Intravitreal injection of anti-vascular endothelial growth factor agents for ocular vascular diseases: Clinical practice guideline

Purpose: To provide the clinical recommendations for the administration of intravitreal anti-vascular endothelial growth factor (VEGF) drugs especially bavacizumab for ocular vascular diseases including diabetic macular edema, neovascular age-related macular degeneration, myopic choroidal neovascularization, retinal vein occlusion and central serous chorioretinopathy. Methods: Twenty clinical questions were developed by the guideline technical committee. Relevant websites and databases were searched to find out the pertinent clinical practice guidelines to answer the questions. The technical committee provided possible answers (scenarios) according to the available evidences for each question. All scenarios along with their levels of evidence and the supported articles were sent to the experts for external review. If the experts did not agree on any of the scenarios for one particular clinical question, the technical committee reviewed all scenarios and their pertinent evidences and made the necessary decision. After that, the experts were asked to score them again. All confirmed scenarios were gathered as the final recommendations. Results: All the experts agreed on at least one of the scenarios. The technical committee extracted the agreed scenario for each clinical question as the final recommendation. Finally, 56 recommendations were developed for the procedure of intravitreal anti-VEGF injection and their applications in the management of ocular vascular diseases. Conclusion: The implementation of this guideline can standardize the management of the common ocular vascular diseases by intravitreal injection of anti-VEGF agents. It can lead to better policy-making and evidence-based clinical decision by ophthalmologists and optimal evidence based eye care for patients. © 2018 Journal of Ophthalmic and Vision Research

Intravitreal injection of anti-vascular endothelial growth factor agents for ocular vascular diseases: Clinical practice guideline

Purpose: To provide the clinical recommendations for the administration of intravitreal anti-vascular endothelial growth factor (VEGF) drugs especially bavacizumab for ocular vascular diseases including diabetic macular edema, neovascular age-related macular degeneration, myopic choroidal neovascularization, retinal vein occlusion and central serous chorioretinopathy. Methods: Twenty clinical questions were developed by the guideline technical committee. Relevant websites and databases were searched to find out the pertinent clinical practice guidelines to answer the questions. The technical committee provided possible answers (scenarios) according to the available evidences for each question. All scenarios along with their levels of evidence and the supported articles were sent to the experts for external review. If the experts did not agree on any of the scenarios for one particular clinical question, the technical committee reviewed all scenarios and their pertinent evidences and made the necessary decision. After that, the experts were asked to score them again. All confirmed scenarios were gathered as the final recommendations. Results: All the experts agreed on at least one of the scenarios. The technical committee extracted the agreed scenario for each clinical question as the final recommendation. Finally, 56 recommendations were developed for the procedure of intravitreal anti-VEGF injection and their applications in the management of ocular vascular diseases. Conclusion: The implementation of this guideline can standardize the management of the common ocular vascular diseases by intravitreal injection of anti-VEGF agents. It can lead to better policy-making and evidence-based clinical decision by ophthalmologists and optimal evidence based eye care for patients. © 2018 Journal of Ophthalmic and Vision Research

Evaluation of the Biosolids Compost Maturity in South Isfahan Wastewater Treatment Plant

The composting process is a useful method of producing a stabilized material that can be used as a source of nutrients and soil conditioner. Maturity of compost is essential for its optimal use as a soil amendment and a source of plant nutrients as well. Immature composts pose problems of malodors and flies and phytotoxicity and pollution during use. Stability and maturity both are required for compost quality control. Compost maturity tests can be classified into physical, chemical, plant, and microbial activity assays. In this study, several methods of evaluating the stability and maturity of composted biosolids were compared based on chemical and biological properties. The sludge used of windrow composting was obtained from the drying beds of South Isfahan wastewater treatment plant. The results showed that, C/N ratio after 100 days of composting reached to 15/1; NH4/NO3 ratio decreased with increase of the time dewatered sludge compost, which this loss is 57.3%. The content of volatile solids, 28.8% decreased with composting time. The number of fecal coliforms in the initial sewage sludge compost was 17.9×106 and at the end of composting was 898MPN/g of total solids and the compost process provided class A pathogen criteria. Use of chemical and biological parameters exhibited three phases: rapid decomposition (day 40), stabilization (day 80) and maturation (day 100) in biosolids compost. Thus, the biosolid compost was mature and ready for use as an agricultural substrate after about 100 days of composting