effect of long-term steroid therapy on linear growth of nephrotic children

Steroids are still the mainstay of management of nephrotic syndrome [NS]. It was shown that steroids could impair growth and development of children. However, other clinical studies have shown conflicting results. Hospital records of 147 children with diagnosis of NS who were followed during 1988-2008 are reviewed relating to height measurements. All patients were treated with prednisolone and had been followed for at least five years. Height measures were transformed into standard deviation score [SDS]. Information on dose and duration of prednisolone therapy, histological findings of biopsy as well as concomitant use of steroid-sparing agents [SSA] were also analyzed. Mean age at onset of NS was 5.94 years and at last follow-up visit 15.08 years. All patients had normal renal function during entire duration of the study. Analysis of the whole population did not show any significant alterations in the height SDS [Ht[SDS]] between the first and the last follow-up visit [P=0.5; -0.76 +/- 2.0 vs. -0.89 +/- 2.05 respectively]. The patients were divided into two subgroups. Subgroup A, which achieved growth improvement, was composed of 62 children [initial [Ht[SDS]] -1.63; final [Ht[SDS]] -0.08; P<0.001] and subgroup B, that showed growth retardation, included 85 children [initial [Ht[SDS]] -0.13; final [Ht[SDS]] -1.59; P<0.001]. No statistically significant retardation of linear growth was observed in the study population as a group following treatment with prednisolone according to the guidelines of ISKDC. Although about 62 subjects had growth retardation, children treated with prednisolone were not different from those who had increased growth

Transition to phacoemulsification at the Farabi eye hospital, Iran

To provide objective evidence on the transition of cataract surgical care at Farabi Eye Hospital, Iran. Two separate years, 2003 and 2006, were selected for evaluation. One thousand nine hundred fifty-seven surgical records of age-related cataract cases were randomly selected and reviewed. Three hundred fifty-three patients [405 eyes] in 2006 and 125 patients [153 eyes] in 2003 were selected randomly for a follow-up examination. The two phases were compared in terms of surgical routines, patient characteristics and outcomes for statistical differences. P <0.05 was considered statistically significant. The phacoemulsification rate increased from 25% to greater than 90% between 2003 and 2006, rates of corneal incisions and use of foldable intraocular lenses tripled, administration of general anesthesia dropped from 80% to 12%, the outpatient admission rate rose from 5.2% to 71%, 4% vs. 66% of the operations were performed by a senior phacoemulsification surgeon and the number of advanced surgeons changed from 6% to 38% [all P-values < 0.001]. In 2006, more patients at the two extremes of age, more patients with poor systemic conditions and myopes underwent surgery [all P-values < 0.05]; the cataract surgery volume increased by 49% and post-operative visual acuity improved [P= 0.03] while patient satisfaction was unchanged. We objectively documented the transition in cataract surgery technique to phacoemulsification at the Farabi Eye Hospital in the mid-2000s. This was accompanied by significant expansion of the spectrum of cataract surgery candidates and remarkable attainment of surgical skill