bluuebunny/crossref_metadata_2025 huggingface dataset:
Postoperative Corneal Epithelial Remodeling After Intracorneal Ring Segment Procedures for Keratoconus: An Optical Coherence Tomography Study
Authors: David Clémentine , Reinstein Dan Z. , Archer Timothy J. , Kallel Sofiene , Vida Ryan S. , Goemaere Isabelle , Cuyaubère Roxane , Borderie Marie , Laroche Laurent , Borderie Vincent , Bouheraoua Nacim
Published: June 2021

PURPOSE:

To assess epithelial corneal remodeling by anterior segment optical coherence tomography (AS-OCT) after intracorneal ring segments (ICRS) implantation in keratoconic eyes.

METHODS:

This prospective observational study included patients with keratoconus receiving ICRS of different arc lengths according to their tomographic pattern. AS-OCT and corneal topography (Scheimpflug camera) were performed before and 1, 3, and 6 months after surgery. Corneal pachymetry mapping was performed and total corneal and epithelial thicknesses (3-mm central and 16 points on 6-mm zone) were measured over the pupil center using AS-OCT. Topographic parameters were also assessed.

RESULTS:

A total of 68 keratoconic eyes were analyzed (Amsler-Krumeich stages 1 to 4) in four groups of 17 eyes: 210° ICRS, 320° ICRS, double 160° ICRS, and single 160° ICRS. Corneal pachymetry mapping revealed that epithelial thickness increased significantly in the internal zones juxtaposed to the ICRS without smoothing during the postoperative period (
P
< .05). Mean maximum epithelial thickness increased from 67 ± 6 to 79 ± 7 µm for 210° ICRS, 66 ± 9 to 82 ± 4 µm for 320° ICRS, 63 ± 6 to 78 ± 7 µm for double 160° ICRS, and 62 ± 5 to 77 ± 5 µm for single 160° ICRS (
P
< .0001). Significant epithelial thickening at the apex of the cone was observed in all groups (
P
< .05).

CONCLUSIONS:

Significant epithelial thickening occurs after ICRS implantation adjacent to the ICRS to compensate for the ridge created with a thickening of epithelium over the cone due to regularization of the stromal surface.

[
J Refract Surg
. 2021;37(6):404–413.]
Factors Predicting the Need for Re-treatment After Laser Refractive Surgery in Patients With High Astigmatism: A Large Database Analysis
Authors: Mimouni Michael , Kaiserman Igor , Spierer Ronen , Spierer Oriel , Rabina Gilad , Varssano David , Sorkin Nir
Published: June 2021

PURPOSE:

To identify the potential risk factors that increase the likelihood of requiring re-treatment following refractive surgery in patients with high astigmatism (3.00 diopters or greater).

METHODS:

This retrospective study included patients who underwent laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) between January 2005 and December 2019 at the Care-Vision Laser Centers, Tel-Aviv, Israel. Patients with high astigmatism (3.00 diopters or greater) were included and divided into two groups according to whether or not they underwent additional refractive surgery (re-treatment) during the study period.

RESULTS:

Overall, 2,024 eyes (2,024 patients) were included in the final analysis of this study. In total, 3.1% of the eyes (n = 63) underwent re-treatment. Throughout the study period, there was a significant reduction in the 2-year annual re-treatment rates, with a decline from 7.0% for primary surgeries performed in 2005 to 0.0% for primary surgeries performed in 2017 (
r
=−0.65,
P
= .015). The re-treatment group had significantly older preoperative age. They were also more likely to be male and have preoperative against-the-rule astigmatism and preoperative mixed astigmatism. Binary logistic regression analysis demonstrated that preoperative age, male gender, mixed astigmatism, and earlier year of surgery were all associated with higher re-treatment rates.

CONCLUSIONS:

The following factors are associated with higher rates of re-treatment in patients with high astigmatism: older preoperative age, male gender, and mixed astigmatism. These factors may be incorporated into nomograms to reduce future re-treatment rates in this population.

[
J Refract Surg
. 2021;37(6):366–371.]
Intraocular Lens Refractive Index and Its Impact on External Surface Reflections
Authors: Kymionis George D. , Kim Jaeryung , Petrelli Myrsini , Grentzelos Michael A. , Hashemi Kattayoon , Wagnières Georges
Published: June 2021

PURPOSE:

To determine and compare the origin of the external surface reflections produced by commonly used intraocular lenses (IOLs).

METHODS:

The specular reflection taking place at the anterior surface of eight types of IOLs (IOL power = 22.00 diopters [D]) with different refractive indices (RIs), optical design, and ultraviolet and blue light-filtering function were measured. The experimental set-up included a laser beam light source (3.5 mW, 532 nm) and a saline-filled model eye containing the IOL to be examined. External surface reflections were measured using a power meter, and the IOL surface reflectance (%) was compared among the eight IOLs investigated.

RESULTS:

External reflections from the anterior surface of the studied implants increased as the RI of the IOL material increased. The IOL models composed of high RI material (RI = 1.56 ± 0.02) were found to have a more than threefold higher external surface reflections compared to those with low RI (RI = 1.45 ± 0.02). Ultraviolet or blue light-filtering functions showed no significant correlation with the external reflectance.

CONCLUSIONS:

IOLs with a high RI are associated with external surface reflections that are more than threefold higher than those with lower RI. The “cat's eye” phenomenon seen in pseudophakic eyes by an outside observer strongly depends on the RI, but is independent of the filter incorporated in the IOL.

[
J Refract Surg
. 2021;37(6):398–402.]
The Economic Impact of Presbyopia
Authors: Donaldson Kendall E.
Published: June 2021

Presbyopia is the world's number one cause of vision loss with more than 1 billion individuals affected globally. The total global costs associated with correcting near vision impairment due to uncorrected presbyopia have been estimated at $30.8 billion for a comprehensive eye care model. Both cost to the patient and cost to society, which is greater in low-income countries relative to high-income areas, should be considered. Ultimately, surgical correction of the nonaccommodating dysfunctional natural lens may provide the “cure” for presbyopia. Presbyopia-correcting intraocular lenses (IOLs) may provide better visual acuity and fewer adverse effects. Patients are pursuing cataract surgery at a younger and younger age. Although this expands the viable pool for lens exchange, this younger group of patients has extreme demands and has a much more scrutinizing frame of reference for comparison (a milder cataract). Thus, they are at a much higher risk for dissatisfaction and have a much higher chance of noticing potential adverse effects from multifocal IOLs. Setting appropriate expectations and thoroughly educating patients preoperatively helps create a partnership with the patient and a strong foundation for a successful surgical outcome. A cure for presbyopia has always been considered the holy grail of ophthalmology. In 2021, ophthalmologists are moving closer to achieving this goal while also creating a safer, more productive, cost-effective solution to presbyopia on an individual and on a global level.

[
J Refract Surg
. 2021;37(6 Suppl):S17–S19.]
Riesz-type representation formulas for subharmonic functions in sub-Riemannian settings
Authors: Abbondanza Beatrice , Biagi Stefano
Published: June 2021

In this paper we use a potential-theoretic approach to establish various representation theorems and Poisson-Jensen-type formulas for subharmonic functions in sub-Riemannian settings. We also characterize the Radon measures in \begin{document}$ \mathbb{R}^N $\end{document} which are the Riesz-measures of bounded-above subharmonic functions in the whole space \begin{document}$ \mathbb{R}^N $\end{document}.
Sporazumi o priznanju krivnje u postupcima pred međunarodnim kaznenim sudovima
Authors:   Faculty of Law, University of Split, Pajčić Matko , Bonačić Marin ,   Faculty of Law, University of Zagreb
Published: June 2021

Sporazumi o priznanju krivnje između tužitelja i okrivljenika, na temelju kojih se okrivljenik potvrdno očituje o krivnji u zamjenu za neki ustupak od strane tužitelja, izvorno su nastali u pravnim sustavima angloameričke pravne tradicije. Iako prvotno nisu bili predviđeni, ti sporazumi javili su se i pred međunarodnim te internacionaliziranim kaznenim sudovima. Do toga je prvi put došlo u postupku pred Međunarodnim kaznenim sudom za bivšu Jugoslaviju u trenutku kada je Sud bio opterećen velikim brojem predmeta s jedne strane, a s druge strane pritiskom da ubrza postupke i završi s radom. U daljnjem razvoju iskristalizirala su se dva temeljna modela: sporazumi pod utjecajem angloameričke pravne tradicije te sporazumi pod većim utjecajem kontinentalne pravne tradicije. U radu se razmatraju temeljna obilježja tih dvaju modela te njihove sličnosti i razlike. Uz to, razmatra se i usklađenost sporazuma s ciljevima međunarodnog kaznenog pravosuđa.
Prikaz knjige: Ivana Jaramaz Reskušić "Izbori i izborna korupcija u Rimskoj Republici, s Kratkom raspravom o izbornom natjecanju Kvinta Tulija Cicerona i govorima Za Plancija i Za Murenu Marka Tulija Cicerona", Pravni fakultet u Zagrebu, Zagreb, 2020.
Authors:   Faculty of Law, University of Sarajevo, Hebib Mirza
Published: June 2021

U poznatom djelu De re publica Marko Tulije Ciceron piše kako država jest stvar naroda, a narod skupina mnoštva udružena prihvaćanjem prava i zajedničkom korišću. U idealno zamišljenom demokratskom društvu to je uistinu tako – rasprava, dijalog i razmjene ideja, u okviru kojih cjelokupno društveno uređenje izvire iz naroda, krećući se prema cilju ostvarivanja općeg dobra. U okviru demokratske političke kulture modus operandi kreiranja i izgradnje političkih institucija jesu izbori. Kroz njih konstantno dolazi do izražaja vječna težnja ostvarenja pravednog društva u kojem će istinski biti – res publica, res populi. Korijeni takve političke kulture, u punom smislu riječi, kakvu mi danas poznajemo, razvili su se u fazi republikanskog uređenja rimske države (509. g. pr. Kr. – 27. g. pr. Kr.). Tijekom tih pet stoljeća, provodeći magistratske skupštinske izbore gotovo svake godine, postavljeni su pravni temelji moderne političke organizacije. Uz preuzimanje naprednih, civilizacijski nenadmašenih koncepata, primjetna je povijesna konstanta očuvanja i društvenih devijacija i etički neprihvatljivih postupaka. Osobit problem, koji se javljao kroz povijest, a prisutan je i danas, predstavljaju različite zlouporabe na putu dolaska na vlast, pri čemu pojedinci, vođeni nemoralnim pobudama i partikularnim interesima, nerijetko kroz različite oblike koruptivnog djelovanja ugrožavaju funkcioniranje zajednice. Svakog istraživača zainteresiranog za razumijevanje funkcioniranja demokratske države put znanstvene spoznaje vodi na rimsko ustavnopravno uređenje. Ono je osnova europske demokratske političke kulture – skelet civilizacijski nenadmašenih ideja, ali i nekih devijantnih društvenih pojava. U izdanju Pravnog fakulteta Sveučilišta u Zagrebu nedavno je objavljena znanstvena monografija Izbori i izborna korupcija u Rimskoj Republici autorice Ivane Jaramaz Reskušić, redovite profesorice na Katedri za rimsko pravo, koja ovom monografijom nastavlja svoju dosljednost u istraživanju javnopravnih aspekata funkcioniranja rimske države, koji su u hrvatskoj, ali i regionalnoj romanističkoj znanosti, uglavnom bili zapostavljeni. Monografija je podijeljena na četiri poglavlja i zaključak, nakon čega slijede latinska vrela s paralelnim prijevodom na hrvatski jezik.
Hospitales y modernización: el caso de las Hijas de la Caridad en los hospitales de Chile (1850-1900)
Authors: Valdés della Maggiora María Paz
Published: June 2021

El presente artículo analiza el trabajo realizado por las Hijas de la Caridad de San Vicente de Paul en los hospitales de Chile durante el siglo XIX. En base a escritos originales de las vicentinas y reglamentos hospitalarios, postula que los cambios introducidos por dichas religiosas fueron fundamentales permitiendo que los hospitales fueran desligándose de la beneficencia colonial e ir adentrándose en los parámetros establecidos por la ciencia moderna.
Automatically Moving Robot Intended for the Elderly with Voice Control
Authors: Piyaneeranart Manussawee , Ketcham Mahasak
Published: June 2021

This research aims at an automatically moving robot intended for the elderly with voice control using voice recognition that gives a direction to the robot by a voice command. The development of this robot employed an algorithm that converts voice to text to control the robot mobility. The performance testing of the automatically moving robot intended for the elderly with Thai language voice commands revealed an accuracy of voice-to-text conversion for commanding the robot to move in designated directions of 100 percent, and the accuracy of voice-to-text conversion for commanding the robot to move in designated directions using English language was 80 percent, while that for both Thai and English commands was 70 percent. Errors in voice-to-text conversion occurred when commands were not clearly spoken or pronounced or when commands were issued from people located in a very noisy place.
Research and Application of Encryption System Based on Quantum Circuit for Mobile Internet Security
Authors: Li Yuehua , Wang Chengcheng , Sun Jiahao , Guan Zhijin , Chen Jiaqing , Wang Zelin
Published: June 2021

Nowadays, the IoT technology is developing rapidly. In order to protect the information security of the IoT, this paper applies the characteristics of quantum circuit, such as high complexity and no feedback, into the field of encryption technology, and designed a encryption system based on quantum circuit. The system uses quantum circuit to construct the encryption algorithm, and realizes the mathematical operations and transformation in quantum logic which can be realized through quantum logic gates. Encryption system of quantum circuit can improve the encryption complexity, and its anti-attack ability is ( -1)! times of the traditional method, thus it can effectively protect the information security of the IoT. In order to increase the practicability of the system, this paper designed an interface module to facilitate the interaction of the system with the outside world .What’s more, the IoT application system is designed in which the validity and correctness of the encryption system are verified.
Eye Movement Feature Set and Predictive Model for Dyslexia
Authors: Appadurai Jothi Prabha , Bhargavi R.
Published: June 2021

Dyslexia is a learning disorder that can cause difficulties in reading or writing. Dyslexia is not a visual problem but many dyslexics have impaired magnocellular system which causes poor eye control. Eye-trackers are used to track eye movements. This research work proposes a set of significant eye movement features that are used to build a predictive model for dyslexia. Fixation and saccade eye events are detected using the dispersion-threshold and velocity-threshold algorithms. Various machine learning models are experimented. Validation is done on 185 subjects using 10-fold cross-validation. Velocity based features gave high accuracy compared to statistical and dispersion features. Highest accuracy of 96% was achieved using the Hybrid Kernel Support Vector Machine- Particle Swarm Optimization model followed by the Xtreme Gradient Boosting model with an accuracy of 95%. The best set of features are the first fixation start time, average fixation saccade duration, the total number of fixations, total number of saccades and ratio between saccades and fixations.
Institutional and Government Markets
Authors: Mandal Pratap Chandra
Published: June 2021

Institutional and government markets constitute not-for-profit market with the main objective of general welfare of people. Such markets are characterized by low budgets and captive patrons. Companies serving institutional markets establish and maintain separate departments to meet the specific requirements. Governments are the major and bulk buyers of goods and services in all countries. Government organizations, appointed by governments, have specified procedures which suppliers should follow. Suppliers experience a number of issues while dealing with government organizations. Suppliers require following formal procedures. The procedures may be time-consuming and suppliers may face bureaucracy. Governments adopt digital measures and adopt online buying to streamline the processes, to shorten the time required, and to overcome a number of hurdles. Companies dealing with institutional and government markets should be aware about all these aspects to succeed in the long run and also contribute to the growth of institutional and government markets.
The ability of Aliarcobacter butzleri strains isolated from foods of animal origin in Costa Rica to form biofilm
Authors: Chaves Marco , Vazquez-Valverde Daniel , Fernandez-Jaramillo Heriberto , Arias-Echandi Marìa Laura
Published: June 2021

Aliarcobacter butzleri is a zoonotic emerging food and waterborne pathogen widely distributed in nature. It is present in food processing environments and can easily be spread through the food industry because of its ability to form biofilm. The aim of this work was to determine the ability of strains isolated in Costa Rica from different food matrixes of animal origin to form biofilm. Thirty-eight A. butzleri strains previously isolated and identified from animal origin products were analyzed using the method described by Stepmovic et al. (2000), in three culture broths, brain heart infusion broth, Boer broth and Houf broth. Results showed that 67% of poultry origin strains, 62.5% of meat origin strains and just 8% of milk origin strains showed ability to form biofilm. The findings of this study confirm the adherence ability of A. butzleri to form biofilm, a characteristic that can promote dispersion and cross contamination along food industry processing lines.
New evidence of pectenotoxins in farmed bivalve molluscs from Sardinia (Italy)
Authors: Mudadu Alessandro G. , Bazzoni Anna Maria , Melillo Rita , Satta Cecilia Teodora , Cau Simona , Congiu Virgilio , Soro Barbara , Bazzardi Riccardo , Lorenzoni Giuseppa , Piras Gabriella , Bardino Nadia , Vodret Bruna , Virgilio Sebastiano
Published: June 2021

Several planktonic dinoflagellates can produce lipophilic phycotoxins that represent a significant threat to public health as well as to shellfish and fish farming. Poisoning related to some of these toxins is categorised as diarrhetic shellfish poisoning. We analysed 975 shellfish samples from Tortolì in the central-eastern region of Sardinia (Italy) from January 2016 to March 2020, to investigate the prevalence of different lipophilic marine biotoxins in mollusc bivalves. The results highlighted the predominant presence of toxins belonging to the okadaic acid group in all samples with toxin concentrations exceeding legal limits, and revealed the new occurrence of pectenotoxins in oysters and clams with a winter seasonality in recent years. The origin of shellfish toxicity was associated with the same Dinophysis species, mainly D. acuminata. Based on both these results and other precedents, monitoring and recording systems are strongly recommended.
Il sistema di sorveglianza dell’antibiotico resistenza AR-ISS: uno strumento efficace per migliorare la gestione degli antibiotici
Authors: Pantaleo E. , Gamalero E. , Leli C. , Rocchetti A.
Published: June 2021

Obiettivi: analizzare i dati di resistenza agli antibiotici raccolti dal Laboratorio di Microbiologia e Virologia dell'Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo di Alessandria per gli anni 2019 e 2020. Metodi: negli ultimi decenni, l’antibiotico resistenza è aumentata a livello globale, diventando una delle maggiori sfide per la salute pubblica dei giorni nostri. Il fenomeno attualmente è inserito nella lista dell’Unione Europea dei problemi sanitari speciali ed è monitorato tramite il sistema di sorveglianza EARSNet. In Italia, il sistema di sorveglianza dell’antibiotico resistenza AR-ISS, coordinato dall'Istituto Superiore di Sanità, è uno strumento essenziale per studiare e descrivere la comparsa e la diffusione del fenomeno. Il sistema di si basa su una rete di laboratori ospedalieri presenti su tutto il territorio nazionale, che inviano dati di routine sulla suscettibilità agli antibiotici per patogeni selezionati da infezioni invasive. In questo lavoro, nell'ambito della rete AR-ISS, vengono presentati i report di sorveglianza annuali 2019 e 2020 dell'Azienda Ospedaliera di Alessandria tramite statistiche riassuntive ed istogrammi. Risultati: sono state analizzate le specie batteriche sotto sorveglianza e i dati del 2020 confrontati con quelli del 2019. Inoltre, viene valutata la tendenza europea ed italiana del quinquennio 2015-2019 per quattro combinazioni farmaco/batterio. Particolare attenzione è stata rivolta a possibili previsioni di resistenza agli antibiotici. Conclusioni: i programmi di sorveglianza forniscono informazioni attuali e storiche indispensabili per una corretta stewardship antibiotica; inoltre, possibili previsioni future della resistenza agli antibiotici potrebbero essere utili per guidare le decisioni sulle strategie di mitigazione.
Prophylactic measures to prevent cerebral oxygen desaturation events in elective beach-chair position shoulder surgeries: a systematic review and meta-analysis
Authors: Tantry Thrivikrama Padur , Muralishankar Baikunje Golitadka , Karanth Harish , Shetty Pramal Karkala , Shenoy Sunil Purushotham , Kadam Dinesh , Tanthry Gururaj , Shetty Rithesh
Published: June 2021

Background: Prophylaxis for cerebral desaturation events (CDEs) during anesthesia in the beach chair position (BCP) for shoulder surgeries has not been evaluated. We systematically analyzed the effectiveness of various prophylactic measures used in this clinical setting.Methods: We performed a meta-analysis (PROSPERO; no. CRD42020167285) of trials reporting CDEs and regional cerebral oxygen saturation (rSO2) and jugular venous oxygen saturation (SjvO2) values in anesthetized patients undergoing shoulder surgery in BCP. Considering the type of prophylactic measures used (pharmacological or non-pharmacological), a subgroup analysis was planned. Outcomes included (1) rSO2 and SjvO2 data with and without prophylactic measures for CDEs, recorded for different time intervals, and (2) the number of patients experiencing CDEs and hypotension. Results: Twelve studies (786 patients) were included in the analysis. We observed lower absolute rSO2 values for early and all-time periods for vasoactive agent prophylaxis. The lowest achieved rSO2 values were also lower for vasoactive agent prophylaxis. Risk of CDEs was higher with vasoactive agent prophylaxis. Subgroup analysis identified targeted mild hypercarbia as effective in preserving cerebral oxygenation. Similarly, targeted mild hypercarbia prevented the fall in rSO2 with position change. Meta-regressions revealed statistically significant highest estimates for vasoactive agent prophylaxis in contrast to targeted mild hypercarbia. Likelihood of not developing CDEs was higher for targeted mild hypercarbia. In contrast to rSO2, most prophylactic methods reduced hypotensive episodes. Conclusions: Targeted mild hypercarbia can reduce BCP-related CDEs. Evidence does not favor prophylactic use of vasoactive agents for the prevention of cerebral desaturations irrespective of whether their use interferes with cerebral oximetry readings.
Ivermectin as an adjunct treatment for hospitalized adult COVID-19 patients
Authors: Niaee Morteza Shakhsi , Namdar Peyman , Allami Abbas , Zolghadr Leila , Javadi Amir , Karampour Amin , Varnaseri Mehran , Bijani Behzad , Cheraghi Fatemeh , Naderi Yazdan , Amini Fatemeh , Karamyan Masoumeh , YadYad Mohammad Jafar , Jamshidian Ramin , Gheibi Nematollah
Published: June 2021

Objective:

To evaluate different doses of ivermectin in adult patients with mild COVID-19 and to evaluate the effect of ivermectin on mortality and clinical consequences.

Methods:

A randomized, double-blind, placebo-controlled, multicenter clinical trial was performed at five hospitals. A total of 180 mild hospitalized patients with COVID-19 confirmed by PCR or chest image tests were enrolled and allocated to six arms including hydroxychloroquine 200 mg twice per day, placebo plus hydroxychloroquine 200 mg twice per day, single dose ivermectin (200 μg/kg), three low interval doses of ivermectin (200, 200, 200 μg/kg), single dose ivermectin (400 μg/kg), and three high interval doses of ivermectin (400, 200, 200 μg/kg). The primary endpoint of this trial was all-cause of mortality or clinical recovery. The radiographic findings, hospitalization and low O2 saturation duration, and hematological variables of blood samples were analyzed.

Results:

A total of 16.7% (5/30) and 20.0% (6/30) patients died in arms treated with hydroxychloroquine 200 mg twice per day and placebo plus hydroxychloroquine 200 mg twice per day, respectively, and a reduction in mortality rate in patients receiving ivermectin treatment to 0%, 10%, 0% and 3.3% for arms 1-4 were observed. Risk of mortality was also decreased about 15% in the ivermectin treated arms.

Conclusions:

Ivermectin as an adjunct reduces the rate of mortality, time of low O2 saturation, and duration of hospitalization in adult COVID-19 patients. The improvement of other clinical parameters shows that ivermectin, with a wide margin of safety, had a high therapeutic effect on COVID-19.
Exclusive Outlook of a Community Health Professional
Authors: Sethi Divya , Taywade Manish
Published: June 2021

Community health nursing (CHN) is a vast area to learn. This article focuses on experiences during my master's in CHN and mostly about the understanding and depth of the subject. This field not only deals with the intellectual part but also lays equal importance to the relationship we share with the people in the community. This is the career where your collaborative skills for individuals, families, groups, and communities will help to make things happen. My perspective to look into this stream changed which all are sharing in this article. A sharing experience in words to encourage all those upcoming youths in health care professional who do not have interest in this field. The most important boon felt is the least mental exhaustion. This profession needs passionate health care providers who can be smart and innovative enough to bring a small change at a huge level. It will provide you satisfaction for your service to humanity. Surely, this story of the journey of learning will motivate you to opt for this beautiful stream.
COVID-19 and Pregnancy
Authors: Singh Shalendra , Patnaik Subhasish , Hota Rabi Narayan , Ambooken George Cherian , Krishna Venigalla Sri
Published: June 2021

The anesthetic management of a pregnant patient with coronavirus disease 2019 (COVID-19) presents various unique challenges in terms of patient preparation, intraoperative management, and postoperative concerns, all while taking concurrent measures to prevent the spread of the virus from the patient to the healthcare workers. Anesthetic management of parturient in the era of the COVID-19 pandemic is further complicated by the fact that intubation and extubation are highly aerosol-generating procedures, and are generally advised to be avoided. While various organizations have come up with guidelines on the management of pregnant patients with COVID-19, definitive evidence-based guidelines for the same are lacking. This article aims to consolidate the available literature on the management of pregnant patients with COVID-19, with special impetus on the anesthetic management of these patients.
Lichen Planus Pemphigoides Versus Bullous Pemphigoid
Authors: Bhoite Ketki Shekhar , Mahajan Sunanda Arun , Saini Shefali A.
Published: June 2021

Monoclonal antibodies targeting the immune checkpoint pathways including programmed cell death 1 and programmed cell death ligand-1 have been used in several malignancies. Dermatological toxicities ranging from more common pruritus to rare autoimmune bullous reactions and lichenoid eruptions are an emerging consequence. We report a case of a 74-year-old male diagnosed with nonsmall cell lung carcinoma. He was treated with injection durvalumab following which he developed an itchy, erythematous to hyperpigmented, papular eruption over body. It was diagnosed as a lichenoid drug eruption based on clinicohistopathological correlation and was treated with topical corticosteroids and emollients. Following this, he presented with tense bullae all over the body including the areas of previous lichenoid eruption, associated with pruritus. The histopathology, immunofluorescence, and serology were diagnostic of bullous pemphigoid. However, considering the history, lichen planus pemphigoides (LPP) was the closest differential diagnosis. We treated him with systemic corticosteroids and tetracycline with resolution of the lesions in few weeks and was advised against the continuation of durvalumab therapy. In this article, we have highlighted this adverse event as well as a way to differentiate between LPP and bullous pemphigoid.
Dual Drug Reactions Induced by a Single Drug
Authors: Rao Angoori Gnaneshwar , Reddy Vangali Srikanth , Fathima Kousar , Tejal M. , Muppirala Divya , Sunki Preethi , Sruthi C. H. , Jhawar Jayshree , Myneni Vidyadharani
Published: June 2021

It is rare to encounter a dual drug reaction induced by a single drug. Herein, we present a case of such dual drug reaction caused by Urtica urens, a homeopathic drug in a young farmer who consumed U. urens for relief from common cold. He was relieved of symptoms of drug reaction following dechallenge and symptomatic treatment.
Oral Itraconazole and Topical Eberconazole Therapy in the Treatment of Tinea Cruris and Corporis
Authors: Saple Dattatray G. , Save Sushrut , Tambe Swagata Arvind
Published: June 2021

Background:

Dermatophytosis is a common fungal infection in India. In recent times, there has been a change in the course of the disease with an increase in the number of chronic, widespread, and recurrent cases.

Aims and Objectives:

The aim of this study is to (1) To study the clinical efficacy of itraconazole as a monotherapy in the treatment of tinea cruris and corporis and (2) To study the predictors of noncompliance to treatment in recurrence of infection.

Methods:

The current study was an unblinded prospective study conducted at a private clinic on 100 randomly selected patients, with a clinical and mycological diagnosis of tinea cruris and corporis. A detailed history was taken regarding the total duration of disease, duration of previous therapy, causes of noncompliance to previous treatmentand associated comorbidities after obtaining informed consent. The patients were put on a regime of oral itraconazole 100 mg twice daily and topical eberconazole twice daily for 12 weeks. Patients were followed up at 2, 6, 12 weeks, 6 months, and 1 year. Statistical analysis was performed using the SPSS software version 22. using appropriate statistical tests.

Results:

In our study, the mean age of the participants was 38 years, with the male: female ratio being 2.15:1. Only nine patients were treatment naïve, whereas 91 had received treatment previously. Most common factor responsible for discontinuation of therapy was partial relief which was mistaken as cure by the patient. Clinical cure rate at 2, 6, and 12 weeks was 38%, 68%, and 83%, respectively. Mycological cure rate at 2, 6, and 12 weeks was 56%, 81%, and 83%, respectively.

Conclusion:

itraconazole 100 mg twice daily is an effective and safe treatment for tinea cruris and corporis. Improving the patient's compliance and treatment adherence enhances the rate of clinical as well as mycological cure and avoids recurrences.
Assessing the results of anophthalmic prostheses
Authors: Vardizer Yoav , Sobeh Tamer , Prat Daphna Landau , Simon Guy J Ben , Tomkins-Netzer Oren
Published: June 2021

Purpose:

Anophthalmic sockets cause disfigurement that may result in emotional and social distress. The choice of procedure and implant is based upon the surgeon’s experience. There remains no standardization of cosmetic result. We sought to identify quantifiable anatomical features and functional properties related to a successful cosmetic result in patients with ocular prosthesis and to determine correlations between self-reported and third-party assessment of cosmetic success.

Methods:

This was a prospective observational study, which included 107 adult patients (50.1% female; age 53.08 ± 18.64 years, range 18–89) with acquired anophthalmia following prosthesis fitting. Patients completed a self-assessment questionnaire on self-perception of body image and ocular properties. Three independent examiners assessed cosmetic score. Assessed variables included prosthesis movement, eyelid symmetry, prosthesis stability, and socket fullness.

Results:

The general cosmetic result was 8.1 ± 2.19 (on a predetermined scale of 1–10) as perceived by the patients and 7.2 ± 0.19 by the examiners. Interexaminer correlation was high for all variables (P < 0.05). A good cosmetic result was correlated with prosthesis movement (P = 0.02), eyelid symmetry (P = 0.001), and prosthesis stability (P = 0.01). Factors that correlated with a good cosmetic result on multivariate analysis were prosthesis movement (odds ratio [OR] 4.95, P = 0.004), eyelid symmetry (OR 4.51, P = 0.006), and socket fullness (OR 3.56, P = 0.005). No correlation was observed between patients’ perceptions of the overall cosmetic result and those of the examiners.

Conclusion:

The cosmetic result of prosthesis use among anophthalmic patients is generally good, as perceived by both patients and examiners. Good eyelid position and symmetry, orbital fullness, and prosthesis motility were associated with a better cosmetic result.
Cataract surgery in retinitis pigmentosa
Authors: Chatterjee Samrat , Agrawal Deepshikha , Agrawal Deepanshu , Parchand Swapnil M , Sahu Anupam
Published: June 2021

Purpose:

The aim of this study was to evaluate visual outcomes of cataract surgery in patients with retinitis pigmentosa.

Methods:

This retrospective case series includes a review of the medical records of all patients with retinitis pigmentosa undergoing cataract surgery between 2005 and 2018. The primary outcome measure was corrected distant visual acuity and change in vision impairment after surgery.

Results:

Of the 103 (132) patients, 60 (58.3%) were men and 43 (41.7%) were women. The mean age of the study population was 51.3 ± 11.3 (22–74) years. The mean symptom duration was 35.4 ± 44.5 (1–300) months. The most common morphology of cataracts was a combination of nuclear sclerosis, posterior subcapsular, and cortical cataract (n = 65 eyes, 49.3%). Phacoemulsification (87 eyes, 65.9%) was the preferred surgical technique. The mean preoperative corrected distant visual acuity of 1.21 ± 0.87 log MAR units improved significantly (P < 0.001) to 0.60 ± 0.56 log MAR units after surgery. The number of blind patients reduced from 27 (26.2%) to 8 (7.8%) patients. Zonular dialysis and posterior capsule tear were seen in six (4.5%) eyes each. Good preoperative vision (odds ratio: 6.1 [95% confidence interval: 2.9–13.0], P < 0.0001) was associated with better outcome, wheras reduced central macular thickness (odds ratio: 3.5 [95% confidence interval: 1.3–9.2], P = 0.011) was associated with poor outcome.

Conclusion:

A considerable number of patients presented with advanced cataracts and severe vision impairment. Significant improvement in visual acuity and alleviation of vision impairment was seen after surgery, with few complications. Good preoperative visual acuity predicted a good outcome, whereas macular thinning predicted a poor outcome.
Systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio levels are associated with keratoconus
Authors: Elbeyli Ahmet , Kurtul Bengi Ece
Published: June 2021

Purpose:

The aim of this study was to assess the systemic immune-inflammation index (SII) levels, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) in patients with keratoconus (KC).

Methods:

A total of 42 patients with KC (KC group) and 42 age- and sex-matched healthy subjects (control group) were included into this cross sectional study. Complete blood count parameters were assayed. SII, NLR, red cell distribution width (RDW), and PLR values were calculated. The SII value was calculated as follows: platelet count × (neutrophil/lymphocyte).

Results:

SII, NLR, RDW, and PLR values were significantly higher in KC group compared to control group [709 ± 236 vs. 418 ± 117 (P < 0.001), 2.5 ± 0.8 vs. 1.76 ± 0.3 (P < 0.001), 14.3 ± 1.6% vs. 12.9 ± 0.54% (P < 0.001), and 143 ± 36 vs. 106 ± 23 (P < 0.001), respectively]. Using the receiver operating characteristics (ROC) curve analysis to predict KC, the highest area under the curve (AUC) was determined SII (0.846 for SII, 0.778 for NLR, and 0.796 for PLR).

Conclusion:

SII, NLR, RDW, and PLR levels were significantly increased in patients with KC. This study supports the idea that several inflammatory pathways may play important role in the pathogenesis of this disorder. SII may be much better marker than NLR and PLR for predicting the inflammatory status of the disease.
Incidence and causes of negative dysphotopsia after uncomplicated cataract surgery – A randomized clinical trial
Authors: Sharma Pankaj , Kalia Sonal , Chouhan Jugal Kishor
Published: June 2021

Purpose:

The purpose of this study is to find incidence of negative dysphotopsia (ND) in eyes undergoing clear corneal phacoemulsification and identify its causes including corneal wound hydration and type of intraocular lens (IOL).

Methods:

In this randomized clinical trial, consenting adult patients undergoing phacoemulsification were randomized to receive a hydrophobic (Alcon Acrysof® SN60WF) or a hydrophilic acrylic IOL (CT Asphina® 603P, Carl Zeiss Meditec) in a 1:1 ratio. At time of surgery, eyes were again randomized in 1:1 fashion to receive stromal wound hydration or not (n = 80 each in four groups). Primary outcome measure was the incidence of ND between eyes receiving stromal hydration versus no hydration. Those with ND were observed for 5 years after surgery.

Results:

Of the 320 eyes, 29 (9.06%) reported ND of which 24 (83%) were transient. Eyes with wound hydration had significantly higher proportion of ND (n = 21/160, 13%) compared to no hydration (n = 8/160, 5%) (P = 0.01). Additionally, eyes with wound hydration were three times more likely to experience ND (odds ratio = 3.29, 95% CI = 1.3–8.2, P = 0.01). Majority of eyes (20/21, 95%) with ND after hydration had it transiently while half (4/8, 50%) of those with ND without wound hydration had it persistently at 6 weeks (P < 0.001) and continued to experience ND for 5 years but did not request intervention.

Conclusion:

ND occurred in 9% cases with majority being transient. Corneal wound hydration led to significant higher likelihood of experiencing transient ND. Those with persistent ND for more than 6 weeks (1.5%) continue to experience ND for at least 5 years.
Rhinomanometric reference intervals for normal total nasal airflow resistance
Authors: Merkle J. , Kohlhas L. , Zadoyan G. , Mosges R. , Hellmich M.
Published: June 2021

Background: Reference intervals (RIs) or mean values for normal total nasal airflow resistance are essential for the diagnosis of nasal obstruction. Data relating to nasal airflow are not standardised, and valid and reliable RIs do not exist for the time being. This meta-analysis aimed to determine such “standard” 95%-RIs. Methodology: Research of related literature listed in Medline, Embase, Cochrane, and Web of Science databases. Results: Airflow resistance data were gathered from 38 studies using active anterior rhinomanometry at a differential pressure of 150Pa to examine patients under congested and decongested mucosal conditions. In the meta-analysis overall values and RIs for normal total nasal airflow resistance under congested nasal mucosal conditions were calculated for all subjects at 0.25Pa/cm3/s (95%-RI 0.10-0.40Pa/cm3/s), adults regardless of gender at 0.25Pa/cm3/s (95%-RI 0.12-0.38Pa/cm3/s), men at 0.24Pa/cm3/s (95%-RI 0.09-0.39Pa/cm3/s), and women at 0.26Pa/cm3/s (95%-RI 0.08-0.44Pa/cm3/s). Asian, African and Caucasian ethnic groups exhibited rising airflow resistance mean values: 0.23Pa/cm3/s (95%-RI 0.08-0.39Pa/cm3/s), 0.25Pa/cm3/s (95%-RI 0.11-0.38Pa/cm3/s) and 0.26Pa/cm3/s (95%-RI 0.13-0.38Pa/cm3/s), respectively. Lower overall mean values resulted under decongested nasal mucosal conditions. Conclusion: The reference intervals and mean values ascertained in this meta-analysis improve the diagnosis of nasal obstruction and may represent a useful supplement in existing guidelines for the standardisation of rhinomanometric measurements.
The effects of smoking on quality of life recovery after surgery for chronic rhinosinusitis
Authors: Katotomichelakis Michael , Simopoulos Efthimios , Tripsianis Gregory , Zhang Nan , Danielides Gerasimos , Gouma Panagiota , Bachert Claus , Danielides Vassilios
Published: June 2021

Background: The effects of smoking on quality of life (QoL) results in chronic rhinosinusitis (CRS) patients still remain a matter of debate. Objective: To explore the impact of smoking on QoL and determine how quantity of daily smoking and duration affect QoL results after endoscopic sinus surgery (ESS). Methodology: Patients with CRS were prospectively asked to evaluate their QoL pre- and after ESS. All subjects' QoL was evaluated by means of validated questionnaires either specific (Questionnaire of Olfactory Deficits), for assessing psychology (Zung Anxiety Scale, State -Trait Anxiety Inventory, Zung Depression Scale and Beck Depression Inventory) or generic (Short-Form-36). Smoking habits were expressed in pack-years. Results: No statistically significant differences were found in the pre-treatment scores in any of the questionnaires between smokers and non smokers. Post-operatively, all QoL questionnaires' results were significantly improved among both groups, although non smokers exhibited significantly greater improvement compared to smokers. There was a negative impact of the number of pack-years on the changes of QoL results; less improvement was observed as the number of pack-years was increasing. Conclusion: Although smoking did not improve preoperative QoL results and proved not to be a contra-indication factor for ESS regarding QoL, smokers presented worse treatment outcomes. Quantity and duration of smoking were significantly associated with worse postoperative results in all QoL questionnaires.
Интегрированные решения неплотно определенных полулинейных интегро-дифференциальных включений: существование, топология и приложения
Authors: Pietkun Radoslaw
Published: June 2021

Пусть заданы линейный замкнутый, но не обязательно плотно определенный оператор $A$ в банаховом пространстве $E$ с непустым резольвентным множеством
и многозначное отображение $F\colon I\times E\multimap E$ со слабо секвенциально замкнутым графиком.
Рассматривается интегро-дифференциальное включение
$$
\dot{u}\in Au+F(t,\int u)
\quadна I,
\qquad
u(0)=x_0.
$$
Основное внимание уделяется случаю, когда $A$ порождает интегрированную полугруппу:
доказывается существование так называемых интегрированных решений,
если пространство $E$ слабо компактно порождено и $F$ удовлетворяет условию
$$
\beta(F(t,\Omega))\le \eta(t)\beta(\Omega)
\quadдля всех ограниченных множеств \Omega\subset E,
$$
где $\eta\in L^1(I)$, а $\beta$ обозначает меру некомпактности Де Блази.
В случае, когда $E$ сепарабельно, показано, что
множество всех интегрированных решений является компактным $R_\delta$-подмножеством пространства $C(I,E)$ со слабой топологией.
Этот результат используется для исследования нелокальной задачи Коши,
задаваемой с помощью граничного оператора с невыпуклыми значениями.
Приводятся также некоторые приложения к уравнениям в частных производных с многозначными членами.
Библиография: 26 названий.
Сохранение пороговых резонансов и отцепление собственных чисел от порога непрерывного спектра квантовых волноводов
Authors: Nazarov Sergei Aleksandrovich
Published: June 2021

Пороговый резонанс возникает на нижней грани непрерывного спектра квантового волновода (задача Дирихле для оператора Лапласа) при условии, что при таком спектральном параметре существует нетривиальное ограниченное решение: либо захваченная волна, затухающая на бесконечности, либо почти стоячая волна, стабилизирующаяся на бесконечности. Во многих задачах асимптотического анализа важно уметь различать, какой из волн инициирован пороговый резонанс - в работе обсуждаются несколько способов выяснения его качества. Кроме того, показано, как путем точной настройки профиля регулярного возмущения стенки волновода можно сохранить пороговый резонанс, и получены асимптотические формулы для околопороговых собственных чисел, появляющихся в дискретном или непрерывном спектре при уничтожении порогового резонанса.
Библиография: 60 названий.
Perception of farmers on the contribution of vegetables to livelihoods in Yakurr local government area, Cross River state, Nigeria
Authors: Effiong J. B , Aboh C. L , Aya C. F
Published: June 2021

This study assessed the perception of farmers on the contribution of vegetables to livelihoods in Yakurr Local Government Area of Cross River State, Nigeria. The study identified the socio-economic characteristics of farmers in the study area, perception of the contribution of vegetables to livelihoods and identified the factors affecting vegetable farming in the study area. Multi-stage sampling techniques were adopted in selecting 126 respondents for the study. Data were collected with the aid of a questionnaire and analyzed using descriptive statistics such as percentage, frequency, mean and ranks. The result of the study showed that majority (75.4%) of the respondents were females. Most of the farmers (41.3%) were aged between 36 and 45 years. Some (44.4%) were involved in the cultivation of only vegetables and had farm holdings of 1-2 hectares. Majority had monthly income of N71,000.00 to N90,000.00. The result of the type of vegetables grown by the respondents revealed that fluted pumpkin ranked 1st (x=2.68) while Utazi ranked 9th (x=1.93). Also the result of the perception of farmers on the contribution of vegetables to livelihoods of farmers showed that vegetables contributed to the income of respondents for training as fashion designers in the study area and were generally excellent. Factors affecting contribution of vegetables to livelihoods were inadequate land, inadequate finance, pests and diseases among others. Vegetables, therefore played a very important role in the livelihoods of farmers in the study area. The study concluded that vegetables are necessary for the improvement of livelihoods of farmers in Yakurr Local Government Area, Cross River State, Nigeria.