Biosystematic Study in Some Dracocephalum Species (Lamiaceae) Based on Morphology and Anatomy in Iran

The genus Dracocephalum L. (Lamiaceae) with about 60 to 70 species is a genus in the sub-tribe Nepetinae, tribe Mentheae of Lamiaceae family, native to temperate regions of the Northern Hemisphere. They are mostly perennial herbs, and rarely annual. Flora Iranica reports 8 Dracocephalum species and the Flora of Iran reports 10 Dracocephalum species in Iran out of which, 4 species are endemic. We collected 7 Dracocephalum species and studied species delimitation and species relationship by morphometric and anatomic results. The species were efficiently delimited by morphological and anatomical characters. Morphological and anatomical characters revealed closer affinity between D. moldavica and D. subcapitatum and D. thymiflorum were placed with distance from these species.

Transapical Antegrade Ascending Aorta Stent-Grafting: Going Through the Front Door

Objective Ascending aorta stent-grafting (AASG) is a new option that has shown initial promising results. In selected cases, when neither conventional surgery nor transfemoral retrograde approach are feasible, antegrade transapical (TA) access can be performed. The aim of this single-center retrospective study was to evaluate outcomes of patients undergoing AASG through a TA approach. Methods We analyzed all patients undergoing AASG through a TA approach at our institution. Three different devices were used, including Relay Stent-Graft System (Terumo Aortic, UK), Gore Conformable Thoracic Aortic Graft (W. L. Gore & Associates, Inc., USA), and Valiant Thoracic Stent Graft (Medtronic, Ireland). All patients underwent clinical and computed tomographic angiogram (CTA) evaluation before hospital discharge. Results From May 2010 to December 2019, 3 consecutive patients underwent AASG at our institution. Mean age was 69 years. Three different types of endografts were used in 1 patient each. All patients stayed in the intensive care unit for 24 hr and mean hospital stay was 12 days. We did not observe any major adverse event. One patient died of pneumonia 2 months after the procedure and the other 2 patients are alive and in good clinical conditions at a mean follow-up of 56 months. Predischarge CTA showed good anatomic results with no endoleaks in all cases. Conclusions This initial experience shows that AASG is feasible and provides encouraging clinical and anatomic results in selected high-risk patients.

Topical Triamcinolone Acetonide-Loaded Liposomes Formulation Used as an Adjuvant to Intravitreal Ranibizumab Therapy for Neovascular Age Related Macular Degeneration

Novel strategies have been developed to reduce or to avoid the intravitreal injections (IVTs) of the antiangiogenic (ranibizumab; RBZ) and the anti-inflammatory (triamcinolone acetonide; TA) agents used to treat vitreoretinal diseases. One of the strategies include liposomes. In this study, it was evaluated the safety and efficacy of topical triamcinolone-loaded liposomes formulation (TALF) as an adjuvant to intravitreal RBZ therapy in treatment-naive patients with neovascular age related macular degeneration (nAMD). Subjects were randomly assigned to the RBZ-TALF or the RBZ-pro re nata (RBZ-PRN) group. Patients from the RBZ-TALF group were instructed to apply TALF for a 12-month period after a single dose of RBZ. Patients from the RBZ-PRN group received three monthly RBZ-IVTs. Retreatment with RBZ was considered in case of nAMD reactivation. Related to safety, non-ocular abnormalities were observed during TALF therapy. Owing to the efficacy, non-significant differences are identified in visual acuity or central foveal thickness when the RBZ-PRN and RBZ-TALF groups are compared. Importantly the average number of RBZ injections was significantly lower in the RBZ-TALF group (2.5 ± 1.4 vs 6.1 ± 1.3 IVTs; p=0004). Therefore, TALF used as an adjuvant to RBZ reduce the number of RBZ-IVTs retreatment with optimal visual and anatomic results.

Wies procedure for correcting involutional entropion of the lower lid in geriatrics

Objective: To evaluate the anatomic outcome and recurrence rate of the Wies procedure for treating involutional entropion of the lower lid in geriatrics. Materials and methods: This retrospective case series was conducted in the Ophthalmology department of a tertiary care hospital from January 1, 2016 to December 31, 2017. Geriatric patients (≥ 65 years) who had undergone the Wies procedure, i.e., transverse lid split and everting sutures for correction of involutional entropion of the lower lid were included. All the surgeries were done under local anaesthesia by a single ophthalmologist. The follow-up period was 12 months. A successful outcome was defined as restoration of lid margin to its position with no lash touching the cornea and no recurrence within 12 months. Results: Eighteen eyes of 13 patients with a mean age of 67.6 ± 2.2 SD years were included. There were 11 males (61%) and 7 females (39%). Bilateral entropion correction was done in five patients. Nine right eyes and nine left eyes were included. Anatomical success was 94.4% at 12 months. Recurrence was seen in one (5.6%) patient at 12 months. Conclusion: The Wies procedure for correction of involutional entropion with horizontal lid laxity in the geriatric population provided good anatomic results in our study. The recurrence rate was minimal within 1 year. The recurrence rate can be reduced by an accurate initial entropion assessment.

Anomalous origin of the left coronary artery from the pulmonary artery in a patient of advanced age: a case report and analysis

A 61-year-old Chinese man presented with a nearly 30-year history of an anomalous origin of the left coronary artery. He had been diagnosed with an anomalous origin of the left coronary artery in 1989. He then underwent regular echocardiographic examinations and it was found that his heart was gradually enlarging. After a >20-year asymptomatic period, he developed recurrent chest discomfort and palpitation. Coronary computed tomography angiography suggested that the left coronary artery anomaly originated from the pulmonary artery; additionally, the right coronary artery was tortuous and thickened. Coronary angiography showed that the right coronary artery was huge and buckling. The patient underwent corrective surgery of the anomalous origin of the left coronary artery from the pulmonary artery, aortic valve mechanical valve replacement, mitral valve plasty, and tricuspid valve plasty in Fuwai Hospital (National Center of Cardiovascular Disease of China), and the anatomic results of the surgery were good.

Application of synthetic and biological implants for fixation of rectovaginal septum in rectocele repair

OBJECTIVE. Comparative assessment of results was made in application of synthetic and biological implants for rectocele repair. MATERIAL AND METHODS. The patients (n = 61, aged 34-61 years old) underwent operation concerning an isolated rectocele at the period from 2012 to 2015. Diamond-shaped plasty was performed using transvaginal approach. Synthetic composite mesh was used in 33 patients of the first group and biologic implant was applied in 28 women of the second group. RESULTS. Defecography showed reduction of middle size of rectocele in both groups in term of one year after surgery. However, the difference was insignificant in patients with biological implants. According to individual comparative analysis, the patients (n =9 (32,1 %) of the second group had the same size of rectocele as it was in preoperative period, but only 3 (9,1 %) patients of the first group had the same proportion. CONCLUSIONS. The anatomic results were significantly worse after application of biological implants, which appeared to be less reliable.