Antibiotic Treatment in End Stage Cancer Patients; Advantages and Disadvantages.

Aim: In this study our aim was to elucidate whether advanced cancer patients benefit from antibiotic treatment in the last days of life in addition to reviewing the relevant costs and effects. Materials And Methods: We reviewed medical records from 100 end-stage cancer patients and their antibiotic use during the hospitalization in Imam Khomeini hospital. Patient's medical records were analyzed retrospectively for cause and periodicity of infections, fever, increase in acute phase proteins, cultures, type and cost of antibiotic. Results: Microorganisms were found in only 29 patients (29%) and the most microorganism among the patients was E. coli (6%). About 78% of the patients had clinical symptoms. The highest dose of antibiotics was related to Ceftriaxone (40.2%) and in the second place was Metronidazole (34.7%) and the lowest dose was related to Levofloxacin, Gentamycin and Colistin (1.4%). Fifty-one patients (71%) did not have any side effects due to antibiotics. The most common side effect of antibiotics among patients was skin rash (12.5%). The average estimated cost for antibiotic use was 7 935 540 Rials (24.4 dollars). Conclusion: Prescription of antibiotics was not effective in symptom control in advanced cancer patients. The cost of using antibiotics during hospitalization is very high and also the risk of developing resistant pathogens during admission should be considered. Antibiotic side effects also occur in patients, causing more harm to the patient at the end of life. Therefore, the benefits of antibiotic advice in this time is less than its negative effects.

Another step toward final call on Remdesivir efficacy as a treatment for hospitalized COVID-19 patients: a multicenter open-label trial

IntroductionAfter emerging the global pandemic of SARS-CoV2 some preliminary studies demonstrated the efficacy of antiviral treatments. But shortly thereafter, inconsistencies in the results of further clinical trials raised doubts on the efficacy of these agents. In this study, we aimed to evaluate the effect of Remdesivir on hospitalized COVID-19 patients outcomes. Material and methodsThis study was an open-label, single-armed, clinical trial on hospitalized patients diagnosed with COVID-19 who had progressive respiratory symptoms despite receiving standard care. All patients received Remdesivir and their characteristics, outcomes, time of treatment initiation, and respiratory support stages during hospitalization were registered and followed up for 14 days. Results145 patients with the mean age of 52.89 {+/-} 1.12 years enrolled in this study, 38 (26.2%) died at the end of 14 days period. The mean time interval from the onset of the symptoms to antiviral treatment was 10.63{+/-}0.56 days. Thirty deceased patients (78.9%) were men, showing 2.8 times higher mortality chance compared to women (ORadj=2.77; 95%CI=1.08-7.09). The type of respiratory support on the first day of treatment initiation showed a significantly lower mortality chance in patients receiving O2 only than those who needed non-invasive and/or mechanical ventilation (ORadj=3.91; 95%CI=1.64-9.32). The start time (early vs late administration) and duration (less or more than 7 days) of antiviral treatment had no statistically significant association with mortality or ventilation escalation among the patients (p-value > 0.05). ConclusionIn this study, we showed that Remdesivir probably is not effective on the outcome of hospitalized COVID-19 patients.

Simulation, fabrication, and characterization of a tunable electrowetting-based lens with a wedge-shaped PDMS dielectric layer.

Microlenses with tunable focal length have wide applications in optofluidic devices. This work presents a numerical and experimental investigation on a tunable electrowetting-based concave lens. Optical properties such as focal length of the lens and visibility of images were investigated numerically and experimentally. A finite element analysis and a ZEMAX simulation were used for determination of surface profile and focal length of the lens. The results show that the theoretical surface profile and focal length of the lens are in good agreement with the experimental ones. The lens has a wide tuning focal length equal to 6.5 (cm). Because the polydimethylsiloxane (PDMS) layer is wedge shaped (as both the dielectric and hydrophobic layers), lower applied voltage is needed. A commercial program was used to find the focal length of the lens from maximum visibility value by tuning the applied voltage.

Real-time measurement of flow rate in microfluidic devices using a cantilever-based optofluidic sensor.

Real-time and accurate measurement of flow rate is an important reqirement in lab on a chip (LOC) and micro total analysis system (µTAS) applications. In this paper, we present an experimental and numerical investigation of a cantilever-based optofluidic flow sensor for this purpose. Two sensors with thin and thick cantilevers were fabricated by engraving a 2D pattern of cantilever/base on two polymethylmethacrylate (PMMA) slabs using a CO2 laser system and then casting a 2D pattern with polydimethylsiloxane (PDMS). The basic working principle of the sensor is the fringe shift of the Fabry-Pérot (FP) spectrum due to a changing flow rate. A Finite Element Method (FEM) is used to solve the three dimensional (3D) Navier-Stokes and structural deformation equations to simulate the pressure distribution, velocity and cantilever deflection results of the flow in the channel. The experimental results show that the thin and thick cantilevers have a minimum detectable flow change of 1.3 and 4 (µL min(-1)) respectively. In addition, a comparison of the numerical and experimental deflection of the cantilever has been done to obtain the effective Young's modulus of the thin and thick PDMS cantilevers.

Measurement and control of pressure driven flows in microfluidic devices using an optofluidic flow sensor.

Measurement and control of pressure-driven flow (PDF) has a great potential to enhance the performance of chemical and biological experiments in Lab on a Chip technology. In this paper, we present an optofluidic flow sensor for real-time measurement and control of PDF. The optofluidic flow sensor consists of an on-chip micro Venturi and two optical Fabry-Pérot (FP) interferometers. Flow rate was measured from the fringe shift of FP interferometers resulted from movement fluid in the on-chip micro Venturi. The experimental results show that the optofluidic flow sensor has a minimum detectable flow change of 5 nl/min that is suitable for real time monitoring and control of fluids in many chemical and biological experiments. A Finite Element Method is used to solve the three dimensional (3D) Navier-Stokes and continuity equations to validate the experimental results.

Infantile masturbation and paroxysmal disorders.

A recurrent paroxysmal presentation in children leads to different diagnoses and among them are neurologic and cardiac etiologies. Infantile masturbation is not a well known entity and cannot be differentiated easily from other disorders. Aim of this study is to elucidate and differentiate this condition from epileptic seizures. We report 3 cases of 10 to 30 mth old girls of infantile masturbation that their symptoms initiated at 2, 3 and 8 mth of age. These present with contraction and extension of lower extremities, scissoring of legs, perspiration, changing face color. In 2 cases body rocking and legs rubbing initiated then there after. Masturbation is one of the paroxysmal non-epileptic conditions of early infancy and is in differential diagnosis of epileptic seizures.