Flower-petal inverted flap for internal limiting membrane in myopic eyes with macular hole and rhegmatogenous retinal detachment

We demonstrate a modified internal limiting membrane (ILM) inverted flap technique for closure of macular holes (MHs) concurrent with rhegmatogenous retinal detachment in myopic eyes. Multiple ILM flaps were created in a flower?petal configuration around the MH over the detached retina after shallowing the retina as much as possible. Traction was always in a direction that allowed the optic disc to act as an anchor to limit iatrogenic breaks and to bridge the hole with multiple, more secure flaps should one of the flaps revert or break away. The technique proved safe and efficient in MH closure in our series of eight cases. The modification described provides an effective approach for challenging myopic cases in which ILM flap creation is needed over a detached retina.

Treatment outcomes of children with acute lymphoblastic leukemia in a middle-income developing country: high mortalities, early relapses, and poor survival / Desfechos do tratamento de crianças com leucemia linfoblástica aguda em um paísem desenvolvimento de renda média: altas taxas de mortalidade, recidivas precocese baixa sobrevida

Abstract Objective Acute lymphoblastic leukemia is the most common childhood cancer, yet surprisingly, very few studies have reported the treatment outcomes and the relapse rate of patients from low/middle-income countries. Method This study was a 5-year retrospective cohort study. It was conducted at Oncology Center of Mansoura University in Egypt and aimed to estimate the treatment outcomes and the relapse rates of newly diagnosed acute lymphoblastic leukemia in children. Results Two hundred children suffering from acute lymphoblastic leukemia were studied; forty-six patients (23%) died during induction and most of those deaths were related to infection. Forty-one patients (27%) relapsed out of the 152 patients who achieved complete remission. The most common site of relapse was the bone marrow, followed by the isolated central nervous system, 53.7% and 31.7%, respectively. Seventy-eight percent of relapses occurred very early/early rather than later. The majority of relapse patients' deaths were related to infection and disease progression. The 5-year overall survival rate for patients was 63.1% (82.1% for non-relapsed compared to 36.6% for relapsed patients). Conclusion There was a high incidence of induction deaths related to infection and high percentages of very early/early relapses, with high mortalities and low 5-year overall survival rates. These findings suggest the urgent need for modification of chemotherapy regimens to be suitable for the local conditions, including implementation of supportive care and infection control policies. There is also a requirement for antimicrobial prophylaxis during induction period combined with the necessary increase in government healthcare spending to improve the survival of acute lymphoblastic leukemia in Egyptian children.

Resumo Objetivo Estimar os desfechos do tratamento e as taxas de recidiva de crianças recém-diagnosticadas com leucemia linfoblástica aguda. É o câncer infantil mais comum, mas surpreendentemente poucos estudos relataram os desfechos do tratamento e a taxa de recidiva em pacientes de países de renda baixa/média. Método Estudo de coorte retrospectivo de cinco anos. Foi feito no Centro de Oncologia da Universidade de Mansoura, no Egito. Resultados Foram estudadas 200 crianças com leucemia linfoblástica aguda, das quais 46 (23%) morreram durante a indução e a maioria dessas mortes estava relacionada à infecção. Dos 152 pacientes que alcançaram a remissão completa, 41 (27%) apresentaram recidiva. O local mais comum de recidiva foi a medula óssea, seguido pelo sistema nervoso central isolado, com 53,7% e 31,7% dos casos, respectivamente. Das recidivas, 78% ocorreram muito precocemente ou precocemente, em vez de tardiamente. A maioria das mortes de pacientes com recidiva estava relacionada à infecção e progressão da doença. A taxa de sobrevida global em cinco anos para os pacientes foi de 63,1% (82,1% para não recidivados em comparação com 36,6% para os recidivados). Conclusão Houve uma alta incidência de mortes na indução relacionadas à infecção e altos percentuais de recidivas muito precoces ou precoces, com altas taxas de mortalidade e baixas taxas de sobrevida global em cinco anos. Nossos achados sugerem a necessidade urgente de modificação dos esquemas quimioterápicos para adequação às nossas condições locais, implantação de políticas de cuidados de suporte e controle de infecções. Há também a necessidade de profilaxia antimicrobiana durante o período de indução, junto com um aumento necessário nos gastos governamentais com a saúde, para melhorar a capacidade de sobrevivência das crianças egípcias com leucemia linfoblástica aguda.

Antibacterial and Antiviral Activities of Essential Oils of Northern Moroccan Plants.

Aims: This study was designed to evaluate the antimicrobial activity of five essential oils (EOs) extracted from the aerial parts (leaves and flowering tops) of three species growing in the north of Morocco: Origanum elongatum, Thymus capitatus and Mentha suaveolens. Study Design: Chemical analysis of EOs, antibacterial and antiviral activities of EOs. Place and Duration of Study: Department of Biology (Faculty of Sciences), Institute of Agrochemistry and Food Technology (IATA), between September 2009 and December 2009. Methodology: The EO constituents were extracted by hydrodistillation and analysed by GC-MS. The antibacterial activity of EOs was tested against three reference strains, Salmonella enterica subsp. enterica CECT 915T, Listeria monocytogenes CECT 4031T, and Escherichia coli O157:H7 CECT 4267, and two food isolated strains Salmonella sp. S64 and Listeria monocytogenes L23, using the diffusion method and the microtitration assays. The antiviral effect of EOs was evaluated for the inactivation of murine norovirus (MNV-1), a human norovirus surrogate. Results: GC and GC/MS analyses revealed that thyme EO predominantly contains carvacrol (58.77-68.63%), p-cymene (4.84-5.63%), γ-terpinene (2.78-3.75%) and β- caryophyllene (2.62-2.91%). Oregano EO was mainly constituted by carvacrol (19.21- 40.12%), thymol (3.57-14.24%), p-cymene (16.08-16.19%) and γ-terpinene (7.27- 13.48%). While, mint EO was characterized by piperitenone oxide (41.84%), (-)-isopulegol (11.95%) and limonene (7.35%). All extracts exhibited an antibacterial activity at different levels against strains reported as the causal agents of foodborne diseases, but a low antiviral activity (0.87-0.50 log10 TCID50/ml reduction) was observed. Conclusion: Results suggest the potential use of tested EOs as bio-preservatives in the food industry. However, their antiviral activity needs to be further investigated.

comparison of performance of macintosh and airtraq/[TM]laryngoscopes for tracheal intubation in toothless patients

The Airtraq laryngoscope designed to facilitate tracheal intubation of normal and difficult airway patients. The study was done on 30 patients ASA l-3adult aged from 45 years or older. We found that IDS score differ significantly between the Macintoch and Airtraq laryngoscope group 6 [0.7] and 0.4 [0.2] respectively [p<0.001]. Fewer manoeouvers were required in Arirtraq group to improve the glottic exposure compared to the Macintoch group. Also SPO2 fall in 1 patient below 96%. IN Airtraq compared with 6 in Macintoch group [less than 93%]. Also the Airtraq significantly reduced the incidence of minor complications

Immunological Role of Nasal Staphylococcus aureus Carriage in Patients with Persistent at Allergic Rhinitis

Nasal carriage of staphylococcus aureus (S.aureus) exerts immunomodulatory effect in patients with atopic dermatitis and it may contribute to airway inflammation and allergic response in patients with allergic rhinitis. We Aim to investigate the frequency of nasal S.aureus carriage in patients with persistent allergic rhinitis and its possible influence on their symptoms and immune markers. We chosed 20 non smoker patients with house dust mite (HDM) allergy causing allergic rhinitis and 20 non smoker healthy subjects matched for age and sex. For all subjects rhinoscopy was done; skin prick test; nasal culture for S.aureus; nasal interleukin 4;nasal total IgE; serum total IgE and serum specific IgE(SSIgE) for HDM. Nasal S.aureus was detected in 16/20 patients (80) and 5/20 (25) in healthy subjects with highly significant statistical difference p0.01. Correlation of nasal staph.aureus count and different systemic and local immune markers revealed highly significant positive correlation between nasal S.aureus count and serum total IgE (r

Immunological Role of Nasal Staphylococcus aureus Carriage in Patients with Persistent at Allergic Rhinitis

Nasal carriage of staphylococcus aureus (S.aureus) exerts immunomodulatory effect in patients with atopic dermatitis and it may contribute to airway inflammation and allergic response in patients with allergic rhinitis. We Aim to investigate the frequency of nasal S.aureus carriage in patients with persistent allergic rhinitis and its possible influence on their symptoms and immune markers. We chosed 20 non smoker patients with house dust mite (HDM) allergy causing allergic rhinitis and 20 non smoker healthy subjects matched for age and sex. For all subjects rhinoscopy was done; skin prick test; nasal culture for S.aureus; nasal interleukin 4;nasal total IgE; serum total IgE and serum specific IgE(SSIgE) for HDM. Nasal S.aureus was detected in 16/20 patients (80) and 5/20 (25) in healthy subjects with highly significant statistical difference p0.01. Correlation of nasal staph.aureus count and different systemic and local immune markers revealed highly significant positive correlation between nasal S.aureus count and serum total IgE (r