Screening for Occult Macular Pathology Prior to Cataract Surgery Using Optical Coherence Tomography

Yousef A Fouad, Amr Mohamed ElGwaily, Yasmine Maher Shaaban Department of Ophthalmology, Ain Shams University Hospitals, Cairo, EgyptCorrespondence: Yousef A Fouad, Department of Ophthalmology, Ain Shams University Hospitals, Ramses st., Abbassiya, Cairo, 11517, Egypt, Tel +201063781237, Email [email protected]: To study the prevalence of occult macular pathology using optical coherence tomography (OCT) during the preoperative evaluation for cataract surgery and associated risk factors.Methods: A retrospective analysis of patients’ medical records and imaging. Adult patients who underwent cataract extraction who had normal preoperative fundoscopic examination and available preoperative OCT imaging were included.Results: The analysis included 121 eyes belonging to 121 patients. The prevalence of occult macular pathology was 21.5%, with the most common being interface abnormalities (8.3% of the eyes), drusen (4.1%), and diabetic macular edema (4.1%). Visually significant pathologies were noted in 6.6% of the eyes. Occult macular pathology was rare in patients aged less than 50 years (4.5%) and common among patients 70 years of age or older (43.3%). The most significant predictors of occult macular pathology were advanced age (OR: 1.06, p = 0.033) and diabetes mellitus (OR: 6.79, p = 0.002).Conclusion: Relying on fundoscopic evaluation alone would miss 1 in 5 eyes with occult macular pathology and 1 in 15 with pathologies that would alter the visual outcome. Preoperative OCT screening prior to cataract surgery should be considered, especially in patients with advanced age and diabetes mellitus.Keywords: cataract, macular, optical coherence tomography, preoperative assessment, imagin

Towards screening Barrett’s Oesophagus: current guidelines, imaging modalities and future developments

Barrett’s oesophagus is the only known precursor to oesophageal adenocarcinoma (OAC). Although guidelines on the screening and surveillance exist in Barrett’s oesophagus, the current strategies are inadequate. Oesophagogastroduodenoscopy (OGD) is the gold standard method in screening for Barrett’s oesophagus. This invasive method is expensive with associated risks negating its use as a current screening tool for Barrett’s oesophagus. This review explores current definitions, epidemiology, biomarkers, surveillance, and screening in Barrett’s oesophagus. Imaging modalities applicable to this condition are discussed, in addition to future developments. There is an urgent need for an alternative non-invasive method of screening and/or surveillance which could be highly beneficial towards reducing waiting times, alleviating patient fears and reducing future costs in current healthcare services. Vibrational spectroscopy has been shown to be promising in categorising Barrett’s oesophagus through to high-grade dysplasia (HGD) and OAC. These techniques need further validation through multicentre trials

Gastroesophageal reflux disease and vocal disturbances

CONTEXT: Gastroesophageal reflux disease is a chronic disease in which gastroduodenal contents reflux into the esophagus. The clinical picture of gastroesophageal reflux disease is usually composed by heartburn and regurgitation (typical manifestations). Atypical manifestations (vocal disturbances and asthma) may also be complaint. OBJECTIVE: To analyse the clinical, endoscopic, manometric and pHmetric aspects of patients suffering from gastroesophageal reflux disease associated with vocal disturbances. METHODS: Fifty patients with gastroesophageal reflux disease were studied, including 25 with vocal disturbances (group 1 - G1) and 25 without these symptoms (group 2 - G2). All patients were submitted to endoscopy, manometry and esophageal pHmetry (2 probes). The group 1 patients were submitted to videolaryngoscopy. RESULTS: Endoscopic findings: non-erosive reflux disease was observed in 95% of G1 patients and 88% of G2. Videolaryngoscopy: vocal fold congestion, asymmetry, nodules and polyps were observed in G1 patients. Manometric findings: pressure in the lower esophageal sphincter (mm Hg): 11.6 ± 5.2 in G1 and 14.0 ± 6.2 in G2 (P = 0.14); pressure in the upper esophageal sphincter (mm Hg): 58.4 ± 15.9 in G1 and 69.5 ± 30.7 in the controls. pHmetric findings: De Meester index: 34.0 ± 20.9 in G1 and 15.4 ± 9.4 in G2 (P<0.001); number of reflux episodes in distal probe: 43.0 ± 20.4 in G1 and 26.4 ± 17.2 in G2 (P = 0.003); percentage of time with esophageal pH value lower than 4 units (distal sensor): 9.0% ± 6.4% in G1 and 3.4% ± 2.1% in G2 (P<0.001); number of reflux episodes in proximal probe: 7.5 ± 10.9 in G1 and 5.3 ± 5.7 in G2 (P = 0.38); percentage of time with esophageal pH values lower than 4 units (Proximal probe): 1.2 ± 2.7 in G1 and 0.5 ± 0.7 in G2 (P = 0.21). CONCLUSIONS: 1) The clinical, endoscopic, and manometric findings observed in patients with vocal disturbance do not differ from those without these symptoms; 2) gastroesophageal reflux intensity is higher in patients with vocal disturbance; 3) patients without vocal disturbance can also present reflux episodes in the proximal probe

Investigation on the mechanical and fracture properties of lightweight pumice epoxy composites

Pumice, which is prevalent in Ethiopia, is formed naturally during the quick cooling and solidifying of molten lava. Pumice is a naturally occurring mineral that, due to its high thermal resistance and lightweightness, can be an excellent candidate for reinforcing material for polymers. The present study investigates epoxy-based composites reinforced with pumice particles by varying the pumice content (0, 10, 20, and 30 vol%). The densities of all composites reduce in comparison with neat epoxy as the volume proportion of pumice increases credited to the low density pumice particles. Tensile stress–strain curves depict neat epoxy with higher deformation than other pumice particulate-filled composites in the linear elastic area followed by rapid brittle failure. Tensile modulus of all the composites increases in the range of 13%–67% in comparison with neat epoxy. The compressive characteristics of composites are greatly improved by the addition of pumice. Compressive moduli and specific compressive moduli of all composites increase with increasing volume fraction of pumice by 54%–58% and 65%–93%, respectively, in comparison with neat epoxy. The fracture toughness of P-10, P-20, and P-30 composites improved by 18%, 54%, and 59%, respectively, as compared with neat epoxy mainly attributed to the foam-like structure of pumice particles. SEM micrographs are used to analyze the morphology of compression-tested specimens. Property mapping highlights the advantages of utilizing composites from present work over numerous syntactic foams