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Bandar Abbas, with a population of over half a million people, has a number of private dental offices. Due to importance of biological quality of water for therapeutic activities, the study was designed to evaluate the microbiological water unit water lines of mentioned dental offices. In this cross-sectional study of 30 randomly selected active dental offices, sample waters were taken from injection of air - water and high-speed handpieces. At the same time from feed water samples were taken. At first all of samples were tested for residual chlorine. Microbial tests were including total coliforms and E. coli experiments, Legionella, Staphylococcus aureus, Pseudomonas aeruginosa. For statistical analysis software SPSS version 16 and statistical tests, T-test and ANOVA were used. In 66.4% of the feed water source and 100 percent of handpieces and syringes line, water is not meeting the standard. Most microbial load in feed water supply was related to coliform sp, and dominant microorganism load in syringes have been related to Legionella, in handpieces, Pseudomonas has the most microbial load. Only 8 percent of the municipal water supplied to the respective offices residual chlorine standard. High levels of bacterial contamination observed in the results of this study indicate that extensive growth of bacterial films on the dental unit water lines. [ABSTRACT FROM AUTHOR]

Background: Cerebral ischemia is considered as one of the leading causes of death and involved in neuronal apoptosis. This study aimed to evaluate the Bax and Bcl-2 expression in the rat hippocampus after reperfusion following transient ischemia. Materials and Methods: In this experimental study, transient global cerebral ischemia (15 and 30 minutes) was induced in adult male Wistar rats (n=5 in each group) by the occlusion of bilateral common carotid artery followed by reperfusion for 24 and 72 hours. Five Sham-operated animals, without any intervention, considered as a control group. The expression of Bcl-2 and Bax genes were detected by reverse transcription (RT)-PCR in all groups. Results: Transcription and expression of both Bcl-2 and Bax genes were increased after global cerebral ischemia in all experimental groups; the two gene expression increment in the experimental groups (2, 3 and 4) was more detectable than the first group. Conclusion: According to the results, transient cerebral ischemia activates Bcl-2 and Bax apoptotic genes that play an important role in the protection and induction of cell death in the hippocampal neurons, respectively. [ABSTRACT FROM AUTHOR]

Introduction: The bladder tumor is common in urinary system and its usual diagnostic method is cystoscopy that is an invasive method. In this study the sensitivity and specifity of the urinary FDP(Fibrin Degradation Products) in diagnosis of transitional cell carcinoma of bladder was determined and compared with urine cytology during the course of disease. Methods: In this evaluation study of diagnostic test, sixty cases with confirmed bladder carcinoma admitted to Rahnemoon hospital in Yazd were included. Urine samples were collected before any intervention for cytologic examination and also for checking the FDP according to manufacture's instruction (FDP AuraTeck kit). Patients were randomly divided into three groups based on the stages and grades of disease. Sensitivity and specifity of each test was also determined. Results: Sixty urine samples were evaluated. 34 patients were male and 26 were female. Mean age of patients was 62.3±11 years. Sensitivity of FDP and cytology in patients with grade I was 63% and 8%, in grade II 64% and 28%, and in grade III and also grade IV 89% and 50% respectively. These values in patients with stage Ta were 64% and 34%, in stage T1 and T2 65% and 22% and in stage T3 and T4 63% and 43% respectively. Overall the sensitivity of FDP was 68% and for cytology was 38% (P<0.005). The positive predictive value for FDP was 100% and the negative predictive value was 30.4%. Conclusions: Our study showed that urinary FDP is a valuable diagnostic test which has greater sensitivity and specifity than cytology in bladder carcinoma and it's accuracy is not affected by the stage and grade of the tumor. [ABSTRACT FROM AUTHOR]

Introduction: Ophthalmology education is evolving with the use of new teaching approaches. Teaching based on gamification is one of the new developments in health professions education. This study was conducted to investigate the effect of gamification-based virtual reality on the learning outcome of students regarding the highly important topic of approach to eye trauma., Materials and Methods: This randomized educational intervention trial with a control group was conducted at Kermanshah University of Medical Sciences (KUMS). A total of 10 ophthalmology residents and 60 medical students were recruited in this study (each group comprised 5 residents and 30 medical students). Individuals were randomly divided into two teaching groups gamification method (intervention group) and lecture-based method (Control group). Data were collected through questionnaires and tests and analyzed by SPSS-26 software using descriptive and analytical statistics., Results: Residents and medical students evaluated the usability of this method to be favorable (132.72 ± 10.17). In resident students (16.80 ± 2.58, 13.60 ± 1.14, P ≤ 0.05) and medicine students (17.27 ± 4.50, 15.20 ± 0.71, P ≤ 0.05), the mean score of learning outcome score in the intervention group was higher than the control group., Conclusion: Gamification-based teaching is an effective educational strategy that can be used as a complementary educational tool for teaching ophthalmology residents and medical students., (© 2024. The Author(s).)

(-)-Phenserine ("phenserine") and (+)-phenserine (posiphen; buntanetap) are longer-acting enantiomeric analogs of physostigmine with demonstrated promise in the treatment of Alzheimer's and Parkinson's diseases. Both enantiomers have short plasma half-lives, and their pharmacokinetics might be improved through the use of either once or twice-daily administration of an extended-release dosage form. Phenserine was observed to form a colored degradation product in near-neutral and alkaline pH environments, and at pH 7, the half-life of posiphen was determined to be ~ 9 h (40 °C). To limit luminal degradation which would reduce bioavailability, a gastroretentive tablet composed of a polyethylene oxide-xanthan gum matrix was developed. When placed in simulated gastric fluid (pH 1.2), approximately 70% of the phenserine was released over a 12 h period, and no degradants were detected in the release medium. In comparison, a traditional hydrophilic-matrix, extended-release tablet showed measurable amounts of phenserine degradation in a pH 7.2 medium over an 8 h release interval. These results confirm that a gastroretentive tablet can reduce the luminal degradation of phenserine or posiphen by limiting exposure to neutral pH conditions while providing sustained release of the drug over at least 12 h. Additional advantages of the gastroretentive tablet include reduced gastric and intestinal concentrations of the drug resulting from the slower release from the gastroretentive tablet which may also limit the occurrence of the dose-limiting GI side effects previously observed with immediate-release phenserine capsules., (© 2024. The Author(s), under exclusive licence to American Association of Pharmaceutical Scientists.)

Objective To evaluate the perceptions of the coronavirus disease 2019 (COVID-19) initiated workplace strategies implemented in radiation oncology departments across Australia. Methods A multidisciplinary team from Princess Alexandra Hospital developed a survey to address the impact of the pandemic strategies on areas such as patient care, staff education, well-being, flexible working arrangements, and research. The survey was conducted from November 2020 to April 2021. Results Out of 210 respondents from seven institutions, 45% reported burnout and 57% experienced work work-related stress. A significant majority of respondents were in favour of continued remote work (86%, 131/153). Radiation oncologists identified administrative or non-clinical work (92%, 34/37), telehealth clinics (32%, 12/37), or radiation therapy planning (22%, 8/37) as suitable for remote work. Additionally, 54% (21/39) of the radiation oncologists plan to use telehealth more frequently, with 67% (26/39) feeling more confident with the technology. The majority (81%, 171/210) of participants favoured continuation of hybrid in-person and virtual meetings. Virtual solutions were adopted for quality assurance activities (72%, 118/165) and 52% (60/116) indicated preference for ongoing utility of virtual platforms. However, 38% (79/210) of the respondents expressed concerns about the negative impact on junior staff training. Conclusion These findings reveal a strong inclination towards technological advancements and remote work arrangements to enable flexible working conditions. Our study suggests the need for ongoing reforms, focusing on improving clinical service delivery efficiencies and enhancing job satisfaction among clinicians.

Vascular conjunctival tumors are uncommon, usually benign lesions. Here, we report a 65-year-old male who presented with a nasal interpalpebral bulbar firm, oval, and dark-brown and non-mobile conjunctival mass. The systemic and ocular examinations including fundoscopy and gonioscopy were within normal limits. With a diagnosis of conjunctival malignant melanoma (CMM), the patient underwent excisional biopsy, partial sclerectomy, and cryotherapy. Microscopic examination revealed dilated vascular channels filled by red blood cells, separated by fibrous interstitium and no sign of malignancy. Therefore, a diagnosis of conjunctival cavernous hemangioma was made. Our case demonstrates that the conjunctival cavernous hemangioma can mimic malignant conjunctival lesions as well as extrascleral extension of uveal melanoma or uveal prolapse due to scleral necrosis., (© 2024. The Author(s).)

Purpose: Chronic ailments usually decrease the quality of life due to the requirement for repetitive administration of drugs. Glaucoma is a chronic eye disease occurred because of increased intraocular pressure (IOP). Controlled-release inserts can overcome this challenge by a gradual release of the antiglaucoma drugs. This study aimed to fabricate ocular inserts of brimonidine tartrate (BMD) for the management of glaucoma., Methods: Different polymers including poly (D, L-lactide), polycaprolactone, cellulose acetate, and Eudragit RL100® were used to develop the BMD-loaded nanofibrous inserts by electrospinning technique. The inserts were characterized. The morphology and drug-polymer compatibility were examined by scanning electron microscopy (SEM), and Fourier-transform infrared (FTIR) spectroscopy and in vitro drug release in PBS. The IOP-lowering efficacy and irritancy of optimized formulation were assessed in the caprines., Results: SEM images demonstrated nanofibers with uniform morphology and a mean diameter<300 nm were fabricated. The nanofibers were high-strength and flexible enough to be placed in the conjunctival sac. FTIR showed drug-polymer compatibility. In vitro release study indicated a sustained-release profile of the drug during 6 days for inserts. In vivo evaluation indicated that the optimized formulation is capable of maintaining the IOP in a non-glaucomatous range for an extended duration of 6 days. In addition, the formulation was non-irritant to the caprine eye., Conclusion: Due to the prolonged IOP-lowering efficiency, BMD-loaded nanofibrous inserts can be considered suitable for the controlled release of drugs and thus enhance patient compliance by reducing the frequency of administration., Competing Interests: There is no conflict of interest., (©2024 The Authors.)

Background: Different devices have diverse accuracy in diagnosing glaucoma, and therefore choosing the best device is challenging. Thereby, this study was conducted to evaluate the diagnostic sensitivity and specificity of imaging devices in glaucoma and explore the need for an updated meta-analysis on this issue., Methods: In this systematic review and meta-analysis, PubMed, Scopus, and Web of Science databases were searched for articles published between January 2004 and 2022. Cross-sectional or diagnostic studies were selected, and sensitivity, specificity, positive predictive value, and negative predictive value were measured., Results: A total of 28 cross-sectional studies were included for meta-analysis. Devices were divided into 2 groups, based on the optic nerve area and the macular area. For the nerve area, the pooled sensitivity was 77% (CI 95%, 70-83; I2, 90.01%) and the pooled specificity was 89% (CI 95%, 84-92, I2, 93.22%), and for the macular area, the pooled sensitivity was 87% (CI 95%, 80-92, I2, 91.79%), and the pooled specificity was 90% (CI 95%, 84-94; I2, 86.30%). We analyzed each device separately. For optical coherence tomography(OCT), the pooled sensitivity was 85% (CI 95%, 81-89; I2, 87.82%) and the pooled specificity was 89% (CI 95%, 85-92; I2, 84.39%); for Heidelberg retinal tomography (HRT), the pooled sensitivity was 72% (CI 95%, 57-83; I2, 88.94%) and the pooled specificity was 79% (CI 95%, 62-90; I2, 98.61%), and for optical coherence tomography angiography (OCTA), the pooled sensitivity was 82% (CI 95%, 66-91; I2, 93.71%) and the pooled specificity was 93% (CI 95%, 87-96; I2, 64.72%)., Conclusion: The macular area was more sensitive and specific than the optic nerve head. Furthermore, OCT had higher sensitivity, and OCTA had higher specificity when compared with other imaging devices., Competing Interests: The authors declare that they have no competing interests., (© 2023 Iran University of Medical Sciences.)

Whereas most patent ductus arteriosus (PDAs) are identified and treated in the childhood, and the long term outcome studies have approved the outstanding results (positive cardiac reverse remodeling) in these group of patients, the outcome of percutaneous PDA closure in adults is not comprehensible. The aim of this retrospective cohort study which consecutively recruited 121 adult patients (age >16 years) who underwent the transcatheter closure (TCC) of PDAs between 2012 and 2018 is, evaluation at least 1-year follow-up of adult patients after PDA closure and compare the hemodynamic and the cardiac reverse remodeling findings with the previous studies in adults and children., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background and Purpose: Prolonging the drug release can be a suitable approach to overcome the challenges related to topical ophthalmic administration of drugs especially the ones prescribed for chronic ailments. The sustained delivery of the drug would reduce the required frequency of administration which could extremely improve patient compliance and feeling of well-being. This study aimed to develop nanofibrous inserts for sustained ophthalmic delivery of timolol maleate (TIM) for the treatment of glaucoma., Experimental Approach: Polycaprolactone-based nanofibers containing TIM were prepared using pure polycaprolactone or a blend of it with cellulose acetate or Eudragit RL100 polymers by the electrospinning method. Following the preparation, polymeric inserts were evaluated for morphological and physicochemical properties. The in vitro drug release was assessed and the in vivo efficacy of a selected insert in decreasing the intraocular pressure (IOP) was also evaluated in the equine eyes., Findings / Results: Prepared nanofibers indicated diameter ranged between 122-174 nm. The formulations showed suitable physicochemical properties and stability for ophthalmic administration. In vitro release study showed prolonged release of drug during more than 3 days. In vivo evaluation revealed that the prepared insert is non-irritant and non-toxic to the equine eyes while having suitable efficacy in decreasing the IOP during 6 days., Conclusions and Implication: Prepared TIM inserts indicated a higher efficacy than commercial TIM eye drop in lowering IOP during a prolonged period. Thus, these formulations can be considered suitable for enhancing patient compliance by reducing the frequency of administration in the treatment of glaucoma., Competing Interests: The authors declared no conflict of interest in this study., (Copyright: © 2022 Research in Pharmaceutical Sciences.)

Color blindness (color vision deficiency) is a disorder that impairs the true perception of colors. Using the information in this study, appropriate policy can be made to identify high-risk groups, as well as educational policies for families to perform more effective genetic diagnosis methods. This study aims to examine the prevalence of color blindness in Iranian students through a meta-analysis. Articles related to color blindness published between January 1990 and December 2020 were searched in Scopus, Cochrane Library, Web of Science (WoS), Science Direct, Embase, SID, MagIran, IranDoc, Medline, and Google Scholar databases. The keywords used were based on medical subject topics (MeSH Terms) and, after careful review, articles were selected according to varied sections of Participants, Exposure, Comparison, and Outcomes (PECO). Participants: students; Exposure: students with color blindness were examined; Comparison: Students from multiple provinces and regions of Iran were surveyed for color blindness; Outcomes: the pooled prevalence of color blindness in Iranian students reported from different provinces. The prevalence of color blindness in Iranian students was 3.8% (95% CI: 2.7-5.4%). The pooled prevalence of color blindness in Iranian male and female students was 4.7% (95% CI: 3.5-6.4%) and 0.7% (95% CI: 0.3-1.3%), respectively. The pooled prevalence of red-green color blindness (Tritan) was 41.7% (95% CI: 18.9-68.8%). The pooled prevalence of red color blindness (Protan) was 13.9% (95% CI: 7.8-23.8%), and the pooled prevalence of green color blindness (Deutan) based on meta-analysis was 45.3% (95% CI: 29-62.7%). Due to the high prevalence of color blindness in students, especially male students, it is necessary to be screened for through genetic tests in couples before having children., Competing Interests: The authors declare that they have no conflict of interest., (Copyright © 2022 Rezaei et al.)

Purpose: To investigate the pattern of ocular involvement in Behcet's disease (BD) with predictors of patients' final state of vision., Methods: This historical cohort encompassed the clinical records of 200 patients diagnosed according to the International Criteria for BD (ICBD), over a period of 17 years between 2004 and 2021., Results: The prevalence of Behcet's uveitis (BU) was more common in females and patients in the fourth decade of life. Ninety-five patients (47.5%) had evidence of ocular involvement in the initial ophthalmologic evaluation, and 171 patients (85.5%) manifested evidence of BU during the follow-up visits of which bilateral non-granulomatous panuveitis was the most common anatomical pattern of involvement (32.9%) followed by posterior (27.6%), anterior (26.5%), and intermediate (13.8%) uveitis. The prevalent accompanying signs were oral aphthous (67%), skin lesions (29%), and genital ulcers (19.5%). Cystoid macular edema (CME) was the most frequent ocular complication (62%), followed by cataract (57.5%) and epiretinal membranes (ERM) (36.5%). Univariate analysis showed the following determinants: male gender, younger age at onset, panuveitis, posterior uveitis, retinal vasculitis, and longer duration of uveitis as poorer visual prognostic factors of the disease. Multivariate analysis demonstrated a higher chance of poor visual prognosis of BD in patients with panuveitis, posterior uveitis, retinal vasculitis, and longer duration of uveitis., Conclusion: This cohort study demonstrated an overview on epidemiological patterns of BU along with the visual prognostic factors in Iranian patients., Competing Interests: There are no conflicts of interest., (Copyright © 2022 Ghavidel et al.)

Purpose: To evaluate the efficacy and safety of intravitreal injection (IVI) of bevacizumab (IVB) versus aflibercept (IVA) in premature infants with type 1 prethreshold retinopathy of prematurity (ROP) in the posterior Zone II., Methods: The study was a multicenter, historical cohort of premature newborns diagnosed with type 1 prethreshold ROP in the posterior Zone II, treated with IVB or IVA. Demographic features, complications, and treatment outcomes were then compared between the two groups., Results: Seventy-six patients received aflibercept (the IVA group), and 210 received bevacizumab (the IVB group). The two groups were not significantly different in terms of postmenstrual age (PMA) at the time of ROP diagnosis and other known risk factors for ROP development and progression. All eyes in both the groups responded to IVI; however, recurrence was observed in four eyes (1.9%) in the IVB group and 12 (15.8%) in the IVA group ( P = 0.001). Recurrence occurred 9.1 ± 0.83 (5-12) and 15.5 ± 0.98 (12-18) weeks after primary treatment in the IVB and IVA groups, respectively ( P = 0.000). In the IVA group, retinal vascularization was completed in 38.18 ± 6.5 weeks (21-48) after IVI, and it happened in 23.86 ± 9.3 weeks (13-60) in the IVB group ( P = 0.009). Furthermore, vascularization reached the peripheral retina in 73.25 ± 6.5 (56-84) and 58.75 ± 8.8 (45-93) weeks, PMA in the IVA and IVB groups, respectively ( P = 0.03). No acute postoperative complications were observed in the treated eyes in either group., Conclusion: This study shows that both IVA and IVB are effective and well tolerated for the management of type 1 prethreshold ROP in the posterior Zone II; however, IVA needs a significantly longer time for vascularization completion and has a higher recurrence rate compared with IVB., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Current Ophthalmology.)

Polyethylene oxide (PEO) is a widely used polymer in the development of abuse-deterrent oral formulations. Different manufacturing processes including direct compression (DC) followed by sintering, wet granulation (WG) followed by compression and sintering, and hot melt extrusion (HME) can be used to manufacture abuse-deterrent oral drug products. Three different manufacturing processes (DC, WG, HME) were evaluated to test the retention of their abuse-deterrent features following attempts to grind the tablets or extrudates. In vitro drug release studies were conducted on 10% and 32% drug-loaded tablets/extrudates prepared using these manufacturing methods, and the release profiles from all formulations showed good extended-release properties. Drug content analysis on the granules obtained from tablets prepared by direct compression showed non-uniform drug distribution where an unexpectedly high drug content was present in the smallest size (< 250 µm) granules, sizes which are likely to be inhaled by abusers. Granules from tablets prepared by wet granulation showed improved drug distribution across all granule sizes formed after grinding. Drug content testing on the granules obtained from extrudates prepared using hot melt extrusion showed excellent drug content uniformity along with sufficient strength to resist grinding into smaller particles. The retention of the abuse-deterrent properties of a dosage form following attempts to extract or abuse the drug is an important product characteristic, and the product design, formulation components, and manufacturing processes can all play critical roles in the retention of the desired abuse-deterrent properties., (© 2021. The Author(s), under exclusive licence to American Association of Pharmaceutical Scientists.)

Background: COVID-19 patients, especially the patients requiring hospitalisation, have a high risk of several complications such as opportunistic bacterial and fungal infections. Mucormycosis is a rare and opportunistic fungal infection that mainly affects diabetic and immunocompromised patients. An increase has been observed in the number of rhino-orbital mucormycosis in patients with COVID-19 admitted to Imam Khomeini Hospital, Kermanshah, Iran, since October 2020. This is a report of the frequency, risk factors, clinical manifestations, treatment and prognosis of COVID-19 associated with mucormycosis infection., Methods: The medical records of COVID-19 patients with rhino-orbital mucormycosis who were diagnosed in an educational therapeutic hospital in Kermanshah, west of Iran were surveyed. Several parameters were analysed including demographic, clinical, therapeutic and laboratory characteristics., Results: Twelve patients with COVID-19-associated rhino-orbital mucormycosis were identified from 12 October to 18 November 2020. All cases reported as proven mucormycosis had a history of hospitalisation due to COVID-19. Comorbidities mainly included diabetes mellitus (83.33%) and hypertension (58.33%). Seventy-five per cent of patients received corticosteroids for COVID- 19 treatment. The sites of involvement were rhino-sino-orbital (83%) and rhino-sino (17%). Amphotericin B/liposomal amphotericin B alone or in combination with surgical debridement or orbital exenteration was used as the first-line therapy. The overall mortality rate was 66.7% (8/12)., Conclusions: We found a high incidence of mucormycosis among COVID-19 patients. Diabetes mellitus and corticosteroid use were the dominant predisposing factor of mucormycosis. Mucormycosis is a life-threatening and opportunistic infection; therefore, physicians should know the signs and symptoms of the disease so that a timely diagnosis and therapy can be performed., (© 2021 Wiley-VCH GmbH.)

Background: Pseudoexfoliation (PXF) syndrome is the most common cause of secondary glaucoma worldwide. This systemic disorder causes further damage to the optic nerve and ultimately increases the need for surgical interventions. Therefore, intraocular pressure (IOP) control is very important in these patients. The aim of this study was to compare IOP changes after phacoemulsification in subjects with PXF syndrome compared to those without this syndrome., Methods: 61 patients were enrolled in this prospective clinical study. Subjects were assigned into two groups based on presence or absence of PXF syndrome. IOP and anterior chamber angle parameters including: angle opening distance (AOD) and trabecular-iris surface area (TISA) measured one day preoperatively and 3 months postoperatively. Intraoperative metrics factors including: infusion fluid usage (IFU), cumulative dissipated energy (CDE) and aspiration time (AT) were obtained from the phacoemulsification machine at the end of each surgery. IOP changes, anterior chamber angle parameters and intraoperative metrics factors were compared between groups., Results: Mean IOP before surgery was significantly higher in the PXF group (14.70 mm Hg) compared to controls (12.87 mm Hg) (P-value < 0.01). Phacoemulsification decreased IOP in both, but to greater extent in the PXF group (p-value < 0.01). AOD and TISA also increased significantly following surgery in both groups. The results showed that postoperative IOP was negatively correlated with preoperative IOP in both groups (p-value < 0.01). Also, IOP after phacoemulsification was negatively correlated with IFU in the PXF group (p-value = 0.03)., Conclusions: Patients with PXF syndrome exhibited a reduction in IOP and increase in anterior chamber angle parameters after phacoemulsification. We observed a greater IOP reduction in PXF subjects when it was compared to controls. Higher preoperative IOP and intraoperative IFU were associated with more IOP reduction in the PXF group.

Background: Patients with chronic renal failure are commonly cared using a blood filtration mechanism like hemodialysis. Little information is available regarding ocular changes following hemodialysis for people with chronic renal failure. Accordingly, this study intended to estimate the pre- and post-hemodialysis thickness of retina and choroid and other ocular findings in patients with chronic renal failure., Methods: This research is a "before and after" clinical experiment, without control. This prospective study was conducted on patients with chronic renal failure who were in Imam Khomeini Hospital for hemodialysis in 2017. The sample size of this study was estimated to be 67 (134 eyes). In this study, after acquiring consent (by the associated assistant) from all patients, thorough ocular examinations including IOP control, VA and fundus examination, reflection, and macula and choroid OCT were performed 30 min before and after hemodialysis and entered in SPSS V. 16 software by the project manager. Finally, these data were analyzed practicing T-pair tests or their nonparametric equivalent, the Wilcoxon test., Results: Based on the results of this examination, studying 67 participating patients, 134 eyes were examined, of which 80 eyes (59.8%) belonged to men, and 54 eyes (40.2%) belonged to women. The mean and standard deviation of participants' age in the study was reported to be 57.3 ± 15 years, and the dialysis duration was 3.0 ± 2.11 h. According to the Wilcoxon test, the average rank in terms of weight, patient temperature, pulse, blood sugar, urea, potassium, ocular pressure, 500-micron nasal choroidal thickness, and myopia in diopter vary significantly before and after dialysis (p < 0.05). However, according to the Wilcoxon test, choroidal thickness in the subfoveal area of the eye (p = 0.600), the retinal thickness in the subfoveal area (p = 0.839), the amount of astigmatism in diopter (p = 0.757) and the amount of hypermetropia in diopter (p = 0.068) before and after dialysis do not have a significant difference. Based on the t test, it was reported that the average creatinine score, the best corrected vision, and the 500 and 1000-micron temporal and nasal choroidal thickness had a significant difference (p < 0.05)., Conclusion: Based on the results of the current study, it was settled that the corrected vision, ocular pressure, as well as the 500-micron nasal choroidal thickness, and myopia in diopter and the 1000-micron temporal and nasal choroidal thickness of patients before and after hemodialysis vary. This difference shows the impact of hemodialysis on changes in ocular characteristics in patients with renal insufficiency.

Abuse-deterrent formulations (ADFs) using physical/chemical barrier approaches limit abuse by providing resistance to dosage form manipulation to limit drug extraction or altered release. Standardizing in vitro testing methods to assess the resistance to manipulation presents a number of challenges, including the variation in particle sizes resulting from the use of various tools to alter the tablet matrix (e.g., grinding, chipping, crushing). A prototype, direct-compression ADF using a sintered polyethylene oxide (PEO) matrix containing dextromethorphan, an enantiomeric form of the opioid, levorphanol, was developed to evaluate testing methodologies for retention of abuse-deterrent properties following dosage form tampering. Sintered PEO tablets were manipulated by grinding, and drug content and release were evaluated for the recovered granules. Drug content analysis revealed that higher amounts of drug were contained in the smaller size granules (< 250 μm, 190% of the theoretical amount) compared with the larger particles (> 250 μm, 55-75% of theoretical amount). Release testing was performed on various size granule fractions (> 850 μm, 500-850 μm, 250-500 μm, and < 250 μm) using USP type I (basket), type II (paddle), and type IV (flow-through) apparatus. The USP type I and type II apparatus gave highly variable release results with poor discrimination among the release rates from different size granules. The observed sticking of the hydrated granules to the baskets and paddles, agglomeration of hydrated granules within the baskets/vessels, and ongoing PEO hydration with subsequent gel formation further altered the particle size and impacted the rate of drug release. The use of a flow-through apparatus (USP type IV) resulted in improved discrimination of drug release from different size granules with less variability due to better dispersion of granules (minimal sticking and aggregation). Drug release profiles from the USP type IV apparatus showed that the larger size granules (> 500 μm) offered continued resistance to drug release following tablet manipulation, but the smaller size granules (< 500 μm) provided rapid drug release that was unhindered by the hydrated granule matrix. Since < 500-μm size particles are preferred for nasal abuse, improved direct-compression ADF formulations should minimize the formation of these smaller-sized particles following tampering to maintain the product's abuse-deterrent features.

Background: One of the major challenges in gene therapy is producing gene carriers that possess high transfection efficiency and low cytotoxicity (1). To achieve this purpose, crystal nanocellulose (CNC) -based nanoparticles grafted with polyethylenimine (PEI) have been developed as an alternative to traditional viral vectors to eliminate potential toxicity and immunogenicity., Methods: In this study, CNC-PEI10kDa (CNCP) nanoparticles were synthetized and their transfection efficiency was evaluated and compared with linear cationic PEI10kDa (PEI) polymer in HEK293T (HEK) cells. Synthetized nanoparticles were characterized with AFM, FTIR, DLS, and gel retardation assays. In-vitro gene delivery efficiency by nano-complexes and their effects on cell viability were determined with fluorescent microscopy and flow cytometry., Results: Prepared CNC was oxidized with sodium periodate and its surface cationized with linear PEI. The new CNCP nano-complex showed different transfection efficiencies at different nanoparticle/plasmid ratios, which were greater than those of PEI polymer. CNPC and Lipofectamine were similar in their transfection efficiencies and effect on cell viability after transfection., Conclusion: CNCP nanoparticles are appropriate candidates for gene delivery. This result highlights CNC as an attractive biomaterial and demonstrates how its different cationized forms may be applied in designing gene delivery systems.

Escherichia coli is one of the most suitable hosts for production of antibodies and antibody fragments. Antibody fragment secretion to the culture medium improves product purity in cell culture and diminishes downstream costs. In this study, E. coli strain BL21 (DE3) harboring gene encoding bispecific anti-MUC1 nanobody was selected, and the autoinduction methodology for expression of bispecific anti-MUC1 nanobody was investigated. Due to the replacement of IPTG by lactose as inducer, less impurity and toxicity in the final product were observed. To increase both intracellular and extracellular nanobody production, initially, the experiments were performed for the key factors including temperature and duration of protein expression. The highest amount of nanobody was produced after 21 h at 33°C. The effect of different carbon sources, glycerol, glucose, lactose, and glycine as a medium additive at optimum temperature and time were also assessed by using response surface methodology. The optimized concentrations of carbon sources were obtained as 0.75% (w/v), 0.03% (w/v), 0.1% (w/v), and 0.75% (w/v) for glycerol, glucose, lactose, and glycine, respectively. Finally, the production of nanobody in 2 L fermenter under the optimized autoinduction conditions was evaluated. The results show that the total titer of 87.66 µg/mL anti-MUC1 nanobody, which is approximately seven times more than the total titer of nanobody produced in LB culture medium, is 12.23 µg/L ., Competing Interests: All authors declare that they have no conflict of interest., (© 2020 The Authors. Engineering in Life Sciences published by WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim.)

This study was designed to compare the Intelligence Quotient (IQ) among 3 to 7-year-old strabismic and nonstrabismic children in an Iranian population. In this cross-sectional study, 108 preschool children with equal numbers of strabismic/non-strabismic disorder (age 3-7 years) were randomly selected from exceptional strabismus clinics of Ahvaz and were evaluated with the preschool and primary scale of intelligence versions of Wechsler (WPPSI). In the current study, 108 children were evaluated. In strabismic patients the mean performance, verbal and total IQ were 89.46±19.79, 89.57±21.57 and 91.54±22.08 respectively.These mean scores in normal children  were 91.89±47.53 , 87.56±15.6 and 89.96±17.62 consecuently. The results showed that these three different IQ subscales were not significantly different among 3 to 7 years old strabismic and nonstrabismic children ((P&gt;0.05 for all comparisons). There was no significant difference in IQ between two sexes (P&gt;0.05) while Persian tribe children had greater IQ score compared to other tribes (P<0.05). Also, higher paternal educational status of children related to higher IQ score. IQ score was better in combined deviations and was higher in exotropes than esotropes; however, these differences were not statistically significant.(p&gt;0.05) In this evaluation, we did not found a significant negative interference of strabismus on IQ score of preschool children. It can be concluded that paternal educational level and tribe have a significant effect on intelligent quotient, while this is not the case on sex and ocular deviation.

This study evaluated the safety and effects of propranolol as a premedication before cataract surgery and compared them with the usual combination doses of fentanyl and ketamine. Among all reffered patients to Feiz Hospital of Esfahan for cataract surgery, 122 patients between Mar to Sep 2010 were enrolled in this study and randomly allocated into one of the following equal groups: 40 mg propranolol, 2 hours before surgery and combination of 15 mg ketamine and 50 µg fentanyl l. 5 min before surgery. The ability to control of hemodynamic instabilities caused by stress and to gain patients satisfaction was compared between two groups. Also, the efficacy of each premedication to control of hemodynamic changes during surgery were evaluated and compared. No significant differences were seen in the patients satisfaction and controlling of stress induced hemodynamic changes between two groups (P>0.05). However, patients in ketamine + fentanyl group showed more nausea and less pain during and after surgery. Moreover, no significant adverse effects were reported during and after the surgery. Our results demonstrated that propranolol can be used safely as a premedication in cataract surgery in the comparable efficacy to ketamine plus fentanyl premedication.

Corrosion and scaling is a major problem in water distribution systems, thus evaluation of water corrosivity properties is a routine test in water networks. To evaluate water stability in the Bandar Abbas water distribution system, the network was divided into 15 clusters and 45 samples were taken. Langelier, Ryznar, Puckorius, Larson-Skold (LS) and Aggressive indices were determined and compared to the marble test. The mean parameters included were pH (7.8 ± 0.1), electrical conductivity (1,083.9 ± 108.7 μS/cm), total dissolved solids (595.7 ± 54.7 mg/L), Cl (203.5 ± 18.7 mg/L), SO₄(174.7 ± 16.0 mg/L), alkalinity (134.5 ± 9.7 mg/L), total hardness (156.5 ± 9.3 mg/L), HCO₃(137.4 ± 13.0 mg/L) and calcium hardness (71.8 ± 4.3 mg/L). According to the Ryznar, Puckorius and Aggressive Indices, all samples were stable; based on the Langelier Index, 73% of samples were slightly corrosive and the rest were scale forming; according to the LS index, all samples were corrosive. Marble test results showed tested water of all 15 clusters tended to scale formation. Water in Bandar Abbas is slightly scale forming. The most appropriate indices for the network conditions are the Aggressive, Puckorius and Ryznar indices that were consistent with the marble test.

Post traumatic endophthalmitis is an uncommon but severe complication of ocular trauma. We aimed to identify the incidence of post traumatic endophthalmitis and its contributing risk factors in Feiz hospital (Isfahan, Iran) from 2006 until 2010. Medical records of 1042 patients with open globe injury were analyzed and data were collected including age, sex, location of being injured, visual acuity (VA), time from injury to hospitalization and to repair, site of ophthalmic injury and the presence of foreign body. The frequency of post-traumatic endophthalmitis was about 2.1% (N = 22) of all patients. Nine of 22 cases with endophthalmitis were under 8 years. The visual acuity at the time of admission was seen to be contributed to high rate of endophthalmitis. Intraocular foreign body was detected in 139 patients; and the rate of endophthalmitis was 5% among these patients. Statistical analysis showed significant relationship between presence of foreign body and higher rate of endophthalmitis. Also, duration of hospitalization was significantly different between two study groups (P = 0.019). There were no significant differences between two groups in terms of other studied variables. Patients with low age, low visual acuity at admission, presence of intraocular foreign body and long duration of hospital stay had a higher risk of endophthalmitis after the repair of the globe. Compared to the reports of other large institutions, we can attribute the low incidence rate of endophthalmitis in our institution to the early use of systemic antibiotics such as gentamycin and cephalosporins in the first hour of hospitalization until discharge.

A lesser known complication of long-term corticosteroid therapy is chronic central serous chorioretinopathy (CSCR). Although idiopathic CSCR is known to be mild with spontaneous improvement and minimal effects on the vision, chronic CSCR is different and may cause irreversible visual loss. We report four patients with CSCR on corticosteroid therapy after kidney transplant. The interesting point about these patients is that they were of a younger age group compared with classic CSCR cases, and there were two females among the patients. Organ transplantation and corticosteroid therapy are the risk factors for CSCR. We should discontinue or at least reduce corticosteroid dosage. Knowledge about this rare complication after kidney transplantation (even in unusual age and sex) is important.

Background: Compensatory ocular counter-torsion (COCT) is supposed to maintain the eyes aligned with the visual environment following head tilt. Because of some recent controversies the functional capacity of this phenomenon was defined according to the extent of induced astigmatic axis error following head tilt., Materials and Methods: Objective autorefractometry was performed on 70 eyes with a regular astigmatism of ≥2D at vertical, right head tilt and left head tilt positions of 5°, 10°, 15°, 20° and 25°. Astigmatic axis error was calculated according to the difference between the defined axis at each tilted head position and the defined axis at the vertical head position. A tiltometer was used for this purpose to show the angle of head tilt without disturbing the process of refractometry., Results: The mean astigmatic axis error was 3.2° ± 1.5° and 18.4° ± 4.2° at the head tilt angles of 5° and 25° respectively. The mean percentage of tilt angle compensation by COCT was 36% and 26% at the head tilt angles of 5° and 25° respectively. There was a direct relation between the head tilt angle and the induced astigmatic axis error (ANOVA, P < 0.001, 95% of confidence interval [CI]). Astigmatic axis error values at right head tilt were significantly lower than their corresponding values at left head tilt (ANOVA, P = 0.04 95% CI)., Conclusion: Any minimal angle of head tilt may cause erroneous measurement of astigmatic axis and should be avoided during refraction. One cannot rely on the compensatory function of ocular counter-torsion during the refraction.

Purpose: To report normal interpupillary distance (IPD) values in different age groups of an Iranian population., Methods: This study was performed on 1,500 randomly selected subjects from 3,260 consecutive out-patients with refractive errors referred to Farabi Eye Hospital, Isfahan, Iran over a period of two years (2008 to 2010). Measurement of refractive errors and IPD for far distance were performed using an autorefractometer (RMA-3000 autorefractometer, Topcon, Tokyo, Japan)., Results: Mean IPD in adult subjects was 61.1±3.5 mm in women and 63.6±3.9 mm in men (p<0.001). Mean IPD increased 4.8 mm during the second decade, 1.7 mm during the third decade, and 0.6 mm during the fourth and fifth decades of life., Conclusion: The observed increase in IPD after the age of 30 years indicates that factors other than skeletal growth may affect this parameter.

Purpose: To evaluate the long-term outcomes of two-step versus single application of mitomycin-C (MMC) during photorefractive keratectomy (PRK) for high myopia., Methods: This randomized clinical trial included consecutive patients with high myopia (exceeding 7 D). Patients underwent PRK and were randomized to two methods of MMC 0.02% application as follows: in the single application group, MMC was applied for 45 seconds followed by irrigation; in the two-step group MMC was used identically followed by repeat application for another 15 seconds and corneal surface irrigation. Visual acuity, refractive error, pachymetry, topography, corneal haze and complications were compared between the two groups 18 months after surgery., Results: One hundred and forty patients (70 subjects in either study arm) underwent PRK according to the study protocol. Mean spherical equivalent refractive error was significantly reduced from baseline to -1.16±0.39 D in the single application group and to -1.07±0.39 D in the two-step group. Sixteen (11.5%) versus 8 (5.7%) eyes lost one or more line(s) of best corrected visual acuity in the single application group as compared to the two-step group (P=0.05). Corneal haze was observed in 18 (12.9%) and 8 (5.7%) eyes in the single application versus two-step group, respectively (P=0.04). Grade 3 corneal haze was not observed in the two-step group but occurred in five eyes (3.6%) in the single application group (P=0.03). No eyes developed corneal ectasia during the follow-up period., Conclusion: Two-step intraoperative application of MMC 0.02% in highly myopic eyes undergoing PRK can reduce the frequency and severity of haze formation.

Transplantation of retinal cells has recently provided a promising therapeutic approach for retinal degeneration. Here, we differentiated initially retinal progenitors (RPs) from adherent feeder-free human embryonic stem cells (hESCs) with the use of defined media supplemented with a specific combination of growth factors. The differentiated RPs highly (>80%) expressed related molecular features that included Six3 at an early stage in addition to Crx, Rx, Pax6, Otx2, and Chx10 at later stage. Next, we examined the induction of photoreceptors by Shh and/or the coculture of rabbit retinal pigmented epithelium with hESCs-derived RPs. The differentiation of retinal cells was demonstrated by protein and gene expression in all groups. However, S-Opsin, a cone photoreceptor marker, had higher expression in the presence of Shh, whereas expressions of Gli and Hes1 decreased in the same group. Finally, hESC-derived RPs were treated with Shh transplanted into the subretinal space of sodium iodate-injected albino-type adult rabbits and analyzed 4 weeks later. Transplanted retinal cells survived, migrated into retinal layers, and restored a small but significant B-wave. The grafted cells expressed photoreceptor markers, S-Opsin and Rhodopsin. Our results indicate that putative hESC-derived retinal cells express related genes and proteins. Further, our results show that retinal-like cells can be useful replacements for photoreceptors in retinal diseases.

Purpose: To compare keratometric measurements using a Javal type manual keratometer with IOLMaster in eyes undergoing photorefractive keratectomy (PRK) for myopia., Methods: In this comparative case series, we studied patients aged 21 to 27 years scheduled for myopic PRK. Keratometry was performed preoperatively and three months after the procedure using a Javal type manual keratometer and the IOLMaster. We compared postoperative measurements obtained by both instruments with the clinical history method (CHM)., Results: Seventy eyes of 35 patients with mean age of 23.45±1.55 years were studied. Mean preoperative spherical equivalent was -4.53±1.3 D. Average preoperative IOLMaster and manual keratometric readings were 45.95±1.23 D and 46.32±1.18 D, respectively. Postoperatively, mean IOLMaster measurements was 38.03±0.68 D and that of manual keratometry was 43.15±1.1 D. Compared to CHM measurements, the 95% limits of agreement were -5.95 to -0.85 for the IOLMaster and -1.44 to 4.04 for manual keratometry., Conclusion: Keratometric measurements with the IOLMaster and a Javal type manual device are comparable after PRK; both are largely deviant from the CHM and can yield misleading results.