Manual small incision cataract surgery in dense cataract: Morocco comparative study

BACKGROUND: The purpose of this study was to compare manual small incision cataract surgery (MSICS) with phacoemulsification and manual extracapsular extraction in terms of corneal edema, endothelial loss, and induced astigmatism. MATERIAL AND METHODS: A prospective study carried out in the ophthalmology department of the military hospital of Rabat in Morocco, including 15 eyes of 15 patients with brown cataracts. All patients were operated on by the same surgeon: 5 by phacoemulsification (PKE), 5 by manual extracapsular extraction (EEC) via corneal incision, and 5 by MSICS via tunneled sclero-corneal incision. Each patient underwent pre-, intra- and post-operative evaluation including: 1 — measurement of astigmatism before surgery and 3 months after (after removal of EEC threads); 2 — specular microscopy before and 3 months after surgery; 3 — clinical assessment of corneal edema before and at each follow-up: 1st and 7th day, 1st and 3rd month; 4 — evaluation of operating time. RESULTS: 9 men and 6 women were included. Mean age was 67 years. The mean axial length was 22.98mm. All surgeries were uneventful, and all patients were implanted in the capsular bag with a monofocal implant. Initial endothelial cell count was comparable in the 3 groups (p = 0.48). The endothelial loss was most significant in the PKE group (16%), followed by the EEC group (5.1%) and then the MSICS group (4.5%) (p < 0.01). The change in corneal astigmatism was most significant in the EEC group (2.1D), followed by the MSICS group (0.88 D), then the PKE group (0.65 D) (p = 0.01). In the PKE group, all patients showed moderate to severe corneal edema at 1st postoperative, and in 2 cases, the edema persisted at the 7th day and then regressed at the 1st and 3rd month. Only 2 cases of moderate edema at day 1 in the EEC group, and 1 case in the MSICS group, regressed at the 7th day. Phacoemulsification was the least time-consuming, with an average operating time of 13 minutes, compared with 28 minutes for MSICS and 34 minutes for EEC (p < 0.01). CONCLUSION: MSICS is a technique that resembles manual EEC, with a self-sealing tunneled scleral-corneal incision that avoids a full-thickness corneal incision and, consequently, sutures at the end of the procedure. It requires a learning curve. Our results concur with most of the data in the literature. MSICS is a safe technique, but it remains little used in cataract surgery. We believe that it should be preferred in patients with dense cataracts

Céphalée : faut-il demander une imagerie ?

La céphalée est un motif fréquent de consultation. Elle est primaire dans la majorité des cas et ne nécessite aucune exploration radiologique, et moins fréquemment secondaire en rapport des étiologies très variées. Dans cet article, à travers trois observations cliniques, les auteurs mettent le point sur les indications de l’imagerie devant les céphalées, ceci afin d’éviter les retards du diagnostic des céphalées secondaires pouvant aboutir à des séquelles parfois irréversibles notamment ophtalmologiques

Basal cell carcinoma of the medial canthus: resection and reconstruction by glabellar flap

The inner canthus is the site of aggressive basal cell carcinomas. The management of these tumors requires knowledge of the basic principles of reconstruction in reconstructive surgery. Surgical resection with exhaustive control of the excision margins should be performed. Even when the tumor is small, the need for healthy margins often results in a moderate to a large palpebral defect that cannot be repaired with direct sutures. The goal of reconstruction is to achieve a mobile eyelid, good corneal protection, and a good aesthetic result with acceptable donor site sequelae. In this manuscript, we describe a case of basal cell carcinoma of the medial canthus that underwent resection followed by reconstruction with a glabellar flap

Facial palsy and diplopia revealing idiopathic intracranial hypertension in a child

Idiopathic intracranial hypertension is rare in the pediatric population. It’s characterized by increased intracranial pressure in the absence of any evident underlying neurologic disease. Abducens nerve palsy is the most common cranial nerve deficit related to that condition. The association of sixth and seventh cranial nerve damage is uncommon. In this report, we describe the case of an 8-year-old girl who presented with headache, diplopia and peripheral facial palsy related to idiopathic intracranial hypertensio

A giant dermoid cyst of the orbit present in adulthood — a case report

Dermoid cysts are common orbital developmental tumors in childhood. They account for 3 to 9% of primary orbital tumors. They are considered to be congenital, but not all of them are diagnosed at birth. Dermoid cysts are benign choristomas that arise from sequestration of ectoderm along the lines of embryonic fusion of mesodermal processes destined to be bone. In most cases, the lesion is close to the zygomatic-frontal suture leading to a superotemporal subcutaneous mass in the eyebrow or eyelid. The intraorbital location is relatively rare and more prone to complications, particularly compressive. We report the case of a 41-year-old man with a large intraorbital tumor. The imaging aspects were evocative of an extraconal dermoid cyst. The tumor was resected through a transconjunctival route. Histopathologic examination confirmed the diagnosis of dermoid cyst

Hémangiome géant de la surrénale : à propos d’un cas avec revue de la littérature

La glande surrénale est une localisation extrêmement rare de l’hémangiome, uniquement une cinquantaine de cas ont été rapportés dans la littérature. Nous rapportons une observation d’hémangiome surrénalien géant, colligée dans le service de chirurgie viscérale de l’hôpital militaire d’instruction Mohammed V, chez une patiente de 73 ans qui présentait un syndrome de masse abdominale. Le traitement a été une exérèse chirurgicale de la tumeur par laparotomie médiane. L’évolution a été simple avec un recul d’une année. La revue de la littérature nous a permis de retenir les éléments suivants : - La latence clinique de l’hémangiome surrénalien, rendant sa découverte essentiellement fortuite - Le diagnostic est très difficile, malgré les moyens d’imagerie modernes notamment l’IRM, qui ne permet d’évoquer le diagnostic qu’en cas de signes radiologiques typiques, qui ne sont pas toujours présents. - Le traitement repose sur la résection chirurgicale de préférence par laparoscopie si la taille tumorale le permet, et si un plateau technique et une équipe chirurgicale expérimentée sont disponibles. - Le diagnostic définitif est apporté par l’examen anatomopathologique de la pièce de résection opératoire. - L’évolution spontanée se fait vers l’augmentation du volume tumoral, l’effet de masse, et la rupture. L’évolution postoperative est favorable

Effect of the Chemical Unhairing Process on Pulled Wool Characteristics

Textile research is being driven to find sustainable materials as an alternative to raw fibers. In fact, reusing fibrous waste, as a byproduct, is one of the most important environmental challenges that confront the world. This research focused on studying pulled wool fibers as a natural fiber to reduce environmental loading. There are large amounts of residual pulled wool fibers that can be recycled and valorised. Therefore, raw and pulled wool fibers were characterized and compared. Scanning Electron Micrographs (SEM) results show that on the pulled wool fiber, the surface became rougher and the scales appear affected and less dense. Based on the X-ray diffraction (XRD) results, the crystallinity of the pulled fiber decreased lightly. Attenuated Total Reflectance-Fourier Transform Infra Red (ATR-FTIR) spectroscopy analyzes presented some changes in chemical composition. A High-Performance Liquid Chromatography (HPLC) test showed an increase in the amount of cystic acids. The pulled wool fiber indicates that it might have damaged some crosslinks of macromolecular chains in the fiber. Thus, physical, chemical and mechanical properties are affected during the chemical unhairing process. This research purpose was to increase the potential for better value of pulled wool as it presents the natural fiber most used in several applications

Bilateral Traumatic Facial Paralysis with Hearing Impairment and Abducens Palsy

The temporal bone is often affected in basilar skull fractures. Fractures involving the petrous portion are particularly significant, as they may be associated with neurovascular sequelae. Bilateral facial paralysis secondary to bilateral temporal bone fracture is a rare clinical entity, even more so when associated with other cranial nerve damage such as abducens nerve paralysis and hearing impairment. Only 4 similar cases have been reported in the literature to date. In this paper, we describe a 28-year-old male patient with bilateral facial paralysis, unilateral abducens palsy, and bilateral hearing loss due to bitemporal fractures that developed after a motor vehicle accident. Conservative management was preferred. The 6-month follow-up showed remarkable improvement. This report highlights the effectiveness of conservative management in posttraumatic complete facial and abducens palsy

The Valorization Potential of Tannery Wool Waste in the Textile Industry

According to environmental issues and guidelines, increasing efforts are being focused on reducing the harmful impact of textile wastes either by lowering the use of chemicals or by recycling wastes into new products to give them a new life cycle. In this paper, we investigate the physical and chemical properties of wool wastes coming from tanning industry, where the process of pulling the wool from the hide is based on chemical processes. These so-called “’Pulled wool’” properties are compared to virgin raw wool obtained from the same pelt, to evaluate the degradation of the fiber induced by the chemicals. SEM observations indicate that the pulled wool fiber surface appeared rougher, and the scales appeared to have been affected. Based on the X-ray diffraction, the crystallinity of the pulled fibers appeared to have been slightly reduced. Attenuated ATR-FTIR analyses indicated some changes in chemical composition. HPLC tests showed an apparent increase in the amount of cystic acids indicating damage of some macromolecular chains crosslinking. Thus, some properties appeared significantly affected during the chemical unhairing process. Based on these characteristics of pulled wool, potential applications to valorize it could be suggested, as we show that it remains suitable for conventional textile processes

A New Fractal Multiband Antenna for Wireless Power Transmission Applications

The Microwave Power Transmission (MPT) is the possibility of feeding a system without contact by using microwave energy. The challenge of such system is to increase the efficiency of transmitted energy from the emitter to the load. This can be achieved by rectifying the microwave energy using a rectenna system composed of an antenna of a significant gain associated with a rectifier with a good input impedance matching. In this paper, a new multiband antenna using the microstrip technology and fractal geometry is developed. The fractal antenna is validated into simulation and measurement in the ISM (industrial, scientific, and medical) band at 2.45 GHz and 5.8 GHz and it presents a wide aperture angle with an acceptable gain for both bands. The final antenna is printed over an FR4 substrate with a dimension of 60 × 30 mm2. These characteristics make the antenna suitable for a multiband rectenna circuit use