Epidemiology and sociodemographic aspects of ocular traumatic injuries in Iran

Although the incidence of ocular trauma has been clearly described in developed countries, few published data are available on the epidemiology and the effects of parameters that can influence the incidence and severity of ocular injuries in Iran. The present study tried to determine epidemiological aspects of ocular traumatic injuries and evaluate their effects on different types of ocular injury. The case series included 1950 consecutive patients with acute ophthalmic trauma presented to the emergency ward of Farabi Hospital in Tehran. Information was collected by interviewing patients and having them fill in a questionnaire. The final diagnosis was made by a medical resident. If there was a difficulty or doubt in diagnosis or classification, confirmation of diagnosis was made by senior faculty. Ocular injuries were classified into globe and non-globe injuries according to the site of injury. Mechanical globe injuries were classified according to Birmingham Eye Trauma Terminology (BETT) into closed and open injuries. The mean age of patients was 28.8 ± 12.8 years; 87.6% were male. The most common causes of injury were work-related (49.0%) and chance events (42.0%). The most frequent ocular injury was globe injury (95.6%), including mechanical (77.6% closed and 5.9% open), chemical (7.6%), photic (2.3%) and thermal (2.2%) injuries. Non-globe injury also occurred in 10.8% of patients; both globe and non-globe injuries occurred in 6.5% of patients. The hospitalization rate in all patients was 8.8%. Previous history of eye trauma was significantly more common in the group with isolated globe injuries (P < 0.001). History of eye trauma is a risk factor for globe injuries and female gender is a risk factor only for non-globe injuries. These two factors may predict future eye injury and increase its risk by 5.2 and 1.6 times, respectively.     

Apigenin inhibits growth of the Plasmodium berghei and disrupts some metabolic pathways in mice

Due to the challenges in the control, prevention, and eradication of parasitic diseases like malaria, there is an urgent need to discover new therapeutic agents. Plant‐derived medicines may open new ways in the field of antiplasmodial therapy. This study is aimed to investigate the toxicity and in vivo antiplasmodial activity of apigenin, a dietary flavonoid. Apigenin cytotoxicity was investigated on Huh7 cell line, brine shrimp (Artemia salina) larva, and human red blood cells. In vivo toxicity of apigenin was assessed by metabolomics approaches. Apigenin exhibited significant suppression of parasitemia in a dose‐dependent manner; it suppressed Plasmodium berghei growth by 69.74%, 50.3%, and 49.23% at concentrations of 70, 35, and 15 mg/kg/day, respectively. The IC₅₀ value for apigenin after 24 hr exposure to Huh7 cells was 225 μg/ml. Apigenin did not show noticeable toxicity on A. salina and also on the membrane integrity of red blood cells. After 24 hr exposure of mice to apigenin, alterations were seen in the metabolism of glucocorticoids and mineralocorticoids, bile acid metabolism (alternative pathway), sulfur metabolism, bile acid metabolism, metabolism of estrogens and androgens, cholesterol catabolism, and biosynthesis of cholesterol. These findings indicate that apigenin has potential in vivo antiplasmodial activity against P. berghei infected mice with high selectivity against malaria, but it can disrupt some metabolic pathways in mice.     

Relationship between occurrence of Guillain-Barre syndrome and mass campaign of measles and rubella immunization in Iranian 5-14 years old children

BACKGROUND: Case reports and epidemiologic studies have reported a relation between different vaccines including measles, rubella, mumps and Guillain-Barre syndrome (GBS). In this study we investigated relation between receiving measles and/or rubella vaccines and occurrence of GBS after national immunization campaign in 2003 in Iran. MATERIALS AND METHODS: We used the national surveillance system for acute flaccid paralysis from the beginning of 2002 to the end of 2004 and studied the incidence of GBS disease among 5-14-year-old children. The 3-year time span of the study was divided into fifteen 10 weeks intervals and the number of reported and confirmed GBS case reports in each time period was analyzed supposing their distribution was according to Poisson distribution. RESULTS: From 2002 through 2004 there were 370 patients confirmed GBS case reports among persons 5-14 years of age. The annual incidence in this age group remained relatively constant over the 3-year period and ranged from 0.65 per 100,000 population in 2004 to 0.76 in 2003. The estimated average annual incidence of GBS in persons <15 years of age was 1/100,000 (CI 95%: 0.88-1.13), and 0.7/100,000 in persons 5-14 years of age (CI 95%: 0.58-0.83). No obvious seasonal pattern in GBS occurrence was observed. The mean number of GBS patients during each 10 week study interval was 23.8. Twenty-five patients with GBS were reported in the time period which coincided with national immunization campaign. The probability of occurring >/=25 cases of GBS in that time period according to Poison distribution with expected case numbers of 23-8 is equal to 0.43 (p=0.43). CONCLUSION: The yearly incidence rate of GBS in this study was similar to other studies. According to our results, there was no increase in GBS Incidence in the 4 weeks national Immunization campaign and 6 weeks after it in comparison to other 10 weeks periods before or after this time period.     

Prevalence of the refractive errors by age and gender: the Mashhad eye study of Iran

Background: Refractive errors are a common eye problem. Considering the low number of population‐based studies in Iran in this regard, we decided to determine the prevalence rates of myopia and hyperopia in a population in Mashhad, Iran. Design: Cross‐sectional population‐based study. Participants: Random cluster sampling. Of 4453 selected individuals from the urban population of Mashhad, 70.4% participated. Methods: Refractive error was determined using manifest (age >15 years) and cycloplegic refraction (age ≤15 years). Myopia was defined as a spherical equivalent of ?0.5 diopter or worse. An spherical equivalent of +0.5 diopter or worse for non‐cycloplegic refraction and an spherical equivalent of +2 diopter or worse for cycloplegic refraction was used to define hyperopia. Main Outcome Measures: Prevalence of refractive errors. Results: The prevalence of myopia and hyperopia in individuals ≤15 years old was 3.64% (95% CI: 2.19–5.09) and 27.4% (95%CI: 23.72–31.09), respectively. The same measurements for subjects >15 years of age was 22.36% (95%CI: 20.06–24.66) and 34.21% (95%CI: 31.57–36.85), respectively. Myopia was found to increase with age in individuals ≤15 years and decrease with age in individuals >15 years of age. The rate of hyperopia showed a significant increase with age in individuals >15 years. The prevalence of astigmatism was 25.64% (95%CI: 23.76–27.51). Conclusions: In children and the elderly, hyperopia is the most prevalent refractive error. After hyperopia, astigmatism is also of importance in older ages. Age is the most important demographic factor associated with different types of refractive errors.     

The Prevalence of Amblyopia and Its Determinants in a Population-based Study

Purpose: To determine the prevalence of amblyopia and its determinants in a population-based study in Mashhad County, Iran.

Methods: This cross-sectional, population-based study was conducted on the population of Mashhad County aged >1 year using randomized stratified cluster sampling. Examinations were performed after selection of the participants and their free transportation to the sampling site. The examinations included the measurement of uncorrected and corrected visual acuity, cycloplegic and non-cycloplegic refraction, cover testing, slit-lamp biomicroscopy, and ophthalmoscopy. In this study, amblyopia was defined as best corrected visual acuity (BCVA) of 20/30 or less or 2-line interocular optotype acuity differences with no pathology.

Results: After considering the exclusion criteria, the data of 2739 individuals, 65.6% of whom were women, were analyzed. The mean age of the participants was 29.5±17.5 years. The prevalence of amblyopia was 4.6% (95% CI: 3.77%-5.43%) in the total population. The lowest prevalence was 2.24% in the age group 5-15 years (95% CI: 0.99%-3.48%) and the highest prevalence was 7.14% in the age group 55-65 years (95% CI: 2.64%-11.56%). Anisometropic amblyopia was observed in 45.24% of the amblyopic participants. Isometropic, mixed (strabismic/anisometropic), and strabismic amblyopia were other common causes of amblyopia, with a prevalence of 24.6%, 16.67%, and 13.49% in amblyopic patients, respectively. The odds ratio (OR) of having amblyopia for each 1-year increase in age was 1.02 (95% CI: 1.01-1.03). Amblyopia was less common in people with better socioeconomic status.

Conclusion: This study showed the prevalence of amblyopia in all age groups in a population-based study for the first time. The findings of this study regarding the relatively high prevalence of amblyopia in the older population and its lower prevalence in young people indicate attention to amblyopia in recent years.     

Determinants of operative mortality following primary coronary artery bypass surgery.

BACKGROUND: The purpose of this study was to determine the factors which can help to predict operative mortality before performing the operation, and afterwards. METHODS: The study population consisted of 504 patients (91 women and 413 men) who underwent primary isolated coronary artery bypass surgery from December 1997 to September 1999 by the same surgeon in a referral center in Tehran, Iran. Perioperative data were gathered and analyzed both in a univariate and multivariate model. RESULTS: After the operation patients spent 7.3 +/- 4.0 days in hospital. The total operative morbidity was 20.5%. Arrhythmias were the most common complication, with atrial fibrillation as the predominant feature. Major complications of the operation were: low cardiac output (4.2%); prolonged ventilatory support (2.4%); hemorrhage and exploratory reoperation (2.0%); postoperative myocardial infarction (1.4%); postoperative renal failure in (1.4%); and postoperative cerebrovascular accident (0.8%). Operative mortality rate in this study was 2.98%. Factors associated with high operative mortality in univariate analysis were: recent myocardial infarction, low ejection fraction, non-elective operation, left main coronary artery disease and prolonged cardiopulmonary bypass time. CONCLUSION: Our data suggest that prior to operation, operative mortality can be best predicted by urgency of operation and left ventricle ejection fraction. After performing the operation, prognostic factors include preoperative LVEF < or = 35%, non-elective operation, and prolonged cardiopulmonary bypass time. Further study is required to assess the generalization of our findings to Iranian patients.