Clinical characteristics and surgical outcomes of transcutaneous versus transconjunctival excision of Wolfring gland ductal cysts.

PURPOSE: To analyze the clinicopathological characteristics and surgical outcomes of patients with Wolfring gland ductal cysts (WGDCs). METHODS: A retrospective, consecutive, interventional comparative case series was performed over a period of 7 years. Data on demographic and clinical characteristics, pathological findings and outcomes of surgically excised cysts were collected. A comparison between the transconjunctival and transcutaneous approaches was also assessed. RESULTS: Forty-eight patients (48 eyelids) were included in the final analysis. The most common presenting symptom was painless eyelid swelling (81.3%). The median symptom duration was 11.5 months (IQR, 18.25). The upper eyelid was involved in 31 (64.6%) patients, 29/31 of whom had cysts in a medial or centromedial location. Forty-five (93.8%) cysts were bluish gray and transilluminable with clear contents on lid eversion and a median largest dimension of 22 mm (IQR, 8). A transverse conjunctival fibrotic band was observed along the proximal tarsal border in the cyst area in all patients. Signs of chronic trachoma were noted in 38 (79.2%) patients. Preoperative significant ptosis was present in 28/31 (90.3%) of the upper eyelid cysts. Thirty cysts (62.5%) were excised through the skin, and 18 cysts (37.5%) were excised transconjunctivally. Intraoperative cyst rupture, the need for conjunctival grafting and postoperative residual upper lid ptosis were significantly greater in the transconjunctival group (p = 0.009, p < 0.001, and p = 0.016, respectively). CONCLUSION: The present study highlights the clinicopathological characteristics of a relatively large series of surgically excised WGDCs. Transcutaneous excision of WGDCs has proven to be an effective treatment with fewer adverse sequelae than the transconjunctival approach.

Molecular cytogenetic analysis of multi-miscarriage products of conception in clinical cases from Al-Anbar Governorate, west of Iraq.

Most clinical miscarriages often occur throughout the first trimester of pregnancy, with fetal chromosomal abnormalities being identified as the primary reason for such occurrences. The objective is to analyze the fetal chromosomal aberrations in the product of conception among Iraqi patients suffering from recurrent miscarriages. The cross-sectional study was performed on 60 cases of products of conception in women suffering from multiple miscarriages, obtained from Department of Obstetrics and Gynecology is located in Ramadi Teaching Hospital for Child and Maternity, as well as other Private Clinics in the Ramadi City. Long-term culture of conventional cytogenetic analysis using the G-banding technique was employed to determine the chromosomal disorder of fetal tissue part or villus samples. Fetal chromosomal abnormalities were detected in 86.7 %. Numerical chromosomal abnormalities were revealed in 98.1 %, while structural abnormalities were detected in 1.9 %. Additionally, the commonest gestation loss occurs in parents under 35 years in the first trimester (92.3 %). Trisomy 21 was the most frequent (46.2 %) in gestational loss. Fetal chromosomal abnormalities have been linked with gestational loss in Iraqi couples. Therefore, it is recommended that cytogenetic analysis should be performed to identify the genetic cause of recurrent miscarriage. This is important for providing appropriate genetic counseling and educating couples about the risk of future pregnancies.

Metagenomic analysis of the ocular toxoplasmosis in children uveitis from Fayoum governorate, Egypt.

Granulomatous anterior uveitis with single or numerous gelatinous nodules was found in children living in rural Egypt. All ocular diseases were originally thought to be water-born and related to digenic flukes. The current study sought to learn more about the causes of anterior granulomatous uveitis in Egyptian youngsters who used to swim in rural water canals. 50 children with eye lesions that had not responded to medical treatment were recruited. Four samples were surgically extracted and examined using real-time PCR, transmission electron microscopy (TEM), and shotgun metagenomic sequencing (SMS). Toxoplasma gondii was detected free within the syncytium's distal section, while the proximal part exhibited active synthesis of a presumably extra-polymeric material, possibly released by the microbial population. Toxoplasma gondii was found in 30 samples. Serologically, distinct anti-Toxoplasma antibodies were not found in 91.6% of patients. SMS showed that the T. gondii ME 49 strain had the greatest percentage (29-25%) in all samples within an Acinetobacter-containing microbial community. These findings suggested that these bacteria entered the body via the exterior route rather than the circulatory route. The lack of genetic evidence for subsequent parasite stages invalidates the prior findings about the assumed trematode stage.

Probing Stereoselectivity in Ring-Opening Metathesis Polymerization Mediated by Cyclometalated Ruthenium-Based Catalysts: A Combined Experimental and Computational Study.

The microstructures of polymers produced by ring-opening metathesis polymerization (ROMP) with cyclometalated Ru-carbene metathesis catalysts were investigated. A strong bias for a cis,syndiotactic microstructure with minimal head-to-tail bias was observed. In instances where trans errors were introduced, it was determined that these regions were also syndiotactic. Furthermore, hypothetical reaction intermediates and transition structures were analyzed computationally. Combined experimental and computational data support a reaction mechanism in which cis,syndio-selectivity is a result of stereogenic metal control, while microstructural errors are predominantly due to alkylidene isomerization via rotation about the Ru═C double bond.

Insidious onset neck pain - a symptom not to be dismissed.

Chronic neck pain is an extremely common symptom in the general population. Most cases have underlying musculoskeletal aetiologies and are managed conservatively. However, a very small number of patients presenting with chronic neck pain will have significant underlying pathology, e. g. a spinal cord tumour. Intramedullary spinal cord tumours are uncommon at all ages, particularly in adults, and there are some controversies in their treatment. The case of an 18-year-old man with chronic neck pain who was subsequently shown to have a pilocytic intramedullary astrocytoma is presented. This report highlights the need to consider rare, but potentially serious, diagnoses in individuals presenting with non-resolving, but seemingly innocent, symptoms over a prolonged period.

The use of F-wave and sural potential in the diagnosis of subclincal diabetic neuropathy in Saudi patients.

OBJECTIVE: To compare nerve conduction parameters in asymptomatic diabetic patients and with no clinical signs of neuropathy and in control subjects. METHODS: Forty-eight diabetic Saudi subjects (20 males, 28 females) and 48 age-and-sex-matched control subjects were studied. The mean age of patients +/- standard deviation was 45.6+/-11.7 years. The mean duration of diabetes from time of diagnosis was 10.8+/-3.1 years, and their mean fasting plasma glucose was 8.5+/-0.9 mmol/l. Nerve conduction studies were performed on the right lower limb. RESULTS: In diabetic patients the tibial and peroneal nerve conduction velocity values were 48.6+/-4.7 and 46.3+/-5.2 m/s. They were not significantly different from controls (p>0.01). The tibial and peroneal distal motor latency values were 5.1+/-0.6 and 4.7+/-0.9 ms, and not significantly different from controls (p>0.01). The sural nerve distal sensory latency in patients was 3.2+/-0.7 ms and the sural sensory nerve action potential amplitude was 4.9+/-2.5 uV. These values were significantly different from controls (p<0.01). The tibial and peroneal minimal F-wave latency values in patients were 32.5+/-1.9 ms/m and 32.9+/-1.6 ms/m, and were significantly different from controls (p<0.001). The F-wave average duration values in patients were 11.8+/-1.5 ms for the tibial nerve and 9.0+/-1.4 ms for the peroneal nerve. These were significantly different from control (p<0.001). CONCLUSION: The peroneal and tibial minimal F-latency and average F-duration provide the most sensitive nerve conduction; indicators for the diagnosis of subclinical neuropathy in diabetes.

Growth velocity in children in rural Khartoum, Sudan.

The results of a mixed cross-sectional and longitudinal anthropometric survey of Sudanese children up to the age of sixteen years are reported. Weight velocity, height velocity, mid arm circumference velocity, and mid arm muscle circumference velocity, and the age at which 50% of females have reached menarche have been calculated. Growth velocities are lower than for English children and the puberty growth spurts occurs about one year later in Sudanese than in English children