bluuebunny/crossref_metadata_2025 huggingface dataset:
Mengembangkan Kemampuan Motorik Halus Anak Usia 4-5 Tahun Melalui Kegiatan Melukis Dengan Jari di TK Nikita PTPN V Bukit Selasih
Authors: Sari Tri Rahma Karlina , Sulistiyani Sulistiyani , Sulastri Sulastri
Published: February 2024

When these elements perform their respective roles in a positive interaction, meaning that one element is interrelated, mutually supporting, complementary with other elements to achieve a more perfect motor condition. Children with brain disorders appear less skilled in moving their bodies. Finger painting is a painting technique activity without any tools by applying paint to wet paper using the fingers of the hands done by the child to pour his imagination through paintings done by the fingers of the hands by the child. This finger painting technique is a painting technique without the use of tools. This research method uses classroom action research, which is a research method that occurs in the classroom during the interaction between teachers and students. The purpose of this classroom action research is to improve and improve the quality of learning and help empower teachers in solving problems in learning at school, and to improve and improve learning practices at school, as well as to increase the relevance of education, quality of education and efficiency in education management.
Keywords; Finger painting, Fine motor skills, early childhood
Peningkatan Kemampuan Bahasa Siswa Melalui Kegiatan Membaca Permulaan Dengan Menggunakan Kartu Bergambar di Kelompok B TK Santa Thersesia I Pangkalpinang
Authors: Sepryyana Bernadet
Published: February 2024

The low level of early reading skills is the background of why this research was conducted, so this study aims to improve early reading skills through the letter card game method in group B of Theresia I Pangkalpinang Kindergarten. This study used the subject of group B students of Theresia I Kindergarten totaling 18 people.  The object of research focuses on improving the ability to read beginning through the method of playing letter cards. The data collection method used checklist observation, interviews and documentation. The results showed that there was an increase in early reading skills by 22.2% at the end of cycle I and at the end of cycle II an increase of 49.9%. This improvement in early reading skills can be seen from students being able to read pictures, being able to point and point to the letter symbols requested, being able to read simple words and sound the letters in the word, being able to connect pictures with words, being able to arrange letters into meaningful words and, being able to group vowels and consonants. The implementation steps used to improve students' beginning reading skills are by using group competition games, the teacher provides an explanation of the alphabet, and giving verbal awards and applause to the winning group.
Keywords: Language skills, beginning reading, letter card game method
Serum Levels of Interleukin-1 Beta are Decreased in Patients with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis at the Time of Hospitalization
Authors: Huyen Tran Thi , Phuong Pham Thi Minh , Lan Pham Thi , My Le Huyen , Vinh Nguyen Thi Ha , Doanh Le Huu
Published: February 2024

BACKGROUND: Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse drug reactions. Some immunological and genetic factors are believed to be involved in the pathogenesis of the disease, including tumor necrotic factor-alpha, interferon-gamma, and interleukin (IL)-17. IL-1β is one of the most prominent cytokines associated with the innate immune response.
AIMS: The study aimed to evaluate the serum level of IL-1β in SJS/TEN and the relation between it and the progress of SJS/TEN.
METHODS: This was a cross-sectional descriptive study conducted at the National Hospital of Dermatology and Venereology, in Hanoi, Vietnam, from October 2017 to September 2019. 48 SJS/TEN patients, 43 erythema multiforme (EM) patients, and 20 healthy controls (HCs) participated. IL-1β levels were measured using the fluorescence covalent microbead immunosorbent assay (ProcartaPlex Immunoassay Panels kit, Thermo Fisher Scientific, USA). The Mann–Whitney U test was used to compare serum IL-1β levels. The Wilcoxon tests were used to compare quantitative variables before and after the treatment. Differences were considered to be statistically significant at p < 0.05.
RESULTS: 19 SJS patients (39.5%) and 29 TEN patients (60.5%) participated in our study. The mean age was 49.3 years; the range was 19–77 years (47.9% males; 52.1% females). The most common causative drugs were traditional medicine (29.1%), carbamazepine (12.5%), and allopurinol (12.5%). On the day of hospitalization, the mean serum level of IL-1β of the SJS/TEN group was 26.4 ± 81.7 pg/mL, ranging from 0.5 pg/mL to 447 pg/mL. This level was significantly lower than that of the HCs group (p < 0.001) but not lower than that of the EM group. The mean serum level of IL-1β in the SJS/TEN patients on the day of hospitalization was 26.4 ± 81.7 pg/ml, higher than that on the day of re-epithelialization (1.9 ± 5.6 pg/mL) and the difference was statistically significant with p < 0.01.
CONCLUSION: Serum IL-1β level in SJS/TEN patients is lower than in HCs. It is not a good biomarker to differentiate SJS/TEN from EM.
Overview of Leprosy Reactions at Universitas Sumatera Utara Medical Faculty Hospitals between 2017 and 2021
Authors: Lubis Ramona Dumasari , Yosi Ariyati
Published: February 2024

BACKGROUND: Leprosy, or Morbus Hansen, is a chronic granulomatous disease caused by Mycobacterium leprae that involves the skin and peripheral nerves, with or without motor disorders. Leprosy reactions are immune-mediated acute or subacute inflammatory episodes that interfere with chronic disease and are classified into three types: type 1 (RR), type 2 (ENL), and the Lucio phenomenon.
AIM: The purpose of the study is to describe the epidemiology of leprosy reactions at Universitas Sumatera Utara (USU) teaching hospitals and provide a description of factors associated with the reactions that might provide valuable information for future studies.
METHODS: This is a cross-sectional analytic study with total sampling on medical records of patients in the Dermatology and Venereology Polyclinic at H. Adam Malik Hospital Medan and USU Education Hospital in 2017–2021.
RESULTS: The incidence of leprosy reactions at the USU Medical Faculty Education Hospital in 2017–2021 was 41 cases. The majority of reaction types were type 2 reactions (68.3%). Risk factors for type 1 reactions were a history of reactions, being elderly, multiple lesions or nerve involvement, and co-infections, whereas the risk factors for type 2 reactions were LL, younger age, bacterial index >4+, stress, and co-infections. The highest age group proportion was 18–59 years (95.1%) and was more common in men (70.7%), which mostly appeared before treatment (39.1%). The incidence of leprosy reactions was 26 new cases per 100 patients.
CONCLUSION: The highest proportion of leprosy reactions was type 2, within the adult age group (18–59 years), males, and before treatment.
Le Doctor of Business Administration
Authors: Kalika Michel , Platt Stephen
Published: February 2024

Ce chapitre offre au lecteur des perspectives sur la manière dont le DBA répond à un besoin émergent et de plus en plus répandu sur le marché de l’Executive Education pour des formations d’une nature différente de celles offertes par les formations de courte durée conçues pour les cadres supérieurs et les chefs d’entreprise.
Le Doctor of Business Administration
Authors: Collins Claire , McKenzie Jane
Published: February 2024

Le DBA est un doctorat d’une valeur équivalente à celle du PhD, mais il joue un rôle distinct dans le système d’enseignement supérieur. Les programmes sont idéalement conçus pour développer le capital intellectuel des entreprises, car les cadres supérieurs et les dirigeants qui terminent le programme contribuent à la fois aux connaissances académiques de l’entreprise et de la gestion et à l’avancement de la pratique des affaires. Les diplômés continuent généralement à appliquer les capacités de réflexion complexes qu’ils ont développées au profit des organisations et de la société plutôt que de devenir des universitaires à plein temps, bien que certains d’entre eux se lancent dans des carrières multiples. Ce chapitre explore plus en détail les raisons pour lesquelles certains choisissent le DBA plutôt que le PhD et les différences essentielles entre les programmes.
Le Doctor of Business Administration
Authors: Mielly Michelle , Joannidès de Lautour Vassili
Published: February 2024

Avec l’allongement de la durée de la vie active, un nombre croissant de professionnels hautement qualifiés se tournent vers les études doctorales à un âge plus avancé. Cela peut s’expliquer par de nombreux facteurs, notamment l’augmentation du niveau d’éducation, qui fait que le Master est plus omniprésent que jamais, que les années d’activité professionnelle se prolongent au-delà de 60 ans, ou que de plus en plus de professionnels décident de s’orienter vers une carrière universitaire après des années de travail en entreprise. Cela suggère que les normes actuelles en matière de formation doctorale sont en train de changer et continueront à le faire, et que de plus en plus d’organisations embaucheront des experts titulaires d’un doctorat professionnel. Les établissements d’enseignement supérieur devraient concevoir des programmes de doctorat professionnel pour répondre aux besoins de cette population en mettant fortement l’accent sur les implications théoriques et pratiques des résultats de leurs étudiants. En concevant des programmes ayant un impact sur la société et l’organisation, ils pourraient ainsi s’assurer que leurs diplômés contribueront de manière positive à leurs domaines de pratique, même à un âge avancé.
Le Doctor of Business Administration
Authors: Garfield Joy
Published: February 2024

La relation entre le directeur de thèse de DBA et le doctorant est un facteur clé de la réussite du programme. Elle peut être complexe, dynamique et enrichissante non seulement pour le directeur de thèse et le doctorant, mais aussi pour l’université et l’entreprise qui emploie le doctorant. La relation peut également être considérée comme spéciale et comme un partenariat d’égal à égal, mutuellement bénéfique et collaboratif. Comme pour toute relation spéciale, il faut une confiance et un respect mutuels, ainsi que la reconnaissance de l’individualité, de l’expérience et des pressions extérieures qui peuvent avoir un impact sur le parcours de recherche.
Le Doctor of Business Administration
Authors: Collins Claire , McKenzie Jane
Published: February 2024

Une relation constructive et évolutive entre le directeur de thèse et le doctorant est essentielle à la réussite du PhD et du DBA. Cependant, d’après notre expérience, les exigences de la direction de thèse sont différentes lorsque la relation implique des doctorants matures et expérimentés ayant des priorités et des raisons différentes de s’engager dans la recherche par rapport au traditionnel doctorant de PhD ; contribuer à la pratique et à la théorie, étudier et conserver un emploi à temps plein, travailler à distance de la communauté du campus universitaire et rester enraciné dans un domaine de pratique familier qui continue à renforcer les modes de pensées existants, sont autant de tensions qui modifient la dynamique de la relation d’encadrement. Ce chapitre vise à aider les doctorants et les directeurs de thèse à comprendre ce que ces tensions signifient pour établir une relation efficace. En tant que candidat au DBA, il peut être utile de réaliser que votre directeur de thèse travaille dur pour adapter des routines et des pratiques bien établies et performantes afin d’aider à votre progression et à produire une thèse solide qui répond toujours aux mêmes normes académiques qu’un PhD. La communication doit constamment tenir compte des différentes priorités des deux parties dans le partenariat de direction de thèse.
Focus sur les traitements linguistiques d’un projet d’humanités numériques. Édition et cartographie hypertextuelle de réécritures
Authors: Suchecka Karolina , Gasiglia Nathalie
Published: February 2024

Les Humanités Numériques sont des recherches interdisciplinaires invitant des acteurs des SHS à dialoguer entre eux et avec les sciences informatiques. Notre projet réunit littérature, linguistique et informatique pour élaborer l’édition savante numérique des réécritures du mythe d’Orphée et Eurydice, dans laquelle nous détectons, à l’aide d’outils informatiques dédiés, les réemplois intertextuels. Dans cet article, nous comparons d’abord l’efficacité de techniques linguistiques-informatiques permettant leur détection, nous démontrons ensuite, en présentant comment apparier des dénominations d’entités, que l’intégration de méthodes linguistiques améliore la qualité des résultats.
Histoire et linguistique. L’enjeu éthique de l’événement discursif : la parole des sans
Authors: Guilhaumou Jacques
Published: February 2024

Jacques Guilhaumou présente un bilan des relations entre histoire et linguistique depuis l’apparition, au cours des années 1970-1980, d’une discipline scientifique nouvelle, l’analyse du discours. Il propose ensuite deux exemples de travaux en histoire du discours situés dans le champ de la parole des « sans ». Il s’agit en premier lieu d’une description discursive sur la base d’un corpus d’entretiens de « dits exclus » et en second lieu d’une analyse performative du corpus « Le Vrai Débat » des Gilets jaunes.
Linguistique et archéologie (et paléogénétique)
Authors: Demoule Jean-Paul
Published: February 2024

Les relations entre archéologie et linguistique sont consubstantielles, dans la mesure où l’archéologie a d’abord été définie comme une « science auxiliaire de l’histoire », l’essentiel des sources étant les textes, que l’archéologie ne venait que compléter. Au cours du XXe siècle l’archéologie, en développant de nouvelles méthodes, a pris son indépendance pour devenir l’étude des sociétés à travers leurs vestiges matérielles. Parmi ces méthodes, l’informatique a joué très tôt un rôle essentiel afin de traiter des masses de données, ce qui impliqua leur formalisation. Par ailleurs, préhistoire et linguistique ont convergé dans la recherche problématique d’une « langue-mère », recherche très en vogue dans les années 1990, avant de l’être moins ensuite. En revanche, cette même association, maintenant complétée par la génétique, s’est efforcé depuis deux siècles d’expliquer historiquement l’existence de grandes familles linguistiques, celle des langues indo-européennes avant tout, mais aussi austronésiennes et langues bantoues. À ce stade de nos connaissances, il semble que les modèles purement migrationnistes et arborescents méritent d’être complétés par des modèles en réseaux.
Validation psychologique d’hypothèses linguistiques, et inversement. Autour de l’expression « du coup »
Authors: Col Gilles , Knutsen Dominique
Published: February 2024

Nous proposons une rencontre entre nos disciplines respectives, psychologie et linguistique, afin d’étudier une question relevant des deux disciplines mais généralement traitée séparément. Notre tentative est une recherche de confluence disciplinaire, à partir des qualités et des défauts de chaque discipline. Notre objectif est d’analyser à différentes échelles d’observation une question concernant la langue et les processus langagiers : l’expression « du coup » en dialogue. Nous estimons qu’une analyse à deux voix distinctes et complémentaires devrait nous permettre aussi de cerner une question langagière complexe.
Langage et système de soins. Répétition et dilution
Authors: Velut Stéphane
Published: February 2024

Le monde hospitalier recèle, depuis deux décennies environ, les mêmes discours managériaux que celui de l’entreprise. À travers quelques exemples puisés dans des courriels internes, séminaires de management et textes officiels, deux formes particulières de langage sont analysées. La première utilise un procédé de répétition de termes tendant à rendre insignifiant le texte tout en trahissant non tant l’intention de son auteur que sa conception de la subordination. La seconde vise à noyer la lecture dans un excès de formules consensuelles oblitérant le sens même du texte et, souvent, sa vacuité.
Enjeux sémiotiques et construction du sens en mathématiques
Authors: Venant Fabienne
Published: February 2024

Le langage est une thématique active dans le champ de la didactique des mathématiques. Dans les dernières décennies, les aspects sémiotiques ont pris une importance croissante, notamment grâce aux travaux menés dans le paradigme socio-culturel, fondé sur les travaux de Vygotsky et de Bakhtine. Dans ces recherches, le langage est abordé pour son rôle dans le développement de la pensée, la conceptualisation mathématique et le développement d’un raisonnement mathématique. Le but de ce texte est de présenter quelques-uns des enjeux sémiotiques dans l’enseignement et l’apprentissage des mathématiques et d’illustrer brièvement l’utilisation de modèles sémiotiques pour comprendre les processus de formation des connaissances mathématiques.
L’expression du point de vue en lexicographie spécialisée : la linguistique au carrefour du droit et de l’économie
Authors: Petit Mélanie
Published: February 2024

Dans une perspective interdisciplinaire, nous proposons d’étudier les marques linguistiques de l’expression du point de vue dans des dictionnaires spécialisés en droit et en économie, sous forme imprimée et numérique. Les dictionnaires étudiés n’étant pas exempts de formulations d’opinion, nous nous interrogerons sur les problèmes posés par la présence de celles-ci dans des ouvrages supposés garants d’objectivité et destinés à des apprenants. La dimension formelle des dictionnaires est prise en considération car elle peut aussi potentiellement orienter le lecteur dans une direction prédéfinie.
Traitement du signal et linguistique
Authors: Ravier Philippe
Published: February 2024

Cet essai témoigne de l’interdisciplinarité entre la linguistique et le traitement du signal. Les fondements du traitement du signal sont présentés, ainsi que des travaux des linguistes visant à modéliser le rôle de la prosodie en sémantique de l’oral. Les deux mondes sont réunis dans une expérience où la prosodie, caractérisée grâce aux outils de traitement du signal, est le vecteur discriminant utilisé pour une classification sémantique automatique des mots du discours. Dans cette tâche délicate, un processus de navette entre les caractérisations prosodique (traiteurs de signaux) et sémantique (linguistes) est mis en évidence dans l’idée de définir conjointement des catégories interprétatives qui sont prosodiquement pertinentes.
MULTI-LABEL CLASSIFICATION OF THORACIC DISEASES USING STRUCTURED DEEP LEARNING FRAMEWORK
Authors: Arora Ruchika , Saini Indu , Sood Neetu
Published: February 2024

The current medical scenario indicates that thoracic diseases are the primary cause of illnesses of human beings worldwide. COVID-19 outbreak results in the generation of tremendous Chest X-Ray (CXR) and Computed Tomography (CT) image data archives because CXR and CT imaging are the foremost effective screening tools that characterize patterns and features of pathologies present in the lungs. After careful observation, these chest radiographs show that images are often labeled with more than one pathology, that extends disease diagnosis problem to tedious multi-label classification task. So, this paper proposes a modified mish activation function and compound loss-based Separable Convolution Neural Network (SCNN) model that accomplishes image-level detection of multiple pathologies and COVID-19 from multi-modality chest radiographs. We investigate the power of separable convolution in the CNN network that interprets spatial and depth-wise dimensions of each pixel in CXR and CT images. A modified mish called as Swmish, a non-monotonic activation function, is introduced that preserves negative gradient flow of input and capture fine-grained detail of multiple regions. Moreover, a compound loss function of dice coefficient and binary cross entropy is applied that strongly optimizes the model during training. The generality of the proposed SCNN model is confirmed after conducting comprehensive experiments on multi-label CXR and COVID19-CT datasets. The proposed model gains an AUC score of 0.91 and loss of 0.13 on the multi-label CXR dataset and achieves a testing accuracy of 0.97, AUC score of 0.99 and a loss of 0.11 on the COVID19-CT dataset. These results show that the proposed model achieves highest evaluation metrics in classifying binary and multi-label thoracic abnormalities from multi-modality chest radiographs.
Acute Hyperoxia Improves Spinal Cord Oxygenation and Circulatory Function Following Cervical Spinal Cord Injury in Rats
Authors: Lin Yen-Ting , Gonzalez-Rothi Elisa J. , Lee Kun-Ze
Published: February 2024

Spinal cord injury is associated with spinal vascular disruptions that result in spinal ischemia and tissue hypoxia. This study evaluated the therapeutic efficacy of normobaric hyperoxia on spinal cord oxygenation and circulatory function at the acute stage of cervical spinal cord injury. Adult male Sprague Dawley rats underwent dorsal cervical laminectomy or cervical spinal cord contusion. At 1–2 days after spinal surgery, spinal cord oxygenation was monitored in anesthetized and spontaneously breathing rats through optical recording of oxygen sensor foils placed on the cervical spinal cord and pulse oximetry. The arterial blood pressure, heart rate, blood gases, and peripheral oxyhemoglobin saturation were also measured under hyperoxic (50% O2) and normoxic (21% O2) conditions. The results showed that contused animals had significantly lower spinal cord oxygenation levels than uninjured animals during normoxia. Peripheral oxyhemoglobin saturation, arterial oxygen partial pressure, and mean arterial blood pressure are significantly reduced following cervical spinal cord contusion. Notably, spinal oxygenation of contused rats could be improved to a level comparable to uninjured animals under hyperoxia. Furthermore, acute hyperoxia elevated blood pressure, arterial oxygen partial pressure, and peripheral oxyhemoglobin saturation. These results suggest that normobaric hyperoxia can significantly improve spinal cord oxygenation and circulatory function in the acute phase after cervical spinal cord injury. We propose that adjuvant normobaric hyperoxia combined with other hemodynamic optimization strategies may prevent secondary damage after spinal cord injury and improve functional recovery.
Tripartite Motif-containing Protein 11 Silencing Inhibits Proliferation and Glycolysis and Promotes Apoptosis of Esophageal Squamous Cell Carcinoma Cells by Inactivating Signal Transduction and Activation of Transcription Factor 3/c-Myc Signaling
Authors: Xuan Tingting
Published: February 2024

Esophageal squamous cell carcinoma (ESCC) is a common type of human digestive tract cancer with poor survival. Tripartite motif-containing protein 11 (TRIM11) is an oncogene in certain cancers that can regulate glycolysis and signal transduction and activation of transcription factor 3 (STAT3) signaling. This study was designed to investigate the role and the mechanism of TRIM11 in ESCC. First, TRIM11 expression in ESCC tissues and the correlation between TRIM11 expression and prognosis were analyzed using bioinformatics tools. After TRIM11 expression was detected by Western blot in ESCC cells, TRIM11 was silenced to evaluate its effect on the malignant phenotypes of ESCC cells. Cell proliferation and apoptosis were assessed by cell counting kit-8 assay, ethynyl-2’- deoxyuridine staining, and flow cytometry, respectively. The glucose uptake and lactate secretion were detected to examine glycolysis. In addition, Western blot was employed to detect the expression of proteins related to apoptosis, glycolysis, and STAT3/c-Myc signaling. Then, ESCC cells were treated with STAT3 activator further to clarify the regulatory effect of TRIM11 on STAT3/c-Myc signaling. TRIM11 was upregulated in ESCC tissues and cells, and high expression of TRIM11 was associated with a poor prognosis. TRIM11 knockdown inhibited the proliferation and glycolysis while facilitating apoptosis of ESCC cells. Besides, the expression of p-STAT3 and c-Myc was significantly downregulated by TRIM11 silencing. Of note, the STAT3 activator partially reversed the effects of TRIM11 depletion on the proliferation, apoptosis, and glycolysis in ESCC cells. Collectively, TRIM11 loss-of-function affects the proliferation, apoptosis, and glycolysis in ESCC cells by inactivating STAT3/c-Myc signaling.
Ocular Hypotony Causing Choroidal Detachment Following Scleral Fixation of Intraocular Lens − A Case Report
Authors: Saka Idris , Balogun Modupe , Yusuf Gafar Folohunso
Published: February 2024

This article reports a case of choroidal detachment (CD) probably from reduced volume of the globe and ocular hypotony following scleral fixation of intraocular lens (SFIOL) in a diabetic. Ocular hypotony is a complication of intraocular surgeries such as glaucoma filtering procedures, penetrating keratoplasty, and vitreous surgery. Urgent identification and management of CD is important to ensure a favorable visual outcome. We report a case of CD from prolonged ocular hypotony (OH) following SFIOL in a Nigerian male. Our patient was a 59-year-old diabetic male who presented with poor vision in left eye following cataract surgery. Left eye examination revealed quiet anterior segment with aphakia and a normal posterior segment. A +10 Dioptre sphere lens over the index eye improved visual acuity to 6/12. He was scheduled for SFIOL which was uneventful. He developed sudden decline in vision 1 week postoperative, examination revealed a serous choroidal detachment that resolved completely with high dose oral and topical steroids, systemic vitamin C, and doxycycline to a final unaided visual acuity of 6/24 at 2 weeks, and 6/9 at 3 months.
Neuro-ophthalmic abnormalities among patients with stroke in a tertiary institution in Nigeria
Authors: Yusuf Ibrahim Abiodun , Mahmoud Abdulraheem Olarongbe , Wahab Wasiu Kolawole , Aderounmu Azeezat Bola
Published: February 2024

Context: Despite the high burden of stroke in Nigeria, there is paucity of information on the prevalence of neuro-ophthalmic abnormalities, presence of which may negatively impact the rehabilitation of the patient. Aim: This study aimed to determine the prevalence of neuro-ophthalmic abnormalities and provide evidence for the inclusion of neuro-ophthalmic care in the holistic management of stroke patients in order to provide high-quality integrated ophthalmic and stroke services in tertiary facilities across the country. Materials and Methods: Consecutively consenting patients within 3 months of stroke who met the inclusion criteria were recruited. Information was obtained in a standardized manner and each patient had a neuro-ophthalmic examination conducted. Frequency of neuro-ophthalmic abnormalities was determined. Associations between neuro-ophthalmic abnormalities and location of stroke were determined and a P value <0.05 was taken as significant. Results: A total of 100 patients with a mean age of 61.0 ± 12.64 (range 28–95) years were recruited, and males made up 62.0%. The major risk factors for stroke were hypertension (91.0%) followed by diabetes mellitus (25.0%) and dyslipidemia (11.0%). Most (80%) subjects had ischemic stroke, and subcortical location (35.0%) was the most common site of stroke. Neuro-ophthalmic abnormalities were present in 23.5% of the cases. There was a statistically significant correlation between the individual neuro-ophthalmic findings and the location of injury in the brain (P < 0.001). Conclusions: Neuro-ophthalmic abnormalities are prevalent among stroke patients; hence, early detection and care for these abnormalities should be integrated into management to improve outcome and patients’ quality of life after stroke.
Glaucomatocyclitic Crisis in a Nigerian Child
Authors: Sarimiye Tarela F. , Adebusoye Steve
Published: February 2024

Background:

Glaucomatocyclitic crisis is a condition that elicits significant elevated intraocular pressure (IOP) with minimal non-granulomatous anterior uveitis. It is usually unilateral, occasionally recurrent, and easily treatable in most cases. It is seen mainly in young adults but is rarely reported in children. This is to report an uncommon case of glaucomatous cyclitic crisis (Posner-Schlossman syndrome) in a Nigerian child.

Case report:

A 15-year-old boy presented with pain, haloes around light, photophobia, and decreased vision in the left eye over the course of the day. He has a similar history from 5 years ago, with a brief resolution on steroid eye drops. Ocular examination in the left eye revealed minimal non-granulomatous anterior uveitis with significantly elevated intraocular pressure. He was treated with topical steroid and ocular hypotensive and his IOP was 14 mmHg at 14 hours, down from 44 mmHg at the start. The anterior chamber was quiet by the fourth day of treatment. The clinical picture in this child was consistent with Posner-Schlossman syndrome. Following resolution of the inflammation and discontinuation of all medications, the patient is being followed up as a glaucoma suspect because of the subtle disc finding and the slight risk of glaucoma development later.

Conclusion:

Although glaucomatocyclitic crisis is uncommon in children, it should be considered in the differential diagnosis of uveitis and glaucoma in paediatric patients.
Bilateral Congenital Anophthalmia and Hydrocephalus in Calabar, Nigeria: A Case Report
Authors: Nkanga Elizabeth D. , Okonkwo Sunday O. , Jimoh Abdulrasheed. , Ochigbo Sunday O. , Nkanga Dennis G. , Udoh Jacob J.
Published: February 2024

Congenital anophthalmia is a rare deformity with a complex aetiology. It can co-exist with disorders of central nervous system. The aim of this report is to present the socio-demographic, clinical data and management challenges of an abandoned HIV-exposed neonate with bilateral congenital anophthalmia and hydrocephalus, in Calabar, Nigeria.

A 6-day-old female term neonate presented to the Newborn Intensive Care Unit of a tertiary hospital in Calabar, Nigeria, with a history of inability of mother to see the baby’s eyeballs since birth. There was no family history of a similar eye defect, consanguinity, or other associated histories. Ophthalmic examination findings included: mucopurulent discharge, shortened eyelids and palpebral fissure and absent eyeballs. A Transfontanelle ultrasound scan of the large head showed an obstructive hydrocephalus. Mother abandoned the baby in the hospital.

Management of bilateral congenital anophthalmia is multidisciplinary. There may be an association with HIV infection. Abandonment of malformed babies is of psychosocial importance.
Eyelid Sarcoidosis Lesion in Abuja, Nigeria
Authors: Okudo Adaora C. , Babalola Olufemi E. , Umobong Emanso O. , Titiloye Hilda A.
Published: February 2024

We report a case of sarcoidosis involving the eyelid in a Nigerian setting. Lid masses are sometimes overlooked by patients and attending physicians. This report is on a 47-year-old Ghanaian male who presented to private eye clinic in Abuja, Nigeria. He had multiple eyelid lesions, skin lesions on his scalp, back of his ear and neck. He had a history of coughing and wheezing. Histopathology of skin biopsy confirmed that they were sarcoid lesion. Chest X-ray showed hilar lymphadenopathy. He was placed on tablets prednisolone 20 mg daily for 8 weeks. The symptoms abated and have not reoccurred 3 years posttreatment. In conclusion, atypical eyelid lesions with pulmonary involvement should be biopsied and sent for histopathology. Systemic steroids are effective in treating lid involvement of sarcoidosis. The management of sarcoidosis requires a multidisciplinary approach between the physician, dermatologist, and ophthalmologist.
Unilateral Orbital Compartment Syndrome Unmasking Dengue Haemorrhagic Fever: An Unusual Presentation
Authors: Singh Ankita , Saraswat Aatish
Published: February 2024

Dengue fever may be a potentially life-threatening condition owing to massive capillary leakage and severe bleeding, causing dengue shock syndrome. The earlier literature did not classically describe ophthalmic manifestations in dengue fever. We report a case of a 43-year-old male who presented with sudden onset swelling and pain in the left eye for 2 days along with a history of fever with myalgia for 5 days, for which he did not take any treatment. After a clinical evaluation, a provisional diagnosis of orbital compartment syndrome was made, which required urgent decompression. On investigation, the patient had thrombocytopenia (platelet count of 10,000/μL). A positive dengue non-structural protein-1 (NS-1) antigen, along with thrombocytopenia, confirmed the diagnosis of dengue haemorrhagic fever. Dengue IgM antibodies were also found to be positive. The patient was given supportive therapy and urgent platelet transfusions. Lateral canthotomy for orbital decompression, performed after platelet transfusion. However, retropulsion was not possible despite the surgical intervention. During the follow-up period, the left eye chemosis was slightly reduced. However, the visual acuity did not show improvement in the left eye throughout the follow-up. It is recommended that ophthalmologists be aware of such ocular manifestations as the likely initial presentation of dengue fever. Prompt and appropriate treatment through a multidisciplinary approach should prevent sight-threatening complications.
Clinical and demographic review of corneal ulcers in University of Ilorin Teaching Hospital
Authors: Adepoju FG , Tota-Bolarinwa BT , Abikoye PO , Okeke GO , Alafe HS
Published: February 2024

Background: Corneal ulceration is one of the major causes of avoidable blindness and visual impairment globally. Objectives: The aim of this study was to analyze clinical and demographic data of corneal ulcers at the Department of Ophthalmology, University of Ilorin Teaching Hospital (UITH), Ilorin, Kwara state between 2017 and 2021. Methods: A retrospective survey of all cases of corneal ulcer under review period was done. Demographic and clinical data were retrieved from hospital records and analyzed using Statistical Package for Social Sciences (SPSS) version 20. Results: A total of 92 cases were reviewed, consisting of 66 males, majority (76.1%) are married, and traders and artisan accounted for 54.3%. The age ranges from 6 months to 78 years with 41.2 years as average. The major identified risk factors were trauma (16.3%) and harmful traditional medications (13%). Visual acuity (VA) in 82.6% of the patients at presentation was <3/60 to no perception of light (NPL), while 10.9% presented with VA of 6/6 to 6/18. The most dominant causes of corneal ulcers were microbial keratitis (72.8%) and hypopyon keratitis (12.5%). Time of onset to presentation was within 1 week in 33 patients (35.9%), 29 patients (31.5%) after a week, while others presented over a month. After treatment, VA was 69.5% (<3/60–NPL), 21.7% (6/6–6/18), and 8.7% (6/18–3/60). Five patients had evisceration, two out of which were auto-evisceration. Conclusion: Ocular trauma was the most common risk factor with microbial keratitis as the most dominant cause. Poor treatment outcome resulted from late presentation, use of herbal, self and over-the-counter medications. Appropriate health promotion activities need to be conducted to address the identified risk factors at all levels of care.
A Case of Usher Syndrome Presenting with a Right Lamellar Hole
Authors: Babalola Yewande Olubunmi
Published: February 2024

A 23-year-old lady presented to the Eye Clinic with poor night vision since childhood, worse in the right eye. There was an associated history of difficulty hearing noticed by her mother, which has progressively worsened. The presenting visual acuity was hand movement in the right eye and 6/60 in the left eye, respectively. She gave a history of recent and frequent involvement in domestic and road traffic accidents, which precipitated her presentation to the eye clinic. There were no concurrent systemic illnesses. Binocular indirect ophthalmoscopy revealed bilateral widespread bone spicule pigmentation, waxy disc pallor, and attenuated vessels with bilateral atrophic changes worse in the left eye. The optical coherence tomography scan revealed a lamella hole in the right eye. The otorhinolaryngologist made a diagnosis of sensorineural deafness. A diagnosis of Usher syndrome with a right lamellar hole was made in light of the clinical findings.
Retinoblastoma in a Referral Center in Nigeria
Authors: Ademola-Popoola Dupe S. , Yusuf Ibrahim A. , Obajolowo Tokunbo S. , Akinremi Sikirat O. , Gobeh A.S.
Published: February 2024

Background:

Improvement in survival from retinoblastoma (RB) improved to about 98% in developed countries because of early presentation and prompt intervention at designated RB care center, whereas in low-resourced countries, late presentations and poor survival are not unusual. This study reviews the changing pattern of presentations over a 7-year period when various efforts were deployed to improve early presentation and intervention in a low-resourced setting.

Materials and methods:

Data were extracted from RB clerk sheets that were used for documentation of clinical records of patients with RB managed at a single tertiary referral center for RB in Nigeria between 2013 and 2019. The data were analyzed for changing trend of clinical presentation and lag time. Ethical approval was obtained from the institution.

Results:

Two hundred and twenty-two eyes of 148 children were reviewed. There were 79 males and 69 (46.6%) females, and male to female ratio was 1.14:1. There were 74 (50%) unilateral, 72 (48.6%) bilateral, and 2 (1.4%) trilateral cases.

Discussion:

Overall, 66 (44.6%) and 82 (55.4%), patients had shown symptoms by 6 months and 1 year, respectively, whereas only 39 (25.7%) had presented by 1 year. Early disease stage presenting as leukocoria increased from 22.2% to 85.7%, whereas late presentation as proptosis declined from 55.5% to 10.7% between 2013 and 2019. Some cases were identified during vision screening performed by community health workers during routine immunization at primary healthcare clinics. At presentation, 188 (84.7%) RB eyes were intraocular, 32 (14.4%) orbital, and 2 (0.9%) had systemic spread. The median of the lag-time (delay) between when symptom was noticed to presentation reduced gradually each year by 1 month, from a median of 9 months in 2013 to 4 months in 2018.

Conclusions:

In Nigeria, early presentation as leukocoria increased, whereas late presentation as proptosis and lag time in RB reduced significantly from year 2013 to 2019 which was supported by deliberate efforts to educate the public and institute training across all levels of health care. In low-resourced country like ours, achieving early presentation of RB cases would increase the survival of affected children.
Association between contrast sensitivity and disease severity in primary open-angle glaucoma
Authors: Onoja Okwori Peter , Eze Ugochukwu Anthony , Kator Chaha , Lawan Abdu
Published: February 2024

Background:Glaucoma, a leading cause of irreversible visual impairment, is characterized by progressive optic neuropathy. Early detection of glaucoma and initiation of appropriate treatment modalities can prevent visual loss. We aimed to use the Mars Letter Contrast Sensitivity Test (MLCST) chart to evaluate our glaucoma patients and assess factors that may influence it.Methods:This was a hospital-based cross-sectional, comparative descriptive study with a total of 50 glaucoma patients and 50 normal participants (controls) who were age- and sex-matched for the study. All participants underwent a detailed ocular history and examination before undergoing central visual field analysis using the Humphrey visual field analyzer, and then a contrast sensitivity (CS) test was performed using MLCST.Results:There was a statistically significant difference between the mean CS of the control group (1.67 ± 0.09) and the glaucoma group (1.40 ± 0.17). Using the mean defect (MD) from perimetry to determine disease severity, there was a progressive reduction in the mean CS in mild glaucoma (1.58 ± 0.17) compared to moderate (1.44 ± 0.11) and severe glaucoma (1.29 ± 0.20) at aPvalue of <0.001. The MD, best-corrected visual acuity, and cup-to-disc ratio were significantly different between the two groups (P< 0.05). These variables also correlated negatively with the CS test in glaucoma patients (r = −0.32,P = 0.001;r = −0.33,P = 0.001;r = −0.41,P< 0.001, respectively).Conclusion:CS is significantly depressed in patients with glaucoma, with a progressive reduction in CS as the disease severity worsens.
The Impact of the COVID-19 Pandemic on Postgraduate Ophthalmology Training Program in Nigeria
Authors: Sarimiye Tarela F. , Monye Henrietta , Olawoye Olusola , Hughes Sowunmi
Published: February 2024

Background:

The severe acute respiratory syndrome coronavirus 2 which causes coronavirus disease 2019 (COVID-19) has resulted in a challenging and an unprecedented pandemic in the 21st century. This pandemic affects almost all aspects of human life including the medical field.

Methods:

This was a cross-sectional, descriptive multicenter survey of resident doctors in ophthalmology training programs in Nigeria. An anonymous web survey was created on Google form and circulated to ophthalmology residents in Nigeria using electronic communication tools between April and July 2020.

Results:

Seventy-two ophthalmology residents in 25 residency training institutions across five geopolitical zones of the country participated in the online survey. There was a significant decrease in the number of patients attended to in the clinic per week by respondents, time spent in consulting per patient, number of unit admissions per week, frequency of eye camps and outreaches per month, and number of surgeries performed by the unit per month (P = 0.000) in the COVID era compare to the pre-COVID era. Two-thirds of respondents felt their posting schedules had been affected at least to a moderate extent, this in turn affected their eligibility for examinations. Three-quarters of the respondents also felt that the pandemic had negatively affected trainer–trainee and mentor–mentee relations in terms of knowledge transfer. Respondents recommended a greater focus on online learning.

Conclusion:

In this survey, the impact of the COVID-19 pandemic has been shown to negatively impact ophthalmology residency training. A need for a paradigm shift in training may be the way forward.
Impact of Covid-19 on clinical care among patients attending the Glaucoma clinic of University of Ilorin Teaching Hospital
Authors: Obajolowo Tokunbo Sarah , Ibrahim Yusuf Abiodun , Aderounmu Azeezzat Bola , Adeoti Sodiq Gbolahon , Olatunji Fatai Olasunkanmi
Published: February 2024

Background: The outbreak of this novel disease brought about many challenges in non-COVID-19 patient care, including difficulty accessing eye care services, especially in developing countries. This study aimed to determine the impact of COVID-19 pandemic on clinical care among patients attending the glaucoma clinic of a teaching hospital. Methods: A hospital-based cross-sectional study was carried out at the glaucoma clinic of the teaching hospital. Clinic records of participants were reviewed, and questionnaires were filled out over the phone by a trained ophthalmic assistant. Results: One hundred and five participants were recruited into the study with a M:F of 1.6:1 and a mean age of 51.1 years (±18.9). As a primary treatment for glaucoma, 58 (55.2%) participants were on intra-ocular pressure (IOP)-lowering medication, while 43 (40.9%) participants had trabeculectomy with mitomycin C application. Seventy (66.7%) participants missed their clinic appointment on an average of 1.52 ± 1.0 (SD) and a range of between one and five. Most of the participants (52, 51.5%) missed their clinic appointment largely on the assumption that the clinic was not running. Thirty-one (29.5%) participants reported that they experienced a reduction in income as a result of the pandemic, which affected the procurement of intra-ocular pressure (IOP)-lowering medications. Conclusion: Effective delivery of clinical care for participants was severely affected by the pandemic. Social, economic, and financial status of participants were all affected, which had a negative effect on the maintenance of quality care and may worsen IOP control in glaucoma care, which may lead to disease progression.
Factors Associated with Dropout from Community Mental Health Clinic in Chandigarh during COVID-19 Pandemic
Authors: Sidana Ajeet , Agrawal Abhinav , Kaur Jaswinder
Published: February 2024

Background:

Dropout of patients with mental illness is high. There is inadequate research on dropout of patient with mental illness from community mental health clinics.

Aim:

The aim of the study was to assess the dropout rate from three community mental health clinics and evaluate factors associated with dropout in relation to the patient, caregivers, community clinics, and COVID-19 pandemic.

Methods:

Patients aged 18 years and above registered in community outreach clinics (COC) from March 24, 2018, to March 23, 2020, i.e., before the lockdown, for treatment of mental illnesses including substance use disorders (SUDs) were included in the study. Responses on factors associated with dropout were collected on predesigned questionnaire telephonically after resumption of regular clinics.

Results:

A total of 5450 patients were registered at COCs. Neurotic and anxiety disorders, SUDs, and bipolar affective disorders were the common diagnoses. The dropout rate was 21%. Sixteen percent of patients did not perceive the need to continue treatment against 84% who felt the need for treatment. However, 87% already felt improvement with treatment. Thirty percent of patients were concerned about side effects of medicine and 52% expressed difficulty to purchase medicines from market, in case of nonavailability of free medicines. Forty-nine percent of patients reported fear of contracting COVID-19 infection as the reason for dropout postlockdown.

Conclusion:

Fear of contracting COVID-19, compulsory testing, and quarantine was the reasons for dropout attributable to the pandemic. Patients-related and medication-related factors were other major reasons for dropout.