Mahdi Abounoori

Introduction Since December 2019, a serious health crisis caused by severe acute respiratory syndrome-Coronavirus-2 affected all aspects of human lives. The available data about COVID-19-associated Rhino-Orbital-Cerebral Mucormycosis (CA-ROCM) survival issues are based on studies on small populations with limited follow-up durations. Therefore, this multicenter cohort of a large population with CA-ROCM is aiming to report the one-year survival rate and investigate the potential responsible risk factors affecting the mortality. Materials and Methods This prospective, longitudinal, multicenter study included CA-ROCM patients from eight tertiary ophthalmology centers across Iran. Demographic, clinical, and therapeutic data were collected and patients were followed for a year. Survival analysis was performed using Cox proportional hazards models to identify mortality-associated risk factors. The research protocol is also available on ClinicalTrials.gov (NCT05097664). Results Among the 246 patients, 183 (74.4%) survived within a year and 63 (25.6%) died. Significant mortality risk factors included need for orbital exenteration (HR = 3.01 vs. other treatments, p = 0.019), advanced disease stage (HR = 2.43 stage IV vs. II, p = 0.02), age (HR = 1.05, p < 0.001), and diabetes duration (HR = 1.05, p = 0.002). Paradoxically, steroid administration for COVID management was associated with improved survival (HR = 2.72 for no steroids, p = 0.018). Discussion COVID-19-associated Rhino-Orbital-Cerebral Mucormycosis carries a substantial one-year survival rate of 74.4% in Iran. Age, diabetes, advanced disease stage, and need for orbital exenteration are the probable fatal risk factors. Interestingly, administration of steroids for COVID management was associated with a better survival.

Objective: This prospective case–control study examined the novel immunoinflammatory markers obtained from blood counts of patients with Graves’ orbitopathy (GO), Graves’ disease (GD) and healthy subjects. Methods: Demographic data, white cell count parameters, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), platelet-to-neutrophil ratio (PNR), red cell distribution width (RDW), RDW-to-platelet ratio (RDW/PLT), MPV-to-lymphocyte ratio (MPV/ALC), eosinophil-to-lymphocyte ratio (ELR) and systemic immune-inflammatory index (SII) were evaluated. The European Group on Graves Orbitopathy scale and Clinical Activity Score were used for clinical activity and severity assessment. Results: The GO group showed significantly higher mean MPV (p˂0.001) and MPV/ALC (p=0.03) than the GD group. The PLR (p=0.02), MPV/ALC (p=0.04) and SII (p=0.04) were significantly higher in the GO than healthy group. A significantly higher absolute neutrophil count (p=0.005), NLR (p=0.001), MPV (p=0.001), MPV/ALC (p=0.003), MPV/PLT (p=0.04), RDW (p˂0.001), RDW/PLT (p=0.02) and SII (p=0.01) as well as lower ALC (p=0.01) and PNR (p˂0.001) was observed in the active than inactive GO. Moderate to severe GO group had a significantly higher NLR (p=0.006), PLR (p=0.04), ELR (p=0.006), MPV (p=0.03), MPV/ALC (p=0.002), RDW (p˂0.001), RDW/PLT (p=0.02) and SII (p=0.03) as well as a lower ALC (p=0.01) and PNR (p=0.01) than mild GO. Conclusions: The MPV/ALC ratio and MPV levels may identify GD patients at risk of GO. The MPV, MPV/ALC, ALC, NLR, PLR, PNR, RDW, RDW/PLT, MPV/PLT and SII may help distinguish the GO activity and severity. However, the study’s small sample size and single-centre design may limit the generalisability of the results. Furthermore, the lack of longitudinal follow-up precludes assessing marker evolution over time.

ObjectiveTo provide a comprehensive overview of predisposing factors and clinical-microbiological profile of neonatal corneal ulcer.MethodsThe literature search was undertaken in PubMed, SCOPUS, Embase, Web of Science, and Google Scholar databases on published papers from inception to May 31, 2023. The included articles were independently assessed for methodological quality using a Joanna Briggs Institute checklist. Weighted analysis was utilized, assigning a weight of one to each case report and a weight equivalent to the sample size for the case series/original studies.ResultWe included 34 relevant case reports/series and one original study. Seventy-four neonates were enrolled with a boy-to-girl ratio of 1.3:1 and a median age of 17 days (1-27 days). Prematurity and neonatal intensive care unit (NICU) care (21.6%), congenital horizontal tarsal kink (13.5%), neonatal herpes infection (13.5%), congenital entropion (5.4%), and jaundice (5.4%) were the most common potential risk factors and coexisting conditions. Microbiology evaluation showed positive results in 53.8% (21/39 cases). Viral and bacterial infections were the most common cause, followed by fungal infections. Herpes virus (18.9%), Pseudomonas aeruginosa (18.9%%) and Staphylococcus epidermidis (6.7%) were the most prevalent causative agents. Negative microbiology was significantly more common in neonates with structural abnormalities (14.9%) compared to others (6.8%) (p = 0.01).ConclusionBased on the findings of reported studies, this systematic review has increased awareness of the risk factors and etiologies that lead to developing corneal ulcers in neonates.

Additional Comments to the Author: Howbeit, this study is striking, it needs some revisions. The revisions are as follows: In the method section, please state inclusion and exclusion criteria. The diagnosis of MC should be clearly described based o...

Objectives: This study evaluated the relationship between acquired cataract’s different types and the ABO and Rh blood classes. Methods: Overall, 520 patients, by randomized sampling method, participated in this retrospective cross-sectional study. After reviewing the patient’s medical records and laboratory results, the patient’s demographics, ABO group, Rh, and cataract type were documented. Results: A total of 520 patients were included in the research, with a mean age of 67.57 ± 11.85. Most of them were female (n = 286, 55%). Mix (n = 230, 44%) and nuclear sclerotic (NS) (n = 167, 32%) cataracts were the most common types. The posterior subcapsular cataract (PSC) prevalence in females was significantly higher than in males (16.1% vs.7.3% p = 0.002). Also, men had more NS cataracts than females (89, 38% vs. 78, 27.3%) (p = 0.009). Patients with PSC were significantly younger than others (all p-values < 0.001). Our results showed that cataract types are independent of blood group types and Rh (P > 0.05). Conclusion: Although our findings showed that cataract types are independent of blood group types and Rh, they can be compared with future studies on the association of other Blood-Group Systems in developing acquired cataracts.

Background Outdoor activities were restricted during the COVID-19 outbreak, although digital learning grew. Concerns have been raised about the impact of these environmental changes on myopia status. This research aimed to examine myopia shift during the COVID-19 pandemic and offer the community evidence-based data. Methods The literature search was undertaken in PubMed, SCOPUS, Science Direct, Web of Science and Google Scholar databases on published papers before 17 May 2022. The main outcome was mean spherical equivalent refraction (SER) before, at the onset and at the end of follow-up during the COVID-19 pandemic. Results Among 518 articles, 10 studies were included in the meta-analysis. The mean SER differences during the COVID-19 pandemic follow-up (mean follow-up time was 10 months) compared with before the pandemic was 0.15 dioptre (D) (95% CI −0.39 to 0.69, p=0.58). After age adjustment using meta-regression, the mean SER differences during the COVID-19 follow-up compared with before the pandemic was – 0.46 D (95% CI −0.59 to −0.34, pConclusion During home quarantine, the mean SRE shifting in paediatrics accelerated. This phenomenon should be given more attention by policymakers, eyecare experts, educators and parents.

Purpose: Intraorbital epidermoid and dermoid cyst (DC) has been reported in the literature rarely. The current study evaluates clinicopathologic, radiologic, and management of intraorbital DC cases over ten years.Methods: In this cross-sectional study, the medical records of patients with intraorbital DC treated at the academic referral center for ocular surgery were retrospectively reviewed. Data reviewed included the patient's de-mographic characteristics, clinical features, imaging, surgical technique, and pathology report.Results: Nine patients with a rare presentation of intraorbital DC were reviewed within the study period in five presentations (five intraosseous, one intraconal, one dumbbell-shaped with a large part in anterior orbit, one juxta levator palpebral muscle, and one recurrent case with intracranial extension). They ranged from 8 to 53 years of age, with a median of 29 years, and five (55.6%) were female. Histopathological evaluation revealed two cysts were epidermoid. Conclusion: The current study provides more clinical and radiologic manifestations of rare presentations of DC that highlight the importance of high clinical suspicion in the approach to atypical DC.

Background: To decrease diabetes prevalence, society will have to make efficient policies. Objectives: This study was done to raise public awareness by estimating the incidence of type 2 diabetes mellitus (T2DM) in Semnan province from 2015 to 2020 and predicting its incidence until 2025. Methods: A Box-Jenkins time series analysis was used in this longitudinal study. The number of referrals with diabetes was estimated month by month from 2015 to 2020. The autoregressive integrated moving average (ARIMA) model parameters were determined using the Time Autocorrelation Function and Partial Autocorrelation Function graphs after using appropriate data transformation methods to create a stationary time series. Dickey-Fuller test was used to perform an accurate examination of the static assumption. ARIMA (3,1,4) was selected as the best fit for the data after analyzing the Akaike statistics of the proposed models. Finally, until 2025, the ARIMA (3,1,4) model projected the number of diabetic patients in Semnan province. Results: The total incidence of T2DM ranged by year was 75203 in 2015 and 165143 in 2020. The time series has an increasing trend, but there is no seasonal variation or periodic pattern. The data about the T2DM incidence indicated an upward trend. Furthermore, the number of T2DM patients is expected to reach 14546.35 (95% CI: 13667.88 - 15374.72) in 2021 and will reach 16956.45 (95% CI: 13499.26 - 19819.49) by the end of 2025. Conclusions: This study reported an increasing trend in T2DM incidence, which necessitates a national commitment to proactive remedies, including public policies and economic incentives for localities to begin diabetes preventive initiatives.

Physicians are the occupation at risk for Transient Osteoporosis of the Hip. Therefore, sudden hip pain in them should be further evaluated with magnetic resonance imaging. Conservative treatment may help avoid further injury and speed up healing.