Treatment of moderate to severe keratoconus with 6-mm Intacs SK

·AIM:To evaluate the effect of Intacs SK corneal ring segment implant for treatment of patients with moderate to severe keratoconus, who have clear central cornea and cannot tolerate contact lens. ·METHODS:In this prospective, non-comparative, intervent- ional case series study performed in Dena Hospital, Shiraz, Iran, thirty-seven eyes of thirty-six patients with moderate to severe keratoconus, clear central cornea, and contact lens intolerance were enrolled and underwent Intacs SK corneal ring segment implantation. Preoperatively, uncorrected distance visual acuity (UCDVA), best-corrected distance visual acuity (BCDVA), central corneal thickness(CCT) and average keratometry (Av-K) were measured and compared with post-operative results at one week, one month, three months, and six months. ·RESULTS:Mean preoperative UCDVA and BCDVA were (1.32±0.31) logMAR and (1.07±0.27) logMAR, respectively. Av-K was (52.13±0.39)D, and the CCT was (432±39.5)μm. Post-operative examinations showed a clinically significant improvement in both UCDVA and BCDVA (P <0.001). There was also a significant effect based on the time of assessment on both UCDVA and BCDVA and both parameters had a continuous improvement during the follow-up period. Three months after operation there was a statistical significant reduction of Av-K (P =0.0001), but there were no significant changes in CCT (P =0.149). ·CONCLUSION:Intacs SK corneal ring segment implants seem to be a safe and effective treatment option for patients who have keratoconus, clear central cornea, and contact lens intolerance.

Use of ginger versus stretching exercises for the treatment of primary dysmenorrhea: a randomized controlled trial

BACKGROUND： Dysmenorrhea is a common gynecologic problem. In some cases, non-medical treatments are considered to be more effective, with fewer side effects. Ginger and exercise are alternative treatments for dysmenorrhea, but in the present study they were not combined. OBJECTIVE： In this study, the effects of ginger and exercise on primary dysmenorrhea were compared. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： This randomized controlled tdal was performed in Mazandaran University of Medical Sciences, Iran. Two groups of female students were recruited by simple random allocation. In each group, 61 students with moderate to severe primary dysmenorrhea with regular menstrual cycles and without a history of regular exercise were assessed. The ginger group received 250 mg ginger capsules from the onset of menstruation. In the exercise group, belly and pelvic stretching exercises were performed for 10 min, 3 times per week. MAIN OUTCOME MEASURES： Intensity of pain was assessed according to a visual analogue scale after the first and the second month. RESULTS： Exercise was significantly more effective than ginger for pain relief （31.57± 16.03 vs 38.19 ± 20.47, P = 0.02）, severity of dysmenorrhea （63.9% vs 44.3% mild dysmenorrhea, P = 0.02） and decrease in menstrual duration （6.08 ± 1.22 vs 6.67± 1.24, P = 0.006）, in the second cycle. CONCLUSION： Stretching exercises, as a safe and low-cost treatment, are more effective than ginger for pain relief in primary dysmenorrhea.