Results of pars plana vitrectomy after complicated phacoemulsification surgery

Purpose: To identify the causes and outcomes of pars plana vitrectomy (PPV) in patients undergoing phacoemulsification with intraoperative complication and to analyze whether the interval between phacoemulsification and PPV interferes with best-corrected final visual acuity. Methods: This descriptive and retrospective analytical study was conducted in Paraná Eye Hospital in 2013. Data were collected from medical records of 38 patients who underwent complicated phacoemulsification and also required PPV. Results: The most frequent complication as a result of phacoemulsification was posterior capsule rupture, observed in 35 patients (92.10%), followed by capsular bag detachment, in three patients (7.89%). Twenty-eight patients (73.68%) had cortical fragments that were removed during PPV. Twelve patients (31.57%) had their intraocular lens repositioned. PPV was performed on the same day of phacoemulsification in one patient (2.63%), within 1 week in 15 patients (39.47%), between 1 week and 1 month in 13 patients (34.21%), and 1 month after phacoemulsification in 9 patients (23.68%). Conclusion: This study is in agreement with worldwide literature, asserting that major complications of phacoemulsification are posterior capsule rupture and capsular bag detachment, and in addition, there is an improvement in the final visual acuity in almost half the cases, even when there are complications during modern cataract surgery, when complementary appropriate treatment is provided

New Insights into Alleviating Diabetes Mellitus: Role of Gut Microbiota and a Nutrigenomic Approach

The scientific literature has shown that diet is able to modify the gut microbiota and contribute to obesity and diabetes development. This process—characterized by inflammation and gut barrier disruption—can affect the immune system and alter the adipogenesis and insulin resistance. This chapter describes the advances in nutrigenomics and Human Intestinal Microbiota (HIM) modification, and its relation with diabetes mellitus type two (DM2). In context where health and feeding are the main concerns of the human being, food innovation takes a special interest to people that look for a healthy diet or demand a functional aliments, such as nutraceutical. Some products derived from diet and interaction with HIM module the expression of many genes on the host, the so-called epigenome, with favorable effects. Novel functional fiber like low-glycemic oligosaccharides and sweeteners shows a potential prebiotic activity giving a new focus of nutritional guidelines for control and prevention of DM2. The use of prebiotics derived from functional fiber sources, such as fructo-oligosaccharides and beta-glucans as well as lignin and keffir, can contribute to the development of a healthy HIM by promoting the growth of specific bacteria, some of them associated with the prevention of obesity and diabetes

The Microbiome and the Epigenetics of Diabetes Mellitus

Gut microbiota (GM) in the epigenetic mechanisms of diabetes mellitus and the reprogramming of the cells is a novel and emerging concept. The purpose of this chapter is to describe the modification of the GM and its relation with DM2. The increased risk of this disease is associated with changes in the amount of Bacteroides/Clostridium in the Firmicutes/Bacteroidetes ratio of people having DM. A dysbiosis state associated generates low-grade inflammation with similar characteristics that occur under metabolic syndrome, whose pattern is recognized by Toll-like receptor that recognizes important patterns of immunity. The synthesis of butyrate generated by intestinal microorganisms inhibits the metabolic pathway of histone deacetylase, promoting cellular differentiation, proliferation, and insulin resistance. On the other hand, the direct relationship between the neuroendocrine system and the GM has been demonstrated through the production of serotonin by enterochromaffin cells, whose action could influence the etiopathogenic factors of DM2

AHLU RA’YI WA AHLU RIWAYAH

Ahlu Ra’yi Wa Ahlu Riwayah (suatu kajian Fiqhi) perkembangan hukum Islam masa Nabi, Sahabat, Tabiin terdapat hal yang sangat mendasar yang di jadikan sandaran hukum. Dalam mengistimbatkan hukum, dasar mereka adalah al-Qur’an dan Sunnah. Bahkan Rasullullah pernah berpesan agar umat-Nya senangtiasa berpegang teguh kepada kedua sumber hukum tersebut. Hal ini dapat di jadikan sebagai penunjang agar umat Islam tidak sesat. Ahlu ra’yi dan ahlu riwayah merupakan ulama Fiqhi. Keduanya mengistimbatkan hukum yang jelas statusnya. Perbedaan keduanya Nampak jika ahlu ra’yi mengutamakan akal oikran mereka tetapi tidak mengabaikan al-Qur’an dan Sunnah. Sementara ahlu riwayah mengutamakan dalil Naqli dan sunnah rasul sebagai sandaran hukum. Ahlu ra’yi menggunakan akal pikiran mengingat kondisi tempat begitu jauh dari kota madinah sebagai pusat kekuatan Islam. Ahli fukaha disana banyak menemukan masalah baru yang mereka tidak jumpai pada zama rasullullah, sahabat dan tabiin. Dan tempat mereka begitu maju tempat berkembangnya kerajaan islam yaitu Bani Abbasiyah. Sementara ahlu riwayah mengutamakan nash-nash al-Qur’an sudah Qat’I dan mengunakan riwayat yang marfu, ijma dan qiya