Comparative Analysis of Silicone Tube Intubation Versus Probing and Balloon Dilation for Congenital Nasolacrimal Duct Obstruction: A Systematic Review and Meta-Analysis.

OBJECTIVE: Congenital nasolacrimal duct obstruction (CNLDO) is a pediatric disorder with a wide range of pathology. If untreated, the condition may end up with serious complications. Multiple treatment options for CNLDO exist throughout the literature, and there is an ongoing debate on the best intervention for each disease subgroup and the best timing of such interventions. This study compares the success and failure rates of silicone tube intubation (STI) against probing and balloon dilation (BD). METHODS: The authors searched the literature for relevant articles using PubMed, Scopus, web of Science, and Cochrane Library until January 2024. Using RevMan 5.4, the authors compared STI's success and failure rates to probing and BD using risk ratios (RRs) and a random-effect model. In addition, the complication rate of monocanalicular intubation (MCI) versus bicanalicular intubation (BCI) was investigated. The authors used the leave-one-out method to check for influential studies and to resolve heterogeneity. RESULTS: The screening process resulted in 23 eligible articles for inclusion in the authors' review. Silicone tube intubation had a higher chance of resolving the symptoms of CNLDO than probing (RR = 1.11; 95% CI: 1.04, 1.20; P = 0.004) while having less risk of surgical failure (RR = 0.48; 95% CI: 0.30, 0.76; P = 0.002]. Monocanalicular intubation showed no statistically significant difference when compared with BCI in terms of surgical success and failure; however, MCI had a lower risk of complications (RR = 0.68; 95% CI: 0.48, 0.97; P = 0.04). In addition, STI did not demonstrate any significant difference from BD. CONCLUSION: There was no significant difference in success/failure between MCI and BCI; monocanalicular had fewer complications. Silicone tube intubation did better in terms of surgical success than probing, especially in children over 12 months, suggesting that it is the preferred intervention for older patients with CNLDO.

Utilization of Ophthalmic Technology and Advances in Endothelial Keratoplasty: A Case Report.

INTRODUCTION AND IMPORTANCE: The authors report a case of a 65-year-old male with corneal decompensation associated with poor vision with a recent history of cataract surgery. CASE PRESENTATION: A patient presented with complaints of poor vision in the left eye. The patient had undergone phacoemulsification surgery 4 months prior to presentation. The presenting best corrected vision was 20/400 in the left eye with the presence of corneal edema and central Descemet's membrane detachment (DMD) extending to the inferior two-thirds of the cornea with a fibrotic demarcation line separating detached Descemet's from intact, attached Descemet's. CLINICAL DISCUSSION: Anterior segment optical coherence tomography (AS-OCT) confirmed the diagnosis of Type 1 DMD. The patient was managed with femtosecond laser-assisted descematorrhexis with intraoperative AS-OCT, and a ready preloaded Descemet stripping endothelial keratoplasty graft. CONCLUSIONS: This report emphasizes that many technological advancements in the field can be employed to improve the outcomes of endothelial keratoplasty, especially when fibrosis is associated with the combined PDL and DMD.

Awareness Regarding Sex Hormone Disruptors in Everyday Products Among Females of Reproductive Age in Al-Jouf, the Kingdom of Saudi Arabia.

Background and objective Endocrine-disrupting chemicals (EDCs) are natural or synthetic molecules that can alter and affect the operations of the hormonal system of an organism. These compounds include plastic consumer products and food containers such as phytoestrogen, which is also naturally present in food. EDCs can be found in the cord blood and maternal blood of pregnant women, as well as colostrum. Hence, they may affect not only the mother but also the offspring. In this study, we aimed to evaluate the awareness among females of reproductive age regarding the nature, source, as well as physiological and psychological burden associated with sex hormones disruptors. Methods A descriptive cross-sectional study was conducted among females between the age of 15-45 years in the Al-Jouf region, Saudi Arabia. A self-administrated questionnaire was used as the data collection tool; it consisted of multiple-choice questions to obtain information on the awareness among the females. In this study, females were classified into those with good knowledge and those with poor knowledge based on their level of knowledge by using a scoring system with a total score of 12. IBM SPSS Statistics version 24 (IBM Corp., Armonk, NY) was used to analyze the collected data. Results The study included 491 females; 6.6% of them had been using soya-containing products for a long time, and 32.5% reported using oatmeal for a long time. The majority (86.2%) did not use any other hormonal therapy. There were significant differences in the knowledge about sex hormone disruptors among the participants, and women with poorer knowledge about sex hormone disruptors were significantly less likely to report the long-time usage of soya-containing food when compared to women with greater knowledge (2.2% vs. 4.2%, p<0.001). The results showed that women with poorer knowledge were also significantly less likely to report the usage of hormonal therapies when compared to women with greater knowledge (6.7% vs. 7.2%, p<0.001), indicating that the usage of these chemicals is higher in women with greater knowledge although they are aware of their effects. Conclusion The study showed that females had good knowledge about the nature and usage of EDCs but poor knowledge about their impact. The knowledge of females was associated with their behavior regarding the usage of such products.

Psoriasis in Northern Saudi Arabia: Clinical features and implications for quality of life.

Introduction: Psoriasis is a chronic non-contagious inflammatory skin disorder, which might impair patient's social relationships, limit leisure activities, and lower self-esteem. Psoriasis patients might be stigmatized leading to psychological disorders such as anxiety and depression. Objectives: This study aimed to outline the clinical features of psoriasis and its effects on quality of life, and the feeling of stigmatization among psoriasis patients. Methods: This cross-sectional questionnaire-based study was conducted on 109 adult psoriasis patients in Arar City, Saudi Arabia. The study collected data on socio-demographic and clinical characteristics of psoriasis patients, self-reported psoriasis severity using the self-assessment Simplified Psoriasis Index (sa-SPI-s), patients' quality of life using the dermatological life quality index (DLQI), and the feeling of stigmatization using the six-items stigmatization scale. Results: The mean age of psoriasis onset in studied patients was 20 (±7.65) years, females represented 58.72%, and 22% were unemployed. Joint and nail affection were reported in 46.79% and 51.38%, respectively. One third of patients had positive family history of psoriasis. Seasonal variation, life stressors, smoking and skin injuries were frequent provocative factors for psoriasis lesions. The average sa-SPI-s was 10.08 (±10.41), which was correlated with patients' ages, disease duration, obesity, and pruritis. The average DLQI and six-items stigmatization scale for psoriasis patients were 8.95 (±5.77) and 7.61 (±4.5), respectively that were correlated with sa-SPI-s. Conclusion: The clinical manifestations and chronicity of psoriasis impaired patients' quality of life and accompanied with social stigma due to skin disfigurement. These effects need to be addressed for better care of patients.