Evaluation of Tear Function among Acne Vulgaris Patients Undergoing Treatment with Isotretinoin

Purpose: To evaluate the effect of Isotretinoin on tear secretion among patients with Acne Vulgaris.Patients and Methods: In this prospective study patients candidate for isotretinoin (Accutane) therapy for two months underwent complete eye examination. The best corrected visual acuity was measures and slit lamp examination of anterior segment, evaluation of tear break-up-time and Schirmer’s test were performed. The post surgical examination carried out two months post therapy consisted of complete eye examination and evaluation of dry eye level.Findings: Thirty nine patients entered the study. There were 5 patients complaining of eye strain before treatment, which rose to 19 patients after Isotretinoin therapy (p<0.001). The tear break up time was 13±1 seconds which decreased to 9±1 (p<0.001) after therapy and the Schirmer’s test mean reading was 22±2mm, which was reduced to 18±5 (p<0.001) after treatment. There were 4 patients with blepharitis before the treatment which rose to 19 patients after the end of Isotretinoin treatment (p<0.001).Conclusion: Isotretinoin usage (0.5-1mg/kg for two months) impairs the tear secretion and causes dry eye and blepharitis among patients. Considering the young age of patients using this drug, some of them candidates for keratorefractive surgery, a history of Isotretinoin usage should be considered before commencing the surgery. We recommend postponing the refractive surgery among these patients until the signs of dry eye are subsided.

The survey of Khandaghloo dam reservoir of Mahneshan city of Zanjan province

Reservoirs are one of the most constructions for control and water supply for different usage that could have various social an economical effects. The Khandaghloo dam reservoir with area of 100 ha located in Mahneshan city of Zanjan province and related to Parichay river watershed. Khandaghloo reservoir is valuable water body that the aim of its establishment was supply of water for agriculture farms. The reservoir has been studied for responsible and sustainable fisheries exploitation proposes. Results showed that the reservoir categorizes as eutroph to super eutroph based on different indices.Also phosphorous is limiting factor of the water body.Totally 42 genera from 6 phyla including green-blue algae cyanophyta, diatoms (Bacillariophyta), green algae, chlorophyta, euglenophyta, pyrrophyta and xanthophyta has been identified and cyanophyta was the dominant group that comprise 74.3 % of phytoplankton population. The zooplankton of the reservoir comprised 4 phyla and 20 genera. 1 genera of the protozoa and rhizopoda, 1 genra of the ciliophora ,15 genera of rotatoria, 2 genera of cladocera has been identified in zooplankton communities. Tubificidae and chironomidae has been identified in all months of the survey. The mean total length of crayfish was 130.5±20.5 mm ( 636) and mean weight was measured as 69.4±34.1 g with maximum and minimum weight of 1.9 and 207.2 g respectively .Total biomass of crayfish in Khandaghloo reservoir estimated as 3.4 tones with a range of 1.1–5.7 tones. But it is recommended not to harvest for at least two year due to high mortality of the populations.The fishes of the reservoir comprised common carp Chinese carp (silver carp, big head and grass carp) (released), Caspian kutum (accidentally released by fishery sector) and some endemic species as Siamahii. The catch of the reservoir fluctuated between 8 to 26 tones during 2000-2010.The fish production of Khandaghloo reservoir ranged from 167 to 324 kg/ha based on different methods that by consideration of 100 ha area of the reservoir, the total production of fish fluctuated between 16.7 to 32.4 tones. The fingerling restocking of Chinese carp in Khandaghloo reservoir with density of 1500 fingerling/ha recommended as 68% of phytoplanktonivorous fish (silver carp) ,12% zooplanktonivorous fish (big head), 6.6% of Crass carp and 10% of benthophagous fish (common carp)

Association of vitamin D deficiency and premature coronary artery disease

Background: Evidence suggests hypovitaminosis D is associated with increased risk of coronary artery disease (CAD) and its extent and related risk factors. However, some investigations have produced contrary results. Therefore, we aimed to evaluate the association between serum vitamin D levels and the severity of premature coronary artery involvement. Methods: This randomized prospective, case-control study was conducted in Babol from April 2013 to June 2017. We collected the demographic data and measured serum 25-OH-D levels of 294 patients (age≤50 years) diagnosed with CAD with coronary angiography as case group as well as 438 age and sex-matched controls. CAD severity was assessed using the Gensini score. Statistical analyses were used to assess the associations and p<0.05 was considered as significant. Results: The mean serum level of 25-OH-D was 13.12±11.13 and 18.28±8.34 in case and control groups, respectively (P=0.036). In the case group, mean serum vitamin D levels were significantly lower among hypertensives (P=0.018), those with a family history of CVD (P=0.016) and those who used aspirin (P=0.036). The mean Gensini score of patients in the case group was 45.02±23.62 and was higher among men (P=0.022). There was a weak significant correlation between the serum vitamin D levels and the Gensini score (P=0.001 & R=-0.543). The mean Gensini score was not significantly different between patients with deficient (47.02±22.78), insufficient (26.0±21.72) and sufficient (39.0±43.84) vitamin D levels (P>0.05). Conclusion: The results showed that the lower levels of vitamin D is associated with increased risk and extent of coronary artery involvement as well as some of the risk factors of CAD, including male gender, hypertension and positive family history for CVD

Stable Route Selection in ODMRP with Energy Based Strategy

MANET is a set of mobile nodes connected by wireless link and are free to move dynamically and unpredictable in environment, but this dynamic nature of the network topology cause many challenges in MANET. Multicasting is an efficient way of providing necessary services for Ad hoc applications. Due to the dynamic nature of the network topology and restricted resources, finding and maintaining the routes for multicasting the data is still more challenging. Many Protocols have designed for multicasting in MANETs that On-Demand Multicast Routing Protocol is one of them. ODMRP is on-demand and mesh based protocol that uses forwarding group to establish a mesh for each multicasting group. In this paper, we discuss stable route selection in ODMRP for forwarding data. In basic ODMRP route selection function uses minimum delay. But in proposed approach we consider nodes energy in route selection from source to destination. For presenting PDR improvement in proposed approach, we discuss group size and mobility speed in control overhead and end to end delay. Result of simulation illustrate that our approach can improve stability of route due to energy consumption

SD1000: High Sustained Viral Response Rate in 1361 Patients With Hepatitis C Genotypes 1, 2, 3, and 4 Using a Low-cost, Fixed-dose Combination Tablet of Generic Sofosbuvir and Daclatasvir: A Multicenter, Phase III Clinical Trial

Background. The combination of sofosbuvir and daclatasvir is a potent, pangenotypic regimen suitable for mass-scale hepatitis C treatment, especially in resource-limited countries where newer, expensive combinations are not available. This combination has been widely tested on genotype 4. However, Phase III trials of this combination in other genotypes have been cost prohibitive. With the introduction of generic, low-cost sofosbuvir and daclatasvir, large-scale studies in resource-limited countries are now possible. Methods. Sofosbuvir at 400 mg and daclatasvir at 60 mg were coformulated into a fixed-dose combination (FDC) tablet (Sovodak, Rojan Pharma, Tehran, Iran). Patients from 46 centers were dosed for 12 or 24 weeks with or without ribavirin, in line with existing guidelines. Responses to treatment were evaluated 12 weeks after the end of treatment (for a sustained virological response at Week 12; SVR12). Results. There were 1361 patients recruited. Overall, the patients were 21% female, with a mean age of 50 years; 39% were cirrhotic; 22% were treatment-experienced; 47% were genotype 1, 41% were genotype 3, and 2% were other genotypes. The genotype was not known in 10% of the patients. The intention-to-treat and per-protocol SVR12 rates were 94.7% and 98.8%, respectively. The safety profile was unremarkable, treatment was well tolerated, and compliance with the single-tablet regimen was excellent. Conclusions. The treatment with FDC of sofosbuvir and daclatasvir achieved high SVR12 rates, equivalent to those seen in Phase III trials of other pangenotypic options, and has been conducted at a similar scale in a representative, real-world population at a cost of under $100 per patient, which makes this combination suitable for elimination protocols in resource-limited countries. Keywords:sofosbuvir; daclatasvir; Hepatitis C; sustained virological response; generic drug