Isolation and identification of multidrug-resistant Escherichia coli from cattle, sheep, poultry and human in Cumilla, Bangladesh

Aims@#Antimicrobial resistance (AMR) is a significant public health concern of modern civilization. The potential risk of AMR is significant in terms of both human and animal health. This study aims to assess the antimicrobial resistance pattern of selected antimicrobials against Escherichia coli of animal, poultry and human origin in the Cumilla district of Bangladesh.@*Methodology and results@#A total of 200 samples were collected from different sources. Isolation and identification of commensal E. coli were performed following standard bacteriological and molecular techniques. Antimicrobial susceptibility testing was performed following the Kirby-Bauer disc diffusion technique. Ampicillin, tetracycline and sulfamethoxazole-trimethoprim resistance genes were detected by polymerase chain reactions (PCR). A total of 152 (76%; 95% confidence interval (CI) 70-81%) E. coli were isolated from cattle, sheep, chicken and human, where 37.5% of isolates were found to be multidrug-resistant (MDR). In the cultural sensitivity test, E. coli showed the highest resistance to sulfamethoxazole-trimethoprim (71%), tetracycline (63%), ampicillin (62%), where gentamicin (23%) showed the lowest resistance, followed by ceftriaxone (26%). The prevalence of resistance genes like blaTEM, tetA, tetB, tetC, sul1 and sul2 were 100%, 95%, 11%, 8%, 58% and 52%, respectively.@*Conclusion, significance and impact of study@#The emergence of multidrug-resistant commensal E. coli and resistance genes circulating in animals, poultry and humans limit the treatment options for serious infections.

Genomic characterization of velogenic avian orthoavulavirus 1 isolates from poultry workers: Implications to emergence and its zoonotic potential towards public health

Objective: To carry out the genetic characterization and evolutionary analysis of three avian orthoavulavirus 1 (AOAV-1) isolates from poultry workers with respiratory symptoms. Methods: Using Illumina MiSeq, whole-genome sequencing was carried out to assess the evolutionary dynamics of three AOAV-1 isolates. A phylogenetic and comparative analysis of all coding genes was done using bioinformatics tools. Results: Phylogenetic analysis and genetic distance estimation suggested a close relationship among human- and avian-originated velogenic strains of genotype XIII, sub-genotype XIII.2.1. Several substitutions in the significant structural and biological motifs were exclusively identified in the human-originated strains. Conclusions: To our knowledge, this is the first report of a velogenic AOAV-1 isolate from natural infection of the human upper respiratory tract. Our findings highlight the evolution and zoonotic potential of velogenic AOAV-1 in a disease endemic setting.

Pattern of buccal and palatal bone density in the maxillary premolar region: an anatomical basis of anterior-middle superior alveolar (AMSA) anesthetic technique

Background@#The anterior-middle superior alveolar (AMSA) anesthetic technique has been reported to be a less traumatic alternative to several conventional nerve blocks and local infiltration for anesthesia of the maxillary teeth, their periodontium, and the palate. However, its anatomic basis remains controversial. The present study aimed to determine if the pattern of cortical and cancellous bone density in the maxillary premolar region can provide a rationale for the success of the AMSA anesthetic technique.Method: Cone-beam computed tomography scans of 66 maxillary quadrants from 34 patients (16 men and 18 women) were evaluated using a volumetric imaging software for cortical and cancellous bone densities in three interdental regions between the canine and first molar. Bone density was measured in Hounsfield units (HU) separately for the buccal cortical, palatal cortical, buccal cancellous, and palatal cancellous bones. Mean HU values were compared using the Mann-Whitney U test and one-way ANOVA with post-hoc analysis. @*Results@#Cancellous bone density was significantly lower (P ≤ 0.001) in the palatal half than in the buccal half across all three interdental regions. However, there was no significant difference (P = 0.106) between the buccal and palatal cortical bone densities at the site of AMSA injection. No significant difference was observed between the two genders for any of the evaluated parameters. @*Conclusions@#The palatal half of the cancellous bone had a significantly lower density than the buccal half, which could be a reason for the effective diffusion of the anesthetic solution following a palatal injection during the AMSA anesthetic technique.

Pattern of buccal and palatal bone density in the maxillary premolar region: an anatomical basis of anterior-middle superior alveolar (AMSA) anesthetic technique

Background@#The anterior-middle superior alveolar (AMSA) anesthetic technique has been reported to be a less traumatic alternative to several conventional nerve blocks and local infiltration for anesthesia of the maxillary teeth, their periodontium, and the palate. However, its anatomic basis remains controversial. The present study aimed to determine if the pattern of cortical and cancellous bone density in the maxillary premolar region can provide a rationale for the success of the AMSA anesthetic technique.Method: Cone-beam computed tomography scans of 66 maxillary quadrants from 34 patients (16 men and 18 women) were evaluated using a volumetric imaging software for cortical and cancellous bone densities in three interdental regions between the canine and first molar. Bone density was measured in Hounsfield units (HU) separately for the buccal cortical, palatal cortical, buccal cancellous, and palatal cancellous bones. Mean HU values were compared using the Mann-Whitney U test and one-way ANOVA with post-hoc analysis. @*Results@#Cancellous bone density was significantly lower (P ≤ 0.001) in the palatal half than in the buccal half across all three interdental regions. However, there was no significant difference (P = 0.106) between the buccal and palatal cortical bone densities at the site of AMSA injection. No significant difference was observed between the two genders for any of the evaluated parameters. @*Conclusions@#The palatal half of the cancellous bone had a significantly lower density than the buccal half, which could be a reason for the effective diffusion of the anesthetic solution following a palatal injection during the AMSA anesthetic technique.

Current status of the anterior middle superior alveolar anesthetic injection for periodontal procedures in the maxilla

Periodontal procedures require adequate anesthesia not only to ensure the patient's comfort but also to enhance the operator's performance and minimize chair time. In the maxilla, anesthesia is often achieved using highly traumatic nerve blocks, apart from multiple local infiltrations through the buccal vestibule. In recent years, anterior middle superior alveolar (AMSA) field block has been claimed to be a less traumatic alternative to several of these conventional injections, and it has many other advantages. This critical review of the existing literature aimed to discuss the rationale, mechanism, effectiveness, extent, and duration of AMSA injections for periodontal surgical and non-surgical procedures in the maxilla. It also focused on future prospects, particularly in relation to computer-controlled local anesthetic delivery systems, which aim to achieve the goal of pain-free anesthesia. A literature search of different databases was performed to retrieve relevant articles related to AMSA injections. After analyzing the existing data, it can be concluded that this anesthetic technique may be used as a predictable method of effective palatal anesthesia with adequate duration for different periodontal procedures. It has additional advantages of being less traumatic, requiring lesser amounts of local anesthetics and vasoconstrictors, as well as achieving good hemostasis. However, its effect on the buccal periodontium appears highly unpredictable.

Effectiveness of anterior middle superior alveolar injection using a computer-controlled local anesthetic delivery system for maxillary periodontal flap surgery

BACKGROUND: Profound anesthesia with adequate duration is required in periodontal flap surgery, which involves the manipulation of both hard and soft tissues. The anterior middle superior alveolar (AMSA) injection may be an alternative to multiple injections required for this purpose in the maxilla. The present study aimed to assess the effectiveness of AMSA injection using computer-controlled local anesthetic delivery (CCLAD) system to anesthetize buccal hard tissue (BHT), buccal soft tissue (BST), palatal hard tissue (PHT), and palatal soft tissue (PST) around the maxillary teeth. METHODS: Thirty-five patients who were indicated for open flap debridement in a whole maxillary quadrant were given AMSA injection using the CCLAD. The effectiveness of anesthesia was evaluated using subjective and objective parameters around each tooth. Supraperiosteal infiltrations were administered to complete the surgery wherever the AMSA injection was ineffective. RESULTS: The AMSA injection was more effective on the palatal tissues than on the buccal tissues, as 94.14% of PST and 87.89% of PHT sites were anesthetized compared to 49.22% and 43.75% of BHT and BST sites, respectively. There was no significant difference in the frequency of anesthesia around the anterior and posterior teeth. The PHT was significantly more anesthetized (P = 0.003) in males than in females. CONCLUSIONS: The AMSA injection using CCLAD is highly effective on palatal tissues and could be used as a first-line anesthesia for periodontal flap surgery. However, its effect on buccal tissues is less predictable, with supraperiosteal infiltration often required to supplement the AMSA injection.

systematic review of ACL reconstruction rehabilitation

Background: Anterior Cruciate Ligament [ACL] reconstruction is a well-known surgical knee procedure performed by orthopaedic surgeons. There is a general consensus for the effectiveness of a postoperative ACL reconstruction rehabilitation program, however there is little consensus regarding the optimal components of a program

Objective of the Study: to assess the merits and demerits of current ACL reconstruction rehabilitation programs and interventions based on the evidence supported by previously conducted systematic reviews

Methods: a Systematic search in the scientific database [Medline, Scopus, EMBASE , and Google Scholer] between 1970 and 2017 was conducted for all relevant Systematic reviews discussing the primary endpoint [ ACL reconstruction rehabilitation ] studies were analyzed and included based on the preset inclusion and exclusion criteria. Study screening and quality was assessed against PRISMA guidelines and a best evidence synthesis was performed

Results: the search results yielded five studies which evaluated eight rehabilitation components [bracing, Continuous passive motion [CPM], neuromuscular electrical stimulation [NMES], open kinetic chain [OKC] versus closed kinetic chain [CKC] exercise, progressive eccentric exercise, home versus supervised rehabilitation, accelerated rehabilitation and water based rehabilitation]. A strong evidence suggested no added benefit of short term bracing [0-6 weeks post-surgery] compared to standard treatment. Whilst a moderate evidence reinforced no added advantage of continuous passive motion to standard treatment for boosting motion range. Furthermore, a moderate evidence of equal effectiveness of closed versus open kinetic chain exercise and home versus clinic based rehabilitation, on a range of short term outcomes. There was inconsistent or limited evidence for some interventions including: the use of NMES and exercise, accelerated and non-accelerated rehabilitation, early and delayed rehabilitation, and eccentric resistance programs after ACL reconstruction

Conclusion: short term post-operative bracing and continuous passive motion [CPM] introduce no benefit over standard treatment and thus not recommended. A moderate evidence suggested equal efficiency for 1] CKC and OKC are equally effective for knee laxity, pain and function, at least in the short term [6-14 weeks] after ACL reconstruction and 2] home based and clinic based rehabilitation. Nevertheless, the degree of physiotherapy input remains unclear

Designing and characterizing of tramadol hydrochloride transdermal patches prepared with Ficus carica fruit mucilage and povidone

The purpose of this investigation was to prepare matrix type transdermal patches of Tramadol HCl using various ratios of Ficus carica fruit mucilage and Povidone. The matrix type transdermal patches were prepared using Tramadol HCl with Ficus carica fruit mucilage and Povidone. The interactions between Tramadol HCl with F. carica fruit mucilage and Povidone were performed by Differential Scanning Calorimetry [DSC] and Fourier Transform Infrared spectroscopy [FTIR]. The prepared patches were examined for physicochemical characterization and in vitro drug permeation studies [using a Keshary-Chien diffusion cell across hairless Albino rat skin], skin irritation studies and accelerated stability studies. The drug was found to be free from negligible interactions with the polymers used. The formulated patches possessed satisfactory physicochemical properties, in vitro drug permeation and devoid of serious skin irritation. The selected formulation [F-5] was retains the characteristics even after the accelerated environmental conditions. The study concludes that F. carica fruit mucilage with Povidone is a good combination for preparing transdermal patches

Effect of antimicrobial photodynamic therapy as an adjunct to nonsurgical treatment of deep periodontal pockets: a clinical study

Introduction: deep periodontal pockets pose a great challenge for nonsurgical periodontal treatment. Scaling and root planing [SRP] alone may not suffice in cases where surgical therapy cannot be undertaken. Various recent studies have suggested the use of antimicrobial Photodynamic Therapy [aPDT] for the management of periodontal infections. The aim of this study was to evaluate the effects of using aPDT along with SRP, compared to SRP alone for the management of deep periodontal pockets

Methods: thirty patients with chronic periodontitis, who met the criteria of having periodontal pockets with depth ? 6 mm and bleeding on probing [BOP] in at least 2 different quadrants, were included. After SRP, one quadrant was randomly selected for aPDT [test], while another served as control. Clinical parameters i.e. plaque index [PI], modified sulcular bleeding index [mSBI], probing depth [PD] and clinical attachment level [CAL] were measured at baseline, 1 month and 3 months post-treatment intervals

Results: all clinical parameters significantly improved in both groups after 1 and 3 months. At 1-month interval, inter-group difference in mean change was statistically significant [P < 0.05] in terms of mSBI [0.85 +/- 0.41in test vs 0.54 +/- 0.47 in control group] and PD [1.77+/-0.86 in test vs 1.3 +/- 0.95 in control group]. At 3 months interval, no statistically significant difference was observed between test and control groups except in terms of mSBI [0.97 +/- 0.45 in test vs 0.73 +/- 0.42 in control group]

Conclusion: aPDT appears to play an additional role in reduction of gingival inflammation when used along with nonsurgical mechanical debridement of deep periodontal pockets

Evaluation of the effects of Er,Cr:YSGG laser, ultrasonic scaler and curette on root surface profile using surface analyser and scanning electron microscope: an in vitro study

Introduction: the periodontal therapy is primarily targeted at removal of dental plaque and plaque retentive factors. Although the thorough removal of adherent plaque, calculus and infected root cementum is desirable, it is not always achieved by conventional modalities. To accomplish more efficient results several alternative devices have been used. Lasers are one of the most promising modalities for nonsurgical periodontal treatment as they can achieve excellent tissue ablation with strong bactericidal and detoxification effects

Methods: thirty freshly extracted premolars were selected and decoronated. The mesial surface of each root was divided vertically into four approximately equal parts. These were distributed into four group based on the root surface treatment. Part A [n = 30] was taken as control and no instrumentation was performed. Part B [n = 30] was irradiated by Erbium, Chromium doped Yttrium Scandium Gallium Garnet [Er,Cr:YSGG] laser. Part C [n = 30] was treated by piezoelectric ultrasonic scaler. Part D [n = 30] was treated by Gracey curette. The surface roughness was quantitatively analyzed by profilometer using roughness average [Ra] value, while presence of smear layer, cracks, craters and melting of surface were analyzed using scanning electron microscope [SEM]. The means across the groups were statistically compared with control using Dunnett test

Results: among the test groups, Er,Cr:YSGG laser group showed maximum surface roughness [mean Ra value of 4.14 micro m] as compared to ultrasonic scaler [1.727 micro m] and curette group [1.22 micro m]. However, surface with smear layer were found to be maximum [50%] in curette treated samples and minimum [20%] in laser treated ones. Maximum cracks [83.34%] were produced by ultrasonic scaler, and minimum [43.33%] by curettes. Crater formation was maximum [50%] in laser treated samples and minimum [3.33%] in curette treated ones. 63.33% samples treated by laser demonstrated melting of root surface, followed by ultrasonic scaler and curettes

Conclusion: Er,Cr:YSGG laser produced maximum microstructural changes on root surface that can influence the attachment of soft periodontal tissues as well as plaque and calculus deposition. In vivo studies are needed to validate these results and to evaluate their clinical effects

An Exploration of Disaster Risk in Farmer’s Community of Angaria Sub-sub-district in Bangladesh.

Aims: Analysis of risk, farmer’s perceptions on risk and their adaptation practices through exploration of agriculture based farmer’s community perceptions were lack on the perspective of Angaria sub-sub-district of Dumki sub-district of Patuakhali district in Bangladesh. That is why this study was conducted to gain understanding on agriculture farmers' risk profile, its impact and potential risk reduction strategy through community participation. Study Design: A total of 23 Focus Group Discussion’s (FGD) and 04 Key Informant Interviews (KII) were conducted. A well structured pretested questionnaire schedule was developed keeping in mind the objectives and variables under this study. Place and Duration of Study: Angaria sub-sub-district of Dumki sub-district of Patuakhali district in Bangladesh, from January, 2015 to May, 2015. Methodology: Primary data was collected through face to face FGD, KII methods and extensive field visit. Secondary data was collected from different secondary sources. Results: The agriculture sector of the study area is potentially exposed by different primary and secondary risk factors such as cyclone, flood, drought, pest attack etc. which threats to agriculture production and pose the farmers to make their livelihood diversified. But due to the changing trend in risk profiles; increasing its persistence time and frequency and intensity, farmers' adaptation capacities and sustainability are more exposed to vulnerability and adaptive capacity of the farmers are decreasing in the study area. They are transforming from on-farm agriculture practices to nonfarm alternative livelihood options –not as innovative adaptive resilient options. Conclusion: Recurring disasters phenomena threatened and undermined farmers capacity to adaptations, resulted more dependence on alternative nonfarm livelihood options than appropriate on farm adaptive options. Future extensive field based research in these regards will fulfill the required information to get the most efficient small farmers friendly risk management plan which will be beneficiary to the country by establishing climate smart disaster risk management in agriculture sector.

Extracorporeal shockwave lithotripsy; which parameter determines the outcome: calculus radiodensity or calculus size

To evaluate the effect of urinary calculi attenuation values from non enhanced computed tomography [stone radiodensity] and stone size in determining the outcome of treatment by ESWL. Descriptive case series study. Department of Diagnostic Radiology, Lahore General Hospital Lahore, in collaboration with the Department of Urology, Lahore General Hospital Lahore. Study was carried out over a period of six months from January 2012 to July 2012. Seventy patients with solitary renal calculus of 05 mm - 20 mm size were evaluated for calculus attenuation values in Hounsfield Units on non enhanced computed tomography. Patients were being grouped according to calculus attenuation values as: 1] less than 500 HU [soft] 2] 500-1000 HU [medium] 3] more than 1000 HU [Hard]. Patients were also distributed in three groups according to stone size as: 1] 5-10 mm 2] 11-15 mm 3] 16-20 mm. Patients were being subsequently treated with ESWL. During each ESWL session 3000 shockwaves were given. Stone clearance was documented by USG within three month after start of treatment. Out of 70 patients stones were cleared in 84.3% [n=59] patients. According to the stone density, the rate of stone clearance was 100% [n=19] in group 1, 88.9% [n=27] in group 2 and 66.7% [n=24] in group 3. Regarding the stone size, stones were cleared in 88.9% [n=9] in group 1, 77.4% [n=31] and 90% [n=30] in group 3. The best outcome was in patients with stone diameter of 16-20 mm and a density of < 500 HU. The worst outcome was in patients with stone diameter of 11-15 mm and a density of >1000 HU. The attenuation value of stone has a greater impact on ESWL outcome than the stone size. Further these attenuation values of urinary tract stones before ESWL helps in determining the treatment outcome and in planning alternative treatment in patients with likelihood of poor outcome from ESWL

IT IT study [the incubation time in tetanus study]

To determine the effect of incubation time on morbidity and mortality in patients with tetanus. Cross Sectional Descriptive Study This study was carried out in the Medicine Department of Saidu Hospital from Jan 2009 to Dec 2012. A total of 30 patients both males and females were included. These tetanus Patients were classified in two Groups. Group I [Short incubation period i.e. less than 7 Days] and Group II [Long incubation period i.e. seven or more than 7days]. The association of short and long incubation time with mortality and morbidity was assessed. There was no mortality in this study. While morbidity was assessed in terms of hospital stay, whether stay was more than 10 days or less than 10 days. In Group I, 17 [85%] patients had a hospital stay of more than 10 days while in Group II Only 3[30%] had a hospital stay of more than 10 days. The results were analyzed using the chi square test of independence. The p value was 0.003. We conclude that short incubation period has definitely association with morbidity which in this study was hospital stay of more than 10 days

Normative spirometric values in adult kashmiri population.

Background. Normative values of pulmonary functions of healthy population are affected by different geographic, ethnic, climatic and demographic factors. Objective. Present study was designed to derive normative spirometric values, prediction equations for future reference in adult Kashmiri population. Methods. Pulmonary function testing was carried out on 3080 normal healthy non-smoking individuals (1974 males; age 18-65 years) of Kashmir valley. Multiple regression analysis was used to develop prediction equations for use in this population. Results. Forced vital capacity (FVC, L/s) (4.3±0.8 versus 3.0±0.5; p<0.05), forced expiratory volume in the first second (FEV1, L/s) (3.9±0.7 versus 2.6±0.5; p<0.05) and peak expiratory flow rate (PEFR, L/s) (7.9±1.8 versus 5.3±1.2; p<0.05) were significantly higher in males in comparison with females. All the other parameters except FEV1/PEFR ratio were significantly higher among males (p<0.05). Irrespective of gender, all the parameters declined with increasing age. Females had higher FEV1/PEFR ratio (p<0.05) in age group of 15-30 years. Overall the inter-group difference across the districts studied was not significant. Spirometric parameters manifested an overall negative correlation with increasing body mass index (BMI), although FVC and FEV1 in males with low BMI were high (p<0.05). Conclusion. These prediction equations can be utilised as reference values for future use in adult Kashmiri population.

Formulation and evaluation of ficus glomerata mucilage sustained release matrix tablets of gliclazide

The main aim of present investigation was to develop sustained release matrix tablets of Gliclazide using fruit mucilage from the plant Ficus glomerata. Varying ratios of drug and polymer viz. 1:0.25, 1:0.5, 1:0.75, 1:1.0 and 1:1.25 were selected for the study. The flow properties of powdered mucilage and physical properties of matrix tablets were performed. The swelling behavior and release rate characteristics were studied. The in vitro drug release data was analyzed by zero order, first order, Higuchi plot, Peppas plot and Hixon-Crowell Models. It was observed that as the proportion of mucilage increased the release of drug from the matrix tablets was retarded. Stability studies were conducted at 40 +/- 2°C and RH 75 +/- 5% for 3 months indicates that Gliclazide was stable in the matrix tablets. The Differential Scanning Calorimetric [DSC] and Fourier Transform Infrared [FTIR] study revealed that there was no negative chemical interaction between drug and the mucilage used. From the dissolution study, it was concluded that dried Ficus glomerata mucilage can be used as an excipient for making sustained release matrix tablets

Comparison and agreement between venous and arterial gas analysis in cardiopulmonary patients in Kashmir valley of the Indian subcontinent

Arterial blood gas [ABG] analysis is routinely performed for sick patients but is fraught with complications, is painful, and is technically demanding. To ascertain agreement between the arterial and peripheral venous measurement of pH, pCO[2], pO[2], and bicarbonate levels in sick patients with cardiopulmonary disorders in the valley of Kashmir in the Indian subcontinent, so as to use venous gas analysis instead of arterial for assessment of patients. Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, a 650-bedded tertiary care hospital in North India located at an altitude of 1584 m. One hundred patients who required ABG analysis were admitted. Peripheral venous blood was drawn within 5 min of an ABG measurement, and the samples analyzed immediately on a point of care automated ABG analyzer. Finger pulse oximetry was used to obtain oxygen [SpO[2]] saturation. Data were analyzed using Pearson correlation and bias [Bland Altman] methods. The venous measurements of pH, pCO[2], pO[2] and bicarbonate, and the digital oxygen saturation were highly correlated with their corresponding arterial measurements. Bland Altman plots demonstrated a high degree of agreement between the two corresponding sets of measurements with clinically acceptable differences. The difference in pO[2] measurements was, however, higher [-22.34 +/- 15.23] although the arterial saturation and finger oximetry revealed a good degree of agreement with clinically acceptable bias. Peripheral venous blood gas assessment in conjunction with finger pulse oximetry can obviate the routine use of arterial puncture in patients requiring ABG analysis

Frequency of glaucoma in children with vernal conjunctivitis using steroids

To determine the frequency of glaucoma in children with vernal conjunctivitis using topical steroids, referred to a tertiary eye care centre. Descriptive case series. This study was carried out at department of Ophthalmology, Liaquat University Eye Hospital Hyderabad, Sindh - Pakistan, from July 2002 to December 2004 [Thirty months]. A total of 200 patients with chronic allergic conjunctivitis using topical steroids [Betamethasone, Dexamethasone, Prednisolone] for more than six months were examined. A thorough examination including visual acuity, Goldmann applanation tonometry, Schiot'z tonometry, Gonioscopy, slit lamp examination and dilated Ophthalmoscopy were performed. Out of 200 patients examined, fifteen [7.5%] were found having raised intraocular pressure [secondary glaucoma] due to prolonged use of topical steroids. The rise of intraocular pressure was bilateral in three patients [1.5%], and unilateral in twelve patients [6.0%]. The topical steroids were discontinued. One patient with vernal conjunctivitis using topical steroids since more than two years developed left optic disc pallor with constriction of visual field, and posterior sub capsular cataract. The intraocular pressure was not controlled by ocular hypotensive agents, and glaucoma filtration surgery was advised. This study identifies the risk of intraocular pressure elevation in patients with allergic conjunctivitis, using topical steroids for longer periods. Long term use of topical and systemic steroids produces secondary open angle glaucoma similar to chronic simple glaucoma. We can conclude that Dexamethasone and Prednisolone are possible risk factors for producing glaucoma

Effects of spesific exercises on patients with myocardial infarction relevant to complications

A descriptive study applied on a sample consisted of [30] patients, selected from Ibn Al- Nafees hospital in Baghdad city from the 1st of March through the 30th of May [2000] to know the effect of training exercises on patients with myocardial infarction to prevent respiratory complication and venous thrombosis. This study aimed to know the effect of training exercises on patients with myocardial infarction to prevent respiratory complication and venous thrombosis. A purposive study of [30] patients with myocardial infarction, [15] of them were in the study group and the other [15] patients were in the control group. Tow parts instruments were conducted, it consisted of a personal and demographic data sheet for patients and the other was an instrument constructed to assess the effect of training exercises on patients with myocardial infarction to prevent respiratory complication and venous thrombosis. To establish validity a panel of [5] experts gave suggestions about the instrument, their option and comments were taken into consideration. While the reliability coefficient was "r=0.85" and that was statistically accepted. Frequency, percentage and chi square test were used to analyses the data of the present study. The study results revealed that there is a significant effect of the training exercises in the appearing of venous thrombosis symptoms, about the pain in calf and redness of the leg, besides that there is a significant effect on the symptoms of respiratory complications in the study group. From the results of the present study the investigators recommended that the exercises can be used by professional nurses at cardiac care units for reasonable outcome of nursing care