84 research outputs found
Clinical Outcomes After Continuous Intracorneal Ring implantation in Post-LASIK Ectasia: (Long-Term Follow-up)
Purpose: The aim of the present study was to evaluate the clinical outcomes after implantation of MyoRing in patients with ectasia secondary to LASIK. Patients and Methods: This study was a retrospective, consecutive, nonrandomized interventional case series. The MyoRing was implanted after creation of a stromal pocket using a PocketMaker microkeratome (Dioptex, GmBH, Linz, Austria) in 6 eyes of 6 patients with ectasia secondary to LASIK. Uncorrected distance visual acuity, corrected distance visual acuity, sphere, cylinder and keratometric changes were reported after a 3 year follow-up period. Results: Uncorrected distance visual acuity and corrected distance visual acuity were improved in 5 and 3 patients respectively. One patient showed decreased UDVA after 3 years and in 3 patients the corrected distance visual acuity decreased at the last visit compared to the preoperative reading. Maximum keratometry, sphere and cylinder were improved from preoperative values in 4, 2 and 5 patients respectively. Conclusion: Because of the mixed results in our small group of patients, it seems that MyoRing implantation using mechanical dissection is not a very effective method for treatment of patients with post LASIK ectasia. However, large comparative multicenter studies are recommended to further verify these results.Keywords: Ectasia, Cornea, LASIK, Corneal ring, Iran
Challenges in the design, conduct, analysis, and reporting in randomized clinical trial studies : A systematic review
This study was funded by Iran University of Medical Sciences (grant number 97-01-27-33259).Peer reviewedPublisher PD
Full-ring Intrastromal Corneal Implantation for Correcting High Myopia in Patients with Severe Keratoconus
The aim of this study was to evaluate the effect of the mechanical implantation of a MyoRing in patients with severe keratoconus and high myopia. The study involved 32 eyes of 32 patients (14 men and 18 women; mean age: 29.6 ± 6.7; age range: 20 – 44). The patients underwent MyoRing implantation with mechanical dissection using a Pocket Maker microkeratome, and outcomes were assessedat3 months after surgery. The main outcome measures were uncorrected and corrected distance visual acuity (UDVA and CDVA, both in Logarithm of the Minimum Angle of Resolution [logMAR] units), manifest refraction, and keratometry readings. There was a significant improvement in the UDVA, from 1.14 ± 0.32 to 0.35 ± 0.24 (P Ë‚ 0.001), and in the CDVA, from 0.47 ± 0.20 to 0.22 ± 0.15 (P Ë‚ 0.001). There was also a significant improvement in the spherical equivalent refractive error (-10.51 ± 2.81 D to -1.32 ± 2.29 D) (P Ë‚ 0.001). There was a significant decrease of manifest refraction in the mean sphere and cylinder of 7.70 and 2.6 D, respectively (P < 0.001). Furthermore, with regard to corneal topography, there was a significant reduction of 3.55 D (P Ë‚ 0.001) in the mean keratometry reading. The results show that the mechanical implantation of a MyoRing is effective for the correction of myopia in patients with keratoconus and high myopia.Â
Iranian general populations' and health care providers' preferences for benefits and harms of statin therapy for primary prevention of cardiovascular disease
Acknowledgements This study was conducted at the Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences Tehran, Iran. Lown Scholar Program of the Harvard T.H. Chan School of Public Health helped in funding and designing the study. We thank the respectful staff of the Non-Communicable Diseases Office of the Ministry of Health and Medical Education in Iran for their help and advice on developing the survey. We gratefully thank Prof. MA Puhan for sharing their experience on the design and implementation of best-worst scaling. Funding This study is a part of a project funded by the National Institute of Medical Research. Development (NIMAD) (Grant No. 964114) and was supported by the Iran University of Medical. Sciences. The funding bodies had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.Peer reviewedPublisher PD
The effects of synbiotic supplementation on serum inflammatory markers and edema volume in breast cancer survivors with lymphedema
Breast cancer-related lymphedema (BCRL) is one of the most common complications of breast cancer treatments, which may be exacerbated by obesity. Dysbiosis may negatively impact the management of obesity and lymphedema by increasing inflammation. The objective of this study was to assess the effects of supplementation with synbiotics on inflammatory markers, serum leptin concentration and edema volume in overweight and obese BCRL women following a low-calorie diet (LCD). In a randomized double-blind controlled clinical trial, 88 breast cancer survivors with lymphedema were supplemented once a day for 10 weeks with either a synbiotic or a placebo capsule. Both groups were under a low-calorie diet (LCD). At the end of the study, synbiotic supplementation resulted in a significant reduction in leptin (P=0.003) and TNF-α (P=0.039) between the study groups. Besides, edema volume was significantly reduced within the synbiotic group after the intervention. We did not observe any significant effects of the synbiotic supplementation in hs-CRP, and IL-1β between the study groups (P=0.550, P=0.118 respectively). Conclusively, synbiotic supplementation along with an LCD program in breast cancer survivors with lymphedema had beneficial effects on the concentration of serum inflammatory markers and edema volume
Effects of vitamin D3 supplementation on clinical symptoms, quality of life, serum serotonin (5-hydroxytryptamine), 5-hydroxy-indole acetic acid, and ratio of 5-HIAA/5-HT in patients with diarrhea-predominant irritable bowel syndrome
Vitamin D deficiency, common in the population with irritable bowel syndrome (IBS), can induce the main factors that lead to IBS clinical symptoms, such as depression, anxiety, and inflammation. Serotonin (5-HT) plays an important role in the pathophysiology of IBS, and its production and secretion are increased from the lumen due to stress and inflammation. The aim of this study was to evaluate the effect of vitamin D3 supplementation on the pathogenesis of diarrhea-predominant IBS (IBS-D). Seventy-four IBS-D patients (age: 18-65 y) participated in a randomized, double-blind, placebo-controlled trial study from February 2017 to May 2018, at Rasoul-e-Akram Hospital, Tehran, Iran. Subjects were allocated into two groups receiving 50,000 IU/week of vitamin D3 or placebo for 9 weeks. IBS severity score system (IBS-SSS), IBS-quality of life questionnaire (QoL), hospital anxiety and depression Scale (HADs), visceral sensitivity index (VSI) and serum 25(OH) vitamin D3, serotonin, 5-hydroxy-indole acetic acid and ratio of 5-HIAA/5-HT were evaluated before and after the interventions. Symptoms severity, QoL, HADs-depression, and VSI score improved significantly in the vitamin D group as compared to the placebo group (P-values: <0.001, 0.049, 0.023, and 0.008; respectively). There were no significant differences in abdominal bloating, HADs-anxiety, serum 5-HT, 5-HIAA, and 5-HIAA/5-HT between the two groups at the end of the study. Based on our results, we recommend serum vitamin D be evaluated in the process of treatment of these patients to ameliorate symptoms and quality life of IBS-D patients with vitamin D deficiency and/or insufficiency
Intrastromal Corneal Ring Segment Implantation (Keraring 355°) in Patients with Central Keratoconus: 6-Month Follow-Up
We evaluate the efficacy and safety of Keraring 355° intrastromal corneal ring segment (ICRS) implantation aided by PocketMaker microkeratome for the correction of keratoconus. Patients underwent ICRS insertion using mechanical dissection with PocketMaker microkeratome and completed 6 months of follow-up. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), refraction, topographic findings, safety, efficacy index, and adverse events were reported for six months postoperatively. We evaluated 15 eyes of 15 patients (12 men) with a mean age of 28.87 ± 6.94 years (range 21–49 years). At final postoperative examination, there was a statistically significant reduction in the spherical equivalent refractive error compared to preoperative measurements (−5.46 ± 1.52 to −2.01 ± 1.63 D, P< 0.001). Mean preoperative UCVA (logMAR) before implantation was 0.79 ± 0.48, and postoperative UCVA was 0.28 ± 0.15, P= 0.001. Mean preoperative BSCVA (logMAR) before implantation was 0.36 ± 0.21; at final follow-up examination BSCVA was 0.18 ± 0.9, P= 0.009. Mean K decreased from 48.33 to 43.31 D, P< 0.001. All patients were satisfied with ICRS implantation; 86.7% were moderately to very happy with the results. No intraoperative or postoperative complications were demonstrated. This preliminary study shows that ICRS (Keraring 355°) implantation is an efficient, cost-effective, and minimally invasive procedure for improving visual acuity in nipple type keratoconic corneas
An assessment of health research impact in Iran
Background: In recent years, Iran has made significant developments in the field of health sciences. However, the
question is whether this considerable increase has affected public health. The research budget has always been
negligible and unsustainable in developing countries. Hence, using the Payback Framework, we conducted this
study to evaluate the impact of health research in Iran.
Methods: By using a cross-sectional method and two-stage stratified cluster sampling, the projects were randomly
selected from six medical universities. A questionnaire was designed according to the Payback Framework and
completed by the principle investigators of the randomly selected projects.
Results: The response rate was 70.4%. Ten point twenty-four percent (10.24%) of the studies had been ordered by
a knowledge user organization. The average number of articles published in journals per project was 0.96, and half
of the studies had no articles published in Scopus. The results of 12% of the studies had been used in systematic
review articles and the same proportion had been utilized in clinical or public health guidelines. The results of 5.3%
of the studies had been implemented in the Health Ministry’s policymaking. 62% of the studies were expected to
affect health directly, 38% of them had been implemented, and among the latter 60% had achieved the expected
results. Concerning the economic impacts, the most common expected impact was the reduction of ‘days of work
missed because of illness or disability’ and impact on personal and health system costs. About 36% of these studies
had been implemented, and 61% had achieved the expected impact.
Conclusion: In most aspects, the status of research impact needs improvement. A comparison of Iran’s ranking of
knowledge creation and knowledge impact in the Global Innovation Index confirms these findings. The most
important problems identified were, not conducting research based on national needs, and the lack of
implementation of research results.
Keywords: Research impact assessment, Payback, Health research syste
Validity of self-reported substance use : research setting versus primary health care setting
Funding Information: This study has been supported by the Vice Chancellery for Research & Technology of Rafsanjan University of Medical Sciences. The context of this article are the views of the authors and the funder had no role in design of the study and collection, analysis, and interpretation of data, decision to publish and writing the manuscript. Acknowledgments The Rafsanjan University of Medical Sciences provided funding for this study. Also we thank the people who participated in the study.Peer reviewedPublisher PD
The relationship between diet quality indices and odds of breast cancer in women:a case–control study
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