AIM: To evaluate the clinical success of living related conjunctival limbal and amniotic membrane transplantation for treatment of chemical injury induced limbal stem cell deficiency.METHODS: From July 2005 to December 2007, 10 eyes of 9 male patients with chemical injury induced limbal stem cell deficiency were included in the study. All subjects underwent living related conjunctival limbal and amniotic membrane transplantation. Blepharorrhaphy was performed in two cases. Systemic immunosuppression with cyclosporine and prednisolone was initiated.RESULTS: Complete corneal epithelialization was observed in 3 eyes (30%). In one of the patients immunologic rejection and corneal melting led to perforation 1.5 months after surgery. The increasing dose of systemic immunosuppression was used to control it. Three eyes were described as primary failure because graft could not re-epithelialize the corneal surface. The remained four eyes showed partial re-epithelialization, but failed to cover the entire corneal surface with epithelium. Best corrected visual acuity ranged from hand movement to counting finger at 1 meter before the surgery and after the surgery was light perception to 20/80. Five eyes had visual improvement without any additional procedure. Dry eye and persistent inflammation were known as main causes of failure.CONCLUSION: Living related conjunctival limbal allograft and amniotic membrane transplantation can be a good option in the management of limbal stem cell deficiency in selected cases in which tear production and control of ocular inflammation are adequate.

OBJECTIVES: The genus Shigella comprises the most infectious and diarrheagenic bacteria causing severe diseases, mostly in children under five years of age. This study aimed to detect nine virulence genes (ipaBCD, VirA, sen, set1A, set1B, ial, ipaH, stx, and sat) in Shigella species (spp.) using multiplex polymerase chain reaction (MPCR) and to determine the relation of Shigella spp. from pediatric diarrheal samples with hospitalization and bloody diarrhea in Tehran, Iran. METHODS: Shigella spp. were isolated and identified using standard microbiological and serological methods. The virulence genes were detected using MPCR. RESULTS: Seventy-five Shigella spp. (40 S. sonnei, 33 S. flexneri, 1 S. dysenteriae, and 1 S. boydii) were isolated in this study. The prevalence of ial, sen, sat, set1A, and set1B was 74.7%, 45.4%, 28%, 24%, and 24%, respectively. All S. flexneri isolates, while no S. sonnei, S. dysenteriae, or S. boydii isolates, contained sat, set1A, and set1B. All isolates were positive for ipaH, ipaBCD, and virA, while one (1.4%) of the isolates contained stx. The highest prevalence of virulence determinants was found in S. flexneri serotype IIa. Nineteen (57.6%) of 33 S. flexneri isolates were positive for ipaBCD, ipaH, virA, ial, and sat. The sen determinants were found to be statistically significantly associated with hospitalization and bloody diarrhea (p = 0.001). CONCLUSION: This study revealed a high prevalence of enterotoxin genes in S. flexneri, especially in serotype 2a, and has presented relations between a few clinical features of shigellosis and numerous virulence determinants of clinical isolates of Shigella spp.
Bacteria ; Child ; Diarrhea ; Dysentery, Bacillary ; Enterotoxins ; Hospitalization ; Humans ; Iran* ; Multiplex Polymerase Chain Reaction ; Pediatrics ; Prevalence ; Serogroup ; Shigella* ; Virulence

PROPOSE: In this study, we re-assessed the criteria defined by the radiological society of North America (RSNA) to determine novel radiological findings helping the physicians differentiating COVID-19 from pulmonary contusion. METHODS: All trauma patients with blunt chest wall trauma and subsequent pulmonary contusion, COVID-19-related signs and symptoms before the trauma were enrolled in this retrospective study from February to May 2020. Included patients (Group P) were then classified into two groups based on polymerase chain reaction tests (Group Pa for positive patients and Pb for negative ones). Moreover, 44 patients from the pre-pandemic period (Group PP) were enrolled. They were matched to Group P regarding age, sex, and trauma-related scores. Two radiologists blindly reviewed the CT images of all enrolled patients according to criteria defined by the RSNA criteria. The radiological findings were compared between Group P and Group PP; statistically significant ones were re-evaluated between Group Pa and Group Pb thereafter. Finally, the sensitivity and specificity of each significant findings were calculated. The Chi-square test was used to compare the radiological findings between Group P and Group PP. RESULTS: In the Group PP, 73.7% of all ground-glass opacities (GGOs) and 80% of all multiple bilateral GGOs were detected (p < 0.001 and p = 0.25, respectively). Single bilateral GGOs were only seen among the Group PP. The Chi-square tests showed that the prevalence of diffused GGOs, multiple unilateral GGOs, multiple consolidations, and multiple bilateral consolidations were significantly higher in the Group P (p = 0.001, 0.01, 0.003, and 0.003, respectively). However, GGOs with irregular borders and single consolidations were more significant among the Group PP (p = 0.01 and 0.003, respectively). Of note, reticular distortions and subpleural spares were exclusively detected in the Group PP. CONCLUSION We concluded that the criteria set by RSNA for the diagnosis of COVID-19 are not appropriate in trauma patients. The clinical signs and symptoms are not always useful either. The presence of multiple unilateral GGOs, diffused GGOs, and multiple bilateral consolidations favor COVID-19 with 88%, 97.62%, and 77.7% diagnostic accuracy.
COVID-19 ; Contusions/diagnostic imaging* ; Humans ; Lead ; Lung/diagnostic imaging* ; Lung Injury/etiology* ; Retrospective Studies ; SARS-CoV-2 ; Tomography, X-Ray Computed/methods*