· AIM: This study was conducted to compare the outcomes of amniotic membrane transplantation (AMT) with conjunctival autograft transplantation (CAT) in primary and recurrent pterygium. The main outcome measurement was the recurrence rate after surgery.· METHODS: This study was designed as a prospective study on consecutive cases of pterygium from April 2004 to Feb2006. The cases were randomly divided into two groups of AMT (26 cases) and CAT (24 cases). All subjects were operated with an extensive excision of the fibro vascular tissues with AMT or CAT approach. Patients were followed for recurrence and complications for 24 months. The surgical procedures were performed by a single surgeon.The associations between demographic variables, surgical techniques (AMT, CAT), recurrences and postoperative complications were analyzed.· RESULTS: The patients' male to female ratio was 4:1. Involvement of right to left eye ratio was 3:2. Pterygium in70% of cases was primary and in 30% was recurrent. The most common clinical signs were red eye and reduced visual acuity while the most common complications were recurrence and corneal scar. In the first month of follow up, the recurrence rates in AMT and CAT approaches were 3.8% vs 8.3%respectively and these rates increased to 46.2% vs 25% respectively after 24 months of follow up.· CONCLUSION: The success rate of 2 years follow up was better in CAT technique. The AMT technique for pterygium surgery has an unacceptably high recurrence rate.

The thyroid gland is a rare site for cancer metastasis. We report a 75-year-old man who was referred with a history of hematuria and generalized bone pain for the past few months. He had a past history of partial left lobe thyroidectomy for follicular adenoma. Subsequently he was referred for a thyroid mass and a subtotal thyroidectomy showed a poorly-differentiated carcinoma. On the latest admission, the patient underwent resection of a bladder tumour with malignant histology and an immunohistochemical profile of CK7+/CK20+/34 Beta E12+/CEA-/PSA-. Re-examination of thyroid sections with immunohistochemical stains revealed the malignant cells to be CK7+/CK20+/34 Beta E12+/CEA-/TTF1-. The findings were compatible with metastasis of the bladder transitional cell carcinoma to the thyroid gland.Scans revealed multiple liver and bone metastases. The patient died 2 months after the diagnosis.

Objective: To investigate the scolicidal effect of the Satureja khuzistanica (S. khuzistanica) essential oil from aerial parts of this herbal plant. Methods: The essential oil was obtained by hydrodistillation method. Gas chromatography (GC) and gas chromatography mass spectrometry (GC-MS) were employed to determine the chemical composition of the essential oil. Protoscolices were collected aseptically from sheep livers containing hydatid cyst. Protoscolices were exposed to various concentrations of the oil (3, 5 and 10 mg/mL) for 10, 20, 30, and 60 min. Viability of protoscolices was confirmed by 0.1% eosin staining. Results: A total of 19 compounds representing 97.6% of the total oil, were identified. Carvacrol (94.9%) was found to be the major essential oil constituent. Scolicidal activity of S. khuzistanica essential oil at concentration of 3 mg/mL was 28.58, 32.71, 37.20 and 42.02%, respectively. This essential oil at concentration of 5 mg/mL killed 51.33, 66.68, 81.12, and 100% of protoscolices after 10, 20, 30 and 60 min, respectively. One hundred scolicidal effect was observed with S. khuzistanica essential oil at the concentration of 10 mg/mL after 10 min (comparing with 7.19% for control group). Conclusions: The essential oil of S. khuzistanica is rich in carvacrol and may be used as a natural scolicidal agent.

AIM: To compare one step macular hole and cataract surgery with two step surgery in patients with macular hole and cataract.
●METHODS: ln a clinical trial conducted on patients suffering from cataract with macular holes inTabriz, the effects of simultaneous surgery of macular hole and cataract performed on these patients were studied. ln this study, 22 patients ( Group A ) were, first, undergone phacoemulsification and intraocular lens embedment, and one month later, 23-gauge pars plana vitrectomy together with the retinal internal limiting membrane ( lLM ) removal. Twenty - one patients ( Group B ) were undergone simultaneous phacoemulsification, intraocular lens embedment, 23-gauge pars plana vitrectomy, and the retinal lLM removal.
●RESULTS: Group A was comprised of 7 males and 15 females, and Group B of 9 males and 12 females ( P=0. 545) . The mean age of patients in Group A and B were 66.63±4. 75 and 67. 71±4. 99y, respectively (P=0. 472). Three months after surgeries were performed, the macular holes of 2 patients from Group A and 5 patients from Group B were open ( P = 0. 240 ). Uveitis was observed in 1 patient from Group A and 4 from Group B (P=0. 185). The increase of intraocular pressure (lOP) was merely observed in 2 patients from Group B ( P=0. 233 ) . Posterior capsule opacification ( PCO ) was observed, three months after surgeries, in 2 patients from Group A and 4 from Group B (P=0. 412).
● CONCLUSION: The results suggested that, no significant difference existed between patients from the two groups in terms of outcome and postoperative complications, although,Group B patients, the recipients of simultaneous surgeries, experienced more complications compared to their Group A counterparts.

Scientifi cally known as Allium Cepa L., onion is a plant which contains various benefi ts and has been used as food and medicine over the years by many nations and races. This research is conducted to identify the benefi ts of onion for human body from the perspectives of Islamic medical scholars and scientifi c research. The literature data for this study has been collected from four Islamic medical books and 14 articles of a variety of related journals. The cumulative data has been analysed by using Nvivo10.0 to identify emerging suitable categories and subsequently generate the fi ndings. The fi ndings of this study discovered that there are at least 17 benefi ts of onion. This includes six which are based on the perspectives of Islamic scholars which are to treat epiphora, to treat ear problems, to medicate infections from dog bites, to neutralize poisons, to stimulate sexual desire and to treat water-borne diseases. Another 11 benefi ts identifi ed in the scientifi c researches include its potential as an antiplatelet agent, anti-fat formation agent, antioxidant agent, antithrombotic agent, anticarcinogen agent, antidepressant agent, antiinfl ammatory agent, antiasthmatic agent, and antibiotic agent, as well as it helps decrease hyperglicemia levels and reduce the risk of atherosclerosis. Thus, this study suggest that onion should be highlighted as one of organic treatment/remedy as well as an alternative to conventional treatment.
Onions

In this article, the affiliation of the first author should be changed.

STUDY DESIGN: In this prospective study, we measured the pad pressures of the Milwaukee brace in adolescent hyperkyphosis treatment. PURPOSE: We evaluated the skin-brace interface forces exerted by the main pads of the Milwaukee brace. OVERVIEW OF LITERATURE: A fundamental factor associated with brace effectiveness in spinal deformity is pad force adjustment. However, few studies have evaluated the in-brace force magnitude and its effect on curve correction. METHODS: Interface forces at four pads of the Milwaukee brace were measured in 73 patients withround back deformity (mean age, 14.04±1.97 years [range, 10–18]; mean initial Cobb angle,67.70°±9.23° [range, 50°–86°]). We used a modified aneroid sphygmomanometer to measure the shoulder and kyphosis pad pressures. Each patient underwent measurement in the standing and sitting positions during inhalation/exhalation. RESULTS: The mean pad pressures were significantly higher in the standing than in thesitting position, and significantly higher pressures were observed during inhalation compared toexhalation (p=0.001).There were no statistically significant differences between right and left shoulder pad pressures (p>0.05); however, the pressure differences between the right and left kyphosis pads were statistically significant (p<0.05). In a comparison of corrective forces with bracing for less or more than 6 months, corrective force was larger with bracing for less than 6 months (p=0.02). In the standing position, there were no statistically significant correlations between pad pressures and kyphosis curve correction. CONCLUSIONS: In the sitting position, there was a trend toward lower forces at the skin-brace interface; therefore, brace adjustment in the standing position may be useful and more effective. There was no significant correlation between the magnitude of the pad pressures and the degree of in-brace curve correction.
Adolescent* ; Braces* ; Congenital Abnormalities* ; Humans ; Inhalation ; Kyphosis ; Posture ; Prospective Studies ; Scheuermann Disease ; Shoulder ; Sphygmomanometers

PURPOSE: Delorme's procedure is infrequently applied in young adults because of its assumed higher recurrence rate. The aim of this prospective study was to assess the efficacy of the Delorme's technique in younger adults. METHODS: Fifty-two consecutive patients were entered in our study. We followed patients for at least 30 months. Their complaints and clinical exam results were noted. RESULTS: Our study included 52 patients (mean age, 38.44 years; standard deviation, 13.7 years). Of the included patients, 41 (78.8%) were younger than 50 years of age, and 11 (21.1%) were older than 50 years of age. No postoperative mortalities or major complications were noted. Minor complications were seen in 5 patients (9.6%) after surgery. The mean hospital stay was 2.5 days. In the younger group (age < or =50 years), fecal incontinence was improved in 92.3% (12 out of 13 with previous incontinence) of the patients, and recurrence was seen in 9.75% (4 patients). In the older group (age >50 years), fecal incontinence was improved in 20% (1 out of 5 with previous incontinence) of the patients, and recurrence was seen in 18.2% (2 patients). In 50% of the patients with a previous recurrence (3 out of 6 patients) following Delorme's procedure as a secondary procedure, recurrence was observed. CONCLUSION: Delorme's procedure, especially in younger patients, is a relatively safe and effective treatment and should not be restricted to older frail patients. This procedure may not be suitable for recurrent cases.
Aged ; Fecal Incontinence ; Humans ; Length of Stay ; Prospective Studies ; Rectal Prolapse ; Recurrence ; Young Adult

OBJECTIVESince appropriate and time-table methods in trauma care have an important impact on patients'outcome, we evaluated the effect of Advanced Trauma Life Support (ATLS) program on medical interns' performance in simulated trauma patient management.

METHODSA descriptive and analytical study before and after the training was conducted on 24 randomly selected undergraduate medical interns from Imam Reza Hospital in Mashhad, Iran. On the first day, we assessed interns' clinical knowledge and their practical skill performance in confronting simulated trauma patients. After 2 days of ATLS training, we performed the same study and evaluated their score again on the fourth day. The two findings, pre- and post- ATLS periods, were compared through SPSS version 15.0 software. P values less than 0.05 were considered statistically significant.

RESULTSOur findings showed that interns'ability in all the three tasks improved after the training course. On the fourth day after training, there was a statistically significant increase in interns' clinical knowledge of ATLS procedures, the sequence of procedures and skill performance in trauma situations (P less than 0.001, P equal to 0.016 and P equal to 0.01 respectively).

CONCLUSIONATLS course has an important role in increasing clinical knowledge and practical skill performance of trauma care in medical interns.

It has been shown that some opium derivatives promote cell death via apoptosis. This study was designed to examine the influence of opium addiction on brain and liver cells apoptosis in male and female diabetic and non-diabetic Wistar rats. This experimental study was performed on normal, opium-addicted, diabetic and diabetic opium-addicted male and female rats. Apoptosis was evaluated by TUNEL and DNA fragmentation assays. Results of this study showed that apoptosis in opium-addicted and diabetic opium-addicted brain and liver cells were significantly higher than the both normal and diabetic rats. In addition, we found that apoptosis in brain cells of opium-addicted and diabetic opium-addicted male rats were significantly higher than opium-addicted and diabetic opium-addicted female, whereas apoptosis in liver cells of opium-addicted and diabetic opium-addicted female rats were significantly higher than opium-addicted and diabetic opium-addicted male. Overall, these results indicate that opium probably plays an important role in brain and liver cells apoptosis, therefore, leading neurotoxicity and hepatotoxicity. These findings also in away possibly means that male brain cells are more susceptible than female and interestingly liver of females are more sensitive than males in induction of apoptosis by opium.
Animals ; Apoptosis ; Brain ; Cell Death ; DNA Fragmentation ; Female ; Humans ; In Situ Nick-End Labeling ; Liver ; Male ; Opium ; Rats ; Rats, Wistar