Diagnosis and Treatment of Lacrimal Gland Prolapse: A Narrative Review.

BACKGROUND: Lacrimal gland prolapse (LGP) is considered to be one of the causes for upper eyelid contour abnormality that should be recognized and treated properly to yield satisfactory outcomes in blepharoplasty. To describe current findings about the prevalence, pre- and intraoperative diagnosis of LGP and its treatment options. METHODS: PubMed and Google Scholar were thoroughly searched for articles published describing the diagnosis and treatment of LGP. RESULTS: The reported prevalence of LGP by various authors varies between 10 and 60% based on their preoperative or intraoperative reports. Techniques such as dacryoadenopexy, modified dacryoadenopexy, and dacryoplasty have been described to secure the prolapsed lacrimal gland back into its original position. Additionally, creating a Whitnall's barrier has also been suggested as a method to reposition the gland. While all these surgical procedures have shown promising immediate results, there is a lack of published data on their long-term outcomes. CONCLUSION: Diagnosis and proper treatment of LGP could enhance the cosmetic results of upper eyelid blepharoplasty. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Assessing the success rate of treatment in simple and complex congenital nasolacrimal duct obstruction: a systematic review and meta-analysis.

PURPOSE: To assess and compare the success rate (SR) of probing and intubation in patients with congenital nasolacrimal duct obstruction (CNLDO). METHODS: We conducted a literature search for identifying relevant studies published in English using PubMed, Google Scholar, Scopus, and Web of Science databases from the date of inception to Feb 2023. After extracting data, the SR was compared between the study groups: simple and complex CNLDO. To compare the treatment outcome, the mean difference of the SR was considered as the effect size. Random effects model or fixed effects model were performed for statistical inferences. RESULTS: A total of 21 studies were eligible to be analyzed. The pooled SR of treatment was 88% in simple, and 57% in complex CNLDO. Exerting intubation in increased the SR from 87% (SR of probing) to 92% in simple CNLDO which was not significant. However, compared to probing, intubation has a significantly higher SR in complex CNLDO (46 to 82%). While the SR of probing was significantly lower in complex CNLDO, the difference between the SR of intubation was not significant between groups. Although increasing the age does not have an adverse effect on the SR in simple CNDLO, it causes a significant decrease in the SR of complex group. CONCLUSION: This study revealed that even though the addition of NLD intubation does not provide significant benefits beyond probing alone for patients with simple CNLDO, in children with complex CNLDO, NLD intubation should be considered as a primary treatment due to its substantial increase in surgical success rates. Delaying the treatment would increase its success in patients with complex but not the simple CNLDO.

Button Battery-Induced Necrotizing Keratoconjunctivitis: Case Report.

We report a case of a 2-year-old girl who presented to the ocular emergency department with a button battery retained in the inferior fornix of the left eye for more than 48 hours. The child developed necrotizing keratoconjunctivitis, which was treated with antibiotics, amniotic membrane graft, prompt removal of button battery, and other supportive measures.

Galactomannan antigen assay from bronchoalveolar lavage fluid in diagnosis of invasive pulmonary aspergillosis in intensive care units patients.

BACKGROUND: Invasive pulmonary aspergillosis (IPA) is an important infection in critically ill patients including patients of intensive care units (ICU). Different diagnostic tools are available and since its mortality is high, it is vital to start the antifungal therapy as soon as possible. Knowing the epidemiology of this disease in each ICU and area will help to better and more rapid management of such patients. The aim of this study is to determine the frequency of IPA based on the level of galactomannan in bronchoalveolar lavage fluid in ICU of Al-Zahra hospital, Isfahan, Iran. MATERIALS AND METHODS: This was a cross sectional study, which was conducted in Al-Zahra hospital, Isfahan, Iran, between 2010 to 2011. The study population was all the patients admitted to ICU and were suspected to have invasive Aspergillus spp pneumonia. The level of galactomannan in bronchoalveolar lavage was measured and demographic data were gathered by the questionnaire. RESULTS: The frequency of IPA in this study was calculated as 2.43% while galactomannan level in bronchoalveolar lavage fluid of this patient (2.50) was significantly higher than others (0.03 ± 0.02). CONCLUSION: Larger studies are required to determine the exact frequency of IPA and the best antifungal therapy for it.

Simethicone for the Preparation before Esophagogastroduodenoscopy.

Aim. The presence of air bubbles and foam in stomach and duodenum is a common problem during esophagogastroduodenoscopy (EGD). Methods. Candidates of elective EGD received 40 mg chewable tablet of simethicone (n = 90) or placebo (n = 83), with 30 mL water, 15-30 min before the EGD. Foam/air bubbles during endoscopy were assessed and graded on a 4-point scale, and patients' satisfaction with the endoscopy was scored from 0 to 10. Results. The amount of gastric but not duodenal foam/air bubbles was significantly lower in the simethicone group compared with the placebo group (P = 0.002). Duration of endoscopy was, on average, one minute shorter in the simethicone group compared with the placebo group (P < 0.001). Patients' satisfaction with the procedure was the same in the two groups. Conclusion. Administration of simethicone prior to EGD reduces the amount of gastric foam and bubbles and provides better visibility for evaluating the mucosa. It also decreases the duration of endoscopy. Further trials are required to find the final effect of the drug on diagnosis of pathological lesions.

Octadecyl silica membrane disks modified with a new Schiff's base for the preconcentration of lead and copper before their determination in water samples.

A simple and fast method for the extraction and determination of ppt level of Pb2+ and Cu2+ ions using octadecyl-bonded silica membrane disks modified by a new tetradentates Schiffs base [Bis(2,4-dimethoxy benzaldehyde) ethylen diimine](TDSB) and inductively coupled plasma atomic emission spectrometry is described. Extraction efficiency, and influence of flow rate, pH, type and the least amount of acid for stripping of Cu2+ and Pb2+ from the modified disks and break through volume were evaluated. The maximum capacity of the membrane disks modified by 5 mg of TDSB used was found to be 347 +/- 7 and 470 +/- 6 microg of copper and lead, respectively. The concentration factor is 500 (for 2500 mL water sample and flow rate of 20 mL min(-1)) and detection limit of the proposed method is 12.5 and 150.5 pg/ml for Cu2+ and Pb2+, respectively. The method was applied to the determination of Cu2+ and Pb2+ ions from various water, wastewater, black tea, and hot pepper samples.

Novel method for the fast preconcentration and monitoring of a ppt level of lead and copper with a modified hexagonal mesoporous silica compound and inductively coupled plasma atomic emission spectrometry.

A novel method for the rapid extraction and determination of a ppt level of Pb2+ and Cu2+ ions using partial silylated MCM-41 modified by a new salophen and inductively coupled plasma atomic emission spectrometry (ICP-AES) is introduced. The preconcentration factor of the method is 500, and the detection limits of Pb2+ and Cu2+ are 335 and 34 ng L(-1), respectively. The time and efficiency of extraction, the pH and flow rate, the type and minimum amount of acid for stripping of Pb2+ and Cu2+ from modified MCM-41 and the break-through volume were investigated. The maximum capacity of 4 mg of silylated MCM-41 modified by salophen used was found to be 150 +/- 4 and 117 +/- 3 microg of Pb2+ and Cu2+, respectively.

Determination of SCN- in urine and saliva of smokers and non-smokers by SCN(-)-selective polymeric membrane containing a nickel(II)-azamacrocycle complex coated on a graphite electrode.

The construction, performance characteristics, and application of a novel polymeric membrane coated on a graphite electrode with unique selectivity towards SCN- are reported. The electrode was prepared by incorporating Ni(II)-2,2,4,9,9,11-hexamethyltetraazacyclotetradecanediene perchlorate into a plasticized poly(vinyl chloride) membrane. The influences of membrane composition, pH and foreign ions were investigated. The electrode displays a near Nernstian slope (-57.8 mV decade-1) over a wide concentration range of 1 x 10(-7)-1 x 10(-1) M of SCN- ion. The electrode has a detection limit of 4.8 x 10(-8) M (2.8 ng/cm3) SCN- and shows response times of about 15 s and 120 s for low to high and high to low concentration sequences, respectively. The proposed sensor shows high selectivity towards SCN- over several common organic and inorganic anions. The electrode revealed a great enhancement in selectivity coefficients and detection limit for SCN-, in comparison with the previously reported electrodes. It was successfully applied to the direct determination of SCN- in milk and biological samples, and as an indicator electrode in titration of Ag+ ions with thiocyanate.