Interocular optical biometry differences as predictors of postoperative cataract surgery refractive outcomes: A retrospective cohort study.

INTRODUCTION: Few studies have reported the impact of preoperative interocular discrepancy in optical biometry (axial length, corneal power, white-to-white, central corneal thickness) on postoperative refractive outcomes. This study aims to investigate any predictive value of preoperative optical biometry differences between eyes on postoperative refractive outcomes. MATERIALS AND METHODS: A retrospective cohort study of patients who have undergone optical biometry measurement before unilateral phacoemulsification in the Queen Elizabeth Hospital, Sabah, Malaysia from 2018 to 2020. Biometry data of interest includes axial length (AL), keratometry(K), white-to-white (WTW) and central corneal thickness (CCT). The postoperative outcomes of interest were the patient's preoperative refractive target, postoperative best-corrected visual acuity (BCVA), postoperative refractive outcomes, and optical biometry prediction error. RESULTS: The interocular biometry discrepancies which were associated with higher odds of prediction error >0.5D from the refractive target were Interocular Corneal Power Difference (IKD)-average≥0.8 D (Odds Ratio, OR=1.97; 95% Confidence Intervals, 95%CI: 1.06, 3.67) and Interocular WTW Difference ≥1.5 mm (OR=2.77; 95%CI: 1.11, 6.92). In cases with prediction error >1.0D, the measurements were Interocular AL Difference ≥0.4 mm (OR=2.99; 95%CI: 1.11, 8.06), IKD flat≥0.4D (OR=2.76; 95%CI: 1.31, 5.82) and Interocular CCT Difference ≥15µm (OR=3.53; 95%CI: 1.29, 9.64). CONCLUSION: Interocular axial length difference ≥0.4mm and interocular central corneal thickness difference ≥15µm are associated with refractive error >1.0D from the pre-operative target. Interocular average corneal power difference ≥0.8D and interocular white-to-white difference ≥1.5mm have higher odds of refractive drift >0.5D from the refractive aim. The above cutoff values help clinicians to identify which patients have a higher risk of refractive shift post-cataract surgery and counsel the patient before cataract operation.

The Effectiveness of Therapeutic and Psychological Intervention Programs in PTC-GAZA.

The wars on Gaza (2008, 2012 & 2014) have left thousands of children and adults exposed to traumatic events (UNICEF, 2017). This study seeks to study and compare the usefulness of three different intervention programs, namely Therapeutic, Psycho-social support and Focusing. These interventions have been developed based on a holistic and integrated approach aimed at empowering resilience among Palestinian patients with Posttraumatic Stress Disorder (PTSD). PTSD was assessed through a validated scale developed by Altawil (2016). The aforementioned interventions were found to be successful: a) In the Family Therapy Programme (FTP), PTSD diagnosis reduced from 82% before intervention to 20% after intervention; b) In the Community Wellness Focusing Programme (CWF), PTSD diagnosis reduced from 97% before intervention to 19% after intervention; c) In the Psycho-Social Support Programme (SANID), PTSD diagnosis reduced from 50% before intervention to only 14% after intervention. Establishing the impact of interventions can be difficult without good tools for evaluation or assessment. Therefore, PTSD scales must consider culture, specific needs and the context of trauma exposure using both quantitative and qualitative assessment tools. Future tools should examine On-going Traumatic Stress Disorder (OTSD) so that it reflects on-going conflict and trauma in war-torn environments worldwide.

Primary trabeculotomy compared to combined trabeculectomy-trabeculotomy in congenital glaucoma: 3-year study.

PURPOSE: To compare the outcome of primary trabeculotomy with that of combined trabeculectomy-trabeculotomy (CTT) with mitomycin C (MMC) in children with congenital glaucoma. METHODS: This is a prospective comparative study, carried out on a cohort of 28 eyes (28 infants) with congenital glaucoma. Infants with proved congenital glaucoma [based on intra-ocular pressure (IOP), cup/disc (C/D ratio), corneal diameter and axial length measurements] were randomly allocated to either group A (trabeculotomy) or group B (CTT with MMC). Postoperatively, all patients were followed regularly for 3 years; for IOP and C/D evaluation. Criteria for successful outcome included resolution of corneal oedema, reversal of disc cupping, and IOP 18 mmHg or less. RESULTS: Success rate in each group was 85.7% (p = 1.00). All preoperative parameters, including horizontal corneal diameter, axial length, IOP and C/D ratio, were not statistically significantly different between the two groups. Also, postoperative C/D ratio, IOP, IOP difference and percentage difference (compared to preoperative values), at different follow-up visits, were not statistically significantly different between both surgical techniques. Comparing preoperative to postoperative IOP and C/D ratio in each group was statistically significant. CONCLUSION: Both primary trabeculotomy and CTT with MMC had similar outcomes, which could mean that trabeculotomy could be resorted to first.

Is viscotrabeculotomy superior to conventional trabeculotomy in the management of Egyptian infants with congenital glaucoma?

PURPOSE: The aim of this study was to assess the efficacy of viscotrabeculotomy in the management of congenital glaucoma as compared to conventional trabeculotomy, in Egyptian infants. METHODS: This is a prospective interventional randomized comparative study in which patients with primary congenital glaucoma were randomly allocated to either group A or B; viscotrabeculotomy (VT); and trabeculotomy (T), respectively. Patients were followed up regarding intra-ocular pressure (IOP), cup/disc (C/D) ratio and horizontal corneal diameter (HCD) for 6 months. A probability value (p value) <0.05 was considered significant. RESULTS: Twenty-one eyes in group A and 20 eyes in group B were enrolled in the study. The mean preoperative IOP was 23.5 and 24.3 mmHg in the VT and T groups, respectively. Postoperatively, IOP dropped at six months to 14.7 and 17 mmHg in the VT and T groups, respectively. That was significant in either group when compared to preoperative IOP, but not significant between both groups at the same point of comparison. CONCLUSIONS: Both techniques were equally effective in the reduction in IOP in the management of congenital glaucoma, but viscotrabeculotomy did not appear to add more benefit to the surgical outcome than classic trabeculotomy.

Dielectrophoretic response of DNA shows different conduction mechanisms for poly(dG)-poly(dC) and poly(dA)-Poly(dT) in solution.

Although the subject of some scrutiny over the years, the mechanism of conduction in DNA has not yet been resolved, with competing theories suggesting either electronic and ionic conduction mechanisms. In this paper we use dielectrophoresis to determine the electrical properties of poly(dG)-poly(dC) (GC) and poly(dA)-poly(dT) (AT) DNA in solution. The molecules show different conduction mechanisms; GC DNA exhibits conduction primarily through the molecule, whereas in AT DNA conduction through the counterion cloud surrounding the molecule in solution is more significant.

Surgically induced astigmatism following glaucoma surgery in Egyptian patients.

PURPOSE: The altered visual function induced by changes in corneal curvature following filtration surgery is distressing to patients. The aim of this study was to evaluate surgically induced astigmatism following trabeculectomy in comparison with deep sclerectomy. METHODS: In a prospective interventional comparative study, patients with primary open-angle glaucoma were randomly allocated to either group A or B; deep sclerectomy with mitomycin C 0.2 mg/mL and trabeculectomy with mitomycin C 0.2 mg/mL, respectively. Keratometry was performed using Topcon KR-7000P autokerato-refractometer preoperatively and at 6 months postoperatively. Vector analysis was used to analyze the surgically induced astigmatism. RESULTS: Sixty eyes of 45 patients in group A, and 60 eyes of 42 patients in group B were enrolled for vector analysis. The mean preoperative astigmatic vector power was -0.49±1.65 D and +0.47±2.18 D in groups A and B, respectively. The mean postoperative astigmatic vector power was -1.14±1.55 D in group A and -0.35±1.8 D in group B. The mean change in astigmatic vector powers was -0.67±1.63 D in group A and -0.82±2.0 D in group B. When compared with preoperative data in either group, the differences were significant, P=0.001 & 0.007 in groups A and B respectively, whereas the postoperative difference between either group was insignificant (P=0.723). A total of 40% of corneas got flatter in group B compared with 25% in group A, P=0.057. CONCLUSIONS: Both trabeculectomy and deep sclerectomy induced considerable postoperative astigmatism. A longer follow-up period is recommended to study the different patterns of astigmatism in either procedure.

Anti-inflammatory activity of the aqueous extract of ficus deltoidea.

Ficus deltoidea (Family Moraceae) leaves have been used traditionally by the Malays to treat ailments such as wounds, sores, and rheumatism. The aim of the present study was to determine the anti-inflammatory activity of the aqueous extract of F. deltoidea leaf (FDA) using acute and chronic inflammatory models. FDA, in the doses of 30, 100, and 300 mg/kg, was administered intraperitoneally in rats (n = 6) before the animals were subjected to the carrageenan-induced paw edema test, cotton pellet-induced granuloma test, and formalin test. The first two tests represent acute and chronic models of inflammation, respectively. The first and second phases of the formalin test represent neurogenic pain and inflammatory-mediated pain, respectively; thus, only the second phase was measured in the present study. Results showed that FDA exerted significant (p < .05) anti-inflammatory activity in all assays, with dose-response effects seen in the paw edema and formalin tests. In conclusion, the leaf of F. deltoidea possesses anti-inflammatory activity against acute and chronic inflammatory responses and against pain-associated inflammatory response. These findings justify the traditional uses of F. deltoidea leaves for treatment of inflammatory-mediated ailments.

Preliminary analysis of the anti-inflammatory activity of essential oils of Zingiber zerumbet.

Nonsteroidal anti-inflammatory drugs (NSAIDs) have been widely used for the treatment of inflammation. However, despite their effectiveness, most NSAIDs cause various side effects that negatively affect the management of inflammation and, in part, pain. Thus, there is a need to search for new anti-inflammatory agents with few, or no, side effects. Natural products of plant, animal, or microorganism origin have been good sources of new bioactive compounds. The present study was carried out to evaluate the acute and chronic anti-inflammatory activities of the essential oil of the rhizomes of Zingiber zerumbet (Zingiberaceae) using the carrageenan-induced paw edema and cotton pellet-induced granuloma tests, respectively. The effect of the essential oil on inflammatory- and noninflammatory-mediated pain was also assessed using the formalin test. Essential oil of Z. zerumbet, at doses of 30, 100, and 300 mg/kg, was administered intraperitoneally to rats. The substance exhibited significant anti-inflammatory activity both in acute and chronic animal models. The essential oil also inhibited inflammatory- and noninflammatory-mediated pain when assessed using the formalin test. In conclusion, the essential oil of Z. zerumbet possessed anti-inflammatory activity, in addition to its antinociceptive activity, which may explain its traditional uses to treat inflammatory-related ailments.

Antinociceptive activity of a synthetic chalcone, flavokawin B on chemical and thermal models of nociception in mice.

The present study examined the potential antinociceptive activity of flavokawin B (6'-hydroxy-2',4'-dimethoxychalcone), a synthetic chalcone using chemical- and thermal-induced nociception models in mice. It was demonstrated that flavokawin B (FKB; 0.3, 1, 3 and 10 mg/kg) administered via both oral (p.o.) and intraperitoneal (i.p.) routes produced significant and dose-dependent inhibition in the abdominal constrictions induced by acetic acid, with the i.p. route producing antinociception of approximately 7-fold more potent than the p.o. route. It was also demonstrated that FKB produced significant inhibition in the two phases of the formalin-induced paw licking test. In addition, the same treatment of flavokawin B (FKB) exhibited significant inhibition of the neurogenic nociceptive induced by intraplantar injections of glutamate and capsaicin. Likewise, this compound also induced a significant increase in the response latency period to thermal stimuli in the hot plate test and its antinociceptive effect was not related to muscle relaxant or sedative action. Moreover, the antinociception effect of the FKB in the formalin-induced paw licking test and the hot plate test was not affected by pretreatment of non-selective opioid receptor antagonist, naloxone. The present results indicate that FKB produced pronounced antinociception effect against both chemical and thermal models of pain in mice that exhibited both peripheral and central analgesic activity.

Antinociceptive and anti-inflammatory effects of the ethanol extract of Alpinia conchigera rhizomes in various animal models.

Alpinia conchigera Griff. (Zingiberaceae), locally known to the Malays as "lengkuas ranting", is native to Peninsular Malaysia. The Malays traditionally used it to treat infection and rashes, and as a health drink. This study evaluated the analgesic and anti-inflammatory activities of the ethanol extract of A. conchigera rhizomes in mice and rats, respectively. The analgesic activity was elucidated using the acetic acid-induced writhing test, hot plate test, and formalin test, while the anti-inflammatory activity was determined using carrageenan-induced paw edema. The extract (30, 100, and 300 mg/kg) given intraperitoneally (i.p.) exhibited antinociceptive and anti-inflammatory activities in all tests used. The range of percentage of analgesia obtained for all doses of extract in the writhing test was 50-92%, and in the early and late phases of the formalin test was 25-62% and 63-98%, respectively. In addition, naloxone (5 mg/kg) given subcutaneously (s.c.) was found to reverse the extract (300 mg/kg)-induced antinociceptive activity in the writhing, hot plate, and formalin tests. Based on the results obtained, it can be concluded that the ethanol extract of A. conchigera rhizomes possessed a peripheral and central antinociceptive activity that was mediated, in part, via the opioid receptor, as well as anti-inflammatory activity.

In vivo analgesic effect of aqueous extract of Tamarindus indica L. fruits.

OBJECTIVE: To study the effects of Tamarindus indica L. aqueous fruit extract on the antinociceptive activities in rodent models. METHODS: The analgesic effect was evaluated using acetic acid-induced writhing, hot plate and formalin tests. RESULTS: The extract (60-600 mg/kg) significantly (p < 0.05) inhibited the writhing test in a dose-dependent manner with the percentage of analgesia recorded between 51.8 and 74.1%. In addition, the extract also significantly (p < 0.05) increased the latency time in the hot plate test in a dose-dependent manner. Further study showed that the extract elicited inhibitory activity in both the early and late phases of the formalin test. Moreover, pretreatment with 5 mg/kg naloxone, a nonselective opioid receptor antagonist, significantly (p < 0.05) modified the antinociceptive effect of the extract in all tests. CONCLUSION: The aqueous extract of T. indica possesses potential antinociceptive activity at both the peripheral and central levels, which are mediated via activation of the opioidergic mechanism.

Antiinflammatory and antinociceptive activities of Zingiber zerumbet methanol extract in experimental model systems.

OBJECTIVE: The present study was carried out to determine the antiinflammatory and antinociceptive activities of a methanol extract of Zingiber zerumbet rhizomes (MEZZ) using various experimental model systems. MATERIALS AND METHODS: The MEZZ was prepared by macerating oven-dried (50 degrees C) powdered rhizomes (1.2 kg) of Z. zerumbet in 80% methanol in a ratio of 1:20 (w/v) for 48 h. The supernatant was collected, filtered and evaporated to dryness under reduced pressure (50 degrees C) yielding approximately 21.0 g of the crude dried extract. The crude dried extract was stored at -20 degrees C prior to use and was dissolved in normal saline (0.9% NaCl) immediately before administration at concentrations required to produce doses of 25, 50 and 100 mg/kg. RESULTS: All dosages of MEZZ showed significant (p < 0.05) antiedema activity when assessed using the carrageenan-induced paw edema test and the cotton-pellet-induced granuloma test. The MEZZ exhibited significant (p < 0.05) antinociceptive activity when assessed by the writhing, hot plate and formalin tests. Pretreatment with naloxone (5 mg/kg) significantly decreased the latency of discomfort produced by the 100 mg/kg dose of MEZZ in the hot plate test. CONCLUSION: MEZZ produced antiinflammatory and antinociceptive activities which may involve the inhibition of bradykinin-, prostaglandin-, histamine- and opioid-mediated processes.

Anti-inflammatory effect of zerumbone on acute and chronic inflammation models in mice.

The anti-inflammatory activity of zerumbone (1), a natural cyclic sesquiterpene isolated from Zingiber zerumbet Smith was investigated using carrageenan-induced paw edema and cotton pellet-induced granuloma tissue formation test in mice. It was demonstrated that intraperitoneal administration of 1 at a dose of 5, 10, 50 and 100 mg/kg produced significant dose-dependent inhibition of paw edema induced by carrageenan. It was also demonstrated that 1 at similar doses significantly suppressed granulomatous tissue formation in cotton pellet-induced granuloma test.

Atrovirinone inhibits proinflammatory mediator synthesis through disruption of NF-kappaB nuclear translocation and MAPK phosphorylation in the murine monocytic macrophage RAW 264.7.

In a previous communication we showed that atrovirinone, a 1,4-benzoquinone isolated from the roots of Garcinia atroviridis, was able to inhibit several major proinflammatory mediators of inflammation. In this report we show that atrovirinone inhibits NO and PGE(2) synthesis through inhibition of iNOS and COX-2 expression. We also show that atrovirinone inhibits the secretion of IL-1beta and IL-6 in a dose dependent fashion whereas the secretion of IL-10, the anti-inflammatory cytokine, was enhanced. Subsequently we determined that the inhibition of proinflammatory cytokine synthesis and inducible enzyme expression was due to a dose-dependent inhibition of phosphorylation of p38 and ERK1/2. We also showed that atrovirinone prevented phosphorylation of I-kappaBalpha, which resulted in a reduction of p65NF-kappaB nuclear translocation as demonstrated by expression analysis. We conclude that atrovirinone is a potential anti-inflammatory drug lead that targets both the MAPK and NF-kappaB pathway.

Antinociceptive and antiedematogenic activities of andrographolide isolated from Andrographis paniculata in animal models.

The current study was performed to evaluate the antinociceptive and antiedematogenic properties of andrographolide isolated from the leaves of Andrographis paniculata using two animal models. Antinociceptive activity was evaluated using the acetic acid- induced writhing and the hot-plate tests, while antiedematogenic activity was measured using the carrageenan-induced paw edema test. Subcutaneous (s.c.) administration of andrographolide (10, 25, and 50 mg/kg) did not affect the motor coordination of the experimental animals but produced significant (p < .05) antinociceptive activity when assessed using both tests. However, 2 mg/kg naloxone failed to affect the 25 mg/kg andrographolide activity in both tests, indicating that the activity was modulated via nonopioid mechanisms. Furthermore, andrographolide showed significant (p < .05) antiedematogenic activity. In conclusion, the results obtained suggest that andrographolide has antinociceptive and antiedematogenic activities; it may be useful for treating pain and inflammation once human studies are conducted.

In vivo anti-nociceptive and anti-inflammatory activities of the aqueous extract of the leaves of Piper sarmentosum.

ETHNOPHARMACOLOGICAL RELEVANCE: Piper sarmentosum (Piperaceae) is a medicinal plant traditionally used by the Malays to treat headaches, toothaches, coughs, asthma and fever. AIM OF THE STUDY: In order to establish the pharmacological properties of the leaf of this plant, studies were performed on anti-nociceptive and anti-inflammatory activities. MATERIALS AND METHODS: The aqueous extract of Piper sarmentosum (AEPS) was prepared in the doses of 30, 100 and 300 mg/kg. Anti-nociceptive activity of AEPS was evaluated by abdominal constriction and hot-plate tests. AEPS was also pre-challenged with 5mg/kg naloxone to determine the involvement of opioid receptors. Anti-inflammatory activity was evaluated using carrageenan-induced paw edema assay. RESULTS: Subcutaneous administration of AEPS exhibited anti-nociceptive activity (P<0.05) in a dose-dependent manner in the abdominal constriction and hot-plate tests. Pre-treatment with naloxone completely (P<0.05) diminished the extract anti-nociceptive activity in both tests. The AEPS, at all doses used, exerted significant (P<0.05) anti-inflammatory activity in a dose-dependent manner. CONCLUSIONS: The AEPS exhibits opioid-mediated anti-nociceptive activity at the peripheral and central levels, as well as anti-inflammatory activity, which confirmed the traditional uses of the plant in the treatment of pain- and inflammatory-related ailments.

Antinociceptive and anti-inflammatory effects of the ethanol extract of Alpinia conchigera Griff. leaves in various animal models.

The ethanolic extract of Alpinia conchigera Griff. leaves (EACL) was evaluated for its antinociceptive and anti-inflammatory activities in several in vivo experimental models. Antinociceptive activity was determined using the acetic acid-induced abdominal writhing test, the hot plate test and the formalin test. Anti-inflammatory activity was determined using the carrageenan-induced paw edema test. The extract (30, 100 and 300 mg/kg i.p.) was found to possess significant, dose-dependent inhibitory activity in all test models. In addition, the antinociceptive effect of the extract in the acetic acid-induced writhing and hot plate tests was reversed by naloxone, suggesting that this activity is mediated through activation of the opioid system. These findings suggest that EACL presents notable analgesic and anti-inflammatory activities, which support its folkloric use for painful and inflammatory conditions.

Evaluation of the antinociceptive activity of Ficus deltoidea aqueous extract.

The aqueous extract of Ficus deltoidea leaves was evaluated for possible antinociceptive activity in three models of nociception, namely, acetic acid-induced abdominal writhing, formalin and hot plate test. The results of the present study showed that intraperitoneal administration of the F. deltoidea leaves aqueous extract at the dose of 1, 50 and 100 mg/kg, 30 min prior to pain induction produced significant dose-dependent antinociceptive effect in all the models used, which indicating the presence of both central and peripherally mediated activities. Furthermore, the antinociceptive effect of the extract in the formalin and hot plate test was reversed by the non-selective opioid receptor antagonist naloxone suggesting that the endogenous opioid system is involved in its analgesic mechanism of action. Thus, the present results demonstrated that F. deltoidea leaves aqueous extract contains pharmacologically active constituents which possess antinociceptive activity justifying its popular therapeutic use in treating conditions associated with the painful conditions.

Antibiotic therapy for seminal infection. Effect on antioxidant activity and T-helper cytokines.

OBJECTIVE: To investigate the effect of antibiotic therapy on seminal infection. STUDY DESIGN: The seminal plasma of 50 men was evaluated in three groups: (1) men with seminal infection (20), (2) men with leukocytospermia only (18), and (3) men of proven fertility (12). The evaluation protocol included semen analysis, culture and antibiotic sensitivity test, total antioxidant activity, alpha-tocopherol and retinol, T-helper cytokines, IL-2, IL-8, IL-4 and antisperm antibodies. RESULTS: Sperm parameters were worse with seminal infection: 25 versus 84 million per milliliter for fertile men. Antioxidant activity, total alpha-tocopherol and retinol were reduced in leukocytospermia (P < .02, .01) and seminal infection (P < .01, .05) as compared to controls. Antisperm antibodies IL-2 and IL-8 were highly expressed, while IL-4 was low in men with leukocytospermia and bacteriospermia. Gram-negative organisms were more associated with expression of T-helper 1 cytokines than T-helper 2 cytokines. Antibiotic therapy significantly improved the sperm parameters, antioxidant activity and IL-4 but reduced IL-2 and IL-8 and had no effect on antisperm antibody titer. CONCLUSION: Antibiotic therapy improves sperm parameters by increasing antioxidant activity and IL-4 and by reducing IL-2 and IL-8.

Congenital lobar emphysema: a case with bronchial septum.

Congenital lobar emphysema has been described under various designations. Although the etiology is not clear, some form of bronchial obstruction has been documented in about 50% of the patients. A rare case of congenital lobar emphysema with a membranous septum in the left main bronchus is described. Although prompt lobectomy has been the treatment of choice in most cases, this case demonstrates the importance of early bronchoscopy to exclude treatable intra luminal abnormalities.