[Effect of relaxing incisions for post penetrating keratoplasty astigmatism on graft curvature]

To evaluate changes in graft steepness after graft refractive surgery [GRS] and to discover influential factors and a coefficient to predict the amount of postoperative shift. Keratoconic patients with history of penetrating keratoplasty [PKP] who underwent GRS due to high post-PKP astigmatism were included. Changes in mean keratometry after GRS were evaluated to find possible influential factors such as age, graft anatomical features, number of incisions, use of compression sutures, and total arc length on achieved vector astigmatic correction. There was a significant increase in average keratometry by 0.86 +/- 1.07 D postoperatively [P<0.001]. Mean keratometric coupling ratio [CR] and coupling constant [CC] were 0.62 +/- 1.09 and -0.34 +/- 0.70, respectively. A significant association was found between preoperative spherical equivalent keratometry and keratometric CR, and between achieved correction in vector keratometric astigmatism and keratometric CC. Additionally, age had a significant negative association with keratometric CR and CC. A significant increase in graft steepening occurred after GRS. For every diopter reduction in vector keratometric astigmatism, a mean of 0.34 D increase in graft curvature is expected postoperatively

[Persistent corneal epithelial defect as a complication of tetracaine abuse]

To describe the clinical signs, diagnosis and treatment of toxic keratopathy in a patient who abused tetracaine drops. A 32-year-old man was referred to the emergency ward of our center with persistent corneal epithelial defect associated with a ring infiltrate in the corneal stroma, without any history of ocular trauma or contact lens use. The patient was hospitalized and a thorough ocular examination was accomplished. A detailed history in our patient revealed topical anesthetic abuse keratitis. The topical anesthetic was deliberately taken from the pharmacy without a prescription. The hallmark of topical anesthetic abuse keratitis was a persistent corneal epithelial defect and a complete ring infiltration in the corneal stroma in our case. Functional and anatomic results after appropriate treatment were not favorable in this case. Although topical anesthetic abuse keratitis is rare, it should be carefully explained to patients that although topical anesthetics numb the eye, more than a few drops can actually prevent healing and may lead to permanent damage. The unrestricted availability of topically applied ophthalmic anesthetics as over-the-counter medications in Iran must be reevaluated

[Effect of educational program based on PRECED model on quality of life in patients with typeII diabetes]

The Problems caused by diabetes have direct and indirect impacts on quality of life of diabetic patients. By increasing of these problems quality of life of patients will decrease. This study was done to assess the effect of the educational program based on PRECEED [predisposing reinforcing enabeling causes educational diagnosis evaluation] model in promoting quality of life of patients with typeII diabetes. This pre-and post-intervention quasi-experimental study was conducted on 78 patients with type 2 diabetes referred to diabetes clinic in Minoodasht located in Golestan province of Northern Iran. The educational program based on PRCEDE Model and patients educational needs was designed. The data were collected using two questionnaires. lifequality WHOQOL-BREF questionnaire and PRCEDE Model-based educational questionnaire. The subjects were followed for one month after intervention to identify the role of educational intervention on patients. The data was analyzed by using SPSS-16 and Paired t-test. After the intervention, the mean score of quality of life increased from 80.39 +/- 11.35 to 81.35 +/- 8.31. No significant difference was existed in the total score of quality of life after intervention but there were significant differences in the physical health [P<0.05], self-evaluation of quality of life of patients [P<0.01] and self-assessment of health of patients after educational intervention. This study showed that the educational program based on PRECEDE model was effective in improving quality of life of patients with regard to physical health and selfassessment of their health status

[ effect of previous history of Tuberculosis on female infertility in Rooyan institute of infertility patients]

The reason of infertility can have a direct influence on the plan and outcome of management. In this paper we intend to show the effect of tuberculosis [TB] history on female infertility among infertile couples attending to Rooyan infertility management center. In this case-control study our cases were those who were diagnosed as infertile female and controls were those women whose husbands were infertile due to some male factor. We used logestic regression for analyzing the association of history of Tuberculosis and female infertility with attributable risk estimation. 308 cases were compared to 314 controls. Considerng the odds ratio and its 95% confidence interval, there was a asignificant difference between the history of TB and infertiliy [OR=4.7, 95% CI: 1.01-29.91]. The attributable risk of TB for female infertility was 0.023 +/- 0.01 [which is significant at 5% level]. The attributable risk of TB for female infertility was 0.023 +/- 0.01 [which is significant at 5% level. These figures show that at least 2% of female infertility can be prevented by prevention and proper treatment of tuberculosis

Risk factors for malnutrition in 6- to 30-months old children seen at health centers in Hormozgan province

Malnutrition is a major health problem in Iran. A nationwide survey [ANIS] in 1998 revealed that over 800.000 children in this country were suffering from moderate or severe malnutrition. The southern province of Hormozgan is one of the most severely effected regions, so there is a need to determine disease associations and risk factors for child malnutrition in this area. In this case-control study, we selected 1725 children aged 6 to 30 months from both rural and urban areas of Hormozgan. Data for the study were obtained by filling questionnaires and studying family health files. Using the weight-for-age Z score [WAZ] as outcome measure, we examined the effects of 21 different variables, including putative risk factors, confounder, and background variables. Father's job [p<0,004], parents' education, interval between pregnancies, urban versus rural residence [p<0.001], family size [p<0.03], and misconceptions regarding the growth chart were recognized as risk factors for malnutrition. Moreover, the mean age of the cases was 2.3 years higher than that of the controls [p<0.001]. Complete vaccination [p<0.0018] and attending day care centers [p<0.005] emerged as protective factors. Poverty [low-income jobs, rural residence, large family size, etc] is an important factor causing malnutrition among children in Hormozgan. In contrast, immunization end mother's knowledge of the child's growth chart are major protective factors. Therefore, the health system must continue its support for the current immunization program. It should also try to improve the quality of its health education programs targeted at mothers attending state-run health and medical clinics