Application of a new grading scale for tear ferning in non-dry eye and dry eye subjects

The final publication is available at Elsevier via http://dx.doi.org/10.1016/j.clae.2014.09.007 © 2014. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/Purpose: To apply the Masmali tear ferning (TF) grading scale on non-dry eye (NDE) and dry eye (DE) subjects to test the validity of the grading scale in practice, and to describe the grading scale range for NDE and DE. Method: Forty NDE subjects (20 males, 20 females) and 40 DE subjects (23 males, 17 females) ranging in age from 19 to 53 years (mean ± SD: 25.3 ± 5.5) with no other ocular disease, no contact lens wear, and not pregnant or breastfeeding were recruited. McMonnies scores were used for subject grouping. Phenol red thread (PRT) and slit-lamp test were used. A tear sample was collected from right eye, which was then dried to produce a ferning pattern, that was observed using a digital microscope, and graded. Results: Mean McMonnies, PRT and TF grade in NDE subjects were 7.1 ± 3.8, 27.4 ± 4.3 mm and 0.78 ± 0.40, respectively. Median McMonnies, PRT and TF grade in DE subjects were 16.5 ± 3.0, 9.0 ± 2.0 mm and 2.3 ± 1.48, respectively. In NDE subjects, grades 0.0–1.8 were observed (82.5% Grade 0.0–1.00). Grades 2.0–4.0 were observed in DE subjects (72.5% Grades 2.0–3.0). For all subjects, there were large correlations between TF grade and PRT (r = −0.79), PRT and McMonnies (r = −0.60), and TF and McMonnies (r = 0.73). Conclusions: The Masmali TF grading scale showed good validity in describing the TF patterns. Grades ≥2 can be classified as abnormal patterns. The TF test has the potential to be used in the clinic

Repeatability and Diurnal Variation of Tear Ferning Test

This is a non-final version of an article published in final form in: Masmali, A. M., Al-Bahlal, J. M., El-Hiti, G. A., Akhtar, S., Purslow, C., Murphy, P. J., & Almubrad, T. (2015). Repeatability and Diurnal Variation of Tear Ferning Test: Eye & Contact Lens: Science & Clinical Practice, 41(5), 262–267. https://doi.org/10.1097/ICL.0000000000000116Objectives: To investigate tear ferning (TF) test repeatability between sessions by observing changes in the tear fern pattern during the day. Methods: Twenty-three healthy young adults (15 men and 8 women), ranging in age from 20 to 32 years (mean±SD: 22.9±3.3 years) without signs or symptoms of dry eye disease, ocular disease, or contact lens wear were enrolled in the study. Schirmer I, tear break-up time (TBUT) test, and McMonnies questionnaire were used to screen volunteers. Schirmer I and TBUT tests were applied to both eyes in each subject. Four samples of tear fluid were collected from the right eye of each subject using glass capillaries at set intervals during a single day (9 AM, 11 AM, 2 PM, and 4 PM). The TF patterns obtained from samples were classified according to the Masmali TF grading scale to increments of 0.1. Results: The median values obtained from the McMonnies, Schirmer, and TBUT tests were 4.0±2.0, 30.0±7.0 mm (OD), and 16.0±10.0 sec (OD), respectively. There were no statistically significant differences between the TF grades for tear samples collected at different times of the day (Wilks' Lambda, P=0.351). The majority (84.8%) of TF grades was between 0.0 and 1.5; the remaining 15.2% of subjects had TF between grades 1.6 and 1.9. The overall mean grade for the TF was 1.1±0.3. There were small insignificant correlations between TF grades and the McMonnies questionnaire (r=0.1.30) and TBUT (r=0.248) and a negligible correlation with Schirmer test (r=−0.046). Conclusions: The results found no significant differences within the TF for tear samples collected at different times of the day, suggesting that there is little diurnal variation evident.The authors extend their appreciation to the College of Applied Medical Sciences Research Center and the Deanship of Scientific Research at King Saud University for its funding of this research

A computer-based image analysis for tear ferning featuring

The present work focuses on the development of a novel computer-based approach for tear ferning (TF) featuring. The original TF images of the recently developed five-point grading scale have been used to assign a grade for any TF image automatically. A vector characteristic (VC) representing each grade was built using the reference images. A weighted combination between features selected from textures analysis using gray level co-occurrence matrix (GLCM), power spectrum (PS) analysis and linear specificity of the image were used to build the VC of each grade. A total of 14 features from texture analysis were used. PS at different frequency points and number of line segments in each image were also used. Five features from GLCM have shown significant differences between the recently developed grading scale images which are: angular second moment at 0° and 45°, contrast, and correlation at 0° and 45° these five features were all included in the characteristic vector. Three specific power frequencies were used in the VC because of the discrimination power. Number of line segments was also chosen because of dissimilarities between images. A VC for each grade of TF reference images was constructed and was found to be significantly different from each other's. This is a basic and fundamental step toward an automatic grading for computer-based diagnosis for dry eye

Self-medication practice among undergraduate medical students of a Saudi tertiary institution

Purpose: To assess the knowledge, attitude and magnitude of self-medication among medical students of Jazan University, Jazan, Saudi Arabia.Methods: A cross-sectional, self-administered questionnaire-based study was conducted among undergraduate medical students of Jazan University, Jazan, Saudi Arabia. A total of 300 students were selected by random sampling.Results: Self-medication practice was highly prevalent among the medical students, with 87 % reporting that they indulge in it. Self-medication was more prevalent among female students than male. Sedatives were the most common drugs used by students for self-medication (58 %). The most common reason adduced for self-medication practice was their belief that they have sufficient information, previous experience, and the experience of others, such as family members and colleagues, with regard to the drugs. A huge proportion (84.5 %) of the respondents agreed that selfmedication could be harmful and is associated with adverse effects, while 52.6 % stated that they would not advise other persons to indulge in self-medication.Conclusion: Self-medication is prevalent among third-year medical students of Jazan University in Saudi Arabia. Although the students exhibited sufficient awareness of self-medication, the findings highlight the need for intervention programmes regarding the practice of self-medication.Keywords: Self-medication, Prevalence, Awareness, Sedatives, Medical student

Crystal structure of 3-tert-butyl-7-azadioxindole, C11H14N2O2

C11H14N2O2, orthorhombic, P212121 (no. 19), a = 7.3227(3) Å, b = 10.9955(4) Å, c = 26.3709(9) Å, V = 2123.30(14) Å3, Z = 8, Rgt(F) = 0.0372, wRref(F2) = 0.0907, T = 150 K

Assessment of Tear Film Quality among Smokers Using Tear Ferning Patterns

Purpose. To investigate the effect of cigarette smoking on the ocular tear film. Methods. Thirty healthy young male cigarette smokers (20–38 years old) and 30 healthy age matched nonsmokers were enrolled in the study. McMonnies questionnaire, slit lamp, and PRT test were used to screen the subjects. Tear samples were collected from the right eyes and tear ferning patterns were observed and graded. Results. The mean MacMonnies scores and TF grades were significantly higher in the smoker subjects (mean ± SD = 9.83±5.22 and 0.96±0.54, resp.) compared to nonsmokers (mean ± SD = 5.96±3.06 and 0.41±0.38, resp.). The mean values obtained from PRT and TBUT tests were 22.23±6.35 mm and 12.17±3.81 s for smokers and 22.16±5.63 mm and 14.13±2.62 s for nonsmokers, respectively. Strong correlations were found between MacMonnies scores and both PRT (r=0.596) and TF (r=0.516). There was statistically significant difference in TF grades (p=0.00), TBUT (p=0.036) and McMonnies (p=0.02) between smokers and nonsmokers. Conclusion. Cigarette smoking could have a significant effect on the tear film quality of the eye.</jats:p

Synergistic effects of Pandanus fascicularis extracts and azithromycin: in vitro and in silico antimicrobial investigation against MDR clinical strains

BackgroundAntibiotic-resistant bacteria are becoming a significant global concern. To combat the spread of resistance or reverse multidrug resistance, developing novel antimicrobials and/or resistance modulators is essential. This study aimed to evaluate the synergistic effects of the methanolic extract of Pandanus fascicularis fruits (MEPFF) in combination with azithromycin against multidrug-resistant bacteria.MethodsPhytochemical analysis along with the determination of total phenolic content (TPC), total flavonoid content (TFC), and total antioxidant capacity (TAC) of MEPFF, was performed using standard procedure. The extract's DPPH free radical scavenging activity was assessed to evaluate its potential antioxidant activity. The minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of MEPFF against Staphylococcus aureus, Bacillus cereus, Escherichia coli, and Pseudomonas aeruginosa were determined, followed by an analysis of the synergistic effect with azithromycin, as well as the activity of azithromycin alone. Subsequently, the drug-likeness, antibacterial activity, and toxicological properties were analyzed using in silico tools.ResultsThe quantitative investigation found terpenoids, flavonoids, tannins, phenolics, saponins, cardiac glycosides, and alkaloids in MEPFF. The TFC, TPC, and TAC of MEPFF were found at 183 ± 9.54 mg QE, 248.33 ± 11.06 mg GAE, and 95.33 ± 8.33 mg AAE/gm extract. The extract showed significant antioxidant activity in the DPPH experiment, with an IC50 value of 12.13±0.53 µg/ml. Azithromycin and the extract together have far greater antibacterial action against all four bacterial strains. The minimal inhibitory concentration (MIC) is 3.67 ± 1.15 to 5.83 ± 0.76 mg/mL, while the minimum bactericidal concentration (MBC) is 4.33 ± 1.26 to 7.33 ± 1.04 mg/mL. In silico studies revealed that pandamarilactone-1, nonpandamarilactone-B, and thiamine had the best docking energy (−9.9, −8.9, and −8.5 kcal/mol), suggesting most active compounds against MPh-II protein.ConclusionThe extract enhances antibiotic therapy and suggests that the aforesaid synergistic drug-herb combinations may treat MDR bacterial infections

A Convex Combination between Two Different Search Directions of Conjugate Gradient Method and Application in Image Restoration

The conjugate gradient is a useful tool in solving large- and small-scale unconstrained optimization problems. In addition, the conjugate gradient method can be applied in many fields, such as engineering, medical research, and computer science. In this paper, a convex combination of two different search directions is proposed. The new combination satisfies the sufficient descent condition and the convergence analysis. Moreover, a new conjugate gradient formula is proposed. The new formula satisfies the convergence properties with the descent property related to Hestenes–Stiefel conjugate gradient formula. The numerical results show that the new search direction outperforms both two search directions, making it convex between them. The numerical result includes the number of iterations, function evaluations, and central processing unit time. Finally, we present some examples about image restoration as an application of the proposed conjugate gradient method.</jats:p