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INTRODUCTION: Evaluation of anterior segment parameters is crucial in ophthalmic procedures such as intraocular surgeries and contact lens fitting. However, the use of tropicamide in diabetic patients presents challenges due to its potential impact on biometric measurements. This study aims to investigate and compare the effects of 0.5% and 1% tropicamide on anterior segment parameters in diabetic patients. METHODS: This double-masked randomized clinical trial enrolled 98 patients with diabetes mellitus. Participants were randomly assigned to receive either 0.5% or 1% tropicamide. Anterior segment parameters were measured using Pentacam HR (Oculus Optikgeräte GmbH, Wetzlar, Germany) before and 30 minutes after tropicamide administration. Parameters included anterior chamber depth (ACD), anterior chamber volume (ACV), anterior chamber angle (ACA), keratometry, central corneal thickness (CCT), white-to-white distance (WTW), and pupillary diameter (PD). RESULTS: Both concentrations of 0.5% and 1% tropicamide induced significant changes in anterior segment parameters. There was a notable increase in PD (2.99 ± 0.62, 3.11 ± 0.55, respectively, both P-values < 0.001), ACD (both 0.10 ± 0.05, both P-values < 0.001), ACV (16.69 ± 9.56, 17.51 ± 9.26, respectively, both P-values < 0.001), and WTW (0.06 ± 0.14, 0.03 ± 0.30, respectively, both P-values < 0.001), along with a decrease in ACA (-3.50 ± 10.65, -3.30 ± 6.87, P-value < 0.001 and P-value=0.001, respectively), and CCT (-6.10 ± 8.06, -6.39 ± 9.97, respectively, both P-values < 0.001) post-dilation. However, no significant changes were observed in keratometry (front Km (-0.03 ± 0.19, -0.04 ± 0.21, respectively), back Km (0.01 ± 0.05, 0.004 ± 0.05, respectively), P-values> 0.05). CONCLUSION: Both concentrations of tropicamide exhibited comparable effects on anterior segment parameters in diabetic patients. These post-dilation changes should be considered for accurate intraocular lens power calculation and decision-making for cataract, phakic intraocular lens, and refractive surgeries.
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In this report, we shared our experience in the treatment of a patient with unresectable sinonasal melanoma, in whom a complete radiographic response was seen after a course of conventional external beam radiotherapy. Given that local control has an important role in maintaining the quality of life of patients.
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BACKGROUND: The clinical significance of metabolic syndrome (MetS) during adolescence and its association with adulthood adverse outcomes is a controversial issue. This study aimed to investigate the association of MetS and metabolic phenotypes with a high carotid intima-media thickness (CIMT) in early adulthood. METHODS: MetS was defined as proposed by Cook, de Ferranti, the National Cholesterol Education Program (NCEP), and the pediatric International Diabetes Federation (IDF). Metabolic phenotypes were defined based on the binary clustering of cardiovascular risk factors. The participants were adolescent's individual selected from a large cohort study and followed for 18.2 years. Multivariate-adjusted odds ratios (ORs) were calculated for a high CIMT incidence (≥95th percentile). RESULTS: In this study, 862 adolescents (52.3% males), with the mean age of 13.4 ± 2.2 years, were included. The presence of MetS, based on the definitions proposed by Cook (OR = 1.90, 95% CI: 1.01-3.57, P = 0.046) and de Ferranti (OR = 1.74; 95% CI: 1.04-2.90, P = 0.033), was associated with the increased risk of a high CIMT in early adulthood. Metabolic phenotypes, including high waist circumference (WC)/hypertension (HTN), high WC/low high-density lipoprotein-cholesterol (HDL-C), and high triglyceride (TG)/high WC, showed higher risks of a high CIMT. However, these positive associations become insignificant after adjusting for the adulthood BMI, except for the high WC/low HDL-C phenotype (OR = 2.04, 95% CI: 1.02-4.11, P = 0.044). CONCLUSION: The high WC/low HDL-C phenotype had a better predictive value and could be used as a simpler alternative for MetS to identify adolescents with a higher risk of high CIMT during early adulthood.
Subject(s)
Carotid Intima-Media Thickness , Metabolic Syndrome , Adolescent , Adult , Child , Cohort Studies , Female , Glucose , Humans , Iran/epidemiology , Lipids , Male , Metabolic Syndrome/diagnostic imaging , Metabolic Syndrome/epidemiology , Phenotype , Risk FactorsABSTRACT
Denosumab, a monoclonal antibody that specifically targets cytokine receptor activator of nuclear factor-kappa B ligand (RANKL), is a potentially viable option in resistant aneurysmal bone cysts.
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Background: Neoadjuvant chemoradiation is one of the main treatment approaches in esophageal cancer treatment, which can improve outcomes of a patient with esophageal cancer. In the current study, we aimed to compare the response rate and side effects of 2 distinctive neoadjuvant chemoradiation protocols. Methods: The study was a randomized clinical trial that was performed on 70 patients with esophageal and gastroesophageal junction cancer in Iran. The study participants were randomly assigned to 1 of our treatment groups. The first group received capecitabine (625 mg/m2/TID) and oxaliplatin (50 mg/m2/weekly), while the second group was given a combination of carboplatin (AUC:2/weekly) and paclitaxel (75mg/m2/weekly). Both groups were given weekly 50.4-54 Gy dose of RT. Chi square and Fisher exact tests have been used for data analysis. All statistical tests were performed using SPSS software Version 22.0 and the significance level was set at 0.05. Results: Complete pathological response was detected in 18(51.4%) of patients in group I and 8 (22.8%) in group II (p=0.013). We also observed higher thrombocytopenia in CarTax arm 19 (54.2%) in comparison to CapOX arm 8(22.8%), and the difference was statistically significant (p=0.007). No statistical difference was found regarding neutropenia, fatigue, anorexia, esophagitis, and diarrhea. Conclusion: The CapOxRT regime provides more favorable outcomes and also it is more tolerated by patients.
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Background: Breast cancer is one of the most common cancers. Researchers are trying to diagnose the disease through easier and safer methods. Serum markers such as ferritin and vitamin D level would be very helpful. This research could pave the way for more comprehensive studies on how to use this serum factor in breast cancer screening, as well as early detection of the disease in its early stages. Methods: This study consisted of two groups, the first group comprising patients diagnosed with breast cancer before undergoing any treatment and the second group as control were healthy people. Serum ferritin and vitamin D levels were measured. Pathological information of the patient's tumor, including ER, HER2, KI67, lymphovascular invasion, and disease stage, were collected as well. Data were analyzed by IBM SPSS advanced statistics version 23.0 (SPSS Inc., Chicago, IL). P-value of ≤0.05 was considered significant. Results: Eighty-eight subjects were enrolled in this study, 29 (33%) breast cancer patients and 59 (67%) healthy women. In breast cancer patients, serum ferritin levels were 106.55±111.25, which were higher than healthy women's serum ferritin 52.71±36.95 (p=0.083). Furthermore, 18 (66.7%) of breast cancer patients and 55 (93.2%) of healthy women had low serum ferritin levels (p=0.001). 3 (11.1%) patients in the cancer group had serum vitamin D deficiency, while all subjects in the control group had serum vitamin D higher than 10 ng/dl (p =0.009). Conclusion: The results of this study showed a correlation between breast cancer and vitamin D deficiency, and elevated ferritin. Perhaps with further studies, there could be a role in predicting the prognosis and screening of breast cancer for these associations.
