Transfusion-related acute lung injury in multiple traumatized patients

Background: Many of the multiple traumatized patients who refer to the hospital need transfusion. Transfusion-related acute lung injury (TRALI) is a serious clinical syndrome associated with the transfusion of plasma-containing blood components. In the article, we present a case of TRALI following transfusion of packed red blood cells Case Presentation: A 24 year old male referred to Shahid Beheshti Hospital due to multiple trauma with left femoral and humerus fractures. Due to severe anemia he received 3 units of packed red blood cells. The symptoms of TRALI began 2 hours after transfusion. He was transferred to intensive care unit (ICU) due to metabolic acidosis and severe hypoxia. The TRALI was confirmed after ruling out the other probable pulmonary diseases. He recovered and was discharged. Conclusion: Transfusion related acute lung injury should be considered in any case receiving transfusion of plasma containing blood components

SVR Algorithm as a Tool for More Optimal Intergalactic Medium Simulation in the Epoch of Reionization

All kinds of simulations of the intergalactic medium, such as hydrodynamic simulation, N-body simulation, numerical and semi-numerical simulation, etc., have been used to realize the history of this medium. One of these simulations is 21SSD, which is specifically focused on the epoch of reionization. This simulation deepens our understanding of the physics behind the intergalactic medium by considering the free parameters related to the Wouthuysen-Field coupling fluctuations and X-ray and Lyman line transfers in the intergalactic medium, and by presenting the plots of the power spectrum, brightness temperature, etc. in different redshifts. However, due to many physical phenomena that play significant roles in this epoch, simulations of the intergalactic medium are usually extremely complex, time-consuming, and require very powerful hardware. In this work, by using the Support Vector Regression algorithm and based on the 21SSD simulation datasets, we have tried to make the machine fully understand the brightness temperature changes in terms of redshift for different astrophysical free parameters values. At first, we trained the machine with the results of the 21SSD simulation. Then, the machine was able to predict the brightness temperature in terms of redshift with very high accuracy for other interval coefficients. Although we have used this algorithm to estimate the brightness temperature, it seems that this algorithm can be easily used for other parts of cosmology and astrophysics. With its help, it is possible to save time and obtain results with extraordinary accuracy similar to complex simulations, even with normal hardware

A New Constraint on the Simulation of the Intergalactic Medium through the Evolution of the Neutral Hydrogen Fraction in the Epoch of Reionization

The thermal history of the intergalactic medium is full of extremely useful data in the field of astrophysics and cosmology. In other words, by examining this environment in different redshifts, the effects of cosmology and astrophysics can be observed side by side. Therefore, simulation is our very powerful tool to reach a suitable model for the intergalactic medium, both in terms of cosmology and astrophysics. In this work, we have simulated the intergalactic medium with the help of the 21cmFAST code and compared the evolution of the neutral hydrogen fraction in different initial conditions. Considerable works arbitrarily determine many important effective parameters in the thermal history of the intergalactic medium without any constraints, and usually, there is a lot of flexibility for modeling. Nonetheless, in this work, by focusing on the evolution of the neutral hydrogen fraction in different models and comparing it with observational data, we have eliminated many models and introduced only limited simulation models that could confirm the observations with sufficient accuracy. This issue becomes thoroughly vital from the point that, in addition to restricting the models through the neutral hydrogen fraction, it can also impose restrictions on the parameters affecting its changes. However, we hope that in future works, by enhancing the observational data and increasing their accuracy, more compatible models with the history of the intergalactic medium can be achieved.Comment: 14 pages, 3 figures, 4 table

EFFECTS OF ORAL IRON SUPPLEMENT ON BREATH-HOLDING SPELLS IN CHILDREN

Objectives:Breath holding spells are one of the most frequent and important diagnostic challenges in pediatrics. The aim of this study, conducted on pediatric patients referring to the pediatric neurology clinic in Hormozgan province, was to evaluate therapeutic effects of iron on breath holding spellsMaterials and Methods:35 children (19 males and 16 females), aged between 3 to 60 months, with a history of breath-holding spells, were included in the trial. To obtain all relevant data a specifically designed questionnaire requiring information on sex, age, age of onset of spells, type of spells, frequency of attacks before and after treatment with oral iron supplement, and determinants of body iron stores was completed for all the patients, based on the mother's statements. The patients were treated by an oral iron preparation for three months.Results:The age of onset of spells ranged between 6 to 24 months. The cyanotic type of spell was detected in 31 children, the pallid type in 3, and the mixed type in one child. There were 14 children with iron deficiency anemia and 20 children with reduced iron stores. Just one child had a normal iron profile. Complete therapeutic response was documented in 24 children, good response in 9, and poor response in one and in one child no change in frequency of spells was seen.Conclusion:Although no significant therapeutic difference was seen in the different response groups, it seems that iron supplement may play an important role in reducing breath holding spells in children.Keywords:Iron, Breath holding spell, children, Iron deficiency Anemi

Safety and Efficacy of MLC601 in Iranian Patients after Stroke: A Double-Blind, Placebo-Controlled Clinical Trial

Objective. To investigate the safety and efficacy of MLC601 (NeuroAid) as a traditional Chinese medicine on motor recovery after ischemic stroke. Methods. This study was a double-blind, placebo-controlled clinical trial on 150 patients with a recent (less than 3 month) ischemic stroke. All patients were given either MLC601 (100 patients) or placebo (50 patients), 4 capsules 3 times a day, as an add-on to standard stroke treatment for 3 months. Results. Sex, age, elapsed time from stroke onset, and risk factors in the treatment group were not significantly different from placebo group at baseline (P > .05). Repeated measures analysis showed that Fugl-Meyer assessment was significantly higher in the treatment group during 12 weeks after stroke (P < .001). Good tolerability to treatment was shown, and adverse events were mild and transient. Conclusion. MLC601 showed better motor recovery than placebo and was safe on top of standard ischemic stroke medications especially in the severe and moderate cases

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10&nbsp;years; 78.2% included were male with a median age of 37&nbsp;years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020