Introduction: Hypertriglyceridemia (HTG)-induced acute pancreatitis (AP) during pregnancy is a rare but serious condition associated with high maternal and fetal complications. This condition is more common in multiparous women and typically occurs in the third trimester or early postpartum period, especially in the presence of risk factors such as pre-existing HTG and diabetes. Case Presentation: A 29-year-old primigravid woman presented at 21 weeks gestation to the obstetrics emergency department with acute, severe, persistent epigastric and left upper abdominal pain lasting for one day. Physical examination revealed tachycardia, slightly elevated blood pressure, and tenderness in the epigastrium and left upper quadrant. She had a history of primary infertility lasting three years but no other significant medical or surgical history. Her family history was negative for any specific diseases. Laboratory examinations showed elevated serum amylase levels (1170 IU/L) and a markedly high serum triglyceride level (8100 mg/dL). A diagnosis of acute HTG-induced pancreatitis was made, and the patient was successfully treated with a combination of plasma exchange, low molecular weight heparin, and an insulin/potassium/dextrose infusion. Pregnancy was completed with an elective cesarean delivery at 38 weeks gestation, with no episodes of recurrence or related complications observed during the follow-up period. Conclusions: Acute pancreatitis should be considered as a differential diagnosis in pregnant women presenting with epigastric pain across all trimesters, even in patients with no family or personal history of HTG, as early diagnosis can significantly improve maternal outcomes.

Background and objectives: Coronavirus disease 2019 (COVID-19) has been reported to be more severe and highly fatal in patients with co-morbidities. Thyroid dysfunction leads to multisystem derangements, as thyroid hormones have major role in the development and functioning of all the human cells. The present study evaluated the variation in the clinical and biochemical parameters of COVID-19 patients with preexisting hypothyroidism. Methods: This retrospective cohort study was carried out on eight COVID-19 patients with hypothyroidism who were admitted to a tertiary care hospital in Mangalore, India. Various clinical and biochemical parameters of the patients were recorded. Results: Out of eight patients, three were men and five were women. With respect to other co-morbidities, six patients had associated type-2 diabetes mellitus and the remaining two patients had no other co-morbidities apart from hypothyroidism. Regarding the severity of COVID-19, one patient had mild symptoms, two had moderate symptoms, and the remaining five patients had severe COVID-19 symptoms. Most biochemical and hematological parameters in all patients were deranged from normal values. Moreover, only 25% of the patients recovered from the disease. Conclusion: Most COVID-19 patients with hypothyroidism had low oxygen saturation and high level of inflammatory markers. In addition, the risk of mortality in COVID-19 patients with hypothyroidism and type 2 diabetes mellitus was higher compared to patients with hypothyroidism alone. It is recommended to closely monitor COVID-19 patients with hypothyroidism and limit the use of steroids during the course of treatment.

Hydraulic fracturing is a new and widely used method for extracting reserves and energy resources in the depths of the earth. In the near future, due to increase in energy consumption on the one hand and depletion of energy reserves on the other, using of this method will become a necessity. One of the most important and effective parameters in this process is the pressure and how it is applied in order to create fractures and fracture progression in rock layers. Another important parameter is the interaction between pre-existing natural fractures with different angles and hydraulic fracture.  Due to the high costs of this process, the purpose of this study is to achieve the optimal state for the maximum progress of hydraulic fracture and the lowest amount of breakdown pressure at the same time. Numerical modeling was performed in two dimensions by Particle Flow Code ( PFC ) software from Itasca company on samples of Pocheon granite rocks with brittle behavior using distinct element method. PFC software uses circular disks in two dimensions to construct and make the sample using distinct element method. These particles are in contact with each other through bonds. In this program there are walls that interact with these disks to apply load on the sample. The flat joint model is used in order to create contacts between particles, and discrete fracture network is uded to to create pre-existing natural fractures for interacting with hydraulic fracture. Given that in the distinct element method (PFC software) our sample consists of a large number of particles in two dimensions that the general characteristics of the sample are formed based on the interaction between these particles, so we need parameters as input data to our software, existing disks and the link between them, to finally obtain the specifications of the same laboratory sample after modeling. These specifications and input data are referred to as micro parameters, and the final specifications, which are the same as our mechanical parameters in the laboratory, are referred to as macro parameters. To find the micro parameters of the sample we use the trial and error method. Here, our modeling is based on Brazilian and uniaxial compression experiments and … performed by Zhuang et al. laboratory investigations. Due to the limitations of PFC software for fluid flow modeling and limitations for using of CFD relationships, pressure equals to fluid pressure can be used as a new solution. In this way, by modeling a number of walls that form a complete circle with overlapping each other, and by considering the servo control mechanism, we move them in the opposite direction of their normal vectors and off-center, creating a comprehensive pressure Which is actually same as the fluid pressure. From the obtained results, it was found that with increasing the loading rate, the sample reaches the breakdown pressure and breaks in less time, but the amount of breakdown pressure increases. Also, by increasing the natural fracture angle relative to the horizon (clockwise), the specimen breaks at a lower breakdown pressure. Finally, by increasing the natural fracture distance from the center of the sample, the effect of the presence of the joint in the sample decreases and the breakdown pressure approaches the seamless state.

Purpose: This study was performed to evaluate the ability of toric intraocular lenses (IOLs) to correct pre-existing corneal astigmatism in cataract patients.Methods: Fifteen eyes that had corneal astigmatism of 1.5 diopters (D) or more were enrolled in this retrospective study. Standard superior posterior limbal sutureless approach for phacoemulsification was done and a Staar silicone plate haptic toric IOL (AA4203TF or TL) was inserted through a 3.2 mm incision in the capsular bag.Results:' After a 6 month follow up the uncorrected visual acuity was 0.25± 0.138 LogMAR, and 100% of patients had a 20/40 or better and 69.2% a 20/30 or better unaided vision. Postoperative refractive astigmatism was 0.75 or less in 69.2%. Mean astigmatism correction was 1.560 for 2.000 and 2.220 for 3.500 toric lenses.Conclusion: Toric IOLs are safe and reliable tools to correct preexisting astigmatism.They showed promising results to reduce corneal astigmatism of 1.50 to 3.00. There was no difference in the outcome between Staar AA4203TF and TL IOL.