Ear and Face Mucormycosis; A Case Report.

Mucormycosis is an invasive fungal infection belonging to order of Mucorales which causes a high rate of mortality. This infection is mostly common in the immunosuppression conditions such as diabetes mellitus, chemotherapy, organ transplantation and hematologic malignancies.

Patient-reported outcomes of sleep, mood and quality of life after treatment of chronic hepatitis C infection using direct-acting antiviral agents.

OBJECTIVES: The aim was to investigate the effect of hepatitis C virus (HCV) infection treatment with direct-acting antiviral (DAA) drugs on patients' mood, sleep quality and quality of life (QoL). METHODS: Chronic HCV-infected patients receiving DAAs were evaluated prospectively. Patients were evaluated before the beginning of treatment and 12-24 weeks after finishing their treatment duration using the Pittsburgh Sleep Quality Index, Beck depression inventory questionnaire and SF-36 health-related QoL questionnaires. RESULTS: A total of 120 patients with a mean age of 41.03 ± 7.68 years were evaluated (68.3% males). The mean follow-up duration was 141.79 ± 27.88 days after finishing the treatment. Significant improvement in the scores of sleep quality (5.13 ± 1.5 vs. 3.43 ± 1.35), mood (12.77 ± 4.02 vs. 9.27 ± 3.14) and QoL (77.49 ± 5.15 vs. 83.95 ± 3.39) post treatment compared with pretreatment were observed (p < 0.05). Changes in patients' sleep and mood were not related to their QoL change (p > 0.05). DISCUSSION: DAAs for the treatment of HCV have a significant effect on improving their sleep, mood and QoL. The changes in sleep quality, mood and QoL of patients were independent and were not affected by each other.

EVALUATING SHORT-TERM EXPOSURE TO WI-FI SIGNALS ON STUDENTS' REACTION TIME, SHORT-TERM MEMORY AND REASONING ABILITY.

This study investigated the effect of short-term exposure to Wi-Fi signals on the cognitive functions of the mind. After obtaining permission from the local Ethics Committee of Shiraz University of Medical Sciences and approval by the Iranian Registry of Clinical Trials (IRCT2017041233398N1), 45 male and female students from Shiraz University of Medical Sciences volunteered to participate in this study. They were exposed to Wi-Fi signals in two sham and exposure sessions, each for 2 hours. After completion, they took part in reaction time, short-term memory, and reasoning ability tests. After scoring, the data were analysed by SPSS software. In addition, the electric field strength and power density were calculated. The results showed no statistically significant differences between the mean scores of reaction time, short-term memory, and reasoning ability in sham and exposure. Also, the obtained values from the electric field strength and power density (E = 4.1 Vm-1, P = 0.446 Wm-2) were lower than that of threshold values by the International Commission on Non-Ionizing Radiation Protection (ICNIRP). Our results can greatly reduce concerns regarding the effects of short-term exposure to Wi-Fi waves on cognitive functions.

AN ASSESSMENT OF RADIATION EXPOSURE DOSES IN PATIENTS UNDERGOING PRIMARY PERCUTANEOUS CORONARY INTERVENTION BASED ON ANGIOGRAPHIC RECORDS.

The stochastic and non-stochastic (deterministic) effects of radiation dose in patients undergoing primary percutaneous coronary intervention (PPCI) have been investigated using data recorded by an angiographic monitoring system. A total of 132 patients with acute myocardial infarction referred to the angiography department of Vali-Asr hospital, Fasa, Iran, during the second half of 2016 were recruited. Quantities like dose-area product (DAP), total air kerma (Ka,r) and fluoroscopy time (FT) were calculated and converted into effective dose (ED) and peak skin dose (PSD). The values for Ka,r, DAP and FT equaled 80 399.20 ± 63 312 mGy cm2, 1392.80 ± 1155.373 mGy and 524.11 ± 423.057 s, respectively, which were within the ranges reported in previous studies. After considering standard dose thresholds for Ka,r and PSD, it was revealed that only a small portion of patients had reached these thresholds and exceeded them (<3%). Moreover, ED < 20 mSv for the majority of patients was fairly consistent with results from a recent research in eight Belgian hospitals. It was shown that angiographic records are reliable for assessing radiation dose in patients.

Blocking Short-Wavelength Component of the Visible Light Emitted by Smartphones' Screens Improves Human Sleep Quality.

BACKGROUND: It has been shown that short-wavelength blue component of the visible light spectrum can alter the circadian rhythm and suppress the level of melatonin hormone. The short-wavelength light emitted by smartphones' screens can affect the sleep quality of the people who use these devices at night through suppression of melatonin. OBJECTIVES: In this study, we examined the effects of covering the screens of smartphones with different filters (changing the effective wavelength of the light) on sleep delay time in 43 healthy students. MATERIALS AND METHODS: Volunteer students were asked to go to bed at 23:00 and to use their mobile phones in bed for watching a natural life documentary movie for 60 minutes. No filter was used for one night while amber and blue filters were used for other 2 nights. Photospectrometry method was used to determine the output spectrum of the light passing through the filters used for covering the screens of the mobile phones. The order for utilizing amber or blue filters or using no filter was selected randomly. After 1 hour, the participants were asked to record their sleep delay time measured by a modified form of sleep time record sheet. RESULTS: The mean sleep delay time for the "no-filter" night was 20.84±9.15 minutes, while the sleep delay times for the nights with amber and blue filters were 15.26±1.04 and 26.33±1.59 minutes, respectively. CONCLUSION: The findings obtained in this study support this hypothesis that blue light possibly suppresses the secretion of melatonin more than the longer wavelengths of the visible light spectrum. Using amber filter in this study significantly improved the sleep quality. Altogether, these findings lead us to this conclusion that blocking the short-wavelength component of the light emitted by smartphones' screens improves human sleep.

Does Exposure to Static Magnetic Fields Generated by Magnetic Resonance Imaging Scanners Raise Safety Problems for Personnel?

MRI workers are occupationally exposed to static and time-varying gradient magnetic fields. While the 24-hour time-averaged exposure to static magnetic fields is about a few mT, the maximum static field strength can be as high as 500 mT during patient setup. Over the past several years, our laboratory has performed extensive experiments on the health effects of exposure of animal models and humans to different sources of electromagnetic fields such as cellular phones, mobile base stations, mobile phone jammers, laptop computers, radars, dentistry cavitrons and MRI. This study is to investigate the adverse health effects in MRI workers and also to assess the effect of exposure of MRI workers to static magnetic fields on their cognitive functions. In the first phase of this study a questionnaire was designed to collect information from 120 MRI personnel. The collection of data about the adverse health effects was based on self-reporting by the participants. In the second phase, 47 volunteer university students were asked to continuously move around a 1.5 T MRI scanner. Visual reaction time and working memory tests were performed on all participants before and after the experiment. Forward digit span and backward digit span were used for assessing the working memory. Furthermore, participants were asked to report the symptoms they had experienced during the movement. The first phase of our study showed increased frequencies of adverse health effects in MRI workers. In this study the rates of self-reported symptoms such as a headache, sleep problems, myalgia, palpitation, fatigue, concentration problems, attention problems, nervousness and backpain were possibly affected by static magnetic field. Furthermore we found that reaction time and working memory could be influenced by the movements of the body around a MRI scanner. It can be concluded that movement through a high magnetic field can also lead to some adverse cognitive effects in MRI staff.

Feasibility of 153Sm production using MNSR research reactor through a multi-stage approach.

The main objective of this study was to explore the feasibility of producing 153Sm radioisotope in miniature neutron source reactors (MNSRs) in Isfahan-Iran. As the first step of this study, the MNSR's geometry was created by using the MCNP6.2 simulation code and afterwards a validity check was performed by comparing the results with the experimental data. Then, by applying values obtained through simulation, the production process was followed up to 20 irradiation cycles using different irradiation and cooling periods (irradiation setups). The results showed that the proposed simulation technique has an acceptable agreement with the experiments (with a difference of nearly 6%). In spite of limitations, such as irradiation time and flux in such reactors, our results showed that by choosing the correct irradiation setup, it is possible to produces 153Sm up to 852.26 mCi g-1 in 20 successive irradiation cycles. However, after the 10th cycle, the production reached 90% of the maximum point. Nevertheless, the continuance of the irradiation process with a new target (by 10 plus 10 discrete irradiation) can double the total activity in comparison with 20 successive irradiation cycles, without any increase in the fuel consumption of the reactor. These findings increase the prospect of a large-scale production of the life-saving 153Sm radioisotope in MNSR reactors.

The feasibility study of 177Lu production in Miniature Neutron Source Reactors using a multi-stage approach in Isfahan, Iran.

Miniature neutron source reactors (MNSRs) are among the safest and economic research reactors with potentials to be used for neutron studies. This manuscript explores the feasibility of 177Lu production in Isfahan MNSR reactor using direct production route. In this study, to assess the specific activity of the produced radioisotope, a simulation was carried out through the MCNPX2.6 code. The simulation was validated by irradiating a lutetium disc-like (99.98 chemical purity) at the thermal neutron flux of 5 × 1011 ncm2s-1 and an irradiation time of 4min. After the spectrometry of the irradiated sample, the experimental results of 177Lu production were compared with the simulation results. In addition, factor from the simulation was extracted by replacing it in the related equations in order to calculate specific activity through a multi-stage approach, and by using different irradiation techniques. The results showed that the simulation technique designed in this study is in agreement with the experimental approach (with a difference of approximately 3%). It was also found that the maximum 177Lu production at the maximum flux and irradiation time allows access to 723.5mCi/g after 27 cycles. Furthermore, the comparison of irradiation techniques showed that increasing the irradiation time is more effective in 177Lu production efficiency than increasing the number of irradiation cycles. In a way that increasing the irradiation time would postpone the saturation of the productions. On the other hand, it was shown that the choice of an appropriate irradiation technique for 177Lu production can be economically important in term of the effective fuel consumption in the reactor.

Analysis of Relative Biological Effectiveness of Proton Beams and Iso-effective Dose Profiles Using Geant4.

BACKGROUND: The assessment of RBE quantity in the treatment of cancer tumors with proton beams in treatment planning systems (TPS) is of high significance. Given the significance of the issue and the studies conducted in the literature, this quantity is fixed and is taken as equal to 1.1. OBJECTIVE: The main objective of this study was to assess RBE quantity of proton beams and their variations in different depths of the tumor. This dependency makes RBE values used in TPS no longer be fixed as they depend on the depth of the tumor and therefore this dependency causes some changes in the physical dose profile. MATERIALS AND METHODS: The energy spectrum of protons was measured at various depths of the tumor using proton beam simulations and well as the complete simulation of a cell to a pair of DNA bases through Monte Carlo GEANT4. The resulting energy spectrum was used to estimate the number of double-strand breaks generated in cells. Finally, RBE values were calculated in terms of the penetration depth in the tumor. RESULTS AND CONCLUSION: The simulation results show that the RBE value not fixed terms of the depth of the tumor and it differs from the clinical value of 1.1 at the end of the dose profile and this will lead to a non-uniform absorbed dose profile. Therefore, to create a uniform impact dose area, deep-finishing systems need to be designed by taking into account deep RBE values.

Does Occupational Exposure of Shahid Dastghieb International Airport Workers to Radiofrequency Radiation Affect Their Short Term Memory and Reaction Time?

BACKGROUND: Airport workers are continuously exposed to different levels of radiofrequency microwave (RF/MW) radiation emitted by radar equipments. Radars are extensively used in military and aviation industries. Over the past several years, our lab has focused on the health effects of exposure to different sources of electromagnetic fields such as cellular phones, mobile base stations, mobile phone jammers, laptop computers, radars, dentistry cavitrons and MRI. The main goal of this study was to investigate if occupational exposure of Shahid Dastghieb international airport workers to radiofrequency radiation affects their short term memory and reaction time. METHODS: Thirty two airport workers involved in duties at control and approach tower (21 males and 11 females), with the age range of 27-67 years old (mean age of 37.38), participated voluntary in this study. On the other hand, 29 workers (13 males, and 16 females) whose offices were in the city with no exposure history to radar systems were also participated in this study as the control group. The employees' reaction time and short term memory were analyzed using a standard visual reaction time (VRT) test software and the modified Wechsler memory scale test, respectively. RESULTS: The mean± SD values for the reaction times of the airport employees (N=32) and the control group (N=29) were 0.45±0.12 sec and 0.46±0.17 sec, respectively.  Moreover, in the four subset tests; i.e. paired words, forward digit span, backward digit span and word recognition, the following points were obtained for the airport employees and the control group, respectively: (i) pair words test: 28.00±13.13 and 32.07±11.65, (ii) forward digit span: 8.38±1.40 and 9.03±1.32, (iii) backward digit span: 5.54±1.87 and 6.31±1.46, and (iv) word recognition: 5.73±2.36 and 6.50±1.93. These differences were not statistically significant. CONCLUSION: The occupational exposure of the employees to the RF radiation in Shahid Dastghieb international airport does not have any significant detrimental effect on their reaction time as well as short term memory.

The CNAO dose delivery system for modulated scanning ion beam radiotherapy.

PURPOSE: This paper describes the system for the dose delivery currently used at the Centro Nazionale di Adroterapia Oncologica (CNAO) for ion beam modulated scanning radiotherapy. METHODS: CNAO Foundation, Istituto Nazionale di Fisica Nucleare and University of Torino have designed, built, and commissioned a dose delivery system (DDS) to monitor and guide ion beams accelerated by a dedicated synchrotron and to distribute the dose with a full 3D scanning technique. Protons and carbon ions are provided for a wide range of energies in order to cover a sizable span of treatment depths. The target volume, segmented in several layers orthogonally to the beam direction, is irradiated by thousands of pencil beams which must be steered and held to the prescribed positions until the prescribed number of particles has been delivered. For the CNAO beam lines, these operations are performed by the DDS. The main components of this system are two independent beam monitoring detectors, called BOX1 and BOX2, interfaced with two control systems performing the tasks of real-time fast and slow control, and connected to the scanning magnets and the beam chopper. As a reaction to any condition leading to a potential hazard, a DDS interlock signal is sent to the patient interlock system which immediately stops the irradiation. The essential tasks and operations performed by the DDS are described following the data flow from the treatment planning system through the end of the treatment delivery. RESULTS: The ability of the DDS to guarantee a safe and accurate treatment was validated during the commissioning phase by means of checks of the charge collection efficiency, gain uniformity of the chambers, and 2D dose distribution homogeneity and stability. A high level of reliability and robustness has been proven by three years of system activity needing rarely more than regular maintenance and working with 100% uptime. Four identical and independent DDS devices have been tested showing comparable performances and are presently in use on the CNAO beam lines for clinical activity. CONCLUSIONS: The dose delivery system described in this paper is one among the few worldwide existing systems to operate ion beam for modulated scanning radiotherapy. At the time of writing, it has been used to treat more than 350 patients and it has proven to guide and control the therapeutic pencil beams reaching performances well above clinical requirements. In particular, in terms of dose accuracy and stability, daily quality assurance measurements have shown dose deviations always lower than the acceptance threshold of 5% and 2.5%, respectively.

SU-E-T-298: Evaluation of the CNAO Spot Scanning Technique Based on the First Clinical Deliveries.

PURPOSE: The first Italian hospital-based facility for hadrontherapy is the Centro Nazionale di Adroterapia Oncologica (CNAO) which started the clinical activity on September 2011 with protons beams. The control of the treatment is performed online by the Dose Delivery (DD) system which guides the whole treatment by measuring beam characteristics as number of delivered particles and beam position. The author will present the comparison between the required and delivered quantities. METHODS: The CNAO facility is based on a synchrotron designed to accelerate and deliver proton and carbon ion beams in the clinical ranges. Unlike most of the proton-therapy centres, the delivery technique adopted at CNAO is the "quasi-discrete" active scanning where dedicated magnets are used to drive a pencil beam through the target and the beam is normally not switched off during the transition between adjacent spots. These operations are performed by the DD system which, based on the treatment planning and the online analysis of dedicated beam monitor chambers, drives the scanning magnets. Spot by spot the DD records data which allow the comparison between the measured number of particles and position and the prescription. RESULTS: The data collected by the dose delivery during the treatments were analyzed in detail, each treatment consisting in more than 30 identical fractions. This allows checking the stability and the accuracy of the CNAO delivery over identical spot sequences. The comparison between the measured number of particles, the measured position of each spot, and the corresponding prescribed quantities will be presented in detail. Critical points will be discussed together with the proposed improvement of the system. CONCLUSIONS: The results confirm the good performance of the CNAO beam delivery obtained during the commissioning phase.

Comparison of fern and evaporation tests for detection of ruptured fetal membranes.

Timely diagnosis of ruptured fetal membranes during the pregnancy is important. This study in the Islamic Republic of Iran compared the sensitivity and specificity of the evaporation test that requires no special equipment with the standard fern test requiring a microscope. Two groups of 50 pregnant women were studied: 1 with artificially ruptured membranes (gold standard) and 1 with intact membranes. The positive and negative predictive values of the fern test were 92% and 96% and for the evaporation test were 89% and 98%. The evaporation test is a simple, easy and non-expensive diagnostic test for ruptured membranes.

Comparison of fern and evaporation tests for detection of ruptured fetal membranes

Timely diagnosis of ruptured fetal membranes during the pregnancy is important. This study in the Islamic Republic of Iran compared the sensitivity and specificity of the evaporation test that requires no special equipment with the standard fern test requiring a microscope. Two groups of 50 pregnant women were studied: 1 with artificially ruptured membranes [gold standard] and 1 with intact membranes. The positive and negative predictive values of the fern test were 92% and 96% and for the evaporation test were 89% and 98%. The evaporation test is a simple, easy and non-expensive diagnostic test for ruptured membranes