bluuebunny/crossref_metadata_2025 huggingface dataset:
Red light irradiation as an intervention for myopia
Authors: Huang Zhu , He Ting , Zhang Junna , Du Chixin
Published: August 2022

Myopia is one of the main causes of visual impairment worldwide. Preventing myopia and providing myopia-related interventions are of paramount importance. Based on a thorough review of the available literature, we conclude that red light irradiation can produce hyperopia, resulting in myopia prevention and control. Further, we suggest that red light irradiation may be a powerful tool for myopia prevention and control in the future. At the same time, red light has a protective effect on the cornea and retina at the cellular level, suggesting that red light irradiation may be a safe and effective modality for delaying myopia. Therefore, this form of irradiation is expected to play an important role in the prevention and control of myopia. However, more studies are needed to enhance the current state of knowledge and inform medical guidelines more comprehensively.
Advances in the diagnosis of herpes simplex stromal necrotising keratitis: A feasibility study on deep learning approach
Authors: Natarajan Radhika , Matai Hiren D , Raman Sundaresan , Kumar Subham , Ravichandran Swetha , Swaminathan Samyuktha , Alex John Sahaya Rani
Published: August 2022

Purpose:

Infectious keratitis, especially viral keratitis (VK), in resource-limited settings, can be a challenge to diagnose and carries a high risk of misdiagnosis contributing to significant ocular morbidity. We aimed to employ and study the application of artificial intelligence-based deep learning (DL) algorithms to diagnose VK.

Methods:

A single-center retrospective study was conducted in a tertiary care center from January 2017 to December 2019 employing DL algorithm to diagnose VK from slit-lamp (SL) photographs. Three hundred and seven diffusely illuminated SL photographs from 285 eyes with polymerase chain reaction–proven herpes simplex viral stromal necrotizing keratitis (HSVNK) and culture-proven nonviral keratitis (NVK) were included. Patients having only HSV epithelial dendrites, endothelitis, mixed infection, and those with no SL photographs were excluded. DenseNet is a convolutional neural network, and the two main image datasets were divided into two subsets, one for training and the other for testing the algorithm. The performance of DenseNet was also compared with ResNet and Inception. Sensitivity, specificity, receiver operating characteristic (ROC) curve, and the area under the curve (AUC) were calculated.

Results:

The accuracy of DenseNet on the test dataset was 72%, and it performed better than ResNet and Inception in the given task. The AUC for HSVNK was 0.73 with a sensitivity of 69.6% and specificity of 76.5%. The results were also validated using gradient-weighted class activation mapping (Grad-CAM), which successfully visualized the regions of input, which are significant for accurate predictions from these DL-based models.

Conclusion:

DL algorithm can be a positive aid to diagnose VK, especially in primary care centers where appropriate laboratory facilities or expert manpower are not available.
A prospective study of a new presbyopia pseudophakic intraocular lens: Safety, efficacy and satisfaction
Authors: Bianchi German R
Published: August 2022

Purpose:

To evaluate the safety, visual performance, and patient satisfaction of a new presbyopic pseudophakic intraocular lens (IOL).

Methods:

A prospective non-randomized case-series study was performed in Buenos Aires, Argentina. Patients included in the study underwent a programmed Femtosecond laser assisted cataract surgery (FLACS), performed between October and December 2020, with a 6-month follow-up period. The Intensity (Hanita Lenses) IOL was bilaterally implanted. Spherical equivalent (SE) refraction, uncorrected distance and near visual acuity (UDVA/UNVA), defocus curve, endothelial cell density (ECD), central corneal thickness (CCT), and a satisfaction questionnaire were evaluated.

Results:

A total of 56 patients (112 eyes), aged 65 ± 6.12 years were included. The mean ± SD of preoperative SE was 1.85 ± 2.24 D (range; −4.50 to 4.75), which had decreased 6 months after surgery to −0.08 ±0.32 D (range; −0.75 to 0.63). No eyes experienced a loss of lines of vision, and 94% obtained SE values between ± 0.50 D. Defocus curve for different additions was 0.03 LogMAR (logarithm of the minimum angle of resolution) for −3.0 D, −0.005 LogMAR for −1.5 D, and −0.07 LogMAR for 0 D. The ECD, CCT remained stable (P: 0.09 and 0.58, respectively) and all patients achieved their preoperative expectations, with a 6-month follow-up period.

Conclusion:

Patients who underwent a safe bilateral implantation with Intensity IOL achieved a high degree of spectacle independence and satisfaction, 6 months after surgery.
Outcomes of medical and surgical management in eyes with idiopathic elevated episcleral venous pressure
Authors: Ganesh Nagalekshmi , Alam Md Shahid , George Ronnie J , Balekudaru Shantha , Vijaya Lingam
Published: August 2022

Purpose:

Idiopathic elevated episcleral venous pressure (IEEVP) is a rare cause of secondary glaucoma and is a diagnosis of exclusion. The aim of this study was to describe the clinical presentation and analyze the outcomes of medical and surgical management in eyes diagnosed with idiopathic elevated episcleral venous pressure.

Methods:

A retrospective analysis of eyes diagnosed with IEEVP over a 5-year period between April 2012 and March 2016 was performed. The demographic details, medical history, and clinical course of the cases were obtained from the medical records. Data pertaining to the severity of glaucomatous damage, response to medical management, need for surgical intervention, and their outcomes were analyzed.

Results:

Fifteen eyes of 13 patients were included. Thirteen eyes (86.6%) had open angle configuration. Among the 13 eyes that had glaucoma, eight eyes (61.5%) had severe glaucoma, four eyes (30.7%) had moderate glaucoma, and one eye (7.6%) had mild glaucoma. The median follow-up was 210 days. Seven of the 15 eyes (46.6%) required a glaucoma filtration procedure, and three underwent prophylactic sclerotomies. 71.4% of these eyes had complete success. One out of the seven operated eyes required choroidal drainage post-operatively.

Conclusion:

IEEVP is an extremely rare condition and presents with raised intra-ocular pressure and tortuous episcleral vessels. The management of IEEVP is similar to that of primary open angle glaucoma. Uveal effusion is to be anticipated, and hence, combining trabeculectomy with prophylactic sclerotomies is advisable.
Eye care seeking behavior among rural adults in South India: Tamil Nadu Rural Eye Examination (TREE) Study Report 1
Authors: Rangavittal Subhiksha , Narayanan Anuradha
Published: August 2022

Purpose:

To present the eye care seeking behavior among rural adults in South India.

Methods:

This cross-sectional study was conducted between 2019 and 2020 covering three blocks of the Thiruvannamalai district, Tamil Nadu, India. Door-to-door survey was performed to collect demographic information, status of literacy, occupation, and details of previous eye examination. Distance visual acuity was tested for individuals available in the house using a log MAR (logarithm of minimum angle of resonance) chart. Association between demographic details, details of previous eye examination, and status of vision was analyzed using logistic regression.

Results:

A data of 12,913 individuals were included for the analysis, of which 6460 (50.03%) were females. Of the total individuals, 2007 (15.54%) had undergone an eye examination previously. There were 1639 (28.50%) people who had a vision less than 0.2 log MAR in at least one eye. The odds of reported ‘previous eye examination’ were more among females [odds ratio (OR) 1.48, 95% confidence interval (CI): 1.32–1.66, P < 0.001]; individuals aged above 60 years [OR: 11.46, 95% CI: 9.44–13.91, P < 0.001], between 40 and 60 years [OR: 10.43, 95% CI: 8.85–12.30, P < 0.001], and between 18 and 40 years [OR: 2.48, 95% CI: 2.16–2.84, P < 0.001]; illiterates (OR: 1.76, 95% CI: 1.45–2.15, P < 0.001); and farmers (OR: 1.32 95% CI: 1.12–1.55, P = 0.001).

Conclusion:

The study presents the utilization of eye care among rural South Indian adults. Almost 84.46% of individuals had not undergone any eye examination. Robust measures to promote eye care management would help in effective utilization of eye care services among rural adults.
Ocular manifestations in moderate-to-severe psoriasis in India: A prospective observational study
Authors: Kharolia Anjali , Parija Sucheta , Moharana Bruttendu , Sirka Chandra Sekhar , Sahu Sandip Kumar
Published: August 2022

Purpose:

Ocular manifestations in psoriasis are due to direct eye involvement with psoriatic plaques or psoriasis-related, immune-mediated inflammatory processes. The commonly reported pathologies are blepharitis, conjunctivitis, keratitis, dry eyes, and uveitis. Limited data is available on the ocular findings in psoriasis patients in India. In this study, we evaluated various ocular changes associated with moderate-to-severe psoriasis.

Methods:

In this prospective cohort study, treatment-naive psoriasis patients with Psoriasis Area Severity Index (PASI) score of more than 10 were included. The Ocular Surface Disease Index (OSDI) score, Schirmer’s score, tear film breakup time (TBUT), corneal and conjunctival staining score, and meibomian gland dysfunction score were noted. All these parameters were re-evaluated at 8 weeks of follow-up after systemic treatment.

Results:

Sixty-eight patients were enrolled in the study. The most common ocular pathologies observed in this study were tarsal hyperemia and anterior blepharitis in 128 (94.1%) and 64 (47%) eyes, respectively. Mild, moderate, and severe dry eyes were seen in 26 (19.1%), 14 (10.2%), and 34 (25%) eyes, respectively. Thirty-nine (57.3%) patients complained of significant difficulty watching television or digital screen. In 21 patients evaluated on follow-up at 8 weeks, cornea and conjunctiva’s ocular surface staining score increased and TBUT decreased significantly.

Conclusion:

The most common ocular pathologies observed in this study were anterior blepharitis and moderate dry eye, which significantly affected most patients’ daily routines. Screening patients with greater severity of psoriasis would help in early management of such problems.
The impact of amphotericin B-fortified preservation media on donor rim cultures and posttransplant infection
Authors: Hussey Vincent , Sheils Catherine R , Salimiaghdam Nasim , Young Kirsten , Farid Marjan
Published: August 2022

Purpose:

To determine the impact of amphotericin B supplementation to donor cornea preservation solutions on the rates of positive donor rim fungal cultures and postkeratoplasty fungal infections.

Methods:

This was a retrospective analysis of cases undergoing corneal transplantations at a single tertiary referral center from 2016 to 2021. Patients undergoing corneal transplantations with and without amphotericin B supplementation to the storage media were reviewed for donor rim culture results and postoperative infection. The primary outcome measures were positive donor rim fungal culture results and postkeratoplasty fungal infection.

Results:

A total of 1238 corneal transplants were analyzed. Of these, 849 were stored in preservation solution without amphotericin B, while 389 had amphotericin B included. There was a lower incidence of positive donor rim fungal cultures in cases with amphotericin B supplementation (1.8%) compared to the cases without amphotericin B (2.9%), although this difference was not statistically significant (P = 0.24). Of the 389 cases with amphotericin B supplementation, one (0.25%) went on to develop clinically significant infection, while three of 849 (0.35%) cases without amphotericin B developed infection. The sample size was too small to determine the effect of amphotericin B on the incidence of postkeratoplasty fungal infection.

Conclusion:

The addition of amphotericin B to donor cornea preservation solution resulted in a downward trend of positive donor rim fungal cultures and postkeratoplasty fungal infections, although these differences did not reach statistical significance. Further studies with larger sample sizes are necessary to appropriately determine the impact of amphotericin B supplementation in the storage solution on positive donor rims and postkeratoplasty fungal infections.
Impact of the COVID-19 pandemic on the trends in corneal donor mortality data from Eye Bank records in India
Authors: Das Anthony Vipin , Kommu Deepti Raj , Chilukuri Raviteja , Chilukuri Harihar , Chaurasia Sunita
Published: August 2022

Purpose:

To describe the causes and trends of corneal donor mortality from eye bank data in India during the coronavirus disease 2019 (COVID-19) pandemic.

Methods:

This retrospective eye bank-based study included 13,529 donors who donated their cornea between January 2018 and December 2021. Donors in whom the cause of mortality was documented were included as cases. The data were collected from the eye bank records.

Results:

Overall, 13,529 corneal donors were included in the study. Most of the donors were males (69.71%). The mean age of the donors was 51.55 ± 20.54 years, whereas the median age was 51 (inter-quartile range: 35–68) years. The mean age of males (49.3 ± 19.47 years) was lesser than the mean age of females (56.72 ± 21.94 years) at the time of donation. The most common age group at the time of donation was during the sixth decade of life with 2,139 (15.81%) donors. The mean age of the donors decreased by a decade from 54.95 ± 20.51 years in 2018 to 44.35 ± 18.88 years in 2021. The most common cause of donor mortality was cardio-respiratory arrest in 5,190 (38.36%) donors and trauma in 3,469 (25.64%) donors, followed by suicide in 2,790 (20.62%) donors. The trend of cardio-respiratory arrest decreased from 53.01% to 9.5% (p = <0.00001), whereas the trends of trauma increased from 21.93% to 36% (p = <0.00001) and suicide increased from 12.71% to 36.41% (p = <0.00001) between 2018 and 2021.

Conclusion:

Corneal donors are more commonly males in their sixth decade of life. The most common cause of donor mortality was related to cardio-respiratory arrest with a concerning rising trend in suicide cases over the years seen significantly during the pandemic.
Does Obesity Affect the Outcomes of Clinically Localized Prostate Cancer in the Era of Extraperitoneal Robot-Assisted Radical Prostatectomy?
Authors: Tung Mu-Chiao , Wu Chun-Hsien , Wu Richard C. , Kuo Wade Wei-Ting , Mai Hsing-Chia , Chen Sih-Han , Chiang Chao-Yang , Lin Victor C.
Published: August 2022

Purpose:

Obesity has been proven to affect the outcomes in open radical prostatectomy. However, the relationship between obesity and the outcomes of robot-assisted radical prostatectomy (RARP) was not conclusive. Herein, we aimed to investigate the impact of obesity on the clinical outcomes after RARP.

Materials and Methods:

From April 2016 to June 2020, 164 patients underwent RARP by a single experienced surgeon at our institute. Patients with previous transurethral resection of prostate (n = 30), hernioplasty (n = 13), and transperitoneal RARP (n = 26) were excluded. Finally, 105 patients were enrolled and divided into different groups according to their body mass index (BMI) and waist circumference (WC) using the definition of Taiwan National Health Institute. BMI was categorized into three groups (normal: BMI <24, overweight: BMI between 24 and 27, and obese: BMI ≥27 [kg/m2]). WC was categorized into two groups (normal: WC <90 and central obesity: WC ≥90 [cm]). Perioperative outcomes and functional outcomes including preoperative, postoperative erectile function, and postoperative continence status were evaluated.

Results:

Among BMI groups, 29 patients were normal, 43 patients were overweight, and 33 patients were obese. Console time and sum time showed a significant difference in different BMI groups (P = 0.034 and 0.016, respectively). Of the 101 patients with available magnetic resonance imaging, 74 patients' WC were normal, and 27 patients were central obese. Blood loss in central obesity group was significant more than normal WC group (300 ml vs. 200 ml, P = 0.04). No significant differences were observed in pathological and functional outcomes in both groups.

Conclusion:

Obesity and central obesity seemed to result in longer operation time and more blood loss in extraperitoneal RARP while functional outcomes can be maintained regardless of the obesity degree. Large-scale studies are necessary to further explore the relationship between obesity and the outcomes of RARP in future.
Обобщенная модель стохастической игры полковника Блотто
Authors: Kharlamov Victor Vladimirovich
Published: August 2022

В статье рассматривается обобщение стохастической модификации игры полковника Блотто, также известной как игра гладиаторов. В исходной модели каждый из двух игроков обладает набором гладиаторов с заданными силами. Сражение команд гладиаторов происходит путем индивидуальных поединков гладиаторов. В каждом поединке вероятность победы гладиатора пропорциональна его силе. Kaminsky et al. в 1984 году получили выражение для вероятности победы в терминах взвешенных сумм экспоненциальных величин. В настоящей работе дается интерпретация указанного результата с точки зрения теории марковских цепей с непрерывным временем, рассматривается более общая постановка задачи, для которой удается получить аналогичное выражение.
О континуантах цепных дробей с рациональными неполными частными
Authors: Dolgov Dmitry Aleksandrovich
Published: August 2022

Цепные дроби с рациональными неполными частными с правым сдвигом естественным образом возникают в ходе применения $k$-арного алгоритма Соренсона к отношению натуральных чисел $a$, $b$. Применение этого алгоритма дает возможность получать разные виды таких дробей. С ними связаны особые формы континуантов, т. е. многочленов, с помощью которых можно выразить числитель и знаменатель подходящей дроби. В данной работе введены соответствующие дроби и континуанты, исследованы свойства экстремальных значений континуантов с ограничениями на переменные из алгоритма Соренсона с правым сдвигом, в частности асимптотическое поведение, получена конструкция, аналогичная треугольнику многочленов Фибоначчи.
Логические расширения оператора параметрического замыкания
Authors: Marchenkov Sergey Seraphimovich
Published: August 2022

В обзоре рассматриваются все логические расширения оператора параметрического замыкания - расширения, которые получаются внесением в язык параметрического замыкания произвольных логических связок либо квантора общности. Помимо собственно оператора параметрического замыкания образуются операторы позитивного и импликативного замыкания, а также оператор замыкания с полной системой логических связок и конъюнктивно-кванторный оператор замыкания. Приводятся основные факты о классификациях множеств $P_k$, порождаемых данными операторами.
О мультипликативной сложности многочленов
Authors: Sergeev Igor Sergeevich
Published: August 2022

В работе оценивается мультипликативная (нескалярная) сложность $\mu(M_{d,n})$ вычисления класса $M_{d,n}$ комплексных многочленов $n$ переменных степени не выше $d$. Установлено, что при постоянном $d \ge 2$ справедливо соотношение $\mu(M_{d,n}) \asymp n^{\lceil d/2\rceil}$: новой является нижняя оценка при нечетных $d$. Для сложности класса кубических многочленов полученные оценки имеют вид $n^2/18 \lesssim \mu(M_{3,n}) \lesssim n^2/4$.
Слабо надкритический ветвящийся процесс в неблагоприятной случайной среде
Authors: Afanasyev Valeriy Ivanovich
Published: August 2022

Пусть $Z_{n}\}$ - слабо надкритический ветвящийся процесс в случайной среде и $\{S_{n}\}$ - его сопровождающее случайное блуждание. Рассмотрим естественный мартингал $W_{n}=Z_{n}\exp(-S_{n})$, где $n\geq 0$. Доказаны две предельные теоремы для случайного процесса $W_{\lfloor nt\rfloor}$, где $t\in [0,1]$, рассматриваемого либо при условии неблагоприятной среды $\{\max_{1\leq i\leq n}S_{i}<0\}$, либо при условии неблагоприятной среды $\{S_{n}\leq u\}$, где $u$ - положительная постоянная.
Критические ветвящиеся процессы, эволюционирующие в неблагоприятной случайной среде
Authors: Vatutin Vladimir Alekseevich , Dyakonova Elena Evgen'evna
Published: August 2022

Пусть $Z_{n},n=0,1,2,…\} $ - критический ветвящийся процесс в случайной среде, а $\{ S_{n},n=0,1,2,…\} $ - его сопровождающее случайное блуждание. Известно, что если приращения этого случайного блуждания принадлежат (без центрирования) области притяжения устойчивого закона, то существует такая правильно меняющаяся на бесконечности последовательность $a_{1},a_{2},…$, что при $n\rightarrow \infty$ условные распределения \begin{equation*} \mathbf{P}(\frac{S_{n}}{a_{n}}\leq x|Z_{n}>0),\quad x\in (-\infty,+\infty), \end{equation*} слабо сходятся к распределению строго положительной и собственной случайной величины. В данной работе мы дополняем этот результат описанием асимптотического поведения вероятности \begin{equation*} \mathbf{P}(Z_{n}>0, S_{n}\leq \varphi (n)), \end{equation*} если $\varphi (n)\rightarrow \infty$ при $n\rightarrow \infty$ таким образом, что $\varphi (n)=o(a_{n})$.
Calf Circumference Measurement Protocols for Sarcopenia Screening: Differences in Agreement, Convergent Validity and Diagnostic Performance
Authors: Rose Berlin Piodena-Aportadera Melissa , Lau Sabrina , Chew Justin , Lim Jun Pei , Ismail Noor Hafizah , Ding Yew Yoong , Lim Wee Shiong
Published: August 2022

Background: Although recommended by the Asian Working Group for Sarcopenia 2019 consensus (AWGS’19) as a screening tool for sarcopenia, there remains no consensus regarding the position (sitting, standing) or laterality (right, left) for the measurement of calf circumference (CC). This study aimed to determine the agreement between CC measurements, correlations with muscle mass and function, and diagnostic performance for sarcopenia screening.Methods: We studied 176 healthy community-dwelling older adults (mean age, 66.8±7.1 years) from the GERILABS-2 study. CC was measured using non-elastic tape in four ways: left and right sides in the sitting and standing positions. Sarcopenia was diagnosed using the AWGS’19 criteria. We produced Bland-Altman plots to assess the agreement, partial correlations for muscle mass and function to compare convergent validity, and area under the receiver operating characteristic curve (AUC) to compare diagnostic performance.Results: The prevalence rate of sarcopenia was 17.4%. Sitting CC was larger than standing regardless of laterality (right 35.31±2.95 cm vs. 34.61±2.74 cm; left 35.37±2.96 cm vs. 34.70±2.83 cm; both p<0.001), consistent with the systematic bias on Bland-Altman plots showing the overestimation of sitting over standing measurements (right bias=0.70 cm; 95% confidence interval [CI], -0.48–1.88; left bias=0.67 cm, 95% CI, -0.35–1.68). After adjusting for age and sex, CC was significantly correlated with appendicular skeletal mass, hand grip strength, knee extension, gait speed, chair stand, and short physical performance battery. Although right-sided CC measurements had better diagnostic performance (AUC=0.817), the difference was not statistically significant compared to the other positions (p>0.05). The optimal cutoff was <34 cm for all measurements, except for the left standing position (cutoff <35 cm).Conclusion: Standing CC measurements are recommended for sarcopenia screening in community-dwelling older adults because of their good agreement without systematic bias, convergent validity, and diagnostic performance.
Knowledge, Attitude, and Practices among HIV/Leishmaniasis Co-Infected Patients in Bihar, India
Authors: Devipriya J. S. , Gupta Ashok Kumar , Pavan Garapati , Dhingra Sameer , Murti Krishna , Ravichandiran Velayutham , Pandey Krishna
Published: August 2022

Visceral leishmaniasis (VL) is a serious public health concern in the Indian state of Bihar, which has been exacerbated by an increasing HIV/AIDS incidence that has resulted in poor clinical outcomes. So far, there has been no investigation into the knowledge, attitude, and practices (KAP) of people who have been subjected to hospital-based supervision for VL or HIV/VL co-infection. This study assessed the KAP toward VL infection among 210 VL-infected patients (126 participants with VL and 84 participants with HIV/VL) using a pretested standard questionnaire. The findings are summarized descriptively and KAP scores are classified dichotomously (good/poor). Multivariable logistic regression and bivariate correlation were used in the analysis. The study showed that both VL-infected and co-infected patients exhibited similar deficits in KAP scores toward VL. The HIV/VL participants who had a personal or family history of VL were more likely to have appropriate awareness of and preventive practices toward VL. The independent predictors of attitude index in HIV/VL participants were education, VL family history, and marital status. There was a weak but significant positive correlation between knowledge and practice (rs = 0.321, p<0.001), and attitude and practice (rs = 0.294, p<0.001), while knowledge was strongly correlated with attitude (rs = 0.634, p<0.001). Based on the study findings, it is recommended that treatment programs in Bihar should concentrate on strengthening KAP among VL and HIV/VL co-infected patients to prevent reinfection-related complications. Behavior change communication intervention is ideal for tackling this problem. This proposal entails building a comprehensive public health program in endemic regions.
Comparison of Seizure Characteristics and Recurrence Rates in Children with Viable Parenchymal Neurocysticercosis and Tuberculoma in India
Authors: Panda Prateek Kumar , Ramachandran Aparna , Sharawat Indar Kumar , Sherwani Poonam , Bhat Nowneet Kumar
Published: August 2022

Inflammatory granulomas (neurocysticercosis [NCC] and tuberculomas) are important causes of seizures in children and adults in the developing world. Although several studies have explored seizure characteristics individually in patients with either NCC or tuberculoma, none has compared the seizure recurrence rate between them. This study included patients aged 5 to 18 years with viable parenchymal NCC or tuberculomas who had completed regular follow-up of at least 12 months at a tertiary institute in India. Their baseline seizure and electroencephalographic characteristics, antiseizure medications (ASMs), and breakthrough seizure rates at 12, 24, and 52 weeks were noted. A total of 103 and 54 patients with active NCC and tuberculomas respectively were included. The number of patients who had at least one breakthrough seizure at 12, 24, and 52 weeks in both groups was comparable (P = 0.32, 0.27, and 0.13), and the vast majority were controlled on monotherapy (98% cases in each group). The proportion of patients who required an increase in the dose or change of ASMs or polytherapy, the proportion of children who had status epilepticus at or before 12 months, abnormal electroencephalogram at 12 months, and calcified and active granuloma in neuroimaging at 12 months were also comparable between the two groups (P > 0.05 for all). The number of patients who had ASM-related adverse events and discontinued ASM due to serious adverse events was comparable between both groups, except for hepatotoxicity in the tuberculoma group. The predictors for breakthrough seizures that were found to be statistically significant in the NCC group were the presence of perilesional edema in the baseline magnetic resonance imaging (P = 0.02) and more than five active granulomas (P = 0.01); predictors in the tuberculoma group were the presence of severe perilesional edema causing midline shift in the baseline magnetic resonance imaging (P = 0.01) and more than five active granulomas (P = 0.04). The recurrence rates of breakthrough seizures over the next 12 months in newly detected cases of active NCC and tuberculomas were comparable.
Use of individual development plans: experiences from junior faculty in the “NURTURE” mentored research program at Makerere University College of Health Sciences
Authors: Nakanjako Damalie , Bamuturaki Grace , Nambooze Harriet , Sewankambo Nelson
Published: August 2022

Introduction: Individual Development Plan (IDP) is a multi-component career planning worksheet that guides trainees through an iterative self-assessment. This paper provides the first investigation of IDP use and experiences among junior faculty at academic institutions in low-and middle-income countries (LMICs) where IDP is seldomly used by trainees.

Methods: An online survey determined the utilization and impact of IDP among junior faculty trainees enrolled on “NURTURE” mentored research program to support career development for faculty at Makerere University College of Health Sciences (MakCHS) between 2016-2020. Responses were received between March and June 2021, a period of intense COVID-19 pandemic in the country.

Results: Of 64 trainees 64(39%) were female and 60/64(98%) developed an IDP during the fellowship period; of whom 45/60(75%) had never been exposed to IDP. Trainees’ benefits included intentional thinking about own career goals and support to execute the goals as well as self-management skills of time management and communication, among others.

Conclusion: IDP was well-received by junior faculty trainees, with several self-management and motivation benefits to the scholars. We recommend that academic programs and faculty at academic institutions in LMIC should consider taking on the IDP approach to promote focused career development for all trainees including junior faculty.

Keywords: Individual development plan; career development; academic institutions; LMIC; junior faculty.
Support for the response to COVID-19 in Uganda: contribution of the global health security program at Makerere University's Infectious Diseases Institute
Authors: Lamorde Mohammed , Ayebare Rodgers , Bulwadda Daniel , Nanyondo Judith , Nakiire Lydia , Walwema Richard , Otita Morgan , Mukiibi Peter , Nabukenya Immaculate , Kakooza Francis , Kambugu Andrew
Published: August 2022

Background: Outbreaks are occurring at increasing frequency and they require multisectoral and multi-stakeholder involvement for optimal response. The Global Health Security Agenda is a framework that governments and other stakeholders can use to strengthen countries’ capacities to prevent, detect and respond to outbreaks but there are few examples of academic programs using this approach.

Methods: This is a narrative review of contributions of Makerere University through the Global Health Security Program at the Infectious Diseases Institute (IDI). Information was sourced from peer-reviewed publications and grey literature highlighting work done between 2017 - 2021.

Results: Aligned to GHSA, IDI made contributions to strengthen national and subnational capacities for biosafety and biosecurity, sample collection and transportation, electronic disease surveillance, infection prevention and control, case management prior to COVID-19 that were subsequently used to support response efforts for COVID-19 in Uganda.

Conclusion: The IDI Global Health Security program provides a model that can be used by institutions to deliberately developcapacities relevant to outbreak preparedness and response.

Keywords: Epidemics; University; Ebola.
Mobile Phone-based Intervention to promote un-interrupted HIV treatment during the COVID-19 pandemic
Authors: Nakanjako Damalie , Kakyama Mayanja Eisah , Semwanga Rwashana Agnes , Semitala Fred , Katureebe Cordelia , Ssali Mina , Muddu Martin , Ssinabulya Isaac
Published: August 2022

Introduction: Keeping HIV-infected adults away from the health care system during the COVID-19 travel restrictions, presents a challenge to HIV treatment adherence.

Methods: This study focused on the initial two phases where Phase 1 designed a Makerere College of Health Sciences (MakCHS) Unstructured Supplementary Service Data (USSD)-based application; and Phase 2 piloted patient enrolment onto the application and determined the feasibility of remote follow-up of patients receiving long-term antiretroviral therapy (ART).

Results: A off/online user application, MakCHS Health app, was developed. Overall, 112 patients [(66(59%) female] receiving ART at Mulago ISS clinic, Kampala, were enrolled onto the MakCHS Health app. Up to 89 (80%) utilized the app to access medical help. Patients’ medical queries included needs for drug refills, missed taking HIV medication, medical illnesses, access to COVID-19 vaccination and other personal needs that required clinicians’ attention.

Conclusion: Piloting a MakCHS Health application for patient follow-up was feasible and well-received by HIV treatment providers and patients receiving ART. We recommend scale up of the application to enroll all patients receiving long-term treatment for HIV/AIDS, and subsequently expand to. other HIV treatment programs in similar settings.

Keywords: M-Health; patient follow up; Chronic HIV treatment; Antiretroviral therapy.
Repatriation of South Sudanese refugees from the West Nile districts, Uganda. What do we learn from the process?
Authors: Komakech Henry , Garimoi Orach Christopher
Published: August 2022

Introduction: Repatriation is a fundamental and often preferred solution to the refugee crisis around the world. This study explored the process of repatriation of the South Sudanese refugees from the West Nile districts in Uganda.

Methods: This was a retrospective analysis of the process of repatriation of refugees in three west Nile refugee districts of Adjumani, Arua, and Moyo, Uganda. Both qualitative and qualitative data were collected.

Results: The findings showed that several stakeholders were involved in the repatriation exercise including the government at central and district levels, United Nations agencies and non-governmental organizations, and refugee communities. The key steps undertaken during repatriation include information and education campaigns to promote returns focussing on security and socio-economic conditions in South Sudan and the facilitation of confidence-building visits in the areas of origin. During the repatriation exercise, key interventions provided included health care screening and treatment, and the provision of reintegrationsupport services including the provision of food security items and cash allowances.

Conclusions: The findings highlight the fundamental steps followed during a well-planned, structured, and effective repatriation of South Sudanese refugees from Uganda. Understanding repatriation requires an appreciation of how it is implemented to support offering an effective, durable, and lasting solution to refugees to promote their health and welfare.

Keywords: Refugee; repatriation; process of repatriation; South Sudan; West Nile; Uganda.
A century of Makerere and 22 years of academic publishing: African Health Sciences into a new gear
Authors: K Tumwine James
Published: August 2022

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Longitudinal patients’ cohorts for impactful research and HIV care at the Infectious Diseases Institute
Authors: Castelnuovo Barbara , Kamya Moses , Parkes Ratanshi Rosalind , N Kiragga Agnes , Nakanjako Damalie
Published: August 2022

Introduction: Observational studies provide important evidence supporting the feasibility and effectiveness of health interventions. The 20-year-old Infectious Diseases Institute (IDI) established to respond to infectious diseases, specifically HIV/AIDS, invested in the set-up of longitudinal cohorts. In this paper we discuss the results of these cohorts and their impact on the response to the HIV pandemic in Uganda.

Methods: IDI invested in experienced system developers, clinic and laboratory capacity to create the infrastructure to host longitudinal cohorts. Several cohorts were created, including patients initiated and followed up on ART, specialized cohorts (e.g. TB co-infection) and long-term cohorts with patients on ART for over 10 years and aged 60 and above. These cohorts function as platforms for sub-studies, attracting collaborators and students.

Results: Data from the IDI cohorts contributed evidence to ART programs on when to start, which drugs to use, how to best monitor and which models of care to implement. Sub-studies contributed to management of opportunistic infections, understanding immunological response and the emerging complications of non-communicable diseases.

Conclusion: Cohorts provide a platform for clinical care, training, and research to inform strategic responses and put Makerere University at the center of the response to the HIV pandemic in the region.

Keywords: Longitudinal Cohorts; Uganda; HIV.
Developing capacity for implementation and evaluation of vaccine trials in Uganda: Perspective of the Makerere University Walter Reed Project
Authors: Naluyima Prossy , Mwesigwa Betty , Tindikahwa Allan , Mugamba Stephen , Thaddeus Ssensamba Jude , Musingye Ezra , Mirembe Grace , Kibuuka Hannah , Wabwire-Mangen Fred
Published: August 2022

Introduction: Infectious diseases and neglected tropical diseases continue to be a major challenge in resource limited settings, causing significant morbidity and mortality. Although vaccines are a key biomedical prevention tool, resource limited settings often lack the infrastructure, regulatory frameworks, and skilled human resource to conduct vaccine clinical trials. To address this gap, the Makerere University Walter Reed Project (MUWRP) was established and has contributed to vaccine research in Uganda and globally.

Methods: This was achieved through training a strong vaccine clinical trial workforce; development of requisite clinical trial infrastructure for research activities and management of investigational products; conducting phase I-III vaccine trials and contribution to national ethical and regulatory frameworks that protect participants.

Results: As of 2022, MUWRP had successfully conducted and completed five phase I/II HIV vaccine clinical trials, five for Ebola and Marburg, while one phase I/II Schistosomiasis and one phase III COVID-19 vaccine clinical trial are ongoing.

Discussion: The completed vaccine trials provided critical scientific knowledge on the safety and immunogenicity of investigational products which informed the design of better vaccines for diseases of global health importance.

Conclusion: Academia, through establishment of appropriate partnerships can contribute to the identification of solutions to complex public health challenges.

Keywords: Vaccines; community participation; developing countries.
Collaborative research to respond to the HIV epidemic: a case of Uganda (Makerere University)-Case Western Reserve University Research Collaboration 1988-2021
Authors: Muzanyi Grace , Nakibuuka Justine , Mayanja Harriet
Published: August 2022

Background: Collaborative research between institutions may not yield results to transform communities. Many research collaborations come to the end of their life time without achieving their originally set goals and with a dearth of community transformation to show for it.

Objective: To delineate and highlight the achievements of the Uganda (Makerere University)-Case Western Reserve University Research Collaboration.

Methods: We retrospectively compiled and reviewed the data on research, training and policy impact achievements of the Uganda (Makerere University)-Case Western Reserve University Research Collaboration over a period of 30 years of its existence.

Results: Over the last 35 years, the Uganda (Makerere University)-Case Western Reserve University Research Collaboration trained a total of 104 Ugandans with Masters, PhDs and other varied graduate training programs. More than 70 large tuberculosis/TB+HIV studies were conducted with more than 360 manuscripts published including landmark local and global TB/HIV policy impact publications.

Conclusion: The Uganda (Makerere University)-Case Western Reserve University Research Collaboration has in the past 35 years built the capacity of Ugandan and international students through conducting landmark research, training and mentoring and contributed to TB HIV management policy changes in Uganda.

Keywords: UCWRU; collaboration; training; mentoring.
Tracing Makerere University’s 100 years’ contribution to lung science/medicine
Authors: J Kirenga Bruce , Nidoi Jasper , Muttamba Winters , Walusimbi Simon , Lalitha Rejani , Mayanja-Kizza Harriet , Yoo Samuel , Imoko Joseph , Kawuma Joseph , Worodria William
Published: August 2022

Dear Editor, African Health Sciences Journal,This year, 2022, Makerere University will be celebrating 100 years of existence. As current lung science/medicine experts, we felt it as important to trace the University’s contribution to lung science and medicine. In this letter, we trace and describe some of the early work done by Makerere University/Mulago Hospital affiliated scientists, identify prominent players in lung science over the 100 years, and present the university’s scholarly contribution to this field, as available in online databases. We include both Makerere University and Mulago Hospital affiliated scientists, because for many years, staff of these two institutions have worked together in teaching, research and patient care.
Human anatomical dissection in the generation Z’s medical syllabus
Authors: Romero-Reverón Rafael
Published: August 2022

Today’s entrance-level medical students were born around the early 2000s and so are of Generation Z so called, being the first generation to grow  up digitally hyper-connected. In the medical syllabus, human anatomical dissection has been the cornerstone for properly grasping the inter-  relationships between different parts of the human body and improving practical skills along with gaining a threedimensional appreciation of  anatomical structures. Generation Z’s medical students have diverse approaches to dealing with human anatomical dissection so, to teach human  anatomy, Faculty need to devote both time and creativity in order to be comfortable using available social-media platforms for that purpose. In these  covid-19's pandemic times these new approaches to teaching may be a matching method to help to fight the pandemic.
The incidence and morphology of the Gantzer’s muscle in a Kenyan population
Authors: Munguti Jeremiah , Nyaanga Fiona , Neema Bridget , Omondi Dennis , Kipkorir Vincent , Darbar Shane , Sibuor William , Amuti Thomas
Published: August 2022

Gantzer’s muscle is an accessory head of the flexor pollicis longus (FPL). Its incidence, attachments as well as relations to nervous structures have  been shown to exhibit population variations, which have important clinical bearings. Data from our setting however remains partly elucidated. To  study the muscle, the skin of the anterior forearm and fascia were removed to expose the flexor compartment of the forearm. The flexor muscles  were also identified and reflected. The Ganzter’s muscle was identified as that muscle belly originating from the flexor digitorum superficialis, the  radius, the medial humeral epicondyle or the ulna coronoid process and inserted on the flexor pollicis longus or the flexor digitorum superficialis  muscle. Its prevalence, laterality, origin, insertion, shape and relation to the anterior interosseous nerve were determined. The data obtained was  entered into SPSS and percentages calculated for the different variables. The muscle was found in 19/43 (44%) cadavers on the right and on 20/43  (46%) on the left. In 5 out the 43 cadavers (11%), the muscle was present bilaterally while in the rest, it existed solely as either on the right orleft (predominantly on the left, 46%). The Gantzer’s muscle was also noted to predominantly originate from the Flexor Digitorum Superficialis  muscle (72% on the left, 76% on the right) and insert on the Flexor pollicis longus (100%). As regards its shape, it was predominantly triangular, on  both right side (65%) as well as the left side (54%). In majority of the cases, the muscle also lay posterior to the anterior interosseous structures  (100% on the left and 89% on the right). In conclusion, the Gantzer’s muscle is relatively common in our population, exhibits marked population variations and as such should be taken into account especially during surgical approach to the anterior elbow to avoid its inadvertent injury.
Clinico-anatomical relationships between the internal carotid artery and sphenoid sinus usingcomputed tomography
Authors: Aliu Abdulhameed , Asala Samuel Abayomi
Published: August 2022

Unexpected and sometimes inexplicable massive haemorrhage arising from intracranial injury to the internal carotid artery (ICA) is a life-  threatening complication of endoscopic transsphenoidal skull base surgeries. Pre-interventional computed tomography (CT) assessment of the  anatomical relationships between the ICA and the sphenoid sinus is necessary to understand and prevent this complication. The aim of this study  was to determine the normal anatomical variations between the sphenoid sinus and internal carotid artery using CT and evaluate their relationship  with sinus dimensions. The CT scans of 323 sphenoid sinuses of patients aged 18 to 80 years were retrospectively studied. The images were taken  with a GE Bright Speed Multi detector Helical CT Scanner and viewed using the Digital Imaging and Communication in Medicine (DICOM) viewer. The  anteroposterior, craniocaudal and transverse diameters were measured and used to determine sinus volume. Protrusion of the ICA into the  sinus cavity, dehiscence, and presence of septal ttachments to the sinus walls bordering the ICA were studied. The prevalence of ICA protrusion, dehiscence of sinus wall, and septal attachment were 28.48%, 17.34% and 13.93% respectively. There was a statistically significant relationship  between protrusion of ICA and the anteroposterior and transverse sinus diameters. The relationship between dehiscence of the wall over the ICA  and sinus volume as well as the transverse diameter was statistically significant. A careful CT identification of these normal but potentially  dangerous variations between the ICA and the wall of the sphenoid sinus prior to surgery is essential for a safe cranial base endoscopic  transsphenoidal procedure.
Abdominal Aortic Aneurysm: A Case Report in Western Maharashtra, India
Authors: Devi A. Manitombi , Bhukya Subhash , Acharya Alok P. , Jamwal VDS , Tandon Aseem
Published: August 2022

An arterial aneurysm is defined as a permanent localized dilatation of the vessel at least 150% compared to a relative normal adjacent diameter of  that artery. Abdominal aortic aneurysm (AAA) is defined as localized enlargement of the abdominal aorta such that the diameter is greater than 3  cm. AAA is potentially life-threatening finding. AAA may be detected incidentally or at the time of rupture. We reported a case of fusiform type of  abdominal aortic aneurysm in a donated cadaver which was found during the routine dissection of a 76-year-old male died of acute myocardial  infarction in western Maharashtra. The dimensions were measured by using both manual and verniers caliper method. The dimensions were 7 cm  in length, 3.5cm in width, 11 cm in circumference, unruptured and positioned below the renal arteries, just above the aortic bifurcation. Owing to  the vital role of aorta in the abdomen, we believe that the knowledge of this vascular pathology will be enlightening the field of medicine.