Trachoma and Some Other Eye Diseases in a Libyan Village

The population of a Libyan desert village (oasis) was examined for trachoma and other eye diseases in 1976 and in 1980 to assess the problem, study the pattern and assess the influence of socio-economic factors on the prevalence and intensity of the disease and its visually disabling lesions. Also to study the problem of blindness and its magnitude in such a community. A bacteriological study of the population was also undertaken for the first time in this country. Every member of this desert village (1000 people) was examined by the author and the visual acuity recorded. Each was assessed for trachoma and other eye conditions and a conjunctival smear from the upper palpebral conjunctiva was taken for Giemsa staining. Every school child with active trachoma had a bacteriological swab taken from the conjunctivae to see if there is any association between trachoma and bacterial infections in this community. Those who did not have good vision were examined in detail to assess the cause of the poor vision. Ocular examination of the whole population was repeated in 1980 and compared with the findings of 1976 and the improved situation in 1980 were both noted. It was found that Giemsa staining methods have possibly little value in areas of moderate to mild intensity of trachoma such as Marada. Newer methods will need to be assessed for field studies in such situations e. g. the "Rapid serological test". Socio-economics and environmental factors especially housing and water supply are important factors in trachoma control. Face washing is possibly the most important method of trachoma control and relies on health education for its success. It can also be applied to poor countries where trachoma control is required. The incidence of blindness was totally different from census figures stressing the importance of either full surveys or randomised samples as the methods of choice for the recording of blindness. Cataracts and glaucoma are very important causes of blindness in trachoma endemic areas. Some interesting points are raised and need to be looked at in detail in future studies in such areas (a) Do some of the cicatrical scars disappear in time in areas where the disease is mild? (b) What is the strong association between pterygium and trachoma? (c) and most important what is the best method for the early detection of preventable blindness caused by chronic simple glaucoma in such a community

Differential Diagnosis of Parkinsonism and Tremor Disorders: Basal Ganglia Imaging With a Novel Isotope

There have been continual changes in medical diagnosis and treatment throughout the generations. Present medical practice emphasises accuracy and accountability, and an evidence base for diagnosis and therapeutic intervention. The differential diagnosis of tremor disorders and parkinsonism serves as a good example of evolving concepts and treatment approaches, and is the subject of the present thesis. It is necessary first to review present knowledge about the accuracy of diagnosis and why this is important (Chapter 1), then to review how imaging techniques have contributed to the knowledge base (Chapter 2) and then report current understanding of the dopamine transporter (Chapter 3) - as it is at this site that the new isotope -123I-N-fluoropropyl-2beta-carbomethoxy-3beta-(4-iodophenyl) nortropane (123I-FP-CIT) is known to work. It is the aim of the present thesis to examine an advanced phase of clinical application of the technique of SPECT imaging with 123I-FP-CIT to the differential diagnosis of selected movement disorders as follows: In study 1 (Chapter 4) the design and result of study of 220 subjects with idiopathic Parkinson's disease (iPD), multiple system atrophy (MSA), progressive supranuclear palsy (PSP), essential tremor (ET) and healthy volunteers are presented. A new technique of assessing 123I-FP-CIT SPECT by visual inspection was developed which proved to be useful in differentiating essential tremor from other parkinsonian syndromes. Semi-quantitative analysis showed limited usefulness of 123I-FP-CIT SPECT in differentiating iPD from atypical parkinsonism. This study provides evidence against significant association between iPD and ET. Study 2 (Chapter 5) addressed the issue of the correlation of severity, staging and duration of parkinsonian features with 123I-FP-CIT striatal uptake in 41 patients with iPD. A positive correlation of striatal uptake was identified for these variables and for bradykinesia, but not for tremor suggesting that tremor could have an origin outwith the dopamine transporter system. The clinical lateralisation of parkinsonian signs was studied in relation to striatal uptake with the finding that clinical asymmetry in iPD was more marked than the degree of the asymmetry in 123I-FP-CIT uptake. The patterns of 123I-FP-CIT uptake in iPD, 8 MSA, 3 PSP and 6 healthy volunteers were reported, confirming that the posterior putamen is the most affected part in iPD and showing that there are limitations in attempting to differentiate parkinsonism subtypes using this technique. In study 3 (Chapter 6) 10 patients with tremor and/or clinical features suggesting possible parkinsonism (but not fulfilling diagnostic criteria for either iPD or ET) were compared to 9 unilateral patients fulfilling diagnostic criteria for iPD and 6 healthy volunteers. Reduced 123I-FP-CIT striatal uptake was found bilateral in 7 tremor patient and all 9 of the unilateral iPD patients, confirming the presymptomatic phase of the illness not only in early parkinsonism cases but even in monosymptomatic cases who have yet to develop definitive clinical features. Of the 10 tremor cases, 3 showed striatal uptake values above the range established for iPD patients fulfilling clinical criteria, even although the duration of disease in the tremor patients was similar to that in definite iPD patients. Three of the 10 tremor patients showed normal striatal uptake. This indicated the usefulness of this technique in demonstrating the nigrostriatal change at a very early stage of disease, helping to exclude or confirm the diagnosis of parkinsonism. In study 4 (Chapter 7) the relationship between cerebrovascular disease and parkinsonism was studied. 123I-FP-CIT striatal uptake in 12 patients with vascular parkinsonism was compared to 6 healthy volunteers. Also an index case of isolated tremor related to ischaemic lesion was reported. A reduction in uptake was shown in all vascular parkinsonism patients except one. Two distinct patterns of dopaminergic loss, both of which differ from idiopathic Parkinson's disease were identified, indicating that vascular lesions may disrupt the dopaminergic system to produce parkinsonian features. In summary, a simple visual inspection of 123I-FP-CIT SPECT scans helps in differentiating parkinsonian syndromes from essential tremor and detecting changes in the dopaminergic system in patients with unilateral parkinsonism, even in patients not fulfilling diagnostic criteria for iPD. However there are limitations in using this technique in differentiating iPD from MSA or PSP. A reduction in striatal uptake was shown in vascular parkinsonism patients supporting a dopaminergic source of symptoms in this group. The correlation of disease staging, severity and duration with striatal 123I-FP-CIT uptake indicates the potential usefulness of SPECT in monitoring disease progression and the effects of putative neuroprotective therapy. In conclusion, this new technique represents a significant advance in medical diagnosis of movement disorders.

UPOTREBA POLIETILENSKOG GLIKOLA (6000) ZA DEAKTIVIRANJE TANINA U LIŠĆU DRVEĆA ZA BRŠĆENJE U ISTOČNOJ LIBIJI

This study was conducted to investigate the effect of different levels of Polyethylene glycol (PEG) on in vitro gas production of some tree leaves grown in Eastern Libya. The samples used were Ceratonia siliqua, Pistacia lentiscus, and Acacia cyanophylla. They were incubated anaerobically with rumen liquor from growing male sheep equipped with a permanent cannula. Cumulative gas production was measured after 3, 6, 12, 24, 48 and 72 hours from the incubation of samples with rumen liquor. PEG was added at levels 15, 30 and 45 mg per 0.2 g dry matter. The chemical analysis showed that the crude protein (%) was 8.2, 9.5, 13.4, for P. lentiscus, C. siliqua and A. cyanophylla, respectively, and that of the ether extracts were nearly the same in all the studied samples. The NDF contents were ranged between 44.5% for C. siliqua and 37% for A. cyanophylla with P. lentiscus lie in the middle (39.8%). The percentages of condensed tannins were 25.4, 21.5 and 4.1 for A. cyanophylla, P. lentiscus and C.siliqua respectively. The average cumulative gas production (ml/0.2 g DM) after 48h of incubation was higher (P<0.05) for C. siliqua then P. lentiscus followed by A. cyanophylla (22.9, 12.6 and 8.2) respectively. Addition of Polyethylene glycol (15, 30 and 45 mg PEG/0.2 g DM) increased (P<0.05) the cumulative gas production compared with control (13.5, 16.4 and 20 vs. 8.4). The current study concluded that PEG can be used to alleviate the undesirable effects of anti-nutritional Polyphenols found in some grazing tree leaves.Ovo je istraživanje provedeno radi ispitivanja djelovanja raznih razina polietilenskog glikola (PEG) na in vitro proizvodnju plina lišća nekog drveća što raste u Istočnoj Libiji. Upotrijebljeni uzorci bili su Ceratonia siliqua, Pistacia lentiscus i Acacia cyanophylla. Uzorci su inkubirani anaerobno s tekućinom iz buraga muških ovaca u porastu s trajno ugrađenom kanilom. Nakupljeni plin mjeren je nakon 3, 6, 12, 24, 48 i 72 sata od inkubacije uzoraka s tekućinom iz buraga. PEG je dodan u razinama od 15,30 i 45 mg na 0,2 g suhe tvari. Kemijska analiza je pokazala da su vrijednosti sirovih bjelančevina iznosile 8.2, 9.5 i 13.4 za P.lentiscus, C.siliqua odnosno A.cyanophylla, a bjelančevine drugih ekstrakata bile su gotovo iste u svim ispitivanim uzorcima. Sadržaj NDF iznosio je 44,5% za C.siliqua i 37% za A.cyanophylla dok je P.lentiscus bio u sredini (39,8%). Ostatci kondenziranih tanina bili su 25.4, 21.5 i 4,1 za A.cyanophylla, P.lentiscus odnosno C.siliqua. Prosječni nakupljeni plin (ml/0,2 g DM) nakon inkubacije od 48h bio je viši(P<0,05) za C.siliqua zatim slijede P.lentiscus i A.cyanophylla (22.9,12.6 i 8.2).Dodavanje polietilenskog glikola (15,30 i 45 mg PEG/0.2 g DM) povisilo je (P<0,05) ukupnu proizvodnju plina u usporedbi s kontrolom (13.5,16.4 i 20 vs.8.4). Prema ovom istraživaanju PRG se može upotrijebiti za ublažavanje nepoželjnog djelovanja antinutritivnih polifenola što se nalaze u lišću drveća za bršćenje

The Effects of Task-Based Language Teaching (TBLT) on the Reading Comprehension in EFL Classes

This study investigated the effects of Task-Based Language Teaching (TBLT) on the reading comprehension in EFL classes at proficiency Cyprus Universities. In addition, this study attempted to find out whether the Task-Based Language Teaching has any advantages or disadvantages in teaching reading skills to EFL learners. This study attempted to determine the effects of the Task-Based Language Teaching on the reading comprehension of foreign EFL learners. This study uses both quantitative and qualitative methods collected data from different two universities. The two different universities are Cyprus International University and Mediterranean Karpasia University