[ survey on the attitude of professors and residents of clinical wards about disclosing the results of diagnoses for incurable patients at Urmia university of medical sciences]

One of the most important and complicated problems in medical ethics is to disclose the full truth about diagnosis of incurable diseases which leads to death, and each therapist may be encountered with it during the years of medical profession. The aim of this study was to survey on attitude of professors and residents of clinical wards to disclose the diagnosis for incurable patients leading to death. In this descriptive study, sampling was carried out by a survey. All faculty members and their residents of teaching hospitals of Urmia University of Medical Sciences, Urmia, Iran, were surveyed as sample in 2007. Of 145 subjects, 138 responded to the questionnaire. The collected data were analyzed using Pearson and Spearman correlation tests with a p

[Assessment of the effect of 20% oral sucrose on pain relief from hepatitis B vaccine injection in full term infants]

Newborns often experience pain during routine invasive procedures. Although the pain caused by immunization injections could be controlled, but this procedure in infants is often done without pain relief. The aim of this study was to assess the effect of 20%oral sucrose on the relief of pain from Hepatitis Bvaccine injection in full term infants. In this randomized clinical trial, 60 infant were selected and divided randomly into two groups. In the case group, 2 ml of 20% sucrose were given orally to the infants 2 minutes prior to the intramuscular injection of Hepatitis B vaccine. By contrast, the control group received 2 ml of sterile distilled water instead of sucrose. Infants' pain levels were assessed with the Neonatal Infant Pain Scale [NIPS] prior to the administration of the sucrose or water, as well as immediately after and 5 minute after the injection. Our findings show that there were no significant differences in the pain levels prior to the injection between the two groups regarding sex, gestational age, birth weight, mode of delivery, and postnatal age. There were also no significant differences in pain severity immediately after the injection between the two groups. However, 5 minute after the injection the average level of pain severity in the 20% sucrose group was significantly lower than the control group [P = 0.012]. Oral administration of 20% sucrose does not have an effect on the pain level immediately after intramuscular injection, but it relieves the pain 5 minute after the injection

[ review article of pharmacologic vitreolysis]

The vitreoretinal interface is involved in a wide range of vitreoretinal disorders and separation of the posterior vitreous face from the retinal surface is an essential part of vitrectomy surgeries. A diverse range of enzymatic and non-enzymatic agents are being studied as an adjunct before or during vitrectomy to facilitate the induction of posterior vitreous detachment. There is a significant body of knowledge in the literature about different vitreolytic agents under investigation for a variety of pathologies involving the vitreoretinal interface which will be summarized in this review. Articles retrieved by Pubmed search using keywords "Vitreolysis", pharmacologic Vitreolysis, plasmin and vitrectomy, and microplasmin and vitrectomy, were used in this review. recent reports have raised strong hopes that pharmacologic vitreolysis may eventually find its way to clinical practice. Further investigations will demonstrate whether enzymatic vitreolysis could be used as an adjunct and/or alternative treatment for treatment of vitreoretinal disorders

DRD1-DRD5 expression profiles in arthritis rheumatoid patients using real time PCR

The cause of rheumatoid arthritis [RA] as a chronic inflammatory autoimmune disease is still unknown. It appears that both genetic and environmental factors play a role in its pathogenesis. Recent studies reveal that in addition to the CNS, immune cells synthesis neurotransmitters so that these catecholamines can regulate immune functions. The aim of this study is to evaluate the dopamine receptor gene expression profiles on peripheral blood mononuclear cells of rheumatoid arthritis patients in comparison with normal individuals. In the present study, we investigated dopamine receptor gene expression in PBMCs of 40 RA patients and 40 healthy individuals using Real Time-PCR. The specificities of the obtained Real time PCR products for the respective dopamine receptors fragments were confirmed by sequenced analysis capillary system. We found that DRD1-DRD5 types of dopamine receptors genes expression profiles of rheumatoid arthritis patients differ compared to healthy individuals. Moreover, a significant difference of DR2 and DR4 gene expression was seen in rheumatoid arthritis patients. This study showed that some types of dopamine receptors genes expression profiles alter in rheumatoid arthritis patients with comparison to healthy individuals Moreover, this alteration possibly could result in dysfunction of dopaminergic system in immune cells and finally lead to rheumatoid arthritis

[Evaluation of the safe dose of intravitreal bevacizumab in rabbit eyes]

To evaluate the safety of different doses of intravitreal bevacizumab in rabbit eyes. Twelve eyes of 6 rabbits underwent intravitreal injection of 5, 7.5 and 10 mg of bevacizumab. In each rabbit, one eye was considered for bevacizumab injection and the fellow eye served for either placebo injection or observation. All eyes were examined before and I, 2, 3, 7, 14 and 28 days after intravitreal injections. Electroretinography [ERG] was performed before and 14 days after the injections. 28 days after the injections, all eyes were enucleated and examined with light and electron microscopy. In the clinical examination, significant vitritis was observed in one of the 10 mg injected eyes from first post-injection which was eliminated by the 7th day. Cataract was seen in the same eye. Post-injection ERGs showed no significant changes. Increase in Muller-like cells was observed in the histological examination in the injected eyes. Intravitreal injection of 5 and 7.5 mg doses of bevacizumab was safe in rabbit eyes; however, the 10 mg dose was associated with intraocular inflammation

[Outcomes and prognosis of treatment for retinoblastoma with primary chemotherapy and focal treatment]

To determine globe and patient survival in children with retinoblastoma at a major referral center in Iran. Hospital records of 156 eyes of 105 patients with retinoblastoma referred to the Ocular Oncology Center at Rasoul Akram Hospital, Tehran, Iran from 2001 to 2007 were reviewed. Demographic data, family history, presenting symptoms, duration of symptoms, ocular findings and treatment modalities were evaluated. Main outcome measures included patient survival with the event of death, and globe survival with the event of enucleation. Mean age at the time of diagnosis was 28.5 +/- 23.0 [range 3-120] months. Mean follow-up was 30.9 +/- 29.0 [range 3-72] months. Male to female ratio was 47/58. Five patients had positive family history. Involvement was unilateral in 52% and bilateral in 48% of patients. Enucleation was performed as primary treatment in 76 eyes [48.7%] and as secondary treatment for recurrence in 11 eyes [7.1%]. Sixty nine eyes [44.2%] were salvaged by different globe preserving modalities. Kaplan-Meier 5-year survival estimate for globe preservation according to the International Classification of Retinoblastoma [ICRB] was 100% for group A, 93.5% for group B, 86.7% for group C, 57.1% for group D and 0% for group E. Kaplan-Meier estimates for 5-year patient survival was 100% for ICRB groups A and B, 92.3% for group C, 73.3% for group D and 79.9% for group E. Five year patient survival rate was better in ICRB groups A to D than in group E [P=0.004]. Advances in treatment, early diagnosis and prompt referral have improved the prognosis of patients with retinoblastoma in terms of globe and patient survival

[Okihiro syndrome: a variant of Duane's syndrome]

Purpose: to report a case of Duane's syndrome with radial ray deficiency known as Okihiro syndrome

Patients and findings: a 18-year-old female with history of operation for Duane's syndrome presented to our clinic with a complaint of left eye retraction in adduction. Her systemic examination revealed left thumb aplasia. In CT scan, aplasia of the thumb, first metacarpus, and scaphoid bone of the left hand were reported. Other systemic examinations were normal. Systemic and ocular examination of family members were normal

Conclusion: Duane's syndrome is frequently associated with other congenital anomalies and a thorough systemic and ocular examination should be performed in these patients