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Purpose The aim was to study the efficacy and safety of addition of dexmedetomidine to local anesthesia (LA) for patients undergoing external dacryocystorhinostomy (DCR). Patients and methods A total of 70 adult patients who presented for external DCR were included in this prospective double-blinded study. They were randomly distributed into two equal groups. All patients received LA with 8 ml mixture, composed of 3.5 ml of lidocaine 2% without epinephrine and 3.5 ml of plain bupivacaine 0.5%. Either 1 ml normal saline (0.9%) or that containing 20 µg dexmedetomidine was added to the mixture for each group. The onset and the duration of sensory blockade as well as perioperative sedation were verified. Visual analog score was evaluated in the postoperative period till 12 h postoperatively. Anesthesia-related perioperative complications and patient satisfaction were also reported. Results Dexmedetomidine added to a LA block in external DCR significantly decreased the onset ofanesthesia to2.23±2.11 min(P=0.015)andincreasedthedurationofsensory block to 200.45±37.98 min (P=0.0001). In addition, it significantly decreased the postoperative pain score 6-8 h postoperatively (P<0.05). Moreover, increased sedation level and patient satisfaction were noted (P<0.05), without significant increase in the incidence of adverse effects or complications. Conclusion Addition of low-dose dexmedetomidine to LA infiltration in external DCR hastens the onset and prolongs the effective period of the sensory block. Enhancement of postoperative analgesia, increased perioperative sedation. and improved satisfaction of the patients were achieved without significant complications. [ABSTRACT FROM AUTHOR]

Background The purpose of this study was to compare photorefraction using Plusoptix vision screening with that of standard cycloplegic refraction, to detect variability between different observers. Patients and methods In this prospective comparative study, the right eyes of 203 children were included. Refraction was performed for each child using Plusoptix photorefraction screener by two separate observers. Under the effect of cyclopentolate eye drops, retinoscopic cyclorefraction was performed for those under 4 years of age, and cyclorefraction using autorefractometer was performed for those 4 years or older. Results In this study, 203 patients with 203 eyes were included, 110 (54.2%) of them were boys and 93 (45.8%) were girls. The mean age of the children was 6.61±4.49 years (range from 4 months to 16 years), and 74 (36.5%) of them were less than 4 years of age and 129 (63.5%) at least 4 years of age. There was no significant difference between the two observers, as regards mean spherical equivalent (+0.52±1.54 D with range of −3.8 to +5.38 for observer 1 and 0.540±1.63 D with range of −3.8 to +4.8 for observer 2). In all age groups, there was no significant difference between photorefraction results and the final objective refraction, as regards mean spherical equivalent (0.540±1.62 and 0.549±1.62 D, respectively). Myopic shift was noted with higher refractive errors. Conclusion Compared with standard cycloplegic refraction, photorefraction using Plusoptix screener was found to be a valuable and reproducible method in spite of the tendency to myopic shift at higher refractive errors in children. [ABSTRACT FROM AUTHOR]

Background: Integrating immunotherapy and chemotherapy is most likely to be the basis for new optimism in targeting cancer therapies to form local tumor microenvironment and attack tumors early in their development. This regimen has some potential risks such as myelo- and immunosuppression and chemo-resistant tumor cells. Aim: The present study aimed to investigate the combination of chemotherapy, immunotherapy, and the prospective of mobilized stem cells for optimization and modulation of the immune system to overcome immunosuppression and kill distant cancer cells. Materials and Methods: Ehrlich ascetic carcinoma (EAC) cell line-bearing mice treated with cyclophosphamide (CTX) followed by adoptively transferred with in vitro-activated T-cells either harvested from naïve or EAC-bearing host with or without unfractionated bone marrow (BM) cells or granulocyte-colony stimulating factor-mobilized hematopoietic stem cells (HSCs) 1-day post-CTX treatment. All mice were vaccinated with EAC lysate and Hiltonol. Results: Cotransfer of activated T-cells obtained from EAC-bearing mice with HSC-progenitors induced the highest antitumor effect through increasing the percentage of apoptosis and decreasing DNA replication in S phase of EAC cells. Besides, marked an increase in the percentage of myeloid cells in spleen and stem cell populations in BM cells. Interestingly, Adoptive T-cell transfer (ACT) derived from EAC-bearing host with or without BM cells induced mobilization of stem cells from BM to circulation increasing their expansion. Conclusion: Combination of chemotherapy with ACT plus vaccination may constitute a potent antitumor therapy that provides more efficacious antitumor responses when it is combined with BM cells fostering more effective antitumor immunotherapy strategies. [ABSTRACT FROM AUTHOR]