Non-extractive spectrophotometric determination of memantine HCl, clomipramine HCl and fluvoxamine maleate in pure form and in pharmaceutical products by ion-pair complex formation with rose bengal.

OBJECTIVES: The objective of this work is to develop a simple, sensitive and non-extractive spectrophotometric method for the determination of memantine HCl (MEM), clomipramine HCl (CLM) and fluvoxamine maleate (FLV). MATERIAL AND METHODS: The proposed method was based on the formation of colored ion-pair complexes between the basic nitrogen of the target drugs and rose bengal (RB) dye in a weak acidic medium. RESULTS: The formed complexes were measured at 576nm for MEM, CLM and at 575nm for FLV. The reaction conditions were optimized to obtain the maximum color intensity. Beer's law was obeyed in the range of 2-20, 1-16 and 6-30µg/mL for MEM, CLM and FLV, respectively. The limit of detection (LOD) was 0.476, 0.185, 0.806 and the limit of quantitation (LOQ) was 1.443, 0.559 and 2.443 for MEM, CLM and FLV, respectively. The composition ratio of the ion-pair complexes was found to be 1:1 as determined by Job's method. CONCLUSION: The proposed method was applied successfully for the analysis of the cited drugs in pure and dosage forms. Results of the proposed method were statistically compared with the reported methods by applying student's t- and F-tests and no significant differences were observed.

Micellar high performance liquid chromatographic method for separation and validation of two anti-hepatitis C- virus drugs in pure form, human plasma and human urine.

OBJECTIVES: In the present study, an eco- friendly micellar liquid chromatographic technique was validated for separation and quantification of two drugs; namely ribavirin (RIV), and sofosbuvir (SBV) in pure form, pharmaceuticals containing them, human plasma and human urine. These drugs are administered co-administered for treatment of Hepatitis C virus (HCV) that causes hepatitis C in humans. MATERIAL AND METHODS: These drugs were separated using Nucleosil 100-5 phenyl column. Sodium dodecyl sulphate (SDS) solution (0.05M, pH 7.0) containing triethylamine (0.3%) and n-butanol (10%) was used as a mobile phase with 1.2 mLmin-1 flow rate and 215nm detection wavelength. Nine minutes were required for resolving the two drugs from the matrix. RESULTS: The method showed good linearity for RIV and SBV with correlation coefficients (r2) more than 0.9996 within the concentration ranges of (20-400) and (40-400) ngmL-1 in pure form, (30-300) and (50-300) ngmL-1 in human plasma and (20-400) and (40-400) ngmL-1 in human urine, respectively. CONCLUSION: The recommended method was applied for examination of RIV and SBV in pure and pharmaceuticals. The obtained results were statistically matched with reported methods with no significant differences. Also, the recommended method was effectively applied for estimation of both drugs in spiked human urine and plasma without purification or extraction steps and real samples of plasma and urine of humans having therapy of RIV and SBV, as well as, performing tablets dissolution-rate tests with satisfactory results.

Quantifying Argonaute 2 (Ago2) expression to stratify breast cancer.

BACKGROUND: Argonaute-2 (Ago2) is an essential component of microRNA biogenesis implicated in tumourigenesis. However Ago2 expression and localisation in breast cancer remains undetermined. The aim was to define Ago2 expression (mRNA and protein) and localisation in breast cancer, and investigate associations with clinicopathological details. METHODS: Ago2 protein was stained in breast cancer cell lines and tissue microarrays (TMAs), with intensity and localization assessed. Staining intensity was correlated with clinicopathological details. Using independent databases, Ago2 mRNA expression and gene alterations in breast cancer were investigated. RESULTS: In the breast cancer TMAs, 4 distinct staining intensities were observed (Negative, Weak, Moderate, Strong), with 64.2% of samples stained weak or negatively for Ago2 protein. An association was found between strong Ago2 staining and, the Her2 positive or basal subtypes, and between Ago2 intensity and receptor status (Estrogen or Progesterone). In tumours Ago2 mRNA expression correlated with reduced relapse free survival. Conversely, Ago2 mRNA was expressed significantly lower in SK-BR-3 (HER2 positive) and BT-20 (Basal/Triple negative) cell lines. Interestingly, high levels of Ago2 gene amplification (10-27%) were observed in breast cancer across multiple patient datasets. Importantly, knowledge of Ago2 expression improves predictions of breast cancer subtype by 20%, ER status by 15.7% and PR status by 17.5%. CONCLUSIONS: Quantification of Ago2 improves the stratification of breast cancer and suggests a differential role for Ago2 in breast cancer subtypes, based on levels and cellular localisation. Further investigation of the mechanisms affecting Ago2 dysregulation will reveal insights into the molecular differences underpinning breast cancer subtypes.

Quantifying Tip60 (Kat5) stratifies breast cancer.

Breast cancer is stratified into four distinct clinical subtypes, using three key biomarkers (Her2/Neu gene status, Estrogen and Progesterone receptor status). However, each subtype is a heterogeneous group, displaying significant variation in survival rates and treatment response. New biomarkers are required to provide more precise stratification of breast cancer cohorts to inform personalised treatment options/predict outcomes. Tip60 is a member of the MYST sub-family of histone acetyltransferases (HATs), and is directly involved in genome maintenance, gene regulation and DNA damage response/repair pathways (key chemotherapeutic influencing mechanisms). We aimed to determine if quantifying Tip60 staining patterns improved breast cancer stratification. We defined Tip60 protein in vivo, quantifying location (cytoplasmic, nuclear), percent of cells and staining intensity in a breast cancer tissue microarray (n = 337). A significant association of specific Tip60 staining patterns with breast cancer subtype, ER or PR status and Tumour grade was found. Importantly, low Tip60 mRNA expression correlated with poor overall survival and relapse free survival. We found Tip60 is a biomarker able to stratify breast cancer patients, and low Tip60 expression is a significant risk factor indicating a higher chance of disease reoccurrence. This work highlights Tip60 regulation as a key factor influencing the development of breast cancer.

EARLY ASSESSMENT OF RENAL TRANSPLANTS USING BOLD-MRI: PROMISING RESULTS.

Non-invasive evaluation of renal transplant function is essential to minimize and manage renal rejection. A computer-assisted diagnostic (CAD) system was developed to evaluate kidney function post-transplantation. The developed CAD system utilizes the amount of blood-oxygenation extracted from 3D (2D + time) blood oxygen level-dependent magnetic resonance imaging (BOLD-MRI) to estimate renal function. BOLD-MRI scans were acquired at five different echo-times (2, 7, 12, 17, and 22) ms from 15 transplant patients. The developed CAD system first segments kidneys using the level-sets method followed by estimation of the amount of deoxyhemoglobin, also known as apparent relaxation rate (R2*). These R2* estimates were used as discriminatory features (global features (mean R2*) and local features (pixel-wise R2*)) to train and test state-of-the-art machine learning classifiers to differentiate between non-rejection (NR) and acute renal rejection. Using a leave-one-out cross-validation approach along with an artificial neural network (ANN) classifier, the CAD system demonstrated 93.3% accuracy, 100% sensitivity, and 90% specificity in distinguishing AR from non-rejection . These preliminary results demonstrate the efficacy of the CAD system to detect renal allograft status non-invasively.

Development and application of degradation kinetics of thin layer chromatographic densitometry and conductometric methods for butoconazole nitrate determination.

Two simple methods were developed for determination of butoconazole nitrate (BN). The first developed method was stability-indicating HPTLC-densitometric method (method A) which is based on the quantitative densitometric separation of butoconazole nitrate (BN) from its degradation products on silica gel 60 F254 and measurement of the bands at 290nm. The developed stability study of BN was performed under different stress conditions including oxidative, hydrolytic, thermal and photolytic. Degradation was observed under acidic hydrolytic and oxidative conditions. Moreover, the HPTLC method was used to study the kinetics of BN acid degradation, determining as first order kinetics. The degradation rate constant of BN was found to be 0.076 hr-1 and t 1/2 value was determined at 9.12 hr in acidic medium. The second method (Method B) was conductometric method which is based on the reaction of BN with phosphotungstic acid (PTA) to form an ion associate in 50% methanol-water system. Validation of the proposed methods was carried out. All proposed methods were successfully applied for the commercial dosage form of BN. Statistical analysis of the results has been carried out revealing high accuracy and good precision.

Late Dacron Patch Inflammatory Reaction after Carotid Endarterectomy.

OBJECTIVE: The aim was to analyse the incidence and presentation of carotid patch inflammatory reactions following carotid endarterectomy (CEA). METHODS: This was a cohort study using a prospectively maintained database. All patients who underwent elective CEA at a tertiary vascular centre between 2002 and 2016 were included. Computed tomography scan angiogram, duplex scan, and leucocyte scintigraphy were used to assess patients with suspected inflammatory patch complications. Re-intervention procedures and outcomes were noted. Histopathology and organisms cultured from the harvested material during re-intervention were assessed. RESULTS: During the study period, 633 patients underwent elective CEA. Fifty-one underwent eversion endarterectomy: 111 did not require a patch, whereas 471 patients had a patch repair. Four hundred and twenty eight had a Dacron patch repair and 43 a biological patch. Eight patients returned with late Dacron patch inflammatory complications (1.3% of all CEA and 1.9% of Dacron patch closures) after a period ranging from 18 months to 7 years (mean 4.1 ± 2.1 years). Seven of the eight patients underwent surgical re-intervention, and the eighth patient was deemed high surgical risk. One patient underwent a vein bypass, three had vein patch repair, one required internal carotid artery (ICA) ligation after patch excision, and two were managed by debridement, with omohyoid and sternomastoid muscle covering of the patch. The patient who required ICA ligation suffered a fatal stroke. The remaining patients had a satisfactory outcome. All patients showed evidence of foreign body reaction in pathological examination with no pathological organism cultured from swabs or tissue harvested during surgery. CONCLUSION: Late wound complications after CEA may be related to inflammatory reaction of the Dacron patch rather than infection. Infection should be excluded first. Reconstruction with vein is effective. However, debridement with sternomastoid and omohyoid muscle covering of the patch may be considered in high risk patients after exclusion of infection with regular follow-up.

Effect of diesel exhaust particles on renal vascular responses in rats with chronic kidney disease.

Several recent studies have indicated the possible association between exposure to particulate air pollution and the increased rate of morbidity and mortality in patients with kidney diseases. The link of this observation to vascular damage has not been adequately addressed. Therefore, this study aims to investigate possible vascular damage that might be associated with exposure to diesel exhaust particles (DP) in adenine (AD)-induced chronic kidney disease (CKD) in rats, and the possible ameliorative effect of gum acacia (GA). CKD was induced by feeding AD (0.75%, w/w), and DP (0.5 mg/kg) was instilled intratracheally every second day and GA was given concomitantly in the drinking water at a dose of 15% w/v. All treatments were given concomitantly for 28 days. Changes in renal blood flow (RBF) and systolic and diastolic blood pressure were monitored in these animals after anesthesia, together with several other endpoints. Exposure to DP significantly reduced RBF and this was significantly potentiated in AD-treated rats. Phenylephrine-induced decreases in RBF and increases in systolic and diastolic blood pressure were severely potentiated in rats exposed to DP, and these actions were significantly augmented in AD-treated rats. GA did not significantly affect the vascular impairment induced by AD and DP given together. This study provides experimental evidence that exposure to particulate air pollution can exacerbate the vascular damage seen in patients with CKD. © 2016 Wiley Periodicals, Inc. Environ Toxicol 32: 541-549, 2017.

The in vivo effects of adenine-induced chronic kidney disease on some renal and hepatic function and CYP450 metabolizing enzymes.

Adenine-induced model of chronic kidney disease (CKD) is a widely used model especially in studies testing novel nephroprotective agents. We investigated the effects of adenine-induced CKD in rats on the activities of some xenobiotic metabolizing enzymes in liver and kidneys, and on some in vivo indicators of drug metabolism (viz pentobarbitone sleeping time, and plasma concentration of theophylline 90 min post administration). CKD was induced by orally feeding adenine (0.25 % w/w) for 35 days. Adenine induced all the characteristics of CKD, which was confirmed by biochemical and histological findings. Glutathione concentration and activities of some enzymes involved in its metabolism were reduced in kidneys and livers of rats with CKD. Renal CYP450 1A1 activity was significantly inhibited by adenine, but other measured isoenzymes (1A2, 3A4 and 2E1) were not significantly affected. Adenine significantly prolonged pentobarbitone-sleeping time and increased plasma theophylline concentration 90 min post administration. Adenine also induced a moderate degree of hepatic damages as indicated histologically and by significant elevations in some plasma enzymes. The results suggest that adenine-induced CKD is associated with significant in vivo inhibitory activities on some drug-metabolizing enzymes, with most of the effect on the kidneys rather than the liver.

Umbilical hernia following gastroschisis closure: a common event?

PURPOSE: To assess incidence and natural history of umbilical hernia following sutured and sutureless gastroschisis closure. METHODS: With audit approval, we undertook a retrospective clinical record review of all gastroschisis closures in our institution (2007-2013). Patient demographics, gastroschisis closure method and umbilical hernia occurrence were recorded. Data, presented as median (range), underwent appropriate statistical analysis. RESULTS: Fifty-three patients were identified, gestation 36 weeks (31-38), birth weight 2.39 kg (1-3.52) and 23 (43 %) were male. Fourteen patients (26 %) underwent sutureless closure: 12 primary, 2 staged; and 39 (74 %) sutured closure: 19 primary, 20 staged. Sutured closure was interrupted sutures in 24 patients, 11 pursestring and 4 not specified. Fifty patients were followed-up over 53 months (10-101) and 22 (44 %) developed umbilical hernias. There was a significantly greater hernia incidence following sutureless closure (p = 0.0002). In sutured closure, pursestring technique had the highest hernia rate (64 %). Seven patients underwent operative hernia closure; three secondary to another procedure. Seven patients had their hernias resolve. One patient was lost to follow-up and seven remain under observation with no reported complications. CONCLUSIONS: There is a significant umbilical hernia incidence following sutureless and pursestring sutured gastroschisis closure. This has not led to complications and the majority have not undergone repair.

The preventive effect of ß3 adrenoceptor stimulation against experimentally induced reflux esophagitis.

UNLABELLED: A ß3 adrenoceptor agonist plays an important regulatory role in stimulation of thermogenesis and lipolysis and it appears to have anti-ulcer and spasmolytic effects. So the present aim was to examine the effect of BRL 37344 (a selective B3 adrenoceptor agonist) on reflux esophagitis. METHODS: Forty-eight rats were divided into twelve sham-operated with BRL 37344 and/or omeprazole with or without indomethacin. RE was induced in rats, then gastric acid output, pH, plasma nitric oxide (NO), esophageal PGE2, malondialdehyde (MDA) and reduced glutathione (GSH) were measured and the esophageal injury was assessed by macroscopic damage score. RESULTS: Pretreatment with BRL significantly increased plasma NO, GSH, decreased acid output, esophageal MDA and esophageal injury in comparison to pretreatment. In addition, there was a no significant increase in esophageal PGE2. CONCLUSION: It can be concluded that BRL 37344 has an anti-oxidant protective effect in rats with RE.

Incidence of tetracycline residues in chicken meat and liver retailed to consumers.

The incidence of tetracyclines' (TCs) residue (oxytetracycline, tetracycline, chlorotetracycline and doxycycline) in fresh chicken samples (meat and liver) collected during one year was recorded. TC residues were analysed using an HPLC-DAD method. The limit of detection for meat was 4.4, 5, 10 and 7 ng g(-1) for OTC, TTC, CTC and DOC, respectively, compared with 5.5, 6, 12 and 9 ng g(-1) stated for liver. The recovery of the method ranged from 91% to 70% depending upon both matrix type and tetracycline kind. The results revealed that 66 (44%) samples contained TC residues including 21 (42%) breast, 19 (38%) thigh and 26 (52%) liver samples. The corresponding contaminated ranges were 124-5812, 107-6010 and 103-8148 µg kg(-1). A total of 12 (8%), 13 (7.33%) and 20 (13.33%) samples of breast, thigh and liver, respectively, had TC residues above the Codex maximum residue limit (MRL). Liver samples had a higher incidence and level than those found in breast or thigh samples.

Potential therapeutic targets for chordoma: PI3K/AKT/TSC1/TSC2/mTOR pathway.

Chordomas are radio- and chemo-resistant tumours and metastasise in as many as 40% of patients. The aim of this study was to identify potential molecular targets for the treatment of chordoma. In view of the reported association of chordoma and tuberous sclerosis complex syndrome, and the available therapeutic agents against molecules in the PI3K/AKT/TSC1/TSC2/mTOR pathway, a tissue microarray of 50 chordoma cases was analysed for expression of active molecules involved in this signalling pathway by immunohistochemistry and a selected number by western blot analysis. Chordomas were positive for p-AKT (92%), p-TSC2 (96%), p-mTOR (27%), total mTOR (75%), p-p70S6K (62%), p-RPS6 (22%), p-4E-BP1 (96%) and eIF-4E (98%). Phosphatase and tensin homologue deleted on chromosome 10 expression was lost in 16% of cases. Mutations failed to be identified in PI3KCA and RHEB1 in the 23 cases for which genomic DNA was available. Fluorescence in situ hybridisation analysis for mTOR and RPS6 loci showed that 11 of 33 and 21 of 44 tumours had loss of one copy of the respective genes, results which correlated with the loss of the relevant total proteins. Fluorescence in situ hybridisation analysis for loci containing TSC1 and TSC2 revealed that all cases analysed harboured two copies of the respective genes. On the basis of p-mTOR and or p-p70S6K expression there is evidence indicating that 65% of the chordomas studied may be responsive to mTOR inhibitors, rapamycin or its analogues, and that patients may benefit from combined therapy including drugs that inhibit AKT.

Gynecological efficacy and chemical investigation of Vitex agnus-castus L. fruits growing in Egypt.

Flavonoid glycosides, orientin and apigenin 3, 8-di-C-glycosides in addition to, iridoid compound, aucubin were isolated from the ethanolic extract of Vitex agnus-castus fruits. Their structures were identified on the basis of the spectroscopic data. The estrogenic activity of the ethanolic extract in two dose levels 0.6 and 1.2 g kg(-1) per body weight (b.w.) was studied by the vaginal smear, and uterine weight methods for normal and ovariectomized female rats. The extract induced significant increase in the uterine weight of ovariectomized rats at two dose levels comparable to that of control group. The percentages of the total average number of scores were increased significantly too. Significant increases in plasma progesterone and total estrogens levels were shown at the two dose levels when compared to that of control group. On the other side, the extract induced significant reduction in luteinizing and plasma prolactin hormones.

Effects of Garlic (Alliumsativum) and chloramphenicol on growth performance, physiological parameters and survival of Nile tilapia (Oreochromis niloticus)

We studied and compared the effects of chloramphenicol antibiotic and garlic (Allium sativum), used as immunostimulants and growth promoters, on some physiological parameters, growth performance, survival rate, and bacteriological characteristics of Nile tilapia (Oreochromis niloticus). Fish (7±1g/fish) were assigned to eight treatments, with three replicates each. Treatment groups had a different level of Allium sativum (10, 20, 30, and 40g/kg diet) and chloramphenicol (15, 30, and 45mg/kg diet) added to their diets; the control group diet was free from garlic and antibiotic. Diets also contained 32% crude protein (CP) and were administered at a rate of 3% live body weight twice daily for 90 days. Results showed that the final weight and specific growth rate (SGR) of O. niloticus increased significantly with increasing levels of Allium sativum and chloramphenicol. The highest growth performance was verified with 30g Allium sativum / kg diet and 30mg chloramphenicol / kg diet. The lowest feed conversion ratio (FCR) was observed with 30g Allium sativum / kg diet and 30mg chloramphenicol / kg diet. There were significant differences in the protein efficiency ratio (PER) with all treatments, except with 45mg chloramphenicol / kg diet. No changes in the hepatosomatic index and survival rate were observed. Crude protein content in whole fish increased significantly in the group fed on 30g Allium sativum / kg diet, while total lipids decreased significantly in the same group. Ash of whole fish showed significantly high values with 30g Allium sativum and 15mg chloramphenicol / kg diet while the lowest value was observed in the control group. Blood parameters, erythrocyte count (RBC), and hemoglobin content in fish fed on diets containing 40g Allium sativum and all levels of chloramphenicol were significantly higher than in control. Significantly higher hematocrit values were seen with 30 and 45mg chloramphenicol / kg diet. There were no significant differences in the mean corpuscular volume (MCV) and mean corpuscular hemoglobin concentration (MCHC). Plasma glucose decreased significantly with increasing levels of Allium sativum but increased significantly with increasing levels of chloramphenicol. Total lipids were significantly reduced with diets containing 40g Allium sativum and 30mg chloramphenicol / kg diet, while total plasma protein content was significantly higher in fish fed on diets containing 10, 20, and 30g Allium sativum, and 30 and 45mg chloramphenicol / kg diet. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activities in plasma decreased significantly with increasing levels of Allium sativum and chloramphenicol. All Allium sativum and chloramphenicol levels decreased total bacteria and coliforms in water, muscles and intestine when compared to the control group. Treated groups had lower mortality rate than the control group during the challenge test. In conclusion, it can be suggested that adding 3% Allium sativum to fish diet can promote growth, reduce total bacteria, and improve fish health.

Chemical and biological evaluation of the essential oils of different Melaleuca species.

The essential oils of the fresh leaves of M. ericifolia, M. leucadendron, M. armillaris and M. styphelioides were isolated by a hydrodistillation method and analysed by a gas chromatography/mass spectrometry (GC/MS) technique. The essential oil of M. ericifolia contained methyl eugenol (96.84%) as a major constituent, whereas M. leucadendron was rich in 1,8-cineole (64.30%). The essential oil of M. armillaris was rich in 1,8-cineole (33.93%) followed by terpinen-4-ol (18.79%), whereas M. styphelioides was rich in caryophyllene oxide (43.78%) and (-) spathulenol (9.65%). The essential oils of these species possessed antimicrobial and antifungal activities. M. ericifolia exhibited the highest inhibitory effects against Bacillus subtiles and Aspergillus niger. The antiviral activities of the essential oils against Herpes simplex virus type 1 (HSV-1) were studied in African green monkey kidney cells (Vero) by a plaque reduction assay. The volatile oil of M. armillaris was more effective as a virucidal (up to 99%) than that of M. leucadendron (92%) and M. ericifolia (91.5%). The effects of the essential oils on the antioxidant system status in carbon tetrachloride treated animals were studied. The essential oil of M. armillaris exhibited a marked antioxidant effect, it improved vitamin E, vitamin C and superoxide dismutase parameters so it can be used as a free radical suppressor.

Correction of irregular astigmatism with excimer laser assisted by sodium hyaluronate.

PURPOSE: To demonstrate the usefulness of excimer laser surgery assisted by sodium hyaluronate for the correction of irregular astigmatism after previous corneal refractive surgery. DESIGN: Prospective noncomparative case series. PARTICIPANTS: Fifty eyes with surgically induced irregular astigmatism. All the patients had been subjected previously to one or more of the following: laser in situ keratomileusis (LASIK), incisional keratotomy, photorefractive keratotomy, phototherapeutic keratotomy, laser thermokeratoplasty, and corneal trauma. Irregular astigmatism developed thereafter. METHODS: Stability of the corneal topography pattern before surgical decision was observed for at least 6 months with the C-SCAN corneal topography with Ray Tracing (Technomed GmbH, Germany) and the Eye-Sys 2000 Corneal Analysis System (Eye Sys Co., Houston, TX). The lowest pachymetry value was 310 microm in the thinnest portion of the cornea. Ablation was performed with the Technolas 217 C-LASIK excimer laser (Bausch and Lomb Chiron Technolas GmbH, Dornach, Germany), in phototherapeutic keratectomy mode, assisted by a mask of 0.25% sodium hyaluronate. We performed our ablation either on the surface or under a flap, whether elevated or newly cut. MAIN OUTCOME MEASURES: Uncorrected and best-corrected visual acuity, manifest and cycloplegic refraction, superficial corneal surface quality, image distortion, and predicted corneal visual acuity. RESULTS: At 3 months of follow-up, the irregular corneal surface was significantly improved in all cases (n = 50). The superficial corneal surface quality improved from 70.5% +/- 9.16% to 75.6% +/- 10.38 (P < 0.0001). Six eyes lost 1 line of best-corrected visual acuity, three eyes lost 2 lines, and five eyes lost 3 or more lines. The real corneal ablation depth obtained was equal to 63% of that programmed because of the influence of masking substance. Mean uncorrected visual acuity improved from 20/80 +/- 20/125 to 20/63 +/- 20/100 (P = 0.01). Predicted corneal visual acuity improved from a mean of 20/32 +/- 20/80 to 20/25 +/- 20/63 (P = 0.004). Image distortion improved from a mean of 13.95 +/- 3.64 to 12.16 +/- 3.92 (P < 0.0001). We obtained a hyperopic shift in 56% and myopic shift in 40% of eyes. After 6 months of follow-up the irregular corneal surface continued to improve in all cases (n = 32). The superficial corneal surface quality improved from 69.38% +/- 9.48% to 73.13% +/- 8.87 (P = 0.002). Two eyes lost 2 lines of best-corrected visual acuity, and 3 eyes lost 1 line. Ray tracing was significantly improved in all cases at the end of follow-up regarding superficial corneal surface quality (P = 0.002) and the image distortion (P = 0.05). Improvement of predicted corneal visual acuity was not significant (P = 0.11). The procedure proved to be safe, with a safety index of 1.1. Differences between the surface and stromal treatments and between pattern and nonpattern irregular astigmatism were not statistically significant. CONCLUSION: It is possible to produce a more regular corneal surface and to improve best-corrected visual acuity in patients with irregular astigmatism using plano-scan excimer laser assisted by viscous masking solution of 0.25% sodium hyaluronate.

Development of an Arabic battery for remediation of selective auditory attention disorder in children.

A battery of Arabic speech material was developed for remediation of selective auditory attention disorder (SAAD) in children and standardized on 40 normal children aged from 6 to 12 years. This battery included: the Word Intelligibility by Picture Identification (WIPI) test, newly developed sentences for speech discrimination in noise, bisyllabic words and monosyllabic words. The tests were recorded against a background noise of either multitalker babble or stories. Variables affecting the results of the new battery, namely age, type of speech material and type of background noise, were studied. A significant positive correlation was found between the age of the child and the test scores. The WIPI test was the easiest test, giving the highest scores. The monosyllabic words test was the most difficult, yet normal children gave mean scores around 92%. The type of background noise showed a non-significant effect on the test scores. Results of two cases with SAAD are also presented.

Laser in situ keratomileusis for undercorrection and overcorrection after radial keratotomy.

PURPOSE: To evaluate laser in situ keratomileusis (LASIK) in the management of overcorrection and undercorrection after radial keratotomy (RK). SETTING: Instituto Oftalmológico de Alicante, Alicante, Spain. METHODS: This prospective study comprised 20 eyes of 13 patients. The eyes were divided into 2 groups: 11 eyes that were overcorrected after RK and 9 eyes that were undercorrected after RK. Both groups were treated with LASIK after a mean interval of 22 months +/- 8.4 (SD) (range 12 to 45 months). The follow-up was 6 months. RESULTS: Six months after LASIK, there was a significant decrease in the spherical equivalent in both groups. Ninety-one percent of eyes in the overcorrected group and 89% in the undercorrected group were within +/-1.0 diopter of the intended correction. There was a significant improvement in the uncorrected visual acuity in both groups. In the overcorrected group, 91% showed no change or improvement in their best corrected visual acuity; in the undercorrected group, 89% showed no change or improvement. CONCLUSIONS: Laser in situ keratomileusis was relatively safe in treating both overcorrection and undercorrection after RK. With proper intraoperative precautions, LASIK can effectively treat the residual refractive defects after RK.