Hertel exophthalmometry is a reliable method for measuring the ocular protrusion. However, as with most clinical measures, there is a negligible interobserver variation that seems to be unavoidable.

Background: Despite efforts made by the medical community and public health officials for combating 76 obesity, the prevalence of overweight and obesity has increased over the past 20 years. 77 Obesity was associated with some cardiovascular risk factors and increased the incidence of 78 cardiovascular disease. Diagnosis of Coronary Artery Disease (CAD) in patients with obesity 79 will affect secondary prevention of the disease and management programs; for this reason it is 80 necessary to use a suitable method for determining obesity Objectives: The current study aimed to investigate the relationship between some anthropometric indices and Coronary Artery Disease (CAD) risk factors and also to determine predictive factors of CAD among the indices. Patients and Methods:This cross-sectional study was performed on 300 men and nonpregnant woman with CAD aged 18 -60 years referred to Hazrate Rasool Hospital in Tehran, Iran. Anthropometric indices, including waist circumference, waist-to-height ratio, Neck Circumference (NC), body mass index and Abdominal Volume Index (AVI) and hematological factors were measured using the standard methods. According to angiography reports, the participants were divided into patients with or without CAD. To evaluate the possible correlations between anthropometric indices and CAD risk factors, Pearson correlation coefficients were used. The Receiver operating characteristic (ROC) curve was used to determine the sensitivity and specificity and the best cut-off point of anthropometric indices. Results: The mean age of the CAD-positive group was 53.43 ± 4.96 years and the mean age of the CAD-negative group was 49.9 ± 6.83 years (P > 0.05). All of the anthropometric indices and cardiovascular risk factors were higher in the CAD-positive group, while there was a significance correlation between HDL-c (High-density lipoprotein) and these risk factors (P < 0.05). The area under the curve of AVI had the highest value (0.722) compared to other anthropometric indices. The results of multiple-regression analysis showed that NC was a better predictor of the risk of CAD compared to other anthropometric indices (P = 0.46, OR = 1.207 and CI = 1.004 -1.451). Conclusions: According to the results of the study, abdominal obesity is as a risk factor for atherosclerosis. Therefore, the use of a simple, low cost and high precision method for determining visceral obesity and preventing the CAD is warranted.

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Introduction:Acute lymphoblastic leukemia (ALL) is one of the most common cancers in children and accounts for about ⅓ of cancers in children. The annual incidence of ALL is 4 patients per 100,000 children. Their peak age is between 2-5 Year. One of the most important prognostic factors is cytogenetic abnormalities which are very effective in determining treatment policy.Aim:To determine the frequency of cytogenetic findings and its effect on the outcome of children with ALL.Materials and Methods:This retrospective cross-sectional analytical study was conducted on children with ALL who their disease was diagnosed between 2001and 2009. Furthermore, 206 patients with ALL were examined by referring to Clinic of Ali Asghar Hospital in Tehran. Data was collected from medical records and analyzed by SPSS16 software.Results:206 children with ALL were enrolled in the study. The estimated event-free survival rate of all enrolled patients was more than 70%. There was a significant relationship between type of cytogenetic disorder and clinical outcome of patients (P˂0.0001), where the highest mortality was observed in patients with t (9;22) and t (4;11). There was no significant correlation between the sex and age with the clinical outcome of the patient (P = 0.064; p=0.322). There was a statistically significant relationship between mediastinal mass and clinical outcome (P = 0.002), indicating that the presence of cells growth in an involuntary way can be cause of the cancer. A significant association was found between the clinical outcome of patients and radiotherapy (P = 0.043), indicating that radiotherapy is effective in improving cancer.Conclusion:The findings demonstrated that the average survival rate without recurrence in children was at level of the European countries. However, the strong chemotherapy weakened the role of many prognostic factors in ALL patients, but some translocations are prognostic factors in predicting death in patients with ALL. Therefore, patients with this factor need to receive more confident treatment policy. Comprehensive studies are required by focusing on more samples because of low number of relapses and deaths in the present study.

Background: Proximal femur morphology determines the choice of cemented or uncemented Total Hip Arthroplasty (THR), and Dorr classification is widely used to type this characteristic. As a result, a considerable reliability for such typing system is expected. Objectives: The current study aimed at assessing inter and intra-observer reliability of Dorr classification in proximal femur morphology. Methods: A total of 50 standard hip radiographs from patients with trauma or THR candidates were evaluated by 6 observers, including 2 senior orthopedic residents, 2 orthopedic surgeons, and 2 hip fellowship-trained orthopedic surgeons, using the Dorr classification system. Subsequently, radiographs were re-numbered and re-evaluated, 6 weeks after the first review. Cohen's Kappa statistic was used for statistical analysis of inter and intra-observer reliability. Results: The mean intra-observer and inter-observer kappa value for the residents was 0.560 and 0.592, respectively. The mean intra-observer and inter-observer kappa value for the orthopedists was 0.566 and 0.540, respectively. The mean intra-observer and inter-observer kappa value for the hip fellowships was 0.477 and 0.490, respectively. Conclusions: A minimum to moderate inter and intra-observer reliability of Dorr classification system was seen between the observers of the current study. These results suggest that the classification of the femur morphology is more challenging than previously described and characterization of a single Dorr type, especially in case of uncertainty between type B and C of Dorr might need reconsideration, in order to prevent its adverse effect on the patients' outcome.