Can optic disc vessel density help in cases of residual disc elevation after shunt surgery in cases of idiopathic intracranial hypertension?

AIM: To detect if we can use the reduction in the optic disc vessel density as an indicator to the reduction in intracranial tension in patients with residual optic disc elevation after shunt surgery as fundus examination in those cases is not conclusive. PATIENTS AND METHOD: 21 patients with papilledema due to idiopathic intracranial hypertension underwent shunt surgery. Full neurological and ophthalmological assessments were done. The optic disc vessel density was measured before and 3 months after surgery. Patients were then divided according to the resolution of papilledema into 2 groups: 1) Residual disc elevation group. 2) Completely resolved disc edema group. CSF pressure was measured via lumber puncture preoperative for all patients and 3 months post-operative only for patients with residual disc edema. A comparison between both groups was done. RESULTS: There was a highly statistically significant difference between the two groups as regard the papilledema grade (the residual disc elevation group had a higher grade of papilledema) with P-value=0.000. As regard the difference in the preoperative optic disc vessel density between the two groups, there were statistically significant differences (optic disc vessel density was more in the residual disc elevation group). As regard the postoperative optic disc vessel density, there were non-significant differences between the two groups in whole image, inside disc and peripapillary vessel density (either in macro or microvasculature). CONCLUSION: The optic disc vessel density decreased with normal postoperative CSF opening pressure in cases with residual disc elevation postoperatively. Thus, in cases of residual optic disc swelling after shunt surgery, we can detect the reduction of intracranial pressure by the reduction in the optic disc vessel density which is a safe non-invasive technique. That may help in cases of residual disc elevation.

Petroleum wastewater: Environmental protection, treatment, and safe reuse: An overview.

Oil petroleum production consumes about 1.0-7.2 bbl. The needed water for such production ranges between 0.47 and 7.2 L water to 1.0 L crude. Between 80 and 90% of the consumed water is disposed of as wasted effluents. Consequently, there is an important connection between petroleum production and the contamination of the environment and surface water in addition to their ecotoxicological effects. The objective of the present review is to through light on the hazardous impact of petroleum wastewater on the environment and water ways. The present study presents several wastewater treatment technologies in handling the petroleum produced water (PPW) and reducing the hazardous impact to the environment. Safe reuse is also presented including simple, advanced, and environmentally friendly techniques. The reported treatment technologies are divided into five main categories: membrane technologies, biological treatment processes, electro-chemical coagulation, physical/chemical treatment processes (dissolved air flotation (DAF)/air flotation (IAF), adsorption, and chemical flocculation), and catalytic oxidation including chemicals such as advanced and Fenton oxidation processes (AOPs). The analysis and observation of each treatment process are also presented. Implementing of these processes in sequential and/or in combined to avoid the drawbacks of any poor treatment are discussed. The present review discusses; also, in detail each of these treatment technologies and their efficiency including the observation and conclusions of each one. The study shows; also; how the final treated effluent can be reused for non-potable purposes as an additional water resource according to the degree of decontamination. An additional advantage of treatment is protection of both the environment and the water ways by avoiding any discharge of such hazardous wastewater.

Identifying asthma-related risks during hospitalization using the child asthma risk assessment tool.

Objective: The Child Asthma Risk Assessment Tool (CARAT) identifies risk factors for asthma morbidity. We hypothesized that CARAT-identified risk factors (using a CARAT adapted for inpatient use) would be associated with future healthcare utilization and would identify areas for intervention.Methods: We reviewed CARAT data collected during pediatric asthma admissions from 2010-2015, assessing for risk factors in environmental, medical, and social domains and providing prompts for inpatient (specialist consultation or social services engagement) and post-discharge interventions (home care visit or home environmental assessment). Confirmatory factor analysis identified groups of CARAT-identified risk factors with similar effects on healthcare utilization (latent factors). Structural equation models then evaluated relationships between latent factors and future utilization.Results: There were 2731 unique patients admitted for asthma exacerbations; 1015 (37%) had complete CARAT assessments and were included in analyses. Those with incomplete CARAT assessments were more often younger and privately-insured. CARAT-identified risk factors across domains were common in children hospitalized for exacerbations. Risks in the environmental domain were most common. Inpatient asthma consults by pulmonologists or allergists and home care referrals were the most frequent interventions indicated (62%, 628/1015, and 50%, 510/1015, respectively). Two latent factors were positively associated with healthcare utilization in the year after index stay - social stressors and known/suspected allergies (both p < 0.05). Stratified analyses analyzing data just from those children with prior healthcare utilization also indicated known/suspected allergies to be positively associated with future utilization.Conclusions: Inpatient interventions to address social stressors and allergic profiles may be warranted to reduce subsequent asthma morbidity.

Assessment of early vascular changes in adult females with polycystic ovary syndrome: correlation with insulin resistance.

Polycystic ovary syndrome (PCOS) is the commonest endocrine disorder in females in the reproductive period with estimated prevalence of 5% to 18% [1]. It contributes to the mortality and morbidity in patients with PCOS due to the increased risk of different metabolic and cardiovascular (CV) complications [2]. Despite the presence of obesity in 40-60% of cases [3], the disease may occur in non-obese women. The occurrence of metabolic disorders in non-obese PCOS patients, suggests that the syndrome itself may play a role in the development of metabolic and CV co-morbidities [4]. The identification of early stages of atherosclerosis in patients with PCOS might be useful in the development of new strategies to control modifiable CV risk factors [5]. Assessment of vascular endothelial function (ED) as an initial reversible step in atherosclerosis development, may serve as an integral index for CV risk factor burden [6]. In addition, carotid intima media thickness (CIMT) is a helpful marker for atherosclerosis and for the identification of increased risk of CV disease [7]. Our study assessed the early vascular changes in Egyptian women with PCOS both physically and functionally by looking at the CIMT using high resolution Doppler ultrasound and by measuring ED using brachial artery flow-mediated vasodilatation (FMD). Our results indicate that patients with PCOS have significant ED and premature atherosclerosis which is, to a great extent, independent of obesity and IR. This suggests that PCOS patients are at increased risk for premature CVD and may benefit from early detection and management.

Growth of microalgae adapted to high-light temperature conditions in different types of wastewater.

To obtain microalgae strains adapted to wastewater in the Mediterranean region, microalgae present in the Nile River were cultivated at both high-light temperature (HLT) and low-light temperature (LLT) conditions. It was found that the species which became dominant under HLT was chlorophyta of the genus Scenedesmus. In contrast, under LLT, bacillariophyta became dominant. The microalgae strain (Scenedesmus arcuatus) was subsequently isolated and cultivated in different types of primary treated wastewater under HLT and LLT conditions. The different types of primary treated wastewater were black water (BW), grey water (GW), and sewage water (SW). Growth rates reached during the exponential phase at HLT using GW, BW, and SW were between 0.38 and 0.4 (day-1). At LLT, 1.5-2.7 folds of lower growth rates were determined due to limitation by CO2. Removal of COD and inorganic N and P from sewage wastewater reached up to 88, 96, and 100%, respectively. Results thus indicate that microalgae adapted to the climate conditions can be efficiently used for COD removal and nutrient recovery from wastewater in the Mediterranean.

A Successful Collaboration Between an Urban School District, a Health System, and a Public Health Department to Address COVID-19 While Returning Children to the Classroom.

We sought to create and implement a set of COVID-19 mitigation processes including reliable testing to minimize in-school transmission of SARS-CoV-2. A large urban school district (> 33,000 students), a city health department, and a free-standing children's hospital partnered to implement multi-layered mitigation procedures which included access to polymerase chain reaction (PCR) testing with same day or next morning results. We tracked COVID-19 cases as well as probable/confirmed transmissions and identified needed mitigations through frequent huddles. During the 2020-2021 school year, there were 13 weeks of hybrid in person learning and 9 weeks of 5 day a week learning. Of the 1936 cases documented, only 3.2% resulted in subsequent school-related transmission. When children felt ill in the classroom, they were isolated within 10 min of reporting ill symptoms (> 90% of the time). PCR test results were routinely available to the school district by 6AM the following morning (79-99% of the time, depending on the learning model). An adaptive, fast-learning partnership across school district, public health, and a children's hospital minimized school-related transmission of COVID-19 and allowed children to safely return to the classroom.

Urea-Based Imprinted Polymer Hosts with Switchable Anion Preference.

The design of artificial oxyanion receptors with switchable ion preference is a challenging goal in host-guest chemistry. We here report on molecularly imprinted polymers (MIPs) with an external phospho-sulpho switch driven by small molecule modifiers. The polymers were prepared by hydrogen bond-mediated imprinting of the mono- or dianions of phenyl phosphonic acid (PPA), phenyl sulfonic acid (PSA), and benzoic acid (BA) using N-3,5-bis-(trifluoromethyl)-phenyl-N-4-vinylphenyl urea (1) as the functional host monomer. The interaction mode between the functional monomer and the monoanions was elucidated by 1H NMR titrations and 1H-1H NMR NOESY supported by molecular dynamic simulation, which confirmed the presence of high-order complexes. PPA imprinted polymers bound PPA with an equilibrium constant Keq = 1.8 × 105 M-1 in acetonitrile (0.1% 1,2,2,6,6-pentamethylpiperidine) and inorganic HPO42- and SO42- with Keq = 2.9 × 103 M-1 and 4.5 × 103 M-1, respectively, in aqueous buffer. Moreover, the chromatographic retentivity of phosphonate versus sulfonate was shown to be completely switched on this polymer when changing from a basic to an acidic modifier. Mechanistic insights into this system were obtained from kinetic investigations and DSC-, MALDI-TOF-MS-, 1H NMR-studies of linear polymers prepared in the presence of template. The results suggest the formation of template induced 1-1 diad repeats in the polymer main chain shedding unique light on the relative contributions of configurational and conformational imprinting.

Pediatric asthma medication therapy management through community pharmacy and primary care collaboration.

OBJECTIVES: To design and implement a collaborative medication therapy management (MTM) program targeting pediatric patients with high-risk asthma in a community pharmacy. SETTING: Underserved inner city of Cincinnati, OH. PRACTICE DESCRIPTION: A large national grocery store chain pharmacy and an academic hospital developed a partnership aimed at improving asthma care for shared patients. An interdisciplinary project team was formed, including 2 clinical pharmacists, 1 pharmacy district clinical coordinator, 1 pharmacy division clinical coordinator, 1 associate professor at a college of pharmacy, 1 pharmacy resident, and 3 pediatric physicians. This pilot project involved 2 Kroger Pharmacy sites and Cincinnati Children's Hospital Medical Center's (CCHMC) 3 pediatric primary care centers. PRACTICE INNOVATION: Kroger and CCHMC staff identified shared high-risk asthma patients (those cared for at the included primary care centers who used Kroger for their medication fills) with the use of information from validated symptom assessments (Asthma Control Test), refill history, and recent health care utilization. Community pharmacists recruited jointly identified patients and provided a targeted MTM intervention. Education focused on asthma diagnosis, types of asthma medications, appropriate medication administration, and environmental triggers. Pharmacists suggested medication changes to prescribers via facsimile. Pharmacists followed up with patients in 30 days to assess asthma control, provide additional education, and propose further recommendations. EVALUATION: Outcomes evaluated included the average number of recommendations made to patients and prescribers and acceptance rates for each of those measures. RESULTS: Six patients completed the project. Pharmacists provided an average of 3.7 recommendations to each patient and 1.5 to prescribers for each patient; 77.3% and 100% recommendations were accepted, respectively. CONCLUSION: This pilot project describes the design and implementation of a pharmacist-physician collaborative program for high-risk pediatric asthma patients. The greatest outcome of this project was the formation of a collaborative team between pharmacists and physicians that continues to work together on additional family-centered initiatives.

Treatment of leather industrial wastewater via combined advanced oxidation and membrane filtration.

The liming/unhairing operation is among the important processes of the leather industry. It generates large amounts of effluent that are highly loaded with organic hazard wastes. Such effluent is considered one of the most obnoxious materials in the leather industry, causing serious environmental pollution and health risks. The effluent is characterized by high concentrations of the pollution parameters. Conventional chemical and/or biological treatment of such wastewater is inefficient to meet the required limits of standard specifications, due to the presence of resistant and toxic compounds. The present investigation deals with an effective treatment approach for the lime/unhair effluent using the Fenton reaction followed by membrane filtration. The experiment was extended to a laboratory pilot-scale in a continuous treatment study. In this study the raw wastewater was treated with the predetermined Fenton's optimum dose followed by membrane filtration. The wastewater was efficiently treated and the final effluent met the standards for unrestricted water reuse.

Anaerobic/aerobic treatment of greywater via UASB and MBR for unrestricted reuse.

The aim of the present study was to investigate the efficiency of integrated up-flow anaerobic sludge blanket (UASB) as anaerobic system followed by membrane bioreactor (MBR) as aerobic system for the treatment of greywater for unrestricted reuse. Pilot-scale UASB and MBR units were installed and operated in the NRC, Egypt. Real raw greywater was subjected to UASB and the effluent was further treated with microfiltration MBR. The necessary trans-membrane pressure difference is applied by the water head above the membrane (gravity flow) without any energy input. The average characteristics of the raw greywater were 95, 392, 298, 10.45, 0.4, 118.5 and 28 mg/L for total suspended solids (TSS), chemical oxygen demand (COD), biochemical oxygen demand (BOD), total phosphates, nitrates, oil and grease, and total Kjeldahl nitrogen (TKN), respectively. The pH was 6.71. The UASB treatment efficiency reached 19.3, 57.8, 67.5 and 83.7% for TSS, COD, BOD5 and oil and grease, respectively. When the UASB effluent was further treated with MBR, the overall removal rate achieved 97.7, 97.8, 97.4 and 95.8% for the same parameters successively. The characteristics of the final effluent reached 2.5, 8.5, 6.1, 0.95, 4.6 and 2.3 mg/L for TSS, COD, BOD, phosphates, oil and grease and TKN, respectively. This final treated effluent could cope with the unrestricted water reuse of local Egyptian guidelines.

Cytogenetic Subclone Burden: A New Biomarker Predicting Chronic Lymphocytic Leukemia Patients Outcome.

BACKGROUND: Chronic lymphocytic leukemia is the most prevalent adult leukemia that occurs in older patients and presents a variable course of the disease. Risk stratification of CLL is a matter of continuous improvement. Thus, this study aimed to assess the impact of the quantification of 17p del and 11q del cytogenetic subclones on the outcome of patients with chronic lymphocytic leukemia. PATIENTS AND METHODS: This is a prospective study that involved 100 subjects with CLL. For all included patients; assessment of the cytogenetic subclones burden for 17p del and 11q del using the FISH technique was carried out. RESULTS: CLL patients with a high 17p del (>33%) cytogenetic subclone burden showed significantly shorter lymphocyte doubling time (LDT), time to first treatment (TTFT), and progression free survival (PFS) compared to those with a lower burden. On contrary 11q del subclone(>30%) burden had an insignificant impact on LDT, TTFT and PFS. CONCLUSION: Quantification of 17pdel burden (>vs.≤33%) could be used for refining risk stratification of CLL patients.

Social Determinants of Health Screening in Type 1 Diabetes Management.

Type 1 diabetes management is intricately influenced by social determinants of health. Economic status impacts access to vital resources like insulin and diabetes technology. Racism, social injustice, and implicit biases affect equitable delivery of care. Education levels affect understanding of self-care, leading to disparities in glycemic outcomes. Geographic location can limit access to health care facilities. Stressors from discrimination or financial strain can disrupt disease management. Addressing these social factors is crucial for equitable diabetes care, emphasizing the need for comprehensive strategies that go beyond medical interventions to ensure optimal health outcomes for all individuals with type 1 diabetes.

Peripheral Blood B-Cell Subsets Frequency and Distribution and the BSF-2(IL-6) to CSIF:TGIF(IL-10) Ratio as Severity-Associated Signatures in Primary Open-Angle Glaucoma: A Case-Controlled Study.

Although primary open-angle glaucoma (POAG) is a major cause of blindness worldwide, patients' immune response and its relation to the disease course have not been fully unraveled in terms of analyses of circulating B-cell subsets, as well as the association of these subsets with the severity of POAG clinical features. SUBJECTS AND METHODS: Flow cytometry was used to determine B-cell subset frequencies from 30 POAG patients grouped by hierarchical cluster analysis or the mean deviation (MD) of the visual field (VF) and correlated with the patients' clinical and pathological data, as well as with BSF-2(IL-6) and CSIF:TGIF(IL-10), which were quantified in peripheral blood samples of patients and controls by ELISA. RESULTS: The total B-cell frequency was increased in the POAG group in comparison to the control group (n = 30). Frequencies of specific B-cell subsets, such as double-negative (DN) and naïve B-cell subsets, were increased in relation to the severity of the POAG disease. However, the unswitched memory B compartment subset decreased in the POAG group. Other non-typical B-cell subsets such as DN B cells also showed significant changes according to the POAG disease severity course. These differences allow us to identify POAG severity-associated inflammatory clusters in patients with specifically altered B-cell subsets. Finally, ocular parameters, biomarkers of inflammation, and other glaucoma-related or non-clinical scores exhibited correlations with some of these B-cell subpopulations. CONCLUSION: The severity of the POAG disease course is accompanied by changes in the B-cell subpopulation, namely, DN B cells. Furthermore, the existing relationship of the B-cell subset frequencies with the clinical and the inflammatory parameters BSF-2(IL-6), CSIF:TGIF(IL-10), and the BSF-2(IL-6) to CSIF:TGIF(IL-10) ratio suggests that these B lymphocyte cells could serve as potential molecular bio-markers for assessing POAG disease severity and/or progression.

Aflibercept or ranibizumab for diabetic macular edema.

Background: Vascular endothelial growth factor (VEGF) is the primary substance involved in retinal barrier breach. VEGF overexpression may cause diabetic macular edema (DME). Laser photocoagulation of the macula is the standard treatment for DME; however, recently, intravitreal anti-VEGF injections have surpassed laser treatment. Our aim was to evaluate the efficacy of intravitreal injections of aflibercept or ranibizumab for managing treatment-naive DME. Methods: This single-center, retrospective, interventional, comparative study included eyes with visual impairment due to treatment-naive DME that underwent intravitreal injection of either aflibercept 2 mg/0.05 mL or ranibizumab 0.5 mg/0.05 mL at Al-Azhar University Hospitals, Egypt between March 2023 and January 2024. Demographic data and full ophthalmological examination results at baseline and 1, 3, and 6 months post-injection were collected, including the best-corrected distance visual acuity (BCDVA) in logarithm of the minimum angle of resolution (logMAR) notation, slit-lamp biomicroscopy, dilated fundoscopy, and central subfield thickness (CST) measured using spectral-domain optical coherence tomography. Results: Overall, the 96 eyes of 96 patients with a median (interquartile range [IQR]) age of 57 (10) (range: 20-74) years and a male-to-female ratio of 1:2.7 were allocated to one of two groups with comparable age, sex, diabetes mellitus duration, and presence of other comorbidities (all P >0.05). There was no statistically significant difference in baseline diabetic retinopathy status or DME type between groups (both P >0.05). In both groups, the median (IQR) BCDVA significantly improved from 0.7 (0.8) logMAR at baseline to 0.4 (0.1) logMAR at 6 months post-injection (both P = 0.001), with no statistically significant difference between groups at all follow-up visits (all P >0.05). The median (IQR) CST significantly decreased in the aflibercept group from 347 (166) µm at baseline to 180 (233) µm at 6 months post-injection, and it decreased in the ranibizumab group from 360 (180) µm at baseline to 190 (224) µm at 6 months post-injection (both P = 0.001), with no statistically significant differences between groups at all follow-up visits (all P >0.05). No serious adverse effects were documented in either group. Conclusions: Ranibizumab and aflibercept were equally effective in achieving the desired anatomical and functional results in patients with treatment-naïve DME in short-term follow-up without significant differences in injection counts between both drugs. Larger prospective, randomized, double-blinded trials with longer follow-up periods are needed to confirm our preliminary results.

Ultrasonographic assessment of muscle layer thickness and its relation to patient outcome in a medical intensive care unit.

AIM: Low skeletal muscle mass in ICU patients is associated with poor clinical outcome. Ultrasonography is a noninvasive method that can measure muscle thickness at the bedside. We aimed at studying the relation of the ultrasonography measured muscle layer thickness (MLT) at time of ICU admission with the patients' outcome namely mortality, duration of mechanical ventilation (MV) and ICU length of stay (LOS). In addition to define the best cut-off values that can predict mortality in medical ICU patients. METHOD: this observational prospective study was conducted on 454 adult critically ill patients admitted to the medical ICU of a university hospital. At the time of admission, MLT of the anterior mid-arm and lower 1/3 thigh were assessed using ultrasonography with and without transducer compression. The clinical scores for assessment of disease severity; Acute Physiology and Chronic Health Evaluation score (APACHE-II) and Sequential Organ Failure Assessment score (SOFA) in addition to nutrition risk; modified Nutrition Risk in Critically ill score (mNUTRIC) were estimated for all patients. ICU LOS, duration on MV and mortality were reported. RESULTS: The mean age of our patients was 51 years ± 19. The ICU mortality rate was 36.56%. The baseline MLT was negatively associated with APACHE-II, SOFA and NUTRIC scores but not with duration of MV or ICU-LOS. The non-survivors had lower values of baseline MLT. A cut-off value of 0.895 cm (AUC: 0.649, 95% CI of 0.595-0.703) using the mid-arms as a reference point with maximum probe compression showed the highest sensitivity (90%) to predict mortality compared to other techniques however with low specificity (22%). CONCLUSION: the baseline ultrasonography measured mid-arm MLT is a sensitive risk assessment tool that can reflect disease severity and predict ICU mortality.

Role of adipose-derived stem cells in healing surgically induced trauma of the rat's tunica albuginea.

Background: Injection of adipose-derived stem cells (ADSCs) into the injured tunica albuginea (TA) may prevent fibrosis, restore the balance between pro- and antifibrotic pathways, and potentially mitigate erectile dysfunction caused by abnormal TA healing. Aim: To assess the potential role of ADSC injection on structural, ultrastructural, functional, and molecular changes in surgically induced trauma of the rat's TA. Methods: Forty adult male albino Wistar rats were divided into 5 groups of 8 rats each: group 1, sham; group 2, injury to TA without treatment; group 3, injury to TA and suture repair; group 4, injury to TA and injection of ADSCs without suture repair; group 5, injury to TA followed by injection of ADSCs and suture repair. Outcomes: After 6 weeks, all groups were subjected to functional, histologic, and ultrastructural examination and molecular expression of healing growth factors. Results: The intracavernous pressure (ICP; mean ± SD) was 114 ± 2, 32 ± 2, 65 ± 2, 68 ± 2, and 111 ± 2 mm Hg in groups 1 to 5, respectively. There were significant differences in ICP between each of groups 3 to 5 and group 2 (P < .05), and groups 3 and 4 each had significant differences with group 1 (P < .05). No significant difference in ICP occurred between groups 3 and 4 (P > .05). There were significant histologic and ultrastructural alterations in tunical tissues from group 2; however, these changes were markedly less in group 5 in terms of lower levels of fibrotic changes, elastosis, and superior overall neuroendothelial expression. Groups 3 and 4 showed improved structural and ultrastructural parameters when compared with group 2. Group 5 demonstrated lower levels of transforming growth factor ß1 and basic fibroblast growth factor expression. Clinical Implications: This experimental model may encourage administration of ADSCs to prevent the deleterious effects of trauma to the TA. Strengths and Limitations: Injecting ADSCs can improve the healing process and erectile dysfunction in a rat model following TA injury, and combining ADSC injection with surgical suturing resulted in superior outcomes. The main limitation was the absence of long-term ICP measurements and a longer follow-up period that may provide further insight into the chronic phase of the healing process. Conclusion: ADSC injection may prevent structural, ultrastructural, functional, and molecular alterations in surgically induced trauma of the rat's TA and enhance the effect of tunical suturing after trauma.

Safety and efficacy of implantable phakic contact lens versus implantable collamer lens in myopia correction.

Background: Phakic intraocular lenses (pIOLs) have proven to be excellent substitutes for excimer laser keratorefractive surgery in certain situations. We aimed to assess the efficacy and safety of two pIOLs, the implantable collamer lens (ICL V4c) versus the implantable phakic contact lens (IPCL V2), for myopic correction. Methods: In this prospective randomized clinical trial, we allocated eligible eyes with myopia > - 6 diopters into IPCL or ICL implantation groups, each including 100 eyes of 100 individuals. Preoperative and postoperative assessments at 3, 6, and 12 months included measurements of the spherical equivalent (SE), uncorrected distance visual acuity (UCDVA), best-corrected distance visual acuity (BCDVA), intraocular pressure (IOP), maximum keratometry (K1), minimum keratometry (K2), mean keratometry (Kmean), anterior chamber depth (ACD), anterior chamber angle (ACA), and endothelial cell density (ECD). Results: The groups had comparable demographic characteristics and baseline visual and anatomical values (all P > 0.05). The UCDVA, BCDVA, and SE of the two groups were comparable at baseline and at all postoperative follow-up examinations (all P > 0.05). Both groups experienced significant improvements in UCDVA, BCDVA, and SE at three months postoperatively (all P = 0.001), and measurements remained stable for up to 12 months. Keratometry readings were comparable between the groups over the follow-up period and remained unchanged at all visits (all P > 0.05). The ACA in the ICL group was significantly decreased at three months postoperatively (P = 0.001) and then widened significantly at 6 and 12 months (both P = 0.001). In the IPCL group, the postoperative ACA was significantly decreased at three months (P = 0.001) and was comparable to that in the ICL group (P > 0.01). However, at the 6- and 12-month postoperative visits, the ACA was significantly narrower in the IPCL group than in the ICL group (both P = 0.001). The ACD in both groups was decreased at three months postoperatively (both P = 0.001) and remained stable until the end of the study. The ECD remained comparable between the groups at all postoperative visits (all P > 0.05). We did not observe a significant ECD reduction in either group at any postoperative follow-up visit (all P > 0.05). We encountered no serious complications in either group. Conclusions: ICL and IPCL had comparable safety and efficacy outcomes in terms of anterior chamber morphometrics, visual and refractive results, and corneal parameters. Further multicenter randomized clinical trials with longer follow-up periods, larger sample sizes, and measurement of additional anterior chamber and corneal morphometrics, vault, and other vision parameters are needed to verify these findings.

Non-penetrating deep sclerectomy versus combined trabeculotomy-trabeculectomy in primary congenital glaucoma.

Background: The primary mode of therapy in children with primary congenital glaucoma (PCG) and mild or no corneal edema is goniotomy, which has a high success rate. However, in developing countries, the diagnosis of PCG is usually delayed, and corneal cloudiness interferes with goniotomy. Therefore, trabeculotomy may be the best choice in such eyes. We compared the short-term efficacy and safety of primary combined trabeculotomy-trabeculectomy (primary CTT) with that of non-penetrating deep sclerectomy (NPDS) in managing PCG. Methods: This prospective, randomized, comparative study included patients with PCG referred to Al-Azhar University Hospitals within a 1-year period. Eyes were randomly allocated to one of two groups: eyes in NPDS group underwent NPDS, and those in primary CTT group underwent primary CTT. Baseline and frequent postoperative assessments of intraocular pressure (IOP), cup-to-disc ratio (C/D ratio), corneal diameter, and axial length were performed for up to 6 months. The success rates were recorded in both groups. Results: Forty eyes of 26 patients were included, with 20 eyes allocated to each group. The mean (standard deviation) age of all patients was 12.9 (9.5) months, with comparable ages and sex ratios between groups (both P > 0.05). Both groups demonstrated a significant reduction in IOP and C/D ratio at each postoperative visit compared to the baseline visit (all P < 0.001), with no significant difference detected between the groups (all P > 0.05), except for a significantly lower IOP in NPDS group at 1 month (P < 0.05). The corneal diameter and axial length were comparable between groups at baseline and remained unchanged at all postoperative visits (all P > 0.05). The groups had comparable success rates (P > 0.05). No serious complications were detected. Conclusions: CTT and NPDS both yielded reasonable IOP control and reversal of cupping in eyes with PCG. We observed equal effectiveness of the surgical procedures without major safety concerns. Further large-scale clinical trials with longer follow-up periods are needed to verify our preliminary findings.

Can mobilization of bone marrow stem cells be an alternative regenerative therapy to stem cell injection in a rat model of chronic kidney disease?

Chronic kidney disease (CKD) is a priority health problem affecting 36% of Egyptians. Adipose-derived mesenchymal stem cells (ADMSCs) have multidifferentiation capacity and the ability to restore several types of cells including damaged renal cells. Granulocyte colony-stimulating factor (G-CSF) is known to mobilize hematopoietic stem cells from bone marrow to the peripheral circulation. The aim of this study was to compare the effect of endogenous CD34+ cells mobilization and exogenous ADMSCs administration in the treatment of a rat model of adriamycin (ADR)-induced CKD. A total of 48 male albino rats of the local strain (200 ± 50 g) were equally divided into four groups: control negative, ADR (control positive), ADMSCs group, and G-CSF group. Six rats from each group were sacrificed after 4 weeks and the other 6 after 12 weeks. Renal function was assessed frequently by measuring serum creatinine, albumin, urea, 24-h urinary protein level, and hemoglobin level throughout the study. Oxidative stress markers malondialdehyde (MDA) and total antioxidant (TAO) were measured on day 28. CD-34+ cell percentage was measured on day 9. After the sacrification of the rats, kidneys were removed for histopathological assessment. Results revealed that both ADMSCs and G-CSF significantly improved serum creatinine, albumin, urea, 24-h urinary protein level, and histopathological damage score, with the G-CSF-treated group showing better improvement in 24-h urinary protein level, serum albumin, and histopathological damage score compared with ADMSCs-treated group. The G-CSF group also had significantly higher levels of CD34+ cells. Oxidative stress markers (MDA and TAO) levels were significantly improved with both therapies. We conclude that mobilization of endogenous hematopoietic stem cells by G-CSF is more effective than exogenously injected ADMSCs in protecting the kidneys against AD-induced toxicity.

Oxoanion Imprinting Combining Cationic and Urea Binding Groups: A Potent Glyphosate Adsorber.

The use of polymerizable hosts in anion imprinting has led to powerful receptors with high oxyanion affinity and specificity in both aqueous and non-aqueous environments. As demonstrated in previous reports, a carefully tuned combination of orthogonally interacting binding groups, for example, positively charged and neutral hydrogen bonding monomers, allows receptors to be constructed for use in either organic or aqueous environments, in spite of the polymer being prepared in non-competitive solvent systems. We here report on a detailed experimental design of phenylphosphonic and benzoic acid-imprinted polymer libraries prepared using either urea- or thiourea-based host monomers in the presence or absence of cationic comonomers for charge-assisted anion recognition. A comparison of hydrophobic and hydrophilic crosslinking monomers allowed optimum conditions to be identified for oxyanion binding in non-aqueous, fully aqueous, or high-salt media. This showed that recognition improved with the water content for thiourea-based molecularly imprinted polymers (MIPs) based on hydrophobic EGDMA with an opposite behavior shown by the polymers prepared using the more hydrophilic crosslinker PETA. While the affinity of thiourea-based MIPs increased with the water content, the opposite was observed for the oxourea counterparts. Binding to the latter could however be enhanced by raising the pH or by the introduction of cationic amine- or Na+-complexing crown ether-based comonomers. Use of high-salt media as expected suppressed the amine-based charge assistance, whereas it enhanced the effect of the crown ether function. Use of the optimized receptors for removing the ubiquitous pesticide glyphosate from urine finally demonstrated their practical utility.