bluuebunny/crossref_metadata_2025 huggingface dataset:
Cross-linked hyaluronic acid viscoelastic scleral implant in trabeculectomy
Authors: Mudhol Rekha , Bansal Rolika
Published: May 2021

Purpose:

Patients with glaucoma undergoing trabeculectomy develop bleb cicatrix causing poor postoperative intraocular pressure (IOP) control and low success rates. Several approaches have been explored over the years for better outcomes. This study assesses the safety, efficacy, and outcome of trabeculectomy with HealaFlow® (Anteis S. A, Geneva, Switzerland), a high-molecular-weight cross-linked hyaluronic acid viscoelastic gel, and comparing it with the antimetabolite Mitomycin-C (MMC).

Methods:

A prospective, interventional, case-controlled study conducted at a tertiary care hospital in Southern India on 60 eyes of patients requiring trabeculectomy divided in two groups – HealaFlow scleral implant and adjuvant low-dose MMC (0.1 mg/mL). Postoperative IOP reduction along with bleb morphology was assessed over follow-up at 1 week, 1 month, 3 months, 6 months, and 12 months.

Results:

Preoperatively IOP in the two groups was statistically similar. Postoperative IOP on day 1 had statistically significant reduction in both groups with greater reduction in MMC group. However, by 12 months, the IOP reduction was statistically similar in both groups, i.e., 46.24% (to 11.04 ± 2.55 mmHg) and 54.47% (to 11.99 ± 3.37 mmHg) in HealaFlow® group and MMC group, respectively (P > 0.05). The bleb morphologies were similar and complications were seen equally, which resolved by 4 weeks. A complete success rate of 89.29% and a qualified success rate of 10.71% were observed equally in both groups.

Conclusion:

Absorbable biosynthetic cross-linked hyaluronic acid and low-dose MMC are equally safe and efficacious in trabeculectomy with significant IOP reduction and good bleb morphology. Therefore, it is a novel substitute for MMC.
Perspectives of physicians regarding the role of webinars on medical education during the COVID-19 pandemic
Authors: Odayappan Annamalai , Venkatesh Rengaraj , Tammineni Raveendra , Nachiappan Sivagami , Iswarya Mani
Published: May 2021

Purpose:

To understand the perspectives of physicians regarding the role of webinars on continuing medical education.

Methods:

An online survey comprising of 34 questions in nine sections was conducted using Google Forms. The link for the questionnaire was shared via e-mail and social media to practicing physicians. The survey accepted responses from September 10, 2020, to September 30, 2020.

Results:

In total, 509 ophthalmologists and 91 physicians from other specialties participated in the survey. The physicians were predominantly employed in nongovernmental institutes (25%) or were in private practice (33.2%). The preference was to attend a weekend webinar (62.8%), in the evening (52.8%), not extending more than 2 hours (97.7%), by ≤3 reputed national speakers (89.8%), each given 15 to 30 minutes for their presentation, and the topic being clinical or surgical skill demonstration (47.5%) or recent advances (39.5%). The residents were perceived to be the most benefited (65.3%). There was an equal preference for watching a webinar live or recorded (50.7% vs. 49.3%). Zoom Video Communications, Inc., was described as the platform that offers the best experience (43.8%). Webinars were considered to be better than conferences or continuing medical education (CME) activities (55.8%). The majority (43.8%) also preferred to get CME credit points by attending paid webinars. However, the broad consensus was that webinars should not completely replace the conferences (42.5%).

Conclusion:

Our survey evaluated the participants’ perspective and the advantages and the disadvantages of a webinar and provides suggestions for the conduct of an ideal webinar with maximum active participation. Future programs would greatly be benefited by this survey.
Orbital and adnexal amyloidosis: Thirty years experience at a tertiary eye care center
Authors: Banerjee Prabrisha , Alam Md. Shahid , Subramanian Nirmala , Kundu Debi , Koka Kirthi , Poonam Nisar Sonam , Mukherjee Bipasha
Published: May 2021

Purpose:

The aim of this work was to study the clinical presentation, management and outcomes of orbital and adnexal amyloidosis.

Methods:

This retrospective analysis included all the patients diagnosed with orbital and adnexal amyloidosis between January 1990 and December 2019. Positive staining with Congo Red and apple-green birefringence on polarized light microscopy established the diagnosis. Data analyzed included demographic profile, varied presentations, management, and outcome.

Results:

Thirty-three eyes of 26 patients were included. The male:female ratio was 1:1. The mean age of the study population was 42.6 ± 16 years. The median duration of symptoms was two years. Unilateral involvement was seen in 19 eyes (right = 11, left = 8). The most common presenting feature was acquired ptosis. Eyelid was the most commonly affected site followed by orbit and conjunctiva. Two patients had systemic involvement in the form of multiple myeloma and lymphoplasmacytic lymphoma. Complete excision was done in seven (26.9%) cases while 19 (73.1%) cases underwent debulking. Three patients underwent ptosis surgery. The median duration of follow-up was 1.5 years. Three cases had recurrence and underwent repeat surgery.

Conclusion:

Orbit and adnexa is a rare site for amyloidosis. It is usually localized; however it can occur as a part of systemic amyloidosis. Eyelid is the most common site of involvement and patients usually present as eyelid mass or ptosis. Complete excision is difficult and most of the patients usually undergo debulking surgery. All patients should undergo screening for systemic amyloidosis
Drug reservoir function of voriconazole impregnated human amniotic membrane: An in vitro study
Authors: Hazarika Manali , Prajna Namperumalsamy Venkatesh , Senthilkumari Srinivasan
Published: May 2021

Purpose:

Earlier our group has demonstrated the drug reservoir function of the human amniotic membrane (HAM) using stable moxifloxacin and fortified cefazolin ophthalmic formulations and found it as a suitable tool to deliver drugs for an extended duration. The purpose of this study was to evaluate the extended-release kinetics of voriconazole from the impregnated human amniotic membrane (HAM) in vitro.

Methods:

HAM buttons were incubated with freshly prepared 1% topical ophthalmic formulation of voriconazole for 5 different exposure time to investigate the ideal exposure time for the extended-release of voriconazole from HAM. The drug release kinetics was studied in simulated tear fluid for 5 weeks and the amount of voriconazole released at different intervals was estimated using high-performance liquid chromatography (HPLC) with photodiode array (PDA) detector.

Results:

There was a marginal increase in drug entrapment efficiency with increased drug exposure time but neither the drug entrapment nor the drug release was found to be statistically significant (P ≥ 0.5). Voriconazole was detectable even at 5 weeks.

Conclusion:

A sustained release of voriconazole was achieved up to 5 weeks, when voriconazole was incubated with amniotic membrane for all the studied drug soaking times. Thus, voriconazole impregnated amniotic membrane can be considered for the sustained delivery for its in fungal keratitis.
Perforating ocular trauma due to shotgun pellet - Clinical profile and visual outcome
Authors: Shah Faisal Qayoom , Asif Jasmine , Syed Tariq Qureshi
Published: May 2021

Purpose:

The aim of this study was to determine visual and anatomical outcome of perforating injuries due to shotgun pellet.

Methods:

This was a prospective observational study carried out between July 2016 and Jan 2019 at a tertiary care referral center in Srinagar, Jammu and Kashmir. A total of 172 eyes with perforating injuries of 170 patients were included in the study and were followed up for 6 months with best-corrected visual acuity, slit-lamp examination for status of anterior chamber and lens, fundus examination for status of retina and media, intraocular pressure measurements, and OCT (optical coherence tomography) and FFA (fundus fluoresceine angiography) in selected cases. The relative improvement of visual acuity after treatment was interpreted by applying paired two-tailed t tests. Prognostic significance of other variables was calculated using Chi-square and Chi-square for linear trend tests, for two dependent outcome variables of good outcome and poor outcome.

Results:

WHO category 4 visual impairment was found in 66 (38.4%) eyes, whereas category 0 was found in 24 (14%) of eyes. Retina was found to be attached 99 (57.6%) of study eyes.

Conclusion:

Perforating injury is a severe form of ocular trauma with grave consequences in terms of functional and anatomical outcome.
Ocular manifestation of rickettsial disease in South Indian population
Authors: Ganekal Sunil , Singnal Kruthika , Rajappa Suresha , Hegde Sharat
Published: May 2021

Purpose:

The aim of this work was to study the ocular manifestations and its management in spotted fever and typhus group of rickettsial disease.

Methods:

A retrospective analysis of 50 patients with serologically confirmed Rickettsial disease. In all patients, relevant history, investigations and treatment details were collected and they underwent complete ophthalmic evaluation including measurement of best-corrected visual acuity, anterior segment examination and dilated fundus examination.

Results:

Mean age was 12.5 ± 8.99 years. Of the 50 patients, 40 patients were ≤18 years of age and 27 (54%) had ocular involvement. Out of 27 patients, bilateral involvement was seen in 10 patients. Most of the patients had no ocular symptoms. Ocular findings included, Retinal vasculitis 6 (22.22%); macular edema 4 (14.81%); vasculitis with macular edema 1 (3.7%); Retinitis 7 (25.92%); Papilloedema 6 (22.22%); Papilloedema with 6th cranial nerve palsy 1 (3.7%); Isolated 6th cranial nerve palsy 1 (3.7%) and optic neuritis 1 (3.7%). Ocular involvement was more common in double antigen group (68%) than spotted fever group (50%) or Scrub typhus group (21%) (P = 0.01). Ocular involvement was seen in 94% of the patients with CNS involvement. Cases with bilateral involvement (P = 0.01), pediatric age group (P = 0.01) and CNS involvement (P = 0.02) had poor visual outcome.

Conclusion:

Rickettsioses patients can have ocular manifestations with predominant posterior segment involvement during acute phase of illness. Ocular involvement was more common in the double antigen group. For any patient who presents with fever and rash living in endemic area, ophthalmic evaluation should be part of routine checkup during the acute phase of illness associated with less frequent ocular symptoms.
Delayed postoperative opacification of three hydrophobic acrylic intraocular lens: A scanning electron microscopic and energy dispersive spectroscopic study
Authors: Bhattacharjee Harsha , Buragohain Suklengmung , Javeri Henal , Das Dipankar , Bhattacharjee Kasturi
Published: May 2021

Purpose:

The aim of this study was to report scanning electron microscopic (SEM) and energy dispersive spectroscopic (EDS) findings of three specimens of opaque hydrophobic acrylic intraocular lens (IOL) explanted in delayed postoperative period for visual indications.

Methods:

Clinical data and photographs from each subject were obtained. Explanted IOLs were examined under gross and light microscopy followed by SEM coupled with EDS.

Results:

All three subjects underwent IOL implantation following senile cataract extraction at an average age of 64.3 ± 0.3 years, and the IOLs were in situ for a duration of 11.3 ± 4.04 years. The IOL explantation and exchange were done due to late postoperative opacification of the IOL and significant visual deterioration. The milky iridescent opacity affected the full thickness of IOL optics in the first two specimens and in the third only two surfaces were involved. SEM detected surface cracks in the first specimen, typical conglumated surface, pores and accumulation of crystals with surface deposit of nano-particles on the second specimen and uneven surface erosion in the third specimen. SEM detected mainly sodium (Na) and chloride (Cl) spikes. All patients recovered normal vision following IOL exchange.

Conclusion:

SEM features of the IOL optics and absence of calcium and phosphate spikes in EDS and other findings were consistent and suggestive of hydrolytic biodegradation of hydrophobic acrylic IOL polymer in ocular media and was responsible for delayed postoperative opacification of the hydrophobic IOLs and visual loss.
Overcoming challenges in implementing measures across multiple centers of a chain of hospitals to combat COVID-19 pandemic
Authors: Singh Mandeep J , Verma Deepika , Banerjee Tirtha B , Singh Ankita , Bhatt Kanika
Published: May 2021

Purpose:

Coronavirus outbreak was first reported towards the end of 2019 and has now been declared a pandemic by the World Health Organization. Post declaration, India announced lockdown and various guidelines were issued by Health authorities worldwide for the organizations to function in this emergency aeon. Different organizations strategized differently to respond to COVID 19 pandemic. The aim was to implement COVID 19 guidelines across all the centres of a chain of Eye hospitals in India in short span of time overcoming the challenges.

Methods:

A SMART strategy was confabulated within the team. There were numerous challenges like lack of time, rapidly changing guidelines, no travelling scenarios, training and educating the staff in huge numbers, rapidly evolving situation, change management, need of increased vigilance, and language barrier at certain centres, sustaining quality assurance and motivating the staff in stressful times. The challenges were surpassed using a power packed strategy, dedicated efforts and team work grasping the available tools and technology from a single location. This template can serve us and other hospitals to respond in a better way for similar future challenges.

Results:

The COVID 19 protocols were implemented across all the centres successfully. The entire Quality assurance system drifted to online platform and education and awareness methods took the digital thread. Teamwork synergized with the aforementioned things and we came out with flying colours achieving the goals in short span of time overcoming all the barriers.

Conclusion:

Difficult times bring challenges and challenges teach us the innovative ways to convert them into opportunities. A well planned strategy, best utilization of available resources, team work and continuous monitoring can bring the best outcomes forward.
Retinoblastoma in twins: Risk assessment of genotypic variants
Authors: Raval Vishal , DeBenedictis Meghan , Bowen Randy , Soto Hansell , Davanzo Jacquelyn , Singh Arun
Published: May 2021

Purpose:

To describe methods of risk assessment in twins with retinoblastoma (RB).

Methods:

A case series of four RB probands with a twin sibling. Family status, clinical presentation, and RB1 germline status-based risk assessment were analyzed.

Results:

Two pairs had a positive family history (unilateral and bilateral RB in one of the parents (#1 and #2, respectively) and two pairs (#3 and #4) were sporadic. One of the familial twins (#1) had a high risk (90%) of manifesting RB in the twin. The other case (#2) with an absent RB1 germline mutation in the twin had a 0% risk of developing RB. Among sporadic cases of twins (#3), genetic testing did not identify a germline mutation (tumor sample unavailable) in the proband which downgraded the risk of germline mutation from 15% to <1%. The twin never developed RB (5 years of age at last follow-up). Pathogenic mosaicism for germline RB1 mutation (c.1723C>T) could be identified (tumor tissue available) in the proband (# 4). Identical germline mutation (and RB tumor) was also noted in the twin. In each case, there was concordance between the assessed risk and manifestation of RB.

Conclusion:

Assessment of risk of RB in a twin presents with a unique challenge. Depending upon the genotype variant, the risk of developing RB can vary from 0% to 90%. In addition to family history, clinical manifestation in the proband, zygosity status, and RB1 germline status are critical in formulating risk-appropriate surveillance guidelines.
Assessment of a software guided system to reduce pre-existing astigmatism in cataract surgery
Authors: Raut Rajeev M , Jeswani Kumud D , Raut Madhuri R , Raut Bhargav R
Published: May 2021

The aim of this pilot study was to assess the astigmatism after small incision cataract surgery by use of a novel software guided surgical technique. The software system guides the surgeon toward a hypothetical shape of the cornea. When this shape is achieved, the vertical meridian is relaxed and the incision does not produce any astigmatism. How that hypothetical shape is to be achieved by the surgeon is described. If preoperative astigmatism exists, the hypothetical shape calculated by the system takes that into account. This enables the surgeon to reduce preexisting astigmatism, without having to change the site or size of the standard 6 mm 12 o clock incision of SICS.

Results:

Results indicated that preoperative astigmatism reduced in 11 out of 14 cases at the end of 8 weeks, remained unchanged in one, and increased by less than 0.5D in two cases. This proves the hypothesis that the vertical corneal meridian is under higher tension and relaxing it by flattening the perpendicular meridian has a reducing effect on postoperative astigmatism.
Adoption of newer teaching methods to overcome challenges of training in ophthalmology residency during the COVID-19 pandemic
Authors: Pradeep Thanuja G , Sundaresh Divya Dabir , Ramani Soumya
Published: May 2021

The coronavirus disease 2019 (COVID-19) pandemic has disrupted training programs across all specialties. Surgical specialties, such as ophthalmology, that need continued microsurgical training are affected the most. The pandemic has resulted in ophthalmology residents being taken off their regular duties in ophthalmology and inducted into COVID duties. The focus on COVID care has de-emphasized training in ophthalmology. We highlight the challenges that teachers face in continuing the training programs of theory, clinical skill, and surgical skill transfer. Embracing technology is the need of the hour. We discuss the multiple options available to enable continued training programs and emphasize the need for all training institutes to include technology as an additional component of their training curricula.
Fundus evaluation in COVID-19 positives with non-severe disease
Authors: Bypareddy Ravi , Rathod B L Sujatha , D Shilpa Y , R Hithashree H , Nagaraj Kalpana Badami , C Hemalatha B , Basumatary Jessica , Bekal Deeksha , R Niranjan , G Anusha P
Published: May 2021

Purpose:

The aim of this work was to study and document retinal changes in coronavirus disease-2019 (COVID-19) positive patients with nonsevere disease using a nonmydriatic handheld fundus camera.

Methods:

A cross-sectional observational study was conducted on patients affected by COVID-19 who were admitted at our center. Our study included patients with no, mild, and moderate symptoms (nonsevere cases). Intensive care unit (ICU)-admitted patients were excluded considering the difficulty in procuring the fundus image by the handheld camera due to patients positioning. Patients with systemic conditions (diabetes, hypertension, and severe anemia) known to cause retinopathy were also excluded. Bedside anterior segment examination, fundus examination using indirect ophthalmoscopy and fundus imaging of each patient using a nonmydriatic handheld fundus camera was done by a trained ophthalmologist posted for COVID duty.

Results:

In a cohort of 138 patients, 94 (68.1%) were men and 44 (31.9%) were women. A total of 276 eyes were evaluated. The mean age of the patients was 38.51 ± 14.4 years. Anterior segment evaluation showed no abnormality in any of the eyes. On fundus screening using nonmydriatic handheld camera, a single streak of superficial retinal hemorrhage was noted at the posterior pole of the fundus in the left eye of one patient (0.72%), which was away from fovea. Laboratory tests revealed low hemoglobin (between 10 and 10.9 g/dL falling under mild Anemia) in 12 patients, elevated total leucocyte count in 6 patients, raised LDH in majority of patients (323 ± 101 Units/L) and elevated CRP (14.6 ± 30.99 mg/L). Rest of the lab parameters were within the normal range.

Conclusion:

In our study, COVID patients with mild-to-moderate symptoms did not show any inflammatory/infective or vaso-occlusive lesions in the retina attributable to COVID-19 infection, except one patient who had a single streak hemorrhage in the macula away from fovea, probably incidental.
COVID-19 and ophthalmology: A scientometric analysis
Authors: Kalra Gagan , Kaur Rishemjit , Ichhpujani Parul , Chahal Rutvi , Kumar Suresh
Published: May 2021

Purpose:

Coronavirus disease pandemic has impacted global healthcare tremendously and ophthalmology is one of the high-hit specialties. An increasing number of research items are upcoming with COVID-19-related research in ophthalmology and this report aims at performing a scientometric analysis of all the available research pertaining to COVID-19 and ophthalmology.

Methods:

A Web of Science (https://webofknowledge.com) query TS = (“novel coronavirus 2019” OR “coronavirus 2019” OR “COVID 2019” OR “COVID 19” OR “nCOV” OR “SARS-CoV-2” OR “COVID-19”) AND WC = (“Ophthalmology”) was deployed on February 22, 2021, to retrieve all research items on the topics of interest. R software (v4.0.1) with Bibliometrix library was deployed to visualize metrics to quantify geographical distribution, source metrics, author metrics, document metrics, and keyword metrics.

Results:

A total of 616 research items appeared in our search results that were drafted by 2398 authors and published in 63 sources. India, USA, UK, and China had the greatest number of research items among others. Indian Journal of Ophthalmology, Eye, and Graefe’s Archive for Clinical and Experimental Ophthalmology were sources with greatest number of research items. Documents per author were 0.257 and authors per document were 3.89. The collaboration index was noted to be 4.28.

Conclusion:

Our scientometric analysis presents descriptive quantitative metrics for COVID-related research in the field of ophthalmology and provides evidence for the increased global collaboration that global researchers have fostered to fight this pandemic.
Pediatric cataract surgery practices in the COVID-19 era: Perspectives of a tertiary care institute in Northern India
Authors: Gupta Parul Chawla , Sukhija Jaspreet , Khurana Surbhi , Kaur Savleen , Korla Shagun , Valliappan Abinaya , Ram Jagat
Published: May 2021

Purpose:

To discuss the impact of COVID-19 pandemic on the pediatric cataract surgery services in a tertiary care institute in India, as well as the protocol followed for these surgeries.

Methods:

COVID-19 has hampered outpatient and elective services and surgeries throughout the world. During the national lockdown imposed in March in India, outpatient services were suspended in our institute, leading to a tremendous backlog of pediatric patients with cataract. Since the delay in surgery in pediatric cataract can cause amblyopia, our institute had resumed pediatric cataract surgeries in June 2020 at the time of Unlock-1 in the country.

Results:

We have discussed the percentage of reduction in pediatric cataract surgeries in 2020 during the Unlock 1, 2, 3, and 4, as compared to the number of surgeries done by the pediatric ophthalmology unit in the same months last year. We had introduced triage and telemedicine in our department. We have discussed the preoperative, intraoperative, and postoperative protocol followed in our institute for children with pediatric cataract, and also the measures which can be taken for the safety of patients and staff.

Conclusion:

It is essential to ensure COVID-19 protocol, i.e., wearing a mask, social distancing, and frequent hand hygiene, among the patients and health care personnel. Redesigning pediatric cataract surgery practices is essential to ensure the safety of the health care workers and the patients.
A novel approach to anterior segment imaging with smartphones in the COVID-19 era
Authors: Dutt Sreetama , Vadivel Siva S , Nagarajan Shanmuganathan , Galagali Amrutha , Christy Josephine S , Sivaraman Anand , Rao Divya Parthasarathy
Published: May 2021

Purpose:

To report a novel, telemedicine-friendly, smartphone-based, wireless anterior segment device with instant photo-documentation ability in the COVID-19 era.

Methods:

Anterior Imaging Module (AIM) was constructed based on a 50/50 beam splitter design, to match the magnification drum optics of slit-lamps with a three-step or higher level of magnification. The design fills the smartphone sensor fully at the lowest magnification and matches the fixed focus of the slit-lamp. It comes with a smartphone for instant photo-documentation, an in-built software application for data-management and secure HIPAA compliant cloud storage, and a Bluetooth trigger for a one-tap image capture. The construction of the device is explained, and the optical resolution measured using U.S. air-force resolution test. AIM’s performance was characterized with traceability to internationally relevant performance standards for digital slit-lamps after image quality assessment through a pilot study.

Results:

Clinically useful anterior segment images were obtained with both diffuse and slit illumination at different magnification settings with the highest magnification (40X) resolution of 359 lines per cm and the lowest magnification (16X) resolution of 113 lines per cm.

Conclusion:

AIM is a novel, wireless, telemedicine-enabled design that digitizes existing, analog slit lamps with at least three-step magnification. The settings ensure the focus is determined purely by the position of the slit-lamp. Hence, the image viewed and captured on the smartphone is exactly what the clinician sees through the eyepiece. This helps in maintaining distance from the patient in the ongoing COVID-19 pandemic, as well.
A case series of presumed fungal endogenous endophthalmitis in post COVID-19 patients
Authors: Shah Kunal K , Venkatramani Devendra , Majumder Parthopratim Dutta
Published: May 2021

The novel coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2, has challenged the medical community. Several ocular manifestations secondary to COVID-19 have been documented. Prolonged hospitalization exposes the patient to various multiresistant bacteria making them prone to various secondary infections. This case series describes four cases of presumed fungal endogenous endophthalmitis in patients who recovered from COVID-19.
Cavernous sinus thrombosis with central retinal artey occlusion in COVID-19: A case report and review of literature
Authors: Raj Anuradha , Kaur Navjot , Kaur Navdeep
Published: May 2021

Coronavirus disease-2019 (COVID-19) is showing a wide spectrum of ocular manifestations. They are creeping from vision sparing to irreversible visual loss as a result of its thromboembolic events. Hypercoagulability associated with COVID-19 is also called “sepsis-induced coagulopathy” and may predispose to thromboembolic phenomenon that decides the morbidity and mortality of this pandemic. A 37-year-old man presented with no perception of light in the left eye with optic atrophy and macular pucker on fundus examination. Visual evoked potential showed extinguished P 100 wave. His past medical history revealed severe pneumonia secondary to severe acute respiratory syndrome-coronavirus-2 (SARS-CoV 2) infection about 3 months back.
Retinal manifestations in patients following COVID-19 infection: A consecutive case series
Authors: Goyal Mallika , Murthy Somasheila I , Annum Sridhar
Published: May 2021

Purpose:

To describe retinal manifestations seen in patients associated with COVID-19 infection at a multi-specialty tertiary care hospital in Southern India.

Methods:

In this retrospective chart review, all consecutive cases presenting to the Retina-Uveitis service from May 2020 to January 2021 with retinal manifestations associated with COVID-19 infection or its sequelae or as a result of treatment given for COVID-19 were included.

Results:

Of the 7 patients, 3 were female, and 4 were male. Four patients had onset of symptoms during the active phase of COVID-19 infection. Four had bilateral and three had unilateral involvement. The manifestations ranged from mild to vision threatening. Vision threatening manifestations included infections: endogenous endophthalmitis, candida retinitis and tubercular choroidal abscess and bilateral pre-foveal hemorrhages. Milder manifestations included paracentral acute middle maculopathy, central serous chorio-retinopathy and voriconazole induced visual symptoms. Final visual acuity was 6/36 or better in the four severe cases and 6/9 or better in the mild cases.

Conclusion:

This study highlights the retinal manifestations associated with COVID-19 infection and its sequelae. As these patients presented with an association with COVID-19 (either during or after recovery), ophthalmologists should be vigilant and screen for such entities in case of complaints of visual symptoms or in the presence of systemic sepsis. The outcomes can be good with prompt and aggressive management.
Acute monocular vision loss as presenting symptom of delayed stroke from internal carotid occlusion in COVID-19
Authors: Deshpande Gunjan , Giri Pramod
Published: May 2021

Covid-19 infection has been declared a pandemic by the World Health Organization. We present a unique case of a middle-aged gentleman, who recovered from asymptomatic Covid-19 infection and presented again with delayed stroke. He had vision loss secondary to internal carotid artery occlusion in the absence of neurological symptoms. To the best of our knowledge, this is the first case that describes cerebrovascular stroke due to delayed large vessel occlusion secondary to Covid-19 infection presenting as monocular vision loss.
Evaluation of ganglion cell-inner plexiform layer thickness in the diagnosis of preperimetric glaucoma and comparison to retinal nerve fiber layer
Authors: Deshpande Gunjan A , Gupta Richa , Bawankule Prashant , Raje Dhananjay , Chakraborty Moumita
Published: May 2021

Purpose:

The aim of this study was to evaluate the diagnostic ability of optic nerve head (ONH), RNFL, and GC-IPL parameters in differentiating eyes with PPG from normals.

Methods:

This was a retrospective, cross-sectional, observational study. We studied 73 eyes of 41 patients and compared them to 65 eyes of 34 normal persons. Each patient underwent detailed ocular examination, standard automated perimetry, GC-IPL, ONH, and RNFL analysis. PPG was defined as eyes with normal visual field results and one or more localized RNFL defects that were associated with a glaucomatous disc appearance (e.g., notching or thinning of neuroretinal rim) and IOP more than 21 mm Hg. Diagnostic abilities of GC-IPL, ONH, and RNFL parameters were computed using area under receiver-operating curve (AUROC), sensitivity and specificity, and likelihood ratios (LRs).

Results:

All GC-IPL parameters differed significantly from normal. The ONH, RNFL, and GC-IPL parameters with best area under curves (AUCs) to differentiate PPG were vertical cup to disc ratio (0.76), inferior quadrant RNFL thickness (0.79), and inferotemporal quadrant GC-IPL thickness (0.73), respectively. Similarly, best LRs were found for clock hour 5, 6, and 12 thicknesses among RNFL; inferior sector and inferotemporal sector thicknesses among GC-IPL parameters.

Conclusion:

Diagnostic abilities of GC-IPL parameters were comparable to RNFL parameters in differentiating PPG patients from normals. The likelihood of ruling in a disease was greater with GC-IPL parameters.
Dry eye disease and retinal nerve fiber layer changes in chronic smokers
Authors: Narnoli Prasansha , Dhasmana Renu , Khanduri Rakhee
Published: May 2021

Purpose:

To study the effect of smoking on tear film parameters and retinal nerve fiber layer thickness (RNFL) in chronic smokers.

Methods:

This was a cross-sectional study, which included 60 (120 eyes) smokers who have smoked at least 10 pack-year and an equal number of healthy subjects as a control for comparison. In addition to history, a detailed slit-lamp examination was done to evaluate the anterior and posterior segments. All patients underwent Schirmer’s I test (SIT) with Whatman-41 filter paper, tear meniscus height (TMH), and RNFL with a Fourier-domain optical coherence tomography (OCT) and tear film breakup time (TBUT) with 2% fluorescein and cobalt blue filter using slit-lamp biomicroscopy.

Results:

The (mean ± SD) age of the participants was 56.48 ± 10.38 years. There was a statistically significant reduction in tear film parameters in smokers compared to nonsmokers (P = 0.000). The incidence of MGD was found to be higher in smokers when compared to nonsmokers with a P value of 0.000. RNFL in all four quadrants was also significantly reduced in smokers compared to nonsmokers (P = 0.00).

Conclusion:

This study shows that chronic smoking leads to an increased incidence of dry eye disease and is associated with RNFL thinning. Smoking can result in cumulative RNFL loss in patients with ocular neurodegenerative disorder and OCT of these patients may have to be interpreted keeping this in mind.
Impact of the new TNM Staging System (8th edition) on oral tongue cancers
Authors: Ammann Yanic , Beutner Ulrich , Vital Domenic G. , Morand Grégoire , Broglie Daeppen Martina A. , Born Diana , Stoeckli Sandro J. , Huber Gerhard F.
Published: May 2021

AIM OF THE STUDY
For tumours of the oral tongue, the most recent 8th edition of the AJCC/UICC staging system has introduced depth of infiltration (DOI) as a novel parameter. With this study we wanted to investigate its impact regarding this risk stratification compared with the preceding 7th edition.

METHODS
Between 2008 and 2017, 161 patients of two tertiary referral centres in Switzerland (Kantonsspital St. Gallen and University Hospital Zurich) with T1 N0 or T2 N0 tongue cancers were enrolled in this study. The primary tumours were restaged according to the 8th edition of the TNM classification. Kaplan-Meier curves for overall and disease-specific survival were calculated.

RESULTS
According to the 7th edition, of the 161 patients, 102 were staged after surgery as pT1 (stage I) and 59 as pT2 (stage II). According to the 8th edition, 36 patients (22.4%) were re-staged to a higher stage. Of these 36 patients, 8 (22.2%) experienced a recurrence, and 9 (25%) died. In the remaining, not re-staged group, 20 patients (16.0%) experienced a recurrence (p = 0.55) and 14 (11.2%) died (p = 0.025*). The 7th edition showed a statistically significant difference between pT1 and pT2 tumours for overall survival (p = 0.025), but not for disease-specific survival (p = 0.091), whereas the 8th edition was able to well discriminate between pT1, pT2 and pT3 for both overall (pT1 vs pT2, p = 0.016*; pT2 vs pT3, p = 0.031*) and disease-specific survival (pT1 vs pT2, p = 0.037*; pT2 vs pT3, p = 0.023*).

CONCLUSION
The recent TNM 8th edition provides a more accurate prediction of overall and disease-specific survival for this subgroup of patients. Hence, a more aggressive treatment should be considered for patients re-staged to pT3 due to depth of infiltration.
Cost-effectiveness analysis of statins in primary care: results from the Arteris cohort study
Authors: Romanens Michel , Adams Ansgar , Bojara Waldemar , Balint Sandor , Warmuth Walter
Published: May 2021

BACKGROUND
The Swiss Federal Office of Public Health performed a health technology assessment regarding statins in primary care. The chosen models may lead to a situation where a clinically indicated statin therapy is estimated not to be cost effective.

METHODS
We performed a cohort study regarding cardiovascular events, comparing SCORE and AGLA risk categories with tertiles of carotid plaque burden and used two models for cost-effectiveness analysis of high-potency statins.

RESULTS
Subjects (n = 2842) were followed up for 5.9 ± 2.9 years with the occurrence of 154 cardiovascular events (extrapolated 10-year risk was 9.2%). Carotid plaque imaging (total plaque area, TPA) significantly improved cardiovascular risk prediction compared with AGLA and SCORE for event-free survival prediction, test accuracy (discrimination) and calibration. Discrimination was significantly improved by about 4% with the inclusion of TPA. Cost-effectiveness analysis using quality-adjusted life years (QALYs) and sensitivity analyses (based on 16 models) ranged between CHF 144,496 and −128,328 per QALY. Cost-effectiveness analysis using direct and indirect costs showed that a treat-them-all strategy in the Swiss population would be cost effective with a return-on-investment per patient in 10 years of between CHF 4442 and 19,059, and the use of carotid imaging was also cost effective (incremental cost-efficiency ratio −2.97 to −7.86).

CONCLUSIONS
Carotid ultrasound significantly improved cardiovascular risk stratification and is cost effective. The Swiss Medical Board QALY model presents several drawbacks, which are shown in our sensitivity analysis, where results vary considerably and are not useful for clinical decision making. A “treat them all” strategy with statins in the Swiss population aged 30–65 years may be cost effective, when indirect costs of avoidable cardiovascular events are included, even at an unacceptably low value of a statistical life year.
EFFECT OF NON-AUDIT SERVICES ON AUDITOR’S INDEPENDENCE: EVIDENCE FROM ACCOUNTING PRACTITIONERS IN ABIA STATE
Authors: Ogbodo Okenwa , Ajuonu Anurika
Published: May 2021

This study investigates the effect of the provision on non-audit services on Auditor’s independence: evidence from accounting practitioners and consequent effect on the auditor’s objectivity and professional skepticism in the financial statement audited. The study used the Institute of Chartered Accountants of Nigeria (ICAN) and Association of National Accountants of Nigeria (ANAN) domiciled in Abia State. The data for the study were generated from primary source: questionnaires were the major instrument for data collection. The instrument was subject to both content and faces validity by experts. Three questions were structured in Likert scale form and the formulated hypotheses were tested with ordinary Logistic regression using SPSS package. The study found that non-audit services have no effect on auditor’s independence, the auditor’s objectivity and professional skepticism. The study therefore recommends that the audit committee should have full oversight of the auditor’s independence, including the nature and extent of the work they do and their fees. The audit committee should make its charter public. The charter should give investor information about how the audit committee chooses its auditors and how it decides the type of service they can provide.
Physical, Chemical, and Sensory Characteristics of Frozen Salted Edamame During Storage at Room Temperature
Authors: Amilia Winda , Wiyono Andi Eko , Ferzia Dhifa , Rusdianto Andrew Setiawan , Suryaningrat Ida Bagus , Mahardika Nidya Shara , Suryadarma Bertung
Published: May 2021

Edamame soybeans are a superior product in Jember Regency. Edamame has the advantage of protein, calcium and iron content. In general, edamame soybeans are a perishable food commodity that must be processed immediately. One of the processed edamame products is frozen salted edamame which is a practical ready-to-eat snack. Frozen salted edamame has attracted the interest of the people of Jember and people outside the city. This product is popular with people outside the city, so they often buy it to take home as a souvenir from Jember Regency. Uncontrolled environmental conditions during the trip with sudden temperature changes without cold storage cause the potential for physical damage or deterioration of quality in frozen salted edamame. Therefore, further observations are needed to determine changes in the quality of frozen salted edamame products during the trip without cold storage at room temperature storage. The purpose of this study was to determine the effect of room temperature storage time on physical quality, chemical quality, and organoleptic quality of frozen salted edamame products. The design of this study used a completely randomized design with a single factor, namely five treatments for different durations (0 hours, 12 hours, 24 hours, 36 hours, and 48 hours after removed from the freezer). The analyzes carried out in this study were the test of texture, color, pH, total dissolved solids, total acid, antioxidant activity, moisture content, and organoleptics. The results showed that the frozen salted edamame product decreased during storage time at room temperature. Based on the results of research, the duration of storage for frozen salted edamame products at room temperature has an effect on the value of color, pH, total dissolved solids, total acid, and water content, but does not affect the texture and antioxidant activity. The quality of the product also decreased in color, taste, aroma, and texture attributes.
Antibacterial Activity of Kaempferia Galanga L. Hard Candy Against Streptococcus pyogenes and Staphylococcus aureus Bacteria Growth
Authors: Belgis Maria , Nafi’ Ahmad , Giyarto Giyarto , Wulandari Afina Desi
Published: May 2021

Aromatic ginger (Kaempferia Galanga L.) is a spice plant that has a high volatile content with active compounds of ethyl p-methoxy cinnamate (23.65%) and ethyl cinnamate (5.98%). These two compounds have been reported to have antibacterial activity against Streptococcus pyogenes and Staphylococcus aureus, which are two types of bacteria that can cause sore throat. The application of aromatic ginger essential oil on hard candy can potentially reduce inflammation in the throat. This study aims to determine the effect of aromatic ginger essential oil concentration on hard candy in inhibiting the growth of Streptococcus pyogenes and Staphylococcus aureus bacteria and to determine their acceptance by the panelists. This research was conducted with 6 treatments of variations in the concentration of aromatic ginger essential oil, including 0%, 0.2%, 0.4%, 0.6%, 0.8%, and 1%. The results showed that the higher the concentration of aromatic ginger essential oil on hard candy would further increase the inhibition of the growth of Streptococcus pyogenes and Staphylococcus aureus bacteria. The highest inhibitory activity and the highest panelist acceptance was 1% essential oil concentration with 3.29% moisture content, 0.12% ash content, and 7.13% reducing sugar. The use of aromatic ginger essential oil on hard candy as a flavoring and well as inhibiting the growth of strep throat-causing bacteria (Streptococcus pyogenes and Staphylococcus aureus) has the potential to be developed.

Keywords: Antibacterial, hard candy, aromatic ginger, essential oil, Streptococcus pyogenes, Staphylococcus aureus
The Analysis of Water Quality Compliance of Jompo River Irrigation in Jember Regency
Authors: Wahyuningsih Sri , Novita Elida , Andriyani Idah , Indarto Indarto
Published: May 2021

Jompo river is one of many tributaries in Jember regency has become one of water sources for residents nearby to meet their daily needs. People activities may lead to the emergence of pollution in Jompo river in long term. The measurement needs to determine water quality of the river. The research site ranged from Patrang to Kaliwates district with six nodes and covered a distance of 625 m. Based on the data analysis, average value of water quality in the river was characterized by 67 mg/l TSS (Total Suspended Solids), 72 mg/l TDS, pH at 6.73, 8.34 mg/l DO, 1.20 mg/l BOD, and EC at 145 µmhos/cm. Based on Government Regulation No. 82 of 2001 and Electricity value, the water quality of Jompo river was included in Grade II criteria. Jompo River was appropriate to irrigation water.
The Effect of Substitution of Seed Flour of Jackfruit (Artocarpus heterophyllus Lam.) on the Physicochemical and Organoleptic Characteristics of Macrons
Authors: Habibah Nurul Ummu , Albaar Nurjanna , Rasulu Hamidin
Published: May 2021

Jackfruit seeds are rich in carbohydrates, so they can be processed into food products such as macrons. Macron is a typical food of Ternate city which is usually made using wheat flour as the base ingredient. The purpose of this study was to determine the best ratio of substitution of jackfruit seed flour in macron manufacturing and to determine the physicochemical and organoleptic characteristics of macrons produced from different substitutions of jackfruit seed flour. This research investigated the substitution of jackfruit seed flour and wheat flour with formulation (P0 = 0%: 100%, P1 = 25%: 75%, P2 = 50%: 50%, P3 = 75%: 25% and P4 = 100. %: 0%), using a completely randomized design (CRD) consisting of five treatments with three replications to obtain 5 x 3 = 15 experimental units. The best treatment results showed the formulation of 25% jackfruit seed flour and 75% wheat flour (P1) in macrons with physical characteristics in the form of texture (fracture power) 12.25 N, color L * 56.42, a * 9.77, b * 25.44. The chemical properties are 18.313% protein, 11.846% fat, 63.693% carbohydrate, 0.916% ash, and 3.5% moisture. The organoleptic properties include aroma 4.12 (preference), taste 3.30 (neutral), color 4.14 (preference) and texture 4.05 (preference). Macron, with the addition of jackfruit seed flour, has a significant effect on physicochemical properties, including texture, color, moisture content, ash content, and protein, as well as organoleptic characteristics such as taste, aroma, color, and texture. Meanwhile, the addition of jackfruit seed flour to macrons has no effect on fat and carbohydrate levels.
Effectiveness Test of Parasitization by Parasitoid Tricogramma japonicum in Controlling White Rice Stem Borer (Scirphopaga innotata)
Authors: Astrodjojo Susilawati , Sudjud Suratman , DAS Sri Soenarsih
Published: May 2021

Rice is an essential food crop besides corn and soybeans. The need for rice each year increases along with population growth. One of the pests affecting rice is the white rice stem borer. The present research aimed to test the effectiveness and to examine the interaction between plant age and the number of Tricogramma japonicum parasitoid. The research was carried out at the Agrotechnology Laboratory of the Faculty of Agriculture, Khairun University, Ternate, and the rice fields of Bumi Restu village SP I, East Wasile district. The research design operative was a randomized block design where factor A (A1 = 21 DAS, A2 = 42 DAS, A3 = 56 DAS) was the age of the plant, and factor B (B0 = 0, B1 = 50, B2 = 100, B3 = 150) was the number of eggs of Corcyra cephalonica. Biological control using different amounts of Trichogramma japonicum parasitoid led to different interactions and results for each tested parameter. For the number of egg groups, there was no interaction with plant age, but the treatments which were found effective in suppressing stem borer populations were B2 and B3 (100 and 150). The most effective pias as indicated by damage intensity parameter was B3 (150), which was applied to plants aged 21 DAP. Furthermore, for plant height, different number of parasitoids poses significantly effective results. Percentage unhulled grain of pias B3 (150) causes insignificant damage. For production there is no interaction with plant age, but pias B2 (100) shows high yield. The conclusion is that pias B3 (150) applied to 21 days of plants is very effective in controlling white rice stem borer.