Enterobacteriaceae in some marine fish fillet

A total of 100 random samples of marine fish fillet represented by Epinephelus alexandrinus fillet, Dicentrachus labrax fillet, Stingray fish fillet and Scomberomorus commerson fillet [25 of each] were collected from different fish markets in Alexandria city. The sample weight was 100 grams. Each sample was kept in a separate sterile plastic bag and transferred in an ice box to the laboratory under complete aseptic conditions without undue delay. All collected samples were subjected to bacteriological examination for isolation and identification of Enterobacteriaceae. The results revealed that the total Enterobacteriaceae count in the examined samples of marine fish fillet were varied from 1.6 x 10[2] to 6.3 x 10[4] with an average of 2.1 x 10[4] + 3.1 x 10[3] cfu/g for Epinephelus alexandrinus fillet, 2.1 x 10[2] to 4.3 x 10[4] with an average of 9.1 x 10[3] + 1.1 x 10[3] cfu/g for Dicentrachus labrax fillet, 3.1 x 10[2] to 6.7 x 10[4] with an average of 1.3 x 10[4] + 7.3 x 10[3] cfu/g for Stingray fish fillet and 2.3 x 10[2] to 1.1 x 10[5] with an average of 6.3 x 10[4] + 5.2 x 10[3] cfu/g for Scomberomorus commerson fillet, respectively. Accurately, all examined samples [100%] out of Epinephelus alexandrinus fillet, Dicentrachus labrax fillet, Stingray fish fillet and Scomberomorus commerson fillet were contaminated with Enterobacteriaceae. Also, the total coliform count in the examined samples of marine fish fillet were ranged from 1.3 x 10 to 2.1 x 10[3] with a mean value of 9 x 10[2] + 7.5 x 10 cfu/g for Epinephelus alexandrinus fillet, 3.1 x 10 to 3.2 x 10[3] with a mean value of 1.1 x 10[3] + 2.3 x 10[2] cfu/g for Dicentrachus labrax fillet, 1.9 x 10 to 7 x 10[3] with a mean value of 2.6 x 10[3] + 1.6 x 10[2] cfu/g for Stingray fish fillet and 6 x 10 to 1.3 x 10[4] with a mean value of 6.4 x 10[3] + 7.1 x 10[2] cfu/g for Scomberomorus commerson fillet. The enteric bacteria isolated were Enterobacter aerogenes [44%] was the most frequent bacterial species isolated from Epinephelus alexandrinus fillet samples, followed by Proteus vulgaris [28%], Citrobacter diversus and Shigella species [20% of each] then Klebsiella ozanae and Provedencia spp [16% of each]. In regard to Dicentrachus labrax fillet samples, the most frequent bacterial species isolated was Enterobacter aerogens [40%], followed by Klebsiella peumoniae [32%], Citrobacter diversus[28%], Proteus vulgaris and Provedencia species [20% of each], Citrobacter freundii [16%] then Enterobacter cloacae, Klebsiella ozanae and Shigella species [12% of each]. Concerning Stingray fish fillet samples, Serratia liquifaciens [44%] represented the highest rate of isolation followed by Enterobacter aerogens and Enterobacter cloacae [36% of each], Citrobacter freundii [28%], Citrobacter diversus and Enterobacter cloacae [24% of each], Shigella species [20%] and Proteus vulgaris [16%]. On the other hand, Citrobacter freundii [28%], Enterobacter aerogens [24%], Proteus vulgaris [20%] then Klebsiella ozanae, Proteus rettgeri and Shigella species [12% of each] were isolated from the examined samples of Scomberomorus commerson fillet The Enteropathogenic Escherichia coli was isolated from 8%, 16%, 20% and 28% of the examined samples of Epinephelus alexandrinus fillet, Dicentrachus labrax fillet, Stingray fish fillet and Scomberomorus commerson fillet, respectively. Also, Salmonella species were recovered from 8%, 12% and 8% of the examined samples of Dicentrachus labrax fillet, Stingray fish fillet and Scomberomorus commerson fillet, respectively. The serotypes of Salmonella organisms isolated from Dicentrachus labrax fillet, Stingray fish fillet and Scomberomorus commerson fillet were S. enteritidis [4% for each] and S. Haifa [4% for each]. However, only one strain [4%] isolated from Stingray fish fillet were serologically identified as S. typhimurium. Enterobacteriaceae count, Coliform count, the isolated enteric bacteria, the isolated enteropathogenic E.coli and the isolated Salmonella organisms as well as the public health significance were discussed and the prophylactic measures to reduce the counts and the isolates in marine fish fillet were recommended

Bacteriological and immunological study in diabetic foot

Background: Diabetes mellitus is increasing rapidly through the world, so the diabetic foot syndrome become more and more important as a major diabetic complication

Objectives: The aim of study was to determine the association between the up-regulation of circulating level ofIL-6 in diabetic patients with foot ulcer compared with diabetic patients without foot ulcer

Subjects and methods: The study included 60 subjects, they were divided into three groups; group I included 20 diabetic patients without foot ulcer syndrome, group II included 20 diabetic patients with diabetic foot ulcer syndrome [DFUS] and group HI included 20 apparently healthy subjects as a control. All subjects were subjected to clinical assessment, routine laboratory investigations and specific investigations including assay of glycosylated haemoglobin, serum IL-6 and bacteriological culture and sensitivity for ulcer

Results: There is no significant difference among the three studied groups regarding the gender, age, duration of the disease and type of treatment. There was significant difference between group I and other groups regarding hypertension [p<0.02]. There was no significant difference between the three studied groups regarding WBC. There was a significant difference between the three studied groups as regards neutrophils and platelets counts f [p=0.009] nd [p=0.03] respectively. There was a highly significant difference between the three studied groups as regards Hb concentration [p<0.001]. There was a highly significant difference [p<0.00l] between group II and both group I and group III as regards ESR [43 +/- 77.2, 13+/-3.9, 11+/-3], random blood sugar [RBS] [319.7+/-47, 238+/-47.8, 92.5+/-10.8], glycosylated haemoglobin [HbAlc] [9.93+/-1.35, 8.83+/-1.4, 4.6+/-0.6], Urea [49.9+/-37, 52.5+/-41, 20.6+/-2.4] and IL-6 [18.9+/-5.6, 4.9+/-2.7, 2,77+/-I].There was positive significant correlations [p<0.001] between IL-6 and levels of RBS [r=0.72], and HbAlc [r=0.62], respectively. Also, a positive significant correlation between IL-6 and neutrophils% [r=0.35, p<0.005] was found The most common isolated microorganisms from foot culture were mixed gram + ve cocci and gram -ve bacilli representing 60% and lonely gram + ve cocci and gram -ve bacilli were 20% respectively. Also, it was found that the most gram +ve organism was Staphylococcus aureus and the most gram -ve organism was E. coll and the most effective antibiotic was Ampicillin-Sulbactam 70% followed by Imipenem 30%

Conclusion: Diabetic patients with foot ulcer were found to have higher IL-6 level than diabetic patients without foot ulcer and they were prone to complications or mortality. This assay could facilitate early and accurate diagnosis and greatly aid timely institution of appropriate treatment

Ocular manifestations in subacute bacterial endocarditis

Subacute Bacterial Endocarditis [SBE] is a flammable bacterial infection of the endocardium and usually builds on a pre-existing heart disease. Ocular events are a particularly rare complication that occurs in a child. A 10 year old patient having a history of recurrent tonsillitis and hospitalized in pediatric for kidney failure, shows a decrease in visual acuity reduced to finger counting at 1 meter. Ophthalmologic examination revealed papilledema, premacular hemorrhage, Roth spots and several intraretinal hemorrhages in both eyes and the presence of a segmental vasculitis in the left eye. Under etiological assessement, a transthoracic echocardiography was performed retaining the diagnosis of infective endocarditis. Blood culture isolated viridans streptococci. The patient received appropriate systemic antibiotics. Two months later, the evolution was marked by the recovery of visual acuity to 10/10 and net regression both papilledema as hemorrhagic lesions. Although rheumatic fever has become an exceptional condition in developed countries, it may still be a rheumatic valve that is grafted sepsis. In infective endocarditis, several ophthalmologic manifestations have been described in the literature. They result for most of infectious emboli in the retinal vessels and in some cases may reveal endocarditis. Besides vital prognosis engaged in bacterial endocarditis, visual functional prognosis may also be threatened by serious eye damage. Thus, an eye examination

Knowledge, perceptions and practices towards medical ethics among physician residents of University of Alexandria hospitals, Egypt

This cross-sectional study was conducted to assess the knowledge, perceptions and practices towards medical ethics of physician residents at university hospitals in Alexandria, Egypt. A self-administered structured questionnaire was used for knowledge and perceptions and a checklist for observations of doctor -patient interactions in the outpatient setting. Only 18.0% of the 128 participating residents had obtained their knowledge from their medical education and 29.9% were dissatisfied with the roles played by the ethics committee. Most of the residents had satisfactory knowledge and 60.2% had satisfactory perceptions regarding ethical issues. The lowest perception score was in the domain of disclosing medical errors. Only 48.0% of the residents were compliant with the principles of medical ethics in practice and 52.0% of patients were dissatisfied with their treating physicians. The study identified areas of unsatisfactory knowledge and practices towards ethical issues so as to devise means to sensitize residents to these issues and train them appropriately

Problems and perceived needs for medical ethics education of resident physicians in Alexandria teaching hospitals, Egypt

There is a call for greater preparation for the ethical challenges encountered by physicians in their future professional duties. This study in Egypt aimed to reveal problems and perceived needs for medical ethics education of resident physicians working at University of Alexandria hospitals. In a descriptive, cross-sectional survey, 128 residents answered a self-administered questionnaire. More than half were of the opinion that their medical ethics course was ineffective; 56.3% mentioned poor curricular planning. The majority complained that the subject was not tailored to specialties, the course was too short, there was a shortage of resources to facilitate the educational process and that assessment was done for knowledge but not for skills. Problems related to staffing were low staff:student ratios and staff lack of experience. Trainees, regardless of clinical discipline, felt that there was a great need for improvement to their medical ethics education

Can opposite clear corneal incisions have a role with post-laser in situ keratomileusis astigmatism?

To evaluate the astigmatic correcting effect of paired opposite clear corneal incisions [OCCIs] on the steep axis in patients with residual astigmatism after laser in situ keratomileusis [LASIK] Thirty-one eyes of 24 patients with a mean age of 28.4 years +/- 2.46 [range, 19-36 years] were recruited for the study. Inclusion criteria included residual astigmatism of=1.5 diopter [D] after LASIK with inadequate residual stromal bed thickness that precluded ablation. The cohort was divided into two groups; group I [with astigmatism ranging from-1.5 D to-2.5 D] and group II [with astigmatism>-2.5 D]. The steep axis was marked prior to surgery. Paired three-step self-sealing opposite clear corneal incisions were performed 1-mm anterior to the limbus on the steep axis with 3.2-mm keratome for group I and 4.1 mm for group II. Patients were examined 1 day, 1 week, 1 month, 3 months and 6 months, postoperatively. Visual acuity, refraction, keratometry, and corneal topography were evaluated preoperatively and postoperatively. Analysis of the difference between groups was performed with the Student t-test. P<0.05 was considered statistically significant. The mean uncorrected visual acuity [UCVA] improved from 0.35 +/- 0.13 [range, 0.1-0.6] to 0.78 +/- 0.19 [range, 0.5-1] in group I and from 0.26 +/- 0.19 [range, 0.1-0.5] to 0.7 +/- 0.18 [range, 0.4-1] in group II. The increase in UCVA was statistically significant in both groups [P=0.001, both cases]. The mean preoperative and postoperative keratometric astigmatism in group I was 2.0 +/- 0.48 D [range, 1.5-2.5 D] and 0.8 +/- 0.37 D [range, 0.1-1.4 D], respectively. The decrease in keratometric astigmatism was highly statistically significant in group II [P=0.001.]. Mean surgically induced astigmatic reduction by vector analysis was 1.47 +/- 0.85 D and 2.21 +/- 0.97 D in groups I and II respectively. There were no incision-related complications. Conclusions: Paired OCCIs were predictable and effective in correcting post-LASIK astigmatism and required no extra surgical skill or expensive instruments. OCCIs are especially useful in eyes with insufficient corneal thickness for LASIK retreatment

Silent composite hemoglobinopathy characterized by gene sequencing

We report the case of 35 years old Tunisian women with a chronic anemia non investigated for a long time. Laboratory analysis using advanced technology of DNA sequencing revealed a compound heterozygote for Hb O Arab and cd 39 beta[degree sign]-thalassemia. It's the first time that such a genotype has been characterized by gene sequencing

[Allelic polymorphisms of Gene UDP- Glucuronosyltransferase 1A1 of a Population n Tunisia]

The UDP-glucuronosyltransferase 1A1 gene that encode the enzyme UGT1A1 responsible for glucuronidation undergoes several variations that may affect the enzymatic activity or expression and which are the cause of metabolic disorders related to the glucuronidation of bilirubin, such as Gilbert's syndrome and Crigler Najjar's syndrome. Among the most common variations, there is the repeat polymorphism A [TA] n TAA in TATA box and biallelic mutation G211A in exon 1. We consider in this work to determine their frequencies in a healthy population. The polymorphism A [TA] n TAA showed that genotype [TA7/TA7] was described as being associated with Gilbert's syndrome and was encountered in 11% of the population studied. This percentage is close to the value described in the Caucasian population, estimated at 10%. Concerning the polymorphism G211A, our results show that the mutated allele is encountered in 15.7% of our study population. This frequency differs greatly from that reported for Caucasians and Afro-Americans but it is similar to that perceived at the Japanese. All these results suggest that the Tunisian population appears to be heterogeneous view UGT1A1 gene mutation status. Regarding the origins and distribution of such polymorphisms in our population, the study reveals a high haplotypic heterogeneity and emergence of the particular haplotype [TA] 6-G considered ancestral. The comparison of the haplotype structure generally leads to the development of a hypothetical tree of the origin and spread of different haplotypes

prognostic significance of galectin-3 and p-selectin in transitional cell carcinoma of the urinary bladder

Bladder carcinoma is one of the most common malignancies in urology. The most common type of the bladder cancer is transitional cell carcinoma [TCC]. TCC of bladder has a recurrence rate of more than 50%. Therefore, it is important to find some indicators that can predict for recurrence or the development of metastasis. This study investigates the prognostic significance of preoperative serum levels of galectin-3 and P-selectin in patients with transitional cell carcinoma [TCC] of the urinary bladder. Preoperative serum levels of galectin-3 and P-selectin were measured by ELISA [enzyme-linked immune-sorbent assay]. The study showed that Galectin-3 and P-selectin serum levels were higher in patients with bladder cancer than in healthy controls. Patients with metastasis had significantly higher levels of both serum Galectin-3 and P-selectin than with localized diseases. High levels of serum Galectin-3 and P-selectin were significantly associated with the clinical tumour stage. However, no significant difference detected between serum levels of galectin-3 and P-selectin in grade II and grade III TCC subgroups. Also, there is a positive correlation between serum Galectin-3 and P-selectin in both control and patient groups. Univariate analysis showed that preoperative serum level of Galectin-3, P-selectin and clinical stages were indicative for clinical progression and tumour specific survival. In a multivariate analysis, clinical stages were an independent prognostic marker for clinical progression and tumour specific survival. These results indicate that both serum Galectin-3, P-selectin levels and clinical tumour stages are closely related to poor prognosis in bladder cancer. So, their levels in bladder cancer patients may be useful in identifying patients at high risk of tumor recurrence

Evaluation of the role of timolol 0.1% gel in myopic regression after laser in situ keratomileusis

To evaluate the efficacy of the concomitant administration of antiglaucoma medications namely timolol 0.1% gel in cases with myopic regression after myopic laser in situ keratomileusis [LASIK]. Prospective observational clinical trial. Ninty five eyes of 75 patients were included in this study prospectively. The mean myopic regression was-1.29 +/- 0.83 diopters [range-0.5 to-4.62] after myopic LASIK. The eyes were divided into two groups: 50 eyes administrated timolol 0.1% gel once daily for 12 months [treated group], and 45 eyes were age matched [control group]. We assessed the amounts of myopic regression in terms of changes in the refraction [spherical equivalent and astigmatism], intraocular pressure [IOP], pachymetry and the refractive power of the cornea measurements for all participants. The refractive error and visual acuity were similar between the two groups at baseline. The treated group had an improvement in spherical equivalent significantly from-1.29 +/- 0.83 to-0.94 +/- 1.07 diopters [P=0.012]. Astigmatism was changed from-0.94 +/- 0.53 to-0.86 +/- 0.60 diopters but this change was not statistically significant [P=0.20]. The IOP was decreased significantly from 12.6 +/- 1.9 to 9.0 +/- 1.1 mm Hg [P<0.001]. Central corneal thickness was changed from 425.6 +/- 19.86 to 429 +/- 18.1 micro m but not statistically significant [P=0.56]. The central corneal power decreased significantly from 37.2 +/- 1.8 to 36.4 +/- 1.3 diopters [P<0.05]. Timolol 0.1% gel was effective for reduction and improvement of myopic regression especially the spherical errors after myopic LASIK

Correlation of central corneal thickness and optic nerve head topography in patients with primary open-angle glaucoma

To evaluate whether changes in optic nerve head topography and visual field in patients with primary open-angle [POAG] are related to central corneal thickness [CCT]. Eighty eyes of 50 patients with POAG underwent ophthalmic examination; optic nerve head imaging with the Heidelberg Retina Tomography II [HRT II], ultrasound corneal pachymetry, and visual field evaluation with the Humphrey visual field analyser [program 24-2]. Correlation between CCT, age, gender, family history of glaucoma, visual acuity, intraocular pressure [IOP], optic disc surface area, vertical and horizontal cup: disc ratios, neuroretinal rim area, mean deviation of visual field, and number of glaucoma medications was analyzed. Patients were divided into a thin CCT group <540 micro m or a thick CCT group >540 micro m. Pearson correlation was used for correlation coefficient and a P value of <0.05 was considered statistically significant. Thin CCT was significantly correlated with vertical and horizontal cup: disc ratios, neuroretinal rim area loss, and smaller optic disc surface area [r=0.043, r=0.021, r=0.036, and 0.031 respectively]. Thin CCT was also significantly associated with worsened mean deviation of visual field, and increased number of glaucoma medications [r=0.065 and r=0.423]. Patients with positive family history correlated with with greater vertical cup: disc ratio, and more glaucoma medications but this was not statistically significant. In patients with POAG those with thinner CCT are likely to develop greater glaucomatous optic nerve and visual field damages than those with a thicker CCT

Accuracy of intraocular lens power calculation in high myopia

To study the accuracy of different recent intraocular lens [IOL] calculation formulas in predicting a target postoperative refraction +/- 1.0D [Diopters] in patients with long eyes [axial length >/= 26.0 mm] undergoing phacoemulsification. This study comprised 127 eyes of 87 patients who presented with cataract and axial eye length ? 26 mm. Before phacoemulsification and IOL implantation; axial length measurement using immersion ultrasound A-scan technique, and autokeratometry with or without computerized corneal topography for K readings were done. The IOL power was calculated using four formulas, namely the SRK-T, Hoffer-Q, Holladay-2, and Haigis formulas. Four months after surgery, refraction was done. Differences between actual postoperative refraction and assumed target refraction using the different formulas were analyzed. P < 0.05 was considered statistically significant. In all 127 eyes, the mean axial length was 31.71 mm [range, 26.06-37.11 mm] and the mean K was 44.68 D [range, 40.05-55.14D]. The mean preoperative spherical equivalent [SE] was ?17.52D [range, ?12.25 to ?30.50D]. After surgery, the mean spherical equivalent was ?0.8 +/- 0.83D [range, +1.25 to ?3.75D]. The mean postoperative refractive SE when implanting a plus power IOLs was ?0.3 +/- 0.51D [P < 0.001] while the mean postoperative refractive SE when implanting a minus power IOLs was +1.21 +/- 0.11D denoting a highly significant tendency toward hyperopia [P < 0.001]. Concerning the minus power group, most postoperative refractive error was within +1.0 to +2.0D in the actual implanted IOL and in all other formula calculated IOL power. However, Haigis formula showed the least deviation while SRK-T and other formulas showed a greater tendency toward hyperopia. In eyes with high axial myopia, the performance of SRK-T, Hoffer-Q, Holladay-2 and Haigis formulas are comparable in low plus-powered IOL implantation. Haigis formula is the best formula when minus power IOL is implanted

Graves opthalmopathy and psychoendocrinopathies

To assess the psychiatric and endocrinological changes in patients with Graves ophthalmopathy [GO]. A prospective, controlled, University Hospital based study. The current study comprised 60 patients diagnosed with GO at Mansoura Ophthalmic Center. Thirty five patients of them with moderate to severe GO formed the study group and twenty five patients with negligible to very mild GO formed the control group in the euthyroid state. The study group was further subdivided based on their predominant clinical signs into a proptosis subgroup and a muscle restriction subgroup. Psychiatric changes were assessed with the Middlesex Hospital Questionnaire [MHQ]. Biochemical analyses included serum-free thyroxine and thyroid-stimulating hormone [TSH] concentrations, TSH receptor antibody [TRAb] activity and antrthyroglobulin particle agglutination [TGPA] and antithyroid microsomal particle agglutination [MCPA]. The proptosis group reported significantly higher scores on anxiety, depression, and phobia than the muscle restriction group [P<0.0001]. The proptosis and muscle restriction subgroups reported significantly higher scores on all subscales compared to the control group [P<0.05]. The scale scores of depression and phobia showed a positive correlation with scores of anxiety [P<0.0001]. The serum TRAb activity showed a significant correlation with anxiety, phobia and hysteria [P<0.0001]. The psychiatric aspect of GO should be evaluated during routine follow-up and should be considered when making management decisions. Thyroid specific antibodies may be useful in confirming the diagnosis of GO

Ultrasonographic imaging of the urinary tract pre and post experimental urethral obstruction in bucks

The purpose of this study is to throw a light on the validity of ultrasonographic examination of urinary tract pre and post urethral obstruction in Egyptian mixed breed non castrated bucks [male goats].Nine bucks were subjected to direct penile ligation at the distal bend of the sigmoid flexure after surgical exposure of the penis to induce urethral obstruction and subsequent urine retention. Clinical and ultrasonographic examinations were carried out immediately pre experimental urethral obstruction and continued periodically every 12 hrs, throughout 48 hrs. post experimental urethral obstruction. The Ultrasonographic appearance and measurements of urinary tract compartments were assessed and compared at different examination positions using linear array endorectal probe [7.5-2.6 MHZ] and convex array general purpose probe [6-2.6 MHZ]. Both kidneys were visualized ultrasonographically through transabdominal approach and the bladder was visualized through transabdominal and transrectal approaches in all bucks. Both of them revealed normal architexture, echogenicity and dimensions before ligation. The course of the urethra in the pelvis and in the penis was not imaged in any of the bucks before ligation. There were significant increase in kidneys and bladder dimensions after urethral obstruction. The proximal portion of the pelvic urethra was visualized clearly in all bucks 24 hrs. post urethral ligation. The course of the ureters was not visualized ultrasonographically by means of the transrectal or transbdominal approaches pre-and post experimental urethral obstruction. It could be concluded that using of ultrasonography is considered a good clinical diagnostic tool for examination of the urinary tract in bucks affected with urine retention

Laser in situ keratomileusis for treated myopic anisometropic amblyopia in children

To evaluate the effects of laser in situ keratomileusis [LASIK] in decreasing myopic anisometropia in children with spectacles or contact lens intolerance and its validity in facilitating treatment of resultant myopic anisometropic amblyopia. LASIK was performed in 18 eyes of 18 children having myopic anisometropic amblyopia not successfully treated with the standard amblyopia treatment for 6 months. Children were followed up at 1 week, 1, 2, 6, 12, 18 and 24 months. Postoperative amblyopia therapy was continued with occlusion of the dominant eye for 6 h daily for the first 3 months and then for 4 h per day as long as possible. The mean spherical equivalent refraction in the operated eye had reduced significantly from -9.08 +/- 1.86D preoperatively to -0.97 +/- 1.16D at 2 years postoperatively. The mean spherical equivalent in the non-operated fellow eye was -1.0 +/- 1.15D preoperatively and -2.50 +/- 1.15D at 2 years. The mean spherical equivalent myopic anisometropia was -7.75 +/- 2.25D preoperatively and -0.50 +/- 0.3ID at 2 years, representing a 93.5% reduction in myopic anisometropia. The mean regression value was -2.28 +/- 1.62D, however, 18 eyes [72%] were within 3.OD of the fellow eye. The mean BCVA was significantly improved from 0.72 +/- 0.13 preoperatively to 0.47 +/- 0.17 by 2 years after LASIK with amblyopia treatment. LASIK is a safe and effective alternative method for correcting myopic anisometropic amblyopia, especially in children with spectacles or contact lens intolerance, with more better visual acuity and binocular vision

Facilitation of amblyopia management by laser in situ keratomileusis in children with myopic anisometropia

To evaluate of the effects of Laser in situ keratomileusis in lowering anisomyopia in children and its validity in facilitating the treatment of the resultant anisometropic amblyopia. Laser in situ keratomileusis [LASIK] was performed to 18 eyes of 18 children having myopic anisometropia amblyopia not successfully treated with the standard amblyopia treatment for 6 months. Children were followed up at 1 week, 1, 2, 6, 12, 18 and 24 months. Postoperative amblyopia therapy was continued with occlusion of the dominant eye for 6 hours daily for the first 3 months and then for 4 hours per the synoptophore [combined with occlusion] was done to improve the binocular function. The mean spherical equivalent refraction in the operated eye had reduced significantly from-9.25 +/- 3.43 D preoperatively to 1.5 +/- 1.23 D 2 years postoperatively. The mean spherical equivalent in the non operated feNow eye was-1.0 +/- 1.18 D preoperatively and-2.25 +/- 1.05 D by 2 years. The mean spherical equivalent anisometropia was-7.75 +/- 2.34 D preoperatively and-0.5 +/- 0.31 D at 2 years, representing a 93.5% reduction in anisometropia. At 6 months, 14 eyes [77.8%] were within +/- 1.0 of the targeted refraction and at 2 years, 10 eyes [55.6%] were within +/- 1.0 D. The mean regression value was-2.25 +/- 1.7 D, however, 15 eyes [83.3%] were within 3.0 D of the fellow eye. The mean BCVA was significantly improved from 0.26 +/- 0.21 preoperatively to 0.82 +/- 0.17 by 2 years after surgery with amblyopia treatment. Binocular vision status had improved after 2 years follow up with part-time reduced occlusion treatment. No significant surgical or general anesthesia complications were noted. LASIK is a safe and effective alternative method for correcting myopic anisometropia facilitating treatment of amblyopia, not responding to conventional methods of treatment, with more better visual acuity and binocular vision. An important factor in treatment success is the compliance with the long-term amblyopia treatment regimen. It should be considered as a first-line treatment option, surpassing glasses and con tact lenses in eliminating anisometropia and aniseikonia

Drug and substance abuse in refractory epilepsy

Drugs and substances abuse in patients with refractor epilepsy were investigated in this study which includes 924 patients with intractable epilepsy were studied for serum levels of antiepileptic drugs and for drugs and substances abuse. Positive results for abuse were detected in 246 patients [26.62%], 56.5% of them were in the age group 20 - 30 years. Males outnumbered females with a sex ratio 1.46: 1. Cannabis was the first abused drug as it was detected in 29.27% followed by opiates in 21.95%, alcohol in 17.88%, benzodiazepine in 16.26%, tricylic in 8.54%, barbiturates in 6.1%. So, a screening test for drugs and substances abuse must be done in cases with resistant epilepsy even if patients deny the use of them

In vitro selection and molecular characterization of salt tolerant canola plantlets

In this study, a system for in vitro selection of salt tolerant canola clones [plantlets] was developed. The developed system relies on somaclonal variation and the high regenerative capacity of hypocotyl explants of the Egyptian canola cultivar Serw 4 via direct and indirect shoot organogenesis. The optimized regeneration system involves callus formation from hypocotyl explants of 4 day-old seedlings on MS medium supplemented with 1.5 mg/l 2,4-D and shoot proliferation from proliferated microcalli colonies on MS + 4.0 mg/l BA. Shoot organogenesis frequecny ranged from 35 to 40%. This system was used for in vitro selection of salt tolerant plantlets from hypocotyl explants of seedlings germinated on salt containing medium. Under selection pressure, shoot organogenesis frequencey dropped to 5% for selected cell lines and zero for non-selected cell lines onto 0.3% NaCl. The biochemical and molecular characterization of the selected and non-selected clones were performed using: proline accumulation, total protein content, SDS-PAGE and RAPD analysis. The salt-tolerant plantlets were characterized by improved growth on saline media, rapid accumulation of proline, high content of total protein, synthesis of new set of high molecular weight proteins [38 and 94 KD] and unique RAPD banding profiles. The criteria of the selected clones outlined above may be a part of biochemical make up performed by these canola clones to tolerate extreme salt stress

Moderate sedation with midazolam- ketamine versus propofolketamine for bone marrow biopsy

Small- dose ketamine in combination with sedative drugs has increasingly been used for sedation and analgesia during local anaesthesia in outpatient procedure. This study compared the efficacy of sedation and analgesia of ketamine midazolam versus ketamine propofol combinations in bone marrow biopsy. Sixty patients of either sex undergoing bone marrow biopsy procedure under local anesthesia participated in this study. They were randomly allocated into two groups of 30 patients each, all received ketamine 0.5 mg /kg with either midazolam 0.05 mg/kg [KM group] or propofol 2.5 mg/kg [KP group]. Supplementary dose of ketamine was administered to achieve adequate sedation level. Time to induce sedation, recovery oxygen time, saturation and adverse effects were recorded. The sedation levels were satisfactory in both groups except two patients in KM group and one in KP group. The most common side effects in KP group were pain on injection and hypoxia, where nausea and vomiting were the commonest side effects with KM group. Induction and recovery times were significantly shorter in KP group. Both combinations provided adequate sedation for bone marrow biopsy procedure but KP offer a quicker onset of sedation and a faster, smoother recovery

Sex hormones and oxidant- antioxidant status in post-menopausal women with coronary artery disease

The strikingly lower prevalence of acute coronary syndromes in pre-menopausal women than in men of similar age, then the progressive narrowing of that difference with age after menopause, suggests an important role for sex hormones and probably oxidative stress in the development of coronary artery disease. The aim of this study is to evaluate the sex hormones and oxidant stress [malondialdehyde, which is a metabolite of lipid peroxidation] and anti-oxidants [vitamin C and E] status in postmenopausal women with stable coronary artery disease and in those with acute coronary syndromes. This study was conducted on 40 non-hormone user postmenopausal women with coronary artery disease. They were divided into 3 groups: the 1[st] group [17 patients] who had an acute myocardial infarction, the 2[nd] group [10 patients] had unstable angina and the 3[rd] one [13 patients] had stable angina. This is an addition to 20 apparently healthy postmenopausal women of similar age. All cases and control subjects were subjected to thorough history taking, full clinical examination, routine laboratory investigations, resting echocardiography and special laboratory investigations including detection of serum level of; total and free testosterone, total estradiol, morning and nocturnal serum cortisol, malondialdehyde and plasma levels of alpha-tocopherol and vitamin-C. We found a higher serum level of total and free testosterone in cases than control subjects [P-value 0.016 and 0.031 respectively] and the serum free testosterone was significantly higher in the group of acute myocardial infarction than the group of stable angina [P-value 0.008]. The serum level of total estradiol was significantly lower in cases than in control group [P value 0.0001]. Serum malondialdehyde was significantly higher in cases than control subjects [P<0.0001], and it was significantly higher in cases of acute myocardial infarction in comparison to stable angina cases [P-value 0.005]. Vitamin E [[alpha]-tocopherol] and vitamin C were significantly lower in cases than control group [P 0.0001 and 0.048 respectively]. The serum levels of free testosterone as well as malondi-aldehyde were higher in postmenopausal women with coronary artery disease. However, serum level of estradiol, vitamin E and C were lower in them in comparison to control subjects