Surgical versus optical treatment for anisometropia in adults: A randomized controlled trial

Background: We evaluated and compared outcomes of laser-assisted in situ keratomileusis (LASIK) versus optical spectacle correction for the treatment of anisometropia in adult patients. Methods: This prospective, randomized controlled clinical trial included 50 eyes of 50 patients. We randomly allocated participants to Group A (25 eyes with anisometropia assigned to LASIK treatment) and Group B (25 eyes with anisometropia assigned to optical spectacle correction). All patients underwent preoperative and postoperative visual acuity, subjective and cycloplegic refraction, fundus, slit-lamp, and corneal topography examinations. Results: In Group A, at 1-month postoperatively, there were statistically significant differences in uncorrected distance visual acuity, corrected distance visual acuity, refractive sphere, cylinder, and spherical equivalent (SE) as compared to baseline. At 3-months postoperatively in Group A, SE showed good stability within ± 0.50 diopter (D) in 22 eyes (88%) and within ± 0.75 D in 23 eyes (92%), while two eyes had an SE beyond 1.00 D emmetropia. Five eyes had amblyopia with minimal improvement in two eyes in Group A after LASIK, and no improvement in three eyes treated with spectacles in Group B. Two amblyopic eyes had developed ocular deviations by the end of the study that referred to the strabismus unit. Conclusions: Our outcomes revealed that LASIK was more effective and advantageous than spectacles in the treatment of different types of anisometropia in adults. However, future randomized trials should focus on optical versus surgical treatment of anisometropia and anisometropic amblyopia in both pediatric and adult patients, to verify these conclusions before generalizing this treatment modality

Outcomes of the Q value-based nomogram in managing pediatric versus adult keratoconus: a prospective interventional study

Background: Keratoconus (KCN) is an ectatic disorder of the cornea characterized by stromal weakness and apical protrusion of the cornea, and is associated with a gradual and painless reduction in visual acuity. KCN in pediatric patients has certain important characteristics, such as a progressive and aggressive nature. We aimed to analyze the visual, refractive, and topographic outcomes of implanting a single 210° arc-length Keraring segment according to a novel, objective, Q value-based nomogram (Q-N) for the treatment of pediatric versus adult KCN. Methods: This prospective, multicenter, non-randomized, open-label trial included 47 eyes of 47 patients who were allocated to one of two groups. The adult group included 33 eyes of patients greater than or equal to 18 years of age, whereas the pediatric group included 14 eyes of patients aged 14 – 17 years. All patients underwent femtosecond laser-assisted implantation of a single 210° arc-length Keraring segment according to the Q-N and were followed up for 6 months. All eyes underwent visual acuity measurement, cycloplegic refraction, and corneal topography at baseline and 6 months after surgery. Results: The study groups were comparable in terms of sex proportions and KCN grades (both P > 0.05). The adult group exhibited significant postoperative improvements in mean uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), sphere, cylinder, spherical equivalent (SE), and Kmax (all P < 0.001) with a mean change of -0.56 logarithm of the minimal angle of resolution (logMAR), - 0.40 logMAR, 3.07 diopters (D), 0.70 D, 3.42 D, and - 5.26 D, respectively. The pediatric group exhibited significant postoperative improvements in mean UDVA, CDVA, sphere, SE, and Kmax (all P < 0.05) with a mean change of - 0.62 logMAR, - 0.34 logMAR, 3.18 D, 3.67 D, and - 5.37 D, respectively. There were no significant differences between the groups in terms of the mean change in visual, refractive, and topographic variables (all P > 0.05). No postoperative complications were observed in either group. Conclusions: Use of the objective Q-N was efficient in the treatment of pediatric KCN, with postoperative improvements in the mean visual, refractive, and topographic parameters, comparable to outcomes in adult keratoconus. Q-N achieved good corneal remodeling with subsequent improvements in visual, refractive, and topographic outcomes in both adult and pediatric patients with keratoconus. To verify our preliminary findings, we recommend further multicenter randomized clinical trials using the Q-N nomogram in a larger sample of pediatric patients with KCN as an adjunct treatment before or after CXL

Assessment of Plasma von Willebrand factor antigen in non-metastatic Prostate Cancerpatients: across-sectional study of the Sudanese Population

Backgrounds: VonWillebrand disease (VWD) is reportedly the most common inherited bleeding disorder and can also arise as an acquired syndrome (AVWS). These disorders arise due to defects and/or deficiency of the plasma protein von Willebrand factor (VWF)..High plasma vWF concentrations have been reported in patients with various types of cancer, such as prostatic cancer.Metastasization may be associated with activation of haemostatic processes resulting in increased levels of circulating factor VIII-related antigen (FVIIIRAg) (von Willebrand factor antigen). Objective: To evaluate the status of VWF AginSudanese patients with Prostate Cancer attending RICK Methodology: This is a cross-sectional study carried out in Khartoum state at Khartoum oncology (RICK) hospital, during the period from April to June 2018, 45 samples were collected from patients with non-metastatic CA prostate, their ages ranged between 51 to 82 years. The vWF level was measured using Enzyme-linked immunosorbent assay (ELISA). Data were analyzed by the statistical package for social science (SPSS).   Results: Serology for vWF antigen was done for 45 cases of prostate cancer. According to the age, 2(8%) of patients with age 51-66 had a high concentration of VWF while 24(92%) had normal vWF antigen concentration; of those with age 67-82 years, 4(21%) had high vWF antigen and 15(79%) had normal antigen. Conclusion: The study revealedthat more than 80% of Sudanese patients withnon-metastatic prostate cancer have anormal concentration of VWF. Keywords: vWF, Prostate cancer, Age, ELIS

Defining categories to select representative attack test-cases

7 pagesRapport LAAS-CNRSTo ameliorate the quality of protection provided by intrusion detection systems (IDS) we strongly need more effective evaluation and testing procedures. Evaluating an IDS against all known and unknown attacks is probably impossible. Nevertheless, a sensible selection of representative attacks is necessary to obtain an unbiased evaluation of such systems. To help in this selection, this paper suggests applying the same approach as in software testing: to overcome the problem of an unmanageably large set of possible inputs, software testers usually divide the data input domain into categories (or equivalence classes), and select representative instances from each category as test cases. We believe that the same principle could be applied to IDS testing if we have a reasonable classification. In this paper we make a thorough analysis of existing attack classifications in order to determine whether they could be helpful in selecting attack test cases. Based on our analysis, we construct a new scheme to classify attacks relying on those attributes that appear to be the best classification criteria. The proposed classification is mainly intended to be used for testing and evaluating IDS although it can be used for other purposes such as incident handling and intrusion reporting. We also apply the Classification Tree Method (CTM) to select attack test cases. As far as we know, this is the first time that this method is applied for this purpose

Treatment of Extensive Plaque Psoriasis and Psoriatic Arthropathy using Methotrexate in a Patient with High Serum Alkaline Phosphatase

Background: Psoriasis is an autoimmune inflammatory, chronic, and relapsing disease of the skin, which can also present with severe joint inflammation and deformity. There are many treatment options, but the severe forms of psoriasis are treated successfully with cytotoxic and biologic therapies. Methotrexate being cheap and available in Sudan is considered a good option for patients with severe and extensive forms of psoriasis.One of the main drawbacks is hepatotoxicity. The aim of this report is to share an experience of treating the patient with oral methotrexate in the presence of a relative contraindication to this therapy. Method: We present a 60-year-old female with extensive skin psoriasis and psoriatic arthropathy. Investigations showed high serum alkaline phosphatase and low serum albumen. Other liver enzymes, CBC, ultrasound abdomen were all unremarkable. Patient was admitted and a weekly dose of methotrexate was given in addition to topical preparation and supportive treatment; three months later, patient improved andwas moved to topical therapy. A check of serum alkaline phosphatase and albumen every week was done. Results: The patient was successfully and safely treated with methotrexate. Serum alkaline phosphatase was normal within the second month treatment, and serum albumen was normal after only one month of treatment. Conclusion: High serum alkaline phosphatase is considered a relative contraindication to the use of methotrexate, high level can be found in bone diseases. Serum albumen can be low in dermatologic diseases with excessive shedding of scales and can be corrected with protein formulas and high protein diets. Recommendations: Methotrexate is recommended for the treatment of severe morbid forms of psoriasis. The biologic therapy for severe forms of psoriasis is now available and can be a good alternative for the treatment of severe forms of psoriasis in good centers and for patients who can afford and in patients with absolute contraindications to methotrexate therapy

Hematological Changes in Sudanese Patients with Falciparum Malaria Attending Elnihoud Teaching Hospital

Backgrounds: Malaria is a major public health problem in the tropical and subtropical areas of the world, including Africa. Most cases of malaria in Africa are caused by Plasmodium falciparum. Objectives: This study was aimed to assess the hematological changes in patient with falciparum malaria and to estimate the incidence of leucopenia, thrombocytopenia, and its response to anti-malaria therapy, and to correlate the association of the hematological changes with P. falciparum-positive (study group) and P. falciparumnegative (control group). Methodology: A total of 453 participants (353 cases and 100 as control group) were enrolled in this study, all of them were randomly selected from Elnihoud Teaching Hospital, Elnihoud Locality, West Kordufan State, Sudan. Questionnaire was filled by every participant and thick and thin blood films for malaria were prepared and stained by giemsa stain and the CBC was done by sysmex automated hematological analyzer. Results: Thrombocytopenia, leucopenia, microcytic hypochromic red blood cells and relative lymphocytosis have significant association with falciparum malaria with Pvalues 0.008, 0.001, 0.008, and 0.004, respectively. Conclusion: Patients with thrombocytopenia and/or leucopenia with malaria should receive anti-malaria therapy and follow-up by CBC, and shouldn’t be hurried for a bone marrow examination

Scientific trends on research on denture stomatitis based on Scopus database : a bibliometric analysis

Denture stomatitis is a clinical condition that affects people who wear removable maxillary dentures. It causes redness, soreness, and erythema and ultimately affects the general condition of the patient. The objective of this study was to analyze the le

In vitro assessment of the antifungal effects of neem powder added to polymethyl methacrylate denture base material

Denture with antimicrobial activities is desirable to prevent Candida albican adhesion subsequently decreasing the susceptibility of denture stomatitis incidence. Azadirachta Indica, commonly known as Neem powder has antimicrobial effect but the effect of its addition to acrylic denture base on C. albicans adhesion has not been investigated. The aim of this study was determine whether adding neem powder to acrylic denture base materials could reduce Candida albicansadhesion. One hundred and twenty acrylic resin denture specimens were fabricated and divided into heat-polymerized (n=60) and auto-polymerized (n=60) groups. Each group was further divided into 6 groups (n=10) based on the neem concentration: 0, 0.5, 1, 1.5, 2 and 2.5 wt% of the polymer. After polymerization, the specimens were polished, stored in distilled water, sonicated, sterilized, submerged in artificial saliva containing C. albicans, and finally, placed in an incubator at 37°C. Slide counting and direct culture methods were used to assess the antifungal effects of the neem addition. An analysis of variance and post hoc Tukey?s test were performed for the data analysis (p?0.05 was statistically significant). Based on the results, the neem addition significantly decreased the C. albicans count when compared to the control group (p?0.05). Moreover, the count decreased as the neem concentration increased (lowest count with 2.5 wt%). The results suggest that adding neem powder to acrylic resin denture base materials reduces the adhesion of C. albicans; therefore, the incorporation of neem could be a possible denture stomatitis prevention method