Recent developments on dry eye disease treatment compounds

Dry eye syndrome is a common tears and ocular surface multifactorial disease, described by changes in the ocular surface epithelia related to reduced tears quantity and ocular surface sensitivity, leading to inflammatory reaction. Managing the eye inflammation proved helpful to patients with dry eye disease and current treatment is based on the use of topically applied artificial tear products/lubricants, tear retention management, stimulation of tear secretion and using anti-inflammatory drugs. In this article we revise the corresponding literature and patents assembling the new treatment approaches of novel and future pharmaceutical compounds destined for the dry eye disease treatment. The most frequent categories of compounds presented are secretagogues and anti-inflammatory drugs. These compounds are the research outcome of novel therapeutic strategies designed to reduce key inflammatory pathways and restore healthy tear film

Effect of Pain Management Post Cesarean Section on Mothers' Satisfaction

The aim of this study was to assess effect of pain management post cesarean section on mothers' satisfaction. The study design was an intervention study design. It was conducted on postnatal cesarean section room at Ain Shams Maternity University Hospitals. The study sample involved 150 mothers divided into 75 mothers as control group who received post cesarean section hospital routine analgesics for pain relief and their pain assessed at 6, 12 and 18 hours after the surgery and 75 mothers as intervention group who received foot and hand massage for 20 minutes and their pain assessed at 6, 12 and 18 hour after the surgery. Post cesarean section mothers were selected according to the following criteria: conscious mother, with intact hand and foot skin and free from arthritis, phlebitis, burn wound, injury, inflammation, eczema, cardiovascular and respiratory diseases. Four tools were used for data collection, a structured interviewing questionnaire sheet, a numerical rating scale, short form McGill pain questionnaire and likert scale. The results showed that, a significant improvement of pain level among intervention group compared to control group at different assessment time, [P =0.000] and these lead to a high satisfaction regarding pain management among mothers in intervention group than in control group. So, this study is highly recommended designing health educational training program for nurses about foot and hand massage as it is an inexpensive pain relief measure, with no harm to mothers. Also there is need for further study to investigate health team attitude regarding this method

Pattern of childhood meningitis in Assiut university hospital: risk factors for adverse outcome

The current prospective clinical trial study included 60 cases [39 males and 21 females] of acute meningitis admitted to the pediatric department, Assiut University Hospital during the period from September 2000 to August 2001. Their age ranged from 3 months to 8 years. All cases were subjected to complete history and clinical examination. The following routine laboratory investigations were done on admission: chemical, cytological and bacteriological examination of the cerebrospinai fluid [CSF], blood picture, C-reactive protein [CRP], renal function test, serum electrolytes [Na, Ca, K], parameters of coagulation prohle, tuberculin test, stomach wash for tubercle bacilli, chest X-ray, tibrinogen degradation product [FDP], and arterial blood gases. According to the presenting age, the cases were classified into 3 age groups: first group [38 cases]: aged 3 months to 1 year to 5 years to 8 years. According to the antibiotic treatment protocol, the patients were randomly classified into two groups: 30 cases received crystalline penicillin and cefotaxime while the other 30 cases received chloramphenicol and ampicillin. Out of the 60 studied cases, 37 were treated with dexamethasone as adjunctive therapy for 48 hours. Bacteriological and hematological monitoring parameters were reevaluated for the studied cases till discharge or death. All the survivors were screened for hearing loss by measuring auditory brain stem response [ABR]. The results showed that the incidence of meningitis was higher during winter months. Out of the 60 studied cases, 31.9% had haemophilus influenzae B [Hib], 23.4% had streptococcus pneumoniae [St. pn] and 18.3 % had Nesseria meningitides in the CSF film and culture, while 26.6 % were considered as aseptic meningitis after exclusion of TB. In the youngest age group, Hib was the dominant pathogen. The clinical manifestations of meningitis differed according to the age, but not according to the causative organism. The outcome of cases did not significantly differ according to the type of antibiotic protocol used in the study. Out of the 60 studied cases, 20% died, while 36.1% had complete recovery, and 43.3% recovered with neurological sequelae. The best cure rate was in cases of Hib meningitis [58%], while N. mengititides infection was associated with significantly higher incidence of mortality [72.7%] and cases with St. pn had higher incidence of neurological complications [72%]. Hearing loss was detected in 40% of survivors. The addition of dexamethasone to the treatment protocol was associated with significant reduction in the incidence of hearing loss especially among those infected with Hib. The risk factors for hearing loss and fatal outcome were: seizures on admission, impaired level of consiousness, change in muscle tone, raised FDP, low prothrombin concentration and N. meningitides as causative organism

Conclusion: Acute bacterial meningitis is a real health problem in Upper Egypt, and is still associated with a high incidence of mortality and morbidity. Vaccination against Hib and N. meningitides should be carried out to decrease the incidence of meningitis. The addition of steroid as adjuvant therapy could be of value in reducing the development of hearing loss. Further studies on bigger number of cases are needed to validate the risk factors detected in this study