Epidemiology of head lice infestation in primary school pupils, in Khajeh city, east Azerbaijan Province, Iran

Pediculus capitis [Anoplura: Pediculidae] or head louse is an obligate ectoparasite transmitted mainly through physical contact. This study was conducted to survey the prevalence of head lice infestation rate and some risk factors in Primary School pupils, in Khajeh City East Azerbaijan Province, Iran We selected 20 primary schools of Khajeh City during 2008 and 2009. Totally 500 pupils including 200 boys and 300 girls from all grade 1-5 were selected by multistage, systematic random sampling in rural areas of Khajeh City and were examined for lice. In addition, a standard questionnaire recorded information about demographic features of each pupil. Results were analyzed by SPSS software. The total prevalence of head lice infestation in this study was 4.8%. and the prevalence rate was significantly higher in girls [6.66%] than in boys [2%]. Epidemiological factors such as: sex, school grade, family size, parent's education, type of house, hair washing [per week], number of using comb per day, were evaluated and results showed significant difference in head lice infestation and sex, school grade, family size, father education, and type of house [P<0.05]. Pediculosis is a public health problem in many parts of the world, and due to the higher prevalence of pediculosis in crowded families, family by lower levels of father's education and socioeconomic status in our study and rural area, it is necessary to give health education for families to prevent of pediculosis in this area

Primary placement of titanium peg on hydroxyapatite orbital implant

To determine the efficacy of primary placement of a titanium sleeve and peg on hyroxyapatite [HA] orbital implants. This retrospective non-comparative interventional case series was performed on 34 patients undergoing enucleation. A standard enucleation technique with primary HA implantation was performed, in which titanium sleeve and peg were placed primarily during the initial surgery. The patients were visited one, three and six months after placement of the prosthesis for evaluating complications and prosthesis movement. Twelve patients [35.3%] had one or more complications including discharge [26.4%], peg drilled off center [23.5%]; conjunctival overgrowth [11.8%], implant and peg exposure [each in 8.8%], sleeve extrusion, conjunctival thinning, peg on an angle and conjunctival cyst [each in 5.9%] and sleeve obstruction [2.9%]. Movement of the prosthesis [2-3[+]] was achieved in 97% of the cases in supraduction, infraduction, abduction and adduction. Primary peg placement at the time of enucleation with the HA implant is a promising technique with relatively minor complications

[Complications of hydroxyapatite pegging: comparison of polycarbonate versus titanium pegs]

To compare the complications of pegging between the polycarbonate peg system and the titanium peg system. Complications associated with pegging [polycarbonate: Bio-Eye or titanium: Dr-Perry new P-K] were reviewed from the hospital records of 153 patients over 5 years. Out of 153 cases, 96 [62.3%] were male and 57 [37.7%] were female. Mean age was 27.7 years [6-59 years]. In 88 cases, the peg was polycarbonate with sleeve system and in 65 cases, a titanium peg was used. There was at least one complication in 41 [46.6%] cases with polycarbonate and 18 [27.7%] cases with titanium [P= 0.018]. The rates of the most common complications including granulation tissue, discharge, conjunctiva over growth, and peg falling out were 35%, 23%, 13%, and 8%, respectively in the polycarbonate peg group and 15%, 5%, 1.5%, and 0 in the titanium peg group. The rate of the last 3 complications in the titanium peg group was statistically lower than the polycarbonate group. Twenty-five [28.4%] cases with polycarbonate peg and 5 [7.5%] cases with titanium peg had two or more complications [P= 0.03]. Peg removal for treatment of complications was required in 11 out of 41 complicated cases [28.8%] of the polycarbonate group but in 2 out of 18 complicated cases [11.1%] of the titanium group [P= 0.03]. Both pegging systems incurred complications which were less severe and less prevalent with the titanium peg system. Surgical intervention for treatment of complications in the titanium peg system was required less than the polycarbonate peg. It may be concluded that the titanium peg is a good substitute to the polycarbonate peg system

[Clinical features and results of surgery for Duane's retraction syndrome]

To report clinical features, types, and results of surgery for Duane's retraction syndrome [DRS]. This is an existing data study on the records of patients with DRS. The study was conducted on the hospital records of patients who were referred for DRS to a tertiacy eye center in Tehran, Iran during 8 years. The follow-up period after the surgery was at least 6 months. Data of 42 cases was studied. Mean age was 11.7 years [14 months to 25 years]. Twentyseven cases [64%] were female and 15 cases [36%] were male. The involved eye was left in 24 [57%], right in 13 [31%], and both eyes in 5 cases [12%]. Ocular alignment in primary position was esotropia in 20 [47.5%], exotropia in 14 [33.5%], and orthotropia in 8 cases [19%]. The most common type of DRS was type 1 [57%] followed by type 11 [31%] and type I11 [9%]. There was one case [3%] of synergistic divergence. Shooting phenomen was present in 17 [41%] patients. Ocular abnormalities were present in 16% and systemic abnormalities in 7%. Thirty-three cases [78.5%] underwent operation. Indications of surgery were ocular deviation [79%], abnormal head posture [51.5%], palpebral fissure changes and retraction [51.5%], and shooting [27%]. The operation was performed on one or two horizontal rectus muscles in 63% and on three or four muscles in 39%. Type of surgery was biomedial rectus recession and bilateral rectus recession in 63%, vertical muscles transposition in 27%, and splitting of the lateral rectus in 24%. In 61% of patients the affected eye improved with one operation. Abnormal head posture was improved in 76%. Cases with residual deviation, abnormal head posture, vertical deviation, or shooting phenomena were operated. DRS can be diagnosed clinically most of the times; signs and symptoms can be significantly improved with appropriately tailored operation on extraocular muscles

Botulinum Toxin injection into inferior Oblique Muscle for treatment of acquired superior Oblique Palsy

To evaluate the effect of Botulinum toxin-A [BTA] injection into the inferior oblique [10] muscle in releaving the symptoms of superior oblique [SO] palsy.The study was conducted on patients who were referred for acquired SO palsy with less than 2 years of duration. About 10-20 unit of BTA was injected into the belly of the inferior oblique muscle through the inferotemporal quadrant of the involved eye without opening the conjunctiva. Results: Eighteen eyes from 16 patients were injected. Mean age was 33.7 years and mean duration of paresis was 6 months. Trauma was the cause of paresis in 81.2%. Six months after the injection, mean deviation decreased from 6.4 A to 1.9A; mean I0 over-activity decreased from +6.4 to +1.9; mean SO upper-activity decreased from -1.7 to -0.6; mean subjective torsion decreased from 9.3° to 0.4°; and mean head tilt decreased from 8.4° to 1.1°.Botulinum toxin-A injection into the 10 muscle can decrease the symptoms of patients with SO palsy and cause faster rehabilitation of these patients before stabilization of signs for final decision

[ use of Mersilen mesh for wrapping of hydroxyapatite [HA] orbital implant: a new procedure with low complications]

To report the results of a wrapping technique for hydroxyapatite orbital implants by using mersilen mesh. This study is prospective interventional case series conducted on records of 55 consecutive patients who received a mersilen mesh-wrapped HA orbital implant after enucleation of a secondary procedure. We recorded results and potential problem before and after pegging due to mersilen mesh. Twenty nine males [52.7%] and 26 females [47.3%] underwent the procedure. Mean age was 27.6 +/- 13.7 [33 months to 71 years]. Average follow up was 19.1 +/- 8.1 [1 month to 68 months]. There were 28 [51%] primary enucleations and 27 [49%] secondary orbital implants. Thirty eight patients [65.5%] underwent peg placement. Average duration to pegging was 6.5 +/- 11.27 months [5 months to 39 months]. Before pegging, 2 patients [5.2%] had implant exposure; one after a primary implant and another following a secondary implant. One exposure resolved spontaneously and one case required a mucous membrane graft. None of the patients had socket inflammation after pegging. One case had exposure, 4 cases had granulation tissue, and 3 patients had discharge. Mersilen mesh is an alternative option to sclera as a wrapping material for porous orbital implants. It is simple to use, readily available, and low-cost