Photorefractive Keratectomy for Mild-to-Moderate Myopics with Thin Corneas: A 3-Year Follow-up Results

Background: The purpose of this study was to evaluate the 3-year visual outcomes in mild-to-moderate myopic patients with thin corneas who underwent photorefractive keratectomy (PRK) with or without mitomycin C (MMC).Methods: Thirty myopic eyes with a mean spherical equivalent (SE) of −3.76 ± 1.72 (−6.50 to −1.25) diopter (D) and a mean corneal thickness of 486.03 ± 11.93 (452-499) µm at the thinnest point underwent PRK. MMC was used if they had > 4.0 D myopia. All surgeries were performed with the VISX STAR S4 Excimer Laser (Abbott Medical Optics, Abbott Park, Illinois, USA).Results: Uncorrected visual acuity showed a significant improvement 3 years after surgery when compared to baseline and reached 0.01 ± 0.04 LogMAR (P < 0.001). Best-corrected visual acuity was 0.00 ± 0.01 LogMAR preoperatively and did not change significantly postoperatively. Spherical (P < 0.001) and cylindrical (P < 0.001) error significantly decreased. Manifest refraction SE showed a significant decrease when compared to before the operation and reached −0.08 ± 0.16 D (P < 0.001). At 3 years, mesopic contrast sensitivity was not significantly different from baseline at any spatial frequency. Vertical coma showed a significant decrease and reached −0.10 ± 0.27 µm (P = 0.004). Total coma (P < 0.001), spherical aberration (P < 0.001), and total high order aberrations (P < 0.001) also increased significantly.Conclusions: Based on the 3-year results, PRK (+MMC in patients with SE > 4.0 D) is a safe, effective, and predictable treatment option for mild-to-moderate myopic patients whose minimum corneal thickness is < 500 µm

Intraoperative OCT for Monitoring Corneal Pachymetry during Corneal Collagen Cross-Linking for Keratoconus

Biomechanical reinforcement of the cornea by collagen cross-linking (CXL) using riboflavin and ultraviolet A (UV-A) irradiation is a well-established treatment for halting the progression of keratoconus. Corneal pachymetry is one of the most important factors with respect to the safety of CXL. In addition to the initial pachymetric changes, significant changes in corneal pachymetry may occur during the different steps of the procedure, highlighting the role of intraoperative pachymetric measurements. Intraoperative optical coherence tomography (OCT) can be used safely and effectively to monitor the corneal pachymetry during CXL. Among the advantages of this technology is its ability to provide a more detailed profile of the corneal thickness in a noncontact manner compared to the ultrasound method. These features are especially advantageous for monitoring corneal pachymetry in the setting of CXL in KCN patients, considering the marked irregularity of the epithelium and stroma in these patients. OCT has also been used for evaluation of other aspects of the CXL procedure like evaluation of in vivo riboflavin penetration in to the corneal stroma

The Impact of Education via Short Message Service (SMS) versus that of by e-mail: A Quasi-Experimental Study Among Parents of Children with Leukemia in Shiraz, Iran

Educating parents of children with leukemia increases the quality of provided care to pediatric patients. This study has been designed to determine the impact of education via email and Short Message Service (SMS) on caring knowledge of chemotherapy complications in parents of children with acute lymphoblastic leukemia (ALL). The valid and reliable questionnaire consisted of personal information and knowledge of the effects of chemotherapy in children with leukemia. Seventy four SMS were sent to the parents in form of 5 categories of education about how to care complications of chemotherapy during 10 weeks of the study. The findings of this study indicated that, the awareness of parents increased significantly within a week and a month after the education (

Effectiveness of Compassionate Mind-Based Cognitive Therapy on Adolescents' Behavioral Activation-Inhibition Systems and Theory of Mind

Background and Aim:High-risk behaviors have devastating physical, psychological, and social consequences for the adolescents. This study aimed to investigate the effectiveness of compassionate mind-based cognitive therapy on behavioral inhibition-activation systems and the theory of mind of adolescents with high-risk behaviors. Materials and Methods:The study design was quasi-experimental with control and intervention groups and a follow-up phase.The statistical population included all high school boys with high-risk behaviors in Tabriz. The sample consisted of 30 students who were purposefully selected, and randomly allocated into experimental and control groups. High-Risk Behaviors Questionnaire, Brain-Behavioral Systems Scale, and the Theory of Mind Questionnaire were used to collect data. Data were analyzed using multivariate analysis of variance test and employing SPSS-24 software. Results:Compassion-focused cognitive therapy decreased activation, increased inhibition, and improved theory of mind among adolescents with high-risk behaviors (P<0.01). Conclusion:Based on the findings of this study, it can be concluded that cognitive therapy based on compassionate mind through the component of mindfulness by reducing rumination, leads to a reduction of negative emotions and thus reduces high-risk behaviors in adolescents. Thus, it can be said that treatment based on Compassion can be used as an effective treatment to improve adolescent psychological problems with high-risk behaviors

The Investigation of Alpha-Tubulin Differential Expression in Oligodendroglioma Brain Tumor Aiming MALDI-TOF-TOF

Background: Tubulin is known as a heterodimer protein, which includes alpha and beta tubulin subunits. This structural protein plays important roles in pathogenesis and healing different diseases. Biomarkers help in fast and accurate detection of cancer. Proteomic studies can be useful both in biological and clinical research, also help obtain protein expression profiles by using two-dimensional electrophoresis, mass spectrometry, and bioinformatics tools. Finding candidate proteins as cancer biomarkers is an interesting area in proteomic investigations.Methods: In the present study, the total protein content of healthy cells of the brain and brain tumor cells were extracted, purified and quantified by Bradford assay. Two-dimensional electrophoresis used for protein separation followed by statistical analysis. Primary protein detection was performed based on the differences in isoelectric pH, the molecular weight of proteins and protein data banks, which was further confirmed by Matrix Assisted Laser Desorption Ionisation-Time-of-Flight (MALDI-TOF-TOF).Results: In this study, an alpha-tubulin expression found changed (overexpression) in Oligodendroglioma tumors comparing control identified by proteomics analysis. Also, alpha-tubulin position showed in the oligodendroglioma tumors cluster diagram.Conclusion: Proteome analysis approach has allowed biology and medical studies. Alpha-tubulin introduced as a candidate biomarker for the diagnosis and prediction of oligodendroglioma tumors

Efficacy of Carbone Dioxide laser Debridement along with Low level laser Therapy in Treatment of Grade 3 Necrotic Burn Ulcer in a Paraplegic Patient (A Case Report)

Introduction: A deep burn ulcer, especially in areas with sensory-motor dysfunction, is hard to cure.Case Report: The patient was a 20-year-old paraplegic girl with a grade 3 necrotic burn ulcer for 3 weeks. We used a fractional Co2 laser along with chemical debridement with trichloroacetic acid (TCA 80%) and low-level laser therapy (LLLT) with a 808 nm infrared laser, 6 J/cm2 for the necrotic area, and a 650 nm red laser, 2 J/cm2 for the open wound area. Complete healing occurred after 25 sessions without surgery.Conclusion: Laser debridement along with LLLT and TCA administration may be useful to treat necrotic ulcers without surgery

Effectiveness of Hesabyar Cognitive Rehabilitation on Neuropsychological Functions of Children with Special Learning Disabilities

Background: Children with learning disabilities have cognitive impairments not attributable to their intelligence. The present study aimed to evaluate the effectiveness of Hesabyar Cognitive Rehabilitation on neuropsychological functions of children with special learning disabilities.Methods: This was a quasi-experimental study which had pre-test and post-test design and conducted with a control group. The statistical population included all the male elementary students with special learning disabilities in Semnan, Iran, in the academic year 2019-2020. The sample consisted of 40 students (20 participants in each group) with special learning disabilities that were treated. The Conners Psychological Scale was used for data collection. The experimental group underwent cognitive load rehabilitation every other day for 10 sessions while the control group did not receive any treatment. The data were analyzed using the statistical method of multivariate analysis of covariance and SPSS version 24.Results: The mean±SD of age in the experimental group and the control group were respectively 11.2±0.9 and 11.5±0.8. The results of ANCOVA analysis showed that Hesabyar Cognitive Rehabilitation program made significant changes in components of variables, including selective attention (P=0.002), sustain attention (P=0.001), attention shifting (P=0.001), attention divided (P=0.004), attention span (P=0.002) l-term memory (P=0.011) [components of difficulty in memory function and learning], executive functions (P=0.001), problem with speed and cognitive processing ability (P=0.016), as well as components of academic performance problems, namely attention functions (P=0.004), computational science (P=0.002), argument/calculations (P=0.014), and attitudinal discussions (P=0.001) [components of academic performance problems: mathematics].Conclusion: Based on the findings of this study, Hesabyar Cognitive Rehabilitation program is one of the treatments that can be used to minimize the problems of students with math learning disorders

Associations between dietary risk factors and ischemic stroke: a comparison of regression methods using data from the Multi-Ethnic Study of Atherosclerosis

OBJECTIVES We analyzed dietary patterns using reduced rank regression (RRR), and assessed how well the scores extracted by RRR predicted stroke in comparison to the scores produced by partial least squares and principal component regression models. METHODS Dietary data at baseline were used to extract dietary patterns using the 3 methods, along with 4 response variables: body mass index, fibrinogen, interleukin-6, and low-density lipoprotein cholesterol. The analyses were based on 5,468 males and females aged 45-84 years who had no clinical cardiovascular disease, using data from the Multi-Ethnic Study of Atherosclerosis. RESULTS The primary factor derived by RRR was positively associated with stroke incidence in both models. The first model was adjusted for sex and race and the second model was adjusted for the variables in model 1 as well as smoking, physical activity, family and sibling history of stroke, the use of any lipid-lowering medication, the use of any anti-hypertensive medication, hypertension, and history of myocardial infarction (model 1: hazard ratio [HR], 7.49; 95% confidence interval [CI], 1.66 to 33.69; p for trend=0.01; model 2: HR, 6.83; 95% CI, 1.51 to 30.87 for quintile 5 compared with the reference category; p for trend=0.02). CONCLUSIONS Based primarily on RRR, we identified that a dietary pattern high in fats and oils, poultry, non-diet soda, processed meat, tomatoes, legumes, chicken, tuna and egg salad, and fried potatoes and low in dark-yellow and cruciferous vegetables may increase the incidence of ischemic stroke

The clinical and genetic spectrum of autosomal-recessive TOR1A-related disorders.

In the field of rare diseases, progress in molecular diagnostics led to the recognition that variants linked to autosomal-dominant neurodegenerative diseases of later onset can, in the context of biallelic inheritance, cause devastating neurodevelopmental disorders and infantile or childhood-onset neurodegeneration. TOR1A-associated arthrogryposis multiplex congenita 5 (AMC5) is a rare neurodevelopmental disorder arising from biallelic variants in TOR1A, a gene that in the heterozygous state is associated to torsion dystonia-1 (DYT1 or DYT-TOR1A), an early-onset dystonia with reduced penetrance. While 15 individuals with TOR1A-AMC5 have been reported (less than 10 in detail), a systematic investigation of the full disease-associated spectrum has not been conducted. Here, we assess the clinical, radiological and molecular characteristics of 57 individuals from 40 families with biallelic variants in TOR1A. Median age at last follow-up was 3 years (0-24 years). Most individuals presented with severe congenital flexion contractures (95%) and variable developmental delay (79%). Motor symptoms were reported in 79% and included lower limb spasticity and pyramidal signs, as well as gait disturbances. Facial dysmorphism was an integral part of the phenotype, with key features being a broad/full nasal tip, narrowing of the forehead and full cheeks. Analysis of disease-associated manifestations delineated a phenotypic spectrum ranging from normal cognition and mild gait disturbance to congenital arthrogryposis, global developmental delay, intellectual disability, absent speech and inability to walk. In a subset, the presentation was consistent with fetal akinesia deformation sequence with severe intrauterine abnormalities. Survival was 71% with higher mortality in males. Death occurred at a median age of 1.2 months (1 week - 9 years) due to respiratory failure, cardiac arrest, or sepsis. Analysis of brain MRI studies identified non-specific neuroimaging features, including a hypoplastic corpus callosum (72%), foci of signal abnormality in the subcortical and periventricular white matter (55%), diffuse white matter volume loss (45%), mega cisterna magna (36%) and arachnoid cysts (27%). The molecular spectrum included 22 distinct variants, defining a mutational hotspot in the C-terminal domain of the Torsin-1A protein. Genotype-phenotype analysis revealed an association of missense variants in the 3-helix bundle domain to an attenuated phenotype, while missense variants near the Walker A/B motif as well as biallelic truncating variants were linked to early death. In summary, this systematic cross-sectional analysis of a large cohort of individuals with biallelic TOR1A variants across a wide age-range delineates the clinical and genetic spectrum of TOR1A-related autosomal-recessive disease and highlights potential predictors for disease severity and survival

OPD scan III accuracy: Topographic and aberrometric indices after accelerated corneal cross-linking

Purpose: To determine topographic and aberrometric changes after accelerated cross-linking (ACXL; 18 mW/cm2 for 5 min) as measured with OPD Scan III (Nidek Inc., Tokyo, Japan) and their repeatability in patients with mild and moderate keratoconus (KCN). Methods: In this prospective study, 25 eyes with mild KCN [Ksteep = 47.24 ± 3.11 diopter (D)] and 20 moderate cases (Ksteep = 52.86 ± 4.39 D) were examined under mesopic conditions (20 lux) twice, 30–45 min apart, at baseline and 6 and 12 months afterwards. Extracted indices were Ksteep, Kflat, ocular and corneal irregularity, ocular and corneal total higher order aberrations (HOAs), coma, trefoil, and spherical aberration (SA). Repeatability index (RI) and intraclass correlation coefficients (ICCs) were determined. Results: In mild cases, Ksteep and corneal irregularity had lower RI, but Kflat and ocular irregularity had higher RI (all P > 0.050) at 1 year. The RI for ocular total HOAs, coma, and SA decreased and showed no significant change for trefoil (all P > 0.050). Moderate cases showed non-significant increases in RI for Ksteep, Kflat, ocular and corneal irregularity (all P > 0.050), and all aberrometry indices, and significant increases in RI for ocular coma (P = 0.046) and corneal trefoil (P = 0.037). At 1 year, ICC was >0.75 for all indices except ocular and corneal trefoil (ICC = 0.613 and 0.390) in moderate cases. Conclusions: At one year after ACXL, OPD Scan III showed acceptable repeatability in mild cases. In moderate cases, topographic indices had acceptable repeatability but poorer compared to the mild group. Overall, ocular HOAs showed better repeatability than corneal ones. These changes should be considered in the interpretation of measurements