amin masjedi

Helicobacter pylori infection is a common infection that affects human beings. This infection also affects children. Different diagnostic methods such as serology, stool antigen detection, rapid urease test and histology are used to detect this microorganism. The aim of this study was to determine the correlation between serology and histology/rapid urease test.Patients and In this study, two groups (case and control) were selected and matched for age and sex. The case group comprised of 77 children with confirmed H. pylori infection, as they had positive rapid urease test and histology results. The control group included 77 healthy children. Both case and control groups were checked serologically for detection of anti H. pylori IgM, IgG and IgA antibody titers. Receiver operating characteristic (ROC)-analysis software was used for data analysis. Amongst the case group 54.6% were female and 45.4% were male. The most common complaints were abdominal pain (96%) and anorexia (82%). Using ROC-analysis method three cut-off points for IgG, IgM and IgA were obtained. These points were 3.3 U/ML for IgA, 6.4 U/ML for IgM and 9.9 U/ML for IgG. Considering cut-off points for each antibody, higher levels were considered as positive and lower levels as negative. Antibody titers were compared with gold standard methods including histologic and rapid urease tests. IgA level had a sensitivity of 64%, specificity of 58%, accuracy of 59.3%, positive predictive value of 31.5% and negative predictive value of 76.9%. IgM level had a sensitivity of 76%, specificity of 36.1%, accuracy of 74.2%, positive predictive value of 31.5% and negative predictive value of 76.9%. IgG level had a sensitivity of 58.6%, specificity of 61.3%, accuracy of 60.6%, positive predictive value of 36.9% and negative predictive value of 79.3%. Therefore, these antibodies have a relatively high negative predictive value and a low positive predictive value. Thus, their negative results are more valuable. The most sensitive antibody is IgM and most specific antibody is IgG. However, the performances of all serological tests for H. pylori are poor in children and these tests should not be used for diagnosis of H. pylori infection and treatment decisions for the pediatric age group.

This study was planned to evaluate the efficacy, safety and complication of photorefractive keratectomy (PRK) as a retreatment of residual myopia after previous laser in situ keratomileusis (LASIK). In this descriptive study in ophthalmology ward, Feiz Hospital, Isfahan University of Medical Sciences, Iran, with the consideration of inclusion and exclusion criteria, 170 eyes of the 92 patients were selected and underwent PRK with mitomycin C. One hundred-twenty seven eyes were in the first group (myopia≤-2 diopter [D]) and 43 eyes were in the second group (myopia>-2 D). This study was performed on 170 eyes of 92 patients with an average age of 35 years old (56 women and 36 men). The average interval between procedures was 17.5±3.2 months. After 1 year, 94.7% of the eyes had uncorrected visual acuity (UCVA) (20/40 or better) and 65.8% of eyes had UCVA (20/20 or better). 135 eyes (79.4%) were within ±0.5 D and 168 eyes (98.8%) were within ±1.00 D of target refraction. Two eyes lost one line of best corrected visual acuity (BCVA) and 14 eyes had BCVA gain. In this study 20 eyes presented with corneal haze after one year after PRK (11.8%). Five eyes (3.9%) in first group (myopia≤-2.0 D) developed corneal opacity from the patients in second group (myopia>-2.0 D) 15 cases (34.9%) encountered corneal opacity. Before and after PRK, spherical equivalents of eyes were -1.84±0.6 and -0.15±0.2 D respectively (P<0.001), mean UCVA was 0.34±0.23 and 0.92±0.14 of lines (P<0.001), mean BCVA was 0.94±0.4 and 0.98±0.5 of lines (P=0.84) and the mean corneal thickness was 428±20 and 407±12 microns respectively (P=0.032). PRK is an effective and safe procedure as a retreatment of post LASIK residual myopia. The treatment of higher grade of residual myopia has higher rate of postoperative complication.

To evaluate the effect of local lidocaine application on the incidence of the oculocardiac reflex (OCR) during scleral buckling (SB) for rhegmatogenous retinal detachment (RRD) under general anesthesia. In a randomized clinical trial, eyes with RRD scheduled for SB under general anesthesia were randomized to adjunctive local application of 1 ml lidocaine 2% versus normal saline to the muscles after conjunctival opening. Surgical stimulation was initiated 5 minutes afterwards. Additionally, 100 mg of lidocaine 2% was added to 50 ml of normal saline in the treatment group which was used for irrigation during surgery; control eyes were irrigated with normal saline. The incidence of the OCR, rate of postoperative nausea/vomiting (PONV), total intravenous (IV) analgesic dose, duration of surgery, and period of hospitalization were compared between the study groups. Thirty eyes of 30 patients including 22 (73.3%) male and 8 (26.7%) subjects with mean age of 49.4±16.3 years were operated. OCR and PONV occurred less frequently, and total intravenous analgesic dose was significantly lower in the lidocaine group (P < 0.05 for all comparisons). However, no significant difference was noted between the study groups in terms of duration of surgery and period of hospitalization. Adjunctive local application of lidocaine during SB under GA for RRD decreases the rate of OCR and PONV, reduces the intravenous analgesic dose, but does not affect the duration of surgery or hospitalization.

To report toxoplasmosis in triplet. Case Report: We report toxoplasmosis in triplet patient. Two of them presented with congenital toxoplasmosis with chorioretinal manifestation. One of this two has recurrence of chorioretinitis after complete and successful treatment with triplet antibiotic therapy. One of this triplet has no ocular or systemic manifestation of congenital toxoplasmosis. So it may be a case of bichorionic triplet with congenital toxoplasmosis. Due to sparing of one of the triplet, toxoplasmosis infected the one chorion of this bichorionic triplet.

Refractive eye are the most common people eye complaints and there are different ways to refractive correction. In this study we compare the effect of two phakic intraocular lenses, Artiflex versus Implantable Contact Lens (ICL).

In a prospective clinical trial study, 40 eyes of 20 patients who came to ophthalmology clinic to correct their refractive error were examined. In 20 eyes artiflex was inserted randomly and in the other 20 eyes, ICL was inserted. After 6 months uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), contrast sensitivity, intraocular pressure (IOP), specular microscopy and anterior uveitis was assessed in both groups.

In this study, there is no statistical difference between UCVA, BCVA, IOP, cataract incidence, contrast sensitivity, specular microscopy 6 months after surgery in both groups. 40% of eyes in Artiflex group developed anterior chamber reaction 6 months post-operatively but no patient in ICL group. So there is obvious difference in the rate of anterior chamber reaction between these two groups.

These two lenses have similar outcomes except in the incidence rate of anterior chamber reaction that is greater in the artiflex group. So these two lenses are safe with predictable outcome in treating high myopia.

This study aimed to evaluate the changes of posterior corneal curvature after photorefractive keratectomy (PRK) in patient with myopia greater than 6 diopters.

The study was conducted on 107 eyes of 57 patients with the preoperative spherical equivalent refractive error of at least minus six diopters. Subjects underwent PRK for treatment of myopia or myopic astigmatism and were followed 4 months later to evaluate their refractive error. The posterior corneal curvature was evaluated by orbscan II topography preoperatively and 4 months after PRK.

The diameter of posterior corneal best-fitted sphere (BFS) in 3, 5, 7 and 10 millimeter zones before surgery was 6.089 ± 0.2666, 6.137± 0.253, 6.299 ± 0.268, and 6.506± 0.312 millimeters respectively and after surgery these values had changed to 5.673± 0.362, 5.809± 0.341, 6.056± 0.309, and 6.347± 0.334 millimeters respectively.

PRK for treatment of high myopia makes significant changes in the diameter of all measured zones of posterior cornea. The amount of alteration changed with regard to the selected zone, with the maximum effect in 3 and minimum effect in 10 millimeter zones.

This study aimed to evaluate the difference between the effect of standard photorefractive keratectomy (PRK) and Q-value adjusted ablation PRK with Allegretto Eye-Q on the ocular refraction. In this clinical trial study performed in Parsian clinic of Isfahan, 75 candidates for photorefractive surgery were included. All of these patients underwent standard PRK in one eye and Q-value adjusted ablation PRK in the other eye. The efficacy of therapy was measured by visual acuity, contrast sensitivity, subjective refraction and patients’ satisfaction, 3 months after the surgery. The mean score of postoperative visual acuity in standard PRK group and Q-value adjusted group was 10.48 ± 1.38 and 10.51 ± 1.22 respectively without correction. The mean postoperative refraction of standard PRK and Q-value adjusted PRK was 0 ± 0.37 and 0.05 ± 0.3 respectively. There was no significant statistical difference in visual acuity, refraction, contrast sensitivity and postoperative satisfaction between the two groups. There is no significant difference between efficacy of standard PRK and Q-value adjusted PRK in optimizing visual acuity, subjective refraction, contrast sensitivity and patient satisfaction.

To compare the outcomes and complications of alcohol-assisted versus mechanical corneal epithelial debridement for photorefractive keratectomy (PRK). This randomized controlled trial included 1,250 eyes of 625 patients undergoing PRK for correction of myopia and myopic astigmatism. Each patient was randomly assigned to alcohol-assisted or mechanical epithelial removal. A total of 658 eyes underwent alcohol-assisted epithelial removal while the epithelium was removed mechanically in 592 eyes. Mean spherical equivalent was -4.37±2.3 D in the alcohol group and -3.8±1.3 D in the mechanical group (P = 0.78). There was no significant difference in postoperative pain between the study groups (P = 0.22). Uncorrected visual acuity? 20/20 and? 20/40 was achieved in 90.9% versus 93.4% (P = 0.08), and 98.9% versus 99.5% (P = 0.36) of eyes in the alcohol and mechanical groups, respectively. Final refractive error within 1D of emmetropia was achieved in 90% versus 92.2% of eyes in the alcohol and mechanical groups, respectively (P = 0.23). Alcohol-assisted debridement required less time than mechanical debridement (96±18 vs. 118±26 seconds, P=0.035). There was no significant difference between the two groups in terms of early and late postoperative complications. Alcohol-assisted and mechanical epithelium removal are comparable in terms of efficacy and side effects. The method of epithelial debridement in PRK may be left to the surgeon's choice.