A considerable proportion of 6-year-old children have strabismus and/or significant, potentially amblyogenic refractive errors. The relatively high rate of hyperopia and astigmatism in the studied population needs more attention. The results of the study emphasize the need for adequate diagnostic and therapeutic eye care services for preschool children.

We present a case of accidental injection of tranexamic acid instead of bupivacaine during spinal anesthesia. One minute after intrathecal injection of 3.5 mL of solution, the patient developed myoclonus of his lower extremities. Accidental intrathecal injection of the wrong drug was suspected and a used ampule of tranexamic acid discovered in the trash can. The ampules of tranexamic acid (500 mg/5 mL) and bupivacaine (5 mg/mL, Merck, Darmstadt, Germany) were similar in appearance. General anesthesia was induced. Ten hours later, the patient developed myoclonus of his upper extremities and face. His polymyoclonus was successfully treated with phenytoin, sodium thiopental infusion, sodium valproate and supportive care of the hemodynamic, and respiratory systems. The patient's condition progressively improved to full recovery.

Background Increased protein intake is suggested as a strategy to slow or reverse the loss of muscle mass and strength observed in sarcopenia, but results from studies that directly tested this possibility have been inconsistent. Objectives We assessed the evidence on the effects of whole protein supplementation or higher-protein diets, without the use of amino acids or supplements known to stimulate hypertrophy, alone or in combination with resistance exercise (RE) interventions, on lean body mass (LBM) and strength in older adults. Design A systematic search was conducted using PubMed, Medline, Web of Science and Cochrane CENTRAL databases from January 1990 up to July 2021. Randomized controlled trials that assessed the effects of protein supplementation and/or higher-protein dietary interventions in older adults (mean age ≥ 50 years), on total LBM, appendicular lean mass (ALM), handgrip (HG) and knee extension strength (KE) were included. Results 28 studies were identified. In pooled analysis, compared with lower protein controls, protein supplementation did not have a significant positive effect on total LBM [weighted mean difference in change (WMD):0.34, 95% CI: –0.21,0.89, I2:90.01%], ALM [WMD:0.4, 95% CI: –0.01,0.81, I2:90.38%], HG [WMD:0.69, 95% CI: –0.69,2.06, I2:94.52%] or KE [WMD:1.88, 95% CI: –0.6,4.35, I2:95.35%]. However, in interventions that used also RE, statistically significant positive effects of protein were observed for ALM [WMD:0.54, 95% CI:0.03,1.05, I2:89.76%] and HG [WMD:1.71, 95% CI:0.12,3.30, I2:88.71%]. Meta-regression revealed no significant association between age, per-meal protein dose, duration, and baseline protein intake with change in any outcome. Sub-group analysis revealed the statistically significant effects on ALM only occurred in sarcopenic/frail populations (WMD:0.88, 95% CI:0.51,1.25, I2:79.0%). Most studies (n = 22) had some risk of bias. Conclusions In older adults performing RE, increased protein intake leads to greater ALM and HG, compared with lower protein controls. Without RE, protein has no additional benefit on changes in total LBM, ALM or HG.

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Background Existing epidemiological data on dietary acid load and cardiovascular disease (CVD) are controversial. There is no literature evaluating the association between dietary acid load (DAL) with cardiometabolic risk factors and inflammatory markers in elderly. Objective To evaluate the association between DAL and cardiometabolic risk factors amongst Iranian elders. Method A cross‐sectional study was completed using 357 Iranian elders above >60 years of age. Anthropometric, clinical, and biochemical measurements were performed. Dietary intake was assessed using a validated and reliable food frequency questionnaire. DAL was estimated using the Potential Renal Acid Load (PRAL) score, Net Endogenous Acid Production (NEAP) and the Net Endogenous Acid Excretion (NAE) score. Metabolic syndrome (MetS) was defined according to the ATP‐III criteria. Multivariable‐adjusted odds ratios (ORs) of CVD risk factors were estimated using logistic regression. Results After adjustment for confounders, a higher PRAL score was associated with higher odds of hypertriglyceridemia (OR: 2.28, 95% CI: 1.15, 4.50). We also observed that the NEAP score was positively associated with MetS (OR: 17.2, 95% CI: 2.34, 127). Finally, there was a positive association between NAE and lipid accumulation product (LAP) (OR: 1.81, 95% CI: 1.04, 3.17) and hypertriglyceridemia (OR: 2.46 95% CI: 1.22, 4.95). Conclusion Men with higher DAL scores had a higher risk of MetS, hypertriglyceridemia and LAP. Our findings suggest that further prospective studies are required to appraise DAL‐CVD risk factors in populations with varying dietary patterns.