Double Head Research Articles

Brain Perfusion Scintigraphy in Evaluation of Pathogenesis of Fatigue in Patients with Primary Biliary Cholangitis (PBC) – A Pilot Study

Primary biliary cholangitis (PBC) is an autoimmune cholestatic liver disease characterized by a breakdown of immune tolerance to mitochondrial and nuclear antigens, causing injury to the biliary epithelial cells. Fatigue is the commonest reported symptom in PBC and has a negative impact on patients' perceived quality of life, often through social isolation. It is unrelated to the severity of liver disease and appears unresponsive to current therapies, including ursodeoxycholic acid and transplantation. Fatigue in PBC is complex, with numerous associated peripheral and central nervous system (CNS) features. Initially, cholestasis causes degenerative CNS change affecting areas of the brain regulating autonomic dysfunction and sleep, and these changes lead directly to some manifestations of fatigue and the associated cognitive impairment. The aim of the study was to examine global cerebral blood flow with brain perfusion scintigraphy SPECT in well-defined group of PBC Caucasian patients with verbally reported fatigue. Twenty consecutive PBC female patients (median age 58.9, ranges 38-80; 4 cirrhotic) with mean duration of the disease 3.3 years, were prospectively enrolled into the study. Fatigue Impact Scale (FIS) questionnaire was administered to every patients at the moment of brain examination. Brain perfusion scintigraphy SPECT was performed after intravenous injection of 760-800 MBq of technetium99m labeled exametazime (99mTc –HMPAO). Then patients were examined using double head gamma camera system, and data were analyzed with dedicated nuclear medicine software. In analyzed cohort the median FIS score was 70.5 points (ranges 21-160), which was higher than previously reported. There were no correlation between age of patients at the SPECT/FIS examination, duration of the disease, the presence of liver cirrhosis, Mayo Risk Score, and FIS domains: Cognitive, Physical and Social, as well as with brain blood flow. However, positive correlation between Cognitive dimension of FIS measure and right frontal lobe perfusion impairment assessed with SPECT technic (p<0.05) was found. The results of this study showed that right lobe perfusion impairment might impact brain function in PBC. Cognitive dimension was stage-independent symptom in analyzed cohort, and cognitive impairment might be, in turn, associated with functional brain lesion.

Stenting of Spontaneous Coronary Artery Dissection From a Pathological Point of View.

A 32-year-old female recently postpartum was admitted with chest pain and shortness of breath. She was diagnosed with acute inferior myocardial infarction and taken to catheterization laboratory in cardiogenic shock. The proximal right coronary artery was occluded, and an everolimus-eluting stent (Abbott Vascular, Santa Clara, CA) was implanted successfully. Left coronary angiography showed 50% stenosis of proximal left anterior descending (LAD) and total occlusion of left circumflex. The patient remained in cardiogenic shock despite insertion of an intra-aortic balloon pump and temporary pacemaker and died after cardiac arrest. At autopsy (Figure [A]), coronary arteries showed no gross atherosclerosis, but diffuse coronary artery dissections, involving left main, LAD, left circumflex, and right coronary artery. The stent was implanted in the true lumen (TL, Figure [A3 through A5]), though it was not well expanded and the underlying dissection was still observed. The dissection in the right coronary artery extended both proximally and distally, but severe narrowing was only observed in the distal right …

Use of surfactants to mitigate precipitation of nonstable asphaltensdes

ABSTRACT In this work, we examine the effectiveness inhibition of three different surfactants (cationic, anionic, and non-ionic) with respect to aggregation of the most unstable fraction, asphaltenes, obtained from Algerian crude oil that flocculates and precipitates during oil transport and storage. Their efficacy is compared with native resins that are extracted from the same oil. We reveal from the results that the cationic surfactant didodecyl dimethyl ammonium bromide (DDAB) displayed the highest capacity to inhibit asphaltenes aggregation. This surfactant can shift considerably the aggregation onset of asphaltenes with respect to the non-ionic octylphenopoly(ethyleneglycolether) X (TX-100) and anionic dodecyl benzene sulfonic acid (DBSA) surfactants. This finding is explained by the presence of both double alkyl chain and basic head polar (positive charge) in surfactant structure on one hand and the structural properties of studied asphaltenes (rich oxygenated negative charge sites and low aromaticity) on the other hand. Finally, the comparison between the effectiveness of native resin and the studied surfactants indicate the following order: DDAB > resin> TX-100> DBSA.

Protective role of vitamin C on sperm morphology and biochemical enzymes in lead nitrate treated albino rats

Lead is a well known heavy metal and is found in various components of earth environment and is a major industrial byproduct. Manipulation of lead from these sources causes toxicity in human beings by oxidative stress, which results in decrease fertility due to increase in the production of abnormal sperm population. Vitamin C is an antioxidant and acts by scavenging the free radicals, thus ameliorating the oxidative stress. The present study was carried out to evaluate the effect of lead nitrate and Vitamin C on testis. The study was conducted on 30 male albino rats of Wistar strain, weighing 150-250 gm. The rats were divided into 5 groups (6 rats in each group). Group 1 served as control and rest 4 groups were experimental. Except the control group, the animals of other 4 groups received lead nitrate and vitamin C orally for 6 days a week for 2 months. All the animals were sacrificed at the end of experiment and the result showed abnormal sperm count 5% in control group while it was 66% in group 4 and 17% in group 5. Sperm abnormalities observed were double head, banana head, amorphous head, defective head, headless, bent neck, bent tail, double tail, defective tail and looped tail. Malondialdehyde, a marker of lipid peroxidation was increased in experimental group while glutathione reductase (GR) enzyme was decreased in testicular tissue but this change in enzyme showed some improvement in vitamin C treated groups.

Surgical Management of Double-Head Pterygium Using a Modified Split-Conjunctival Autograft Technique

Aim: To describe a modified split–conjuctival autograft technique for double–head pterygium and evaluate the postoperative outcomes. Methods: A retrospective analysis of all patients who underwent split-conjunctival autograft surgery for double–head pterygium from November 2012 to March 2014. Conjunctival autograft was split vertically, in order to obtain limbal sides of cojunctival autograft for both sides. No adjunctive agent was used. Records of included patients were reviewed and outcomes and recurrence rates were noted. Results: Eight cases of double–head pterygia were noted in 158 total cases of pterygia evaluated (5%). The baseline characteristics included 2 female and 6 male with an age between 26 and 71 (average 42.63) years. All eyes had 12–month follow–ups in average (6–21 months). No intraoperative or postoperative complications were noted. No recurrence was observed. Conclusion: A modified, vertical–split conjunctival autograft without any adjunctive agents is a successful and safe technique in management of double–head pterygium.

Is Suturless and Gluelesslimbal Conjunctival Autograft for Primary Pterygium Surgery Efficient and Safe ?

Aim of the study:evaluate the safety and efficacy of sutureless glue free limbal conjunctival autograft for the management of primary pterygium surgery. Material and method:This prospective,interventional randomized,non comparative study was held at AlZahraaUniversity Hospital between May, 2013 and June, 2015. It included 20 eyes of 17 patients, 12 males(70.6%), and 5 females(29.4%). Their mean age±SD was 52.50±18.31 years (Range:30-75 years). They were presented to the outpatient clinic of Al Zahraa University Hospital with primary pterygium. Inclusion criteria included primary pterygium,non atrophic, with healthy conjunctiva. Exclusion criteria included atrophic pterygium, pseudopterygium, ocular surface pathology, infection, previous limbal surgery or double head pterygium. Surgeries were done under local anesthesia. Simple pterygium excision was done leaving a bare sclera. The size of bare sclera was measured. A conjunctival graft 2 mm larger in width and length than the recipient bed was created from the superior temporal quadrantand was extended to the limbus to include limbal stem cells. The graft was gently moved to the recipient bed with the epithelial side up and keeping the limbal edge toward the limbus.Hemostasis was allowed to occur spontaneously without use of cautery to provide autologous fibrin to glue the conjunctival autograft naturally in position without tension.All patients were followed up after 48 hours, weekly for one month then monthly for 12 months. Results:Pterygia were located nasally in all cases. Pterygia were presented right eye in10(50%) and left eye 10(50%). Mean graft size±SD was 5.5±1.5 millimeter (Range: 5-7 mm). Mean duration of graft fixation ±SD was 10±2.82 minutes (Range:10–12minutes).Mean operative time±SD was 25±1.41 minutes(Range: 24-26 minutes) with good cosmetic outcome in all cases. There was minimal postoperative pain and discomfort, without graft dislocation or dehiscence and without recurrence of pterygia during the follow up period. Conclusion:Sutureless and gluelessconjunctivallimbalautograft following primary pterygium excision is safe,easy,effective and economic technique in primary pterygium surgery.

Symmetry Enforced, a priori RF Shimming in MRI for the Human Head at High Field Strengths

To obtain an a priori RF shim set for in vivo measurements of the human head where derivation and implementation are feasible on standard MRI systems without the need for sophisticated hard- or software. The method is targeted for initial anatomical scout scans and adjustments on high field scanners. Tailoring a rotationally symmetric phantom to be electrically large will produce characteristic interference patterns. This pattern is employed to enforce rotational symmetry in MRI images acquired with a multi-element transmit coil by adjusting transmit phases and/or amplitudes. Using the a priori shim on a human head defocuses the transmit fields, resulting in images with reduced signal dropouts. Three different sized adult heads were scanned with the predetermined shim set and a coil array consisting of eight transceiver elements. The images were found to show better image homogeneity than CP mode excitation and performed only slightly worse compared to a per subject RF shim. Relatively homogeneous excitation can be achieved with a pre-determined RF shim set. The homogeneity is sufficient for static field shimming and scout imaging. Primary application is the development of double resonant head coils with a fixed RF shim set for the proton channel intended for high field imaging in systems that do not poses parallel transmission capabilities.

Effects of unsaturated fatty acids on the kinetics of voltage-gated proton channels heterologously expressed in cultured cells.

Arachidonic acid (AA) greatly enhances the activity of the voltage-gated proton (Hv) channel, although its mechanism of action and physiological function remain unclear. In the present study, we analysed the effects of AA on proton currents through Hv channels heterologously expressed in HEK293T cells. The dramatic increase in proton current amplitude elicited by AA was accompanied by accelerated activation kinetics and a leftward shift in the voltage-dependence of activation. Mutagenesis studies suggest the two aforementioned effects of AA reflect two distinct structural mechanisms. Application of phospholipase A2 , which liberates AA from phospholipids in the membrane, also enhances Hv channel activity, supporting the idea that AA modulates Hv channel activity within physiological contexts. Unsaturated fatty acids are key components of the biological membranes of all cells, and precursors of mediators for cell signalling. Arachidonic acid (AA) is an unsaturated fatty acid known to modulate the activities of various ion channels, including the voltage-gated proton (Hv) channel, which supports the rapid production of reactive oxygen species (ROS) in phagocytes through regulation of pH and membrane potential. However, the molecular mechanisms and physiological functions of the effects of AA on Hv channels remain unclear. In the present study, we report an electrophysiological analysis of the effects of AA on the mouse Hv channel (mHv1) heterologously expressed in HEK293T cells. Application of AA to excised inside-out patch membranes rapidly induced a robust increase in the amplitude of the proton current through mHv1. The current increase was accompanied by accelerated activation kinetics and a small leftward shift of the current-voltage relationship. In monomeric channels lacking the coiled-coil region of the channel protein, the shift in the current-voltage relationship was diminished but activation and deactivation remained accelerated. Studies with several AA derivatives showed that double bonds and hydrophilic head groups are essential for the effect of AA, although charge was not important. The application of phospholipase A2 (PLA2), which generates AA from cell membrane phospholipids, stimulated mHv1 activity to a similar extent as direct application of ∼ 20 μM AA, suggesting that endogenous AA may regulate Hv channel activity.

Analysis of morphological variation of condyle by cone-beam computed tomography: Report of two cases

Bifid mandibular condyle is a rare entity, in which the head of the condyle presents with double head usually separated by notching between the heads, thus it is also known as double-headed condyle. It is a frequent and purely incidental finding, mostly found in asymptomatic individuals during routine radiological investigation. It may occur as a developmental anomaly or due to trauma. Here, we report two unique cases of unilateral bifid condyles, which was an incidental finding during diagnostic imaging procedure.

Physiologically Based Pharmacokinetic (PBPK) Model for Biodistribution of Radiolabeled Peptides in Patients with Neuroendocrine Tumours.

Objective(s):The objectives of this work was to assess the benefits of the application of Physiologically Based Pharmacokinetic (PBPK) models in patients with different neuroendocrine tumours (NET) who were treated with Lu-177 DOTATATE. The model utilises clinical data on biodistribution of radiolabeled peptides (RLPs) obtained by whole body scintigraphy (WBS) of the patients.Methods:The blood flow restricted (perfusion rate limited) type of the PBPK model for biodistribution of radiolabeled peptides (RLPs) in individual human organs is based on the multi-compartment approach, which takes into account the main physiological processes in the organism: absorption, distribution, metabolism and excretion (ADME). The approach calibrates the PBPK model for each patient in order to increase the accuracy of the dose estimation. Datasets obtained using WBS in four patients have been used to obtain the unknown model parameters. The scintigraphic data were acquired using a double head gamma camera in patients with different neuroendocrine tumours who were treated with Lu-177 DOTATATE. The activity administered to each patient was 7400 MBq.Results:Satisfactory agreement of the model predictions with the data obtained from the WBS for each patient has been achieved.Conclusion:The study indicates that the PBPK model can be used for more accurate calculation of biodistribution and absorbed doses in patients. This approach is the first attempt of utilizing scintigraphic data in PBPK models, which was obtained during Lu-177 peptide therapy of patients with NET.

Zwitterionic nanoparticles constructed from bioreducible RAFT–ROP double head agent for shell shedding triggered intracellular drug delivery

Nanomedicines have emerged as indispensable platforms for cancer theranostics, however, the therapeutic outcomes were often compromised not only by the multiple biological barriers during the itinerary from the initial injection site to the intracellular action site but also the insufficient drug release at the pathological site. Herein, novel bioreducible double head agent, combining reversible addition-fragmentation chain transfer agent and ring opening polymerization initiator through disulfide linkage, was firstly prepared. Well-defined cRGDfK-polycarboxybetaine methacrylate-SS-polycaprolactone block copolymers (termed as cRGD-PCSSL) were facilely synthesized using this initiator. Subsequently, shell sheddable and drug-encapsulated zwitterionic nanoparticles were constructed by one-step self-assembly with doxorubicin (DOX) (termed as cRGD-PCSSL/DOX NPs). The reduction-responsive shedding of PCB shells resulted in the rapid loss of cRGD-PCSSL/DOX NPs stability in the presence of glutathione, facilitating the rapid DOX release. Results of flow cytometry and fluorescence microscopy demonstrated that cRGD-PCSSL/DOX NPs could be internalized by HepG2 cells via receptor-mediated endocytosis with fast intracellular drug release, leading to considerable cytotoxicity in comparison with free DOX. Importantly, the low protein adsorption and excellent serum stability properties of cRGD-PCSSL/DOX NPs translated into prolonged systemic circulation and enhanced tumor accumulation. Furthermore, intravenous injection of cRGD-PCSSL/DOX NPs in tumor-bearing mice exhibited significantly higher antitumor efficiency and lower systemic toxicity compared to free DOX. Consequently, the novel zwitterionic NPs, which facilely overcome the dilemma between multifunctionality and complexity by programmatically circumventing the multiple biological barriers, would represent a promising platform for enhanced anticancer drug delivery. Statement of significanceHerein, novel bioreducible RAFT and ROP double-head agent was first reported for the synthesis of cRGDfK-polycarboxybetaine methacrylate-SS-polycaprolactone zwitterionic block copolymers (cRGD-PCB-SS-PCL, termed as cRGD-PCSSL) through controllable polymerization methods. Firstly, this synthetic route surmounted the major disadvantage of most current used methods, which required thiol exchange reaction between active disulfide bond and free thiol groups at the chain ends. Secondly, the prepared cRGD-PCSSL/DOX NPs reasonably integrated cRGD for active tumor targeting and receptor-mediated endocytosis, zwitterionic PCB with nonfouling property for prolonged systemic circulation, disulfide linkage for reduction-responsive drug release, biodegradable PCL for hydrophobic anticancer drug loading. Finally, the systematic evaluation fully verified that the in vitro optimized cRGD-PCSSL/DOX NPs translated into significantly better therapeutic efficiency with reduced side effects in vivo.

Abstract 12443: In-Beam PET Verification of Catheter-free Arrhythmia Ablation by Scanned Carbon-12 Ion Beam Irradiation

Introduction: Highly precise irradiation using carbon-12 (12C) ions is a new means for catheter-free ablation. Besides energy deposition leading to the dose distribution, nuclear interactions lead to by-product β+-activity that can be measured using positron-emission-tomography (PET). Hypothesis: In-beam PET scanning during focused myocardial irradiation using 12C can adequately depict 12C dose deposition. Methods: Pigs were irradiated with 25, 40, and 55 Gy for AV node (AVN), LA-PV junction, and local LV freewall ablations. PET measurement was performed by means of a double head camera system installed at irradiation site. Coincidences were captured in end-expiration during beam extraction pauses of the accelerator. Results: Evaluation of PET images was qualitatively performed using the coronal plane of the activity distribution superimposed on the contrast-CT in the center of the target contour. Strong β+-activities were measured in AVN and LV ablations. In AVN ablations, activity was localized to the target location, without target activity spreading to the level of the aortic root or coronary sinus (Figure A). Local LV irradiations revealed strong activity in the target location, slightly extending into left lung and chest wall (Figure B). In 55 Gy animals, the cardiac entry channel showed increased activity, decreasing in 40 Gy and more so in 25 Gy animals. Conclusion: This is the first study applying in-beam PET to track 12C dose-deposition into the target location for catheter-free ablation in intact animals. Correlation of β+-activity to electrophysiological outcome, lesion induction, and potential side-effects may be critically important in dosing therapy and predicting outcomes.

Automating double ring infiltrometer with an Arduino microcontroller

In this paper, we describe the designed and tested system of automated double ring infiltrometer (DRI) that we have developed using an Arduino microcontroller, a Hall effect sensor, a peristaltic pump, a water level sensor, and a constant-level float valve. The system can be used for infiltration measurements in both single ring falling head and double ring constant head methods. The precise measurements of the current method compared to previous designed systems are not affected by sunlight, and due to the method of flow measurement, remain accurate even for low infiltration values. The set-up has an easy real-time data storage on a micro-SD card without a need of a portable computer in the field. It only requires a single reservoir for both inner and outer rings to which, water can be added anytime needed without affecting the measurements. The system automatically detects when the steady state infiltration rate is reached and concludes the testing and stops measurements. The system is mounted in a portable and weather resistant box and is applied to run DRI testing in the field to check the applicability and accuracy of the portable set-up in field measurements. Manual testing was also performed in the field for comparison with the automated system measurements. Overall system architecture, and the design of hardware and software components are presented in details. The system configuration is illustrated for better understanding of the set-up.

The effects of pre-salting methods on salt and water distribution of heavily salted cod, as analyzed by 1H and 23Na MRI, 23Na NMR, low-field NMR and physicochemical analysis

The effect of different pre-salting methods (brine injection with salt with/without polyphosphates, brining and pickling) on the water and salt distribution in dry salted Atlantic cod (Gadus morhua) fillets was studied with proton and sodium NMR and MRI methods, supported by physicochemical analysis of salt and water content as well as water holding capacity. The study indicated that double head brine injection with salt and phosphates lead to the least heterogeneous water distribution, while pickle salting had the least heterogeneous salt distribution. Fillets from all treatments contained spots with unsaturated brine, increasing the risk of microbial denaturation of the fillets during storage. Since a homogeneous water and salt distribution was not achieved with the studied pre-salting methods, further optimizations of the salting process, including the pre-salting and dry salting steps, must be made in the future.

Clustering based Data Collection using Data Fusion in Wireless Sensor Networks

is one of the important techniques in Wireless Sensor Networks (WSNs). In this paper introduce Double Cluster Head Model (DCHM) for secure and accurate data fusion in WSNs. Data fusion is used to reduce the traffic load and conserves energy of the sensors. In this clustering technique each cluster has two Cluster Heads (CHs) and they are assuming to be trust. After clustering each sensor nodes needs to maintain a reputation and trust table which is used to find the compromised nodes. Each CH perform the data fusion process independently and its sends the fused data to the base station. In this base station dissimilarity coefficient is computed and compared with threshold value which is preset by the users. If the dissimilarity coefficient exceeds the threshold, the CHs will be added to blacklist, and the CHs must be reelected by the sensor nodes in a cluster. And also feedback is sent from the base station to the reputation and trust system, which can helps to identify and delete the compromised sensor nodes. Through a series of extensive simulations, it can found that the DCHM performed very well in data fusion security and accuracy.

Penetrating the Glycan Shield on HIV‐1

The HIV‐1 envelope spike, the sole target of virus‐directed neutralizing antibodies, is covered by a dense array of N‐linked glycans, which comprises rough half its molecular weight. Because these glycan are generated by self‐biosynthetic machinery, the human immune system can only recognize them as non‐self if they are arranged either in a unique cluster of glycans (such as the triple glycan cluster recognized by antibody 2G12) or as part of a glyco‐peptide epitope (such as observed with antibodies PG9 or 35O22). For the few surfaces on HIV‐1 that are glycan‐free, such as that recognized by the CD4 receptor, antibodies need to contend with the dense glycan that surrounds the site. Here we use crystal structures of a soluble trimeric form HIV‐1 (SOSIP.664) to investigate requirement for penetration to the nominally glycan‐free site of CD4 attachment. We analyze the crystal structure of a fully glycosylated HIV‐1 Env trimer to gain insight into the degree that surrounding N‐linked glycan sterically cover the CD4‐binding site. We also analyze crystal structures of trimeric HIV‐1 Env with antibody VRC01, a CD4‐binding‐site directed antibody capable of neutralizing ~90% of HIV‐1 isolates. The double head of a human antibody, a consequence of the heavy chain‐light chain pairing, appears to be sterically constrained relative to the single‐headed llama vHH antibodies. The vaccine implications of these findings will be discussed.

Effect of Selective Medicinal Plant Extract on Blood Glucose, Sperm Shape and Various Physiological Parameters

Salvadora persica, Moringa pergrina and Citrullus colocynthis are three traditional important medicinal species used in indigenous medicinal herbal drugs to cure various diseases in South Asia and Middle East countries. The objective of the present study is to investigate the effects of oral administration of extracts of Salvadora persica leaves, Moringa pergrina leaves and Citrullus colocynthis seeds on different physiological parameters of mice. The leaves of Salvadora persica, Moringa pergrina and Citrullus colocynthis seeds were collected from Ibri and Al-Musanaa, dried and crushed into powder and extract was obtained by soxhalet apparatus. The extract was then administered to mice at a dosage of 0.5%, 1.0%, 1.5% and 2.0% for twenty one days. The mice treated with different concentrations of plant extracts showed different physiological changes, Salvadora persica leaf extract at 1.5% and 2.0% showed hypo activity, grooming, prostration, while mice treated with 0.5% and 1.0% showed no effective behavioral changes. The Moringa pergrina leaf extract dosage of 0.5%, 1.0%, 1.5% and 2.0% produced significant weight loss and affected the blood sugar level. Citrullus colocynthis seed extract at 1.5% and 2.0% showed abnormal sperms shape like circular head, double head and double tails whereas at 0.5% and 1.0% exhibited normal sperm shape.

Runs, strings and alphabets

In [1] Deshpande and Shiwalkar explore the number of double heads that may appear in sequences of coin tosses. They sought to answer questions such as,‘If a (fair) coin is tossed r times, how many possible outcomes result in 0 double heads, how many result in 1 double head, …, how many result in (r – 1) double heads?’Their answer involves Fibonacci expressions. Hirschhorn [2] extended these results using generating functions which on expansion led to some closed form expressions and the statistics of their distribution. Griffiths [3] continues this theme. Another article that touches on the basic idea – a run of particular outcomes – is [4] which is also the source of other references; [5] is also concerned with the same idea.

Toxic Effects of Miller on Chromosomes and Sperms of Albino Males Mice

The genotoxicity of Miller (glyphosate) herbicide was evaluated in males albino mice Mus muscles BALB/c strain. The tested parameters were chromosomal aberrations and sperm abnormalities to evaluate a possible damage effects on genetic material and sperms. The herbicide was administered orally to adult male laboratory mice in 4 different doses (0, 250, 500, and 750 mg/kg of body weight). The mice were killed at two periods: after 3 and 6 weeks. The results of chromosome aberration assay revealed that all the tested doses and periods induced structural chromosomal aberrations (CAs) such as centromeric gaps, chromatid gaps, delations, dicentric chromosomes and ring chromosomes. The results of sperm abnormality assay revealed that miller has the ability to induce sperm abnormalities in all doses used comparing to untreated mice, which represented by hookless sperm, swollen head sperm, amorphous head sperm, sperm without head, defective hook sperm, banana head sperm, double head sperm, sperm without tail, double tail sperm, bent midpiece defect and coiled tails.

Safety profile and complications of autologous limbal conjunctival transplantation for primary pterygium

PurposePrimary pterygium is a fibrovascular proliferation over the nasal cornea, probably resulting from the limbal stem cell deficiency. Intraoperative mitomycin-C application seems to associate with reduced recurrences, however produced ocular surface problems and vision threatening complications. The present clinical study investigated the safety profile of autologous limbal conjunctival transplantation in terms of recurrence rate, as the main outcome measure and complications as the secondary outcome. MethodsThe present study was randomised, interventional and prospective clinical study conducted from a tertiary Hospital. Pterygium excision was performed with limbal conjunctival autograft availed from the affected eye. Secondary pterygia resulting from inflammation, trauma and other diseases were excluded. Patients were followed up for 18months for recurrence and other complications. Microsoft Office Excel 2007 was used for statistical analysis. ResultsA total of 71 eyes of sixty-eight patients with primary pterygia included between November 2007 and October 2010. The study recruited 35 (51%) males and 33 (49%) females with mean age of 36.9 with ±12.82years standard deviation (mean, SD) ranging from 19 to 75years. Age grouped by range intervals categorised into six groups. Pterygium was diagnosed in 32 (45%) right eyes and 39 (55%) left eyes. There were 65 (91.55%) nasal and 4 (5.63%) temporal pterygium and no case of double head pterygia found. Average horizontal extension of the pterygium measured was 1.67mm (±4.23) from the apex to the corneal limbus. Graft oedema in 1 (0.71%) patient, graft bleed in 2 (1.42%) cases and 1 (0.72%) case of granuloma observed. No recurrences encountered during 18months follow up. ConclusionsPterygium occurred predominantly in the younger population group 36.9mm (±12.82) probably due to the increased outdoor activity with high exposure to sunlight and dusty atmosphere. Absence of recurrences was probably attributable to the smaller pterygium size of 1.67mm (±4.23), use of the autologous limbal conjunctival graft and treatable intra and post operative complications successfully.