Bone mineral density in children with relapsing nephrotic syndrome

Given the high relapse rate of disease in children with steroid dependent nephrotic syndrome and the osteoporotic effect of long periods of steroid therapy, this survey was performed to find the bone mineral status of these patients. Bone mineral density and content [BMD and BMC] were measured using Dual energy X-ray absorptiometry in 37 nephrotic children, six girls and 31 boys aged from four to 21- yrs, as patient group and 37 age and sex-matched healthy individuals as control group. Historical data were collected by chart review. As compared to the control group, the patients were shorter in stature. The percentage of BMC of lumbar and BMD of femoral bones of the patients was significantly lower than control group. According to the Warner method, 12% of the patients were osteoporotic and the BMD of their femoral and lumbar bones was inversely correlated with cumulative steroid dose. Bone loss can occur in some steroid-dependent nephrotic patients, especially those with low age of onset and those with longer duration of the disease and higher cumulative dose of steroid. Therefore, measurements of BMD and BMC could be recommended, at least, for the selected patients

LASIK retreatment for Myopia and Myopic Astigmatism

To evaluate the results of laser in situ keratomileusis [LASIK] retreatment in patients with postoperative regression. In a retrospective interventional case series, 153 eyes of 113 patients who had undergone LASIK retreatment for postoperative regression were evaluated. Both initial LASIK and retreatment were performed with a Nidek: EC 5000 excimer laser, and flap was made with a Moria microkeratome. Mean age was 29.63 +/- 2.2 yr [range, 20 to 54 yr] and mean follow-up was 11 months [range, 3 to 34 mth] after the initial surgery and 13.1 months [range, 12 to 18 mth] after retreatment. Retreatment was performed 3-34 months after the primary LASIK. Mean spherical equivalent [SE] was -5.39 +/- 2.69 diopters [D] [range, -1.50 to -14.00 D] before initial LASIK and -1.76 +/- 1.08 D [range, -0.50 to -5.00 D] before retreatment. Mean astigmatism was -1.38 +/- 1.07 D [range, -0.50 to -5.00 D] before initial LASIK and -1.12 +/- 0.50 D [range, -0.50 to -2.50 D] before retreatment. One year after retreatment, mean UCVA was 20/25, and mean SE was -0.29 +/- 0.02 D. Best corrected visual acuity [BCVA] improved in all eyes. Two eyes received more than one retreatment. Twenty eyes had flap wrinkling, 2 eyes had diffuse lamellar keratitis [DLK], and 2 eyes had epithelial ingrowth after the initial LASIK. Four eyes had epithelial ingrowth and 2 eyes developed mild keratectasia after retreatment. LASIK retreatment is a safe and effective option with small amounts of myopia and myopic astigmatism regression. The rate of retreatment is higher in patients with myopic astigmatism and in patients with less than 40 years of age, also the risk of complications in retreatment is higher than the initial LASIK. Refractive changes are more stable after retreatment. The risk of keratectasia is higher in final residual stromal bed thickness less than 250 lam after the reoperation

In-vitro susceptibility of infective keratitis causative bacteria to topical povidone iodine

Purpose: To evaluate the in-vitro susceptibility of bacterial isolates from the cases of corneal ulcer to povidone iodine. Setting: Department of ophthalmology, and clinical microbiology research center, Shiraz University of Medical Sciences, Shiraz, Iran. Patients and The in-vitro susceptibility and Minimum Inhibitory Concentration [MIC] of the bacteria isolated from the cornea of 50 cases of bacterial corneal ulcer to povidone iodine was determined by broth dilution method. Concentrations of 1%, 2%, 5% and 10% of povidone iodine were tested. Bacterial isolates included 50% S. epidermidis, 20% P. aerogenosa, 10% S. aureus, 4% Acintobacter, 4% S. pneumoniae, 4% E-coli, 2% Proteous, 2% S. viridance, 2% Diphtheroid and 2% Bacillous. Povidone iodine bactericidal efficacy for gram positive bacteria was at least 82.36%, 91.2%, 100% and 100% in 1%, 2%, 5% and 10% concentrations after 5 minutes exposure time. The bactericidal efficacy of this agent over the gram negative bacteria was at least 62.5%, 87.5%, 100% and 100% in 1%, 2%, 5% and 10% concentrations after 5 minutes exposure time, respectively. Povidone iodine was shown to have a broad spectrum in- vitro bactericidal efficacy in cases of bacterial keratitis. If further invivo studies confirm the efficacy of this agent over the bacterial keratitis, it would be suggested as a broad spectrum medication for the treatment of these cases