Assessment of Radiation Dose to the Lens of the Eye and Thyroid of Patients Undergoing Head and Neck Computed Tomography at Five Hospitals in Mashhad, Iran

Introduction: In recent years, the number of computed tomography (CT) scans, which is a high-dose technique, has increased significantly. Head and neck CT is performed frequently and thyroid, particularly in children, has always been considered a sensitive organ. In recent years, radiobiologists and health physicists have been more concerned about the safety of lenses of the eyes, as cataract is no longer considered a deterministic effect. Material and Methods: In the present study, incurred doses to the thyroid and lens of the eye of 140 patients who underwent common head and neck CT at five hospitals were measured by thermoluminescent dosimeters (TLD-100). The patients were divided into two age groups of pediatrics and adults. TLD chips were placed on the patient’s skin surface. For each patient, scan parameters, sex and age were recorded. Exposed TLDs were read by a manual TLD reader. Results: The verage absorbed dose of the thyroid, as well as the lenses of the left and right eyes were 5.89±1.74, 15.84±2.81 and 16.25±2.57, respectively, for the pediatric patients and 5.00±1.17, 17.64±1.69 and 24.41±1.89 for adults. Patient-specific organ doses were influenced by the scanned region, scan protocol and patient's age. Conclusion: In the present study, the mean eye dose was much lower than the 500 mGy threshold recommended by International Commission on Radiological Protection (ICRP) for lens of the eye damage, thus, it appears to be clinically safe. While CT scan remains a crucial tool, further dose reduction can be achieved by controlling different factors affecting patient doses

Durability of E-glass vinyl ester composite structures and their modeling in ABAQUS

The use of fiber-reinforced polymer composite materials (FRP) in various applications such as aerospace, automotive, sports equipment, and oil and gas industries has been growing in recent years. Nonetheless, the potential use of FRP pipes in harsh environmental conditions of oil and gas industry-related applications could become significantly greater if there was minimal degradation to the mechanical and physical properties of the materials used to form the pipes. The feasibility study of this potential, however, requires several systematic investigations for assessing the long-term durability of glass fiber-reinforced polymer composite pipes. This paper presents results from our preliminary investigation on the response of E-glass/Vinyl ester composite pipes aged in water and seawater at various temperatures. Scanning electron microscopy is used to assess the material’s response, and ABAQUS simulations are used to assess the capacity of the modeling software to predict the moisture absorption process in E-glass/Vinyl ester composites using a diffusion module. As the results obtained in the experiments and ABAQUS simulations have good agreement, ABAQUS can be used to simulate the long-term durability of E-glass/Vinyl ester composite pipes exposed to humid environments

Effects of moisture absorption on degradation of E-glass fiber reinforced Vinyl Ester composite pipes and modelling of transient moisture diffusion using finite element analysis

The main purpose of this study is to investigate the effects of humidity and temperature on the properties of GFRP specimens. Tubular specimens fabricated by a filament winding machine are submerged in the studied environment and the accuracy of Fick’s law on moisture diffusion behaviour is studied. The results prove that decreasing the exposure temperature reduces the diffusion coefficient and absorbed moisture. To analyse the effects of moisture uptake on mechanical and physical properties, buckling tests and scanning electron microscope were used. ABAQUS is employed to simulate the moisture absorption. The outcome shows good agreements between experimental and FEA results

Enoxaparin utilization evaluation in inpatients with or at risk of thromboembolic disorders: A one-year, single-centered, retrospective Study

The aim of this study was evaluation of enoxaparin utilization in hospitalized patients who had received enoxaparin either for prophylaxis or for treatment of thromboembolic disorders. A total of  356 patients were included in this retrospective study and were analyzed for enoxaparin utilization in terms of prescription patterns, treatment strategy, dosing regimen, indications/contraindications, adverse drug reactions, bleeding events, drug-drug interactions and monitoring parameters. The inpatient records and charts were used to extract the relevant data. 47.8% of the patients were prescribed inappropriate doses of enoxaparin, and 35.7% were treated with enoxaparin for inappropriate duration. Lack of appropriate monitoring of platelet count, complete blood count (CBC), activated partial thromboplastin time (aPTT), serum potassium level and serum creatinine during enoxaparin therapy was also noted in nearly one third of the patients. Furthermore, dose adjustment was not performed for 85% of the patients who had elevated serum creatinine. Co-administration of enoxaparin and anti-platelet drugs (aspirin and clopidogrel) or non-steroidal anti-inflammatory drugs were noted in 72% of the patients. No cases of major bleeding occurred but hematuria was observed in 16.3% of the patients. High doses of enoxaparin (120 mg/day), concurrent administration of antiplatelet drugs and increased age were found to be the main risk factors for bleeding. Overall, inappropriate utilization of enoxaparin in terms of prescription, dosing regimen, drug interaction and monitoring was observed in a large proportion of the patients which indicates the need for more careful consideration of the patients' conditions and the treatment guidelines before treatment with enoxaparin in the studied healthcare setting

Peripheral Giant Cell Granuloma: A Review of 123 Cases

Background: Peripheral giant cell granuloma is one of the reactive hyperplastic lesions of the oral cavity, which originates from the periosteum or periodontal membrane following local irritation or chronic trauma. The purpose of this study was to present the clinical characteristics of peripheral gi-ant cell granuloma in a group of Iranian population. Methods: A series of 123 consecutive confirmed cases of peripheral giant cell granuloma after biopsy were evaluated. Age, sex, anatomic location, consistency, etiologic factor, pain and bleeding history, color, surface texture, and pedicle situation were recorded and were analyzed by chi-square test and values were considered to be significant if P < 0.05. Results: Age ranged from 6 to 75 years (mean 33 years). Women affected more than men (M/F 1:1.1). Peripheral giant cell granuloma was seen in the mandible more than in the maxilla and in the anterior region more than in the posterior region. In most cases, lesions were pink, pedunculated and had non-ulcerated surface. In less than half of the cases, there was no history of bleeding and also pain was rarely reported. Calculus was the most common etiologic factor. Conclusion: The results confirmed that the clinical features of peripheral giant cell granuloma in a group of Iranian population are almost similar to those reported by other investigators

The prospective validation of EuroSCORE II risk scoring system for patients underwent cardiac surgery: brief report

Background:&nbsp;Various prediction models have been developed aiming to estimate risk-adjusted mortality, morbidity and length of intensive care unit stay following cardiac surgeries. The European system for cardiac operative risk evaluation II (EuroSCORE II) is a prediction model which maps 18 predictors to a 30-day post-operative risk of death. The objective of this study was to evaluate the performance of the EuroSCORE II risk-analysis predictions among patients who underwent heart surgeries. Methods:&nbsp;A prospective cross-sectional study was conducted to collect required variables for all consecutive patients underwent heart surgeries in Emam Reza hospital, Mashhad, Iran, from March 2014 to March 2015. Once the patient was hospitalized a cardiologist or a general physician evaluated pre- peri- and post-operative state to fill out the pre-designed structural paper form. Comparing the observed and expected mortality, the sensitivity, specificity, area under the receiver operating characteristic curve (AUC) and finally the discrimination power of the model for our patients were calculated and reported. The model value was calculated using the online tool. Results:&nbsp;A total of 1337 patients (60% males) were included, the observed mortality rate was 3.2%. Although the overall performance was acceptable, the model showed poor discriminatory power (AUC=0.667, CI 95%: 0.648-0.685) and accuracy with sensitivity=61.88% and specificity=66.23%. Conclusion:&nbsp;Our single-center study, based on consecutive patients who underwent cardiac surgery showed that EuroSCORE II demonstrated a moderate statistical overall performance with poor discrimination and calibration measures remain as concerning issues regarding 30-day post-operative mortality prediction after adult cardiac surgery. Poor performance measures for this system show the need for reformulating this risk stratification tool aiming to improve post cardiac surgery outcome predictions in Iran

Design, Development, and Deployment of a Web-Based Registry for Cardiovascular Intensive Care Unit (CVICU)

Introduction: The cardiovascular intensive care unit (CVICU) registry provides physicians with tools for monitoring, managing, and following up on patients. The CVICU registry provides researchers with the ability to analyze and evaluate integrated data patients. Our goal with this study is to explain the design, development, and deployment of a comprehensive, integrated, qualified cardiovascular intensive care unit registry, as well as to characterize individuals admitted to CVICUs. Material and Methods: From June 2012, a cohort study of ICU admissions for adults (≥18 years) in a teaching hospital’s CVICU began. The study includes retrospective collection of existing data from paper records and hospital information systems (HIS) and ongoing prospective collection using the proposed CVICU registry portal. Results: Between June 2013 and June 2022, 2587 admissions were included, among which 1041 (40.2%) were women, 1546 (59.8%) were man, and the median age was 58 ranging from 18 to 93 years and their mean (SD) age was 56.8 (13) years. About 11.1% of the patients died in the CVICU. The primary indications for CVICU care included mechanical ventilation (29.7%), weaning time (??%), readmission (4.9%), cardiovascular (17.4%), myocardial infarction (1.7%), diabetes (9.3%), hypertension (14.3%). Of these, about 73% had coronary artery bypass grafting (CABG), 15% valve surgery and the remains has other cardiovascular surgeries. About 39% experienced an on-pump surgery. In addition, patients had 6.4 hours weaning time after operation. The overall CVICU length of stay (LOS) rate was 3.6 days and mean predicted by APACHE IV, APACHE II, SOFA, and SAPS II were 5.67, 3.03, 4, and 4 days, respectively. Conclusion: The use of registries equipped physicians and researchers with an integrated data pool to manage and evaluate information. Appropriate patient registries allow effective decision-making for appropriate interventions, resource allocation, and ongoing data monitoring and analysis. Ultimately, this leads to the optimal outcomes for patients. This registry aims to generate valuable knowledge about cardiovascular ICU patients in Iran and to collect accurate and qualified data

T2* magnetic resonance imaging of the liver in thalassemic patients in Iran

AIM: To investigate the accuracy of T2*-weighted magnetic resonance imaging (MRI T2*) in the evaluation of iron overload in beta-thalassemia major patients