Background and purpose: Prolonging the drug release can be a suitable approach to overcome the challenges related to topical ophthalmic administration of drugs especially the ones prescribed for chronic ailments. The sustained delivery of the drug would reduce the required frequency of administration which could extremely improve patient compliance and feeling of well-being. This study aimed to develop nanofibrous inserts for sustained ophthalmic delivery of timolol maleate (TIM) for the treatment of glaucoma. Experimental approach: Polycaprolactone-based nanofibers containing TIM were prepared using pure polycaprolactone or a blend of it with cellulose acetate or Eudragit RL100 polymers by the electrospinning method. Following the preparation, polymeric inserts were evaluated for morphological and physicochemical properties. The in vitro drug release was assessed and the in vivo efficacy of a selected insert in decreasing the intraocular pressure (IOP) was also evaluated in the equine eyes. Findings / Results: Prepared nanofibers indicated diameter ranged between 122-174 nm. The formulations showed suitable physicochemical properties and stability for ophthalmic administration. In vitro release study showed prolonged release of drug during more than 3 days. In vivo evaluation revealed that the prepared insert is non-irritant and non-toxic to the equine eyes while having suitable efficacy in decreasing the IOP during 6 days. Conclusions and implication: Prepared TIM inserts indicated a higher efficacy than commercial TIM eye drop in lowering IOP during a prolonged period. Thus, these formulations can be considered suitable for enhancing patient compliance by reducing the frequency of administration in the treatment of glaucoma.

Background: High blood sugar is a typical reaction to stress. In the diabetic population, hyperglycemia can be a serious issue and has been linked to higher mortality rates. Recent studies have shown that anesthetics reduced glucose tolerance; however, it is still unclear how propofol, ketamine, and thiopental of Na affect glucose metabolism. The present study compared the blood glucose levels of thiopental of Na, ketamine, and propofol among patients with cataract surgery. Materials and Methods: The study included 135 ASA II and III adult patients of both genders who were older than 65, known to have type II diabetes, receiving intravenous (IV) sedation, and scheduled for cataract surgery. The three groups were comparable with regard to patients, age, gender, weight, duration of the operation time, duration of recovery time, duration of diabetes, and anesthesiologist’s physical status (based on the American Society of Anesthesiology). Patients were randomly assigned to one of three groups, including receiving IV thiopental of Na 5 mg/kg/h (group T), ketamine 2 mg/kg/h (group K), or propofol 2 mg/kg/h (group P) after the induction of IV sedation with 1-2 mic/kg fentanyl and 0.03 mg/kg midazolam. Changes in blood glucose levels were examined as dependent variables in patients with cataract surgeries while under the influence of these medications up to 6 hours after. Results: The results showed that blood glucose concentrations increased significantly over time in all groups. Moreover, blood glucose concentrations did not differ significantly between the groups receiving the thiopental of Na ketamine or propofol at any measurement time. During the first post-administrative hour, the thiopental of Na, ketamine, and propofol groups demonstrated blood glucose levels of 114.2±16.24 mg/dL, 136.2±12.28 mg/dL, and 122.2±13.84 mg/dL, which were not statistically significant (P=0.72). Regarding the frequency and severity of blood glucose level changes during or after surgery, the groups did not significantly differ at any point in time. Conclusion: The findings of the present study suggest that the thiopental of Na, ketamine, and propofol have equal effects on glucose metabolism.

Color blindness (color vision deficiency) is a disorder that impairs the true perception of colors. Using the information in this study, appropriate policy can be made to identify high-risk groups, as well as educational policies for families to perform more effective genetic diagnosis methods. This study aims to examine the prevalence of color blindness in Iranian students through a meta-analysis. Articles related to color blindness published between January 1990 and December 2020 were searched in Scopus, Cochrane Library, Web of Science (WoS), Science Direct, Embase, SID, MagIran, IranDoc, Medline, and Google Scholar databases. The keywords used were based on medical subject topics (MeSH Terms) and, after careful review, articles were selected according to varied sections of Participants, Exposure, Comparison, and Outcomes (PECO). Participants: students; Exposure: students with color blindness were examined; Comparison: Students from multiple provinces and regions of Iran were surveyed for color blindness; Outcomes: the pooled prevalence of color blindness in Iranian students reported from different provinces. The prevalence of color blindness in Iranian students was 3.8% (95% CI: 2.7–5.4%). The pooled prevalence of color blindness in Iranian male and female students was 4.7% (95% CI: 3.5–6.4%) and 0.7% (95% CI: 0.3–1.3%), respectively. The pooled prevalence of red–green color blindness (Tritan) was 41.7% (95% CI: 18.9–68.8%). The pooled prevalence of red color blindness (Protan) was 13.9% (95% CI: 7.8–23.8%), and the pooled prevalence of green color blindness (Deutan) based on meta-analysis was 45.3% (95% CI: 29–62.7%). Due to the high prevalence of color blindness in students, especially male students, it is necessary to be screened for through genetic tests in couples before having children.

Background: One of the main pillars of sustainable development is health and wellness which is an integral part of improving the quality of life. Lack of hygiene facilities and human resources and their inadequate distribution in urban and rural areas are major problems in providing health services in third world countries. The main and important reasons for inequalities in the distribution of health sector resources include inappropriate and poor budget allocation to the health sector, inadequate and longterm planning. This study was conducted to determine the degree of development of Abadan, Khorramshahr and Shadegan cities in terms of health indicators using numerical taxonomy model. Methods: This descriptive study was conducted in 3 cities of Abadan, Khorramshahr and Shadegan in Khuzestan province in 2016. The data collection tool was a checklist containing information needed to calculate 15 health indices that were collected from Abadan Medical School Deputy of Health. The numerical taxonomy of these cities was evaluated in terms of degree of development of health indicators. Results: According to the values of the upper and lower limits of homogeneity distance and the values of the shortest distance between cities, it was found that all cities (regions) were homogeneous and were in the same group. Finally, the results showed that Abadan is considered to be developed (0.47), Shadegan under developed (0.78) and Khorramshahr undeveloped (0.81). Conclusion:Regarding the results obtained for improving the health status and managing the health sector, it is suggested that a comprehensive development-based program to be developed for reducing gaps and inequalities in terms of health indicators and to pay specific attention to the main development indicators of health care system based on population in each region.

Background Different devices have diverse accuracy in diagnosing glaucoma, and therefore choosing the best device is challenging. Thereby, this study was conducted to evaluate the diagnostic sensitivity and specificity of imaging devices in glaucoma and explore the need for an updated meta-analysis on this issue. Methods In this systematic review and meta-analysis, PubMed, Scopus, and Web of Science databases were searched for articles published between January 2004 and 2022. Cross-sectional or diagnostic studies were selected, and sensitivity, specificity, positive predictive value, and negative predictive value were measured. Results A total of 28 cross-sectional studies were included for meta-analysis. Devices were divided into 2 groups, based on the optic nerve area and the macular area. For the nerve area, the pooled sensitivity was 77% (CI 95%, 70-83; I2, 90.01%) and the pooled specificity was 89% (CI 95%, 84-92, I2, 93.22%), and for the macular area, the pooled sensitivity was 87% (CI 95%, 80-92, I2, 91.79%), and the pooled specificity was 90% (CI 95%, 84-94; I2, 86.30%). We analyzed each device separately. For optical coherence tomography(OCT), the pooled sensitivity was 85% (CI 95%, 81-89; I2, 87.82%) and the pooled specificity was 89% (CI 95%, 85-92; I2, 84.39%); for Heidelberg retinal tomography (HRT), the pooled sensitivity was 72% (CI 95%, 57-83; I2, 88.94%) and the pooled specificity was 79% (CI 95%, 62-90; I2, 98.61%), and for optical coherence tomography angiography (OCTA), the pooled sensitivity was 82% (CI 95%, 66-91; I2, 93.71%) and the pooled specificity was 93% (CI 95%, 87-96; I2, 64.72%). Conclusion The macular area was more sensitive and specific than the optic nerve head. Furthermore, OCT had higher sensitivity, and OCTA had higher specificity when compared with other imaging devices.