A review of artificial intelligence applications in anterior segment ocular diseases

Background: Artificial intelligence (AI) has great potential for interpreting and analyzing images and processing large amounts of data. There is a growing interest in investigating the applications of AI in anterior segment ocular diseases. This narrative review aims to assess the use of different AI-based algorithms for diagnosing and managing anterior segment entities. Methods: We reviewed the applications of different AI-based algorithms in the diagnosis and management of anterior segment entities, including keratoconus, corneal dystrophy, corneal grafts, corneal transplantation, refractive surgery, pterygium, infectious keratitis, cataracts, and disorders of the corneal nerves, conjunctiva, tear film, anterior chamber angle, and iris. The English-language databases PubMed/MEDLINE, Scopus, and Google Scholar were searched using the following keywords: artificial intelligence, deep learning, machine learning, neural network, anterior eye segment diseases, corneal disease, keratoconus, dry eye, refractive surgery, pterygium, infectious keratitis, anterior chamber, and cataract. Relevant articles were compared based on the use of AI models in the diagnosis and treatment of anterior segment diseases. Furthermore, we prepared a summary of the diagnostic performance of the AI-based methods for anterior segment ocular entities. Results: Various AI methods based on deep and machine learning can analyze data obtained from corneal imaging modalities with acceptable diagnostic performance. Currently, complicated and time-consuming manual methods are available for diagnosing and treating eye diseases. However, AI methods could save time and prevent vision impairment in eyes with anterior segment diseases. Because many anterior segment diseases can cause irreversible complications and even vision loss, sufficient confidence in the results obtained from the designed model is crucial for decision-making by experts. Conclusions: AI-based models could be used as surrogates for analyzing manual data with improveddiagnostic performance. These methods could be reliable tools for diagnosing and managing anterior segmentocular diseases in the near future in remote areas. It is expected that future studies can design algorithms thatuse less data in a multitasking manner for the detection and management of anterior segment diseases

The Study of Nurses Knowledge and Performance Quality of Qazvin Hospitals about the Process of Blood Transfusion

Introduction: Supplying blood and blood products, maintenance, transfer and injection of each component have its own specific process. Therefore, those responsible must at least have the awareness that relates to the transfusion medicine. The safety and effectiveness of blood transfusion depend on the knowledge and skills of nurses, who have taken the responsibility. The aim of this study is to assess the educational needs of nurses in the field of blood transfusion that leads to creating a good medical process for nurses in clinical departments of hospitals. Methods: In this cross-sectional study, 124 nurses who participated in, were selected through random sampling in Qazvin hospitals in 1396. A questionnaire including 25 questions was used to evaluate the knowledge and performance of their awareness of different aspects of blood medicine, including maintenance, transferring, injection and post blood transfusion reactions. The scores of knowledge and performance encoded in three levels: low, medium, and good. Data analysis and correlation of variance were performed by using the software SPSS version 20. Results: Research results showed that most of the subjects are in the age group 20-30 years (68.7%) and females (93%) and have a bachelor's degree in nursing (95.6%). Results showed that the mean score of knowledge was 9.58±2.13, and score range was 9 (between 3 to 12). The mean score of performance was 38.96±2.17, with range 10 (scores were between 30 to 40). The analysis of variance used to examine the relationship. The results suggested that there was a significant relationship between performance and knowledge of subjects (P<0.05). Conclusions: According to this study, nurse’s knowledge level and awareness of blood transfusion are the media. Therefore, training, managers controlling and supervision programs seem to be necessary due to the great importance of the blood transfusion process and threaten the safety of patients. So, we recommend that this issue must be seriously included in academic courses and retraining in the field of blood transfusion, according to the latest available standards at the time of the nurse’s employment

Increased Demand for Blood Transfusion in Cardiac Surgery: Simple but Unsolved Common Problem

Background: Despite the general concern about the safety of blood transfusion and mounting evidence exist for more restrictive practice; there is no national consensus guideline and uniformity of institutions for blood transfusion associated with coronary artery bypass graft surgery in Iran. The aim of this study is an assessment of current transfusion practice and compares it with one decade ago.Method: The authors retrospectively analyzed the data of all patients undergoing elective surgery (first time operation) during one year, in two different decade interval (2003 and 2015) in a tertiary heart center.Results: A total of 801 patients were evaluated and compared (n=249 in 2015, n=552 in 2003). There is a significant increase in use of blood transfusion in both operating room and at ICU than the last decade (60.6% vs. 42.4%, P<0.001, and 54.4% vs. 39.9%, P <0.001, respectively). The incidence of preoperative anemia was four times higher in patients who received transfusion, compared to those who did not, in both groups. With compared to the past, the patients are older, have less preoperative hematocrit, more diabetic, more need to intra-aortic balloon pump, shorter operation time, and less postoperative bleeding .Conclusion: With advanced knowledge about transfusion complications and conservative approach to transfusion practice, the need to blood transfusion is increased in current cardiac operations in our center, due to association of more co-morbidities

Self-Actualization: Self-Care outcomes among elderly patients with hypertension

Background: This study aims to analyze the experiences of older patients with hypertension to realize the outcomes of their self-care behaviors for controlling hypertension. Materials and Methods: This is a qualitative research with a conventional content analysis approach. The participants consisting of 23 people were selected through purposive sampling. Data were collected through semi-structured interviews until data were saturated. Granheim and Lundman's conventional content analysis was applied to analyze the data. Results: After data analysis, four main categories including self-efficacy, active lifestyle, spirituality, and stress management were obtained. These categories show the experience and outcomes of self-care behaviors among elderly patients with hypertension. Conclusions: Awareness of the elderly of their potentials and role in disease control in addition to relying on the power of spirituality provides positive results in hypertension management. Self-actualization of the elderly resulted in resisting against the destructive effects of internal and external stress and moving in the direction of growth. Health professionals should be vigilant to encourage and promote education about the importance and advantages of self-care for elderlies

Effects of three months treatment with sertraline on intraocular pressure and cup-to-disc ratio in patients with anxiety disorders/mixed anxiety and depressive disorder/major depressive disorder and without underlying eye disease

Exposure to selective serotonin reuptake inhibitors causes pupillary dilator muscle stimulation, active mydriasis, rapid rise in the level of the intraocular pressure (IOP), damage to the optic nerve at the back of the eye, and ultimately leads to acute angle closure glaucoma. The aim of this study was to assess the effects of sertraline on the levels of IOP and cup-to-disc ratio (CDR) in patients with anxiety disorders or mixed anxiety and depressive disorder or major depressive under daily treatment with sertraline and without underlying eye disease for three months. In this study,30 eligible patients in the sertraline group and 30 healthy volunteers in the control group include the study and were referred to an ophthalmologist. Ophthalmologic examinations were assessed at the baseline and on the first and third months of the study. The average daily dose of sertraline was 95&plusmn;2.5 mg.During the study, the IOP changes in the sertraline and control groups were 0.26&plusmn;0.43 and 0.00&plusmn;0.00 mmHg (p<0.001, p=NS) respectively and the CDR changes in sertraline and control groups were 0.03&plusmn;0.05 and -0.01&plusmn;0.05 (p=0.002, p=0.03) respectively. There was a significant difference in the IOP and CDR increasement between two groups ([F (1.7, 104.2) = 3.7, p = 0.03] and [F (2, 116) = 8.3, p < 0.001] respectively). In the present study, although changes in the IOP and CDR&nbsp; levels in the sertraline group were significant and was equal the daily change in the persons without glaucoma or patients with normal-tension glaucoma, but the slight and continuous increase in the IOP level associated with changes in pupil size and CDR, especially in patients at risk of glaucoma in the long term, can cause a disruption in hydrodynamic homeostasis. More studies with longer duration and different dosage of sertraline need to confirm our results.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp

Efficacy of Stretching Exercises on Fibromyalgia Impact and Quality of Life in Patients under Medical Treatment: A Randomized Clinical Trial, 2021

Background and purpose: There is no specific treatment for fibromyalgia. Previous studies suggest that exercise is helpful in controlling the symptoms and psychosocial aspects of the disease. Stretching exercises are emphasized less than aerobic and resistance exercises in these patients. The main reason for re-examining this issue in current study was the contradictory feedback of patients with fibromyalgia to stretching exercises which was observed during recent years in clinical treatments. The aim of this study was to evaluate the effect of stretching exercise on the quality of life of patients and the impact of fibromyalgia. Materials and methods: This study was a per-protocol randomized clinical trial. Forty-nine patients with fibromyalgia diagnosed based on 2010 diagnostic criteria for fibromyalgia who were referred to our sports medicine clinic by a rheumatologist and then a psychiatrist were studied. They were randomly divided into two groups. Twenty-five patients in the intervention group did stretching exercise and received medication while 24 patients in the control group received standard medication for five weeks. SF-36 questionnaire was used to evaluate the quality of life and Revised Fibromyalgia Impact Questionnaire (FIQR) was used to assess the disease state at the beginning of the study and also at weeks 5 and 9. Results: There are contradictory results about the effect of stretching exercises on fibromyalgia patients. The current study showed no significant differences between the two groups in the mean scores for physical health (P= 0.4), mental health (P= 0.88), and fibromyalgia impact (P= 0.36). Conclusion: Isolated stretching exercises are not effective in improving fibromyalgia. Further studies are suggested to investigate the effect of more specific stretching exercises on fibromyalgia.  (Clinical Trials Registry Number: IRCT20200131046322N3

Evaluation of the frequency of ABO and Rh-Hr blood-group systems in different acquired cataracts type

Abstract Objectives This study evaluated the relationship between acquired cataract’s different types and the ABO and Rh blood classes. Methods Overall, 520 patients, by randomized sampling method, participated in this retrospective cross-sectional study. After reviewing the patient’s medical records and laboratory results, the patient’s demographics, ABO group, Rh, and cataract type were documented. Results A total of 520 patients were included in the research, with a mean age of 67.57 ± 11.85. Most of them were female (n = 286, 55%). Mix (n = 230, 44%) and nuclear sclerotic (NS) (n = 167, 32%) cataracts were the most common types. The posterior subcapsular cataract (PSC) prevalence in females was significantly higher than in males (16.1% vs.7.3% p = 0.002). Also, men had more NS cataracts than females (89, 38% vs. 78, 27.3%) (p = 0.009). Patients with PSC were significantly younger than others (all p-values  0.05). Conclusion Although our findings showed that cataract types are independent of blood group types and Rh, they can be compared with future studies on the association of other Blood-Group Systems in developing acquired cataracts