Bubbling With Confidence: A Study of Numerous Deep Anterior Lamellar Keratoplasty Cases Using Anwar's Big Bubble Technique.

PURPOSE: This study aims to assess the postoperative results, variability, and complications of a hundred deep anterior lamellar keratoplasty cases. Study design and duration: This is an observational study. The study was conducted at Pak International Medical College (PIMC) for a duration of four years (January 2019-January 2023). METHODOLOGY: Our study collected information on a hundred cases of deep anterior lamellar keratoplasty (DALK) utilizing Anwar's big bubble technique, consisting of patients with keratoconus, superficial corneal scars, and macular dystrophy. Consenting patients had their pre and postoperative visual acuities and keratometry readings recorded. Overall success and complications were recorded and compared with the present literature. RESULTS: Big bubble formation was achieved in 87% (n = 87) eyes and not achieved in 13% (n=13). There was a significant reduction in keratometry values after the procedures as well as improved vision in all patients, with 84% reporting significant improvement. Descemet membrane exposure was achieved in 91% (n=91). Complications included the failure of Anwar's big bubble formation in 13% (n=13) patients and the failure to expose Descemet's in nine patients (9%). CONCLUSION: DALK using the big bubble technique is a safe and effective procedure in patients with corneal diseases who have a healthy Descemet membrane and endothelium.

Relationship Of Serum Visfatin Levels With Serum Electrolytes, Liver Profile, Hepatic Enzymes And Anthropometric Parameters In Pregnant Women With Preeclampsia And Eclampsia During 3rd Trimester.

BACKGROUND: Eclampsia and preeclampsia are among the serious complications of gestation and threaten the lives of both mother and foetus. A protein called visfatin, one of these adipokines, is evaluated for its effects on serum electrolytes, lipid profile and hepatic enzymes in preeclamptic and eclamptic patients. METHODS: A sum of 234 pregnant women were enrolled in this crosssectional study and divided in to 2 main groups, i.e., Group A (eclamptic/preeclamptic) Group B (control) pregnant women respectively. Serum visfatin levels (ng/mL), serum electrolytes and liver enzymes were determined for every patient, using relative diagnostic kits. Anthropometric measurements were also noted. RESULTS: A total of 234 women (cases; n=160, controls; n=74) with gestation age of ≥20 weeks participated in this study. Group A had 86 (36.75%) women with preeclampsia and 74 (31.62%) women with eclampsia whereas Group B had 74 (31.62%) normotensive pregnant women. A strong significantly positive association was recorded for systolic (R2=78.78; p-value <0.000) and diastolic blood pressure (BP) (R2=78.52; p-value <0.000). Similar result was obtained for serum sodium ions (R2=3.09; p-value <0.002) and chloride ions (R2=7.36; p-value <0.000). Alkaline phosphatases (ALP) (R2=63.47; p-value <0.000) had also shown a strong positive and statistically significant association with visfatin levels. CONCLUSIONS: Serum visfatin significantly decreased the sodium and chloride levels whereas the levels of potassium remained unaffected. A very strong and positive association of visfatin levels with levels of bilirubin and alkaline phosphatases was also observed (ALP) but it found no effect on aspartate transferases (AST).

Ryanodine receptor point mutations confer diamide insecticide resistance in tomato leafminer, Tuta absoluta (Lepidoptera: Gelechiidae).

Insect ryanodine receptors (RyR) are the molecular target-site for the recently introduced diamide insecticides. Diamides are particularly active on Lepidoptera pests, including tomato leafminer, Tuta absoluta (Lepidoptera: Gelechiidae). High levels of diamide resistance were recently described in some European populations of T. absoluta, however, the mechanisms of resistance remained unknown. In this study the molecular basis of diamide resistance was investigated in a diamide resistant strain from Italy (IT-GELA-SD4), and additional resistant field populations collected in Greece, Spain and Brazil. The genetics of resistance was investigated by reciprocally crossing strain IT-GELA-SD4 with a susceptible strain and revealed an autosomal incompletely recessive mode of inheritance. To investigate the possible role of target-site mutations as known from diamondback moth (Plutella xylostella), we sequenced respective domains of the RyR gene of T. absoluta. Genotyping of individuals of IT-GELA-SD4 and field-collected strains showing different levels of diamide resistance revealed the presence of G4903E and I4746M RyR target-site mutations. These amino acid substitutions correspond to those recently described for diamide resistant diamondback moth, i.e. G4946E and I4790M. We also detected two novel mutations, G4903V and I4746T, in some of the resistant T. absoluta strains. Radioligand binding studies with thoracic membrane preparations of the IT-GELA-SD4 strain provided functional evidence that these mutations alter the affinity of the RyR to diamides. In combination with previous work on P. xylostella our study highlights the importance of position G4903 (G4946 in P. xylostella) of the insect RyR in defining sensitivity to diamides. The discovery of diamide resistance mutations in T. absoluta populations of diverse geographic origin has serious implications for the efficacy of diamides under applied conditions. The implementation of appropriate resistance management strategies is strongly advised to delay the further spread of resistance.

The outcome of bone mineral density measurements on patients referred from general practice.

The incidence of osteoporosis is increasing and the general practitioner is integral to identifying these patients. It is, therefore, of interest to characterize the referral pattern of patients scheduled for determination of bone density by means of dual-energy X-ray absorptiometry scanning. Altogether, 1551 scans from first-time referred women were analyzed with respect to normal bone mineral density (BMD), osteopenia, and osteoporosis as the outcome, and the results were compared with age and body mass index (BMI). Using multiple regression analysis, risk estimates for osteoporosis were calculated with respect to patient characteristics. Only 21% of the referred patients had osteoporosis and 34% had osteopenia. Of these, 24% had osteopenia and a Z-score below -1. Half of the referred patients were women less than 60 yr with a markedly low risk of osteoporosis. A BMI less than 20 kg/m(2) increased the predictive value considerably. A low BMI is a good indicator for referral of women less than 60 yr for measurements of bone density. Forty-five percent of the referred women from general practitioners had a normal BMD.

Do energy density and dietary fiber influence subsequent 5-year weight changes in adult men and women?

OBJECTIVE: We examined whether associations between dietary components and, in particular, energy density (ED) predicted subsequent 5-year weight changes. RESEARCH METHODS AND PROCEDURES: The present longitudinal population study was part of the Danish World Health Organization Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) and the 1936 cohort dietary studies. Effects of components were studied in relation to subsequent 5-year weight changes in 862 men and 900 women, 30 to 60 years old. Linear multiple regression analyses were conducted. RESULTS: Mean 5-year changes in body weight (BW) were 1.2 +/- 3.9 and 1.3 +/- 4.6 kg for men and women, respectively. In general, neither ED nor any of the dietary components was associated with subsequent change in BW. In women, ED was positively associated with weight gain among the obese (BMI > 30 kg/m2) and inversely associated with weight gain in normal-weight women (BMI < 25 kg/m2) (p = 0.01). However, in men there was a non-significant inverse trend between ED and weight gain in the obese and no significant interaction. DISCUSSION: To our knowledge, this is the first prospective study to examine the associations between ED and subsequent changes in BW, and despite a general belief that ED is a major determinant of obesity, the present study did not generally lend support for an association. However, among certain subgroups, an energy-dense diet may be a risk factor for weight development.