[Opposite clear corneal incisions versus on-axis incision during phacoemulsification to correct pre-existing astigmatism]

To compare the efficacy of adding an opposite clear corneal incision [OCCI] on the steep axis during phacoemulsification in reducing the pre-existing corneal astigmatism. This randomized clinical trial was performed on 120 eyes with corneal astigmatism of >1D undergoing phacoemulsification. Incisions were made based on the type of astigmatism as follows: superior or superior+OCCI in the with-the-rule and temporal or temporal+OCCI in the against-the-rule astigmatism. Patients were followed with refraction, keratometry and topography. Statistical analyses were done using one and two ways ANOVA and Tukey-a test. Mean corneal astigmatism was 1.82 +/- 0.86 D in the superior+OCCI group and 1.74 +/- 0.86 D in the temporal+OCCI group preoperatively which respectively decreased to 1.31 +/- 0.59 [P= 0.013] and 1.19 +/- 0.64 [P= 0.009] postoperatively. No significant changes occurred in the amount of astigmatism in none of the two single incision groups. Paired OCCI on steep axis is a useful technique to correct mild to moderate pre-existing astigmatism with no need to extra skill or instrumentation

Evaluation of independent prognostic importance of hyperuricemia in hospital death after acute myocardial infarction

To evaluate the role of hyperuricemia [serum uric acid level greater than 7 mg/dl] as an independent short term [in hospital] prognostic factor after acute myocardial infarction [AMI]. Included in the study were 2218 patients who were hospitalized with well established AMI from June 1996 through to December 2002 in the Coronary Care Unit of Ekbatan General Hospital, Hamedan University of Medical Sciences, Iran. All patients with exclusive criteria, were omitted from study. Furthermore, frequency of hyperuricemia in patients [N=59] who expired after AMI was compared with patients [N=104] whom were discharged from the hospital after AMI. Frequency of hyperuricemia was measured according to the extension of myocardial necrosis [as the most important prognostic risk factor] based on serum creatine phosphokinase level greater or less than 2000 IU, which was 13.3% and 20.7% in the case group, and 9.5% and 9.7% in the controls, respectively. These findings indicate that hyperuricemia is not an independent prognostic risk factor in hospital death after AMI

Albendazole versus metronidazole in the treatment of patients with giardiasis in the Islamic Republic of Iran

We examined the therapeutic effects of albendazole compared to metronidazole in 120 patients with giardiasis in Hamdan. Patients were randomized to receive albendazole [400 mg, once daily for 5 days] or metronidazole [250 mg, 3 times a day for 5 days]. Demographic data of the patients, results of stool for Giardia trophozoites before and after treatment, and drug side- effects were recorded. After treatment 6 [10.0%] of the albendazole group had trophozoites compared with 14 [23.3%] of metronidazole group [P < 0.05]. Patients in the albendazole group had fewer side- effects while 43.3% of the metronidazole group experienced a metallic taste and 35.0% experienced loss of appetite. Albendazole is an easy, safe and effective treatment for giardiasis

[ effect of sex and obesity on the lumbar lordosis]

Background and Objective: The curves of vertebral column have an important role to shock absorption and stability of the spine. The goal of this study was to evaluate the correlation between total and segmental lumbar lordosis with sex and obesity

Methods: One hundred volunteers [54 males and 46 females] aged between 20-70 years and without a history of low back pain were selected. A standing lateral radiograph of the lumbar spine was taken for each volunteer. Then by using Cobb methods, the total and segmental lumbar lordosis was measured from radiographic film. The age, sex, height and weight of each participant were recorded and also BMI for each participant were calculated. Data were statistically analyzed and the difference between points were considered significant at P<0.05

Findings: The mean total lumbar lordosis for women was 57° and for men were 52.5° and the segmental lordosis for the two groups, women versus men was as follows: L1-L2: 5° vs. 4° L2-L3: 9° vs. 8° L3-L4: 10.5° vs. 9° L4-L5: 15° vs. 13° L5-S1: 19.5° vs. 22°. Women being overweight had significantly greater total lumbar lordosis and segmental lordosis at L1-L2 and L2-L3

Conclusion: In comparison to men, women had significantly greater total lumbar lordosis and segmental lordosis at L3-L4. The overweight among female influence on amount of total lumbar lordosis and segmental lordosis at L1-L2 and L2-L3

[Evaluation of radiographic findings in chronic low back pain]

Background and Objective: Low back pain is one of the problems that involve many of people during their life, especially in old ages. It is estimated 80% of individuals experience low back pain. According to high prevalence of this problem, it is necessary to evaluate its epidemiologic characteristics. The aim of this study was to evaluate the radiographic findings in chronic low back pain

Methods: This study was performed on 547 patients with chronic low back pain referred to Yahyanejad hospital in 2001. Plain anterior-posterior radiographies were taken and if there was any doubt about spondylolysis, right and left oblique radiographies were requested. All findings were detected from these graphs

Findings: 408 women [74.6%] and 139 men [25.4%] were participated in this study. In 286 of cases, there was not any radiologic finding. The most frequent radiographic findings were: Spondylolysis [21.6%], narrowing L4-L5 [7.9%]. There was a significant relation between spondylolisthesis, narrowing >L4, flat back and narrowing L4-L5 and age [P<0.05]. Also spondylolisthesis L4-L5 and narrowing L5-S1 were more frequent in female [P=0.005 and P=0.041, respectively]

Conclusion: More than half of patients have positive radiographic findings. So, it is advisable to take lumbosacral radiography before any treatment of chronic low back pain

[Treatment results with oral rocaltrol pulse among patients with secondary hyperparathyroidism in hemodialysis ward]

Background and Objective: Renal osteodystrophy is one of the most important complications of ESRD [End Stage Renal Disease]. Prescription of calcium, low phosphate diet and rocaltrol are essential in these patients. The aim of this study was to determine the prevalence of renal osteodystrophy and secondary hyperparathyroidism in ESRD patients were covered by Semnan- Fatemieh hemodialysis center and detect the oral rocaltrol pulse response on secondary hyperparathyroidism and renal osteodystrophy in some of these patients

Methods: In first step, 31 patients with ESRD checked for serum calcium [Ca[2+]] phosphorous [P], alkaline phosphatase and iPTH [IRMA] and bone deformity in bone x-ray from 2000-2001. In second step, 12 patients were categorized in three groups according to iPTH level and treated with 1, 2, 4 microgram oral-rocaltrol pulse, three times a week for 6 months, respectively. Then Ca2+, P, alkaline phosphatase, iPTH levels and bone graphy compared with before treatment results

Findings: From 31 patients with age average 52 +/- 17.7 and hemodialysis duration average 36 +/- 22.3 months, 3.5 Percent had Ca[2+] level equal or higher than 10.4 mg/dl, 77.3 percent had P level equal or higher than 4.5 mg/dl, 80.6 percent had iPTH level higher than 120 pg/ml and 72.4 percent had alkaline phosphatase level higher than 175 Iu/l. No meaningful correlation observed between hemodialysis duration with serum Ca[2+], P and alkaline phosphatase level. In 12 patients treated with oral rocaltrol pulse, meaningful differences observed only between serum iPTH level before and after treatment [P<0.003]

Conclusion: In most studied patients, serum P and iPTH level was extremely high that suggest poor control of P and hyperparathyroidism. Oral rocaltrol pulse prescription for 6 months decreased iPTH level but had no effect on Ca[2+], P and alkaline phosphatase