Amir-Al-Momenin Hospital

To compare the recurrence rate and surgical outcomes of amniotic membrane transplantation (AMT) and free conjunctival autograft (CAT) for pterygium surgery. In this prospective study, 60 patients with primary pterygium were randomly assigned to two groups of CAT or AMT and were compared in terms of recurrence rate, mean healing time of corneal epithelial defects, the mean level of inflammation, and complications. The mean ± SD age of patients was 48.98 ± 9.8 years (range, 27–71 years). 73.3% were men, and 26.7% were women. The groups did not differ with respect to demographic characteristics (P > 0.05). Patients were followed for an average of 12.6 ± 1.3 months. The recurrence rates were 6.7% and 3.3% in the AMT and CAT groups, respectively (P > 0.05). Comparison of mean inflammation score showed higher inflammation in the AMT group in the first, third, and sixth postoperative month (P < 0.05). Mean healing times of corneal epithelial defects were 2.5 ± 0.572 and 2.67 ± 0.479 days in the CAT and AMT groups, respectively (P = 0.173). No significant complication was observed during or after both surgical methods. No statistically significant difference was seen in visual acuity changes and epithelial healing in CAT and AMT groups, but more inflammation and recurrence rate were seen in AMT group.

Low quality of life (QOL) is a feature that has been overlooked in thalassemia major (TM) patients. Our aim was to assess QOL in school-aged TM patients in Zabol city and surrounding rural areas in southeast of Iran. The study was performed in 2014. QOL was evaluated using Pediatric Quality of Life Inventory 4 (PedsQL4) questionnaire addressing physical, emotional, social, and educational, along with psychological health in 80 TM patients. Also, 80 age-matched and sex-matched subjects without any chronic illness served as control group. Mean age of the patients was 11.7±4.1 years old. Total QOL scores was 51.4±13.3 in the patients. In comparison, mean value of total QOL score in controls was 91.1±3.3 (P<0.0001). Poor and moderate QOL were observed in 44.7% and 48.7% of the patients, respectively. Mean functioning scores for physical, emotional, social, educational, and psychological dimensions in the patients were 56.2±119, 69.6.4±23.3, 27.1±22.1, 52.3±18.1, and 48.9±11.8, respectively. The lowest level of QOL was related to the social field (81.3% with less than average score), while the highest QOL was related to the emotional aspect (58.8% with good QOL; >75 scores). Overall, female sex, poor compliance with chelation therapy, and residency in urban areas were significantly associated with poor QOL. In conclusion, providing a psychiatric health package seems to be essential for improving QOL in TM patients, especially in social field.

Hydatidosis is a common infestation caused by Echinococcus spp. Solitary hydatid cyst of the lung is not uncommon but coexistence of two or more pulmonary cysts are less common. These cysts may drain into the bronchial tree or very rarely into the pleural cavity which causes a poor outcome. Certain people such as slaughters, tanners, stockbreeders, shepherds, butchers, veterinarians and all whose job makes them to work closely with animals are at higher risk of the infection and developing echinococcosis. Herein, we present a 14-year-old shepherd who developed severe chest pain and hydropneumothorax following a minor trauma to his chest. He had two pulmonary hydatid cysts, one of which drained to the left pleural cavity and caused the symptoms. Another cyst was complicated during his hospital course. The patient was treated surgically, received albendazole and discharged home uneventfully. A high index of suspicion is of utmost importance for the correct diagnosis and treatment of hydatid disease in hyperendemic areas and in those whose occupation might put them at a higher risk of contraction of hydatid disease.

Background: Neck pain constitutes a common disorder in modern societies. Numerous complications and episodes of recurrence have been observed with neck pain while few statistically evidence-based exercise protocols have been designed. The objective of this study was to detect and compare the applicability of two proprioceptive and endurance measurement protocols to treat patients with chronic non-specific neck pain. Methods: This was a single blinded, randomized clinical trial conducted at Mostapha Khomeini Hospital, Behbahan, Iran. Forty seven patients (16 males and 31 females) with chronic non-specific neck pain participated in this study. Subjects were randomized into two groups: endurance training and proprioceptive training. Each training was performed for ten subsequent days. A pressure biofeedback was used to measure the endurance of neck muscles and a laser resource device to measure the cervicocranial joint position error prior to therapy, on fifth, tenth sessions after the 1 st day of treatment and 45 days after the last treatment day. Results: Significant differences were found between before and after therapy in terms of endurance index, joint position error, and pain measurments (p<0.05, p<0.01 and p<0.05) in both groups. After therapy, endurance index was significantly more pronounced in the endurance group, whereas the improvement in joint position error index was more pronounced in the proprioceptive group. Conclusion: The use of endurance and proprioceptive based measurement programs as was used in this study can be recommended to improve endurance, reduce proprioceptive error and pain in patients with chronic non-specific neck pain. Endurance exercise was a more efficient method for improving endurance and proprioceptive training was better in resolving joint position error and pain. Both protocols appeared to be applicable to treat patients with chronic non-specific neck pain.

Common variable immune deficiency (CVID) is among the most primary immune deficiency disorders with unknown etiology which mostly presents in adulthood; however, some patients might show their symptoms during childhood. CVID usually increases predisposition to malignancies. Lymphoproliferative malignancies such as lymphoma are the most incident malignancies among the patients; however, the prevalence of Hodgkin lymphoma (HL) is low among the patients and just a few cases of the disorder reported in children. A 13 year old girl admitted to our ward with bilateral cervical lymphadenopathy has emerged since 13 months ago without any associated symptoms. She was a known case of CVID diagnosed at 1 year of age and was under regularly treatment of monthly IVIG and prophylactic antibiotic since then. The diagnostic approach to her lymphadenopathy led to HL diagnosis and she has undergone the standard chemotherapy protocol for HL which took about 6 months without any radiotherapy and showed complete remission. After 6 years of standard follow ups, she is still in complete recovery. To our knowledge, this report seems to be the tenth case of HL emergence in patients diagnosed with CVID during their childhood and the second case of HL emergence despite regularly receiving of monthly IVIG. Low stage of her HL (2A) and favorable response to the chemotherapy with prolong remission might be explained by the regularly prescription of IVIG since early stages of life; albeit these conclusions need to be approved with further studies in the future cases.