Differentiation of acanthamoeba keratitis from other non-acanthamoeba keratitis: Risk factors and clinical features.

INTRODUCTION: Infectious Keratitis is one of the most common ocular emergencies seen by ophthalmologists. Our aim is to identify the risk factors and clinical features of Acanthamoeba Keratitis (AK). METHODS: This retrospective chart review study was conducted at King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia, and included all the microbial keratitis cases, male and female patients of all ages. The main outcome is the differentiation between various microbial keratitis types. RESULTS: We included 134 consecutive eyes of 126 persons. We had 24 cases of acanthamoeba keratitis, 22 bacterial keratitis, 24 fungal keratitis, 32 herpetic keratitis, and 32 bacterial co-infection. Contact lens wear was found in 33 eyes (24.6%). Among acanthamoeba keratitis patients, 73% were ≤ 39 years of age, and 73% were females (P <0.001). Also, in AK cases, epithelial defect was found in all cases (100%), endothelial plaques were found in 18 eyes (69.2%), 12 cases had radial keratoneuritis (46.2%), and ring infiltrate was found in 53.8% of AK cases. CONCLUSIONS: We determined the factors that increase the risk of acanthamoeba infection and the clinical characteristics that help distinguish it from other types of microbial keratitis. Our findings suggest that younger females and patients who wear contact lenses are more likely to develop acanthamoeba keratitis. The occurrence of epitheliopathy, ring infiltrate, radial keratoneuritis, and endothelial plaques indicate the possibility of acanthamoeba infection. Promoting education on wearing contact lenses is essential to reduce the risk of acanthamoeba infection, as it is the most significant risk factor for this infection.

The Perception of Spectacles Use Among the General Population in Ha'il Region, Saudi Arabia: A Cross-Sectional Study.

Purpose: The study aims to assess the perception of optical spectacles use among the Ha'il region population in Saudi Arabia. Patients and Methods: A cross-sectional survey was distributed via various social media applications to the residents of the Ha'il region. An online questionnaire was designed and included informed consent and questions assessing the participants' perceptions about wearing eyeglasses, contact lenses, and general eye health. Results: 32.4% of the participants think that long-term eyeglasses wearing worsens vision, and 43% think eyeglasses wearing improves vision. 75.2% believe that long-term use of glasses could cause lifetime dependency on eyeglasses. Regarding contact lenses, 45.9% believe that long-term wearing worsens vision, and 24.1% think long-term wearing of contact lenses improves vision. 60% think long-term use of lenses causes lifetime dependency on those contact lenses. Conclusion: Our results highlighted the misconceptions among the study population regarding wearing prescribed eyeglasses and contact lenses. Thus, education programs and media are warranted to correct the misconceptions about spectacles and raise the awareness about refractive errors and treatment options.

The Use of Pain Severity and Its Impact as a Predictor for MRI Findings: A Cross-Sectional Study in Ta'if, Saudi Arabia.

Background Low back pain (LBP) is common and considerably impacts daily lives across all age groups. MRI is not frequently used as a first-line investigation for patients presenting with LBP, except in the presence of red-flag symptoms. This study aimed to use pain severity and its impact as a predictor for MRI findings to help physicians decide whether a patient needs an MRI. Methods This cross-sectional study was conducted at the outpatient clinic of the neurosurgery department. The questionnaire included demographic data of the patients, red-flag symptoms, and the Dallas Pain Questionnaire (DPQ). The primary physician then determines whether the patient should have an MRI appointment. Results The study included 100 patients with LBP, of which 71 had chronic LBP (CLBP). Out of these 71, an MRI was requested for 62, but only 26 had findings related to LBP. Regarding the impact of CLBP on daily activities as measured by the DPQ, there was a significant association between those whose CLBP affected their daily activities and the decision to request an MRI. However, no significant statistical association was found between the three other parameters of the DPQ and the primary physician's decision to request an MRI. Conclusion Concerning the use of the DPQ questionnaire to predict MRI findings in patients with CLBP, the study indicates that significant pain impact on the DPQ does not necessarily correlate with MRI findings related to LBP. This suggests that the DPQ evaluation tool has no advantage over a physician's clinical judgment.

An Unusual Presentation of Hearing Impairment in an Adult with Pineal Region Germinoma: A Case Report.

Tumors of the pineal region typically present with symptoms and signs of mass effect and increased intracranial pressure. However, although rare and can be overlooked, hearing impairment is a potential clinical finding in these cases. The authors describe a 24-year-old male who presented to the emergency room complaining of bilateral hearing impairment. Brain computed tomography showed a pineal region tumor. Histopathological examination demonstrated features consistent with germinoma. This case reports a rare presentation rarely seen in the literature and in practice as evident by the conducted literature review. Therefore, we highlight the importance of considering hearing impairment as a presenting symptom of pineal region tumors since prompt recognition and intervention, as demonstrated in this case, can lead to successful outcomes.

Corneal asphericity and its related factors.

Background: Proper correction of spherical aberration using intraocular lenses requires precise selection of the sphericity of intraocular lens surfaces based on individual biometric data and corneal asphericity coefficient (Q value). This study aimed to determine and analyze the corneal Q value and its related factors among Saudi participants. Methods: In this cross-sectional study, normal right eyes of healthy Saudi participants aged 17 - 58 years who visited Al-Kahhal Medical Complex, Dammam, Saudi Arabia, were included. The Pentacam rotating Scheimpflug camera was used to determine the average Q value at 6-mm diameter. Q values were obtained from each quadrant (superior, nasal, inferior, and temporal) and two meridians (horizontal and vertical). Mean Q values of the anterior and posterior corneal surfaces were also obtained. Other factors including age, sex, refractive error, and central corneal radius were documented. Results: Five hundred right eyes from 500 participants were included. The mean (standard deviation [SD]) (range) age was 27.2 (7.1) (18 - 58) years. The mean (SD) (range) Q value of 500 eyes was - 0.24 (0.10) (- 0.71 to + 0.09) anteriorly and - 0.16 (0.14) (- 0.70 to + 0.23) posteriorly, being significantly more prolate anteriorly (P < 0.05). The corneas were significantly more prolate in the nasal than in the temporal quadrant, in the superior than in the inferior quadrant, and in the horizontal than in the vertical meridian (all P < 0.05). There were statistically significant differences in anterior, nasal, temporal, inferior, horizontal, and vertical Q values among age groups (all P < 0.05) but not in the superior or posterior Q values (both P > 0.05). The corneas became less prolate with increasing age (P < 0.05). However, Q values were comparable between the sexes (all P > 0.05). There was no significant correlation between anterior (r = + 0.08; P = 0.095) or posterior (r = - 0.08; P = 0.092) Q value and spherical equivalent, but a significant trend was detected toward more prolate shape with increasing myopia in the temporal and inferior quadrants (r = + 0.19; P < 0.001, r = + 0.10; P = 0.022, respectively). There was a significant negligible correlation between the posterior Q value and central corneal radius (r = - 0.18; P < 0.001) but no significant correlation between the anterior Q value and central corneal radius (r = + 0.02; P = 0.673). Conclusions: Most corneas in this Saudi population were prolate in contour. Anterior corneal asphericity was positively correlated with age and was not significantly related to sex, refractive error, or central corneal radius. Further studies are needed to verify our preliminary findings.

Assessment of Cortical Plasticity in Schizophrenia by Transcranial Magnetic Stimulation.

Neural plasticity refers to the capability of the brain to modify its structure and/or function and organization in response to a changing environment. Evidence shows that disruption of neuronal plasticity and altered functional connectivity between distinct brain networks contribute significantly to the pathophysiological mechanisms of schizophrenia. Transcranial magnetic stimulation has emerged as a noninvasive brain stimulation tool that can be utilized to investigate cortical excitability with the aim of probing neural plasticity mechanisms. In particular, in pathological disorders, such as schizophrenia, cortical dysfunction, such as an aberrant excitatory-inhibitory balance in cortical networks, altered cortical connectivity, and impairment of critical period timing are very important to be studied using different TMS paradigms. Studying such neurophysiological characteristics and plastic changes would help in elucidating different aspects of the pathophysiological mechanisms underlying schizophrenia. This review attempts to summarize the findings of available TMS studies with diagnostic and characterization aims, but not with therapeutic purposes, in schizophrenia. Findings provide further evidence of aberrant excitatory-inhibitory balance in cortical networks, mediated by neurotransmitter pathways such as the glutamate and GABA systems. Future studies with combining techniques, for instance, TMS with brain imaging or molecular genetic typing, would shed light on the characteristics and predictors of schizophrenia.

Phosphonium-based Ionic Liquid Modified Activated Carbon from Mixed Recyclable Waste for Mercury(II) Uptake.

The contamination of water surfaces by mercury is a dangerous environmental problem due to its toxicity, which leads kidney damage. Activated carbon from mixed recyclable waste modified by phosphonium-based ionic liquid (IL-ACMRW) was therefore prepared and evaluated for Hg(II) remediation. The activated carbon used in this study was prepared from mixed waste, including cardboard, papers and palm wastes as cheap raw materials. The mixed Recyclable Waste Activated Carbon was combined with trihexyl(tetradecyl)phosphonium Bis2,4,4-(trimethylpentyl)phosphinate (Cyphos® IL 104) ionic liquid to form an adsorbent with organic-inorganic content, in order to improve the Hg(II) uptake from aqueous solutions. FTIR confirms the presence of P, C=O and OH after this modification. The adsorption process was investigated and the evaluated results showed that the capacity was 124 mg/g at pH 4, with a contact time of 90 min, an adsorbent dose of 0.4 g/L, and a Hg(II) concentration of 50 mg/L. This Hg(II) adsorption capacity is superior than that reported in the literature for modified multiwall carbon nanotubes. The adsorption of Hg(II) on the modified activated carbon from mixed recyclable waste was found to follow the pseudo second-order kinetics model. Isotherms of adsorption were analyzed via Freundlich and Langmuir models. The results indicated that Freundlich is the best model to describe the process, suggesting multilayer adsorption.