The present study was undertaken to determine the risk of strabismus and ambylopia in children who underwent operation for hydrocephalus and to compare our results with those in previous studies.
...Full orthoptic and ophthalmological examinations, including cycloplegic refraction, were performed in all subjects.
Ten of 25 patients (40%) were found to have manifest squint. Four of these had esotropia and six had exotropia. No paretic squint or alphabetic pattern strabismus was determined. Refraction measurements revealed amblyogenic refractive errors (significant refractive errors that cause amblyopia) in five of the 25 (20%) patients in this study. Strabismus and the risk of amblyopia were found to be significantly higher in patients who experienced shunt revision than those who had not (P<0.05).
Amblyopia, strabismus, and other acquired defects in the visual system related to hydrocephalus should be closely monitored and treated when indicated. Regular ophthalmic supervision will provide and help to maintain the best possible standard of vision in children with hydrocephalus.
This study was designed to report a case of acanthamoeba keratitis in a 5-year-old child without a history of trauma or contact lens usage.
The history, clinical presentation, diagnostic, and ...therapeutic approaches were reviewed.
A 5-year-old child without any history of trauma or contact lens use was referred to our university clinic with an initial diagnosis of disciform herpetic keratitis. After 2 weeks of antibacterial and antiviral therapy, a corneal biopsy was performed for diagnostic purposes. The biopsy revealed acanthamoeba. Subsequently intensive therapy with chlorhexidine diacetate 0.02%, ketoconazole tb, hexamidine di-isethionate 0.1% was initiated. At the end of the first month, topical prednisolone acetate 1% was added to reduce inflammation, Chlorhexidine diacetate 0.02% and oral ketoconazole were discontinued, and hexamidine di-isethionate 0.1% was lowered to 4 x 1 and was administered for an additional 4 months. At the end of 5 months, all medications were withdrawn and amblyopia treatment was started.
When dealing with keratitis in children, acanthamoeba should be considered even without history of contact lens usage or trauma.
Brimonidine, a highly selective alpha(2)-adrenoceptor agonist, was studied to determine its ocular hypotensive effect and side effects in patients with elevated intraocular pressure (IOP) while on ...continuing therapy with timolol. This was a prospective, randomized, placebo-controlled study in 15 patients with primary open-angle or pseudoexfoliation glaucoma on therapy receiving timolol 0.5% twice daily, with IOP greater than or equal to 22 mm Hg in one eye. IOP measurements, blood pressure and pulse rate were assessed on 2 days at a baseline and 1, 2, 4, 6 and 8 h later. A single drop of brimonidine 0.2% or placebo was added to treatment with timolol. The reductions in IOP at all time intervals observed with brimonidine + timolol were significantly greater than those with timolol + placebo. The maximum mean net decrease in IOP was 19.23 +/- 10.60% at 4 h. Statistically significant decreases in systemic blood pressure and pulse rate without clinical symptoms were observed in the group receiving brimonidine + timolol. This study suggests that a combination of brimonidine and timolol may have potential in the treatment of glaucoma. Further clinical trials with brimonidine are indicated to assess its further role as adjunctive agent.
Making use of certain operators of fractional calculus, we introduce a new class F
δ
(
n,
λ,
α) of functions which are analytic in the open unit disk μ and obtain a necessary and sufficient condition ...for a function to be in the class F
δ
(
n,
λ,
α). We also determine the radii of close-to-convexity, starlikeness, and convexity. Finally, an application involving fractional calculus of functions in the class
F
δ
(
n,
λ,
α) is considered.
To investigate the effectiveness of topical anesthesia with sedation using intranasal midazolam in patients with symptomatic congenital nasolacrimal duct obstruction undergoing probing.
In this ...prospective study, probing was performed with general anesthesia (30 cases) and with topical anesthesia using intranasal midazolam (0.3 mg/kg; 44 cases) in 74 patients who were divided into two groups, those 6 to 36 months old and those older than 36 months. The groups were compared after 12 to 48 months (mean, 18.2 months).
For the patients 6 to 36 months old, the success rate was 80% in the group who received general anesthesia and 88.9% in the group who received topical anesthesia with intranasal midazolam; the difference between the two groups was not statistically significant (P > .05). For the patients older than 36 months, the success rate was 20% in the group who received general anesthesia and 25% in the group who received topical anesthesia with intranasal midazolam; there was no statistically significant difference between the two groups (P > .05).
Probing with topical anesthesia in the office setting is usually recommended for patients younger than 8 months. Our results show that this is suitable for children until 4 years of age with the support of intranasal midazolam sedation. Probing under topical anesthesia with intranasal midazolam is cost-effective, safe, and comparable in efficacy to probing under general anesthesia but with less risk.
5G networks provide higher flexibility and improved performance compared to previous cellular technologies. This has raised expectations on the possibility to support advanced V2X services using the ...cellular network via Vehicle-to-Network (V2N) and V2N2V connections. Replacing direct V2V connections by V2N/V2N2V communications to support critical V2X services requires low V2N/V2N2V latencies. It is then necessary to quantify the latency values that V2N and V2N2V connections can achieve over 5G end-to-end (E2E) connections, but these depend on the particular 5G network deployments and configurations and to date the number of related studies is limited. This paper progresses the state-of-the-art by introducing a novel E2E latency model to quantify the latency of 5G V2N/V2N2V communications. The model includes the latency introduced at the radio, transport, core, Internet, peering points and application server (AS) for single MNO and multi-MNO scenarios. This paper estimates the E2E latency for a large variety of possible 5G network deployments that are being discussed or envisioned to support V2X services. This includes the possibility to deploy the V2X AS from the edge of the network to the cloud. The model is utilized to analyze the impact of different 5G network deployments and configurations on the E2E latency. The analysis helps identify which 5G network deployments and configurations are more suitable to meet V2X latency requirements. The conducted analysis highlights the challenge for centralized network deployments that locate the V2X AS at the cloud to meet the latency requirements of advanced V2X services. Locating the V2X AS closer to the cell edge reduces the latency. However, it requires a higher number of ASs and also a careful dimensioning of the network and its configuration to ensure sufficient network and AS resources are dedicated to serve the V2X traffic.
5G has been designed to support applications such as connected and automated driving. To this aim, 5G includes a highly flexible New Radio (NR) interface that can be configured to utilize different ...subcarrier spacings (SCS), slot durations, scheduling, and retransmissions mechanisms. This flexibility can be exploited to support advanced V2X services with strict latency and reliability requirements using V2N2V (Vehicle-to-Network-to-Vehicles) communications instead of direct or sidelink V2V (Vehicle-to-Vehicle). To analyze this possibility, this paper presents a novel analytical model that estimates the latency of 5G at the radio network level. The model accounts for the use of different numerologies (SCS, slot durations and Cyclic Prefixes), modulation and coding schemes, full-slots or mini-slots, semi-static and dynamic scheduling, different retransmission mechanisms, and broadcast/multicast or unicast transmissions. The model has been used to first analyze the impact of different 5G NR radio configurations on the latency. We then identify which radio configurations and scenarios can 5G NR satisfy the latency and reliability requirements of V2X services using V2N2V communications. This paper considers cooperative lane changes as a case study. The results show that 5G can support advanced V2X services at the radio network level using V2N2V communications under certain conditions that depend on the radio configuration, bandwidth, service requirements and cell traffic load.
To determine the clinical sedative effect and dosage of intranasal midazolam in refraction and fundus examination of children with strabismus.
Refraction and fundus examination with (n = 28) and ...without (n = 24) sedation were performed in 52 children with strabismus whose ages ranged from 7 to 26 months. We delivered a 5-mg/mL solution of midazolam via a syringe for 60 seconds to provide a dose of 0.2 mg/kg. We repeated the dose to a maximum of 0.3 mg/kg if there was no clinical sedative response after 10 to 15 minutes. The ease of examination and sedation for each patient was scored by a blinded observer. The groups were evaluated for ease of examination and the time needed to complete it.
We obtained clinically adequate sedation at a mean (+/- standard deviation) of 15 minutes (+/- 2.69 minutes). Sedation was achieved with a mean dose of 2.64 mg/kg (+/- 0.66 mg/kg). Children receiving midazolam had significantly calmer examination scores. The time needed to complete the examination was statistically significantly shorter for these children than for children not receiving sedation (P < .05).
Intranasal midazolam is a beneficial drug and method of delivery for the sedation of anxious children with strabismus undergoing refraction and fundus examination. Sedation prior to examination is effective in reducing the anxiety and time associated with ophthalmologic examination of children with strabismus.
To determine the incidence and severity of hearing loss in different frequencies in patients with pseudoexfoliation. Furthermore, possible links between homocysteine and pseudoexfoliation were ...evaluated.
Seventy-five consecutive patients with pseudoexfoliation and 75 sex- and age-matched subjects without pseudoexfoliation as control group were included in this prospective case-control study. Pure-tone audiometry was obtained in all subjects in both groups. Blood samples were obtained from 70 patients with pseudoexfoliation after overnight fasting for levels of homocysteine and analyzed by routine laboratory measurements.
Fifty-two (69%) patients with pseudoexfoliation and 39 (52%) controls had sensorineural hearing loss in speech frequencies. The difference between pseudoexfoliation and control group with regard to the frequency of sensorineural hearing loss in speech frequencies was statistically significant (p=0.03). No relationship was found between the degree of glaucomatous damage and hearing threshold variables in the patients with pseudoexfoliation glaucoma. Plasma homocysteine levels showed no significant difference when patients with pseudoexfoliation and hearing loss were compared with patients with pseudoexfoliation and normal hearing threshold (p=0.5). Hyperhomocysteinemia was found in 58% (29/50) of pseudoexfoliation patients with hearing loss, and 55 % (11/20) of pseudoexfoliation patients with normal hearing threshold (p=0.8). No statistically significant correlation was found between plasma homocysteine and hearing loss in patients with pseudoexfoliation.
These findings suggest an association between sensorineural hearing loss and pseudoexfoliation in patients with pseudoexfoliation and glaucoma. The severity of hearing loss was not correlated with the degree of glaucomatous damage. There is no association between increased homocysteine levels and hearing loss in patients with pseudoexfoliation.
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