Reviews in Clinical Medicine

176-182

Authors: Hasan Ravari; Azin Banihashem; Mohammad Vejdani; Gholamhosein Kazemzadeh

Vascular access failure is known as a principal cause of morbidity of end stage renal disease (ESRD) patients. The major reason for vascular access failure is the neointimal hyperplasia which leads to venous thrombosis and stenosis. The efficacy of different pharmacological therapies has been studied in increasing the vascular access patency duration or decreasing the thrombosis of arteriovenous grafts or fistulas. In the current review, we reviewed the results obtained in different randomized control trials considering the efficacy of pharmacotherapy on the thrombosis rate and duration of vascular access grafts patency in HD patients.

189-193

Authors: Ali Mousavi Jafarabad; Seyed Amirmasoud Hashemian

Currently, a large burden of hospital admissions is related to minor head trauma and its related imaging studies. One of the challenging issues for emergency physicians is brain computed tomography scan. Sensible use of computed tomography studies could minimize unnecessary radiation exposure and resource use. On the other hand, it can result in delayed or missed early treatment of intracranial injury. The aim of this review is to evaluate and summarize the costs and benefits of using diagnostic measurements in minor head trauma with particular focus on computed tomography scan and the advances and limitations of available guidelines. We studied different issues related to the current approach to minor head trauma in emergency departments. Altogether, it seems using brain computed tomography scan in the setting of emergency is a cost-effective method for the selected patients with minor head injury. However, concerning considerable costs of caring for patients with head injury and high sensitivity of brain computed tomography in terms of minor head injury, it seems reasonable to use brain computed tomography scan for a wider range of patients with minor head injury.

200-206

Authors: Asad Andalibalshohada; Seyed Abdolrahim Rezaii; Farshid Abedi

Hepatitis C virus (HCV) causes 308000 deaths due to liver cancer and 758000 deaths due to cirrhosis every year. Almost 170 million people have HCV infection around the world. Information regarding this virus helps us to determine the prevalence of other hepatitis C genotypes in population, especially in intravenous drug users. It is assumed that some genotypes are more common in certain areas or groups of people. A recent study strongly confirms the central role of injecting network traits, not only as a transmission factor but also as a predictor of HCV genotype and phylogenetic determination in different communities. Hepatitis C genotypes and subtypes have different prevalence considering the country. Risk factors such as transfusion, hemodialysis, root of acquisition and etc, are detected in intravenous drug users. Several conducted studies have investigated the prevalence, risk factors, and predominance of HCV genotypes infection in different parts of Iran.

211-217

Authors: Somayeh Tafaghodi Yousefi; Mohammad Etezad Razavi; Alireza Eslampour

Amblyopia is one of the most important reversible eye disorders in children and different treatments are suggested. Early diagnosis and effective treatment in amblyogenic age are important criteria. These critical periods correspond to the period when the child’s developing visual system is sensitive to abnormal input caused by stimulus deprivation, strabismus or significant refractive errors. Traditional treatments such as glass wearing, contact lens used with patch therapy have limitations. Laser corneal refractive surgeries introduce an alternative for the treatment of anisometropic amblyopia. Current indications for refractive surgery include anisometropia, bilateral high myopia and accommodative esotropia. Several reports confirmed that with recent development in keratorefractive surgery, it could be a safe method to be used in children. The goal of the permanent surgical treatment is to reduce refractive errors, treat amblyopia and make better the binocular function. Corneal haze is certainly a major concern in children receiving surface ablation, especially in high myopic treatments. However, controversies still exist on whether it could be done in this population or not. This article reviews the available data about refractive surgery for treating anisometropic amblyopia.

225-228

Authors: Morteza Hariri Ahari; Elham Pishbin

Vitamin D receptors are located in body tissues and cells. In various physiological processes of the body the primary circulating form of vitamin D, 25-hydroxyvitamin D, will become the active form, 1,25-dihydroxyvitamin D, through many enzymatic. Although different functions of vitamin D has been identified, reducing the possibility of several chronic diseases, including common cancers, autoimmune, infectious, and cardiovascular diseases is proposed as the major role of this component. According to various experimental and clinical studies, vitamin D affects the immune system activity. In this review we study the possible effects of vitamin D on sepsis. The purpose of this review is to evaluate and summarize the role of vitamin D in the immune system, with particular focus on infections and sepsis. We studied different areas related to vitamin D in the literature review including its roles sepsis and infection incidence, as well as seasonal and racial variation in sepsis. Based on evidence, vitamin D positively affects the immune system, so it might act as a therapeutic strategy. Despite several experimental studies which demonstrated the beneficial effects of vitamin D on improved functioning of the immune system, its association with prevention or management of infections and sepsis is not revealed through clinical investigations.

232-237

Authors: Zahra Bahremand; Peyman Hashemian; Fatemeh Moharreri; Ehsan Soltani

Attention deficit hyperactivity disorder is one of the most common psychiatric disorders in childhood. Around 25-50% of these children suffered from some kind of sleep disorder especially with chronic form of insomnia. The physicians usually have a plan for improving hyperactivity and attention deficit of this disease but unfortunately, they forget to manage the sleep disorders, which are a major part of patients’ problems. Nowadays, we know that there is a noticeable relationship between attention deficit hyperactivity disorder and sleep disorders and by improving these children’s sleep, not only the daily functions improve, but also the symptoms of attention deficit hyperactivity disorder maybe become better. Thus, it is needed to avoid the administration of psychostimulants, which have recognized side effects. Moreover, having better sleep, we will see a better relationship between children and their parents and finally a rise in the standard of life of family members, which is a very important goal in our treatment. This review article evaluates available evidence on sleep medication in children with attention deficit hyperactivity disorder to present an appropriate guidance for this high prevalence problem.