Macular Thickness in Moderate to Severe Amblyopia

PURPOSE: To compare the macular retinal thickness of moderately to severely amblyopic eyes with non-amblyopic eyes as controls. METHODS: This case control study was conducted on 56 children aged 4 to 10 years old (64.3% female subjects). Twenty-eight children had unilateral amblyopia (28 amblyopic eyes as cases and 28 normal fellow eyes as internal controls) and 28 children had normal visual acuity in both eyes and were considered as external controls (n = 56 eyes). Among our cases, 14 had strabismic amblyopia and 14 had anisometropic amblyopia. Macular retinal thickness was measured using optical coherence tomography at the center and in 1-, 3-, and 6-mm rings. RESULTS: Best-corrected visual acuity of the amblyopic eyes was less than that of the internal and external controls, and the best-corrected visual acuity of their fellow eyes was also less than that of the external controls. Thickness of the central macula and a 1-mm ring area in the amblyopic eyes was higher than that of both internal and external controls. Difference of central macular thickness ≥20 µm between two eyes of the amblyopic children was significantly more than non-amblyopic subjects. CONCLUSIONS: Based on the results of this study, the macular retinal thickness was significantly higher in moderate to severe amblyopic eyes compared to their fellow eyes and external controls. This might be due to macular developmental disorders in amblyopic eyes. Therefore, optical coherence tomography imaging is recommended if subtle macular abnormalities are suspected in moderate to severe amblyopic eyes.

Genotypic Diversity of Multidrug Resistant Shigella species from Iran / 감염과화학요법

BACKGROUND: In many developing countries, shigellosis is endemic and also occurs in epidemics and treatment of multidrug-resistant (MDR) isolates are important. The aims of this study were to determine the antimicrobial susceptibility, prevalence of class 1 and 2 integrons and the clonal relatedness of isolates. MATERIALS AND METHODS: Antimicrobial susceptibility tests were performed by disc diffusion method. Polymerase chain reaction (PCR)-sequencing technique was employed for detection and characterization of integrons. The genetic relatedness was evaluated by using enterobacterial repetitive intergenic consensus (ERIC) PCR. RESULTS: There was a high percentage of resistance to trimethoprim-sulfamethoxazole (TMP/SMX) (93.7%), ampicillin (AMP) (87.3%), streptomycin (STR) (84.5%) and tetracycline (TET) (78.9%). Multidrug resistant phenotype was seen in 95.1% of total isolates. Most common MDR profile was TMP/SMX/STR/AMP resistant pattern. Among the 142 Shigella spp. analyzed in this study, 28 isolates were positive for class 1 integron with two types of gene cassette arrays (dfrA17/aadA5 = 31.7% and dfrA7 = 3.8%). The class 2 integron was more frequently detected among the isolates (94.7%) with dfrA1/sat1/aadA1 (69.4%) and dfrA1/sat1 (30.6%) gene cassettes. ERIC-PCR results showed 6, 5, 4 and 3 main genotypes among S. flexneri, S. sonnei, S. boydii and S. dysenteriae isolates, respectively. CONCLUSIONS: Our findings revealed that multidrug resistant Shigella species with high prevalence of class 2 integron were very common in Iran. In addition, ERIC-PCR patterns showed limited variety of clones are responsible for shigellosis in the region of the study.

Genotypic Diversity of Multidrug Resistant Shigella species from Iran / 감염과화학요법

BACKGROUND: In many developing countries, shigellosis is endemic and also occurs in epidemics and treatment of multidrug-resistant (MDR) isolates are important. The aims of this study were to determine the antimicrobial susceptibility, prevalence of class 1 and 2 integrons and the clonal relatedness of isolates. MATERIALS AND METHODS: Antimicrobial susceptibility tests were performed by disc diffusion method. Polymerase chain reaction (PCR)-sequencing technique was employed for detection and characterization of integrons. The genetic relatedness was evaluated by using enterobacterial repetitive intergenic consensus (ERIC) PCR. RESULTS: There was a high percentage of resistance to trimethoprim-sulfamethoxazole (TMP/SMX) (93.7%), ampicillin (AMP) (87.3%), streptomycin (STR) (84.5%) and tetracycline (TET) (78.9%). Multidrug resistant phenotype was seen in 95.1% of total isolates. Most common MDR profile was TMP/SMX/STR/AMP resistant pattern. Among the 142 Shigella spp. analyzed in this study, 28 isolates were positive for class 1 integron with two types of gene cassette arrays (dfrA17/aadA5 = 31.7% and dfrA7 = 3.8%). The class 2 integron was more frequently detected among the isolates (94.7%) with dfrA1/sat1/aadA1 (69.4%) and dfrA1/sat1 (30.6%) gene cassettes. ERIC-PCR results showed 6, 5, 4 and 3 main genotypes among S. flexneri, S. sonnei, S. boydii and S. dysenteriae isolates, respectively. CONCLUSIONS: Our findings revealed that multidrug resistant Shigella species with high prevalence of class 2 integron were very common in Iran. In addition, ERIC-PCR patterns showed limited variety of clones are responsible for shigellosis in the region of the study.

[Prevalence of CTX-3 family gene among clinical isolates of Escherichia coli and Klebsiella pneumoniae from patients hospitalized in Sina Hospital, Tabriz]

Background: Emerging resistance to beta-lactam antibiotics among gram negative bacteria limits their usage. This study was done to determine the frequency of ESBLs producers and presence of CTX-M3 family gene [including CTX-M 3, 15, 22 subfamily] in Escherichia coli and Klebsiella pneumoniae isolated from different clinical specimens in Sina Hospital, Tabriz

Methods: 71 isolates of E. coli and 63 K. pneumoniae were isolated from different clinical specimens sent to Division of Microbiology, Sina Hospital, Tabriz, Iran. Bacteria were identified by conventional phenotypic methods. ESBL production in E. coli and K. pneumoniae was first detected with combined disc method using Mueller-Hinton agar and later presence of CTX-M3 family gene was detected by PCR technique

Results: In this study, 41 [57.74%] E.coli and 45 [71.42%] K. pneumoniae isolates were observed as ESBL producers. Among them, 30 [73.17%] E. coli and 26 [57.77%] K.pneumoniae were found carrying CTX-M3 gene. Among various antibiotics used for ESBL detection, highest resistance towards cefpodoxime [92%] was observed in E.coli, while in K.pneumoniae 90% isolates show resistance towards cefpodoxime and azterornam

Conclusion: Our study revealed that there is a high frequency of ESBLs producing isolates of E. coli and K. pneumoniae in our hospital set up. The problem elucidates the importance of designing more controlled surveillance of antibiotic resistance and need for large-scale epidemiologic studies to identify outcomes of the ESBL-production in gram negative bacilli

results of photorefractive keratectomy with mitomycin-C in myopia correction after five years

Objective: To evaluate the results of photorefractive keratectomy [PRK] with mitomycin C in myopia correction after five years

Methods: This is a cross sectional study which included 145 eyes of 74 patients in 18 to 51 years age group that were undergoing Photorefractive keratectomy with mitomycin C using Allegretto Wave Eye-Q 400-Hz excimer laser platform in Markazi Eye Center, Tehran, Iran. All the surgical procedures were performed by the same surgeon. After five years follow-up evaluation including BCVA, UCVA, Refractive error measurement and external eye examination was performed

Results: The mean diopter of spherical equivalent before surgery was -3.40 +/- 1.73. The following findings were obtained after 5 years follow up visit: The mean spherical equivalent value: -0.08 +/- 0.40, the mean Log MARUCVA: 0.02 +/- 0.07, the mean Log MAR BCVA: 0.00 +/- 0.04

Conclusion: PRK is an effective, safe and predictable method used to correct myopia. The wave frontoptimized algorithm of the Allegretto Wave Eye-Q 400-Hz excimer laser platform demonstrated good refractive and visual results. Presence of variables such as gender, age and astigmatism before operation have no significant impact on the result of this operation

Pulmonary Tuberculosis Diagnosis: Where We Are? / 결핵및호흡기질환

In recent years, in spite of medical advancement, tuberculosis (TB) remains a worldwide health problem. Although many laboratory methods have been developed to expedite the diagnosis of TB, delays in diagnosis remain a major problem in the clinical practice. Because of the slow growth rate of the causative agent Mycobacterium tuberculosis, isolation, identification, and drug susceptibility testing of this organism and other clinically important mycobacteria can take several weeks or longer. During the past several years, many methods have been developed for direct detection, species identification, and drug susceptibility testing of TB. A good understanding of the effectiveness and practical limitations of these methods is important to improve diagnosis. This review summarizes the currently-used advances in nonmolecular and molecular diagnostics.

Prevalence of preventable causes of low vision in different ages and genders

Much of the vision loss from age-related eye disease can be prevented. The purpose of this study is to determine the prevalence of preventable causes of low vision. In this study, files of 204 patients were evaluated. Low vision was defined as best-corrected visual acuity in the better eye between 20/70 to 20/200. Diagnosis of anterior and posterior segment disease was based on the eye examination that performed with Topcon slit-lamp biomicroscope and direct and indirect ophthalmoscope examination. The prevalence of preventable causes of low was respectively: diabetic retinopathy, in 33 patients [16.18%], glaucoma in 6 patients [2.94%], and amblyopia in 2 patients [1%]. The majority of cases have treatable and/or preventable causes; reduction of low vision or blindness can be achieved by appropriate screening strategies

Microleakage comparison of four dental materials as intra-orifice barriers in endodontically treated teeth

The aim of this in vitro study was to compare polymicrobial microleakage of calcium enriched mixture [CEM] cement, mineral trioxide aggregate [MTA], amalgam, and composite resin as intra-orifice sealing materials. Seventy single-rooted mandibular premolars were instrumented and obturated by cold lateral compaction technique. The teeth were randomly divided into four experimental groups according to used material: CEM, MTA, amalgam and composite resin [n=15] and two control groups [n=5]. In experimental groups, 2 mm of coronal gutta-percha was removed and replaced with the study material. All the teeth were mounted in a two-chamber apparatus and the coronal portion was exposed to human saliva. The day the turbidity occurred was recorded for each sample. Data were analyzed using one-way ANOVA. The negative control group showed no leakage while the average microleakage time in the positive control group was 3.5 days. The average bacterial leakage times for amalgam, composite resin, MTA, and CEM groups were 27.42 +/- 3.6, 29.35 +/- 3.15, 52.57 +/- 2.87, and 50.42 +/- 2.73 days, respectively. There was no significant difference between CEM and MTA groups [P=0.27] and also between amalgam and composite resin groups [P=0.36]. However, in term of average leakage time, MTA and CEM groups exhibited significant differences with amalgam and composite resin groups [P<0.001]. According to the results of the present in vitro study, in terms of coronal sealing in endodontically treated teeth, CEM and MTA are more effective than amalgam and composite resin

Sensitivity pattern of methicillin resistant and methicillin sensitive Staphylococcus aureus isolates, against several antibiotics including tigecycline in Iran: a hospital based study

Methicillin resistant Staphylococcus aureus [MRSA] is a major nosocomial pathogen causing significant morbidity and mortality. The aim of this study was to evaluate in vitro activity of tigecycline and other new agents against MRSA, isolated from surgical wound and soft tissue infections in an Iranian 1000-bed tertiary hospital. In vitro activity of tigecycline and other antibiotics were tested against 102 strains of Staphylococcus aureus isolated from different patients hospitalized at Milad hospital from May 2008 to June 2008. All strains were identified according to routine bacteriological methods. Susceptibility testing was performed by disk diffusion methods as recommended by Clinical Laboratory Standards Institute [CLSI]. Cefoxitin [30 micri g] disk used for detection of methicillin resistant strains of S.aureus. One hundred two strains of S.aureus were isolated from patients admitted to our hospital. The majority of patients was from surgical wards including open heart, orthopedic ward and had post operation wound infections. Of 102 strains 36[35.3%] isolates were MRSA. All isolates including MRSA strains were susceptible to tigecyline, linozolide and vancmycin. Of 102 isolated strains 96 [94.1%] were susceptible to teicoplanine and six stains [5.9%] were intermediate. Resistant rate to other antibiotics including clindamycinm erythromycin pencillin, co-trimoxazole, rifampicin and ciprofloxacin were 35.3%, 27.7%, 97.7%, 26.5%, 16.7%and 33.7% respectively. All strains of S.aureus, isolated from wound and soft tissue in our hospital were susceptible to tigecyline, linozolide and vancomycin