Histopathological Changes of the Retina After Nd: YAG Laser Thrombolysis in Branch Retinal Vein Occlusion: An Experimental Study

Introduction: The efficacy of many therapeutics techniques for treatment of branch retinal vein occlusion (BRVO) has been the subject of many investigations. The aim of the present work is to evaluate the transluminal Nd: YAG laser thrombolysis as a new therapeutic approach used for treatment of BRVO in rabbits as an experimental model.Methods: Four rabbits were considered as a control (n=8 eyes); occlusion of the branch retinal veins was performed by using a dye enhancing thrombus formation in right eyes of 10 rabbits (n=10 eyes). Thrombi in the retinal veins were induced by intravenous injection of rose bengal solution as a photosensitizer immediately before the argon laser application with a power of 1200 mW, a spot size of 100 μm, and a duration of 20 ms. One week later, transluminal Nd: YAG laser thrombolysis (30 mJ, 3 pulses/4 ns) was employed to the site of occluded veins, until the thrombi were partially or completely shattered. The rabbits were followed up after 4 days, 1 week and 2 weeks for slit lamp fundus examination and the treated retinas were isolated for histopathological examination.Results: Argon laser photothrombosis induced complete BRVO with some vitreous hemorrhage, destruction, and necrosis in the surrounding retinal layers. Moreover, one week later, Nd: YAG laser thrombolysis showed complete venous flow, minimal vitreous hemorrhage, reperfused retina, complete veins improvement. Follow up after 2 weeks revealed more improvement of all retinal layers.Conclusion: Treatment with transluminal Nd: YAG laser thrombolysis represented a novel therapeutic modality in BRVO

Histopathology of Corneal Lenticules Obtained from Small Incision Lenticule Extraction (SMILE) versus Microkeratome Excision

Purpose: To study the alterations on the lenticules extracted after femtosecond (Femto) small incision lenticule extraction (SMILE) versus the corneal free cap removed using a microkeratome. Methods: The visuMax (500 kHz; laser energy: 180 nJ) was used for small-incision lenticule extraction. Free caps from human cadaveric corneas were excised by microkeratome. The collected lenticules were examined with the light and transmission electron microscope (TEM) for histological analysis, DNA fragmentation was assessed by agarose gel electrophoresis, DNA damage was evaluated using comet assay, and corneal proteins secondary structure was assessed by Fourier transform infrared spectroscopy (FTIR). Results: Light microscopic examination showed the presence of more edematous stroma under Femto SMILE than under free cap with a percentage change of 101.6%. In the Femto SMILE group, TEM examination showed pyknotic keratocytes, disruption, and cavitation of the collagen arrays stromal area under Femto SMILE. The DNA fragmentation for the Femto SMILE group revealed one undefined band with a size of 1.1 Kbp. The comet assay analysis indicated the presence of 3% and 8.0% tailed cells for the free cap and Femto SMILE groups, respectively. The tail lengths were 1.33 ± 0.16 and 1.67 ± 0.13 μm (P < 0.01), the percentage of tail DNA was 1.41 ± 0.18% (P < 0.01) and 1.72 ± 0.15%, and the tail moments were 1.88 ± 0.12 AU and 2.87 ± 0.14 AU (P < 0.001) for the free cap and Femto SMILE groups, respectively. FTIR spectroscopy of the Femto smile group revealed disorders in the secondary and tertiary structure of the proteins. Conclusion: Femto SMILE technique induced more structural changes, DNA fragmentation, DNA damage, and corneal proteins secondary structure alteration than those induced by a microkeratome cutting. These changes may be attributed to the deep penetration of high energy levels to the corneal layer. These findings may highlight the potential impact of the Femto SMILE on the cornea and the necessity for managing the laser parameters used

Menopause Anxiety and Depression; How Food Can Help?

BACKGROUND: Anxiety and depression are reported as two major frequent and chief complaints among peri-menopausal women in several societies. AIM: The objective of the study was to study the effect of using two dietary supplements to beat depression and anxiety associated with menopause. SUBJECTS AND METHODS: Sixty-six volunteers’ menopausal women participated on the study for 8 weeks, 35 subjects consumed daily cookies prepared mainly from soya flour and flaxseed, and 31 females consumed daily a blend composed mainly of raw unroasted peanut and raw sesame. Follow-up was performed with menopause rating scale, anxiety score, depression score, and biochemical parameters. RESULTS: Soya cookies were rich in plant-based protein and total phenols while blend was a good source of unsaturated fatty acid. Blend consumers showed significant percentage reduction in beck anxiety score and beck depression score after intervention, more than cookies consumers group. The anthropometrics parameters were statistical significant changed on both groups, more on the group who consumed the soya cookies. Soya cookies demonstrated an anti-inflammatory effect, while blend had an antioxidant and anti-inflammatory effects as was shown on the serum assay of interleukin-6 and malondialdehyde as an inflammatory marker and an antioxidant marker, respectively. CONCLUSION: From the results, it can be concluded that the supplementation of products enriched with unsaturated fatty acid was more beneficial to slow down the psychological menopause symptoms than natural estrogen rich product consumption

The Effect of Anterior Stromal Puncture Using Q-Switched Nd:YAG Laser on Corneal Wound Healing

Introduction: Recurrent corneal erosion occurs when the wounded corneal epithelium failed to adhere to the underlying stroma. Therefore, this work aimed to assess the effect of treatment of corneal injury using Q- switched Nd:YAG laser.  Method: Twenty one New Zealand male rabbits weighing 2-2.5 kg and 3 months old were classified into three main groups. The control group: did not received any treatment (n=3 rabbits). The rest of the animals (n= 18 rabbits), corneal epithelium was injured by syringe needle and blade 15 and divided into:(A) Normal healing group: which was divided into three subgroups (n=3 rabbits each), and the animals were left for normal healing for1 day, 1 week, and 4 weeks respectively, (B) Laser treated group: divided into three subgroups (n=3 rabbits each) and subjected to anterior stromal puncture using Q-switched Nd: YAG laser on corneal sub-epithelium or superficial stroma, and the animals were left for 1 day, 1 week, and 4 weeks respectively. After the demonstrated periods, the corneas were isolated for estimation of total protein content, sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE), total antioxidative capacity (TAC), total oxidative capacity (TOC) and oxidative stress index (OSI).Results: The present results of corneal total protein showed increment in the percentage change in normal healed groups after 1 day, 1 week and 4 weeks by values of 93%, 68% and 39%. In Q-switched Nd: YAG laser treated group the results showed better improvement in corneal protein than normal healed group with percentage changes of 58%, 29%, and 7.5% respectively. In SDS- PAGE, a protein band at 110 KD appeared in the migrating epithelium for both normal healed group and Q-switched Nd:YAG laser treated group with changes in the peaks intensities at middle and  low molecular weight regions. Moreover, after 4 weeks the peak at 110 KD disappeared in the wounded epithelium treated with Q-switched Nd:YAG. After four weeks, the OSI in laser treated corneas showed pronounced balance between antioxidative capacity and oxidative capacity.Conclusion: Anterior stromal puncture by Q-switched Nd:YAG laser is an effective, simple, safe and promising procedure to treat recurrent corneal erosion than normal healing

Effects of Tree Shelters on the Survival and Growth of Argania spinosa

The argan tree is endemic species of Morocco. It occupies an area of more than 8700 km2 and plays essential ecological and economical roles. In spite of their value, the argan woodlands are subject to rapid and uncontrolled degradation during the last decades, mainly due to overgrazing and systematic collection of argan nuts. The present study was carried out to investigate the effects of two types of tree shelters on survival and growth of Argania spinosa seedlings planted in the southwest of Morocco in order to improve the results of reforestation programs which usually end by repeated failures. The experiment was conducted in the Mesguina forest for two growing seasons after transplantation in the field. After two years, the use of tree shelters significantly increased tree survival and allowed a gain of 20%. Height growth was positively affected by tree shelters. The use of tree shelters showed no significant decrease in basal diameter. In contrast, the height to diameter ratios of sheltered trees were much higher compared to the control. Thus, the use of the tree shelters could aid the early establishment and growth of Argania spinosa under conditions similar to those of the experiment

Obesity Related Metabolic Disorders and Risk of Renal Disease: Impact of Hypocaloric Diet and Avena Sativa Supplement

BACKGROUND: The recognition of the complications of obesity in various organs and systems should make clinicians and dietitians aware of the importance of early strategies to fight obesity in all age groups.AIM: The objective of this study was to evaluate the early effect of using Avena sativa (oat) flour supplement compared to a hypocaloric diet in the management of obesity-related metabolic disorders.MATERIAL AND METHODS: Snack was prepared from wholemeal wheat flour (100% extraction) and oat flour. Chemical analysis of the raw materials and the formulae was carried out. 106 obese women with their mean body mass index were 37.73 ± 0.56 kg/m² volunteered for 8 weeks period. They were divided into two groups; group (A), consumed hypocaloric diet supplemented by the prepared snack, while group (B) subjects followed the low caloric balanced diet. All patients were monitored clinically, anthropometrically, dietary 24 h recall and biochemically.RESULT: Data demonstrated significantly decreased in the mean levels of the anthropometric parameters. Group (A) showed a higher decrease in the waist circumference, WHR, body fat% and SBP; while in group (B) weight, BMI, chest circumference and DBP were the most affected parameters. The reduction in the biochemical parameters was higher in the group (A). At the baseline, high values of cystatin-C were found in both groups which may indicate early renal injury. At the end of the study, a significant reduction of the cystatin concentration was observed among both groups (-24.54 & -12.23%).CONCLUSION: The healthy effect of the dietary oat supplement on the reduction of central obesity, percentage body fat and different metabolic disorders criteria was confirmed than with hypocaloric diet

Serum Ceramide Kinase as a Biomarker of Cognitive Functions, and the Effect of Using Two Slimming Dietary Therapies in Obese Middle Aged Females

AIM: Highlighting the impact of obesity on mental and cognitive functions using serum ceramide kinase enzyme concentration as a biomarker for cognitive evaluation in the middle aged females, and also targeting to control the obesity and simultaneously postponing the deterioration of the cognitive functions, by implementing two slimming dietary therapies each incorporating different functional ingredients known to boost cognition.SUBJECTS AND METHODS: Ninety six obese middle aged females, divided into two groups volunteered to follow a low caloric balanced diet combined with two bread supplements composed essentially of barley flour and wheat germ mixed with either 5% turmeric, group (A); or with 5% ginger, group (B) for 4 weeks, phase (1); to be followed by the hypocaloric diet alone for another 4 weeks, phase (2).RESULTS: By the end of phase (1), the biochemical analysis showed a positive response of the levels of C-peptide and modified homeostatic model assessment of insulin resistance; also increased levels of the serum ceramide kinase enzyme, coupled with improved cognitive functions tests. Improvement of the relevant metabolic profile, fasting blood glucose, blood pressure and the anthropometric measurements was detected.CONCLUSION: Using dietary therapy supported by special formulas which contain active ingredients succeeded in reducing weight and improving both the metabolic profile and the cognitive functions

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Outbreak of H3N2 influenza at a US military base in Djibouti during the H1N1 pandemic of 2009.

PMC3855413BACKGROUND: Influenza pandemics have significant operational impact on deployed military personnel working in areas throughout the world. The US Department of Defense global influenza-like illness (ILI) surveillance network serves an important role in establishing baseline trends and can be leveraged to respond to outbreaks of respiratory illness. OBJECTIVE: We identified and characterized an operationally unique outbreak of H3N2 influenza at Camp Lemonnier, Djibouti occurring simultaneously with the H1N1 pandemic of 2009 [A(H1N1)pdm09]. METHODS: Enhanced surveillance for ILI was conducted at Camp Lemonnier in response to local reports of a possible outbreak during the A(H1N1)pdm09 pandemic. Samples were collected from consenting patients presenting with ILI (utilizing a modified case definition) and who completed a case report form. Samples were cultured and analyzed using standard real-time reverse transcriptase PCR (rt-RT-PCR) methodology and sequenced genetic material was phylogenetically compared to other published strains. RESULTS: rt-RT-PCR and DNA sequencing revealed that 25 (78%) of the 32 clinical samples collected were seasonal H3N2 and only 2 (6%) were A(H1N1)pdm09 influenza. The highest incidence of H3N2 occurred during the month of May and 80% of these were active duty military personnel. Phylogenetic analysis revealed that sequenced H3N2 strains were genetically similar to 2009 strains from the United States of America, Australia, and South east Asia. CONCLUSIONS: This outbreak highlights challenges in the investigation of influenza among deployed military populations and corroborates the public health importance of maintaining surveillance systems for ILI that can be enhanced locally when needed.JH Libraries Open Access Fun

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication