A Simple Surgical Approach for the Management of Acquired Severe Lower Punctal Stenosis

Purpose. Evaluation of using pigtail probe to detect and open severely stenosed lower lacrimal punctum followed by self-retaining bicanalicular intubation. Study design. A prospective nonrandomized clinical study. Methods. The study included 24 patients with severe lower punctal stenosis (grade 0 according to Kashkouli scale) attending at Menoufia University Hospitals. The upper punctum and canaliculus were patent. All patients were complaining of epiphora and had a thorough ophthalmological examination including dye disappearance test and slit-lamp examination. Pigtail probe was used from patent upper punctum to detect the lower stenosed punctum which was opened with a scalpel. Syringing of the lower lacrimal passages was done to confirm its patency, and self-retaining silicone bicanalicular stent was inserted. The silicone tube was left in place for 6 months before it was removed. Patients were then followed-up for 1 year after the surgery. Results. One year after surgery, epiphora was absent (grade 0) in 16 eyes (66.7%) and was present only occasionally (grade 1) in 4 eyes (16.7%). The difference from preoperative epiphora was statistically significant. One year after surgery, fluorescein dye disappearance time was grade 1 (<3 minutes) in 20 cases (83.3%), and grade 2 (3–5 minutes) in 4 cases (16.7%). There was a statistically significant difference compared with preoperative results. Conclusion. Using the pigtail probe is effective in treatment of severe punctal stenosis. Maintaining the punctal opening and prevention of restenosis can be achieved by using self-retaining bicanalicular stent after confirmation of nasolacrimal duct patency. This trial is registered with NCT03731143

Preparation and characterization of HDPE/chitosan composites for bone replacement applications

A study carried out in the Netherlands has reported that the mean rates of infections related to surgery that involves implants are in the range of 1.5% in the case of total knee implantation and 6.8% for femur head replacement, where polyethylene is widely used as cotyle. Such infections result in disease for the patient and prolongation of hospital stay, then increasing cost of care. Chitosan is the second most abundant polysaccharide found in nature after cellulose and it is the most promising bio-based polymer for tissue engineering. Chitosan is nontoxic and shows biocompatibility and antimicrobial properties. In view of preventing the disease arising from infections, this work investigates the study of HDPE composites containing chitosan in different shapes and compositions. The HDPE composites have been prepared by melt extrusion with the aim to achieve materials with good mechanical properties and antimicrobial activity for bone replacement applications. Their thermal behavior has been investigated by means of Thermogravimetric and Differential Scanning Calorimetry analyses. Dynamic-Mechanical Analysis and Scanning Electron Microscopy have provided information about mechanical behavior of the composites and the distribution of the filler within the polymer matrix, respectively