A rare ocular complication of mumps: kerato-uveitis

PURPOSE: To report a child who developed kerato-uveitis associated with mumps infection. METHODS: A prospective study of a child who was observed at the Department of Ophthalmology, Marmara University, Faculty of Medicine, during spring 2003. RESULTS: An 11-year-old male patient noticed decreased vision in his left eye. His right eye was completely normal. Visual acuity was perception of hand movements in the left eye. Ocular examination revealed ciliary injection and diffuse hyperemia of the conjunctiva, interstitial keratitis characterized by prominent stromal infiltrates and edema, folds in the Descemet's membrane, and microcystic epithelial edema in his left eye. The patient had been diagnosed as having mumps 10 days previously by a pediatrician. Complete recovery of the keratitis occurred on the 10th day of topical steroid treatment. CONCLUSIONS: Keratitis and/or iritis are rare complications of mumps. Corneal involvement is characterized by unilateral and painless interstitial keratitis that may cause a significant decrease in vision. Keratitis resolves with treatment and does not have any sequelae.     

Results of autografting of marginal conjunctiva in pterygium excision

PURPOSE: To investigate and compare the efficiency of autografting of marginal conjunctiva (autograft of marginal conjunctiva technique, AMCT) and the bare sclera technique (BST) in pterygium excision. MATERIALS AND METHODS: In this study, 51 eyes of 51 patients who underwent pterygium surgery using the AMCT (group 1) were compared to 45 eyes of 45 patients who underwent pterygium excision using the BST (group 2), with regard to epithelialisation, recurrence and complication of the procedures. Patients were followed up for 15.37 +/- 12.01 months in group 1 and for 18.57 +/- 10.42 months in group 2. RESULTS: Postoperative epithelialisation was completed in 4.34 +/- 1.27 days in group 1 and in 5.61 +/- 1.71 days in group 2. Epithelialisation was completed earlier in group 1 than group 2 (p < 0.05). Recurrences were detected in 7 eyes (13.73%) of group 1 and in 17 eyes (37.78%) of group 2. The difference between the groups was statistically significant (p < 0.01). No postoperative complications were seen in either of the groups. CONCLUSIONS: The AMCT was found to be a more efficient procedure than the BST. Autografting of marginal conjunctiva may be a useful alternative treatment in pterygium surgery due to higher success and lower recurrence rates.     

The effect of N-acetyl serotonin on ultraviolet-radiation-induced cataracts in rats

AIMS: To investigate the effects of ultraviolet radiation (UVR) on cataract development in rat lenses and whether or not N-acetyl serotonin has an effect on changes in these lenses. MATERIAL AND METHODS: The study was performed using 5 groups of Sprague-Dawley albino rats, with each group consisting of 15 rats. The 5th group being the control group did not receive any applications, whilst the other 4 groups received a daily dose of 0.2 J/cm(2)/day UVR (305 nm wavelength) for 60 days. A dose of 4 mg/kg/0.1 ml N-acetyl serotonin was injected intraperitoneally to group 1 and group 2 every day and on alternate days, respectively. Group 3 received an intraperitoneal injection of 0.1 ml phosphate buffer solution every day, whilst group 4 received no injection. On the 60th day, an intracardiac withdrawal of blood was performed, after the rats had been anesthetized with ether. Following the withdrawal of blood, the rats were killed using a high dose of ether and their eyes were enucleated. The lens fresh weights, plasma malondialdehyde (P-MDA), erythrocyte glutathione peroxidase (E-GSHPx), erythrocyte glutathione reductase, blood reduced glutathione (B-RGSH), erythrocyte catalase (E-CAT), lenticular malondialdehyde, lenticular superoxide dismutase (L-SOD), lenticular glutathione peroxidase (L-GSHPx) and lenticular glutathione (L-GSH) levels were all assessed. RESULTS: The lens fresh weights were determined to be lower in group 1 and in the control group in comparison with the other groups (p < 0.01). Whilst the P-MDA level was found to be lower (p < 0.001), the E-GSHPx level was higher (p < 0.01) in the control group than in the other groups. The E-GSHPx level was higher in groups 1 and 2 than in groups 3 and 4 (p < 0.01). The B-RGSH level was higher in the control group than in the other groups (p < 0.001). The E-CAT level was higher in both the control group and group 1 than in groups 2, 3 and 4 (p < 0.01), whilst it was higher in group 2 when compared to groups 3 and 4 (p < 0.01). The L-SOD levels were found to be higher in the control group and group 1 than in groups 2, 3 and 4 (p < 0.001). Whilst the L-GSHPx levels were determined to be higher only in the control group (p < 0.001), the L-GSH levels were higher in the control group and group 1 than in the other groups (p < 0.001). CONCLUSIONS: In recent years, the depletion of the atmospheric ozone layer has resulted in the penetration of more UVR to the earth, which causes various effects on different tissues of organisms. N-acetyl serotonin, a melatonin precursor, may well be effective in the prevention of the negative effects induced by the UVR upon the lens tissue, in which case the capability of melatonin to capture free radicals as well as its antioxidative properties should be taken into consideration.     

Clinical Characteristics and Treatment Responses in Cases Diagnosed as Reactive Attachment Disorder

The aim of our study is to report the relation between pathological care and impairment in social interaction, communication, language development, and stereotypical behaviors. Fifteen cases (9 boys, 6 girls) who have the symptoms listed above and who were misdiagnosed with pervasive developmental disorder (PDD), were referred to our clinic for evaluation and treatment. After the cases were evaluated by a semi-structured interview, symptoms related to pathological care were fortified; maternal depressive symptoms associated with child neglect and overexposure to television viewing. The cases and the mothers/primary caretakers were treated in a standardized psycho-educational program of 3 months. After this period improvements were observed in all of the symptom clusters. Twelve cases (80%) had improvements in eye contact. Eleven cases (73.3%) began to engage in reciprocal play and ten cases (66.6%) showed social imitative behaviors. Six cases (40%) began to form sentences. Stereotypic behaviors diminished in six cases (40%) and disappeared in nine cases (60%). According to our findings, although the symptoms of PDD and reactive attachment disorder (RAD) resemble each other, presence of pathological care and good response to treatment in RAD can be important for the differential diagnosis with PDD.     

The angle kappa in strabismic individuals

PURPOSE: To determine angle kappa values in strabismic individuals by means of a synoptophore. METHODS: One hundred-and-eight strabismic subjects and 102 healthy subjects who served as a control group were enrolled in the study. A complete ophthalmologic examination, including determination of refractive status, best-corrected visual acuity measurement, slit-lamp biomicroscopic anterior segment evaluation, intraocular pressure measurements with a Goldmann applanation tonometer, and dilated fundus examination, was done on all study participants. Orthoptic examination included Krimsky prism reflex test, prism cover test, and duction tests. Strabismic patients were grouped into two categories according to their deviation types: exotropic and esotropic. A synoptophore (Clement Clarke, London, England) with a specially designed slide (Maddox test slide series A White Binding No: 16; Clement Clarke, London, England) was used to measure angle kappa. RESULTS: Of the 108 strabismic patients, 62 were males and 46 were females with a mean age of 23.38 +/- 3.68 years (range: 8 to 82 years). There were 54 males and 48 females with a mean age of 32.74 +/- 1.63 years (range: 7 to 68 years) in the control group. The exotropic group had significantly higher angle kappa values than either the controls or the esotropic group (independent sample t-test, p < 0.001). None of the study participants had negative angle kappa values. Higher average kappa values were obtained in left eyes than in right eyes in all three groups (student t-test, p < 0.01 for all groups). CONCLUSION: This study showed that exotropic patients have higher angle kappa values when compared to esotropic patients. Ophthalmologists must take the kappa angle into account when performing a Hirschberg or Krimsky test in young and uncooperative patients in order to improve surgical results.     

A comparison of urodynamic findings between patients with complete and incomplete traumatic spinal cord injuries

Objective: To compare urodynamic findings between patients with complete and incomplete traumatic spinal cord injuries (SCI) and to determine whether it is important to test with urodynamic study in patients with incomplete SCI.

Design: Retrospective study

Setting: Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey

Participants: A total of 66 patients with 36 complete and 30 incomplete traumatic SCI were included in the study, from July 2012 to September 2014.

Interventions: Urodynamic study

Outcome Measures: Maximum cystometric capacity (MCC) , vesicle pressure at MCC, detrusor function (detrusor overactivity or not), bladder complience, bladder storage and emptying disorders, post-void residual volume (PVR) and bladder emptying method were recorded. It was also recorded whether the patients used anticholinergic drugs before urodynamic study.

Results: In urodynamic findings MCC, vesicle pressure at MCC, PVR, there was no statistically significant difference between complete and incomplete traumatic SCI patients. Also there was no statistically significant difference in low-compliance of detrusor frequency and bladder storage and emptying disorder frequency. Clean intermittent catheterization (CIC) was the most commonly recommended method after urodynamic studies in both groups of patients with SCI.

Conclusions: In urodynamic study findings, there was no statistical difference between complete and incomplete traumatic SCI patients. The present study demonstrate that even if patients with incomplete SCI appear to be functionally better than the patients with complete SCI, urodynamic studies should still be performed in patients with incomplete SCI to identify bladder characteristics and to identify appropriate treatment.     

Antimicrobial resistance profile of Staphylococcus aureus isolated from clinical samples and foods of animal origin

Staphylococcus aureus has been well established as a clinical and epidemiological pathogen and can cause infections at many anatomical sites. Increasing insusceptibility to β-lactams and the glycopeptides complicates the treatment of these infections. We isolated 584 strains of S. aureus from various clinical and animal origin food samples during (from January 2006 to December 2007) the survey. Resistance to 15 antibiotics frequently used in human medicine and veterinary practice was also determined. A remarkable level of penicillin resistance was detected in both clinical (98.3%) and food (92.0%) S. aureus isolates. But, there were no S. aureus strains that were resistant to vancomycin, teicoplanin, linezolid, and quinupristin/dalfobristin. The rate of resistance to tetracycline, ciprofloxacin, levofloxacin, methicillin, gentamicin, tobramycin, norfloxacin, and moxifloxacin among the human and foods S. aureus isolates ranged from 50.3% to 56.3% and 1.4% to 9.5%, respectively. In our survey, in vitro susceptibility data suggested that the incidence of resistance among the S. aureus strains isolated from food were not remarkably high, excluding penicillin. Although the transfer of antibiotic resistance of S. aureus from foods to humans probably occurs less frequently than is generally assumed, the increasing prevalence of resistance in the strains of human origin may have important therapeutic implications.     

A case series of neonatal arrhythmias

Objective: Neonatal arrhythmias (NAs) are defined as abnormal heart rates in the neonatal period. They may occur as a result of various cardiovascular, systemic and metabolic problems.

Methods: A retrospective chart review was performed on newborns who were diagnosed with NA during hospitalization in a neonatal intensive care unit (NICU), or who were admitted to the NICU because of an arrhythmia diagnosis in two NICUs in Turkey from May 2011 to June 2013.

Results: Seventeen neonates with arrhythmias were identified. The incidence of NA was 0.4% and 0.3% in the two NICUs, and was 0.37% in the study population as a whole. Mean gestational age was 37 (29–40) weeks. Nine of the infants (53%) were diagnosed with fetal arrhythmia (FA) during the last week of gestation. The distribution of NA types was as follows: six (35%) supraventricular tachycardia (SVT), six (35%) premature atrial contractions (PACs), two (11%) premature ventricular contractions (PVCs), two (11%) multiple arrhythmias such as SVT?+?PAC and AV block?+?PVC, and one (5%) AV block. Wolff–Parkinson–White syndrome was present in one patient. An association of NA with congenital heart malformations was identified in five cases.

Conclusions: Cardiac arrhythmias are important causes of infant morbidity, and an occasional cause of infant mortality if undiagnosed and untreated. It is important for the physician to be aware of the etiology, development and natural history of arrhythmias in the fetal and neonatal period.