Safety and efficacy of eye drops from umbilical cord blood platelet lysate to treat resistant corneal ulcer

Background: Umbilical cord blood (UCB) is a novel treatment of resistant corneal ulcers owing to the unique anti-inflammatory molecules and growth factors it contains. Platelet lysates are a potential future alternative. The aim of the present study was to assess the role of human UCB platelet lysate in treating resistant corneal ulcers. Methods: This was prospective, non-comparative, interventional case series involving 40 eyes of patients aged 6 – 65 years with persistent corneal ulcers from the Mansoura Ophthalmic Center and Mansoura Research Center for Cord Stem Cells. Patients were classified according to the cause of persistent corneal ulcer into four groups: group I, including 14 eyes with dry eye disease; group II, including six eyes post-keratoplasty; group III, including four eyes with corneal chemical burn; and group IV, including 16 eyes with persistent corneal ulcer from other causes. All participants underwent detailed ophthalmic examinations, and baseline and final best-corrected distance visual acuity (BCDVA) were recorded. Eye drops were prepared from UCB platelet lysate and administered to all patients along with detailed meticulous instructions for the method of use. Clinical progression of wound healing was continuously observed. The treatment response was identified as complete healing, improvement, or treatment failure. Results: BCDVA improved significantly in all studied groups (all P < 0.05). In group I, complete healing, improvement, and treatment failure occurred in 71%, 29%, and 0% of cases. In group II, complete healing, improvement, and treatment failure occurred in 67%, 33%, and 0% of cases. In group III, complete healing, improvement, and treatment failure occurred in 50%, 50%, and 0% of cases. In group IV, complete healing, improvement, and treatment failure occurred in 63%, 12%, and 25% of cases. No adverse events associated with the treatment were observed or subjectively self-reports in the study period. Conclusions: Eye drops from UCB platelet lysate were a novel therapeutic blood component with unique growth factors and anti-inflammatory compounds that could be an effective and safe treatment option in managing persistent corneal ulcers of different causes. A future randomized clinical trial with a large sample size and a longer follow-up is required to confirm these preliminary outcomes

Combined umbilical cord patching with amniotic membrane graft for corneal surface reconstruction

Background: Umbilical cord patch (UCP) grafts have been successfully used for glaucoma shunt tube coverage and conjunctival surface reconstruction. In recent years, the technique has emerged as a novel alternative for the reconstruction of corneal perforation and descemetocele. This study aimed to evaluate the effectiveness of combined UCP grafting and human amniotic membrane (HAM) transplantation for the management of corneal perforation or descemetocele. Methods: This prospective, non-comparative, interventional case series included nine eyes of nine patients with corneal descemetoceles and 28 eyes of 28 patients with corneal perforations, all in a clinically quiescent state. UCP grafting and HAM transplantation were combined to treat all patients. We re-examined the patients daily throughout the first week, weekly for 1 month, and then monthly for the first 6 months using slit-lamp examination and anterior segment optical coherence tomography. Results: We included 37 eyes with descemetocele or corneal perforation in a clinically quiescent state. The mean (standard deviation) ages of patients with corneal descemetocele and corneal perforation were 56.3 (18.8) years and 54.3 (18.1) years, respectively. The male-to-female ratios in patients with corneal descemetocele and corneal perforation were 56% to 44% and 61% to 39%, respectively. Postoperative corneal thickness increased significantly in eyes with descemetocele compared to preoperative values (P < 0.001). Postoperative best-corrected distance visual acuity improved significantly compared to preoperative values in eyes with descemetocele or corneal perforation (both P < 0.001), with relief of accompanying ocular symptoms. We did not observe any recurrence or complications such as rejection, infection, suture-related problems, or severe inflammation and all had a formed anterior chamber up to the final follow-up visit. Conclusions: Combined UCP grafting and HAM transplantation could be a promising alternative treatment for corneal perforation or descemetocele in clinically quiescent eyes, providing satisfactory reconstruction and functional outcomes. Further studies with robust designs, larger sample sizes, and longer follow-up are needed to verify the efficacy and safety of this modified surgical technique in enhancing vision and restoring anterior segment anatomical integrity in compromised corneas

Derangement of Basic Amino Acids and Nitric Oxide Levels in Patients Undergoing Cardiothoracic Surgery

Background: A cyclic relationship exists, between; arginine, citrulline, and ornithine. Arginase is a specific enzyme that plays a role in this relationship. This study aimed to elucidate the role of surgical trauma and anesthesia on plasma levels of the previous acids and nitric oxide (NO) and to determine whether the changes in these levels can be correlated to the duration of surgery and anesthesia exposure. Patients and methods: The study included: group A 41 patients who underwent coronary bypasses and group B 17 patients who underwent lung cancer surgery. The amino acid analyzer was used for the detection of amino acids, while NO was estimated by a Spectro-photometric method. Results: The study revealed a significant decrease in the intra-operative levels of arginine, citrulline, ornithine, and NO compared to their pre-operative levels in both groups. Conclusion: Depletion of these basic amino acids is possibly multifunctional and can be associated with an increase in arginase, surgical trauma, anesthesia, and stress

Simultaneous versus Sequential Accelerated Corneal Collagen Cross-Linking and Wave Front Guided PRK for Treatment of Keratoconus: Objective and Subjective Evaluation

Aim. To compare objective and subjective outcome after simultaneous wave front guided (WFG) PRK and accelerated corneal cross-linking (CXL) in patients with progressive keratoconus versus sequential WFG PRK 6 months after CXL. Methods. 62 eyes with progressive keratoconus were divided into two groups; the first including 30 eyes underwent simultaneous WFG PRK with accelerated CXL. The second including 32 eyes underwent subsequent WFG PRK performed 6 months later after accelerated CXL. Visual, refractive, topographic, and aberrometric data were determined preoperatively and during 1-year follow-up period and the results compared in between the 2 studied groups. Results. All evaluated visual, refractive, and aberrometric parameters demonstrated highly significant improvement in both studied groups (all P<0.001). A significant improvement was observed in keratometric and Q values. The improvement in all parameters was stable till the end of follow-up. Likewise, no significant difference was determined in between the 2 groups in any of recorded parameters. Subjective data revealed similarly significant improvement in both groups. Conclusions. WFG PRK and accelerated CXL is an effective and safe option to improve the vision in mild to moderate keratoconus. In one-year follow-up, there is no statistically significant difference between the simultaneous and sequential procedure

The Role of Medical Image Modalities and AI in the Early Detection, Diagnosis and Grading of Retinal Diseases: A Survey.

Traditional dilated ophthalmoscopy can reveal diseases, such as age-related macular degeneration (AMD), diabetic retinopathy (DR), diabetic macular edema (DME), retinal tear, epiretinal membrane, macular hole, retinal detachment, retinitis pigmentosa, retinal vein occlusion (RVO), and retinal artery occlusion (RAO). Among these diseases, AMD and DR are the major causes of progressive vision loss, while the latter is recognized as a world-wide epidemic. Advances in retinal imaging have improved the diagnosis and management of DR and AMD. In this review article, we focus on the variable imaging modalities for accurate diagnosis, early detection, and staging of both AMD and DR. In addition, the role of artificial intelligence (AI) in providing automated detection, diagnosis, and staging of these diseases will be surveyed. Furthermore, current works are summarized and discussed. Finally, projected future trends are outlined. The work done on this survey indicates the effective role of AI in the early detection, diagnosis, and staging of DR and/or AMD. In the future, more AI solutions will be presented that hold promise for clinical applications

Outcome of coronary angiography and percutaneous coronary intervention in Egyptian women with chronic stable angina

Background: A suboptimal degree of attention has focused on the detection and management of coronary artery disease (CAD) in women until recently. We sought out to study the anatomy of coronary arteries in women by the means of coronary angiography in comparison to men. The results of percutaneous coronary intervention (PCI) and in hospital outcomes were studied and compared to men. Methods: The study included 488 female and 492 male patients with chronic stable angina undergoing coronary angiography ± PCI taken consecutively. The angiographic results, interventional details and procedural success, and related complications were collected and statistically analyzed. Results: Female patients had similar coronary risk factors with higher incidence of diabetes mellitus and lower history of smoking. The likelihood of non-atherosclerotic affliction of the coronaries was 47% in women vs. 25.5% in men (P < 0.001). The prevalence of multivessel affliction and more complex lesions were significantly lower in the female patients compared to their male counterparts (P < 0.001). Female patients had lower rate of PCI procedures and lower number of stents implanted (P < 0.001) including drug eluting stents. The success rates were similar in both the sexes, with relatively higher complication rate in the female group. Conclusion: Egyptian women have generally similar risk profile to male patients with CAD and tend to receive less aggressive therapy. They showed less severe coronary atherosclerosis than men and potentially have lower PCI procedures with similar acute success rates and relatively higher procedure-related complications

Complete amenorrhea following NovaSure endometrial ablation for resistant menorrhagia: a case report

Heavy menstrual bleeding (HMB) or menorrhagia is the most common form of dysfunctional uterine bleeding (DUB). In spite of medical treatment for DUB, many women will eventually require a hysterectomy, which is an invasive treatment option. NovaSure ablation offers a same day non-invasive alternative to hysterectomy and hysteroscopic ablation. A 38-year-old woman presented with HMB in 2015. The attacks of HMB interrupted her lifestyle, and she refused to continue with medical treatment, which failed to resolve her symptoms. This patient was admitted to the hospital four times over 2015 due to the anemia caused by the DUB. Medroxyprogesterone acetate and oral contraceptive pills failed to control the patient’s bleeding episodes. Hysteroscopic examination of the uterine cavity showed a normal cavity, and the endometrial biopsy showed proliferative endometrium. She was counseled about NovaSure ablation as the last treatment option before hysterectomy. The NovaSure ablation procedure took 90 s, and the patient was discharged from the hospital 6 h after the procedure. At follow-up, the patient is completely amenorrheic, and she is satisfied with her results. This study demonstrated that NovaSure endometrial ablation is a safe, effective, non-invasive alternative to hysteroscopic endometrial ablation for treatment of DUB

A Study on the Effect of Operating Parameters on the Efficiency of a Mercury Removal Unit from Natural Gas

In this study, an industrial fixed-bed for mercury adsorption from natural gas, was evaluated by mathematical models. Equilibrium isotherms, kinetics equations, and adsorption models were applied to available data to evaluate sorbent characteristics, and then study bed’s performance under different case studies. Models solutions are evaluated by linear-regression and coefficient of determination. The study confirmed that the system is characterized by irreversible equilibrium. Examining of kinetics equations indicated the inclusion of chemisorption and intra-particle diffusion as ratelimiting steps. Bohart-Adams model was found the best fitting model with good match between model’s assumptions and available bed’s information. Model prediction for bed’s design-basis was examined and found good match with manufacturer’s data-sheet

MODELING AND SIMULATION OF A HYDROCRACKING UNIT

Hydrocracking is used in the petroleum industry to convert low quality feed stocks into high valued transportation fuels such as gasoline, diesel, and jet fuel. The aim of the present work is to develop a rigorous steady state two-dimensional mathematical model which includes conservation equations of mass and energy for simulating the operation of a hydrocracking unit. Both the catalyst bed and quench zone have been included in this integrated model. The model equations were numerically solved in both axial and radial directions using Matlab software. The presented model was tested against a real plant data in Egypt. The results indicated that a very good agreement between the model predictions and industrial values have been reported for temperature profiles, concentration profiles, and conversion in both radial and axial directions at the hydrocracking unit. Simulation of the quench zone conversion and temperature profiles in the quench zone was also included and gave a low deviation from the actual ones. In concentration profiles, the percentage deviation in the first reactor was found to be 9.28 % and 9.6% for the second reactor. The effect of several parameters such as: Pellet Heat Transfer Coefficient, Effective Radial Thermal Conductivity, Wall Heat Transfer Coefficient, Effective Radial Diffusivity, and Cooling medium (quench zone) has been included in this study. The variation of Wall Heat Transfer Coefficient, Effective Radial Diffusivity for the near-wall region, gave no remarkable changes in the temperature profiles. On the other hand, even small variations of Effective Radial Thermal Conductivity, affected the simulated temperature profiles significantly, and this effect could not be compensated by the variations of the other parameters of the model

MORPHOLOGICAL AND ANATOMICAL STUDIES OF Artemisia vulgaris L. (ASTERACEAE) I. Morphological characteristics

Abstract: Mugwort has a long history of use in herbal medicine especially in matters connected to the digestive system. However, it is ill-defined especially under local conditions. This is the first part in a two-part study concerning with the botanical attributes of mugwort. In this paper a detailed morphological study of the plant is carried out. Flowering behavior was followed up by recording the cumulative number of inflorescences developing flower buds, inflorescences in blooming and the total number of developed inflorescences at seven day intervals. Mugwort plant developed a maximum number of 307 inflorescences per plant. Mugwort fruit is a cylindrical achene encloses the seed without a pappus. Seed is ridged, brown, oblong (1-2 mm long) with a narrow base and have minute bristles a