Telemedical assessment of optic nerve head and retina in patients after recent minor stroke or TIA

The aim of the study is to telemedically assess the prevalence of simple optic nerve atrophy and retinal arteriolar anomalies in subjects who have had a minor stroke or TIA within 14 days, and to compare these results with an age-matched control group. By using a mobile examination unit, retinal photographs were taken with a 45° non-mydriatic colour fundus camera (KOWA NM-45, non-mydriatic-alpha) in patients who had suffered from a minor stroke or TIA within 14 days of the time of the examination. Retinal photographs were focused on the optic nerve head region. Pupils were not dilated. The documented medical history and the retinal images were stored on a server using browser independent web-based software running on PCs, tablets and smartphones. After completing the upload of the medical interview and the retinal images into the electronic patient chart, all retinal images were evaluated via telemedicine by an experienced senior consultant ophthalmologist. Age-matched normotensive, non-diabetic subjects (aged 40–89 years) who reported no systemic or ocular diseases were used as the control group. Both study groups were divided into five decades of life (40–49; 50–59; 60–69; 70–79; 80–89 years). We calculated the prevalences and the ratios of prevalences of optic nerve atrophy and retinal arteriolar anomalies between the stroke and the control group per decades of life. 139 minor stroke or TIA subjects (aged 40–89 years) and 1611 age-matched control subjects were examined. In the stroke group, we found significantly increased prevalences of optic nerve atrophy and retinal arteriolar anomalies throughout the 5th–8th decade of life when compared to age-matched controls. The prevalence of optic nerve atrophy in stroke subjects outranged the prevalence in the controls depending on age-class by a factor of 3–21. Simple optic nerve atrophy is frequent in patients who have suffered from an ischemic stroke or TIA, and it seems to indicate vascular damage, indicating the necessity for telemedically assisted assessment of the optic nerve.     

The effects of Continuous Care Model on depression, anxiety, and stress in patients on hemodialysis.

This quasi-experimental study was carried out to determine the effects of the Continuous Care Model on stress, anxiety, and depression in patients on hemodialysis in Hamedan, Iran in 2005. Thirty-eight patients were selected randomly and the Depression Anxiety Stress Scale (DASS-21) was used for data collection. Data analysis showed a significant relationship between applying the Continuous Care Model and DASS-21 scores. According to the findings, applying this care model can improve the lives of patients on hemodialysis.     

Prevalence of coagulase-positive staphylococci in the skin of dogs; antibacterial resistance and plasmid profile of the isolates

This study was designed to understand the prevalence of coagulase-positive staphylococci in the skin of dogs and the role of dogs as reservoirs of pathogenic and antimicrobial-resistant staphylococci. Swab samples were taken from the surface of the skin at muzzle sites of 100 clinically normal dogs. Antibiotic susceptibility of coagulase-positive staphylococci isolates was assessed by antibiotic disc diffusion method using filter paper discs and plasmid DNAs were extracted from the isolates. Staphylococci were isolated from 79 of the 100 dogs sampled and of these 51 were coagulase positive. All coagulase-positive staphylococci isolates were resistant to penicillin G, amoxicillin, cefazolin, streptomycin, erythromycin, ampicillin, tetracycline, gentamicin, trimethoprim-sulfamethoxazole, and enrofloxacine at 100%, 100%, 72%, 48%, 44%, 44%, 12%, 4%, 8%, and 4% respectively. Characterization of plasmid DNAs by agarose gel electrophoresis showed that 22 out of the 51 coagulase-positive staphylococci isolates harbored a single plasmid. The results of the present study indicate that pathogenic and resistant staphylococci are located in the skin of the dogs and may transfer to human and other hosts. It is important to establish reliable antibiotic sensitivity data regarding these bacteria to select suitable antibacterial treatment.     

Sleep patterns and habits in high school students in Iran

Background  

Sleep patterns and habits in high school students in Iran have not been well studied to date. This paper aims to re-address this balance and analyse sleep patterns and habits in Iranian children of high school age.     

Head trauma

Computed tomography is currently the modality of choice in imaging acutely traumatized patients. This is based upon CT's documented ability to detect surgically significant lesions. Furthermore, the use of MRI is limited by a lack of bone detail, the degradation of MR images in frequently uncooperative patients, and a limited supply of nonferromagnetic monitoring equipments. CT and MRI are largely equivalent in their ability to diagnose epidural hematoma, but CT is readily available and quick. MRI provides information in addition to that obtained by CT in many instances, such as subacute and chronic subdural hematomas, contusions, and intracerebral hematomas.     

Short-latency somatosensory evoked potentials correlate with the severity of the neurological deficit and sensory abnormalities following cerebral ischemia

Short-latency somatosensory evoked potentials (SSEPs) were studied in 49 patients who had suffered hemispheric or thalamic ischemia, including 6 patients with transient ischemic attacks (TIAs) and 3 patients with reversible ischemic neurological deficits (RINDs). SSEPs were abnormal in 30 patients (61%). SSEP abnormalities correlated with the presence of sensory deficit and the degree of neurological deficit. SSEPs were normal following TIA but were abnormal in 2 of 3 patients with RINDs. SSEPs were abnormal in some patients without sensory deficits suggesting that sensory pathways may be affected when clinically inapparent.     

Effect of anterior chamber air bubble on prevention of experimental Staphylococcus epidermidis endophthalmitis

Background  

Bacterial endophthalmitis is a serious complication of penetrating ocular trauma and cataract surgery. The purpose of this study is to assess the ability of an anterior chamber air bubble to prevent experimental Staphylococcus epidermidis endophthalmitis.