AIM: To determine the frequency of HIV-related ocular involvement and to describe the characteristics of involvement in a special clinic in Tehran.METHODS: In this cross sectional study, 141 patients (125 male and 16 female, 282 eyes) of HIV-infected patients with various stages of HIV infection that were referred to Center of behavioral diseases were evaluated during a period of 7 months. Every patient had a complete profile including demographic data, method of HIV transmission, recent CD4 T cell lymphocyte count, serological studies for common sexual or blood-born viruses and toxoplasmosis, history of antiretroviral therapy, and associated systemic disease. RESULTS: A total of 141 patients were evaluated. HIV-related ocular involvement was detected in 15 patients (10.6%), including 3 mycobacterium tuberculosis-related choroiditis, 2 cytomegalovirus retinitis, 2 retinal toxoplasmosis, 2 herpes simplex virus-related lesions, 1 HIV-associated retinopathy, 1 herpes zoster ophthalmicus, 1 undetermined vitritis, and 3 cases of cranial nerve involvement including 2 cases of gaze palsy and 1 case of papilitis. In our study, mean CD4 T cell lymphocyte count was fewer in patients with ocular involvement than in patients without ocular involvement (204.7±123.8 vs 403.7±339.7, P=0.029), but there was no difference in other possible associated factors between two groups.lesions are the most common HIV-related ocular involvements in Tehran that is different from those of recent publications in developed countries.

AIM: To evaluate correlation of retinopathy and diabetic peripheral neuropathy (DPN) as microvascular complications of diabetes and also to identify their risk factors in patients with type 2 diabetes.MEHTODS: We conducted a cross-sectional study in an outpatient diabetes clinic during an 18-month period. 100 patients (51 male and 49 female), all affected by non-insulin-dependent diabetes mellitus (NIDDM), were examined for the presence of diabetic neuropathy and diabetic retinopathy.RESULTS: 78.1% of patients with retinopathy had DPN; and 79.1% of patients with DPN had retinopathy. Analysis of the association between DPN and retinopathy showed no significant correlation between them. 90.9% of patients with proliferative diabetic retinopathy (PDR) had DPN; and 27.8 %of patients with DPN had PDR. Both the univariate analysis and multiple logistic regression analysis revealed significant correlation between them (r =0.42, P =0.02).CONCLUSION: A severe diabetic retinopathy is associated with diabetic neuropathy. Our study further supports that diabetic neuropathy might be used as a tell-tale sign of diabetic retinopathy, necessitating more intensive ophthalmic care, especially in long-lasting diabetes.

BACKGROUND AND OBJECTIVES: Although repositioning maneuvers have shown remarkable success rate in treatments of benign paroxysmal positional vertigo (BPPV), the high recurrence rate of BPPV has been an important issue. The aims of present study were to examine the effects of otolith dysfunction on BPPV recurrence rate and to describe the effect of vestibular rehabilitation exercises on BPPV recurrence in BPPV patients with concomitant otolith dysfunction. SUBJECTS AND METHODS: Forty-five BPPV patients included in this study (three groups). Patients in group 1 had no otolith dysfunction and patients in groups 2 and 3 had concomitant otolith dysfunction. Otolith dysfunction was determined with ocular/cervical vestibular evoked myogenic potential (oVEMP and cVEMP) abnormalities. Epley’s maneuver was performed for the patients in all groups but patients in group 3 also received a 2-month vestibular rehabilitation program (habituation and otolith exercises). RESULTS: This study showed that BPPV recurrent rate was significantly higher in patients with otolith dysfunction in comparison to the group 1 (p < 0.05). Vestibular rehabilitation resulted in BPPV recurrence rate reduction. Utricular dysfunction showed significant correlation with BPPV recurrence rate. CONCLUSIONS: Otolith dysfunction can increase BPPV recurrence rate. Utricular dysfunction in comparison to saccular dysfunction leads to more BPPV recurrence rate. Vestibular rehabilitation program including habituation and otolith exercises may reduce the chance of BPPV recurrence.
Benign Paroxysmal Positional Vertigo ; Exercise ; Humans ; Otolithic Membrane ; Recurrence ; Rehabilitation

OBJECTIVEThe high burden of injuries in Iran necessitates the establishment of a comprehensive trauma care system. The purpose of this paper is to describe the current status of trauma system regarding the components and function.

METHODSThe current status of trauma system in all components of a trauma system was described through expert panels and semi-structured interviews with trauma specialists and policy makers.

RESULTSCurrently, various organizations are involved in prevention, management and rehabilitation of injuries, but an integrative system approach to trauma is rather deficient. There has been ongoing progress in areas of public education through media, traffic regulation reinforcement, hospital care and prehospital services. Meanwhile, there are gaps regarding financing, legislations and education of high risk groups. The issues on education and training standards of the front line medical team and continuing education and evaluation are yet to be addressed. Trauma registry has been piloted in some provinces, but as it needs the well-developed infrastructure (regarding staff, maintenance, financial resources), it is not yet established in our system of trauma care.

CONCLUSIONSIt seems that one of the problems with trauma care in Iran is lack of coordination among trauma system organizations. Although the clinical management of trauma patients has improved in our country in the recent decade, decreasing the burden of injuries necessitates an organized approach to prevention and management of trauma in the context of a trauma system.

Accidents, Traffic ; prevention & control ; Emergency Medical Services ; Humans ; Iran ; Leadership ; Wounds and Injuries ; prevention & control ; therapy

Objective: To explore the anti-inflammatory and antioxidant effects of caraway on atopic dermatitis (AD) in mice. Methods: AD was induced in two stages, including sensitization and challenge with the application of 2,4 dinitrochlorobenzene 2% and 0.2%, respectively. Clinical symptoms and histological analysis of the skin were assessed. The effects of caraway on oxidant/ antioxidant parameters as well as Th1- and Th2-related cytokines were also evaluated. Results: Caraway reduced the severity of dermatitis in AD-induced mice, as evidenced by significant inhibition of Th2-related cytokines (IL-4 and IL-13) and increased Th1-related cytokine (IFN-γ). Additionally, treatment with caraway significantly increased superoxide dismutase and catalase activity and decreased the malondialdehyde level in the serum of AD mice. Furthermore, caraway inhibited the differentiation of Th2 cells while favoring Th1 cell differentiation in the spleen via regulating their master transcription factors GATA3 and T-bet. Conclusions: Caraway could improve AD autoimmune responses and could be considered a potential candidate to treat AD disease.