Microstructure Development and Phase Evolution of Alumina- mullite Nanocomposite

In this work, alumina-mullite composites (5-15 vol.%) were prepared using sol-gel derived alumina composite nanopowders. The results revealed the formation of intragranular and intergranular mullites inside and between the alumina grains, respectively. Accordingly, the intragranular mullites (average grain size, 0.3 ?m) were smaller than the intergranular mullites (average grain size, 0.5 ?m). Moreover, the alumina grains (average grain size, 1.0 ?m) are larger than the mullites. Meanwhile, the mullites showed positive results in the prevention of the alumina grains growth and the retardation of densification. The relative density of alumina-15 vol.% mullite that was sintered at 1650?C for 2 h, was obtained as 98.7 %. After sintering at 1750?C for 2 h, the mullite was decomposed

Optimizing cholecystectomy time in moderate acute biliary pancreatitis: A randomized clinical trial study

Background: In mild to moderate gallstone pancreatitis, cholecystectomy is the most appropriate treatment for prevention of further biliary attacks. However, the timing of cholecystectomy is not precisely determined. The present study was conducted to compare outcomes of very early (within 48 h) versus delayed (more than 1 week) laparoscopic cholecystectomy in patients with acute biliary pancreatitis (ABP). Methods: This randomized clinical trial study was conducted in Shahid Beheshti Hospital of Kashan University of Medical Sciences from September 2016 to Mar 2019. Two hundred and eight cases with mild to moderate ABP were randomly assigned to 2 groups, with 104 patients in group 1 (operation within 48 h) and 104 in group 2 (operation after one week). Age, sex, biochemical parameters, clinical manifestation at the time of admission, operation time, recurrent biliary problems, relapse, peri-operative complications, conversion rate, and hospital length of stay in the two groups were recorded and compared. In addition, Ranson's score and Revised Atlanta criteria, the American Society of Anaesthesiologists Physical Status ASA-PS, Charlson Co-Morbidity Index (CCI), complexity of surgery and Clavien-Dindo score were also determined. Results: There were no differences in demographics, peri-operative complications 4 (4) vs. 4 (4), P = 1), conversion rate (10.6 vs. 11.5; P = 0.825) and procedure time (83 vs. 81 minutes, P = 0.110) between the two groups. There were no deaths in either group; however, the length of hospital stay was shorter in the early group compared to the delayed one, (3.66 ± 1.12 vs. 10.35 ± 1.76, P < 0.001). Conclusion: Cholecystectomy within 48 h decreases significantly the length of hospital stay, without any difference in conversion rate, procedure time, or complication rate. © 2020 The Author(s) Biological sciences; Health sciences; Surgery; Internal medicine; Acute biliary pancreatitis; Laparoscopic cholecystectomy; Mild to moderate acute biliary pancreatitis. © 2020 The Author(s

The efficacy and safety of prokinetic agents in critically ill patients receiving enteral nutrition: a systematic review and meta-analysis of randomized trials.

BACKGROUND: Intolerance to enteral nutrition is common in critically ill adults, and may result in significant morbidity including ileus, abdominal distension, vomiting and potential aspiration events. Prokinetic agents are prescribed to improve gastric emptying. However, the efficacy and safety of these agents in critically ill patients is not well-defined. Therefore, we conducted a systematic review and meta-analysis to determine the efficacy and safety of prokinetic agents in critically ill patients. METHODS: We searched MEDLINE, EMBASE, and Cochrane Library from inception up to January 2016. Eligible studies included randomized controlled trials (RCTs) of critically ill adults assigned to receive a prokinetic agent or placebo, and that reported relevant clinical outcomes. Two independent reviewers screened potentially eligible articles, selected eligible studies, and abstracted pertinent data. We calculated pooled relative risk (RR) for dichotomous outcomes and mean difference for continuous outcomes, with the corresponding 95 % confidence interval (CI). We assessed risk of bias using Cochrane risk of bias tool, and the quality of evidence using grading of recommendations assessment, development, and evaluation (GRADE) methodology. RESULTS: Thirteen RCTs (enrolling 1341 patients) met our inclusion criteria. Prokinetic agents significantly reduced feeding intolerance (RR 0.73, 95 % CI 0.55, 0.97; P = 0.03; moderate certainty), which translated to 17.3 % (95 % CI 5, 26.8 %) absolute reduction in feeding intolerance. Prokinetics also reduced the risk of developing high gastric residual volumes (RR 0.69; 95 % CI 0.52, 0.91; P = 0.009; moderate quality) and increased the success of post-pyloric feeding tube placement (RR 1.60, 95 % CI 1.17, 2.21; P = 0.004; moderate quality). There was no significant improvement in the risk of vomiting, diarrhea, intensive care unit (ICU) length of stay or mortality. Prokinetic agents also did not significantly increase the rate of diarrhea. CONCLUSION: There is moderate-quality evidence that prokinetic agents reduce feeding intolerance in critically ill patients compared to placebo or no intervention. However, the impact on other clinical outcomes such as pneumonia, mortality, and ICU length of stay is unclear

Microstructure development and phase evolution of alumina-mullite nanocomposite

In this work, alumina-mullite composites (5-15 vol.%) were prepared using sol-gel derived alumina composite nanopowders. The results revealed the formation of intragranular and intergranular mullites inside and between the alumina grains, respectively. Accordingly, the intragranular mullites (average grain size, 0.3 μm) were smaller than the intergranular mullites (average grain size, 0.5 μm). Moreover, the alumina grains (average grain size, 1.0 μm) are larger than the mullites. Meanwhile, the mullites showed positive results in the prevention of the alumina grains growth and the retardation of densification. The relative density of alumina-15 vol.% mullite that was sintered at 1650°C for 2 h, was obtained as 98.7 %. After sintering at 1750°C for 2 h, the mullite was decomposed

Application and usage of tactile aid in Iran

Background: Most deaf and severe to profound sensorineural hearing loss patients are incapable to communicate well because of a lack of receiving sound signals. Cochlear implant is one of the effective measures, which has been of great help to the deaf. Up to now, more than 1000 cochlear implants have been accomplished successfully in Iran. Since cochlear implantation is faced with numerous problems and difficulties, we should establish other methods for sound communication. Tactile aids can be a very effective help regarding this issue. Methods: We designed and accomplished a study on the use of tactile aid, along with rehabilitation and training of these patients in our department. We designed four educational stages to check the improvement of subjects who used one-, two-, and seven-channel tactile aids. Results: Hundred percent of the cases passed the first stage (detection) successfully. In the second stage (beginning pattern perception) all the cases with two and seven channel tactile aids were able to distinguish all kinds of sounds. They could differentiate between speech and non-speech sounds. In the third stage (recognition of speech), all the cases were able to recognize environmental and "sound maker" sounds, but only 43 of the individuals were able to recognize speech sounds and repeat correctly with two-channel tactile aids. In the fourth stage (comprehension of words), identification and repetition of the words were only possible with seven-channel tactile aids. Conclusion: The results of our study show that tactile aids are well accepted by the patients with severe to profound sensorineural hearing loss who do not benefit from usual hearing aids

SYNTHESIS OF NANO SIZED MESOPOROUS γ - Al2O3POWDER FROM DOMESTIC HAMEDAN KAOLIN

A method for producing high surface area nano-sized mesoporous alumina from inexpensive Iranian kaolin as raw material is proposed. In this method, first, kaolin was purified for purifying Kaolin, High Grade Magnetic Separation and leaching with HCl and chemical bleaching treatment by using sodium dithionite (Na 2 S 2O4 ) as reducing agent in acidic media (H 2SO 4 ) were used. Purified kaolin was calcined. After that, Al (hydr) oxide from acid -leachates of calcined kaolin was precipitated with ammonia, in presence of polyethylene glycol. Finally, a white powder of nano-sized alumina particles was obtained after calcination. BET surface area, X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR) and scanning electron microscopy (SEM) were used to characterize the sample. The resulting alumina with relatively high surface area (201.53 m 2 g -1 ) and narrow mean pore diameter (6.91 nm), consists of a particle size distribution ranging from 22 to 36 nm