[Investigation of antibacterial activity of pimpinella affinis leaves against e. coli and s. aureus and separation of active fractions]

Background: Pimpinella affinis [Apiaceae family] is a vegetable in the north of Iran. Objective: This study was conducted to investigate antibacterial activity of Pimpinella affinis [against E. coli and S. aureus] and separate its active fractions

Methods: Antibacterial activities of /i-hexane, ethyl acetate and methanol extracts of leaves of P. affinis [against li. coli and S. aureus] were measured using broth microdilution method in MIC. Subsequently, the ethyl acetate extract was separated in to 29 fractions using column chromatography and thin layer chromatography [TLC]. Also, antibacterial activities of the fractions have been measured

Results: According to the results, among the extracts, ethyl acetate extract showed the best activities against E. coli and S. aureus [MICs=1.0 and 2.0 mg/ml, respectively]. Also, among the obtained fractions from ethyl acetate extract, F3-F5, F8 and F9 showed best inhibitory activities [MIO5.0

Conclusion: The results showed that the Gram positive S. aureus is more sensitive to the extracts than the Gram negative E. coli. Also, partitioning of the ethyl acetate extract leaded to obtain antibacterial fractions [F3-F5, F8 and F9] with 200-fold more active than the ethyl acetate extract

Predictors and Outcomes of Vitrectomy and Silicone Oil Injection in Advanced Diabetic Retinopathy

PURPOSE: To evaluate visual and anatomical results and identify factors that influence vitrectomy and silicone oil (SO) injection outcomes in proliferative diabetic retinopathy (PDR). METHODS: This retrospective study included 236 eyes with PDR that were undergoing vitrectomy and SO injection with >3-month follow-up. The primary outcomes were final best-corrected visual acuity (BCVA) and retinal attachment rate. RESULTS: At the final visit (mean, 88 ± 58 weeks), complete, partial, and no retinal attachment were observed in 86.9%, 10.6%, and 2.5% of patients, respectively. A total of 155 eyes had experienced SO removal, while 81 had SO in place. The mean initial BCVA was 1.9 ± 0.7 logarithm of the minimum angle of resolution (logMAR) and significantly improved to 1.7 ± 0.8 logMAR (p = 0.001). Initial macular detachment (adjusted odds ratio [AOR], 0.25), development of iatrogenic break (AOR, 0.25), and use of heavy SO (AOR, 0.13) were independently associated with a lower risk of final retinal attachment, and SO removal was associated with a higher incidence (AOR, 7.55). Better baseline BCVA was associated with a higher risk of final BCVA ≥20 / 200. CONCLUSIONS: Despite an encouraging outcome based on anatomical data in advanced PDR treated with vitrectomy and SO, the functional prognosis was not satisfying for patients. Eyes with better vision at baseline had a more favorable prognosis, whereas eyes with initial macular detachment, intraoperative iatrogenic break, or heavy SO showed more unfavorable outcomes. In selected cases, extending the time of SO use did not worsen the prognosis.

Investigation in protective effects of sophora pachycarpa extracts on serum level of sex hormones, urea and uric acid in carbon tetrachloride-intoxicated in male rats

Background: Carbon tetrachloride [CC14] is an industrial solvent that causes liver, kidneys, lungs, testis and brain as well as in blood diseases by generating free radicals. Previous studies on the chemical composition of S. pachycarpa have shown the presence of antioxidant compounds such as flavonoids

Objective: In the present study we investigated protective effects of Sophora pachycarpa extracts on serum level of sex hormones, urea and uric acid in carbon tetrachloride-intoxicated in male rats

Methods: Thirty six male wistar rats [195-200 g] were selected and randomly divided into 6 groups [n=6]: 3 pre-treatment groups received s.pachycarpa extract at doses 50 mg/kg/day, 100 mg/kg/day and 250 mg/kg/day by gavage for 21 days prior to intraperitoneal injection of CC14 500 micro/kg on 21[st] day, control group, CC14 group received 500 micro/kg CC14 on the 21[st] day, post-treatment group received extract at doses 100 mg/kg/day for 10 day at 12h after CCI4 250 micro/kg injection. At the end of the treatment, blood was collected by cardiac puncture from all of the animals and serum levels of sex hormones, urea and uric acid were assessed

Results: Serum levels of follicle stimulating hormone was significantly increased in serum of pre-treatment group III and serum level of luteinizing hormone and testosterone in serum of pre-treatment groups compared to CC14 was significantly increased [P<0.05]

Also serum levels of urea in pre-treatment and post-treatment groups and serum level of uric acid in serum of pre-treatment II and III [100 and 250 mg/kg] was significantly decreased compared to CC14 [P<0.05]

Conclusion: Together, our data suggest that Sophora pachycarpa extract can potentially ameliorate toxic effects of CCI4

Prevalence and risk factors of diabetes mellitus in a central district in Islamic Republic of Iran: a population-based study on adults aged 40-80 years

Previous studies on type 2 diabetes mellitus in the Islamic Republic of Iran were mainly performed in provinces with large populations. This study determined the prevalence and risk factors of diabetes mellitus in an adult population [40-80 years old] from Yazd district. Multistage, systematic cluster random sampling was used in a cross-sectional, population-based survey. Demographic, clinical and anthropometric data were collected, with diabetes defined as fasting blood sugar >/= 7 mmol/L or a positive medical history of diabetes. The age- and sex-standardized prevalence of diabetes in 2090 individuals participants was 24.5% [95% CI: 22.2-26.8%], including 10.5% new cases. For each year of ageing, the prevalence of diabetes increased significantly by 4% and this trend was more pronounced in females than males. Low education and hypertension were significantly associated with diabetes prevalence. The prevalence of diabetes mellitus in Yazd is greater than the average levels nationwide and those of nearby countries

[Randomized trial of intravitreal clindamycin and dexamethasone versus pyrimethamine, sulfadiazine, and prednisolone in treatment of ocular toxoplasmosis]

To compare the efficacy of intravitreal clindamycin and dexamethasone with classic treatment for ocular toxoplasmosis. In this prospective, randomized single-masked clinical trial a total of 68 patients with active ocular toxoplasmosis were assigned randomly to 2 treatment groups: 34 in the intravitreal clindamycin plus dexamethasone [IVCD] group and 34 in the classic treatment [CT] group. The IVCD group received 1 to 3 injection[s] of 1 mg intravitreal clindamycin and 400 microg dexamethasone, and the CT group received 6 weeks of treatment with pyrimethamine and sulfadiazine plus prednisolone. Antitoxoplasmosis antibodies [immunoglobulin [Ig] M and IgG] were measured using an enzyme-linked immunosorbent assay. The mean number of injections in the IVCD group was 1.6. Lesion size reduction was statistically significant after treatment in both IVCD and CT groups [P< 0.001 and P: 0.009, respectiveiy]. The difference in mean percentage of reduction at 6 weeks was not significant: 57 +/- 27.6% in the IVCD group versus 58.4 +/- 29.3% in the CT group. In comparison to baseline, VA increased by 0.44 +/- 0.24 and 0.29 +/- 0.19 logarithm of the minimum angle of resolution units in the IVCD and CT groups, respectively [P< 0.001]; however, the difference in VA improvement between the groups was not significant. The interaction effect of IgM and treatment group on lesion size reduction was significant [P= 0.002]; this indicated that IgM-positive cases responded better to CT and IgM-negative cases responded better to IVCD treatment. Vitreous inflammation reduction was comparable between the groups. Within 2 years, 4 eyes [2 in each group] had 1 episode of recurrence. Adverse drug reactions occurred in 2 patients in the CT group. No major injection-related complication was encountered in the IVCD group. Intravitreal injection of clindamycin and dexamethasone may be an acceptable alternative to classic treatment in ocular toxoplasmosis. It may offer more convenience, a safer systemic profile, greater availability, and fewer follow-up visits and hematologic evaluations

[Combined application of wet-bulb globe temperature and heart rate under hot climatic conditions: a guide to better estimation of the heat strain]

Working under hot climatic conditions, especially in summer, has a high potential for inducing heat strain in workers. The wet-bulb globe temperature [WBGT] index has an inherent limitation to estimate the heat strain due to not taking into account the non-environmental factors. The aim of this study was to evaluate the combined application of WBGT index and a physiological strain index [PSI[HR]] based on heart rate in the estimation of the heat strain under hot climatic conditions. This cross-sectional study was conducted on 122 men in the center and south of Iran [51 and 71 workers from Isfahan steel company and Assaluyeh national petrochemical company, respectively] between July and September 2010. The WBGT index, heart rate and the auditory canal temperature were measured at rest and during the work. Data were analyzed using descriptive statistics and logistic regression. Results of the logistic regression analysis revealed that the WBGT index is a poor predictor for heat strain with a sensitivity and specificity of 53% and 65%, respectively. However, the combined application of the WBGT and PSI[HR] indexes was a better predictor for heat strain and its sensitivity and specificity were 75% and 69%, respectively. A combined application of the WBGT and PSI[HR] indexes can be a valid estimator of heat strain for hot climatic conditions in the center and south of Iran

morphological variations of culexpipiens larvae [diptera: culicidae] in Yazd province, central Iran

Culexpipiens complex shows variations in morphological and biological characters including different biological forms and has medical and veterinary importance. Because of having morphological variations, sometimes it is not easy to separate this species from Cx. quinquefasciatus and Cx. torrenlium. The aim of this study was to identify the Culexpipiens complex species in order to use in control programs in the future. This study was carried out in two randomly selected rural villages in Yazd County, eastern Iran using dipping technique from April to October 2009. The data were analyzed using SPSS software version 16. Average of siphon index in fourth-instrar larvae was 3.86 +/- 0.03, the minimum and maximum were calculated 2.43 and 5.14, respectively. Siphon/Saddle index was measured as average, minimum and maximum 3.2 +/- 0.2, 2.78, and 4.42 respectively. In our study, only 4 specimens had single seta 1 on segments III and VI [2.5%] and the remaining beard double seta [97.5%]. The maximum 3-6 branches seta la-S and Ib-S [95%] were observed on siphon. More populations of Culex pipiens from different areas of Iran need to be studied to gain complete information about the taxonomy and ecology of the species in the country

[Ecological study of culex pipiens, the dominant species of culicidae mosquitoes and its control solutions in Yazd province]

Culex pipiens is extremely active in blood feeding in the urban areas. The role of this species in causing annoyance to the people, in addition to transmission of fillers, and viruses has increased their importance. Building of towns without proper principles of health and improvement of sewage systems is considered as the essential factor for producing larval habitat. The present study was carried out for ecological identification of Culex pipiens as the most prevalent mosquito and planning control programs. In this experimental study were selected two cities that had the highest problem of mosquitoes. Suitable shelters were selected for sampling after survey on resting sites and larval breeding places of mosquitoes. Sampling carried out eleven times from May to December in 2009. Different sampling methods carried out such as larval collection, pyrethrum space spray collection, hand collection, light trap, and collection of mosquitoes from pit shelters. In this study, the samples were of three genera Anopheles, Culex and Culiseta and five species of mosquitoes. Totally, 19054 mosquito larvae were caught from different breeding places. Cx. pipiens was predominant and consisted of 82.2% of the larvae. From 523 adult mosquitoes, 118 were collected by pyrethrum space spray collection. Cx. Pipiens with a 90% frequency was the most abundant mosquito, and Cx. sinaiticus was reported for the first time from Yazd Province. Culex pipiens was the predominant species and its seasonal peak activity was from late June to early July. Comparison of abdominal physiological states of the species caught by pyrethrum space spray collection with pit shelter collection showed the exophilic behavior of this species

[Intravitreal bevacizumab [avastin] injection alone or combined with triamcinolone versus macular photocoagulation as primary treatment for diabetic macular edema; an interim analysis]

To report the efficacy of a single intravitreal injection of bevacizumab [IVB] alone or in combination with intravitreal triamcinolone acetonide [IVT] versus macular laser photocoagulation [MPC] as primary treatment for diabetic macular edema [DME]. This randomized three-arm clinical trial included 103 eyes of 97 patients with clinically significant DME and no previous treatment. The eyes were randomly assigned to one of the three study arms: the IVB group received 1.25 mg IVB [37 eyes], the IVB/IVT group received 1.25 mg IVB together with 2 mg IVT [33 eyes], and the MPC group underwent focal or modified grid laser photocoagulation [33 eyes]. Primary outcome measure was change in best-corrected visual acuity [BCVA]. Changes in BCVA [logMAR] at 12 weeks were -0.22 +/- 0.23, -0.13 +/- 0.31 and +0.08 +/- 0.31 in the IVB, IVB/IVT and MPC groups, respectively. The marginal regression model based on generalized estimating equation analysis demonstrated that changes in visual acuity was statistically significant in the IVB group at both 6 [P<0.001] and 12 [P=0.024] weeks but only at 6 weeks in the IVB/IVT group. Significant decrease in central macular thickness [CMT] was observed in the IVB and IVB/IVT groups at 6 weeks. Up to 12 weeks, IVB treatment in eyes with DME yielded better visual outcome than laser photocoagulation, although it was not associated with a significant decrease in CMT. IVT seemed to have no further beneficial effect in combination with IVB

[Vitrectomy with internal limiting membrane peeling in acute central retinal vein occlusion presenting with low vision]

To evaluate the visual and anatomical outcomes of pars plana vitrectomy and indocyanine green [ICG] assisted internal limiting membrane [ILM] peeling in fresh central retinal vein occlusion [CRVO] with primary low vision. In a prospective interventional case series, 15 eyes of 15 patients with fresh CRVO [less than 3 months' duration] and presenting best-corrected visual acuity [BCVA] less than 20/200, underwent standard 3-port pars plana vitrectomy and ICG assisted ILM peeling. BCVA and central macular thickness [CMT] by optical coherence tomography [OCT] were evaluated 2 weeks and 1, 2, 4 and 6 months postoperatively and when needed thereafter. The patients included 8 male and 7 female subjects with mean age of 54.7 +/- 11.9 [range 29-75] years. Mean duration of symptoms at the time of surgery was 51.7 +/- 17.8 [range 26-85] days. CRVO was ischemic in 12 eyes [80%] and non-ischemic in 3 eyes [20%]. Patients were followed for 9.5 +/- 4.8 [range 6-23] months. Mean BCVA [logMAR] was 1.86 +/- 0.37 at presentation which improved to 1.65 +/- 0.40 at 2 weeks [P=0.23], 1.68 +/- 0.39 at one month [P=0.095], 1.60 +/- 0.46 at 2 months [P=0.069], 1.72 +/- 0.72 at 4 months [P=0.423], 1.58 +/- 0.69 at 6 months [P=0.140] and 1.42 +/- 0.37 at last visit [P=0.006]. Mean CMT was 605.5 +/- 279.2 +/- m preoperatively which was decreased to 527.4 +/- 274.3 microm at 2 weeks [P=0.371], 624.4 +/- 336.7 microm at one month [P=0.773], 546.4 +/- 344.9 microm at 2 months [P= 0.491], 343.3 +/- 256.9 microm at 4 months [P=0.250], 369.3 +/- 207.5 microm at 6 months [P=0.078] and 368.9 +/- 199.0 microm at final visit [P=0.03]. Pars plana vitrectomy with ILM peeling in patients with fresh CRVO and low presenting visual acuity [<20/200] may improve visual acuity and decrease in CMT in long-term follow-up, but does not seem to have any significant effect in comparison to the natural course of CRVO. Certain postoperative complications such as vitreous hemorrhage are relatively common requiring repeat vitreoretinal surgery. Therefore, we do not recommend this procedure for such patients

[Causes of visual impairment among patients referred to rehabilitation clinics of Shahid Beheshti medical university]

To describe causes of low vision and blindness in patients referred for low vision aids to rehabilitation clinics at Shahid Beheshti Medical University during 2005. Visual acuity was classified to five groups based on best-corrected visual acuity [BCVA] in the better eye according to World Health Organization [WHO] criteria and by using standard Snellen chart which included mild, moderate, severe and profound low vision and blindness. The causes of blindness and low vision were determined using the 10[th] version of International Classification of Diseases [ICD-10] based on the main cause in both eyes. The study was performed on 432 patients including 275 [65%] male and 148 [35%] female subjects with mean age of 43.6 +/- 25.5 [range 3-92] years. Mild to moderate and severe low vision and blindness were present in 28.8%, 46.4% and 24.8% of cases, respectively. The main causes of visual impairment were diseases of the retina and choroid [74.5%], optic nerve and optic tract diseases [9.8%], vitreous and globe disorders [3.5%], congenital cataract [3.1%] and glaucoma [2.6%]. The pattern of distribution of the causes was almost similar in all age subgroups. Diseases of the retina and choroid are the main cause of visual impairment among patients referred to eye rehabilitation clinics

[Accuracy of compensating distance during transferring orientation relation with ear bow]

In transferring relationship of jaws to opening axis of articulator by earbow earpiece of face bow is adapted on ear pin of articulator. So this study was done in order to compare position of earpiece representing external auditory meatus and ear pin of an articulator. This descriptive study was done on 30 students [15 males, 15 females, 20 to 25 years of age] with functionally acceptable occlusion. Kinematic center of rotation was located and maxillary cast was transferred to the Hanau articulator [Medular-196]. In the next step, ear-bow is used to register orientation relation of maxilla and after positioning the fork on maxillary cast which was mounted in preview step, the position of center of earpiece of ear-bow was marked on graphs paper which were attached on two round aluminum plate positioned to condylar part of articulator. The last step was to compare registered points to ear pin position of articulator. Kolmogorov-Smirnov and t test were used to examine difference between genders and left and right sides at a significant level of P<0.5. Positions of earpieces in 66.7% of the samples in the left part of the face and 70% in the right part were located upper; and more forward as the current ear pin of the condylar compartment. There were no significant differences between both sides and difference based on gender. Considering all achieved results in this study, the current locations of the ear pins in mentioned articulator are not suitable for our samples and some changes must be considered in mounting of casts

High concentration of soluble form of vascular endothelial cadherin in sera of patients with prostate cancer

For many years, prostate-specific antigen [PSA] was used to screen prostate cancer [PC] patients. However, recent controversial findings have cast doubt on the accuracy of this biomarker for diagnostic and prognostic purposes, and have stimulated the search for new candidates. This study was conducted to determine the capability of a soluble adhesion molecule known as soluble vascular endothelial cadherin [sVE-cadherin] or CD144 to distinguish prostate cancer or benign prostate hyperplasia [BPH] patients from healthy individuals. Patients recently diagnosed as having PC [N=35] or BPH [N=35] and age-matched controls [N=30] were study enrolled. The concentration of sVE-cadherin and PSA was measured by ELISA. Gleason score in s with PC was determined by pathological examination of tumor biopsies. The concentration of sVE-cadherin in the serum of patients with PC and BPH was significantly higher hat in the healthy men. No association was found between the concentration of this soluble adhesion molecule and PSA values. Moreover, concentrations of sVE-cadherin did not correlate with Gleason scores in patients with PC. The high concentration of sVE-cadherin in our patients suggests that this bio-marker is a potentially tool to identify high-risk patients. However, further research in patients with PC and other pathological conditions is needed to support the efficacy of this molecule in PC screening

Homeostasis status between prooxidants and antioxidants as a potent marker in Iranian preeclamptic patients

To measure the plasma oxidant, lipid peroxidation and antioxidants, ascorbate, to magnify the prooxidants and antioxidants status as a marker of pre-eclampsia. Included in the study were 50 preeclamptic and 100 normotensive pregnant women of singleton gestations in their third trimester, presented in Allavi Hospitals in Ardabil province of Iran from August 2004 to April 2005. Among these patients plasma malonaldehyde [MDA] and vitamin C concentration were analyzed. Blood samples [5 ml] were collected aseptically in heparin bulb. Spectrophotometric methods were employed to determine the plasma concentrations of vitamin C. The Statistical Package for Social Sciences software was used to analyze the data. In preeclampsia, significant increase in prooxidant MDA was observed as compared to controls. A significant fall in antioxidants vitamin C was noted in preeclampsia as compared to control. The MDA showed a significant balance to the level of vitamin C. Administration of regular nutritive supplementation containing reducing systems like vitamin C should help in maintaining the equilibrium during normal pregnancy and theoretically in preeclampsia too but to what extent they help in clinical practice is still being investigated

Causes and results of vitrectomy for spontaneous non-diabetic vitreous hemorrhage

To determine the visual and anatomical outcomes and complications of vitrectomy for non-traumatic non-diabetic vitreous hemorrhage [NDVH] and to report the causes of the condition among patients at Labbafinejad Medical Center, Tehran-Iran, from 1993 to 2003. Records of patients who underwent vitrectomy for non-traumatic NDVH with 6 months follow up were reviewed for demographic characteristics, causes of NDVH and results of surgery. Fifty eyes [54.2% right eyes] of 49 patients [51% male] with mean age of 62.7 +/- 10.3 years were enrolled in the study. Mean visual acuity [VA] was 2.36 +/- 0.52 LogMAR and relative afferent pupillary defect [RAPD] was positive in 91.7% of the eyes, preoperatively. Causes of non-traumatic NDVH detected intraoperatively were: branch retinal vein occlusion [56%], central retinal vein occlusion [16%], choroidal neovascularization [12%], and posterior vitreous detachment with break, Eales disease, familial exudative vitreoretinopathy, and Terson syndrome [each in 4%]. Mean VA increased significantly at 6th month [1.38 +/- 0.72 IogMAR] compared to preoperative value. [P<0.0001] The most common causes of decreased VA were: macular pigmentary derangement [26%], optic atrophy [16%], severe lens opacity [12%], and epiretinal membrane [8%]. Despite the statistically significant increase in mean VA following vitrectomy, underlying macular pathology limits significant improvement of central VA in most cases of non-traumatic NDVH

Clinical aspects and results of lensectomy in hereditary lens subluxation

To evaluate the clinical manifestations and results of lensectomy in patients with hereditary lens subluxation at Labbafinejad Medical Center, Tehran-Iran from 1996 to 2003. In an interventional case series, records of patients with hereditary lens subluxation who had undergone lensectomy were reviewed. Patients with at least 6 months of follow up were included. Background disease, best corrected visual acuity [BCVA] before and after surgery, intraocular pressure [IOP], and post-operative refraction and complications were evaluated. The study was performed on 87 eyes of 49 patients including 27 male and 22 female subjects. Mean follow up was 20 +/- 18 months. Marfan syndrome [79.5%], Weill-Marchesani syndrome [8.2%], simple ectopia lentis [8.2%], and homocystinuria [4.1%]. The most common indication for surgery was non-correctable refractive error [92.1%]. Mean BCVA was 1.13 LogMAR preoperatively which improved to 0.26 Log MAR post-operatively [P< 0.001]. BCVA better than 20/40 was achieved in 82.8% of cases after surgery. Angle-supported anterior chamber intraocular lens [AC IOL] was implanted in 85.1% of the eyes. Prophylactic band was applied in 63 eyes [72.4%]. Retinal detachment developed in four eyes, which was successfully treated. Lensectomy with implantation of angle-supported AC IOL in patients with hereditary subluxated lens will improve vision significantly without significant complications

Results of vitrectomy in idiopathic Macular Hole

To evaluate the visual and anatomical outcomes and complications of vitrectomy with or without removal of internal limiting membrane [ILM] in idiopathic macular hole [IMH] at Labbafinejad Medical Center, Tehran-Iran, 1993-2003. Hospital records of patients who had undergone vitrectomy for IMH and completed 6 months of follow up were reviewed for demographic data and outcomes of surgery .The study was conducted on 30 eyes [46.7% right eyes] of 29 patients [69% female] with mean age of 65.2 +/- 5.6 years. Mean duration of symptoms was 3.2 +/- 3.7 months [66.7% less than 6 months]. Preoperatively macular holes were in stages 2, 3, and 4 in 3.0%, 36.7%, and 33.3%, respectively. ILM removal was performed in 21 eyes [70%]. Mean visual acuity was 099 +/- 0.6 LogMAR preoperatively which reached to 0.87 +/- 0.39 LogMAR postoperatively [P=0.05]. Single operation anatomical success rate was 80% [24 eyes] and final success rate was 86.7% [26 eyes]. Retinal breaks developed in 3 eyes [10%] intraoperatively. ILM removal had no effect on increasing the rate of macular hole closure. ILM removal has no significant role on closure of IMH with less than 6 months of duration

[Vitrectomy in giant retinal tear: anatomic results and influencing factors]

To evaluate the success rate of vitrectomy in giant retinal tears [GTR] and factors influencing it. In an interventional case series, hospital records of 68 eyes of 63 patients operated for GRT were reviewed. Standard three port vitrectomy plus placement of an encircling band, retinopexy, and internal tamponade was performed for all eyes. Possible influencing factors including age, sex, visual acuity, afferent pupillary defect, grade of PVR, size and location of GRT, macular status, extent of RD, interval from onset of symptoms to operation, co-existing eye diseases, surgical technique, post-operative complications, and results after silicone oil removal were evaluated. Anatomic success was classified as complete success, relative success, and failure. Mean age of the patients was 31.2+]-17.2 and 50 patients [79.3%] were male. Underlying ocular disease existed in 39 eyes, of which high myopia was the most prevalent [33.8%]. The eyes were operated after a mean of 30 days from beginning of symptoms. Silicone oil was used for internal tamponase in 64 eyes and was removed from 36 eyes. Patients were followed from 1 to 54.5 months [median 10 months]. Anatomic success rate was 73.7%. Preoperative stage of PVR was the only factor found to be associated with worse anatomic results. Anatomic success rate was comparable to that of other centers and significantly better than results of a previous from our center. Early operation of eyes with GRT before development of PVR results in better anatomic success

[Confounding factors on the effect of Intravitreal triamcinolone for refractory diabetic macular edema]

To evaluate the influence of different confounding factors on the effect of intravitreal triamcinolone acetonide injection for refractory diabetic macular edema. In a prospective placebo-controlled randomized clinical trial, 88 eyes with refractory diabetic macular edema were randomly assigned into two groups including 45 in the treatment group [4 mg intravitreal triamcinolone acetonide] and 43 in the placebo group. Multivariate analysis was performed for three main outcomes, including visual acuity, central macular thickness, and the amount of hard exudates. Confounding factors that showed some effect on the main outcomes were used for building multivariate models. It was revealed that blood urea nitrogen, fasting blood sugar, serum cholesterol, initial visual acuity, presence of cystoid macular edema, amount of hard exudates, and size of foveal avascular zone had some influence on visual acuity outcome; previous macular photocoagulation, serum cholesterol, baseline central macular thickness, initial intraocular pressure, amount of hard exudates, and size of foveal avascular zone had some influence on visual acuity outcome; previous macular photocoagulation, serum cholesterol, baseline central macular thickness, initial intraocular pressure, amount of hard exudates, and size of foveal avascular zone had some influence on central macular thickness changes; and serum cholesterol, baseline central macular thickness, and amount of hard exudates had some influence on hard exudates in both groups. Size of foveal avascular zone, initial intraocular pressure, amount of hard exudates, and baseline central macular thickness also had an additive effect on the outcomes in the treatment group. Many confounding factors may influence the effect of intravitreal triamcinolone. These factors should be considered when adopting intravitreal triamcinolone. These factors should be considered when adopting intravitreal triamcinolone as a treatment strategy for refractory diabetic macular edema

[Effect of oral prednisolone on visual outcomes and complications after scleral buckling]

To evaluate the effect of oral prednisolone on visual outcome and complications of scleral buckling [SB] in patients with rhegmatogenous retinal detachment [RRD]. In a randomized double-blind placebo-controlled trial, patients with acute RRD who underwent SB were randomly divided into two groups. Oral prednisolone was administered for the treatment group and placebo for the control group. The two groups were compared for visual acuity [VA] , retinal detachment [RD], cystoid macular edema [CME], and proliferative vitreoretinopathy [PVR]. The trial was performed on 25 patients in the treatment group and 27 patients in the placebo group. Mean preoperative VA [LogMAR] was 1.46 +/- 0.81 overall, including 0.85 +/- 0.62 in location were equal in both group. [P=0.45] Significant PVR was seen in one eye in the treatment group and 3 eyes in the placebo group. [P=0.39]. Postoperative oral prednisolone does not seem to affect visual outcomes and complications of scleral buckling in phakic patients