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Purpose: To evaluate the medium-term motor outcomes of three horizontal muscle surgery in patients with large-angle infantile esotropia. Methods: The charts of 18 patients with large-angle (> 55 prism diopters [PD]) infantile esotropia who underwent bilateral medial rectus muscle recession and one lateral rectus muscle resection were retrospectively reviewed. Preoperative and postoperative deviations at last examination, overcorrections and undercorrections, necessity of additional horizontal surgery, and follow-up durations were recorded. Results: The median age of patients at surgery was 22 months (range: 10 to 168 months). Orthotropia to within 10 PD or less was achieved in 14 of 18 patients (78%) in a median follow-up of 32 months (range: 5 to 63 months). The mean preoperative deviation of 68.8 ± 9.54 PD decreased to a median of 1 PD (range: esotropia 30 to exophoria 4 PD) postoperatively (The median age of patients at surgery was 22 months (range: 10 to 168 months). Orthotropia to within 10 PD or less was achieved in 14 of 18 patients (78%) in a median follow-up of 32 months (range: 5 to 63 months). The mean preoperative deviation of 68.8 ± 9.54 PD decreased to a median of 1 PD (range: esotropia 30 to exophoria 4 PD) postoperatively ( P < .005). Marked residual esotropia necessitating additional surgery occurred in 4 patients, but significant overcorrection was not observed. Conclusions: The success rate of the three horizontal muscle surgeries appears to be high enough in medium-term follow-up in patients with large-angle infantile esotropia. Overcorrection that necessitates additional horizontal muscle surgery does not seem to be significant in the medium term, according to this study. [J Pediatr Ophthalmol Strabismus 2014;51(3):160–164.]

Purpose To report a technique of intra-scleral fixation of the iris hooks for trans-scleral capsular bag fixation in patient with zonular dialysis. Methods Two scleral flaps, two scleral tunnels and two sclerotomies were formed. The anterior capsule was captured and pulled by the iris hooks resulting in the IOL adopting an appropriate position at which point the iris hooks extracted from the sclerotomies. The tips of the iris hooks were implanted into the scleral tunnels. Each of them was fixed with a 10.0 nylon suture to the scleral bed. The scleral flaps and conjunctiva were sutured. One of the iris hooks was seen loosened at the first-week postoperative examination but the IOL remained centralized. The loosened hook was removed. Results No complications were witnessed during the patient’s 24-month follow-up. Conclusion Intra-scleral fixation using iris retractors in the capsular bag for patients having suffered dislocation of IOL despite the attachment of a capsular hook because of zonular dialysis can be safely implemented.

To investigate the frequency of converting a residency dissertation to a journal article in Turkey. To compare the different residency programs and their publications rates; to sub classify of dissertations according to sub-specialties. Ophthalmologists who graduated before 2010 conducted surveys. The surveys questions included graduation year, residency program, topic of the dissertations, type of the study (prospective, retrospective, or experimental), publication rate from the dissertations, and type of journal for published dissertations. Three-hundred-eight ophthalmologists conducted surveys. Fifty seven (18.5%) dissertations were published in SCI-Expanded Indexed journals (39 of them (23%) from the university hospital programs and 17 of them (13%) from state hospital programs (p=0.036)) and 97 of dissertations were published in national journals. 92 of 170 (54%) dissertations from the university based residency programs and 59 of 131 (45%) dissertations from the state hospital based residency programs were published in national journals or international journals indexed in the SCI-Expanded Index (p=0.17). A publication rate from dissertations was similar between big city university programs and small city university programs (23.3%; 22.6%). The most frequently studied topics of dissertations were cataract-refractive surgery (21.5%), followed by retina (21%), glaucoma (21%), cornea-anterior segment (19%), and strabismus (7%). Of the study design, 57% of them were prospective, 32% were retrospective, and 10.5% were experimental study. In this study, it seems to be that lesser than one fifth of Ophthalmology Residency dissertations in Turkey converted to journal articles in SCI-Expanded journals. It is obvious that the overall quality of the dissertations was inadequate to be published in indexed journals and it is necessary to take some measures to increase the scientific quality.

To evaluate medium-term outcomes of overminus lens treatment in patients with intermittent exotropia [X(T)]. A retrospective analysis was performed of the outcomes of 19 children with X(T) who were prescribed overminus lens (−2.00 to −4.00 D) for a median period of 18 months (6–33). The success was evaluated using two assessment methods: 1. Newcastle Control System (NCS), and 2. Jampolsky’s assessment. The mean age of the patients was 6.8 ± 3.3 years (range 3–14 years). After the therapy, the median NCS score significantly improved from 5 to 1 ( p  < 0.001). Sixteen children (84 %) showed a NCS score of 2 or less after overminus lens treatment. According to Jampolsky’s assessment, 84 % of the patients showed marked improvement from the baseline (47 % had qualitative improvement, 37 % quantitative decrease in the angle of deviation in addition to a qualitative improvement). The median pre-treatment distant angle decreased from 25 prism diopters (PD) to 18 PD after the treatment ( p  = 0.002). Overcorrecting minus lens treatment has a reasonable rate of success in the medium term and may be advised as primary therapeutic alternative for X(T). Both NCS and Jampolsky’s scoring system appear to be useful and comparable for follow-up of patients with X(T).

ABSTRACT Objectives: This study aimed to evaluate the rate of successful transitions, identify factors associated with early versus late transitions, and diagnosis and treatment changes after transition into adult rheumatology. Studies have shown that transition success rates vary widely, with several factors influencing outcomes, including the presence of structured transition programs, patient readiness, and the nature of the disease.2,3 The European Alliance of Associations for Rheumatology (EULAR) and the Pediatric Rheumatology European Society (PReS) have emphasized the need for standardized transition policies and multidisciplinary approaches to improve transition outcomes.4 However, the implementation of such guidelines remains inconsistent across different regions and healthcare settings.5 The transition process is of paramount significance for both healthcare providers and researchers, as prolonged transition periods have been linked to increased mortality and morbidity rates.6\"9 Unfortunately, unsuccessful transitions remain distressingly high, with prior research indicating that nearly half of the patients struggle to navigate a smooth transition from pediatric to adult rheumatology care.210 The transition process involves not only the transfer of care from pediatric to adult rheumatology departments but also encompasses broader challenges such as the adaptation to adult healthcare settings, changes in treatment protocols, and reclassification of diseases. PATIENTS AND METHODS This retrospective investigation was carried out at the Dokuz Eylul University Research and Application Hospital. A late transition was defined as a period exceeding three months from the last pediatric rheumatology admission to the first adult rheumatology admission. Since patients were usually followed at three-month intervals to prescribe drugs and evaluate treatment compliance in adult rheumatology, the distinction between early and late transition was determined as three months.

The aim of this study was to synthesize, characterize, and screen some new 1-(4-((2-(4-substitutedphenyl)hydrazono)methyl)phenyl)-1H-1,2,4-triazole derivatives for their antimycobacterial activities. The target compounds were gained by condensation of 4-(1 -1,2,4-triazol-1-yl)benzaldehyde with appropriate phenylhydrazines. Their structures were elucidated by IR, H-NMR, and mass spectrometry. The antimycobacterial activities of the compounds were determined against H37Rv. The biological assay results showed that the methylsulfonyl-substituted derivative displayed the highest antimycobacterial activity in this series. Although the methylsulfonyl-substituted derivative exhibited significant antimycobacterial activity, none of the synthesized compounds was as effective as isoniazid, rifampin, ethambutol, and ciprofloxacin against .

Although skin tag is associated with diabetes mellitus, no data in the literature show that the presence of skin tag is associated with diabetic macro and microangiopathy. The purpose of this study was to investigate the frequency of hypertension, dyslipidemia, obesity, macro and micro angiopathy in type 2 diabetic patients with and without skin tag. We evaluated 99 (40 female and 59 male) type 2 diabetic patients. All patients were evaluated for blood pressure, body mass index, lipids, HbA1c, macroangiopathy (peripheral vascular disease, cerebrovascular disease and coronary heart disease), microangiopathy (neuropathy, nephropathy, retinopathy) and skin tag. Age, HbA1c and body mass index were 65.0 ± 14.2 years, 8.1 ± 2.0% and 30.5 ± 6.4 kg/m2, respectively. The frequency of skin tags 53.5%, dyslipidemia 68.7%, hypertension 69.7%, obesity 39.4%, macroangiopathy 61.6% (peripheral vascular disease 12.1%, cerebrovascular disease 16.2%, and coronary heart disease 49.5%), microangiopathy 63.6% (neuropathy 21.2%, nephropathy 38.4%, retinopathy 38.4%) were detected. Higher body mass index (p = 0.04) and frequency of obesity (p = 0.03) were detected in patients with skin tag than without skin tag. Age (p = 0.8), gender (p = 0.6), HbA1c (p = 0.4) and the presence of dyslipidemia (p = 0.4), hypertension (p = 0.6), macroangiopathy (p = 0.2), and microangiopathy (p = 0.9) were not different in patients with and without skin tag. We conclude that presence of skin tag is merely related to obesity and may not be strongly associated with macro- and microangiopathy in type 2 diabetic individuals. Further studies with large patient population are required to elucidate the association between the presence of skin tag and diabetic angiopathy.

Background Chronic hepatitis B infection is characterized by hepatic immune and inflammatory response with considerable variation in the rates of progression to cirrhosis. Genetic variants and environmental cues influence predisposition to the development of chronic liver disease; however, it remains unknown if aberrant DNA methylation is associated with fibrosis progression in chronic hepatitis B. Results To identify epigenetic marks associated with inflammatory and fibrotic processes of the hepatitis B-induced chronic liver disease, we carried out hepatic genome-wide methylation profiling using Illumina Infinium BeadArrays comparing mild and severe fibrotic disease in a discovery cohort of 29 patients. We obtained 310 differentially methylated regions and selected four loci comprising three genes from the top differentially methylated regions: hypermethylation of HOXA2 and HDAC4 along with hypomethylation of PPP1R18 were significantly linked to severe fibrosis. We replicated the prominent methylation marks in an independent cohort of 102 patients by bisulfite modification and pyrosequencing. The timing and causal relationship of epigenetic modifications with disease severity was further investigated using a cohort of patients with serial biopsies. Conclusions Our findings suggest a linkage of widespread epigenetic dysregulation with disease progression in chronic hepatitis B infection. CpG methylation at novel genes sheds light on new molecular pathways, which can be potentially exploited as a biomarker or targeted to attenuate inflammation and fibrosis.

This research is a descriptive study aiming to examine the relationship between nursing students' locus of control and being ready for self directed learning. The sample of the study consists of the entire first, second, third and fourth graders studying at Uludag University, School of Health in the academic year of 2012-2013. The study was conducted with 171 students who volunteered and filled in the forms completely. In the study the Locus of Control Scale and Self Directed Learning Skill Scale were used. Descriptive statistics, correlation analysis and two independent sample t test were used in the data analysis. It was found that students with high levels of internal locus of control are more ready to self-directed learning and that there is not a relationship between locus of control and self-directed learning by the year of study.