending aorta with dissecting aneurysm (AAD) with a largeintra-operative diameter (15cm) that has not been recorded in the medical literature so far. He presented with dyspnea, chest pain and amazing symptom of superior vena cava syndrome. The patient underwent open heart surgery with resection of ascending aorta aneurysm with classic Bentall operation. The post-operative period was associated with uneventful course and the patient was discharged with good condition on 12th post-operative day.CONCLUSION: A six months’ follow-up revealed abolishment of chest pain and superior vena cava (SVC) syndrome and good prosthetic composite graft function with no recurrence of pseudo aneurysm or dissection.KEYWORDS: aneurysm, ascending aorta, superior vena cava syndrom

Greenhouse electrification via transactive energy management strategy

Distributed energy resources have grown significantly in Canada and the world over the past decade, particularly in the agricultural sector. As P2P (peer-to-peer) energy trading plays a fundamental role in renewable energy uptake and system flexibility for the low-carbon energy transition, this paper provides an overview of this approach from a techno-economic standpoint for two greenhouses located in Leamington, Ontario. The real-time site solar irradiation, ambient temperature, and load demand over 8760 h have been utilized to drive the designs. In this investigation, two cases are assessed for pepper greenhouse: Case I: energy purchase from the grid and Case II: energy purchase from excess energy of neighbor which is cucumber-tomato greenhouse. The integration of 50 kW PV/1 kWh battery/35 kW converter achieves the feasibility criteria by recording net present cost (NPC) and cost of energy (COE), which are $29.6k and$0.044/kWh, respectively

Determinant criteria for designing Health benefit package in selected countries

Health benefit package described as primary health interventions that provided with government using general funds for all regardless their financial ability. This study was aimed at determine appropriate pattern for Iran using comparative survey of Health benefit package in various countries. A review exploration was done, scholars was selected population of both developed and developing countries, required information was also extracted by articles, searches and reports of reliable sources and date were analyzed by SPSS, in brief. The vast majority frequencies was respectively allocated to accessibility (40.7%), cost- effectiveness (29.6%), prioritize, efficacy and cost (22.2%). most countries located in WHO African region were selected cost-effectiveness and accessibility, WHO southeast Asia region were selected, coverage, prioritize, efficacy and quality and finally most WHO Europeans region were elected effectiveness and services costs for including services in Health benefit package. According to most Health benefit package designer emphasis on criteria including accessibility and costeffectiveness, to design Health benefit package for Iran, these criteria must be noticed

Pemerolehan Bahasa Siswa Tunagrahita Kelas VI SD

Language Acquisition of Mental Retardation Students at 6th Grade Elementary School. The aim of this research is to explain the comparison of vocabulary acquisition between student with severe mental retardation and student with mild mental retardation. This qulitative research used case study as strategy. Data collection technique used observation method and list of Swadesh Vocabulary. SLB YKK Pacitan was the location of this research. The result show that student with mild mental retardation can understand the vocabularies about 79%, and Nisa student with severe mental retardation can understand the vocabularies about 46%. This result proves that the ability of student with mild mental retardation to master vocabularies is better than the ability of student with severe mental retardation. Athough, the age of student with severe mental retardation is older than student with mild mental retardation. The mental age of the child with mental retardation influences their language ability