Epidemiology of eye diseases in monocular blind veterans in 19 provinces of Iran from 2010 to 2016

Background and Aim: Blindness is one of the permanent physical damage that is found frequently in war survivors. In monocular blind veterans, preservation and care of the remaining eye is very important. This study aimed to investigate diseases and disorders of both eyes of monocular blind veterans. Methods: A total of 1820 monocular blind veterans from 19 provinces of Iran were surveyed between 2010 and 2016. Demographic data including age, gender, marital status, injury rate, associated injuries, educational level and employment status were collected. After examination of the veterans� eyes, diseases of the both eyes and eyelid disorders were recorded by an ophthalmologist. Furthermore, treatment plans were provided to each patients. Results: The mean age of 1820 participants was 45.8 ± 7.8 years. About two-thirds (73.6) of participants had injuries other than blindness. More than half (54.2) of the blind eyes had diseases, the most frequent of which was phthisis bulbi (11.0). A total of 405 (22.2) of the non-blind eyes were healthy. The frequencies of diseases in non-blind eyes were as follows: refractive error, 620 (34.1); presbyopia, 533 (29.3); cataract, 62 (3.4); glaucoma, 32 (1.7); and others, 168 (9.3). Except for the glaucoma, these diseases were associated with age (P<0.05). Entropion (13.1) and incomplete eyelid closure (9.8) were the most common eyelid disorders. The majority of the blind (93.7) and non-blind (94.3) eyes needed follow-up in the next year of the study. Conclusion: In monocular blind veterans, the most frequent diseases and disorders of the blind eyes, non-blind eyes and eyelids were phthisis bulbi, refractive errors and entropion, respectively. Regarding the importance of preserving the vision of non-blind eyes and the frequency of diseases in both eyes of these veterans, periodic examination is necessary. © 2018 Baqiyatallah University of Medical Sciences. All Rights Reserved

Epidemiological study of child casualties of landmines and unexploded ordnances: A national study from Iran

Background Despite landmine-risk education programs and extensive demining activities on the Western border of Iran, landmines and unexploded ordnance (UXOs) still cause civilian and child casualties three decades after the Iraq-Iran war (1980-1988). The objective of this study was to understand the epidemiological patterns and risk factors of injury in child casualties of landmines and UXOs in Western and Southwestern Iran. Methods Children who were 18 years old or younger at the time of study and who sustained injuries from landmines and UXOs were identified through a search at the Iranian National Veterans Registry. These children participated in a 5-day gathering. The information on socioeconomic status, health-related issues, quality of life, health care utilization, and clinical profiles concerning the landmine and UXO injuries were collected. The method of data collection consisted of three component surveys: health interview, social survey, and medical examinations. Social surveys and health interviews were conducted in a face-to-face method by utilizing a questionnaire consisting of 39 questions addressing household and individual components, including information on time and type of injuries, physical activity, mental health, and quality of life. A comprehensive team of physicians in different subspecialties evaluated and examined children to assess the current medical and psychiatric conditions and physical activity, and recommended and arranged further medical, rehabilitation, or surgical planning. Results Seventy-eight child casualties were identified and participated in the study. The mean age of the participants at the time of study was 16.11 years old (SD=2 years). The mean age of victims at the time of injury was 8.2 years (SD=3.12 years; ranged from 2 to 15 years old). Sixty-seven (85.9) of the children were male. Provinces of Kurdistan and Kermanshah had the highest number of casualties, with a total number of 54 children (68.3). Eighty percent of the injuries were caused by landmines, and UXO explosions were reported in 20 of the cases. Overall, 24 children (30) had received some landmine-risk education before or after the events. Sixty percent of the explosions had happened in the morning between 9:00 am and 12:00 pm. Playing and grazing livestock were the most prevalent activities/reasons at the time of injury, which were reported in 77 of the subjects. Sixty-three percent of incidents had multiple casualties and in only 13 explosions were the children the only victims of the explosion. The most prevalent injuries were amputations in 41 subjects (52.56), followed by hearing loss in 23 subjects (29.5). Amputations were more common in upper extremities (62) than in lower extremities (38). Conclusion Landmines and UXOs comprise a significant safety hazard to the children living in the Western border of Iran decades after the Iraq-Iran War. The large number of injuries and lack of risk training among victims suggest that landmine cleanings and landmine-risk education should be age-specifically targeted and expanded substantially. © World Association for Disaster and Emergency Medicine 2015

Tear and serum MMP-9 and serum TIMPs levels in the severe sulfur mustard eye injured exposed patients

Introduction: Sulfur mustard (SM) intoxication produces local and systemic changes in the human body. In this study, the relationship between tear and serum matrix metalloproteinase (MMP)-9 and serum tissue inhibitors of metalloproteinases (TIMPs) are assessed in serious eye-injured SM-exposed casualties. Methods: A group of 128 SM-exposed patients with serious ocular injuries in three subgroups (19 mild, 31 moderate, and 78 severe cases) is compared with 31 healthy controls. Tear and ocular status and serum MMPs and MMP-9/TIMPs complex levels were evaluated using enzyme-linked immunosorbent assay (ELISA). Results: Serum level of MMP-9 was significantly higher in the SM-exposed group compared to the control group (P = 0.009). Mean serum MMP-9 level in the SM-exposed group with ocular abnormalities was significantly higher than that in the SM-exposed group without ocular abnormalities. SM-exposed people with corneal calcification had significantly higher serum MMP-9/TIMP-1 level compared to the SM-exposed ones without this problem (P = 0.045), The SM-exposed group with severe ocular injuries had significantly higher MMP-9/TIMP-1 than the controls (P = 0.046). The SM-exposed group had significantly lower levels of MMP-9/TIMP-4 complex than the controls (P < 0.001). The SM-exposed group with tear meniscus and fundus abnormality had significantly higher MMP-9/TIMP-4 levels than the SM-exposed group without these problems (P = 0.009 and P = 0.020). Conclusion: Serum MMP-9 level had increased in SM-exposed groups with ocular problems, while TIMP-1 and TIMP-2 levels had remained unchanged. Serum TIMP-4 drastically decreased in SM-exposed group, which clearly explains the severity of the systemic and ocular damages