Dear Editor, I have read with great interest the article by Moradian et al on "Topical Umbilical Cord Serum for Corneal Epithelial defects after Diabetic Vitrectomy. They have performed the study to investigate whether topical umbilical cord serum (TUCS) has any beneficial role in healing corneal epithelial defects (CED) after diabetic vitrectomy. However, I have a few concerns about the study. . .

Purpose: To evaluate the role of topical umbilical cord serum (TUCS) therapy in treating corneal epithelial defects (CEDs) after diabetic vitrectomy. Methods: In this double-masked, randomized clinical trial, we included 80 eyes of 80 patients who were candidates for vitrectomy due to proliferative diabetic retinopathy complications. In cases of corneal edema obscuring the fundus view during surgery, the corneal epithelium was removed using a 6-mm trephine and a blade no. 15. The day after the surgery, patients were randomly divided into two groups: (1) the TUCS group that received 20% TUCS six times/day in addition to the conventional treatment of CED and (2) the control group, which was prescribed artificial tears as placebo in addition to the conventional treatment of CED. The rate of healing of CEDs was measured via two maximum linear dimensions perpendicular to each other at the start of therapy and on postoperative days 1– 5, 7, and 12. Results: Of 80 eyes, 40 were assigned to each treatment group. The mean times to complete CED healing were 2. 4 ± 0. 7 and 3. 8 ± 2. 1 days in the TUCS and control groups, respectively (P < 0. 001). Persistent CED occurred in two eyes in the control group but in no eyes in the TUCS group. Conclusion: TUCS therapy may be safe and effective in healing CEDs after vitrectomy in patients with diabetes.

Background: Congenital heart defects (CHDs) are the most common congenital malformations at birth. Substance abuse has increased dramatically over the past two decades. It also can affect neonates of drug-abusing mothers. Objectives: This study aimed to elucidate the possible association of maternal drug abuse with CHDs in their newborn infants. Patients and Methods: In this study, 72 neonates who were born during 6 years in three teaching hospitals are studied. Echocardiography was performed by a single pediatric cardiologist using two-dimensional and color Doppler echocardiography. The data were analyzed using descriptive statistics. Results: 1) Of 72 included cases, 38 (52. 78%) had abnormal echocardiographic findings; 2) from 38 abnormal echocardiography, 35 (48. 61% of total and 92. 11% of abnormal echoes) had mild congenital heart defect (CHD), and 3 had complex CHD; 3) There was no significant difference in the prevalence of neonatal congenital heart defect with the type of misused drugs (opiates or methamphetamines). Conclusions: In our study, the prevalence of CHD in newborns of drug abuser mothers was significantly higher than the normal population of infants. Hence, echocardiographic screening of these newborns seems to be logical.

Background Dextrocardia is a malposition of the heart defined as the right-sided development of the heart. It can increase the likelihood of congenital heart defects or diseases (CHD) and the risk of related morbidities and mortalities. We aimed to determine the frequency of CHDs among Dextrocardia patients. Materials and Methods In a retrospective cross-sectional study the records of patients with Dextrocardia who referred to Imam Reza Hospital (tertiary referral center) of Mashhad between 2006 and 2016 were studied. Data were analyzed using SPSS software version 16. 0. Results In total 163 patients, 85 of whom (54%) were males were studied. Their mean age was 11. 41+ 0. 326 years. The frequency of major Dextrocardia subtypes were: Situs inversus in 77 (47%), Situs Solitus in 59 (36%), and Situs ambiguous in 28 (17%) patients. The frequency of associated complex congenital heart defects (CHD) was 55% in Situs inversus, 77% in Situs solitus and 100% in Situs ambiguous. Isolated associated CHD had a greater frequency in the Situs inversus and Situs solitus groups. The most common isolated associated CHD was septal defects. Conclusion More than 90% of all patients with Dextrocardia, had CHD whereas all patients with Dextrocardia and Situs ambiguous had complex CHD.

Introduction: Semantic system plays a key role in all areas of language including understanding and expression of language. Based on a traditional view, the left hemisphere is dominant for processing of various linguistic information, including semantic information. It is believed that lesions in the left hemisphere impair the semantic component of language. In this study, we aim to study different types of semantic impairment in patients with aphasia; so that with early diagnosis of these sematic impairment we can identify patients who need treatment.Materials and Methods: This is a cross-sectional, descriptive-analytic study. A total of 39 subjects, comprising 13 patients with left cerebral ischemic stroke in the temporoparietal region and 26 healthy subjects, were evaluated using pyramids and palm trees test, concrete and abstract word synonym test, and Bilingual Aphasia Test (BAT).Results: In concrete and abstract word synonym test, patients with left hemisphere damage had lower performance than the normal group. Only in the verbal version of the pyramids and palm trees test, patients with left hemisphere damage obtained significantly lower scores than the normal participants. In the BAT test, patients with left hemisphere had a heterogeneous performance.Conclusion: Based on these findings, although a large part of semantic processing is performed by the dominant hemisphere of the brain, the right hemisphere has a complementary role in semantic processing.

INTRODUCTION: Birth defects are a series of disorders that occur during embryonic life. In Iran, no national situation analysis is available to show the rate of congenital disorders. We aimed to estimate the prevalence of structural birth defects in Iran. METHODS: We searched for English studies on PubMed, Scopus and Google Scholar from January 1990 to July 2016. The search for Persian articles was performed in Scientific Information Database and Magiran. Two reviewers assessed the identified articles independently. The relevant studies were selected based on predefined criteria. Data were analyzed using the Comprehensive Meta-Analysis software. Random effect method was used for meta-analysis. RESULTS: In total, 42 studies were included. The prevalence of congenital anomalies was as follows: orofacial clefts, 1. 4 per 1, 000 births (95% confidence interval [CI]: 1. 2– 1. 6); neural tube defects, 3. 2 per 1, 000 births (95% CI: 2. 5– 4. 3); urogenital anomalies, 3. 9 per 1, 000 births (95% CI: 1. 2– 12. 9); musculoskeletal malformations, 3. 3 per 1, 000 births (95% CI: 2. 3– 4. 9); cardiovascular anomalies, 3. 3 per 1, 000 births (95% CI: 2. 2– 5. 1); Down syndrome, 0. 9 per 1, 000 births (95% CI: 0. 7– 1. 2); gastrointestinal disorders, 1. 4 per 1, 000 births (95% CI: 0. 9– 2. 1). CONCLUSION: Our results show that urogenital disorders are the most prevalent births defects in Iran, followed by musculoskeletal and cardiovascular malformations.

Objectives. The neurocutaneous sural artery flap taken from the calf is the one of best procedures to cover defects of the lower leg, ankle, and foot. Patients alld Methods. We report our experience with 15 Patients presenting with chronIc and traumatic wounds of the ankle and foot. Results. All cases were successfully operated at our center during the five year period from 1998 to 2003. Among the complications, we encountered 3 cases of partial necrosis. Due to its good vascularity and long pedicle, this flap has a wide range of rotation in the dorsum, sole, heel, and malleoules, and is a dependable and versatile procedure for surgeons. Another advantage is easy and quick dissection. Donor site scar and anesthesia of the lateral side of the leg is a disadvantage of this flap.