Acute dacryocystitis secondary to Burkholderia cepacia and Sphingomonas paucimobilis mixed infection: A novel case report.

Acute dacryocystitis caused by Burkholderia Cepacia and Sphingomonas Paucimobilis is uncommon. To the best of our knowledge, presence of mixed pathogens Burkholderia Cepacia and Sphingomonas Paucimobilis causing acute dacryocystitis in immunocompetent patients never been described. Burkholderia Cepacia and Sphingomonas Paucimobilis been reported only as a single microorganism causing other ocular infections in immunocompromised patients. Middle age, medically free female patient, presented to the emergency department at our hospital, with a history of nasolacrimal duct obstruct (NLDO) complaining of inferior preocular swelling associated with localized pain diagnosed as acute dacryocystitis. She was on oral Amoxicillin/clavulanic acid, oral Nitroimidazole antimicrobial and topical Tobramycin from elsewhere. However, no improvement had been noticed. We kept the patient on the same medications and swaps taken for culture and sensitivity. Patient presented to the first follow-up appointment with no improvement on her status. Culture and sensitivity revealed 2 pathogens: Burkholderia Cepacia and Sphingomonas Paucimobilis. We have changed the antibiotic to oral Trimethoprim/ Sulfamethoxazole as it showed positive sensitivity to the pathogens based on the sensitivity chart. Second follow-up appointment patient's condition improved.

Do Saudi parents have sufficient awareness of pediatric eye diseases in Riyadh?

PURPOSE: The current study aimed to assess Saudi parents' awareness regarding pediatric eye diseases that can be screened and treated. METHODS: A cross-sectional study was conducted in Riyadh, Saudi Arabia. Targeted participants were selected randomly. An online questionnaire was used for data collection. A Chi-ANOVA test was used with considering a confidence interval of 95%. RESULTS: Of 1500 participants, 1070 (71%) Saudi adults responded. Most of the participants' knowledge test score about eye health and care was poor (91.9%). The majority of those who had acceptable knowledge were married with 94.3%. Knowledge about the eye problem in diabetes was the highest with 82.8%, then 54.3% had acceptable knowledge about eye emergencies, general eye health with 36.5%, and 26.2% for refractive error problem, whereas knowledge about strabismus, visual deprivation, glaucoma, and eye tumors was lowest (18.9, 16.1, 10.6, and 9.6%, respectively). The most commonly reported sources of knowledge were community members. Those who were at the university level of education had a higher level of acceptable knowledge (64.4%) with a mean of 5.63. Retired participants had the highest mean level of knowledge (7.25). After that, it showed that those in the medical field had the second highest mean level of knowledge (6.55). However, students recorded the lowest mean knowledge score with 2.47. CONCLUSION: The current study found evidence of a lack of awareness among parents about common pediatric eye diseases and proper eye care behaviors. Therefore, awareness programs should be targeting both parents with a focus on mothers. The higher the educational level, the higher the chances of health awareness.

Association between Race and Cancer-Related Mortality among Patients with Colorectal Cancer in the United States: A Retrospective Cohort Study.

Colorectal cancer (CRC) is the third most common cause of mortality in the United States (US). Differences in CRC mortality according to race have been extensively studied; however, much more understanding with regard to tumor characteristics' effect on mortality is needed. The objective was to investigate the association between race and mortality among CRC patients in the US during 2007⁻2014. A retrospective cohort study using data from the Surveillance, Epidemiology, and End Results (SEER) Program, which collects cancer statistics through selected population-based cancer registries during in the US, was conducted. The outcome variable was CRC-related mortality in adult patients (≥18 years old) during 2007⁻2014. The independent variable was race of white, black, Asian/Pacific Islander (API), and American Indian/Alaska Native (others). The covariates were, age, sex, marital status, health insurance, tumor stage at diagnosis, and tumor size and grade. Bivariate analysis was performed to identify possible confounders (chi-square tests). Unadjusted and adjusted logistic regression models were used to study the association between race and CRC-specific mortality. The final number of participants consisted of 70,392 patients. Blacks had a 32% higher risk of death compared to whites (adjusted odds ratio (OR) 1.32; 95% confidence interval (CI) 1.22⁻1.43). Corresponding OR for others were 1.41 (95% CI 1.10⁻1.84). API had nonsignificant adjusted odds of mortality compared to whites (0.95; 95% CI 0.87⁻1.03). In conclusion, we observed a significant increased risk of mortality in black and American Indian/Alaska Native patients with CRC compared to white patients.

Public Awareness regarding the Differences between Ophthalmologists and Optometrists among Saudi Adults Living in Riyadh: A Quantitative Study.

Awareness of the patients to the differences between ophthalmologists and optometrists has been recognized as an important factor influencing patient utilization of available eye care services. This study aimed at assessing the public's knowledge of the differences between ophthalmologists and optometrists among the residents of Riyadh, Saudi Arabia. An online questionnaire was administered to adults in Riyadh, Saudi Arabia, from January to February in 2018. The number of the respondents was 1579. Results show that 50% (n=789) of the participants had fair knowledge of the differences between ophthalmologists and optometrists, while 32% (n=505) had poor knowledge. After multivariate logistic regression analysis, there was a significant association between satisfactory knowledge and visiting an optometrist (odds ratio (OR): 0.75, 95% CI: 0.57-0.98), age older than 26 (OR: 1.73, 95% CI: 1.17-1.19), higher level of education (OR: 1.92, 95% CI: 1.54-2.4), and wearing spectacles (OR: 0.57, 95% CI: 0.45-0.73). Given the low level of public knowledge regarding the differences in the duties between ophthalmologist and optometrists among a Saudi population, there is great potential for general population education through awareness campaign and social media regarding eye care provider's duties and practices.

Goniosynechialysis for secondary angle closure glaucoma in aphakic patient after pars plana vitrectomy.

PURPOSE: To report the effectiveness of Goniosynechialysis (GSL) treating elevated intraocular pressure (IOP) in an aphakic eye with peripheral anterior synechiae (PAS) formation after vitrectomy. OBSERVATIONS: A 39-year-old gentleman with history of lamellar keratoplasty for corneal ectasia and blunt trauma to the right eye necessitating vitrectomy and lensectomy presented to our glaucoma unit with a secondary angle closure and an IOP of 50 mmHg. This was successfully treated with GSL and one year after surgery, the patient maintains a normal IOP without the use of medication. CONCLUSIONS AND IMPORTANCE: GSL may successfully restore angle integrity in aphakic patients following vitreoretinal surgery and avoid the need for a glaucoma drainage device.