Successful treatment of corneal hypertrophic scar in Hurler syndrome.

In Hurler syndrome, corneal opacification is a common finding but rarely manifests as hypertrophic scars. A 6-year-old boy with Hurler syndrome had a hypertrophic scar on his left eye, which was successfully treated with superficial keratectomy.

Proposing a novel multi-instance learning model for tuberculosis recognition from chest X-ray images based on CNNs, complex networks and stacked ensemble.

Mycobacterium Tuberculosis (TB) is an infectious bacterial disease. In 2018, about 10 million people has been diagnosed with tuberculosis (TB) worldwide. Early diagnosis of TB is necessary for effective treatment, higher survival rate, and preventing its further transmission. The gold standard for tuberculosis diagnosis is sputum culture. Nevertheless, posterior-anterior chest radiographs (CXR) is an effective central method with low cost and a relatively low radiation dose for screening TB with immediate results. TB diagnosis from CXR is a challenging task requiring high level of expertise due to the diverse presentation of the disease. Significant intra-class variation and inter-class similarity in CXR images makes TB diagnosis from CXR a more challenging task. The main aim of this study is tuberculosis recognition from CXR images for reducing the disease burden. For this purpose, a novel multi-instance classification model is proposed in this study which is based on CNNs, complex networks and stacked ensemble (CCNSE). A main advantage of CCNSE is not requiring an accurate lung segmentation to localize the suspicious regions. Several overlapping patches are extracted from each CXR image. Features describing each patch are obtained by CNNs and then the feature vectors are clustered. Local complex networks (LCN) and global ones (GCN) of the cluster representatives are formed and feature engineering on LCN (GCN) generates other features at image-level (patch-level and image-level). Global clustering on these feature sets is performed for all patches. Each patch is assigned the purity score of its corresponding cluster. Patch-level features and purity scores are aggregated for each image. Finally, the images are classified with a proposed stacked ensemble classifier to normal and TB classes. Two datasets are used in this study including Montgomery County CXR set (MC) and Shenzhen dataset (SZ). MC/SZ includes 138/662 chest X-rays (CXR) from which 80 and 58/326 and 336 images belong to normal/TB classes, respectively. The experimental results show that the proposed method with AUC of 99.00 ± 0.28/98.00 ± 0.16 for MC/SZ and accuracy of 99.26 ± 0.40/99.22 ± 0.32 for MC/SZ with fivefold cross validation strategy is superior than the compared ones for diagnosis of TB from CXR images. The proposed method can be used as a computer-aided diagnosis system to reduce the manual time, effort and dependency to specialist's expertise level.

The Association of Sleep Duration and Quality with Heart Rate Variability and Blood Pressure.

BACKGROUND: The current study was conducted to evaluate the relation of sleep duration and quality with blood pressure (BP) and heart rate variability (HRV). MATERIALS AND METHODS: This cross-sectional study was carried out in 2017 among 260 staff of a university hospital in Isfahan, Iran. They were selected by multi-stage random method from different wards. Time domain spectral analysis was used to measure a number of HRV parameters. The long-term components of the HRV were estimated using the standard deviation of the normal-to-normal interval (SDNN). The square root of the mean squared differences of successive NN intervals (RMSSD) was calculated by statistical time domain measurements; SNN50, and PNN50 were measured. Pittsburg sleep quality index (PSQI) questionnaire was used to assess sleep quality. RESULTS: Higher PSQI score correlated with lower SDANN rise (OR=0.92). Fairly bad to very good subjective sleep quality had association with lower SDANN (OR=0.43). Very high sleep latency to very low sleep latency ratio had association with lower SDANN (OR=0.39) and lower PNN50 (OR= 0.44). Sleep duration and HRV parameters had no significant association. Fairly bad sleep efficiency to very good sleep efficiency ratio was correlated with lower SDANN (OR= 0.29). Very high daytime dysfunction to very low daytime dysfunction ratio had correlation with lower SDANN (OR=0.35). Very bad compared to very good subjective sleep quality had significant correlation with higher Heart rate (HR) (B=0.03). Very high sleep latency compared to no sleep latency was associated with higher HR (B=4.74). Very high compared to very low amount of sleep disturbances correlated with higher SBP levels (B=15.2). Using sleep medication less than once a week compared with no history of taking such drugs was associated with higher HR (B=16.4). CONCLUSION: Our findings showed that poor sleep quality are adversely associated with HRV, HR and BP. This finding should be considered in clinical and preventive recommendations.

Distribution of staphylococcal cassette chromosome mec types among methicillin-resistant coagulase negative staphylococci in central Iran.

BACKGROUND AND OBJECTIVES: Methicillin-resistant coagulase-negative staphylococci (MR-CoNS) are important nosocomial pathogens. They may serve as a reservoir of SCCmec, the genomic island encoding amongst other methicillin resistance. This study was designed to determine the distribution of different SCCmec types from MR-CoNS isolated from clinical specimens in a tertiary hospital in central Iran, having high frequency of nosocomial methicillin-resistant staphylococcal infections. MATERIALS AND METHODS: We evaluated isolates from patients attending the Vali-Asr Hospital located in the center of Iran, from February to December 2012. Multiplex PCR was performed for SCCmec typing. For isolates in which SCCmec could not be typed directly, additional ccr and mec complex analyses were performed. RESULTS: Totally, 70 MR-CoNS isolates, comprising of 47 S. epidermidis strains (67%), 10 S. saprophyticus (14.3%), 9 S. hemolyticus (13%) and 4 S. lugdunensis (5.7%) were identified. Thirty-nine were characterized as type IVa 19 (27%), type III 11 (16%), type II 7 (10%) and type V 2 (3%). Only 20 isolates (28.6%) carried the ccr complex, while the current methods could not characterize the 11 remaining isolates. CONCLUSION: A high level of SCCmec genetic diversity was found among MR-CoNS isolates. MR-CoNS may act as a reservoir of SCCmec IV for MRSA. This issue should be taken into consideration seriously.

Glomerular Hyperfiltration as Predictor of Cardiometabolic Risk Factors among Children and Adolescents: The Childhood and Adolescence Surveillance and Prevention of Adult-V Study.

BACKGROUND: The prevalence of glomerular hyperfiltration and chronic kidney disease is increasing worldwide in parallel with obesity hypertension epidemic. The effect of increases in glomerular filtrations (GFR) in children with metabolic syndrome has not been studied. The purpose of the present study is to investigate the relationship between GFR and cardiometabolic risk factors in a large sample of pediatric population. METHODS: In this nationwide survey, 3800 participants were selected by cluster random sampling from 30 provinces in Iran. Anthropometric measures, biochemical, and clinical parameters were measured. We also measured estimated GFR (eGFR) using the recently modified Schwartz equations and other known cardiometabolic risk factors such as elevated total cholesterol, high low-density lipoprotein cholesterol (LDL-C), and obesity. RESULTS: The response rate was 91.5% (n = 3843). The mean and standard deviation (SD) (Mean ± SD) of eGFR for girls, boys, and total population were 96.71 ± 19.46, 96.49 ± 21.69, and 96.59 ± 20 ml/min/1.73 m2, respectively. Overall, 38.7% of the participants did not have any cardiometabolic risk factor. In multivariate models, the risk of elevated systolic blood pressure (BP) (odds ratio [OR]: 1.48; 95% confidence interval [CI]: 1.08-2.02), elevated diastolic BP (OR: 1.48; 95% CI: 1.08-2.02), elevated LDL-C (OR: 1.35; 95% CI: 1.07-1.70), and obesity (OR: 1.70; 95%CI: 1.24-2.33) were significantly higher in participants with higher eGFR level than those with the lower level but not with low level of high-density lipoprotein cholesterol (OR: 0.72; 95% CI: 0.60-0.88). CONCLUSIONS: This study demonstrates an association between glomerular hyperfiltration and obesity-related hypertension in a large sample of the Iranian pediatric population, independently of other classical risk factors.

The association of sleep and late-night cell phone use among adolescents / Associação entre o sono e o uso noturno de celular entre adolescentes

Abstract Objective: This study aims to assess the relationship of late-night cell phone use with sleep duration and quality in a sample of Iranian adolescents. Methods: The study population consisted of 2400 adolescents, aged 12-18 years, living in Isfahan, Iran. Age, body mass index, sleep duration, cell phone use after 9 p.m., and physical activity were documented. For sleep assessment, the Pittsburgh Sleep Quality Index questionnaire was used. Results: The participation rate was 90.4% (n = 2257 adolescents). The mean (SD) age of participants was 15.44 (1.55) years; 1270 participants reported to use cell phone after 9 p.m. Overall, 56.1% of girls and 38.9% of boys reported poor quality sleep, respectively. Wake-up time was 8:17 a.m. (2.33), among late-night cell phone users and 8:03 a.m. (2.11) among non-users. Most (52%) late-night cell phone users had poor sleep quality. Sedentary participants had higher sleep latency than their peers. Adjusted binary and multinomial logistic regression models showed that late-night cell users were 1.39 times more likely to have a poor sleep quality than non-users (p-value < 0.001). Conclusion: Late-night cell phone use by adolescents was associated with poorer sleep quality. Participants who were physically active had better sleep quality and quantity. As part of healthy lifestyle recommendations, avoidance of late-night cell phone use should be encouraged in adolescents.

Resumo Objetivo: Avaliar a relação entre o uso de celular à noite e a duração e a qualidade do sono em uma amostra de adolescentes iranianos. Métodos: A população estudada consistiu em 2.400 adolescentes, entre 12 e 18 anos, que residem em Isfahan, Irã. Foram documentados a idade, o índice de massa corporal, a duração do sono, o uso de celular após as 21h e prática de atividade física. Para avaliação do sono, usamos o Índice de Qualidade do Sono de Pittsburgh (PSQI). Resultados: A taxa de participação foi de 90,4% (n = 2.257). A idade média (DP) foi de 15,44 ± (1,55) anos; 1.270 relataram o uso do celular após as 21h. Em geral, 56,1% das meninas e 38,9% dos meninos relataram sono de má qualidade, respectivamente. Os indivíduos que usaram celular à noite acordaram às 8h17 (2,33) e os que não usaram acordaram às 8h03 (2,11). A maior parte (52%) dos usuários de celular à noite apresentou má qualidade de sono. Aqueles sem algum tipo de atividade física apresentaram maior latência do sono do que seus pares. Os modelos ajustados de regressão logística binária e multinomial mostraram que os usuários de celular à noite foram 1,39 vez mais propensos a ter má qualidade do sono do que seus pares (p < 0,001). Conclusão: O uso de celular à noite por adolescentes foi associado a pior qualidade do sono. Os participantes fisicamente ativos apresentaram melhor qualidade e maior tempo de sono. Como parte das recomendações de estilo de vida saudável, os adolescentes devem ser incentivados a evitar o uso de celular à noite.

The association of sleep and late-night cell phone use among adolescents.

OBJECTIVE: This study aims to assess the relationship of late-night cell phone use with sleep duration and quality in a sample of Iranian adolescents. METHODS: The study population consisted of 2400 adolescents, aged 12-18 years, living in Isfahan, Iran. Age, body mass index, sleep duration, cell phone use after 9p.m., and physical activity were documented. For sleep assessment, the Pittsburgh Sleep Quality Index questionnaire was used. RESULTS: The participation rate was 90.4% (n=2257 adolescents). The mean (SD) age of participants was 15.44 (1.55) years; 1270 participants reported to use cell phone after 9p.m. Overall, 56.1% of girls and 38.9% of boys reported poor quality sleep, respectively. Wake-up time was 8:17 a.m. (2.33), among late-night cell phone users and 8:03a.m. (2.11) among non-users. Most (52%) late-night cell phone users had poor sleep quality. Sedentary participants had higher sleep latency than their peers. Adjusted binary and multinomial logistic regression models showed that late-night cell users were 1.39 times more likely to have a poor sleep quality than non-users (p-value<0.001). CONCLUSION: Late-night cell phone use by adolescents was associated with poorer sleep quality. Participants who were physically active had better sleep quality and quantity. As part of healthy lifestyle recommendations, avoidance of late-night cell phone use should be encouraged in adolescents.

Methodology and Early Findings of the Fifth Survey of Childhood and Adolescence Surveillance and Prevention of Adult Noncommunicable Disease: The CASPIAN-V Study.

BACKGROUND: This paper presents the methodology and early findings of the fifth survey of a school-based surveillance program in Iran. METHODS: This nationwide study was conducted in 2015 as the fifth survey of a surveillance program entitled "Childhood and Adolescence Surveillance and PreventIon of Adult Non- communicable disease" (CASPIAN-V) study. The protocol was mainly based on the World Health Organization-Global School student Health Survey. We studied 14400 students, aged 7-18 years, and their parents living in 30 provinces in Iran. Fasting blood was obtained from a sub-sample of 4200 randomly selected students. RESULTS: The participation rate for the whole study and for blood sampling were 99% and 91.5%, respectively. The mean (SD) age of participants was 12.3 (3.2) years, consisting of 49.4% girls and 71.4% urban residents. Overall, 16.1% were underweight (17.4% of boys and 14.8% of girls), and 20.8% had excess weight consisting of 9.4% (8.7% of boys and 10.2% of girls) of overweight and 11.4% (12.5% of boys and 10.3% of girls) of obesity. Abdominal obesity was documented in 21.1% of students (21.6% of boys and 20.5% of girls). Low HDL-C was the most prevalent abnormality of the lipid profile (29.5%) followed by high serum triglycerides (27.7%). Of students, 59.9% consumed whole wheat bread; and 57% reported that they never or rarely added salt to table. The reported daily consumption of fresh fruits, vegetables, and milk was about 60%, 32% and 40%, respectively. 13.7% of participants had at least 30-min daily leisure-time physical activity. CONCLUSIONS: The current findings provide an overview of the current health status and lifestyle habits of children and adolescents. This surveillance program would help planning preventive programs at individual and community levels.

Automated extraction and preconcentration of multiresidue of pesticides on a micro-solid-phase extraction system based on polypyrrole as sorbent and off-line monitoring by gas chromatography-flame ionization detection.

A simple and efficient automated method for extraction and preconcentration of some organophosphorus and organochlorine pesticides from drinking and agriculture waters has been developed. In this work, a pyrrole-based polymer was synthesized and applied as an efficient sorbent for micro-solid-phase extraction (mu-SPE). Polypyrrole (PPY) was synthesized by chemical oxidation of the monomer in nonaqueous solution. The mu-SPE of selected pesticides, from aqueous samples was performed using 20mg of PPY. After extraction, analytes were desorbed in ethyl acetate and analyzed using gas chromatography-flame ionization detection. The acid-base and other physico-chemical interactions with the analytes facilitated the adsorption of analytes, with good selectivity and reproducibility. Under the optimized extraction conditions, the method showed good linearity in the range of 0.001-0.3 microg ml(-1) of water sample (phosphate buffer 1.0 x 10(-3) M, pH 8.5), RSD=1.5-4.2% (n=4), and limits of detection 200-600 pg ml(-1). Each mu-SPE cartridge could be used for up to 20 extractions.