Retinoblastoma: Update on Current Management

Retinoblastoma (Rb) is the most common primary intraocular malignancy in children with an incidence from 1:15,000 to 1:20,000 live births. It can present as a unilateral or bilateral involvement of the eyes. It is generally induced by biallelic mutation of the RB1 tumor suppressor gene that leads to malignant transformation of primitive retinal cells. The most common presentation is leukocoria, followed by strabismus. The initial assessment and future treatment of such tumor should be based on the laterality, the stage of the tumor, and the presenting age of the child. In general, the primary target of therapy is to preserve the child’s life. However, preserving the globe and preserving vision should be achieved whenever it’s possible. Retinoblastoma treatment has evolved from enucleating the affected globe to also involving external beam radiation therapy, cryotherapy, laser photocoagulation, thermotherapy, brachytherapy, and chemotherapy (intravitreal, intra-arterial, and systematic). This chapter is intended to discuss briefly the clinical presentation of Rb, as well as a comprehensive review about the evolution and current treatment modalities with a focus on cases with low-risk features

Use of Topological Data Analysis in Reservoir Engineering: Application to Inverted 4D Seismic Data

Data analysis is one of the most important topics in any industry. In petroleum engineering, the complexity of reservoir data presents a challenge for engineers to study and make decisions. A new approach to analyze complex data is called topological data analysis, which aims to extract meaningful information from such data. It relies on the concept that complex data have shapes and these shapes can be translated to information. The objective of this research was to use topological data analysis in studying reservoirs connectivity and compartmentalization. This topic is an essential component of reservoir engineering because it ensures the accuracy of forecasts and development plans, the correctness of reservoir simulation, and the success of performance diagnostics and optimization. In addition, introducing topological data analysis to reservoir engineering allows identification of reservoir engineering data behavior, detection of anomalies and events, and minimizing uncertainties. Topological data analysis had been applied on inverted four-dimensional (4D) time-lapse seismic datasets. Two simulation models were used to generate the datasets: Brillig, and Norne. First, data were prepared for topological data analysis. Then, similarity distance function and lenses were defined and used to create topological data analysis graphs. Once completed, graph features were identified and analyzed. Lastly, the results were validated. Topological data analysis was able to compartmentalize the reservoir models with various process configurations. It identified regions that matched the actual reservoir compartments in the simulation model. It has been proven to extract valued information from petroleum engineering data

Patient going for PRK treatment for refractive error in Al-Jouf region, Saudi Arabia

Introduction: Photorefractive keratectomy (PRK) has been widely used as an efficient, secure, and cost-effective method for treating patients with low to moderate myopia. This study was aimed to evaluate the prevalence of accepted and rejected reasons candidates going for PRK treatment for refractive error in Aljouf region, Saudi Arabia. Material and Methods: This retrospective study was conducted among 255 candidates going for PRK treatment for refractive in the department of ophthalmology at tertiary care hospital in Aljouf region, Saudi Arabia from August 2023 to October 2023.The following measurements of eye were noted for the enrolled patients in the study: visual acuity (VA) sine correction (SC) Visual acuity cum correction (CC), refractive error (RE) Central corneal thickness (CCT), Pentacam Astigmatism, keratometry (K1 and K2), spherical, cylindrical, and axis power in diopters, cycloplegic refraction, and pupillary diameter in normal daytime illumination in a room. Results: Total 255 patients were included in this study among them 119 (46.67%) male and 136 (53.33%) female with average age of 26 in both male and female. Total 160 were fit and 95 were not fit. Visual acuity cum correction (CC) ocular dexter (OD) and Visual acuity cum correction (CC) ocular sinister (OS) reported both statistically significant with p value <0.001. Both K Max OS and K Max OD are statistically significant. The dry eye was evaluated by using Schimer test with mean of 15.00 and 10.00 with p value <0.001 were found significant. Conclusion:  This study concluded that 62.74% were reported fit and 37.26% were not fit for PRK treatment for refractive error because of the dry eye, Keratoconus, rocotane, amblyopia, hyperopia, diabetics and pregnancy in Aljouf region, Saudi Arabia. The Pentacam Astigmatism and dry eye was found statistically significant in both fit and unfit group

Preterm infants with necrotising enterocolitis demonstrate an unbalanced gut microbiota

©2017 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd Aim: This Lebanese study tested the hypothesis that differences would exist in the gut microbiota of preterm infants with and without necrotising enterocolitis (NEC), as reported in Western countries. Methods: This study compared 11 infants with NEC and 11 controls, all born at 27-35 weeks, in three neonatal intensive care units between January 2013 and March 2015. Faecal samples were collected at key time points, and microbiota was analysed by culture, quantitative PCR (qPCR) and temperature temporal gel electrophoresis (TTGE). Results: The cultures revealed that all preterm infants were poorly colonised and harboured no more than seven species. Prior to NEC diagnosis, significant differences were observed by qPCR with a higher colonisation by staphylococci (p = 0.034) and lower colonisations by enterococci (p = 0.039) and lactobacilli (p = 0.048) in the NEC group compared to the healthy controls. Throughout the study, virtually all of the infants were colonised by Enterobacteriaceae at high levels. TTGE analysis revealed no particular clusterisation, showing high interindividual variability. Conclusion: The NEC infants were poorly colonised with no more than seven species, and the controls had a more diversified and balanced gut microbiota. Understanding NEC aetiology better could lead to more effective prophylactic interventions and a reduced incidence

Evidence of protection against clinical and chronic hepatitis B infection 20 years after infant vaccination in a high endemicity region

Vaccination against hepatitis B virus (HBV) immediately after birth prevents neonatal infection by vertical transmission from HBV carrier mothers. There is an ongoing debate whether infant vaccination is sufficient to protect against infection when exposed to HBV later in life. We studied 222 Thai infants born to HBsAg -/+ and HBeAg -/+ mothers who were vaccinated with recombinant hepatitis B vaccine at 0-1-2-12 months of age. A subset of 100 subjects received a booster dose at age 5 years. Blood samples collected yearly for 20 years were examined for anti-HBs antibodies and serological markers of hepatitis B infection (anti-HBc, HBsAg, and in selected cases HBeAg, anti-HBe, HBV DNA). During the 20-year follow-up, no subject acquired new chronic HBV infection or clinical hepatitis B disease. During the first decade, possible subclinical breakthrough HBV infection (anti-HBc seroconversion) was only observed in subjects born to HBsAg +/HBeAg + mothers (6/49 [12.2%]). During the second decade, breakthrough HBV infections were detected in all groups (18/140 [12.8%]). Increases in anti-HBs concentrations that were unrelated to additional HBV vaccination or infection were detected in approximately 10% of subjects in each decade. Primary infant vaccination with a recombinant hepatitis B vaccine confers long-term protection against clinical disease and new chronic hepatitis B infection despite confirmed hepatitis B exposure. (http://www.clinicaltrials.gov NCT00240500 and NCT00456625)

Polyvascular Disease in Patients Presenting with Acute Coronary Syndrome: Its Predictors and Outcomes

We evaluated prevalence and clinical outcome of polyvascular disease (PolyVD) in patients presenting with acute coronary syndrome (ACS). Data for 7689 consecutive ACS patients were collected from the 2nd Gulf Registry of Acute Coronary Events between October 2008 and June 2009. Patients were divided into 2 groups (ACS with versus without PolyVD). All-cause mortality was assessed at 1 and 12 months. Patients with PolyVD were older and more likely to have cardiovascular risk factors. On presentation, those patients were more likely to have atypical angina, high resting heart rate, high Killip class, and GRACE risk scoring. They were less likely to receive evidence-based therapies. Diabetes mellitus, renal failure, and hypertension were independent predictors for presence of PolyVD. PolyVD was associated with worse in-hospital outcomes (except for major bleedings) and all-cause mortality even after adjusting for baseline covariates. Great efforts should be directed toward primary and secondary preventive measures

A set of reference sequences for the hepatitis C genotypes 4d, 4f, and 4k covering the full open reading frame

Infection with genotype 4 of the Hepatitis C virus is common in Africa and the Mediterranean area, but has also been found at increasing frequencies in injection drug users in Europe and North America. Full length viral sequences to characterize viral diversity and structure have recently become available mostly for subtype 4a, and studies in Egypt and Saudi Arabia, where high proportions of subtype 4a infected patients exist, have begun to establish optimized treatment regimens. However knowledge about other subtype variants of genotype 4 present in less developed African states is lacking. In this study the full coding region from so far poorly characterized variants of HCV genotype 4 was amplified and sequenced using a long range PCR technique. Sequences were analyzed with respect to phylogenetic relationship, possible recombination and prominent sequence characteristics compared to other known HCV strains. We present for the first time two full-length sequences from the HCV genotype 4k, in addition to five strains from HCV genotypes 4d and 4f. Reference sequences for accurate HCV genotyping are required for optimized treatment, and a better knowledge of the global viral sequence diversity is needed to guide vaccines or new drugs effective in the world wide epidemic