Background: Use of topical glaucoma medications has been reported to cause ocular surface (OS) discomfort and inflammation. This study explores the profile of inflammatory cytokines and OS symptoms induced in response to preserved and non-preserved drops. Methods: Prospective, randomized evaluation on 36 treatment-naïve patients over 24 months of three differently preserved glaucoma drop preparations: Preservative-free (PF), polyquad (PQ) and benzalkonium chloride (BAK). Study participants were evaluated at baseline and then at 1, 3, 6, 12 and 24 months while on medication. At each visit, participants completed the OS disease index (OSDI) questionnaire, had basal tear sampling and impression cytology (IC) of the conjunctival epithelium. Quantitative polymerase chain reaction was performed to measure the gene expression of inflammatory cytokines [interleukin (IL)-6, IL-8, IL-10, IL-12A, IL-12B, IL-17A, IL-1β and tumour necrosis factor-α] in the IC samples. Corresponding protein expression of cytokines in tear samples was assessed by the Becton-Dickinson cytometric bead arrays. Results: Compared to PF and PQ groups, mRNA and protein expression of IL-6, IL-8 and IL-1β increased in samples from the BAK group in a time-dependent fashion, whereas all other cytokines showed a non-significant increase. In the BAK group, there was a strong correlation between OSDI and the levels of IC/IL-1β (r = .832, R 2 = .692 and P = .040); IC/IL-10 (r = .925, R 2 = .856 and P = .008) and tear/IL-1β (r = .899, R 2 = .808 and P = .014). Conclusions: BAK-preserved topical drops stimulate a sterile inflammatory response on the OS within 3 months which is maintained thereafter, whereas PF-drops and PQ-preserved drops showed no significant OS inflammation.

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Abstract:Objective(s): The study objectives are to evaluate of nurses' practices concerning chest pain management that are provided for patients in the emergency unit and to finding out the relationship between the nurse's practices and the demographic characteristics that includes (age, gender, level of education, years of experience, and training session).Methodology: A descriptive study which was using the quantitative design. The study was conducted at the Medical City/ Baghdad Teaching Hospital; Al-Karama Teaching Hospital, and Al-Kindi Teaching Hospital Starting from Sep. 2nd 2012 up to the 15th of April 2013. To achieve the objectives of the study, A non-probability (purposive) samples of (70) a nurse who was consisted of all nurses who provide emergency nursing care for patients which suffering from chest pain and according to special criteria. Data were collected by an application of direct check list observation as a means of data collection. Nurses were observed while they are working in the emergency unit during the day. Instrument validity was determined through content validity, by a panel of experts. Reliability of the instrument was determined through the use of Pearson correlation coefficient for the researcher and co-observes reliability approach, which was (0.85). Analysis of data was performed through the application of descriptive statistics (frequency, percentage, mean of score, Relative sufficiency) and inferential statistics (Chi-square (X2) test).                                                                            Results: The results of the study indicated the evaluation of the mean of scores and relative sufficiency for nurse's practices to management of chest pain for patients in the emergency unit was out of comparison and there is no significant association between training session of sample and nurses’ practices scores. While there is high significant association between ages, gender, level of education, years of experience in emergency unit and nurses’ practices.Conclusion: The study concluded most of nurses that work in emergency unit have inadequate practices to manage chest pain.Recommendations: The study recommends to prepare special training programs for nurses in this area to reinforce their practices and promote their experiences and providing opportunity for nurses in emergency unit to continuing updating their education to maintain knowledge and practices.Keywords: Chest pain, Management, Myocardial ischemia, Nursing practice                       Â

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