Efficacy of Topical Azithromycin versus Systemic Doxycycline in Treatment of Meibomian Gland Dysfunction

Background. Ocular surface disease (OSD) is a multifactorial and highly frequent problem. Inadequate or unstable tear film is the main cause, which leads to visual impairments. One of the primary causes of OSD is meibomian gland dysfunction (MGD), with a prevalence of 3.5 to 70%. The aim of this work was to compare the efficacy of azithromycin topical eye drops versus oral doxycycline in MGD individuals. Methods. This prospective comparative cohort research was carried out on 56 patients of both sexes of any age with symptomatic MGD. Randomly, patients were classified into two equal groups: Group 1 was treated twice daily for 4 weeks with topical azithromycin 1% eye drops, while group 2 received oral doxycycline 100 mg capsules twice daily for 4 weeks. Results. In the 1st follow-up, there was a significant difference between the studied groups in pain and discomfort degree (P value = 0.024) as group 1 showed a higher number of patients with a mild pain degree (P value = 0.013) while group 2 showed a higher number of patients with a severe pain degree (P value = 0.022). There was an insignificant difference between the studied groups in moderate pain degree and lid margin telangiectasia. Conjunctivitis, frothy discharge, and meniscus floaters were significantly higher in group 2 than in group 1 (P value = 0.013, 0.028, and 0.031, respectively). In group 1, the break-up time test was significantly higher than in group 2 (P value = 0.023). In the 2nd follow up, in group 2 only meniscus floaters were significantly higher than in group 1 (P value = 0.044), while in group 1 break-up time test was significantly higher than in group 2 (P value = 0.029). Otherwise, there is no significant difference between both the groups. Conclusions. Meibomian gland dysfunction (MGD) could be treated effectively with oral doxycycline and topical azithromycin by improving symptoms, clinical signs, and stabilization of tear film. Moreover, the topical azithromycin group seemed to be superior over the oral doxycycline group in improving the quality of tear film in the short term, having fewer side effects, more compliance, and better tolerability

Pyridoxine supplementation during oocyte maturation improves the development and quality of bovine preimplantation embryos

Recently, inhibition of cathepsin B (CTSB) activity during in vitro maturation (IVM) and culture (NC) improved the developmental competence and quality of bovine oocytes and embryos. E-64 is a widely used inhibitor to inhibit CTSB activity, however, E-64 inhibits not only CTSB activity but also the activities of other proteases including cathepsin L (CTSL), papain, calpain, and trypsin. Pyridoxine, the catalytically active form of vitamin B6, plays a crucial role in several cellular processes and has the ability to inhibit CTSB activity. However, whether pyridoxine has an improving effect during IVM of bovine oocytes is still unknown. In this study, we investigated the effect of pyridoxine supplementation during IVM on the developmental competence of bovine oocytes and the quality of the produced blastocysts. Supplementation of pyridoxine to the maturation medium significantly decreased the activity of CTSB in both bovine cumulus cells and oocytes. Moreover, pyridoxine improved both the blastocyst and hatched blastocyst rates. In addition, the presence of pyridoxine during IVM also significantly improved the quality of the produced embryos by increasing the total cell number as well as decreasing the CTSB mRNA expression and apoptotic rate. These results indicate that pyridoxine is a promising tool to improve the developmental competence of bovine oocytes and subsequent embryo quality

Efficacy of subtenon steroid injection alone or in combination with topical steroid in the management of trematode-induced anterior granulomatous uveitis

Background Presumed trematode-induced uveitis is a newly recognized cause of intraocular granulomatous inflammation in children, usually presenting with single or multiple pearl-like white nodules in the anterior chamber (AC) with or without subconjunctival lesions or corneal opacities. Objective The aim of this study was to evaluate the efficacy of subtenon steroid injection alone or in combination with topical steroid in the management of trematode-induced anterior granulomatous uveitis. Patients and methods This is a prospective comparative study, that included the children who presented with AC granulomas at the Uveitis Unit at Tanta Ophthalmology Hospital, Tanta, Egypt. The patients were divided into two groups: Group A, who received subtenon steroid injection only, and Group B, who received both subtenon steroid injection and topical steroid eye drops. The basic demographic data, visual acuity (VA), granuloma site and size, and AC activity (cells and flare) were recorded and analyzed. A systemic work-up, including stool and urine analysis, full blood count, chest X-ray, and schistosomiasis titer, was performed. The patients were followed up on the first day, at 2 weeks, 1, and 3 months Results The study included 30 eyes of 30 patients. The mean age of the patients was 13.4±2.42 years, and 87% of the patients were males. Group B patients demonstrated statistically significant better improvement in VA, AC activity, and granuloma site and size compared to Group A patients (P<0.001). The granuloma in group A did not change in size and continued to exhibit AC activity. Conclusion The combination of subtenon and topical steroid was found to be more effective in the treatment of granuloma than the subtenon injection alone

Epidemiology of Hepatocellular Carcinoma in Fayoum Governorate-EgyptEpidemiology of Hepatocellular Carcinoma in Fayoum Governorate-Egypt

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death worldwide, and the burden is expected to increase in coming years. HCC has become the second most prevalent cancer among men in Egypt. This study aimed to estimate the prevalence; identify the risk factors and detect clinical features of HCC in Fayoum governorate. The study was a descriptive cross-sectional study with a convenient sample conducted at Tropical &amp; Hepatology Medicine Department in Fayoum University Teaching Hospital. An interview structured questionnaire was used; thorough clinical examination with biochemical and serological investigation. The majority of cases came from rural area, farmers constituted 39.3% of cases. More than 90% of cases suffering from hepatic cirrhosis and more than half of cases having Bilhariziasis. Hepatitis C was the main aetiology 79.8%, followed by hepatitis B 15.4%. Most of focal lesions were in right lobe 57.1% and in the form of single lesion 57.1%. AFP was found to be a weak diagnostic predictor with low sensitivity. HCC was multifactorial pathogenesis with many risk factors (cirrhosis, HCV and schistosomiasis). HBV infection has a declining role in hepatocarcinogenesis. Proper surveillance program is needed for early detection and diagnosis of HC

Lycopene Reduces the In Vitro Aging Phenotypes of Mouse Oocytes by Improving Their Oxidative Status

Postovulatory aging is a major problem that limits the success of many assisted reproductive technologies (ARTs). Oxidative stress is a leading cause of oocyte aging. This study investigated the effects of lycopene supplementation of in vitro maturation (IVM) medium during the aging of mouse oocytes on the oocytes’ morphology and oxidative stress status. Mouse cumulus-oocyte complexes (COCs) were collected and cultured in the IVM medium either for 17 h, (freshly matured oocytes), or for 48 h, (in vitro-aged oocytes), with or without lycopene. The rate of fragmented and degenerated oocytes and the oocyte levels of hydrogen peroxide (H2O2), malondialdehyde (MDA), total antioxidant capacity (TAC), reduced glutathione (GSH), catalase (CAT), and superoxide dismutase (SOD) were estimated and compared. Oocytes aged with 200 nM lycopene revealed significantly less fragmentation and degeneration, lower H2O2 and MDA levels, and higher TAC, GSH and SOD levels than those aged without lycopene. CAT levels were unchanged by lycopene treatment. Taken together, our data showed beneficial effects of lycopene during in vitro aging of mouse oocytes by reducing the oxidative stress damages that lead to their apoptosis. The present study introduces lycopene as a natural supplement to reduce the postovulatory aging-dependent abnormalities of mammalian oocytes

Whole-food phytochemicals antioxidative potential in alloxan-diabetic rats

Background: The importance of whole-food antioxidants in terms of promoting antioxidant recycling in the body in complex human diseases is not fully understood. We aim to discuss the benefits of whole-food antioxidants in ameliorating the diabetic complications in vivo and to address the effect of germination versus heat processing or drying on the potential therapeutic effect of whole grains and legumes. We studied the antioxidant status of alloxan-diabetic (AD) male Spargue Dawley rats, injected intraperitoneally with alloxan dose of 150 mg/kg body weight, and fed on experimental diets based on the flour of soybean, broadbean and whole-wheat for five weeks. Results: Diabetes-induced oxidative stress in liver was manifested by significant increase in hepatic malondialdehyde (MDA), erythrocytes superoxide dismutase (eSOD) and plasma alpha-tocopherol (α-T) levels, reduction in hepatic glutathione (GSH) levels and catalase (CAT) activity. Consumption of soybean and whole-wheat both had beneficial effects on the oxidative status of AD rats more than broadbean. Feeding dried wheat was effective in improving MDA, GSH and α-T levels. Soybeans and wheat lowered triacylglycerols (TAGs) and tended to lower total cholesterol. Germination enhanced the effect of soybeans on TAGs and in the case of soy and wheat enhanced the effect on total cholesterol. Conclusion: Whole foods containing naturally occurring phytochemicals and antioxidant vitamins such as legumes and whole grains are recommended, alongside medication, for controlling hyperglycaemia, blood lipids and oxidative status in diabetes. Keywords: Isoflavones, Lignans, Germination, Reactive oxygen species, Alloxan, Rat

Risk of hepatitis B virus reactivation with direct-acting antivirals against hepatitis C virus: A cohort study from Egypt and meta-analysis of published data

International audienceBackground & aims: Hepatitis B virus (HBV) reactivation in chronic hepatitis C (CHC) patients treated with direct-acting antivirals (DAAs) became an issue. However, its frequency has been poorly estimated, because of the varying definitions used and evaluation of heterogeneous study populations, including those concurrently treated for HBV.Methods: We prospectively followed HBV surface antigen (HBsAg)-positive Egyptians undergoing interferon-free DAAs, to estimate the risk of HBV reactivation and HBV-related hepatitis. We also conducted a meta-analysis to estimate the reactivation risk using published data obtained from a systematic review of PubMed/Embase, in addition to our Egyptian data. We applied a standard definition of HBV reactivation proposed by the international liver associations (APASL and AASLD).Results: Of 4471 CHC patients, 35 HBsAg-positive patients started interferon-free DAAs without HBV nucleos(t)ide analogues in our Egyptian cohort. Ten experienced HBV reactivation (28.6%), of whom 1 developed hepatitis (10.0%). Our systematic review identified 18 papers. The pooled reactivation risk in HBsAg-positive patients was 18.2% (95% CI: 7.9%-30.7%) without HBV therapy and 0.0% (95% CI: 0.0%-0.0%) with HBV nucleos(t)ide analogue. The pooled risk of hepatitis in those with HBV reactivation was 12.6% (95% CI: 0.0%-34.7%). The pooled reactivation risk in HBsAg-negative, antibody to HBV core antigen-positive (anti-HBc-positive) patients was negligible (0.1%, 95% CI: 0.0%-0.3%), irrespective of the presence of antibody to HBsAg (anti-HBs).Conclusions: We confirmed high HBV reactivation risk in HBsAg-positive patients undergoing DAAs, with only a minority developing clinically important hepatitis. The risk is negligible for HBsAg-negative anti-HBc-positive patients