Nowadays, hypertension is one of the most important causes of death all over the world because of its adverse effects on cardiovascular system. For this reason its study is very valuable. Vitamin D is one of the important factors that may influence blood pressure. Many studies have shown the modulatory effect of this vitamin on rennin-angiotensin system as well as its inhibitory effect on vascular smooth muscle hypertrophy. According to the fact that vitamin receptors are distributed in almost all organs of human body, we can't consider its role just as factor in calcium homeostasis. Therefore many other important roles could be attributed to it. So vitamin D deficiency could arise many problems. There are many causes for vitamin D deficiency. The most important is insufficient exposure to UV-B. In epidemiological studies the vitamin D deficiency is considered to be associated with high blood pressure, as emphasized in many cross-sectional studies. Concerning the cohort prospective studies, the relationship between vitamin D deficiency and hypertension is reported in some cases. The interventional studies about the association between vitamin D and hypertension are not many and the results are different or contradictory. Controversial results might be due to differences in dose of supplements or duration of supplement therapy. The aim of this systematic review is to assess the researches about the association between vitamin D deficiency and hypertension and discuss the power of them. This can be helpful to lighten the path to prospective investigations.

hypertension is a common complication of kidney transplantation with the prevalence of 80%. Studies in adults have shown a high prevalence of hypertension (HTN) in the first three months of transplantation while this rate is reduced to 50- 60% at the end of the first year. HTN remains as a major risk factor for cardiovascular diseases, lower graft survival rates and poor function of transplanted kidney in adults and children. In this retrospective study, medical records of 400 kidney transplantation patients of Sina Hospital were evaluated. Patients were followed monthly for the 1st year, every two months in the 2nd year and every three months after that. In this study 244 (61%) patients were male. Mean±SD age of recipients was 39.3±13.8 years. In most patients (40.8%) the cause of end-stage renal disease (ESRD) was unknown followed by HTN (26.3%). A total of 166 (41.5%) patients had been hypertensive before transplantation and 234 (58.5%) had normal blood pressure. Among these 234 individuals, 94 (40.2%) developed post transplantation HTN. On the other hand, among 166 pre-transplant hypertensive patients, 86 patients (56.8%) remained hypertensive after transplantation. Totally 180 (45%) patients had post-transplantation HTN and 220 patients (55%) didn’t develop HTN. Based on the findings, the incidence of post-transplantation hypertension is high, and kidney transplantation does not lead to remission of hypertension. On the other hand, hypertension is one of the main causes of ESRD. Thus, early screening of hypertension can prevent kidney damage and reduce further problems in renal transplant recipients.

Purpose: To evaluate the efficacy of preoperative oral clonidine (5 µg/kg) in preventing ocular hypertension in the early period after cataract surgery with posterior chamber intraocular lens implantation under general anesthesia.Methods: This randomized double-masked clinical trial comprised 62 eyes of 62 patients with senile cataract who underwent cataract extraction and posterior chamber intraocular lens implantation without any viscoelastic use. They were randomly assigned into two groups of preoperative oral clonidine (5 µg/kg) and placebo. Intraocular pressure (lOP) was measured preoperatively and 6, 12, and 24 hours postoperatively. Results: There was less increase in mean lOP in the clonidine group at 6 hours (+0.41±4.55, P=0.6) and 12 hours (0.06±3.62, P=0.9) compared to the placebo group (5.77±4.25, P=<0.001 and 4.70±3.19,P<0.001,respectively) after surgery. There was no statistically significant difference between the two groups in mean lOP 24 hours post operatively (clonidine group 15.41±3.96, placebo group 16.00±341) but compared to preoperative lOP, less increase in mean lOP was seen in the clonidine group (1.38±4.64, P=0.1 as compared to the placebo group (+3.80±2.92, P<0.001).Conclusion: A single dose of oral clonidine (5 µg/kg) preoperatively can produce a significant lOP-lowering effect in the early period after cataract surgery, especially in the first 12 hours.

Context: Portal hypertension (PH) is a progressive complication due to chronic liver disease. In addition to pathophysiologic changes in the micro-circulation, in PH are established fibrous tissue (periportal fibrous septal) and regenerative hyperplastic nodules (from micro- to macro-nodules) promoting hepatic architectural distortion.Evidence Acquisition: A literature search of electronic databases was undertaken for the major studies published from 1981 to today. The databases searched were: PubMed, EMBASE, Orphanet, Midline and Cochrane Library. We used the keywords: "portal hypertension, children, immune system, endocrine system, liver fibrosis".Results: It is believed that PH results from three “phenotype”: ischemia-reperfusion, involving nervous system (NS); edema and oxidative damage, involving immune system; inflammation and angiogenesis, involving endocrine system. However, its exact cause still underdiagnosed and unknown.Conclusions: PH is a dynamic and potentially reversible process. Researchers have tried to demonstrate mechanisms underlying PH and its related-complications. This review focuses on the current knowledge regarding the pathogenesis, and immune, endocrine-metabolic factors of disease. The strong positive association between immune system and development of PH could be efficient to identify non-invasive markers of disease, to modify prognosis of PH, and to development and application of specific and individual anti-inflammatory therapy.

Purpose: To evaluate the incidence of steroid-induced ocular hypertension (OHT) after myopic photorefractive keratectomy (PRK).Methods: Myopic PRK was performed on 506 eyes of 269 patients. Refractive error was between -1.00 and -5.00 diopters of sphere and less than 4 diopters of cylinder. Baseline intraocular pressure (IOP) before the operation and at different time intervals after the operation was measured using Goldman Applanation Tonometry. Corrected lOP more than 21 mmHg was considered as OHT.Results: OHT occurred in 40 (7.9%) eyes. lOP rise occurred after 2-3 weeks in 40% (mean IOP= 23.5±3 mmHg), 4-6 weeks in 50% (mean IOP= 25.06±4.2 mmHg) and 8-12 weeks in 10% (mean IOP= 28.98±3.12 mmHg). There was no correlation between IOP and preoperative spherical equivalent. IOP recovered to normal in all patients after discontinuation of topical steroid and using 0.5% timolol. Mean duration for normalization of IOP was 28.5±27.7 (range 7-108) days. There was no case of steroid-induced glaucoma. Conclusion: Topical steroids may cause OHT in patients undergoing PRK. Early detection of lOP rise and meticulous treatment with close follow-up are recommended. We suggest measuring IOP in post- PRK patients at least after 2 to 3 weeks of corticosteroid treatment initiation. 

Nephrotic syndrome is a rare manifestation of renal artery stenosis, presented mainly in adulthood. This is the report of a 4 months old boy admitted for hypertension and nephrotic syndrome. Left renal artery stenosis and renal hypoplasia were documented by laboratory and imaging studies. Proteinuria improved with medical treatment, with no need to surgical repair. Blood pressure remained normal during follow up, with no need to further medical treatment.