bluuebunny/crossref_metadata_2025 huggingface dataset:
A critical review of environmental assessment legislation in the Democratic Republic of the Congo
Authors: Osei Francis Acheampong , Effah Esther Asantewaa
Published: January 2024

Background: Many countries undertake development activities that utilize resources from the environment. In the Democratic Republic of the Congo (DRC), the Congolese Environmental Agency is supervised by the Ministry of Environment and Sustainable Development to undertake an environmental assessment of all projects that pose risks to the environment. The present study conducted a critical review of the country’s existing environmental assessment legislation, identifying strengths and weaknesses in the Environmental and Social Impact Assessment (ESIA) system. Methods: A literature survey was done in the Google Scholar, Taylor & Francis, and Elsevier databases, which were also guided by the PRISMA. All full-text articles included in the study were written or translated (using online translation software) into the English language, and also, reported on environmental impact assessment as well as legislation. A textual examination of the included literature was done. A set of adapted analytical criteria was used to critically review the ESIA system in the DRC. The results were discussed, and recommendations were given. Results: It was found that the decree was not effective and efficient for the ESIA study. Some of the key limitations of the ESIA decree included the lack of scoping in the entire ESIA process, alternatives that were limited in scope, fees and charges that were not explicitly stated in the legislation, and the lack of public participation at some stages. Conclusion: The ESIA system in the DRC is ineffective and needs revision to improve its effectiveness.
Worldwide arsenic levels in human breast milk and probabilistic health risk assessment: A systematic review and meta-analysis
Authors: Mohammadi Younes , Dargahi Abdollah , Leili Mostafa , Samiee Fateme
Published: January 2024

Background: The exposure to toxic metals is a major global health concern due to their stability, bioaccumulation, and high toxicity. These metals can be transmitted to the fetus through the placenta and exposure can last throughout life. This systematic review focused on the potential risks of arsenic (As) in breast milk to newborns and infants. Methods: Multiple keywords, such as "human milk" and "breast milk", associated with "toxic metal", "heavy metal" or "arsenic" were used to search related databases. Of the 151 articles found, 45 studies were eligible for qualitative review, and 34 were included in the meta-analysis. Results: The lowest and highest levels of arsenic were found to be 0.04±0.70 and 27.75±28.30 μg/L, respectively. The overall pooled average concentration (95% CI) of arsenic in breast milk was 0.11 (95% CI: 0.11, 0.12). The results indicated that infants who consume breast milk are within a safe limit for cancer risk. Conclusion: The exposure to significant metals is associated with disease development. Therefore, ongoing knowledge creation through mental acts and continuous observation is necessary to better understand the effects of heavy metals in future studies.
Investigation of the Prevalence of Back Pain and Related Risk Factors in Different Trimesters of Pregnancy in Pregnant Women Referring to Selected Health Centers in Shahrekord, Iran, During 2022-2023
Authors: Raisi Dehkordi Ziba , Sourinejad Hadis , Adibmoghaddam Elham , Babaiefar Simindokht , Hajivalizadeh Fatemeh
Published: January 2024

Background and aims: Back pain is one of the most common and often neglected problems in pregnancy. This study aimed to investigate the prevalence of back pain and its associated risk factors during the trimesters of pregnancy in pregnant women referring to selected healthcare centers in Shahrekord from 2022 to 2023. Methods: This cross-sectional study was conducted on 521 eligible pregnant women referring to selected holistic healthcare centers in Shahrekord, Iran, during 2022-2023. Data were collected using a demographic characteristics checklist completed as a self-report, and the presence of back pain was evaluated based on the perception and feeling that the mother herself had of any pain in the lower back area. The data were analyzed using SPSS (version 26), and P<0.05 was considered the significance level. Results: The prevalence of back pain in pregnant women was 62.7% in general, with a significant difference among trimesters of pregnancy (P<0.001). Among the investigated risk factors, there was a significant association between employment (P=0.01), type of delivery (P=0.002), type of anesthesia (P<0.001), history of back pain before pregnancy (P<0.001), and standing break of more than three hours (P<0.001) and the prevalence of back pain. In addition, increasing gestational age (P<0.001, odds ratio=1.308, 95% confidence interval=1.255–1.363) was a significant predictor of back pain in pregnancy. Conclusion: The results revealed that more than half of women experience back pain during pregnancy, and the most powerful factor in the prevalence of this disorder is increasing gestational age. Considering the high prevalence and effects of pain on the quality of life of pregnant women, it is important for service providers to identify and develop policies and design effective interventions to prevent or solve this problem.
Association of HLA rs3135388 and rs9271366 Single-Nucleotide Polymorphisms With Multiple Sclerosis in the Chaharmahal and Bakhtiari Province, Iran
Authors: Parchami Barjui Shahrbanou , Forouzandeh Shahrakei Zahra , Jivad Nahid
Published: January 2024

Background and aims: Genetics and environment are synergistic in multiple sclerosis (MS). Human leukocyte antigen (HLA) class II has a strong genetic association with MS. The aim of this study was to determine the association of HLA rs3135388 and rs9271366 single-nucleotide polymorphisms (SNPs) with MS. Methods: The rs3135388, rs9271366, and rs422951 SNPs were genotyped in 173 Iranian relapsing-remitting MS (RRMS) patients and 200 matched healthy controls, using the polymerase chain reaction-restriction fragment length polymorphism method. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using statistical software to estimate the risk factor for disease. The allele and genotype frequencies of SNPs were determined based on data analysis using SPSS, version 20. Results: Our results identified a strong association in the allele distribution for both rs3135388 and rs9271366 SNP, such that the A allele of rs3135388 (OR=1.765; 95% CI: 1.071–2.909) and the G allele of rs9271366 were found to be more frequent in MS patients than in healthy controls (OR=1.861; 95% CI: 1.025–3.3378). The mutated G allele for rs422951 SNP was relatively frequent (OR=1.128; 95% CI: 0.745–1.707). Conclusion: Our findings revealed the critical role of the rs3135388 and rs9271366 SNPs in MS disease progression. Genotyping MS patients could facilitate personalized medical management.
Effectiveness of Gait Training Using Dynamic Bodyweight Support System on Locomotor Abilities of Ambulatory Children With Different Neural Disorders
Authors: Zeinalzadeh Afsaneh , Lotfi Reza , Barmaki Hasan , Lotfi Mohammad , Shadman Alireza , Asadi Ali , Kobravi Hamid Reza
Published: January 2024

Background: In this study, we evaluated the efficacy of dynamic bodyweight-supported training on the gait quality of children with different neural disorders. Methods: Seventeen ambulatory children, aged 3 to 11 years, experiencing gait limitations, were selected to participate in the designed gait training program. Each child participated in 10 practice sessions held three days a week, with each training session using the dynamic body weight support system, comprising three stages, and lasting 20 minutes. Clinical assessments were conducted using four functional tests: "Five Time Sit to Stand Test (FSST)", "Modified Time Up and Go (MTUG)", "Time Up and Down Stairs (TUDS)", and "Pediatric Berg Balance Scale" (BBS). Results: Statistical tests demonstrated a significant increase in the post-values of the BBS after gait training. Notably, children with higher relative cognitive abilities showed more improvement. Additionally, there was a significant enhancement in the assigned score for the level of independence. As all participants had received conventional physical therapies for more than three years, reaching their maximum obtainable improvements with conventional training methods, the observed improvements could be attributed to the designed training protocol even without a control group. Conclusion: Designed gait training protocol using a dynamic weight support system proved effective in enhancing balance, improving gait quality, and increasing the level of independence during performing functional tests in ambulatory children suffering from different locomotor disabilities.
Autoimmune Parkinsonism: A Newer Manifestation of Contactin-Associated Protein-Like 2 Autoimmunity: A Case Report
Authors: Sumedha Maturu Mohan V. , Datla Aravind Varma , Devabhaktuni Rajesh Babu , Maturu Prajwala , Mandwe Deepak Sahebrao
Published: January 2024

Contactin-associated protein-like 2 (CASPR2) antibodies are part of an expanding spectrum of disorders. Although they were initially associated with Morvan’s syndrome and peripheral nerve hyperexcitability, their clinical manifestations are more varied than previously recognized. In this report, we present a rare case of a middle-aged woman who experienced gait disturbances, sleep disturbances, behavioral changes, and postural abnormalities over a period of five months. A thorough examination revealed a Parkinsonian phenotype. Considering the timeline and symptomatology, an autoimmune work-up was conducted, which detected CASPR2 antibodies in the patient’s serum. Treatment with high-dose intravenous Methylprednisolone followed by rituximab effectively reversed her clinical manifestations without residual neurological deficits.
Meta-genomic Analysis of Parasites of Hyalomma Ticks of Cattle
Authors: Ul Rehman Zia , Ur Rahman Sarfraz , Munir Muhammad Zubair , Jabar Abdul , Hussain Irtaza , Rashid Muhammad Imran
Published: January 2024

Introduction: Ticks are the obligate blood-feeding parasites responsible for transmitting various pathogens to domestic animals and humans. Ticks and tick-borne diseases are a continuous threat to livestock development in tropical and subtropical areas of the globe. To the best of our knowledge, this was the first study on the microbiome population of Hyalomma spp. infesting livestock in Pakistan. Methods: Ticks were collected from hemo-parasite-positive cattle and were identified using standard entomological keys. Then, selected ticks were kept in the biochemical oxygen demand (BOD) incubator for egg laying and hatching at optimum temperature and humidity. A total of 16 (saliva and gut) samples were amplified through the reverse line blotting (RLB) primer of which 9 out of 16 were positive. Out of 9 positive samples, 4 samples of saliva and 5 samples of gut showed a polymerase chain reaction (PCR) product of 390 bp on 1.5% agarose gel stained with cyber green safe gel dye. Similarly, all 16 samples were amplified through the PCR by applying primers specific to the genus Anaplasma. Out of 16 amplified samples (8 saliva and 8 gut), 9 samples exhibited a positive amplification of 345 bp on 1.5% Agarose gel. After the identification of the genus, all 16 samples were subjected to species identification through PCR by applying primers specific to Theileria annulata, Babesia bovis, and Babesia bigemina. Results: The results indicated that 9 out of 16 samples are positive for Theileria, showing a PCR product of 460 bp on Agarose gel, while none of the single samples was positive for B. bovis and B. bigemina, respectively. Overall, 16 samples were subjected to metagenomics analysis within the saliva and gut of Hyalomma ticks, and consequently, Anaplasma and T. annulata were identified. Hence, it was found that the Hyalomma tick reported in Pakistan is responsible for the transmission of T. annulata and Anaplasma spp., and both parasites are responsible for causing theileriosis and anaplasmosis in cattle. Conclusion: It can be concluded that Hyalomma anatolicum transmits both T. annulata and Anaplasma species but not Babesia species in cattle. Thus, H. anatolicum ticks are potent vectors for T. annulata and Anaplasma species.
Evaluation of Immunity Responses Against Excretory-Secretory and Lysate Antigens Purified from Leishmania major
Authors: Fattahi Bafghi Ali , Mozayan Mohammad Reza , Emtiazi Hamideh , Hezardastan Elaheh , Asadi Raziyeh
Published: January 2024

Introduction: Leishmaniasis is one of the 10 most important infectious diseases in the world, including the three diseases for which the development of vaccines, drugs, and insecticides is difficult to tackle. Despite over a century of efforts made in the field, no suitable vaccine, medicine, or insecticide has been introduced for the disease to date. In this survey, we intended to evaluate the immunity responses against Excretory-Secretory and Lysate Antigens purified from Leishmania major. Methods: A sufficient amount of L. major [MRHO/IR/75/ER] was first cultured in Novy-MacNeal-Nicolle (NNN) and RPMI 1640 media in the in vitro environment. Once peripheral blood mononuclear cells (PBMCs) were prepared, they were cultured with antigens in a 5% CO2 incubator, and their supernatant was then measured using the interleukin-4 (IL4) and interferon-γ (INF)-γ the enzyme-linked immunosorbent assay (ELISA) kit. Results: An average concentration of IL4 and INF-γ of the cell culture containing phytohaemagglutinin showed a significant difference between the average concentration of these two cytokines in the cell culture of all antigens (P<0.05), but it indicated insignificant difference between the antigens (P>0.05). Conclusion: Since the larger the immunogenic and protective components are exposed to the human immune system, the more concrete the results will be, investigations should thus be conducted at the cellular and even molecular levels. Moreover, the antigen used should be a conjugation of adjuvants, immunogens, and proliferators of macrophages to provide sufficient stimulation of the immune system against the Leishmania parasite.
Association between nutritional risk status and health related quality of life: An investigation on the aging patients with cardiovascular disease
Authors: Faraji Gavgani Leili , Alipour Somayeh , Khabiri Roghayeh , Laghousi Delara , Sarbakhsh Parvin , Farajiazad Haniyeh , Abbasalizad Farhangi Mahdieh , Jahangiry Leila
Published: January 2024

Introduction: Acknowledging the considerable influence of undernutrition on health outcomes and HRQOL, this study sought to appraise the nutritional risk status of elderly patients with cardiovascular diseases (CVD) through the utilization of the Nutritional Risk Screening (NRS). Additionally, the investigation aimed to evaluate the correlation between NRS status and HRQOL within the context of patients referred to a cardiac hospital in Tabriz, Iran. Methods: This cross-sectional study was conducted in Tabriz, Iran. The participants were selected randomly from patients referring to Shahid Madani Heart Hospital, a comprehensive university hospital during July to December 2018. A linear regression was used for control of confounding variables (age, gender, education level, marital status, and income levels) and predict the relationship between nutrition risk status and HQRL. Results: Of the 200 patients with CVD participated in this study, 68 (34%) of participants had normal nutrition status, 108 (54%) were at risk for undernutrition, and 24 (12%) had undernutrition. A total of 24 aging patients with undernutrition, 13 (54%) were divorced or widowed. 86% of patients with diabetes were at risk for undernutrition and 13.9% had undernutrition. There were statistically significant relationship between undernutrition and HRQOL dimensions, age, gender, and marital status. Conclusion: The study revealed a correlation between elevated undernutrition scores in patients and factors such as older age, female gender, and marital status of being divorced or widowed. Furthermore, the results imply that a notable elevation in the risk score for undernutrition in patients is significantly linked to impaired HRQOL among elderly individuals with CVD.
Artificial intelligence in cardiovascular medicine: An updated review of the literature
Authors: Zargarzadeh Arian , Javanshir Elnaz , Ghaffari Alireza , Mosharkesh Erfan , Anari Babak
Published: January 2024

Screening and early detection of cardiovascular disease (CVD) are crucial for managing progress and preventing related morbidity. In recent years, several studies have reported the important role of Artificial intelligence (AI) technology and its integration into various medical sectors. AI applications are able to deal with the massive amounts of data (medical records, ultrasounds, medications, and experimental results) generated in medicine and identify novel details that would otherwise be forgotten in the mass of healthcare data sets. Nowadays, AI algorithms are currently used to improve diagnosis of some CVDs including heart failure, atrial fibrillation, hypertrophic cardiomyopathy and pulmonary hypertension. This review summarized some AI concepts, critical execution requirements, obstacles, and new applications for CVDs.
Doppler Finding, Cardiovascular Function Assessment, and Fetuses’ Survival Following the Fetoscopic Laser in Twin-to-Twin Transfusion Syndrome
Authors: Ezazi Bojnordi Tahmineh , Eslamian Laleh , Marsoosi Vajiheh , Golbabaei Alireza , Sheikh Vatan Mehrdad , Shamshirsaz Alireza A. , Eshraghi Nasim , Ghaemi Marjan
Published: January 2024

Introduction: This study aimed to evaluate the effectiveness of selective laser photocoagulation of communicating vessels (SLPCV) on cardiac function in twins with twin-to-twin transfusion syndrome (TTTS). Methods: This retrospective cohort study evaluated 178 women with twin pregnancies complicated with TTTS and scheduled for SLPCV between 16 and 26 weeks of gestation. The severity of TTTS was determined by Quintero staging and the severity of cardiovascular disorders by the CHOP (Children’s Hospital of Philadelphia) score. Patient survival was evaluated through a one-month-after-birth follow-up of fetuses. Results: The study revealed significant improvements in Doppler indices in both donors and recipients after SLPCV. The CHOP score also significantly decreased after the intervention. One-month-after-birth survival rates were 55.1% in donors and 56.7% in recipients. Some Doppler indexes of fetuses before SLPCV could predict survival until one month after birth. Conclusion: The study suggests that SLPCV can improve cardiac function in fetuses with TTTS and that some Doppler indexes can predict survival outcomes. Additionally, the severity of TTTS can be a powerful indicator of the severity of cardiovascular complications.
Immune Response in Laser Tattoo Removal: A Systematic Review
Authors: Tjipta Arya , Ramadhan Hafiz , Lubis Rahmi Amelia
Published: January 2024

Introduction: The immune response to laser tattoo removal poses a significant challenge in its management, primarily due to its unpredictable nature, which can range from mild hypersensitivity reactions to severe anaphylaxis. Such responses can potentially hinder the effectiveness of laser tattoo removal procedures. Therefore, gaining a comprehensive understanding of the immune response to tattoo removal using laser techniques is of utmost importance to develop more efficient management strategies. This study aims to address this need by analyzing eight carefully selected articles obtained through a thorough literature review. Methods: To explore the immune response associated with laser techniques in tattoo removal, we employed a rigorous research methodology. A thorough literature review was conducted using reputable search engines such as Google Scholar, SagePub, and PubMed to collect relevant articles. Initially, 788 potential articles were identified through this process. Following meticulous scrutiny, only eight articles that met stringent inclusion criteria were selected for our study. This meticulous selection process ensures that the information presented here is derived from high-quality and pertinent research. Results: Based on the analysis of the eight selected articles, our findings illuminate the various immune responses that emerge following tattoo removal using laser techniques. These responses include hypersensitivity reactions, allergic manifestations, and, in certain instances, anaphylaxis. Hypersensitivity reactions typically manifested as erythema, edema, and pruritus, while allergic responses were observed in the form of urticaria. In summary, our study highlights that the immune response to laser tattoo removal primarily elicits hypersensitivity and, in some cases, anaphylaxis reactions. Conclusion: Our study underscores the significance of clinicians being vigilant regarding potential immune responses during laser tattoo removal. It is crucial to closely monitor patients to promptly address any adverse reactions. Further research holds the potential to enhance our understanding, paving the way for improved management strategies that can enhance patient safety and treatment success.
Nursing Students’ Reflections on the Clinical Learning Environment of the Oncology Unit: A Qualitative Study
Authors: Bagheri Maryam , Ashouri Elaheh , Mohammadi Pelarti Akram
Published: January 2024

Background: The clinical learning environment is an important part of nursing education with a significant impact on nursing students’ perceptions and experiences. This study aimed to explore nursing students› reflections to determine the effects of the first rotation in the clinical learning environment of the oncology unit on their perceptions and practices. Methods: A descriptive qualitative study design was used. Data were collected using reflective diaries of forty 5th-semester nursing students about their experiences of learning in the oncology unit. Conventional content analysis was used for data analysis using MAXQD 10 software. Results: Participants’ perceptions of the clinical learning environment of the oncology unit were categorized into four main categories, namely challenging encounters, perceived needs, internal transcendence, and professional role development. Conclusion: According to the results, nursing students’ unpleasant experiences must be managed. Careful attention should be devoted to the unique characteristics of this ward. Different educational strategies are needed, and clinical instructors must play their roles as facilitators in challenging conditions to promote nursing students’ clinical learning in oncology.
Nursing Instructors and Students, Views Related to Discrimination in Nursing Care: A Qualitative Study
Authors: Sadeghi Roya , Hashemi Zahra , Abdoli Fatemeh , Sadeghi Tabandeh
Published: January 2024

Background: One of the moral challenges in the healthcare system is discrimination in providing care to patients. The present study aimed to report the experiences of nursing instructors and students regarding discrimination in nursing care. Methods: This qualitative study was conducted using conventional content analysis through semi-structured interviews with 8 nursing instructors and 13 nursing students. The participants were selected using the purposive sampling method. Data collection continued until data saturation. Data were analyzed using Graneheim and Lundman’s proposed method. Data collection and analysis were concurrent. Results: According to the findings, "Discrimination paradigm," "Discrimination as a negative concept," and "The role of nursing instructors" (teaching moral values, being a role model, and evaluating moral standards) were identified as the main categories. Conclusion: According to the results of this study, nursing instructors are recommended to introduce moral topics to students, act as role models for them, and teach them how to deal with ethical challenges.
Unveiling the Depths of Existential Inquiry: A Qualitative Examination of Psychological Literature (2000-2023)
Authors: Lima Alencar Kenia Cristiana de , de Freitas Marta Helena
Published: January 2024

Introduction: This is a continuation of the previous article, “Exploring Existential Questions: A Comprehensive Review of Psychological Literature (2000-2023) – Part 1”, the aim of which, following on from an analysis that was more quantitative in nature, is to present the results of a more in-depth analysis of the articles by means of a qualitative and/or mixed approach, published between 2000 and 2023, with the aim of understanding how Psychology has appropriated the themes of existential vacuum and meaning of life over this period.
Method: Of the group of articles studied in Part I, only articles with qualitative or mixed approaches were analyzed in this second phase, in accordance with the following aspects: year of publication, theoretical references used in the articles, concepts employed in the studies, context and studied populations, emerging themes and relationship between the topic and psychotherapy, religiosity and spirituality.Results:Of the 264 articles selected in Part 1, 191 quantitative articles were excluded, leaving 73 articles with a qualitative or mixed approach, initially classified as follows: 46 theoretical/qualitative, 17 empirical/qualitative, 7 mixed and 3 interventions.
The Effectiveness of the Israeli Digital Diplomacy Targeting the Arab Public on Social Media Platforms
Authors: Koa Moeen , Nassar Hiba
Published: January 2024

This study assessed the effectiveness of the Israeli occupation state's digital diplomacy directed at the Arab public according to a three-dimensional framework. The study employed content analysis to analyze a sample of posts from two Israeli official pages on Facebook from October 13 to November 13, 2022, based on three dimensions proposed by Bjola and Jiang (2015): agenda-setting, presence-expansion, and conversation-generating. The results showed that despite the effectiveness of the occupying state's digital diplomacy according to these dimensions, the authors see these dimensions as superficial metrics that do not express the efficacy of this type of diplomacy. The high number of posts shared on the two pages and the significant number of comments cannot be seen as an indication of the efficiency of the message, the achievement of widespread acceptance for both pages and the topics they raise, as the overwhelming percentage of the responses observed on the two pages were hostile and critical. Therefore, the current study considers the need to develop this model to ensure that the feelings expressed by the pages' followers are measured to reflect the correct value of digital diplomacy's effectiveness.

هدفت هذه الدراسة إلى تقييم فعالية الدبلوماسية الرقمية لدولة الاحتلال الاسرائيلي الموجهة للجماهير العربية وفقاً للإطار الثلاثي الأبعاد، حيث اعتمدت الدراسة على المنهج المسحي وأداة تحليل المحتوى في تحليلها لمجموعة من منشورات الصفحات التابعة لدولة الاحتلال على منصة الفيسبوك، خلال الفترة الممتدة من 13 تشرين أول/ أكتوبر إلى 13 تشرين ثاني/ نوفمبر 2022، تم تحليلها وفقاً لثلاثة أبعاد شملت: جدول الأعمال، توسيع الوجود، وتوليد المحادثات. بينت النتائج أنه بالرغم من فاعلية الدبلوماسية الرقمية لدولة الاحتلال وفقاً لهذه الأبعاد، إلا أنها ترى في هذه الأبعاد قياساً ظاهرياً، لا يعبر تعبيراً فعلياً عن فاعلية هذه الدبلوماسية، إذا يرى الباحثان من خلال دراسة حالة الدبلوماسية الرقمية لدولة الاحتلال الإسرائيلي أنه على الرغم من نسبة المشاركة العالية لمنشورات الصفحتين، ونسبة التعليقات الكبيرة، فإن هذا الأمر لا يعد مؤشراً على كفاءة الرسالة، وتحقيق قبول شعبي لكلتا الصفحتين، وما تطرحانه من موضوعات، حيث أن النسبة الساحقة من الردود والمشاركات التي تلاحَظ في الصفحتين كانت ذات طابع نقدي وسلبي، وبالتالي ترى الدراسة الحالية ضرورة تطوير هذا النموذج بما يضمن قياس المشاعر التي يبديها المتابعون للصفحات لعكس قيمة صحيحة لفاعلية الدبلوماسية الرقمية.
Management of Penetrating Eye Injury with Intraocular Foreign Body
Authors: Putra Andi Cleveriawan Arvi , Victor Andi Arus , Elvioza Elvioza , Djatikusumo Ari , Andayani Gita Lisa , Ramayundanta Anggun
Published: January 2024

Background: To report the importance of vitrectomy procedure in penetrating eye injury with retain intraocular foreign body (IOFB) at the proper time. Methods: An observational case report. A 17-year-old man came to hospital and was diagnosed aspenetrating eye injury with retain intraocular foreign body of the left eye. The visual acuity of the left eyewas only 2 meters finger counting. Immediate surgery of scleral buckling, vitrectomy, intraocular foreignbody removal and intravitreal vancomycin-ceftazidime injection were performed on the next day. Results: There were metallic IOFB, retinal vasculitis and focal retinitis seen when vitrectomy wasperformed. One month after vitrectomy, the visual acuity of the left eye has improved to 6/12 with correction. Conclusion: Proper and prompt management of penetrating eye injury could contribute in preserving agood anatomical and functional result. In the existence of IOFB, vitrectomy should be done promptly inthe first surgical window to gain a better resultKeywords: penetrating eye injury; intraocular foreign body
The Influence of Childbirth Procedures to the Axial Length and Sclera Rigidity
Authors: Hayati Hayati , LR Fifin , DH Norma
Published: January 2024

Background: Various clinical and experimental studies attest that biochemistry and biomechanical of sclera are factors of influence shape and sclera size which is influence refraction status of the eye. Sclera streatching influenced by intraocular pressure (Valsava maneuver when bearing down effort), extracellular matrix (influenced by estrogene, progesterone and relaxin when pregnant), myopia and age.Objectives: To investigate the influence of delivery procedures of to the axial length and sclera rigidity.Methods: Samples of 60 eyes in two groups; vaginal deliveries (bearing down effort group) and operative deliveries (Caesar group) were tested in the pre and post test control design. Both groups underwent two examinations at prepartum and postpartum including visual acuity, anterior segment, posterior segment, measurement of axial length and sclera rigidity.Results: There were significant differences in the axial length mean in the bearing down effort group; the prepartum axial length is 22.81 Â± 0.94 mm and the post-partum is 23.20 Â± 0.80 mm. Pre-partum axial length mean is 23.05 Â± 1.24 mm and increased to 23.40 Â± 1.37 mm in the post-partum samples of Caesar group. This study also found that there were significant differences in the sclera rigidity mean in bearing down effort group which is 0.0144 Â± 0.0006 in the prepartum and increase to 0.0163 Â± 0.0060 in the postpartum. For the Caesar group, the sclerea rigidity mean was 0.0142 Â± 0.0480 in the prepartum and increased to 0.0150 Â± 0.0050 in the postpartum. Although no significant effects of bearing down effort to axial length and sclera rigidity was observed, the clinical results indicated that 53,85% of myopia in the bearing down effort groups experienced the increase postpartum corrected-lens approximately between -0,25 D to -0,75D and â€“ 0, 25 D to â€“ 1,00 D in 47,61% of myopia (Caesar groups).Conclusion: There is a significant difference in axial length and sclera rigidity prepartum and postpartum in both groups.
Horner Syndrome Related to Nasopharyngeal Carcinoma
Authors: Diana Nova , Nusanti Syntia , Sidik M.
Published: January 2024

Background: Horner syndrome classically presents with ipsilateral blepharoptosis, pupillary miosis, and facial anhidrosis. The syndrome results from interuption of the sympathetic innervation to the eye and ocular adnexae. Case Illustration: A 43-year-old male complaining of drop of upper eyelid right eye, anhidrosis right side of face, and numbness on his right face since 7 months previously. He had painless, slowly enlarging, right-sided neck mass that was first noticed approximately 7 months before presentation. The biopsy and CT scan confirmed nasopharyngeal carcinoma (NPC). Best corrected visual acuity of both eyes was 6/6, normal IOP and ocular movement. There was mild ptotic eyelid 2 mm of his right eye. Both anterior segment within normal limit. There was unequal pupils greater in the dark, with pupil size of the right eye 3 mm and left eye 5 mm. The pupils were reactive to light, without afferent pupillary defect. Both posterior segment examination were unremarkable. There was reduced sensibility of the right face at maxila and mandibular region. The patient was diagnosed with Horner syndrome with involvement of right trigeminal nerve at maxillary and mandibular division, and involvement of sweat glands corellate with preganglionic lesion. Conclusion: Nasopharyngeal carcinoma that affects oculosympathetic pathway may give clinical signs as Horner syndrome. There was found involved of sweat gland in this case, it is correlated with lesion in preganglionic. But the anhidrosis occurs only in maxila and mandibular region, therefore post ganglionic involvement can not be ruled out. Keywords: Horner syndrome, nasopharyngeal carcinoma
Various Tamponade in Surgery for Retinal Detachment Associated with Proliferative Vitreoretinopathy
Authors: Martha Faraby , Victor Andi A , Elvioza Elvioza , Djatikusumo Ari , Andayani Gitalisa A , Yudantha Anggun R
Published: January 2024

Background: To review the literature and report relative efficacy and safety of various tamponade agents used with surgery for rhegmatogenous retinal detachment (RRD) complicated by proliferative vitreoretinopathy (PVR) regarding functional success rate, anatomical success rate, and adverse effects. Methods: We searched articles from PubMed and Clinical Key database starting from the year of 1990 to November 2014. Information needed from all articles were extracted into data extraction sheet. We reviewed the efficacy of both tamponade agents regarding the postoperative visual acuity, macular attachment, and adverse effect. Results: Eight articles were included after fulfilling inclusion and exclusion criteria. Our analysis showed all studies shows an increasing visual acuity and percentage of macular attachment postoperatively of all type tamponade agents. Functional and anatomical success rate of Sulfur hexafluoride gas (SF6) was high in study with PVR stage B or less (94-98%). In patient with complex or recurrent RD associated with PVR, silicone oil had a better functional success (51% vs 32.5%) and better anatomical success (80% vs 60%) than SF6 gas. The anatomical success rate also higher in C3F8 than in SF6 group (73.9% vs 57.5% respectively). Functional and anatomical success rate of HSO as tamponade was high in patients with a severe PVR located mainly in the inferior quadrants (92.3%).Conclusion: As tamponade agents, C3F8 and silicone oil appear to have more visual and anatomic advantages over SF6 in participants with complex or recurrent RD associated with PVR. Silicone oil was better than C3F8 gas to obtain final visual and anatomic successs in patient with recurrent RD associated with higher grade PVR. Heavy silicone oil would be useful in particular cases complicated by recurrent inferior RD with PVR. Retinal redetachment, glaucoma, cataract, hypotony and keratopathy were reported in both gases and silicone group. Keywords: Tamponade in retinal detachment surgery, SF6, C3F8, silicon oil, and heavy silicone oil
Experience of Sutured Limbal Stem Cell Conjunctival Autograft after Pterygium Excision
Authors: Eddyanto Eddyanto , Z Ismi , Fazarrahmah Fazarrahmah , IR Windi
Published: January 2024

Background: To know the effectiveness of sutured limbal stem cell conjunctival autograft after pterygium excision in order to avoid recurrencies. Method: This is a prospective study of limbal stem cell conjunctival autograft after pterygium excision during December 2011 until April 2012. Type of operation were pterygium excision followed by cojunctival limbal stem cell autograft. Follow up be conducted at day 1, 1 week, 1 and 3 month post operatively. The recurrence rate was evaluated using Portable PASW statistics 18 software. Result: Twenty cases of pterygium had been operated. Ten cases could be evaluated 3 months. Three males and 7 females, average age was 50.2 Â± 10.55 year, range 38-72. 2cases were pre existing recurrence pterygium. BCVA pre operation range 1.00 - 0.1. BCVA post operation range 1.00 â€“ 0.20. One of 10 cases was recurrence after this study, the BCVA decrease and need repeated excision and limbal stem cell conjunctival autograft. There is no statistically significant correlation of the type of pterygium pre and recurrence post operatively. Moderate association was noted between BCVA pre operation and recurrence rate post operatively. Very strong association was noted between age of these patient and recurrence post operatively. There is a significantly differrence of BCVA before and after operations. Conclusion: Sutured limbal stem cell conjunctival autograft after pterygium excision in order to avoid recurrencies was effective 3 months after operation. The recurrence rate is 10%. This study need more samples and comparring group with other technique in order to know this tehnique is better than other or not. Keywords: Ocular surface disorder, corneal conjunctivalisation, pterygium excision, limbal stem cell transplantation
Visual Improvement in Retinal Vein Occlusion Patient Who Had Intravitreal Bevacizumab with and without Laser Photocoagulation
Authors: Febiana Marita , Sovani Iwan , Dahlan M Rinaldi , Karfiati Feti
Published: January 2024

Background: Intravitreal bevacizumab (IVB) appears to be an effective and safe drug for reducing macular edema and improving visual acuity secondary to RVO. Grid photocoagulation to macular edema caused by BRVO significantly improved long-term visual prognosis. In CRVO, reduced the angiographic evidence of macular edema, but did not lead to improvement in the vision of treated eyes. Methods: an observational, retrospective study from medical record of patients RVO underwent IVB and combined treatment at Cicendo National Eye Center conducted between January and December 2012. A total of 49 eyes from 49 patients met the inclusion criteria. Data was compiled on demographic characteristics, pre and postoperative visual acuities. The main outcome was proportion of visual gain in 1 month after therapy. Result: All patients (49 eyes) completed the 1 months follow-up with 17 patients BRVO who had treatment IVB and 11 patients with combined treatment. And 14 patients CRVO who had treatment IVB and 7 patients had combined treatment. The proportion of BRVO and CRVO eyes have the same visual improvement in IVB and combined treatment groups (BRVO 58.8% vs 72.7%, p=0.120 and CRVO 57.1% vs 57.1%, p=1.000). Conclusion: There was no significant difference in the proportion of visual improvement between IVB and combined treatment groups in BRVO and CRVO at one months follow up. Keywords: branch retinal vein occlusion, central retinal vein occlusion, intravitreal bevacizumab, laser photocoagulation
Diagnosis and Management of Devicâ€™s Disease
Authors: Desrina Desrina , Nusanti Syntia , Sidik M.
Published: January 2024

Background: To report diagnosis and management of Devicâ€™s Disease with good visual outcome.Case Illustration: A 51 years-old male came with sudden blurred vision of his right eye since 3 days.The patient also complained of lower limbs weakness, urinary retention, and defecation disorder.Ophthalmology examination revealed visual acuity of no light perception in the right eye and 6/12 inthe left eye. Light reflex of both eyes decreased. Funduscopy examination of the right eye showed anindistinct edge and hyperemic optic nerve head, cup-disc ratio was hard to be evaluated, artery/vein ratioofÂ  2/3, macular reflex was positive and the retina was good. Funduscopy of the left eye was within normallimit. No pathological finding in brain Magnetic Resonance Imaging (MRI). Thoracolumbal MRI supportlongitudinal transverse myelitis. The patient was diagnosed as Devicâ€™s Disease and treated initiallywithintravenous methylprednisolone 1 g/day for five days followed by methyl prednisolone orally.Conclusion: Early diagnosis of Devicâ€™s Disease is important because immediate therapeutic interventionis required to get excellent result, prevent relapse and further disability.
Management of Sturge Weber Syndrome
Authors: Irfani Irawati , Hardwiyani Sri
Published: January 2024

Background: Sturge-Weber syndrome (SWS) is a neurocutaneous syndrome, characterized by theassociation of facial port-wine hemangiomas in the trigeminal nerve distribution area, with vascularmalformation(s) of the brain (leptomeningeal angioma) with or without glaucoma. It reports a 3 monthold baby girl presented to Pediatric Ophthalmology Unit Cicendo Eye Hospital with Sturge Weber Syndrome.Case Illustration: A 3 month old baby girl presented to Pediatric Ophthalmology Unit Cicendo EyeHospital as a referral from Pediatric Department. Here in, the patient presented with port wine stain,cerebral lesion according to MRI. Her intraocular pressure on first examination was 29.33 mmHg on herright eye and 18.33 mmHg, then she was underwent examination under anesthesia and trabeculotomy-trabeculectomy procedure on December11th 2014. There was a complication of choroidal detachment aftersurgery,and the patient received oral corticosteroid to overcome the problem.On the last visit,this patient presented with controlled intraocular pressureand minimal abnormality in the retina.Conclusion:Treatment for Sturge Weber Syndrome usually symptomatic. Treatment of choice for glaucoma due to Sturge Weber Syndrome is surgical intervention rather than medical therapy.Keywords: Sturge-Weber syndrome, glaucoma
Clinical Outcomes of Laser Peripheral Iridotomy in Eyes with Primary Angle Closure Suspect and Primary Angle Closure
Authors: Hilda Faresa , Suryono Astrianda , Artini Widya
Published: January 2024

Background: Primary angle closure glaucoma (PACG) is a leading cause of bilateral blindness worldwide. Laser peripheral iridotomy (LPI) has been proposed as the standard prophylactic option for patients with the risk of developing the spectrum of disease, from primary angle closure suspect (PACS) toprimary angle closure (PAC) then to PACG. We aim to evaluate the effect of LPI on intraocular pressure(IOP), anterior chamber depth (ACD) and angle width, as prophylactic management in PACS and PAC.Methods: Literature search was conducted from MEDLINE database using Pubmed search engine.Inclusion criteria were all studies (interventional and observational) that reported outcomes of LPI onPACS and/or PAC eyes. Exclusion criteria were outcomes of LPI on PACG eyes.Results: There were 8 studies included in this literature review; 4 studies evaluated patients with PACS,1 study evaluated patients with PAC, while 3 studies had compared between PACS and PAC. FollowingLPI, majority of the studies showed a decrease of IOP when compared to baseline. While, 5 studiesevaluated changes of central ACD and majority of those studies indicated deepening of ACD. Fourstudies had assessed the angle width changes after LPI that revealed advancement of angle width.Conclusion: The results of this literature review showed that LPI in PACS and PAC eyes showed decrease of IOP within a specified period, the deepening of central ACD and increase of angle width.Keywords: Primary angle closure suspect, primary angle closure, laser peripheral iridotomy
The Effect of Prophylactic Nepafenac 0.1% Eye Drops on Macular Changes after Phacoemulsification in Non- Proliferative Diabetic Retinopathy Patients Using Spectral Domain Optical Coherence Tomography (SD-OCT)
Authors: Soedarman Soefiandi , Djatikusumo Ari , Widyawati Syska , Setiawati Arini
Published: January 2024

Background: To evaluate the effect of prophylactic nepafenac eye drops on macular thickness changes after phacoemulsification surgery in mild to moderate NPDR patients. Method: This study is an open label randomized clinical trial. Thirty-six subjects who met the inclusion criteria underwent phacoemulsification. One group (18 subjects) were given nepafenac 0.1% eye drops and the rest were given placebo. Foveal thickness was measured by SD-OCT before surgery and the fourth week after phacoemulsification. Best corrected visual acuity (BCVA) and degree of inflammation in the anterior chamber were also being assessed. Result: There was a statistically significant increase foveal thickness in the placebo group 4 weeks after phacoemulsification (p=0.022). Clinically, percentage degree of inflammation in anterior chamber in placebo group was higher than nepafenac group (38.9% : 5.6%) but not significantly different between 2 groups (p=0.27). Nepafenac group achieved clinically better BCVA than the placebo group 4 weeks after phacoemulsification, although statistically there was no significant difference between 2 groups (p=0.991). Conclusion: Nepafenac 0.1% eye drops could prevent foveal thickening 4 weeks after phacoemulsification in mild to moderate NPDR patients. Clinically, nepafenac 0.1% eye drops could decrease the risk of inflammation in the anterior chamber, risk of CME, and vision deterioration although did not reach statistically significant. Keywords: Nepafenac, macular thickness, phacoemulsification, retinopathy diabetic
The Comparison of S100 A8/A9 Protein Receptor Expression between Progressive and Non-Progressive Pterygium
Authors: Puspinarti Cerah , Iskandar Elza , Erna Riani , Wresnindyatsih Wresnindyatsih , Bahar Erial
Published: January 2024

Background: S100 A8/A9 protein suggest have an activity at inflammation pathway caused fibroblast proliferation which is support the patofisiology teori of pterygium. Methods: This research is a cross sectional study consists of 21 subject who suffered primary nasal or temporal pterygium. All subject divided into 2 grup, progressive dan non progressive pterygium with this following criteria: length of pterygium at the cornea, diameter ilots de Fuch, thickness of corpus compare with apex dan hiperemia of pterygium. The tissue of pterygium after excised were examined through histopatology and immunohistochemical with HE and reagent Mab 27E10 staining to see S100 A8/A9 protein reseptor expression. And than we calculate between staining cell and intencity of the brown-colour of reseptor that call staining Index to see the trend to proggressive pterygium. Results: From 21 subject of study, amount of 11 subject (52,38%) progressive pterygium and 10 subject non progressive pterygium (47,62%). We found S100 A8/A9 protein reseptor expression at proggressive group were higher than non progressive group. Cut off point in staining index is 25 that show the pterygium has trend to be proggresive at that point or more. Histopatology examination there are strong correlation progresifity pterygium with squamous epithel prolifertion, cell inflamation, and vascular proliferation. Conclusion: There is a significant differentiate in S100 A8/A9 protein receptor expression between progressive and non progressive pterygium. Keywords: S100 A8/A9 protein, progressive pterygium, immunohistochemical
Advanced Glaucoma as A Late Manifestation of Axenfeld-Rieger Syndrome
Authors: Congga Olly , Syamsu Noor , Waspodo Noro , Devi Andi Tenrisanna , Akib Marliyanti Nurrahma
Published: January 2024

Background: To report a case of advanced glaucoma manifestation in Axenfeld-Rieger syndrome.Case Illustration: A 9 years old girl presented to our outpatient clinic with blurred vision in both eyesexperienced since the last 3 years. According to her labor history, she was born normal, full-term, birthweight is unknown. History of protruding eyes felt since last 1 year. History of previous treatment inSinjai given timolol 0.5% drop twice daily in both eyes 2 weeks ago. For ophthalmology examination,we performed visual acuity examination, orthopthic examination, Perkins tonometry, slit-lamp biomicorscopy, gonioscopy, funduscopy, biometry, B-scan ultrasonography, and Hertel mirror exophthalmometer measurement.Conclusion: Abnormalities of the angle may be found in patients with a diagnosis of Axenfeld-Riegersyndrome. These conditions are all associated with increased intraocular pressure and an icreasedincidence of glaucoma with around 50% of patients developing glaucoma. Early treatment will givebetter visual outcomes and good prognosis to Axenfeld-Rieger syndrome.Keywords: Axenfeld-Rieger syndrome, glaucoma