Effect of Low Intensity Cathodal Direct Current on Rate of Healing and Quality Of Life in Diabetic Patients with Ischemic Foot Ulcer

Introduction: Adjunctive treatment using electrical stimulation has recently been shown to promote healing in patients with diabetic foot ulcer. The aim of the present study was to evaluate whether low intensity cathodal direct current electrical stimulation improves healing rate of foot ulcers and health related quality of life in diabetic patients. Materials and methods: A total of 30 type 2 diabetic patients with ischemic foot ulcer were included in the present randomized, single-blind, placebo controlled trial. Participants were randomly assigned to receive either electrical stimulation therapy (direct current with low intensity, ES group, n=15) or sham treatment (placebo group, n=15) for 1 h/day, 3 days/week, for 4 weeks (12 sessions). Improvement ratio of wound and quality of life was evaluated at the 1st and 12th sessions. The quality of life was assessed using SF-36 questionnaire. Results: The mean of improvement ratio was significantly higher in the electrical stimulation group (59.4%) compared with that of the placebo group (27.07%) at the 12th session (P=0.02). Overall score of quality of life significantly increased in the electrical stimulation group as compared with that for the placebo group (0.01). Conclusion: By promotion of wound healing, applied low intensity cathodal direct current may increase the health-related quality of life in diabetic patients with ischemic foot ulcer.Key words: Diabetics, Ischemic foot ulcers, Low intensity direct current, Wound improvement rate, Quality of lif

Rzadki przypadek współwystępowania nadczynności przytarczyc i zespołu Turnera - opis przypadku

Przedstawiony przez autorów opis przypadku zawiera ocenę kliniczną, wyniki badań laboratoryjnych, radiologicznych, patomorfologicznych 37-letniej kobiety, u której początkowo rozpoznano osteomalację przebiegu zespołu Turnera i zastosowano suplementację wapnia i witaminy D. Ze względu na szybką progresję Ca we krwi rozszerzono diagnostykę, rozpoznając dodatkowo nadczynność przytarczyc spowodowaną gruczolakiem tego narządu.We present the clinical, laboratory, radiological and pathological findings in the case and review the literature. Our patient, a 37-year-old woman of short stature, was referred because of musculoskeletal pain. After primary evaluation, she underwent treatment with calcium and vitamin D supplement with the diagnosis of osteomalacia in Turner’s syndrome. The rise of serum calcium during medical therapy, which was an unusual finding, attracted the clinician’s attention to another underlying disorder. Further evaluation revealed primary hyperparathyroidism due to an adenoma of the parathyroid gland. Even though this is a rare diagnosis, its presence should be considered in any patient with Turner’s syndrome presenting with severe osteoporosis and a rise in serum calcium during treatment

Investigation of Mechanical Properties of Quicksand Stabilized with Bitumen Emulsion and Reinforced with Waste Polypropylene Fibers and The Effect of Freeze and Thaw on Its Performance

The existing quicksands in the desert are among the problematic soils whose stabilization has been considered by experts. Emulsion bitumen is one of the environmentally friendly stabilizers of these sands. Also, the method of reinforcement with (fibers) has many advantages due to the increase in soil strength in the same way and the formation of thickness in the soil mass. The aim of this study was to investigate the effect of polypropylene fibers and emulsion bitumen on improving sandy soil properties and the effect of freeze-thaw cycles on the behavior of soils stabilized by these two substances; For this purpose, samples of aeolian sand soil with 0%, 0.25%, 0.5%, 0.75% and 1% waste polypropylene fibers of 0, 5, 10, 15% bitumen emulsion were made and tested for California load-bearing capacity and uniaxial compressive strength. Also, to evaluate the effect of the freeze-thaw cycle, the samples were subjected to uniaxial resistance test after enduring 3 and 7 freeze-thaw cycles. The results show that the addition of fibers and bitumen to the sand first increases the specific gravity and CBR and decreases from one percent onwards by increasing the fibers of these two parameters; It has compressive strength and ultimate strain with increasing fiber percentage; In general, increasing the percentage of fibers from 0 to 1% on average increases the compressive strength by 91% and the final strain by 54% and increasing the percentage of bitumen from 5 to 15% on average increases the compressive strength by 4% and the final strain by 13%. In addition, the results show that the compressive strength of the samples decreases by an average of 15% and 19% after withstanding 3 and 7 freeze-thaw cycles, respectively; however, after enduring 3 and 7 freeze-thaw cycles, the compressive strength increases with increasing the percentage of fibers to 75%. &nbsp

Relationship of venous blood gas with cervical esophagogastric anastomotic leak

Objective: this study investigated the relationship between various parameters of venous blood gas analysis of gastric fundus veins and cervical esophagogastric anastomotic leaks after transhiatal esophagectomy. Background: decreased tissue perfusion is one of the causes of anastomotic leak. There are various methods used to assess gastric conduit perfusion, with different results, and we lack a reliable method. Method: this descriptive study, performed from March 2008 to October 2010, consisted of 45 patients with esophageal cancer who underwent transhiatal esophagectomy. After gastrolysis, blood samples were taken from a gastric fundus vein and submitted for venous blood gas analysis. The cervical wounds were examined 5 days postoperatively. The patients were divided into 2 groups based on the presence of leakage, and mean values of the venous blood gas analysis were compared. Results: we observed significant differences in mean pH, PCO2, and O2 saturation between the 2 groups (p = 0.04, p = 0.03, and p = 0.04, respectively). Conclusion: venous blood gas analysis of gastric fundus veins appears to be a feasible and fast method for intraoperative assessment of microperfusion in the gastric fundus. © The Author(s) 2012

Pituitary Macroprolactinoma with Mildly Elevated Serum Prolactin: Hook Effect

A 45-year-old man was admitted in our department with complaints of severe headache for over 6 months period. He also suffered from several problems such as visual field defect, decreased energy and libido, body hair loss, cold intolerance, decreased appetite and dry skin. On physical examination, he was afebrile: BP (blood pressure): 110/70 mm/Hg, PR (pulse rate) :65 beat/min, BMI (body mass index): 24. He had no terminal hair on face or chest and subcutaneous adipose tissue mass had been decreased substantially. Laboratory tests revealed; Hb: 12 g/dL (N: 14–17 g/dL), Total testosterone: 1.2 ng/mL (N:–-10 ng/mL), Luteinizing hormone (LH):3.3MIU/mL (N:1–8 MIU/mL), Follicle Stimulating hormone (FSH):1.3 MIU/mL (N:1–7 MIU/mL), T4:3.4 micg/dL (N:4–12 micg/dL), TSH:0.6 MIU/mL (N:0.5–5 MIU/mL), Prolactin:100 ng/mL (2–24 ng/mL), serum cortisol:6 MIU/mL (N:4–21 MIU/mL), IGF1:162 ng/mL (50–245). Pituitary MRI showed macroadenoma (29*16*14 mm) in left side of sella turcica which bulged to suprasellar cistern with pressure effect on left optic nerve (Figure 1, 2). Visual field examination revealed mild temporal hemianopia. These findings are consistent with macroadenoma and mild prolactin elevation. We also observed a discrepancy between pituitary tumor size and prolactin level. The correct estimate of serum prolactin was obtained after serial dilutional measurement. Serum prolactin after dilution was 6470 ng/mL. With these findings pituitary macroadenoma was diagnosed and treatment with cabergoline (dopamine agonist) 0.5 mg/week was started. After one month follow-up he had no symptoms, visual field defect was improved and pituitary MRI showed significant shrinkage of tumor

Pituitary Macroprolactinoma with Mildly Elevated Serum Prolactin: Hook Effect

A 45-year-old man was admitted in our department with complaints of severe headache for over 6 months period. He also suffered from several problems such as visual field defect, decreased energy and libido, body hair loss, cold intolerance, decreased appetite and dry skin. On physical examination, he was afebrile: BP (blood pressure): 110/70 mm/Hg, PR (pulse rate) :65 beat/min, BMI (body mass index): 24. He had no terminal hair on face or chest and subcutaneous adipose tissue mass had been decreased substantially. Laboratory tests revealed; Hb: 12 g/dL (N: 14–17 g/dL), Total testosterone: 1.2 ng/mL (N:–-10 ng/mL), Luteinizing hormone (LH):3.3MIU/mL (N:1–8 MIU/mL), Follicle Stimulating hormone (FSH):1.3 MIU/mL (N:1–7 MIU/mL), T4:3.4 micg/dL (N:4–12 micg/dL), TSH:0.6 MIU/mL (N:0.5–5 MIU/mL), Prolactin:100 ng/mL (2–24 ng/mL), serum cortisol:6 MIU/mL (N:4–21 MIU/mL), IGF1:162 ng/mL (50–245). Pituitary MRI showed macroadenoma (29*16*14 mm) in left side of sella turcica which bulged to suprasellar cistern with pressure effect on left optic nerve (Figure 1, 2). Visual field examination revealed mild temporal hemianopia. These findings are consistent with macroadenoma and mild prolactin elevation. We also observed a discrepancy between pituitary tumor size and prolactin level. The correct estimate of serum prolactin was obtained after serial dilutional measurement. Serum prolactin after dilution was 6470 ng/mL. With these findings pituitary macroadenoma was diagnosed and treatment with cabergoline (dopamine agonist) 0.5 mg/week was started. After one month follow-up he had no symptoms, visual field defect was improved and pituitary MRI showed significant shrinkage of tumor

A fully distributed revocable ciphertext-policy hierarchical attribute-based encryption without pairing

Several appealing features of cloud computing such as cost-effectiveness and user-friendliness have made many users and enterprises interested to outsource their sensitive data for sharing via cloud. However, it causes many new challenges toward data confidentiality, access control , scalability, and flexibility. Ciphertext-policy Hierarchical attribute-based encryption (CP-HABE) can be a promising solution to the mentioned problems. But, the existing HABE schemes have several limitations in their key delegation and user revocation mechanisms. In this work, to solve these problems, we introduce the concept of \textit{fully distributed revocable } CP-HABE (FDR-CP-HABE) system and propose the first FDR-CP-HABE scheme. The proposed scheme provides a high level of flexibility and scalability in the key delegation and user revocation mechanisms. Moreover, our proposed system is pairing-free and realizes lightweight computing in decryption phase. Indeed, by exploiting the computational operation outsourcing technique, most of the operations have been done by the powerful cloud service provider and very few computations have been leaved to the data user. Also, in our scheme the storage cost on the data user side has been decreased, compared to the other similar works. Moreover, using the hardness assumption of Decisional Bilinear Diffie-Hellman (DBDH) problem, we show that the proposed scheme is adaptively semantically secure in the standard model

Giant prolactinoma: case report and review of literature

“Invasive giant prolactinoma” is a large prolactinoma (>4 cm in dimension) presenting with serum prolactin levels of >1000 ng/dL and mass related clinical symptoms. Here we report a patient with a giant prolactinoma presented with central hypogonadism, suppressed adrenal and thyroid function, supra sellar extension, visual field impairment and high prolactin level. The patient was treated with cabergoline, levothyroxin and prednisolone. After 18 months, tumor size markedly reduced, associated with adrenal function and visual field improvement, but central hypogonadism and secondary hypothyroidism persisted. Previous studies showed normalization of thyrotropin secretion after treatment but it remained low in our patient even after 18 months follow up