Relaesable scleral flap suture in trabeculectomy: preliminary results of a new technique

To demonstrate a technique for a releasable scleral flap suture placed to reduce post-trabeculectomy complications. Under a fornix based conjunctival flap, a rectangular partial thickness scieral flap is fashioned. A scierostomy is made followed by a peripheral iridectomy and the scieral flap is secured. A trapezoid suture is then placed from the sciera across the scleral flap to exit on the corneal surface and then tightend under the conjunctival flap which is then secured. During the follow-up, this suture can be safely removed on the slit lamp if the lOP is high. If the lOP is ideal, the suture can be left in place. Immediate postoperative complications as flat anterior chamber and choroidal detachment didn't occur. The suture was removed only if the filtration was not sufficient and the lOP was high. The releasable scieral flap suture was effective in preventing post trabeculectomy complications. In addition, it can be easily removed on the slit lamp without the need to fish under the conjunctiva, or to search for equipments as lasers

Efficacy of aloe vera extracts in attenuating neurological endangerment- induced by dexamethasone in adult male rats

The current study aimed at performing phytochemical screening of 24 plant samples belonging to Liliaceae family and investigating the phytosterols, hydrocarbons, fatty acids and amino acids content of Aloe vera plant parts [flowers, leaves, roots and stalks] and Aloe hijazensis [leaves and roots] as well as the isolation and identification of certain compounds from Aloe vera. The study was extended to investigate the possible potential role of methanolic extracts of different Aloe vera plant parts in attenuating neurological insult-induced by dexamethasone. Plants materials were collected from Saudi Arabia from different sources and were phytochemically screened according to the recorded procedures. The lipoidal matters were investigated by GLC and amino acids by HPLC and total proteins percentage was carried out. The structures of isolated compounds were established by GC/MS and NMR. Extracts were prepared for the biological evaluation and eighty adult male Sprague-Dawley rats were divided into ten groups, group [1] was served as normal control group; groups [6 to10] were intramuscularly injected with dexamethasone in a dose of 8 mg/ kg b.wt. / day. At the same time animal groups were orally administered with Aloe vera flowers [2 and 7], leaves [3 and 8], roots [4 and 9] or stalks extracts [5 and 10], in a dose of 32 mg/kg b.wt./ day. The study was extended to 28 days. Two Aloe species were selected from the 24 samples screened. Different plants parts of A. vera and A. hijazensis showed variation in their lipids and proteins chemical composition. One triterpene [lupeol] and mixture of sterols were isolated from leaves and roots of A. vera. Co-administration with A. vera extracts and dexamethasone produced remarkable effective role against hyperglycemia and hyperinsulinemia. Also, A. vera extracts could restore brain glycogen content and serum IGF-1 level. Moreover, A. vera extracts monitored each of brain ATPase and LDH activity. Interestingly, brain biochemical variables indicative for oxidative stress showed marked improvement on A. vera extracts supplementation. Improvement in brain glycogen level may be attributed to -sitosterol content of A. vera extracts [recorded in major quantity in all samples except roots in the present study] and the screening of A. vera extracts showed the presence of anthraquinones and coumarins which are known to have a powerful antioxidant activity. Simultaneous supplementation with each of A. vera extract and dexamethasone has an officious role in modulating neurological impact-induced by dexamethasone and this might be accomplished by their antihyperglycemic effects, antioxidative activities and cytoprotective properties

Aberration profile of the Alcon[R] Acrysof[R] Acrylic intraocular lenses: in vivo assessment

To evaluate the aberration profile of patients implanted with the Alcon[R] Acrysof[R] Acrylic intraocular lenses [IOLs]. Dar El-Oyoun specialized eye hospital, Cairo, Egypt. Twenty cataractous eyes that underwent phacoemulsification and implantation of Alcon[R] Acrysof[R] MA60BM IOL. One month after surgery, all patients had an aberration profile study using the VISX[R] wavescan system, more attention being paid to the higher order aberrations. Patients showed predominance of higher order spherical aberrations [100%], comalike aberrations [60%] and trefoil aberrations [40%]. Modifications should be made to IOL designs to minimize such aberrations aiming to obtain super vision

Humoral and cellular immune responses induced in mice by purified iridoid mixture that inhibits penetration of schistosoma mansoni cercariae upon topical treatment of mice tails

When tested for possible blocking effect on the cercarial, serine proteinase, elastase [CE] activity, an iridoid mixture extracted from leaves of Citharexylum quadrangular abolished 31% of the enzyme activity at final concentration l5 micro g. When formulated in jojoba oil and applied to mice tails followed by infection with Schistosoma mansoni cercariae, the iridoid mixture blocked cercarial penetration and caused significant reducetion [94%; P < 0.05] in worm burden in treated mice in comparison to controls. Also, immunomodulatory effects of iridoid mixture, iridoid-treated S. mansoni worm homogenate on mice were studied by measuring IgG and IgM levels against E. coil lysates [ECL], solube S. mansoni worm antigenic preparation [SWAP] and cancer bladder homogenates [CBH] as antigens by ELISA. Cellular immune responses were studied by calculating mean percent of CD4+, CD8 +/- T, B-mesenteric lymph node cells [MLNC] and CD4+, CD8 +/- T thymocytes by direct immuno-fluorescence staining in treated mice as compared to untreated homogenate given mice or untreated mice. Injecting mice with serial dilutions of iridoid mixture resulted in fluctuation, peaks and troughs, in both IgG and IgM responses against the above mentioned antigens. lst and 2nd immunizations with iridoid mixture treated homogenate resulted in significantly elevated [P < 0.05]. 1gM and IgG levels against the 3 used antigens in comparison with sera from control mice. Immunized mice with homogenate treated with iridoid mixture showed a significant increase [P < 0.05] in CD4+T thymocytes, a non significant increase in CD8+T thymocytes, a significant increase [P<0.05] in CD4+T lymphocytes [MLNC] and a non significant increase in CD8+T- and B-lymphocytes [MLNC] compared with mice immunized with untreated homogenate or non-injected normal mice

Spectroscopic investigation of some biologically active coumarins and their thionated derivatives

UV, IR and 1H-NMR spectra of some selected compounds of coumarins, furocoumarins, a simple chromone and their thionated derivatives were investigated. 13C-NMR assignment of seven thionated derivatives and mass spectra of six of them were reported. Moreover, 21 compounds were tested for their anticancer activity

Clinical and experimental evaluation of continuous spinal anesthesia

Continuous spinal anesthesia is becoming more and more popular in many countries. This study was conducted to evaluate this technique through clinical and experimental work. Sixty-three adult male patients ASA class I and II were included in this clinical study. They were divided into three groups according to the drug injected intrathecally [lidocaine, meperidine HCl and ketamine HCl]. Inability to thread the catheter into the subarachnoid space occurred in 6.3% of cases. Any breakage of catheters were not experienced. 95.2% had adequate analgesia, while 4.8% had patchy analgesia in lidocaine group. Motor paralysis was more intensive in lidocaine group than meperidine and ketamine group. The study showed that CSA provided good cardiovascular stability and provided good titration of the drug injected. No neurological or respiratory complications observed in the study. The incidence of postdural puncture headache was 3.2%. Thirty male rabbits were included in the experimental study. They were divided into six groups according to the drug injected intrathecally [methylene blue, omnopic 300, lidocaine, meperidine and ketamine]. The use of microcatheter minimized the leakage of CSF. The distribution of the radiopaque dye was uniform. A clear motor affection was noticed in all groups

Metatarsal osteotomy for the treatment of hallux valgus

One hundred feet in 85 patients operated upon for correction of symptomatic hallux valgus deformity. The age of patients ranged from 14 to 60 years. Seventy patients had unilateral operation while 15 patients had been operated upon bilaterally. Forty-four patients were females and 41 were males. Distal metatarsal osteotomies. Mitchell, modified Hohmann, and chevron techniques were performed as well as Wilson oblique osteotomy. The results were rated excellent and good in 84.4% in Wilson group, 62.4% in Mitchell group, 64.7% in modified Hohmann group and 50% in chevron group. The Wilson oblique osteotomy is technically uncomplicated and yields a high percentage of satisfactory results. Modified Hohmann and the Mitchell osteotomies inspite of their technical demand had been found relatively simple and the results were uniformly good. The three osteotomies were found to be the proven methods of surgery recommended in adolescent and young adults and even older patients provided that there are no degenerative changes. Chevron osteotomy inspite of being straightforward and simple procedure, yet it is recommended in the treatment of patients who have limited degree of deformity

Salter innominate osteotomy for the treatment of Perthe's disease

Salter innominate osteotomy had been performed in a selected group of thirty patients with Perth's disease who were considered to have poor prognosis on the basis of age, stage of the disease, Catterall grading and the presence of uncovering of the femoral head. The mean age incidence was 8.6 years. The period of post operative follow up ranged from 12 - 27 months with an average of 19.3 months. There were 12 patients [40%] Catterall group III and 18 [60%] Catterall group IV. There were 24 [80%] boys and 6 [20%] girls. The clinical results were satisfactory in 25 patients [83.4%] [17 [56.7%] good, and 8 [26.7%] fair] and poor in 5 patients [16.6%]. The radiographic results were satisfactory in 27 patients [90%] [7[23.3%] excellent, 8 [26.7%] good and 12 [40%] fair] and poor in 3 patients [10%]

Ultrasonography of rotator cuff tear

This study included twenty six patients suspected to have rotator cuff tear. Ultrasonography was done for all patients after full clinical and radiological evaluation. It has been proved that ultrasonography is a rapid and non-invasive mean of diagnosing rotator cuff tears, the technique is simple and the anatomy is straightforward in most cases

Evaluation of intra-venous diazepam anaesthesia on liver functions

Diazepam has been based as premedication and main intravenous anesthetic agent in 60 patients subjected to different minor and major surgical interventions. A battery of liver function tests was applied on blood samples collected before, immediately after, 21 hr, 48 hr, and one week after operation. By using this battery of tests, the immediate and delayed effects of diazepam on liver functions could be evaluated. Diazepam was used in some cases with impaired liver functions, but no statistically significant changes could be detected. Thus intra-venous diazepam anaesthesia can be safely used in the presence of liver disease provided other factors i.e. hypoxia, hypercabia, etc., which affect liver functions are avoided. We would like to thank Dr. A.S. Ibrahim [M.D.], Lecturer of Statistics, Cancer Institute, Cairo University for his kind help in the statistical analysis of the results