Aphakic and pseudophakic cystoid macular edema

To evaluate the effectiveness of medical treatment in patients with aphakic and pseudophakic cystoid macular edema [CME]. A two years prospective study of 25 cases with CME following cataract surgery. Every case underwent full ophthalmological examination and fluorescein fundus angiography. All cases treated by topical non-steroidal anti-inflammatory [Diclofenac 01%] ophthalmic solution 1-2 drops 4 times a day, 10 cases received 0 - [B - hydroxyaethyl] -rutosidea [Venoruton - 300] capsules 1200 mg in two divided oral dose daily for 2 weeks together with the topical diclofenac. Follow-up ranged 6 - 30 months [mean 19 months]. The 25 eyes of 25 patients all unilateral. 21[84.0%] pseudophakic and 4[16.0%] aphakic. Mean duration of CME [10.50 months]. Mean BCVA 0.2. Two groups were identified according to medical treatment, Group A - 15 cases received diclofenac 0.1% alone with 13 [86.7%] improved in a mean period of 8.5 weeks, 2 [13.4%] not improved and 3 [23.1%] with on/off phenomenon. Group B - 10 cases received topical diclofenac 0.1% together with Venoruton 300 capsules 9 [90.0%] improved in a mean 5 weeks, 1 [10.0%] not improved and 1 [11.2%] with on/off phenomenon. Topical non - steroidal anti-inflammatory drugs [Diclofenic 0.1%] ophthalmic solution proved to be beneficial in the prevention and treatment of chronic aphakic and pseudopahkic cystoid macular edema. Oral O - [B - hydroxyaethyl] - rutosidea [Venoruton 300] capsules was beneficial in the present study in augmenting the action of topical diclofenac by shortening the duration of recovery and lowering the rate of recurrence [on/off] phenomenon, but needs further studies

Sagittal reformatted CT scan in evaluation of the role of the agger nasi cell and nasofrontal bony beak in chronic frontal sinusitis

The present study aimed at investigation of the role of the Agger nasi cell and the nasofrontal bony beak as a cause of compromised or obstructed frontal recess and chronic frontal sinus disease. The relationship of these structures to the frontal recess had been studied with the use of conventional and helical computed tomography [CT] in the coronal and axial planes along with sagittal reformatted images in 30 patients with chronic frontal sinusitis. Data from coronal and sagittal images as well as data from conventional and helical scanning C.T were compared. Endoscopic frontal recess clearance was performed for 25 out of 30 patients with chronic frontal sinusitis. Endoscopic examinations revealed prominent Agger nasi cell in 86.7% and 33.3% septal deviation. Coronal C.T images revealed 63.3% compromised frontal recess by Agger nasi cell, while prominent nasofrontal beak was seen in 13.3% of cases. During the follow-up period, 22 patients had complete resolution of all symptoms, 6 of them had occasional attacks of frontal sinusitis, 3 patients showed no improvement at all and 2 patients required further surgery

surgical outcome following functional endoscopic sinus surgery in term of mucociliary transport

In patients who develop sinusitis and must undergo nasal and sinus procedures, it is important to recognize the changes that occur within the mucociliary apparatus. Mucociliary transport has been assessed pre and post functional endoscopic sinus surgery [FESS] using saccharin method. The mean preoperative saccharin transport time [STT] in two groups of patients: Group II [bilaterally diseased, n = 40] and Group III [unilaterally diseased, n = 20] was 43.9 and 45.8 minutes, respectively, which were significantly longer than that of controls [Group I, n =20] i.e. 15.75 minutes. They were reduced insignificantly two months following FESS and reduced significantly four and six months following FESS. The results suggested that the impairment of mucociliary transport in chronic paranasal sinusitis may be significantly improved following FESS

Role of the haller's cell in chronic maxillary sinusitis

This study aimed to investigate the anatomical variations [such as Haller's cell], which encroach on the osteomeatal complex area and whether they are more prevalent in a symptomatic group than in a control group. The study also aimed to detect whether the prevalence of Haller's cell seen on CT poses a technical problem as regards the surgeon and whether the Haller's cell has a role in chronic maxillary sinusitis. A detailed analysis of coronal and axial CT scans of the paranasal sinuses was obtained from forty patients scanned for intraorbital disease [control group] along with one hundred patients with chronic rhinosinusitis diagnosed on the basis of their history and outpatient endoscopy and confirmed by radiology and surgery [sinus group]. Identification of the anatomic variation and mucosal abnormalities with special attention directed to Haller's cells was made. The results showed a significant prevalence of the Haller's cells [14%] in sinus group versus the control group [7.5%]. In those patients with Haller's cells, osteomeatal narrowing was 85.7% and 0% in sinus and control groups, respectively. While, maxillary sinus mucosal abnormalities were 85.7% and 33.3% in sinus and control groups, respectively

Diaphanoscopic localisation of lacrimal drainage system in endoscopic endonasal dacryocystorhinostomy

The advent of the rigid endonasal endoscope and the development of functional endoscopic sinus surgery [FESS] technique has awakened interest in an endonasal endoscopic dacryocystorhinostomy [EN-DCR] in treating nasolacrimal obstruction. However intraoperative endonasal localisation of the pathologically changed ducts may prove difficult and time consuming due to the considerable anatomical variations from one patient to the next. The aim of this work is to shed light about the value of using a special optical probe for diaphanoscopic localisation of the nasolacrimal duct intraoperatively during EN-DCR. Fourty eight EN-DCRs done for 40 patients who were subdivided into 2 equal groups A and B. EN-DCRs done for group A without diaphanoscopy and for group B with diaphanoscopy. The average duration of surgery was 78 minutes [SD +/- 13, range, 60-115 minutes for group A] and 38 minutes [SD +/- 13, range, 19-79 minutes] for group B. The total success rate was 83.3 percent [82.6 percent and 91.3 percent for group A and B respectively]. In this study, it appears that EN-DCR with diaphanoscopy is a simple, practical and useful complementary imaging for EN-DCR permitting rapid surgery without undue damage to the tissue. Moreover it showed high success rate more than EN-DCR without diaphanoscopy which may be due to precise localisation of the rhinostomy site without undue damage to the adjacent structures. Use of recently developed lacrimal duct endoscope in preoperative evaluation procedures has been emphasized

Inhalant allergens and ELISA as valuable tool in diagnosis

One hundred patients [50 Saudi and 50 Egyptian patients] with perennial rhinitis and perennial rhinitis with seasonal exacerbation were examined clinically and by means of laboratory investigations to shed light about the pathogenesis of the disease and the clinical value of various tests in the assessment of the patients. In 65 percent of the cases [50 percent of the Egyptian and 80 percent of the Saudi patients] allergy was proven. The most common allergen is weed pollen mix followed by grass pollen mix and house dust in Egyptian patients and by house dust and grass pollen mix in Saudi patients. In this study, investigations of blood eosinophils, total IgE and circulating specific IgE antibodies in the patient's sera by enzyme linked immunoassay [ELISA] were found to be of value in the assessment of patients with allergic rhinitis. Advantages and disadvantages of ELISA have been discussed. Combination of skin prick test and ELISA is recommended to increase the reliability of both tests

Incidence of allergic rhinitis ABO blood groups

It is well defined that there is an association between ABO system and some diseases. In 1941, Levine discovered the association between haemolytic diseases of the newborn and the Rh blood group. The best example of association is that the incidence of cancer stomach, pernicious anaemia and salivary gland tumours is significantly higher in people with blood group [A] than in people with blood group [0] [McCannelt, 1966]. This study has been done to spot light on the possibility of the association between ABO system and allergic rhinitis. One hundred patients suffering from symptoms of allergic rhinitis were examined and followed up and investigations have been done in the form of ABO blood group determination, total IgE measurement and determination of circulating specific IgE antibodies in human serum by enzyme linked immunoassay. 65 percent of all patients have been diagnosed clinically and by laboratory investigations as allergic rhinitis patients. The present study showed that the incidence of allergic rhinitis was more in patients with group [A] while it is considered rare in the patients with group [O] and there is no relation in the patients with blood group [AB] and [B]

association between allergic rhinitis and food hypersensitivities

The relationship between respiratory allergies and food allergies are becoming increasingly well recognized and may rest on the presence of related determinants on allergenic proteins from different sources. Fifty patients suffering from symptoms of allergic rhinitis, when eating some food items, were examined, investigated and followed up in the outpatient clinic. 52 percent of all patients showed specific IgE antibodies in their sera against one or more of these food items: egg white, milk, fish, wheat, peanut and soya bean. 21 of the patients [total 26 patients] who showed food allergy, showed association of allergy against one or more of other inhalant allergens and 5 patients only showed food allergy alone. Ten patients out of the twenty one showed food allergy, and pure pollen allergy against grass and weed pollen mix. Twenty four patients [92 percent] out of twenty six showed blood eosinophilia. Twenty one patients [81 percent] out of twenty six showed high total IgE range. To date, cross-reactivities of IgE antibodies appear to be the most probable explanation for the observed clinical symptoms. Similarly, a clinical history of food allergy may be associated with latent respiratory allergy. When both respiratory and food allergies appear in the clinical history of allergic subjects, avoidance of both sources may be considered to be a good therapeutic measure; desensitization to one of the allergenic proteins may also result in desensitization to the other

Nasal mucociliary clearance in patients with secretory otitis media

Impaired mucociliary function of respiratory tract mucosa is associated with secretory otitis media in some well recognized syndromes. In this study using the saccharin method, nasal mucociliary function has been determined in 3 groups of subjects who were not suffering from any significant nasal problem. Group I is of normal volunteers [number=40], Group II is of patients suffering from bilateral secretory otitis media [n=30], and Group III is of patients suffering from unilateral secretory otitis media [n=10]. In Group I, the mean [ +/- SD] value of saccharine transport time was 17.8 +/- 4.5 while it is 47.8 +/- 8 in group II, but in Group III there is a difference in saccharine transport time between right and left sides where it is slower at the side of the affected ears and normal at the side of the non-affected ears. So, from this study it has been concluded that there is a positive correlation between mucociliary function of the nasal and middle ear cleft mucosa

Causative organisms of acute suppurative otitis media versus chronic suppurative otitis media

One hundred forty patients suffering from acute suppurative otitis media [60 patients, Group I] for the first time with perforation and chronic suppurative otitis media with acute exacerbation [80 patients, Group II] were studied. In group I Streptococcus was isolated from 30 cases and Staph. aureus was isolated from 20 cases. In group II Pseudomonas aeruginosa was isolated from 40 cases, Staph. aureus was isolated from 26 cases and Proteus was isolated from 10 cases. As regards the antibiotic sensitivity test, in group I, Cephalosporin inhibited 18 cases out of 30 cases of Strept. infection and all cases of Staph. aureus infection [20 cases]. In group II quinolone group antibiotics inhibited all cases of Pseudomonas infection [40 cases] and 8 cases out of 20 cases of Proteus infection while cephalosporin inhibited 22 cases out of 26 cases of Staph. aureus infection