bluuebunny/crossref_metadata_2025 huggingface dataset:
Spread of COVID-19 in the Russian regions in 2020: factors of excess mortality
Authors: Kolosnitsyna Marina G. , Chubarov Mikhail Yu.
Published: December 2022

The paper identifies major factors associated with the pandemic spread in the Russian regions, using econometric models and nonlinear «Random Forest» models to assess their significance. The study is based on data of the Russian regions for March-December 2020, a balanced panel sample included 780 observations. Prevalence of the pandemic was estimated based on the excess mortality rate.

The study has identified a positive relationship between excess mortality and the share of migrants and a negative relationship between excess mortality and the share of pensioners in the region. Importance of climatic factors has been confirmed: high temperatures, other things being equal, reduce excess mortality, while high humidity, on the contrary, increases it. Excess mortality is higher in the regions with lower population mobility. Mortality is higher in the regions with high per capita incomes and regions with significant unemployment. Vice versa, excess mortality is lower in the regions with better doctor and nurse staffing levels.

The study results show that in case of repeated waves of the epidemic or emergence of new viruses, public health policy should be geographically differentiated. Priority should be given to epidemiological situation in the regions with humid climate and low temperatures, high incomes, intensive migration, and high unemployment rates. Significant investments in medical education, higher number of medical specialists and their more even distribution across regions are required. This approach turns out to be more effective in terms of reducing mortality rather than restrictions on population mobility.
« Non sans vergogne »
Authors: Cabrol Hervé
Published: December 2022

L’auteur cherche à réhabiliter une émotion sociale en voie de disparition pour rendre compte d’une caractéristique de la posture du gestalt-thérapeute, du superviseur et du formateur en gestalt-thérapie.
The (De)Stabilizing effect of juvenile prey cannibalism in a stage-structured model
Authors: Takyi Eric M. , Cooper Kasey , Dreher Ava , McCrorey Caroline
Published: December 2022

Cannibalism, or intraspecific predation, is the act of an organism consuming another organism of the same species. In predator-prey relationships, there is experimental evidence to support the existence of cannibalism among juvenile prey. In this work, we propose a stage-structured predator-prey system where cannibalism occurs only in the juvenile prey population. We show that cannibalism has both a stabilizing and destabilizing effect depending on the choice of parameters. We perform stability analysis of the system and also show that the system experiences a supercritical Hopf, saddle-node, Bogdanov-Takens and cusp bifurcation. We perform numerical experiments to further support our theoretical findings. We discuss the ecological implications of our results.
Global stability of a continuous bioreactor model under persistent variation of the dilution rate
Authors: Rincón Alejandro , Hoyos Fredy E. , Restrepo Gloria
Published: December 2022

In this work, the global stability of a continuous bioreactor model is studied, with the concentrations of biomass and substrate as state variables, a general non-monotonic function of substrate concentration for the specific growth rate, and constant inlet substrate concentration. Also, the dilution rate is time varying but bounded, thus leading to state convergence to a compact set instead of an equilibrium point. Based on the Lyapunov function theory with dead-zone modification, the convergence of the substrate and biomass concentrations is studied. The main contributions with respect to closely related studies are: i) The convergence regions of the substrate and biomass concentrations are determined as function of the variation region of the dilution rate (D) and the global convergence to these compact sets is proved, considering monotonic and non-monotonic growth functions separately; ii) several improvements are proposed in the stability analysis, including the definition of a new dead zone Lyapunov function and the properties of its gradient. These improvements allow proving convergence of substrate and biomass concentrations to their compact sets, while tackling the interwoven and nonlinear nature of the dynamics of biomass and substrate concentrations, the non-monotonic nature of the specific growth rate, and the time-varying nature of the dilution rate. The proposed modifications are a basis for further global stability analysis of bioreactor models exhibiting convergence to a compact set instead of an equilibrium point. Finally, the theoretical results are illustrated through numerical simulation, showing the convergence of the states under varying dilution rate.
High-yield production and purification of the fusion pH-responsive peptide GST-pHLIP in Escherichia coli BL21
Authors: Cienfuegos-Jiménez Oscar , Morales-Hernández Abril , Robles-Rodríguez Olivia A. , Bustos-Montes Sergio , Bañuelos-Alduncin Kevin A. , Cortés-Castillo Aurora R. , Barreto-Hurtado Hugo D. , Carrete-Salgado Luis , Marino-Martínez Iván A.
Published: December 2022

The pH Low Insertion Peptide (pHLIP) has versatile applications in several diseases due to its differential behavior at slightly different pH values. pHLIP is an unstructured and peripheral membrane-associated peptide at neutral pH and an α-helical transmembrane peptide at acidic values. Similar to what happened to insulin and growth hormone, pHLIP´s expanding applications require high-yield production to further scale-up its usefulness. To date, synthesis of the pHLIP has not been reported in a prokaryotic platform, mainly relying on solid-phase synthesis. Bacterial production arises as an option for high-amount peptide generation and larger pHLIP fusion protein-synthesis; however, cell-based pH-responsive peptide production could be challenging due to intracellular peptide interactions or degradation due to unstructured conformations. An Escherichia coli (E. coli)-BL21 cell culture was induced with Isopropyl ß-D-1-thiogalactopyranoside (IPTG) in order to produce a Glutathione S-transferase-pHLIP (GST-pHLIP) fusion construct. Purification was done with Glutathione (GSH)-decorated magnetic beads using 4 ml of the induced cell culture. The production was quantified with Bradford reagent and characterized with SDS-PAGE and Western blot, contrasting Bradford results with densitometry analysis to obtain production approximate absolute values. A purified approximate total yield of ~26 µg with an apparent GSH-bead saturation and a total production of ~82 µg was obtained. Our Western Blot assay confirmed the presence of the GST-pHLIP construct in all the IPTG-induced fractions. Conclusion: A high-yield pHLIP production irrespective of its membrane affinity in acidic environments or its unstructured nature was achieved. Our study could be useful to scale up pHLIP synthesis for future applications.
Detection and Classification of Neonatal Jaundice Using Color Card Techniques – A Study
Authors: S Bharani Nayagi , T. S. Shiny Angel
Published: December 2022

--- In a newborn baby, the particular complication is jaundice. Jaundice is due to many reasons. An increase in the bilirubin level denotes the presence of jaundice. Neonatal hyperbilirubinemia is most common in the first postnatal week. Early prediction and classification of jaundice are essential to reduce the mortality rate. Diagnosis of the disease using computer vision techniques helps to achieve accuracy in prediction and classification. Here I studied and extracted the information from medical data mining and achieved the goal. It involves examining, analyzing, extracting, selecting, and classifying the features. Finally, it provides treatment suggestions It enables the physician to perform early prediction and provide appropriate jaundice treatment. Computer vision and machine learning techniques make the process easy and simple. The optimized method of classification increases accuracy.
Cremaster muscle thickening: the anatomic difference in men with testicular retraction due to hyperactive cremaster muscle reflex
Authors: Kavoussi Parviz K , Henderson Hayden T , Hudson Kayla , Mehrabani-Farsi Romtin , Machen Graham Luke
Published: December 2022

The objective was to assess whether men suffering from testicular retraction secondary to hyperactive cremaster muscle reflex have an anatomic difference in the thickness of the cremaster muscle in comparison to men who do not have retraction. From March 2021 to December 2021, 21 men underwent microsurgical subinguinal cremaster muscle release (MSCMR) on 33 spermatic cord units, as 12 of them had bilateral surgery, at Surgicare of South Austin Ambulatory Surgery Center in Austin, TX, USA. During that same time frame, 36 men underwent subinguinal microsurgical varicocele repair on 41 spermatic cord units, as 5 were bilateral for infertility. The thickness of cremaster muscles was measured by the operating surgeon in men undergoing MSCMR and varicocele repair. Comparison was made between the cremaster muscle thickness in men with testicular retraction due to a hyperactive cremaster muscle reflex undergoing MSCMR and the cremaster muscle thickness in men undergoing varicocele repair for infertility with no history of testicular retraction, which served as an anatomic control. The mean cremaster muscle thickness in men who underwent MSCMR was significantly greater than those undergoing varicocele repair for infertility, with a mean cremaster muscle thickness of 3.9 (standard deviation [s.d.]: 1.2) mm vs 1.0 (s.d.: 0.4) mm, respectively. Men with testicular retraction secondary to a hyperactive cremaster muscle reflex demonstrate thicker cremaster muscles than controls, those undergoing varicocele repair. An anatomic difference may be a beginning to understanding the pathology in men who struggle with testicular retraction.
A tailor-made physical therapy protocol for a rare pediatric tumor
Authors: Pattanshetty Renu B , Pawar Nikita Nitin , Rao Mounica Srinivas
Published: December 2022

Solid pseudopapillary carcinoma of pancreas is a cystic exocrine tumor of the pancreas which is common in females in the third and fourth decades. This report presents a rare case of an 11-year-old girl who operated for Frantz tumor and was referred for physical therapy. The therapy was beneficial in reducing the pain, improving the range of motion, and overall quality of life of the patient. To the best of our knowledge, this is the first case report found in the medical literature that reports of physical therapy management in a rare reported case of pediatric solid pseudopapillary carcinoma of pancreas.
Musculoskeletal Disorders
Authors: Biswas Kanu Gopal , Majumdar Piya , Sahu Subhashis
Published: December 2022

BACKGROUND:

Carpentry and related jobs are the major occupations for a large number of people in the rural and urban areas of India which is mainly unorganized.

AIMS AND OBJECTIVES:

Carpentry work is unorganized informal sectors, particularly in developed countries such as India, and there is a lack of data on musculoskeletal disorders and the issues are being undermined nowadays, so we intend to study and evaluate the prevalence of musculoskeletal disorders among carpenters, analyzing major causes behind such predicaments with a special emphasis on working posture.

MATERIALS AND METHODS:

For the present study, 148 male carpenters aged between 20-60 years were randomly taken from different wooden furniture manufacturing units in West Bengal, India, and 148 referent subjects from different working sectors with similar socioeconomic status who have been categorized depending upon their experience. Socio-demographic features along with physical measures, physiological status, working posture, and discomfort at different body parts were evaluated following standard protocol.

RESULTS:

Based on the observations, it was found that most of the carpenters were suffering from work-related health predicaments, mainly musculoskeletal problems due to awkward working posture. Some of the working postures adopted by carpenters were identified as very strenuous. They complain about pain during working hours and also during the rest period. It was observed that the head, neck, shoulder, arm, elbow, wrist, upper back, lower back, waist, leg, knee, and ankle were majorly affected areas due to their repetitive nature of work with awkward posture. Body part discomfort rating showed that the lower back was mostly stressed and the elbow and leg were least. It was also found that their working place and their working environment and unergonomic tools make work more strenuous.

CONCLUSION:

So, some ergonomic interventions are required to improve the quality of life of the carpenter work, and scheduled rest-pause may enable the workers to recover from strain.
Role of magnetic resonance imaging in assessment of extensor compartment abnormalities of knee joint – A cross-sectional study
Authors: Patil Santosh D. , Raman Vihag , Goudar Pradeep Siddappa , Patil Aravind D. , Patil Priyanka
Published: December 2022

INTRODUCTION:

The patellofemoral joint (PFJ) is a complex joint structure with high functional and biomechanical requirements. The magnetic resonance imaging (MRI) is an effective tool for definition and characterization of knee pathology as it can accurately detect, localize, and characterize various pathologies of the knee joint.

OBJECTIVES:

(1) Evaluate MR images to identify different pathologies that are seen in the extensor compartment of the knee joint. (2) Quantitative assessment of patellofemoral measurements to determine predisposing risk factors that contribute to patellofemoral joint instability.

METHODOLOGY:

A cross-sectional study was conducted from January 2017 to December 2017 with a sample size of 30 in the Department of Radiodiagnosis at The KLE's Dr. Prabhakar Kore Hospital and MRC, Belagavi. The data were collected using a pretested semi-structured questionnaire. The pro forma included sociodemographic profile of the study subjects, clinical presentation MRI to identify different pathologies that are seen in extensor compartment of the knee joint and quantitative assessment of patellofemoral measurements to determine predisposing risk factors that contribute to patellofemoral joint instability.

RESULTS:

Among the study population majority of people had normal synovium, laterally subluxated/dislocated patella. Among the study population, the majority had normal lateral trochlear inclination angle, normal trochlear facet asymmetry, normal trochlear depth, normal sulcus angle, and trochlear dysplasia. Twenty-four (80%) people had normal Insall–Salvati index, 27 (90%) people had normal lateral patella femoral angle, 25 (83.30%) people had normal lateralization of the patella, 28 (93.30%) people had normal tibial tubercle to trochlear groove distance, majority, i.e., 11 (36.70%) had Hoffa's fat pad edema followed by chondromalacia patella, trochlear dysplasia, medial patellofemoral ligament tear, patella alta, synovial plicae, subluxated/dislocated patella, transient dislocated patella, Osgood–Schlatter disease, and patellar tendonitis.

CONCLUSION:

MRI has also been useful in identifying extensor compartment pathologies that lead to anterior knee pain.
Effect of long-distance load marching on physiological responses at desert environment
Authors: Arya Kavita , Yadav Angad , Bhattacharyya Debojyoti , Chatterjee Subhojit , Pal Madhusudan
Published: December 2022

AIM:

The present study was undertaken to examine the effect of long-distance load marching on the physiological responses, walking efficiency, and mobility of soldiers at sandy desert environment.

METHODS:

A total of nine physically fit soldiers (age, 30.00 [SE 0.9] years; height, 175.56 [SE 1.18] cm; and weight, 77.83 [SE 1.37] kg) volunteered for long-distance (6 km) load marching by self-selected speed when carrying 22 kg (28.27% of body weight [BW]) load and no load (NL). Heart rate (HR), respiratory frequency (RF), and core body temperature (CBT) were recorded. Relative workload (RWL) and Physiological Cost Index (PCI) were calculated to assess the work intensity and mobility.

RESULTS:

It was observed that HR (P = 0.01), RWL (P = 0.01), and PCI (P = 0.01) were significantly increased by 23.79, 39.71, and 77.73%, respectively, and mobility was significantly reduced (P = 0.01) by 18.56% during marching with 22 kg load as compared to NL.

CONCLUSION:

It may be that marching without external load at speed of 4.85 ± 0.54 km/h should not be continued for more than 2 h, whereas marching with load of 28.27% of BW at speed of 3.95 ± 0.55 km/h should be restricted to maximum 30 min. This combination of load, speed, and duration provides information about soldiers' routine load carriage tasks, which may help in optimizing the load carriage task to reduce the chances of cumulative carriage-related injuries and, therefore, may contribute to improved soldiers' operational readiness and mobility.
Out-of-Pocket Expenditure for the Diagnosis of Cervical, Breast, and Oral Cavity Cancer
Authors: Singh Shahana , Thulasingam Mahalakshmy , Nagappa Bharathnag , Singh Chitrita , Rajan Vishnu , Karunanithi Gunaseelan
Published: December 2022

Background:

Cancer as a disease has widespread financial impact on patients. Most public funded government schemes provide insurance only after the diagnosis is made. Patients incur a substantial out-of-pocket expenditure even before the diagnosis.

Objectives:

The study was done with the objective of determining the total cost (direct out-of-pocket expenditure and indirect cost) incurred from the symptom onset to diagnosis among patients diagnosed with cancer of the uterine cervix, oral cavity, and breast.

Materials and Methods:

In this hospital-based study conducted in the Regional Cancer Center of a tertiary hospital in South India, 100 patients were interviewed using a predesigned, pretested questionnaire. For cost calculation, the reference period was duration between the first contact to the health facility for the symptoms suggestive of cancer, and the histopathological diagnosis. The total direct (out-of-pocket expenses) and indirect (income lost) costs were determined by interviewing the participants. The Mann-Whitney and Kruskal-Wallis test were used to compare the out-of-pocket expenses across age, gender, and tumor type categories.

Results:

The median (first quartile [Q1] and third quartile [Q3]) cost incurred while diagnosing the three cancers was Indian rupees (INRs) 3660 (1280, 12,660); the median (Q1, Q3) direct cost was INR 1710 (350, 10,930) and the median (Q1, Q3) indirect cost was INR 250 (0, 2000). Those who visited a private health facility for their symptoms incurred a significantly higher direct cost (P< 0.05). Further, those aged 15–44 years, above the poverty line, male, who had completed more than primary education, or were diagnosed with cervical cancer incurred higher costs, although this was not statistically significant.

Conclusion:

Patients of common cancers incur a high out-of-pocket expenditure even before initiation of treatment. Measures such as providing all diagnostic modalities under a single roof and adopting a standardized protocol for various investigation procedures may help in reducing the costs incurred by patients.
COVID-19 vaccination and recurrent anterior uveitis
Authors: Sanjay Srinivasan , Yathish GC , Singh Yogeshpreet , Kawali Ankush , Mahendradas Padmamalini , Shetty Rohit
Published: December 2022

A 35-year-old Asian Indian female previously diagnosed with bilateral anterior uveitis and on oral methotrexate developed bilateral anterior uveitis following first/second dose of coronavirus disease 2019 (COVID-19) vaccination. She had skipped her weekly dose of oral methotrexate following first dose of vaccination. Following the second dose, she reduced her oral methotrexate from 25 to 15 mg on her own, but did not stop like the previous occasion. She had extensive workup for her uveitis in the past with only positive severe acute respiratory syndrome coronavirus (SARS-CoV-2) antibodies. She developed unilateral anterior uveitis after she had COVID-19 in July 2022, which resolved with topical steroids and continuation of immunosuppression. This report illustrates that COVID-19 or its vaccination may presumably play a role in triggering the immune system and can cause recurrent ocular inflammation even in the absence of an extraocular inflammation.
Assessment of optic disk by disk damage likelihood scale staging using slit-lamp biomicroscopy and optical coherence tomography in diagnosing primary open-angle glaucoma
Authors: Singh Kanchan , Bhushan Prashant , Mishra Deepak , Kaur Kirandeep , Gurnani Bharat , Singh Anjali , Pandey Swasti
Published: December 2022

Purpose:

The current study was aimed at assessment of optic disk by disk damage likelihood scale (DDLS) staging using slit-lamp biomicroscopy and optical coherence tomography (OCT) in diagnosing primary open-angle glaucoma (POAG) patients.

Methods:

This was a cross-sectional observational study of 106 POAG patients, which was conducted from April 2017 to April 2018. All patients underwent slit-lamp fundoscopy with a +78 D lens and high-definition (HD)-OCT, and the vertical cup disk ratios (VCDRs) were recorded. Disk size and neuroretinal rim assessment were done, and the disk was then staged using the recent version, which stages the optic nerve head (ONH) from 1 to 10 as read from the DDLS nomogram table. DDLS scores >5 indicate glaucomatous damage. Pearson coefficient was used to correlate the DDLS staging by slit-lamp biomicroscopy with best-corrected visual acuity (BCVA), intraocular pressure (IOP), disk size, and VCDR and VCDR, mean deviation, and DDLS staging by HD-OCT.

Results:

The mean age of the patients was 59.54 ± 6.61 years. The male: female ratio was 2:1. The mean IOP was 16.04 ± 1.97 mmHg, and BCVA was 0.72 ± 0.13 LogMAR units. The mean VCDR on 78 D slit-lamp biomicroscopy was 0.76 ± 0.09 (standard deviation [SD]) (range 0.1–0.77), whereas on HD-OCT, the mean VCDR was 0.81 ± 0.09 (SD) (range 0.07–0.81). The mean deviation on visual field testing in decibels was −14.43 ± 3.31 (SD). The correlation coefficient between DDLS staging by slit-lamp biomicroscopy and DDLS staging by HD-OCT parameters was r = 0.96.

Conclusion:

There is a positive correlation between the DDLS system of optic disk evaluation on slit-lamp biomicroscopy and most of the HD-OCT evaluation parameters.
Central macular thickness and subfoveal choroidal thickness changes on spectral domain optical coherence tomography after cataract surgery in pediatric population
Authors: Sen Pradhnya , Shah Chintan , Sachdeva Mani , Sen Alok , More Amruta , Jain Elesh
Published: December 2022

Purpose:

To evaluate the central macular thickness (CMT) and subfoveal choroidal thickness (SFCT) changes on spectral domain optical coherence tomography (SD-OCT) after cataract surgery with intraocular lens (IOL) implantation in a pediatric population.

Methods:

This was a longitudinal, prospective, interventional study which included 90 pediatric patients who underwent cataract extraction with IOL implantation. Serial SD-OCT scans were done at postoperative day 1, 1-month, and 3-month follow-up. CMT and SFCT were measured at each visit.

Results:

A statistically significant increase in CMT was noted at 1 month (from 199.3 mm to 210.04 mm) post surgery, which declined over a 3-month period (202.70 mm, P = 0.0001). In case of SFCT, a constant increase was observed for over 3 months of follow-up (baseline: 296.52 mm; 1 month: 309.04 mm; and 3 months: 319.03 mm, P = 0.0001). The traumatic cataract group showed more pronounced changes in CMT and SFCT than the non-traumatic cataract group. No significant difference was observed regarding these parameters between those who underwent primary posterior capsulotomy (PPC) versus those who did not. None of the patients in the study group developed cystoid macular edema. These posterior segment–related anatomical changes did not affect the final visual outcomes.

Conclusion:

Cataract surgery induces potential inflammatory changes in the macula and choroid in pediatric patients. Such changes are more pronounced in trauma-related cases; however, they are not significant enough to affect the visual outcomes. Similarly, the additional surgical step of PPC does not induce significant anatomical or functional changes.
Indistinct retinal outer layers in the walls of the idiopathic full-thickness macular hole - A potential predictive biomarker for surgical outcomes
Authors: Patel Rushik , Delhiwala Kushal , Khamar Bakulesh
Published: December 2022

Purpose:

To evaluate the absence of external limiting membrane (ELM) and ellipsoid zone (indistinct retinal outer layers, I-ROL) in the walls of idiopathic full-thickness macular holes (FTMHs) circumferentially on optical coherence tomography (OCT) and its correlation with surgical outcome.

Methods:

In this retrospective observational study, OCT images of patients undergoing vitrectomy for FTMHs with at least 3-months of postoperative follow-up were analyzed for preoperative circumferential extent of I-ROL. Derived macular hole indices such as hole form factor (HFF), macular hole index (MHI), tractional hole index (THI), and hole diameter ratio (HDR) were also calculated. The circumferential extent of I-ROL was correlated with derived hole indices as well as anatomical closure, foveal architecture, and restoration of ELM following surgery.

Results:

All nine eyes (eight patients) with FTMH (mean size: 610.11 ± 122.95 microns) in the study showed I-ROL in ≥1 quadrant. The mean HFF, MHI, THI, and HDR values were 0.72 ± 0.09, 0.35 ± 0.05, 0.71 ± 0.24, and 0.53 ± 0.14, respectively. All eyes achieved type-1 hole closure with improvement in best-corrected visual acuity to 0.58 ± 0.32 LogMAR from 0.81 ± 0.26 LogMAR. Regular foveal architecture was achieved in six eyes. Out of these, five eyes had I-ROL in ≥2 quadrants, and one eye had I-ROL in <2 quadrants (P = 0.0476). Restoration of ELM was seen in aforementioned six eyes (complete = 5, partial = 1). Out of the five eyes with complete ELM restoration, four had a circumferential extent of I-ROL in ≥2 quadrants (P = 0.0476). Complete restoration of ELM was associated with the complete restoration of the ellipsoid zone in three eyes.

Conclusion:

Preoperative circumferential extent of I-ROL in FTMH walls can be a potential predictive OCT marker for the type of closure, postoperative foveal architecture, and ELM restoration.
The effect of different thickness scleral lens on corneal parameters in eyes with keratoconus
Authors: Iqbal Asif , Thomas Rinu , Mahadevan Rajeswari
Published: December 2022

Purpose:

To investigate the impact of different-thickness scleral lenses (SLs) on corneal thickness, curvature, and fluid reservoir thickness in keratoconic eyes.

Methods:

Schiempflug imaging and AS-OCT was captured before and immediately following 6 h of SL wear. Different-thickness lenses were used while keeping the other parameters the same. The timing of the measurement for day 1 and day 2 was matched to allow for the control of the confounding influence of diurnal variation.

Results:

Immediately after 6 h of lens wear, no statistically significant difference (P > 0.05) was noted in corneal edema in any region and quadrants between thin- and thick-lens wearers. The calculated percentage of corneal edema was also within the range of overnight closed eye physiological swelling. Pentacam measured higher central corneal thickness compared to AS-OCT in both baselines and after 6 h of lens wear. The current investigation reported minimal but not statistically significant (P > 0.05) flattening in anterior and steepening in posterior curvature parameters in both thin and thick SLs. The mean reduction in the fluid reservoir thickness was 80.00 ± 3.99 and 79.36 ± 3.84 microns after 6 h of thin- and thick-lens wear, respectively, which was not statistically significant (P > 0.05). A statistically significant positive correlation (r = 0.67, P = 0.02) was found between lens thickness and change in anterior steep k with thick-lens wear.

Conclusion:

Central lens thickness of 200–400 mm did not cause any significant change in corneal curvature and fluid reservoir thickness and did not induce clinically significant corneal edema after short-term SL wear.
Role of amniotic membrane transplantation in treating acute ocular manifestations in Steven–Johnson syndrome and its long-term impact
Authors: Singh Prabhakar , Raj Amit , Gupta Abhishek , Pradhan Swetalina , Aftab Naila , Biswas Saranya
Published: December 2022

Background:

Steven–Johnson syndrome (SJS) is a serious disorder affecting the skin and mucous membrane, causing multiple flaccid bullae and purpuric rashes with sheet-like epithelial detachment including the ocular surface. The long-term outcomes following SJS are dismal and manifest as corneal vascularization, lid-wiper keratopathy, and severe dry eyes. The disease course can be modified if amniotic membrane graft is performed at the first week of disease, and the above-said complications can be avoided. This procedure thus not only decreases the morbidity but also improves the quality of life.

Purpose:

This video discusses the long-term sequelae of SJS which can be modified with timely intervention during the acute stage and thus significantly decreases morbidity.

Synopsis:

The video demonstrates the simple technique of amniotic membrane transplantation in the acute stage in SJS and its impact in long run.

Highlights:

There should be a low threshold for doing early amniotic membrane transplantation in patients with SJS with ocular surface involvement. Early intervention can change the disease course and decrease disease morbidity significantly.

Video link:

https://youtu.be/qgIiVcW56Oo

Key word: Amniotic membrane transplantation, chronic sequelae, SJS
Comparison of peripapillary capillary plexus using optical coherence tomography angiography and retinal nerve fibre layer analysis using spectral domain optical coherence tomography in glaucoma patients, glaucoma suspects, and healthy subjects
Authors: Dutta Ananya , Thulasidas Mithun , Sasidharan Ajita , Pradeep Balam , Rajesh Prabu V
Published: December 2022

Purpose:

To assess the association between radial peripapillary capillary (RPC) plexus using optical coherence tomography angiography (OCTA) and retinal nerve fibre layer (RNFL) thickness using spectral domain OCT (SD-OCT) in primary open-angle glaucoma (POAG) patients, glaucoma suspects, and healthy subjects.

Methods:

In this single-centre cross-sectional observational study, POAG, glaucoma suspects, and healthy patients underwent OCT-RNFL and optic nerve head angiography scans. The RNFL thickness and the vascular parameters obtained from RPC plexus, including perfusion density (PD), flux index (FI), and vessel density (VD), were analysed.

Results:

In all, 120 eyes of 120 patients, including 40 POAG patients, 40 glaucoma suspects, and 40 healthy subjects, were included. The pairwise comparison of mean RNFL thickness, FI, and VD showed significant difference (P < 0.001) in all sectors between POAG, glaucoma suspects, and healthy eyes. However, PD showed no significant difference between glaucoma suspects and healthy eyes. The average RNFL thickness was found to have a better diagnostic ability than VD to distinguish POAG eyes from healthy eyes and glaucoma suspects based on receiver operating characteristics curve and area under the curve. VD had better diagnostic accuracy than RNFL when glaucoma suspects and healthy were compared.

Conclusion:

OCT-RNFL has better diagnostic capability in differentiating glaucoma from healthy eyes compared to OCTA. However, OCTA was found to be better in screening out glaucoma suspects from healthy eyes. The VD is a better OCTA parameter than FI and PD to differentiate POAG and glaucoma suspects from healthy eyes.
Comparative evaluation of an automated preloaded delivery system with a non-preloaded system
Authors: Joshi Rajesh S
Published: December 2022

Purpose:

To evaluate a single surgeon’s experience with an automated preloaded intraocular lens (IOL) delivery system and a nonpreloaded system.

Methods:

This was a prospective, observational case series. Phacoemulsification was performed under topical anesthesia by creating a temporal clear corneal incision. Patients were consecutively assigned to either the Clareon group (n = 50; the IOL was injected into the capsular bag by using an automated injector system) or the AcrySof group (n = 50; the IOL was injected into the capsular bag by using a conventional injector system). The main outcome measures were ease of implantation, intraoperative complications, postoperative centration, and visual acuity.

Results:

Additional manipulation in the anterior chamber was not required in 38 (74%) eyes in the Clareon group and 41 (82%) eyes in the AcrySof group. However, seven eyes in the Clareon group and one eye in the AcrySof group required trailing haptic dislodgement from the optic. Furthermore, two eyes in the Clareon group and five eyes in the AcrySof group required injector rotation (varying from 10° to 90°) in the wound. Moreover, in two eyes of the Clareon group, the silicon plunger of the injector system crossed over the optic. None of the patients developed iris trauma and PCR during IOL manipulation. All the IOLs were centered in the capsular bag.

Conclusion:

The automated IOL delivery system enables the controlled delivery of an IOL in the capsular bag. The effect of carbon footprints created by plastic generated from the delivery system and the implications of the CO2 cylinder on the environment should be addressed.
PAX6 disease models for aniridia
Authors: Abdolkarimi Dorsa , Cunha Dulce Lima , Lahne1 Manuela , Moosajee Mariya
Published: December 2022

Aniridia is a pan-ocular genetic developmental eye disorder characterized by complete or partial iris and foveal hypoplasia, for which there is no treatment currently. Progressive sight loss can arise from cataracts, glaucoma, and aniridia-related keratopathy, which can be managed conservatively or through surgical intervention. The vast majority of patients harbor heterozygous mutations involving the PAX6 gene, which is considered the master transcription factor of early eye development. Over the past decades, several disease models have been investigated to gain a better understanding of the molecular pathophysiology, including several mouse and zebrafish strains and, more recently, human-induced pluripotent stem cells (hiPSCs) derived from aniridia patients. The latter provides a more faithful cellular system to study early human eye development. This review outlines the main aniridia-related animal and cellular models used to study aniridia and highlights the key discoveries that are bringing us closer to a therapy for patients.
Diagnostic ability of superficial vascular density measured by optical coherence tomography angiography to differentiate high myopic eyes from eyes with primary open angle glaucoma
Authors: Santhosh Liz Mary , Elias Anna , Anup Manju , Nair Abhilash , Anantharaman Giridhar , Prakash Nimmi
Published: December 2022

Purpose:

To determine if high myopia and glaucoma can be differentiated based on the measurement of superficial vascular density in the peripapillary and macular areas by using Optical Coherence Tomography Angiography (OCTA).

Methods:

This prospective, observational, cross-sectional, comparative study was conducted on patients between 40 and 60 years of age diagnosed as primary open-angle glaucoma (POAG) or high myopia and compared with age-matched controls. The main outcome measures were the difference in SVD% in peripapillary and macular areas in POAG and high myopic eyes. Detailed ophthalmic examination and OCTA of the disc and peripapillary area and macula were performed. The SVD in each zone was calculated using ImageJ software and their difference were analyzed.

Results:

In total, 128 eyes of 70 patients were enrolled. Peripapillary SVD% in controls was 45.07 ± 3.44, 40.36 ± 8.27 in high myopia, and 31.80 ± 9.008 in POAG. The mean difference in peripapillary SVD% of POAG to control was − 13.479, of POAG to high myopia was −8.777 (both P < 0.001), and of high myopia to controls was −4.701 (P = 0.012). Macular SVD% in controls was 27.30 ± 3.438, 22.33 ± 6.011 in high myopia, and 21.21 ± 5.598 in POAG. The mean difference in macular SVD% of POAG to controls was −6.088, of high myopia to controls was −4.965 (both P < 0.001), and of POAG to high myopia was −1.122 (P = 0.984; not statistically significant).

Conclusion:

OCTA is a useful diagnostic tool in distinguishing glaucomatous and myopic eyes. The measurement of peripapillary SVD has a greater discriminatory ability than that of the macular area.
Comparison of stereoacuity in patients of anisometropia, isometropia and emmetropia
Authors: Khan Nida , Zaka-ur-Rab Simi , Ashraf Mohammad , Mishra Aradhna
Published: December 2022

Purpose:

To compare the stereoacuity in patients with anisometropia, isometropia, and emmetropia.

Methods:

A cross-sectional study was conducted on 1403 subjects (range: 5–45 years) divided into anisometropes (n = 403), isometropes (n = 500), and emmetropes (n = 500). There were 258 amblyopic eyes among anisometropes and 156 amblyopic eyes among isometropes. Stereoacuity was measured using the Titmus stereo test consisting of a combination of contour targets.

Results:

There were 675 males and 728 females. A significant (P < 0.001) reduction in stereoacuity was found in anisometropes as compared to isometropes and emmetropes. The stereoacuity was even worse in amblyopes as compared to non-amblyopes. Most patients with anisometropia of <3.0 D had fair stereoacuity. However, as the degree of anisometropia increased to >3.0 D, stereoacuity deteriorated gradually. Marked reduction of stereoacuity was observed in severe degree of anisometropia (>6.0 D). Overall, an anisometropia of ≥2.12 D was associated with reduced stereoacuity. Among the anisometropes, it was found to be the poorest in myopia, followed by myopia with astigmatism, hypermetropia with astigmatism, and hypermetropia.

Conclusion:

The level of stereoacuity was worse in anisometropes as compared to isometropes and emmetropes. Amblyopes had a greater reduction in stereoacuity than non-amblyopes. Stereoacuity decreased as the degree of anisometropia increased. Among the anisometropes, myopes had worst stereoacuity than hypermetropes.
Clinical outcomes of femtosecond laser–assisted cataract surgery versus conventional phacoemulsification: A retrospective study in a tertiary eye care center in South India
Authors: Medhi Santana , Senthil Prasad R , Pai Aruna , Muthukrishnan Gomathi Ramya , Mariammal A , Chitradevi R , Shekhar Madhu
Published: December 2022

Purpose:

To compare the clinical outcomes of femtosecond laser–assisted cataract surgery (FLACS) versus conventional phacoemulsification (CP) in terms of refractive outcomes, cumulative dissipated energy, and intraoperative complications.

Methods:

In this retrospective study performed in a tertiary care ophthalmic hospital, we reviewed 2124 eyes that underwent FLACS or CP. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), cumulative dissipated energy (CDE), and intraoperative complications were analyzed in the study.

Results:

Out of 2124 eyes, 873 underwent FLACS and 1251 underwent CP. The postoperative mean UCVA after one month was 0.05 ± 0.11 logMAR and 0.14 ± 0.23 logMAR for FLACS and CP, respectively (P < 0.00001). Mean CDVA one month post operation was 0.02 ± 0.07 logMAR and 0.06 ± 0.19 logMAR for FLACS and CP, respectively (P < 0.0001). The CDE for the FLACS group was 6.17 ± 3.86 (P < 0.00001) and it was 9.74 ± 6.02 for the CP group. The intraoperative complication for the FLACS group was 1.60% and the CP group was 2.39% (P < 0.00001).

Conclusion:

The visual outcomes were better in FLACS compared to CP. The CDE was lower for the FLACS group and FLACS had significantly less intraoperative complications.
Evaluation of antifungal susceptibility and clinical characteristics in fungal keratitis in a tertiary care center in North India
Authors: Vanathi Murugesan , Naik Ravinder , Sidhu Navneet , Ahmed Nishat Hussain , Gupta Noopur , Tandon Radhika
Published: December 2022

Purpose:

To study the antifungal susceptibility of common corneal pathogenic fungi to antifungal agents in the North Indian population.

Methods:

Prospective study of the antifungal sensitivity testing (natamycin, amphotericin B, voriconazole, itraconazole, fluconazole, posaconazole, caspofungin, micafungin) of fungal isolates from 50 cases of culture positive fungal keratitis by using E test method. Details noted included demographic data, visual acuity, clinical details, grade of keratitis, healing time, and success in medical management.

Results:

Of 50 patients with fungal keratitis (mean age: 40.28 ± 16.77 years), 12 eyes healed within 3 weeks, 14 had a delayed healing response, and 24 had chronic keratitis. Among the 15 cases of Fusarium isolates, 93.3% were sensitive to natamycin, while 40% to amphotericin B; 66.6% to voriconazole, 13.4% to itraconazole and fluconazole each. 80% of Fusarium cases (n = 12) showed susceptibility to posaconazole. Among Aspergillus flavus isolates, 53.4% (n = 8) were sensitive to natamycin, with only 40% (n = 7) showing sensitivity to amphotericin B and good susceptibility to azoles. MIC against susceptible Fusarium spp. for natamycin was 3–16 µg/mL, amphotericin B: 1–8 µg/mL, voriconazole: 0.5–1.5 µg/mL, itraconazole: 0.5–12 µg/mL, posaconazole: 0.094–1.5 µg/mL. MIC against Aspergillus flavus was natamycin: 8–32 µg/mL, amphotericin B: 0.5–16 µg/mL, voriconazole: 0.025–4 µg/mL, itraconazole: 0.125–8 µg/mL, posaconazole: 0.047–0.25 µg/mL; against Aspergillus niger isolates, to natamycin was 6 µg/mL (n=1), amphotericin B 8–12 µg/mL (n = 3), voriconazole: 0.125–0.19 µg/mL (n = 3), itraconazole: 0.38–0.75 µg/mL, posaconazole: 0.064–0.19 µg/mL and against Aspergillus fumigatus (n = 1), was natamycin4 µg/mL, amphotericin B - 8 µg/mL, voriconazole 0.25 µg/mL, itraconazole 1 µg/mL, and posaconazole 0.19 µg/mL. MIC against susceptible Acremonium spp. for natamycin was 1.5–16 µg/mL, amphotericin B: 0.5–8 µg/mL, voriconazole: 0.19–3 µg/mL, itraconazole: 0.125 µg/mL, posaconazole: 0.125–0.5 µg/mL and against susceptible Curvularia was natamycin 0.75–4 µg/mL, amphotericin B 0.5–1 µg/mL, voriconazole 0.125–0.19 µg/mL, itraconazole 0.047–0.094 µg/mL, posaconazole 0.047–0.094 µg/mL. MIC against Mucor spp.+ Rhizopus spp. (n = 1) was natamycin: 8 µg/mL, amphotericin B: 0.75 µg/mL, posaconazole: 1.5 µg/mL. MIC against of Alternaria (n = 1) was voriconazole: 0.19 µg/mL, posaconazole: 0.094 µg/mL. MIC against Penicillium (n=1) was natamycin: 8 µg/mL, voriconazole: 0.25 µg/mL, itraconazole: 0.5 µg/mL, and Posaconazole: 0.125 µg/mL.

Conclusion:

Our observations highlight the variations in susceptibility to antifungal agents. Posaconazole seems to be effective with low MIC against common corneal pathogenic fungal isolates.
Genotype Profiles of Rotavirus Strains in Children under 5-year-old Outpatients with Diarrhea in Bandung, West Java, Indonesia
Authors: Prasetyo Dwi , Ermaya Yudith Setiati , Sabaroedin Iesje Martiza , Widhiastuti Dyah , Bachtiar Novilia Sjafri , Kartasasmita Cissy Bana
Published: December 2022

Introduction:

Diarrhea is a global leading cause of morbidity and mortality among children under five, with rotaviruses being the most common cause. This study aimed to determine the genotypes of rotavirus in children under 5 years with diarrhea in Bandung, Indonesia.

Methods:

This cross-sectional study was conducted from 2014 to 2018 on 450 children under five with acute diarrhea in primary health centers in Bandung, Indonesia. Fecal samples were examined for rotavirus antigen using an enzyme-linked immunosorbent assay method, and genotype was determined through sequencing using polymerase chain reaction. Results were statistically analyzed using Pearson Chi-square in Epi Info version 3.5.4, with P < 0.05 considered statistically significant.

Results:

Rotavirus was identified in 8.9% of the subjects, slightly higher in boys (n = 24, 9.8%) than girls (n = 16, 7.8%). We found that the most rotavirus positive in age group is >12–24 months and >24–59 months, while the highest percentage is at the age of ≤6 months (11.8%). Moderate malnutrition was observed in more subjects (12.8%). Vomiting was more frequent in patients positive (55%, P = 0.013) and fever was seen in 32.5% (P = 0.645). No signs of dehydration were seen in most subjects (75%), P = 0.227. Rotavirus genotypes identified were G1P[8] (18, 45%), G3P[8] (14, 35%), G3P[6] (4, 10%), G3P[9] (2, 5%), G2P[4] (1, 2.5%), and nontypeable (NT) (1, 2.5%).

Conclusions:

The dominant rotavirus genotype is G1P[8], followed by G3P[8], G3P[6], G3P[9], G2P[4], and NT. The most common rotavirus positive in age group is >12–24 months and >24–59 months, while the highest percentage is at the age of ≤6 months.
Capsule-Deficient Cryptococcal Meningitis
Authors: Shende Trupti , Singh Gagandeep , Xess Immaculata , Khullar Swati , Yadav Renu Kumari , Agarwal Reshu , Srivastava M. Vasantha Padma
Published: December 2022

Cryptococcosis is a serious systemic mycosis. Its incidence has escalated in the past four decades. Cryptococcus neoformans causes localized or disseminated infection in immunocompromised and immunocompetent patients. The capsulated form is commonly encountered which can be diagnosed on an India ink preparation or antigen detection. However, the noncapsulated forms are very rare and require a high index of suspicion for correct diagnosis. Herein, we present a case of cryptococcal meningitis due to a noncapsulated strain in an apparently immunocompetent patient with no proven immunodeficiencies along with review of world literature. Such cases are a diagnostic challenge for the clinician as well as microbiologist.
Quality of life after laparoscopic sleeve gastrectomy: Pre-operative, 1-year and 5-year results
Authors: Mouawad Christian , Aoun Rany , Dahboul Houssam , El Feghali Elie , Kassar Serge , Alkassis Marwan , Osseis Michael , Noun Roger , Chakhtoura Ghassan
Published: December 2022

Introduction:

The negative impact of obesity on the quality of life (QoL) and its association with multiple comorbidities is unquestionable. The primary objective of this study was to compare the QoL of patients before, 1 year and 5 years after laparoscopic sleeve gastrectomy (LSG). Secondary objectives were to evaluate the resolution of obesity-related comorbidities and weight loss success.

Materials and Methods:

We included patients who underwent LSG for body mass index (BMI) ≥30 kg/m2 between August 2016 and April 2017 and completed the Moorehead-Ardelt QoL Questionnaire II (MA II). Statistical analysis was conducted using SPSS IBM Statistics for Windows version 21.

Results:

In total, 64 patients participated with a female majority (73.44%) and a mean age of 36.09 with an average BMI at 40.47. Percentage of excess BMI loss and excess weight loss (% EWL) at one and 5 years after surgery went from 90.18% to 85.05% and 72.17% to 67.09%, respectively. The total MA II score before LSG was − 0.39 ± 0.94. Postoperatively, it increased to 1.73 ± 0.60 at 1 year and 1.95 ± 0.67 at 5 years. The positive impact of LSG on QoL was more significant in patients presenting ≥30% of weight loss and in females. At 5 years, a significant improvement in many comorbidities was noted except for arterial hypertension, coxalgia, gastro-oesophageal reflux disease and lower extremities’ varices.

Conclusion:

LSG maintains a long-term QoL improvement, a significant EWL and a resolution of the most common obesity-associated comorbidities such as diabetes, dyslipidaemia and symptoms related to sleep apnoea.