Optic nerve sonography in the diagnostic evaluation of pseudopapilledema and raised intracranial pressure: A cross-sectional study

Introduction. Differentiating pseudopapilledema from papilledema which is optic disk edema and a result of increased ICP (intracranial pressure) is important and can be done with noninvasive methods like orbital ultrasound examination. Method. This was a cross-sectional study in which patients with optic nerve head swelling were referred for LP exam after optic nerve head swelling diagnosis confirmation and having normal brain imaging (CT scan). Before LP (lumbar puncture) exam the patients were referred for optic nerve ultrasound test of both eyes. Results. Considering 5.7 mm as the upper limit for normal ONSD (optic nerve sheath diameter), sensitivity and negative predictive value of optic sonography in diagnosis of pseudopapilledema are 100 for both eyes. Calculated accuracy validity of ONSD measurement in detecting pseudopapilledema is 90 for the right eye and 87 for the left eye. Conclusion. Our study demonstrated a close correlation between optic nerve sheath dilation on ocular ultrasound and evidence of elevated ICP with optic disk swelling. With the aid of noninvasive diagnostic tests we can avoid unnecessary concerns along with expensive and invasive neurological investigations while targeting the correct diagnosis in bilateral optic disk swelling. Our study showed optic nerve sonography as a reliable diagnostic method for further usage. © 2015 Masoud Mehrpour et al

Bioinformatics analysis of calcium-dependent protein kinase 4 (CDPK4) as Toxoplasma gondii vaccine target

Objectives Toxoplasma gondii (T. gondii), an obligate intracellular apicomplexan parasite, could affect numerous warm-blooded animals, such as humans. Calcium-dependent protein kinases (CDPKs) are essential Ca2+ signaling mediators and participate in parasite host cell egress, outer membrane motility, invasion, and cell division. Results Several bioinformatics online servers were employed to analyze and predict the important properties of CDPK4 protein. The findings revealed that CDPK4 peptide has 1158 amino acid residues with average molecular weight (MW) of 126.331 KDa. The aliphatic index and GRAVY for this protein were estimated at 66.82 and - 0.650, respectively. The findings revealed that the CDPK4 protein comprised 30.14 and 34.97 alpha-helix, 59.84 and 53.54 random coils, and 10.02 and 11.49 extended strand with SOPMA and GOR4 tools, respectively. Ramachandran plot output showed 87.87, 8.40, and 3.73 of amino acid residues in the favored, allowed, and outlier regions, respectively. Also, several potential B and T-cell epitopes were predicted for CDPK4 protein through different bioinformatics tools. Also, antigenicity and allergenicity evaluation demonstrated that this protein has immunogenic and non-allergenic nature. This paper presents a basis for further studies, thereby provides a fundamental basis for the development of an effective vaccine against T. gondii infection

Comparison of several improved versions of particle swarm optimizer algorithm for parameter estimation of squirrel-cage induction motors / Mohammad Yazdani-Asrami, Mehran Taghipour Gorjikolaie and S. Asghar Gholamian

In this paper, three versions of Particle Swarm Optimization (PSO) are proposed to estimate the equivalent circuit parameters of squirrel cage induction motor. It is believed that how inertia weight changes during iterations can impact on final results. Constricted coefficients, linear model and exponential version are used as inertia weight, each of them presents different variations for inertia weight and consequently for particle movements and speed of such movements. In the linear version, particles start searching process with high speed and their speed will decrease by constant ramp, this kind of variation let to search all solution space in a short time and local search at the final iterations with low speed, also exponential version presents same treatment as linear version with non-linear variations in inertia weight and speed of movement. But, mathematical analysis shows that they trap into local minima and scientists presents constricted version to solve this problem. In order to evaluate proposed versions additional to make changing in PSO’s version, sensitivity of proposed methods is analyzed using three sets of data. Results confirm the ability of proposed method which can estimate parameters with a possible least error

Developing a Questionnaire for Iranian Women's Attitude on Medical Ethics in Vaginal Childbirth

Background: Vaginal delivery is one of the challenging issues in medical ethics. It is important to use an appropriate instrument to assess medical ethics attitudes in normal delivery, but the lack of tool for this purpose is clear. Objectives: The aim of this study was to develop and validate a questionnaire for the assessment of women’s attitude on medical ethics application in normal vaginal delivery. Patients and Methods: This methodological study was carried out in Iran in 2013 - 2014. Medical ethics attitude in vaginal delivery questionnaire (MEAVDQ) was developed using the findings of a qualitative data obtained from a grounded theory research conducted on 20 women who had vaginal childbirth, in the first phase. Then, the validation criteria of this tool were tested by content and face validity in the second phase. Exploratory factor analysis was used for construct validity and reliability was also tested by Cronbach’s alpha coefficient in the third phase of this study. SPSS version 13 was used in this study. The sample size for construct validity was 250 females who had normal vaginal childbirth. Results: In the first phase of this study (tool development), by the use of four obtained categories and nine subcategories from grounded theory and literature review, three parts (98-items) of this tool were obtained (A, B and J). Part A explained the first principle of medical ethics, part B pointed to the second and third principles of medical ethics, and part J explained the fourth principle of medical ethics. After evaluating and confirming its face and content validity, 75 items remained in the questionnaire. In construct validity, by the employment of exploratory factor analysis, in parts A, B and J, 3, 7 and 3 factors were formed, respectively; and 62.8%, 64% and 51% of the total variances were explained by the obtained factors in parts A, B and J, respectively. The names of these factors in the three parts were achieved by consideration of the loading factor and medical ethics principles. The subscales of MEAVDQ showed significant reliability. In parts A, B and J, Cronbach’s alpha coefficients were 0.76, 0.72 and 0.68, respectively and for the total questionnaire, it was 0.72. The results of the test–retest were satisfactory for all the items (ICC = 0.60 - 0.95). Conclusions: The present study showed that the 59-item MEAVDQ was a valid and reliable questionnaire for the assessment of women’s attitudes toward medical ethics application in vaginal childbirth. This tool might assist specialists in making a judgment and plan appropriate for women in vaginal delivery management

The status of retinoblastoma gene expression in brain tumors

Objective: Malignant brain tumors, including Glioblastoma Multiforme (GBM), are among the deadliest brain tumors. Given the fact that the expression of the retinoblastoma (RB) gene in malignant tumors can change the tumor behavior, we seek to investigate the alterations of RB expression in brain tumors. Materials and Methods: The archives of the Pathology Department of Yazd Hospitals were examined, and all the brain tumors diagnosed between 2013 and 2017 were extracted. All paraffin embedded blocks underwent immunohistochemical staining for RB gene expression. Based on a pre-set checklist, demographics data, tumor type, location, and survival status were entered into and analyzed by SPSS version 25. p-value less than 0.05 was considered statistically significant. Results: Out of 90 blocks studied, 64.4% belonged to male patients and 35.5% to female patients. The frequencies of brain tumors subtypes were non-glioma (45.6%), low grade astrocytoma (14.4%), anaplastic astrocytoma (18.9%) and GBM (21.1%), respectively. The intensity of RB expression was significantly different between men and women (p-value=0.008), and in different subtypes of the tumors (p=0.04). Multivariate analysis revealed that GBM (HR: 9.933, 95% CI 1.888-52.254, p-value=0.007), age >50 (HR: 8.648, 95% CI 5.116-16.406, p-value= 0.0001), female sex (HR:2.139, 95% CI 1.212-3. 775, p-value= 0.09), RB negative tumors (HR:2.502, 95% CI 1.061-5.896, p-value= 0.036) significantly affect patient survival. Conclusions: There was a significant difference between men and women, and among different subtypes of the brain tumors in terms of RB gene expression. RB expression had a significant effect on patient survival independent from patient’s age, sex, and tumor subtypes

Juxta Cortical Tibia Metastatic Deposition in Gastric Cancer: A Case Report

We report a 41 years old man with rapidly growing and tender lump on the anteromedial surface of tibia. The patient had the history of gastrectomy and gastrojejunostomy due to gastric carcinoma. On admission, the Simple X-ray of lower extremity disclosed a slight thinning of the anterior cortex of tibia without cortical destruction. The whole-body bone scan with 99mTC MDP revealed activity of lesion in all 3 phases. The histopathological evaluation showed an infiltration of bone with tumor cells. Review No the literature revealed in previous cases of skeletal metastasis from gastric cancer in the tibia like this

Molecular Epidemiology of Cryptosporidiosis in Iranian Children, Tehran, Iran

Background: Cryptosporidium is a worldwide protozoan parasite and one of the most common causes of infection and diarrhea in humans and cattle. The aim of the present study was determina­tion of subtypes of Cryptosporidium among children with diarrhea in Tehran by se­quence analysis of the highly polymorphic 60-kDa glycoprotein (GP60) gene.Methods: Fecal samples were collected from 794 diarrheic children. Initial identification of Crypto­spo­ridium was carried out on stool samples by Ziehl-Neelsen acid-fast staining method. DNA was extracted from positive microscopically samples and Cryptosporidium genotypes and subtypes were determined, accordingly."nResults: Out of 794 collected samples, 19 (2.40 %) were positive for Cryptosporidium oocysts. Sequences analysis of GP60 gene showed that 17 (89.47 %) of the positive isolates were Crypto­spori­dium parvum and 2 (10.52 %) were C. hominis. All subtypes of C. parvum isolates belonged to allele families IIa (6/17) and IId (11/17). The most common allele in all 17 isolates belonged to IId A20G1a (41.18%). A22G1 (IF) subtype was detected in two C. hominis isolates of the chil­dren."nConclusion: The predominancy of C. parvum species (specially, IId A20G1a sub­type) in current study underlines the importance of zoonotic Cryptosporidium transmission in Iran

Tear Deformation Time and optical quality in eyes wearing silicone hydrogel contact lenses

Purpose To evaluate tear film stability and optical aberrations in eyes wearing plano Lotrafilcon B contact lenses (CL). Methods Tear Deformation Time (TDT) and aberrometric parameters were assessed in 86 normal emmetropic eyes before and 6 h after wearing CL. Result A statistically significant decrease in TDT and increase in root mean square (RMS) values of higher order aberrations (HOA) were revealed 6 h after CL insertion (both P < 0.001). The low order aberrations (LOA) RMS values measured with CL were higher than those in naked eyes, but the difference was not statistically significant. None of individual Zernike polynomials showed any significant alteration. Conclusion Our findings indicated that the Lotrafilcon B contact lens affects HOA more than LOA. The tear film was less stable after wearing CL. © 2016 Iranian Society of Ophthalmolog

Empowerment: Challenges in Measurement

Empowerment is core to health promotion however, there is a lack of consensus in the wider literature as to how to define it and at what level it may occur. Definitional inconsistency inevitably leads to challenges in measuring empowerment yet, if it is as important as is claimed this must be addressed. This paper discusses the complexities of measuring empowerment and puts forward a number of recommendations for researchers and policy makers as to how this can be achieved noting some of the tensions that may arise between theoretical considerations, research and practice. We argue that empowerment is a culturally and socially defined construct and that this should be taken into account in attempts to measure it. Finally we conclude that, in order to build up the evidence base for empowerment, there is a need for research clearly defining what it is and how it is being measured

Can the prophylactic quadrivalent HPV vaccine be used as a therapeutic agent in women with CIN? A randomized trial

Background: Human papillomavirus (HPV) is one of the most significant risk factors for cervical cancer. The HPV vaccine has a very significant impact on the incidence of cervical cancer. The present study aimed to investigate the impact of prophylactic quadrivalent HPV vaccine in the treatment of women with cervical intraepithelial neoplasia (CIN 1-3). Methods: This randomized controlled trial was conducted in the Shahid Sadoughi University of Medical Sciences (SSUMS), Yazd, Iran, from October 2011 to November 2015 in women with histologically confirmed residual/recurrent CIN 1 or high-grade CIN (CIN 2-3). Eligible women were assigned randomly to an intervention and a control group. Women in the intervention group were given HPV vaccinations while those in the control group were not. Participants were followed up for 24 months. Primary and secondary outcomes, and adverse effects of the treatment in the two groups were compared using Student's t test, the chi-square test, or Fisher's exact test. P values < 0.05 or less were considered statistically significant. Results: Three-hundred and twelve women were randomized to the two groups; the data of 138 in the intervention group and 104 in the control group were analyzed. The mean age of the women was 32.59 ± 4.85 years. Differences in age, marital status, and grades of CIN weren't significant between the two groups. At the end of the two-year follow-up period, the number of women with CIN 2-3 in the intervention and control groups was reduced by 75 (from 93 to 23) versus 40 (from 69 to 41). The efficacy of the HPV vaccine in women with CIN 1-3 was 58.7 (p = 0.018). No serious adverse effects related to the vaccines were reported. Conclusions: The prophylactic quadrivalent HPV vaccine after treatment may have a therapeutic effect in women with residual/recurrent CIN 1 or high-grade CIN (CIN 2-3). Trial registration: Iranian Registry of Clinical Trials, IRCT20190603043801N1. Registered 24 July 2019 - Retrospectively registered, http://www.irct.ir/user/trial/40017/view © 2020 The Author(s)