Cardiac failure secondary to hypocalcemia

Hypocalcemic cardiomyopathy due to hypoparathyroidism is a very atypical and rare circumstance, which is usually intractable to conventional therapy for cardiac failure, but responds satisfactorily to restoration of normocalcemia.We describe a young woman who developed clinical signs of hypocalcemia due to hypoparathyroidism, reduced left ventricular ejection fraction and polymorphic ventricular tachycardia as consequences of hypocalcemia.This case underscores the importance of biochemical abnormalities like hypocalcemia as a rare cause of secondary cardiomyopathy and emphasizes on the need for effective and immediate treatment of hypocalcemia and its related causes

Value of Admission HbA1c Level in Non-diabetic Patients With Unstable Angina

Introduction: There have been incompatible evidences about the prognostic value of HbA1c on the adverse outcomes in acute coronary syndrome. Also, these data are so limited in nondiabetic patients with unstable angina.Methods: In this cross-sectional study, HbA1c level of 231 nondiabetic patients admitted with unstable angina, was measured using high performance liquid affinity chromatography (HPLC) at admission. Then transthoracic echocardiography (TTE) was performed for evaluation of ejection fraction (EF) using Simpson method.Results: Our data revealed that HbA1c was significantly higher in patients with EF≤ 50% in comparison with EF>50% group (P value=0.01).Conclusions: HbA1c may be a helpful prognostic marker in nondiabetic patients admitted in emergency department with diagnosis of unstable angina

Hearing threshold evaluation of dentistsin Babol (North of Iran)

Introduction: Noise in dental offices is one of the risk factors in the workplace. One of the major effects of noise is hearing loss. This study aimed to determine the effects of noise on hearing thresholds of dentists of Babol city. Methods: This descriptive analytical cross-sectional study was performed on 40 dentists in Babol City (as case group) and 40 office workers (as control group). Hearing thresholds were measured from all the subjects. The mean hearing threshold was calculated at different frequencies in each group and compared with the number 15 db. The data were analyzed by statistical software SPSS 17 and p≤0.05was considered significant. Results: The mean and standard deviation of hearing thresholds for the right ear of dentists and the control group without considering the different frequencies were 13.6156±9.14210 db and 10.0156±5.4488 db (p=0.036), respectively and for the left ear were 12.5115±8.7609 db and 10.059±5.9254 db respectively. Hearing threshold of right and left ear of young and middle age dentists was not significant. The hearing thresholds of the dentists with work experience of 15 years or less were not significant for the right and left ear. Auditory thresholds were significant between male and female only for the left ear (p=0.02). Conclusion: There was a change in hearing thresholds at all frequencies. A clear difference was in the left ear of men and women and hearing loss was higher in men. Also, age and working experience were not among the contributing factors to the incidence of noise-induced hearing loss

Acellular pertussis vaccine efficacy: An updated systematic review and meta-analysis

Background: Recent studies indicate an increased incidence of pertussis disease in recent years. The aim of this study was to evaluate the efficacy of the acellular vaccine for children (as a replacement of current whole cell vaccine in the Expanded Program on Immunization) and for high-risk adults in Iran through updating current best available evidence. Methods: We performed a systematic literature review in relevant databases we focused on previously published systematic reviews to select those that address our questions. The AMSTAR (assessing the methodological quality of systematic reviews) tool was used for screening available reviews. Then search in databases was done until Feb 2014 to update the evidence. We pooled results using meta-analysis methods by Stata statistical package. Results: Eleven systematic review articles were included in the initial evaluation. In the end, two systematic reviews on acellular vaccine booster doses and the acellular vaccine in children were selected as the baseline evidence. In the update phase, new clinical trials were screened, and the results were updated. Overall pooled estimate of relative efficacy of acellular to whole cell was 0.68 (95% CI, 0.55-0.81) for children immunization Pooled estimates for the efficacy of acellular versus placebo were 0.70 (95% CI, 0.60-0.80). Overall pooled estimate of efficacy of booster dose of acellular was 0.87(95% CI, 0.85-0.88) compared to placebo. In addition pooled estimate of acellular vaccine efficacy based on response to antigen was 0.78(95% CI, 0.64-0.93) in highrisk group. Conclusion: The results show higher performance and safety of the acellular vaccine in the prevention of pertussis in children versus the whole cell vaccine. Moreover, the efficacy of the acellular vaccine in high-risk adult groups is acceptable. This study provides evidence in favor of the introduction of an acellular vaccine to the national program of immunization. Studies on cost effectiveness and aspects of policy analysis are recommended

Facilitators and Barriers to Implementing Healthy School Canteen Intervention among Malaysian Adolescents:A Qualitative Study

This study evaluated implementing a school-based intervention to promote healthier dietary habits in the school environment among Malaysian adolescents using qualitative methods. This qualitative study was conducted in four secondary schools in Perak and Selangor (two urban and two rural schools) that received the intervention (either training or training and food subsidy). A total of eight focus groups (68 students aged 15 years old) and 16 in-depth interviews were conducted with canteen operators, school convenience shop operators, school teachers and school principals in each school. Thematic analysis was used to analyse the qualitative data to identify suitable themes. We found several initiatives and changes by the schools’ stakeholders to change to a healthy school canteen programme. The stakeholders also noticed the students’ food preferences that influence healthy food intake in canteens and convenience shops. The food vendors and school administrators also found that subsidising healthy meals might encourage healthy eating. Among barriers to implementing healthy school initiatives were the student’s perception of healthy food and their eating habits, which also affect the food vendors’ profit if they want to implement a healthy canteen. The school-based intervention has the potential to promotes healthier eating among school adolescents. Continuous training and monitoring of canteen operators and convenience shops are needed, including building partnerships and educating the students on healthy eating to cultivate healthy eating habits

Cardiometabolic Risk Factors and Physical Activity Patterns Maximizing Fitness and Minimizing Fatness Variation in Malaysian Adolescents:A Novel Application of Reduced Rank Regression

Patterns of physical activity (PA) that optimize both fitness and fatness may better predict cardiometabolic health. Reduced rank regression (RRR) was applied to identify combinations of the type (e.g., football vs. skipping), location and timing of activity, explaining variation in cardiorespiratory fitness (CRF) and Body Mass Index (BMI). Multivariable regressions estimated longitudinal associations of PA pattern scores with cardiometabolic health in n = 579 adolescents aged 13–17 years from the Malaysian Health and Adolescent Longitudinal Research Team study. PA pattern scores in boys were associated with higher fitness (r = 0.3) and lower fatness (r = −0.3); however, in girls, pattern scores were only associated with higher fitness (r = 0.4) (fatness, r = −0.1). Pattern scores changed by β = −0.01 (95% confidence interval (CI) −0.04, 0.03) and β = −0.08 (95% CI −0.1, −0.06) per year from 13 to 17 years in boys and girls respectively. Higher CRF and lower BMI were associated with better cardiometabolic health at 17 years, but PA pattern scores were not in either cross-sectional or longitudinal models. RRR identified sex-specific PA patterns associated with fitness and fatness but the total variation they explained was small. PA pattern scores changed little through adolescence, which may explain the limited evidence on health associations. Objective PA measurement may improve RRR for identifying optimal PA patterns for cardiometabolic health. © 2019 by the authors. Licensee MDPI, Basel, Switzerland

Prevalence of obsessive-compulsive disorder in Iran

BACKGROUND: Estimates of the annual prevalence for Obsessive Compulsive Disorder (OCD) were consistent across the international sites range, 1.9% – 2.5%. The nine population surveys, which used Diagnostic Interview Schedule, estimated a six-month prevalence of OCD ranging from 0.7% to 2.1%. This study performed in order to determine the prevalence of OCD in a population-based study among Iranian adults aged 18 and older and to study the association of them with factors such as sex, marital status, education, type of occupation and residential area. METHODS: A cross-sectional nationwide epidemiological study of the Iranian population aged 18 and older was designed to estimate the prevalence of psychiatric disorders and their association with the above mentioned factors. 25180 individuals were selected and interviewed through a randomized systematic and cluster sampling method from all Iranian households. Schedule for Affective Disorders and Schizophrenia (SADS) and Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) criteria were used in diagnosis of OCD. 250 clinical psychologists interviewed the selected subjects face to face at their homes. RESULTS: The prevalence of OCD in Iran is 1.8% (0.7% and 2.8% in males and females; respectively). 50.3% of the survey sample were men, 49.9% women, 29.1% single, 67.45% married, 0.4% separated or divorced, 2.5% widow/widower and 4% undetermined. All of the above-mentioned factors were examined in the univariate and multivariate logistic regression models. Although the data did not fit the models well, but in univariate models, sex, the category "single" of marital status, age, the categories "business" and "housewife" and residential areas showed significant effect adjusting for the factors, but the models didn't fit the data properly. CONCLUSION: The study suggests that the prevalence of OCD is not rare in the community of Iran and is within the range of other countries. Similar to prior studies in other communities, OCD is more common in females than males

Evaluation and enhancement of biological treatment of volatile organic emissions at oil and gas production and refining industries

Petrochemical refineries and production sites are considered as the second greatest source of volatile organic compounds (VOCs) emissions after vehicle exhausts. Some of these VOCs are toxic and some of them can create ground level ozone in the presence of sunlight. Biological systems which are based on the natural ability of microorganisms to utilize organic pollutants as their carbon and energy sources and transform them to less toxic compounds are considered among the most promising cost effective emission treatment methods. Less energy consumption and lower overall operational costs, fewer by-products generation and smaller carbon footprint are the main advantages of this technology as compared to conventional treatment systems. In spite of several successful lab-scale applications of biological treatment technology for removal of hazardous compounds, there is still a need for pilot and field-scale experiments to evaluate the performance of this system for removal of complex industrial contaminants mixtures. Hence, the goal of this research was to investigate the performance, robustness and strength of a pilot and a field-scale biofiltration treatment unit for removal of fluctuant VOCs from downstream and upstream oil and gas production, respectively. Moreover, two strategies for improving bioavailability and biodegradability of hydrophobic VOCs were examined in the lab in order to optimize the removal efficiency of low water soluble compounds. A pilot-scale biotrickling-biofiltration (BTF-BF) unit was evaluated for removal of VOCs from a wastewater sump at a coastal petrochemical refinery located in south Texas (Site 1: CITGO Corpus Christi Refinery). In the present PhD research and based on the notable results of the pilot test, the BTF-BF unit was scaled-up and implemented as a field-scale unit for elimination of VOCs from a tank battery in a production site at east Texas (Site 2: Apache TAMU#2). VOC emissions at both sites were sampled by 6 L SUMMA canisters analyzed using gas chromatography-mass spectrophotometry (GC-MS), following method TO-15. Aromatics were the most abundant compounds, followed by alkanes at site 1 in contrast to site 2 which was dominated by alkane emissions. During the operation of the pilot-scale unit at an empty bed residence time (EBRT) of 90 seconds, an average 85% removal for the total VOCs was achieved which was comparable to an average 55% removal efficiency at site 2 at an EBRT of 120 seconds using field-scale unit. This difference was because site 1 was mainly composed of readily biodegradable aromatic compounds while 90% of VOCs composition at site 2 was relatively recalcitrant alkanes. While biofilters/biotrickling filters are being demonstrated as very efficient and cost-effective treatment technologies for removal of VOCs, poor performance has been observed for some hydrophobic VOCs due to low bioavailability. In another part of this PhD study, lab-scale experiments in liquid cultures were performed in order to evaluate effectiveness of fungal growth at acidic pH environments as well as application of surfactants on improving bioavailability and biodegradability of mixture of benzene and xylene (BX). A wastewater inoculum from the CITGO Corpus Christi Refinery was used as the microbial culture. BX-degrading microorganisms were enriched at neutral and acidic pH mineral medium to favor bacterial and fungal growth, respectively. Two synthetic nonionic surfactants (Brij 35 and Tween 20) and one biosurfactant (Saponin) were evaluated at neutral and acidic pH microcosm studies. Bench scale experiments demonstrated that acclimating the wastewater inoculum at pH 4 increased fungal to bacterial ratio. The larger surface area of fungal to bacterial biofilms as well as hydrophobic aerial mycelia of fungi probably facilitated the BX uptake. Hence, the benzene removal increased from 72% at the pH 7 control culture to 83% at the pH 4 control culture. An increase of 22% was observed at the same experimental conditions for the o-xylene removal. The microcosm results revealed the highest percentage increase for the removal of benzene and oxylene at pH 7 occurred during the addition of 0.1 critical micelle concentration of Saponin (4 mg/L). On the other hand, Brij 35 was demonstrated as the optimum surfactant which was most favorable for enhancing the bioavailability and biodegradability of BX when fungi were used as the working consortium. In contrast, Tween 20 had a negative effect on the biodegradation of both benzene and o-xylene at any dose. The observed retardation was related to the toxicity of this surfactant which was confirmed by the plate count analysis. The experimental data fit well with a pseudo first-order biodegradation kinetics model. It was observed that benzene and o-xylene were biodegraded faster at pH 7 than pH 4 and the addition of an optimum surfactant type increased the microbial growth rate and biodegradability of these two VOCs in the mixture

INSTABILITY OF UNBOUNDED TRANSVERSE MIXING LAYER IN SHALLOW WATERS

This paper examines the role of waves in the development of the instability of an unbounded transverse mixing layer in shallow waters. In supercritical state waves become significant. The matching of the wave-like asymptotic solution in the far field to the solutions near the inflection and the returning surfaces poses a difficult mathematical problem. We therefore conducted numerical simulations to find solutions directly from the shallow-water equations. The simulations found that the growing waves in the unstable current had a consistent structure throughout the linear stage of the instability's development. The excitation, reflection and transmission of waves produced a modulating instability that maintained a consistent structure as the amplitude of the instability increased over many orders of magnitude. This role of the waves on the supercritical instability, as delineated by our numerical simulations, is not solely describable by the classical analytical method.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