Q value based ablation profile versus topography-guided lasik: a contralateral comparative study

Background: laser in situ keratomileusis [LASIK] has become the most widely used form of refractive surgery. The objective of this surgical technique was to modify the anterior corneal shape by ablating tissue from the stroma by means of the excimer laser after creating a hinged corneal flap. By this way, we were able to change the refractive status of the patient and provided better unaided vision. Continuous improvements in the original technique made the surgical procedure safer, more accurate and repeatable. These progressions are due to the development of novel technologies that are responsible for new surgical instrumentation, which makes the surgical procedure easier for the surgeon and better excimer laser ablation algorithms, which increase the optical quality of the ablation and thus the safety of the vision correction procedure

Aim of work: the aim of this study was to compare between Q value based ablation and topography-guided LASIK as regards safety, visual acuity, contrast sensitivity and high order aberration HOAs [spherical, coma and trefoil]

Patients and methods: this study was conducted on 60 eyes of 30 patients, thirty eyes of them underwent topography guided LASIK and the other 30 underwent Q value based ablation. Preoperative CDVA [corrected distant visual acuity] was done. Postoperative UDVA and CDVA were measured. Postoperative high order aberrations were measured 3 months postoperatively

Results: our results showed that there was no statistically significant difference between both groups as regards UDVA, spherical equivalent, high order aberrations and Strehl ratio point spread function

Conclusion: topographic guided ablation and Q value based groups provided essentially equivalent outcomes after myopic LASIK, with statistically insignificant difference between both profiles, although both laser profiles have been found to be effective, safe and predictable

Recommendations: we recommended doing more research regarding this study with larger number of cases and doing further investigations

first two vancomycin resistant staphylococcus aureus isolates in mansoura university hospital; epidemiology and antimicrobial study

Staphylococcus aureus, a major cause of potentially life threatening infections acquired in health care and community settings, has developed resistance to most classes of antimicrobial agents with dramatic increase in the number of health care associated infections due to methicillin resistant S. aureus [MRSA]. During the period of our study 974 S. aureus strains were isolated from different types of infections in different wards of Mansoura University Hospitals [MUH], 530 [54.4%] isolates were methicillin sensitive S. aureus [MSSA] and 444 [45.6%] isolates were MRSA. Simplified population analysis of MRSA strains revealed, 27 [6.08%] heterogeneous vancomycin intermediate sensitive S. aureus [hVISA], 12 [2.70%] vancomycin intermediate sensitive S. aureus [VISA], while 2 [0.45%] isolates were vancomycin resistant S. aureus [VRSA]. hVISA strains were isolated from different infections, mainly from blood stream infections [29.63%] and infected skin ulcers and bedsores [29.63%], where the 12 VISA strains were isolated from infected skin ulcers and bedsores [41.66%], infected surgical wounds [41.66%] and lower respiratory tract infections [16.67]. The 2 VRSA isolates were isolated from blood stream infection [one case] and an infected bedsore [the other case]. One of the 2 VRSA cases was isolated from children hospital and the other one was isolated from medical wards. Minimal inhibitory concentration [MIC] of different antimicrobial agents for S. aureus with diminished sensitivity to vancomycin was done by microdilution method revealing a significant difference in resistance among VISA, hVISA and VRSA with vancomycin, linzolide, meropenem. Time kill study of different antibiotics for VRSA isolates showed that, vancomycin exhibited no kill activity at 1X MIC, but killing activity was achieved only at 2X and 4X. Other tested antibiotics were significantly had killing activity more than vancomycin at concentration of 1X MIC. Daptomycin, quinipristin/dalfopristin, tigecyclin, meropenem, ciprofloxacin, and erythromycin were significantly had killing activity more than linezolide at concentration of 1X MIC. In conclusion, the first two identified VRSA isolates from children hospital and medical wards still susceptible to some antibiotics which are not used widely such as, daptomycin, quinipristin/dalfopristin and tigecyclin, also hVISA and VISA had antimicrobial susceptibility pattern similar to VRSA isolates

toxic effect of prolonged ultram administration on cerebral cortex of albino rats. Toxicological and histological study

Ultram [Tramadol] is a widely used opioid analgesic effective in treating both acute and chronic pains and has acceptable adverse effects. The aim of the present study was to evaluate the cerebrocortical toxicity resulting from one month and two month Ultram administration in to albino rats using biochemical and histological parameters. The study was carried out on 25 adult male albino rats divided into: control group received 0.5 ml /day saline orally by orogastric tube for two months, a short-term Ultram-treated group that received a dose of 30 mg/kg/day [1/10 LD50] for one month orally and a long-term Ultram-treated group that received the same dose for two months. The study revealed that Ultram administration caused a significant elevation of serotonin level in the cerebral cortical tissues of rats which was directly proportional to the duration of Ultram admistration. Histologically, there were many changes in the organization and ultrastructure of neurons in the different layers of cerebral cortex associated with an increased response of the supporting neuroglial cells. Intense neurological tissue lesions were more evident with the two months Ultram dosing than with one month. The correlation between the biochemical results and the histological findings proved that Ultram induced neuronal lesions could be mediated by the elevated cerebrocortical serotonin level which gives serious alarms for reconsidering the rush towards the excessive use of ultram

Asymptomatic bacteriuria among primary school children in Dakahlia governorate

Nine hundred and sixty primary school children from Dakahlia governorate were screened for asymptomatic bacteriuria [ABU]. The prevalence of ABU was found to be 4.1%. ABU was more predominant [P 0.001] in children from rural areas [5.9%] than in those coming from urban areas [1.5%]. Females had significantly [P<0.0001] higher ABU prevalence [6.5%] than males [1.6%]. There was no difference in the prevalence of bacteriuria between younger children and older ones. From the total bacterial isolates E-Coli were the most common bacteria 2.6%, followed by Enterobius faocalls 1.8%, Klebsiolla pneumonia 0.4%, then coagulase negative staphylococci 0.3%. In conclusion, ABU is not a common finding in primary school children in our locality. It is more common in girls and in those coming from rural areas. E-CoIi is the most common isolated bacteria

Assessment of results of endoscopic sinus surgery: a prospective analytical assessment of 6 weeks versus 6 months results using visual analogue scales

Ten patients who underwent functional endoscopic sinus surgery for ostiomeatal complex disease were included in this study. Each patient was assessed three times: preoperatively, 6 weeks postoperatively and 6 months postoperatively. Assessment was done using an eleven point Visual analogue scale referring three major symptoms: Nasal obstruction, Headache and postnasal discharge. An attempt was made to explore any consistency of the scale results between 6 weeks and 6 months values. An attempt was also made to discover any pattern of correlation between the improvements of the various symptoms. Results showed statistically significant [p <0.05] improvement in VAS at 6 weeks. Improvement was maintained at 6 months with no statistically significant difference between 6 weeks and 6 months. No correlation was found statistically between improvements in Headache and postnasal discharge or between headache and nasal blockage. However, a statistically significant correlation was found between postnasal discharge and nasal blockage scale values [Spearman rank correlation coefficient value = 0.754]

Role of CT scan in assessment of bronchiectasis

In recent years, CT which is clearly safer and easier to perform and causes no patient discomfort, has been used to establish the presence and extent of bronchiectasis. The aim of this work is to evaluate the role of CT scan in the diagnosis of bronchiectasis; 40 patients with a suspected clinical diagnosis of bronchiectasis were analyzed. The type, site and lobar distribution of bronchiectasis were scored. Although the pathologic types of bronchiectasis have a characteristic feature on CT, differentiation between the various forms is much less important than simple identification of the disease process itself. Spiral CT is a reliable method in assessment of bronchiectasis in patients enable to hold their breath but high resolution CT is a method of choice due to its greater sensitivity

Pneumothorax in mechanically ventilated neonates with hyaline membrane disease

A prospective study was done on twenty two neonates who have developed pneumothorax during mechanical ventilation because of severe hyaline membrane disease. A control group was formed of equal number of neonates who were mechanically ventilated and did not develop pneumothorax. No significant difference, in the mean birth weight, one minute Apgar score or the age at initiation of mechanical ventilation, was found between the two groups. The maximum inspiratory time prior to air leak was significantly longer in the study group, while the peak inspiratory pressure was not significantly higher. In 16 cases pneumothorax developed during the acute phase of the disease while the patients were receiving intermittent mandatory ventilation [IMV]. In 6 cases, alveolar rupture occurred in the recovery phase during weaning the patients were on continuous positive airway pressure [CPAP]/ Pneumothorax was right sided in 12 cases, left side in 9 and bilateral in one. The overall mortality in the study group was 54%

Factors affecting outcome in mechanically ventilated neonates with severe respiratory failure

A prospective study to identify the predictors of outcome was carried out in forty neonates who were incubated and mechanically ventilated because of severe respiratory failure. Patients were divided into 2 groups according to the outcome, survivors and non-survivors. Our study has demonstrated clearly that birth weight is one of the main decisive factors affecting the outcome. Mortality was significantly higher in the very low birth weight infants. Other factors as asphyxia at birth, primary illness necessitating mechanical ventilation, initial degree of acidosis were also responsible. The incidence of associated complications as D. L. C., sclerema and septicemia was significantly higher in the group of non survivors. Hypothermia on admission, initial degree of hypercarbia and hypoxaemia and iatrogenic pulmonary complications as pneumothorax and bronchopulmonary dysplasia were not major factors affecting the outcome. Early ventilation during the first day life was associated with higher mortality. Fifty five per cent of nonsurvivors died during the first 3 days of life and 90% during the first week

Evaluation of the sensitivity of different methods for detection of seminal stains

identification of seminal stain by finding spermatozoa has long been regarded as the best and most certain means of detection. When the demonstration of complete spermatozoa was impossible, especially in persons having azoospermia as a result of disease or vasectomy, several methods have been sought for seminal fluid identification. The study showed that Florence test remained positive till five or six fold dilutions. On the other hand, Barberios and dithizone tests retained their positivity till 10-fold dilutions. As regards thin layer chromatography, the Rf value of fresh seminal stains was significantly higher than that of old seminal stains in undiluted specimen, but both could be identified till 1:64 dilution. A high creatine phosphokinase activity was reported with both fresh and old seminal stains, but it was significantly higher with fresh than with old stains till 1:16 dilutions. The activity of CK in fresh seminal stains remained high for less than a week [6 days]. This indicated that the presence of high CK activity might provide additional evidence for seminal fluid identification