Comparison of Clear Corneal Incision Morphology Changes in Biaxial Microincision Cataract Surgery by Transverse and Torsional Phacoemulsification: Cohort Study

Objective: To compare the effects of transverse versus torsional phacoemulsification by using the biaxial microincision cata ract surgery technique on corneal structures and clear corneal incision (CCI) morphology. Material and Methods: We evaluated comparative case series of patients with moderate density nuclear cataracts who un derwent biaxial microincision transverse or torsional phacoemulsifica tion. Seventy patients have included in the study and they were divided into 2 groups: transverse and torsional. The main outcome measures included, corrected distance visual acuity, central corneal thickness, central corneal endothelial cell density, endothelial cell loss (ECL), and changes in the CCI morphology. Results: Each group comprised 35 (35 eyes) patients. Epithelial misalignment on the CCI morphology was highly significantly meaningful with the transverse group on the po stoperative first day (p<0.001). Descemet membrane detachment on the first day postoperatively was high in both groups, especially in the transverse group, but the difference was not statistically significant (p=0.073). In the postoperative 3rd month, the mean ECL was 23.6% in the transverse group, and 19.0% in the torsional group, and there was no statistically significant difference between groups (p=0.187). Con clusion: In biaxial microincision cataract surgery, the corneal damage caused by transverse phacoemulsification seems to be higher compared to the torsional mode

Retinal neurodegeneration in metabolic syndrome: a spectral optical coherence tomography study

• AIM: To evaluate the effects of metabolic syndrome (MetS) on retinal neurodegeneration by optical coherence tomography (OCT). • METHODS: Patients diagnosed as MetS were compared with the age and sex-matched healthy control group (CG). Waist circumference measurements, fasting serological biochemical tests, and systemic blood pressures of all participants were evaluated. The MetS group was divided into 3 subgroups according to the number of MetS components: hypertension, diabetes mellitus, dyslipidemia (low-, high-density lipoprotein, hypertriglyceridemia), and visceral obesity findings; 3-component MetS3, 4-component MetS4, and all-component MetS5. All patients underwent complete eye examination and spectral OCT retinal imaging. • RESULTS: Totally 58 eyes of 58 patients were included in the MetS group and 63 eyes of 63 age and sex-matched healthy subjects were included in CG. MetS group was composed of 22 subjects in MetS3, 21 subjects in MetS4, and 15 subjects in the MetS5 subgroup. Mean foveal thickness (MetS, 218.7±23.1 µm vs CG, 228.8±21.9 µm, P=0.015), mean inferior (MetS, 283.4±17.0 µm vs CG, 288.7±38.4 µm, P=0.002), superior (MetS, 287.0±18.5 µm vs CG 297.3±17.1 µm, P=0.001), nasal (MetS 287.3±16.7 µm vs CG 297.9±13.9 µm, P=0.000) and temporal (274.5±17.6 µm vs CG 285.6±13.6 µm, P=0.000) thickness in the 3 mm Early Treatment of Diabetic Retinopathy Study (ETDRS) circle was significantly lower in the MetS group. There was no statistically significant difference in the mean inferior, superior, nasal, and temporal thickness of 6 mm ETDRS circle, total macular volume, peripapillary and macular retinal nerve fiber layer, macular ganglion cell layer with inner plexiform layer, and ganglion cell complex. No statistically significant difference was found in these values between the MetS3, MetS4, and the MetS5 groups. • CONCLUSION: A significant reduction in central macular region thickness in MetS is detected and macular thickness is more susceptible to MetS induced neurodegeneration than peripapillary retinal nerve fiber layer. © 2023 International Journal of Ophthalmology (c/o Editorial Office). All rights reserved.Authors’ contributions: Polat E was responsible for designing the study protocol, supervision the study, conducting the search, screening potentially eligible studies, data collection, updating reference lists, and creating all tables. Celik E was responsible for designing the study protocol, contributed to writing the report, extracting and analyzing data, interpreting results, and creating all tables. Togac M was responsible for writing the protocol and report, contributed to data extraction, and provided feedback on the report. Sahin A was responsible for writing the literature review, data collection

Fakoemülsifikasyon Cerrahisinde İmplantasyon Sırasında Gelişen Göz İçi Lens Hasarına Neden Olan Faktörler

Aim: To evaluate the factors affecting intraocular lens (IOL) integrity during implantation in phacoemulsification surgery.Materials and Methods: In this study, medical records of 3,856 patients (4,778 eyes) who underwent phacoemulsification and foldable IOLimplantation by cartridge between August 2010 and July 2019 were retrospectively reviewed. The 11 eyes of 11 patients who had undergone IOLremoval and reimplantation were noted for IOL damage during implantation. In other eyes, implanted IOL material, injector and cartridge typeinformation were recorded.Results: The properties of implanted 4,195 IOLs of 4,778 were hydrophobic acrylic (835 SA60AT, 2,438 AAB00, 922 ZCB00). The remaining 583 IOLswere hydrophobic surfaced high water content acrylic (UD 613). Hydrophobic acrylic IOLs with high water content were inserted with a disposableplastic syringe and foldable cartridge, and hydrophobic acrylic IOLs were inserted with a reusable metal syringe and disposable non-foldablecartridge. Of the 11 IOLs whose integrity was impaired during implantation, 8 were hydrophobic surfaced high water content acrylic and 3 werehydrophobic acrylic (p<0.001). There was no statistically significant difference between hydrophobic acrylic lenses (p=0.103).Conclusion: The material structure of the one-piece hydrophobic surfaced high water content acrylic foldable IOLs, the implantation systemand foldable cartridge used are the factors that can potentiate the development of damage in the IOL during implantation. For a problem-freeimplantation, it should be done carefully and slowly from inserting the IOL into the cartridge until it is placed in the capsule bag.Amaç: Fakoemülsifikasyon cerrahisinde implantasyon sırasında göz içi lens (GİL) bütünlüğünü etkileyen faktörleri değerlendirmek. Gereç ve Yöntem: Bu çalışmada, Ağustos 2010-Temmuz 2019 tarihleri arasında fakoemülsifikasyon ve kartuş yardımlı katlanabilir GİL implantasyonu yapılmış 3.856 hastanın (4.778 göz) tıbbi kayıtları geriye dönük olarak incelendi. İmplantasyon sırasında GİL bütünlüğü bozulan 11 hastanın 11 gözü çalışmaya dahil edildi. Diğer gözlerin GİL ve implantasyon sistemi verileri kaydedildi. Bulgular: İncelenen 4.778 GİL’nin 4.195’i hidrofobik akrilik (835’i SA60AT, 2.438’i AAB00 ve 922’si ZCB00) ve 583’ü hidrofobik yüzeyli yüksek su içerikli akrilik (UD 613) idi. Hidrofobik yüksek su içerikli akrilik GİL’ler tek kullanımlık plastik enjektör ve katlanan kartuş, hidrofobik akrilik GİL’ler yeniden kullanılabilir metal enjektör ve tek kullanımlık katlanmayan kartuş ile göz içine yerleştirilmişti. Bütünlüğü bozulmuş 11 GİL’in 8’i hidrofobik yüzeyli yüksek su içerikli akrilik iken 3’ü hidrofobik akrilikti (p<0,001). Hidrofobik akrilik GİL’ler kendi aralarında kıyaslandığında istatistiksel olarak anlamlı fark görülmedi (p=0,103). Sonuç: Tek parça hidrofobik yüzeyli yüksek su içerikli akrilik katlanabilir GİL’lerin materyal yapısı, kullanılan implantasyon sistemi ve katlanabilir kartuş yapısı, implantasyon sırasında GİL’de hasar gelişimine neden olabilecek faktörlerdir. Sorunsuz bir implantasyon için, GİL’nin kartuşa yerleştirilmesinden kapsül içine yerleştirilene kadar geçen süreçte dikkatli ve yavaş uygulama yapılmalıdır

Mask-Associated Dry Eye (MADE) in healthcare professionals working at COVID-19 pandemic clinics

Background: Healthcare professionals working at COVID-19 pandemic clinics have to work with masks during long hours. After the widespread use of masks in the community, many mask-related side effects were reported to clinics. The increase in the number of applicants with dry eye symptoms due to mask use in ophthalmology clinics has led to the emergence of the concept of mask-associated dry eye (MADE). We think that it would be valuable to evaluate ocular surface tests with a comparative study using healthcare professionals working in pandemic clinics, which we think is the right study group to examine the effects of long-term mask use. Aims: We aimed to evaluate the mask-associated dry eye (MADE) symptoms and findings in healthcare professionals who have to work prolonged time with face masks in coronavirus disease 2019 (COVID-19) pandemic clinics. Patients and Methods: In this prospective, observational comparative clinical study, healthcare professionals who use the mask for a long time and work in COVID-19 pandemic clinics were compared with an age and sex-matched control group consisting of short-term masks users, from April 2021 to November 2021. All participants underwent the Ocular Surface Disease Index (OSDI) questionnaire, tear film break-up time (T-BUT), Oxford staining score, Schirmer's test I, and meibography with infrared transillumination. Results: The long-term mask user group consisted of 64 people, while the short-term mask user group consisted of 66 people (260 eyes, total). The OSDI score and Schirmer I measurement were not statistically different between the two groups. T-BUT was statistically significantly shorter in the long-term group (P: 0.008); lid parallel-conjunctival fold, Oxford staining score, and upper and lower lid meibography score were found to be significantly higher in the long-term group (P < 0.001, P: 0.004, P: 0.049, P: 0.044, respectively). Conclusion: Healthcare professionals with longer mask-wearing times are at greater risk of ocular surface damage. It may be considered to prevent this damage by blocking airflow to the ocular surface, such as by wearing a face mask properly or fitting it over the nose with surgical tape. Those who have to work with a mask for a long time during the COVID-19 pandemic should keep in mind the ophthalmology follow-up for eye comfort and ocular surface health

Combined Effects of Dietary Bacillus subtilis and Trans-cinnamic Acid on Growth Performance, Whole Body Compositions, Digestive Enzymes and Intestinal bacteria in Rainbow Trout (Oncorhynchus mykiss)

In this study, the combined effects of dietary Bacillus subtilis (BS, 10 7 g/cfu) and different levels (0.025%, 0.050%, 0.075% and 0.150%) of trans-cinnamic acid (CA) on fish growth performance, whole body compositions, digestive enzymes, intestinal bacteria and internal organ index of rainbow trout (Oncorhynchus mykiss) were investigated. Six different experimental groups including control group (C), C+BS, 0.025%CA+BS, 0.050%CA+BS, 0.075CA+BS, 0.150%CA+BS) were established. According to the results obtained, growth performance, whole body compositions and digestive pH were not statistically significant among groups. Further, no significant differences were found between experimental groups in terms of the intestinal enzymes (trypsin, alkaline phosphatase and lipase) and gastric pepsin. Significantly higher levels of intestinal amylase were found in the control+BS, 0.025%CA+BS, 0.050% CA+BS, and 0.075%CA+BS compared to the control and 0.150%CA+BS groups. Moreover, coliform and Enterobacteriaceae counts were highest in the control+B. subtilis and lowest in the 0.150% CA + B. subtilis groups

Effects of zinc exposure on the accumulation, haematology and immunology of Mozambique tilapia, Oreochromis mossambicus

Changes in the haematological and innate immune parameters and accumulation in the liver, gill and muscle tissues were investigated in Mozambique tilapia (Oreochromis mossambicus, L.1758), which were semi-statically exposed to several zinc concentrations in vivo. The fish were exposed to low (1 mg L-1), medium (2.5 mg L-1) and high (5 mg L-1) concentrations of zinc for 14 days. In this study, significant changes were seen in the haematological and innate immune parameters of the fish exposed to zinc in comparison to those of the control group (p&lt;0.05) at day 14. In all groups exposed to zinc, a decrease in the erythrocyte count (RBC) and lymphocyte percentage and an increase in hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) values and neutrophile percentage occurred (P&lt;0.05). A decrease in white blood cell (WBC) count and an increase in mean corpuscular hemoglobin concentration (MCHC) values occurred with medium and high concentrations (P&lt;0.05). As per hematocrit (Hct) values, a decrease with high concentrations and an increase with low and medium concentrations were found (P&lt;0.05). In all groups exposed to zinc, a decrease in phagocytic activity was found, and an increase in lysozyme and myeloperoxidase activities were observed with medium and low concentrations (P&lt;0.05). A decrease was found in nitroblue tetrazolium (NBT) activity with medium and high concentrations; in the lysozyme and myeloperoxidase activities was found with high concentrations (P&lt;0.05). In this study, the highest zinc accumulation rate was found in the liver tissue, and the lowest rate was found in the muscle tissue. Accumulation of zinc metal in the tissues was found to increase directly proportional with the ambient concentration and exposure duration (P&lt;0.05). In conclusion, it was found that exposure of O. mossambicus to Zn concentrations affected haematological and innate parameters adversely. Therefore, these parameters can be used to predict the effect of metals such as zinc on fish populations.Keywords: Zinc, haematology, immunology, accumulation, Oreochromis mossambicusAfrican Journal of Biotechnology Vol. 12(7), pp. 744-75

The Use Of Feiba In Hemophilia A Patient With Inhibitory And Sign Of Severe Intraabdominal Hemorrhage

The development of a factor VIII inhibitory is the most serious problem of Hemophilia A. High dose FVIII, recombinant FVIIa or FVIII inhibitor bypass activator (FEIBA) only or combined may use in the treatment of hemophilia with inhibitory. We present here 42 year-old male was admitted to our clinic with sign of shock, abdominal tenderness and image of mass. In laboratory, Hemoglobin was found 5 gr/dl, aPTT: 106 sec, FVIII: %0 and inhibitory level was found 14 BU. Abdominal computerized tomography was shown hemorrhage in abdominal cavity and in psoas muscle. In treatment; We used blood transfusion and 100 U/kgx2/d FEIBA along 4 days. General symptoms and signs was healed after 2 days and hematologic parameters turned to normal. Immune tolerans treatment program was planned for patient, later. FEIBA treatment is very useful in hemophilia patients suffered from hemorrhage and inhibitors in addition to supportive treatment

Gökkuşağı Alabalığı Yemlerine Probiyotik ve Antibiyotik İlavelerinin Balıkların Sağlık Karakteristikleri Üzerine Etkileri

Bu çalışmada yeme antibiyotik (amoksisilin+klavulanik asit) ve probiyotik ilavesinin gökkuşağı alabalıklarında (Oncorhynchus mykiss) bazı immünolojik ve serum biyokimyasal sağlık karakteristikleri üzerine etkilerinin araştırılması amaçlanmıştır. Yeme ilave edilen antibiyotik veya probiyotik katkılarının lizozim aktivitesi, myeloperoksidaz aktivitesi, serum total protein, albümin, globülin, trigliserit ve kolesterol değerleri üzerine herhangi bir etkisinin olmadığı belirlenmiştir. Antibiyotik ile beslenen balıkların serum glikoz düzeyleri kontrole göre önemli oranda artmıştır. Bununla birlikte antibiyotik ile beslenen balıkların GOT değeri kontrole göre önemli oranda azalmıştır. Ayrıca LDH ve ALP değerleri antibiyotik ve probiyotik ilavesi ile kontrole göre azaldığı belirlenmiştir. Bu çalışma, tek bir deneysel model olup farklı balık türlerinde ve farklı balık patojenlerinde karşı probiyotik kullanımı farklı dozlara veya zamana bağlı olarak değişebilir. Bu nedenle bu çalışma çeşitli kan parametrelerinin değerlendirilmesi açısından diğer çalışmalara ışık tutmaktadır

Subcutaneous C.E.R.A. for the Treatment of Chronic Renal Anemia in Predialysis Patients

Background: We investigated the efficacy, safety and tolerability of once-monthly administration of C.E.R.A. in erythropoiesis stimulating agents (ESAs) naive predialysis patients with CKD for anemia treatment Study Design: Single arm, open label study. Methods: A total of 75 patients (mean (SD) age was 52.8 (16.4) years, 76.0% were female) were included in this study conducted between 12 August 2008 and 30 October 2009 in 9 centers across Turkey. The mean change in Hb concentration (g/dL) between baseline (week 0) and the efficacy evaluation period (EEP) was the primary efficacy parameter evaluated in three consecutive periods including a dose titration period (DTP; with initial 1.2 ?g/kg dose of C.E.R.A., subcutaneously, 28 weeks), EEP (8 weeks) and a long-term safety period (16 weeks). Results: Our analysis revealed an improvement in Hb levels from baseline value of 9.4 (0.4) g/dL to time adjusted average level of 11.4 (0.7) g/dL in EEP in the per protocol (PP) population and from 9.3 (0.5) g/dL to 11.1 (1.0) g/dL in intent-to-treat (ITT) population. Mean (SD) change in Hb levels from baseline to EEP was 2.0 (0.7) g/dl in the PP population (primary endpoint) and 1.7 (1.1) g/dL in the ITT population. The percentage of patients whose Hb concentrations remained within the target range of 10.0-12.0 g/dL throughout the EEP was 43.9% (95% CI: 28.5-60.3%) in the PP population and 38.7% (95% CI: 27.6% to 50.6%) in the ITP population. A total of 206 adverse events (AE) were reported in 77.0% of patients with hypertension (20%) as the most frequent AE. Conclusion: Once-monthly subcutaneous C.E.R.A. administration is effective and safe in the treatment of anemia in pre-dialysis patients with CKD, who are not currently treated with ESAs

Inherited Bone Marrow Failure Syndromes in Children

Inherited bone marrow failure syndromes are disorders of hematopoiesis that are mostly encountered in childhood. Taking the basis from genetics, they are characterized by pancytopenia, increased risk of developing myelodysplastic syndrome and malignancy. Extrahematopoietic presentations are observed often in addition to symptoms related to defective hematopoiesis (also known as bone marrow failure). The biology, clinical features, and management of the main syndromes such as Fanconi anemia, dyskeratosis congenita, Shwachman-Diamond syndrome, congenital amegakaryocytic thrombocytopenia, Diamond-Blackfan anemia, and severe congenital neutropenia are briefly summarized in this review