Drop Of Serum Research Articles

Rapid diagnostics for point-of-care quantification of soluble transferrin receptor.

BackgroundIron deficiency (ID) and anaemia are major health concerns, particularly in young children. Screening for ID based on haemoglobin (Hb) concentration alone has been shown to lack sensitivity and specificity. The American Academy of Pediatrics (AAP) recommends soluble transferrin receptor (sTfR) as a promising approach to screen for iron deficiency. However, in most settings, assessment of iron status requires access to centralized laboratories. There is an urgent need for rapid, sensitive, and affordable diagnostics for sTfR at the point-of-care.MethodsAn immunochromatographic assay-based point-of-care screening device was developed for rapid quantification of sTfR from a drop of serum within a few minutes. Performance optimization of the assay was done in sTfR-spiked buffer and commercially available sTfR calibrator, followed by a small-scale proof-of-concept validation with archived serum samples.FindingsOn preliminary testing with archived serum samples and comparison with Ramco ELISA, a correlation of 0.93 (P < 0.0001) was observed, demonstrating its potential for point-of-care assessment of iron status.InterpretationThe analytical performance of the point-of-care sTfR screening device indicates the potential for application in home-use test kits and field settings, especially in low- and middle-income settings. An added advantage of sTfR quantification in combination with our previously reported serum ferritin diagnostics is in integration of Cook's equation as a quantitative and minimally-invasive indicator of total body iron stores.FundThrasher Research Fund (Early Career Award #13379), NIH R03 EB 023190, NSF grant #1343058, and Nutrition International (project #10-8007-CORNE-01).

Uso de soro autólogo como adjuvante no tratamento de úlcera de córnea em equino: Relato de caso

The present study reports the use of autologous serum as adjuvant in the treatment of corneal ulcer in horses. On 09/08/2018 was attended at the Veterinary Hospital Dr. Vicente Borelli, a male equine, Quarter Horse, four years old, weighting 460 kg, submitted to a daily diet composed of 5 kg of concentrate and bulky and water ad libitum. The animal participated in equestrian test, it was transported in closed vehicle (truck), as soon as returned to the property presented ocular discomfort. Therefore, a veterinary service was requested which confirmed the diagnosis for corneal ulcer and instituted treatment that was not successful and was referred to the Veterinary Hospital. In the general clinical examination all the parameters were within normality. An ophthalmic clinical examination was performed, identifying blepharospasms, irregularity and opacity of the cornea and anterior chamber, presence of ciliary ejection, with a positive test for fluorescein. A systemic treatment with Flunixin meglumine administration was started during five days. Thus, the topical treatment with autologous serum was made, collected in red tubes with clot activator of 5 mL centrifuged at 3,000 rpm. Two drops of 1% atropine sulfate/BID were instilled. Between days 09/08 and 09/14 two drops of tobramycin sulfate and autologous serum were instituted every one hour. On 09/15 and 09/16, the frequency of tobramycin sulfate and autologous serum was 2 hours, totaling 12 applications per day. A further fluorescein test was carried out with a reduction of approximately 70%. From 09/17 to 09/20 the frequency was changed to six hours among applications. The fluorescein test was redone at which was negative. On 09/21 the use of autologous serum was ceased, maintaining the applications of tobramycin sulfate until 09/24. Also on 09/21 two drops of diclofenac sodium 0.1% were instilled four times a day until 09/28/2018. That same day the patient was discharged. It is concluded that autologous serum acts as an adjuvant in corneal ulcers in horses, conferring satisfactory results, presenting low cost, practicality of preparation and minimizing the use of conventional treatments without clinical response.

Hepatitis C Virus Diagnostics: The Road to Simplification.

Hepatitis C Virus Diagnostics: The Road to Simplification.

Application of autologous serum eye drops after pterygium surgery: a prospective study.

The study aims to determine the effect of 50% autologous serum drops (ASD) on corneal healing and patient comfort following pterygium surgery. Fifty eyes of 50 patients who underwent pterygium excision combined with autologous conjunctival graft were included in this prospective randomized study: in 25 eyes, 50% ASD. In the remaining 25 eyes, conventional artificial tears (CAT) were applied postoperatively until corneal epithelium had completely epithelialized. Corneal epithelium healing speed, visual analog scale (VAS) for postoperative pain assessment, conjunctival inflammation, and recurrences were evaluated. Patients were followed up for 6months. Mean corneal epithelium closure time was 3.16 ± 0.37days (range 3 and 4days) in ASD group and 4.96 ± 0.84days in CAT group (range 4 and 6days), and the difference was statistically significant (p < 0.001). VAS scores were significantly lower in ASD group than CAT group in the first 5days after surgery. In 9 of 50 eyes, moderate conjunctival inflammation continued 1month: 4 (16%) in ASD group and 5 (20%) in CAT group (p = 0.713). In total, pterygium recurrence was seen in 5 (10%) eyes: 2 eyes (8%) in ASD group and 3 eyes (12%) in CAT group (p = 0.637). ASD accelerated corneal epithelial healing following pterygium surgery. ASD group had lesser pain that was seem to be related with accelerated corneal epithelial healing.

Rapid Detection of Clostridium difficile Toxins in Serum by Raman Spectroscopy

BackgroundClostridium difficile infection (CDI) is due to the effects of toxins, toxin A and toxin B on the host. Severe CDI is associated with systemic signs of infection. Animal models of CDI demonstrate a strong correlation between systemic toxemia and the occurrence of severe disease. However, current technologies have low sensitivity to detect C difficile toxemia in human subjects. Raman spectroscopy (RS) is an upcoming technology that is used to detect bacteria and their toxins. We speculate that RS may be a sensitive method to detect clinically relevant concentrations of C difficile toxins in serum. Materials and methodsSerum samples were spiked with varying concentrations of toxin A, toxin B, and both. RS was performed on an air-dried serum drop that was placed on a mirror-polished stainless steel slide. Raman spectra were obtained, background corrected, vector normalized, and analyzed by Partial Least Square Linear Discriminant Analysis and Support Vector Machine for Classification. Model accuracy was measured by cross-validation and bootstrap methods. ResultsToxin-spiked sera of various concentrations (1 ng/mL, 1 pg/mL, and 0.1 pg/mL) were distinguished from control serum 100% with cross-validation error rate ranging from 0% to 18% and bootstrap error rate ranging from 0% to 12% for various concentrations. The sensitivity ranged from 87% to 100% and specificity ranged from 77% to 100% for various concentrations of toxin-spiked serum. ConclusionsWe conclude that RS may be a sensitive method to detect clinically relevant concentrations of C difficile toxins in serum and thus to help diagnose severe CDI in patients in real-time at the point of care.

Maternal Serum Eye Drops in the Management of Pediatric Persistent Corneal Epithelial Defects: A Case Series.

We report our experience with the use of maternally derived serum eye drops as adjunctive treatment in the management of pediatric persistent corneal epithelial defects. Five eyes of 4 patients were identified in a retrospective review of pediatric patients with persistent corneal epithelial defects who received maternal serum drops. Diagnoses associated with the defects comprised pontine tegmental cap dysplasia with bilateral cranial nerve V1, V2, V3, and VII palsies; pontine tegmental cap dysplasia with left cranial nerve V1, VII, and VIII palsies; traumatic left cranial nerve II, V1, V2, and VI palsies due to a basilar skull fracture; and Stevens-Johnson syndrome with ocular involvement. We evaluated the feasibility of using maternally derived serum drops; thus, we looked at the ability to prepare and tolerate the drops as well as any complications that could have been associated with treatment. Other data collected included visual acuity, corneal examination, and current and previous treatments. Both the duration of therapy and time of follow-up ranged from 5 to 28 months. All patients experienced improvement or resolution of their corneal epithelial defects within 3 weeks of initiating serum eye drops. Furthermore, there were no adverse effects from the use of allogeneic serum drops. Maternal serum eye drops are a well-tolerated and potentially beneficial addition to the management of pediatric persistent corneal epithelial defects.

A hook effect-free immunochromatographic assay (HEF-ICA) for measuring the C-reactive protein concentration in one drop of human serum

The immunochromatographic (ICA) assay is a highly promising platform for rapid and simple detection of C-reactive protein (CRP) which is an indicator of the different phases of various diseases, as well as of inflammation and infection. However, the hook effect in the ICA assay limits the quantification of CRP levels at high CRP concentrations.Methods: In this study, we developed a hook effect-free immunochromatographic assay (HEF-ICA) to detect CRP over a wide concentration range. The hook effect results from the simultaneous reaction of an excess target antigens with both immobilized and labeled antibodies respectively. To reduce the potential occurrence of this simultaneous reaction, we separated the migration of the target antigen and gold nanoparticle (AuNP)-labeled antibodies on a nitrocellulose membrane and analyzed the time profiles by modifying the ICA structure.Results: The signal intensity of HEF-ICA was saturated at high CRP concentrations, without decreasing. The titration curve of HEF-ICA was adjusted with the Hill equation, and HEF-ICA was performed with the following parameters: limit of detection, 43 ng mL-1; dynamic range, 119 ng mL-1 to 100 µg mL-1. The accuracy of the newly developed assay was evaluated using 33 clinical samples via comparison with a clinical chemistry analyzer.Conclusion: HEF-ICA enabled the measurement of a wide range of CRP concentrations without the hook effect, and was suitable for point-of-care testing with fingertip blood sampling, as only a minute sample volume (2.5 µL) was required.

Autologous serum eye‐drops and enhanced epithelial healing time after photorefractive keratectomy

BackgroundThe aim of the study is to test whether use of autologous serum eye‐drops can provide earlier epithelial healing following the application of photorefractive keratectomy.MethodSixty patients (60 eyes) underwent photorefractive keratectomy for myopia. Thirty eyes received autologous serum drops (Study group) while 30 eyes received conventional artificial tears (Control group) after photorefractive keratectomy. An 8 mm epithelial opening was prepared with the application of 18 per cent alcohol for 20 seconds. Photorefractive keratectomy was performed using ESIRIS excimer laser (SCHWIND, Kleinostheim, Germany) with an optic zone of 6.5 mm. Total duration of epithelial healing was monitored as the main outcome measure. The comparisons were done with chi‐square test and independent samples t‐test. Statistical significance was considered at p < 0.05.ResultsPreoperative myopic spherical refraction and ablation depths were similar in the study and control groups. The mean duration for epithelial healing was about one day shorter in the eyes receiving autologous serum compared to the eyes receiving conventional treatment (2.2 ± 0.25 days versus 3 ± 0 days, p = 0.001). All eyes achieved 6/7.5 or better uncorrected visual acuity in six months. In both groups, more than 90 per cent of eyes were within ±0.50 D of emmetropia in 12 months. No significant difference was noted for the incidence of +1 haze.ConclusionUse of autologous serum drops reduces epithelial healing duration following surface ablation for two days.

Serum drops for ocular surface disease: national survey of Canadian cornea specialists

ObjectiveTo review the use and preparation of serum drops for the treatment of ocular surface disease in Canada and to assess the need for an improved access to this therapy. DesignCross-sectional study. ParticipantsCornea specialist members of the Canadian Ophthalmological Society and Canadian laboratories preparing serum tears. MethodsA confidential survey was emailed to participants in April 2016 and continued through September 2016. Descriptive statistics on serum drops accessibility, production, and use are reported. ResultsThirty-four cornea specialists (out of 93) and 8 laboratories completed the survey. Half of respondents (47%) described serum drops as inaccessible in their practice setting, mainly because of financial (75%) and logistic (66%) barriers. The use of allogeneic serum was perceived as a potential solution to poor accessibility by 62% of ophthalmologists. A private laboratory or pharmacy produced serum drops for 52% of respondents, whereas 32% coordinated serum drop procurement through a hospital laboratory. No serological tests were routinely performed, and sterility checks were done by one laboratory. Over the last year, each laboratory prepared serum tears for 49 ± 32 patients, representing a median of 15 patients per ophthalmologist. ConclusionsAlthough most cornea specialists agree that serum drops are indicated in several refractory ocular surface disorders, there is significant discrepancy in accessibility to this treatment across Canada. This study confirms the need for an improved access to serum drops. Use of autologous serum is limited by logistic and financial barriers, which could be reduced by the introduction of an allogeneic serum drop.

An integrated method for simultaneously determining 10 classes of per- and polyfluoroalkyl substances in one drop of human serum

Per- and polyfluoroalkyl substances (PFASs) represent a group of synthetic chemicals, and they have quite different physicochemical properties, which result in difficulties of their simultaneous determination in a single injection. A sensitive, reliable, and fully automated method was developed for simultaneously detecting 10 classes of PFASs (total of 43) in human serum using online Turboflow SPE-UHPLC-MS/MS. This method provided high linearity of matrix-matched calibration standards (R > 0.99), excellent method limits of detection (MLODs) (0.013–0.089 ng mL−1), satisfactory matrix spiked recoveries (84.3–109%) and relative standard deviations (RSDs) (intra-day RSDs: 1.3–12.6%, inter-day RSDs: 1.7–13.8%, inter-week RSDs: 1.8–13.5%, inter-month RSDs: 3.1–12.4%), short analysis time (19 min per sample) and small sample amount requirement (25 μL), which were suitable for large-scale epidemiologic studies. Moreover, the method provided the feasibility of real-time monitoring for the degradation kinetics of PFASs precursors both in vitro and in vivo. The quality of the present method was further verified by repetitive analysis of a standard reference material (SRM 1957), with the deviations of the targeted PFAS concentrations ranging from 1.9% to 14.2% (n = 5) between the detected and reference values. The present study also determined values for several PFASs in SRM 1957 other than those on the certificate, for the first time, such as N-EtFOSA, 6:2 Cl-PFESA, and PFBA. Finally, the established method was applied to detect PFASs in serum samples of 15 ordinary people and 15 occupational workers, and 6:2 FTSA was found as the dominant precursor.

Performance of a polymer coated silicon microarray for simultaneous detection of food allergen-specific IgE and IgG4.

Microarray-based component-resolved diagnostics (CRD) has become an accepted tool to detect allergen-specific IgE sensitization towards hundreds of allergens in parallel from one drop of serum. Nevertheless, specificity and sensitivity as well as a simultaneous detection of allergen-specific IgG4 , as a potential parameter for tolerance development, remain to be optimized. We applied the recently introduced silicon chip coated with a functional polymer named copoly(DMA-NAS-MAPS) to the simultaneous detection of food allergen-specific IgE and IgG4 , and compared it with ImmunoCAP and ImmunoCAP ISAC. Inter- and intraslide variation, linearity of signal and working range, sensitivity and application of internal calibrations for IgE and IgG4 were assessed. Native and recombinant allergenic proteins from hen's egg and cow's milk were spotted on silicon chips coated with copoly(DMA-NAS-MAPS) along with known concentrations for human IgE and IgG4 . A serum pool and 105 patient samples were assessed quantitatively and semi-quantitatively with the ImmunoCAP and ImmunoCAP ISAC and correlated with IgE- and IgG4 -specific fluorescence on silicon microarrays. Allergen-specific IgE and IgG4 were detected in parallel using two fluorescent dyes with no crosstalk. Results from the ImmunoCAP correlated better with microarray fluorescence than with ImmunoCAP ISAC except for the allergen ovomucoid. The working range of the silicon microarray for total hen's egg-specific IgE was comparable to the range of 0.1 to >100kUA /L of the ImmunoCAP system, whereas for total cow's milk, the silicon microarray was less sensitive. Detectable allergen-specific IgG4 could be determined only for low concentrations, but still correlated positively with ImmunoCAP results. We confirmed the ability of the polymer coated silicon microarray to be comparably sensitive to the ImmunoCAP ISAC for various food allergens. This suggests that the copoly(DMA-NAS-MAPS) microarray is a low-cost, self-producible alternative to the commercial ImmunoCAP ISAC in allergy research.

The domestic cat antibody response to feline herpesvirus-1 increases with age

Herpesviruses establish lifelong infections, normally characterized by prolonged periods of latency with intermittent episodes of viral reactivation. Feline herpesvirus-1 (FHV-1) infects domestic cats, and epidemiological studies indicate that many or most domestic cats are exposed to FHV-1, but the strength and longevity of the antibody response to FHV-1 is not fully characterized. Here we describe development of an ELISA, using lysates of cat cells infected with FHV-1, that measure feline antibodies against FHV-1. The assay is sensitive, quantitative and has a large dynamic range. We found that serum anti-FHV-1 antibodies primarily recognize FHV-1 proteins of the Late (L) class and are primarily of the IgG isotype. We then analyzed serum from a cross-sectional cohort of 100 client-owned cats that differed in age, sex and vaccination history. While there was no difference in FHV-1 antibody responses between females and males, antibody levels were significantly increased in older cats in comparison with younger animals (p=0.01). Surprisingly, as the length of time since the most recent vaccination increased, there was no corresponding drop in serum anti-FHV-1 antibody. These data suggest that FHV-1 immunity is very long-lived and support the current recommendation that many cats do not require revaccination against FHV-1 annually.

Using corneal confocal microscopy to track changes in the corneal layers of dry eye patients after autologous serum treatment

BackroundIn vivo corneal confocal microscopy allows the examination of each layer of the cornea in detail and the identification of pathological changes at the cellular level. The purpose of this study was to identify the possible effects of a three‐month treatment with autologous serum eye‐drops in different corneal layers of patients with severe dry eye disease using corneal confocal microscopy.MethodsTwenty‐six patients with dry eye disease were included in the study. Corneal fluorescein staining was performed. The corneas of the right eyes were examined using in vivo corneal confocal microscopy before and after a three‐month treatment with autologous serum drops. The densities of superficial and basal epithelial cells, Langerhans cells, the keratocytes and activated keratocytes, the density of endothelial cells and the status of the sub‐basal nerve plexus fibres were evaluated.ResultsA significant decrease in corneal fluorescein staining was found after the three‐month autologous serum treatment (p = 0.0006). The basal epithelial cell density decreased significantly (p = 0.001), while the density of superficial epithelial cells did not change significantly (p = 0.473) nor did the number of Langerhans cells or activated keratocytes (p = 0.223; p = 0.307, respectively). There were no differences in the other corneal cell layers or in the status of the nerve fibres.ConclusionsThe results demonstrate the ability of corneal confocal microscopy to evaluate an improvement in the basal epithelial cell layer of the cornea after autologous serum treatment in patients with dry eye disease. More studies with longer follow‐up periods are needed to elucidate the suitability of corneal confocal microscopy to follow the effect of autologous serum treatment on nerve fibres or other corneal layers in dry eye disease patients.

Development of a simple and quick immunochromatography method for detection of anti-HPV-16/-18 antibodies.

Immunochromatography (IC) is widely used to detect target molecules in biological fluids. Since this method can be performed without a special technique or device, IC is a convenient way to assess the existence of antibodies or pathogens such as viruses and bacteria, simply and quickly. In this study, we established an IC method to detect serum antibodies against oncogenic human papillomavirus (HPV)-16 and HPV-18 L1 proteins using recombinant L1 proteins produced by silkworms as antigens. Infection of oncogenic HPVs is a major risk factor of cervical cancer, which is one of the most common cancers in women worldwide. We first measured blood sera of two groups by magnetic beads enzyme-linked immunosorbent assay (MB-ELISA). For the first group, sera were collected prospectively from young women who planned to receive HPV vaccination. The second group consisted of children under 20 years of age, non-vaccinated healthy women, vaccinated healthy women, dysplasia, cervical intraepithelial neoplasia III, and cervical cancer patients. We confirmed that standard vaccination doses significantly increased serum HPV antibody concentrations, and the level was sustained at least more than 30 months after vaccination. In contrast, an increase in antibody concentration was not observed in patients with precancerous cervical changes and cervical cancer. We next measured the samples in both groups using the IC method we originally developed, and found that the measurement values of IC highly correlated with those of MB-ELISA. The simple and quick IC method would be a useful tool for rapid monitoring of L1 specific antibody levels in a non-laboratory environment. With less than one drop of serum, our IC can easily detect serum HPV-16/-18 antibodies within 15 minutes, without the need for electronic devices or techniques.

In vitro flow-through assay for rapid detection of endotoxin in human sera: A proof-of-concept

An increase in endotoxin concentration in the bloodstream can trigger activation of innate immune response leading to septic shock. There is currently no method available for rapid endotoxin detection at a patient's bedside. We demonstrate a simple, portable and cost-effective strategy to measure endotoxin levels in human serum within 5min using a flow-through assay. A drop of serum containing LPS was spotted on an endotoxin-affinity membrane placed over high-wicking absorbent pads. Subsequent addition of polymyxin B sulfate drug-conjugated gold nanoparticles allowed concentration-dependent visualization of spots by the naked eye in the clinically-relevant range of 10pg/mL to 10ng/mL. The results were quantified using a concentration-calibrated color chart and the assay performance was tested with archival plasma samples of 18 known septicemia patients. The results showed a reasonably good correlation with the patients' hematological data. This proof-of-concept study puts forth an interesting alternative for early septicemia diagnosis in future.

Detecting circulating antibodies by controlled surface modification with specific target proteins: Application to malaria

Sensitive detection of specific antibodies by biosensors has become of major importance for monitoring and controlling epidemics. Here we report a development of a biosensor able to specifically measure antibodies in a drop of unmodified blood serum. Within minutes, the detection system measures presence of antibodies against Plasmodium vivax, a causing agent for malaria. The biosensor consists of a layer of carbon nanotubes (CNTs) which were casted on a carbon working electrode area of a three-electrode system and oxidized. An amine layer was produced next by modifying the surface with EDAC/NHS followed by reaction with a diamine compound. Finally, the protein fragments derived from P. vivax containing well-known antigen sequences were casted on this layer and bound through electrostatic interactions, involving hydrogen and ionic bonding. All these chemical changes occurring at the carbon surface along the biosensor assembly were followed and confirmed by Fourier Transformed Infrared s pectrometry (FTIR) and Raman spectroscopy.The presence of antibodies in serum was detected by monitoring the electrical properties of the layer, making use of cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS) and square wave voltammetry (SWV), against a standard iron probe. Overall, the charge-transfer resistance decreased after antibody binding, because there was an additional amount of protein bound to the surface. This hindered the access of the iron redox probe to the conductive support at the electrode surface. Electrical changes could be measured at antibody concentration as low as ~6–50pg/L (concentrations in the range of 10–15M) and as high as ~70μg/L. Specific measurement with low background was even possible in undiluted serum. Hence, this novel biosensor allows assessing serum antibody levels in real time and in un-manipulated serum samples on-site where needed.

Methionine sulfoxides in serum proteins as potential clinical biomarkers of oxidative stress.

Oxidative stress contributes to the pathophysiology of a variety of diseases, and circulating biomarkers of its severity remains a topic of great interest for researchers. Our peptidomic strategy enables accurate and reproducible analysis of circulating proteins/peptides with or without post-translational modifications. Conventional wisdom holds that hydrophobic methionines exposed to an aqueous environment or experimental handling procedures are vulnerable to oxidation. However, we show that the mass spectra intensity ratio of oxidized to non-oxidized methionine residues in serum tryptic proteins can be accurately quantified using a single drop of human serum and give stable and reproducible results. Our data demonstrate that two methionine residues in serum albumin (Met-111 and Met-147) are highly oxidized to methionine sulfoxide in patients with diabetes and renal failure and in healthy smokers versus non-smoker controls. This label-free mass spectrometry approach to quantify redox changes in methionine residues should facilitate the identification of additional circulating biomarkers suitable for predicting the development or progression of human diseases.

Topical N‐acetylcystein on patients with refractory filamentary keratitis

PurposeTo investigate the effect of topical N‐acetylcystein (NAC) on patients with refractory filamentary keratitis.Methods29 eyes from 20 patients diagnosed with filamentary keratitis were reviewed retrospectively. The cause, treatment methodology, relief of symptoms, number of filaments, change in fluorescein stains score, degree of healing and relapse of the disease were reviewed.Results19 eyes of 14 patients completely healed in average 10.78 ± 8.68 days using drops of topical antibiotics, artificial tears, steroid, serum, cyclosporine, therapeutic lense and punctal plug. After complete remission, one patient with GVHD and two patients with keratoconjunctivitis sicca (KCC) experienced relapse. 10 eyes of 6 patients refractory to the therapy for more than 1 month were additionally prescribed with 10% topical N‐acetylcystein (NAC). In average of 60.33 ± 21.11 days, 7 eyes were completely healed and 2 eyes were partially healed. One eye were ceased of 10% topical N‐acetylcystein (NAC) due to severe eye irritation.ConclusionsTopical N‐acetylcysteine treatment might have some side effect as irritation in the eye, but it could be considered as an effective treatment of refractory filamentary keratitis.

A STUDY OF THE EFFECT OF HYPOTONIC HYPER-HYDRATION FLUIDS ON SODIUM BALANCE IN PAEDIATRIC HAEMATOLOGY/ONCOLOGY PATIENTS RECEIVING CHEMOTHERAPY

AimsTo determine the effect, if any, that hyper-hydration with hypotonic fluids has on sodium balance in paediatric haematology/oncology patients receiving cytotoxic chemotherapy treatment for malignancies.MethodsA literature review was carried out...

Comparison of Amniotic Membrane Transplantation and Umbilical Cord Serum in Acute Ocular Chemical Burns: A Randomized Controlled Trial

To compare the efficacy of topical umbilical cord serum drops (UCS) and amniotic membrane transplantation (AMT) in acute ocular chemical burns. Randomized controlled trial. setting: Tertiary care hospital. Forty-five eyes with acute chemical burns of grade III, IV, and V (Dua's classification) presenting within the first week of injury were randomized into 3 groups (15 each). Patients with perforation/impending corneal perforation were excluded from the study. Groups 1, 2, and 3 received UCS with medical therapy (MT), AMT with MT, and MT alone, respectively. Time to complete epithelialization. The mean time to complete epithelialization was 56.7 ± 14.9, 22.0 ± 10.2, and 22.9 ± 10.1days in MT, AMT, and UCS groups, respectively, with a significant difference between MT and AMT (P= .001) and between MT and UCS (P= .001), but not between UCS and AMT (P= .9). Improvement in pain score was better with UCS than AMT (P value: .012, .002, and .012 on days 7, 14, and 21, respectively). Corneal clarity was better in the UCS group at 21 (P= .008) and 30days (P= .002), but not at 3months (P= .9). By month 3, visual outcome, symblepharon, tear film status, and lid abnormalities were comparable between the 3 groups. UCS and AMT, as an adjuvant to standard medical therapy in acute chemical injury, are equally efficacious. UCS has the advantage of faster improvement in corneal clarity, better pain control, and avoidance of surgery in an inflamed eye.