Risk factor assessment of digital eye strain during the COVID-19 pandemic: a cross-sectional survey

Background: Shifting to online learning during the coronavirus pandemic has increased the number of individuals symptomatic of digital eye strain (DES). This study aimed to determine the frequency and potential risk factors of DES among university staff members and students in this pandemic era. Methods: A cross-sectional online survey was conducted during the pandemic, in May and June 2020. The online questionnaire was designed to collect data on DES-related ocular and extraocular manifestations. The survey was sent via social media to the previous year’s students and staff within the Faculty of Medicine, Tanta University, Tanta, Egypt. The responses were downloaded and analyzed. Results: Of the 412 participants completing the questionnaire, 34 (8.3%) were university staff members with a mean (standard deviation [SD]) age of 36.7 (6.6) years, and 378 (91.7%) were university students with a mean (SD) age of 20.8 (1.8) years. Participants with DES symptoms numbered 294 (71.4%) before the lockdown, increasing to 366 (88.8%) during the last month, with 84 developing new-onset DES. Most participants reported ocular symptoms associated with DES. After the lockdown, both students and staff had a significant prolongation of nighttime digital screen use and TV watching, an increase in the 4-item Patient Health Questionnaire (PHQ-4) severity scale scores, and anxiety and depression, with a reduced duration of daytime reading (all P < 0.05). Students had a significant prolongation of daytime digital screen use and TV watching and an increase in the frequency of eye lubricant use and mean Perceived Stress Scale (PSS)-4 scores (all P < 0.05). Multiple logistic regression analysis revealed that studenthood and increased nighttime screen use were independent risk factors for DES by odds ratios (95% confidence intervals) of 10.60 (2.12 – 53.00) and 3.99 (1.71 – 9.34), respectively (both P < 0.05). Conclusions: Lockdown and closure of the university, with a shift to online learning, increased the exposure of staff and students to digital screens and the number of individuals with DES. Studenthood and prolonged nighttime digital screen use were independent risk factors for DES. Further studies investigating the prevalence and risk factors of DES, comparing similar data during and after the pandemic, may reveal other aspects of DES caused by virtual reality-based training

Study of DNA methyl transferase 3A mutation in acute myeloid leukemic patients

Background: Recent studies have shown that somatic mutations in DNA methyltransferase (DNMT3A) might affect the prognosis of AML.Objective: The aim of this work was to investigate the frequency and prognostic impact of the most frequent mutation of DNMT3A, R882H mutation in AML using simple and rapid molecular techniques.Patients and methods: We have used allele-specific blocker (ASB-PCR) and endonuclease restriction for the detection of DNMT3A R882H mutation in 56 adult patients with AML.Results: DNMT3A R882H mutation was detected in 7/56 (12.5%) of patients. R882H mutation positive patients were older compared to the wild-type AML (p = 0.08). No association was found with initial laboratory parameters including white blood cells (WBC), hemoglobin (HGB) and Bone marrow (BM) blasts (p > 0.05). Thirty-two patients (57.1%) achieved complete remission (CR), 11/56 (19.6%) died before day 28 induction death (ID) and 13/56 (23.2%) had resistant disease (RD). DNMT3A R882H positive patients were not different regarding the response to induction chemotherapy (CR) compared to the negative group (wild-type) (p > 0.05). Median follow-up period for all patients was 1.6 months, Overall survival (OS) was 65%, and the median was 9.89 months. OS of DNMT3A positive patients was not statistically significant compared to wild-type patients (p = 0.09). Disease free survival (DFS) was 54.6% for all patients, with no difference between wild and mutants (0.59) patients.Conclusion: DNMT3A R882H is a frequent mutation in adult de novo AML. The frequency of the mutation tends to increase with age. The two methods used in the study are easy to interpret and are recommended for rapid detection of the mutation required for risk stratification.Keywords: AML, DNMT3A, ASB-PCR, PCR-RFLP, Endonuclease restrictio

Effect of eyelid-warming device on meibomian gland dysfunction

Background Meibomian gland dysfunction (MGD) has a significant effect on patients’ quality of life. Despite the numerous treatment options, it is still difficult to obtain complete relief of signs and symptoms. Blephasteam is an eyelid-warming device that is easy to use and standardized for treatment of MGD. Objective This study aimed to evaluate of the effect of Blephasteam on MGD compared with the traditional warm compresses. Patients and methods This is a prospective comparative interventional study that included 40 eyes of 20 patients with MGD. Patients were subdivided into two groups: in group I, warm compresses were applied to the eyelids twice daily for 20–30 min for 2 weeks, whereas in group II, the patients used the Blephasteam device three sessions per week for 2 weeks. Both groups received treatment by systemic tetracycline, topical antibiotic and steroid, and preservative-free artificial tears eye drops for 2 weeks. The patients were assessed before treatment and after 2 weeks, 1 month, and 3 months using the Standard Patient Evaluation of dry Eye Disease questionnaire for dry eye, breakup time test (invasive and noninvasive; IBUT and NIBUT), and the shape of the lipid layer of the tear film by a tearscope. Results Both groups showed statistically significant improvement regarding the dry eye symptoms, IBUT and NIBUT, and the lipid layer interferometry. However, the follow-up visits showed statistically significant better results in group II than in group I for the Standard Patient Evaluation of dry Eye Disease questionnaire (P=0.044, 0.001, and 0.001, respectively). In addition, the IBUT was statistically significantly better in group II than in group I during the follow-up (P=0.014, 0.007, and 0.002, respectively) as well as the NIBUT (P=0.043, P<0.001, and P<0.001, respectively). There was no statistically significant difference in interferometry between the two groups during the follow-up. Conclusions Both traditional warm compress and Blephasteam were effective in MGD treatment, but Blephasteam was more effective

Regulatory B Cells and Their Cytokine Profile in HCV-Related Hepatocellular Carcinoma: Association with Regulatory T Cells and Disease Progression

Although regulatory B cells (Bregs) have been proven to play a suppressive role in autoimmune diseases, infections and different tumors, little is known regarding hepatocellular carcinoma (HCC), especially in hepatitis C-related settings. Herein, we analyzed the frequency of circulating Bregs, serum levels of IL-10, IL-35 and B-cell activating factor (BAFF) and investigated their association with regulatory T cells (Tregs) and disease progression in HCV-related HCC. For comparative purposes, four groups were enrolled; chronic HCV (CHC group, n = 35), HCV-related liver cirrhosis (HCV-LC group, n = 35), HCV-related HCC (HCV-HCC group, n = 60) and an apparently healthy control (Control-group, n = 20). HCC diagnosis and staging were in concordance with the Barcelona Clinic Liver Cancer (BCLC) staging system. Analysis of the percentage of Breg cells and peripheral lymphocyte subsets (Treg) was performed by flow cytometry. Serum cytokine levels of IL-10, IL-35 and B-cell activating factor (BAFF) were measured by ELISA. The frequency of Bregs was significantly higher in the HCV-HCC group compared to the other groups and controls. A significant increase was noted in late-HCC versus those in the early stages. The frequency of Bregs was positively correlated with Tregs, serum IL-10, IL-35 and BAFF. In conclusion, Peripheral Bregs were positively correlated with the frequency of Tregs, IL-10, IL-35 and BAFF, and may be associated with HCV-related HCC progression