Purpose: To quantitatively analyze central corneal thickness (CCT) in patients with primary angle closure glaucoma (PACG) and primary open‑angle glaucoma (POAG), and to evaluate its correlation with severity of glaucoma.Methods: In this retrospective study, records of patients with previously diagnosed POAG or PACG at a tertiary glaucoma service were reviewed. CCT was measured by ultrasound pachymetry. Mean deviation (MD) on visual field (VF) testing was recorded for glaucoma severity determination. CCT and age‑ and sex‑adjusted CCT were compared among the study groups using Student’s t‑test and analysis of covariance (ANCOVA), respectively. Univariate and multivariate regression models were used for correlation of age, MD and CCT.Results: A total of 115 patients with PACG, 215 with POAG, and 100 normal controls were included with mean age of 64.1±10.4, 59.9±10.5, and 62.04±10.80 years, respectively. CCT was thicker in PACG eyes (545.5±46.1 mm) as compared to POAG eyes (531.7±37.3 mm) and controls (531.0±38.3 mm) even after age and gender adjustment (ANCOVA, P=0.05). CCT was found to decrease with increasing age only in the POAG group (b=-0.57, P=0.01). Disease severity (MD of VF) was significantly and inversely correlated with CCT in both POAG and PACG eyes (b=1.89, P=0.02; and b=1.38, P=0.04, respectively) after age and sex correction.Conclusion: PACG eyes had thicker CCT as compared to POAG and normal healthy eyes in Iranian subjects. Severity of the disease was inversely correlated with CCT in eyes with both POAG and PACG.

Objective and Importance: The authors reported a case of plasmocytoma involving the cerebellopontine angle (CPA), which is a rare presenting location of intracranial extramedullary plasmocytoma. Clinical presentation: The patient was A 55-years-old woman who complained of vertigo and tinnitus for one year before. Admission, Neurological examination showed impairment of cerebellar tests. CT scan revealed a large mass lesion in the left CPA region. Intervention: The patient underwent a left retromastoid craniectomy and resection of the tumor. Histopathological studies of biopsy revealed plasmocytoma. Other studies including bone isotope scan and bone marrow aspiration did not show involvement of other parts of the body. Within 6 months of follow up there was No sign of progression of the tumor in CT scan. Conclusion: There are few reports of CPA solitary plasmocytoma. There is a potential risk for error in diagnosis in imaging and pathology. The current treatment is subtotal or radical resection combined whit radiotherapy.

Objective (s): The objective of this study was to document and explain bilateral differences in the Q angle.Materials and Methods: Two hundred limbs of healthy adult Indian volunteers were studied. The Q angle was measured using a goniometric method with the subjects supine, quadriceps relaxed and lower limbs in neutral rotation. The relative lateral placement of the tibial tuberosity with respect to the centre of the patella was measured. Appropriate statistical tests were used to determine the bilateral variability in the Q angle and the lateral placement of the tibial tuberosity. Inter-observer variation of the above mentioned parameters were studied in twenty limbs.Results: The average Q angle value of all the 200 limbs was 12.73oC; the mean value on the right was 12.86oC and 12.60oC on the left. When the Q angle and the lateral placement of the tibial tuberosity were considered in pairs a significant difference was noted in males. The Q angle value on the right side was more often greater than the left. The relative lateral placement of the tibial tuberosity showed a significant positive correlation with the Q angle. The intra-class correlation coefficient was 0.66 for the Q angle and 0.8 for the lateral placement of the tibial tuberosity.Conclusion: The present study shows that bilateral variability in the Q angle could be attributed to an alteration of the relative placement of the tibial tuberosity with respect to the centre of the patella.

Background and Aim: Muscle fascicle length and pennation angle can be non-invasively studied by applying methods like ultrasonography. The aim of this study was to introduce fascicle length and fascicle angle for the estimation of the strength of skeletal muscle by using ultrasonography.Materials and Methods: The data of this study have been driven from pubmed and authoritative references available on the internet and in libraries. In all fifteen full text articles and 30 abstracts have been collected and reviewed. Keywords such as: muscle, fascicle, pennation angle, force and ultrasonography were searched to fulfill the purpose of this study.Results: Detailed information about the angles of pennation and fascicles length are important to predict muscle force. It has been suggested that changes in muscle pennation angles are positively correlated to the length of fascicle in a muscle contraction. While muscle thickness may in some case be remained constant in this relation.Conclusion: Real-time ultrasonography is a noninvasive procedure to monitor the architecture of the living muscle at rest and during static and dynamic sets. It is a valuable measurement tool to estimate muscle force by measuring the muscle architecture parameters such as angle of pennation and fascicle length.

Introduction: Dose distribution can be affected by diverse parameters, such as beam orientations, and collimator angles. These parameters should respect and maintain the international recommended levels during the realization of the quality assurance protocols of linear accelerators. This study aimed at evaluating the dosimetric effects on treatment quality considering the mechanical error fluctuations in the recommended range. Material and Methods: This study included ten patients with head and neck cancer. All of them were treated using three-dimensional conformal radiotherapy with the simple 3-field classic technique. Initially, an optimized treatment plan was computed for each patient. Afterward, similar calculations were executed by varying isocenter position, gantry and collimator angles. Eventually, dosimetric evaluations based on dose-volume histograms were studied and analyzed by Wilcoxon signed rank test for each plan. Results: The analysis of the dose-volume histograms of tumor volumes and organs at risk, as well as the dosimetry calculation, revealed that the small errors of 0. 5° in gantry and collimator angles have minimal effects on dose distribution. However, the variation in isocenter coordinating up to 1 mm may influence the patients’ treatment quality, particularly in the spinal cord and the brainstem, in which Wilcoxon's test showed significant effects in all plans. Conclusion: According to the results, the quality of the treatment plans is almost insensitive to the errors of the gantry and the collimator angles of the order 0. 5° though it is relatively sensitive to isocenter errors (1 mm). These should be reduced in order to avoid overdose when applying the conventional 3-field technique.

Purpose: The objective of this study was to identify possible risk factors associated with primary open-angle glaucoma (POAG(.Methods: A case-control study included patients seen at Rasoul-Akram Hospital ophthalmology clinic. Cases were consecutive patients with confirmed unilateral or bilateral POAG presented during the study period. Controls were a random sample of all other patients aged 30 or more, seen in the same department in the same period who were randomly selected if they fulfilled the inclusion criteria and then matched with the cases by age and sex. Data on demographic, anthropometric as well as medical characteristics were collected from 191 subjects, by interview and medical examination.Results: Sixty consecutive patients with POAG and 131 controls were chosen. Odds ratios (OR) are calculated for the relation between POAG and family history of glaucoma, body mass index, hypertension, diabetes mellitus, cigarette smoking, migraine, and refractive error. Chi-square and student t tests were used. Results indicated the following: family history of glaucoma: OR: 35, 95% CI: 4.57-282.43, P<0.0001, hyperopia: OR: 0.432, 95% CI: 0.209-0.893, P=0.021, hypertension: OR: 1.46, 95% CI: 0.78-2.73, P=0.223, body mass index: P=0.378 (student t test), migraine: OR: 0.46, 95% CI: 0.098-2.23, P=0.507, and cigarette smoking: OR, 1.81; 95% CI, 0.747-4.41; P= 0.184.Conclusion: This study replicated the finding that family history is a major risk factor for POAG (when adjusting for age and sex), while it failed to show that hypertension, diabetes mellitus, myopia, cigarette smoking, migraine, and body mass index to be associated with POAG. It also suggested a protective role for hyperopia in POAG.

Purpose: To describe a case of acute angle-closure glaucoma associated with oral topiramate (Topamax, Aria Daroo) therapy.Case report: Two weeks after initiation of oral topiramate therapy for epilepsy, a 35-year-old woman presented with blurred vision and headache. Intraocular pressure in both eyes was significantly elevated and her visual acuity was 20/30 Ocular Uterque (OU). Bilateral conjunctival chemosis, shallow anterior chamber and mild corneal edema were observed. Topiramate therapy was discontinued. Topical therapy was initiated in both eyes with betamethasone, atropine and timolol.Results: Symptoms and signs including vision accuracy, refraction and intraocular pressure resolved over the next 2 weeks.Conclusion: Topiramate therapy may be associated with ciliochoroidal effusion resulting in angle-closure glaucoma; therefore, patients on such therapy should be carefully monitored.