Orthokeratology (Ortho-K) - A New Advent

What is orthokeratology?

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Orthokeratology or ortho-K is a new advent in the field of ophthalmology and optometry. It refers to a non-surgical and reversible ophthalmological procedure where specially designed gas permeable contact lenses are used to reshape the anterior surface of the cornea in a gradual and gentle way. It is a kind of vision therapy where cornea is molded according to the type of refractive errors which are myopia (near sightedness; the patient can see clear near objects but not the far ones with accommodation of eyes at rest), hypermetropia or Hyperopia (far sightedness; the patient can see clearly far objects but not the near ones with accommodation at rest), astigmatism (inability of eye to make a sharp focused image of a point object onto the retina, a blurred image is formed) and presbyopia (inability of eyes to focus near object with advancing age).

Ortho-K lenses are worn during sleeping hours only. In other words, these are overnight wear lenses and not to be worn on waking hours. They are removed on waking up and the reshaped surface of the cornea allows clear vision for waking hours without wearing spectacles or contact lenses. 

Orthokeratology is recommended for both children and adults with refractive errors ranging from -1.00 to -10.00 dioptres of myopia and from +1.00 to +5.00 dioptres of hypemetropia as well as for low degrees of astigmatisms. In some countries hyperopic Ortho-K contact lenses are not available but low degrees of astigmatism and myopias are corrected as given in the ranges in this paragraph.

It is a non-invasive and reversible as compared to LASIK eye surgery which is invasive and can permanently change the shape of cornea. So, people who avoid undergoing eye surgery for their refractive errors can get benefited from Orthokeratology.

Who are the best candidates for ortho-K therapy?

• Children are the best candidates for Ortho-K treatment as their myopia progression control is good with Ortho-K. Researchers in Hong Kong and the US have conducted clinical studies which revealed that children who wear Ortho-K lenses had 50% less progression in myopia than children who wear spectacles and contact lenses.
• Sportsmen
• Dry eye complain with contacts
• People who are allergic to contact lenses
• Dusty or hot environment which is not suitable for contact lenses
• Cosmetic purposes for getting rid of spectacles
• Contact dermatitis with spectacle material

How orthokeratology works?

Do Not Use Ear Picks

Do not use ear picks or cotton-tipped swabs! Beware, you may harm your ear!

Ear plug, ear wax

Ear wax or cerumen is normally produced in the ear by ear canal or auditory tube. It is a yellowish waxy material that protects and lubricates the skin of the ear. Moreover, it also offers protection against microbes like bacteria and fungi as well as against certain insects. However, access or impacted earwax presses against the cone shaped eardrum or tympanic membrane and may cause earwax symptoms like ear pain, itching, dizziness, decrease hearing, sensation of fullness and ringing in the ear. Earwax impaction causes conductive hearing loss.

Causes of impacted earwax

The most common cause of impacted earwax is the use of rolled napkin corners or certain kinds of ear pins or ear picks. They clean the ear superficially and press the rest of the wax deeper against eardrum causing impacted earwax symptoms. Use of hearing aids is also associated with impaction of cerumen.

Impacted earwax symptoms

The following impacted earwax symptoms may be observed by the patient:

• Blocked ear
• Ear pain
• Itching or irritation
• Dizziness or giddiness
• Decrease hearing
• Sensation of ear fullness
• Ringing in the ear

How to examine impacted earwax?

Ambu Bag Ventilation: Indications, Contraindications and Complications

Ambu Bag
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Ambu bag is an important device or instrument, a part and parcel of emergency or ambulance equipment. Ambu bag ventilation is an essential emergency skill, all the medical professionals should learn how to use ambu bag or how to perform ambu bag ventilation. It offers the basic airway management for the ventilation and oxygenation of the patients until the other definitive airway is established or where the definitive airway management or endotracheal intubation fails.

Parts of Ambu bag

Parts of ambu bag are:

• Mask
• Rebreathing bag
• Oxygen connecting tube
• Oxygen reservoir
• Pressure gauze

Indications

• Respiratory failure (it may be failure of ventilation or oxygenation)
• Failed intubation

Contraindications

• Upper airway obstruction (absolute contraindication)
• Paralysis and induction (risk of aspiration)

Complications

• Aspiration
• Hypoventilation
• Hyperventilation
• Pneumothorax- hyperventilation with ambu bag may lead to barotrauma causing lethal complication of pneumothorax (4-15%)

Check the video below:

Here is the question, "What is the abbreviation of Ambu stands for?" Write your answer in the comments.

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Keywords: Ambu bag, Ambu bag ventilation, Indications, Contraindications, Complications, Ambulance equipment, Ambu stands for, Emergency equipment, Life saving, 

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Mutual Pleasure: A Crucial Component of Sexual Satisfaction

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Mutual pleasure is the key to achieve sexual satisfaction. Recently, Pascoal and his colleagues conducted an exploratory survey on 449 women and 311 men with heterosexual and committed exclusive relationship, asking for their written responses on “How would you define sexual satisfaction?” The survey offers is the part of sex education. This study was based on two themes:

Personal sexual well-being- it covered the individual sexual experience like pleasure, positive feelings, arousal, sexual openness and orgasm.

Dyadic processes- it emphasised the relational dimensions like mutuality, romance, expression of feelings, creativity, acting out desires and frequency of sexual activity.

They concluded that mutual pleasure is a key component of sexual satisfaction which is the outcome of positive sexual experiences, not mere the absence of conflict or sexual dysfunction.

The below visual image derived from “The journal of Sex Research” indicates what most of the individuals look for to feel satisfied.

Positive feelings

Positive feelings and emotions pave the way to sexual satisfaction. Positive sexual anticipation works as a strong aphrodisiac. Sex education helps gain positive sexual activity.

Quick Action Against Multi-Resistant Bacteria

Bacteria
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Today’s world population is infected with the increased amount of bacterial infections as compared to those who lived 10 years before and during that time bacteria have learned to survive. Even they escape the same antibiotics from which they would usually die. In other words, now bacteria are not coming in handy anymore with many types of antibiotics. 

Many bacterial infections such as tuberculosis, gonorrhea, and staphylococcus aureus infections have shown to become nearly impossible to treat when they are caused by multi-drug-resistant bacteria.

Antibiotics function is to destroy or inhibit a specific part of the bacterium such as its growth, DNA formation and cell wall synthesis. Additionally, there are many other ways antibiotics are utilized to kill bacteria.

In order to combat multi-drug-resistant bacteria, researchers are finding ways to replace the old list of antibiotics with new one that will work in a different way.

The team of doctors under the patronage of Joseph Pogliano and Kit Pogliano from the University of California has tested if it was possible to quickly identify the bacteria by observing their shape, appearance and whether it was possible to identify which antibiotics class would be possible to target their structure. It was concluded that knowing the features of culprit bacteria can provide some clue on what type of antibiotics can be used to kill the bacteria. 

Bacterial cytological profiling 

A research was carried out in which Escherichia Coli (E. Coli) was used to study further the mechanism of already known antibiotics.

Breast Cancer Research and Treatment: Something New

Breast Cancer

Breast cancer is among the most common cancers appearing in the females. Today, it is the second leading cause of death in females. It has been estimated that the chances of a woman dying of breast cancer are 1 in 36. 

Causes of breast cancer

Cause of breast cancer is still unclear. Mostly the factors that take part in the development of cancer are the woman’s lifestyle and habits.

Genetic mutations play a key role in the development of breast cancer. Studies have shown that the use of genetic testing for BRCA1 and BRCA2 mutations continues and is going at a fast pace. Also, it has been noticed how common it is for gene variation to occur.

At some point it has been seen that environment plays a role in the cause of cancer. Obesity, diet, regular heavy alcohol, heavy radiations and estrogen rich pills may be the risk factors for breast cancer.

Symptoms of breast cancer

Breast cancer symptoms include a lump or an area of thickened tissue in the breast, change in size or shape or both, discharge from the nipple, dimpling of the breast skin, rash around the nipple or sunken nipple. The most common breast cancer symptom is a lump or thickened are or breast tissue. But, bear in mind, most of the lumps are not breast cancers.

Chemoprevention

Chemoprevention refers to the method which prevents or reduces the chances of breast cancer with the use of drugs, vitamins or other agents. Fenretinide, a retinoid, is being used to decrease the risk of breast cancer to occur. Retinoids are vitamin A related drugs. A small study has reported that Fenretinide reduces breast cancer risk as much as Tamoxifen.

New laboratory tests

Circulating tumour cells

It has been noticed that a part of tumour often breaks away from its original site and enters the blood circulation. Such products are known as cancer tumour markers. A sensitive test can indicate whether the cancer can reappear again to the patient or not. This test is important for the patients who are at a higher stage of cancer and their treatment is going well.

Wheat Pills: An Over-The-Counter Poison

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"Three or four weeks ago, two teen-age cousins (a boy and a girl) committed suicide by ingesting "Wheat Pills". The girl died before she had reached the hospital. The boy was referred to a tertiary care hospital where he fought for his life for some time and then kicked the bucket eventually."
"Years ago, a gentle man went to bed with two wheat pills in his pocket and was found dead in the morning. He was fully covered with a blanket for the whole night. Phospine gas released from the pills resulted in the poor man's death."“Wheat pills” are an over-the-counter lethal poison. The studies report that the patient ingesting 2 tablets of “wheat pills” does not survive.The problem is that these “wheat pills” are found over-the-counter, available in very low price (about 4-5 PKRs only). In other words, this dangerous drug is easily accessible to the general population.Wheat pills contain aluminum phosphide and are used for the preservation of wheat and other cereals. There is no law and order to limit or look over the supply of this lethal poison.In my practice, I do not remember any patient who ate “wheat pills” and then survived. Unfortunately, each year in Pakistan, hundreds of individuals commit suicide by engulfing these wheat pills.The government should think of it and prohibit the easy availability of this drug.Hope you will like this post and honour us with your opinion.

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Keywords: Wheat pills, Over-the-counter poison, Suicide, Aluminum phosphide

A New Way to Fight HIV

HIV Virion
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The recent HIV news reveals that a mutant protein can block the further activity of HIV. This HIV news refers to an article published in a medical journal “Retrovirology”.

This recent update is being rendered as a wonderful discovery that may help fight HIV infection without affecting the immune system.

The WHO has estimated that about 35 million are affected by HIV and 25 million of them have been killed in the last 30 years.

How HIV infects the body?

The Mechanism of HIV is that it attacks the T cells, important part of our immune system. The virus attaches CD4 T cells, enters into them and takes away every controlling function of the cells into its own processes. HIV virus causes what is called AIDS.

What are the two mechanisms of HIV infection?

In the recent study, Wei and his colleagues observed the adhesion and degranulation-promoting adaptor protein (ADAP). They noted that ADAP helps carry out two main mechanisms of HIV infection:

• Replicating virus and affecting T cells
• Spreading it from one affected T cell to another unaffected T cell

The above two mechanisms of HIV-1 are regulated with the help of ADAP.

The major discovery that Wei et al made is that the mutation of ADAP may stop both the mechanisms. So, targeting ADAP may stop the progression of HIV infection without hurting the immune system.

The AIDS treatment that has been suggested is that HIV-infected individuals should be given T cells expressing the mutant protein. Doing so will halt the progression of HIV infection, reducing AIDS symptoms.

Hopefully, someday AIDS will be cured.

Reference

Wei B, Han L, Abbink TE, Groppelli E, Lim D, Thaker YR, et al. Immune adaptor ADAP in T cells regulates HIV-1 transcription and cell-cell viral spread via different co-receptors. Retrovirology 2013, 10:101. 

Written by:

Wajiha Hassan

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Keywords: HIV infection, HIV news, ADAP, mutant protein, AIDS symptoms

Does Fresh Frozen Plasma Correct International Normalized Ratio?

Does fresh frozen plasma (FFP) correct international normalized ratio? Does elevated INR predict bleeding? Does FFP play any advantageous role in the correction of INR against its risks? The recent studies do not support the previous concepts about FFPs and INR. What do you say? Click to enlarge the below image.

Review by Dr. Nicole Lamparello

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Keywords: Fresh frozen plasma, FFPs, International normalized ratio, INR, Review