Torsional ultrasound mode versus combined torsional and conventional ultrasound mode phacoemulsification for eyes with hard cataract

Mohamed A Fakhry1,2, Malak I El Shazly11Department of Ophthalmology, Kasr El Aini Hospital, Cairo University, Cairo, Egypt; 2Cataract and Refractive Consultant, International Eye Hospital, Cairo, EgyptPurpose: To compare torsional versus combined torsional and conventional ultrasound modes in hard cataract surgery regarding ultrasound energy and time and effect on corneal endothelium.Settings: Kasr El Aini hospital, Cairo University, and International Eye Hospital, Cairo, Egypt.Methodology: Ninety-eight eyes of 63 patients were enrolled in this prospective comparative randomized masked clinical study. All eyes had nuclear cataracts of grades III and IV using the Lens Opacities Classification System III (LOCS III). Two groups were included, each having an equal number of eyes (49). The treatment for group A was combined torsional and conventional US mode phacoemulsification, and for group B torsional US mode phacoemulsification only. Pre- and post-operative assessments included best corrected visual acuity (BCVA), intraocular pressure (IOP), slit-lamp evaluation, and fundoscopic evaluation. Endothelial cell density (ECD) and central corneal thickness (CCT) were measured preoperatively, 1 day, 7 days, and 1 month postoperatively. All eyes were operated on using the Alcon Infiniti System (Alcon, Fort Worth, TX) with the quick chop technique. All eyes were implanted with AcrySof SA60AT (Alcon) intraocular lens (IOL). The main phaco outcome parameters included the mean ultrasound time (UST), the mean cumulative dissipated energy (CDE), and the percent of average torsional amplitude in position 3 (%TUSiP3).Results: Improvement in BCVA was statistically significant in both groups (P < 0.001). Comparing UST and CDE for both groups revealed results favoring the pure torsional group (P = 0.002 and P < 0.001 for UST; P = 0.058 and P = 0.009 for CDE). As for %TUSiP3, readings were higher for the pure torsional group (P = 0.03 and P = 0.01). All changes of CCT, and ECD over time were found statistically significant using one-way ANOVA testing (P < 0.001).Conclusion: Both modes are safe in hard cataract surgery, however the pure torsional mode showed less US energy used.Keywords: torsional, cumulative dissipated energy, cataract&nbsp

Power Quality Issue of Grid Connected DFIG Wind Farm System

Quality of power is known as any power problem manifested as a non-standard frequency, current and voltage which cause failure of end customer apparatus. The wind utilization, generation and its penetration in utility grid are increasing worldwide. One of the master issues in wind generation is the insertion to the network. When the wind energy is injected to the grid generally controls the voltage disturbances on the system power quality, variation of voltage is the almost prevalent kind of disturbance which affects stability and the quality of power for grid-inserted wind system. This study investigates the two widespread kinds of voltage variations such as voltage dip and swell, which can happen if large amount of wind system is connected to an electrical grid. This research also studies the response and performance under faults of a wind farm inserted to distribution systems. In this paper, a wind turbine with induction machine (DFIG) is simulated by using MATLAB/Simulink program. The simulated model is subjected to disturbances which known as; voltages (dip and rise). The results of simulation presents that, how both variations; voltage dip & voltage rise lead to mal-operation as well as shut-down of entire system, therefore deteriorating the improvement of power quality for the grid

Impact of a Designed Nursing Intervention Protocol about Preoperative Liver transplantation Care on Patients’ Outcomes at A University Hospital in Egypt

Background: Literature review cited that, Liver transplantation is now considered as the gold standard for treatment of patients with end-stage liver diseases and early liver tumors in cirrhotic livers. Patient education is vital to the safety and success of a transplant. Aim: the aim is to assess the impact of a designed nursing intervention protocol about preoperative liver transplantation care on patient’s outcomes as indicated by: patients` knowledge & practice mean scores, and complications developed. To fulfill the aim of this study, the following hypothesis was formulated: patients undergoing liver transplantation who will be exposed to the designed nursing intervention protocol about preoperative liver transplantation care will show better outcomes. Material and Methods: A convenient sample of 14 adult male and female patients admitted to Liver Transplant Unit at El Manial University Hospital were included, three of them were died with an attrition rate of 21.4%. Four tools were formulated to collect data pertinent to the study. 1- Sociodemographic and medical data sheet; 2- Pre/Post knowledge assessment questionnaire sheet, 3- Observational checklists, & 4- Complications assessment sheet. Structured interview, reviewing medical records, direct observation and physical examination were utilized for data collection. Results: a  significant statistical difference was found in relation to the total and subtotal mean knowledge and practice scores during different assessment periods  with P values (0.00 for both); as well, 45.5 %  of patients developed respiratory complications (pleural effusion) compared to 53.8 % of their correspondence who developed respiratory complications (pleural effusion, chest infection, and others), in addition, 9.1% of the studied subjects developed  rejection, and ascites as compared to (1.9 %, 5.7%) of their correspondence over the last consecutive three years respectively. Conclusion: Liver transplantation patients showed a positive improvement in their knowledge and practice in relation to breathing, coughing, & using respirometer exercises and range of motion. Replication of this study on a larger sample selected from different geographical areas is highly recommended. Key wards: liver transplantation, designed nursing intervention protocol, preoperative liver transplantation care, knowledge, complications, and patient`s outcome

The provenance of Arabic loan-words in Hausa: A phonological and semantic study.

This thesis consists of an Introduction, three Chapters, and an Appendix. The corpus was obtained from the published dictionaries of Hausa together with additional material I gathered during a research visit to Northern Nigeria. A thorough examination of Hausa dictionaries yielded a large number of words of Arabic origin. The authors had not recognized all of these, and it was in no way their purpose to indicate whether the loan was direct or indirect; the dictionaries do not always give the Arabic origin, and sometimes their indications are inaccurate. The whole of my corpus amounts to some 4000 words, which are presented as an appendix. The entries show the tones and vowel lengths of the words, which do not appear in Hausa orthography, but are in general related to the syllable structure of their Arabic origins. The Arabic items are given in transliteration. Meanings and examples are given for the Hausa items, and for the corresponding Arabic items as fully as is deemed relevant. Items have not always come directly from Arabic, and wherever possible their most likely source has been indicated. A large part of the research was given to this part of the work, and it has been thought desirable to present this corpus in full as a necessary part of the thesis, without which the rest would be much less intelligible. Chapter 1, concerning the historical side suggests that the amount of influence in Northern Nigeria direct from Arabs is much less than has been alleged, and is far exceeded by that of Kanuri, Tuareg, Songhai and Fulani teachers. They came, of course not to bring the Arabic language but to spread Islam, and it was Islam that brought the Arabic language and culture. The Arabic and Hausa languages have different phonological systems and Chapter 2 sets out how these differences affected the borrowed items in Hausa, and points to the great complexity of the relations. Chapter 3 attempts to show how far the loan-words retained their meanings in Arabic and how far these meanings changed in their new environments. It would be impossible in one thesis to deal with all the items, and attention has been focused on the development of Hausa personal names. In many cases the Arabic origins were personal names but in some instances Hausa names have been evolved from other areas e.g. Arabic words for numerals and for days of the week and months of the year. This new and independent development in Hausa is a common feature regarding most loans from Arabic

Evaluation Of Facial Soft Tissue Changes In Excessive Gingival Display Cases After Le Forte I Maxillary Impaction Surgery Using 3D Facial Surface Laser Scanner

Introduction: Facial soft tissue changes in relation to hard tissue movements after orthognathic surgery cases is always of concern to patients , surgical and orthodontics teams. The aim of the present study was to assess facial soft tissue changes and stability using 3D facial laser scanner after orthognathic surgery Le Forte I maxillary impaction in excessive gingival display patients. Methods: The subjects consisted of 12 patients with skeletal vertical maxillary excess (VME) causing an aesthetic concern to the patients in the form of “Gummy smile”, who underwent LeFort I osteotomy with maxillary impaction, Three-dimensional images of the patients were acquired with a 3D laser scanner preoperatively and postoperatively. The changes in facial soft tissue were detected using a colour coded map for analysis. Results: Significant change was recorded in the upper lip, alar base, nasolabial fold and nasal tip areas, without specification of this change in direction. Conclusions: The 3D images captured using the laser scanner in this study can be a useful tool for communication with both patients and professionals but cannot be relied upon solely for accurate analysis of the facial soft tissue changes. The colour coded map analysis cannot be relied upon solely as a method of analysis as it lacks an important aspect of the change which is the direction

Bioactive Wound Dressing Gauze Loaded with Silver Nanoparticles Mediated by Acacia Gum

A wound dressing is very crucial component in wound healing process. Bioactive dressings play important role in wound sterilization and promote tissue healing and growth. The present work investigated the preparation of AgNPs in solid-state using acacia gum as both reductant and stabilizing agent. Sodium hydroxide (NaOH) was employed as activating agent and pH mediator. Acacia is a naturally occurring mixture of polysaccharides and glycoproteins. The obtained particles were in the range of 50 nm. The work was extended to evaluate the antimicrobial of AgNPs treated gauze cotton fabrics against gram positive (S. aureus), gram negative (P. aeruginosa) bacteria,C. albicans(yeast); andA. Niger(fungus). The inhibition zone of the as prepared silver nanoparticles was found to be 24 mm against both types of bacteria, 23 mm againstC. albicans(yeast), and inactive againstA. Niger(fungus). On the other hand, the treated gauze showed bactericidal behavior and a clear zone was found underneath the samples on the agar plate. The reduction percent in number of bacterial colonies of treated gauze fabrics in comparison to controlPseudomonas aeruginosaculture showed a reduction up to 100%. The aforementioned results promote the acquirement of bioactive antibacterial wound dressing

Diabetes-related cardiovascular and economic burden in patients hospitalized for heart failure in the US: a recent temporal trend analysis from the National Inpatient Sample

We aimed to study the cardiovascular and economic burden of diabetes mellitus (DM) in patients hospitalized for heart failure (HF) in the US and to assess the recent temporal trend. Data from the National Inpatient Sample were analyzed between 2005 and 2014. The prevalence of DM increased from 40.4 to 46.5% in patients hospitalized for HF. In patients with HF and DM, mean (SD) age slightly decreased from 71 (13) to 70 (13) years, in which 47.5% were males in 2005 as compared with 52% in 2014 (p trend < 0.001 for both). Surprisingly, the presence of DM was associated with lower in-hospital mortality risk, even after adjustment for confounders (adjusted OR = 0.844 (95% CI [0.828–0.860]). Crude mortality gradually decreased from 2.7% in 2005 to 2.4% in 2014 but was still lower than that of non-diabetes patients’ mortality on a yearly comparison basis. Hospitalization for HF also decreased from 211 to 188/100,000 hospitalizations. However, median (IQR) LoS slightly increased from 4 (2–6) to 4 (3–7) days, so did total charges/stay that jumped from 15,704 to 26,858 USD (adjusted for inflation, p trend < 0.001 for both). In total, the prevalence of DM is gradually increasing in HF. However, the temporal trend shows that hospitalization and in-hospital mortality are on a descending slope at a cost of an increasing yearly expenditure and length of stay, even to a larger extent than in patient without DM

Intravitreal methotrexate infusion for prophylaxis of proliferative vitreoretinopathy after pars plana vitrectomy for rhegmatogenous retinal detachment

Background: Proliferative vitreoretinopathy (PVR) is the leading cause of recurrent retinal detachment after surgical repair of rhegmatogenous retinal detachment (RRD). Our study aimed to assess the efficacy and safety of intravitreal methotrexate infusion (IMI) for the prevention of PVR after pars plana vitrectomy (PPV) in eyes with RRD. Methods: This prospective comparative interventional study was conducted from September 2020 to November 2021 at Ain Shams University Hospitals, Egypt. We recruited a consecutive, non-randomized sample of 47 eyes of 47 patients with RRD undergoing PPV. Participants were allocated to a control group or an intervention group that received IMI during surgery. Each group was subdivided into subgroups of eyes at high-risk of developing PVR and eyes with established preoperative PVR grade C. Outcome measures at the 3-month postoperative follow-up were the rate of retinal attachment, incidence of PVR, reoperation rate to flatten the retina, and changes in the retina and/or optic nerve function as assessed by full-field electroretinogram and flash visual evoked potential. Results: Data from 47 eyes (23 and 24 eyes in the intervention and control groups, respectively) were evaluated. Subgroups IA, IB, and IIB each included 12 eyes, subgroup IIA included 11 eyes, and all subgroups had comparable sex ratios and age distributions. Postoperative PVR at 1 month and between 1 and 3 months was present in 13% and 4% of eyes in the intervention group, respectively. Reoperation to flatten the retina was required in 2 (9%) eyes in the intervention group, while 22 eyes (96%) had complete flattening of the retina at 3 months. No significant differences were found between the study groups and the corresponding subgroups regarding the outcome measures (all P &gt; 0.05). No adverse events attributable to IMI were detected up to 3 months postoperatively. Conclusions: Although IMI was safe for intraocular use in eyes with RRD and PVR grade C or a high risk of developing PVR, it did not affect the anatomical success rate or development of PVR up to 3 months after PPV. Further multicenter randomized clinical trials with longer follow-up periods and larger sample sizes are needed to verify these preliminary outcomes