Primary versus secondary intraocular lens implantation in the management of congenital cataract

Aim This study aimed to compare the efficacy of primary intraocular lens (IOL) implantation following removal of congenital cataract in patients with aphakia younger than 2 years of age, followed by secondary implantation after the age of 2 years. Patients and methods This was a comparative prospective study that included patients with congenital cataract (28 eyes) who underwent lensectomy and anterior vitrectomy in the first year of life; 14 eyes were subjected to primary IOL implantation. Fourteen eyes with left aphakia were subjected to visual rehabilitation until the age of 2 years. Secondary implantation was performed and the two groups were followed for 2 years after implantation by a full ophthalmological examination. Results Postoperative significant uveitis occurred in 14.2% of patients in group A and 35.7% of patients in group B; the difference between the two groups was statistically insignificant. Fixation was good in 71% of patients in group A and in 57% of patients in group B; this difference was nonsignificant. Increasing intraocular pressure was noted in four cases in group B that was statistically significant and the diagnosis of glaucoma was confirmed and managed, whereas in group A, none of the cases had an intraocular pressure higher than 18 mmHg. Conclusion Primary IOL implantation was found to be safe and effective in the management of congenital cataract; it leads to lower incidence of complications and better visual outcomes compared with aphakia and secondary IOL implantation

Ultrasound guided versus fluroscopic guided pulsed radiofrequency therapy of the stellate ganglion in neuropathic pain: A prospective controlled comparative study

Objective: To assess the efficacy and safety of fluoroscopic–guided versus ultrasound (US)-guided techniques for pulsed radiofrequency (RF) therapy of stellate ganglion for refractory neuropathic pain syndromes. Methods: 40 patients with severe chronic neuropathic pain syndromes, Visual Analogue Scale (VAS) score > 7, with poor response to medical treatment were randomly integrated into 2 groups: Group (F): (20 patients) in whom pulsed R.F. therapy is done under fluoroscopy, group (U): (20 patients) in whom pulsed R.F. therapy is done under US guidance. Results: The current study revealed that there is significant reduction of VAS, and of the medical treatment consumption after the block as compared with pre block values, there is no statistically significant difference between the guidance techniques of RF treatment in pain relief. However, the procedure time was significantly lower in U group. Conclusion: Pulsed R.F. blockade of the stellate ganglion in patients with refractory neuropathic pain syndromes can be done safely and efficiently under the guidance of either ultrasound or fluoroscopy. Both radiological techniques provide similar satisfactory guidance without significant complications. Keywords: Stellate ganglion block (SGB), Neuropathic pain, Pulsed R

Plasma chitotriosidase and carotid intima-media thickness in children with sickle cell disease

The relationship between chronic hemolysis with subsequent iron overload, inflammation, and premature atherosclerosis has been documented in hemolytic anemias, particularly β-thalassemia. However, no such relationship has been established in sickle cell disease (SCD). We sought to evaluate SCD as a risk factor for early vascular insult by measuring carotid intima-media thickness (CIMT) and plasma chitotriosidase and to assess the role of the latter as a potential quantitative indicator of vascular inflammation and atherogenesis. Thirty SCD pediatric patients (3-18 years) and 30 matched controls were enrolled. Full clinical history, with hematological and biochemical parameters, was evaluated. CIMT and chitotriosidase activity were also assessed for all study participants. CIMT values were significantly higher in SCD patients (median 0.42; range 0.32-0.6 mm) compared to controls (0.36; 0.34-0.45 mm), P = 0.03. CIMT correlated positively with age (r = 0.460, P = 0.011), and total number of vascular incidents necessitating hospital admission (r = 0.439, P = 0.015). Similarly, chitotriosidase activity was significantly higher among SCD patients (median 59.6; range 7.3-512 nmol/ml plasma/h) compared to controls (32.7; 6.8-63.1 nmol/ml plasma/h), P < 0.001, and showed a positive correlation with serum ferritin (r = 0.517, P = 0.003) and CIMT (r = 0.535, P = 0.002). SCD children are at risk of developing premature atherogenic changes. Plasma chitotriosidase and CIMT may represent useful predictors of these changes.status: publishe

Molecular Typing of Virulence and Antimicrobial Resistance Genes with Mutation Tracking of gyrA Gene of Fluoroquinolone-Resistant Strains of Campylobacter Isolated from Broiler Chickens

 Campylobacter is the most common bacterial cause of gastroenteritis globally. A total of 182 fully identified strains of Campylobacter species (42 C. coli and 140 C. jejuni) collected from 6 broiler farms were subjected to studying the antimicrobial resistance pattern and molecular typing of virulence (cadF, ctdA, dnaJ waaC,iam, and fla) and antimicrobial resistance genes (blaOXA-61, gyrA, tetA, tetO, and IR) with sequencing of gyrA region of one strain of fluroquinolones resistant C. coli and C. jejuni. The identified isolates were highly resistant to erythromycin and sulfamethoxazole-trimethoprim. Furthermore, both meropenem and imipenem were effective against the recovered isolates. The tested C. jejuni and C. coli strains had 100%, 83.3%, and 83.3% prevalence of cadF, ctdA, and dnaJ virulence genes, respectively, while waaC, iam, and fla genes couldn’t be detected. The blaOXA-61 resistance gene was found in all of the Campylobacter spp. examined. Furthermore, gyrA, tetA, tetO, and IR resistance genes were found in 100%, 83.3%, 83.3%, and 66.7% of the retrieved C. jejuni strains, respectively.  Likewise, resistance genes were found in 83.3%, 83.3%, 83.3%, and 66.7% of the retrieved C. coli strains, respectively. Approximately 58% (7/12) of the Campylobacter spp. recovered were MDR. Furthermore, 50% (3/6) of the C. jejuni strains recovered were MDR, while 66.7% (4/6) of the C. coli isolates recovered were MDR with MARI(0.22-0.55). For detection of mutations of the gyrA gene, the sequence data of two isolates (C. jejuni and C.coli) were analyzed against the reference sequence on the gene bank where the C. jejuni strain had six mutations, while the C. coli strain had twenty-three. The current findings suggest that MDR Campylobacter strains in poultry may be able to transmit highly virulent Campylobacter as a foodborne pathogen

Molecular Typing of Virulence and Antimicrobial Resistance Genes with Mutation Tracking of gyrA Gene of Fluoroquinolone-Resistant Strains of Campylobacter Isolated from Broiler Chickens

 Campylobacter is the most common bacterial cause of gastroenteritis globally. A total of 182 fully identified strains of Campylobacter species (42 C. coli and 140 C. jejuni) collected from 6 broiler farms were subjected to studying the antimicrobial resistance pattern and molecular typing of virulence (cadF, ctdA, dnaJ waaC,iam, and fla) and antimicrobial resistance genes (blaOXA-61, gyrA, tetA, tetO, and IR) with sequencing of gyrA region of one strain of fluroquinolones resistant C. coli and C. jejuni. The identified isolates were highly resistant to erythromycin and sulfamethoxazole-trimethoprim. Furthermore, both meropenem and imipenem were effective against the recovered isolates. The tested C. jejuni and C. coli strains had 100%, 83.3%, and 83.3% prevalence of cadF, ctdA, and dnaJ virulence genes, respectively, while waaC, iam, and fla genes couldn’t be detected. The blaOXA-61 resistance gene was found in all of the Campylobacter spp. examined. Furthermore, gyrA, tetA, tetO, and IR resistance genes were found in 100%, 83.3%, 83.3%, and 66.7% of the retrieved C. jejuni strains, respectively.  Likewise, resistance genes were found in 83.3%, 83.3%, 83.3%, and 66.7% of the retrieved C. coli strains, respectively. Approximately 58% (7/12) of the Campylobacter spp. recovered were MDR. Furthermore, 50% (3/6) of the C. jejuni strains recovered were MDR, while 66.7% (4/6) of the C. coli isolates recovered were MDR with MARI(0.22-0.55). For detection of mutations of the gyrA gene, the sequence data of two isolates (C. jejuni and C.coli) were analyzed against the reference sequence on the gene bank where the C. jejuni strain had six mutations, while the C. coli strain had twenty-three. The current findings suggest that MDR Campylobacter strains in poultry may be able to transmit highly virulent Campylobacter as a foodborne pathogen