Prevalence and risk factors of diabetes mellitus in a central district in Islamic Republic of Iran: a population-based study on adults aged 40-80 years

Previous studies on type 2 diabetes mellitus in the Islamic Republic of Iran were mainly performed in provinces with large populations. This study determined the prevalence and risk factors of diabetes mellitus in an adult population [40-80 years old] from Yazd district. Multistage, systematic cluster random sampling was used in a cross-sectional, population-based survey. Demographic, clinical and anthropometric data were collected, with diabetes defined as fasting blood sugar >/= 7 mmol/L or a positive medical history of diabetes. The age- and sex-standardized prevalence of diabetes in 2090 individuals participants was 24.5% [95% CI: 22.2-26.8%], including 10.5% new cases. For each year of ageing, the prevalence of diabetes increased significantly by 4% and this trend was more pronounced in females than males. Low education and hypertension were significantly associated with diabetes prevalence. The prevalence of diabetes mellitus in Yazd is greater than the average levels nationwide and those of nearby countries

Prevalence of pseudoexfoliation syndrome in diabetic patients

Pseudoexfoliation syndrome [PEX] is the most common identifiable cause of secondary glaucoma, the prevalence of which varies considerably among different ethnicities. The aim of this study was to assess the prevalence of PEX in diabetic patients older than 50 years. In this descriptive, cross-sectional study 400 diabetic patients older than 50 years referred to the Yazd Diabetes Research Center were selected consecutively. After completing a questionnaire, ophthalmologic examination was performed with slit-lamp, 3-mirror lens and Direct Ophthalmoscopy. Of the total of 400 patients, 24 patients [6%] had PEX. PEX was significantly higher in older diabetic patients [P = .007]. No significant association was observed with the other variables, including sex, duration of diabetes and retinopathy [p = 0.7]. Also, prevalence of glaucoma in patients with PEX was 14.8%. In our study the prevalence of PEX was 6%. On comparison of results with similar studies on non diabetic patients of the same age group in our region, the prevalence of PEX in diabetic patients is less than non diabetic patients in Yazd

[Aspergillus fumigatus keratitis after laser in situ keratomileusis]

To report a case of unilateral Aspergillus fumigatus interface keratitis after laser in situ keratomileusis [LASIK]. A 22-year-old woman developed corneal infiltrates located at the flap- stroma interface in her left eye 48 hours after myopic LASIK. The infiltration progressed despite administration of topical fortified antibiotics therefore, the flap was lifted and irrigated with antibiotic solution. Six days after LASIK, visual acuity was counting fingers at 30 cm and a large full-thickness corneal infiltrate was located at the flap-stroma interface. On scanning confocal microscopy, fungal hyphae were observed as high-contrast filaments. The LASIK flap was amputated. Corneal scraping revealed fungal filaments in smears and culture. The fungus was identified as Aspergillus fumigatus. Fortified antibiotic drops were discontinued and intensive topical natamycin and systemic ketoconazole were initiated which controlled the keratitis. Two months after surgery the eye was quiet and vision improved to 20/200. Interface fungal infection after LASIK is a potentially vision-threatening complication. Early lifting of the flap, fungal culture and aggressive antifungal treatment are required to treat this complication. Confocal microscopy may be a fast and safe diagnostic tool in determining the presence of fungal hyphae in vivo within the human cornea

Clinical survey of ocular findings in patients with grave's disease

Grave's disease is an autoimmune process manifested by three hallmarks: hyper-thyroidism with diffuse goiter, ophthalmopathy and dermopathy. This disease usually occurs with hyper thyroidism; although the may be euthyroidism. To evaluate the ophthalmic lesion in patients with grave's disease according to sex, age, and the duration of the illness as well as the treatment. Ninety five patients [62% females and 38% males] with grave's disease were included in this study. The subjects underwent a complete ophthalmic examination and the results were recorded. The elevation of IOP and chemosis were significantly higher in males than in females. The prevalence of ophthalmopathy was 60%, and most common ophthalmic signs were proptosis and lid retraction. Eyes lesions were more frequent among 50-70 years old patients. In addition, chemosis, periorbital edema, corneal sensitivity secondary to dry eye, convergence insufficiency, diplopia and proptosis were positively correlated with age. Initially, ophthalmic complains were only given by 15% of the subjects. Lid retraction was decreased with prolonged duration of disease whereas chemosis, conjunctival congestion, and extra-ocular muscle enlargements were increased. Grave's ophthalmopathy was found mostly in males and proptosis with lid retractions were the most important signs of the disease.

Study of four year incidence rate of diabetic retinopathy and its associated factors in type II diabetes patients

It seems that improvement in care and new treatment and screening methods along with better control of diabetes mellitus [DM] has led to a change in incidence of diabetic complications, especially diabetic retinopathy. This study was performed to assess the 4 years incidence rate of diabetic retinopathy in patients with type II diabetes and factors affecting its progression. In this prospective study on diabetic patients referring to Yazd diabetes center, 120 type II diabetic patients without diabetic retinopathy were selected. After complete ophthalmic examination, fasting blood sugar [FBS], post prandial blood sugar, triglyceride and cholesterol levels were measured, and height, weight and blood pressure [BP] were recorded. Then the patients were followed with yearly eye examinations for 4 years. Four year cumulative incidence of diabetic retinopathy was 47.5% [95% CI: 38.6 - 56.4]. The retinopathy was mild, non proliferative diabetic retinopathy [NPDR] in 43 [35.8%] where as 10[8.3%] patients had moderate NPDR and 3[2.5%] patients had severe NPDR. Only one patient had proliferative diabetic retinopathy. The incidence of diabetic retinopathy was 5.8% in first year, 20.3% in second year, 24.4% in third year and 7.4% in fourth year. Duration of diabetes, FBS and systolic BP had a statistically significant relationship with grades of diabetic retinopathy, but there was no significant association between age, sex, Body mass index [BMI], triglyceride and cholesterol levels, method of treatment, smoking and diastolic BP with grades of diabetic retinopathy. Duration of diabetes, blood glucose levels and systolic blood pressure are main risk factors of diabetic retinopathy

Double masked randomized clinical trial comparing Latanoprost with Timolol in open angle glaucoma

To Compare the efficacy and safety of latanoprost once a day with timolol administered twice a day in patients with open angle glaucoma. In this six month double masked randomized clinical trial, 80 patients with primary open angle glaucoma were divided randomly for treatment to either 0.005% latanoprost once a day [n = 40] or 0.5% timolol twice a day [n = 40]. Intraocular pressure was measured, and efficacy was based on intraocular pressure reduction from baseline. Through the day the mean IOP was significantly lower with latanoprost than with timolol. Diurnal IOP [10:00 AM, 4:00 PM, 8:00PM] was reduced from 26.2 to 16.9 mmHg with latanoprost and from 25.8 to 17.4 mmHg with timolol at the end of the 6-month treatment period. Mean IOP reduction ranged from 7.8 to 8.2 mmHg in 35.2% of the latanoprost group and from 6.3 to 6.8 mmHg in 33.9% of the timolol group. Significantly higher percentage of patients had low IOP levels with latanoprost than timolol [P < 0.001]. The decrease from baseline lOP was up to 8.2 mmHg in latanoprost group compared to 6.2 mmHg in timolol group. Latanoprost caused more conjunctival hyperemia than timolol. Timolol caused more systemic side effects than latanoprost. There were greater mean and peak TOP reductions achieved with 0.005% latanoprost QD compared with 0.5% timolol. BID. Latanoprost must be considered a new first-line drug for glaucoma

Evaluation of vitamin C concentration of aqueous humor in senile cataract

Senile cataract is one of the most important preventable causes of blindness. Oxidative agents like ultraviolet [UV] are one of the most important causes of cataract. Vitamin C is an important water soluble antioxidant agent in the aqueous humor. In a cross-sectional study, 85 patients admitted to Rah-Ahan Eye Hospital for cataract surgery were evaluated. The mean age of the patients was 64.3 +/- 1.2 yr of the 85 patients, 41 were men and 44 were women. Under general anesthesia 0.2 cc of aqueous humor from anterior chamber and 5 cc of peripheral blood were taken just before operation. Concentration of vitamin C was measured in these samples and the data was analyzed by SPSS statistical program. Mean concentration of vitamin C was 4.29 +/- 0.12 mg/dl [mean +/- SE] in the aqueous and 0.77 +/- 0.036 mg/dL in the plasma. The differences were statistically significant when compared with normal values. P 0.000 in both conditions. Vitamin C concentrations of aqueous humor were equal in both sexes, but vitamin C concentrations of plasma in women were higher than men [p=0.043]. The concentration of vitamin C was not related to the type of cataract or job of patients. Since vitamin C concentration of aqueous humor and plasma in senile cataract are lower than normal, it is better to advise fresh vegetables and fruits or other supplements to patients who are at risk of senile cataract