The scope of the cataract problem in the Middle East and the Mediterranean

The region is characterized by diversity in cultural, political, economic and health conditions. Blindness in the region varies from 6.4% to 0.2% with cataract ranking highly as an underlying cause. There is a need to develop national policies to deliver affordable, technically suitable, and cost effective management plans to reduce cataract. Economic, demographic, health, and manpower statistics are essential information to be considered in formulating such policies.     

Cetirizine dihydrochloride interaction with some diclofenac complexes.

IR, 1H NMR and mass spectrometric studies showed that cetirizine dihydrochloride interacted strongly with diclofenac sodium, even when the latter was metal bound, forming high molecular weight stable adducts. These new formations were unaffected by the possible steric constraints that may exist because of coordination yet did not have the power to break the formed coordinate bonds. The formed ionic bond took place between the carbonyl ion of diclofenac and the positively charged piperazine ring of cetirizine, forming a ternary compound in the case of the divalent metal clusters (Ca{(dic)2.2H2O}, Mg{(dic)2.2H2O}, Zn{(dic)2.2H2O}) and a quaternary one with the trivalent iron cluster (Fe{dic}3.3H2O). IR bands assigned to nuNH, deltaNH and nuC-N were shifted to lower frequency values in the spectra of the complexes; thus showing that coordination took place at the NH of the diphenylamine. TG and elemental analysis confirmed these results.     

Esthesioneuroblastoma in a young child. Case report

Esthesioneuroblastoma is an uncommon malignant neoplasm that arises from olfactory mucosa, often with intracranial extension.A case report of the youngest victim in the literature (2-year-old boy) is presented.     

One-year follow-up results of combined use of CO<Subscript>2</Subscript> laser and cold instrumentation for Reinke’s edema surgery in professional voice users

The purpose of this study was to present our experience with combined use of CO₂ laser and cold instrumentation for Reinke’s edema surgery and to evaluate 1-year follow-up results of the technique in a series of professional voice users. Fifteen patients with Reinke’s edema who underwent microlaryngoscopic surgery were included. Videolaryngostroboscopy, perceptual and acoustic voice analyses were performed before and after surgery. During the 1-year follow-up, no recurrence of Reinke’s edema was encountered. Significant postoperative improvement was obtained in the quality of voice, in terms of GRBAS scores, Fo, jitter, shimmer and NHR. No evidence of laryngeal cancer was found on the histological examinations. Combined use of CO₂ laser and cold instrumentation provides a reliable and safe method for Reinke’s edema surgery, and cessation of smoking, voice rest and control of the laryngopharyngeal reflux contribute to the success of surgery. We consider that the removal of redundant mucosa of the vocal fold reduces the risk of the recurrence of Reinke’s edema and provides better quality of voice. However, it does not imply that our method is superior to others’, but this procedure constitutes an effective treatment of choice for Reinke’s edema patients, including professional voice users.     

Effects of L-carnitine on neutrophil functions in aged rats

Several age-related alterations occur at the cellular level in the immune system leading to a decrease in the immune response. The present study was designed to determine the effect of L-carnitine on impaired neutrophil functions of aged rats. For this reason, superoxide anion radical production, chemotaxis and phagocytic activity were studied in the neutrophils obtained from the peripheral blood of young and old rats. We orally gavaged L-carnitine (50 mg/kg b.w. per day) or control vehicle into young (2 months) and aged (24 months) rats for 30 consecutive days. The neutrophils of aged rats exhibited an increase in superoxide anion production and decline in phagocytosis and chemotaxis when compared with that in young rat neutrophils. Superoxide anion production in aged rats was significantly decreased by L-carnitine treatment which was accompanied with a significant enhancement of chemotactic and phagocytic activity being restored to control levels. These findings demonstrated that L-carnitine is capable of restoring the age-related changes of neutrophil functions.     

The role of electronic medical records in improving health care quality: A quasi-experimental study

The Teleprimary Care—Oral Health Clinical Information System (TPC-OHCIS) is an updated electronic medical record (EMR) that has been applied in Malaysian primary healthcare. Recognizing the level of patient satisfaction following EMR implementation is crucial for assessing the performance of health care services. Hence, the main objective of this study was to compare the level of patient satisfaction between EMR-based clinics and paper-based clinics.The study was a quasi-experimental design that used a control group and was conducted among patients in 14 public primary healthcare facilities in the Seremban district of Malaysia from May 10, to June 30, 2021. Patient satisfaction was assessed using the validated Short-Form Patient Satisfaction Questionnaire, which consisted of 7 subscales. All data were analyzed using the IBM Statistical Package for Social Sciences version 21.A total of 321 patients consented to participate in this study, and 48.9% of them were from EMR clinics. The mean score for the communication subscale was the highest at 4.08 and 3.96 at EMR-adopted clinics and paper-based record clinics. There were significant differences in general satisfaction and communication subscales, with higher patient satisfaction found in clinics using EMR.With the utilization of EMR, patient satisfaction and communication in delivering healthcare services have improved.     

Two generation reproduction and teratogenicity studies of feeding cyadox in Wistar rats

To investigate the teratogenic potential and reproductive toxicity of cyadox, a growth promoting agent, Wistar rats (F₀) were fed with diets containing cyadox (0, 50, 150 and 2500 mg/kg) or olaquindox (150 mg/kg), approximately equivalent to cyadox 5, 15, 250 or olaquindox 15 mg/kg b.w./day across two generations. Half of the pregnant rats (F₀, F_1b) were subjected to caesarean section on gestational day 20 for teratogenic examination and the other half produced pups F_1a and F_2a, respectively. At the 250 mg/kg b.w./day cyadox group, body weights of F_1b pregnant rats and F_2a on day 21 after birth decreased; fetal body lengths and tail lengths decreased; the number of fetal resorptions increased significantly; litter weights, number of viable fetuses decreased; number of embryo resorptions increased significantly; number of liveborn F_1a, F_1b and F_2a decreased. No macroscopic or microscopic change of any significance was found in the reproductive organs. Significant increases in the incidence of cervial ribs or lumbar ribs in F_2a pups and significant increases of relative organ weight of testis and epididymis in F_1b were observed at the 250 mg/kg b.w./day cyadox group. The NOAEL for reproduction/development of cyadox for rats was estimated to be 150 mg/kg diet, which was equivalent to approximately 15 mg/kg b.w./day.     

Investigation of UCH-L1 levels in ischemic stroke,intracranial hemorrhage and metabolic disorder induced impaired consciousness

Objective

We aimed to determine the levels of ubiquitin C-terminal hydrolase-L1 (UCH-L1) in patients admitted to the emergency department with impaired consciousness due to metabolic or neurological reasons.

Immediate Continence Rates in RALRP: A Comparison of Three Techniques

Methods:We retrospectively analyzed the patients who underwent RALRP for localized prostate cancer by a single surgeon in our clinic from January 1, 2009–February 1, 2016. Continence was defined as no leakage or use of a safety pad for minimal leakage. The main outcome measure was continence at postoperative week 1 and months 1, 6, and 12.Results:Between 2009 and 2016, 239 patients underwent RALRP for localized prostate disease. Seventy-four patients underwent a standard approach (group 1), 88 had posterior reconstruction (group 2), and 77 had posterior reconstruction with total anatomic restoration (group 3). After 1 week, 24.3% of the patients in group 1 (18/74), 31.8% in group 2 (28/88), and 45.8% in group 3 (33/72) were continent (P = .02). One month after the surgery, continence rates for groups 1, 2, and 3 were 56.7, 67, and 75%, respectively (0.065). After 6 and 12 months, continence rates for groups 1, 2, and 3 were 72.9 and 87.8%, 81.8 and 89.7%, and 84.7 and 91.6%, respectively (P = .178 and .7484).Conclusion:Anatomic restoration improves continence rates in the early period after RALRP. Even though other parameters were higher in the total restoration group, immediate continence (at 1 week) was significantly better.     

Novel cardiovascular risk factors and cardiac event predictors in female inactive systemic lupus erythematosus patients

Systemic lupus erythematosus (SLE) is associated with severe and premature cardiovascular disease, which cannot be explained by traditional risk factors alone. This study aims to investigate novel cardiovascular risk factors and cardiac event predictors in inactive SLE female patients who do not have any major cardiovascular risk factors. Twenty-five inactive (SLE disease activity index score <4) SLE female patients and 22 healthy control women were studied. SLE patients with a history of diabetes mellitus, hypertension, hyperlipidemia, smoking, or coronary artery disease (CAD) were excluded. Venous blood samples were analyzed for lipid subfractions and novel cardiovascular risk factors such as lipoprotein (a), homocysteine, fibrinogen, high-sensitivity C-reactive protein (hs-CRP), and serum amyloid A (SAA) levels. Endothelial dysfunction was assessed by flow-mediated dilatation (FMD) from the brachial artery at baseline and during reactive hyperemia. SLE patients and controls were similar in terms of age (40±10 years vs 38±10 years, p = NS). No significant difference was found between the groups regarding family history of premature CAD, blood pressure, body mass index, lipoprotein (a), homocysteine, fibrinogen, SAA, apoprotein A-1 and B levels. Compared with the controls, SLE patients had higher levels of hs-CRP [median (range): 1.82 (0.02–0.98) vs 0.68 (0.02–0.35), p=0.04]. FMD was lower in SLE patients than controls (7.1±2.1 vs 11.4±1.2%, p<0.001). Increased levels of hs-CRP and decreased FMD were found in inactive SLE patients. Increased hs-CRP levels may reflect ongoing low-grade inflammation that could be a cause of impaired FMD in SLE patients. These findings suggest that SLE patients without traditional major cardiovascular risk factors may have increased risk of cardiovascular disease and future cardiac events.