Intravitreal triamcinolone acetonide: Pattern of secondary intraocular pressure rise and possible risk factors.

PURPOSE: To determine the pattern of increase in intraocular pressure (IOP) following intravitreal triamcinolone acetonide (IVTA) and identify possible risk factors associated with this rise in IOP. METHODS: We carried out a retrospective review of records for 185 patients (226 eyes) who received 4 mg of IVTA at the American University of Beirut Medical Center and Hotel Dieu de France eye clinics between 2003 and 2005 RESULTS: Mean follow-up was 8.17 months (range 6 to 24 months). The mean number of IVTA injections per eye was 1.31 +/- 0.69. The mean IOP increased after the first IVTA injection from 15.04 +/- 3.18 mmHg at baseline to a mean maximum of 17.20 +/- 5.75 mmHg (p < 0.0001, paired t-test) at month 3 of follow-up with a return to mean baseline IOP (15.49 +/- 4.79 mmHg) at month 12. Fifty nine of 226 eyes showed IOP higher than 21 mmHg during follow-up. Nine eyes started to have IOP greater than 21 mmHg, 6 to 12 months after a single injection. Intraocular pressure lowering medications were started when IOP exceeded 25 mmHg in 15 of the 226 eyes studied. No risk factors have been found to predict this IOP rise CONCLUSIONS: IOP elevation can occur in a significant number of eyes receiving 4 mg of IVTA. This phenomenon seems to be transient and a small number of eyes required treatment during this period. Eyes that received IVTA need to be monitored for IOP changes especially during the first 3 months, but the IOP may still rise 6 months and even 12 months after a single injection. This study did not show any risk factor that may predict this IOP rise.

Surgical correction of synergistic divergence strabismus. A report of three cases.

BACKGROUND AND PURPOSE: To review and explain some of the characteristics of synergistic divergence and compare the surgical effect on each of those characteristics. METHODS OF STUDY: Three patients demonstrating findings characteristic of synergistic divergence, two bilateral and one unilateral, are reported. Surgery consisted of denervation extirpation of the lateral rectus muscle along with resection of the medial rectus muscle of the affected eye or supramaximal recession of the lateral rectus muscle and resection of the antagonist medial rectus muscle of the affected eye. RESULTS: The simultaneous abduction and the abnormal head posture responded well to surgery. The exotropia was reduced. The deficient adduction, the total absence of active abduction and the infraduction of the synkinetically abducting eye remained unchanged. CONCLUSIONS: Synergistic divergence is a severe exotropic form of Duane's Syndrome where the feature of simultaneous abduction is the most striking. To date, no surgical procedure leads to satisfactory results on all the characteristics of synergistic divergence. Although some important features can be satisfactorily improved, some others do not respond to current surgical techniques.

Weight control measures among university students in a developing country: a cultural association or a risk behavior.

OBJECTIVE: The purpose of the study was to determine the prevalence of university students, in Lebanon, trying to lose weight and assess the relation of trying to lose weight with demographic, scholastic and health behavioral factors. METHODS: The study was cross-sectional conducted in the academic year 2000-2001. A proportionate random sample of 2,013 students was selected among five public and private universities in Beirut. Participants completed a self-administered anonymous questionnaire that included questions on trying to lose weight, demographic, scholastic, and health behavioral factors including smoking, alcohol, and seat belt use. Bivariate and stepwise logistic regression analyses were performed to examine the association between trying to lose weight and the above-mentioned characteristics. RESULTS: The overall prevalence of students trying to lose weight was 30%, with 71% of them being under weight or normal weight. Use of medications and inducement of vomiting constituted 12% and 11%, respectively. Stepwise logistic regression analysis showed that the variables significantly associated with trying to lose weight were socio-economical factors rather than risky behaviors. Students who were at increased odds of performing such methods were females OR = (2.08, 95% CI = 1.6-2.5), employed (OR = 1.36, 95% CI = 1.01-1.8), and registered in a private university (OR = 1.69, 95% CI = 1.25-2.0). The major of students was also a significant predictor. CONCLUSION: In Lebanon, weight reduction could be re-enforced by socio-economical factors and not necessarily be an adolescent risk behavior.

Tobacco use by university students, Lebanon, 2001.

AIMS: The objective was to determine the prevalence of smoking [cigarettes and/or narghile (i.e. water-pipe)] among university students and to examine multiple correlates. DESIGN: Cross-sectional. SETTING: Beirut, Lebanon. PARTICIPANTS: A proportionate random sample of 1964 students from public and private universities in Beirut, Lebanon. MEASUREMENTS: Participants completed a self-administered anonymous questionnaire that included demographic and scholastic items and health behavioral aspects, including smoking, alcohol, physical activity, weight control measures and seat belt use. FINDINGS: The overall prevalence of smoking was 40% (21.1%, 7.6% and 11.3% of the students were smoking only narghile, only cigarettes and both cigarettes and narghile, respectively). Regression analyses showed that males, those of non-Lebanese origin, pursuing undergraduate degrees, performing risky weight control measures and drinking excessive amounts of alcohol had increased odds of smoking cigarettes. Also, age, high level of paternal education and field of study were significant predictors. Narghile smoking was significantly higher among males who drank excessive alcohol. CONCLUSIONS: The authors advocate a collaborative effort to alleviate the consequences of smoking among university students.