ObjectivesOne of the most common head and neck cancers is nasopharynx cancer. Knowledge about the incidence and mortality of this disease and its distribution in terms of geographical areas is necessary for further study and better planning. Therefore, this study was conducted with the aim of determining the incidence and mortality rates of nasopharynx cancer and its relationship with the Human Development Index (HDI) in Asia in 2012.MethodsThe aim of this ecologic study was to assess the correlation between age-specific incidence rate (ASIR) and age-specific mortality rate (ASMR) with HDI and its components, which include the following: life expectancy at birth, mean years of schooling, and gross national income per capita. Data about SIR and SMR for every Asian country for 2012 were obtained from the global cancer project. We used the correlation bivariate method for the assessment. Statistical significance was assumed if p < 0.05. All reported p values are two-sided. Statistical analyses were performed using SPSS (Version 15.0, SPSS Inc.).ResultsA total of 68,272 cases (males, 71.02%; females, 28.97%; sex ratio, 2.45) and 40,530 mortalities (males, 71.63%; females, 28.36%; sex ratio, 2.52) were recorded in Asian countries in 2012. The five countries with the highest ASIR of nasopharynx cancer were Malaysia, Singapore, Indonesia, Vietnam, and Brunei, and the five countries with the highest ASMR were Indonesia, Vietnam, Singapore, Malaysia, and Brunei. The correlation between HDI and ASIR was 0.097 (p = 0.520) [0.105 in men (p = 0.488) and 0.119 in women (p = 0.901)]. The correlation between HDI and ASMR was –0.102 (p = 0.502) [–0.072 in men (p = 0.633) and –0.224 in women (p = 0.134)].ConclusionNasopharynx cancer is native to Southeast Asia. The highest incidence and mortality rates are found in Malaysia, Singapore, Indonesia, Vietnam, and Brunei. No significant relation was found between the standardized incidence and mortality rates of nasopharynx cancer and the HDI components. Further studies are recommended in Southeast Asian countries in order to find the etiology of cancer, as well as its diagnosis and treatment.

SIGNIFICANCE The overall objective of this study was to evaluate facial asymmetry in patients with unilateral Duane retraction syndrome (DRS). The results showed a high frequency of facial asymmetry parameters of the opposite side of head turn in unilateral DRS patients. PURPOSE The purposes of this study were to evaluate the characteristics of facial asymmetry in unilateral exotropic and esotropic DRS and to compare the findings with orthotropic subjects. METHODS This cross-sectional comparative case series study was performed in 44 consecutive patients with head turn caused by DRS and 44 orthotropic subjects from 2016 to 2019. Four pictures were taken from the patients' faces. The first and second pictures were taken when patients had head turn and when the head was completely straight for calculating the facial angle and relative facial size, respectively. The third and fourth pictures were taken when the head was positioned downward (to compare the size of the cheek) and upward (to evaluate nose asymmetry). RESULTS The mean ± SD age of DRS patients and orthotropic subjects was 16.23 ± 9.92 and 20.68 ± 11.82 years, respectively. The frequency of facial asymmetry and all facial parameters (cheek compression, nasal tip and columella deviation, and compression of one of the nostrils) was significantly higher in DRS patients compared with orthotropic subjects (P < .001). In DRS patients with facial asymmetry, columella and nasal tip deviation (P = .006) and cheek and face compression (P = .03) were significantly more prevalent in the opposite direction of head turn. In the DRS group, the mean ± SD age of the patients with and without facial asymmetry was 17.37 ± 9.76 and 7.40 ± 6.54 years, respectively (P = .02). CONCLUSIONS The frequency of facial asymmetry and all facial parameters was significantly higher in DRS patients compared with orthotropic subjects. In unilateral DRS patients, the face was more commonly affected on the opposite side of head turn.

PurposeTo determine the frequency of different types of strabismus and amblyopia in the patients of strabismus clinics from 2008 to 2014.MethodsThis retrospective cross-sectional study was conducted using data from the archives of Farabi Hospital in Tehran, Iran, from 2008 to 2014. The study consisted of using records of strabismic patients. From these, strabismus types and associated abnormalities, types of amblyopia and other ocular pathological findings were recorded.ResultsIn this study, 1174 strabismic patients were studied. Accommodative esotropia (ET) was the most prevalent type of strabismus accounting for 25.04% of all strabismic patients while intermittent exotropia (XT), nonaccommodative ET and partially accommodative ET, with 12.09%, 11.24% and 10.39%, respectively, were relatively common. Also, 63.03% of all strabismic patients had esodeviation with XT coming second accounting for 24.53% of patients. Other ocular pathologic findings in addition to strabismus were found in 236 (20.1%) patients. The most common association with those types of strabismus was inferior oblique over action accounting for 11.07% of all cases, and 88 patients had nystagmus in addition to strabismus. Significantly 45% of patients had no amblyopia and 37% of patients had a combined type of amblyopia which was the most common type of amblyopia found in strabismic patients.ConclusionThe prevalence of ET was two and a half times more than XT and almost half of strabismic patients suffer from amblyopia. This study suggests that strabismus screening of children could be useful in the early detection of strabismus, appropriate management of it and prevention of strabismic amblyopia.

Background: In all countries, health expenditures are a main part of government expenditure, and governments try to find policies and strategies to reduce this expenditure. Overall expenditure index has been raised 30 times during the past 20 years in Iran, while in the health sector, the growth in health expenditures index has been 71 times. The present study aimed at examining health care expenditure in the Islamic Republic of Iran versus other high spending countries. Methods: A comparative panel study was conducted in selected countries with the high mean of health expenditure per capita. Data were collected from the WORLD BANK. Out- of- pocket (OOP), health expenditure per capita, public and private health expenditure, and total health expenditure were compared among the selected counties. Results: Iran has the lowest health expenditure per capita compared to other countries and the USA has the highest health expenditures per capita. In Iran, out- of- pocket expenditure, with more than 50%, was the most cost, while in Luxembourg it was the least cost during 2004 to 2014, with less than 12%. Conclusion: Our findings revealed that politicians and health care executives should find a stable source to finance the health system. Stable sources of financing lead to having a steady trend in health expenditure.

Background: Ovarian cancer (OC) has high incidence and mortality rates among the reproductive system cancers. This study investigated the relationship between the agestandardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of OC and Human Development Index (HDI) in European countries in 2012. Material and

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Background:Refractive error remains one of the primary causes of visual impairment among school children all over the world, and its prevalence varies widely. Objectives: The present study was aimed to determine the prevalence of refractive errors in school children aged 7 to 18 years in Qazvin, Iran. Patients and Methods:In this cross-sectional study, 11821 students (aged 7 to 18 years) were recruited from different schools. Emmetropia was defined as refractive status between +0.25 and -0.25 D sphere. A -0.50 D or greater spherical considered as myopia, -6.00 D or more as high myopia, and +0.50 D or more as hyperopia, and a cylinder refraction greater than 0.75 D was defined as astigmatism. Visual acuity and refraction of all students were tested. Anterior and posterior segment examination and ocular motility evaluation were also performed to rule out the pathological causes of visual impairments. Results:The study was performed on 5641 (47.72%) male and 6180 (52.28%) female students. The prevalence of myopia (from 32.96% at the age of 7 to 79.02% at the age of 18 years) significantly increased (P < 0.001), and hyperopia significantly decreased (from 47.07% in 7-year-old individuals to 8.32% in 18-year-old subjects) with age (P < 0.001). There were significant differences in refractive errors between males and females. Hyperopia and myopia was more common among female in comparison to males (P < 0.001). Astigmatism greater than 0.75 D in one or both eyes was found in 990 children (8.37%). Astigmatism increased from 6.04% in 7-year-old students to 9.86% in 15-year-oldstudents e and then no more difference was found in age group ranged from 15 to 18 years. Conclusions: Based on our study, the prevalence of myopia is more than other types of refractive error, which is similar to that reported in previous studies on other school-age populations in some Asian countries. The high prevalence of refractive error among school-age children indicated that untreated refractive error is one of the most common public health problems.

Purpose:The aim of this study was to determine the agreement between Pentacam HR (Scheimpflug imaging, Oculus) and Orbscan II (scanning slit topography, Bausch and Lomb) in measuring corneal parameters after photorefractive keratectomy (PRK) for hyperopia.Methods:In this prospective cross-sectional study, 38 hyperopic eyes undergoing PRK were examined before refractive surgery and 8 to 10 months postoperatively using Pentacam HR and Orbscan II. Ultrasound (US) pachymetry was also used to measure central corneal thickness (CCT). The radius of anterior (A-) and posterior (P-) best-fit sphere size (BFS), central elevation (CE), and anterior maximum tangential power in 3 mm (TG3) and 3-5 mm (TG5) zones, anterior chamber depth (ACD), and central corneal thickness (CCT) were collected and used in the analyses. To study the agreement between the measurements made by the two devices, the method described by Bland and Altman was used and the 95% limits of agreement were calculated.Results:The 95% limits of agreement show reasonable agreement between the measurements by Pentacam HR and Orbscan II for A-BFS, P-BFS, A-TG3, and CCT, but not for A-CE, P-CE, A-TG5, or ACD. CCT values obtained by both Pentacam HR and Orbscan II correlated well with the values determined by US pachymetry.Conclusion:Pentacam HR and Orbscan II after PRK for hyperopia show reasonable agreement for determining A-BFS, P-BFS, A-TG3, and CCT, but not for A-CE, P-CE, A-TG5, or ACD. CCT measurements with Pentacam HR have reasonable agreement with US pachymetry.