Prognostic factors for visual recovery after successful large macular hole surgery using the inverted flap technique.

PURPOSE: The goal of our study is to describe the functional results and preoperative factors predicting visual recovery after successful inverted flap technique and closure of large full-thickness macular holes (FTMH) and to evaluate the correlations between microstructural foveal changes and final visual acuity. METHODS: Retrospective, descriptive, analytical study including 80 eyes of 78 patients with large FTMH; operated by inverted flap technique with successful closure of the macular hole after surgery. All eyes underwent a full preoperative ophthalmic examination and macular B-scan SD-OCT. We performed the classic inverted flap technique for all patients. Postoperatively, all patients were examined at 7 days, 1, 3, 6, 9 and 12 months after surgery. SD-OCT was performed for all patients on each follow-up. Preoperatively, best-corrected visual acuity (BCVA), FTMH size and basal hole diameter were the main outcome measures. Postoperatively, BCVA, macular thickness, integrity of the external limiting membrane (ELM) and ellipsoid zone (EZ) were recorded. RESULTS: Mean age was 62±8.42 years with female predominance. Mean size of the FTMH was 692.59µm, and mean basal hole diameter was 1436.06µm. Mean BCVA improved from 1.06±0.491 LogMAR preoperatively to 0.52±0.32 at 9 months following surgery (P<0.001). At 9 months, the ELM was absent, partial or fully restored in 6.67, 10 and 83.33% respectively. The EZ was absent, partial or fully restored in 6.67, 33 and 63.33% respectively. ELM regeneration always preceded EZ regeneration at every point of follow-up. Final BCVA was statistically correlated with initial hole size (P=0.006, OR=1.056; CI [1.016-1.098]) and mean symptom duration prior to surgery (P=0.001. OR=0.987; CI [0.976-0.998]). Analysis of the ROC curve demonstrated that a hole diameter>478.5µm and symptom duration>5 weeks were correlated with non-improvement of visual acuity, with 81.3% sensibility and 18.7% specificity. CONCLUSION: We report tomographic microstructural foveal changes and functional results following successful large idiopathic FTMH surgery using the classic inverted flap technique. Preoperative parameters such as initial FTMH diameter and mean symptom duration prior to surgery are crucial prognostic factors influencing final visual results.

Effect of Opuntia dejecta (Salm-Dyck) flowers in liver of fructose-fed rats: Biochemicals, enzymatic and histological studies.

Phytochemical composition and antioxidant activity of flowers decoction at post-flowering stage (F3D) of Opuntia dejecta were determined. The obtained findings demonstrate that F3D has a marked antioxidant activity in all tested assays. Furthermore, the present study was designed to test the protective activity of F3D against induced Diabetes type 2 (DT2) in male rats. Those metabolic syndromes were induced by a high-fructose diet (HFD) (10% fructose solution) for a period of 20 weeks. F3D was administered orally (100 and 300 mg/kg body weight) daily for the last 4 weeks. Metformin (150 mg/kg body weight) was used as a standard drug and administrated orally for the last 4 weeks. The results showed a significant increase in blood glucose, triglycerides and hepatic markers (ALAT, ASAT and ALK-P) in HFD group. A significant increase in hepatic TBARS and a significant decrease in SOD, CAT and GPX were observed in fructose fed rats compared to control group. Administration of F3D showed a protective effect in biochemical and oxidative stress parameters measured in this study. Also, oral administration of F3D restored the histological architecture of rat liver in comparison with rats fed HFD. In conclusion, F3D attenuated hepatic oxidative stress in fructose-fed rats.

Staphylococcal scalded skin syndrome: An uncommon symptomatology revealing an immune deficiency.

Primary immune deficiencies associated with hyper-IgE syndrome are rare diseases with clinical features dominated by recurring cutaneous and visceral bacterial infections, particularly infections due to Staphylococcus species. Most of these infections are associated with milder inflammation compared to normal. We report a primary immune deficiency associated with a hyper-IgE syndrome revealed by a staphylococcal scalded skin syndrome in a 5-year-old girl. The patient presented with a severe staphylococcal infection with extensive skin lesions and disseminated intravascular coagulation. She received intravenous fluids to compensate for fluid losses and anti-staphylococcal antibiotics. Coagulopathy was also corrected. However, the progression was rapidly fatal.

[Phacoemulsification versus manual small incision cataract surgery: Anatomic and functional results]. / Phacoémulsification versus chirurgie de cataracte par mini incision manuelle : résultats anatomiques et fonctionnels.

PURPOSE: Prospective randomised study to compare the impact of phacoemusification (PHACO) and small incision cataract surgery (SICS) on endothelial structure (cell density and morphology) and refractive results (visual acuity, induced astigmatism). METHODS: Prospective study of 57 patients (63 eyes) over 20 months (May 2012-January 2014) undergoing surgery by 2 experienced surgeons. We included patients with senile or presenile cataracts, LOCS III class 2, 3 and 4. Patients were randomized into 2 groups based on their birth month (group 1: PHACO [33]; group 2: SICS [30]). All pre- intra- and postoperative data were collected prospectively. The minimum follow-up was 6 months. We used the SPSS 18.0 for statistical analysis. Statistical tests used included the test-t Student, the Anova test, the Mann-Witney non-parametric test and the Khi2 test. A threshold of significance was set at 0.05. RESULTS: The mean preoperative endothelial cell density was 2447.5±225 c/mm2 with no significant difference between the two groups (P=0.207). The mean percentage of hexagonality was 55.5±8.2% in groups 1 and 2. The most significant cell loss was during the first immediate postoperative period for both groups. At Day 15 postoperative, the decrease in cell loss was significant (P<0.001) with a mean loss of 312.9±208.9 c/mm2 (P<10-2). Postoperatively, the mean best-corrected visual acuity was 0.057 log MAR for all of our patients (P=0.170); no patient had an acuity ≤1/10. The mean astigmatism at the conclusion of follow-up was 1.08±0.42 D in group 1 and 1.51±0.55 D in group 2, with a significant difference (P=0.001). CONCLUSION: Both SICS and PHACO give excellent results, both anatomical and refractive. However, SICS appears to be more advantageous than PHACO in terms of speed, cost, and independence from technology, and appears to be better suited to dense cataracts and mass surgery.

E-Nose and e-Tongue combination for improved recognition of fruit juice samples.

There are many important challenges related to food security analysis by application of chemical and electrochemical sensors. One critical parameter is the development of reliable tools, capable of performing an overall sensory analysis. In these systems, as much information as possible is required in relation to smell, taste and colour. Here, we investigated the possibility of using a multisensor data fusion approach, which combines an e-Nose and an e-Tongue, adept in generating combined aroma and taste profiles. In order to shed light on this concept, classification of various Tunisian fruit juices using a low-level of abstraction data fusion technique was attempted. Five tin oxide-based Taguchi Gas Sensors were applied in the e-Nose instrument and the e-Tongue was designed using six potentiometric sensors. Four different commercial brands along with eleven fruit juice varieties were characterised using the e-Nose and the e-Tongue as individual techniques, followed by a combination of the two together. Applying Principal Component Analysis (PCA) separately on the respective e-Nose and e-Tongue data, only few distinct groups were discriminated. However, by employing the low-level of abstraction data fusion technique, very impressive findings were achieved. The Fuzzy ARTMAP neural network reached a 100% success rate in the recognition of the eleven-fruit juices. Therefore, data fusion approach can successfully merge individual data from multiple origins to draw the right conclusions that are more fruitful when compared to the original single data. Hence, this work has demonstrated that data fusion strategy used to combine e-Nose and e-Tongue signals led to a system of complementary and comprehensive information of the fruit juices which outperformed the performance of each instrument when applied separately.

Chemical composition of essential oils from leaves, stems, flower heads and roots of Conyza bonariensis L. from Tunisia.

The essential oils isolated at the flowering stage in spring, summer and autumn of the aerial and underground parts of Conyza bonariensis L. growing in Tunisia were analysed by GC and GC/MS; 143 constituents were identified, and among them 20 were major. The oils of C. bonariensis gathered in spring were rich in matricaria ester (1.2-67.3%), (Z)-nerolidol (0.3-19.9%) and caryophyllene oxide (0.8-14.3%). In the summer samples, the oils of C. bonariensis were rich in matricaria ester (1.6-76.4%), caryophyllene oxide (1.6-22.6%) and (E)-ß-farnesene (1.1-22.7%). The main constituents in the autumn samples were matricaria ester (trace to 63.5%), geranyl acetone (0.0-25.3%), trans-α-bergamotene (0.0-24.3%) and limonene (2.7-15.3%). The oils showed significant variation among the seasons. Remarkable differences were found between the constituent percentages of the different studied organs. The C. bonariensis sample from Tunisia was a matricaria ester chemotype and was quite different from the samples of other countries of origin.

[Esophageal cervical duplication revealed by stridor: a case report]. / Stridor révélateur d'une duplication oesophagienne cervicale : à propos d'un cas.

Esophageal duplications are rare malformations. They account for 15 to 20% of esophageal malformations. Duplications are cystic or, rarely, tubular. The location is thoracic in 95% of the cases. The clinical manifestations are mostly related to compression of the neighboring organs. Treatment is surgical. We report a case of esophageal duplication in a 22-month-old child; the major symptom was congenital stridor. The diagnosis of esophageal duplication was suspected at the chest computed tomography imaging study and confirmed after excision and pathologic examination.

Sequential leukemic infiltration and human herpesvirus optic neuropathy in acute lymphoblastic leukemia.

Leukemic infiltration is a common cause of optic disk swelling in a patient with acute lymphoblastic leukemia (ALL). Recurrence of optic disk swelling in a patient with previous leukemic infiltration carries a grave prognosis when it is associated with recurrent central nervous system disease. We report a case of recurrent swelling of an optic disk in a patient with T-cell ALL who had previously been treated for CNS relapse with optic nerve involvement. In this case the swelling was associated with cytomegalovirus infection and resolved following treatment with antiviral therapy.

[Study of anemia in giardiasis intestinalis in Tunisian preschool children]. / Etude de l'anemie au cours de la giardiase chez des enfants Tunisiens d'age prescolaire.

The present work is based upon a prospective in study done in a semi-urban area of suburbs of Tunis, from february to November 1997. A total of 302 children aged between 6 month to 5 years were enrolled in the survey. The study aimed at assessing the extention of parasitoses in preschool aged children. The relationship between the Giardiasis intestinalis and ferropenic anemia. The prevalence of anemia is 31.78% (n = 302). The parasitologic analysis has shown that 113 children out of 302 are infected; 37.41%. We observed an obvious predominance of Giardia Lamblia: 62% (n = 113) pathogenic protozoon. The rate of anemia parasited children is amounted to 19.78%. During the Giardiasis, anemia is present in 23.17% of the cases. The Polyparasitism concerns 16% of the infested children. This anemia could be caused by a global bad absorption syndrome or by a ferro-elective bad absorption. A proper sanitary education, a purification action and also a curative treatment of the beaners carriers will be the only guarantees to decrease its morbidity.

Production of ochratoxins by some Egyptian Aspergillus strains.

In all the investigated Aspergillus ochraceus and A. alliaceus strains the maximum quantities of ochratoxins produced on yeast extract-sucrose (YES) medium exceeded that detected on wheat solid medium except A. ochraceus 67. The shake cultures lowered ochratoxins formation. The maximum yields of ochratoxins did not coincide with maximum fungal growth. In most A. strains investigated, the total ochratoxin contents of the culture filtrates highly exceeded that of the mycelia.

Inhibition of aflatoxin production inAspergillus flavus by natural coumarins and chromones.

The activities of three natural coumarins, xanthotoxin and bergapten (fromAmmi majus, Umbelliferae) and psoralene (fromFicus cycomorus, Moraceae), were tested against mycelial growth and aflatoxin production of a toxigenic strain ofAspergillus flavus grown in a rice/corn steep liquor medium. Two other natural chromones, khellin and visnagin (fromAmmi visnaga) were also compared. Complete inhibition of aflatoxin release occurred with either xanthotoxin or khellin at 5 mM. The other three compounds also at 5 mM reduced aflatoxin to 12 to 16% of its original concentration. The mould growth was only slightly inhibited by all the compounds used.

An immunologic study of psoriasis.

Thirty-five patients with psoriasis and 18 normal controls were studied in order to assess the role of humoral immunity in psoriasis. Direct immunofluorescent study of skin biopsy specimens taken from the lesions revealed deposits of immunoglobulins (IgA, IgG, IgM) and complement components (Clq, C3), mainly in the stratum corneum. Deposits were also found in Munro's microabscesses, spongiform pustules of Kogoj, upper layers of the stratum malpighii, dermal blood vessels, and cells of the dermal inflammatory infiltrate. Uninvolved skin of the patients and normal controls revealed negative fluorescent results. There was a significant increase in the mean levels of IgA and IgG in patients with psoriasis, whereas IgM was within the normal range. The present study showed humoral abnormalities in psoriasis that may be involved in its pathogenesis.

Formation of aflatoxins by some Egyptian Aspergillus flavus strains.

In all the fifteen investigated Aspergillus flavus and A. parasiticus strains the maximum quantities of aflatoxins, produced on rice powder-corn steep (RC) medium, ranged from 1.17 to 23.29 times as much as those produced on yeast extract-sucrose (YES) medium. The shake cultures lowered aflatoxin formation. The maximum yields of aflatoxins did not coincide with maximum fungal growth. In most A. flavus strains investigated, the total aflatoxin content of the mycelia highly exceeded that of the culture filtrates.

Aflatoxins: production of the toxins on rice-corn steep medium according to some cultural conditions.

Rice powder-corn steep (RC) medium proved to be the most suitable among 6 nutrient liquid media for both aflatoxin formation and mycelial growth by the Aspergillus flavus strain No. 182, isolated locally. The production of aflatoxins by the mould was studied in relation to some cultural conditions on RC medium. Highest aflatoxin yields (2527 microgram/50 ml) by A. flavus were attained using rice (5%, w/v) + corn steep (4%, w/v), at initial pH level of 4,25 degree C and 6 days incubation. The initial pH levels at either extreme of the range used (3 and 11), and temperatures of incubation below 20 degree C or above 40 degree C were inhibitory to mould growth and aflatoxin formation. The ratio of aflatoxin B1 to G1 varied with different cultural conditions. The aflatoxin content of the mycelia highly exceeded that of the culture filtrates.