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Crigler-Najjar syndrome type II is a metabolic disorder stemming from mutations in the UGT1A1 gene, resulting in heightened levels of unconjugated bilirubin. Here is a case report of a 17-year-old male patient with minor thalassemia and G6PD deficiency who was referred due to worsening jaundice. He has had a history of lifelong jaundice, which has intensified over the past year and a half. Subsequently, the patient was diagnosed with Crigler-Najjar type II based on his medical history, clinical examination, and laboratory findings. Furthermore, the patient’s positive response to phenobarbital treatment confirmed the diagnosis. Consequently, it is imperative to consider CriglerNajjar syndrome in cases of unexplained unconjugated hyperbilirubinemia.

Statement of the Problem: Early detection of caries and the extent of carious lesions for appropriate treatment planning are very important and lead to introduction of new diagnostic tools.Purpose: This study aimed to compare the diagnostic accuracy of VistaCam IX Proxi and bitewing radiography for detection of posterior interproximal caries.Materials and Method: This in vitro study was performed on 40 extracted posterior teeth without cavitated carious lesions. Bitewing radiographs were obtained, infrared (IR) examination was performed, and the teeth were sectioned for histopathological analysis under a stereomicroscope as the gold standard for detection of caries and determination of the extent of carious lesions. Data were analyzed with Cohen’s kappa statistic, and Wilcoxon rank sum test.Results: The specificity of VistaCam IX Proxi and bitewing radiography was 71.4% and 87.7%, respectively. Their sensitivity was 100% and 40% for enamel caries, 72.8% and 54.5% for external half dentin caries, and 82.3% and 58.8% for internal half dentin caries, respectively (p= 0.048).Conclusion: Bitewing radiography had a higher specificity and lower rate of false positive results. However, VistaCam IX Proxi had higher sensitivity for caries detection with lower rate of false negative results. Considering the higher sensitivity and significantly lower frequency of false negative results by VistaCam IX Proxi, it may be reliably used for caries detection specially enamel caries, and can serve as an adjunct to bitewing radiography.

Abstract Background Respiratory problems are among the most challenging situations in emergency care services. Different oxygen therapy methods are usually used to deal with these problems. In recent years, oxygen therapy has been recognized as one of the most widely used therapeutic processes in emergency departments (ED) mainly due to the Covid-19 pandemic. The aim of this study was to develop and evaluate an e-learning course in oxygen therapy for the ED clinicians. Methods This was a pre-post study conducted in three phases in 2021. Initially, the educational requirements of clinicians (n = 181) were investigated using a questionnaire, and in the second phase, an interactive e-learning course was developed. In the third phase, the course was assessed in terms of maintaining the principles of developing an e-learning course, affecting participants’ knowledge, and supporting usability requirements. Results The findings revealed that training in oxygen therapy was essential for the ED clinicians. Therefore, an e-learning course was developed. The content production experts and the participants evaluated the content and usability of the online course at a good level. In addition, there was a statistically significant difference between the nurses’ (p

Background: Among mesenchymal tumors arising in the gastrointestinal tract, gastrointestinal stromal tumors are the most common. GISTs that do not have metastatic spread are treated surgically. Our case report aims to describe a newer & less invasive approach for resection of GISTs & early gastrointestinal tumors. Case Presentation: An Iranian woman 41 years old with stomach stromal tumor is presented. Her complaint was minor epigastric discomfort. Tumor en-bloc resection was performed using a hybrid endoscopic-laparoscopic approach. She was doing very well & discharged the day after the operation. Conclusion: GISTs and early gastrointestinal tumors can be treated with hybrid endoscopic and laparoscopic en-bloc resections instead of invasive surgery. [ABSTRACT FROM AUTHOR]

This study attempts to examine the characteristics of motherhood according to the role presented by mothers on Instagram. It also examines the lifestyle and other aspects of the lives of supermoms and their followers. To achieve these objectives, we used netnography and direct observation. The results of the thematic analysis include six main themes as follows: “the presentation of perfect motherhood”, “the aestheticization of motherhood”, “the reproduction of traditional patterns of motherhood”, “the presentation of the ideal self”, “the stylization of everyday life”, and “the presentation of the happy family with the desired relationship”. Supermoms attempt to reshape the image of motherhood as a desirable role through aestheticization. The ideal and deceptive image of motherhood presented by supermoms on Instagram, though it may be unattainable for other mothers, has created a new image of motherhood. Just as they provide a new image of motherhood, they do not necessarily challenge traditional motherhood. Rather, this image is a continuation of the traditional motherhood pattern, but in a new guise. Although motherhood still means sacrifice and love, and is semantically no different than it was decades ago, Instagram mothers acted differently in their maternal and personal identities, as well as in their parenting.

Introduction: Determining the diagnostic value of available biomarkers in predicting rhabdomyolysis-induced acute kidney injury (AKI) is a priority. This study aimed to review the current evidence about the value of lactate dehydrogenase (LDH) in this regard. Methods: In this narrative review, the papers in PubMed, Embase, and web of science were studied. The keywords prognosis, prognoses, prognostic, LDH, rhabdomyolysis, emergency patients, and acute kidney failure or AKI had been selected from MeSH medical dictionary. Related papers written in English and published from November 2007 to December 2020 were selected. Results: Finally, 14 articles were accepted for analysis. Among the selected articles, four were randomized clinical trials, seven were cross-sectional, and three were case-control studies. The results of the present review showed that abuse of illegal drugs is the most common cause of rhabdomyolysis. AKI is the most serious complication of rhabdomyolysis reported in the studies. These studies have shown a three-fold increase in AKI following drug-induced rhabdomyolysis. The review of the included articles shows that high LDH can predicts AKI, especially in critical and emergency situations such as rhabdomyolysis where there is a risk of death if diagnosed late. These studies show that LDH increases in the presence of renal failure and tissue damage. Conclusion: Serum LDH is an appropriate and cost-effective prognostic indicator that can be used for risk classification of patients at risk for rhabdomyolysis-induced AKI.

Crigler-Najjar syndrome type II is a metabolic disorder stemming from mutations in the UGT1A1 gene, resulting in heightened levels of unconjugated bilirubin. Here is a case report of a 17-year-old male patient with minor thalassemia and G6PD deficiency who was referred due to worsening jaundice. He has had a history of lifelong jaundice, which has intensified over the past year and a half. Subsequently, the patient was diagnosed with Crigler-Najjar type II based on his medical history, clinical examination, and laboratory findings. Furthermore, the patient's positive response to phenobarbital treatment confirmed the diagnosis. Consequently, it is imperative to consider Crigler-Najjar syndrome in cases of unexplained unconjugated hyperbilirubinemia. [ABSTRACT FROM AUTHOR]

Stability studies in distribution smart grids (SGs) are very important due to the increased penetration of distributed energy resource making bidirectional flow of electric power. This paper presents two novel fast voltage stability indices (VSIs) applicable to the radial distribution SGs based on the real‐time measured voltage data only, obtained by the SG infrastructures such as smart metering device. Each VSI depends on the system bus voltages and does not need additional calculations such as power flow solution, converting the actual distribution network into two‐bus equivalent system etc. In other words, for a radial system with n ‐node, the voltage stability analysis is carried out by parallel n ‐microprocessor units independently. The concentrator units can collect and evaluate the computational results and decide about control actions directly or indirectly depending on the system requirements. The accuracy and efficiency of the proposed indicators are tested on a 41‐node radial distribution system. Six load models including constant and composite types have been considered, and also SG in various states of operation and four types of distributed generation are analysed. The comparison results demonstrate that the proposed VSIs are fast and effective to identify the most sensitive node of the radial grids to the voltage collapse based on the smart infrastructures.

Introduction: The prevalence of multiple symptoms, including mental illness, symptoms that mimic diseases such as pancreatitis, nonspecific abdominal pain and cholecystitis, are high in drug-dependent patients. Objectives: The aim of this study was to consider the clinical signs and serum lead levels of individuals referred to four university hospitals with various complaints. Patients and Methods: In this study, 128 sample cases in two groups, the case group and control group, have been examined. The case group included 64 persons using oral opium who were suffering from various complaints and referred to emergency department of mentioned hospitals. The control group included 64 patients without any history of addiction. Results: Mean of blood serum lead level in opium users and control group was 76.34±17.82 mg/dL and 7.68±3.72 mg/dL respectively, and the difference between these groups was significantly meaningful (P

Background: Among mesenchymal tumors arising in the gastrointestinal tract, gastrointestinal stromal tumors are the most common. GISTs that do not have metastatic spread are treated surgically. Our case report aims to describe a newer & less invasive approach for resection of GISTs & early gastrointestinal tumors. Case Presentation: An Iranian woman 41 years old with stomach stromal tumor is presented. Her complaint was minor epigastric discomfort. Tumor en-bloc resection was performed using a hybrid endoscopic-laparoscopic approach. She was doing very well & discharged the day after the operation. Conclusion: GISTs and early gastrointestinal tumors can be treated with hybrid endoscopic and laparoscopic en-bloc resections instead of invasive surgery.

Statement of the Problem: Early detection of caries and the extent of carious lesions for appropriate treatment planning are very important and lead to introduction of new diagnostic tools. Purpose: This study aimed to compare the diagnostic accuracy of VistaCam IX Proxi and bitewing radiography for detection of posterior interproximal caries. Materials and Method: This in vitro study was performed on 40 extracted posterior teeth without cavitated carious lesions. Bitewing radiographs were obtained, infrared (IR) examination was performed, and the teeth were sectioned for histopathological analysis under a stereomicroscope as the gold standard for detection of caries and determination of the extent of carious lesions. Data were analyzed with Cohen’s kappa statistic, and Wilcoxon rank sum test. Results: The specificity of VistaCam IX Proxi and bitewing radiography was 71.4% and 87.7%, respectively. Their sensitivity was 100% and 40% for enamel caries, 72.8% and 54.5% for external half dentin caries, and 82.3% and 58.8% for internal half dentin caries, respectively (p= 0.048). Conclusion: Bitewing radiography had a higher specificity and lower rate of false positive results. However, VistaCam IX Proxi had higher sensitivity for caries detection with lower rate of false negative results. Considering the higher sensitivity and significantly lower frequency of false negative results by VistaCam IX Proxi, it may be reliably used for caries detection specially enamel caries, and can serve as an adjunct to bitewing radiography. [ABSTRACT FROM AUTHOR]

This paper proposes an Optimal Power Flow (OPF) algorithm by Direct Load Control (DLC) programs to optimize the operational cost of smart grids considering various scenarios based on different constraints. The cost function includes active power production cost of available power sources and a novel flexible load curtailment cost associated with DLC programs. The load curtailment cost is based on a virtual generator for each load (which participates in DLC program). To implement the load curtailment in the objective function, we consider incentive payments for participants and a load shedding priority list in some events. The proposed OPF methodology is applied to IEEE 14, 30-bus, and 13-node industrial power systems as three examples of the smart grids, respectively. The numerical results of the proposed algorithm are compared with the results obtained by applying MATPOWER to the nominal case by using the DLC programs. It is shown that the suggested approach converges to a better quality solution in an acceptable computation time.

Abdominal tuberculosis is one of the most critical and life-threatening ailments affecting the digestive system. Distinguishing it from other gastrointestinal disorders is paramount due to the potential complications of treatment overlap. Therapies such as corticosteroids and anti-tumor necrotic factor (anti-TNF) agents, effective against various diseases, can unintentionally exacerbate and propagate tuberculosis. The case in focus involves a 22-year-old man initially presented with abdominal pain. The clinical, endoscopic, and pathological assessments led to a diagnosis of Crohn’s disease. Subsequently, the patient underwent treatment. However, 6 months into the treatment, the patient developed abdominal distension and ascites, necessitating hospital admission and re-evaluation. A comprehensive series of investigations revealed a diagnosis of military tuberculosis. The patient was subsequently administered four anti-tuberculosis drugs, resulting in a complete resolution of symptoms. This case underscores a crucial point: administering anti-TNF agents can inadvertently contribute to tuberculosis dissemination. Hence, a meticulous assessment to exclude tuberculosis before initiating such treatment is paramount. [ABSTRACT FROM AUTHOR]

Objectives Considering the significance of early detection of caries and determining the extent of carious lesions for appropriate treatment planning, as well as introduction of new diagnostic tools, this study aimed to compare VistaCam iX (850 nm infrared), and DIAGNOdent (655 nm) for detection of proximal caries in posterior teeth. Methods This in vitro study was performed on 40 extracted sound posterior teeth. VistaCam and DIAGNOdent examinations were performed. The teeth were sectioned for histopathological examination under a stereomicroscope to determine the presence/absence of caries and extent of carious lesion, if any (to serve as the gold-standard). Data were analyzed with the Cohen’s kappa statistic, and Wilcoxon Rank Sum test. Results The specificity of VistaCam iX and DIAGNOdent was 71.4% and 42.8%, respectively. Their sensitivity was 100% and 40% for enamel caries, and 92.8% and 53.5% for dentin caries, respectively (P=0.048). The specificity and sensitivity of DIAGNOdent were higher, and it had lower rate of false positive and false negative results. Conclusion Considering the higher sensitivity and significantly lower rate of false negative results of VistaCam iX for detection of proximal caries, it may be recommended as an efficient tool for caries detection. [ABSTRACT FROM AUTHOR]

Laser skin resurfacing has changed the approach of facial skin rejuvenation over the past decade. This article evaluates the laser effects on skin rejuvenation by the assessment of laser characteristics and histological and molecular changes, accompanied by the expression of proteins during and after laser-assisted rejuvenation of skin. It is important to note that different layers of skin with different cells are normally exposed to the sun's UV radiation which is the most likely factor in aging and damaging healthy skin. To identify the expression of proteins, using validated databases and reviewing existing data could reveal altered proteins which could be analyzed and mapped to investigate their expression and their different effects on cell biological responses. In this regard, proteomics data can be used for better investigation of the changes in the proteomic profile of the treated skin. Different assessments have revealed the survival and activation of fibroblasts and new keratinocytes with an increase of collagen and elastin fibers in the dermis and the reduction of matrix metalloproteinases (MMPs) and heat shock proteins (HSPs) as a result of different lowpower laser therapies of skin. There are a wide range of biological effects associated with laser application in skin rejuvenation; therefore, more safety considerations should be regarded in the application of lasers in skin rejuvenation. [ABSTRACT FROM AUTHOR]