Traffic crash accidents in Tehran, Iran: Its relation with circadian rhythm of sleepiness / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>Road traffic accidents are one of main problems in Iran. Multiple factors cause traffic accidents and the most important one is sleepiness. This factor, however, is given less attention in our country. Road traffic accidents relevant to sleepiness are studied.</p><p><b>METHODS</b>In this cross-sectional study, all road traffic accidents relevant to sleepiness, which were reported by police, were studied in Tehran province in 2009.</p><p><b>RESULTS</b>The risk of road traffic accidents due to sleepiness was increased by more than sevenfold (odds ratio = 7.33) in low alertness hours (0:00-6:00) compared to other time of day. The risk of road traffic accidents due to sleepiness was decreased by 0.15-fold (odds ratio = 0.15) in hours with maximum of alertness (18:00-22:00) of circadian rhythm compared to other time of day.</p><p><b>CONCLUSION</b>The occurrence of road traffic accidents due to sleepiness has significant statistical relations with driving during lowest point of alertness of circadian rhythm.</p>

Office-based slit-lamp needle revision with adjunctive Mitomycin-C for late failed or encapsulated filtering blebs

The purpose of this study was to assess the results of bleb needling in glaucomatous patients with late failed filtering blebs. A retrospective case series of 27 eyes of 27 patients was considered. All patients underwent needle bleb revision with adjuvant mitomycin-C performed at the slit lamp, during an office visit. Complete success was defined as postneedling intraocular pressure [IOP]=21 mmHg without any antiglaucoma medications and qualified success was IOP=21 mmHg with topical antiglaucoma medications. There were 12 eyes with encapsulated blebs and 15 eyes with flat blebs. The mean interval between index filtering surgery and bleb revision was 32.74 +/- 15.36 months. Mean IOP was 25.07 +/- 4.80 mmHg before surgery and 19.66 +/- 4.97 mmHg at last postoperative follow-up. The mean follow-up was 20.31 +/- 15.63 months. Complete and qualified successes were 7.4% and 51.9%, respectively. Cumulative rates of success at 1, 2, 3, and 4 years were 76%, 65%, 49%, and 37%, respectively. The mean number of antiglaucoma medications was reduced from 3.15 +/- 0.36 preoperatively to 2.33 +/- 1.21 postoperatively [P<0.001]. Slit-lamp needle revision in office is a simple and effective method for treating late encapsulated or flat filtering blebs without significant complications even for late bleb failure