ABSTRACT
Diabetes mellitus is a global health problem affecting 366 million people worldwide and its prevalence is growing rapidly. Diabetic eye disease is present in up to 25% of diabetic subjects. Diabetic retinopathy is a chronic complication of diabetes that can result in blindness. Generally, there are two stages of diabetic retinopathy, non-proliferative and proliferative. The longer a person has diabetes and the poorer metabolic control, the higher the chance of developing diabetic retinopathy. The majority of people with type 2 diabetes will ultimately develop diabetic retinopathy. Multifactorial therapy targeted to lifestyle modification and optional glycemic control reduces the risk. However, diabetic retinopathy develops or progresses with time. Primary [preventive] strategies include glycemic, lipid, and blood pressure control. Glycemic control effectively reduces the incidence of diabetic retinopathy. In additional, its effect on progression of diabetic retinopathy has been demonstrated in randomized clinical trials. Furthermore, tight control of blood pressure significantly reduces the progression of retinopathy and visual loss. However, the Action to Control Cardiovascular Risk in Diabetes [ACCORD] Eye Study Group has shown that intensive blood pressure control has no beneficial effect on reducing the rate of diabetic retinopathy in subjects with type 2 diabetes. Elevated serum lipids and dyslipidemias are associated with a higher risk of diabetic retinopathy. The beneficial effects of lipid-lowering agents on the progression of retinopathy have been reported. Intensive combination therapy for dyslipidemia has been shown to effectively reduce the rate of progression of diabetic retinopathy in type 2 diabetes. Secondary strategies are focused on various pathophysiologic approaches such as blockade of the renin angiotensin system [RAS], anti-vascular endothelial growth factor agents, somatostatin analogues, protein kinase inhibitors, and anti-inflammatory agents. The purpose of the current overview is to look into the medical management of diabetic retinopathy, and to explore the primary [preventive] measures as well as secondary strategies proposed to be effective in its medical management
Subject(s)
Humans , Disease Management , Diabetes MellitusABSTRACT
Imperforate anus is a common anomaly associated with many other anomalies. The aim of this study is determining the frequency of associated anomalies in children with imperforated anus. This retrospective, cross sectional study was conducted over 245 neonates and children [137 male, 105 female and 3 ambiguous genitalia] with imperforated anus diagnosis, in Ali-Asghar Hospital 1999-2008. Our information was extracted from patients' records. SPSS 17 was used for data analysis. 50.6% of the patients had associated anomalies including 18% cardiovascular, 15.5% renal, 14.7% gastrointestinal, 13.9% vertebral, 13.1% genitourinary, and 8.2% external genitalia. The most prevalent associated anomaly was genitourinary system anomalies followed by cardiovascular anomalies. Patients with imperforated anus should undergo a detailed general physical, systemic and radiological examination [infant gram, echo cardiography, ultrasonography of urogenital system] in neonatal period for on time detection of associated anomalies
ABSTRACT
According to some studies, fetal wound in contrast with adult wound heals without scar formation which is probably due to amniotic fluid around the fetus, unique extracellular matrix and the fetal immature immunity. It is supposed that biochemical and physical characteristics of amniotic fluid prepares the conditions for wound healing without scar formation. The goal of this study was to compare the scar diameter of uncomplicated appendectomy by Rocky-Davis incision with scar diameter of cesarean section by Pfanneistiel incision in order to evaluate the effect of amniotic fluid on scar diameter. In this analytic within-patient study all women with uncomplicated appendectomy by Rocky-Davis incision who were pregnant or had history of cesarean in the last 18 months were included [2007-2009]. After 18 months of operation [appendectomy and cesarean], scar diameters were measured in three points [first, middle and end of scar] and the mean was calculated. Then the mean scar diameter of appendectomy was compared with the mean scar diameter of cesarean in each patient. For data analysis we used T-test, Paired T-test, correlation coefficient and regression tests. In this study the effect of weight and height on scar diameter was evaluated. Mean scar diameter of appendectomy was 2.09 +/- 0.677 millimeter and the mean scar diameter of cesarean was 0.467 +/- 0.633 millimeter which was significantly less than appendectomy scar diameter [p=0.008]. It seems that the presence of amniotic fluid in the first hours of healing decreases the future scar diameter
ABSTRACT
Cutaneous tuberculosis [CTB] is a rare form of extra- pulmonary TB in our region. The incidence of CTB seems to be increasing in some countries. CTB continues to be one of the most elusive and difficult diagnoses to make for dermatologists practicing in developing countries. We report the case of a five-year-old boy with an infected discharging ulcer on his face referred to our hospital in Gorgan, north of Iran. After physical, pathological and radiological examination, the diagnosis of CTB was confirmed. The condition improved after standard antitubercular regimen