Neutrophil-to-lymphocyte ratio as a predictive biomarker for early diagnosis of depression: A narrative review.

Depression is a mood disorder that causes persistent feelings of sadness, hopelessness, loss of interest, and decreased energy. Early diagnosis of depression can improve its negative impacts and be effective in its treatment. Previous studies have indicated that inflammation plays an important role in the initiation and development of depression, hence, various inflammatory biomarkers have been investigated for early diagnosis of depression, the most popular of which are blood biomarkers. The Neutrophil to lymphocyte ratio (NLR) may be more informative in the early diagnosis of depression than other widely used markers, such as other leukocyte characteristics or interleukins. Considering the importance of early diagnosis of depression and the role of NLR in early diagnosis of depression, our paper reviews the literature on NLR as a diagnostic biomarker of depression, which may be effective in its treatment. Various studies have shown that elevated NLR is associated with depression, suggesting that NLR may be a valuable, reproducible, easily accessible, and cost-effective method for the evaluation of depression and it may be used in outpatient clinic settings. Closer follow-up can be performed for these patients who have higher NLR levels. However, it seems that further studies on larger samples, taking into account important confounding factors, and assessing them together with other inflammatory markers are necessary to draw some conclusive statements.

Pulmonary function in children post -SARS-CoV-2 infection: a systematic review and meta-analysis.

OBJECTIVE: There are some concerns regarding long-term complications of COVID-19 in children. A systematic review and meta-analysis was performed evaluating the respiratory symptoms and pulmonary function, post-SARS-CoV-2 infection. METHODS: A systematic search was performed in databases up to 30 March 2023. Studies evaluating respiratory symptoms and pulmonary function after COVID-19 infection in children were selected. The major outcomes were the frequency of respiratory symptoms and the mean of spirometry parameters. A pooled mean with 95% confidence intervals (CIs) was calculated. RESULTS: A total of 8 articles with 386 patients were included in meta-analysis. Dyspnea, cough, exercise intolerance, and fatigue were the most common symptoms. The meta-mean of forced expiratory volume (FEV1) and forced vital capacity (FVC) was 101.72%, 95% CI= (98.72, 104.73) and 101.31%, 95% CI= (95.44, 107.18) respectively. The meta-mean of FEV1/FVC and Forced expiratory flow at 25 and 75% was 96.16%, 95% CI= (90.47, 101.85) and 105.05%, 95% CI= (101.74, 108.36) respectively. The meta-mean of diffusing capacity for carbon monoxide was 105.30%, 95%CI= (88.12, 122.49). There was no significant difference in spirometry parameters before and after bronchodilator inhalation. CONCLUSIONS: Despite some clinical respiratory symptoms, meta-results showed no abnormality in pulmonary function in follow-up of children with SARS-CoV-2 infection. Disease severity and asthma background had not confounded this outcome.

Clinical characteristics and management outcomes of acute retinal necrosis.

This study investigates patient's clinical characteristics and management outcomes of PCR-positive Acute Retinal Necrosis (ARN). The patient's clinical characteristics of the disease, and therapeutic approaches were assessed. Data from the medical records of 40 eyes of 40 patients were analyzed. The mean ± standard deviation (SD) of the age of the patients was 47.8 ± 14.1 years (16-84 years old). The median follow-up time was 160 days, with a range of 120-370 days. The mean ± SD of patients' primary and final BCVA was 1.24 ± 0.78 and 1.08 ± 0.86 LogMAR, respectively. The final BCVA increased significantly after the treatment in the last follow-up period in patients who did not undergo PPV (p = 0.029). Although, vision changes were not statistically significant in patients who underwent PPV (p = 0.549). 75% of our patients had a positive aqueous PCR for VZV, and the second most common causative agents were CMV and HSV (10% for each). Besides, rhegmatogenous retinal detachment (RRD) occurred in 25% of our patients. Our analysis showed that the presenting visual acuity and RRD occurrence are the significant prognostic factors for final blindness in ARN.

Epidemiology and Clinical Course of Pediatric Uveitis in a Tertiary Referral Center in Northeastern Iran.

PURPOSE: To describe the distribution, clinical findings, treatment, complications, and visual outcomes of pediatric uveitis at a tertiary referral ophthalmic center. METHODS: The medical records of all patients ≤18 years diagnosed with and managed as uveitis from August 2016 to August 2021 were reviewed retrospectively. RESULTS: Of the 97 patients, 52.6% were female, and the mean age at the onset was 10.5 ± 4.6 years (6 months to 18 years). Uveitis cases were predominantly anterior (33 [34%]), chronic (59 [60.8%]), bilateral (63 [64.9%]), and non-infectious (80 [82.5%]). A total of 36.1% (35 patients) of cases were idiopathic, and the most frequent systemic associations were juvenile idiopathic arthritis (JIA), 16 [16.5%]) and Behcet's disease (15 [15.5%]). Most patients (74 [76.3%]) experienced ocular complications, including vasculitis (29 [29.9%]), posterior synechiae (23 [23.7%]), and cataracts (22 [22.7%]). Patients with uveitis of all anatomic locations experienced an improvement in best-corrected visual acuity during the follow-up period (p < 0.01). CONCLUSION: The most prevalent systemic associations were JIA and Behcet's disease. Ocular Behcet is a common etiology of pediatric uveitis in northeastern Iran. A timely and appropriate treatment could result in satisfactory visual outcomes.

Pulmonary Invasive Fungal Disease: Ultrasound and Computed Tomography Scan Findings.

OBJECTIVE: The importance of ultrasound in diagnosing pulmonary invasive fungal diseases (IFD) has yet to be assessed. Thus, this study aimed to evaluate the frequency of sonographic findings in patients suspected of an invasive pulmonary fungal infection. MATERIAL AND METHODS: This prospective longitudinal study examined all patients with lung lesions in imaging modalities and suspected IFDs referred to Dr. Sheikh and Akbar pediatric hospitals from 2019 to 2022. Considered variables were the halo sign in the computed tomography (CT) scan; the target sign in the ultrasound and contrast-enhanced CT scan; the cavity; wedge-shaped consoli- dation; and pleuritis and extrapulmonary invasion to the chest wall or subdiaphragmatic invasion in both modalities. All patients who underwent lung CT scans and ultrasounds until the final diagnosis were followed up. The degree of agreement between ultrasound and CT scan findings and the sensitivity, specificity, and diagnostic accuracy of these signs were assessed. RESULTS: This study involved 40 patients with an average age of 7.16 ± 4.23 years. Acute leukemia was the commonest underlying dis- ease detected in 17 (42.5%) cases. The target sign in ultrasound (61.9%) and the halo sign in CT scan (71.4%) had the highest frequency among the variables in patients with IFD. Cohen's kappa coefficient agreement in both modalities was 0.5 for the cavity, with significant relation (P = .02). The Cohen's kappa was less than .17 for other findings (P > .05). The diagnostic criteria in the simultaneous examina- tion of the fungus target in ultrasound and halo in CT scan showed a sensitivity of 82.4% and specificity of 76.5%, respectively. CONCLUSION: Combining the characteristic findings of ultrasound and CT-scan provides a higher value in diagnosing pulmonary invasive fungal disease.

Macular microvasculature in patients with thyroid-associated orbitopathy: a cross-sectional study.

PURPOSE: The aim of this study was to evaluate macular blood flow in patients with thyroid-associated orbitopathy (TAO) as compared to healthy subjects. The inflammatory nature of the disease, as well as the vascular congestion caused by the increase in the volume of orbital soft tissue and extraocular muscles, rationalize the assessment of retinal blood flow changes in these patients. METHODS: This is a cross-sectional study with the convenience sampling method. Macular flow density was assessed using optical coherence tomography angiography (OCTA) and compared between patients with TAO and healthy individuals. We also compared macular flow density in two subgroups of patients based on clinical activity score (CAS). RESULTS: Eighty-five cases, including 30 healthy individuals and 55 patients with TAO, participated. The foveal avascular zone (FAZ) area was significantly larger in the patient group than in the control. Patients with active TAO with CAS 3 or more had significantly larger FAZ areas than those with CAS less than 3 (p = 0.04). CONCLUSION: We showed that the FAZ area is larger in active TAO patients and can be considered a possible candidate feature for monitoring disease activity and thyroid-associated vasculopathy.

Serum level of vitamin A in febrile children with and without seizure: A comparative study.

Objective: The role of vitamins and antioxidants in the febrile seizure (FS) has recently become of interest. The role of Vitamin A in seizure is remained controversial. It may suppress or provoke the seizure. In present study, the serum vitamin A level in febrile patients was compared with febrile seizure children for the first time. Method: In a cross-sectional study, eighty children aged 6-60 months including 40 febrile children and 40 children with FS were included. Blood samples were obtained, and the serum level of vitamin A and other blood parameters were measured. Results: Patients were similar in demographic characteristics (p = 0.06 for age and p = 0.41 for sex). The serum vitamin A level was 0.19 (0.12, 0.25) and 0.22 (0.17, 0.29) milligram per liter (mg/L) in febrile and FS group respectively (p = 0.33). In children aged less than 24 months the serum vitamin A level in FS and febrile group was 0.22 ± 0.07 and 0.24 ± 0.12 mg/L respectively (p = 0.56). In children aged more than 24 months the serum vitamin A level in FS group was higher significantly in comparison with febrile group (0.25 ± 0.11 and 0.16 ± 0.07 mg/L respectively, p = 0.01). Conclusion: Serum vitamin A level was not different in febrile children with and without seizure. Surprisingly in children aged more than 24 months, the serum level of vitamin A was higher in FS group than in the febrile children. More studies are needed to confirm the present observation.

Evaluation of orbital soft tissue biomechanical parameters in patients with thyroid eye disease using the non-contact Corvis ST.

INTRODUCTION: In thyroid eye disease (TED), all ocular components and adnexa such as extraocular muscles, orbital adipose tissues, eyelids, and tear glands could be affected. This study aimed to study the orbital biomechanical parameters in patients with TED, in terms of differences with healthy individuals and correlation with clinical findings, using Corvis ST (CST, Oculus Wetzlar). MATERIALS AND METHODS: In this study, 26 consecutive patients with TED were recruited. Demographic data were collected, and patients with TED were assessed for exophthalmos, intraocular pressure, and clinical activity score. Biomechanical response parameters of one randomly-chosen eye of each patient, including whole eye movement length (WEMl) and time (WEMt), were evaluated by the CST, and data were compared between patients and age- and gender-matched healthy controls. RESULTS: The mean age was 39.88 ± 11.61 years old for patients with TED and 34.38 ± 8.57 years old for the healthy subjects. Nine out of 26 patients with TED and nine of 26 healthy individuals were male. The median duration of thyroid disease was 36 (IQR 54) months and the median duration of thyroid ophthalmopathy was 27 (IQR 27) months. Four out of 26 patients (7.7%) had active disease. The mean WEMl was 206.15 ± 61.58 µm in the TED group and 254.23 ± 64.01 µm in the healthy group, the difference of which was statistically significant (p = 0.008). The median of WEMt was 20.90 (1.15) msec in the TED group and 21.45 (0.93) msec in the healthy group (p < 0.001). Also, the mean of WEMl and WEMt were lower in patients with active disease compared to patients with quiescent disease. CONCLUSION: The CST-derived WEMl was significantly smaller in patients with thyroid eye disease compared to normal subjects. The WEMl and WEMt were relatively shorter in the patients with active TED compared to the patients with quiescent TED, although small numbers of patients with active TED limits took a statistically significant conclusion. WEMl and WEMt might be useful in evaluating the compliance of the orbit in patients with TED.

Effect of Tomato (Solanum lycopersicum) Extract in Patients with Primary Insomnia: A Double-blind Randomized Study.

OBJECTIVE: Insomnia is a condition that causes sleep problems, and many people suffer from it. Patients with this disorder have difficulty with beginning or continuation of sleep, so they are exhausted all day long, and their performance reduces. This study was designed to assess the efficacy of capsules that contain tomato extract in patients with primary insomnia. METHODS: In this study, 70 patients with primary insomnia were assigned to 2 groups randomly: intervention and control. The intervention group used to take tomato capsules every night for 2 weeks, and the placebo one used to take placebo capsules every night for 2 weeks. All patients used to fill out Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) questionnaires before and after the intervention. ISI and PSQI results were analyzed separately on SPSS software. RESULTS: A total of 70 patients (35 in the intervention group and 35 in the control group), including 50 females and 20 males, were studied. Female to male ratio and the rate of unemployment were significantly higher in the intervention group (in both cases P < 0.001), but there was no significant difference between the intervention and control groups in other characteristics (Age, marital status, weight, height, education; in all cases P > 0.05). At the end of the study, the amount of actual sleep had increased, and the delay in falling asleep decreased in both groups; the two groups at the end of the study were not significantly different in terms of these two variables (P > 0.05). The ISI score in both groups decreased significantly at the end of the study, and the PSQI score in both groups decreased significantly at the end of the study (In both cases, P < 0.05). The absolute value of ISI score change in the intervention group was significantly higher than the control group (P < 0.001); But the absolute value of PSQI score change was not significantly different between the two groups (P = 0.102). Most importantly, the improvement of both ISI and PSQI scores in the intervention group was significantly better than the control group (P > 0.05). CONCLUSION: This study showed that tomato capsules have sleep-inducing effects, although there was no significant difference in the amount of actual sleep, and the delay in falling sleep in the intervention group compared to the control group.

Efficacy and Safety of Angiotensin Receptor Blockers in Pediatric Patients (Aged 6 to 18) with Hypertension: A Systematic Review.

Angiotensin receptor blockers (ARBs) are commonly prescribed in pediatric hypertension because of the fundamental role of the renin-angiotensin-aldosterone system in the pathogenesis of hypertension. We, therefore, aimed to systematically review articles that investigated efficacy and safety of ARB agents in the pediatric population aged over six years. To do so, the databases of Web of Science, PubMed/MEDLINE, and Scopus were searched to conduct a systematic review by using the following keywords: ("angiotensin receptor blocker" OR "valsartan" OR "losartan") AND ("pediatric" OR "children" OR "child") AND ("high blood pressure" OR "hypertension"). Finally, 12 studies were included in our review, and we found that almost all of them supported the effectiveness and tolerability of different ARB agents. Candesartan cilexetil lowered blood pressure (BP), with a 9 mmHg decline in both systolic and diastolic BP, and proteinuria after four months of treatment. Valsartan and Losartan similarly were shown to be effective in lowering BP in a dose-dependent manner. Headache, dizziness, upper respiratory infection, and cough were the most reported side effects. However, almost all reviewed studies indicated that the safety profile was satisfactory. In conclusion, ARBs are beneficial and well-tolerated antihypertensive medications.  DOI: 10.52547/ijkd.7228.

The clinical relationship between histamine-1 receptor antagonists and risk of cancer: a systematic review and meta-analysis.

BACKGROUND: A systematic research was performed to review the relationship between use of histamine-1 receptor antagonists and cancer risk. METHOD: Databases were searched up to December 2021. Case-control and cohort studies evaluating the relationship between use of histamine-1 receptor antagonists and risk of cancer were selected. The major outcome was cancer risk. Odds ratio (OR) with 95% confidence intervals (CIs) was calculated. Subgroup, cumulative, and sensitivity analysis and Egger test were performed. RESULTS: Five case-controls and one cohort study were included. According to cohort study, use of antihistamines were not associated with cancer risk (RR = 0.92, 95% CI = (0.78-1.07). In case-controls, the frequency of antihistamine use in cases and controls was 11.28% and 14.82% respectively which was associated with decreased cancer risk (p value = 0.02, OR = 0.93, 95%CI = (0.87, 0.99)). Sensitivity analysis showed a change in direction of pooled OR by omitting some studies. Sub-group analysis according to type of cancer showed a decrease in cancer risk in antihistamine users in glioma (p value = 0.03). CONCLUSION: Antihistamines might reduce the risk of certain cancers. More studies with defined background of allergy are needed which can clarify the relevancy of different types of cancer with anti-H1 receptors.

The Effect of Adding Sour Cherry Concentrate to The Usual Treatment of Attention Deficit Hyperactivity Disorder In 6 To 12 Years Old Children.

INTRODUCTION: This study aimed to evaluate the efficacy of sour cherry concentrate in symptoms of Attention Deficit Hyperactivity Disorder (ADHD). METHODS: In a randomized clinical trial, 70 children with ADHD referred to the psychiatric clinic of Ibn-e-Sina Hospital, Mashhad, Iran, in 2021 were selected. Patients were randomly divided into two groups. The intervention group received 75 ml of sour cherry concentrate twice daily in addition to the routine treatment for 2 weeks. The patients were evaluated using The Conner's Parent Rating Scale (CPRS) before and after the study by a psychiatry resident. RESULTS: Based on the findings, no significant differences were observed between the groups in change percent of Cognitive impairments (p = .317), Hyperactivity/impulsivity (p = .525), Oppositional (p = .986), and ADHD index (p = .451). Moreover, 28.6% and 31.4% of children with ADHD consuming the concentrate presented abdominal pain, and asthenia, respectively. CONCLUSION: The present study did not indicate a beneficial effect of sour cherry concentrate on symptoms of ADHD.

Agreement between a Spectral-Domain Ocular Coherence Tomography Biometer with a Swept-Source Ocular Coherence Tomography Biometer and an Optical Low-Coherence Reflectometry Biometer in Eyes with Cataract.

Purpose: To assess the agreement between biometric parameters measured by a spectral-domain optical coherence tomography optical biometer device (Optopol Revo NX) with a validated swept-source biometer (IOLMaster 700) and a validated optical low-coherence reflectometry biometer (Lenstar LS 900), in cataract surgery candidates. Methods: In this prospective comparative study, 100 patients (100 eyes) who were eligible for cataract surgery were involved. Bland-Altman plots were used to assess agreement between devices for biometric parameters including axial length (AL), anterior chamber depth (ACD), lens thickness (LT), and central corneal thickness (CCT). Results: AL measurements were successful in 82 eyes (82.0%) with Revo NX, in 91 eyes (91.0%) with Lenstar LS 900, and in 97 eyes (97.0%) with IOLMaster 700. When Revo NX was compared to IOL Master 700 and Lenstar LS 900, the mean differences were as follows: -0.02 ± 0.02 mm and -0.02 ± 0.03 mm (P = 0.313, P = 0.525) for AL, 0.01 ± 0.03 mm and 0.10 ± 0.03 mm (P = 0.691, P = 0.002) for ACD, -0.15 ± 0.03 mm and 0.001 ± 0.04 mm (P < 0.001, P = 0.95) for LT, and -2.29 ± 0.92 µm, and 0.73 ± 1.43 µm (P = 0.015, P = 0.612) for CCT. Three devices were highly correlated for AL, ACD, LT, and CCT (interclass correlation coefficient > 0.75). Bland-Altman plots showed a narrower 95% limit of agreement (-0.35 to 0.31) between Revo NX and IOLMaster 700 in measuring AL. Conclusions: Despite the higher measurement failure rate in eyes with cataract, the Revo NX showed very good agreement with the IOLMaster 700 and Lenstar LS 900 optical biometers in measuring AL, ACD, LT, and CCT. However, ACD and LT measurements cannot be considered interchangeable between these devices.

Incidence rate and clinical characteristics of acute endophthalmitis following 23-gauge pars plana vitrectomy.

PURPOSE: In this study, we evaluated the incidence and clinical characteristics of post-vitrectomy acute endophthalmitis in a tertiary eye center. METHODS: Data were obtained by reviewing the patients' medical records who underwent primary pars plana vitrectomy (PPvitx) from September 2011 to March 2017. We excluded patients who had any ocular surgery in the past 6 months, immunocompromised patients, and patients with a pre-operative diagnosis of endophthalmitis. The primary outcome was the incidence of acute post-pars plana vitrectomy endophthalmitis. RESULTS: Out of 6474 cases who underwent PPvitx, 12 cases of endophthalmitis (incidence rate of 0.18%) were identified. We found two positive cultures for staphylococcus epidermidis and one positive culture for staphylococcus aureus. Underlying causes of primary vitrectomy in patients who got endophthalmitis were diabetic retinopathy (8 cases), rhegmatogenous retinal detachment (2 cases), and the epiretinal membrane (1 case), and non-clearing vitreous hemorrhage secondary to central retinal vein occlusion (1 case). CONCLUSION: In the present study, the rate of post-vitrectomy acute endophthalmitis was higher than in other reported studies.

Acute retinal necrosis. Management and visual outcomes: a case series.

BACKGROUND: The present study reports the functional and anatomical outcomes of eyes with acute retinal necrosis(ARN). METHODS: This is a retrospective case series conducted at a tertiary Eye Hospital from March 2015 to March 2020. Medical records of patients with clinical and laboratorial-Polymerase Chain Reaction (PCR)-diagnosis of ARN were reviewed. To identify factors related to the outcomes of visual acuity(VA) and retinal detachment (RD) over time, Cox proportional hazards regression modeling and survival analyses were used. RESULTS: Twenty-three eyes of 23 patients (16 male, 7 female) were reviewed. Based on the PCR results, 16 cases (69.6%) had Varicella zoster virus, 3 cases (13%) had Cytomegalovirus, 1 patient (4.3%) had Herpes simplex virus associated ARN, and 1 case (4.3%) had negative PCR. The incident rate for ≥ 2-line VA gain was 0.28/eye-year (EY) (95% CI 0.21 ± 0.26) while the rate of severe vision loss was 0.09/eye-year (95% CI 0.05 ± 0.08). The RD development was observed at a rate of 0.43/eye-year (0.42 ± 0.02), which occurred in 9 eyes with a mean time of 100 days after the initial presentation of ARN. Patients' age was the only factor associated with 2-line or more gain in VA over time with a hazard ratio of 0.921 (95% CI 0.854-0.993, P = 0.032). CONCLUSIONS: Generally, although being crucial, treatment is not highly effective in improvement of VA and decrease of RD development, as well as vision loss, in patients with ARN. However, treatment prevents fellow eye involvement efficiently. Younger age is associated with better response to treatment and more chance to achieve better VA.

Optic nerve head optical coherence tomography angiography findings in patients with thyroid eye disease: a case-control study.

BACKGROUND: To evaluate changes in the vessel density (VD) of the optic nerve head (ONH) microvasculature in thyroid eye disease (TED) using optical coherence tomography angiography (OCTA). This study aimed to applicate the OCTA as a noninvasive modality in screening TED patients to assess sub-clinical changes. METHODS: In a cross-sectional study, the control group patients were healthy individuals with no ocular abnormalities and were euthyroid. All patients with TED had clinical features of the disease. We divided them into two groups using the clinical activity score (CAS). Patients with CAS scores 0-2 were categorized as group A, and scores three or more as group B. All vessels (AV) and small vessels (SV) VD inside disc and radial peripapillary capillary network were measured using the ONH-OCTA. RESULTS: We evaluated 29 patients with TED and 28 healthy controls. The mean whole image AV VD (mean ± SD: 56.33 ± 2.56, p-value = 0.17) and the mean whole image SV VD (mean ± SD: 49.94 ± 2.56, p-value = 0.16) in the TED group had no statically significant difference compared with the control group (AV mean ± SD: 57.20 ± 20.22, SV mean ± SD: 50.84 ± 2.23). We found a non-significant decrease in AV and SV radial peripapillary capillary VD in the TED group. There was a significant decrease in the mean whole image AV VD (mean ± SD: 54.83 ± 3.07, p-value = 0.005) and the mean whole image SV VD (mean ± SD: 48.60 ± 3.18, p-value = 0.013) in CAS group B compared to group A (AV mean ± SD: 57.45 ± 1.33, SV mean ± SD: 50.95 ± 1.37). CONCLUSION: Our study showed non-significant ONH vascular alterations in patients with TED, including reduced VD of ONH in the radial peripapillary capillary. Patients with higher CAS scores had a more noticeable decrease in ONH microvasculature.

Effect of camel milk in asthmatic children: A double-blind randomized pilot study.

OBJECTIVE: Asthma is one of the prevalent diseases in children. There is some evidence regarding the benefits of camel milk in asthma. The present study was carried out to evaluate the effect of camel milk on asthmatic children. PATIENTS AND METHODS: A randomized double-blind pilot study was operated in 2018 in a tertiary center. Sixty children aged more than 6 years with not well-controlled asthma were included. The intervention was consisting of 200-ml camel milk or placebo daily for 2 months. The medication regimen and spirometry parameters were assessed before and after the intervention. Data were analyzed using SPSS software. RESULTS: A total of 57 patients completed the trial. Patients were similar in demographic and baseline characteristics (p > 0.05). There was a significant difference between groups after intervention in use of inhaled corticosteroids (96.7% vs. 70.4%, p value = 0.01), short-acting beta-agonists (53.3% vs. 29.6%, p value = 0.0001) and long-acting beta-agonists (53.3% vs. 40.7%, p value = 0.04) in control and intervention, respectively. The percent of changes in forced expiratory volume (FEV1) in the control and intervention groups was 18.54 ± 14.89 and 21.89 ± 17.83, respectively (p = 0.19). The percent of changes in FEV1/forced vital capacity (FVC) in the control and intervention groups was 8.11 ± 7.12 and 11.11 ± 8.33, respectively (p = 0.14). CONCLUSION: In our pilot study, some children with asthma may benefit from camel milk. Further studies would be useful to evaluate this hypothesis.

Evaluation of the Effect of Religious Fasting on Retinal Vessel Density and Retinal Thickness Using Optical Coherence Tomography Angiography.

We conducted this study to assess the effect of religious fasting on intraocular pressure (IOP) as well as retinal parameters and retinal thickness during Ramadan using optical coherence tomography angiography (OCTA) performed on a spectral domain device. All the participants ate a pre-dawn meal and drink, and then fasted for at least 15 hours. We assessed a total of 61 eyes from 31 healthy volunteers with a mean age of 32.87 ± 8.07. A significant decrease was found in the median IOP after fasting at 10.00 mmHg in comparison with the pre-fasting value of 12.00 mmHg (p < .0001). Retinal peri-papillary capillary (RPC) whole image, RPC inside disk, and RPC mean values showed significant decreases after fasting (p = .011, .012, and .032 respectively). RPC whole vessel density (VD), RPC inside VD, and RPC VD mean values also showed significant decreases after fasting period (p = .025, <.0001, and .003, respectively). Religious fasting during the warm season could decrease IOP. It could also reduce the blood flow of the retina, specifically the macula, and the retinal peri-papillary VD.

Impact of Chronic Functional Constipation on Lower Urinary Tract System: A Cases - Control Study.

INTRODUCTION: Association of constipation with incomplete bladder emptying, functional bladder outlet un-coordination, urinary tract infection (UTI), and upper urinary tract dilatation has been reported. We designed a study to determine the impact of chronic functional constipation on kidney and bladder ultrasound parameters, the results of the uroflowmetry test, and its association with UTI. METHODS: The study group consisted of 24 cases and 48 controls, who were children between 5 to 18 years-old, from June 2017 to June 2018. The case group included children with chronic functional constipation. The healthy children with urinary continence and regular bowel habits without any history of UTI were considered as the control group. The variables were bladder volume, postvoiding urinary residual volume, full and empty bladder wall thicknesses, uroflowmetry parameters and, UTI prevalence. RESULTS: There were no significant differences in the prevalence of UTI, upper urinary tract dilatation on kidney ultrasound, uroflowmetry and, bladder ultrasound parameters between the case and control groups (P > .05 for all). We found abnormal uroflowmetry curves in 58.3% and 35.4% of the case and control groups, respectively (P > .05) and a higher rate of staccato curves in constipated compared to healthy children. CONCLUSION: the prevalence of UTI and upper urinary tract dilatation on kidney ultrasonography are not significantly different between constipated and healthy children. Moreover, it seems that chronic constipation has no significant impact on the storage and emptying functions of the bladder. The higher frequency of staccato curves in constipated compared to healthy children can indicate that fecal mass causes detrusor sphincter dyssynergia.  DOI: 10.52547/ijkd.6568.

Changes in Anterior Chamber Parameters Measured by Pentacam in Coronavirus Disease 2019 Infection: A Longitudinal Study.

PURPOSE: To evaluate changes in anterior segment parameters measured by imaging in coronavirus disease 2019 (COVID-19) infection. METHODS: This longitudinal observational study included patients who recovered from COVID-19. All subjects exhibited a confirmed diagnosis of COVID-19 with a positive result of nasopharyngeal reverse transcription-polymerase chain reaction evaluation. Corneal Pentacam (Oculus, Dutenhofen, Germany) imaging was performed at least two weeks after recovery from systemic COVID-19. Measurements were repeated one and three months later. RESULTS: A total of 20 patients, 11 (55%) of whom were females, with a mean age of 35.5 ± 7.1 years (age range: 25-51 years) recovered from nonhospitalized COVID-19 infection, were enrolled in this study. An increase in the keratometry mean front, keratometry mean back, cornea volume, and anterior chamber depth was observed in the longitudinal evaluation; however, they showed no statistical significance. The anterior chamber volume was statistically increased at three-month follow-up, compared to baseline (baseline: 177.8 ± 36.68 mm3; three months: 182.25 ± 39.58 mm3, P=0.048). CONCLUSION: COVID-19 infection may affect the cornea and anterior segment.