A case report of hearing loss post use of hydroxychloroquine in a HIV-infected patient

The Republic of Ireland, like many other countries is trying to diversify energy sources to counteract environmental, political and social concerns. Bioethanol from domestically grown agricultural crops is an indigenously produced alternative fuel that can potentially go towards meeting the goal of diversified energy supply. The Republic of Ireland’s distribution of existing soils and agricultural land-uses limit arable crop land to around 10% of total agricultural area. Demand for land to produce arable crops is expected to decrease, which could open the opportunity for bioethanol production. Bioethanol production plants are required to be of a sufficient scale in order to compete economically with other fuel sources, it is important therefore to determine if enough land exists around potential ethanol plant locations to meet the potential demands for feedstock. This study determines, through the use of a developed GIS based model, the potential quantities of feedstock that is available in the hinterlands of nine locations in the Republic of Ireland. The results indicate that three locations can meet all its feedstock demands using indigenously grown sugarbeet, while only one location can meet its demands using a combination of indigenous wheat and straw as the two locally sourced feedstocks.Department of Agriculture, Fisheries and Food Research Stimulus Fun

Living in the Blurry World: The Story of HIV-infected Iranian Nurses

Background: Despite progress in reducing HIV-related mortality over the past decade, the prevalence and incidence of HIV infection slightly decreased. Nursing profession as a part of the health care system is most affected by HIV/AIDS. HIV-positive nurses need more support from governments and officials. Little is known about how Iranian HIV-positive nurses experience their life situations.  Aim: This study evaluated the experiences of HIV-positive nurses and their attempts to manage HIV/AIDS in personal and occupational livings. Method: The hermeneutic phenomenological approach developed by van Manen's methodology (1990) was adopted to explore the experience of daily life for HIV-positive nurses. A purposive sampling of eight HIV-positive nurses was recruited. Face-to-face in-depth interviews were conducted with two female and six male nurses who had infected with HIV via occupational exposure. Data were analyzed using thematic analysis. Results: The experiences of HIV-infected nurses derived in one major theme and three subthemes. Major theme “living in the blurry world” extracted from three sub-themes: ‘being-in-the-risky world’, ‘being-in-the-shadow of illness’, and ‘ambiguous being-in-the-world’. Implications for Practice: HIV positive nurses perceive the world full of fear and ambiguities. They prefer to suffer in silence and reluctant to disclose their seropositive status. The results of this study can be used by professionals to better understand the HIV positive nurses' world and make more efforts to improve their workplace experiences and reduce stigma in the future

Clinical and Molecular Study of NPC in Iran: Report of 5 Novel Mutations

How to Cite This Article: Tonekaboni SH, Aryani O, Karimzadeh P, Zaman T, Ashrafi M, Salehpour Sh, Dehghan Manshadi M, Khalili E, Houshmand M. Clinical and Molecular Study of NPC in Iran: Report of 5 Novel Mutations. Ir an J Child Neurol. 2015 Autumn;9:4(Suppl.1): 8-9.Pls see pdf

Proven pulmonary aspergillosis in a COVID-19 patient: A case report

Background and Purpose: Coronavirus disease 2019 (COVID-19) has become a significant clinical challenge in healthcare settings all over the world. Critically ill COVID-19 patients with acute respiratory distress syndrome may be at increased risk of co-infection with pulmonary aspergillosis. This study aimed to describe a clinical case of proven pulmonary aspergillosis caused by Aspergillus tubingensis in a 59-year-old man with a history of hospitalization due to COVID-19 infection.Case report: The Covid-19 infection was confirmed by positive nasopharyngeal polymerase chain reaction. He had a cavitary lesion measured 20 mm in diameter with intracavitary soft tissue density in the left lung in the first chest computerized tomography scan. After 25 days, he showed two cavitary lesions in both lungs which raised suspicion of fungal infection; hence, the patient underwent a trans-thoracic biopsy of the cavitary lesion. The direct examination and culture of the biopsy material revealed Aspergillus species. To confirm the Aspergillus species identification, the beta-tubulin region was sequenced. The patient was treated with oral voriconazole.Conclusion: This report underlined the importance of early diagnosis and management of invasive fungal infections in severe COVID-19 patient

Jolt accentuation of headache: can this maneuver rule out acute meningitis?

Abstract Objective Acute meningitis is a medical emergency and its accurate diagnosis could help physicians to accelerate treatment and reduce the mortality and morbidity of patients. Jolt accentuation of headache (Jolt) is an easy clinical maneuver that can be used to diagnose meningitis, but its diagnostic accuracy is controversial. We aimed to assess the “Jolt maneuver” in diagnosis of suspected acute meningitis patients admitted to the emergency ward of Imam-Khomeini Hospital Complex in Tehran, Iran. Results Out of 250 patients, 227 were included and 64 (28.2%) had cerebrospinal fluid (CSF) changes compatible with meningitis. Jolt was positive in 40 of 64 (62.5%) meningitis patients. Sensitivity, specificity, positive and negative likelihood ratio (+ LR and − LR) of Jolt were 62.5, 88.3%, 5.36 and 0.42, respectively. These indices were also compared to nuchal rigidity, Kernig’s and Brudzinski’s signs. The highest + LR was for Kernig’s sign (6.79) and the lowest − LR was for nuchal rigidity (0.39). CSF culture was positive in two patients (Streptococcus pneumoniae and Aspergillus sp.). We found that in adult patients with fever and acute headache, a positive Jolt maneuver has a good diagnostic accuracy for diagnosis of meningitis and indicates a need for CSF assessment, but negative results cannot exclude it

The Effect of Drag Force on The Body Frequencies and The Power Spectrum of a Bladeless Wind Turbine

The new types of bladeless wind turbines and generating electricity using them is one of the most interesting topics for engineering nowadays. Electricity generation using the structural vibration due the resonance phenomenon is the concept behind a vortex bladeless turbine. The present study numerically investigates the effects of the drag force on the body frequency of an oscillating bladeless wind turbine. A 2-D numerical simulation was performed for a cylinder with a semi-circular cross-section in cross-flow in two different cases. The research was conducted for both uncontrolled and controlled oscillating cylinders. The controlling process was performed using a pair of ring magnets as a spring with a variable coefficient. The flow field, vibration, vortex shedding and structural frequencies, and the resonance phenomenon are studied in this research. Finally, the controlled and uncontrolled frequencies of the cylinder are explored, and the power spectrum for various velocities is analyzed in two different states, namely with and without a tuning system. From the results, it can be concluded that the usage of the controlling system in these turbines can greatly regulate the oscillations and increase the frequency value by limiting the vibration amplitude. According to this principle, it can be inferred that increasing the frequency of fluctuations greatly increases the production capacity of these turbines.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

Brucellosis With Multi-Organ Involvement in a Patient With History of Composite Aortic Graft and Hepatitis B

The brucellosis with multi-organ involvement in a patient with a history of the composite aortic graft (Bentall procedure) and Hepatitis B infection is rare. A 35-year-old man presented to us with fever and loss of consciousness. Four years ago, he was IDU and underwent cardiac surgery because of endocarditis. Recently lumbar spondylodiscitis was diagnosed. The Wright (1/320) and Coombs Wright tests (1/640) were positive. After CNS imaging, lumbar puncture was done. The CSF pleocytosis was lymphocyte dominant. In cardiac echocardiography, large vegetation on prosthetic aortic valve leaflets was seen. The brain MRI was reported abnormal. Treatment of brucellosis started with Ceftriaxone, Doxycycline, Rifampin and Gentamycin. After 4 days, he became oriented, and fever was disappeared then we continued the treatment for 16 days. The patient discharged and followed by daily phone calls. As symptoms of abdominal pain and jaundice were presented on the fifth day, he re-admitted. The patient expired because of hepatorenal and cardiac insufficiency. Drug side effects, activation of Hepatitis B and embolism of cardiac vegetation to other organs were suspected causes of death. We do not suggest medical therapy without cardiac surgery in such cases. When combination therapy is necessary for brucellosis in an HBsAg-positive patient, hepatitis virus activity should be assess by HBV-DNA PCR and the dose of drugs with known hepatotoxic effects such as rifampin and co-trimoxazole should be adjust. Combination therapy with quinolones instead of hepatoxic drugs is one of our suggustions

Disseminated tuberculosis presented with explicit hypercalcemia: A clinical case report

Key Clinical Message Tuberculosis (TB) is a rare but known reason for hypercalcemia usually in those with underlying conditions such as renal failure, diabetes, or severe anemia. It is essential to consider TB in those with refractory or resistant hypercalcemia. Abstract Hypercalcemia or a calcium level above 10.5 mg/dL can be a manifestation of TB that only became symptomatic in a small percentage of the patients. Patients with underlying diseases such as renal failure are more prone to poor prognosis. It is essential to use anti‐TB drugs besides hypercalcemia standard treatment to maintain a normal calcium level in TB‐related hypercalcemia. In thisstudy, we have presented a young adult with disseminated TB and persistent hypercalcemia who responded finally to anti‐TB drugs

Storage Stability and Physicochemical Properties of Flaxseed Oil Microemulsions Stabilized with N-Octenylsuccinate-Derived Starch and Sodium Caseinate

Background: Flaxseed oil is one of the richest sources of omega-3. The aim of this study was to investigate the effects of different wall materials, weight ratio (WR) and storage time on physicochemical properties and storage stability of flaxseed oil microemulsions. Methods: Encapsulation efficiency and emulsion oxidative stability were measured. Fatty acid composition of oil extracted from emulsions was analyzed by gas chromatography (GC). Particle size distribution and morphology of microemulsions were measured by dynamic laser scattering (DLS) technique and scanning electron microscopy (SEM), respectively. Results: The maximum encapsulation efficiency of 95.8% was obtained in the emulsion with the highest n-octenylsuccinate-derivatized (n-OSA) starch content. Increasing n-OSA starch concentration led to a higher microencapsulation efficiency and a lower lipid oxidation. Increasing n-OSA starch/sodium caseinate ratio led to a decrease in peroxide values and thiobarbituric acid contents. GC-FID results showed a superior stability of ω-3 fatty acids and improved nutritional quality in microencapsulated flaxseed oil upon storage. The average droplet size distribution of emulsions ranged from 428 to 728 nm. An increase in total solid content with the same oil concentration led to smaller droplets size. Morphological study performed by SEM confirmed the results obtained by DLS technique. Conclusion: Our findings have important implications for the design and utilization of emulsions as delivery systems for food enrichment

Diarrhea as Initial Manifestation of Systemic Lupus Erythematosus (SLE): A Case Report

Systemic Lupus Erythematosus (SLE) is an autoimmune disease. The most common presentation is a female with fever, arthralgia, and malar rash. Diarrhea usually occurs as a side effect of medications. Although digestive tract involvement in SLE is common, its initial manifestation as diarrhea is rare. This paper describes one of the rare SLE manifestations as merely acute diarrhea and abdominal discomfort