Background: Empirical antibiotic treatment is a common practice to manage chronic dacryocystitis in many healthcare settings in spite of the probability for changing in the types of microbial isolates. The aims of this study were to find out the current clinicomicrobiological profile of adult cases with chronic dacryocystitis and to determine the antibiogram of the isolated organisms to the commonly prescribed antibiotics. Results: Of the 25 samples obtained, 15 (60%) yielded a positive culture, 12 (48%) showed single bacterial isolate while 3 (12%) had mixed (two types) bacterial isolates. A total of 18 different strains of microorganisms were obtained from 25 cases, with 12/18 (66.7%) Gram-positive, 5/18 (27.7%) Gram-negative isolates, and 1/18 (5.5%) was fungal isolate. Coagulase-negative staphylococci were the most frequently found Gram-positive bacteria (22.2%), while Klebsiella species was the predominant of Gram-negative bacteria (16.6%). The majority of the isolated bacterial strains were sensitive to gatifloxacin (88%) and amikacin (88%) while the main resistance of the bacterial isolates, recovered from chronic dacryocystitis, was to cephalexin (59%). Conclusion: There is a continuous possibility of changing the type of pathogens responsible for dacryocystitis as well as their susceptibility to antibiotics. Microbiological study with microbial culture and antibiotic sensitivity test has to be done to all cases of chronic dacryocystitis for a better choice of antibiotic prophylaxis and treatment options, and to guard against the emergence of more drug-resistant strains.

Background: Imbalance between protein synthesis and endoplasmic reticulum (ER) capacity to modify and fold proteins lead to the accumulation of unfolded proteins resulting in ER stress and apoptosis. Chaperones are major defense molecules assisting in protein folding, transport, and cellular signaling. ER stress plays a major role in the pathogenesis of diabetes mellitus (DM) and its complications, e.g., diabetic cataract. In the present investigation, the chemical chaperones 4-phenylbutyric acid (4-PBA), tauroursodeoxycholic acid (TUDCA), and trimethylamine N-oxide (TMAO) are used as potential therapeutic agents for alleviation of DM-induced ER stress and diabetic cataract in rats. Animals are subjected to biochemical analysis of blood and lenses for ER stress and apoptosis markers. Moreover, ophthalmologic examination and histopathologic examination of the lenses were done to confirm the results. Results: Both ophthalmic and lens histopathologic examination revealed that treatment with 4-PBA and TUDCA retarded the occurrence of cataract markedly. Whereas, treatment with TMAO caused a partial improvement of cataract. Moreover, biochemical tests showed that both 4-PBA and TUDCA produced a remarkable improvement in the ER marker levels (VEGF and caspase-12), GSH, MDA, TAC levels in lens tissues. On the other hand, TMAO had no significant effect on these parameters. However, Western blot analysis of lens homogenates showed a suppressed expression of GRP78 and CHOP after treatment with 4-PBA, TUDCA, and TMAO. Moreover, all treated groups showed a significant improvement of lens soluble proteins and their UV spectra absorption. A significant improvement in fasting blood sugar, GSH, serum MDA, and TAC were noted in all treated groups. 4-PBA produced a significant decrease in insulin resistance, whereas TUDCA and TMAO showed insignificant change. Conclusion: The present research found that the tested chaperones could be used as a therapeutic approach for clinically relevant disorders featuring ER dysfunction such as DM and for reducing its complications in the eye mainly cataract. However, TUDCA and 4-PBA were found to have a more potential efficacy in reducing most of the tested parameters as compared to TMAO.

The main objective of this study was to investigate the potential protective effect of ursodeoxycholic acid (UDCA) on fructose/streptozotocin-induced diabetic cataract in rats. The diabetic model (DM) was induced through the administration of 10% fructose in drinking water for 2 weeks followed by streptozotocin injection (intraperitoneal). One week later, hyperglycemia was assisted and diabetic animals were treated with UDCA either as local eye drops (0.5% solution, four times/day) or orally (100 mg/kg b.w.). Cataract formation was monitored biweekly and scored into four stages. After 12 weeks of treatment, rats were subjected to ophthalmological examination, and then, their blood and lenses were prepared for biochemical analysis of glucose, insulin, reduced glutathione, total antioxidant capacity, malondialdehyde, hydrogen peroxide, caspase-12, and lenticular total proteins. In addition, tertiary structure and conformational changes of lenticular soluble proteins were analyzed using SDS-PAGE and UV absorption while changes in lenticular α-crystallin structure were investigated using intrinsic tryptophan fluorescence. Results demonstrated that both local and oral UDCA restored the normal levels of lens T-AOC, MDA, H O , and caspase-12 and improved noticeably the levels of the lens GSH and total proteins. In addition, conformational and tertiary structure changes of soluble lens proteins were significantly reduced in UDCA-treated groups. Morphological examination of lenses revealed decreased score of cataract progression in UDCA-treated groups compared to DM animals. It was concluded that UDCA decreased the incidence of diabetic cataract by maintaining the antioxidant status, reducing the endoplasmic reticulum stress, and suppressing the structural changes of soluble lens proteins.

Background: Diabetic retinopathy is one of the common microvascular complications of diabetes. The formation of advanced glycation end products (AGE) exerts deleterious effects by acting directly to induce cross-linking of proteins promoting vascular damage. Hyperglycemia causes disturbance in glycogenesis pathway resulting in reduction of glucose to sorbitol which is converted to fructose by sorbitol dehydrogenase. Methods: The levels of advanced glycation end products (AGE), lipid profile, and glycosylated Hb were estimated in 266 type I diabetic patients without retinopathy, patients with nonproliferative diabetic retinopathy (NPDR), and proliferative diabetic retinopathy patients (PDR).The association between genotypes of two polymorphisms of sorbitol dehydrogenase gene (SDH) was estimated in the promoter region: a C/G transversion located at _1214 position and a G/C transversion at _888 position. This study showed allele-specific PCR for C-1214G polymorphism and restriction fragment length polymorphism (RFLP) technique for a G/C transversion at _ 888 position. Results: Significant increase was detected in glycosylated Hb levels in diabetic group, both with retinopathy and without retinopathy. Also, a significant increase in Hb1c in PDR group compared to NPDR. Significant increase in total cholesterol, HDL, TG, and AGE in PDR group compared to the group without retinopathy. No significant change was observed in the same parameter between PDR and NPDR group. Significant increase in AGE in both PDR and NPDR group compared to the group without retinopathy. No significant change in PDR group compared to NPDR. The results of this study showed no significant difference in genotype distribution (C/C, C/G, G/G) of the C˗1214G polymorphism between the two groups of patients with and without DR A2-. There was no statistically significant difference between the three genotypes (CC, CG, and GG) of the C˗1214G polymorphism in relation to DR severity in male genders. However, there was a statistically significant difference in female gender with increased frequency of CC genotype (2.7%, 21.9%, and 23.7%). There was no significant difference in genotype distribution (C/C, G/C, and G/G) of the G˗888C polymorphism between the two groups of patients with DR and without DR. However, the CC genotype occurred more frequently in patients with DR than patients without DR (6.7% vs. 3.9%), and G/G genotype occurred more frequently in

Purpose: To evaluate endothelial function after using high concentration and prolonged exposure of mitomycin C following PRK for high myopia and astigmatism. Participants: Twenty-two eyes of highly myopic patients with or without astigmatism seeking refractive correction. Methods: Twenty-two (22) eyes of fourteen(14) patients with high myopia (more than 6 diopters myopia together with astigmatism) seeking for refractive correction at the research institute of ophthalmology-Egypt, were subjected to Photorefractive keratectomy (PRK) using the ALLEGRETTO WAVE EYE-Q 1010 with application of high concentration of mitomycin C 0.027% for more than two minutes after excimer laser ablation. Postoperatively, patients were given topical moxifloxacin eye drops, steroid eye drops, NSAIDs eye drops in addition to oral analgesics. A contact lens was applied to counteract pain and is removed once the epithelium was healed. Patients will be examined 1,6,7 days, 2 weeks and 1,2 months after surgery. Specular microscopy was performed before surgery and again1-2 months after PRK to detect any possible reduction of endothelial function. Final corneal haze as well as BCVA were reported at 1-2 months after stabilization of refractive error. Collected data were subjected to statistical analysis including determination of mean value, standard deviation of each studied item in addition to minimum and maximum values. Comparison tests (t-test) as well as correlation tests were performed. Results: The age ranged from 18-39 years (mean 28.10±6.24).The corrected sphere (D) ranged from-3.0 to-10.0 (mean-6.82±2.08), cylinder (D) ranged from-1.0 to-4.5 (mean-2.56±1.13) and the total sphero-cylindrical correction (D) ranged from-6.25 to-11.25 (mean-8.78±1.52). No significant corneal haze developed in any of the cases included in the study. Regarding specular microscopy, the endothelial cell density(CD)/ mm 2 changed from a mean value of 2667.05±218.35 preoperatively to a mean value of 2697.32± 245.97 at 1-2 months postoperatively with a non-significant difference (p>0.05). The average endothelial cell area (Avg) (µm2) changed from a mean value