Investigation of direct contact membrane distillation (DCMD) performance using CFD and machine learning approaches.

Direct Contact Membrane Distillation (DCMD) is emerging as an effective method for water desalination, known for its efficiency and adaptability. This study delves into the performance of DCMD by integrating two powerful analytical tools: Computational Fluid Dynamics (CFD) and Artificial Neural Networks (ANN). The research thoroughly examines the impact of various factors, such as inlet temperatures, velocities, channel heights, salt concentration, and membrane characteristics, on the process's efficiency, specifically calculating the water vapor flux. A rigorous validation of the CFD model aligns well with established studies, ensuring reliability. Subsequently, over 1000 data points reflecting variations in input factors are utilized to train and validate the ANN. The training phase demonstrated high accuracy, with near-zero mean squared errors and R2 values close to one, indicating a strong predictive capability. Further analysis post-ANN training shed light on key relationships: higher membrane porosity boosts water vapor flux, whereas thicker membranes reduce it. Additionally, it was detailed how salt concentration, channel dimensions, inlet temperatures, and velocities significantly influence the distillation process. Finally, a mathematical model was proposed for water vapor flux as a function of key input factors. The results highlighted that salt mole fraction and hot water inlet temperature have the most effect on the water vapor flux. This comprehensive investigation contributes to the understanding of DCMD and emphasizes the potential of combining CFD and ANN for optimizing and innovating water desalination technology.

Cowpea seeds from plants subjected to restricted-and full-irrigation regimes show differential phytochemical activity.

BACKGROUND: Water scarcity is responsible for losses in the yield of many plants and this is expected to continue due to climate change. However, cowpea which is known for its drought tolerance, is considered as a plant without limitations to climate change. A two-year experiment was conducted to evaluate the effect of water restriction on phenolic compounds, antioxidant capacity and leaf nutrients concentration of four cultivars of cowpea at different growth stages. At second leaf stage, two irrigation regimes were initiated (Water irrigation was applied after 75% and 55% of field capacity, as well watered and drought stress treatment, respectively).Plants samples were collectedat three stages(immature pod, immature seed and dry seed stage) for total phenol and flavonoids content, ortho-diphenols andantioxidant capacity measurement and leaves sampling for nutrients concentration. RESULTS: The results indicated that polyphenolic compounds and antioxidant capacity increased under drought conditions. However, in both irrigation regimes, immature pods had the higher polyphenolic compounds, antioxidant capacity and leaf nutrients concentration rather than immature seeds and dry seeds. Among the genotypes, ILC482 revealed the highest content of total phenolics and ortho-diphenols (6.9 and 3.57 mg GA g-1dry weight, respectively). In addition, nitrogen, phosphorus and magnesium concentration of leaves were higher in ILC482 genotype. Under drought stress, ILC482 maintained higher ABTS radical scavenging capacity (0.0083 mmol Trolox g-1dry weight) compared to other genotypes. CONCLUSIONS: It is suggested that drought stress affect the quality of cowpea productions through polyphenolic compounds, ABTS and DPPH radical scavenging capacity which can be used as a helpful strategy to save water in the regions where water is scare.

Comparison of the Relationship Between SI and RASI Scores With the Outcome of Sepsis Patients.

The aim of this study was to compare the relationship between shock index (SI) and respiratory adjusted shock index (RASI) scores with the final outcome of sepsis patients referred to the emergency department. This was prospective research that examined individuals who had been diagnosed with sepsis, determined by the presence of at least two of the three quick sepsis-related organ failure assessment (qSOFA) criteria and the presence of an infectious disease based on a diagnosis made by a hospital physician of Imam Reza and Ghaemshahr of Mashhad in 2019. Demographic information of patients, SI score, RASI score, and information related to the patient's clinical symptoms were recorded in the checklist. The final outcome of this study was considered mortality. Data analysis was performed using descriptive and inferential tests. In the present study, a total of 178 patients, 46 patients (25.8%) were transferred to the intensive care unit, and 98 patients (55.1%) were admitted to the normal wards. Eighty-five patients (47.75%) died and the mean length of hospital stay of all patients was 11.07 ± 9.23 days. Forty-four patients (24.7%) had referred with a decreased level of consciousness and 44 patients (24.7%) presented with confusion. The rest of the patients reported normal levels of consciousness. Kaplan Mir analysis with log-rank was performed to determine the difference in survival distribution in different SI groups: Survival distribution was not statistically different for the four defined groups (based on statistical quartiles (P = 0.320). Receiver operator curves were considered as the date of death in the case of the deceased and the date of discharge from the hospital in the case of the living as censored. The AUC of the RASI scoring system for predicting mortality was 0.614 (P = 0.009) while this value was not significant for SI (P = 0.152). In logistic regression analysis, it was found that by adjusting for the variables of age, sex, sepsis etiology, blood pressure and heart rate, level of consciousness, and gender, patients with the lower respiratory rate (OR 1.6, z = -0.159 p = 0.007), younger age (OR 1.6, z = -0.029 p = 0.006) and higher RASI score are more in risk of mortality (OR 1.29, z = 1.209, p = 0.031). The results of our study showed that RASI scoring can be a good criterion for predicting the chance of mortality in patients with sepsis and could be used complementary to previous criteria such as SI. Patients with high RASI scores should be given more attention to reducing the chance of death.

Quantified density of performance-degrading near-interface traps in SiC MOSFETs.

Characterization of near-interface traps (NITs) in commercial SiC metal-oxide-semiconductor field-effect transistors (MOSFETs) is essential because they adversely impact both performance and reliability by reducing the channel carrier mobility and causing threshold-voltage drift. In this work, we have applied a newly developed integrated-charge technique to measure the density of NITs that are active in the above-threshold region of commercial SiC MOSFETs. The results demonstrate that NITs trap about 10% of the channel electrons for longer than 500 ns.

Risk Stratification of Pulmonary Thromboembolism using Brain Natriuretic Peptide and Troponin I; a Brief Report.

INTRODUCTION: Pulmonary thromboembolism (PTE) is one of the most prevalent medical disorders, with a notable annual fatality rate. This study aimed to evaluated the accuracy of serum pro-BNP and troponin I levels in PTE diagnosis. METHODS: This cross-sectional study was implemented on 267 patients with suspected PTE (sudden chest pain or sudden dyspnea) in Imam Reza Hospital in Mashhad, Iran. All patients underwent pulmonary computed tomography (CT) angiography (as the gold standard test) and their serum levels of troponin I and pro-BNP were measured. The screening performance characteristics of pro-BNP in detection of PTE cases were measured and reported using receiver operating characteristic (ROC) curve analysis. RESULTS: Two-hundred-sixty-seven patients with a mean age of 67.7 ±11.5 years were evaluated (60.1% male). PTE was confirmed via CT angiography in 121 patients. The area under the ROC curve of troponin I and pro-BNP in detection of PTE was 0.501 ng/mL and 0.972 pg/mL, respectively. The sensitivity and specificity of proBNP at the best cut-off point (100 pg/ml) were 85.4% and 80.2%, respectively. The sensitivity and specificity of troponin I at the best cut-off point (0.005 ng/ml) were 65.5% and 42%, respectively. CONCLUSION: Due to the comparatively good sensitivity and specificity of proBNP in diagnosis of pulmonary thromboembolism, it can be employed as a diagnostic determinant in patients with suspected pulmonary thromboembolism along with other laboratory tests.

Histomorphic Analysis of UV-C Radiation on Osseointegration of Titanium Implants in the Rabbits.

Statement of the Problem: Unsuccessful implant integration leads to pain and implant mobility. Implant photo-functionalization by ultraviolet (UV) light has been suggested as a method that may stimulate osseointegration. Purpose: This study was conducted to analyze the histopathological feature of the titanium implant surface upon treatment with UV-C wave. Materials and Method: In this interventional study, twenty rabbits were enrolled. In the treatment groups, the titanium implants, irradiated earlier with UV-C for four hours laterally, were inserted in one of the femur bones. In the control group, the titanium implants without irradiation were inserted in the other femur bone of the rabbits. After two and four weeks, the animals were sacrificed, and then the samples were histologically and histo-morphometrically analyzed. In addition, the amounts of new bone formation, bleeding, and inflammation were recorded, and the data were subjected to statistical analysis. Results: The results confirmed that UV-C irradiation to titanium implants significantly improved new bone formation (p< 0.001). However, no significant new bone formation was observed between two and four weeks after implant insertion (p< 0.098). Conclusion: The study results showed that irradiating titanium implants with UV-C for four hours significantly improves osseointegration and new bone formation but does not considerably affect inflammation or bleeding around the implant. The study suggests that UV-C radiation can increase the success rate of implant treatment.

Tramadol Treatment Induces Change in Phospho-Cyclic Adenosine Monophosphate Response Element-Binding Protein and Delta and Mu Opioid Receptors within Hippocampus and Amygdala Areas of Rat Brain.

BACKGROUND: Tramadol induces its unique effects through opioid pathways, but the exact mechanism is not known. The study aims to evaluate changes in the level of mu-opioid receptor (µOR), delta-opioid receptor (δOR), and phosphorylated cyclic adenosine monophosphate (cAMP) response element-binding protein (p-CREB) in the hippocampus (HPC) and amygdala (AL) areas of tramadol-treated rats. METHODS: For this purpose, a total of 36 male rats were divided into two main groups for chronic or acute tramadol exposure. The animals were then exposed to 5 mg.kg-1 of tramadol, 10 mg.kg-1 of tramadol, and normal saline. The HPC and AL areas of the animals were dissected upon completion of the period. The levels of p-CREB and µOR were quantified using the western blotting technique. The data were subjected to analysis of variance (ANOVA) followed by Tukey's post-hoc analysis. The differences with the P-value lower than 0.05 were considered as significant. FINDINGS: In the HPC and AL areas of the brain, the level of µOR was decreased by acute tramadol exposure, while no significant difference was observed by chronic tramadol exposure. Moreover, results showed that the level of p-CREB dose-dependently increased by acute and chronic tramadol exposure. CONCLUSION: HPC and AL are essential in the control of tramadol abuse. Tramadol abuse affects gene expression and transcription factors such as CREB. With acute drug tramadol treatments, the level of cAMP response element-binding protein (CREB) rapidly increases, while by chronic tramadol treatment, "peak and trough pattern is observing". The activation of the rewarding mechanism is a precise instance of addictive behavior in tramadol-treated individuals.

Therapeutic potential of stem cells for treatment of neurodegenerative diseases.

Neurodegenerative diseases are caused by a loss of neurons within the peripheral or central nervous system. Inadequate repairability in the central nervous system and failure of treatments are the significant hurdles for several neurological diseases. The regenerative potential of stem cells drew the attention of researchers to cell-based therapy for treating neurodegenerative diseases. The clinical application of stem cells may help to substitute new cells and overcome the inability of the endogenous repairing system to repair the damaged brain. However, the clinical application induced pluripotent stem cells are restricted due to the risk of tumor formation by residual undifferentiated upon transplantation. In this focused review, we briefly discussed different stem cells currently being studied for therapeutic development. Moreover, we present supporting evidence for the utilization of stem cell therapy for the treatment of neurodegenerative diseases. Also, we described the key issues that should be considered to transplantation of stem cells for different neurodegenerative diseases. In our conclusion, stem cell therapy probably would be the only treatment strategy that offers a cure for neurodegenerative disease. Although, further study is required to identify ideal stem cells candidate, dosing and the ideal method of cell transplantation. We suggest that all grafted cells would be transgenically armed with a molecular kill-switch that could be activated by the event of adverse side effects.

Transgenerational influence of parental morphine exposure on pain perception, anxiety-like behavior and passive avoidance memory among male and female offspring of Wistar rats.

Accumulating evidence suggests that epigenetic mechanisms play an important role in the formation and maintenance of memory within the brain. Moreover, the effect of parental drug-exposure before gestation on behavioral state of offspring has been little studied. The main objective of the current study is to evaluate the effect of parental morphine exposure on avoidance memory, morphine preference and anxiety-like behavior of offspring. The total of 32 males and 32 females were used for mating. The animals were treated with morphine. The offspring according to their parental morphine treatment was divided into four groups (n=16) including paternally treated, maternally treated, both of parents treated and naïve animals. The pain perception, anxiety-like behavior, and avoidance memory were evaluated in the offspring. In the current study, the total of 256 offspring was used for the experiments (4 tasks × 4 groups of offspring × 8 female offspring × 8 male offspring). The finding revealed that the avoidance memory and visceral pain were reduced significantly in male and female offspring with at least one morphine-treated parent. Moreover, anxiety-like behavior was reduced significantly in the male offspring with at least one morphine-treated parent. While anxiety-like behavior was increased significantly in female offspring that were treated by morphine either maternally or both of parents. The data revealed that the endogenous opioid system may be altered in the offspring of morphine-treated parent(s), and epigenetic role could be important. However, analysis of variance signified the important role of maternal inheritance.

Combination of intravitreal bevacizumab and erythropoietin versus intravitreal bevacizumab alone for refractory diabetic macular edema: a randomized double-blind clinical trial.

PURPOSE: To evaluate the effect of three intravitreal bevacizumab (IVB) injections alone or in combination with intravitreal erythropoietin (EPO) in the treatment of refractory diabetic macular edema (DME). METHODS: In a randomized double-blind clinical trial, 48 eyes of 34 diabetic patients with refractory DME were enrolled. Eyes were randomly assigned to receive either 3 monthly injections of 0.05 cc (1.25 mg) IVB plus 0.05 cc (1000 unit) EPO or 0.05 cc (1.25 mg) IVB alone. Main outcome was best-corrected visual acuity (BCVA) changes and secondary outcome was central macular thickness (CMT). The patients were followed for 6 months. RESULTS: Mean BCVA changes up to 4 and 6 months were insignificant in both groups. It changed from 0.72 ± 0.56 logMAR at baseline to 0.74 ± 0.5 (P = 0.85) and 0.71 ± 0.44 (P = 0.40) in the combination group and from 0.48 ± 0.39 logMAR to 0.47 ± 0.35 (P = 0.48) and 0.52 ± 0.33 (P = 0.69) in the IVB alone group, at 4 and 6 months, respectively. The difference of mean BCVA changes between the groups was insignificant at both 4 and 6 months (P = 0.07 and P = 0.36, respectively). Within the group changes of mean CMT were significant only in the combination group at 4 and 6 months, from 518 ± 134 µ at baseline to 472 ± 151 to 475 ± 167 µ, respectively (P = 0.01 and P = 0.05). Corresponding changes were not significant in the IVB alone group. However, the difference between the groups was not significant at all visits (P = 0.51 and P = 0.71, respectively). CONCLUSIONS: This clinical trial demonstrated that intravitreal erythropoietin had no additional effect to IVB in the treatment of refractory DME in the short term. TRIAL REGISTRATION: Clinical trials.gov identifier: NCT03821168.

Investigating the Manifestation of Coronary Artery Disease and Determining the Role of Effective Factors in the Need for Pacemaker Insertion in These Patients.

BACKGROUND: Many patients who are candidates for a pacemaker are also at the same time risk factors for coronary artery disease such as high blood pressure, hypertension, diabetes, and hyperlipidemia, and therefore the probability of having coronary artery disease is significant. Effective diagnostic measures can be taken to prove the factors affecting the incidence of CAD in patients undergoing pacemakers at high-risk, including angiography. Therefore, it can prevent complications during and after pacemaker implantation, which leads to an increase in the quality of treatment in patients requiring pacemaker implantation. AIM: Therefore, the purpose of this study was to determine the predictive factors of significant coronary artery disease in patients with pacemaker implantation to identify patients in need of coronary angiography at the time of pacemaker implantation. METHODS: This retrospective study was carried out to examine the patients' files that were placed at the heart of Imam Reza Hospital during the period between March 2017 and September 2017. Demographic data, risk factors, echocardiography findings, and angiography, were collected and then recorded using a checklist. Statistical analysis was performed using SPSS software version 22 and Chi-square, and Mann-Whitney tests were used for determining significates variables. RESULTS: A group of 102 patients who had undergone a permanent cardiac pacemaker insertion due to an atrioventricular (AV) Block were included in the study, and also coronary anatomy was determined coronary angiography. Based on the results, 13.7% of patients with cardiac pacemaker had obstructive coronary artery disease (stenosis > 70%). Factors affecting coronary artery stenosis on angiography include gender, chest pain, history of myocardial infarction, angioplasty, diabetes, smoking, history of aspirin intake, calcium blocker and Plavix, high hematocrit, ST elevation and ST depression in the ECG, and severe mitral regurgitation. CONCLUSION: It seems that in most patients requiring permanent pacemaker insertion because of the atrioventricular (AV) Block, angiography does not change the patient's fate, and so can be ignored. However, in patients who have several risk factors from the listed above, coronary angiography is recommended during admission.

Correlation among the Behavioral Features in the Offspring of Morphine-Abstinent Rats.

BACKGROUND: Critical analysis of new evidence in medical sciences relies on statistics in terms of correlation. The aim of the present study was to evaluate the correlation coefficients among the behavioral features in the offspring of morphine-abstinent parent(s). METHODS: The offspring of rats with various parental morphine-exposure were divided into four groups including offspring with healthy parents (CTL), offspring with paternal morphine-abstinent (PMA) parent, offspring with maternal morphine-abstinent (MMA) parent, and offspring with both morphine-abstinent (BMA) parents. Pain perception, depression-like behavior and avoidance-memory in the offspring were quantified. The association between variables was measured using Pearson correlation analysis. FINDINGS: A strong correlation was observed between pain and depressive-like behavior in female and male offspring of healthy parents. Moreover, in the male and female offspring of healthy parents and BMA, no significant correlation was observed between avoidance memory and pain behavior or depressive-like behavior. However, in the offspring of MMA, a strong correlation was observed between avoidance memory and depressive-like behavior. CONCLUSION: The results revealed that in comparison with the offspring with CTL, the correlation among the behavioral futures in the offspring with MMA or PMA parents is significantly different.

The role of calcium-calmodulin-dependent protein kinase II in modulation of spatial memory in morphine sensitized rats.

It has been shown that drug addiction and memory system are related but the signaling cascades underlying this interaction is not completely revealed yet. It has been demonstrated that binding of Calcium-calmodulin-dependent protein kinase II (CaMKII) to NMDA receptor is important in the memory process. The main objective of the study was to evaluate the role of CaMKII on the spatial memory of rats which previously were sensitized by morphine. The effect of CaMKII inhibitor (KN-93) on memory changes was investigated by hippocampal microinjection of KN-93 on the morphine-sensitized rats. Also, the role of the NMDA receptor in memory retention by KN-93 on the morphine sensitized rat was investigated with NMDA agonist and antagonist. Sensitization was induced by morphine injection (once daily for 3 days) followed by 5 days free of the drug before the trial phase. For the evaluation of spatial memory, the Morris Water Maze test (MWM) was used. Results showed that pre-trial administration of morphine, induced amnesia in MWM (p < 0.05). Also, three days pretreatment with morphine (20 mg/kg) followed by five days washout period, caused to enhance memory retrieval in confront with a pre-trial challenging dose of morphine (5 mg/kg). In addition, KN-93 administration during induction phase in morphine sensitization phenomena facilitated morphine-induced memory retention. In addition, inhibition of the NMDA receptor and KN-93 during the induction phase did not improve memory. However; intra-CA1 co-administration of KN-93 and NMDA during the induction phase of morphine sensitization resulted in improving spatial memory. It can be concluded that the effect of CaMKII on memory retention in morphine-sensitized rats depends on NMDA receptor.

Cocaine- and amphetamine-regulated transcript (CART): A multifaceted neuropeptide.

Over the last 35 years, the continuous discovery of novel neuropeptides has been the key to the better understanding of how the central nervous system has integrated with neuronal signals and behavioral responses. Cocaine and amphetamine-regulated transcript (CART) was discovered in 1995 in the rat striatum but later was found to be highly expressed in the hypothalamus. The widespread distribution of CART peptide in the brain complicated the understanding of the role played by this neurotransmitter. The main objective of the current compact review is to piece together the fragments of available information about origin, expression, distribution, projection, and function of CART peptides. Accumulative evidence suggests CART as a neurotransmitter and neuroprotective agent that is mainly involved in regulation of feeding, addiction, stress, anxiety, innate fear, neurological disease, neuropathic pain, depression, osteoporosis, insulin secretion, learning, memory, reproduction, vision, sleep, thirst and body temperature. In spite of the vast number of studies about the CART, the overall pictures about the CART functions are sketchy. First, there is a lack of information about cloned receptor, specific agonist and antagonist. Second, CART peptides are detected in discrete sets of neurons that can modulate countless activities and third; CART peptides exist in several fragments due to post-translational processing. For these reasons the overall picture about the CART peptides are sketchy and confounding.

Could decorin be a biomarker of coronary artery disease? A pilot study in human beings.

BACKGROUND AND AIM: Nowadays there is a strong necessity in identifying patients who may be exposed to the risk for future cardiovascular events like progressive atherosclerotic disease. Biomarkers are valuable tools for this purpose. Coronary artery calcification (CAC) is utilized as an important tool for the global risk assessment of cardiovascular events in individuals with intermediate risk. Decorin (DCN) is a small leucine-rich proteoglycan that induces calcification of arterial smooth muscle cell and localizes to mineral deposition in human atherosclerotic plaque. The main purpose of this clinical study was to find out the correlation between Decorin serum concentration and CAC in human for the first time. METHODS: In this study 84 patients with coronary artery disease who fulfilled inclusion and exclusion criteria, entered the study. For all patients a questionnaire consisting demographic data and traditional cardiovascular risk factors were completed. CT-Angiography was carried out to determine coronary artery calcium score and ELISA method was used for measuring DCN serum concentrations. RESULTS: No significant correlation between DCN serum concentration and total CAC score and also CAC of left anterior descending, right coronary artery, left main coronary artery and circumflex was found in the study population (P>0.05). CONCLUSIONS: On the basis of our results DCN serum concentration is not a suitable biomarker of coronary artery disease. However, more studies with higher sample size are necessary for its confirmation.

Evaluation of NPP1 as a Novel Biomarker of Coronary Artery Disease: A Pilot Study in Human Beings.

Purpose: Coronary artery calcification (CAC) is utilized as an important tool for global risk assessment of cardiovascular events in individuals with intermediate risk. Ecto phosphodiesterase/nucleotide phosphohydrolase-1(ENPP1) converts extracellular nucleotides into inorganic pyrophosphate and it is a key regulator of tissue calcification that adjusts calcification in tissues like vascular smooth muscle cells. The main purpose of this clinical study was to find out the correlation between ENPP1 serum concentration and CAC in human for the first time. Methods: In this study 83 patients (16 diabetic patients and 67 non-diabetic patients) with coronary artery disease who fulfilled inclusion and exclusion criteria, entered the study. For all patients a questionnaire consisting demographic data and traditional cardiovascular risk factors were completed. Computed tomography (CT)-Angiography was carried out to determine coronary artery calcium score and enzyme-linked immunosorbent assay (ELISA) method was used for measuring ENPP1 serum concentrations. Results: There was a reverse significant correlation between ENPP1 serum concentration and total CAC score and also CAC of right coronary artery (RCA) (P<0.05) in non-diabetic patients. Conclusion: On the basis of our results, ENPP1 serum concentration may be a suitable biomarker for coronary artery disease at least in non-diabetic patients. However, more studies with higher sample size are necessary for its confirmation.

Monitoring the Response of Plasmodium vivax to Chloroquine and Uncomplicated P. falciparum to Artesunate-fansidar Antimalarials in Southeastern Iran.

BACKGROUND: For many years, malaria was a major life-threatening parasitic infection in Iran. Although malaria elimination program is implementing in the country, still some cases annually are reported from malaria-endemic areas. METHODS: This study was conducted in five malaria endemic districts of Sistan and Baluchistan Province, southeastern Iran, neighboring Afghanistan and Pakistan countries. Overall, 170 and 38 vivax malaria and falciparum malaria infected patients were enrolled in the study from 2013-2014. All the cases were selected according to criteria of the WHO guideline for in vivo drug sensitivity tests in malaria parasites. Evaluation of drug sensitivity test was conducted with some modifications. RESULTS: The patients with vivax malaria responded to the regimen of chloroquine in 37.4(±15.9), 40(±13.8) and 42(±17.7) h for Pakistani, Iranian and Afghani nationalities respectively based on MPCT evaluation. The results showed a considerable difference between them and Iranian subjects. MPCT for the patients with falciparum malaria was calculated as 28(±18.05), 26(±12.03) and 36(±16.9) h for Iranian, Pakistani and Afghani nationalities respectively. There was a marginally significant difference between Afghani and other nationalities and between males and females. CONCLUSION: Treatment of all the patients resulted in ACPR and MPCT of P. vivax showed that the parasite became more sensitive to chloroquine than previous years in studied areas.

Emergency Medicine Resident versus Radiologist in Detecting the Ultrasonographic Signs of Acute Cholecystitis; a Diagnostic Accuracy Study.

INTRODUCTION: Dependence of ultrasonography on the operator's skill plays a major role in the differences between various studies in reporting its diagnostic accuracy. Therefore, the present study was done with the aim of comparing the ultrasonography findings performed by emergency medicine resident and radiologist in evaluation of acute cholecystitis. METHODS: The present diagnostic accuracy study has been carried out on patients presenting to the emergency department with complaint of pain in the right upper quadrant of abdomen suspected with acute cholecystitis. All the patients underwent gallbladder ultrasonography by a trained emergency medicine resident and a radiologist and their findings were compared with surgical and pathology findings regarding gallstone and increased gallbladder wall thickness. RESULTS: 51 patients with the mean age of 42.3±15.8 (17-81) years were analyzed (82.4% female). The overall agreement between emergency medicine resident and radiologist in ultrasonographic diagnosis of cholecystitis was 0.421 (95% CI: 0.118-0.724). Based on the pathology and surgical findings, acute cholecystitis was confirmed for all 51 (100%) patients. Meanwhile, based on the ultrasonographic report of radiologist and emergency medicine resident only 45 (88.2%) and 34 (66.7%) patients, respectively, were diagnosed with cholecystitis. Screening performance characteristics of ultrasonography by radiologist for detection of gallbladder stone (p = 0.010) and gallbladder wall thickness (p < 0.0001) were significantly better than emergency medicine resident. CONCLUSION: The screening performance characteristics of ultrasonography by radiologist in detection of gallstones and increased wall thickness of gallbladder were significantly better.

The Relation of Q Angle and Anthropometric Measures with Ankle Sprain; a Case-control study.

INTRODUCTION: Since most studies on ankle sprain are medical and sports-related and not much epidemiologic and etiologic data from the general population exist in this field, the present study evaluates the relationship between Q angle and anthropometric measures with ankle sprain in the general population. METHODS: In the present case-control study, all of the patients over 18 years age presenting to emergency departments (ED) of two educational Hospitals, complaining from ankle sprain, were evaluated during more than 1 year. A checklist consisting of demographic data, height, weight, body mass index (BMI), and history of ankle sprain, as well as degree of Q angle was filled for all participants. The correlation of mentioned variables with incidence of ankle sprain was calculated using SPSS 22. RESULTS: 300 patients with ankle sprain were evaluated (53.5% male). Mean age of the patients was 37.03 ± 14.20 years. Mean weight, height, and BMI were 71.71 ± 11.26 (43 - 114), 168.74 ± 8.63 (143 - 190) and 25.14 ± 3.19 (18.41 - 38.95), respectively. Mean Q angle of the patients was 12.78 ± 3.19 degrees (5 - 23). There was a significant correlation between weight (p < 0.001), BMI (p = 0.001), history of sprain (r: 0.26, p < 0.001) and Q angle (p = 0.002) with incidence of ankle sprain. In addition, there was a significant statistical correlation between weight (p = 0.031), BMI (p = 0.020) and Q angle (p = 0.004) with history of ankle sprain. In patients with a history of ankle sprain, Q angle was wider by about 2 degrees. CONCLUSION: It seems that the prevalence of ankle sprain directly correlates with high weight, BMI, and Q angle and is more prevalent in those with a history of sprain. Although the findings of the present study show a statistically significant correlation between these factors and ankle sprain, the correlation is not clinically significant.