Background: Recent years, have witnessed extended and continuous indication of cardiac pacing. However, increasing number of patients suffered new congestive heart failure (CHF) and aggravated CHF after pacing therapy. We used blood B type nutriuretic peptide (BNP) to predict the occurrence of CHF in patients with different types of pacemakers. To assess single N-terminal brain nutriuretic peptide (NT-pro BNP) as a predictor tool for ventricular dysfunction in different cardiac pacing mode.Methods: Out of 480 consecutive patients with pacemaker more than 6 months, 79 patients with average age of 65±13, and more than 90% ventricular pacing participated in the present study. Those with CHF prior to pacemaker insertion were excluded. The patients underwent medical history and examination, echocardiography (M-mode, Doppler, and Tissue imaging) and blood sampling for pro-BNP. Twenty five, 12, and 42 patients had Dual CHAMBER (DDDR), single CHAMBER pacing with dual CHAMBER sensing (VDDR), and Single CHAMBER (VVIR) pacemakers respectively Results: Single pro-BNP level in patient with DDDR and VDDR pacing was lower than in those with VVIR pacing (P<0.0001) but in Echocardiography left ventricular (LV) dysfunction was not lower in DDDR than VDDR and VVIR pacing patients (P=0.190).Conclusion: Single level of pro-BNP is lower in double CHAMBER pacing in comparison with single CHAMBER pacing. Therefore, it seems that dual CHAMBER pacing causes less LV dysfunction.

Introduction: Lens luxation generally happens secondary to trauma and hereditary disorders into the vitreous body. However, spontaneous dislocation especially into the anterior CHAMBER occurs rarely. We report an unusual case with spontaneous anterior dislocation of a posterior CHAMBER intraocular lens (IOL) 4 years after cataract surgery.Case Presentation: A 42-year-old woman was referred to ophthalmology department with complaint of sudden onset blurring of vision in the left eye 4 years after cataract surgery. No history of trauma and systemic disorder was reported and no capsular fibrosis was found during eye examination. The patient underwent corneoscleral incision under general anesthesia and the IOL was extracted using a viscoelastic material.Conclusions: To our knowledge, this is the first reported case in the literature. This report may imply that IOL related factors could be considered for spontaneous dislocation of intraocular lenses.

Purpose: Cataract surgery is the most common ocular surgery worldwide and in modern era of phacoemulsification with posterior CHAMBER intraocular lens (PC IOL) implantation, refractive aspects of surgery is as important as the surgery itself. After the IOL implantation, the anterior CHAMBER depth (ACD) is increased and the iridocorneal angle is widened. These changes should be considered for accurate IOL selection. In this study we evaluated the actual ACD following implantation of Morcher foldable PC IOL and compared it with the predicted depth.Methods: In a cross-sectional analytic study, ninety four cataractous eyes were operated with standard phacoemulsification and a foldable PC IOL (Morcher Bio Com Fold Type 93 IOL) was implanted. ACD, axial length (AL), refraction, and visual acuity were checked before and 3 months after the surgery.Results: ACD after the surgery was significantly increased, but it was smaller than the predicted depth (5.61 mm). Best corrected visual acuity (BCVA) after the surgery was significantly improved. There was a myopic trend in postoperative refraction.Conclusion: ACD after cataract surgery combined with Morcher Bio Com Fold type 93 lens was different from the predicted depth and this made most patients myopic.

Certain stratified charge divided CHAMBER engines have a very small pre-CHAMBER, equipped with a spark plug and a main CHAMBER connected to the pre-CHAMBER through nozzles. A theoretical model is presented in this research to predict ignition delay and initiation of combustion in the pre-CHAMBER. It considers ame progress in the pre-CHAMBER up to the point where the ame penetrates the main CHAMBER through the connecting nozzles. Step by step calculations then continue in the main CHAMBER and the mass fraction burned and the energy release rate is calculated. The process continues to the point where all the fuel is burned. At each step, due to a one degree rotation of the crank shaft, there is a change in the cylinder volume, due to the movement of the piston and, also, a change in the mole fraction burned, due to the burning of a fraction of the mixture. Considering heat transfer from the cylinder contents to its surrounding area, some important operating parameters, such as indicated power, indicated thermal efficiency, indicated septic fuel consumption, indicated mean elective pressure and volumetric efficiency, are predicted. Stepwise calculations also provide in-cylinder pressure-volume and pressure-crank angle diagrams, as well as the in-cylinder contents temperature variation with the crank position and concentration of species existing in the combustion products. Predicted values obtained by the present model are compared with corresponding experimental values available in the literature to evaluate the accuracy of the model. The comparison shows reasonable agreement between theoretical and measured values.

Purpose: To evaluate anterior CHAMBER aspirates at the conclusion of phacoemulsification and intraocular lens implantation (PE+IOL) for bacterial and fungal contamination.Methods: We prospectively evaluated 80 eyes of 80 patients undergoing routine PE+IOL by performing bacterial and fungal culture on aspirates obtained from the anterior CHAMBER at the end of the surgery.Results: Anterior CHAMBER fluid aspirates were positive for bacteria in 5 eyes (6.33%) with coagulase-negative staphylococcus being the most common organism (three eyes).No instance of positive fungus culture was observed. One of the culture-positive eyes developed postoperative uveitis which resolved during a week of treatment with topical corticosteroids and antibiotics. None of the eyes developed endophthalmitis.Conclusion: In the current series, the rate of anterior CHAMBER contamination by bacteria at the end of phacoemulsification was in the lower range reported by previous studies.