Effect of systemic oxygen as supplement therapy on corneal epithelial wound healing in diabetic patients after pars plana vitrectomy

Introduction: Diabetic patients are prone to developing corneal epithelial defects, either due to diabetic keratopathy or as a result of surgery such as pars plana vitrectomy. The healing time of corneal epithelial defects in this group of patients may also be delayed due to diabetes. Many substances have been investigated to determine their effects on corneal wound healing. Oxygen plays a key role as a nutrient for our tissues in the wound healing process. However, the effect of systemic oxygen on corneal epithelial wound healing is not known. Objective: To compare the corneal epithelial healing time between diabetic patients receiving and not receiving supplementary oxygen after vitrectomy; and to determine whether various factors such as age, duration of diabetes, duration of surgery, glycaemic control and haemoglobin level have any influence on corneal epithelial wound healing time. Methods: A randomised controlled trial was conducted involving diabetic patients planned for vitrectomy in Hospital Tuanku Ja’afar Seremban between October 2013 and October 2014. A 6mm circular corneal epithelial defect was created intra-operatively when there was obscuration of surgical field due to corneal haze. Post-operatively, these patients were randomised into two treatment groups; “Standard” (standard medical treatment of topical Maxitrol™ six-hourly and homatropine 2% six-hourly) or “Oxygen” (standard treatment plus systemic oxygen via simple face mask at 10 litres/min for one hour, in 12-hourly sessions for 3 days. Time taken for the corneal epithelial defect to heal completely was noted. Other parameters recorded were patients’ age, duration of diabetes, duration of surgery, recent HbA1C and haemoglobin level. Results: A total of 32 eyes of 32 patients were recruited in this study, consisting of 15 eyes in the standard treatment group and 17 eyes in the oxygen group. There were no significant differences between the two groups in terms of patient and disease demographics. The mean corneal epithelial wound healing time in the oxygen group was significantly faster than those in the standard treatment group (3.24 days vs 4.27 days, p = 0.040). Regression analysis showed no significant linear relationship between healing time and other factors such as age, duration of diabetes, duration of surgery, glycaemic control and haemoglobin level. Conclusion: Patients who received systemic oxygen therapy on top of the routine postoperative treatment for corneal epithelial defects after vitrectomy had a faster mean healing time. Oxygen administration may be considered in this group of patients to aid the wound healing process

Discutindo a educação ambiental no cotidiano escolar: desenvolvimento de projetos na escola formação inicial e continuada de professores

A presente pesquisa buscou discutir como a Educação Ambiental (EA) vem sendo trabalhada, no Ensino Fundamental e como os docentes desta escola compreendem e vem inserindo a EA no cotidiano escolar., em uma escola estadual do município de Tangará da Serra/MT, Brasil. Para tanto, realizou-se entrevistas com os professores que fazem parte de um projeto interdisciplinar de EA na escola pesquisada. Verificou-se que o projeto da escola não vem conseguindo alcançar os objetivos propostos por: desconhecimento do mesmo, pelos professores; formação deficiente dos professores, não entendimento da EA como processo de ensino-aprendizagem, falta de recursos didáticos, planejamento inadequado das atividades. A partir dessa constatação, procurou-se debater a impossibilidade de tratar do tema fora do trabalho interdisciplinar, bem como, e principalmente, a importância de um estudo mais aprofundado de EA, vinculando teoria e prática, tanto na formação docente, como em projetos escolares, a fim de fugir do tradicional vínculo “EA e ecologia, lixo e horta”.Facultad de Humanidades y Ciencias de la Educació

Acute band keratopathy formation after penetrating keratoplasty: A case report

A 53-year-old male was referred from another eye hospital for right eye corneal perforation secondary to infective keratitis. A penetrating keratoplasty was performed for tectonic purposes. Forty eight hours after penetrating keratoplasty, he developed a band keratopathy located at the interpalpebral area of the corneal button. Despite stopping topical and systemic ciprofloxacin which could have contributed to this, the band keratopathy became more severe. Surgical debridement of the band keratopathy was done and there was no recurrence after that. This case of acute band keratopathy is an uncommon condition that develops within days to weeks of a particular insult to the eye. Various offending medications have been implicated, and treatment options include chelation therapy, surgical debridement and penetrating keratoplasty. Recurrence is common despite treatment and the cessation of possible offending medications. As such, it is prudent to be aware of and recognise the early symptoms and signs of this potentially sight-threatening condition

Bilateral idiopathic optic perineuritis with severe vision loss: A case report

Optic perineuritis is an orbital inflammatory disorder that is either idiopathic or secondary to other conditions such as infection or systemic inflammatory disorders. This condition is very similar to demyelinating optic neuritis, but certain features of the history and magnetic resonance imaging findings are characteristic for and aid in the diagnosis of optic perineuritis. Vision loss varies greatly, from minimal clouding of vision up to only light perception. We report a case of a 44-year-old female with idiopathic bilateral optic perineuritis with vision loss of up to no light perception in both eyes. Radio imaging studies were typical of optic perineuritis and she was started on systemic corticosteroids. She responded very well to steroid therapy and achieved nearly complete visual recovery. There had been no relapse despite cessation of therapy

Traumatic optic neuropathy secondary to acupuncture treatment for glaucoma: A case report

Internal organ injuries have been recognized as a major complication of acupuncture. Reported ocular adverse events include traumatic cataract, oculomotor nerve injury, endophthalmitis and retinal puncture. We report a case of traumatic optic neuropathy and self-sealed globe perforation following acupuncture. A Chinese gentleman with primary open angle glaucoma presented with sudden loss of vision in the right eye after acupuncture therapy. The vision dropped to 2/60 from 6/6 premorbid. Relative afferent pupillary defect was present. Fundus examination showed hemorrhage from the optic disc into the vitreous. It is likely that the optic nerve injury occurred when the acupuncture needle was advanced deep into locations near the optic nerve. Main acupoints used in acupuncture treatment of glaucoma include Tongziliao GB-1, Jingming BL-1 and Chengqi ST-1. It is crucial to have a good understanding of ocular anatomy to avoid potentially blinding complications

Endogenous endophthalmitis secondary to melioidosis in paediatric patients: Case series and review article

Endogenous endophthalmitis is a devastating infection of the eye which can lead to permanent blindness. We report two rare cases of paediatric endogenous endophthalmitis secondary to melioidosis with contrasting visual outcomes. Both patients presented with acute painful visual loss with poor vision on presentation after exposure to open water sources (swimming at two separate locations with waterfalls). Both were diagnosed to have melioidosis endogenous endophthalmitis based on the ocular features clinically and via positive melioidosis serology. They otherwise did not exhibit any symptoms and signs suggestive of systemic melioidosis infection. Even though the two children demonstrated severe ocular involvement, ocular culture from vitreous and aqueous sampling taken from one of the patients did not yield any positive results. No ocular sampling was taken from the other patient. After standard antimicrobial treatment, the first patient responded well with good visual recovery without requiring any surgical intervention for the endophthalmitis. In contrast, our second patient ended up with poor visual outcome despite undergoing multiple intravitreal antibiotic injections and early pars plana vitrectomy. This is because he developed extensive retinal detachment due to the aggressive ocular infection. The diagnosis of endogenous endophthalmitis due to ocular melioidosis remains challenging and requires a high index of suspicion in areas endemic for the causative organism. Early empirical antibiotic treatment should be initiated in suspicious cases, even though the treatment outcomes may vary greatly

Effectiveness of vero cell inactivated vaccine against severe acute respiratory infections (SARI) in Sibu, Malaysia: A retrospective test-negative design

The effectiveness of the vero cell inactivated vaccine (CoronaVac®) against severe acute respiratory infection (‎SARI)‎ caused by SARS-CoV-2 in the real world was assessed. A matched test-negative case-control design was employed using the web-based national information system, as well as the hospitalization dataset in Sibu Hospital. Vaccine effectiveness was measured by conditional logistic regression with adjustment for gender, underlying comorbidity, smoking status, and education level. Between 15 March and 30 September 2021, 838 eligible SARI patients were identified from the hospitalization records. Vaccine effectiveness was 42.4% (95% confidence interval [CI]: −28.3 to 74.1) for partial vaccination (after receiving the first dose to 14 days after receiving the second dose), and 76.5% (95% CI: 45.6 to 89.8) for complete vaccination (at 15 days or more after receiving the second dose). This analysis indicated that two doses of CoronaVac® vaccine provided efficacious protection against SARI caused by SARS-CoV-2 in the short term. However, the duration of protection, and performance against new variants need to be studied continuously

Genetic risk of extranodal natural killer T-cell lymphoma: a genome-wide association study

10.1016/S1470-2045(16)30148-6LANCET ONCOLOGY1791240-1247United State