bluuebunny/crossref_metadata_2025 huggingface dataset:
Helicobacter Pylori Serology in a Sample of Iraqi Patients with Chronic Renal Failure
Authors: Madloom Basim Mohammed , Umran Haider Hamza
Published: May 2024

Background:

The prevalence of gastrointestinal (GI) symptoms is high in patients with chronic renal failure. Peptic ulcer disease occurs in up to one-fourth of them. Many factors are implicated in its causation including Helicobacter pylori infection.

Objective:

The objective of the study was to determine the prevalence of H. pylori seropositivity in patients with GI symptoms and chronic renal failure compared with the prevalence of H. pylori seropositivity in patients with GI tract symptoms with normal renal function and to evaluate the importance of different factors that affect its prevalence depending on serological test for immunoglobulin level against H. pylori.

Materials and Methods:

This case–control study was done at the Department of Medicine, at Al Yarmook Teaching Hospital, Baghdad, Iraq. During the study period from January to June in 2004, ninety patients with chronic renal failure were interrogated for dyspeptic symptoms and 2 mL of blood was withdrawn for ELISA test for anti-H. pylori serological examination. Twenty-five dyspeptic patients with normal renal function were examined as well as control group.

Results:

from 90 patients with chronic renal failure, 42 patients were on hemodialysis and 48 patients were on peritoneal dialysis. There were 52 males and 38 females with age ranging 45.3 in male and female 43.1, respectively. The percentage of positive anti-H. pylori antibody was 60%. Only 44% of the control group had positive anti-H. pylori results. There was no statistically significant difference between anti-H. pylori positive and negative status in patients on hemodialysis, peritoneal dialysis, and control group regarding male and female gender. Again, there was no statistically significant difference in serpositivity in relation to epigastric pain and those without epigastric pain in the group of hemodialysis, peritoneal dialysis, and control group. Patients on peritoneal dialysis with dyspepsia of < 10 years had statistically significant seropositivity compared to those more than 10 years of epigastric pain. Those patients with hemodialysis and control group have no relation of seropositivity with dyspepsia duration.

Conclusions:

H. pylori serpositivity of patients with chronic renal failure was similar to that of the control. There is no relation between dyspepsia and H. pylori serpositivity. Long-term dialysis is associated with a decreased prevalence of H. pylori.
2022 Monkeypox Outbreak in Non-endemic Nations
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh
Published: May 2024

Monkeypox is a zoonotic viral infectious disease that has been predominantly reported in the central and west Africa. A recent outbreak of monkeypox has been reported in the month of May 2022 and since then the outbreak has been reported in 28 nations. As the infection has been reported in non-endemic nations, there is an indispensable need to strengthen the surveillance, preparedness, and outbreak response-related actions to monitor the spread of the infection. To conclude, the 2022 outbreak of monkeypox in non-endemic nations is an eye-opener for public health authorities to be vigilant, and strengthen prevention and control activities.
Clinical and radiological parameters affecting the quality of life in patients with bronchiectasis
Authors: Kola Kondala Rao , Ravula Sarika , Dash Somanath , K Hitesh Cheran
Published: May 2024

Background:

Bronchiectasis is a chronic disorder of the lung caused due to permanent structural changes in the bronchial tree which consequently leads to high morbidity. Many clinical factors lead to severe morbidity in patients and affect the respiratory quality of life.

Aim:

The present study aimed to determine the various clinical and radiological factors affecting the respiratory quality of life of patients with bronchiectasis.

Materials and Methods:

We recruited forty diagnosed patients with bronchiectasis and collected their social, clinical, and radiological data, and correlated various obtained parameters with their respiratory quality of life, based on the St. George Respiratory Questionnaire scoring.

Observation:

We observed low body mass index, higher bronchial obstruction, and worse structural damage to the lungs correlated with worse respiratory quality of life in the patients.

Conclusion:

Parameters worsening the quality of life can be considered prognostic factors for the disease. Treating clinicians can design protocols for patient management and the institutional pulmonary rehabilitation program based on these prognostic factors.
Opportunities for community-based screening of diabetes mellitus in pilgrimages
Authors: Khurjekar Ananya , Tambolkar Isha , Dixit Jagannath
Published: May 2024

Introduction:

The Indian population is considered to have a high risk of developing diabetes mellitus. High-risk people are advised to undergo opportunistic screening since early detection allows for an early start of treatments targeted at improving glycemic control, thereby reducing or delaying the onset of complications. Through this study, we aim to utilize this golden opportunity for screening diabetes among apparently healthy individuals and thus determine the prevalence of diabetes among them.

Materials and Methods:

In June of 2022, an opportunistic screening camp for diabetes was organized during the annual Wari procession by the ADORE trust in a hall at Saswad. Using a public address system, the people who voluntarily entered the premises of the hall were shown a poster exhibit briefed about general knowledge about diabetes including its risk factors, complications, the silent killer nature, and on the Dixit lifestyle to prevent and reverse diabetes. Following this, the people were encouraged to consent to a blood sugar test voluntarily. The team of volunteers used glucometers, systematically recorded random blood sugar level (Random BSL) readings of the participants, and contacted the people with Random BSL above 200 mg/dl to counsel them for further follow-up.

Results:

Out of the 1734 people screened, 269 people were found to have a Random BSL above 200 mg/dl. Thus, 15.51% of the total people screened could be categorized into the “diabetic” category. Out of the 269 people who were found to have a Random BSL above 200 mg/dl, 195 were male and 94 were female.

Conclusion:

An opportunistic screening program is cost-effective, feasible, and has large-scale implications. Such programs must be implemented on a national scale as part of various schemes to combat health issues such as, but not limited to, noncommunicable diseases. From our initiative of opportunistic screening for diabetes, 269 participants whose Random BSL was not in the normal range were picked up. With proper counseling, they can be set on a path to reverse their course and prevent unnecessary complications.
Prevalence and risk factors of tobacco use among urban high school boys in Turkapally, Telangana
Authors: Ameer Shaik Riyaz
Published: May 2024

Background:

Studies on the prevalence and risk factors among school-going children are important. They provide data on the current trends of tobacco use among this vulnerable group. They also help to identify the risk factors and provide valuable data in policy planning. The prevention of tobacco use in this population is of paramount importance to prevent future consequences.

Objective:

The objective of this study is to study the prevalence and risk factors tobacco use among urban high school boys.

Methods:

A cross-sectional study was carried out among 532 government and private high school boys selected by the random sampling method. Data were collected by interview method using predesigned semistructured questionnaire.

Results:

Majority (35.5%) were of 12 years of age. Among smoke forms of tobacco products, most commonly known was bidi and cigarette by 97.2% of boys. The prevalence of tobacco use among boys of high school children in the present study was 7.7%. 73.1% were aware about the hazards of tobacco use. The prevalence of tobacco use was significantly more in children studying in government schools compared to private schools (P < 0.05). As the education class increased from VIII to X, the prevalence of tobacco use increased significantly (P < 0.05). It was significantly more in joint family as compared to children belonging to nuclear family. Father's education and social class were not found to be significant risk factors for tobacco use.

Conclusion:

The prevalence of tobacco use was high in the present study among high school children. It was associated with increasing age, children from government schools and children from joint family.
Economic impact of hypertension in Urban chitradurga
Authors: Naren Kailash , Mangasuli Vijayalaxmi , Vijeth S. B. , Amrutha A. M. , Ahmed Nidaanjum , Sidenu Bhagyalaxmi
Published: May 2024

Background:

The high level of out-of-pocket expenditures (OOPEs) increases the risk for catastrophic expenditure and may further increase the risk of impoverishment.

Objective:

To know the economic impact of hypertension (HTN) in urban Chitradurga.

Materials and Methods:

A cross-sectional study was conducted among 196 hypertensives aged more than 18 years taking treatment for more than 1 year. Newly diagnosed hypertensives and with other debilitating illness were excluded. This study was done in urban field practice area of Chitradurga, for a period of 3 months. Subjects were selected by simple random sampling by line listing all cases. Sociodemographic data and cost of treatment were collected. Along with this cost of consultation, medicine, travel, diagnostic cost, patient's wage lost for treatment and other expenditure details was collected.

Results:

It was found that most of the subjects were above the age of 60 years and unemployed. Only 29.6% of the participants chose to seek care from government hospitals. Around 67.9% of participants had associated comorbidities. Median monthly OOPE toward HTN was found to be Rs. 600 (400–750). When this was analyzed separately for hospitalized and nonhospitalized cases, total cost of expenditure due to HTN was Rs. 2583 and Rs. 700, respectively. The monthly direct cost of subjects seeking care in private hospitals is Rs. 850 which is Rs. 650 more than what the subjects who seek care in government hospitals pay. Total monthly cost was Rs. 400 and Rs. 1050 for government and private hospitals, respectively.

Conclusion:

High OOPE makes it a necessity for intervention.
Knowledge and practice about dengue fever among urban slum dwellers in one district of Andhra Pradesh, India
Authors: Lavanya K. M , Kumar Andey U. Vinod Venkata , Mishra Sushant Kumar , Vutharkar Nageswara Rao
Published: May 2024

Background:

A mosquito-borne disease, dengue is present in many places of India since a long time. Studies have shown that, despite many efforts, the knowledge and practices of people, especially urban slum dwellers remain low. The factors responsible for inadequate knowledge and practices have to be explored and addressed. This study aimed to assess the knowledge and practice about dengue fever among urban slum dwellers of Andhra Pradesh, India.

Materials and Methods:

This was a cross-sectional study conducted among the urban slum dwellers (community-based study) in one district of Andhra Pradesh state. Study variables included knowledge about symptoms of dengue, mode of transmission, and complications. Practices to prevent dengue were also studied.

Results:

In the present study, males were 85 (30.4%) and females were 195 (69.6%). The awareness about dengue among urban slum dwellers is good (75.4%). Awareness of dengue was significantly higher in females than in males. No significant association of awareness of dengue was found with age, literacy status, socioeconomic status, and occupation. Recognition of symptoms of dengue was significantly better among females compared to males.

Conclusions:

The study concludes that the awareness of dengue among urban slum dwellers is good (75.4%). The practices related to mosquito control measures are improving, but, there is still a need to improve knowledge and practice.
Prevalence and risk factors of ocular fundus changes among pregnant women with pregnancy induced hypertension at a tertiary care center
Authors: Muduthanapally Charani
Published: May 2024

Background:

Pregnancy-induced hypertension (PIH) can affect the eyes of pregnant women. There is dysfunction of vascular endothelium among them. There can be further leakage from capillaries and vasospasm if it is left untreated.

Objective:

The objective of this study was to study the prevalence and risk factors of ocular fundus changes among pregnant women with PIH.

Materials and Methods:

A hospital-based, cross-sectional study was carried out among 130 pregnant women with PIH. History of symptoms related to the eyes, age, and gravida was recorded. Torchlight was used to examine the anterior segment. One percentage of tropicamide was used to dilate pupils. Direct ophthalmoscope was used to examine the fundus. Blood pressure was measured as per the standard guidelines. Urine sample was taken to look for the presence of proteins in urine.

Results:

The majority belonged to 23–27 years (50%) and the majority (54.6%) had gestational age >37 weeks. The majority (75.38%) had gestational hypertension. The prevalence of retinopathy was 11.5%. Grade I retinopathy was the most common (7.7%). Age was not associated with retinopathy. The prevalence of PIH among women with preeclampsia was 29.1% compared to 5.1% in women with gestational hypertension and it was significant (P < 0.05). The prevalence of PIH among women with blood pressure >150/100 mmHg was 43.3% compared to 2% in women with blood pressure <150/100 mmHg, and it was significant (P < 0.05). The prevalence of PIH among women with severe proteinuria (+++) was 60% compared to 42.9% in moderate proteinuria (++), 20% in mild proteinuria (+), and only 5.4% in women without proteinuria. These differences were significant (P < 0.05).

Conclusion:

The prevalence of retinopathy among pregnant women with PIH was high. High blood pressure and severe proteinuria and preeclampsia were significantly associated with retinopathy.
Prevalence and risk factors of erectile dysfunction among patients with type II diabetes mellitus at a tertiary care centre in Hyderabad
Authors: Parvthaneni Anuj , Kodithyala Prashanth Kumar , Karangula Sindhuja
Published: May 2024

Background:

Men with diabetes who develop erectile dysfunction (ED) experience a substantial waning in quality-of-life as well as a rise in depressive symptoms. Regrettably, ED may go unnoticed as many clinicians do not question about sexual health.

Objective:

The objective is to determine the prevalence and risk factors of ED among patients with type II diabetes mellitus

Methods:

Analytical, cross-sectional study was carried out among 720 individuals with type II diabetes aged 30–70 years at the diabetes clinic of Malla Reddy Hospital from January 2019 to January 2022 after obtaining ethics committee approval. Peripheral artery disease (PAD) was assessed by taking a ratio of systolic blood pressure recorded at ankle to that recorded in the arm as per standard guidelines. Abridged version of the International Index of Erectile Function was used to assess ED. Glycated hemoglobin (HbA1c), serum testosterone levels, and lipid profile were determined on fasting blood.

Results:

Mean age was 58.4 ± 7.8 years. The overall prevalence of ED in the present study was 68.7%. On univariable analysis, higher age, longer duration of diabetes, presence of hypertension, presence of peripheral arterial disease, higher levels of HbA1c, and lower levels of serum testosterone were significantly associated with the ED. On multivariable analysis increase in the duration of diabetes every 5 years, presence of hypertension, presence of peripheral arterial disease, HbA1c ≥7%, and testosterone <8 nmol/L except age were found to be significantly and independently associated with the ED.

Conclusions:

The prevalence of the ED was high in the present study. It was significantly and independently associated with the deficiency of the testosterone, poor control of the blood sugar, presence of the PAD, and the longer duration of the diabetes.
Prevalence and risk factors of complications related to hypertension at a tertiary care hospital
Authors: Mallela Venkata Rambabu , Pendurthi Amith Kumar , Karumanchi Srjana , Alam Krishna Chaitanya
Published: May 2024

Background:

Studies on complications of hypertension (HTN) are required to identify risk factors so that patients with HTN can be educated. Individuals are more amenable as they seek advice from the clinician and this fact can be taken advantage of, in preventing or delaying complications.

Objective:

The objective of this study is to study the prevalence and risk factors of complications of HTN.

Materials and Methods:

Hospital-based cross-sectional study was carried out among 200 patients with known HTN. Blood pressure was recorded using standard equipment and standard guidelines. Anthropometric measurements such as height and weight were measured as per the standard guidelines. Investigations such as electrocardiogram, ophthalmoscopy, and urine albumin were carried out for all enrolled patients to assess the presence of complications of HTN. Binary logistic regression analysis was carried out to study the independent association between variables and complications of HTN.

Results:

The prevalence of complications of HTN was 57% in the present study. The most common complication of HTN was an ischemic cerebrovascular accident in 25% of the cases and coronary artery disease as well as left ventricular hypertrophy in 21% of the cases each. The odds of having complications of HTN among smokers was 3.138 (95% confidence interval [CI] =1.141–8.629; P = 0.027) times more compared to nonsmokers. The odds of having complications of HTN among those without regular treatment was 8.265 (95% CI = 3.977–17.177; P = 0.000) times more compared to those taking regular treatment. The odds of complications of HTN increased by 1.113 (95% CI = 1.045–1.186; P = 0.001) times with each increase in the duration of HTN.

Conclusion:

The prevalence of complications of HTN among known hypertensive was high in the present study. It was significantly associated with smoking, irregular treatment, and duration of HTN.
Knowledge, attitude, and practice of nurses toward tuberculosis at a tertiary care hospital
Authors: Rani Vibha
Published: May 2024

Tuberculosis (TB) is a communicable disease of great public health importance. Nurses play an important role in treatment adherence, caring with counseling of patients and their family members and can also guide in early detection of side effects produced by anti-TB drugs. So knowledge, attitude, and practices (KAPs) of nurses will have a tremendous role in the delivery of various treatment modalities to TB patients. Present study was carried out to assess the level of KAP regarding TB among nursing staff. This cross sectional study was conducted in a tertiary care teaching hospital in Hyderabad among 115 nurses. Data collection tool was a questionnaire having 11 questions on knowledge, 4 on attitude and 4 on practical aspects of TB. One hundred and fifteen (100%) nurses could tell about the side effects of anti-TB drugs, while 81 (70.4%) told that 6 months is the minimum duration for treatment of new sputum positive TB cases. 96.5% nurses knew about the sample required for diagnosing TB patients while 98.2% felt compassionate toward TB patients and none of the nurses were equipped in wearing N95 masks while treating TB patients. We conclude that nurses had adequate knowledge, good attitude, and satisfactory practical aspects about TB infection though none of them had undergone NTEP training.
Role of diabetes self-management education in improving self-care behavior among adult type 2 diabetics
Authors: Gehlawat Mamta , Thumati Goutham , Gundala Sreenivas
Published: May 2024

Background:

Type 2 diabetes mellitus (T2DM) is a crucial public health issue causing physical, financial, and psychosocial crises globally.

Objectives:

To estimate the effectiveness of diabetes self-management education (DSME) on self-care behavior among T2DM patients.

Materials and Methods:

A systematic review and meta-analysis of intervention trials promoting self-care behavior among T2DM patients was done by searching MEDLINE, Clinicaltrials.gov, Microsoft Academics, ScienceDirect, ICTRP, OAISTER, LILACS and CINAHL to identify eligible trials starting from inception till August 26, 2021. Studies which did not have a self-care behavior intervention, couldn't be found or translated in English, didn't have control arm or had multiple study arms, had <30 study participants per arm, or included adolescent or pregnant individuals were excluded. Data screening, extraction, and analysis were done with help of Rayyan software, Microsoft Excel and JASP software. Cochrane risk of bias tool was used to assess bias in the studies.

Results:

The search yielded 4023 results, of which 20 studies were included in meta-analysis. Our main outcome was “change in self-care behaviour score” owing to the DSME intervention. The pooled standardized mean difference in self-care behaviour was 1.38 (95% confidence interval 0.50–2.27, I2 ¼ 99.2, P < 0.001) with Dersimonian and Laird random effects method.

Conclusion:

Owing to the paucity of studies in low- and middle-income countries, further studies are needed to evaluate the DSME effectiveness in preventing diabetes related complications and enhancing patients' quality of life.
Breakthrough coronavirus disease 2019 infection among health-care workers at a tertiary care center in Chitradurga district
Authors: Mangasuli Vijayalaxmi , Sidenur Bhagyalaxmi , Amrutha A. M. , Sudharani M. , Vijeth S. B.
Published: May 2024

Background:

Coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2), spread rapidly leading to a pandemic in March 2020. To combat this, the COVID-19 vaccination drive was conducted in India and had its first recipients as the health-care workers who represent a high-risk population for the same. It included both Covishield and Covaxin. This study draws attention to the COVID-19 attack rate among health-care workers in a teaching Medical hospital, Basaveshwara Medical College and Hospital, in Chitradurga, Karnataka, India.

Objective:

The objective of the study was to assess breakthrough COVID-19 infection after vaccination among health-care workers.

Methodology:

A cross-sectional study was carried out in Basaveshwara Medical College and Hospital in October 2021 and December 2021. The study participants were more than 18 years old. The participants include BMCH staff including doctors, nurses, watchman, and ward boys. A sample size of 200 was obtained.

Results:

Most of the sample lies in the age group of 18–30 years, consisting of more females than males. 191/200, i.e., 95.5% of the population have been vaccinated against COVID-19, of which 69.5% have taken Covishield vaccine and 26% have Covaxin vaccine. Only 9/200 tested positive for COVID-19, postvaccination, whereas 2/200 were hospitalized for complications of COVID-19, postvaccination.

Conclusion:

Breakthrough COVID-19 among BMCH staff members shows that the vaccination has reduced COVID-19 infection.
How common is elder abuse? A cross-sectional study in urban slums of Siliguri, India
Authors: Roychowdhury Papiya , Mukherjee Abhijit , Kar Titas , Bhattacherjee Sharmistha
Published: May 2024

Background:

Elder abuse is still underreported and unacknowledged despite being a serious social concern linked to significantly higher rates of hospital admission and mortality. Abuse has a profound effect on the victims' physical, mental, and overall quality of life. Abuse can worsen an elderly person's preexisting chronic and incapacitating disease, increasing their dependence, vulnerability, and marginalization.

Objective:

The objective of this study is to evaluate the prevalence and pattern of abuse and identify various factors associated with it among community-dwelling elderly people in slums of Siliguri Municipal Corporation.

Materials and Methods:

A community-based cross-sectional study was conducted among 300 elderly people (60 years and above) in slums of Siliguri Municipal Corporation. A predesigned, pretested, and semi-structured questionnaire was used for data collection. The prevalence and pattern of elder abuse were determined by simple descriptive statistics and binary logistic regression was used to find out the correlates of abuse.

Results:

Abuse was present in 12% of the study population. The elderly above 80 years and females had higher odds of abuse. With respect to the existing property, results showed that ownership of agricultural land is a risk factor of abuse. Most of the study population thought that disrespect accounts for elder abuse, followed by neglect, and verbal abuse. The main perpetrators were daughters-in-law, followed by sons, and spouses.

Conclusion:

The prevalence of geriatric abuse was found to be quite high in the present study. The higher age group and lesser socioeconomic position are just a couple of the causes. Therefore, the continuous issues that make life difficult for the elderly must be addressed.
Application of flipped classroom combined with problem-based learning - An effective learning approach to upgrade learning in medical students: A randomized controlled trial
Authors: Palla Jayasree , Moparthi Sindhura , Kaki Sateesh Babu , Komaram Ravi Babu
Published: May 2024

Background:

As per the recent advancement in medicine, novel learning methodological innovations such as flipped classroom (FC) and problem-based learning (PBL) have earned ample recognition in medical education. The present study was directed with an aim to assess the effectiveness of combined learning method (CLM: FC combined with PBL) over traditional lecture-based classroom (TLC).

Objectives:

The objectives of this study were as follows: to determine whether CLM improves learning outcome among medical students and to determine whether there is any significant difference in students’ perceptions regarding learning method implemented.

Materials and Methods:

A randomized controlled trial (educational interventional study) was conducted with 100 medical students; they were randomly allocated into two equal groups: experimental group (EG) was taught by CLM, whereas control group (CG) was taught by TLC method. Closed- and open-ended questionnaire was used for the collection of data. Statistical analysis was done by applying independent samples t-test and Chi-square test.

Results:

A significant difference in the learning outcome was observed between the mean posttest scores of the two groups (CG = 31.5, EG = 46.2). There was a significant difference in the mean scores of perception between the groups (P ≤ 0.05). Chi-square test showed that students’ satisfaction is associated with the CLM (P = 0.00001).

Conclusion:

FC combined with PBL can be considered a better alternative to the lecture-based classroom for educating medical students on maternal and child health care.
Endophthalmitis Postintravitreal Bevacizumab Injections
Authors: Rizwan Amna , Asghar Asfandyar , Sughra Ume , Yasmin Naila
Published: May 2024

PURPOSE:

The purpose is to study the incidence, characteristics, management, and visual outcome of endophthalmitis postintravitreal bevacizumab (Avastin®) injections.

METHODS:

Retrospective cohort study conducted at Fauji Foundation Hospital that is a tertiary care center in Rawalpindi, Pakistan. The study duration was from January 1, 2015 to March 31, 2020. A total of 2321 eyes of 1407 patients were treated with Intravitreal bevacizumab (IVB) in a minor operation theater using standard aseptic measures. We studied the incidence, clinical characteristics, treatment, and visual outcomes of endophthalmitis post-IVB.

RESULTS:

Seven eyes (0.30%) out of 2321 eyes developed post-IVB endophthalmitis during the study period. Three eyes (42.8%) were culture positive and four eyes (57.2%) were culture negative. Five eyes (71.4%) showed visual improvement and two eyes (28.6%) did not show visual improvement.

CONCLUSION:

Prompt intravitreal antibiotic along with vitreous tap in cases of postintravitreal endophthalmitis may prevent vision loss which provides a useful alternative to immediate pars plana vitrectomy that requires more expertise, equipment, and an operation theater.
Diverse presentations of ectopia lentis and lens coloboma in Marfan’s syndrome
Authors: Dhiman Richa , Kaur Lovepreet , Sharma Nancy , Pandey Mohan Lal
Published: May 2024

Marfan’s syndrome (MFS) is an autosomal dominant connective tissue disorder with defect in the fibrillin-1 gene. The most common ocular manifestation is subluxated lens in the superotemporal direction, accounting for 50%–85% of total cases. The association of lens coloboma with MFS has been described in literature, but the coexistence of lens coloboma with ectopia lentis is a rare feature. Here, we describe three cases of MFS including a case of bilateral lens coloboma with ectopia lentis: case 1 – a 39-year-old male with inferotemporal lens subluxation in the right eye and superotemporal lens subluxation in the left eye with open-angle glaucoma and high myopia, case 2 – a 15-year-old child with bilateral superonasal lens subluxation with lens coloboma, and case 3 – a 56-year-old female with bilateral lens coloboma. Case 1 and case 2 had clear lenses with good refractive correction; hence, they were optically rehabilitated with contact lenses, whereas case 3 was advised for cataract surgery. It is important to distinguish the lens coloboma from a more common entity, ectopia lentis as former usually remains stable while the latter might need a surgical intervention.
Bilateral interface fluid syndrome and glaucoma progression after laser-assisted in situ keratomileusis
Authors: Mansoori Tarannum
Published: May 2024

A 32-year-old male with a past history of bilateral laser-assisted in situ keratomileusis (LASIK), presented with a decrease in vision in both eyes (BE). Clinical examination showed diffuse corneal haze and interface fluid syndrome (IFS), which was confirmed on anterior segment optical coherence tomography. Intraocular pressure (IOP) measurements obtained with Goldmann applanation tonometer (GAT) were low; however, digital tonometry indicated a raised IOP in BE, which was confirmed by measuring IOP with GAT, outside the peripheral edge of the LASIK flap. Treatment with antiglaucoma medications resulted in complete resolution of the interface fluid. However, due to noncompliance with medications, it recurred and glaucoma showed progression. The patient underwent trabeculectomy with mitomycin C in BE, resulting in improvement in the visual acuity, clear cornea, resolution of interface fluid, and normal IOP, till the last follow-up visit. This case had IFS secondary to episodes of raised IOP, which was diagnosed on careful clinical examination. IOP readings using GAT over the central cornea can give spuriously low readings in IFS. Hence, IOP should be measured in the peripheral cornea to obtain correct IOP readings. Early detection of high IOP and its management is essential to halt glaucoma progression.
Multipiece posterior chamber intraocular lens as sutureless, glueless scleral fixated intraocular lens
Authors: Mohanty Anuja , Mahapatra Santosh K. , Mannem Navya
Published: May 2024

PURPOSE:

The purpose of the study is to report the outcomes of sutureless, glueless multipiece posterior chamber intraocular lens (PCIOL) as scleral fixated intraocular lens (SFIOL) implantation in patients with poor or no posterior capsular support.

METHODS:

Medical records of 45 eyes of 42 patients who underwent SFIOL implantation where no suture or glue was used to fixate intraocular lens (IOL) to the sclera from November 2016 to October 2017, with minimum 18 months of follow-up were retrospectively analyzed. The best-corrected visual acuity, indication of surgery, other significant eye examination findings, and complications were analyzed.

RESULTS:

Out of 42 patients, 62% were males and 38% were females. Mean age of subjects was 48.5 ± 16.5 years (range 13–79 years). Mean preoperative and postoperative visual acuity was 1.48 ± 0.6 Logarithm of the Minimum Angle of Resolution (logMAR) units and 0.6 ± 0.3 logMAR units, respectively. Most common complication was vitreous hemorrhage six eyes (13.3%) followed by postoperative hypotony in five eyes (11.11%). Other complications such as transient postoperative intraocular pressure rise, hyphema, tilted IOL, cystoid macular edema, retinal detachment were also noted.

CONCLUSION:

Multipiece PCIOL used as SFIOL without any sutures and glue is a viable, cost-effective method of IOL implantation in eyes with aphakia following surgical complication or trauma, with comparable outcome to other techniques of SFIOL implantation.
Surgical resection of orbital primitive neuroectodermal tumor without adjuvant chemotherapy
Authors: Mehmood Faizan , Agrawal Abhishek , Afroz Nishat , Rizvi Syed Ali Raza
Published: May 2024

Primitive neuroectodermal tumor (PNET) of the orbit is a very rare entity. We report a case of a 10-year-old boy having progressive protrusion of the eyeball, restricted ocular motility, ptosis, and ocular pain for 2 months. On examination, a fixed, nontender, firm, hyperemic, nonpulsatile globular mass was palpated in the superomedial quadrant of the orbit. Computed tomography scans of the orbit depicted a well-defined, soft tissue density lesion within the orbit without evidence of any bone defect or erosion. Surgical resection of the encapsulated lesion through anterior orbitotomy followed by histopathology and immunohistochemistry examination confirmed the diagnoses of PNET. The patient has been on regular follow-up for 2 years and has shown no sign of recurrence.
Comparison of IOP obtained in different kind of eyes with contact and no contact tonometers
Authors: Sbordone Sandro , Ragucci Adele , Iaccarino Gennarfrancesco , Scognamiglio Gabriele , Leone Angelo , Gironi Carnevale Ugo Antonello , Lanza Michele
Published: May 2024

BACKGROUND:

The aim of this study is to analyze and compare the intraocular pressure (IOP) values measured in three different kinds of participants such as healthy subjects (HS), keratoconus patients (KP), and those who underwent myopic photorefractive keratectomy (MPRK). The devices used in this study are the Goldmann Applanation Tonometry (GAT), the dynamic contour tonometry (DCT), the ocular response analyzer (ORA), and the Corvis ST (CST).

SUBJECTS AND METHODS:

This research included 92 eyes of 92 h, 63 eyes of 63 KP, and 58 eyes of 58 MPRKM. Each participant underwent a complete ophthalmic evaluation and IOP measurement with GAT, DCT, ORA, and CST. A statistical analysis was conducted to detect possible differences and correlations.

RESULTS:

First, according to the observed data, HS eyes displayed mean IOP values measured with GAT, DCT, ORA, and CST, respectively, 15.82 ± 2.74 mmHg, 17.63 ± 2.28 mmHg, 16.24 ± 3.14 mmHg, and 17.31 ± 3.21 mmHg. Then, KP eyes showed mean IOP values measured with GAT, DCT, ORA, and CST of, respectively, 14.89 ± 1.64 mmHg, 16.97 ± 2.08 mmHg, 13.09 ± 3.12 mmHg, and 13.78 ± 2.11 mmHg. Finally, MPRK eyes showed mean IOP values measured with GAT, DCT, ORA, and CST of, respectively, 13.92 ± 1.34 mmHg, 15.39 ± 2.86 mmHg, 16.63 ± 2.51 mmHg, and 15.06 ± 1.56 mmHg.

CONCLUSION:

According to the observed data, ORA and GAT might be used interchangeably in HS, whereas GAT, ORA, and CST in KP eyes. Moreover, it has been noticed that in those eyes that previously undergone a myopic PRK, GAT provided lower values of IOP in comparison with other devices.
Localized orbital amyloidosis – A varied presentation
Authors: Ramkumar Akila V. , Muthumalai M. Muthumeena , Agarkar Sumita , Subramaniam Nirmala
Published: May 2024

Localized orbital amyloidosis is rare, usually slowly progressive and benign disorder. The most common signs and symptoms include visible periocular mass, ptosis, proptosis, globe displacement, ocular motility disturbances, recurrent periocular subcutaneous hemorrhages, and dry eyes. Herein, we report a case of localized recurrent orbital amyloidosis with strabismus, restricted eye movement, ptosis, and orbital mass as the presentation in a 60-year-old female and managed with debulking and strabismus surgery, resulting in a good cosmetic and functional outcome.
Masson's tumor of the ocular surface – A rare clinical entity
Authors: Pauly Marian , Sruthi R. , Subramanian Krishnakumar , Giridhar Anantharaman
Published: May 2024

Masson's tumor or intravascular papillary endothelial hyperplasia (IPEH) is a benign vascular lesion usually involving the head-and-neck region. On histopathological examination, it consists of reactive proliferation of endothelial cells with papillary formations which is the key to diagnosis. This rare entity was first described in 1923 by Pierre Masson. Lesions involving orbit and eyelids have been reported before. Here, we report a case of Masson's tumor which occurred in the lid margin and later in the conjunctiva which regressed completely after excision.
The effect of sustained eye rotation upon eye length in healthy myopic adults
Authors: Alkhaldi Saleh A. , Gray Lyle S.
Published: May 2024

AIM:

The aim of the study was to determine whether ocular movement can affect the shape of the globe and lead to measurable change in axial and peripheral eye length.

METHODS:

Ten subjects aged 18–30 years (6 M/4 F) participated with informed consent. The mean spherical equivalent refractive error was ≤−1.00 DS with cylindrical refraction <−1.25 DC. One drop of tropicamide hydrochloride 1% was instilled 20 min before measurement to induce mydriasis and mild cycloplegia. Using IOLMaster, eye length was measured centrally and temporally (25° off-axis) in four different positions. Subjects then rotated their eyes 25° in the temporal direction to fixate on a target for 10 min. After that, the same measurements were repeated.

RESULTS:

Before rotation, the group mean peripheral eye length was significantly shorter than the central eye length (P < 0.05). There was no significant variation in central or peripheral eye length due to off-axis fixation, either after the initial eye rotation or after fixation for 10 min at the off-axis point. The difference between central and peripheral eye lengths was maintained after 10 min of temporal fixation (P < 0.05).

CONCLUSION:

Peripheral eye length was shorter than central eye length showing the prolate shape associated with myopia. The action of the extraocular muscles on the globe has no significant effect upon the retinal shape assessed by off-axis eye length measurement in myopic subjects.
Wolf in sheep's clothing
Authors: Mendonca Teena Mariet , Lashkari Harsha Prasada , Suresh Pooja K , Kondaveti Rahul , Ali Faraz , Rodrigues Gladys R
Published: May 2024

Ewing sarcoma is one of the rare, highly malignant neuroectodermal tumors frequently involving bones. Primary orbital Ewing sarcoma is extremely uncommon. We report a rare case of a 5-year-old boy who presented to us with a painless, slow-growing mass above the medial canthus of the left eye, the clinical appearance of which was masquerading as an internal angular dermoid. The child was subsequently diagnosed to have primary orbital Ewing sarcoma. Primary orbital Ewing sarcoma is a rare tumor with poor prognosis, poses diagnostic challenges, and demands a high index of clinical suspicion.
Outcomes of canalicular trephination versus canaliculodacryocystorhinostomy in common canalicular blocks
Authors: Vukkadala Tejaswini , Bajaj Mandeep Singh , Pushker Neelam
Published: May 2024

AIM:

This study aimed to compare the outcomes and efficacy of canalicular trephination with monocanalicular stenting and canaliculodacryocystorhinostomy (canaliculoDCR) with silicone intubation.

MATERIALS AND METHODS:

A prospective comparative study was done in 30 patients (30 eyes) with common canalicular blocks who were randomized into two groups. Fifteen patients underwent canalicular trephination with monocanalicular stenting and 15 patients underwent canaliculoDCR with silicone intubation. Common canalicular obstruction was diagnosed by preoperative syringing and the location of block was confirmed on probing. Stents were kept in both the groups for 3 months and followed up till 6 months postoperatively. Success was defined based on both anatomical and functional outcomes. Anatomical success was defined by the free passage of fluid on syringing with the fluid felt in the throat. Functional success was defined in terms of relief from epiphora based on the subjective opinion and its categorization by Kraft and Crawford's grading and the fluorescein dye disappearance test (FDDT).

RESULTS:

Eighty percent of eyes in canalicular trephination group and 73.3% of eyes in canaliculoDCR group were anatomically patent on syringing at the final follow-up. Sixty-six percent of eyes in trephination group and 53.3% in canaliculoDCR group were reported to have absent epiphora (complete recovery). Ten eyes in both groups had Grade 0 and 1 FDDT indicating a functional success of 66.6% in both groups.

CONCLUSIONS:

Canalicular trephination can produce results comparable to canaliculoDCR with silicone intubation in cases of common canalicular blocks. The average duration of surgery is significantly less in canalicular trephination which gives this procedure an added advantage.
Retinal displacement following repair of rhegmatogenous retinal detachment
Authors: Shaheen Abdulla R. , Iyer Prashanth G. , Flynn Harry W. , Yannuzzi Nicolas A.
Published: May 2024

Retinal displacement following the repair of rhegmatogenous retinal detachment (RRD) has been reported in recent studies. It was described as vertical movement of the retinal relative to its original location, as evidenced by retinal vessel printing on fundus autofluorescence imaging. This review reports the current literature on retinal displacement. We conducted an English literature search using Medline, PubMed, Embase, and Web of Science. We have reviewed 22 articles describing the diagnosis, frequency, and possible risk factors for retinal displacement. The reported rate of retinal displacement ranged from 6.4% to 62.8%, and the possible risk factors included the detachment-to-repair time, location and extent of RRD, macula-off RD, presence of subretinal fluid, use of perfluorocarbon, use of tamponade, postoperative facedown positioning, type of RRD repair, and presence of proliferative vitreoretinopathy, especially high grade. This review increases awareness of retinal displacement and its associated visual effects.
Single-snip paralimbal incision
Authors: Saxena Juhi , Akhtar Naheed , Gupta Yogesh , Amitava Abadan Khan , Kauser Farnaz , Ahmed Shiraz , Raza S. Aisha , Masood Anam
Published: May 2024

INTRODUCTION:

Less invasive and quicker surgeries have become common. We compared two conjunctival incisional approaches in strabismus, namely Follow standard paralimbal approach for (SPLA) and single-snip paralimbal (SSPLA).

MATERIALS AND METHODS:

Forty-four patients with horizontal strabismus qualifying for uniocular recession–resection surgeries were randomized to SPLA and SSPLA. SSPLA involved a single v-shaped incision, with the apex of the V near the limbus, and the limbs facing away: by pinching up the conjunctiva with a forceps and delivering the single snip with a spring scissors. We compared the postoperative grades of redness, congestion, chemosis, foreign body sensation, and drop intolerance at day 1, 2 weeks, and 6–8 weeks; scar visibility, as yes or no, at 6–8 weeks; success rates, considered to be within 10 prism diopters of orthophoria, at 6–8 weeks; and operation duration in minutes.

STATISTICAL ANALYSIS:

Statistical analysis was done using Mann–Whitney U-test, for inflammatory grades, Chi-square for proportions, and t-test for parametric measures. Statistical significance was set at P < 0.05.

RESULTS:

On postoperative day 1, congestion (P = 0.02), foreign-body sensation (P = 0.04), and total inflammatory score (P = 0.003) were statistically significantly favoring the SSPLA group. While at 2 weeks, only congestion (P = 0.02) was found to be significantly less in the SSPLA group. There were no significant differences in the proportions of scar visibility (5/22 in the SPLA vs. 3/22 in the SSPLA) and success rate: 20/22 vs. 18/22. The SSPLA was quicker on an average by 6 min (P < 0.001, 95% confidence interval: 3.2–8.7).

CONCLUSION:

Compared to the SPLA, the SSPLA is quicker and results in lesser inflammation in the immediate postoperative period.
Accuracy of Barrett versus third-generation intraocular lens formula across all axial lengths
Authors: Solomon Raline , Tamilarasi S , Sachdev Gitansha , Dandapani Ramamurthy
Published: May 2024

PURPOSE:

The purpose of this study is to evaluate and compare the accuracy of Barrett Universal II versus third-generation formula for different intraocular lens (IOL) powers for Indian eyes with different axial lengths (ALs).

DESIGN:

This is a retrospective, nonrandomized consecutive case series.

METHODS:

This study reviewed 981 eyes from 825 patients who had uneventful cataract surgery and IOL implantation. The eyes were separated into subgroups based on AL as follows: short (<22.0 mm), medium (22.01–23.99 mm), and long (>24.0 mm). The predicted refractive outcome using formulas was calculated and compared with the actual refractive outcome to give the prediction error. The percentage of every refractive error absolute value for each formula was calculated at <±0.50D, 0.50D-0.75D, and >±0.75D.

RESULTS:

In all, 981 eyes were analyzed. There were no significant differences in the median absolute error predicted by Barrett and the third-generation formulae. The Barrett Universal II formula resulted in significantly lowest mean spherical equivalent in short eyes (P = 0.0047) as well as a higher percentage of eyes with prediction errors within <±0.50D, 0.50D-0.75D, and >±0.75D. We found that the Barrett Universal II formula had the lowest predictive refraction error and mean absolute error across all ALs.

CONCLUSION:

The Barrett Universal II formula rendered the lowest predictive error compared with SRK/T, Holladay, and Hoffer Q formulas. Thus, the Barrett Universal II formula may be regarded as a more reliable formula for achieving emmetropia and reducing postoperative refractive surprises across all ALs.
A quantitative evaluation of the effect of meals on macular thickness in diabetic patients with diabetic macular edema
Authors: Sinha Yashika , Trehan Hemant Singh , Kurumkattil Raji , Bhatkoti Bhupesh , Dhar Sanjay Kumar , Sharma Vijay Kumar
Published: May 2024

PURPOSE:

Central subfoveal thickness measurement is used in a large number of clinical trials to monitor the progression and treatment response of diabetic macular edema (DME) in patients of diabetic retinopathy (DR). Several studies have been carried out to investigate various factors affecting the central subfoveal thickness in order to minimize errors in the testing. We planned a study to investigate the effect of meals on central macular thickness (CMT) in patients with DME and compare that with nondiabetic patients.

METHODS:

In this observational study, 50 patients of diabetes with DME and 50 normal controls were included. Macular thickness was measured after overnight fasting and 2 h postprandial for both the groups. Any changes in morphology and CMT were evaluated.

RESULTS:

Each group had 22 females and 28 males with a mean age of 60.6 ± 6.6 in the diabetic group and of 49.66 ± 11.13 in the control group. Reduction in the CMT was noticed after the meals (mean: −9.78 ± 12.77 μm; P < 0.001) in those with DME as compared to the control group. This was more prominent in those who had intraretinal cystic spaces (17.14 ± 10.33 μm) and neurosensory detachment (66 µ). Patients with high blood sugar levels had higher CMT and a greater reduction in thickness was noticed in them postprandially (r = 0.414; P = 0.0028).

CONCLUSION:

The CMT values in patients with DME are significantly affected by meals. Hence, an attempt should be made to measure CMT during the fasting state for more accurate results.