PurposeTo compare outcomes of intralesional triamcinolone acetonide (TA) injection and incision and curettage (I&C) in the treatment of chronic chalazion.MethodsPatients with chronic chalazion were randomized in two groups. The patients in the TA received an intralesional injection of TA and patients in the I&C underwent I&C. The patients were followed up 3, 7, 14, 21, 28, and 45 days after the procedures. We defined success as 90% regression in the size of the lesion.ResultsThere were 26 patients in the TA and 25 patients in the I&C enrolled in this study. Complete resolution was achieved in 16 patients (61.5%) in the TA group and 21 patients (84%) in the I&C (P = 0.072). Sex, initial size, and chalazion location did not influence treatment success in either group (P > 0.05). Lesion recurrence occurred in 9 patients (34.61%) in the TA group and 2 (8%) in the I&C (P = 0.04). The average times to resolution were 8.8 ± 5.6 and 5.1 ± 4.5 days in the first and second groups, respectively (P = 0.03). Drug deposition occurred in 24 (92.3%) patients in the TA group, and ecchymosis occurred in 14 (56%) patients in the I&C (P = 0.004) group. Intraocular pressure (IOP) in the TA group and visual acuity (VA) in both groups remained unchanged.ConclusionsBoth TA injection and I&C modalities are effective in the treatment of chronic chalazia. Advantages of I&C in comparison to TA include less recurrence, shorter duration of complications, and a higher success rate.

Cerebral venous sinus thrombosis (CVST) is an uncommon cause of stroke and accounts for 0.5-1% of all stroke cases. A 23-year-old woman who was 33 weeks pregnant visited the hospital complaining of a right temporo-parietal headache which had lasted for 5 days. The headaches were new onset, unilateral, and non-throbbing and were associated with nausea and vomiting. She had no significant past medical history. There was no history of trauma, illicit drug abuse, smoking, or alcohol use. There was no family history of coagulopathy or thrombophilia. A neurological examination demonstrated bilateral grade 2 papilledema. Brain MRI and MR venography were performed that showed a left fronto-parietal subdural hematoma with left transverse sinus thrombosis. Genetic analysis showed a heterozygotic mutation of MTHFR and a homozygotic mutation for Angiotensin-Converting Enzyme (ACE). Screening for other hypercoagulable states were negative. Anticoagulant therapy with a therapeutic dose of heparin was administered intravenously immediately and her symptoms disappeared one week after admission.

Background: Low back pain (LBP) due to acute disc herniation is a common disease bellow the age 45 years of age. Nowadays several types of treatment modalities used to manage these patients. The economic burden of LBP is heavy. LBP rank fifth among category of diseases in cost of hospital care. LBP has higher indirect costs due to absenteeism from work and disability than any other disease. This study was performed to assess the clinical outcomes of non-surgically treatment of LBP patients after six months follow up.