[Evaluation of the validity of two hemoglobinometry methods for measurement of hemoglobin levels in whole blood donors in Yazd, 2010-2011]

Hemoglobin screening methods before blood donation need to be not only simple, rapid and inexpensive but also sensitive for detection of both low and high hemoglobin levels to prevent false rejection of potential donors. The aim of this study was to evaluate the validity of two methods of hemoglobinometry in blood donors. In this cross sectional study, 198 blood donors were randomly selected. The hemoglobin levels of two blood samples taken by means of a single finger stick were determined by Hemocue 201+ and Hemocontrol and hemoglobin level of a venous blood sample was measured by Cobas hematology analyzer as standard method. Venous hemoglobin range of 12.5-17.9 g/dl was regarded as inclusion criteria for blood donation. The sensitivity, specificity and correlation between reference method and each of the hemoglobinometers were assessed. Data analysis was performed by means of correlation tests, regression analysis and paired t-test. Mean hemoglobin levels measured by Cobas, Hemocue and Hemocontrol were 15.9 +/-1.68, 16.28 +/-1.91 and 16.30 +/-196 g/dl, respectively. Hemoglobin levels measured by hemoglobinometers were higher than that measured by the standard reference. This difference was not significant in low hemoglobin levels, contrary to high hemoglobin levels. Each of the two methods showed significant correlation with standard method when hemoglobin levels were lower than normal limit. Increased hemoglobin levels led to decreased correlation coefficient which was not significant with hemoglobin levels higher than 18g/dl. Our study results showed that these heomoglobinometers were not valid for screening high hemoglobin levels in blood donors and a large number of potential donors would be falsely rejected. Further studies to find valid methods are recommended

Pulmonary langerhans cell histiocytosis presenting as simultaneous bilateral spontaneouse pneumothorax in a non-smoker patient

Pulmonary Langerhans Cell Histiocytosis [PLCH] is a rare idiopathic disorder that primarily affects young adult cigarette smokers. Affected patients often present with cough and dyspnea and about 20% of patients present with or later develop pneumothorax. It is striking that more than 90% of patients are smokers. We report a very unusual case of PLCH in a 20-year- old male patient with no smoking history in whom a life- threatening complication such as simultaneous bilateral pneumothorax was the presenting feature. The final diagnosis was made by open surgical biopsy and recurrent pneumothoraces necessitated surgical management with pleurodesis. We emphasize the early use of pleurodesis in managing patients with PLCH and spontaneous pneumothorax

[ effect of intravenous cefazolin on infectious complications following low- risk cesarean]

Cesarean section is one of the most common surgeries in modern obstetrics. Infectious complications such as fever, wound infection, endometritis and urinary tract infection are the most serious complications following cesarean. Nevertheless, there are no uniform recommendations regarding the application of prophylactic antibiotics. Since inappropriate application of antibiotics could impose high costs as well as drug side effects and emergence of resistant microorganisms, this study was carried out with the aim of evaluating the effect of prophylactic antibiotics on infectious complications following the low-risk cesarean section. This prospective, clinical trial study was performed on 257 patients who underwent low-risk cesarean section. The patients were randomly divided into treatment [A] and control [B] groups. The patients in group A received 2gr intravenous cefazolin at cord clamping, while the control group received no antibiotic. The patients were evaluated during the first 48 hours, the first week, the second week, and the sixth week following the surgery and infectious complications were compared in two groups. Out of 257 patients, 16 cases [6.2%] developed infectious complications of whom 6 patients [4.7%] were in group A and 10 patients [7.8%] fell into group B. Complications included fever [2.3% in each group], endometritis [0.8% in group A and 2.3% in group B], urinary infection [1.6% in group A and 3.1% in group B], wound infection [1.6% in group A and 2.3% in group B] and wound dehiscence [1.6% in each group]. No significant difference was observed between the administration of prophylactic antibiotic and the complications. Moreover, the duration of hospital stay following cesarean section was not statistically different in each group. Based on the study findings it can be recommended that prophylactic antibiotic be restricted only to the high-risk cesarean section individuals

Pulmonary metastases: results of surgical resection in 60 cases: treatment modalities other than surgery are needed

Pulmonary metastases occur in 30% of all oncology patients. Surgical resection of lung metastases is a widely accepted procedure but long-term results are disappointing with a 5-year survival rate of 20-40% and the results vary with the histologic type of the primary tumor. Due to unavailability of any study regarding pulmonary metastasectomy in Iran and emergence of new treatment modalities, reassessment of our current practices is essential. We performed a retrospective study of 60 cases of pulmonary metastasectomy during a 5-year period in one of the major thoracic surgery centers in Tehran [Imam Khomeini Hospital]. Bilateral metastases were present in 23% of cases, number of metastases in each patient ranged from 1-12. Average disease-free interval was 12 months, pneumonectomy rate was 21.7% mostly as a second or third attempt and finally, recurrence or death following initial metastasectomy occurred in 12-18 months in most patients. These results confirm that surgery remains unsuccessful in obtaining long-term survival or cure in most patients with pulmonary metastases and treatment strategies other than surgery, such as radiofrequency ablation are needed to avoid performing multiple operations in these patients and improving their quality of life

Strategies for utilizing alternative fuels by Iranian passenger cars

The current paper is an attempt to find a sustainable fuel strategy for passenger cars in Iran. Currently, most of Iran's passenger cars consume gasoline, a non-renewable fossil fuel. This fuel has well-known environmental impacts, including various kinds of pollutions, as well as the threat of quick running out. These general negative characteristics of gasoline are amplified by the high consumption rate of Iran's transportation sector, [e.g. about three times more than that of UK]. The objective of this paper is firstly selecting possible alternative fuels for Iran's transportation sector, and then proposing the percent of cars consuming these alternative fuels [along with gasoline]. The best strategies are proposed based on environmental and economic considerations, and hence are more sustainable decisions comparing with the other strategies. The best strategies are found using partial order theory and Hasse diagram technique, which is a multi-criteria decision analysis [MCDA] tool

Sustainable transport indicators: definition and integration

In this paper, a different interpretation of sustainable transportation, is introduced, in which sustainability with respect to transportation sector for the selected countries is evaluated. This interpretation characterizes 'sustainable development' through 'harmonic development'. It means sustainable development with special focus on transportation can be measured by the degree of conformity between environment, economy, and social aspects on one hand, and transportation on the other hand. The best indicator to perform such a measurement is elasticity. The database used for the study encompasses a series of national indicators for each country Seventy nine countries were initially selected for detailed analysis for the period of 1980 - 1995. The data have been extracted from centralized information sources of international agencies. The key dimensions of sustainable development i.e. social, environmental, and economic characteristics are used. Firstly, a set of sustainable transportation indicators is introduced. These indicators, which in fact are elasticities, show the relative change of non-transportation variables with respect to transportation ones. Second composite indices of three non-transportation groups with respect to four transportation modes are calculated. The composite indices are then aggregated by the Concordance Analysis Technique to achieve comprehensive transportation sustainability indices of countries, and according to these values, the countries are compared, ranked, and classified. Mathematical and statistical analyses of the database support the study quantitatively. The results for the selected indicators and countries show that from sustainable transportation point of view and based on the above-mentioned interpretation of sustainable development, United States is in the ranked first, and Sierra Leon is last among the subset of 79 countries with non-missing data. The results of the study depict an overall scheme for comparative assessment of transportation sustainability of the countries

Larvicidal activity of a neem tree extract [Neemarin] against mosquito larvae in the Islamic Republic of Iran

An insecticide containing azadirachtin, a neem tree [Azadirachta indica] extract, was tested against mosquito larvae in the Islamic Republic of Iran under laboratory and field conditions. LC50 and LC90 values for Neemarin were 0.35 and 1.81 mg/L for Anopheles stephensi, the main local malaria vector, and 0.69 and 3.18 mg/L for Culex quinquefasciatus. The mortality in the pupal stage was significantly higher than the other stages. In field trials, using recommended dosages of 1 and 2 L/hectare, mortality of Anopheles spp. larvae was also higher than Culex spp. Prevention of adult emerged and pupal mortality was the main activity of this compounds. The maximum time of efficacy was 7 days at the highest concentration [2 L/hectare]