Mm In Group Research Articles

Retinal Nerve Fibre Layer Analysis in Non-Glaucomatous Pseudoexfoliation Syndrome Patients

Abstract Background Pseudoexfoliation syndrome (PXS) is a disorder characterized by the progressive accumulation of fibrillary extracellular deposits in several ocular tissues. It is an independent risk factor for glaucomatous optic nerve damage. Retinal nerve fiber layer (RNFL) thickness analysis using optical coherence tomography is a documented investigative tool to detect glaucoma at an early stage. Objective The aim was to evaluate and compare RNFL thickness in PXS patients without glaucoma with their age- and sex-matched healthy controls and detect the possibility of early glaucomatous damage in patients with RNFL thinning. Study Design This was a cross sectional case–control study. Materials and Methods A total of 100 patients were included, of which 50 were cases (Group A) and 50 were controls (Group B). RNFL thickness of cases and controls were compared using Zeiss Cirrus HD-OCT 500 (ZEISS Medical Technology, United States). Results There were no significant differences between the two groups with respect to mean RFNL thickness in nasal (p = 0.129) and temporal quadrants (p = 0.832). The mean inferior RNFL thickness values were 112.9 ± 21.72 μm in Group A and 120.6 ± 10.35 μm in Group B (p = 0.002). The mean thickness of the retinal nerve fiber layer in superior quadrant in Group A was 101.6 ± 23.16 μm, whereas it was 113.5 ± 13.47 μm in group B (p < 0.001). The average RFNL thickness in Group A was 85.1 ± 13.99 μm and it was 88.9 ± 7.01 μm in Group B (p = 0.017). Conclusion There was statistically significant difference in RNFL thickness between cases and controls in inferior and superior quadrants and in global average thickness.

Extracorporeal Shockwave Lithotripsy for Cystine Stones in Children: An Observational, Retrospective, Single-Center Analysis.

Purpose: Cystinuria is a genetic disorder characterized by a defective reabsorption of cystine and dibasic amino acids leading to development of urinary tract calculi from childhood onward. Cystine lithiasis is known to be resistant to fragmentation. The aim was to evaluate our long-term experience with extracorporeal shockwave lithotripsy (ESWL) used as first-line urological treatment to treat cystine stones in children.Methods: We retrospectively reviewed the charts of all children who underwent ESWL for cystine stone. We assessed the 3-month stone-free rate, according to age, younger (group 1) or older (group 2) than 2 years old.Results: Between 2003 and 2016, 15 patients with a median (IQR) age at first treatment of 48 (15–108) months underwent ESWL in monotherapy. Median age was, respectively, 15 and 108 months in each group. The median (IQR) stone burden was 2,620 (1,202–8,265) mm3 in group I and 4,588 (2,039–5,427) mm3 in group II (p = 0.96). Eleven patients had bilateral calculi. ESWL was repeated on average 2.4 times, with a maximum of 4 for patients of group I, and 4.8 times, with a maximum of 9 for group II (p > 0.05). ESWL in monotherapy was significantly more efficient to reach stone-free status for children under 2 years of age: 83% vs. 6.2% (p = 0.040). The median (IQR) follow-up of the study was 69 (42–111) months.Conclusion: ESWL appears as a valid urological option for the treatment of cystine stones, in young children. Even if cystine stones are known to be resistant to fragmentation, we report 83% of stone-free status at 3 months with ESWL used in monotherapy in children under 2 years old with cystinuria. In older children, the success rate is too low to recommend ESWL as a first line approach.

Nondamaging retinal laser therapy in recurrent diabetic macular edema after antiVEGF injections.

Subthreshold yellow nondamaging retinal laser therapy (NRT) could provide a greater safety profile when compared to conventional laser methods. NRT may also improve diabetic macular edema (DME). This study aims to assess whether the severity of DME affects the efficacy of subthreshold yellow NRT. The study included 70 eyes that had previously been treated with ranibizumab for DME and then developed recurrent macular edema, which was treated with NRT once. The central foveal thickness (CFT) and best-corrected visual acuity (BCVA) were evaluated retrospectively 2 months following the NRT. The eyes in the study were divided into 4 different groups according to the baseline CFT values. The initial CFT was 250-300 μm in Group 1 (n = 26), 301-400 μm in Group 2 (n = 24), and >401 μm in Group 3 (n = 20). Group 4 (n = 20) included control subjects with 250-300 µm CFT, diagnosed with DME, and not previously treated. The alterations in the BCVA and CFT were measured. In the study, it was determined that 45 right eyes and 45 left eyes were involved. Statistically significant decrements (42.84 m reduction) in CFT were detected only in the Group 1 (p = 0.01). There was no significant improvement in CFT within Group 2, 3 and 4 (p = 0.29, p = 0.73, p = 0.22, respectively). Solely Group 1 had statistically significant improvement (from 0.54 to 0.39 LogMAR) in BCVA (p = 0.01), while groups 2, 3 and 4 had no improvement at all (p = 0.74, p = 0.96, p = 0.66 respectively). Based on the results, NRT provided an improvement in BCVA and CFT in eyes with CFT less than 300 µm at the shortterm follow-up. However, CFT and BCVA outcomes after NRT were inferior to those achieved after previous ranibizumab treatment. No positive effect of NRT was not observed in patients with moderate and severe macular edema in DME treatment.

Effect of abutment finish lines on the mechanical behavior and marginal fit of screw-retained implant crowns: An in vitro study

Statement of problemThe design of the implant-abutment connection has been widely researched, but the impact of different crown-abutment geometries remains unclear. PurposeThe purpose of this in vitro study was to evaluate the effect of different crown-abutment margin geometries on the mechanical behavior and fit of screw-retained implant-supported single-crown restorations by using mechanical static and fatigue tests and mastication simulation. Material and methodsA total of 45 cobalt-chromium premolar-shaped metal frameworks were fabricated for single-unit implant-supported screw-retained restorations on stock abutments and internal hexagon Ø4.25×11-mm cylindrical implants. They were divided into 3 groups according to margin geometry: S, shoulder; C, chamfer; and F, feather-edge. Three static load until fracture and 24 dynamic load tests were performed by using the International Organization for Standardization 14801:2016 standard (ISO 14801:2016) (number of cycles limit: 5×106 cycles, frequency: 6 Hz). The ProFatigue software program was used to optimize the procedure (S, n=12 specimens; C, n=7 specimens; and F, n=5 specimens). Six additional specimens from each group were subjected to a mastication simulation (limit number of cycles: 1×106 cycles, cyclic loading from Pmin=30 N to Pmax=300 N, frequency: 6 Hz). Results from the fatigue tests were reported descriptively, and the Fisher exact test was used to analyze the difference in failure modes. Data from maximum misfit were evaluated by photogrammetry and statistically analyzed with the Anderson-Darling test and the Kruskal-Wallis and Dunn multiple comparison tests (α=.05). ResultsThe fatigue limit was 456 N for group S, 512 N for group C, and 514 N for group F. The mean ±standard deviation misfit was 2.6 ±0.1 μm for group S, 3.8 ±1.1 μm for group C, and 3.6 ±0.8 μm for group F. Differences in misfit between groups S and C and between groups S and F were statistically significant (P<.05). ConclusionsCrown-abutment connections with chamfer and feather-edge margins showed better mechanical behavior, while shoulder margin exhibited better fit. However, high levels of fit were achieved for all the evaluated geometries.

Is it advantageous to use the intraoperative compression option of proximal femoral nail antirotation in the treatment of osteoporotic intertrochanteric fractures? A retrospective comparative study.

The aim of this study was to retrospectively compare the radiological and clinical results of intertrochanteric fractures treated with proximal femoral nail antirotation (PFNA) that were either intraoperatively compressed or non-compressed. Ninety-four patients (64 female, 30 male; mean age = 77.6 years; age range = 68-81) who underwent intraoperative fracture compression (IOFC) (94 hip joints, group A) and 88 patients (64 female, 24 male; mean age = 77.1 years; age range = 67- 80) who underwent postoperative impaction (POI) alone (88 hip joints, group B) from2012 to 2017 met the following six conditions were observed for over 2 years: AO Foundation/Orthopaedic Trauma Association 31-A1 and 31-A2 trochanteric fractures; Singh index grade ≥ 3; positive or neutral medial cortical support position with slightly valgus reduction; possible compression of more than one cortical bone in the anterior or medial region of the fracture site based on preoperative imaging test; blade position within the center-center; andtip-apex distance of < 25 mm. During the follow- up periods, changes of pain and time to fracture union were evaluated clinically, and the lateral extension distance (for screw back-up) was evaluated radiologically which measuredbetween the lateral end of the screw and lateral edge of the intramedullary nail. The mean follow-up was 38.4 (range = 24-48) months in Group A and 36.7 (24-48) months in Group B. The mean operation time was 68 (range = 40-100) min in group A and 71 (range = 40-105) min in Group B (P = 0.521). Intraoperative blood loss was 78 (range = 50-110) mL in Group A and 81 (range = 50-100) mL in Group B (p=0.715). The mean fluoroscopy time was 2.8 (range = 2.2-3.5) min in Group A and 2.6 (range = 2.1-3.5) min in Group B (P = 0.631). The acute phase pain scores measured by visual analog scale at postoperative 3 months were 35.5 in Group A and 37.6 in Group B (P = 0.073). The lateral extension of the PFNA blade showed significant difference at 24 months after surgery (Group A, 3.6±3.1 mm; group B, 7.8±3.7 mm, P = 0.017). Fracture gaps after surgery were 1.8 (range = 0.5-2.5)mmin Group A and 2.6 (range = 0.7-4.6)mmin Group B, showing significant difference (P = 0.001). The average fracture union time was 16.7 (range = 14-20) weeks in Group A) and 19.7 (range = 16-22) weeks in Group B (P = 0.065). The mean Harris Hip Scores at postoperative 24 months were 84.3 (range = 65-100) in Group A and 85.5 (range= 69-100) in Group B (P = 0.545).p Conclusion: If all the six conditions are met, IOFC seems to appropriate for AO/OTA 31-A1 and 31-A2 intertrochanteric fractures with the smaller postoperative fracture gap and lateral protrusion of the blade, which may contribute to the shortening of fracture union periods. Level IV, Therapeutic Study.

Effect of Strontium-Doped Bioactive Glass on Preventing Formation of Demineralized Lesion.

This study investigated the effect of strontium-doped bioactive glass (SBAG) on the formation of dental demineralized lesions. Materials and methods: The study materials were 48 sound human tooth specimens with both dentine and enamel, divided equally into four groups: Group 1 (SBAG), Group 2 (SBAG+Fluoride), Group 3 (Fluoride), and Group 4 (Water as control). After 14 days of pH cycling, the surface morphology of the specimens was observed by scanning electron microscopy. Crystal characteristics of the precipitates were assessed by X-ray diffraction (XRD). Micro-CT was used to measure the mineral loss and the depths of the demineralized lesions formed. Results: Exposure of collagen in inter-tubular areas in dentine was seen in the control group (Group 4) but not in Groups 1 to 3. In Group 2, there were obvious granular particles on the surface of the dentine. XRD revealed precipitation of apatites on the surface of the tooth specimens in Groups 1 to 3. The mean lesion depths in dentine were 81.80 μm, 30.68 μm, 39.04 μm, and 146.36 μm in Groups 1 to 4, respectively (p < 0.001). Lesions in enamel were only found in the control group. The mean mineral loss values in the dentine lesions were 1.25 g/cm3, 0.88 g/cm3, 0.87 g/cm3, and 1.65 g/cm3, in Groups 1 to 4, respectively (p < 0.001). Conclusion: Strontium-doped bioactive glass has a preventive effect on the formation of demineralized lesions in enamel and dentine.

Association of high myopia with peripapillary retinal nerve fiber layer in patients with hypertension.

PurposeTo identify the impacts of hypertension (HTN), high myopia, and the combination thereof on peripapillary retinal nerve fiber layer (pRNFL) thickness.MethodsAll subjects were divided into four groups: control (group 1); patients with HTN without high myopia (group 2); patients with high myopia without HTN (group 3); and patients with both HTN and high myopia (group 4). The pRNFL thicknesses were compared using a one-way analysis of variance. Univariate and multivariate linear regression analyses were used to identify factors affecting pRNFL thickness in subjects with and without HTN.ResultsThe mean pRNFL thicknesses were 93.9±8.8, 88.7±6.8, 86.4±8.1, and 82.5±9.6 μm in group 1, 2, 3, and 4, respectively, and differed significantly (P<0.001). On multivariate linear regression analyses, age (β = -0.181, P = 0.044), axial length (β = -1.491, P<0.001), and HTN (β = -4.876, P = 0.044) significantly affected pRNFL thickness. Additionally, age and axial length affected the pRNFL thickness in subjects with HTN (age, β = -0.254, P = 0.020; axial length, β = -1.608, P<0.001) much more than in subjects without HTN (age, β = -0.028, P = 0.712; axial length, β = -1.324, P<0.001).ConclusionsHigh myopia and HTN affected pRNFL reduction and a combination of the 2 diseases exacerbated pRNFL damage. This could be a confounding factor in interpreting pRNFL thickness in patients with ophthalmic diseases affecting the pRNFL thickness when combined with the 2 diseases.

Choroidal and retinal thickness variations in anaemia and anaemic retinopathy

ABSTRACT Anemia is the most common hematological disorder noted in the people of the Indian subcontinent. Hemodynamic changes following anemia on the retina and choroid are not frequently studied. The aim of the study was to analyse the subfoveal retinal (CRT) and choroidal (SFCT) thickness changes in patients with anemia. In this retrospective, comparative study, patients who were diagnosed with primary anemia and had a fundus examination by a retinal specialist were included. Patients were divided into 3 groups: Group 1: Patients with anemic retinopathy; Group 2: Patients with anemia without retinopathy; Group 3: Normal healthy controls. One hundred and ninety-seven eyes of 197 subjects (group 1 – 38 eyes, group 2 – 90 eyes; group 3 – 69 eyes) met the inclusion criteria. Mean CRT was 269 ± 117µm, 258 ± 99.7µm and 201 ± 19.2µm and SFCT was 303 ± 68.4µm, 303 ± 50.1µm and 275 ± 38.9µm in groups 1, 2 and 3 respectively. Low haemoglobin corelated negatively with retinal (r = -0.362; p = <0.001) and choroidal (r = -0.294; p = <0.001) thickening and reduced visual acuity (r = -0.157; p = 0.03). In conclusion, patients with anemia have a thicker retina and choroid compared to normal healthy controls.

Macular Morphology in Patients With Diabetic Retinopathy Treated by ILM Peeling: A Propensity Score-Matched Analysis.

To analyze the effects of vitrectomy combined with internal limiting membrane (ILM) peeling in patients with diabetic retinopathy (DR) by propensity score-matched analysis. Patients with proliferative DR that underwent pars plana vitrectomy were divided into two groups: without or with additional ILM peeling. Propensity score-matched analyses of variables were carried out. Optical coherence tomography (OCT) was conducted at the 6-month follow-up. The primary outcome measures were epiretinal membrane (ERM), intraretinal cystic changes, recurrent macular edema, and blurring of the inner segment/outer segment (IS/OS) margin. There were 41 patients in Group 1 (non-ILM peeling) and 41 patients in Group 2 (ILM peeling). ERM was observed in 11 of 41 eyes (26.8%) in Group 1, and three of 41 eyes (7%) in Group 2 at the 6-month follow-up (P = .019). Intraretinal cystoid changes were observed in 13 eyes of Group 1 and four eyes of Group 2 (P = .014). The median central macular thickness was 250.00 ± 135.09 μm in Group 1 and 235.00 ± 101.55 μm in Group 2 (P = .738). Macular edema was observed in 24 eyes (58.5%) in Group 1 and 19 eyes (46.3%) in Group 2 (P = 0.269). There was no significant difference in foveal dip angle between the groups (P = .820). The IS/OS margin was disrupted in 48.8% and 56.1% of eyes in Groups 1 and 2, respectively, without significant difference. There was also no significant difference in best-corrected visual acuity (BCVA) between two groups before surgery, and there was no significant difference in BCVA between two groups at 6 months after surgery (P = .13). The authors' results indicate that vitrectomy combined with ILM peeling can minimize ERM formation and eliminate intraretinal cystoid changes, but the functional recovery is limited. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:420-425.].

Comparison of Central Corneal Thickness Measured by Tono-pachymetry and Ultrasound Pachymetry

Purpose: We compared the accuracy of central corneal thickness (CCT) measurements according to CCT measured by noncontact Tono-pachymetry and ultrasound pachymetry (USP). Methods: CCT was measured in 90 eyes of 90 subjects by two optometrists. The CCT measurements were compared and the correlations between the measurements were analyzed. To evaluate whether the measurements varied depending on CCT, the subjects were classified into three groups according to CCT (group 1: thin thickness group; group 2: medium thickness group; and group 3: thick thickness group). The differences in CCT obtained by the two devices (△CCT = Tono-pachymetry-USP) were compared and analyzed among the three groups. Results: The average CCT measurements by Tono-pachymetry and USP were 523.26 ± 32.93 μm and 527.08 ± 37.33 μm, respectively. CCT by Tono-pachymetry was significantly thinner than by USP (△CCT= -3.82 ± 15.34, p = 0.020). The two measurements were strongly correlated (r = 0.912, p &lt; 0.001). The △CCT values were 5.40 ± 12.13 μm in group 1, -6.37 ± 15.07 μm in group 2, and -10.50 ± 14.39 μm in group 3 (p &lt; 0.001). Conclusions: CCT measured by tono-pachymetry was thinner on average compared to the value measured by USP and the differences in measurements between the two devices were different according to CCT. The thinner the CCT, the thicker the measurement, and the thicker the CCT, the thinner the measurement. Therefore, this trend should be considered when interpreting tono- pachymetry results in clinical practice.

Marginal and internal fit of metal copings cast from wax patterns fabricated by CAD/CAM and conventional wax up techniques

Background: Wax patterns are fabricated with wax using particular waxing instruments in conventional techniques. The present study was conducted to compare marginal and internal fit of metal copings cast from wax patterns fabricated by CAD/CAM and conventional wax up techniques.Materials & Methods: 30 standardized brass dies were randomly divided into 2 groups according to the wax-patterns fabrication method. Group I comprised CAD/CAM technique and group II conventional method. Each group comprised of 15 dies. Results: Marginal gap in group I was 145.2 µm and in group II was 72.6 µm, absolute marginal discrepancy in group I was 215.7 µm and in group II was 90.4 µm, internal gap axial in group I was 82.4 µm and in group II was 61.2 µm, internal gap occlusal in group I was 192.4 µm and in group II was 120.5 µm and internal gap total in group I was 112.6 µm in group II was 74.2 µm. The difference between both groups was significant (P

Long term predictive ability of preoperative retinal nerve fiber layer thickness in visual prognosis after chiasmal decompression surgery

ObjectiveTo investigate the relationship between preoperative retinal nerve fiber layer (RNFL) thickness and the recovery of visual field (VF) and visual acuity (VA) 1 year after surgery in chiasmal compression patients presenting with visual impairment. Patients and methodsTwenty-nine eyes of 16 patients with chiasmal compression and 14 eyes of 14 control subjects were enrolled. All patients undergoing chiasmal decompression surgery via a transsphenoidal approach were prospectively evaluated before and 1 year after surgery with best corrected visual acuity (BCVA, logMAR), mean deviation (MD) value with standard automated perimetry (SAP) and RNFL thickness with optical coherence tomography. Eyes with chiasmal compression were divided into two groups according to the mean preoperative RNFL thickness: ≥ 100 µm (Group 1) and < 100 µm (Group 2). The relationship between the mean preoperative RNFL thickness and visual prognosis parameters (VF, VA) was analyzed. ResultsThe mean preoperative RNFL thickness was 115.92 ± 8.97 µm, 84.0 ± 8.85 µm, and 114.21 ± 7.75 µm in Group 1 (n = 15 eyes), Group 2 (n = 14 eyes) and the control group (n = 14 eyes), respectively. The mean preoperative BCVA was 0.15 ± 0.3 in Group 1, and 0.41 ± 0.39 in Group 2. The mean BCVA increased to 0.03 ± 0.1 in Group 1 in the postoperative period but did not change in Group 2. MD value was − 6.10 ± 5.54 in the preoperative period and − 2.59 ± 2.23 in the postoperative period for Group 1 (p = 0.014), while it was − 18.97 ± 4.14 in the preoperative period and − 18.57 ± 4.51 in the postoperative period in Group 2 (p = 0.24). ConclusionsThis study suggests that lower mean preoperative RNFL thickness was associated with poorer long-term visual prognosis. Preoperative RNFL thickness measurements may be helpful in predicting the recovery of VF and VA after decompression surgery in patients with chiasmal lesion presenting with visual impairment.

Lithium Disilicate Glass-Ceramic Surface Appearance after Acid Surface Treatment

Dental ceramics are widely used and studied in dentistry because they are durable, aesthetically appealing and provide excellent biocompatibility. All glass-ceramic surfaces must be etched using hydrofluoric acid (HF) to increase surface roughness determined by roughness average (Ra) before cementation to a tooth surface. This research aimed to analyze the effect of hydrofluoric acid surface treatment concentration on the surface roughness of lithium disilicate glass ceramic. A total of fifteen discs of lithium disilicate glass ceramic were prepared (10mm in diameter and 1mm in thickness). Specimens were divided into 3 groups (n=5). Group A (control) was no treatment, group B was etched by 5% HF for 2 min, and group C was etched by 9.5% HF for 2 min. The etched surfaces were observed by Scanning Electron Microscope (SEM). The measurement of the Ra of the lithium disilicate glass ceramic was determined with surface roughness tester machine. The results showed that the means of Ra (μm) were 0.096±0.009μm, 0.608±0.054μm, and 0.892±0.101μm in group A, B, and C, respectively. The one-way ANOVA showed there was an effect of hydrofluoric acid surface treatment concentration on the surface roughness of the lithium disilicate glass ceramic. The post hoc test showed there was a difference of Ra (μm) among the experimental study groups (p<0.05). In conclusion, the concentration of hydrofluoric acid influences Ra of lithium disilicate glass ceramic.

Abstract No. 493 Is there any benefit from VIATORR stent overdilation?

VIATORR stent has become the standard of care in transjugular intrahepatic portosystemic shunt (TIPS) placement due to its longer primary and secondary patency rates. However, TIPS shunt maintenance with percutaneous transluminal angioplasty (PTA) with or without stent extension may be needed in many patients. In our practice we routinely overdilate 10-mm VIATORR stents using a 12-mm high-pressure angioplasty balloon if the portosystemic pressure gradients are still inadequate after 10-mm PTA. We intend to retrospectively evaluate the efficacy and safety of this approach. IRB approval was obtained. We enrolled TIPS shunt revision cases with initial TIPS placement indication of either ascites or secondary variceal bleeding prophylaxis from 2010 to -2019. After applying exclusion criteria, 78 cases were recruited to this study, with 40 cases in the 10-mm PTA group as the control and 38 in the 12-mm PTA group. The post-procedural effect on hepatic encephalopathy, 30-day MELD scores and pertinent lab values including serum creatinine (sCr), total bilirubin (TBili), platelet count (PLT) and International Normalized Ratio (INR) plus the secondary patency duration were analyzed. Major and minor complications were evaluated to establish a safety profile. Baseline demographic characteristics of both patient groups were similar (P > 0.05). Multivariate logistic regression was conducted, which did not show any significantly different effect on hepatic encephalopathy, 30-day MELD score and lab values including sCr, TBili, PLT, or INR, or secondary patency duration between the 2 groups. Among all enrolled cases, there were no minor or major complication at 30-day follow-up. VIATORR stent overdilation with 12 -mm PTA may be a safe and effective technique to achieve the target intraprocedural portosystemic gradient when 10 -mm PTA is not adequate. This approach may avoid the need for a parallel TIPS placement procedure.

Effects of tamoxifen therapy on sciatic nerve crush injury: An experimental study in rats.

This study aimed to determine the effects of tamoxifen on sciatic nerve crush injury in a rat model using histopathological, histomorphometric, and immunohistochemical approaches. In this study, 24 male Sprague-Dawley rats aged of 5 to 7 weeks and weighing between 300 g and 400 g were used. The rats were randomly divided into 3 groups: control (group C), sciatic nerve injury (group SNI), and sciatic nerve injury with tamoxifen (group SNT). The sciatic nerve crush injury model was performed using the De Koning's crush force method. In group C, only a skin incision was made and then the skin was sutured. In group SNI, the injury model was performed but no treatment was applied. In group SNT, the injury model was executed, and then 40 mg/kg/day tamoxifen was given for 4 weeks by intraperitoneal methods. At the end of 4 weeks, all animals were killed using high doses of an anesthetic. Approximately, 2-cm sciatic nerve samples were obtained for histopathological, histomorphometric, and immunohistochemical analyses using the old skin incision. In the histopathological examination, vascular congestion and density of vacuolization were significantly lower in group SNT than in group SNI (p<0.05). In the histomorphometric examination, the mean sciatic nerve diameter was 306±62 µm in group C, 510±42 µm in group SNI, and 204±23 µm in group SNT. A significant difference was observed in the sciatic nerve diameter measurements among the 3 groups (p<0.05). In pairwise comparisons, the mean sciatic nerve diameter was significantly lower in group SNT than in group SNI (p=0.00002). Sciatic nerve diameter measurements of both groups were found to be significantly higher than group C (p<0.05). The mean epineurium thickness was 17±0.8 µm in group C, 32±2.5 µm in group SNI, and 17±0.8 µm in group SNT. A significant difference was observed in the epineurium thickness measurements among the 3 groups (p<0.05). In pairwise comparisons, the epineurium thickness was significantly higher in group SNI than in groups SNT and C (p<0.05). In the immunohistochemical analysis, S100 immunoreactivity was found significantly higher in group SNI than in the other 2 groups (p<0.05). The histomorphometric, histopathological, and immunohistochemical data obtained from this study have shown that tamoxifen has a beneficial effect on sciatic nerve crush injury in the experimental rat model.

Remineralizing effect of a new strontium-doped bioactive glass and fluoride on demineralized enamel and dentine

ObjectiveTo investigate the remineralizing effect of a strontium-doped bioactive glass (HX-BGC) and fluoride on demineralized enamel and dentine. MaterialsSixty demineralized human tooth specimens were allocated to four groups. Group 1 received 5% HX-BGC, Group 2 received 5% HX-BGC and 1450 ppm fluoride, Group 3 received 1450 ppm fluoride, and Group 4 received deionized water as negative control. The specimens were subjected to pH cycling for 14 days. The surface morphology, lesion depths, crystal characteristics and collagen matrix degradation of the specimens were assessed by scanning electron microscopy (SEM), micro-computed tomography (mico-CT), X-ray diffraction (XRD), and spectrophotometry with a hydroxyproline (HYP) assay, respectively. ResultsSEM images showed the enamel surface was smooth with regularly arranged enamel rods in Groups 1–3. Granular grains were observed in both inter-tubular and intra-tubular dentine in Groups 1–3. The mean lesion depths in enamel were 80.8 μm, 50.6 μm, 72.7 μm and 130.7 μm in Groups 1–4, respectively (p < 0.001), and those in dentine were 152.6 μm, 140.9 μm, 165.4 μm and 214.1 μm, respectively (p < 0.001). The differences in mean mineral loss in enamel and in dentine between the four study groups follow the same pattern as that of the differences in lesion depth. XRD illustrated apatite formation in each group. There were no significant differences in the HYP concentrations among the four groups (p = 0.261). ConclusionCombined use of HX-BGC and fluoride can reduce mineral loss and promote remineralization of demineralized enamel and dentine through the precipitation of newly formed apatite. Clinical significanceAdjunctive use of HX-BGC may enhance the remineralization effect of fluoride in the management of early dental caries lesions.

Impact of surgical experience on early post-operative regional corneal thickness after phacoemulsification

Background: Currently, phacoemulsification is a very common cataract surgical procedure in which the lens is emulsified and aspirated from the eye through a small corneal incision.Aim: To compare early regional corneal thickness changes following phacoemulsification done by experienced surgeons versus trainee surgeons.Setting: A prospective cohort study was done at Ibn Al Haitham tertiary eye hospital in Baghdad, Iraq.Methods: The data were collected for 5 months, from 01 March 2018 until 31 July 2018. Adult patients undergoing phacoemulsification and intraocular lens surgery were prospectively evaluated and divided into two groups. Group 1 comprised those operated by experienced surgeons, whilst Group 2 patients were operated by trainee surgeons. Slit lamp examination and endothelial specular microscopy were assessed with the measurement of central corneal thickness (CCT) and peripheral corneal thickness (PCT), using Scheimpflug imaging (Pentacam).Results: There was a significant statistical difference in post-operative CCT between Groups 1 and 2, being 596.72 ± 50.69 µm compared to 631.54 ± 67.84 µm in Groups 1 and 2, respectively, with a mean difference of 34.82 µm (p = 0.000). More difference was observed in post-operative PCT (148.38 µm) as it was 734.8 ± 88.55 µm in the experienced group, compared to 883.18 ± 128.43 µm in the trainee group (p = 0.005).Conclusion: Phacoemulsification done by trainee surgeons was associated with higher CCT and PCT.

Analysis of pain markers and epidural fibrosis caused by repeated spinal surgery in Sprague\u2013Dawley rats

BackgroundEpidural fibrosis is one of the aetiologies of pain following a spinal revision surgery. It is reported that the specific members of the mitogen – activated protein kinases (MAPK) family might mediate neuropathic pain. However, roles of epidural fibrosis caused by repeated spinal surgeries and pain-related proteins in causing the post spinal surgery syndrome remain unknown. Using a rat spinal surgery epidural fibrosis and adhesion model, in this study, we evaluated and investigated the relationship between pain markers and epidural fibrosis.MethodsSprague–Dawley rats that underwent the spinal surgery were divided into three groups: group A (single laminectomy), group B (two repeated surgeries) and group C (three repeated surgeries). Dural thickness was measured in each experimental group, and immunohistochemical analysis and western blotting of mitogen-activated protein kinases were performed (ERK, p38 and JNK) using the spine cord.ResultsDural thickness was 6.363 ± 1.911 μm in group A, 13.238 ± 2.123 μm in group B and 19.4 ± 2.115 μm in group C, respectively. In the western blotting, phosphorylated ERK expression gradually increased with the number of repeated surgeries, and expression in groups B (1.77-fold) and C (2.42-fold) increased as compared to expression in group A. Phosphorylated p38 showed an increasing trend with the number of repeated surgeries, and groups B (1.17-fold) and C (1.33-fold) expression increased compared with group A. However, phosphorylated JNK expression did not gradually increase with the number of repeated surgeries, and groups B (1.62-fold) and C (1.43-fold) expression increased compared with group A. Excluding phosphorylated JNK, immunohistochemical analysis revealed that phosphorylated ERK and p38 expression gradually increased with the number of repeated surgeries in the spine dorsal horn, as evidenced by western blotting.ConclusionsRepeated spinal surgeries may increase dural thickness and expression of phosphorylated ERK and p38 in the spinal dorsal horn, and it suggests that the neuropathic pain is likely induced by epidural fibrosis and that the pain increases with the number of repeated surgeries.

Subfoveal choroidal thickness and retinal nerve fiber layer alterations in chronic heart failure patients.

To comparatively evaluate the subfoveal choroidal thickness and the peripapillary retinal nerve fiber layer thickness in patients with chronic heart failure relative to control subjects. A total of 72 chronic heart failure patients and 40 healthy control subjects were enrolled in this study. The patients were categorized into 2 groups: group 1: patients with 30-50% left ventricle ejection fraction and group 2: patients with the corresponding fraction value of <30%. The subfoveal choroidal thickness and the peripapillary retinal nerve fiber layer thickness were measured by spectral domain-optical coherence tomography. The mean subfoveal choroidal thickness was 250.24 ± 68.34 µm in group 1 and 216.72 ± 71.24 µm in group 2, while it was 273.64 ± 77.68 µm in the control group. The differences among the 3 groups were statistically significant. The average peripapillary retinal nerve fiber layer thicknesses were 100.34 ± 8.24, 95.44 ± 6.67, and 102.34 ± 8.24 µm, respectively. No significant differences were noted in the peripapillary retinal nerve fiber layer thicknesses between group 1 and control group, but it was significantly lower in group 2. Our study thus revealed that the subfoveal choroidal thickness was lower in patients belonging to both the chronic heart failure groups in comparison to those in the control group. However, the alteration in the peripapillary retinal nerve fiber layer thickness was noted in only patients with <30% left ventricle ejection fraction. In the clinical practice, reductions in these values are correlated with decreased left ventricle ejection fraction, which may be important for the follow-up of chorioretinal diseases and the evaluation of glaucoma risks in patients with chronic heart failures.

The Effect of Chalazion Excision on Corneal Aberrometric and Densitometric Values.

Objectives:The aim of this study was to investigate the effect of chalazion excision on corneal aberrations and corneal densitometry.Methods:Thirty-six patients with a chalazion in 1 eyelid and 40 healthy subjects were included in the study. Corneal aberration parameters of total root mean square (RMS), RMS high-order aberration (HOA), horizontal trefoil, oblique trefoil, horizontal coma, vertical coma, and spherical aberration values were measured using Scheimpflug corneal topography (Pentacam HR; Oculus Optikgeräte GmbH, Wetzler, Germany). Corneal densitometry values measured from 4 regions of the cornea (0–2, 2–6, 6–10, and 10–12 mm) and 4 corneal depths (anterior, central, posterior, and total) were recorded. Preoperative measurements of the patients (Group 1), postoperative first-month measurements (Group 2), and control group (Group 3) measurements were compared.Results:The total RMS measurement was 1.64±0.48 μm in Group 1, 1.35±0.32 μm in Group 2, and 1.17±0.38 μm in Group 3 (Group 1–2: p=0.007, Group 1–3: p<0.001, Group 2-3: p=0.173). The mean spherical aberration value was 0.183±0.057 μm in Group 1, 0.157±0.048 μm in Group 2, and 0.144±0.050 μm in Group 3 (Group 1–2: p=0.104, Group 1-3: p=0.004, Group 2–3: p=0.781). The total corneal densitometric measurement was 15.95±1.80 gray scale units (GSU) in Group 1, 14.76±1.76 GSU in Group 2, and 14.33±1.49 GSU in Group 3 (Group 1–2: p=0.01, Group 1–3: p<0.001, Group 2–3: p=0.804).Conclusion:It was observed that some corneal aberration and corneal densitometry values were higher in patients with a chalazion compared with those of healthy individuals, and there was a decrease in corneal aberration and densitometry values after surgical excision.