Validation of intraocular pressure measurement using tonometer AVIA across different postures: A Bland Altman analysis.

AIMS/OBJECTIVES: Tonometry is a fundamental procedure in the diagnosis and management of glaucoma. Different tonometers have been proposed but none are as accurate as the Goldman applanation tonometry (GAT). Nonetheless, due to the limitations of GAT, mobile tonometry methods became prevalent. This study aims to examine the reliability of the Tono-Pen AVIA® (TPA) in measuring intraocular pressure (IOP) across different postures. METHODS: A total of 196 eyes were prospectively examined for IOP changes using GAT and TPA. IOP measurements were taken across different postures using the TPA. Reliability of measurements was compared using interclass correlation coefficients (ICC), while agreement was represented using Bland-Altman analysis. Pearson r coefficient was used to measure correlations. RESULTS: When compared to GAT (14.5 ± 4.4 mmHg), IOP readings were significantly higher for TPA at both seated (16.5 ± 4.5 mmHg; p < 0.001) and supine (16.9 ± 5.7; p < 0.001) positions. The ICC values for GAT and TPA among seated and supine patients were 0.79 (0.54-0.90) and 0.76 (0.48-0.87) indicating good reliability between the readings. There were significantly positive correlations between GAT and TPA at both seated (r = 0.626, p < 0.001) and supine (r = 0.727, p < 0.001) positions. Per Bland-Altman analysis, limits of agreement were -8.57 to 4.37 for GAT and seated TPA and -10.34 and 5.34 for GAT and supine TPA. CONCLUSION: Good reliability exists between IOP measurements using GAT and TPA. However, the devices are not interchangeable and therefore cannot be used reciprocally in the same patient.

Safe Reversal of Motor and Sensory Deficits by Repeated High Doses of Mesenchymal Stem Cells in a Patient with Chronic Complete Spinal Cord Injury.

BACKGROUND Spinal cord injuries (SCI) resulting from various types of accidents have a known onset, unlike other progressive neurological diseases. Nonetheless, in most cases, the resulting disability permanently affects the individual's quality of life due to the limited outcome of available treatment options. The neurological deficit associated with SCI results from primary injury induced by the physical trauma and secondary injury involving inflammation, spinal tissue degeneration, and scar formation. Stem cells of different origins and using different treatment protocols have been tried to minimize aspects of secondary injury in the spinal cord. CASE REPORT In this case report, we evaluated the safety and efficacy of intrathecal injections of Wharton's Jelly-derived mesenchymal stem cells (WJ-MSCs) in a patient with chronic traumatic complete SCI. The findings indicated that the treatment was safe with no serious adverse events related to the procedure or administration of stem cells. The long-term follow-up period showed sustained sensory and motor function improvements with enhanced quality of life scores. CONCLUSIONS The results imply a potential role of WJ-MSC in the treatment of chronic and severe SCI. As indicated by previous studies, the mechanism of action points mainly to the ability of MSCs to protect the neural elements that survived the initial mechanical insult by modulating the immune response and promoting neuronal regeneration.

Supradiaphragmatic origin of the right renal artery: a case report.

Renal arteries are the main blood supply to the kidneys. They originate from the abdominal aorta at the level of the first and second lumbar vertebrae. However, variations in their origin are common. Therefore, studying renal arteries before any surgical intervention such as renal transplant surgery, conservative or radical renal surgeries, renal trauma, and others, is crucial to avoid undesirable avoidable complications or morbidities. Herein, we report a case of an isolated right supradiaphragmatic renal artery that was discovered incidentally in a 66-year-old female patient with normal blood pressure.

The Value of Auditing Surgical Records in a Tertiary Hospital Setting.

BACKGROUND: Assessing and improving quality of care should be of paramount importance to health care systems and providers. This study aimed to evaluate the quality of surgical records at the Jordan University Hospital. METHODS: We used the previously validated Surgical Tool for Auditing Records (STAR) to retrospectively evaluate the quality of surgical records of patients who underwent surgery in the general surgery department from 2016 to 2021. Total STAR and section-specific STAR scores were compared using the two independent sample Student's ttest on SPSS Statistics, version 23 (IBM Corp, Armonk, NY). RESULTS: A total of 488 records were selected and evaluated using the STAR. The total STAR scores significantly improved steadily throughout the years compared to the baseline in 2016, reaching the highest in 2021. All domains had improved compared to the baseline except for anesthesia records that did not change from an already high baseline. The highest improvements between STAR domains were observed in Initial Clerking and Consent domains. CONCLUSION: Our study demonstrates that significant improvements in the quality of surgical records can be achieved by simply using an electronic record entry system, personnel education, and systematic auditing.