Correction of anterior hypospadias without urethroplasty: glanular rotation procedure (the Hay technique)

Objectives: The aim was to present a simple technique for the correction of anterior hypospadiases without meatal advancement or urethroplasty.Background: Most of the techniques described for the correction of anterior hypospadias had the risk of complications: recession, flaying of the glans, fistula, and meatal stenosis that is not accepted when dealing with a trivial anomaly that is done only for cosmetic correction. A simple technique for correcting granular and some forms of coronal hypospadias without meatal advancement or urethroplasty is presented.Patients and methods: From June 2013 to June 2016, 183 patients presented for surgical repair of glanular or coronal hypospadias. The technique of glanular rotation procedure (GRP) was applied only for those cases that matched the criteria settled after degloving of the penis with an incision made 2mm proximal to the meatus touching the glans on both sides for 3–4 mm. Once the uppermost part of the meatus is at the same line with the upper end of the glans on both sides, the technique is applicable. The patients were followed in the OPD for 1 year after the repair for the evaluation of the results of the technique: the urinary stream, meatal size and position, presence of fistula, and the final cosmetic appearance.Results: Ninety-eight out of 183 (53.6%) boys had matched the criteria for application of the GRP technique. Their age ranged from 6 months to 3 years. All but three had an apical, slit-like meatus with good stream without stenosis and 2–3mm glans tissue encircling the ventral side of the meatus. Four cases had complications in the form of meatal stenosis in two cases, disruption of the glans in one case, and coronal fistula in one case. The overall complication rate was 4.1%.Conclusion: In properly selected cases, GRP is a simple efficient technique that has the advantage of reconstructing the glans over the urethra without the need of meatal advancement or urethroplasty.Keywords: coronal hypospadias, glanular hypospadias, without urethroplast

Acuity and colour vision changes post intravitreal dexamethasone implant injection in patients with diabetic macular oedema

Purpose To evaluate changes in colour vision following intravitreal injection of Dexamethasone implant (Ozurdex) in patients with diabetic macular oedema (DMO). Both red-green (RG) and yellow-blue (YB) chromatic sensitivity were assessed using the Colour Assessment & Diagnosis (CAD) test which isolates the use of colour signals and provides age-corrected, statistical limits for normal trichromats. To determine whether colour changes and visual acuity (VA) post-treatment relate to central sub-field retinal thickness (CST). Methods Fourteen patients with DMO who were undergoing treatment with Ozurdex were recruited for this study. RG and YB colour thresholds were measured using the CAD test, best corrected visual acuity was assessed using the ETDRS chart and CST was measured using spectral domain optical coherence tomography (SD-OCT). All tests were performed monocularly at baseline and 24 weeks post injection. Results All patients (n = 14 eyes), had significant loss of RG and YB chromatic sensitivity at baseline (p<0.05). The mean age was 56 ± 9.5 years. The age specific, monocular, upper normal limits for a 56 year old subject are 2.66 for RG and 2.85 for YB. In this study, the measured, pre injection thresholds (mean±SD) were 22.6 ± 11.3 for RG and 16.2 ± 3.76 for YB. There was significant improvement in RG threshold post injection (i.e., 19.2 ± 10.8 (p<0.05)). No significant changes were found in the YB thresholds with corresponding mean and range values of: 15.8 ± 4.6 (p = 0.23). CST pre-treatment was 542 ±135 μm. After treatment and by week 24 the CST values decreased to 435 ±127 μm. Conclusions RG colour thresholds provide a sensitive measure of functional change in diabetic subjects with macular oedema. The YB system is damaged severely in the DMO patients studied and shows little or no recovery post treatment. The improvement in VA and particularly in RG colour vision correlate well with the measured decrease in CST. The results suggest that the improvement in the RG chromatic sensitivity can provide a useful biomarker for monitoring the efficacy of treatment in DMO

Colour vision in diabetes

Diabetes Mellitus (DM) has become one of the most important metabolic diseases that reduces one’s quality of life and doubles the risk of early death. Amongst the major complications linked to DM, diabetic retinopathy (DR) leads to gradual loss of vision and blindness. DR is now the second cause of certifiable blindness among the working age adults in the UK. The lifetime costs to the UK government are calculated to be up to £327,000 per person, with almost 50% of these costs being attributed to loss of productivity caused by visual impairment and blindness. The UK is one of the leading countries in the implementation of DR screening programmes. The latter rely heavily on fundus imaging and grading using trained experts and subsequent referral to hospital for further clinical examination and evaluation depending on the grade of retinopathy. It is now known that subtle, structural changes in the retina that are linked to diabetes can precede detectable vascular changes. The former can affect one’s colour vision and this offers the potential of using changes in chromatic sensitivity as an early biomarker of retinal disease. The first part of this thesis focuses on measuring chromatic sensitivity using the colour assessment and diagnosis (CAD) test in diabetic subjects with varying degrees of retinopathy. The severity of colour vision loss is graded in comparison to other factors that are normally linked to diabetes, such as the type, grade, control methods and duration. The results of this study reveal losses of both red / green and yellow / blue chromatic sensitivity in patients with diabetes, but the correlation with factors, normally associated with high risk of diabetes is low. The results from this study do, however, show that the magnitude of chromatic sensitivity losses correlates with the severity of diabetic retinopathy. The second, related study examines the effectiveness of intravitreal injection of a dexamethasone implant (Ozurdex) in patients with diabetic macular oedema (DMO) in stabilising and reducing loss of visual function and in particular the reduction in chromatic sensitivity up to 24 weeks. This treatment demonstrated efficacy in the treatment of chronic DMO and DMO which is resistant to anti-VEGF treatment. The results show that intravitreal treatment with Ozurdex causes improvement is visual acuity, central retinal thickness and significant improvement in red / green chromatic sensitivity

Chromatic sensitivity changes in Type I and Type II diabetics

Purpose: Previous studies have shown that patients with type I diabetes can exhibit significant loss of colour vision that often precedes any clinical signs of retinopathy. In this study we investigated loss of red-green (RG) and yellow-blue (YB) chromatic sensitivity in both type I and type II diabetic patients. The aim was to establish how the type, onset, retinal thickness and the glycated haemoglobin (HbA1c) level affect the severity of RG and YB loss. Methods: 110 patients diagnosed with diabetes (90 type II and 20 type I) took part in this study. BCVA, duration of diabetes, HbA1c and central subfield thickness (CST) were recorded in each patient. RG and YB colour thresholds were measured monocularly using the CAD (Colour Assessment & Diagnosis) test (Expert Rev. Ophthalmol. 6:409-420, 2011). Results: Both type I and II diabetic patients showed significant loss of both RG and YB chromatic sensitivity with thresholds that ranged from just above the upper, age-corrected threshold limits for normal colour vision to complete absence of chromatic sensitivity. There was little or no correlation with type, duration of diabetes, loss of visual acuity, retinal thickness changes or the HbA1C index. The diabetics examined separated into two groups, the majority have RG (72%) and YB (65%) thresholds below ~ 6 standard normal CAD units with little or no difference between type I and II. A subgroup of patients (mostly type II) exhibit much larger thresholds, but no correlation with age or duration of diabetes. Conclusions: RG and YB colour thresholds provide a sensitive measure of functional change in diabetics. Both type I and II diabetic patients exhibit loss of both RG and YB chromatic sensitivity, with little or no difference between the two types. Neural changes in diabetes that cause loss of colour vision do not appear to be linked directly to type, duration or the HbA1c level

Using the renal pelvis flap to replace the whole hypoplastic ureter: a preliminary report

Background Hypoplastic ureter is a rare condition usually associated with hypoplastic kidney, and it ends with nephrectomy in most of the cases. Many techniques have been described as ureteric substitutes in the literature. Here, we describe a new technique using the renal pelvis flap to replace the whole hypoplastic ureter in two cases. Objective The aim of this study was to describe a new surgical technique in the management of ureteric hypoplasia.Patients and methods Of the two boys diagnosed antenatally, unilateral hydronephrosis was detected in one boy and a huge renal cyst was present in the other, with evidence of postnatal progressive obstruction necessitating surgical intervention. On exploration, hypoplastic ureter throughout its entire length was an accidental intraoperative finding. The renal pelvis flap was taken and tubularized to replace the entire ureter, and reimplanted into the urinary bladder. This technique was the primary procedure in one case, whereas it was the secondary procedure in the other case after failure of initial trial of pyeloplasty.Results The postoperative period was uneventful with adequate drainage of the renal pelvis in the short-term follow-up (6 and 3 months consecutively).Conclusion The renal pelvis flap is a new feasible alternative procedure for ureteric replacement in a hypoplastic ureter when there is preserved renal parenchyma.Keywords: renal pelvis flap, ureteral hypoplasia, ureteric replacemen

The effects of rearing water depths and feed types on the growth performance of African catfish (Clarias gariepinus)

African catfish (Clarias gariepinus) has been growing in popularity as a culture species globally. Although considerable research has been carried out on this species’ feeding preferences, no research has been carried out on optimum water level for growth. This is particularly surprising given this species' benthic nature. This study assessed the effect of different combinations of water levels and types of feed on the growth performance of African catfish. The study employed a 3 × 2 factorial design with three ponds of different water levels (0.5, 1 and 1.5 m) and two types of feeds (floating and sinking). Twelve earthen ponds (1 × 2 m) were each stocked with 16 catfish fingerlings (mean weight ~100 g), and their growth was monitored for 12 weeks. The fish cultured in the shallowest water grew significantly faster than those cultured in the deepest ponds. At the same time, fish cultured in the shallowest ponds had the lowest feed intake rates and consequently the lowest feed conversion ratios. Catfish fed sinking pellets grew faster than those fed floating pellets although the difference was not significant. There was no significant interaction between pond water depth and feed type. The results of this study suggest that the growth and feeding efficiency of C. gariepinus can be optimized by culturing in fairly shallow ponds (0.5 m)

HPLC-DAD stability indicating determination of nizatidine in bulk and capsules dosage form

AbstractThis work describes the stability-indicating determination of the H2-receptor antagonist nizatidine in its bulk and capsules dosage form using high performance liquid chromatography coupled with diode array detector (HPLC-DAD). The developed method involved the use of Thermo Hypersil BDS-C8 (4.6×250mm, 5μm particle size) column and a mobile phase composed of 0.05M phosphoric acid and acetonitrile (50:50, v/v). The mobile phase was pumped at a flow rate of 1mL/min. Quantification of nizatidine was based on measuring its peak area at 320nm. The retention time for nizatidine was about 3.61min. The reliability and analytical performance of the proposed HPLC procedure were statistically validated with respect to linearity, range, precision, accuracy, specificity, robustness, detection and quantification limits. Calibration curve of nizatidine was linear in the range of 5–50μg/mL with correlation coefficient >0.9999. The drug was subjected to forced-degradation conditions of acidic and basic hydrolysis, oxidation, dry heat and UV photolysis where it showed considerable degradation in basic and oxidative conditions. The proposed method proved to be specific and stability-indicating by resolution of the drug from its forced-degradation products. The validated HPLC method was applied to the analysis of nizatidine in capsules dosage form where it was quantified with recoveries not less than 98.2%. Assay results were statistically compared to USP 2011 pharmacopeial method where no significant difference was observed between the proposed and reference methods

Haematological and biochemical blood profile of African catfish (Clarias gariepinus) cultured in ponds of different water depth and fed sinking versus floating diet

This study contributes data on haematological and biochemical parameters of African catfish, Clarias gariepinus. It employed a 3 × 2 factorial design with three ponds of different water depth (0.5, 1 and 1.5 m) and two types of feed (floating and sinking). Twelve earthen ponds (1 m x 2 m) were stocked with 16 fingerlings catfish each (mean weight ~100g) and their blood parameters were monitored over 12 weeks. Differences in hematological parameters related to water depth were mostly significant, and better results were recorded in fish reared in shallower water ponds. Feed type showed improved hematological parameters with using of sinking diet. Most biochemical parameters showed significant differences in pond waters depth and feed type with better results coincided with rearing fish in shallower water depth and with sinking feed. Conclusively, culturing Catfish in shallow ponds (0.5 m) and use of sinking feed improve physiological response and health condition