Purpose. To evaluate the efficacy of three intravitreal bevacizumab (IVB) injections versus the same combined with 2% of topical dorzolamide in the treatment of diabetic macular edema (DME). Methods. In this randomized double-masked clinical trial, 32 eyes of 16 treatment-naive patients with bilateral DME were enrolled. The eyes were randomly assigned to receive three monthly injections of IVB (1.25 mg) plus topical dorzolamide 2% twice daily or IVB (1.25 mg) plus topical artificial tear twice daily. Best-corrected visual acuity (BCVA) was the primary outcome of the study followed by the central macular thickness (CMT) and central macular volume (CMV) as the secondary outcomes. Results. Mean BCVA changes were insignificant in both groups. It changed from 0.21 ± 0.08 logMAR at baseline to 0.23 ± 0.09 (P=0.24) in the combination group and from 0.18 ± 0.09 logMAR to 0.21 ± 0.09 (P=0.11) in the IVB alone group, at 3 months, respectively. Changes in mean CMT and CMV were significant in both groups. However, the difference between the groups was not significant at all the visits. In the study, no major ocular complication or systemic side effects were noted regarding IVB or topical dorzolamide. Conclusion. This randomized contralateral clinical trial demonstrated that adjuvant topical dorzolamide with IVB injection had no additional effects on IVB in the treatment of DME over a three-month course. This trial is registered with the Iranian Registry of Clinical Trials under the registration code IRCT20131229015975N5.
Power outage is one of the significant problems for electricity distribution companies. Power outages cause customer dissatisfaction and reduce distribution companies' profits and revenues. Therefore, the electricity distribution companies are trying to moderate the leading causes of the outage. However, the dynamics of environmental conditions create uncertainties that require prioritizing the solutions of outages causes in different situations. Therefore, this study presents a scenario-based approach to prioritize power outage causes. Four case studies have been conducted in four cities of Kerman province in Iran. First, the prioritization criteria and causes of the outage were identified using literature and interviews with experts in this field. Then, the Global Business Network matrix was used to create four possible scenarios. Then, the Best-Worst method and TOPSIS method were applied to weight the prioritizing criteria and prioritize the causes of the outages in different scenarios. The results showed that working in the power network limit zone, as one of the causes of outage in Sirjan and Jiroft cities, has the most priority. Also, the collision of external objects, birds, and annoying trees should be considered by managers as the leading causes of outages in Bam and Kahnuj cities.
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