Background
Acute or chronic obstruction of the urinary tract can be due to a lot of different causes. Patients with pyonephrosis usually complain of a triad of fever, loin pain and elevated white ...blood cell count in cases of acute obstruction; and they may also have hypotension in severe cases of the disease. These patients have to be treated with appropriate decompression, or they may develop septic shock. The urgency of the need for treatment greatly depends on the differentiation between hydronephrosis and pyonephrosis.
There is a lack of reliable clinical prognosticators of pyonephrosis in patients with obstructive hydronephrosis. Hounsfield unit (HU) measurement is considered as an adequate predictor of pyonephrosis and may aid in the diagnosis and management of this disease that may be fatal.
The use of HU values in differentiation between pyonephrosis from hydronephrosis depends on the fact that the pyonephrotic fluid contains infected material, urine, cellular particles and microorganisms, which when combined can increase the HU values on a computed tomography (CT) study.
This study was done to assess the diagnostic value of the HU measured CT in differentiation between hydronephrosis and pyonephrosis.
Results
Thirty-nine patients were included in this study. All patients had loin pain and were diagnosed with pelvicalyceal dilatation by ultrasonographic examination. They then underwent non-contrast CT examination.
Using CT scan, the degree of PC dilatation was significantly higher among hydronephrosis group as hydronephrosis group had 63.1% severe dilatation of PCs versus 30.8% in pyonephrosis group with p value 0.0001.
Pelvic wall thickness > 2 mm was reported in 10 (76.9%) patients of pyonephrosis group versus in three (7.9%) patients among hydronephrosis group with p value 0.0001.
The mean Hounsfield units were significantly higher among pyonephrosis group compared to hydronephrosis group (16 ± 5.2 versus 1.7 ± 5.5) with p value 0.0001.
Sensitivity analysis showed that Hounsfield units can significantly diagnose pyonephrosis using the cutoff point 6.2 units, with sensitivity 92.3%, specificity 93.3%, area under the curve (AUC) 96.9% and p value 0.0001.
Conclusions
Measuring HU in a NCECT scan of the kidney might be helpful for differentiating between hydronephrosis and pyonephrosis especially upon considering 6.2 HU as a cutoff point.
Background
Loss of endothelial cells is inevitable after cataract surgery. Therefore, it is critical to protect the corneal endothelium during cataract surgery to reach good visual outcomes ...afterward. Maintenance of corneal clarity depends on the good function of healthy endothelial cells in addition to an intact pumping system intended to remove fluid from the corneal stoma.
Purpose
Our study aimed to assess changes in the corneal endothelium using specular microscopy, after intracameral injection of ceftazidime in uncomplicated phacoemulsification and compared with a placebo. The changes were measured preoperatively and 1 month postoperatively.
Patients and methods
Our prospective cohort study comprised 40 eyes from 35 patients diagnosed with cataract, all of whom underwent uncomplicated phacoemulsification for cataract extraction.
Results
Endothelial cell density significantly decreased postoperatively compared with preoperative values in both groups. Central thickness of the cornea, coefficient of variation, and visual acuity significantly increased postoperatively compared to preoperative values in both groups. Endothelial cell density showed a significant decrease postoperatively with a
P
value equal to 0.01 for group A (placebo group) and 0.02 for group B (ceftazidime group). Central thickness of the cornea, coefficient of variation, and visual acuity showed significant increases postoperatively with a
P
value equal to 0.026, 0.005, and 0.001 for group A and 0.001, 0.034, and 0.001 for group B, respectively.
Conclusion
Ceftazidime can be considered safe for corneal endothelium when used intracamerally during phacoemulsification cataract surgery for prophylaxis of postoperative endophthalmitis.
Acne is a common inflammatory condition that mostly involves the face, chest and back. A number of different modalities had been employed for treating scars of which laser remains to be a pivotal ...choice. We aimed to compare the efficacy of topical timolol maleate 0.5% after fractional CO2 (AFCO2) laser versus fractional CO2 Laser alone for treatment of atrophic acne scars. A split-face comparative clinical experiment on 30 cases of atrophic post-acne scars that were treated on one side with ablative fractional CO2 laser followed by timolol application while with only ablative fractional CO2 laser on the other side. Following treatment, both sides demonstrated significant improvement with the laser + timolol treated side showing better improvement; yet not significantly higher than the laser only treated side. In conclusion, both topical timolol maleate 0.5% after fractional CO2 laser and fractional CO2 laser may achieve comparable significant improvement. The good safety profile, easy accessibility, low cost, and non-invasive nature merits the use of timolol in acne scars pending verification by larger sample reproduced and controlled trials.
•Several new bis–hydantoin/thiohydantoin derivatives were prepared via convenient methods.•The constructed compounds were assessed for their antibacterial properties.•DFT calculations were used to ...determine the geometrical and electronic structures of compounds 1, 2a, and 2b.•Molecular docking analysis was used to examine the biological activities of compounds 3a–e to 9 against Gram–positive and Gram–negative bacteria.
Concerning the reported biological activities of bis-heterocycles, hydantoin, and thiohydantoin moieties, a series of some new bis-hydantoins/thiohydantoins have been prepared, characterized, and screened for their antimicrobial properties. The regioselectivity of the synthetic reactions was discussed and chemical structures of products were elucidated using spectroscopic techniques in addition to elemental analysis. DFT calculations with the IEF-PCM model, to mimic the implicit solvation, have been performed to study the mechanism of reaction as well as the molecular structures and the relative stabilities of the synthesized compounds. The antimicrobial results show that some bis-hydantoin compounds exhibited high antibacterial response against Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, and Pseudomonas aeruginosa. The inhibitory activity of synthesized compounds may be due to the hydrogen acceptor/donor (HAD) behavior of substituted function groups like thiocarbonyl, carbonyl, acetyl, NH, and OH. The synthetic potential and antimicrobial activities of all compounds under investigation were confirmed using molecular docking simulation into the active sites of different kinds of proteins.
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