Corneal biomechanical properties after soft contact lens wear measured on a dynamic Scheimpflug analyzer: A before and after study.

OBJECTIVES: To evaluate the corneal biomechanics before and after daily use of contact lenses (CLs), measured by Scheimpflug-based devices. METHODS: This prospective clinical study includes participants who were scheduled to use CLs daily for refractive error. The biomechanical parameters were measured by the Corneal Visualization Scheimpflug Technology (Corvis ST) before and one month after using the soft CLs. RESULTS: Twenty-three subjects (46 eyes), including 16 female (76.2%) with a mean age of 28±7.29 years, were enrolled. There was no significant difference among biomechanical factors measured before and after contact lens wear (P>0.05). Using regression analysis of the biomechanical markers, we found a statistically significant association between second applanation length (A2 length) (P=0.001), highest concavity radius (HCR) (P=0.05), deflection amplitude ratio (DA_ratio) (P=0.05) and integrated radius (P<0.001) with age. Regarding spherical equivalent, we found a statistically significant association between central corneal thickness (CCT) (P=0.05), A2 length (P=0.03) and stiffness parameter at first applanation (SPA1) (P=0.02). CONCLUSIONS: We did not find a significant difference in terms of corneal biomechanical parameters between baseline and month 1; but regression analyses showed a statistically significant association between A2 length, HCR, DA_ratio, integrated radius, CCT and SPA1 and certain subject characteristics.

Molecular epidemiology of Escherichia coli sequence type 131 and its H30/H30-Rx subclones recovered from extra-intestinal infections: first report of OXA-48 producing ST131 clone from Iran.

Multidrug-resistant (MDR) O25b-ST131 clone of Escherichia coli is well established as a significant cause of extra-intestinal infections worldwide. However, there have been no studies about the prevalence of ST131 and its H30/H30Rx subclones from Iran. The prevalence of ST131 was 29.8% among phylogroups B2, D, and F of E.coli isolates recovered from extra-intestinal infections. Fifty-seven (90.4%) and six (9.6%) of isolates belonged to serogroups O25b and O16 respectively, and exhibited high rates of MDR (98.4% and 83.3%) and extended spectrum ß-lactamase (ESBL) production (96.8% and 83.3%). The majority (56/57, 98.2%) of O25b isolates belonged to H30 lineage; of those, 24 isolates (42.8%) belonged to H30-Rx subclone. O16-ST131 isolates were H30-negative. The resistance rate values of O16-ST131subgroup were lower for fluoroquinolones/aminoglycosides and higher for carbapenems, cephalosporins, ß-lactam/ß-lactamase inhibitors and trimethoprim/sulfamethoxazole, as compared to O25b-ST131 isolates. Among H30 sub lineage and in comparison with non-Rx isolates, H30-Rx subclone showed higher resistance score and virulence genes (papA and papC), and was also associated with CTX-M group 1. bla OXA-48 carbapenemase was detected in seven O25b and one O16 isolates; of those, one O25b-ST131 isolate was carbapenem-susceptible. The ST131 isolates comprised 15 'enterobacterial repetitive intergenic consensus' (ERIC) clusters, and O16 isolates remained distributed in five groups in cluster with O25b-ST131 isolates. In conclusion, this is the first report of the presence of MDR, bla OXA-48/CTX-M-positive O25b/O16-ST131 isolates in Iran. Contrary to lower prevalence of O16-ST131 subgroup, higher resistance rates to ß-lactam antibiotics may indicate the importance of this subgroup in the spread of MDR E.coli isolates.

Multiple Imputation to Deal with Missing Clinical Data in Rheumatologic Surveys: an Application in the WHO-ILAR COPCORD Study in Iran.

BACKGROUND: The aim of the article is demonstrating an application of multiple imputation (MI) for handling missing clinical data in the setting of rheumatologic surveys using data derived from 10291 people participating in the first phase of the Community Oriented Program for Control of Rheumatic Disorders (COPCORD) in Iran. METHODS: Five data subsets were produced from the original data set. Certain demographics were selected as complete variables. In each subset, we created a univariate pattern of missingness for knee osteoarthritis status as the outcome variable (disease) using different mechanisms and percentages. The crude disease proportion and its standard error were estimated separately for each complete data set to be used as true (baseline) values for percent bias calculation. The parameters of interest were also estimated for each incomplete data subset using two approaches to deal with missing data including complete case analysis (CCA) and MI with various imputation numbers. The two approaches were compared using appropriate analysis of variance. RESULTS: With CCA, percent bias associated with missing data was 8.67 (95% CI: 7.81-9.53) for the proportion and 13.67 (95% CI: 12.60-14.74) for the standard error. However, they were 6.42 (95% CI: 5.56-7.29) and 10.04 (95% CI: 8.97-11.11), respectively using the MI method (M=15). Percent bias in estimating disease proportion and its standard error was significantly lower in missing data analysis using MI compared with CCA (P< 0.05). CONCLUSION: To estimate the prevalence of rheumatic disorders such as knee osteoarthritis, applying MI using available demographics is superior to CCA.

Malaria Status in Economic Cooperation Countries; Achievement and Gaps toward United Nations Millennium Development Goals.

BACKGROUND: Evaluating the malaria status of the Economic Cooperation Organization (ECO) member countries relation to goal 6 of 3rd Millennium Development Goals (MDGs) which includes have halted by 2015 and begun to reverse the incidence of malaria. METHODS: By 2009, we reviewed the MDGs reports, extracted the data from surveillance system, published, and unpublished data. The main stakeholders, from both governmental and international organizations in the country have been visited and interviewed by the research team as part of the data validation process. RESULTS: The malaria incidence is very heterogeneous among ECO countries, which differ less than 200 cases in total country in Kazakhstan, Kyrgyzstan, Turkey, Turkmenistan, Uzbekistan, and Azerbaijan to 82,564 cases (2,428/100,000) in Afghanistan and 59,284 cases (881/100,000) in Pakistan and about 18/100,000 in Iran in 2008. Malaria has been a major public health problem in Pakistan and Afghanistan and will continue to pose serious threat to millions of people due to poor environmental and socioeconomic conditions conducive to the spread of disease. The main malaria endemic areas of Iran are in southeastern part of the country; consist of less developed provinces that are bordered in the east by Afghanistan and Pakistan. There are little valid information about proportion of population in malaria-risk areas using effective malaria prevention and treatment measures indicators. CONCLUSION: All ECO countries could achieve MDGs malaria indicators by 2015 except Pakistan and Afghanistan, unless preparing urgent intervention programs to fulfill the goals.