bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Green Chilli Grown Using Different Grow Bag Packages and Fertilizers for Developing a Domestic Growing Model
Authors: Perera I. J. J. U. N. , Rupasinghe C. P. , Kumarasinghe H. K. M. S.
Published: February 2023

Chilli (Capsicum annuum L.) is one of the most valuable cash crops in Sri Lanka. The purpose of the study was to develop a chilli growing domestic model by synergizing effects of growth media and fertilizers on the growth and yield performances. This experiment was carried out for chilli variety MICH 3 and the study was laid out using a randomized complete block design with two factors, namely, grow bag packages and fertilizers, with four replicates. The grow bag packages consisted of two levels, i.e., commercial coco peat grow bag and multilayer gunny bag, and fertilizers consisted of two levels, i.e. Albert’s fertilizer and compost tea. Both growing medias were characterized for desirable physical and chemical properties. Multilayer gunny bag showed significantly different (p<0.05) growth performance and higher yield compared to the commercial coco peat grow bag. Albert’s fertilizer resulted significantly best growth performance compared to compost tea. However, yield performances were similar in both fertilizers. The combination of multilayer gunny bag and compost tea can be recommended for chilli growing domestic model
UN Decade on Ecosystem Restoration 2021-2030: Are We Ready for the Grand Challenge?
Authors: Geekiyanage N.
Published: February 2023

No abstract available
Growth Performances of Cocoa (Theobroma Cacao) Varieties under Mature Oil Palm with Palm Oil Mill Effluent as Growing Media
Authors: Palihakkara I. R. , Rodrigo W. D. P. , Ekanayake E. M. U. I.
Published: February 2023

Oil palm (Elaeis guineensis) is a leading edible oil-producing plant established in tropical countries which cause many negative impacts. Poor productivity of monoculture plantations and land and aquatic pollution caused by haphazard release of Palm Oil Mill Effluent (POME) are critical concerns. As a remedy, oil palm can be intercropped with cocoa by using POME as a potting media. In this study, we evaluated the growth of two different cocoa varieties with POME as the potting media under 20 years old oil palm shade. Two cocoa varieties (SCA6 x ICS6, and NA32 x ICS1) and three potting media (topsoil only, 40% topsoil with 60% POME, and 60% topsoil with 40% POME) were factorially combined in a randomized complete block design with three replicates under 40% shade, Faculty of Agriculture, University of Ruhuna. Growth parameters of the cocoa seedlings such as plant height, number of leaves, chlorophyll value, stem girth, root and shoot dry weights, root length, number of lateral roots per plant were measured using destructive and non-destructive sampling methods. The potting media consist of 40% topsoil with 60% POME showed significantly the highest plant height, number of leaves, chlorophyll value, stem girth, fresh and dry weight of shoot and roots and length of roots. Hence, potting media with 40% topsoil with 60% POME was recognized as the best potting media for the growth and development of cocoa seedlings of both varieties. Growth of cocoa seedling was well compatible under oil palm shade at full light condition with the use of POME as the potting media.
Performance and Loads of a Wing-Offset Compound Helicopter
Authors: Escobar Daniel , Yeo Hyeonsoo
Published: February 2023

Analysis of a hingeless rotor with a single wing on the retreating side for lift compounding was conducted. The goals included validation of performance and load predictions with wind tunnel test data, study of the impact of different aerodynamic inflow models, and understanding of
benefits by lift compounding with a single wing on the retreating side. The three primary test cases include collective sweeps of the isolated rotor, and the rotor with the wing, at two different incidence angles. The comprehensive analysis was able to accurately predict the performance and
blade structural loads of both the isolated rotor and rotor plus wing configurations. Overprediction of propulsive force leads to underprediction of lift-to-drag ratio in several cases. The normal bending moments were well captured for all cases, while the chord bending moment predictions
had a phase offset from the test data, but magnitude and harmonics were captured. Comparing inflow models found that dynamic inflow and vortex wake (prescribed and free) models provided similar results. At these advance ratios, prescribed and free wake models showed almost no differences.
Additionally, the vortex particle method showed an overprediction of thrust and greater rotorto-wing aerodynamic interference compared to test data. The addition of the wing on the retreating side provided dual benefits of increasing maximum lift-to-drag ratio and reduction of structural loads
for a given total thrust. These effects are a result of both lift share between the rotor and wing, and lift offset, the rotor carries a roll moment to balance the wing's roll moment.
Serratia endocarditis, uncommon organism, with significant complications
Authors: George Anu Anna , Singh Tejveer , Bhattad Pradnya Brizmohan , Sherif Akil A. , Mishra Ajay Kumar
Published: February 2023

Serratia marcescens is an aerobic, Gram-negative bacillus predominantly seen in patients with intravenous drug use, immunosuppression, previous antibiotic exposure, and indwelling catheterization. Gram-negative organism causing infective endocarditis (IE) is rare. Serratia marcescens IE is uncommon and is reported to be seen in 0.14% of all cases. In this report, we discuss in detail about a 38-year-old man with a history of intravenous drug abuse presenting with S. marcescens related prosthetic valve IE.
Management and clinical outcomes of patients with homozygous familial hypercholesteremia in Saudi Arabia
Authors: Kholaif Naji , Mohamed Tahir I. , Alharbi Ibrahim S. , Aljenedil Sumayah A. , AlHumaidan Hind , Al-Ashwal Abdullah , Almahfouz Abdulraof , Algorashi Shahd , Almasood Ali , Baqal Omar J.
Published: February 2023

We report the incidence, patient characteristic with clinical outcomes in patients with homozygous familial hypercholesterolemia (HoFH) in Saudi Arabia. This is a retrospective and prospective, single center study which included 37 patients 14 years and older enrolled and followed up between 2018-2021 for three years. 46% were females, 78% were offspring of consanguineous marriage. LDLR mutation was in 78% and LDL-C/LDLRAP in 3% of patients. Mean LDL-C at the first presentation was 14.2±3.7 mmol/L, average Dutch lipid score was 20.9±6.24. LDL apheresis was performed on 70% of patients. Most patients were on ezetimibe (92%), high-dose statins ( 84%) and  PCSK9 inhibitors (32%). 48.6% had aortic stenosis, out of which 30% had severe aortic stenosis. Ten underwent aortic valve surgery (5 mechanical valve, 3 Ross procedure, 1 aortic valve repair, 1 bioprosthetic valve) and one had transcatheter aortic valve implantation (TAVI). Coronary artery bypass surgery (CABG) was performed on 32% and percutaneous intervention (PCI) on 11% of patients. HoFH patients have complex diseases with high morbidity and mortality, and benefit from a highly specialized multidisciplinary clinic to address their clinical needs. Although there are several therapeutic agents on the horizon, early diagnosis, and treatment of HoFH remain critical to optimize patient outcomes.
Correlation between the actual sleep time 24 hours prior to an examination and the time to achieve chloral hydrate sedation in pediatric patients in South Korea: a prospective cohort study
Authors: Park Mijung , Um Ji , Kim So Hyun , Yoon Jiseon , Lee Yeonjae , Kwon Jiyeong , Baek Seonhee , Kim Dong Yeon
Published: February 2023

Purpose: This study investigated correlations between the actual sleep time 24 hours prior to an examination and the time to achieve chloral hydrate sedation in pediatric patients.Methods: With parental consent, 84 children who were placed under moderate or deep sedation with chloral hydrate for examinations from November 19, 2020 to July 9, 2022 were recruited.Results: Patients' average age was 19.9 months. Pediatric neurology patients and those who underwent electroencephalography took significantly longer to achieve sedation with chloral hydrate. There was a negative correlation between the time to achieve sedation and actual sleep time within 24 hours prior to the examination. Positive correlations were found between the actual sleep time 24 hours prior to the examination and the second dose per weight, as well as between the sedation recovery time and awake hours before the examination.Conclusion: Sleep restriction is not an effective adjuvant therapy for chloral hydrate sedation in children, and sedation effects vary according to pediatric patients' characteristics. Therefore, it would be possible to reduce the unnecessary efforts of caregivers who restrict children's sleep for examinations. It is more important to educate parents about safe sedation than about sleep restriction.
Family-centered interventions for children and adolescents with type 1 diabetes mellitus: an integrative review
Authors: Ispriantari Aloysia , Agustina Rismia , Konlan Kennedy Diema , Lee Hyejung
Published: February 2023

Purpose: The purpose of this study was to investigate the effect of family-centered interventions on improving health outcomes in children and adolescents with type 1 diabetes mellitus (T1DM).Methods: A literature search was conducted according to the PRISMA guidelines, using six electronic databases: EMBASE, CINAHL, Medline, CENTRAL, Scopus, and Web of Science. The inclusion criteria encompassed studies with populations of children and adolescents (age <18 years) and at least one parent/caregiver, or only parents/caregivers if the children were very young, and studies that investigated the health outcomes of children and parents/caregivers diagnosed with T1DM.Results: From 2,746 published studies, only nine studies met the inclusion criteria. The key interventions were non-technology-based interventions (n=4), technology-based interventions (n=2), and combined technology- and non-technologybased interventions (n=3). The interventions had effects on glycated hemoglobin, adherence to diabetes management, diabetes self-management behaviors, and parentchild teamwork in diabetes management. Other essential effects were children's quality of life, children's problem-solving skills, parents' quality of life, and parents' coping and depression.Conclusion: Family-centered interventions can effectively improve health outcomes in children and adolescents with T1DM. In the future, family-centered interventions integrated with other approaches, theories, and models should be developed to achieve the best possible outcomes.
Knowledge, confidence, and educational needs of newborn care among North Korean refugee women: a descriptive study
Authors: Lee In-Sook
Published: February 2023

Purpose: North Korean refugee women struggle with the double burden of adaptation and parenting as mothers in a new environment. This study aimed to identify the knowledge, confidence, and educational needs regarding newborn care among North Korean refugees, and to determine differences between these variables according to participants' characteristics.Methods: Data were collected from September to October 2022, and 150 North Korean refugee women recruited using convenience sampling participated in the study. Descriptive statistics, the t-test, analysis of variance, and Pearson correlation analysis were used for data analysis.Results: The mean scores were as follows: parenting knowledge, 14.97 out of 25; infection prevention knowledge and confidence, 20.09 out of 33 and 51.37 out of 80, respectively; and educational needs, 245.86 out of 310. Significant differences were observed in newborn care, knowledge, and confidence according to maternal age, educational level, family structure, and pregnancy history. Significant positive correlations were observed between the participants' newborn care knowledge, confidence, and educational needs.Conclusion: Personalized educational programs should be implemented to enhance North Korean refugee women's confidence in newborn care, focusing on areas with low knowledge levels and high educational needs and enabling women to achieve healthy pregnancy and childbirth, and to parent well.
Health-related quality of life in children with epilepsy: a concept analysis
Authors: Choi Sinyoung , Bang Kyung-Sook
Published: February 2023

Purpose: This study aimed to conduct a concept analysis of health-related quality of life in children with epilepsy to promote conceptual clarification and facilitate mutual understanding of the concept. Methods: Walker and Avant's concept analysis method was adopted.Results: Health-related quality of life in children with epilepsy consists of six attributes: health status, inner strength, close relationships, resource-rich community, social acceptance, and changeability. According to the ecological system paradigm, these attributes are structured into five dimensions: organism, microsystem, macrosystem, exosystem, and chronosystem. These dimensions provide a comprehensive approach to the relationship between children with epilepsy and their environment. Epilepsy and interactions with multilevel ecological systems that are directly and indirectly related to children with epilepsy precede the concept, followed by positive and negative affective responses.Conclusion: The findings of this study may support effective communication in various practice settings, thereby contributing to the health and well-being of children with epilepsy, as well as the development and expansion of interventions to improve their health-related quality of life.
A Comparative Analysis of Dominant Dietary Patterns in Patients with and Without Oral Squamous Cell Carcinoma
Authors: Razavi Seyed Mohammad , Askari Gholamreza , Zahiri Zahra , Heidari Zahra , Keshani Forooz
Published: February 2023

Background:

As a modifiable risk factor, nutrition plays a pivotal role in the prevention or delay of oral squamous cell carcinoma (OSCC). This study was aimed to investigate and compare the dominant dietary patterns in the patients with and without OSCC.

Materials and Methods:

This case-control study evaluated the usual dietary intake of 80 cases and 120 controls during 2019–2020 using the 117-item Food Frequency Questionnaire, with confirmed validity and reliability. Factor analysis was used to detect the dominant dietary patterns. Data analysis was done by SPSS (version 21) using the Chi-square test, ANOVA, logistic regression analysis, and independent t-test (P < 0.05).

Results:

Three dietary patterns were identified, including the western dietary pattern, health dietary pattern, and traditional dietary pattern. The odds ratio (OR) = 1.181 and confidence interval (CI) = 0.671 and 2.082 were found for the western dietary pattern, OR = 1.087 and CI = 0.617 and 1.914 were detected for the healthy dietary pattern, and OR = 0.846 and CI = 0.480 and 1.491 were reported for the traditional dietary pattern. No significant difference was found between the study groups in the dietary pattern and the risk of disease. This relationship remained insignificant after adjustment for the energy intake and confounding factors.

Conclusion:

There was no significant relationship between adherence to healthy, traditional, and western dietary patterns and OSCC. Consumption of vegetables and nuts had a protective role against the disease, but risky behaviors such as smoking and alcohol use were directly associated with the incidence of the disease.
Comparison of the Effect of Intravenous Fentanyl with Low-Dose Ketamine on Pain Relief in Patients Taking Methadone and Suffering from Limb Fractures
Authors: Forghani Mohsen , Nasr Esfahani Mohammad , Vali Marzie
Published: February 2023

Background:

Given the significance of pain control in addicted patients and the prominence of not using opioids due to patient's drug dependence, the present study aimed at comparing and evaluating the effect of intravenous fentanyl with low-dose ketamine on pain relief in patients taking methadone and suffering from limb fractures.

Materials and Methods:

The present double-blind randomized clinical trial was performed on 100 patients taking methadone and suffering from limb fractures. The patients were divided into two groups receiving 1 μg/kg single dose of fentanyl and 0.3 mg/kg single dose of ketamine (low-dose ketamine). Patients' pain scores and the incidence rate of complications were recorded before the intervention, and 15, 30, and 60 min after drug administration and were then compared between the two groups.

Results:

The mean pain score of patients 15 min after the intervention was significantly lower in the low-dose ketamine group with a mean of 2.50 ± 1.34 as compared with the fentanyl group with a mean of 7.10 ± 1.43 (P < 0.001). However, the mean pain score was not significantly different between the two groups 30 and 60 min after the intervention (P > 0.05). In addition, the incidence rate of complications was not significantly different between the two groups (P > 0.05).

Conclusion:

According to the results of this study, low-dose ketamine as compared with fentanyl relieves pain in the mentioned patients with a faster effect and in a shorter time although no difference can be found between the pain scores of the two groups 30 and 60 min after the intervention.
Multicentricity in Different Molecular Subtypes of Breast Cancer: A Cross-Sectional Study in Isfahan
Authors: Baradaran Azar , Derakhshan Maryam , Raeisi Saba , Neshat Sina , Raeisi Sina
Published: February 2023

Background:

Breast cancer is the most common cancer leading to death in women. Women with multicentric breast cancer were reported more likely to have poor prognosis. Here, we decided to study and compare the frequency distribution of multicentricity in different subtypes of breast cancer.

Materials and Methods:

This is a cross-sectional study that was performed in 2019–20 on medical records and breast pathology reports of 250 patients who undergone mastectomy due to breast cancer. Demographic data of all patients including age, along with other medical data such as menstruation condition, breast cancer grade, multicentricity status, stage, and expression of estrogen receptor (ER), progesterone (PR), and human epidermal growth factor receptor 2 (HER2) receptors were collected from medical records. Samples were divided into four subtypes of Luminal B, Luminal A, HER2 expressing, and basal-like.

Results:

The mean age of patients was 50.21 ± 11.15 years. Ninety-five patients (38%) had multicentricity and HER2 expressing (48.5%) and Luminal A (41.4%) were most common in patients with multicentricity. In addition, basal-like group presented with least multicentricity (13.5%) among the subtypes (P = 0.008). We also showed significant increased chances of multicentricity in Luminal B (odds ratio [OR] = 3.782) (P = 0.033), Luminal A (OR = 5.164) (P = 0.002), and HER2-expressing group (OR = 5.393) (P = 0.011).

Conclusions:

Taken together, we showed significantly increased chances of multicentricity in patients with HER2-expression, Luminal A, and Luminal B groups compared to basal-like group or triple negative. These results were in line with most previous studies; however, we showed higher rates of multicentricity among our population compared to some previous reports.
The Effect of Two Different Dexmedetomidine Doses on the Prevention of Nausea and Vomiting in Discectomy Surgery Under Spinal Anesthesia
Authors: Khanahmad Negar , Rahimi Zahra , Masoudifar Mehrdad , Nazemroaya Behzad
Published: February 2023

Background:

Considering the preventative effect of various medications on such complications after surgery, the present study evaluated the effect of two different dexmedetomidine doses on the prevention of nausea and vomiting in discectomy surgery.

Materials and Methods:

The present controlled, double-blind clinical trial was performed on 135 patients that were candidates for discectomy surgery under spinal anesthesia, which were randomly allocated into three groups. Two different dexmedetomidine doses of 0.2 and 0.5 mcg/kg/h were intravenously administered using an infusion pump for 10 min in the first (DEX-0.2 group) and second (DEX-0.5 group) groups, respectively, with the third placebo group being used as a control group. Hemodynamic parameters, the severity of nausea and vomiting, and the incidence of complications were evaluated and recorded up to 24 h after surgery.

Results:

The results of the present study revealed that, 20 min after the intervention, the severity of nausea and vomiting in the control group (with the mean of 1.95 ± 1.58) was significantly higher than that of the DEX-0.2 and DEX-0.5 groups with the means of 1.52 ± 1.11 and 1.27 ± 0.99, respectively (P = 0.010). In addition, no significant difference was found between the two dexmedetomidine doses in terms of the severity of nausea and vomiting (P > 0.05).

Conclusion:

According to the results of the present study, a low dose of dexmedetomidine may be a more preferable choice as a preventive drug in the incidence of nausea and vomiting in discectomy surgery due to its lower complications, further reduction of nausea and vomiting, and more desirable hemodynamic stability.
Diagnostic Value of Epigastric Ultrasound and Suprasternal Notch Ultrasound in Comparison with Standard Capnography in Confirmation of Endotracheal Tube Placement after Intubation
Authors: Majidinejad Saeed , Heydari Farhad , Asadolahian Mohamadreza
Published: February 2023

Background:

Endotracheal intubation is the basic method of providing a safe cross-sectional airway area and the incorrect placement can be dangerous and causes complications. So this study aimed to access the diagnostic value of color Doppler epigastric ultrasound and linear probe suprasternal notch ultrasound in comparison with standard capnography in confirmation of endotracheal tube (ETT) placement after intubation.

Materials and Methods:

This diagnostic value study was conducted on 104 patients requiring intubation who were referred to the Emergency Department. After the intubation, color Doppler epigastric ultrasound and suprasternal notch ultrasound as well as the standard capnography were used to confirm the placement ETT.

Results:

The sensitivity and specificity of color Doppler epigastric ultrasound were 97.96% and 100%, for suprasternal notch ultrasound were 98.98% and 66.67%, and for combination of the both methods were 96.94% and 100% respectively that showed the significant diagnostic value in the confirmation of ETT placement (P < 0.001). The mean of elapsed time to confirm the ETT placement by the standard capnography method (17.95 ± 2.45 s) was significantly more than the two methods of epigastric ultrasound (10.38 ± 4.65 s) and suprasternal notch ultrasound (5.08 ± 4.45 s) as well as the combined method with the mean of 15.46 ± 8.31 s (P < 0.001).

Conclusion:

The results of this study showed that although ultrasound is a potentially accurate, fast, and reliable method to confirm the endotracheal tube placement, but suprasternal notch ultrasound is considered to be a more appropriate diagnostic technique due to its higher sensitivity and less detection time compared to epigastric ultrasound and combined method.
Hormone Therapy with or Without Platelet-Rich Plasma (PRP) for Treatment Asherman Syndrome; A Randomized Clinical Trial
Authors: Naghshineh Elham , Rouholamin Safoura , Derakhshandeh Zahra
Published: February 2023

Background:

Asherman syndrome is a controversial issue in obstetrics and gynecology without any consensus on its management and treatment. It is characterized by variable lesions inside the uterine cavity and also causes menstrual irregularities, infertility, and placental abnormalities. The study aimed to assess the platelet-rich plasma (PRP) effect in women with intrauterine adhesions by evaluating the improvement of the menstrual cycle and intrauterine adhesion (IUA) stage.

Materials and Methods:

This clinical trial study was performed on 60 women with Asherman syndrome in two groups of 30. For the first group, only hormone therapy was performed and for the second group, hormone therapy with platelet-rich plasma after hysteroscopy. Recovery of Asherman syndrome and IUA stage was assessed at 6 to 8 weeks after hysteroscopy and compared between the two groups.

Results:

Our results demonstrated that there was no significant difference between demographic data in the two groups as well as the menstrual pattern of both groups before or after treatment (P > 0.05). Frequency distribution of IUA after the intervention in the PRP + hormone therapy group in grade I, II, and III were equal to 73.3%, 20%, and 6.7% and in the hormone therapy group were 53.3%, 26.7%, and 20%, respectively (P = 0.22). In addition, hypo menorrhea was observed in 33.3% of PRP + hormone therapy group and 40% of the hormone therapy group with no significant difference between the two groups (P = 0.71).

Conclusion:

Hormone therapy with PRP compared to hormone therapy alone after routine surgical treatment had not a significant effect on the IUA stage, duration, and severity of menstruation.
Non-compliance for wearing spectacles: Prevalence and determinants in school-going children in South India
Authors: Pawar Neelam , Ravindran Meenakshi , Renagappa Ramakrishnan , Ravilla Thulsiraj , Raman Ramalakshmi , Uduman Mohammed Sithiq
Published: February 2023

Purpose:

To study the prevalence and determinants of compliance with spectacle wear among school-age children in South India who were given spectacles free of charge under a school vision screening program.

Methods:

A cross-sectional, descriptive study was performed. The participants were recruited from the school from Tirunelveli and Tuticorin districts of Tamil Nadu, where a school vision screening camp was conducted between January 2012 and October 2012. The school screening was performed under “Lavelle Pediatric Eye Care Project”. Of the 129,720 children examined of 249 schools, 4253 of children had refractive error and 3333 were prescribed and dispensed spectacles. A total of 683 children were interviewed, who were not wearing glasses on follow-up.

Results:

About 20% of the participants (683/3333) were not wearing their spectacles at examination. The most common reasons given for non-wear were lost (44.9%) or broken (35.3%) spectacles. There was no gender preference on compliance to spectacles.

Conclusion:

Compliance with spectacle wear is less even when spectacles are provided free of cost, particularly in children among the age group of 5–15 years. Because factors such as type of school, area (urban or rural), parent’s income, occupation, and their education were not significantly affecting the compliance of spectacle wear, proper encouragement and counseling of the parents and the child become extremely important.
Socioeconomic factors in childhood cataracts – A descriptive study from a tertiary eye care center in India
Authors: Kemmanu Vasudha , Khanum Aayesha , Venkatesh Ramesh , Keshavardhini BB , Bhanumathi M , Muthu Sumitha , Shetty Bhujang
Published: February 2023

Purpose:

While there are a few studies that show the prevalence of blindness and ocular morbidity in children, studies on socioeconomic factors in childhood cataracts are scarce. We aimed to study the socioeconomic status, education and occupation of the parents, consanguinity, and gender inequality among children presenting with cataracts.

Methods:

This was a hospital-based, prospective, descriptive study of 68 children with cataracts (aged 0–18 years). In addition to the data on clinical parameters and surgical management, we also collected data on age, gender, age at which the chief complaint was noticed, consanguinity of parents, socioeconomic class, and occupation and education of parents. All statistical analyses were performed using MedCalc statistical software (MedCalc Software 2019, Ostend, Belgium).

Results:

Sixty-eight children with pediatric cataract, out of which 36 were bilateral, were studied. Thirty children (44%) were in the age group of 1–5 years. Out of the 36 bilateral cataracts, 25 (69.44%) were males and 11 (30.56%) were females. Thirty (44.1%) had a delayed presentation. Also, 31% belonged to middle class and 28% belonged to lower middle class. Moreover, 65% of the mothers had an undergraduate education.

Conclusion:

There is a gender-based inequality and late presentation of childhood cataracts. To improve early detection, red reflex screening should be mandatorily done. Further studies are required to identify barriers to access of eye care specific to girls, in order to plan interventions to improve uptake of treatment. The lower socioeconomic status of the patients should be taken into account in the management of this disease.
Hypersonic vitrectomy in intraoperative posterior capsular rupture with retained nuclear fragments
Authors: Kumar Dhivya Ashok , Agarwal Amar , Agarwal Ashvin , Papour Asael
Published: February 2023

In our report, we present the hypersonic vitrectomy (Vitesse, Bausch and Lomb) being employed for anterior vitreous liquefaction and removal in posterior capsular rupture. The capsular tear with nucleus drop during conventional phacoemulsification was managed by vitrectomy using the hypersonic vitrector after posterior-assisted levitation followed by intraocular lens (IOL) implantation. The minimal cortical and epinuclear lens particles in the anterior chamber and vitreous were also liquefied with a stoke length of 30 to 40 μm and aspirated via the Vitesse vitrectomy system. The same probe performs the vitrectomy and the nucleus removal. The postoperative period was uneventful with clear cornea, normal fundus, and 20/20 best-corrected visual acuity (BCVA). The hypersonic vitrectomy utilizes the ultrasound power of 29.5 kHz and a stoke length of 0 to 60 μm for liquefaction of the vitreous. It can be a safe alternative for vitrectomy and lens removal in a single setting.
Artificial intelligence and machine learning in ocular oncology: Retinoblastoma
Authors: Kaliki Swathi , Vempuluru Vijitha S , Ghose Neha , Patil Gaurav , Viriyala Rajiv , Dhara Krishna K
Published: February 2023

Purpose:

This study was done to explore the utility of artificial intelligence (AI) and machine learning in the diagnosis and grouping of intraocular retinoblastoma (iRB).

Methods:

It was a retrospective observational study using AI and Machine learning, Computer Vision (OpenCV).

Results:

Of 771 fundus images of 109 eyes, 181 images had no tumor and 590 images displayed iRB based on review by two independent ocular oncologists (with an interobserver variability of <1%). The sensitivity, specificity, positive predictive value, and negative predictive value of the trained AI model were 85%, 99%, 99.6%, and 67%, respectively. Of 109 eyes, the sensitivity, specificity, positive predictive value, and negative predictive value for detection of RB by AI model were 96%, 94%, 97%, and 91%, respectively. Of these, the eyes were normal (n = 31) or belonged to groupA (n=1), B (n=22), C (n=8), D (n=23),and E (n=24) RB based on review by two independent ocular oncologists (with an interobserver variability of 0%). The sensitivity, specificity, positive predictive value, and negative predictive value of the trained AI model were 100%, 100%, 100%, and 100% for group A; 82%, 20 21 98%, 90%, and 96% for group B; 63%, 99%, 83%, and 97% for group C; 78%, 98%, 90%, and 94% for group D, and 92%, 91%, 73%, and 98% for group E, respectively.

Conclusion:

Based on our study, we conclude that the AI model for iRB is highly sensitive in the detection of RB with high specificity for the classification of iRB.
Evaluation of liposomal amphotericin B for the treatment of fungal keratitis in a tertiary eye care hospital
Authors: Kumar Vishal , Kumari Pooja , Lomi Neiwete , Vanathi Murugesan , Gupta Noopur , Tandon Radhika , Velpandian T , Ahmed Nishat H , Satpathy Gita
Published: February 2023

Purpose:

To evaluate the efficacy of liposomal amphotericin B (L-AMB) for the treatment of fungal keratitis.

Methods:

Patients with fungal keratitis confirmed by potassium hydroxide (KOH) smear and/or confocal microscopy were administered topical L-AMB and randomized into three groups treated with three different formulations. The medication was administered two hourly till clinical improvement was achieved, followed by six hourly till complete resolution. The outcome measures were time to clinical improvement, resolution of epithelial defect, stromal infiltrate, hypopyon, extent and density of corneal opacity, neovascularization, and best corrected visual acuity (BCVA) at 3 months.

Results:

Mean age of the patients was 46.6 ± 14.8 years, and trauma with vegetative matter was the most common predisposing factor. Aspergillus flavus (36%) was the most common fungus cultured, followed by Fusarium (23%). Mean time to clinical improvement, time to resolution of epithelial defect, mean time to resolution of infiltrate, and time to resolution of hypopyon were 3.45 ± 1.38, 25.35 ± 8.46, 37.97 ± 9.94, and 13.33 ± 4.90 days, respectively, and they were comparable among the three groups. There was a significant difference between treatment failure and success cases in terms of days of presentation (P < 0.01), size of the epithelial defect (P-value 0.04), and infiltrate size at presentation (P-value 0.04). At 3 months follow-up, no statistically significant difference was noted in BCVA and mean scar size among groups.

Conclusion:

L-AMB in a gel form is an effective antifungal agent that promotes the healing of fungal ulcers with notably least vascularization and better tolerance.

Trial registration number: CTRI/2020/04/024550
The effect of virtual reality technology in children after surgery for concomitant strabismus
Authors: Zhang Hao , Yang Su-Hong , Chen Ting , Kang Mei-Xia , Liu Dan-Yan , Wang Dan , Hao Jing , Wang Miao , Yang Zhou , Han Xu , Su Han
Published: February 2023

Purpose:

This study aimed to investigate the effect of virtual reality (VR) technology in children after surgery for concomitant strabismus.

Methods:

A total of 200 children with concomitant exotropia or concomitant esotropia were randomly divided into a training group and a control group according to the single even number random method (100 cases in each group). Patients in the training group received VR intervention training within 1 week after surgery. Patients in the control group did not receive any training.

Results:

Six months after the surgery, the orthophoria (the far or near strabismus degree was ≤8D) rate was significantly higher in the training group than in the control group (P= 0.001), while the eye position regression rate (compared to the strabismus degree within 1 week after the surgery, the amount of regression >10D) was significantly lower in the training group than in the control group (P= 0.001). Six months after the surgery, the number of children with simultaneous vision and remote stereovision was significantly higher in the training group than in the control group (P= 0.017 and 0.002, respectively). The differences in the number of patients with peripheral stereopsis, macular stereopsis, and stereopsis in macular fovea centralis at 1, 3, and 6 months after the surgery between the training and the control groups were not statistically significant (P= 0.916, 0.274, and 0.302, respectively).

Conclusion:

The intervention of VR technology after strabismus correction effectively improved children’s visual function and maintained their eye position.
Transient change in the binocular visual function after femtosecond laser-assisted in situ keratomileusis for myopia patients
Authors: Zhou Youming , Ou Yunxuan , Chin Man Pan , Zhao Dongfeng , Zhang Riping
Published: February 2023

Purpose:

The goal of this study was to compare the difference in binocular visual function for high and low-moderate myopes before and after femtosecond laser-assisted in situ keratomileusis (FS-LASIK).

Methods:

Thirty-three subjects (17 males and 16 females) were divided into two groups according to their preoperative refractive errors in spherical equivalent (SE): low-moderate myopia group (SE ≥−6.00 D) and high myopia group (SE <−6.00 D). The binocular visual function including accommodative amplitude (AA), accommodative facility (AF), positive and negative relative accommodation (PRA and NRA, respectively), horizontal phoria measurement, positive and negative fusion vergence, accommodative–convergence over accommodation (AC/A) ratio, and stereopsis were assessed with the best-corrected vision before patients received FS-LASIK and 7 and 30 days after the surgery. Repeated measures analysis of variance (ANOVA) was applied to study the change in binocular visual function.

Results:

The AF values in both groups were significantly reduced after 7 days of FS-LASIK (baseline vs. day 7 (mean): high myopia group: 7.85 vs. 5.62 cpm, repeated ANOVA, P = 0.01; low-moderate myopia group: 5.95 vs. 4.40 cpm, repeated ANOVA, P = 0.04). This change returned to the baseline level 30 days after the operation. In addition, the horizontal phoria values in both groups were significantly reduced for both distant (P = 0.019 and P = 0.001, respectively) and near (P = 0.003 and P = 0.049, respectively) 7 days after the operation, but they rebound to preoperative state after 30 days.

Conclusion:

A transient change in binocular visual function was noticed after 7 days of FS-LASIK operation, which could cause symptoms of asthenopia. Our data showed all the binocular visual functions returned to baseline level after 30 days of operation.
Retinal perfusion density can predict cardiovascular disease risk in patients with retinal vein occlusion
Authors: Raviselvan Munispriyan , Preethi B , Ratra Dhanashree
Published: February 2023

Purpose:

To correlate microvascular changes and assess the relationship between microvascular changes and cardiovascular disease (CVD) risk in patients with retinal vein occlusion (RVO).

Methods:

Patients over 40 years of age with unilateral RVO were included in this prospective study. Those known to have cardiovascular disease were excluded. A detailed medical history was taken and physical exam was done to measure the height, weight, body mass index (BMI), and systolic blood pressure (SBP). A comprehensive eye check-up was followed by optical coherence tomography angiography (OCTA). Microvascular indices such as vessel density (VD) and perfusion density (PD) were noted. A statistical model was developed for prediction of CVD risk and was integrated with the World Health Organization (WHO)’s risk prediction charts.

Results:

This study included 42 patients with RVO and 22 controls with an age range of 42–82 years. There were 40 males (62.5%) and 24 females (37.5%). Along with age, SBP, and gender, perfusion density was found to have significant impact on CVD risk (P = 0.030). Reduction in PD was associated with increase in CVD risk. PD had a greater influence on CVD in <50 years age than in >70 years group. Using linear regression, a model with accuracy of 72.1% was developed for CVD risk prediction and was converted into color coded charts similar to WHO risk prediction charts.

Conclusion:

These findings suggest a significant correlation between microvascular parameters and CVD risk in RVO patients. Based on these parameters, an easy-to-use and color-coded risk prediction chart was developed.
The economic burden of glaucoma on patients
Authors: Usgaonkar Ugam P S , Naik Ridhima , Shetty Aksha
Published: February 2023

Purpose:

To determine the economic burden of glaucoma on patients.

Methods:

A cross-sectional study was conducted on glaucoma patients diagnosed at least 6 weeks prior to the study and on topical anti-glaucoma medications. After consenting, patients were asked about their monthly income, education, occupation, treatment duration, drugs being used, cost of drugs, one bottle lasts for, financial dependence for treatment, glaucoma surgery, transportation means and cost, etc. Also, information regarding government reimbursement of medical costs was collected.

Results:

Seventy-four patients aged 60.18±11.5 years (40 males and 34 females) were enrolled. Majority were retirees (37.84%) and Homemakers (29.73%). Fifty (68%) participants didn’t earn anything. Sixty-three patients had bilateral involvement and 52.70% were on treatment for >3 years. Prostaglandin analogs were most commonly used drugs (34.21%). Average cost of medications and travelling was

JOURNAL/ijop/04.03/02223307-202302000-00050/560FF01/v/2023-02-27T142246Z/r/image-tiff

669.46 per month and

JOURNAL/ijop/04.03/02223307-202302000-00050/560FF01/v/2023-02-27T142246Z/r/image-tiff

203.38 per visit respectively. Majority were financially responsible for their own treatment (62.16%). Patients had an average monthly income of

JOURNAL/ijop/04.03/02223307-202302000-00050/560FF01/v/2023-02-27T142246Z/r/image-tiff

7108.11. Low-income group spent 26.08 % of their monthly salary on glaucoma treatment. Low-moderate and high-income group spent 5.17% and 1.50% of their monthly income respectively. Only 4.05% were covered by government reimbursement. Gender (P=0.019), occupation (P=0.010), whether undergone surgery (P=0.007), whether accompanied (P=0.027), hours lost during each visit (P=0.016) and treatment impression (P=0.027) showed statistical significance when associated with financial dependence.

Conclusion:

Treatment should be modified according to the patient’s socioeconomic status. Glaucoma education programs and screening camps in remote areas would help in early detection of the disease.
SARS-CoV-2 virus-induced bilateral acute iris transillumination syndrome: The first case series in literature
Authors: Comba Ozge Begum
Published: February 2023

Inflammatory events with highly variable clinical features have been reported with the coronavirus disease 2019 (COVID-19) pandemic, which has affected the whole world. Only one case of COVID-19–associated bilateral acute iris transillumination (BAIT) syndrome has been reported in the literature. We present a case series in which we hypothesize that the immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may have a mechanism similar to the common viruses that cause BAIT, the etiology of which is still unknown.
Two routes of administration of mitomycin C in a trabeculectomy
Authors: Pillai Manju , Kalegore Aniket A , Mathews Ann Mery , Krishnadas SR
Published: February 2023

Background:

The introduction of mitomycin C (MMC) as an adjunct to trabeculectomy was a major advance in the ability to improve the Intra ocular pressure lowering efficiency of the procedure. The time tested traditional way of administration of MMC is via a sponges soaked in it, duration and concentration varies depending on risk of failure. A subconjunctival injection of MMC instead of these sponges is recently being used as a promising alternative.

Purpose:

Here is the video demonstrating the 2 possible ways to prepare and apply MMC during a trabeculectomy surgery.

Synopsis:

Intraoperative injection of MMC in trabeculectomy has several advantages over conventional method ofsponge application. A large MMC treatment area produces more diffuse and elevated blebs. Large-area MMC application also seems to increase long-term success without increasing the complication rates in trabeculectomies. Direct and diffuse application of MMC by injection may promote less scarring and vascularization of the bleb. To achieve the same surface area of exposure with sponges, i.e.achieved with injection, the surgeon must use multiple sponges, all of which must be carefully collected thereafter. The injection method,therefore,eliminates the risk of retained sponges.

Highlights:

injection of MMC may be as safe and as effective as conventional sponge application of MMC with comparable estimated complete treatment success with relatively lower complication rates.

Video link:
https://youtu.be/RLEbK4IeRtU

Key words: Injectable mitomycin C, sponge-soaked mitomycin C, trabeculectomy
Management of pediatric subluxated cataract and different methods to face the challenges
Authors: Allapitchai Fathima , Ravindran Meenakshi
Published: February 2023

Background:

Traumatic cataracts present in multiple and different forms. Based on the nature of injury, it necessitates a customized approach for individual case. Capsulorhexis and in the bag intraocular lens (IOL) placement are vital for long term centration of pediatric IOLs. Paediatric lenses having elastic capsule provide more challenges to perform optimum rhexis and the surgery becomes further complicated, when it is subluxated or fibrosed. Here is a pediatric case with such challenges managed using capsular tension ring (CTR) and capsular tension segment (CTS).

Purpose:

To demonstrate the making of optimum rhexis in a fibrosed capsule in subluxated lens and placing the IOL along with fixation of bag using CTR and CTS.

Synopsis:

A 13-year-old boy sustained an injury in the right eye from an air pistol, underwent lid tear repair in a local hospital, and presented to us one month post trauma with visual acuity of 6/60 in the right eye and 6/6 in the left eye. On examination, there was more than 180° temporal zonular dialysis with fibrosis of the anterior capsule. In this situation, creating an intact capsulorhexis was a challenge which was solved using micro-scissors and micro-vitreo-retinal forceps, in addition to routine instruments. After removing the lens material, CTS was placed initially in the bag to stabilize it while introducing CTR. The CTS was then fixated to the sclera. Foldable IOL was placed in the bag. Technique and tips to make intact rhexis and easy passage of suture are demonstrated.

Highlights:

This video shows tips and different methods adopted in each step of the surgery for successful placement of IOL in bag along with fixation of bag using CTR and CTS in a case of traumatic subluxated cataract with shrunken anterior lens capsule.

Video link:
https://youtu.be/Vwp1qUh1Mrc

Key words: Capsular Tension Ring, Capsular Tension Segment, Paediatric cataract, Subluxated lens, Traumatic cataract
Incidence, outcomes, and risk of surgical failure after development of early hypotony following Aurolab aqueous drainage implant surgery
Authors: Wijesinghe Hiruni Kaushalya , Puthuran George Varghese , Ishrath Deeba , Patnam Vineela , Mani Iswarya , Krishnadas Subbaiah Ramasamy , Gedde Steven Jon
Published: February 2023

Purpose:

To report the incidence, outcomes, and risk of surgical failure after early postoperative hypotony following Aurolab Aqueous Drainage Implant (AADI) surgery for adult and pediatric refractory glaucoma.

Methods:

Medical records of patients who underwent AADI between January 2013 and March 2017 with a minimum of 2-years follow-up were retrospectively reviewed. Early postoperative hypotony was defined as IOP ≤5 mmHg within the first 3 months after AADI. Surgical failure of AADI was defined as IOP >21 mmHg or reduced <20% below baseline on two consecutive follow-up visits after 3 months, IOP ≤5 mmHg on two consecutive follow-up visits after 3 months, reoperation for glaucoma or a complication, or loss of light perception vision.

Results:

Early postoperative hypotony was seen in 15/213 eyes (7%) in the adult group and in 6/101 eyes (6%) in the pediatric group. The onset of hypotony was significantly earlier in the pediatric group (median = 39 days post AADI, IQR = 20–58 days) compared with adult eyes (median = 51 days post AADI, IQR = 30–72 days) (P = 0.02). Eyes with early postoperative hypotony did not have an increased risk of cumulative surgical failure as compared with eyes without hypotony in both adult (33.3% vs. 23.7%; P = 0.48) and pediatric (33.3% vs. 13.7%; P = 0.16) refractory glaucoma. All eyes recovered from hypotony, though one adult eye developed retinal detachment and one pediatric eye developed corneal decompensation and lost vision.

Conclusion:

Early postoperative hypotony was an infrequent complication post AADI and occurred earlier in pediatric eyes. Early postoperative hypotony did not increase risk of surgical failure up to 2 years.