bluuebunny/crossref_metadata_2025 huggingface dataset:
Role Of Endoscopic Gastric Biopsy in Patients With Chronic Dyspepsia For Diagnosis Of H. Pylori
Authors: Majeed Muhammad Zafar , Mustafa Ghulam , Ahsan Haseeb
Published: August 2024

Abstract
Objective: To determine the role of upper GI endoscopy and gastric biopsy to rule out H. Pylori (in patients with long-standing stomach symptoms), which is a manageable cause of chronic dyspepsia.
Methods: This cross-sectional study was conducted at the medical OPDSheikh Zayed Hospital, Rahim Yar Khan. The sample size was 125 patients, having symptoms of chronic dyspepsia. Endoscopy of the participants has been done after getting informed consent. After histopathological analysis, the results were analyzed by SPSS version 23.0. The presence of H pylori has been evaluated in participants of different age groups, residences, symptoms, and conditions.
Results: According to the analysed results, a total of 85 (68%) participants have been diagnosed with the presence of H. Pylori. Prevalence of H. Pylori is highest in the age group of 50 and above i.e. 28 (73.7%), followed by the age group 30-49 43 (67.2%), (p=0.5). There is a slightly higher ratio of H. Pylori in males i.e. 47 (72.3%) than in females i.e. 38 (63.3 Chronic dyspepsia patients who had a gastric ulcer on endoscopy had a dominant proportion of 20 (83.3%) who had H. pylori too on biopsy (p=0.07), similarly, patients who had duodenal ulcers also showed a dominant proportion 29 (80.5%) of a positive result for H. pylori on biopsy (p=0.05).
Conclusion: The presence of H pylori was more than in patients above 30 years of age. So, it is better to have an endoscopic investigation to rule out any malignancy. Endoscopy is more beneficial and easily available in most parts of the country.
IgG4-Related Orbital Disease: An Analysis of Patient Profiles, Clinical Presentation, And Histopathological Features
Authors: Taimur Fariha , Manzoor Amna , Saad Muhammad , Tahir Faizan , Khan Sumeya , Khalid Aashar
Published: August 2024

Objective: To study various presentations of patients with a histopathologically confirmed diagnosis of IgG4 disease.
Methods: This study is a retrospective review of medical records from the IgG4-RD registry at the Al-Shifa Trust Eye Hospital. Nine patients with orbital manifestations were identified. All had histopathologically confirmed diagnoses of IgG4-RD. Data obtained from the medical records included patient demographic information (name, age, gender), brief patient history, clinical presentation, histopathology reports, and diagnoses.
Results: Most patients presented with proptosis and swelling in various parts of the orbital area. Some patients also presented with pain and diplopia. The most common orbital structures involved were the lacrimal gland and the extraocular muscles, with some patients also having soft tissue involvement. 4(44%) patients had bilateral orbital involvement, while the remaining 5(55%) had unilateral disease.
Conclusion: Ophthalmic involvement is a feature of IgG4-RD and has significant implications regarding the diagnosis, prognosis, and treatment of patients with IgG4 disease.
Comparative Analysis In The Treatment Of Myocardial Infarcted Patients In The Tertiary Care Hospital Of Peshawar Against American Heart Association (ASA) Treatment Guidelines
Authors: Khan Sher Afghan , Nawaz Qadeer , Ahmad Sameer , Khattak Zainab , Khan Sana , Munir Attiya
Published: August 2024

Abstract
Objective: To analyze pharmacotherapy provided in the hospital for MI indications and outcomes and to assess the protocols that are practiced for MI patients against the AHA and NICE guidelines.
Methods: This study was conducted from 23rd July 2022 to 13th December 2022 in Cardiology ward of Lady Reading Hospital (LRH), Peshawar, Khyber Pakhtunkhwa, Pakistan. Patients of Myocardial Infarction (n = 240) admitted to hospital during the said period were included in this work.
Results: The results showed that around 77% (185) of male patients suffered from MI as compared to 23% (55) of female patients. In our study only 68% of the patients were kept on aspirin and clopidogrel simultaneously, rest were either only administered aspirin or clopidogrel. The p-value for anti-coagulant and beta-blocker usage was found to be significant as it came out to be less than 0.001 whereas the use of ACE inhibitors was around 0.67, which stated that it was the least important.
Conclusion: MI is as emergency that needs the patients follow up and monitoring and their treatment is administered to the latest and most advanced guidelines whether they are AHA or NICE guidelines. For this a thorough study was conducted on admitted patients in cardiac ward with MI and the drugs data was tabulated. Then studied the different internationally accepted guidelines that are followed by the most advanced hospital in the world ranging from Europe to America.
The data collected showed that the tertiary care hospital of Peshawar do not follow the latest new guidelines. The practicing doctors administered the drugs that were correct almost half decade ago but now new guidelines have overtaken them which leads to improved patients morbidity and decreased mortality.
Exploring The Self-Awareness Of Dental Students And House Surgeons Regarding Oral Cancer: A Qualitative Study On Control And Prevention Strategies
Authors: Orakzai Gulmina Saeed , Farooq Mariya , Ali Misbah , Gillani Syeda Munazza , Awal Jayyad Salim , Ilyas Raif
Published: August 2024

Objective: This qualitative study is carried out to get insights regarding various factors contributing to the high prevalence of this cancer and preventive strategies by dental students and house officers.
Method: This qualitative research was conducted from June 2023 to Dec 2023, at Watim dental college Rawalpindi. Factors perceived to be related to oral cancer were investigated using the focus group discussion (FGD) method. A total of 20 participants (10 final-year students and 10 house surgeons) voluntarily participating in the study were included. Data were transcribed verbatim and thematic analysis was done.
Results: All participants concurred on the severity of oral cancer as a major public health issue in Pakistan and many of them considered tobacco as a major risk factor. Risk factors, control and preventive strategies were summed up under major themes identified as alarming health issues, lifestyle and culture-related risk factors, issues in the dental curriculum and challenges in clinical set-up hampering thorough examination of oral cancer and related risk factors education.
Conclusion: This present study suggests that formal dental education and clinical training are insufficient to cater for this major oral health issue and its associated risk factors. Rigorous measures should be taken to strengthen our existing undergraduate dental curriculum and incorporate courses at the undergraduate level for better understanding and training in this particular field to help them grapple with this rapidly rising health concern.
A Study On The Histopathological Analysis Of Nasal Masses Among Patients Attending The Ent Department Of Pakistan Institute Of Medical Sciences, Islamabad
Authors: Faisal Malik Jawad , Arshad Muhammad , Zafar Moniba , Ashfaq Ahmed Hasan , Shah Syed Fahd
Published: August 2024

Objective: The study was conducted to understand the different histopathological patterns, the classification of nasal tumours, and the relative distribution of the various lesions by age and sex.
Method: In this study, 80 patients admitted to our hospital with nasal weights and numerous clinical presentations were selected. The study period is 2 years. This study was conducted in the Department of Otorhinolaryngology/ ENT and Histopathology department of the Pakistan Institute of Medical Sciences and AFIP for a two-year duration from April 2019 to April 2021.
Results: The most numerous groups of changes were non-cancerous nasal growth; 55 cases (68.25%), then 25 cases (32.25%) of nasal tumours, 16 benign, and 9 malignant cases in cancerous tumours.
Conclusion: Nasal obstruction and rhinorrhea are the most commonly encountered symptoms in our community, with simple inflammatory nasal polyps being the predominant histological pattern. Surgical intervention is considered the optimal treatment modality.
An Assessment of the Knowledge, Practices and Attitudes towards Cholera Preventive Measures among Students at Lusaka Apex Medical University in Lusaka, Zambia
Authors: Chisanga Arthur , Daka Steven , Masebe Esther , Mulenga Remmy , Dorothy Banda , Saul Simbeye Tinkler , Simpokolwe Kaziwe , Kachinda Wezi , Nyahoda Isabel , Katunga Monica , Bernadette Munene , Godwin Chakolwa , Chirwa Emmanuel
Published: August 2024

This study investigated students' knowledge, practices, attitudes, and perceptions concerning cholera prevention, aiming to identify gaps and areas for improvement in public health education and intervention strategies. Employing a cross-sectional design and quantitative research approaches, data were collected from 384 participants at Lusaka Apex Medical University, Chalala Campus, located in Lusaka, Zambia. Findings revealed that 62.9% of respondents had received cholera prevention education, indicating commendable efforts, but significant knowledge gaps persisted, potentially increasing susceptibility to outbreaks. While 25.7% demonstrated a profound understanding, 17.1% remained neutral, and 5.7% admitted to lacking knowledge, underscoring the need for comprehensive educational initiatives. Additionally, 60.0% correctly identified all common cholera symptoms, highlighting the importance of ongoing education. Although 60.0% identified all key prevention methods, targeted campaigns are needed to address knowledge disparities. While 40.0% of students consistently washed hands, 20.0% did so sporadically, necessitating interventions. Boiling water emerged as a prevalent safety measure (34.3%), emphasizing the need for enhanced education. Concerning attitudes, 28.6% expressed high concern about cholera, and 51.4% strongly agreed on the importance of prevention, indicating potential areas for targeted interventions. Despite 71.4% seeking medical attention for cholera-like symptoms, 28.6% did not, emphasizing the importance of promoting timely intervention. Various sources, including healthcare professionals (34.3%) and the internet (28.6%), contributed to cholera prevention knowledge, highlighting the significance of leveraging diverse communication channels. This study offers insights into enhancing cholera prevention efforts among students through targeted education, awareness campaigns, and improved access to healthcare services, ultimately contributing to enhanced public health outcomes.
Evaluation of Acute Diarrhoeal Disease among Females Age 18-23 Years: A Study from Tamil Nadu, India
Authors: Anusha R. , Priya P. , Christuraj P. Allwin , Mahalekshmi S. , Mini S. S. Asha , Sreevidhya S.
Published: August 2024

Acute diarrhea is a sickness for which a specific etiologic agent is frequently unable to be identified clinically. Evolution covers a broad range, from self-limited illness to demise. The causes of acute diarrhea, which is clinically defined as the release of three or more loose or watery stools in a day or a distinct drop in consistency and an increase in frequency depending on the individual, are discussed in this chapter along with their viral and bacterial causes. Female participants in the age range of 18 to 25 are being studied at the Sree Ramakrishna Medical College of Naturopathy and Yogic Sciences and Hospital in Kulasekharam, Tamil Nadu, India. Verbal consent was gained when the study's goal was explained. Thirty individuals participated in this study. There are thirty questions on the questionnaire. Unwilling or uncooperative female participants were excluded from the study at that point. The study concluded that women should know more about the need to eat a balanced diet, the risks associated with junk food, the consequences of gut dysbiosis, and how to prevent consuming contaminated food. Future care should focus on these areas to enhance young females' overall wellness and health.
Speleotourism Potential in Imereti Region on the Example of Tetra Cave
Authors: Bliadze Nana , Kvabziridze Magdana
Published: August 2024

With speleotourism potential, Imereti region is an outstanding region throughout the country. Effective, reasonable utilization of the mentioned resource can bring significant economic and social benefits. From the point of view of tourist motivation, modern speleotourism is divided into 3 main directions: extreme, spectacular and healing tourism. Imereti region has the opportunity to develop all three speleotourism destinations. As for the speleotourism potential of Tetra cave, along with extreme and spectacular destinations, it is also interesting from the point of view of speleotherapy. In general, healing speleotourism is related to the unique microclimatic conditions of caves: particularly dry or humid air, constant temperature, concentration of mineral salts. The air of Tetra Cave is characterized by high, negative ionization and a relatively high background of natural radioactivity, these properties give it important healing properties and provide the opportunity for the development of speleotherapy.
Sustainability of Community Food Barns (LPM) in Aceh Besar Regency in Supporting Food Security
Authors: Handayani Mira , . Azhar , Zikri Irfan
Published: August 2024

The community food barn aims to bring closer access to food for its members and maintain supply stability and grain prices through storage that allows sales to be postponed until farmers receive better prices. This research aims to analyze the level of sustainability of community food storage management in Aceh Besar Regency and identify the factors that influence it. The focus of this research is on four community food barn in three sub-districts, namely (1) Suka Makmur community food barn Harapan Maju, (2) Lhoong community food barn Bersama Sadar, and (3) Kutabaro community food barn Lagang Jaya and community food barn Makmu Beusaree. The purposive sampling method was used to select research locations, while samples were taken using simple random sampling from members of the community food barn group, totaling 144 farmers. The research results showed that Harapan Maju was declared unsustainable in the ecological dimension (value 35.89) due to minimal use of straw waste and high use of chemical pesticide fertilizers. In the economic dimension, Harapan Maju (score 46.31) and Bersama Sadar (score 47.85) are also unsustainable due to suboptimal facilities and limited markets. In contrast, Makmu Beusare (score 57.2) and Lagang Jaya (54.03) are quite sustainable with good financial viability and facilities. In the social dimension, Makmu Beusaree (score of 66.50) and Lagang Jaya (60.92) have high member participation and good community development, while Harapan Maju (score 28.65) and Bersama Sadar (49.60) unsustainable due to lack of community participation and commitment. Factors that influence the sustainability of community food barn management include Environmental Impact Analysis, Environmental Management Efforts, Environmental Monitoring Efforts, soil and water quality, farmer income, government subsidies, as well as social sustainability that depends on food access, community participation, and local economic empowerment. Community food barn plays an important role in strengthening community capacity and participation, as well as improving the quality of life through education, health and decent work.
Listening to Elementary Teachers’ Voices in an Inclusive Classroom: A Retrospect of their Experiences
Authors: P. Bacus Arly Mae
Published: August 2024

This study explored the lived experiences, challenges encountered, coping mechanisms and insights of public elementary teachers in implementing inclusive education in schools. The participants were coming from DepEd Region XI, Division of Davao City, specifically in the schools of Bunawan District. There were ten (10) teachers who participated in the study. This study made use of a phenomenological approach to extract the ideas from the participants. The participants were purposely selected as representatives from the group of elementary school teachers in the same district. The virtual in-depth interview was employed to gather significant information with regard to their respective lived experiences. Using the thematic analysis, the following themes emerged pertaining to their lived experiences: equity amidst inclusivity, challenged but competent teachers, considering learners’ improved social skills and hurdling mainstreaming issues. Further, there were three (3) subthemes identified on the hurdling mainstreaming issues as the challenges encountered by the participants, these are lack of formal training for teachers, lack of parental support and the lack of facilities. The coping mechanisms of teacher participants on the challenges they experienced were: teachers’ training program for mainstreaming classes, cultivating patience as teachers, and teacher-parent partnerships. The educational management insights drawn from the participants were understanding the beauty of learners’ diversity and the importance of a supportive school environment. Thus, The DepEd administrators and heads may craft teacher enhancement programs through face-to-face training or through webinars focusing on handling inclusive classes and implementing instructions in schools.
How Social Media Impacts Promotion of Body Image Dissatisfaction among Youth
Authors: Navadiya Krisha , Rafi Sumbul , Harvansh Bhargava , Shamatmika Raja , Sharma Vanshita
Published: August 2024

The objective of this review paper is to analyze the existing literature on the impact of social media usage and assess the impact of promoting body image dissatisfaction among youth. A systematic review of 70 studies was conducted, focusing on research on both men and female . Findings reveal the negative effects of constantly seeing ‘perfect bodies’ on social media, highlighting increased feelings of dissatisfaction, especially among adolescents. The review identifies a gap in the literature surrounding men and their feelings towards their bodies and suggests future research directions to enhance our understanding of the impact of social media on body Dissatisfaction levels of an individual.
Enhancing Martial Arts Safety Through 6G-Enabled Risk Assessment and Alert Systems
Authors: Liu WenYan , Wang Zhen
Published: August 2024

This paper proposes an advanced approach to enhance athlete safety in martial arts competitions by integrating 6G-enabled technologies with enterprise engineering and semantic integrity principles. Wearable sensors within a 6G network capture vital physiological data, such as temperature, pulse rate, opponent-induced force, and ECG signals. These data are analyzed using an Optimized Support Vector Risk Prediction Model (OSVRPM), optimized through the Vinegar Fly Optimization Algorithm (VFOA), to accurately assess athlete risk levels during competitions. Real-time alert messages, facilitated by the 6G wireless network, are disseminated to medical personnel, judges, referees, and athletes upon identifying heightened risk, ensuring swift intervention and reinforcing safety protocols in martial arts tournaments. This innovative integration exemplifies the application of modeling with enterprise engineering and semantic integrity to safeguard athletes in dynamic competitive environments.
A Novel Method to Measure Dual-Task Capacity in Young Football Players: A Preliminary Study
Authors: Uysal Özgün , Atalay Güzel Nevin , Bayrakcı Tunay Volga , Fırat Tüzün
Published: August 2024

Context

When deciding to return to sport, in the literature, evaluations based on physical abilities have usually been used. However, in the current literature, we have been urged to use more than physical performance evaluations. Classical dual-task testing methods do not simulate in-game loads and cannot sufficiently measure football players’ dual-task capacity.

Objective

To create a dual-task test that would simulate football players’ in-game situations and measure their capacity.

Design

Cross-sectional study.

Setting

Football pitch.

Patients or Other Participants

Twenty-two football players (age = 17.37 ± 0.52 years) who played in a professional club (U19, elite league) were recruited for our study.

Intervention(s)

A novel dual-task test with questions containing scenarios from a football game to cognitively load players while they are performing a modified t test.

Main Outcome Measure(s)

After the warmup period, participants attended 4 tests in random order: juggling (foot), speed dribbling, long passing, and novel dual-task tests.

Results

No significant relationship was found between physical performance parameters and dual-task parameters (all P > .05). A significant increase was found in the completion time of the modified t test when performed under the dual-task condition (Z = −7.568, P < .001). The increase in completion time was 2.14 ± 1.29 seconds. This duration difference was calculated as 22.79% ± 14.58%, as dual-task cost.

Conclusions

Our test provides a new method to measure athletes’ dual-task capacity, which is not related to physical performance and cannot be measured with current tests. This test also showed players with lower dual-task ability could not keep up their performance under dual-task conditions, such as passing a ball to a teammate when being pressed by an opponent. Players with good dual-task ability could maintain their performance (were affected only up to 10%); players with poor dual-task ability could not maintain their performance and were affected by up to 50% (with a mean of 22.79%).
Significance of incarnation in gospel contextualisation and communication interculturally
Authors: Muswubi Takalani A.
Published: August 2024

This article analyses the missional significance of John 1:14 in gospel contextualisation and communication interculturally. All theologies are contextual within an unchanging divine word of God. After the four-decade long contestation, which was at times complex, if not complicated, the consensus was reached between the Evangelical and the Ecumenical scholars. The aftermath of it has a far-reaching implication for an effective and efficient contextualisation and communication of the gospel interculturally. In this regard, the question is: how to maximise an effective and efficient communication of the gospel interculturally? The goal is to point out the significance of John 1:14 in the whole debate for effective and efficient gospel contextualisation and communication interculturally. It is from that context that this article analyses John 1:14 from a missional perspective with an aim to discuss three aspects: firstly, the basic nature of incarnation as a divine accommodation; secondly, the critical debate of gospel contextualisation and communication since the 1970s; and thirdly, the ultimate missional perspective of incarnation as a holistic and divine model of accommodation for effective and efficient gospel contextualisation and communication. And lastly the concluding remarks.Intradisciplinary and/or interdisciplinary implications: This article contributes to the understanding of the nature and significance of incarnation based on John 1:14. It aims to address the ongoing contextualisation debate from the 1970s until today and propose effective ways of contextualising and communicating the gospel in a multicultural South African context and beyond.
Impact of Urinary Tract Infection on Progression of Renal Scars and Formation of New Scars in Patients with Primary Vesicoureteric Reflux
Authors: Sohail Ahmad Md. , Satapathy Amit Kumar , Agrawal Kanhaiyalal , Das Kanishka , Pati Akash Bihari
Published: August 2024

Introduction:

Primary vesicoureteric reflux (VUR) is a prevalent cause of end-stage renal failure in children. Scars on radionuclide imaging indicate irreparable damage to the growing kidneys. This study aims to determine whether a urinary tract infection (UTI) associated with primary VUR promotes the development of new renal scars or progression in the pre-existing ones.

Materials and Methods:

Children with primary VUR on continuous antibiotic prophylaxis at a tertiary teaching hospital’s paediatric nephrourology clinic were observed prospectively. At recruitment, a renal cortical (dimercaptosuccinic acid [DMSA]) scan was done, and the children were followed up every 3 months. Breakthrough UTIs were documented, and follow-up DMSA scans were performed to document new scarring/grade advancement of existing scars in the renoureteric units (RUUs).

Results:

Seventy-two RUUs in 36 patients were monitored. Fifty-four (75%) RUUs were exposed to VUR of different grades, and 46 (85.1%) had a UTI. On the DMSA scan, these showed new scar development in 10/18 (55%) RUUs and scar progression in 13/28 (46.4%) RUUs. Of the 8 RUUs with VUR and without UTI, new scars manifest in 4/5 (80%) and progressed in 1/3 (33%). On univariate analysis, there was no significant difference in the formation of new scars or scar advancement on the DMSA scan between RUU with VUR and UTI and those without UTI. There was a significant positive correlation between the scarring on DMSA scan and the grade of reflux (P < 0.001).

Conclusion:

Primary VUR patients had fresh or progressed scarring regardless of urinary infection. A higher VUR grade at presentation was a significant risk factor for scarring.
Management of biliary calculi through Ayurveda - A case report
Authors: Jangid Sushil Kumar , Binorkar Sandeep Vishnu , Chhatbar Disha Kirtibhai , Ravi Arun Kumar
Published: August 2024

Biliary calculi, commonly known as gallstones, pose a significant health concern globally, often necessitating invasive interventions. This case report documents the successful management of biliary calculi using Ayurvedic principles in a 34-year-old male patient presenting with recurrent biliary colic and evidence of multiple gallstones on ultrasound imaging. The patient underwent a comprehensive Ayurvedic treatment regimen, including dietary modifications and lifestyle adjustments, tailored to balance the aggravated Doshas (fundamental constituents of the body) implicated in the pathogenesis of biliary calculi. Follow-up assessments demonstrated a remarkable reduction in the size and number of gallstones, accompanied by significant alleviation of symptoms and improvement in overall well-being. This case highlights the efficacy of Ayurvedic interventions in managing biliary calculi, offering a safe and holistic approach to treatment while addressing the underlying imbalances in the body. Furthermore, it underscores the importance of individualized therapeutic strategies in Ayurveda, emphasizing the integration of dietary and lifestyle modifications alongside Ayurveda management to achieve favorable outcomes in patients with biliary calculi. Additional research and clinical trials are warranted to validate the efficacy and elucidate the mechanisms of Ayurvedic interventions in the management of biliary calculi.
Safety profile of Naga Bhasma prepared by two classical methods
Authors: Tate Pravin M. , Patgiri B. J. , Prajapati P. K. , Ravishankar B.
Published: August 2024

Background:

Naga Bhasma (NB) (incinerated lead) has been indicated as a remedy for the treatment of a wide range of diseases including Prameha (diabetes), Kasa (cough), Raktapradara (menorrhagia), Shukradosha (defects in semen), etc., However, improperly prepared NB can cause harmful effects on the human body. In modern science also, lead consumption has been accepted to produce toxicity.

Aim:

The present study was undertaken to elucidate and compare the toxicity profile of two samples of NB prepared by two different methods to ascertain the safety aspects.

Materials and methods:

In the first method, NB was prepared by using Parada (mercury), Gandhaka (sulfur), and Nimbu Swarasa (juice of Citrus medica var acida of Watt). In the second method, NB was prepared by using Ashwattha-Twaka-Churna (Ficus religiosa L.), Manahshila (realgar) (Ariloha), and Nimbu Swarasa. In both methods, 30 calcination cycles were given. Charles foster albino rats were used for the pharmacological study. Acute oral toxicity study was carried out as per organization for economic cooperation and development (OECD) 425 and chronic oral toxicity study was carried out as per OECD 408 (90-day oral repeated dose toxicity study). Acute oral toxicity study was conducted at five dose levels, namely 100, 250, 500, 1000, and 2000 mg/kg body weight. Chronic toxicity was carried out at a dose level of 62.5 mg/kg body weight. Animals were sacrificed on the 91st day by cervical dislocation. Blood was collected from the jugular vein and sent for hematological and biochemical investigations were done. Organs were used for histopathological studies. The data were analyzed by unpaired t-test.

Results:

No mortality was observed in the acute toxicity study. Chronic toxicity study shows that both the test drugs do not produce significant toxicity, but both were not completely free from adverse effects at the dose level studied.

Conclusion:

The study shows that both the test drugs do not produce significant toxicity, but they are not completely free from adverse effects at the dose level studied.
Hyaluronic acid induced blindness and orbital ischemic syndrome: a case report
Authors: Turcio-Aceves Octavio , Carrillo-Haro Emma P. , Gutiérrez-García Diana K. , Cárdenas-Belaunzarán Jorge
Published: August 2024

The incidence of filler-induced blindness is unknown due to the few reported cases in the literature, nevertheless, it represents a devastating complication. There is no effective treatment for the filler-induced blindness and ophthalmoplegia. However, retrobulbar hyaluronidase treatment has been used with some apparent beneficial results.

We report a case of a 29-year-old female patient who presented with right eye blindness, ophthalmoplegia, and ptosis secondary to dorso-nasal hyaluronic acid injection as a cosmetic treatment. She was treated immediately with intravenous corticosteroids and dorso-nasal and retrobulbar hyaluronidase in an outpatient clinic. After 6 days, the patient was admitted to our institution with a clinical diagnosis of ptosis, ophthalmoplegia, ischemic ocular syndrome, and ophthalmic and central retinal artery occlusion in her right eye. The ptosis and eye movements improved on her follow-up, but the vision loss was permanent due to severe optic nerve and retinal ischemia. Brain MRI ruled out central nervous system involvement.
Macular perfusion, thickness, and sensitivity in phacovitrectomy versus lens-sparing vitrectomy in rhegmatogenous retinal detachment
Authors: Abdel Kader Ahmed A. , Abdelmalak Mina , Elnahry Ayman G. , Ghalwash Dalia A. , Esmat Soheir , Shuaib Asmaa
Published: August 2024

Purpose

The aim of this study was to compare phacovitrectomy (phacoPPV) to lens-sparing pars plana vitrectomy (PPV) with respect to macular perfusion, thickness, and sensitivity in phakic patients with rhegmatogenous retinal detachment.

Patients and methods

This is a prospective, comparative, nonrandomized, interventional study that included 31 phakic eyes with primary rhegmatogenous retinal detachment. The patients were divided into two groups according to the preoperative lens status: group A who had significant cataract and group B who did not have significant cataract. Group A included 17 eyes for which phacoPPV was performed, while group B included 14 eyes for which lens-sparing PPV was performed. All patients were preoperatively evaluated clinically and with A-scan ultrasonography and were followed up for 4 months after surgery. Optical coherence tomography angiography (OCTA) and microperimetry were done at 2 and 4 months, postoperatively.

Results

The OCTA showed that the lens-sparing PPV was associated with significantly larger foveal avascular zone area (0.4±0.2 mm2) compared to the phacoPPV (0.2±0.1 mm2) at 2 months (P=0.048), as well as at 4 months (0.4±0.1 mm2vs. 0.2±0.1 mm2, respectively, P=0.044). However, the foveal avascular zone perimeter showed no statistically significant differences between the two groups at 2 and 4 months postoperatively. At 2 months, the deep vascular plexus (DVP) parafoveal vessel density was statistically significantly higher in the phacoPPV group (47.9±4.7%) compared to the PPV group (36.4±11.9%) (P=0.048), while at 4 months it was the DVP foveal vessel density that showed a significantly higher mean in the phacoPPV group (35.4±11.9%) compared to the PPV group (20.3±16.1%) (P=0.036). No other statistically significant intergroup differences were found with respect to other parameters for macular perfusion, and other DVP parameters. Similarly, the macular sensitivity, as well as the ganglion cell complex, and the central subfield thicknesses were comparable between the two groups. The visual outcome was also comparable at 2 and 4 months between the two groups.

Conclusion

PhacoPPV and lens-sparing vitrectomy were comparable with respect to OCTA, microperimetry, and visual acuity. The limited differences are too preliminary and the decision to do phacoPPV rather than lens-sparing PPV needs to be based on other determinants like the presence of preoperative lens opacity.
Manually performed limbal relaxing incisions versus femtosecond laser-guided astigmatic keratotomy for correction of corneal astigmatism after phacoemulsification
Authors: Rashwan Ashraf , Natag Ali , Wasfi Ehab , Lotfy Hassan , Shehata Mohamed
Published: August 2024

Purpose

This study aimed to evaluate the safety and efficacy of manually performed limbal relaxing incisions (LRIs) compared with femtosecond laser-guided astigmatic keratotomy (FLAK) in the management of corneal astigmatism after phacoemulsification.

Patients and methods

This is a prospective, comparative, randomized, interventional study that was conducted from March 2018 to September 2022. It included 56 patients (74 eyes) who had corneal astigmatism after conventional phacoemulsification. They were classified into two groups. Group A included 34 patients (41 eyes) for whom manual LRIs using a diamond knife were performed and group B included 22 patients (33 eyes) for whom FLAK was performed. The preoperative evaluation included manifest refraction, uncorrected distance visual acuity, best corrected distance visual acuity, slit lamp examination of the cornea, intraocular pressure measurement, and fundus examination. Corneal astigmatism in diopters (D) was established by corneal tomography and Scheimpflug imaging (Pentacam). Postoperative follow-up visits were scheduled on the first day, at 1 week, 1 month, and 3 months after surgery. Postoperative evaluation included a slit lamp examination for the incisions, uncorrected distance visual acuity, manifest refraction, and Pentacam to evaluate corneal astigmatism.

Results

The mean topographic corneal astigmatism was reduced from 3.36±1.66 D to 1.07±1.11 D, 3 months postoperatively in the LRIs group with a statistically highly significant difference (P=0.000) and from 3.66±1.82 D to 1.19±1.26 D in the FLAK group with a statistically highly significant difference (P=0.000). The mean topographic corneal astigmatism 3 months postoperatively showed a statistically nonsignificant difference between the two groups (P=0.665). Although there was no statistically significant difference between the two groups, the mean arithmetic reduction of astigmatism was higher in the FLAK group (2.47 D) than in the LRIs group (2.29 D). The surgery was uneventful in 92.68% of the cases in group A with only 7.32% showing nonserious corneal perforation, while in group B, the surgery was uneventful in 97% of the cases with only 3% showing nonserious corneal perforation with a statistically nonsignificant difference between the two groups (P=0.431).

Conclusion

Both manually performed LRIs and FLAK were safe, predictable, and effective methods for correcting pre-existing or surgically induced corneal astigmatism after phacoemulsification with a nonsignificant difference in visual and corneal topographic outcomes between the two methods.
Safety and Efficacy of Mitomycin C: Augmented Trabeculectomy: Subtenon’s Injection versus Sponge Application
Authors: Sedani Kanan Vimal , Bhagat Purvi Raj , Chauhan Abhishek Suryakant
Published: August 2024

Objective:

The objective of the study was to study the safety and efficacy of subtenon injection of mitomycin C (MMC) versus sponge application of MMC during trabeculectomy.

Materials and Methods:

Thirty-seven patients having primary glaucoma warranting trabeculectomy were enrolled in the study and their forty eyes were alternately allocated into either of the two groups: subtenon injection (ST) of 0.1 mL of 0.01% of MMC or sponge application (SP) of 0.02% of MMC and were operated by a single surgeon and followed for 3 months. The outcome was analyzed primarily based on reduction in intraocular pressure (IOP) and bleb morphology.

Results:

Similar outcome in terms of complete success (ST – 90% and SP – 85%), qualified success (ST – 5% and SP – 5%), and failure rate (ST – 5% and SP – 10%) was seen at the end of 3 months. The absolute reduction in IOP from the baseline was −10.00 ± 3.67 mmHg (−41.2% ± 12.30) in ST versus −8.90 ± 5.56 mmHg (−35.9% ± 16.1) in the SP group at the end of 3 months. At the end of 3 months, blebs in the ST group had low-to-medium height and in the SP group had low height. Blebs in both the groups were diffuse with mild vascularity. Antiglaucoma medications required postoperatively were 0.20 ± 0.62 versus 0.40 ± 1.10 in the ST and SP group, respectively. The duration of surgery was 19.85 ± 0.75 min in the ST group versus 22.50 ± 0.51 min in the SP group.

Conclusion:

Subtenon injection of MMC is as efficacious and safe as the conventional sponge application technique.
Dermatological Enigma Unveiled: A Rare Case Report on Dowling-Degos Disease
Authors: Goswami Parth Rajendragiri , Pathania Yashdeep Singh , Singh Gyanendra , Patel Tarang , Agarwal Ashwini
Published: August 2024

Dowling-Degos disease (DDD) is an extremely rare hereditary skin condition characterized by the development of painless, small-sized pigmented patches known as macules or keratotic papules. Typically inherited in an autosomal dominant manner, DDD primarily manifests in adulthood, with onset occurring between the ages of 30 and 40 years, and a higher prevalence among females. Although DDD shares clinical similarities with other reticulated pigmentary disorders such as dyschromatosis symmetrica hereditaria, dyschromatosis universalis hereditaria, and reticulate acropigmentation of Kitamura, its distinctive histopathological features set it apart. A 50-year-old female patient presented with hyperpigmented lesions since infancy, predominantly located in flexural areas, prompting consideration of endogenous eczema or DDD. Despite the absence of a family history and normal laboratory test results, a biopsy confirmed the diagnosis based on characteristic histological findings. The identification of DDD underscores the importance of considering rare dermatological entities in differential diagnosis, especially when clinical presentation aligns with established criteria. Further research and awareness are essential for enhancing our understanding and management of this intriguing skin condition.
Nitric Oxide Synthase 3 Gene Polymorphisms and Their Association with Acute Myocardial Infarction and Chronic Stable Angina: A Case–Control Study from Northern India
Authors: Kumar Sunil , Juyal Deepak , Pandey Arun , Tomar Preeti , Sagar Vinay , Yadav Rakesh , Saxena Renu
Published: August 2024

Background:

Coronary artery disease (CAD) that encompasses acute myocardial infarction (AMI), chronic stable angina (CSA), and unstable angina (UA) has numerous known risk factors. Genetic predispositions contribute as major risk in the development of CAD and the genes regulating atherosclerosis are important for disease prevention. Nitric oxide synthase 3 (NOS3) gene responsible for nitric oxide (NO) production is of special importance.

Aim:

To evaluate the role of three NOS3 polymorphisms (-786C/T, 894G/T, and 4a4b) in patients with CAD, particularly in AMI and CSA and their comparison with healthy controls.

Materials and Methods:

One hundred patients in each AMI and CSA group and 100 controls were included and were typed for three NOS3 polymorphisms (-786C/T, 894G/T, and 4a4b) by polymerase chain reaction–restriction fragment length polymorphism. Plasma NO metabolites (NOx) were also evaluated.

Results:

A significant association of 894G/T polymorphism with AMI in dominant model (P = 0.052) and with CSA in dominant and codominant models was detected (P = 0.008 and P = 0.006, respectively). Plasma NO levels were found to be significantly higher (P < 0.0001) in healthy controls (43.80 ± 6.28) compared to AMI and CSA patients (37.05 ± 6.75 and 38.67 ± 5.61). No significant association of -786C/T and 4a4b polymorphism with AMI and CSA risk under recessive, dominant, and codominant models was detected.

Conclusion:

Our study revealed a significant association of 894G/T polymorphism with AMI and independent association of NOx levels with CAD, indicating high risk of CAD in the North Indian population. Our findings will be helpful in identifying the genetic risk factors associated with CAD and better management of the diagnostic as well as therapeutic measures.
Assessing the Safety of a Novel Monoclonal Antibody Cocktail for Postexposure Prophylaxis in Category III Animal Exposures
Authors: Singh Amandev , Sibia Raminderpal Singh , Oberoi Simmi , Bhatia Lovleen , Kaushal Sachin , Dutta Trayambak , Mahajan Manish , Desai Samir
Published: August 2024

Background:

TwinRab™ is a novel life-saving biological containing two monoclonal antibodies (docaravimab and miromavimab) essential for all age victims of category III animal exposures. It effectively neutralizes rabies and similar viruses at the exposure site until the body generates vaccine-induced antibodies. This postmarketing surveillance study assesses the safety of TwinRab™ in current postexposure prophylaxis (PEP) use and aims to reinforce its safety data for future applications.

Methods:

The prospective, open-label observational study was conducted on patients with the World Health Organization category III animal exposures at a government hospital in a northern region of India, by a suspected rabid animal. The study protocol included administering TwinRab™ (40 IU/kg) and a full course of anti-rabies vaccination as PEP.

Results:

Out of 405 participants, 404 completed the study as per the protocol. Adverse events (AEs) occurred in 12.35% of cases, with 9.88% local AEs (primarily pain and tenderness) and 2.47% systemic AEs (fever, malaise, and myalgia). All AEs were mild and resolved without complications. Most participants (88.9%) and investigators (89.1%) rated TwinRab™’s tolerability as excellent.

Conclusion:

The present study demonstrates the evidence of a satisfactory safety profile along with better tolerability of TwinRab™ (40 IU/kg) for category III animal exposures and supports its continued usage.
Laser refractive correction of presbyopia
Authors: Ganesh Sri , Sriganesh Sushmitha Samak
Published: August 2024

Presbyopia is an inevitable and progressive loss of the eye’s ability to focus on nearby objects due to aging, which affects everyone regardless of their refractive error. Uncorrected presbyopia is a significant burden worldwide and affects the quality of life. Conservative options include spectacle correction, contact lenses, and pharmacologic agents. Spectacles are commonly used to correct vision, but have certain drawbacks such as peripheral blur and impaired depth perception. These limitations have been associated with an increased risk of accidental falls. Several surgical options are available to address these issues, including cornea-based, lens-based, or scleral procedures. These procedures involve modifying the cornea’s optics, replacing the crystalline lens, or attempting to restore accommodation. Each of the options has its benefits and limitations. One of the most common surgical methods of presbyopic correction that has recently become popular is presbyopic Laser assisted In situ keratomileusis (LASIK) due to its improved safety and efficacy. This article is a review of all the currently available data and studies regarding the various methods of correction of presbyopia, with an emphasis on the principles and outcomes of the corneal laser refractive procedures for presbyopia correction, such as PresbyLASIK, Supracor, PRESBYOND laser blended vision, and Custom Q.
Implantation of asymmetrical corneal intrastromal rings: A case series
Authors: Saito Marina S , Silva Ana P C , Ribeiro João M C , Bonfante Delso , Rodrigues Pablo F , Moscovici Bernardo K , Barboza Guilherme N C , Barboza Marcello N C
Published: August 2024

This case series reports eight eyes with keratoconus treated with laser implantation of one or two segments of progressive thickness corneal intrastromal ring (PT-ICRS). In this case series, it was evident that the insertion of PT-ICRS induces more pronounced corneal flattening at the thickest point, causing a reduction in distortion (coma) and lower astigmatism, resulting in a remarkable improvement in vision. Compared to the implementation of traditional intrastromal rings, the PT-ICRS variant showed superior results despite the small sample size. However, the same degree of asymmetry enhancement was not observed in cases in which a 330° PT-ICRS was implanted, despite the improvement in visual results when replacing a 320° traditional ring with a 330° PT-ICRS. These conclusions are limited as this is a case series with few cases.
Glaucoma and refractive surgery: A comprehensive review
Authors: Kodali Sivani , Murthy Somasheila , Banad Nandini , Dongre Pankaj , Senthil Sirisha
Published: August 2024

The global surge in refractive surgeries, particularly among myopic individuals, has elicited concerns regarding potential inaccuracies in the measurement of intraocular pressure (IOP) post surgery, primarily associated with central corneal thinning. The incidence of elevated IOP after intraocular refractive surgeries is higher than expected and is multifactorial. Myopic eyes have a higher susceptibility to both primary and secondary glaucoma. Consequently, meticulous preoperative screening for glaucoma is imperative, coupled with systematic postoperative follow-up and evaluation. This comprehensive review analyses the etiology, mechanisms, and therapeutic strategies for managing elevated IOP following refractive surgery. We propose an algorithm to summarize the causative factors of elevated IOP and formulate effective interventions in these instances.
Effect of ageing and cataract formation on the Raman spectroscopic profile of human lens: An observational study
Authors: Nishad Ayasha , Malik Praveen , Dewan Taru
Published: August 2024

Purpose:

To observe the spectroscopic profile of human lens in different age groups and varying grades of cataract and to use the data to arrive at differentiating molecular biology.

Design:

An observational cross-sectional study.

Methods:

The study enrolled 30 patients (30 eyes) with a mean age of 59.6 years diagnosed with immature senile cataracts. The patients underwent small incision cataract surgery, and the harvested lens nuclei were examined under a Raman spectroscope for studying their molecular composition. The relative intensities of the peaks in the Raman spectra were evaluated and compared among different age groups and grades of cataract. A correlation of tyrosine doublet ratio with grade of cataract and age of the subject was calculated.

Result:

Several Raman spectral peaks were observed in the range of 600 cm-1 to 1800 cm-1 with correspondence to tyrosine, phenylalanine, tryptophan, and amides I and III. A strong negative correlation between the grade of cataract and the ratio of tyrosine doublet was seen (r = -0.805). Also, a negative correlation between age and tyrosine ratio was seen (r = -0.62). The wavenumber/spectral peak of tryptophan was observed only in one sample, and amides I and III were identified, but the intensity of the peak for amide II was very small or absent.

Conclusion:

It was observed that the buried conformation of tyrosine was predominant in cases with a higher age or grade of cataract. The buried conformation of tryptophan became less in the higher grades of cataract.