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PurposeTo investigate the effect of the diabetes on cataract formation by Pentacam Scheimpflug topography system.Materials and methodsThirty diabetic patients and thirty-five healthy control subjects were included in the study. Exclusion criteria were smoking, high refractive error, any systemic disease or drug usage associated with cataract formation and to have diabetic retinopathy. The duration of diabetes and HbA1c level were recorded. A comprehensive ophthalmologic examination was performed in all cases. Pentacam (Oculus, Wetzlar, Germany) three-dimensional lens densitometer module was used to measure density of anterior, nuclear and posterior lens regions.ResultsMean age of group 1 and group 2 was 37.80 ± 5.51 years and 36.51 ± 3.77 years, respectively. There were not any difference between groups in the means of age and sex (P = .271; P = .700). The mean duration of diabetes in group 1 was 4.23 ± 3.71 years (6 months–10 year). The mean HbA1c level was 8.12 ± 2.07% (5.4–12.7%). Anterior, nuclear and posterior mean lens densitometry measurements were significantly higher in group 1 (diabetic group) than group 2 (control group) [(8.90 ± 0.59%; 8.05 ± 0.72% P =  < .001), (7.52 ± 0.31%; 7.00 ± 0.59% P =  < .001), (7.25 ± 0.31%; 6.90 ± 0.73% P = .006), respectively].ConclusionDiabetes may have cataractous effect in anterior, nuclear and posterior regions of the lens.

: Dry eye disease (DED) is now widely considered to be the most prevalent ocular surface-related disease and has attracted increasing clinical attention in recent years. DED is well-studied in thyroid orbitopathy, but scarce data are available in patients with papillary thyroid carcinoma (PTC). : We analyzed 29 PTC cases with radioactive iodine (RAI) treatment (Group 1), 22 PTC cases without RAI (Group 2), and 26 normal control individuals (Group 3). All participants were evaluated with the Ocular Surface Disease Index (OSDI), meibomian gland secretion quality, and lid margin grading. Non-contact meibography and non-invasive tear breakup time measurements were completed using the Sirius Scheimpflug camera. Thyrotropin (TSH), free thyroxine, and free triiodothyronine were measured. : TSH values were significantly lower in both patient groups than in controls ( < 0.001). The proportion of participants with a lower meibomian gland secretion quality score ≥ 1 was 34.5% in Group 1, 22.7% in Group 2, and 7.1% in Group 3 ( = 0.002). There was a higher proportion of a meibomian gland atrophy score ≥ 1 in Groups 1 and 2 than in controls ( = 0.007). No differences were found between groups in lower lid margin score, Oxford values, upper meibomian gland expressibility or upper meibography scores ( = 0.485, = 0.064, = 0.256, = 0.069). OSDI scores were higher in both PTC groups than in controls (6.25 and 8.12 vs. 2.52), with borderline overall significance ( = 0.050) and higher pairwise scores versus controls (both = 0.034). : Meibomian gland dysfunction was observed in PTC patients regardless of RAI treatment, suggesting that TSH suppression itself may contribute to the development of ocular surface changes.

PurposeTo investigate the effect of botulinum neurotoxin-A (BTX-A) treatment on dry eye symptoms, tear meniscus, corneal topography and corneal aberrometry in patients with benign essential blepharospasm (BEB) and hemifacial spasm (HFS).Materials and methodsThis prospective study comprised of 6 patients with BEB and 20 patients with HFS. Tear meniscus height (TMH) and depth (TMD), tear break-up time (TBUT), corneal fluorescein staining score (CFSS), Schirmer I test, ocular surface disease index (OSDI) score, corneal topography [corneal power of flat axis (K1), corneal power of steep axis (K2), mean corneal power (Km), astigmatism and thinnest pachymetry] and anterior corneal aberrometry [spherical aberration (SA), vertical coma (vcoma), horizontal coma (hcoma), higher order root mean square (hRMS) and total RMS] were evaluated before BTX-A treatment, 3 weeks after BTX-A treatment and 2 months after BTX-A treatment.ResultsSix patients with BEB and 20 patients with HFS treated with BTX-A were evaluated in this study. Twenty contralateral spasm free eyes of 20 HFS patients were taken as control group. TMH and TMD were found to be significantly higher in eyes with spasm at both 3 weeks and 2 months after injection (TMH: 279.0 ± 123.2 at pretreatment, 380.5 ± 174.7 at third week and 317.0 ± 125.5 at second month p < 0.001 and p = 0.02, respectively), (TMD: 183.7 ± 59.7 at pretreatment, 235.7 ± 91.1 at third week and 209.8 ± 77.1 at second month p < 0.01 and p = 0.015, respectively). TBUT, CFSS, Schirmer I test values were similar (p > 0.05). OSDI scores decreased significantly from 29.6 ± 25.3 to 19.8 ± 20. p = 0.03 at third week and increased again by second month. K2 (43.9 ± 1.7 vs. 43.7 ± 1.6, p = 0.03) and astigmatism (0.8 ± 0.5 vs. 0.6 ± 0.4, p = 0.04) values were significantly lower at third week and increased again by second month. Pachymetry and aberrometric values did not change significantly. In the control group only Schirmer I test value decreased significantly at second month (10.5 ± 6.5 vs. 7.2 ± 5.6, p = 0.008), other parameters did not change.ConclusionBTX-A injection increases tear meniscus and decrease symptoms related to dry eye disease in BEB and HFS patients. It decrease astigmatism and keratometry values, it does not cause a significant change in corneal aberrations. However the positive effects of BTX-A injection on ocular surface is temporary.

Figure 2 Brain diffusion magnetic resonance imaging (MRI) showed a bilaterally enlarged superior ophthalmic vein [Figure 3] and brain-neck computed tomography (CT) venography demonstrated a bilateral superior ophthalmic vein with dolicoectatic appearance. Proptosis, chemosis, dilated conjunctival veins, blood in Schlemm's canal, uncontrollable elevated intraocular pressure, and retinal hemorrhages are major symptoms and signs of CCFs.

This study entitled \"Expectations and Problems of Adolescent Students in Quran Courses\" consists of two main chapters except \"Introduction\" and \"Conclusion\" chapters.In the introduction chapter, the problem and purpose, method, system and sample, hypothesis and restraints of research and previous studies on the subject had been expressed.In the first chapter, general development and religious development characteristics of adolescent young's had been investigated.In the second chapter, Koran Courses where the students study and the ideas of students about Quran Courses and expectations of students from courses had been discussed and interpreted.In the conclusion chapter the data's and consequences that they were gained in the end of research had been assessed and according to the detected problems there had been tabled some solutions.

Aim. This study aimed to describe barriers and facilitators of the adherence of children with human immunodeficiency virus (HIV) to antiretroviral therapy (ART) from the perspectives of their caregivers. Methods. In-depth interviews were held with the caregivers of 15 children. The collected data were analyzed using thematic analysis procedures. The Consolidated Criteria for Reporting Qualitative Research (COREQ) were followed in the study. Results. The perspectives of caregivers were categorized under four themes and subthemes. Barriers and facilitators of the adherence of children with HIV to ART were categorized into 4 main themes: (1) medication-related, (2) child-related, (3) caregiver-related, and (4) health system-related. The results indicated that understanding the factors that influence pediatric ART adherence is critical to the development of adequate strategies. In addition, disclosure of HIV status to the child is also an important factor affecting drug administration in the social environment. Conclusions. To ensure adherence to lifelong ART, targeted caregiver support through continuous supervision, clear guidance on drug preparation, and strategies for effective administration should be integrated into context-specific interventions that address the combined influence of factors related to the child, medication, healthcare, and of the sociocultural environment.

This study investigates the potential of asynchronous video-mediated oral book report assignments to enhance learners' spoken performance and decrease their speaking anxiety. The participants were 42 B1 level preparatory students from the English Language Teaching department who were taking skills-based intensive English education in Turkey. The participants carried out extended speaking tasks in the form of oral book reports within two weeks over 12 weeks (6 oral book reports in total) in the fall term of the academic year 2021/2022. The assigned oral book report videos were analyzed in relation to five categories in the narration rubric, including scores for characters, setting, cohesion or transition, grammar, and pronunciation. In addition, two structured open-ended questionnaires were used to investigate the participants' perceptions of the task's value, their changing performance in the tasks, and perceived changes in their anxiety level over time. Semi-structured interviews were also held to shed more light on the potential of such assignments for language classes. The results indicated that regular video-mediated asynchronous oral book reports helped the participants develop their speaking performance and decrease their speaking anxiety over time. Overcoming time limitations, such assignments have the potential to be used in language classes where teachers can empower every voice.

Introduction: A fast and accurate determination of methicillin resistance in Staphylococcus aureus strains is vital. This study aimed to compare the sensitivity and specificity of the cefoxitin disc diffusion (CDD) test and BD Phoenix automated system considering mecA/mecC positivity as the gold standard and to investigate the presence of Panton-Valentine leukocidin (PVL) toxin gene, a crucial virulence factor of S. aureus strains. Materials and Methods: Overall, 179 Staphylococcus aureus strains from various clinical samples were included. Antibiotic sensitivity was tested using the Phoenix automated system and by applying the Kirby-Bauer disc diffusion method for cefoxitin (30 μg). The mecA, mecC, and PVL presence was determined using the conventional multiplex polymerase chain reaction method. mecA/mecC positivity was considered as the gold standard. Statistical analysis was performed using SPSS 15.0 for Windows (Chicago, IL, USA). Results: Overall, 91 strains (50.8%) were mecA positive and identified as methicillin resistant Staphylococcus aureus (MRSA). No isolates containing the mecC gene were detected. The Phoenix automated system falsely identified six methicillin-sensitive S. aureus (MSSA) isolates, which were mecA and mecC negative as MRSA. The sensitivity and specificity of the CDD test were found to be 100% in determining MRSA, and the sensitivity and specificity the Phoenix automated system were 100% and 93.2%, respectively. The PVL positivity rate in MRSA and MSSA strains was 6.5% and 7.4%, respectively. All PVL-positive strains were isolated from the skin and soft tissues. Conclusion: The CDD test is a reliable method for routine procedures. Methicillin-sensitive strains can be determined as MRSA via the Phoenix automated system. Nevertheless, mecC-controlled MRSA should not be excluded from methods used for determining methicillin resistance. Panton-Valentine leukocidin toxin gene should be determined to enable clinicians to understand the infection severity.

Background Traditional predictors of weaning outcomes primarily focus on acute illness severity and physiological parameters, while geriatric vulnerability domains such as frailty, functional dependence, and nutritional risk are often overlooked. Evidence regarding the incremental prognostic value of these domains for predicting weaning failure in critically ill older patients remains limited. This study aimed to evaluate the association between pre-admission frailty, functional status, comorbidity burden, and acute organ dysfunction with weaning failure in critically ill patients aged ≥ 65 years, and to compare their prognostic contribution with traditional severity scores. Methods This study is a secondary analysis of a national, multicenter, prospective observational cohort conducted across adult ICUs in Türkiye. Consecutive ICU patients aged ≥ 65 years who required invasive mechanical ventilation for more than 24 h were included. Multivariable logistic regression was used to identify factors independently associated with weaning failure. Weaning failure was defined as the need for reintubation within 7 days after extubation, death during the weaning process, or persistent requirement for invasive mechanical ventilation at day 90. Model discrimination was assessed using the area under the receiver operating characteristic curve (AUC). Results A total of 647 critically ill older patients were included in the study. Weaning failure occurred in 347 patients (53.6%). There was no significant difference in age between patients with weaning failure and those successfully weaned. Patients with weaning failure had significantly higher frailty scores, greater comorbidity burden, more severe organ dysfunction, higher nutritional risk, and worse functional dependency. In the final multivariable logistic regression model, higher Clinical Frailty Scale (CFS) (aOR = 1.26 per point; 95% CI = 1.16–1.38) and higher Sequential Organ Failure Assessment (SOFA) score (aOR = 1.12 per point; 95% CI = 1.06–1.19) were independently associated with weaning failure. Conclusions In critically ill older patients, frailty and early organ dysfunction were the factors most strongly associated with weaning failure, whereas chronological age alone showed limited prognostic value, supporting a shift from age-based to vulnerability-based risk assessment.