Search

Berker Bakbak, Banu Turgut Ozturk, Sansal Gedik, Bengu Ekinci Koktekir, Saban Gonul Selcuk University Medical Faculty, Department of Ophthalmology, Konya, Turkey Abstract: A 56-year-old man noted a sudden decrease of vision in his right eye 4 hours after intramuscular triamcinolone acetonide (TA) injection. A diagnosis of unilateral nonarteritic anterior ischemic optic neuropathy (NAION) was made, and the patient was counseled to discontinue using TA. Examination for possible risk factors revealed controlled hypertension. Final visual acuity was finger counting at 1 m, and the optic disc was pale in his right eye. This is the first reported case of unilateral NAION that has occurred in a patient after intramuscular corticosteroid injection. Although a cause-and-effect relationship is difficult to prove, the short duration between the TA injection and the NAION is noteworthy. The history of corticosteroid injection should be questioned in cases with predisposing conditions such as hypertension. Keywords: ischemic optic neuropathy, corticosteroids, optic disc edema

We investigated repair of acrylamide (AA) induced damage in intestines by administration of crocin. We used 40 male Wistar rats in four groups of 10 animals: control, AA, crocin, and AA + crocin groups. We investigated biochemical and histological changes to small and large intestine. AA ingestion decreased glutathione (GSH) levels and total antioxidant status (TAS) in the intestine compared to the control group, while superoxide dismutase (SOD) and catalase (CAT) activities, and total oxidant status (TOS) and malondialdehyde (MDA) levels were increased. Villi were shortened and villus degeneration was observed in ileum of the AA group. Degeneration of surface epithelium and Liberkühn crypts were observed in colon sections. GSH and TAS levels increased after administration of AA together with crocin, while SOD and CAT levels and TOS and MDA levels decreased; significant recovery of histological damage also was observed. We found that crocin exhibits protective effects on AA induced small and large intestine damage by inhibiting oxidative stress. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: Hypertensive crisis is a condition characterized by rapid and inappropriate symptomatic elevation of blood pressure (BP) that is commonly seen in Emergency Departments. Oral or sublingual captopril is commonly used in the Emergency Departments. The unpleasant taste of the sublingual drugs causes uncomfortable condition to the patient. Studies showing no difference between oral and sublingual captopril has been ignored so far. Herein we compared the oral and sublingual captopril efficiency in the hypertensive urgencies. MATERIALS AND METHODS: In this retrospective observational study, 71 patients admitted with hypertensive urgency to Emergency Departments of two hospitals in 2011 whose blood pressure were recorded before captopril administration and blood pressure were recorded after captopril administration at 0-5-15-30-45-60 minutes were included the study. The reductions of the blood pressure of oral and sublingual captopril groups were compared. RESULTS: There were 28 patients at oral and 43 at sublingual captopril group. The mean age ± SD was 58.13 ± 8.66 years and 41 (57.7%) patients were female. The most common complaints were headache, nausea/vomiting and weakness. 65 (91.5%) patients were using antihypertensive drugs before admitted to hospital. The blood pressure at 0, 5, 15, 30, 45 and 60th minutes of therapy didn't show any difference between oral and sublingual captopril use. CONCLUSIONS: There was any difference between oral and sublingual captopril efficiency to control of hypertension in patient with hypertensive urgency. For a more comfortable treatment, oral captopril may be a more convenient choice in the hypertensive urgencies. [ABSTRACT FROM AUTHOR]

Copyright of West Indian Medical Journal is the property of West Indian Medical Journal (WIMJ) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A 40-year-old woman was monitored for mitral, aortic, and tricuspid valve insufficiency caused by rheumatic heart disease and underwent right and left ventricular catheterization and coronary angiography. During the procedure, she suddenly complained of horizontal diplopia. Neuro-ophthalmologic examination revealed 40-prism diopter exotropia in the primary position and adduction paralysis in both eyes. Cranial magnetic resonance imaging revealed an infarct in the brainstem at the pontomesencephalic level in the medial longitudinal fasciculus site. The patient was diagnosed as having wall-eyed bilateral internuclear ophthalmoplegia (WEBINO). To the authors' knowledge, this is the first report of a patient in whom WEBINO developed after cardiac catheterization. [ABSTRACT FROM AUTHOR]

Extranodal marginal zone B-cell non-Hodgkin's lymphoma affecting bilateral orbital regions was diagnosed in an 80-year-old man. He was given chemotherapy and external beam irradiation therapy. Two months after treatment, repeat orbital magnetic resonance imaging showed dramatically improved lesions. In this case report, orbital non-Hodgkin's lymphoma and treatment options are discussed. [ABSTRACT FROM AUTHOR]

Focuses on several studies related to treatment of eye disorders, retinopathy and neuropathy. Correlation between retinopathy and neuropathy in diabetes mellitus type 2; Treatment of oculomotor disorder among children; Test for assessment of visual performance with relevance to corneal refractive surgery.

Presents several studies related to retinal vasculopathies. Relationship between congenital night blindness and mutation in Leucine-rich repeat protein; Assessment of non-embolic transient monocular blindness; Effect of stereotactic radiotherapy optic nerve sheath meningiomas.

Background: Thinking that they are being stigmatized can negatively affect the mental health of healthcare workers, whose workload has already increased during the epidemic. The aim of the study was to develop the ‘Perception of Stigma due to COVID-19 in Physicians’ (PSCP) and to conduct a validity and reliability study. Methods: A 5-point Likert-type 23-item question pool was created. In order to evaluate the content validity, CGI and CGO were calculated by taking expert opinions and 18 items were selected. It was tested with 303 physicians in Turkey to determine the psychometric properties. In order to evaluate the reliability of the scale, internal consistency (Cronbach’s alpha) analyzes, item analysis and test-retest reliability analysis were performed. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used for construct validity. Results: Of the participants 59.1% were female. After analysis, the scale consisted of 10 items and 2 sub-dimensions. The Cronbach’s alpha coefficient was 0.87 for the environmental stigmatization sub-dimension, 0.76 for the perception of personal stigmatization, and 0.88 for the whole scale. Scale items explained 61.56% of the total variance and factor loads varied between 0.66 and 0.85. Scale fit and fit index were found to be acceptable as a result of CFA. Pearson correlation coefficient calculated for test-retest reliability was 0.63, and intraclass correlation coefficient was 0.70 (95% CI 0.38-0.86, p: 0.001). In the final, the total score that can be taken from the scale was between 0-50. The mean total score obtained from the scale was 24.3 7.9. Of the physicians 46.9% scored above the average. It was accepted that as the score obtained from the scale increased, the level of perception of stigma caused by COVID-19 increased in physicians. Conclusions: PSCP is a valid and reliable tool for assessing perception of COVID-19-induced stigma in healthcare workers. Key messages: The scale developed is a tool that can be used in studies aimed at evaluating the stigma perceptions caused by COVID-19 in physicians. During the COVID-19 pandemic, physicians’ level of stigma perception obtained with the PSCP scale was high. [ABSTRACT FROM AUTHOR]

Copyright of West Indian Medical Journal is the property of West Indian Medical Journal (WIMJ) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: Stroke is most second reason in cardiovascular deaths and most common reason of deaths in neurologic accidents. Changing techniques in carotis endarterectomy operations defines operation necessities early and mid term fallow up. We evaluated the early and mid term results of carotis endarterectomy under deep cervical blockage in our study. Study plan:We examine the 12 patients (4 female, 8 male; mean age 67,5(52-78)) whom carotis endarterectomy was performed with longitudinal arteriotomy under locoregional anesthesia. Patient's perioperative properties and postoperative accident was noted as fist week, first month, 6th month and one year control. We searched residual and new stenosis, occlusion and false aneurysms at 3rd and 6th month Doppler ultrasonography follow up. Mean fallow up time was 4.3 months (3-12) Findings: The most clinical findings at patients were transient ischemic attack and unilateral stenosis more than 70%. 6 patients (50%) had coronary artery stenosis and 3 patients (25%) had peripheric arterial obstruction disease. Shunt was used for one patient. Mean carotid artery clamping time was 9.4±1.9 minutes. Perioperative transient left upper extremity paralyse seen at one patient. There was no death. During the fallowing time new neurologic accident, residual or new stenosis, occlusion and false aneurysm were not discovered. Results: Carotis endarterectomy is an easy, fast and effective technique under locoregional anesthesia. In most cases enough surgical area was supplied and early and mid term results of the surgery is in acceptable limits. Especially, during clamping carotid artery with bilateral severe carotis stenosis local anesthesia is comfortable for fallowing up cerebral perfusion by conscious and motor activity speaking with the patient. [ABSTRACT FROM AUTHOR]

In this study, the gamma radiation attenuation was investigated for different composite metallic foams, soil and standard sand samples. Gamma transmission technique with narrow beam geometry, Co-60 radiation source were used in experimental studies. The measurements were used to calculate the linear attenuation coefficients and porosities of these materials. The results were compared according to radiation attenuation and porosity distribution of porous media. The metallic foams had large and non-homogeneous porosity values, therefore sand and soil showed better radiation attenuation property. However, the saturated silica foam had large ability of gamma ray attenuation as well as dry soil. [ABSTRACT FROM AUTHOR]

This study was aimed to determine kinetic and thermodynamic behaviors of selenium on modified bentonite and activated carbon. Thermodynamic parameters such as enthalpy ΔH, free energy change ΔG and entropy change ΔS of selenium adsorption suggested that the adsorption of Se(IV) on activated carbon and organicinorganic modified bentonite was exothermic and endothermic process, respectively. The experimental data fitted very well the pseudo-second-order kinetic model for both adsorbents. [ABSTRACT FROM AUTHOR]

A letter to the editor that talks about Doctor Halit Oguz's response to the report on sildenafil-associated consecutive nonarteritic anterior ischaemic optic neuropathy and central retinal vein occlusion in a haemodialysis patient is presented.

A letter to the editor is presented discussing the case report of nonarteritic anterior ischaemic optic neuropathy as a side effect of sildenafil.

To examine the influence of diabetes education on well-being, 255 patients with type 2 diabetes were recruited according to whether they attended a diabetes education program (n=126) or not (n=129). In patients who had participated in the program, the mean anxiety score was significantly lower, whereas positive well-being and general well-being scores were significantly higher than for patients who had not participated. Factors related to lower well-being included: being female, taking insulin, not attending a diabetes education program and having HbA(1c) level greater than 8%. The odds of having better well-being were two-fold higher in patients participating the diabetes education program compared with those who had not. Diabetes education has a crucial role in improving the well-being of patients with type 2 diabetes. All patients with diabetes should be encouraged to attend a diabetes education program. [ABSTRACT FROM AUTHOR]

Background: Public health literacy (PHL) is a novel perspective on health literacy (HL). Differing from HL's individualist approach, PHL is concerned with public health events and promoting health in the whole society., Objectives: To evaluate PHL, a newly developed concept, and related factors., Methods: In this cross-sectional study, people who visited primary healthcare centers in urban and rural settings were recruited using a questionnaire that includes Public Health Literacy Knowledge Scale (PHLKS) and Adult Health Literacy Scale (AHLS). Out of four Primary Healthcare Centers (PMCs) in western Turkey selected randomly, one PMC was located in a rural setting, while three PMCs were located in an urban setting. Multiple linear regression was used to determine the predictors for PHL., Results: The study group consisted of 1672 people, of which 55.3% were male. The mean age was 40.94 ± 15.22. The median score (min-max) from PHLKS was 13.0 (0-17). Multiple linear regression showed that income level had a negative impact on PHL. Higher education, fondness for reading, hospital admission and HL, however, increased PHL levels. Additionally, living in an urban area and not having auditory problems were positively associated with PHL., Conclusions: Participants had a moderate level of PHL. Improving PHL should be a priority to tackle global and local problems that have an adverse effect on community health. To increase community engagement in public health events, people with low education and HL levels should be targeted in future training programs., Competing Interests: Declaration of conflicting interestsThe authors have no conflicts of interest to declare.

Colorectal cancers (CRCs) have an important share in the prevalence and mortality among all cancers. It was aimed to make a systematic review and meta-analysis of researches about the prevalence of knowing fecal occult blood test (FOBT) and colonoscopy, which are among the CRC screening methods, and the prevalence of having these tests at any time in life. A literature search using five different databases were screened both in Turkish and English language and a total of 1176 studies were reached. Of these, 22 studies were selected to be included in this study. In the evaluation of the researches included in the study, the studies were read in a way to look for answers to PICOS questions. Open Meta-analyst demo program and random effects model was used. The prevalence rate and 95% confidence interval of knowing and having FOBT and colonoscopy were calculated. According to the meta-analysis results, the prevalence of knowing the FOBT among the CRC screening tests was 19.3%, the prevalence of having the FOBT was 13.2%, the prevalence of knowing colonoscopy was 31.7%, and the prevalence of having colonoscopy was 10.0%. As a conclusion prevalence of knowing and having FOBT and colonoscopy was low in risky individuals in Turkiye., Competing Interests: No conflict of interest was declared by the authors., (© Copyright 2023 by Istanbul Provincial Directorate of Health.)

While the importance of beneficial soil microorganisms for soil health and crop performance has been receiving ever-increasing attention, Serendipita indica has been widely studied as a fungal root endophyte with significant potential for increasing the stress tolerance of host plants. Boron (B) toxicity as an adverse soil condition is particularly prevalent in arid and semi-arid regions and threatens crop production. Studies on S. indica -wheat symbiosis are limited, and effects of S. indica on crops have never been reported in the context of B toxicity. Here, two pot experiments were conducted under greenhouse conditions to investigate the effects of S. indica on the growth and yield parameters of bread ( Triticum aestivum ) and durum wheat ( Triticum durum ) grown at different levels of B toxicity in native vs. sterilized soil, and parameters related to root colonization, membrane damage, oxidative stress, chlorophyll, and mineral nutrition were measured to elucidate the physiological mechanisms of damage and benefit. Boron toxicity decreased early vegetative growth and grain yield, but it did not affect the straw dry weight of mature plants, whereas S. indica significantly enhanced the vegetative growth, straw dry weight, and the grain number of both wheat species. Membrane damage as demonstrated by increased lipid peroxidation and relative electrolyte leakage was caused by B toxicity and alleviated by S. indica . The benefits provided by S. indica could not be attributed to any significant changes in tissue concentrations of B or other minerals such as phosphorus. Soil sterilization generally improved plant performance but it did not consistently strengthen or weaken the effects of S. indica . The presented results suggest that S. indica may be used as an effective microbial inoculant to enhance wheat growth under adverse soil conditions such as B toxicity through mechanisms that are possibly unrelated to mineral homeostasis.

Background: It is well-established that healthcare professionals are stigmatized by the society during infectious disease outbreaks. The present study aimed to develop a scale to measure the coronavirus disease 2019-induced perceived stigmatization in physicians and investigate its validity and reliability., Methods: The present methodological type of study was carried out with 303 physicians working with a university hospital. The researchers drafted a 5-point Likert-type "Coronavirus Disease 2019-Induced Perceived Stigmatization in Physicians Scale" by using an item pool consisting of 35 items upon a review of the relevant literature. The internal consistency (Cronbach's alpha coefficient), item-total correlation coefficient, and test-retest analyses were used to assess the reliability of the scale. Exploratory factor analysis and confirmatory factor analysis were performed with an aim to evaluate the construct validity of the scale., Results: The scale consisted of 10 items and 2 domains (environmental perceived stigmatization and personally perceived stigmatization) upon completion of the scale development step. The items on the scale explained 61.66% of the total variance, where the factor loads were between 0.66 and 0.85. The Cronbach's alpha coefficient of the scale was 0.88, and the item-total correlation coefficients were all above 0.3. As a result of confirmatory factor analysis, the resultant model had goodness-of-fit indices with sufficient fit., Conclusion: The Coronavirus Disease 2019-Induced Perceived Stigmatization in Physicians Scale was a reliable and valid tool for the physicians., Competing Interests: Declaration of Interests: The authors have no conflict of interest to declare., (2023 authors.)

Background and Aim: The aim of this study was to evaluate the effectiveness of selective laser trabeculoplasty (SLT) in patients with primary open-angle glaucoma (POAG) and ocular hypertension (OHT), and to assess its effects and safety on corneal endothelial cell morphology., Patients and Methods: Forty patients with POAG (15 cases, 23 eyes) and OHT (25 cases, 48 eyes) were prospectively evaluated. All cases underwent pachymetry, goniolens examination, Humphrey Visual Field Test, Optical Coherence Tomography, and Corneal Confocal Microscopy measurements. Patients whose intraocular pressure (IOP) was more than 21 mmHg in POAG and OHT, underwent SLT. SLT treatment was applied to the inferior 180° region of the trabecular meshwork. Central corneal thickness (CCT), IOP, and specular microscopy examinations were taken at the visits before and after the first day, first week, first month, third and sixth months of the SLT procedure. Retinal nerve fiber layer (RNFL) thickness measurements and visual field tests were performed before and six month post-SLT. Results of the pre-SLT and post-SLT measurements were compared and a P value of lower than 0.05 was considered statistically significant., Results: The results of IOP measurements at first week, first month, third, and sixth month post-SLT were significantly lower than the results before and post-SLT first day. No significant difference was found between the results of initial and final measurements of CCT and specular microscopic corneal endothelial cell morphology evaluation. There was no statistically significant difference between the results of initial and final measurements for RNFL thickness and the results of the visual field tests., Conclusion: SLT is an effective treatment modality for reducing IOP in patients with POAG and OHT and is also a safe procedure in terms of the entirety of corneal endothelial cell morphology., Competing Interests: None

Polyhydroxyalkanoate (PHA) is stored as an important carbon and energy source in bacterial cells. For biomedical applications, gram-positive bacteria can be better sources of PHAs, since they lack outer membrane lipopolysaccharide. Although gram-positive Streptomyces coelicolor A3(2) has been indicated as a high potential PHA producer, pha C gene that encodes the key enzyme PHA synthase in the metabolic pathway is not determined in its genome. BLAST search results of the GenBank database argued that SCO7613 could specify a putative polyhydroxyalkanoate synthase (PhaC) responsible for PHA biosynthesis. Deduced amino acid sequence of SCO7613 showed the presence of conserved lipase box like sequence, 555 GASAG 559 , in which serine residue was present as the active nucleophile. Present study describes deletion of putative S. coelicolor pha C gene via PCR dependent method. We showed that SCO7613 is not an essential gene in S. coelicolor and its deletion affected PHA accumulation negatively although it is not ceased. Transcomplementation abolished the mutant phenotype, demonstrating that the decrease in PHA resulted from the deletion of SCO7613., Competing Interests: CONFLICT OF INTEREST: The authors declared no conflict of interest., (Copyright © 2021 The Author(s).)

Significance: Choroidal vascularity index measured by image binarization method from peripapillary optical coherence tomography sections has been found significantly lower in papilledema patients than healthy controls., Purpose: The purpose of this study was to compare peripapillary choroidal parameters in papilledema patients with control subjects., Methods: Peripapillary spectral domain optical coherence tomography scans of 34 patients with papilledema and 34 healthy controls are acquired for the study. Images are binarized with the ImageJ software (National Institutes of Health, Bethesda, MD) to calculate total choroidal area, stromal area, luminal area, and choroidal vascularity index., Results: Total choroidal area, luminal area, and choroidal vascularity were significantly lower in papilledema patients compared with healthy controls on right (1.343 ± 0.286 vs. 1.694 ± 0.344, P < .001; 0.880 ± 0.209 vs. 1.167 ± 0.255, P < .001; 65.28 ± 2.99% vs. 68.68 ± 2.81%, P < .001, respectively) and left eyes (1.376 ± 0.308 vs. 1.647 ± 0.339, P < .001; 0.899 ± 0.231 vs. 1.134 ± 0.237, P < .001; 64.92 ± 3.44 vs. 68.84 ± 3.23, P < .001, respectively). No difference was found between active and remitted stages of papilledema in terms of choroidal parameters., Conclusions: Peripapillary total choroidal area, luminal area, and choroidal vascularity index are significantly reduced in patients with papilledema. These parameters might be beneficial tools for evaluating choroidal vascularity in papilledema quantitatively and differential diagnosis for optic disc edema., Competing Interests: Conflict of Interest Disclosure: None of the authors have reported a financial conflict of interest., (Copyright © 2021 American Academy of Optometry.)

Purpose: The study aimed to investigate the changes in choroidal thickness (CT), retinal nerve fiber layer thickness (RNFL), and visual field parameters in morbidly obese patients following bariatric surgery., Methods: The study included 40 morbidly obese patients with body mass indexes (BMI) ≥40 who had undergone bariatric surgery (Group 1) and 40 age-and sex-matched healthy subjects with normal BMI values (Group 2). RNFL and CT measurements by optical coherence tomography (OCT) and visual field test were performed preoperatively and the 1 st , 6 th , and 12th months postoperatively. CT measurements were obtained from the subfoveal, nasal (N), and temporal (T) regions at distances of 500 μm and 1,000 μm from the fovea., Results: No significant pathology was detected during ophthalmological examinations following bariatric surgery. The BMIs were found to be significantly lower in all of the periods after bariatric surgery (P < 0.0001). The CT measurements decreased significantly in all periods after bariatric surgery (P < 0.0001). No differences were found in terms of the mean RNFL thicknesses in all postoperative periods (P = 0.125). Visual field tests showed no significant changes during scheduled visits. (P = 0.877). No visual field defect was detected in any patient during the follow-up periods after bariatric surgery., Conclusion: These results have suggested that CT is positively correlated with BMI and decreased with a reduction in BMI progressively. Nutritional disorders resulting from malabsorption have not caused any nutritional optic neuropathy and visual field defect for at least the first postoperative year after bariatric surgery., Competing Interests: None

The aim of the present study was to compare radiation dose received by thyroid gland using different radiotherapy (RT) techniques with or without thyroid dose constraint (DC) for breast cancer patients. Computerized tomography (CT) image sets for 10 patients with breast cancer were selected. All patients were treated originally with opposite tangential field-in field (FinF) for the chest wall and anteroposterior fields for the ipsilateral supraclavicular field. The thyroid gland was not contoured on the CT images at the time of the original scheduled treatment. Four new treatment plans were created for each patient, including intensity-modulated radiotherapy (IMRT) and helical tomotherapy (HT) plans with thyroid DC exclusion and inclusion (IMRT DC(-) , IMRT DC(+) , HT DC(-) , and HT DC(+) , respectively). Thyroid DCs were used to create acceptable dose limits to avoid hypothyroidism as follows: percentage of thyroid volume exceeding 30 Gy less than 50% (V 30  < 50%) and mean dose of thyroid (TD mean ) ≤ 21 Gy. Dose-volume histograms (DVHs) for TD mean and percentages of thyroid volume exceeding 10, 20, 30, 40, and 50 Gy (V 10 , V 20 , V 30 , V 40 , and V 50 , respectively) were also analyzed. The D mean of the FinF, IMRT DC(-) , HT DC(-) , IMRT DC(+) and HT DC(+) plans were 30.56 ± 5.38 Gy, 25.56 ± 6.66 Gy, 27.48 ± 4.16 Gy, 18.57 ± 2.14 Gy, and 17.34 ± 2.70 Gy, respectively. Median V 30 values were 55%, 33%, 36%, 18%, and 17%, for FinF, IMRT DC(-) , HT DC(-) , IMRT DC(+) , and HT DC(+) , respectively. Differences between treatment plans with or without DC with respect to D mean and V 30 values were statistically significant (P < 0.05). When thyroid DC during breast cancer RT was applied to IMRT and HT, the TD mean and V 30 values significantly decreased. Therefore, recognition of the thyroid as an organ at risk (OAR) and the use of DCs during IMRT and HT planning to minimize radiation dose and thyroid volume exposure are recommended., (© 2019 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.)

Introduction: This study aims to determine the disease management self-efficacy level for patients with type 2 diabetes living in a rural area of Turkey., Methods: The study sample consisted of 216 adult patients with type 2 diabetes. Data were collected between April and June of 2015 using the Self-Efficacy Scale for Type 2 Diabetes. The relationship between independent variables and self-efficacy level was evaluated with t-test and one-way ANOVA in independent groups. A multiple regression analysis was performed to identify the determinants of self-efficacy level., Results: Diabetes patients living in rural areas had a moderate level of self-efficacy. Female and unemployed patients, and those who had a low educational level, who spent their lives in a village and did not receive disease management training constituted a risk group in terms of self-efficacy. The multiple regression analysis demonstrated that using oral antidiabetics or insulin (&beta;= &ndash;0.122), lack of education on diabetes complications (&beta;= &ndash;0.125) and insufficient self-management of diabetes (&beta;= &ndash;0.484) reduced the self-efficacy score., Conclusions: Metabolic control parameters suggest that type diabetes patients living in rural areas of Turkey had a poor disease management level and a moderate self-efficacy level. Measures to improve the self-efficacy levels call for a diabetes education program that includes lifestyle modifications and available resources in rural areas, as well as more frequent monitoring of patients living in rural areas.

The objective of the present study is the treatment of oxidative damage caused by acrylamide induced oxidative stress in rats with the administration of a strong antioxidant, namely crocin. High acrylamide (AA) levels have genotoxic, carcinogenic and neurotoxic effects on living organisms. In the present study, 40 Wistar rats were randomly divided into four equal groups. These groups were control, acrylamide (25mg/kg), crocin (50mg/kg), acrylamide+crocin (25mg/kg acrylamide and 50mg/kg crocin) groups. At the end of the application, biochemical and histological variations were examined in liver and blood samples. It was observed that acrylamide administration significantly decreased liver GSH and TAS levels when compared to the control group. On the contrary, it was also observed that AST, ALT, ALP, SOD and CAT activities and TOS and MDA levels increased as a result of acrylamide administration. Histopathological examinations demonstrated inflammatory cell infiltration, hepatocellular necrosis and hemorrhage areas in AA group liver sections. Furthermore, intracytoplasmic vacuolization was detected in hepatocytes. After crocin treatment, it was observed that GSH and TAS levels increased while AST, ALT, ALP, SOD and CAT activities and TOS and MDA levels decreased. Significant decreases were observed in inflammatory cell infiltration and vascular congestion in liver sections and intracytoplasmic vacuolization in hepatocytes after the crocin treatment, while no hepatocellular necrosis and hemorrhages were observed. In the present study, it was demonstrated that crocin treatment removed acrylamide induced liver damage due to the strong antioxidant properties of crocin., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Objective: To investigate the effect and safety of intravitreal injection (IVI) of bevacizumab and ranibizumab on corneal endothelial cell count and morphology in patients with diabetic macular edema., Materials and Methods: A total of 60 eyes from 60 consecutive patients who received 0.5 mg/0.05 ml IVIs of bevacizumab (n = 30, IVB group) or 1.25 mg/0.05 ml ranibizumab (n = 30, IVR group) for three consecutive months were investigated prospectively. Specular microscopy was performed to evaluate endothelial cell count, the percentage of hexagonal cells (pleomorphism), and the coefficient of variation of the cell size (polymegathism); optical biometry was performed to evaluate central corneal thickness. Results before injection and 1 month after the first and third injections were compared., Results: The groups were matched for age (p = 0.11) and gender (p = 0.32). There was no significant difference in endothelial cell count (IVB group, p = 0.66; IVR group, p = 0.74), pleomorphism (IVB group, p = 0.44; IVR group, p = 0.88) and polymegathism (IVB group, p = 0.21; IVR group, p = 0.24) before injection or 1 month after the first and third injections. There was also no difference in central corneal thickness (IVB group, p = 0.15; IVR group, p = 0.58) before injection or 1 month after the first and third injections., Conclusion: Monthly 1.25 mg/0.05 ml IVIs of bevacizumab or 0.5 mg/0.05 ml of ranibizumab for three consecutive months in the treatment of diabetic macular edema does not affect corneal morphology and has no harmful effects on the endothelium.

The objective of this study was to evaluate the measurements of choroidal thickness (CT) in patients with non-arteritic anterior ischaemic optic neuropathy (NAION) at the acute and chronic stages. This case-control study compares three groups: Group 1 included 23 eyes of 23 patients with chronic NAION, Group 2 consisted of 24 eyes of 24 patients with acute NAION, and Group 3 included 24 eyes of 24 age-matched control subjects. The average CTs for Group 1, Group 2, and Group 3 were 261.24 ± 50.04, 280.05 ± 74.94, and 254.74 ± 50.11 µm, respectively. For all measurements, no statistical significance was found between the groups ( p = 0.319, 0.357, 0.680, and 0.178 for the CTs as average, foveal, superior, and inferior, respectively). Similarly, there was no difference between the CT measurements of the affected and unaffected eyes in Group 1 and Group 2 ( p = 0.571, 0.741 for average, respectively). The amount of time after the onset of the disease ranged from 6.0 to 48 months (23.86 ± 16.70 months) in Group 1 and from 1 to 30 days (7.45 ± 8.86 days) in Group 2. There was no correlation between the CTs and follow-up times in Group 1 ( p = 0.768 for average) and no association between the CTs and the thicknesses of the retinal nerve fibre layers in Group 2 ( p = 0.453 for average). CT is not directly influenced by NAION at either the acute or the chronic stage of the disease. These results may also demonstrate that the changes of CT do not increase the risk of experiencing a NAION attack.

Purpose: Genetic factors are known to influence the response to anti-vascular endothelial growth factor (VEGF) treatment in exudative age-related macular degeneration (AMD). The current study was conducted to investigate the association of Apolipoprotein E (ApoE) polymorphism with the treatment response to ranibizumab for exudative AMD., Methods: One hundred nine eyes (109 patients, 59.6% male, mean age 63.84 ± 7.22 years) treated with intravitreal ranibizumab injections were included in the analysis. Smoking status and lesion type were recorded. Patients were categorized into three groups according to visual acuity (VA) change at 6 months after the first injection: VA loss >5 Early Treatment Diabetic Retinopathy Study (ETDRS) letters (Group 1); VA change between five ETDRS letters gain and loss (Group 2); VA improvement >5 ETDRS letters (Group 3). The association of ApoE gene polymorphisms with the three groups was evaluated., Results: Both smoking status and lesion type showed no significant association with VA change (p = 0.12 and p = 0.64, respectively). A lower frequency of ɛ2 and a higher frequency of ɛ4 were observed in Group 3 (2.9 and 25.7%, respectively). VA improvement with more than five ETDRS letters was significantly associated with the presence of the ɛ4 genotype (p = 0.01)., Conclusions: This study demonstrated that carriers of the ApoE ɛ4 polymorphism genotype show demonstrable improvement in VA after treatment with ranibizumab in exudative AMD. ApoE polymorphism identification may be used as a genetic screening to tailor individualized therapeutic approach for optimal treatment in neovascular AMD.

Purpose: To compare the effects of bevacizumab and ranibizumab on the visual function and macular thickness in the contralateral (untreated) eye of patients with bilateral diabetic macular edema (DME)., Materials and Methods: Thirty-nine patients with bilateral DME, who had been treated with both bevacizumab and ranibizumab in the same eye, were considered retrospectively for this study. Recorded outcome measurements included the best-corrected visual acuity (BCVA) assessment with the Early Treatment Diabetic Retinopathy Study (ETDRS) chart and the central subfield macular thickness (CSMT) measurement of the contralateral, uninjected eye before and at 4 weeks after the injections., Results: The median BCVA of the uninjected eye was 50 ETDRS letters and the median CSMT was 459 μm preceding the bevacizumab injection whereas at the control appointment, 4 weeks after the injection, the median BCVA had increased to 52 letters (P = 0.098), and the median CSMT had decreased to 390 μm (P = 0.036). The mean interval between the bevacizumab and ranibizumab treatments was 4.79 ΁ 1.52 months. The measurements of the untreated eye after the ranibizumab treatment showed that the median BCVA decreased from 55 to 52 letters, and the median CSMT increased from 361 μm to 418 μm (P = 0.148 and P = 0.109, respectively)., Conclusions: In contrast to ranibizumab, the intravitreal administration of bevacizumab resulted in a statistically significant decrease in macular thickness in the untreated eye in patients with bilateral DME.

Postoperative fungal endophthalmitis is a rare but devastating complication of cataract surgery. Vitrectomy and intravitreal amphotericin B injection as well as administration of systemic antifungal agents have been suggested as optimal treatments for fungal endophthalmitis. However, this therapy may fail to eliminate fungal species resistant to current antifungal agents. The saprophytic fungus Trichosporon asahii is frequently observed as a cause of endogenous endophthalmitis in immunosuppressed patients. We report a case of postoperative endophthalmitis caused by T. asahii, resistant to amphotericin B. To the best of our knowledge, this is the first report of T. asahii endophthalmitis successfully treated with intravitreal and systemic voriconazole, pars plana vitrectomy, and removal of the intraocular lens and entire lens capsule.

The aim of the study was to assess the factors associated with the anticoagulation treatment in patients with atrial fibrillation (AF). A total of 2242 consecutive patients who had been admitted with AF on their electrocardiogram were included in the study. After excluding valvular AF, 1745 patients with nonvalvular AF were analyzed. Mean CHA2DS2-VASc score [cardiac failure, hypertension, age ≥ 75 (doubled), diabetes, stroke (doubled), vascular disease, age 65 -74 and sex category (female)], frequency of persistent/permanent AF, hypertension, diabetes mellitus (DM), stroke history, body mass index, and left atrial diameter were significantly higher in patients receiving anticoagulant therapy. Stroke history, persistent/permanent AF, hypertension, DM, age, heart failure, and left atrial diameter were independent predictors of warfarin prescription. Labile international normalized ratio was the only independent negative predictor of effective treatment with warfarin. In this study, we demonstrated that stroke history, persistent/permanent AF, hypertension, DM, and left atrial diameter were positive predictors, whereas advanced age and heart failure were negative predictors of oral anticoagulant use in patients with nonvalvular AF., (© The Author(s) 2013.)

Osseous metaplasia may occur in phthisis bulbi, usually caused by long-standing retinal detachment, ocular trauma, or inflammation. However, extensive intraocular bone formation is a rare phenomenon. We report a case with long-standing phthisis bulbi demonstrating subretinal extensive bone formation. Results of histopathologic examination revealed extensive bone formation overlying the choroid with accompanying bone marrow without hematopoiesis.

Purpose: To compare the results of central corneal thickness (CCT) measurements obtained using optical low-coherence reflectometry (OLCR), Fourier domain optical coherence tomography (FD-OCT), and a Scheimpflug camera (SC), combined with Placido corneal topography., Methods: A total of 25 healthy subjects were enrolled in the present study, and one eye of each subject was included. A detailed ophthalmic examination was performed in all cases following CCT measurements with OLCR, FD-OCT, and SC. The results were compared using an ANOVA test. Bland-Altman analysis was used to demonstrate agreement between methods. Intra-examiner repeatability was assessed by using intraclass correlation coefficients (ICCs)., Results: Statistically significant differences were observed between the results of the CCT measurements obtained using the three different devices (p=0.009). Significant correlations were found between OLCR and FD-OCT (r=0.97; p<0.0001), FD-OCT and SC (r=0.91; p<0.0001), and OLCR and SC (r=0.95; p<0.0001). The 95% limits of agreement (LOA) obtained from Bland-Altman plots were from -7.2 μm to 28.7 μm for OLCR versus FD-OCT, from -19.2 μm to 30.4 μm for OLCR versus SC, and from -42.6 to 32.3 μm for FD-OCT versus SC. Intra-examiner repeatability was excellent for each method, with ICCs >0.98., Conclusion: Although the results of CCT measurements obtained from these three devices were highly correlated with one another and the mean differences between instruments were comparable with the reported diurnal CCT fluctuation, the measurements are not directly interchangeable in clinical practice because of the wide LOA values.