The Repeatability of Axial Length Measurements Using a Scheimpflug-based System

Purpose: To assess the repeatability of Pentacam AXL as a Scheimpflug-based system or measuring axial length according to the age, sex, lens type, axial length value, and type of cataract. Methods: The present study was conducted using multistage cluster sampling in Tehran, Iran. Ocular biometry was performed, using the Pentacam AXL, by an experienced optometrist on all the participants. The axial length (AL) measurements were taken thrice, with a gap of 10 minutes. To evaluate the repeatability, the intraclass correlation coefficient (ICC) and the repeatability coefficient (RC) were calculated. To determine the significant difference in the repeatability index among study variables, the tolerance index (TI) was calculated. Results: In this report, 897 eyes of 677 individuals aged between 20 and 91 years (mean ± SD: 64.90 ± 13.62 years) were reported. The ICC of the axial length measurements was 0.981 for all cases. Based on the within-subject standard deviation, the RC was 0.401. The ICC was 0.976 and 0.985 in men and women, respectively. The TI showed better RC of measurements among females. The ICC decreased from 0.999 in participants under 40 years to 0.973 in individuals over 60 years of age. The TI showed a decrease in RC with advancing age. The RC was worse in eyes with nuclear cataracts; the RC was also worse in the first quartile of the signal-to-noise ratio (SNR) compared to the other SNR quartiles. Conclusion: The Scheimpflug-based system Pentacam AXL had high repeatability in measuring axial length. Some variables such as male gender, older age, and nuclear cataract were associated with reduced repeatability of the measurements. A higher SNR was associated with better repeatability of the axial length measurements

Sleep Quality of Students living in Dormitories in Tehran University of Medical Sciences (TUMS) in 2011

Background & Objectives: Sleep quality is an important factor in student life and affects in their learning process. Sleep problems are related to increased health concerns, irritability, depression, fatigue, attention and concentration difficulties, along with poor academic performance. The aim of this paper is to conduct a survey based on a questionnaire that would characterize the quality of sleep in students living in dormitories of Tehran University of Medical Sciences (TUMS). Methods: We conducted a cross-sectional study using the ..

Secular Trend of Birth Height and Weight in a Population of Iranian Neonates during 1991 and 2011

Background: The secular trend in growth is a well-documented and recurrent phenomenon in many developed and developing countries. In this study, we examined the secular trends in birth length and weight among Iranian neonates.Methods: This cross-sectional population-based survey was conducted between 1991 and 2011. Using a two-stage stratified cluster sampling, the birth weights and heights of neonates born in Shahroud, Iran were studied using health records from different households. The mean birth weights and heights for neonates were calculated every year. Secular trends were analyzed using linear regression models and joinpoint regression.Results: A random sample of 11,165 neonates was evaluated, and the mean birth weight of neonates during the investigation period was calculated. The mean birth weight changed from 3232.1±444.1 g in 1991 to 3204.1±436.9 g in 2011, and the mean birth height changed from 49.5±2.2 cm to 49.3±1.9 cm. The mean birth weights and heights between 1991 and 2011 were not significantly different; however, the birth weight increased by 6.75 g annually between 2000 and 2011 (P < 0.021), and the mean birth height increased by 0.03 cm annually between 2003–2011 and 1991–2003 (P = 0.009).Conclusions: The mean birth height and weight of neonates in Shahroud did not change significantly from 1991 to 2011; however, we found a significant improvement after 2000

Secular Trend of Birth Height and Weight in a Population of Iranian Neonates during 1991 and 2011

Background: The secular trend in growth is a well-documented and recurrent phenomenon in many developed and developing countries. In this study, we examined the secular trends in birth length and weight among Iranian neonates.Methods: This cross-sectional population-based survey was conducted between 1991 and 2011. Using a two-stage stratified cluster sampling, the birth weights and heights of neonates born in Shahroud, Iran were studied using health records from different households. The mean birth weights and heights for neonates were calculated every year. Secular trends were analyzed using linear regression models and joinpoint regression.Results: A random sample of 11,165 neonates was evaluated, and the mean birth weight of neonates during the investigation period was calculated. The mean birth weight changed from 3232.1±444.1 g in 1991 to 3204.1±436.9 g in 2011, and the mean birth height changed from 49.5±2.2 cm to 49.3±1.9 cm. The mean birth weights and heights between 1991 and 2011 were not significantly different; however, the birth weight increased by 6.75 g annually between 2000 and 2011 (P < 0.021), and the mean birth height increased by 0.03 cm annually between 2003–2011 and 1991–2003 (P = 0.009).Conclusions: The mean birth height and weight of neonates in Shahroud did not change significantly from 1991 to 2011; however, we found a significant improvement after 2000

Agreements’ profile of Scheimpflug-based optical biometer with gold standard partial coherence interferometry

AIM: To determine the agreement of ocular biometric indices including axial length, keratometric readings, anterior chamber depth, and horizontal corneal diameter between the Pentacam AXL and IOL Master 500. METHODS: The study was a large cross-sectional population-based study (Tehran Geriatric Eye Study) conducted from Jan 2019 to Jan 2020. A total of 160 clusters were randomly selected proportional to size (each cluster contained 20 individuals) from 22 strata of Tehran city. All people aged 60y and above were invited to participate in the study. For all participants, preliminary ocular examinations were performed including the measurement of uncorrected and best-corrected visual acuity, objective and subjective refraction, anterior and posterior segment examinations. All participants underwent an ocular biometry using the Pentacam AXL and IOL Master 500. RESULTS: The 95% limits of agreement (LoA) between the two devices were -0.13 to 0.19, -0.15 to 0.17, and -0.13 to 0.19 in normal, pseudophakic, and cataractous eyes, respectively. With increasing the axial length, the difference between the two devices significantly increased in all three groups of normal, pseudophakic, and cataractous eyes (P<0.001). The 95% LoAs between the two devices regarding the mean keratometry shows that the best LoAs were seen in cataractous (-0.33 to 0.81) and followed by normal eyes (-0.36 to 0.86) and the pseudophakic eyes (-0.48 to 0.90) had the widest LoA. The 95% LoAs for horizontal corneal diameter measurements were -0.08 to 0.86, -0.03 to 0.83, and -0.07 to 0.87 in normal, pseudophakic, and cataractous eyes, respectively. The 95% LoAs of anterior chamber depth measurements between the two devices was -0.39 to 0.19 and -0.37 to 0.13 in normal eyes and cataractous, respectively. CONCLUSION: The Pentacam AXL has excellent agreement with the gold standard, IOL Master 500 in measuring axial length. In eyes with cataracts, the difference between the two devices is more scattered. With the increasing of axial length, the difference between the two devices increased, which should be considered when using Pentacam AXL

Geographical spread of gastrointestinal tract cancer incidence in the Caspian Sea region of Iran : spatial analysis of cancer registry data

BACKGROUND: High incidence rates of gastrointestinal tract cancers have been reported in the Caspian region of Iran. This study aimed to: 1) describe the geographical spatial patterns of gastrointestinal tract cancer incidence based on cancer registry data and, 2) determine whether geographical clusters of statistical significance exist. METHODS: The Babol Cancer Registry, which covers the two major northern Iranian provinces of Mazandaran and Golestan (total population = 4,484,622) was used to identify new gastrointestinal tract cancer cases during 2001 to 2005. Age-specific cancer incidence rates were calculated for 7 gastrointestinal tract cancer sites in 26 wards of the Mazandaran and Golestan provinces. Spatial autocorrelation indices, hierarchical Bayesian Poisson models, and spatial scan statistics were used in measuring the geographic pattern and clusters. RESULTS: There were non-random spatial patterns in esophageal and stomach cancers that were similar for both sexes. Clusters of high incidence were identified in esophageal, stomach, colorectal and liver cancer for both sexes, as well as a possible cluster of pancreas cancer in males. CONCLUSION: Gastrointestinal tract cancers exhibit significant spatial clustering of risk in northern Iran. Further work is needed to relate these geographical patterns to information on potential life-style and environmental factors

The prevalence of ptosis in an Iranian adult population

AbstractPurposeTo determine upper eyelid ptosis prevalence and some related factors in 44- to 69-year-olds of Shahroud in the north of Iran.MethodsIn 2009, using multi-stage cluster sampling, 300 clusters of 40–64-year-olds were selected in Shahroud city, and all 5190 participants were invited to be re-examined in 5 years (2014). The current report is the second phase of the study in which 4737 (91.3%) people participated and underwent vision tests, slit lamp examination, biometry, and ophthalmoscopy in 2014. Upper eyelid ptosis was determined by an ophthalmologist.ResultsThe prevalence of upper eyelid ptosis was 4.7% [95% confidence interval (CI): 4.1–5.4]; 5.2% in women and in 4.0% in men. The prevalence of bilateral and unilateral ptosis was 1.3% (95% CI: 1.0–1.7) and 3.4% (95% CI: 2.8–4.0), respectively. The observed prevalence of ptosis was 3.1% in the 45- to 49-year age group and 5.8% in 65- to 69-year-olds. The prevalence of ptosis increased with age. In the multiple logistic regression model, ptosis prevalence correlated with older age, diabetes (odds ratio = 1.53, 95% CI: 1.16–2.02) and hypertension (odds ratio = 1.41, 95% CI: 1.03–2.92). Mean corneal astigmatism was 1.02 (95%C]: 0.87–1.18) diopter in ptotic eyes and 0.87 (95% CI: 0.84–0.89) diopter in non-ptotic eyes (p = 0.013).ConclusionsThe present report provides valuable information on the prevalence of ptosis in a population of 45-to 69-year-olds. The prevalence of ptosis in this study was considerably high and significantly increased with age

Pre-hypertension and the risk of diabetes mellitus incidence using a marginal structural model in an Iranian prospective cohort study

OBJECTIVES The aim of this study was to evaluate the effect of pre-hypertension and its sub-classification on the development of diabetes. METHODS In this cohort study, 2,941 people 40 to 64 years old without hypertension or diabetes were followed from 2009 through 2014. According to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC)-7 criteria, we classified participants into normal and pre-hypertension groups. The effect of pre-hypertension on the 5-year incidence rate of diabetes was studied using inverse probability of treatment weighting. We modeled the exposure and censored cases given confounding factors such as age, sex, body mass index, smoking, economic status, and education. RESULTS The 5-year incidence rate of diabetes among people with pre-hypertension and those with normal blood pressure (BP) was 12.7 and 9.7%, respectively. The risk ratio (RR) for people with pre-hypertension was estimated to be 1.13 (95% confidence interval [CI], 0.90 to 1.41). The RRs among people with normal BP and high-normal BP, according to the JNC-6 criteria, compared to those with optimal BP were 0.96 (95% CI, 0.73 to 1.25) and 1.31 (95% CI, 1.01 to 1.72), respectively. CONCLUSIONS Our results showed that participants who had higher levels of BP (high-normal compared to optimal BP) had a higher risk of diabetes development. With regard to the quantitative nature of BP, using the specifically distinguishing of stage 1 hypertension or high-normal BP may be a more meaningful categorization for diabetes risk assessment than the JNC-7 classification

Undiagnosed Depression among Hypertensive Individuals in Gaza: A Cross-sectional Survey from Palestine

BACKGROUND፡ The aim of this study was to estimate the prevalence and to determine the associated factors of undiagnosed depression amongst hypertensive patients (HTNP) at primary health care centers (PHCC) in Gaza.METHODS: A cross-sectional survey was conducted including 538 HTNP as a recruitment phase of a clustered randomized controlled trial. Data were collected through face-to-face structured interview, and depression status was assessed by Beck's Depression Inventory (BDI-II). Data were analyzed by STATA version 14 using standard complex survey analyses, accounted for unresponsiveness and clustering approach. Generalized linear regression analysis was performed to assess associations.RESULTS: The prevalence of undiagnosed clinical depression was 11.6% (95% confidence interval [CI]: 8.1, 16.3). Moreover, prevalence of 15.4% (95% CI: 10.8, 21.6) was found for mild depression symptoms. We found that non-adherence to antihypertensive medications (AHTNM) (β = 0.9, 95% CI: 0.17, 1.7), having more health-care system support (β = 2.8, 95% CI: 1.6, 3.9) and number of AHTNM (β = 1.5, 95% CI: 0.6, 2.5) remain significantly positively associated with BDI-II score. On the other hand, older age (β = -0.1, 95% CI: -0.2, -0.02), having better social support (β = -6.8, 95% CI: -8.9, -4.7) and having stronger patientdoctor relationship (β = -4.1, 95% CI: -6.9, -1.2) kept significantly negative association.CONCLUSION: The prevalence of undiagnosed depression was about one-quarter of all cases; half of them were moderate to severe. Routine screening of depression status should be a part of the care of HTNP in PHCC

A framework for exploration and cleaning of environmental data : Tehran air quality data experience

Management and cleaning of large environmental monitored data sets is a specific challenge. In this article, the authors present a novel framework for exploring and cleaning large datasets. As a case study, we applied the method on air quality data of Tehran, Iran from 1996 to 2013. ; The framework consists of data acquisition [here, data of particulate matter with aerodynamic diameter ≤10 µm (PM10)], development of databases, initial descriptive analyses, removing inconsistent data with plausibility range, and detection of missing pattern. Additionally, we developed a novel tool entitled spatiotemporal screening tool (SST), which considers both spatial and temporal nature of data in process of outlier detection. We also evaluated the effect of dust storm in outlier detection phase.; The raw mean concentration of PM10 before implementation of algorithms was 88.96 µg/m3 for 1996-2013 in Tehran. After implementing the algorithms, in total, 5.7% of data points were recognized as unacceptable outliers, from which 69% data points were detected by SST and 1% data points were detected via dust storm algorithm. In addition, 29% of unacceptable outlier values were not in the PR.  The mean concentration of PM10 after implementation of algorithms was 88.41 µg/m3. However, the standard deviation was significantly decreased from 90.86 µg/m3 to 61.64 µg/m3 after implementation of the algorithms. There was no distinguishable significant pattern according to hour, day, month, and year in missing data.; We developed a novel framework for cleaning of large environmental monitored data, which can identify hidden patterns. We also presented a complete picture of PM10 from 1996 to 2013 in Tehran. Finally, we propose implementation of our framework on large spatiotemporal databases, especially in developing countries