[Comparison of specificity and sensitivity of ultrasonography and computed tomography with endoscopic retrograde cholangio pancreatography in diagnosis of biliary tract stones]

Cholelithiasis have concomitant with biliary tract stones [BTS] in about 10-15% of the affected patients. This study was carried out to compare the specificity and the sensitivity of ultrasonography and computed tomography [CT scan] with the endoscopic retrograde cholangio pancreatography [ERCP] for detecting of the biliary tract stones and to evaluate the efficacy of the ERCP therapy. In this descriptive study, 135 patients suspected of BTS whom were candidate for the ERCP were gone under investigation. Ultrasonography of the gallbladder, liver, biliary tract, oral and IV contrast of abdominal CT scan and the ERCP were conducted for each patient. ERCP was considered as key critria to define BTS. The specificity and sensitivity of the ultrasonography and CT scan and the success rate of the therapeutic ERCP was estimated. BTS were observed in 112 patients by ERCP method. The specificity and sensitivity of the ultrasonography was 72.3% and 73.9%, respectively. The specificity and sensitivity of the CT scan was 50.8% and 91.3%, respectively. The success rate of the therapeutic ERCP was estimated as 76.9%. Ultrasonography as a non-invasive, non-expensive and well sensitivity method which is recommended in patient screening of biliary tract stones in compare to ERCP and CT scan

Prediction of landfill leachate amount using HELP model Case study: Semnan landfill

Owing to the non-seperated municipal solid wastes the leachate form in land fills contain high amounts of heavy metall and toxic substances Hence, leachate treatment is a serious problem. In order to design leachate treatment and collection systems, estimation of quality and quantity of leachate is of high necessity. Hydrologic Evaluation of Landfill Performance [HELP] Model was used to estimate leachate generation in th lined lanfill cells for a variety of conditions. The HELP program is a quasi-two-dimensional hydrologic model for conducting water balance analysis of landfills, cover systems, and other solid waste containment facilities. In this paper HELP program is used to predict leachate generating in Semnan landfill after its operational life. HELP model use weather, soil and design data to estimate leachate quantity. The meteorological data were obtained from semnan Atmospheric Data Centre. Soil mechanics examinations in the landfill area were applied to achieve soil data. In addition, design parameters were based on Semnan landfill design specifications. Semnan landfill capacity is designed so as to accommodate municipal solid wastes generated during the next 25 years. In this study result indicated that precipitation and evapotranspiration has the most influenced on leachate generation increase and decrease, respectively. 82% of annual precipitation isn't percolated into Semnan landfill due to evapotranspiration. HELP Model simulations were indicated that the maximum and average value of leachate height above barrier layer is 36 and 3mm, respectively. Semnan landfill is designed under minimum standard condition. Therefore, low height of leachate generated is due to area weather. The precipitation amount is low while the evapotranspiration amount is high in this area. High evapotranspiration is due to high temperature and solar radiation in Semnan landfill area. High evapotranspiration in the landfill cap caused 14.2% of the precipitation to infiltrate into the wastes and became leachate

[Primary intestinal lymphangiectasia]

Primary intestinal lymphangiectasia [PIL] is a rare disease of intestinal lymphatics presenting with hypoproteinemia, bilateral lower limb edema, ascites and protein-losing enteropathy. We report a case of PIL in a 22 year old patient from Tabriz, Iran who presented with anasarca edema, recurrent diarrhea, hypoproteinemia and confirmatory features of PIL on endoscopy and histopathology. Therefore we advise the consideration of PIL in the differential diagnosis of chylous ascitis

12-year experience with primary cardiac tumors

We report our experience with 117 patients with primary cardiac tumors who underwent surgery at our institute [a referral center] between March 1995 and February 2006.The patients comprised 47 men and 70 women with a mean age of 44.97 years [range: 2.5- 81 years]. The predominant symptom was dyspnea on exertion and palpitation. In all the patients, echocardiography was the main diagnostic tool, but magnetic resonance imaging [MRI] and CT scan and coronary angiography were also performed if indicated. Most of the tumors were found in the left atrium [LA] [77.77%], but the other chambers were also involved with lesser prevalence [right atrium: 7.5%, left ventricle: 5.1%, and right ventricle: 2.5%]. Involvement of multiple chambers was found in 8 [6.8%] patients.All the patients survived the surgical procedure and were discharged from hospital. Follow-up ranged from 1-10 years [mean: 2.4 years]. The most prevalent tumor was myxoma [104 cases], followed by sarcoma [4 cases] and fibroma [2 cases]. Four patients had secondary [metastatic] cardiac tumors [two Hodgkin lymphoma, one renal cell carcinoma, and one osteosarcoma] and were consequently excluded from the study

[CFD modeling of particulate matter dispersion from Kerman cement plant]

The dispersion of particulate matter has been known as the most serious environmental pollution of cement plants. In the present work, dispersion of the particulate matter from stack of Kerman Cement Plant was investigated using Computational Fluid Dynamics [CFD] modeling. In order to study the dispersion of particulate matter from the stack, a calculation domain with dimensions of 8000m X 800m X 400m was considered. The domain was divided to 936781 tetrahedral control volumes. The mixture two-phase model was employed to model the interaction of the particulate matter [dispersed phase] and air [continuous phase]. The Large Eddy Simulation [LES] method was used for turbulence modeling. The concentration of particulate matter in the whole calculation domain was computed. The predicted concentrations were compared to the measured values from the literature and a good agreement was observed. The predicted concentration profiles at different cross sections were analyzed. The results of the present work showed that CFD is a useful tool for understanding the dispersion of particulate matter in air. Although the obtained results were promising, more investigations on the properties of the dispersed phase, turbulent parameters and the boundary layer effect is needed to obtain more accurate results

[Use of analytical hierarchy process model [AHP] in landfill site selection of semnan town]

Landfill site selection is an important action in integrated solid waste management process. Difference criteria should be paid attention in site selection, so using of special methods are necessary to assimilate the criteria. In this research, GIS software and Analytical Hierarchy Process were used. First of all, maps were built in considering to economical, social and environmental factors, in next step, each layer, was graded. Low grade showed non coordination or less coordination and high grade showed more coordination. Assimilate of graded map in AHP process, separates area into unsuitable, suitable and very suitable parts. Very suitable parts can have high priority in decision making and also suitable parts can have high priority for development projects in future

Midterm results and surgical technique considerations in pulmonary Thromboendarterectomy. Is hypothermic circulatory arrest always necessary?

Pulmonary Thromboendarterectomy is a curative surgery. However, it is associated with high mortality and morbidity. It's accomplished under a period of circulatory arrest, thereby increasing the risk of surgical complications, especially neurologic squeal. In present study the surgical results of this procedure without the use of circulatory arrest has been presented. Eleven patients with the mean age of 34 +/- 11 year underwent pulmonary Thromboendarterectomy using CPB, moderate hyperthermia, and low pressure perfusion by single surgery from April 2005 to June 2008 in the Rajaee Heart Center, Tehran. Half the patients had the evidence of involvement of segmental branches of pulmonary artery in CT angiography. Most patients presented in the NYHB class III. The mean pre-op PA pressure was 91.3 +/- 26mmHg. All patients were followed between 3-36 months. There were three mortality cases in this study and the first two, were among the early experiences of the surgeon. The most common cause of mortality was respiratory failure and right-sided heart failure secondary to residual pulmonary hypertension., NYHA class improved in all survived. The mean post-op PA pressure was 39 +/- 13 mmHg. Patients were intubated on the average of 75 +/- 4 hours. No neurologic complications were seen. One patient required extracorporeal life support system [ECLS] to wean porn CPB off. Two patients had significant post-op bleeding due to coagulopathy and in the third one surgical source resulted in re-exploration. In this series, mortality was more than one expected however with increased experience and the use of meticulous surgical technics and improvement in peri-operative cares, mortality reduced significantly. Sufficient Thromboendarterectomy is feasible without the use of circulatory arrest, while decreasing probable complication of TCA, especially neurologic ones. Failure to ameliorate pulmonary hypertension during surgery, results, in high mortality and morbidity

[Neural network modeling and prediction of methane fraction in biogas from landfill bioreactors]

A number of different technologies have recently been studied to determine the best use of biogas, however, to choose optimize technologies of using biogas for energy recovery it is necessary to monitor and predict the methane percentage of biogas. In this study, a method is proposed for predicting the methane fraction in landfill gas originating from Labscale landfill bioreactors, based on neural network. In this study, two different systems were applied, to predict the methane fraction in landfill gas as a final product of anaerobic digestion, we used the leachate specifications as input parameters. In system I [C1], the leachate generated from a fresh-waste reactor was drained to recirculation tank, and recycled. In System II [C2], the leachate generated from a fresh waste landfill reactor was fed through a well-decomposed refuse landfill reactor, and at the same time, the leachate generated from a well-decomposed refuse landfill reactor recycled to a fresh waste landfill reactor. There is very good agreement in the trends between forecasted and measured data. R values are 0.999 and 0.997, and the obtained Root mean square error values are 1.098 and 2.387 for training and test data, respectively The proposed method can significantly predict the methane fraction in landfill gas originating and, consequently, neural network can be use to optimize the dimensions of a plant using biogas for energy [i.e. heat and/or electricity] recovery and monitoring system

multicenter study to evaluate the safety and efficacy of heberon [interferon alfa-2b] in combination with ribavirin for the treatment of chronic hepatitis C in Iran

interferon and ribavirin is the most effective treatment for chronic hepatitis C today. The aim of this study was to evaluate the efficacy and safety of thrice-weekly Heberon [interferon alfa-2b] in combination with ribavirin as first-line treatment of chronic hepatitis C.A total of 97 treatment-naive patients received Heberon three million units thrice-weekly subcutaneously in combination with ribavirin for 12 months. Serum HCV RNA levels were measured before and during therapy and 6 months after the end of therapy. End-of-treatment and sustained virological responses was defined as an undetectable HCV-RNA level at the end of treatment, and 6 months after treatment was completed [end of follow-up], respectively.In an intent-to-treat analysis, HCV-RNA was undetectable at the end of treatment in 49.5% of patients. At the end of follow-up, sustained virological response was 36.1%. Combination treatment was generally well tolerated. Six patients stopped therapy because of side effects: severe cytopenia [n=4], depression [n=1], and hyperthyroidism [n=1]. Common side effects of therapy include: Flu-like syndrome [85.6%], generalized alopecia [41.2%], injection site inflammation [37.1%], mood changes [36%], anorexia [34%] and weight loss [32%].Heberon as an IFN product in combination with ribavirin for treatment of patients with chronic hepatitis C is relatively safe, feasible, and potentially efficacious. It has comparable results in achieving end-of-treatment and sustained viro-logical responses in chronic hepatitis C