bluuebunny/crossref_metadata_2025 huggingface dataset:
Antidiabetic and Antiradical Effects of Garcinia kola Seeds in Dexamethasone-Induced Hyperglycemic Rats
Authors: Nkono Ya Nkono Barnabé Lucien , Rouamba Ablassé , Kinyok Mc Jesus , Omokolo Jean Guy Stéphane , Tcheudi Balthazar Tchouanka , Tigui Benjamin Arnaud , Dzeufiet Paul D. Djomeni , Sokeng Sélestin Dongmo , Kamtchouing Pierre
Published: July 2022

Background

In traditional medicine, the maceration of seeds of Garcinia kola (GK) is used to treat various diseases including diabetes. In traditional pharmacopoeia, GK seeds are used to strengthen the immune system and as a stimulant and aphrodisiac.

Aims

This study aimed to evaluate the antidiabetic free radical scavenging effects of the hydroalcoholic extract of GK seeds (HAEGS) in a dexamethasone-induced hyperglycemic (DexIH) rat model.

Settings and Design

This study was an interventional study.

Subjects and Methods

Here using in vivo model, we assessed some pharmacological properties of HAEGS in DexIH rat. Hypoglycemia, antihyperglycemia, spasmolytic and laxative activities were also evaluated in DexIH. In vitro study assessed antiradical activity. The HAEGS was obtained by decoction introducing 250 g with water–ethanol mixture (30:70). The plant extract was administered to the animals at doses of 50 (GK50) and 100 (GK100) mg/kg body weight. All animal experiments were in accordance with ARRIVE guidelines and were performed in accordance with the scientific procedures of UK Animals. Antiradical activity of GK was assessed in vitro by inhibition of the activity of 2,2-diphenyl-1-picrylhydrazyl.

Statistical Analysis Used

Statistical analysis was performed using GraphPad Prism 5.03 software, and P values less than 0.05 were considered statistically significant.

Results

At doses 50 and 100 mg/kg, GK significantly (P < 0.001) regulated DexIH after two weeks of treatment compared to the normoglycemic control and hyperglycemic rats. The extract at both doses significantly (P < 0.001) inhibited the spasmolytic activity in both normoglycemic and hyperglycemic rats compared to Imodium®. In rats DexIH rats, only dose 100 mg/kg significantly (P < 0.05) increased laxative effects when compared to the negative control. In vitro antiradical activity of GK revealed vitamin C-like antiradical activity.

Conclusions

This study justifies the traditional use of GK seeds as an antidiabetic.
Professional Identity Formation of Medical Educators
Authors: Mahajan Rajiv , Goyal Parmod Kumar , Singh Tejinder
Published: July 2022

Context

Process of identity formation in any profession is a unique journey and is influenced by many internal and external factors. The factors which enable the development of professional identity of medical educators have been sparsely studied.

Aim

The aim of this study was to identify the factors which influence the professional identity formation (PIF) of medical educators and the competencies needed to develop such identity, through their self-reflection.

Materials and Methods:

A descriptive exploratory study was designed and executed through self-administered Google Forms having open-ended questions. Themes were generated and concept map was designed.

Results

Internal zeal, mentoring, networking, self-directed learning, supportive workplace environment, and recognition at the workplace were some of the subthemes generated as influencing factors enabling PIF as a medical educator. Some of the competencies reported were subject knowledge, leadership skills, self-directed learning, and ability to carry out educational scholarship projects.

Conclusion

The study elucidates various factors influencing PIF of medical educators, as reflected by medical educators themselves. Institutional policies can be framed accordingly to facilitate the process of PIF of medical educators.
Outcomes of Allograft Medial Patellofemoral Ligament Reconstruction in Children and Adolescents with Hypermobility
Authors: Reddy Gautam , Hayer Prabhnoor Singh , UlIslam Saif , Mehta Nisarg J , Iqbal Hafiz Javaid , Stables Gareth , Barton-Hanson Nicholas G
Published: July 2022

Introduction

Medial patellofemoral ligament (MPFL) reconstruction is used to treat patellofemoral instability either in isolation or in combination with other procedures. Use of allograft can preserve native tissue in children and can be advantageous in patients with connective tissue disorders, including ligamentous laxity. There is limited evidence regarding functional outcomes of allograft MPFL reconstruction in children and adolescents. This study aimed to assess the short to mid-term results of allograft MPFL reconstruction in children with hypermobility at a tertiary pediatric orthopedic center.

Materials and Methods:

We retrospectively reviewed all children and adolescents who had undergone allograft MPFL reconstruction over 4 years. The primary outcome measure was the validated Kujala score for patellofemoral disorders. The secondary outcome measures included complications such as redislocation of the patella needing revision surgery. Patients with hypermobility were quantified using Beighton criteria. Statistical analysis was performed using Graph Pad Prism (V6).

Results

Between 2012 and 2016, the senior author performed 76 allograft MPFL reconstructions in 57 patients. Nineteen patients had bilateral surgery. The mean age was 14 (7–16) years with a female: male ratio of 3:1. The mean Beighton score was 7. Hypermobility was part of a syndrome in ten patients. The mean follow-up was 3 (1–4) years. Nine patients had trochleoplasty and six patients had tibial tubercle osteotomy, in addition to allograft MPFL reconstruction. These fifteen patients, who had additional procedures, were excluded during the analysis of the outcome measures. The mean Kujala score was 89 (80–100). The overall complication rate was 11% (9/76). These included two patella fractures and seven (9%) patients with recurrent instability needing revision surgery. There was no significant difference in complication rates between syndromic and nonsyndromic patients (P = 0.9).

Conclusion

Our study shows excellent short to mid-term functional outcomes of allograft MPFL reconstruction in children and adolescents with hypermobility.
Pericardial Effusion in Postcoronavirus Disease Patients with Preserved Ejection Fraction of the Left Ventricle and Normal Values of N-Terminal-Pro B-Type Natriuretic Peptide-Link with C-Reactive Protein and D-Dimer
Authors: Begić Edin , Iglica Amer , Gojak Refet , Baljić Rusmir , Begić Zijo , Durak-Nalbantić Azra , Halilčević Mirela , Džubur Alen , Begić Alden , Lepara Orhan , Begić Nedim , Šljivo Armin , Naser Nabil , Stanetic Bojan
Published: July 2022

Aim

The aim of this study was to link the values of D-dimer and C-reactive protein (CRP), with the occurrence of pericardial effusion in patients who had coronavirus disease 2019 (COVID-19) and have preserved systolic function of the left ventricle (LV).

Methods

This was a prospective study and included 146 patients who underwent echocardiographic examination 30 days after the acute phase of COVID-19. Patients who were placed on mechanical ventilation, patients who had pulmonary thromboembolism or acute coronary syndrome during the acute period of the disease, patients who had an ejection fraction of the LV <50%, patients who were diagnosed with pericarditis during acute illness or clinical signs of heart failure (or had elevated N-terminal-pro hormone B-type natriuretic peptide value), with verified renal or hepatic dysfunction were excluded from the study, including patients with diabetes mellitus Type 1, patients with cancer, connective tissue disease, or pregnant women. The existence of cardiovascular risk factors (hypertension, diabetes mellitus Type 2, and hyperlipidemia), the presence of previous ischemic heart disease, maximum values of D-dimer, and CRP (during the first 15 days of the disease) was taken into the analysis.

Results

Effusion was verified around the right atrium (RA) in 104 patients (3.85 ± 1.75 mm), in 135 patients next to the free wall of the right ventricle (RV) (5.24 ± 2.29 mm), in front of the apex of the LV in 27 patients (2.44 ± 0.97 mm), next to the lateral wall of LV in 35 patients (4.43 ± 3.21 mm), and behind the posterior wall of LV in 30 patients (2.83 ± 1.62 mm). Mean CRP values during the acute phase of the disease were 43.0 mg/L (8.6–76.2 mg/L), whereas D-dimer mean value was 880.00 μg/L (467.00 –2000.00 μg/L). CRP values correlated with effusion next to the free wall of RV (rho = 0.202; P = 0.018). The D dimer correlated with effusion around RA (rho = 0.308; P = 0.0001).

Conclusion

The clinical picture of the post-COVID patients could be explained by the appearance of pericardial effusion. D-dimer value correlates with the occurrence of effusion around RA, whereas CRP value correlates with effusion next to the free wall of RV.
An Immunohistochemical Expression of CK5/6, CK7, and CK20 on Cell Blocks in Metastatic Cervical Lymphadenopathy
Authors: Kaur Amanpreet , Singh Jaspreet , Devgan Rajiv , Utreja Utkarshni
Published: July 2022

Background

The neck is a common site of both primary and secondary malignancies. Many tumors from the head and neck (oral cavity, larynx, and pharynx), lung, and gastrointestinal tract metastasize to cervical lymph nodes. At most times, tumors are diagnosed by morphology, sometimes it is difficult to diagnose an unknown primary presenting as metastatic lymphadenopathy solely on the basis of morphology. Specific histological cell types can be confirmed by the use of immunohistochemistry.

Aim

The present study evaluated the utility of cell block over fine-needle aspiration cytology (FNAC) and immunohistochemical expression of CK5/6, CK7, and CK20 in metastatic cervical lymphadenopathy.

Methods:

This prospective study design was used on a total of 50 cases. FNAC smears and cell blocks were made in all the cases. All the cell blocks were compared with FNAC findings and further subjected to immunohistochemical (IHC) analysis. The necessary statistical analysis was done.

Results and Conclusion

Our study showed that the combined use of the cell block technique and FNAC was more useful and sensitive in diagnosing the metastatic cervical lymph nodes and the accuracy can be further improved by the use of IHC on the cell blocks. The combined use of CK5/6, CK7, and CK20 in metastatic cervical lymphadenopathy is helpful in diagnosing squamous cell carcinoma and adenocarcinoma with known/unknown primary sites.
Basal cell adenocarcinoma of the minor salivary gland - A rare case report involving the upper lip
Authors: Prakash A. Jacob , Christina S. Sushmitha , Lakshmi M. Vijaya , Polishetty Naveen
Published: July 2022

Minor salivary gland neoplasms constitute up to approximately 25% of all salivary gland tumors. The incidence of malignancy of these tumors is slightly greater than half. Basal cell adenocarcinoma (BCAC) is a rare salivary gland malignancy that occurs most commonly in the parotid gland. In this report, we describe a case of an older woman presenting with BCAC of the upper lip arising from the minor salivary gland.
Metastatic malignant melanoma
Authors: Munde Anita D. , Karle Ravindra R. , Biradar Sudharani , Mishra Sunil
Published: July 2022

Metastatic malignant melanoma (MMM) of the oral cavity is extremely rare which generally presents in the setting of disseminated disease and have extremely poor prognosis. The most common site for MMM in the oral cavity is tongue followed by buccal mucosa for soft-tissue lesions and posterior mandible for bone involving lesions. Primary tumor sites of oral MMM are usually cutaneous lesions of the trunk, head and neck, limbs, and nasal septum mucosa. Patients bearing this diagnosis face median survival time of approximately 9 months with a probability of surviving 5 years after the initial presentation is <5%; hence, an early detection and treatment for the primary and metastatic lesion is crucial. Here, we present an unusual case of MMM of oral cavity involving gingiva and alveolar bone of the mandibular anterior region metastasizing from a primary lesion on the foot.
Prosthetic management of a midfacial defect
Authors: Dholam K. P. , Gurav Sandeep , Singh Gurkaranpreet , Chatterjee Aishwarya
Published: July 2022

Surgical ablation of a large tumor creates a defect which is technically difficult to reconstruct. Radiated tissue bed poses a challenge to reconstruction and is complicated in presence of osteoradionecrosis. This report describes a case of a 62 year old gentleman with oral cancer who underwent surgery and radiotherapy twice. He developed an orocutaneous defect (OCD) following surgery and radiotherapy. Prosthetic rehabilitation of OCD was done. Full facial impression with irreversible hydrocolloid was made and wax sculpture made on the model obtained. Standard laboratory steps were followed for mould fabrication and maxillofacial silicone was used to fabricate the prosthesis. It was retained to the spectacle with silicone adhesives. The silicone facial prosthesis provided to the patient was easy to use, covered the defect and improved the quality of life of the patient.
Immunohistochemical expression of beta-catenin in hepatoblastoma and its clinical significance
Authors: Archana B. , D'Cruze Lawrence , Nazneen Sarah , Thanka J. , Scott Julius Xavier
Published: July 2022

Background:

Primary hepatic malignancies account for 0.5-2% of all solid tumours in childhood. Hepatoblastoma, a rare embryonic tumour in the general population, represents the most frequent primary hepatic malignancy in the paediatric age group, with an incidence of one new case per million under 15 years of age, median age at diagnosis being 1 year. Aberrant activation of the Wnt/beta-catenin signalling pathway is likely to result in tumorigenesis of hepatoblastoma. The nuclear and intra-cytoplasmic accumulations of beta-catenin correlate with the likely prognosis of the disease. Nuclear expression of beta catenin is associated with a shorter survival, higher stage, and seen in embryonal/undifferentiated types.

Aim:

To study the expression of beta-catenin in hepatoblastoma by immunohistochemistry and correlate it with the tumour histology and survival outcome.

Materials & Methods:

This is a retrospective study of 11 children over a period of 5 years with the diagnosis of hepatoblastoma. These children underwent partial hepatectomy or liver transplantation at the Department of Paediatric Surgery. The clinical, histological and survival data were collected. Immunohistochemical analysis with beta-catenin was done and analysed.

Results:

Mean birth weight of the children was 2.75kg.63.6% had an epithelial type of histology. Beta catenin expression by IHC was studied in 11 cases and found to be positive in 4 cases. Nuclear positivity was noted in 2/4 cases of embryonal type and Cytoplasmic and membranous positivity was seen in the other 2/4 cases. Normal liver showed a membranous pattern of positivity in one case. Negative staining was seen in 6 out of 11 cases.

Conclusion:

Beta catenin is considered to be an useful tool for assessing the prognosis of patients with hepatoblastoma and its expression is associated with a poor survival outcome. There are no validated biomarkers for prognosis so far. However, larger studies incorporating molecular profiling is warranted to establish prognostic factors for planning effective treatment strategies.
Effects of tyrosine kinase inhibitors for controlling Ph+ clone and additional clonal abnormalities in a chronic myeloid leukemia
Authors: Ganguly Bani Bandana , Mandal Shouvik , Banerjee Debasis , Kadam Nitin N.
Published: July 2022

Purpose:

The chronic myeloid leukemia (CML) is characterized by the presence of t(9;22)(q34;q11) that results in chimerization of BCR and ABL genes on the rearranged chromosome 22 or Philadelphia chromosome (Ph). Imatinib has been established as the first line of therapy for CML; in case of Imatinib failure or resistance, other second or third generation tyrosine kinase inhibitors (TKIs) are considered. However, acquisition of additional clonal abnormalities (ACAs) interferes in management of CML. We described a complex scenario of cytogenetic remission, relapse, response to TKIs and behavior of ACAs in a case of CML.

Materials and Methods:

Conventional G-banding and FISH cytogenetics, and quantitative PCR studies were conducted in the bone marrow for diagnosis and follow up (FU) of the changes of BCR-ABL gene and ACAs at different time intervals.

Results:

Ph− chromosome disappeared within 6 months of Imatinib therapy, and re-appeared within a year. Subsequent change of TKI to dasatinib eliminated the Ph+ clone, but established an ACA with trisomy 8 (+8). Further change to Nilotinib, eliminated +8 clone, but re-emergence of Ph+ clone occurred with an ACA with monosomy 7 (−7). Reinstate of Dasatinib eliminated Ph+ and −7 clones, but with gradual reappearance of Ph+ and +8 clones. The patient discontinued FU, though participated in a long term examination.

Conclusion:

The complexity of ACAs and Ph+ clones needs frequent monitoring with changes of TKI and technologies.
Tim-3 and PD-1 blocking cannot restore the functional properties of natural killer cells in early clinical stages of chronic lymphocytic leukemia
Authors: Astaneh Mojgan , Rezazadeh Hadiseh , Hossein-Nataj Hadi , Shekarriz Ramin , Zaboli Ehsan , Shabani Mahdi , Asgarian-Omran Hossein
Published: July 2022

Background:

Programmed death-1 (PD-1) and T-cell immunoglobulin- and mucin-domain-containing molecule-3 (Tim-3) are two major immune checkpoint receptors expressed on immune cells and their expression is related to the exhaustion phenotype. In the present in vitro study, blocking of PD-1 and Tim-3 molecules was performed on isolated natural killer (NK) cells from patients with chronic lymphocytic leukemia (CLL) to restore their functional properties.

Materials and Methods:

NK cells fraction was positively isolated from fresh peripheral blood of 18 CLL patients, treated with anti-PD-1 and anti-Tim-3 blocking monoclonal antibodies and co-cultured with K562 target cells to evaluate their apoptosis induction by Annexin V-PI method. Blocked NK cells were also incubated with anti-CD107a antibody to assess their degranulation properties by flow cytometry. The level of secreted tumor node factor-alpha (TNF-α) and interferon-gamma (IFN-γ) by NK cells was also measured by ELISA.

Results:

Our results showed similar functional properties in terms of degranulation and apoptosis of K562 target cells by isolated NK cells from CLL patients in PD-1/Tim-3 blocked and control groups. It was also shown that blocking of PD-1 and Tim-3 could not improve the production of pro-inflammatory TNF-α and IFN-γ cytokines by isolated NK cells from CLL patients.

Conclusion:

Altogether, our results indicated that pretreatment of NK cells with anti-PD-1 and anti-Tim-3 blocking antibodies in CLL patients at early clinical stages cannot improve their functional properties. Besides many other malignancies, the application of checkpoint inhibitors in CLL needs more investigations and complementary studies.
Extra-axial adult cerebellopontine angle medulloblastoma
Authors: Pant Ishita , Chaturvedi Sujata , Gautam Vinod K. S. , Sarma Pragyan , Satti Dinesh Kumar
Published: July 2022

A purely extra-axial position of medulloblastoma in adults at cerebellopontine (CP) angle is extremely rare. To the best of our knowledge, only ten cases have been reported till date. The authors report a case of extra-axial medulloblastoma in a 30-year-old female located at right CP angle. It was surgically treated with a provisional diagnosis of meningioma. Histopathological diagnosis of desmoplastic/nodular medulloblastoma was made with the routine hematoxylin eosin (HE) stain and immunohistochemical markers. This case report highlights the fact that, although extremely rare, the possibility of an extra-axial CP angle mass being a medulloblastoma still needs to be considered in the differential diagnoses, even in adults.
Randomized controlled study for comparison of efficacy and safety between thermocoagulation and cryotherapy in visual inspection with acetic acid positive cervical lesions
Authors: Verma Manju Lata , Singh Uma , Kumari Ruby , Sachan Rekha , Sankhwar Pushp Lata , Solanki Vandana
Published: July 2022

Background:

Less literature is available on the performance of thermocoagulation for treatment of premalignant cervical lesions and its comparison with cryotherapy from low- and middle-income countries like India.

Materials and Methods:

A prospective randomized controlled study was done in the Department of Obstetrics and Gynecology from August 2018 to September 2019 after obtaining ethical clearance from Institutional Review Board (Reg no: ECR/262/Inst/Up/2013/RR/16) Ref no: 278/Ethics/R. cell-18). A total of 68 women with Visual inspection with acetic acid (VIA) positive cervical lesion were randomized into two groups. Group A was treated with cryotherapy and Group B was treated with thermocoagulation. Estimates of cure, adverse effects or complications were presented as frequencies, percentages, and mean ± standard deviation.

Results:

Out of 667 patients, 624 patients underwent VIA testing among which 68 were VIA positive (10.89%, 68/624). The efficacy of thermocoagulation was 93.54% and that of cryotherapy was 90.32%. Immediate side effects were significantly lesser in thermocoagulation group (P = 0.008) in comparison to cryotherapy.

Conclusion:

Thermocoagulation is better treatment modality than cryotherapy for VIA-positive cervical lesions may not be in terms of efficacy but definitely in terms of patient comfort and safety.
Cervical gestational trophoblastic neoplasia
Authors: Jaiswar Shyam Pyari , Agrawal Monica , Deo Sujata , Saad Sumaiya
Published: July 2022

Gestational trophoblastic neoplasia (GTN) is a rare disease and is characterized by an abnormal proliferation of trophoblastic cells of placenta. Since majority of them are chemotherapy sensitive, they are one of the highly curable cancers. However, due to its varied presentation, clinicians still face many challenges in its diagnosis and management. We present a case of 26-year-old woman, P0 + 3 (previous 3 abortions) who presented to us with a history of vaginal bleeding postuterine evacuation after 2 months of incomplete abortion. After clinical, radiological assessment and high human chorionic gonadotropin (hCG) titers, the patient was diagnosed as a case of cervical GTN. Risk assessment by the WHO prognostic scoring system was done and “Low Risk” was assigned to her. She was given total nine cycles of single agent chemotherapy including two consolidation cycles after normalization of hCG titers which patient tolerated well and remained asymptomatic.
Corneal Cross-Linking in Pellucid Marginal Degeneration
Authors: Irajpour Matin , Noorshargh Pegah , Peyman Alireza
Published: July 2022

Purpose:

To evaluate the long-term outcome of corneal cross-linking (CXL) for pellucid marginal degeneration (PMD).

Methods:

In a retrospective study, forty eyes of forty patients were enrolled. All subjects had undergone CXL for PMD at least 5 years before the assessments. Visual acuity, refraction, and topography data were compared to their respective values before CXL.

Results:

The comparison between mean preoperative logMAR uncorrected visual acuity and 5-year postoperative evaluation revealed no significant change (1.20 ± 0.65 and 1.17 ± 0.64,P> 0.05). No statistically significant difference was noted comparing preoperative mean logMAR best-corrected visual acuity (BCVA) and postoperative mean logMAR BCVA (0.24 ± 0.19 and 0.22 ± 0.20,P> 0.05). We did not find any significant difference between pre- and postoperative spherical equivalent and spherical refractive errors (P = 0.419 andP= 0.396, respectively). Regarding the BCVA Snellen lines, 23 eyes had no significant change in pre- and postoperative examinations, 11 eyes had improvement, and 6 subjects showed worsening defined as significant when two or more lines change. The spherical equivalent refractive error improved in 4 subjects, was stable in 25, and worsened in 11 subjects, while a 0.5 diopter or more myopic change was considered significant. Furthermore, regarding steep keratometry values, 25 subjects were stable, 7 had improvements, and 8 worsened.

Conclusion:

CXL appears to be a safe and effective procedure to halt the progression of PMD.
A Comparison between Wavefront-Optimized and Wavefront-Guided Photorefractive Keratectomy in Patients with Moderate-To-High Astigmatism
Authors: Razmjou Hassan , Peyman Alireza , Moshfeghi Saeedreza , Kateb Hamideh , Naderan Morteza
Published: July 2022

Purpose:

To compare clinical outcomes of wavefront-optimized (WFO) and wavefront-guided (WFG) photorefractive keratectomy (PRK) in patients with moderate-to-high astigmatism.

Methods:

Patients with corneal cylinder above 2 diopters and myopic spherical equivalent were randomized into WFO or WFG PRK. Visual acuity (VA), refraction, contrast sensitivity, higher-order aberrations (HOAs), and astigmatic vector differences were documented and compared for 6 months after surgery.

Results:

The total number of 362 eyes from 181 patients was analyzed. The amount of total aberration was reduced 2.7 root mean square (RMS) and 2.9 RMS in the WFO and WFG groups, respectively (P < 0.001 in each group and between the groups). HOAs including coma, trefoil, and spherical aberrations increased in both the groups (P < 0.001) but were significantly more in the WFO group (P < 0.001). The increased spherical aberration was similar in both the groups (P = 0.12). Surgically induced astigmatism was not significantly different between the groups (P = 0.20). The magnitude of error was significantly higher in the WFO group (P < 0.001), but the absolute angle of error and the arithmetic angle of error were not significantly different between the groups (P = 0.20 andP= 0.30, respectively).

Conclusion:

WFO and WFG platforms of PRK appear comparable in terms of VA, refractive correction, and total aberration. Yet, HOAs may increase especially after WFO PRK.
Clinical Features and Outcomes of Congenital Cataract Surgery with Primary Intraocular Lens Implantation in a Tunisian Cohort
Authors: Malek Ines , Sayadi Jihene , Sammouda Takwa , Choura Racem , Mekni Manel , Zghal Imen , Khairallah Moncef , Nacef Leila
Published: July 2022

Purpose:

To describe the clinical features of congenital cataract (CC) in a Tunisian cohort and to assess the surgical outcomes of primary intraocular lens implantation in two groups based on the age at surgery.

Methods:

This study was a prospective analysis of children under 5 years with CC that were operated between January 2015 and 2020. The surgery consisted of phacoaspiration with posterior capsulorhexis and primary implantation. Group 1 comprised children operated at <2 years of age and Group 2 comprised children operated between 2 and 5 years. Peri and postoperative surgical events as well as refractive and visual outcomes were compared between both the groups.

Results:

Fifty-five (84 eyes) infants were enrolled. Group 1 included 30 (48 eyes) children and Group 2 included 25 (36 eyes) patients. The mean follow-up was 27.60 ± 19.89 months. The mean delay between the diagnosis and the cataract surgery was 11.97 ± 13.84 months. Of 14 (16.7%) eyes with postoperative visual axis opacification (VAO), 9 (10.7%) eyes required pars plana membranectomy. The VAO was not statistically associated with the age at surgery (P = 0.112), but significantly correlated with sulcus implantation (P = 0.037). The final mean visual acuity was 0.51 logMAR and comparable between both the groups (P = 0.871). Poor visual outcome was significantly associated with low age at presentation (<6 months;P= 0.039), delay between the diagnosis and time of surgery (P = 0.001), preoperative nystagmus (P = 0.02), and poor parental compliance to amblyopia treatment (P = 0.009).

Conclusions:

Primary implantation seems to be safe and efficient. VAO appears to become an avoidable occurrence owing to better surgical techniques. Amblyopia remains the biggest barrier to final visual outcome.
Preserflo™ Microshunt Combined with Phacoemulsification Versus Preserflo™ Microshunt as a Standalone Procedure in Patients with Medically Resistant Open-Angle Glaucoma
Authors: Fili Sofia , Kontopoulou Kalliopi , Vastardis Iraklis , Perdikakis Georgios , Bechrakis Nikolaos , Kohlhaas Markus
Published: July 2022

Purpose:

To compare the efficacy and safety of PreserFlo™ MicroShunt (Santen, Osaka, Japan) combined with phacoemulsification to PreserFlo™ MicroShunt as a standalone procedure in eyes with moderate to advanced open-angle glaucoma.

Methods:

In an observatory, prospective, clinical study, 30 patients (30 eyes) with moderate to advanced angle glaucoma were allocated to either PreserFlo™ MicroShunt combined with phacoemulsification (15 eyes; Group A) or PreserFlo™ MicroShunt as a standalone procedure (15 eyes; Group B). The follow-up time of the study was 12 months.

Results:

Average intraocular pressure (IOP) at 12 months was 11.62 ± 1.6 mmHg in Group A and 13.8 ± 3.6 mmHg in Group B, which was significantly lower than baseline IOP (Group A: 23.47 ± 8.99 mmHg,P< 0.001; Group B: 23.4 ± 8.68 mmHg,P< 0.001). The absolute reduction of IOP within the 12 postoperative months was not significantly different between the two groups (P = 0.056). The number of the topical medications that were administered 12 months after ocular surgery was 0 in Group A and 0.6 ± 0.8 in Group B, compared to 3.13 ± 1.02 in Group A (P < 0.001) and 2.4 ± 1.45 in Group B (P = 0.004) at baseline. Phacoemulsification combined with PreserFlo™ MicroShunt significantly reduced the number of antiglaucoma agents after 12 months compared to the standalone procedure (P = 0.026). One eye in Group A was referred for bleb revision due to bleb fibrosis and a consequent acute postoperative rise in IOP. One eye in Group A required transscleral cyclophotocoagulation with MicroPulse® laser. One bleb revision was also necessary in Group B at the 4th postoperative week. Endothelial cell density did not significantly change over 12 months in either group (Group A: baseline, 2017.3 ± 346.8 cells/mm2; 12 months, 1968.5 ± 385.6 cells/mm2;P= 0.38; Group B: baseline, 2134.1 ± 382.6 cells/mm2; 12 months, 2094.4 ± 373.3 cells/mm2,P= 0.42). The PreserFlo™ MicroShunt combined with phacoemulsification produced higher absolute success rates after 12 months in patients with moderate to advanced open-angle glaucoma than the PreserFlo™ MicroShunt as standalone procedure (Group A: 80% and Group B: 60%,P= 0.022).

Conclusions:

In eyes with moderate to advanced open-angle glaucoma, PreserFlo™ MicroShunt with or without phacoemulsification is effective in reducing IOP and the number of the antiglaucoma agents with a very small incidence of complications and subsequent glaucoma surgeries. However, adding phacoemulsification to PreserFlo™ MicroShunt successfully reduces IOP without the need for ongoing topical medications as are needed after the standalone procedure.
Outcomes of Bilateral Lateral Rectus Resection in Residual Esotropia Following Bilateral Medial Rectus Recession
Authors: Nabie Reza , Manouchehri Vahideh , Meydan Sepideh Rostam
Published: July 2022

Purpose:

To evaluate the success rate, dose-response ratio, and predictive factors of success in patients with residual esotropia (≥25 prism diopter [pd]) following bilateral medial rectus (BMR) recession who underwent bilateral lateral rectus (BLR) resection.

Methods:

In a retrospective study, medical records were reviewed for 47 patients with equal or more than 25 pd residual esotropia following 6 mm BMR recession. Sex, age at second surgery, the interval between first and second surgery in months, visual acuity, refraction, presence of amblyopia, presence of dissociated vertical deviation or inferior oblique overaction/superior oblique overaction, preoperative and postoperative angle of deviation, amount of BLR resection, and months of follow-up were evaluated. Surgical success was defined as postoperative deviation within 8 pd of orthophoria.

Results:

The mean age of patients at reoperation was 48.59 ± 21.46 months. The mean near and far residual esotropia before BLR resection was 34.57 ± 11.02 and 33.83 ± 10.99 pd, respectively, reduced to 8.12 ± 1.43 pd in near and 6.32 ± 2.1 pd in far postoperatively. The mean BLR resection dosage was 5.53 ± 1.22 mm and each millimeter of BLR resection (1 mm for each eye) corrected an average of 7.95 pd of deviation in near and 7.40 pd in far. The success rate was 74.5%. After analysis using multivariate logistic regression, there were no factors associated with success.

Conclusions:

Bilateral rectus resection in patients with a previous BMR recession has acceptable outcomes. The recommended surgical table can be used as a guide by strabismus surgeons in patients with residual esotropia.
Prevalence and Distribution of Refractive Errors Among Ophthalmic Patients in Madang Province, Papua New Guinea
Authors: Owusu-Afriyie Bismark , Kombra Moses , Gende Theresa , Kia Anna , Mou Isabella
Published: July 2022

Purpose:

To assess the prevalence and distribution of refractive errors in Madang Province, Papua New Guinea (PNG).

Methods:

A retrospective hospital-based study was conducted at Madang Provincial Hospital Eye Clinic. It is a free eye clinic and spectacle costs are further subsidized by a nongovernmental organization. Nonprobability purposive sampling was used to retrieve patients' records at the eye clinic from January to December 2016. Only demographic and clinic data on the patients' first visit to the eye clinic were recorded and these included their age, gender, location, presenting visual acuity (VA), and refractive correction.

Results:

One thousand and one hundred eighty-four patients' records were retrieved, of which 622 (52.53%) had refractive error. The mean age of refractive error presentation was 49.68 ± 16.29 years with a range of 9–86 years. There were more males (55%) than females. About a quarter of the patients (21.2%) presented with moderate visual impairment. There was a statistically significant relationship between visual impairment and age group (P< 0.001). Myopia (53.1%) was the most common type of refractive error followed by hyperopia (32.5%) and astigmatism (14.4%). The uptake of spectacle correction was very high (95.3%) among the patients. More than one-tenth of the patients (12.5%) reported from other provinces. Almost one-third of the patients (31.4%) could not obtain a VA of 6/6 after refraction. About one-fifth (17.0%) of the patients were suspected of functional amblyopia.

Conclusions:

Uncorrected refractive error (URE) is a significant cause of visual impairment in PNG. There is a need for the integration of eye care services into primary health care for early detection, treatment, and prevention of visual impairment caused by UREs.
Management of a Bilateral Post-Uveitic Complex Glaucoma with Pupillary Block, Rupture of the Anterior Lens Capsule, and Malignant Glaucoma Following Laser Peripheral Iridotomies
Authors: El Matri Khaled , Gouider Dhouha , Limaiem Rim , Chebil Ahmed , Henchiri Meher , Falfoul Yousra , El Matri Leila
Published: July 2022

Purpose:

To report a case of a bilateral complex uveitic glaucoma (UG) with pupillary block, rupture of the anterior lens capsule, and malignant glaucoma in a young high-myopic patient and to report anterior segment optical coherence tomography (AS-OCT) findings initially and following surgery.

Methods:

A 21-year-old high-myopic woman who had a history of anterior uveitis with extensive posterior synechiae, presented with acute bilateral ocular pain, redness, and blurred vision following bilateral Nd: YAG laser peripheral iridotomy (LPI).

Results:

Visual acuity was limited to light perception in both eyes (OU), with a flat anterior chamber (AC) and anterior luxation of lens fragments. Intraocular pressure (IOP) was over 60 mmHg OU. AS-OCT showed closed angles and hyperreflective heterogeneous material within the flat AC. The iris and lens fragments were plated against the corneal endothelium OU. We performed an urgent pars plana vitrectomy associated with lensectomy. It was uneventful in OU. Repeated AS-OCT revealed a deep AC, widely open angles, and aphakia. IOP was lowered to 9 mmHg and visual acuity improved to 5/10 in OU.

Conclusion:

Performing LPI might be harmful in the presence of UG with extensive posterior synechia, resulting in complex mechanism glaucoma with aqueous misdirection syndrome associated with a pupillary block due to anterior lens luxation, even in high-myopic eyes. Nd: YAG LPI should not be performed simultaneously in OU, especially in pathologic eyes, to prevent bilateral vision-threatening complications. AS-OCT was of great help, allowing easy and detailed ultrastructural assessment of the ACs, and iridocorneal angles before and after surgery.
Comparison of the diagnostic accuracy of the updated Sydney system and single biopsy
Authors: Torun Cundullah , Yavuz Arda , Akan Kubra , Seneldir Hatice , Toksoz Ayse Nur , Ulasoglu Hak Celal , Tuncer Ilyas
Published: July 2022

Background:

Updated Sydney system (USS) recommends taking biopsies from certain areas of the stomach for the diagnosis of precancerous lesions associated with Helicobacter pylori. Our aim was to evaluate the contribution of each of the biopsy sites to the diagnosis.

Methods:

This prospective study included 97 patients aged 40 and over with dyspeptic complaints. Biopsies were taken from five regions: the lesser curvature of the antrum (LCA), the lesser curvature of the corpus (LCC), incisura angularis (IA), the greater curvature of the antrum (GCA), and the greater curvature of the corpus (GCC). Biopsy specimens were stained with hematoxylin–eosin stain, periodic acid Schiff–alcian blue, and Giemsa histochemical stain and evaluated according to the Sydney classification.

Results:

Thirty-seven (38%) patients were positive for H. pylori in at least one biopsy site. Atrophic gastritis without intestinal metaplasia (IM) was found in 17 (17.5%) of the patients (6.2% in IA, 5.2% in each of LCA, GCA, and LCC, and 2% in GCC). The prevalence of atrophic gastritis with IM was 42.3% (21.6% in LCA, 20.6% in GCA, 20.6% in IA, 14.4% in LCC, and 5.2% in GCC). Endoscopic follow-up was planned in 21 (22%) patients due to the presence of extensive atrophy or incomplete IM. If a single biopsy of the LCA or a biopsy of both LCA and GCA was taken, endoscopic follow-up would have been missed in 12 (57%) or 6 (29%) patients, respectively.

Conclusion:

Taking biopsies in accordance with the USS had higher sensitivity in detecting atrophic gastritis with or without IM compared to single biopsy. One or two biopsies is not sufficient to identify patients for whom endoscopic follow-up is recommended.
Vitamin K and vascular calcification in chronic kidney disease: An update of current evidence
Authors: Lin Yu-Li , Hsu Bang-Gee
Published: July 2022

Vascular calcification, characterized by calcium deposition in the intimal and medial layers of the arterial wall, is frequently encountered in patients with chronic kidney disease (CKD) and leads to an enhanced risk of adverse cardiovascular (CV) outcomes. However, the underlying complex pathophysiology remains incompletely understood. Recently, Vitamin K supplementation aimed at correcting Vitamin K deficiency highly prevalent in CKD holds great promise to mitigate the progression of vascular calcification. This article discusses the functional Vitamin K status in CKD, the pathophysiology linking Vitamin K deficiency and vascular calcification, and reviews current literature from animal models, observational studies, and clinical trials across the different spectrum of CKD. While favorable effects of Vitamin K on vascular calcification and CV outcomes are suggested in animal and observational studies, most recently published clinical trials investigating the effects of Vitamin K on vascular health failed to support the beneficial role of Vitamin K supplementation, despite improving the functional status of Vitamin K. We address the potential reasons for these discrepancies and provide further perspective on Vitamin K research in CKD.
Complementary and Alternative Medicines in Parkinson's Disease
Authors: Ortiz Mario I.
Published: July 2022

Epidemiological studies reviewed in 2016, suggest that 6.1 million people in the world had PD. There is currently no cure for PD. For now, currently, the treatment of PD includes drugs, general measures to control symptoms (ie, physical and occupational therapy), and surgery. Because dysfunction of the basal ganglia system for dopamine depletion occurs in the pathophysiology of PD, the key therapeutic strategy is the use of drugs that increase the amount of dopamine in the affected brain areas. PD is a progressive disease, despite pharmacotherapy or surgical treatments. The progression of symptoms and movement disorders in PD is so severe that patients resort to complementary and alternative medicine (CAM), even without knowing their effectiveness and adverse reactions.
Prevagen®: Analysis of Clinical Evidence and Its Designation as a “#1 Pharmacist Recommended Brand”
Authors: Grossman Sara , Nathan Joseph P. , Siuzdak Alicja , Liang Jessica , Sprycha Christopher
Published: July 2022

Prevagen® is a dietary supplement that is marketed to help with mild memory loss associated with older people. The manufacturer of the product notes that clinical evidence supports this use. Furthermore, the manufacturer notes that Prevagen® is a “#1
Pharmacist Recommended Brand.” The authors’ search of the literature identified one clinical study that evaluated the efficacy and safety of Prevagen®; however, this study possesses significant limitations and therefore one must question the merits of such clinical
evidence. Prevagen®’s designation as a “#1 Pharmacist Recommended Brand” is based on a survey facilitated by Pharmacy Times® that is designed to identify the brand name over-the-counter products that pharmacists recommend most frequently.
Because of the limited clinical data supporting Prevagen®’s efficacy, it is likely that the survey results reflect pharmacists’ familiarity with this product, which may be influenced by extensive advertising techniques. As practitioners of evidence-based medicine,
pharmacists should not recommend a product with limited evidence to support its use. Furthermore, pharmacists should proactively educate their patients, especially those who are most vulnerable, about the rational use of all pharmacologically active substances, including dietary supplements.
Fundamental Properties of Basic Slc-Trivial Fibrations II
Authors: Fujino Osamu , Fujisawa Taro , Liu Haidong
Published: July 2022

We prove that if the moduli

\mathbb{Q}

-b-divisor of a basic slc-trivial fibration is b-numerically trivial then it is

\mathbb{Q}

-b-linearly trivial. As a consequence, we prove that the moduli part of a basic slc-trivial fibration is semi-ample when the base space is a curve.
The Semi-absolute Anabelian Geometry of Geometrically Pro-$p$ Arithmetic Fundamental Groups of Associated Low-Dimensional Configuration Spaces
Authors: Higashiyama Kazumi
Published: July 2022

Let

p

be a prime number. In the present paper, we study geometrically pro-

p

arithmetic fundamental groups of low-dimensional configuration spaces associated to a given hyperbolic curve over an arithmetic field such as a number field or a

p

-adic local field. Our main results concern the group-theoretic reconstruction of the function field of certain tripods (i.e., copies of the projective line minus three points) that lie inside such a configuration space from the associated geometrically pro-

p

arithmetic fundamental group, equipped with the auxiliary data constituted by the collection of decomposition groups determined by the closed points of the associated compactified configuration space.
Спектр Тейлора модулей над алгебрами Ли
Authors: Bilich Boris Igorevich
Published: July 2022

В данной работе мы обобщаем понятие спектра Тейлора на модули над произвольной алгеброй Ли и изучаем его для конечномерных модулей. Мы показываем, что спектр может быть описан как множество простых подмодулей в случае нильпотентных и полупростых алгебр Ли. Мы также показываем, что это неверно для разрешимых алгебр Ли, и получаем точное описание спектра в случае борелевских подалгебр полупростых алгебр Ли.
Sera koşullarında yetiştirilen Yeşilgüllerin (Rosa chinensis Jacq. ‘Viridiflora’) morfolojik, fizyolojik ve kimyasal özeliklerini belirlemek üzerine bir çalışma
Authors: HATİPOGLU Ibrahim Halil , AK Bekir Erol
Published: July 2022

Bu araştırmada, phlloidi adı verilen bir çiçek anomaliliği sebebi ile taç yaprak oluşturmayan ve sadece oluşturduğu uzun ve yeşil çanak yapraklarından dolayı ‘Yeşilgül’ olarak adlandırılan Rosa chinensis Jacq. ‘Viridiflora’ taksonunun bazı morfolojik, fizyolojik ve kimyasal özellikleri ele alınmıştır. Bu bağlamda sera koşullarında çelik ile çoğaltım metodu ile yetiştirilen Yeşilgül bitkilerinin bitki gelişim özellikleri, yaprak özellikleri, stoma morfolojileri, yaprak oransal su kapsamları, yaprakların klorofil içerikleri ve yapraklardaki mikro ve makro besin elementi kapsamları belirlenmiştir. Çalışma sonucunda farklı Rosa taksonları ile karşılaştırılan ‘Yeşilgül’ bitkisinin yayvan/dik yapıda olduğu, ortalama yaprak alanının 17.17 cm2, ortalama pedisel boyunun 1.45 cm, yaprak oransal su kapsamının %77.42, klorofil miktarının 40.87 olduğu tespit edilmiştir. R. chinensis ‘Viridflora’ bitkisine ait yaprakların stoma morfolojisi parametrelerinde ortalama değerler aldığı sonucuna ulaşılmıştır. Referans değerler doğrultusunda Yeşilgül yapraklarında azot, fosfor ve manganez değerleri düşük, bor ve kalsiyum değerleri ise yüksek bulunmuştur. Potasyum, magnezyum, bakır ve demir içerikleri ise referans aralıklarında olarak belirlenmiştir.
Alimentary Figurativeness in the Novel by A.V. Korolev “Laughter”
Authors: Zavyalova Elena
Published: July 2022

The purpose of the study was to determine the functions of alimentary signs in the novel “Laughter” by A.V. Korolev (2001–2011). Elements related to food images, situations, and customs related to gastronomy were identified, analyzed, and systematized. It is proved that the author of the work actively uses stable phrases associated with images of food. Allegorical turns of “Laughter” contain references to the absorption and digestion of food, and a number of coloronyms are based on “food” associations. Most case-law texts are chosen on the same principle. The novel lists animals that are suitable for traditional cuisine. Birds are mentioned many times. The primacy in the plot belongs to quails and chickens, which is explained by a number of circumstances of folklore, social-historical, domestic and physiological nature. In the minds of ordinary characters, food becomes the substratum of existence. Quite often in “Laughter” the theme of Anthropophagy sounds. The reversibility of food to the eater, the transformation of dishes for a wedding celebration into dishes for a funeral meal-fundamentally important for understanding the idea of “Laughter” inversions. A.V. Korolev brings the image of the victim to the fore. Many lines of the novel are connected with the problem of cruelty: Palace intrigues at the court of the Bourbons, mass propaganda during the Third Reich, Stalin's system of terror and informers, “Nord-Ost”. In “Laughter” the writer clearly and in detail recreates the panorama of modern hedonism. The novel by A.V. Korolev could be called “The History of World GourMania.”