[Prevalence and risk factors of diabetic retinopathy in patients referred to diabetes clinic of Kamkar hospital in Qom]

Diabetic retinopathy [DR] is one of the important causes of comorbidity in diabetic patients. Considering the cost of this complication to the health care system, this study was performed to assess the prevalence and identify its risk factors. In this cross-sectional study, 261 diabetic patients, who referred to Kamkar hospital diabetes clinic in Qom, Iran, were investigated. Personal information, data about diabetes, physical examination and laboratory tests were collected in questionnaires. Foundoscopy with dilated pupil was performed by practicing ophthalmologists and findings were categorized according to international classification of diabetic retinopathy. The mean age was 52.2 +/- 11.5 years, and 66% were female. The mean duration of diabetes was 9.08 +/- 7.14 years and the mean HbA1C was 9.25 +/- 2. The overall prevalence of diabetic retinopathy [DR] was 39.1%, which included 15.3% with mild Non proliferative DR [NPDR], 7.7% with moderate NPDR, 4.6% with severe NPDR and 11.5% with proliferative DR [PDR]. Comparison of variables between DR and Non-DR groups shows that the mean of age, duration of diabetes, HbA1C, protein excretion in 24h urine were statistically significantly higher in retinopathic group [p=<0.001, p<0.001, p<0.005 and p<0.01]. Also, the percent of patients with history of hypertension, nephropathy and peripheral distal neuropathy was significantly higher in retinopathic group [p<0.05, p<0.001 and p<0.001]. In final analysis with logistic regression model, duration of diabetes and nephropathy were recognized as independent risk factors for diabetic retinopathy. According to the results of this study, screening of all diabetic patients in early stages of retinopathy, identify and control of its risk factors to decrease the burden of eye complications and improve the quality of life for these patients are important

[Trauma epidemiology and its consequences in victims referred to Kashan trauma center during 2007-8]

Trauma is the most common cause of mortality for people aged 1 through 44 years. Traffic accidents are the leading cause of severe injuries among young people in most countries. This study was conducted to determine the frequency of traffic accident injuries in victims referred to Kashan Trauma Center during 2007-8. This cross-sectional descriptive study was carried out on 1004 trauma cases referred to Kashan Shahid Beheshti Trauma Center during the year during 2007-8. Data including age, sex, type of trauma, and type of intra- and/or extra-thoracic injury were recorded and analyzed. Sixty-six per cent of the cases were male, and the most frequently observed trauma cases were between the ages 21 and 30, followed by 10 and 20. The frequency of trauma in urban and rural areas was 62.5% and 37.5%, respectively. Motorcycle accidents are the most common traffic accidents followed by car accidents. Considering the large number of trauma cases secondary to the traffic accidents and lower levels of education in those cases, appropriate educational programs may be helpful to decrease the mortality rates and other undesirable consequences of accidents

Cephalometric correlation between facial dimensions and sagital and vertical position of anterior teeth

Description of relationship between dental and skeletal parameters can help diagnosis and treatment of malocclusions. This study evaluated the relationship between facial height and vertical and sagital position of anterior teeth. The lateral cephalogerams of 89 patients between ages of 14 to 18 years old were studied. The study casts were analyzed then samples were divided into 2 groups of with or without crowding. Cephalograms were traced and Pearson correlation was determined between parameters that explain facial dimensions and parameters that showed sagital and vertical position of anterior teeth. High correlation was found between ANB and Ul to SN, Ul to FH, and Ui to NA [mm]. SNB had also correlation with Ui to FH and Ul to SN. Additionally, Jaraback index showed a great correlation with L to MP, IMP A and SNB. FMA was similarly correlated with IMP A and FMIA. Significant correlation was detected between basal angle and IMP A [P< 0.001]. The remaining subjects did not have crowding and demonstrated high correlation between ANB and LI to NB. SN-GoGn displayed a great correlation with SNB and FMIA. Ui to FH was highly correlated with FMA, SN-GoGn and L! to MP. High correlation was observed between LI to NB [mm] and LI to MP [P<0.001]. There was correlation between position of anterior teeth and facial dimensions that confirms the existence of balance between dentofacial parts. Therefore, establishment of equilibrium is essential for stability of treatment results

[Symptomatic meckel's diverticulum after appendectomy]

Background: Meckel's diverticulum is the most common anomaly of the intestine. It is usually asymptomatic but could also be symptomatic with complications such as bleeding, intestinal obstruction, and inflammation

Case Report: Two weeks after gangrenous appendectomy of a 44 years old man in Shahid Beheshti Hospital in Kashan city, Iran, he complained of abdominal pain, nausea, bilious vomiting and constipation. Considering him as a suspicious case of intestinal obstruction, we performed laparatomy in which torsion of 10 cm. length of Meckel's diverticulum was confirmed

Conclusion: Since the complications of Meckel's diverticulum are rane in adults, this diagnosis is supposed to be considered as one of the probable reasons of acute abdomen surgery. Although, the common place of Meckel's diverticulum is at 40-60 cm away from ileal operculum, it is recommended to assess ileum at a 100 cm distance from it

Complicated parapneumonic effusion: Etiology and results of lung decortication

Parapneumonic effusion is a common accompaniment of bacterial pneumonia and mostly is resolved with medical management. We studied the etiology and possible underlying causes of complicated parapneumonic effusion and timing of pulmonary decortication. A descriptive study on 34 patients with postpneumonic empyema which required decortication carried out. Post surgical and post traumatic empyema were excluded. Patients' age ranged from 20 to 75 with a mean of 46 years. The most common clinical findings were fever [90%], pleural dull pain [80%], productive cough [73%] and dyspnea [70%]. PPD test was negative in all patients. In 78%, white cell count was normal; in remainder it was more than 10.000. Bacteriological findings were negative and acid fast bacilli were not detected. All patients underwent posterolateral thoracotomy and decortication and completely expansible lung was achieved. Tissue diagnosis after decorticating showed tuberculosis in 8 [24%] patients and necrotic tissue in remainder. Average medical management time and postoperative hospital stay were 38 +/- 2 and 6.7 +/- 2 days, respectively. Morbidity rates were acceptable and there was one late mortality. No recurrence was happened. In parapneumonic effusions not responding to standard treatment, tuberculosis must be considered, especially in addicted persons, positive family history and ESR > 100. In complicated parapneumonic effusion, early thoracotomy and full decortication is recommend because it is diagnostic, allows control of infection, releases the pulmonary entrapment, early discharge from hospital, need not further antibiotic administration and is cost benefit