bluuebunny/crossref_metadata_2025 huggingface dataset:
The use of medicinal plants in the prevention of COVID-19 using the Health Belief Model: A survey based on the Iranian population
Authors: Latifi Masoomeh , Maraki Fatemeh , Parvaresh Mohammad-Javad , Zarei Mohammadreza , Allabakhshian Leili
Published: May 2024

BACKGROUND:

Because of the spread of coronavirus disease 2019 (COVID-19), the preventive measures have increased, such as focusing on the use of medicinal plants in most communities, including Iran. The purpose of this study was to identify the knowledge, attitude, and performance of individuals toward the use of medicinal plants and to identify the predictors of the use of medicinal plants in the prevention of COVID-19.

MATERIALS AND METHODS:

This descriptive-analytical study (February–April 2021) was performed on 3840 Iranian men and women aged 20–70 years selected as a multi-stage cluster study. At the first stage, all provinces were divided into five regions: North, South, East, West, and Center. In the second stage, a provincial center and a city were randomly selected from each region (North: Sari, Babol; South: Bushehr, Bandar Genaveh; East: Mashhad, Sabzevar; West: Hamedan, Toisarkan; Center: Yazd, Ardakan). Data were collected by a researcher-made scale based on the Health Belief Model (HBM). Data analysis was performed applying Pearson correlation coefficient, logistic regression, and linear regression.

RESULTS:

The results showed that people have relatively high knowledge and positive attitude toward the use of medicinal plants in prevention of COVID-19. The most important reason for positive attitude was the perceived benefits with the mean of 75.06%. Also, half of the people had poor performance. Correlation coefficient showed that the use of medicinal plants with perceived sensitivity (p = 0.000, r = 0.3), perceived benefits (p = 0.012, r = 0.126), perceived barriers (p = 0.000, r = 0.179), and perceived self-efficacy (p = 0.000, r = 0.305) had a significant correlation. The strongest correlation between perceived self-efficacy was observed with the use of herbs in prevention of COVID-19. The HBM constructs can predict 26% of the variance for the use of medicinal plants in the prevention of COVID-19, among which perceived self-efficacy (β = 0.230) was the most powerful predictor.

CONCLUSION:

Based on the results, the predictive role of self-efficacy constructs for the use of medicinal plants in prevention of COVID-19 has been confirmed according to the HBM. Therefore, methods of increasing self-efficacy such as training programs and providing appropriate intervention models can be used not only as promoters of using medicinal plants in prevention of COVID-19 but also for improving people's performance in the proper use of medicinal plants.
Undiagnosed hypertension and its correlates among adults attending urban and rural health training centers in a South Indian district
Authors: Appadurai Praveena Daya , Rajanayagam Abel Rodger Nayagam , Asharaf Riaz Mohamed , Govindan Prema Priya
Published: May 2024

BACKGROUND:

In developing countries, many people with high blood pressure are not aware of their disease. Those who are diagnosed to have elevated hypertension may not have access to treatment. It contributes to the high burden of heart diseases, kidney failure stroke, and premature mortality and disability. The objective of this study is to estimate the burden of undiagnosed hypertension and to describe the factors associated with it among adults attending outpatient department of an urban and rural health centers in a South Indian district.

MATERIALS AND METHODS:

A hospital-based cross-sectional study was done among 539 outpatient adults of rural and urban health centers in a South Indian district during May–December 2021 recruited through consecutive sampling. Data were collected using a pretested semistructured questionnaire. Variables significant in univariate analysis were further analyzed using multivariate logistic regression.

RESULTS:

One-hundred and ninety-nine (36.9%) out of 539 participants had undiagnosed hypertension. Multivariate analysis showed the following risk factors as significantly associated with undiagnosed hypertension (age more than 50 (AOR = 5.936, 95% CI = 3.787–9.304), adults with a family history of hypertension (AOR = 1.826, 95% CI = 1.139–2.929), participants without physical activity (AOR = 1.648, 95% CI = 1.089–2.496), and participants from urban area (AOR = 1.837, 95% CI = 1.132–2.982)).

CONCLUSION:

A high burden of undiagnosed hypertension was identified emphasizing the need for strict implementation and monitoring of health promotion, awareness generation, and promotion of healthy lifestyle strategies proposed by the government.
Development and assessment of validity and reliability of a checklist to evaluate the Circulating and Scrub Skills of Operating Room Novices (CSSORN checklist)
Authors: Nasiri Morteza , Yektatalab Shahrzad , Momennasab Marzieh , Vizeshfar Fatemeh
Published: May 2024

BACKGROUND:

Assessment of circulating and scrub skills is an important issue in operating room (OR) programs. However, there is a lack of well-designed tools that are specifically developed for this purpose. Hence, this study aimed to develop and determine the validity and reliability of a checklist to measure the circulating and scrub skills of OR novices.

MATERIALS AND METHODS:

This cross-sectional methodological study was conducted among 124 OR technology students who were selected during three consecutive academic years (2019–2020 to 2021–2022). The developed checklist was evaluated with face validity, content validity (quantitative and qualitative), construct validity (known-groups validity), criterion-related validity (concurrent and predictive validities), internal consistency (Kuder–Richardson 20, KR-20), and inter-rater reliability (intra-class correlation coefficient, ICC). Known-groups validity was evaluated by comparing the difference between the checklist scores of first-semester and third-semester students using independent samples t-test. Additionally, concurrent and predictive validities were evaluated by ICC through measuring the correlation between the total score of checklist and grades of a multiple-choice test and two clinical apprenticeship courses, respectively. Data were analyzed in the Statistical Package for Social Sciences software.

RESULTS:

After reconciling the preliminary checklist in terms of face and content validities, a checklist with 17 sub-scales and 340 items called “Circulating and Scrub Skills of Operating Room Novices (CSSORN)” was developed. Regarding the known-groups validity, the third-semester students had higher scores compared to the first-semester students (p < 0.001 in most sub-scales). Besides, the total score of checklist showed a significant correlation with the criteria of concurrent and predictive validities (ICC = 0.64, ICC = 0.72; P < 0.001). The KR-20 for the entire checklist was 0.90 (range: 0.60–0.93). The ICC for inter-rater reliability was also 0.96 for the entire checklist (range: 0.76–0.99, P < 0.001 in all sub-scales).

CONCLUSION:

The CSSORN had appropriate validity and reliability to be used for measuring the circulating and scrub skills of OR novices. To shed light on the findings, further testing of this checklist on larger populations and in different contexts is suggested.
Elders in natural disasters: Community-based health organization (CBHO) education and preparedness
Authors: Yarmohammadian Mohammad H. , Akbari Faeze , Niaraees Asal , Rezaei Fatemeh
Published: May 2024

BACKGROUND:

The awareness of the elderly needs and assisting requirement should be added to education and preparedness disaster plans. In this study, we want to reach a comprehensive training program considering goals, objectives, time, budgeting, target group, syllabus, educational strategy, and teaching methods for CBOs interested and being served elders in disasters.

METHODS AND MATERIALS:

This qualitative study has been done via interviews with key informants in CBHOs and NGOs and the ministry of health agents in Iran. Besides, content analysis of the documents and instructions provided by the government to direct partnerships with NGOs was reviewed, and focus discussion group to conduct a deductive content analysis research. All data were analyzed with MAXQDA 18.

RESULTS:

Content analysis reached two main goals and seven objectives. The first goal refers to the fact that an educational program should direct not only subjects concerning disasters' effects on the aging population, but also discerning elders' different needs, giving priority to the supply of the basic needs of elders, and looking ahead the physical and mental problems of the elders. The second goal refers to relief skills that CBHOs stakeholders need to obtain for serving elders in a disaster through participating in various exercises.

CONCLUSIONS:

The results can guide community-based stakeholders in considering all the needs of the elderly during disasters and teaching all the syllabus of this research would reduce the adverse effects of disasters on the elderly.
Preparedness toward participation in disaster management: An online survey among dental practitioners in a disaster-prone region of Eastern India
Authors: Narayanan Sri Priya , Rath Hemamalini , Mahapatra Shilpa , Mahakur Manoranjan
Published: May 2024

BACKGROUND:

Dentists are often overlooked resources in the workforce for disaster management (DM). To determine the knowledge, attitudes, willingness, and self-perceived effectiveness to participate in DM among general dental practitioners (GDPs) of Eastern India.

MATERIALS AND METHODS:

A web-based online survey was conducted among 256 Dental Council of India registered GDPs of Cuttack district, Odisha. The 45-item survey comprised closed-ended questions on the demographic data of the participants, years of practice, previous experience in DM, and willingness to participate. Other domains assessed were the participants' objective knowledge of DM, attitude, and self-perceived effectiveness toward participation during disasters. Data were analyzed descriptively, and the Chi-square and Mann–Whitney U tests were used for statistical analysis, with a significance threshold of P < 0.05.

RESULT:

A total of 154 responses were analyzed, giving a response rate of 60.16%. The average age was ≤35 years, 59.1% were BDS dentists and 78.6% had less than 10 years of practice. Only 18% of them had previous experience with DM, and merely 3.2% were formerly trained; however, 95.5% of the dentists were willing to participate in DM. The mean DM knowledge and attitude scores were 16.12 (CI = 15.4–16.8) and 5.79 (5.45–6.13), respectively. Knowledge and attitude showed a significant correlation. About 56% indicated that they would be able to respond effectively to a disastrous event. Significant associations were observed between age group (P = 0.008), years of clinical practice (P = 0.001), qualification (P = 0.012), previous participation (P = 0.029), and self-perceived effectiveness.

CONCLUSION:

The knowledge regarding DM among respondents was at an average level. However, the majority of them were found to have a positive attitude toward participation in DM. Thus, including DM in dental curricula and drills for dental professionals might prove beneficial as almost all GDPs were showing greater self-perceived effectiveness and willingness to participate in disasters.
Picture of the employment status of nurses in the world: Scoping review on pros and cons
Authors: Jelodar Zahra Khakdel , Saghafi Fatemeh , Zackery Ali , Jabbari Alireza
Published: May 2024

Nurses play a vital role in the delivery, quality improvement of healthcare services, and promoting patient health. Therefore, methods of providing nurses are an important issue. This study was conducted to collect evidence on the methods of providing nurses and their advantages and disadvantages by a scoping review method. The Arksey and O'Malley Framework and PRISMA were used in directing the present scoping review. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to conduct the review and report on results. The ISI Web of science, PubMed, Scopus, and ProQuest electronic databases were searched for relevant articles published between January 2010 and December 2020 using the keywords and their synonyms. Finally, 19 articles out of 1813 ones to answer the research questions were selected. The results showed that although two general methods are for the employment status of nurses (full-time and part-time nurses), different classification countries are dissimilar from each other. A total of 13 advantages and 20 disadvantages of the part-time pattern and 6 advantages and 4 disadvantages were extracted from the full-time pattern of studies. None of the patterns has precedence over the other. Despite the strengths and weaknesses, each of the full-time or part-time patterns in its position is beneficial. With proper management and planning, it is possible to minimize their weaknesses and benefited from their advantages. Training part-time nurses to maintain and improve their level is a key point in reducing the disadvantages of this pattern.
Policy requirements in promoting older people health care in Iran: A qualitative study
Authors: Bahmaei Jamshid , Ravangard Ramin , Bahrami Mohammad Amin , Asadollahi Abdolrahim , Bastani Peivand
Published: May 2024

BACKGROUND:

The demographic structure of Iran as a developing country has undergone various changes in recent years. Therefore, the present study sought to analyze policy and upstream documents related to the older people health in Iran in order to identify and analyze the requirements considered by health policymakers to promote the older people health in Iran.

MATERIALS AND METHODS:

This is a qualitative study conducted in 2021 through national qualitative document analysis. All upstream documents published and related to older people health were reviewed between February 1979 and October 2021. The Scott's four-step method was used to extract the related documents.

RESULTS:

Policy requirements for promoting older people healthcare in Iran were categorized into 4 main themes in the form of a conceptual framework and 15 sub-themes. Thus, in order to ensure the health of the older people in Iran, it is necessary to take into account the four categories of managerial requirements, financing, infrastructures, and providing older people services. In other words, the sustainable financing requirements and the infrastructural requirements should firstly exist together as basic requirements. Then, geriatric health management requirements are needed to provide the older people health services along with the previous requirements and finally ensure the health of the older people in Iran.

CONCLUSION:

The results of this study can be helpful in the review of upstream older people health policy documents by policy makers in order to better promote the health of the older people and pave the way for new policies to enter the agenda of policy makers.
The pattern of smartphone usage, smartphone addiction, and associated subjective health problems associated with smartphone use among undergraduate nursing students
Authors: Machado Joyce , Pai Radhika R. , Kotian Reshma R.
Published: May 2024

BACKGROUND:

The usage of smartphones has become common among adolescents, despite knowing the health-related problems of the user. Currently, the availability of electronic gadgets has become economical and this has an impact on society, especially on the behavior of adolescents.

MATERIALS AND METHODS:

A cross-sectional survey design was used to find the pattern of smartphone usage, smartphone addiction, and subjective health problems associated with smartphone usage. The data were obtained from 270 nursing students using the convenient sampling technique using a sociodemographic proforma, semi-structured questionnaire on the pattern of smartphone usage, Smartphone Addiction Scale, self-reported subjective health problems questionnaire, and study habits scale.

STATISTICAL ANALYSIS:

Descriptive and inferential statistics was used for the analysis using SPSS 16.0.

RESULTS:

The study findings revealed that most of the participants 243 (90.0%) were using 4G phones. The majority 88 (32.60%) of the participants were using a smartphone for less than 2 hours at a stretch in a day. Most uses of a smartphone were in the night 155 (57.40%). The main usage of a smartphone was for entertainment purposes 213 (78.90%). Most of the participants 196 (72.6%) were moderately addicted to smartphones. One-third 109 (40.2%) of the participants complained of headache, followed by straining of the eyes 83 (30.6%).

CONCLUSION:

The awareness of smartphone addiction and health-related problems associated with smartphone usage has been shown to decrease its impact. The study concluded that it is very much necessary to identify the pattern of smartphone usage, to prevent the consequences of addiction and health problems associated with smartphone usage.
Medical students' perceptions of the educational environment in a private medical school in southwest Nigeria
Authors: Oguntoye Oluwatosin O.
Published: May 2024

BACKGROUND:

The educational environment plays a very important role in determining the overall performance of students. The aim of this study is to determine the perceptions of undergraduate medical students about their educational environment in a Nigerian university.

MATERIALS AND METHODS:

This was an observational, cross-sectional study conducted among final-year (600 level) undergraduate medical students. The Dundee Ready Education Environment Measure (DREEM) questionnaire was used for the study to assess the educational environment of the medical students.

RESULTS:

A total number of 100 final-year (600 level) undergraduate medical students participated in the study, out of which 27 (27.0%) were males and 73 (73.0%) were females with a male-to-female ratio of 0.37 to 1. The age range of the respondents was 21–30 years with a mean (±SD) of 23.54 (±1.403). The total mean DREEM score was 116.2/200. The total score of SPL domain was 30.2/48 (62.9%). The total score of SPT domain was 27.3/44 (62.0%), while that of SASP was 19.2/32 (60.0%). The total score of SPA domain was 26.6/48 (55.4%) and that of SSP was 13.1/28 (46.8%). For the SPL, SPT, SASP, and SPA domains, the score was above 50%. However, for the SSP domain the score was less than 50%.

CONCLUSIONS:

The total mean DREEM score in this study was 116.2/200, more positives than negatives, with the students' social perspective having the least domain score. There is a need to provide adequate social support system for medical students in general and particularly for those who get stressed.
Language of actions: The effects of teacher's kinesics on student learning and learning environment
Authors: Sajjad Taliya , Khan Humaira Fayyaz , Yasmeen Rahila , Waqas Arfaa
Published: May 2024

BACKGROUND:

A teacher's appropriate use of nonverbal communication skills, mainly kinesics, can play a crucial role in the success of the students. Medical educators are unaware of the effective use of nonverbal communication as an instructional skill that can be used to engage learners, balance learners' participation by controlling the classroom environment, and motivate them to have a passion for learning. The purpose of the study was to explore the students' perceptions regarding the effect of teachers' kinesics on students' learning and their learning environment. This can be helpful for teachers in modifying their teaching styles and delivering quality education.

MATERIALS AND METHODS:

A qualitative study with an exploratory design was conducted at a private medical institute in 2021 for a duration of 6 months. Fourteen medical students volunteered to participate in the study. Focus group discussions were conducted with the students to explore the experiences of the medical students regarding the use of nonverbal communication skills by their teachers and its effect on their learning in the classroom. The data collected was analyzed manually.

RESULTS:

The results of the study revealed that teachers' nonverbal behaviors in the classroom significantly influence students' motivation, engagement, and learning in the classroom. Students preferred interaction with the teachers who were friendly and confident and used their nonverbal communication skills (eye contact, facial expressions, hand gestures) effectively, compared to strict and judgmental teachers.

CONCLUSION:

Teachers need to motivate their students by improving their teaching styles and incorporating nonverbal behaviors positively in the classroom. By creating an impactful learning environment, students' participation and learning will increase, which will, in turn, improve their academic performance.
Generalized peritonitis secondary to a ruptured schistosoma appendix: A case series
Authors: Bello Bashir M , Umar Ibrahim Abubakar , Emetuma Faruk
Published: May 2024

Schistosoma peritonitis is a rare cause of acute abdomen. Similarly, schistosoma appendicitis is also a rare entity. We present a case series of few patients, who presented with clinical features of generalized peritonitis due to a ruptured appendix. Subsequently, a histopathologic examination revealed schistosoma peritonitis. We had two young patients who presented with clinical features of generalized peritonitis due to a ruptured schistosoma appendix; they were resuscitated, and both had laparotomy with histology of the resected appendix revealing schistosoma appendicitis. We presented this article to highlight the fact that even though rare, schistosomal peritonitis secondary to ruptured schistosoma appendicitis is still possible.
Concurrent Sarcina ventriculi infection in a patient with Helicobacter pylori-associated chronic gastritis: A case report
Authors: Awolola Nicholas Awodele , Akinjo Dolapo , Cookey Kalanne Cara , Haruna Muibat , Arhere Ejiroghene Pauline , Onyekwere Charles Asabamaka , Abdulkareem Fatimah Biade
Published: May 2024

Sarcina ventriculi is a Gram-positive, nonmotile, chemo-organotrophic anaerobic organism, which is rare in humans. Although its role as a pathogen in humans remains poorly characterized, it has been associated with delayed gastric emptying, emphysematous gastritis, and gastric perforation in existing literature. The index case was a 34-year-old male who presented with a history of abdominal pain, 1-month history of frequent vomiting, bloating, and abdominal distension. He was evaluated for gastric-outlet obstruction secondary to a possible gastric tumor. Upper gastrointestinal endoscopy showed a stomach that is filled with food debris, hyperemia, and deformed pylorus but no mass was seen. Histology of a mucosal biopsy sample showed active antral predominant gastritis with concurrent H. pylori and S. ventriculi infections. A repeat endoscopy following antibiotic treatment showed the absence of H pylori and S. ventriculi and the patient reported a cessation of symptoms. S. ventriculi was found in association with H. pylori infection.
The efficacy of the EncephalApp in diagnosing minimal hepatic encephalopathy (MHE) among patients with liver cirrhosis in Jos Nigeria
Authors: David Nyam Paul , Duguru Mary John , Davwar Pantong Mark , Omaiye Patience One , Okeke Edith Nonyelum , Ojonugwa Alufiya Ameh , Umejiaku Crystal Chikor , Kenis Shedrack Felangu , Makpu Jireh Dan , Bitrus Sekat Nenman
Published: May 2024

Background and Objectives:

Minimal hepatic encephalopathy is a condition in which patients with liver cirrhosis with normal mental and neurological status on clinical examination show cognitive dysfunction detectable on psychometric or neurophysiologic tests. Routine detection of this condition is not commonly carried out despite the high prevalence among patients with liver cirrhosis and a high risk of progression to overt hepatic encephalopathy. We compared the smartphone based EncephalApp with the standard psychometric hepatic encephalopathy score (PHES) in diagnosing MHE in patients with liver cirrhosis in Jos University Teaching Hospital.

Materials and Methods:

Fifty healthy subjects and 42 patients with liver cirrhosis who did not have overt hepatic encephalopathy and who fulfilled other study criteria were recruited in this cross-sectional analytical study. Both healthy subjects and patients were tested with the EncephalApp, and with the paper-pencil PHES test. Data analysis was done using Statistical Package for the Social Sciences (SPSS) 23.0. A value of P < 0.05 was considered statistically significant.

Results:

The mean age of the control group was 35.9 ± 8.7 years, whereas that of the patient group was 38.9 ± 8.7, P = 0.099. The mean number of years in school for the control group was 16.5 ± 3.4 years, whereas that of the patients was 16.1 ± 3.1, P = 0.471. The prevalence of MHE by PHES was 40.5%. The prevalence of MHE by EncephalApp was 51.4% based on the cutoff of 241.8 s, sensitivity = 54.1% and specificity = 90.0%, AUROC = 0.77.

Conclusion:

The prevalence of MHE in patients with liver cirrhosis in Jos, Nigeria, is about the same with values documented in other parts of the world. The EncephalApp was shown to be a reliable screening tool with good sensitivity, specificity and AUROC in our patients with liver cirrhosis.
Deep anterior lamellar keratoplasty for keratoconus
Authors: Pellegrini Marco , Yu Angeli Christy , Busin Massimo
Published: May 2024

Advanced keratoconus may require keratoplasty when the patient can no longer achieve functional vision with glasses and contact lenses. Deep anterior lamellar keratoplasty (DALK) has become the surgical treatment of choice due to its undisputed advantages over penetrating keratoplasty including the reduced risk of intraoperative complications, the absence of endothelial immune rejection, and the longer graft survival. Albeit “big-bubble” DALK still represents the most popular surgical method, several modifications have been developed over the years. This allowed standardization of the technique, with improved success rates and clinical outcomes. This review presents an overview on the literature on DALK surgery for keratoconus. We discuss state-of-the art surgical techniques, current evidence on the clinical outcomes and complications as well as possible future directions.
Six months' follow-up of combined phacoemulsification–kahook dual blade excisional goniotomy
Authors: Mechleb Nicole , Tomey Karim , Cherfan Daniel , Nemr Antony , Cherfan Georges , Dorairaj Syril , Khoueir Ziad
Published: May 2024

PURPOSE:

This study reports on the combination of excisional goniotomy and cataract extraction in the management of glaucoma in terms of intraocular pressure (IOP) and glaucoma medication reduction.

METHODS:

This is a retrospective case series. Twenty-eight eyes of 22 patients with the diagnosis of cataract and ocular hypertension or glaucoma of any stage underwent combined phacoemulsification and Kahook Dual Blade (KDB) goniotomy, between March 2019 and September 2020. The parameters evaluated were postoperative best-corrected visual acuity, mean IOP reduction, number of IOP-lowering medications, and the surgical success rate defined as IOP reduction >20% and/or reduction in glaucoma medications >1.

RESULTS:

The mean IOP reduction at 6 months was 4.5 mmHg (P = 0.0007), which translates to 24.9% reduction from preoperative IOP. The mean preoperative number of glaucoma medications was 2.9 ± 1.0 (median of 3). It was reduced to 1.1 ± 1.1 (median of 1.5), 1.46 ± 1.17 (median of 2), 1.44 ± 1.28 (median of 2), and 1.56 ± 1.28 (median of 2) at 1 week, 1 month, 3 months, and 6 months, respectively. Twenty-nine percent (8/28) of the patients were off glaucoma medications at 6 months and 46% (13/28) had a reduction of more than 50% of their glaucoma medications.

CONCLUSION:

Combined phacoemulsification–KDB excisional goniotomy may be an effective and safe alternative to more invasive filtering surgery in glaucoma patients of any stage.
Effect of eyeliner and mascara use on tear film and meibomian glands
Authors: Ercan Zeynep E.
Published: May 2024

PURPOSE:

This study was conducted to see whether eyeliner, mascara, or combined eyeliner and mascara (EM) use affects tear production, tear film stability, and meibomian gland (MG) loss.

METHODS:

Two hundred and twenty healthy women underwent noninvasive tear break-up time (NTBUT) measurement, meibography, and Schirmer testing. Study groups were no makeup (NM) group, eyeliner-only group, mascara-only group, and those who used both EM. The one-way analysis of variance test was used for group comparisons. Chi-square test was used for meiboscale comparison.

RESULTS:

NTBUT (seconds) results were 11.5 ± 4.8 (no makeup), 21.3 ± 69 (eyeliner only), 21.8 ± 6.5 (mascara only), and 22.5 ± 7.0 (eyeliner–mascara). The differences between groups were significant (P < 0.0001). All makeup groups (eyeliner only, mascara only, eyeliner–mascara) had significantly diminished values compared with NM group (P < 0.001, P < 0.001 and P = 0.003, respectively). Schirmer test (millimeters) results were 22.7 ± 6.4 (NM group), 21.3 ± 6.9 (eyeliner only), 21.8 ± 6.5 (mascara only), and 22.5 ± 7.0 (eyeliner–mascara) with no significant differences between groups (P = 0.66). Meiboscale grading revealed that NM group had significantly lower values of MG loss compared with eyeliner-only (EO) (P = 0.01), mascara-only (MO) (P = 0.002), and eyeliner-mascara groups (P = 0.007). There were no significant differences between EO and MO (P = 0.31), EO and eyeliner–mascara (P = 0.39), or MO and eyeliner-mascara groups (P = 0.91).

CONCLUSION:

None of the makeup groups had changes in Schirmer wetting. All eye cosmetic groups have significant changes of NTBUT and meibography compared with NM subjects, and yet combined use of EM does not affect ocular surface more adversely than their separate use.
Review of primary posterior capsulorhexis in cataract surgery
Authors: Arbisser Lisa B.
Published: May 2024

This article reviews the history and technique of primary posterior capsulorhexis with emphasis on anterior hyaloid membrane preservation and combined posterior optic capture of intraocular lenses into Berger's space for the purpose of lens stability and secondary cataract elimination among other potential advantages. Applications, variations, efficacy, and safety of the procedure are reviewed.
Intraocular lens power calculation after excimer laser corneal refractive surgery
Authors: Said Reeda B. , Ghorayeb Ralph , Akiki Dany , Wakim Elias , Sukkarieh Georges , Sfeir Joseph , Cherfan George , Jarade Elias
Published: May 2024

PURPOSE:

Our article aims to assess the accuracy of modified and commonly used formulas of intraocular lens (IOL) power calculation after excimer laser corneal refractive surgery.

METHODS:

This is a retrospective study, with data retrieved for 50 eyes of 32 patients who underwent uncomplicated cataract surgery after excimer laser corneal refractive surgery. The expected spherical equivalent was calculated using the American Society of Cataract and Refractive Surgeons (ASCRS) IOL power calculator for Shammas and Barrett True-K, using three-fourth generation formulas (Haigis-L, Barrett True-K no history, and Holladay 2), and using three-third generation formulas (SRKT, Holladay 1, and Hoffer Q) with single k, as a reference, and adjusting these formulas by calculating the keratometry readings by two methods (Jarade's index and formula). The mean refractive error and mean absolute refractive error (MARE) were calculated at the 1 postoperative month.

RESULTS:

When all data was available (eight eyes), 13 formulas were compared. Holladay 1 as modified by Jarade's index and formula, and Hoffer Q as modified by Jarade's formula resulted in MARE <0.75D (P < 0.05). In the group of 25 eyes with only ablation available, the formulas with MARE <0.75D were Haigis L, Barrett TK (from ASCRS), Hoffer Q, and the three conventional formulas in Jarade's index (P < 0.001). In the group of 17 eyes with no available prerefractive data, only Haigis-L and Barret TK (no history) had a MARE <0.75 D.

CONCLUSION:

The use of Hoffer Q or Holladay 1, when prerefractive data are available, gives reliable results with Jarade's index.
Pathophysiology of retinopathy of prematurity
Authors: Strube Yi Ning J. , Wright Kenneth W.
Published: May 2024

Retinopathy of prematurity (ROP) is a vasoproliferative disease occurring in premature infants that affects the blood vessels of the developing retina. ROP results in the development of vascular shunts, neovascularization, and in its most severe form tractional retinal detachment. The development of retinal vascular shunts and neovascularization in ROP is related to local ischemia in the immature and incompletely vascularized retina. Understanding the pathophysiology of ROP helps physicians both in the prevention and treatment of ROP and will be discussed in this review article. The role of oxygen in the pathophysiology of ROP will be reviewed with recent studies discussed.
Clinical experience with an anti-dysphotopic intraocular lens
Authors: Rupnik Zsófia , Elekes Ágnes , Vámosi Péter
Published: May 2024

PURPOSE:

Report experience regarding an anterior capsulotomy fixated intraocular lens (IOL) designed to prevent negative dysphotopsia (ND).

METHODS:

A prospective, nonrandomized clinical study was done at Péterfy Sándor Street Hospital-Clinic, and Jenő Manninger National Trauma Institute, Budapest, Hungary. The Morcher (Masket) 90S IOL has a circumferential groove on the optic that captures the anterior capsulotomy. Thus, part of the optic projects over and anterior to the capsule edge, while the bulk of the IOL is fixated within the capsular bag. We implanted the first version of the 90S IOL into the 40 eyes of 38 patients. These 40 eyes made up the primary investigational cohort. An additional 22 eyes received a modified version of the 90S IOL. The main outcome measure was the presence of ND. There was also a control group of 40 patients who received a single-piece monofocal aspheric hydrophobic acrylic IOL (877 FAB, Medicontur, Budapest, Hungary).

RESULTS:

None of our 66 test patients experienced ND during the follow-up period. After specific questioning, six patients reported nondebilitating PD that improved or disappeared completely in 5 cases. For the 40 eyes of the control group, there were 10 cases of ND on the first postoperative day and in 2 cases ND persisted for more than 1 year postoperatively.

CONCLUSION:

The 90S IOL can be used successfully to prevent ND. Since it is fixated by the anterior capsulotomy, additional advantages such as prevention of anterior capsule contraction, limited tilt, stable toric axis, perfect centration on the visual axis, and a more predictable lens position, among others, may be expected, and are under investigation.
Corneal biomechanics for corneal ectasia
Authors: Esporcatte Louise P. G. , Salomão Marcella Q. , Junior Nelson S. , Machado Aydano P. , Ferreira Érica , Loureiro Tomás , Junior Renato A.
Published: May 2024

Knowledge of biomechanical principles has been applied in several clinical conditions, including correcting intraocular pressure measurements, planning and following corneal treatments, and even allowing an enhanced ectasia risk evaluation in refractive procedures. The investigation of corneal biomechanics in keratoconus (KC) and other ectatic diseases takes place in several steps, including screening ectasia susceptibility, the diagnostic confirmation and staging of the disease, and also clinical characterization. More recently, investigators have found that the integration of biomechanical and tomographic data through artificial intelligence algorithms helps to elucidate the etiology of KC and ectatic corneal diseases, which may open the door for individualized or personalized medical treatments in the near future. The aim of this article is to provide an update on corneal biomechanics in the screening, diagnosis, staging, prognosis, and treatment of KC.
Effectiveness of 0.15% hylan A eye drops in ameliorating symptoms of severe dry eye patients in Saudi Arabia
Authors: Alsheikh Osama , Alzaaidi Sultan , Vargas Jose M. , Al-Sharif Eman , Alrajeh Mohammed , AlSemari Mohammad A. , Alhommadi Abdulrahman , Alsaati Anoud , Aljwaiser Nouf , Alshahwan Eman , Abdulhafiz Mona , Elsayed Rashad , Müller-Lierheim Wolfgang G. K.
Published: May 2024

PURPOSE:

The aim of the HYLAN A study was to investigate if symptoms and/or signs of patients suffering from severe dry eye disease (DED) in Saudi Arabia can be improved by substituting individually optimized artificial tear therapy by high molecular weight hyaluronan (HMWHA) eye drops.

METHODS:

The HYLAN M study, a multicenter prospective randomized open-label study, was performed in 11 centers in eight countries. Patients suffering from severe DED were electronically randomized in two parallel arms. patients with symptoms of at least ocular surface disease index (OSDI) 33 and corneal fluorescein staining (CFS) of at least Oxford grade 3 were included . The patients in the control group continued with their individual optimized therapy as by the time of inclusion. The patients in the hylan A group replaced their individual lubricant eye drops by preservative-free eye drops containing 0.15% hylan A. The total OSDI scores as well as the OSDI subscores for pain and for visual disturbances of each patient at baseline, at 4 weeks, and at 8 weeks of treatment was used to analyse the improvement of symptoms. We focus and report the results obtained at the two study centers in Riyadh, Saudi Arabia (King Khaled Eye Specialist Hospital and Riyadh Military Hospital).

RESULTS:

A total of 13 patients were included in the study. The majority of the study participants were middle aged (40-65 years). Overall, female patients accounted for 76.9% of all study participants. At the initiation of the study, both hylan A and control groups had relatively similar total OSDI scores together with pain and vision subscores. At 4-week follow-up, both groups demonstrated a noticeable decrease in all study variables. Nevertheless, the OSDI scores improved significantly in the group of patients treated with hylan A eye drops at 8 weeks, whereas the scores increased in the control group.

CONCLUSION:

Saudi Arabia has a very high prevalence of patients with severe dry eye disease. Ethnicity, climate, and a high incidence of diabetes mellitus may contribute to this situation. Lubricant eye drops frequently do not provide adequate relief from ocular pain and instable vision in severe chronic ocular surface disease. High molecular weight hyaluronan (HMWHA) eye drops provide superior relief of symptoms of patients suffering from severe DED. This includes ocular pain as well as unstable vision.
Retinopathy of prematurity screening
Authors: Tan Zachary , Isaacs Michael , Zhu Zhuoting , Simkin Samantha , He Mingguang , Dai Shuan
Published: May 2024

PURPOSE:

Neonatal care in middle-income countries has improved over the last decade, leading to a “third epidemic” of retinopathy of prematurity (ROP). Without concomitant improvements in ROP screening infrastructure, reduction of ROP-associated visual loss remains a challenge worldwide. The emergence of teleophthalmology screening programs and artificial intelligence (AI) technologies represents promising methods to address this growing unmet demand in ROP screening. An improved understanding of current ROP screening programs may inform the adoption of these novel technologies in ROP care.

METHODS:

A critical narrative review of the literature was carried out. Publications that were representative of established or emerging ROP screening programs in high-, middle-, and low-income countries were selected for review. Screening programs were reviewed for inclusion criteria, screening frequency and duration, modality, and published sensitivity and specificity.

RESULTS:

Screening inclusion criteria, including age and birth weight cutoffs, showed significant heterogeneity globally. Countries of similar income tend to have similar criteria. Three primary screening modalities including binocular indirect ophthalmoscopy (BIO), wide-field digital retinal imaging (WFDRI), and teleophthalmology were identified and reviewed. BIO has documented limitations in reduced interoperator agreement, scalability, and geographical access barriers, which are mitigated in part by WFDRI. Teleophthalmology screening may address limitations in ROP screening workforce distribution and training. Opportunities for AI technologies were identified in the context of these limitations, including interoperator reliability and possibilities for point-of-care diagnosis.

CONCLUSION:

Limitations in the current ROP screening include scalability, geographical access, and high screening burden with low treatment yield. These may be addressable through increased adoption of teleophthalmology and AI technologies. As the global incidence of ROP continues to increase, implementation of these novel modalities requires greater consideration.
Applications of epithelial thickness mapping in corneal refractive surgery
Authors: Reinstein Dan Z. , Archer Timothy J. , Vida Ryan S.
Published: May 2024

In this review, we discuss the applications of epithelial thickness mapping in corneal refractive surgery. The review describes that the epithelial thickness profile is nonuniform in the normal eye, being thinner superiorly than inferiorly and thinner temporally than nasally. It is postulated that this is due to the eyelid forces and blinking action on the superior cornea. Changes in the epithelial thickness profile have been found to be highly predictable, responding to compensate for changes in the stromal curvature gradient, using the eyelid as an outer template. This leads to characteristic changes in the epithelial thickness profile that can be used for early screening in keratoconus, postoperative monitoring for early signs of corneal ectasia, and for determining whether further steepening can be performed without the risk of apical syndrome following primary hyperopic treatment. Compensatory epithelial thickness changes are also a critical part of diagnosis in irregular astigmatism as these partially mask the stromal surface irregularities. The epithelial thickness map can then be used to plan a trans-epithelial photorefractive keratectomy treatment for cases of irregularly irregular astigmatism.
Discoid lupus erythematosus of eyelids – Diagnostic and therapeutic challenges
Authors: Vijayasankar Palaniappan , Karthikeyan Kaliaperumal
Published: May 2024

Discoid lupus erythematosus (DLE) is the most common form of chronic cutaneous lupus erythematosus commonly seen in photoexposed regions. Eyelid involvement in DLE is relatively rare. We present three cases of DLE with eyelid involvement. It closely mimics many clinical conditions; hence, diagnosis is often late. When left untreated, it can lead to many complications. The aim of this case series is to emphasize that ophthalmologists and dermatologists are aware of the various presentations of DLE in eyelids to prevent any misdiagnosis.
Eight-years Egyptian experience of Boston type I keratoprosthesis following failed penetrating keratoplasty or ocular surface disease
Authors: Othman Ihab S. , Gharieb Hesham M. , Ibrahim Hani M. G.
Published: May 2024

PURPOSE:

To evaluate the outcome and complications after implantation of the Boston type I keratoprosthesis (Kpro) in two groups of eyes.

METHODS:

We retrospectively reviewed records of 28 eyes with failed Penetrating keratoplasty (PKP) (Group A) and 31 eyes with severe ocular surface diseases who implanted Kpro. Follow-up was performed for a mean 37 months. Primary outcomes were Kpro retention and visual improvement, secondary outcomes included the occurrence of complications as endophthalmitis, retro-prosthesis membrane (RPM), intraocular pressure (IOP) abnormalities, posterior capsule opacification (PCO), graft thinning and extrusion.

RESULTS:

Visual improvement was achieved in 20 eyes in Group A, and in 19 eyes in Group B. In group A, the prosthesis was retained in 25 eyes, while prosthesis retention in Group B was in 26 eyes. Group A had higher rates of PCO, high IOP, soft IOP, and graft thinning. Group B had higher risk of RPM, and endophthalmitis. Two eyes in Group A, and Five eyes in Group B required redo procedure.

CONCLUSION:

The Boston Kpro type I is an effective procedure in eyes with high risk of keratoplasty failure and in severe ocular surface diseases, it has a high retention rate, higher in cases following failed PKP.
Dry eye disease and ocular surface characteristics in patients with keratoconus
Authors: Mirza Enver , Oltulu Refik , Oltulu Pembe , Mirza Gunsu D. , Okka Mehmet
Published: May 2024

PURPOSE:

The purpose of this study is to investigate the ocular surface alterations in patients with mild or severe keratoconus (KC).

METHODS:

A total of 80 participants were included in the study. The corneal topography was performed on each participant using Pentacam and the grouping was done accordingly. The patients with Kmax ≥52.0 D (severe KC) were considered Group 1 (n = 28), the patients with Kmax ≥47.2 and <52.0 D (mild KC) were considered Group 2 (n = 30). Healthy control participants with Kmax <47.2 D were considered Group 3 (n = 22). Tear breakup time (TBUT), Schirmer-I test, ocular surface disease index (OSDI) questionnaire, and conjunctival impression cytology (CIC) were evaluated among the groups.

RESULTS:

The mean values of TBUT and Schirmer-I test were significantly lower (P = 0.012, P = 0.012) and the mean scores of OSDI and CIC were significantly higher (P = 0.006, P < 0.001) in Group 1 and Group 2 than in Group 3. The mean values of TBUT and Schirmer-I test were lower and the mean scores of OSDI and CIC were higher in Group 1 than in Group 2 but the differences were insignificant (P > 0.05 for all).

CONCLUSION:

These results indicated that the tests associated with dry eye disease are correlated with KC. Tear film alterations and goblet cell loss are higher in severe KC.
Etiology, clinical profile, and treatment outcome of peripheral ulcerative keratitis
Authors: Kochhar Sonal , Singh Shwetambari , Desai Beena , Purohit Dipali
Published: May 2024

PURPOSE:

To assess the etiology, clinical features, and treatment outcome in patients with peripheral ulcerative keratitis (PUK).

METHODS:

In this retrospective, observational study, forty-eight eyes of 32 consecutive patients with PUK were included. Demographic profile, etiology, clinical features, treatment history, and outcome were documented.

RESULTS:

Of the 32 patients, 19 (59%) were male and the mean age at presentation was 54.72 ± 14.92 years. Sixty-eight percent of patients were from rural backgrounds. Half of the patients had bilateral involvement. Fifty percent of patients presented after 4 weeks of the onset of symptoms. Of 48 eyes at presentation, 11 had mild disease, 9 had moderate disease and 28 had severe disease. At presentation, best-corrected visual acuity <3/60 was found in 26 (54%) eyes. Mooren's ulcer (40% eyes) was the most common etiology for PUK. Rheumatoid factor was positive in 8 of 32 patients (25%). Of 32 patients, 19 (59%) required systemic immunosuppression for the control of disease activity. Surgical intervention to maintain anatomical integrity was required in 27 (56%) eyes. No significant change in vision was seen in pretreatment and posttreatment groups. Four eyes failed to heal after 4 weeks of initiation of treatment due to noncompliance of the patient. None of our patients died during follow-up.

CONCLUSION:

PUK is an indicator of occult systemic autoimmune disease. Mooren's ulcer is the most common cause of PUK. Prompt and adequate immunosuppression is not only eye saving but also lifesaving for patients with PUK of autoimmune origin.