bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of ganglion cell complex and retinal nerve fiber layer thinning in epilepsy patients
Authors: Duran Mustafa , Aykaç Serdar , Eliaçık Sinan
Published: August 2023

Purpose:

This study aimed to compare the perimacular ganglion cell complex (GCC) and peripapillary retinal nerve fiber layer (RNFL) thickness measurements of epileptic and healthy individuals.

Methods:

The right eyes of 38 epileptic and 38 healthy individuals who had been using antiepileptic drugs (AEDs) for at least 1 year were included in the study. Central macular thickness, perimacular GCC thickness and volume, and peripapillary retinal nerve fiber layers were measured by optical coherence tomography (OCT) device. Perimacular 1, 3, and 6 mm circle diameters of Early Treatment of Diabetic Retinopathy Study (ETDRS) were selected for GCC measurements.

Results:

In epilepsy patients, GCC was significantly lower in the 3 mm superior quadrant and 6 mm in all quadrants compared to the control group (P < 0.05). RNFL was significantly thinner in epilepsy patients only in the temporal-inferior quadrant (P < 0.05). There was no significant difference between the patients who received AEDs as monotherapy and polytherapy (P > 0.05).

Conclusion:

We found that epilepsy patients had significant thinning in the GCC layers and temporal-inferior quadrant of RNFL compared to the control group. Our findings from the study show that early retinal changes in epilepsy patients, especially perimacular GCC layers, can be followed up with OCT.
Ocular manifestations in renal diseases
Authors: Goyal Jawahar Lal , Gupta Arushi , Gandhi Pulkit
Published: August 2023

The eyes and kidneys are the targets for end-organ damage in multiple pathologies. Both these organs develop during the same embryonic stage around the fourth to sixth week of gestation, thus sharing a strong correlation between both eye and kidney diseases. Both the eyes and kidneys can be the target of the systemic disease process; however, the eyes can also be affected as a consequence of renal disease or its treatment. Risk factors such as diabetes, hypertension, and smoking are commonly shared between kidney and eye diseases. Ocular manifestations can be predictive of renal disease, and/or patients with renal disease are at higher risk for developing ocular manifestations. Various congenital anomalies of the eyes and kidneys can also present as an oculorenal syndrome. This article summarizes the ocular pathology, which can be seen in renal diseases.
Training ambidexterity – A survey-based analysis on the dexterity of ophthalmologists in performing standard ophthalmic procedures
Authors: Ramesh Shruthy Vaishali , Ramesh Prasanna Venkatesh , Ray Prajnya , Ansar Sheik Mohamed , Madhanagopalan VG , Ramesh Meena Kumari , Rajasekaran Ramesh
Published: August 2023

Purpose:

Our study was designed to determine ophthalmologists’ dexterity in performing standard ophthalmic procedures at various levels of expertise via a structured questionnaire.

Methods:

A structured questionnaire was administered via the Google platform from August 20 to September 19, 2022, to assess the perspectives and preferences of ophthalmologists concerning their proficiency in using their right hand, left hand, or both hands to perform routine tasks required in the practice of ophthalmic medicine and surgery.

Results:

Two hundred and three participants took part in the survey. A majority (n = 162, 79.8%) of the clinicians considered themselves right-handed, nine (4.4%) considered themselves left-handed, and 32 (15.7%) considered themselves ambidextrous. Also, 86% (n = 174) of the participants considered ambidexterity an essential trait in the practice of ophthalmic medicine and surgery. The number of cataract surgeries performed had an impact on the comfort of using both hands for performing anterior vitrectomy (P < 0.001), injection of viscoelastic (P < 0.001), and toric marking (P < 0.05), but not on the performance of capsulorhexis and switching of foot pedals. The number of procedures carried out had an impact on the comfort of using both hands in gonioscopy (P < 0.001), 90 D evaluation (P < 0.001), and 20 D evaluation (P < 0.05). More years of experience had an impact on skills involving the use of both hands for slit lamp joystick usage (P < 0.05) and laser procedures (P < 0.001).

Conclusion:

Irrespective of a person’s handedness, trained ambidexterity in the required fields is achievable and has a significant impact on one’s ability to perform the required skill optimally and appropriately.
Clinical profile and visual outcome in patients with traumatic optic neuropathy
Authors: Sujithra H , Shah Kannisha , Greeshma C
Published: August 2023

Purpose:

To analyze the visual outcome in patients with traumatic optic neuropathy (TON) with respect to different treatment modalities, to study the correlation of initial visual loss with the final visual outcome, and to find out the predictor of final visual outcome in patients with indirect TON.

Methods:

A retrospective analysis of 36 eyes with TON was done. Data on clinical profile, including demographics, mode of trauma, best corrected visual acuity (BCVA), pupillary reflex examination, and anterior and posterior segment examination, was collected. Presence and location of orbital and cranial fractures were identified from computed tomography scan. Visual outcomes following steroid therapy, optic nerve (ON) decompression, and in untreated patients were analyzed. Pre- and post-treatment BCVA were divided into three groups based on logarithm of the minimum angle of resolution (logMAR) as follows: group A: 3, group B: 2.9–1.3, and group C<1.3. BCVA values at follow-up visits were taken as the primary outcome measure. Association between various risk factors and final visual outcome in patients with indirect TON was also analyzed.

Results:

Out of 34 patients whose 36 eyes were studied, three (8.8%) patients were females and 31 (91.2%) patients were males. Most common mode of trauma was road traffic accident (RTA; 91.2%), which was followed by fall (8.8%) and assault (2.9%). Pre- and post-treatment BCVA values of 36 eyes were compared, and improvement in BCVA after treatment was found to be statistically significant. Also, 28.6% of patients with presenting BCVA of no light perception showed improvement compared to 94.1% and 100% in groups B and C, respectively. Orbital wall fractures were seen in 80.5% (n = 29) of the patients, with lateral wall fracture being the most common (58.3%) followed by medial wall (33.3%), roof (27.7%), floor (27.7%), and optic strut (5%).

Conclusion:

Baseline BCVA had significant association with final vision improvement. Lateral wall fracture was the most common fracture associated with indirect TON. Patients treated with high-dose corticosteroids, irrespective of the time of presentation, had a better visual outcome.
Comparison of clinical outcomes of Eyecryl toric and Alcon toric intra-ocular lenses – A real world study
Authors: Korpole Nilay Reddy , Kurada Padma , Kuzhuppilly Neetha I R , Korpole Madhukar Reddy
Published: August 2023

Purpose:

To compare the visual outcomes and residual astigmatism following implantation of Eyecryl toric versus Alcon AcrySof IQ toric intra-ocular lenses (IOLs).

Methods:

This retrospective, observational study included 143 eyes of 141 patients who underwent phaco-emulsification, followed by implantation of Eyecryl toric IOL (n = 83 eyes) or Alcon toric IOL (n = 60 eyes) in an eye hospital in South India from 2018 to 2021. At 1 month post-op, the uncorrected distance visual acuity (UCVA), best corrected distance visual acuity (BCVA), and residual astigmatism of the toric IOL were compared and analyzed.

Results:

The mean pre-op corneal astigmatism was 2.02 ± 0.81 D and 1.70 ± 0.68 D in the Alcon and Eyecryl groups, respectively (P = 0.005). The mean post-op corneal astigmatism at 1 month was 0.50 ± 0.51 D and 0.36 ± 0.42 D in the Alcon and Eyecryl groups, respectively, with no statistically significant difference between them (P = 0.87). The mean post-op UCVA in logarithm of minimum angle of resolution (logMAR) at 1 month was similar between the groups at 0.17 ± 0.18 and 0.17 ± 0.16 in the Alcon and Eyecryl groups, respectively (P = 0.98). The mean post-op BCVA in logMAR at 1 month was 0.06 ± 0.09 and 0.03 ± 0.10 in the Alcon and Eyecryl groups, respectively (P = 0.02).

Conclusion:

Both Eyecryl toric and Alcon AcrySof IQ toric IOLs showed comparable post-operative outcomes in terms of UCVA and residual astigmatism. The post-op BCVA was clinically similar between groups but statistically better in the Eyecryl toric group.
Outcomes of toric intraocular lens realignment surgery done using slit-lamp method and wavefront aberrometry method
Authors: Prasad R Senthil , Sankarananthan R , Pai Aruna , Kamble Nikhil R , Balakrishnan Logesh , Chitradevi R , Shekhar Madhu
Published: August 2023

Purpose:

To compare the slit-lamp method and wavefront aberrometry method based on outcomes of toric realignment surgeries.

Settings:

Tertiary care ophthalmic hospital.

Design:

Retrospective study.

Methods:

This study included all eyes undergoing toric intraocular lens (TIOL) realignment surgery between January 2019 and December 2021 for which TIOL axis assessment by slit-lamp method and wavefront aberrometry method was available. Data were retrieved from electronic medical records, and we documented demographics, uncorrected visual acuity (UCVA), subjective refraction, and TIOL axis by slit-lamp and wavefront aberrometry methods on postoperative day 1 and day 14. In patients with misalignment, TIOL was realigned to the original position in group 1 (27 patients) and to an axis based on calculations provided by wavefront aberrometer in group 2 (25 patients). Post-realignment surgery, UCVA, subjective refraction, and TIOL axis by slit-lamp and wavefront aberrometry methods were assessed and analyzed.

Results:

We analyzed 52 eyes and found that the mean preoperative misalignment with the slit-lamp method (44.9° ±20.0°) and wavefront aberrometry (47.1° ±19.5°) was similar. The corresponding degrees of misalignment post-TIOL repositioning surgeries were 5.2° ±5.2° (slit-lamp method) and 4.7° ±5.1° (wavefront aberrometry) (P = 0.615). Both groups showed significant improvement in median log of minimum angle of resolution (logMAR) UCVA and reduction in median refractive cylinder.

Conclusions:

Slit-lamp method is as good as wavefront aberrometer method to assess TIOL axis. Toric realignment surgery is found to be safe, and realigning TIOL based on either slit-lamp method or wavefront aberrometer method equally improved UCVA and decreased residual refractive cylinder.
What do retina fellows-in-training think about the vitreoretinal surgical simulator: A multicenter survey
Authors: Mondal Sukanya , Kelkar Aditya S , Singh Ramandeep , Jayadev Chaitra , Saravanan V R , Kelkar Jai A
Published: August 2023

Purpose:

To profile vitreoretinal (VR) fellows-in-training from India exposed to the Eyesi surgical simulator, to identify potential barriers to voluntary use, and enumerate the most preferred tools and tasks before incorporating them into a formal skill-transfer curriculum.

Methods:

A questionnaire consisting of 22 questions was designed and circulated through an online portal (surveymonkey.com) to four different institutes of India having a VR surgical fellowship program and using a functional Eyesi (Haag–Streit) simulator. All fellows and trainees who were exposed to the simulator were eligible to participate, irrespective of time spent on the simulator and exposure to training steps on real patients. The responses collected were private and anonymous.

Results:

Of the 37 respondents, most (n = 25, 68%) considered surgical simulators to be the best training tool before operating on the human eye. A majority (n = 35, 94.5%) of participants spent <3 h per week on the simulator, which, most (n = 30, 81%) felt was not enough time. The main reasons for this underutilization were work-hour limitations (54.8%), lack of a structured training program (19.3%), or a dedicated supervisor (16.1%). Again, the majority (n = 33, 89%) of participants responded that VR surgical skills acquired during simulator training were transferrable to the operating room, which was reflected by their response (n = 31, 83.7%) that simulator-based training should be made mandatory before operating room exposure.

Conclusion:

This study gives an insight into the overall practice patterns and preferences in simulation training of surgical VR fellows-in-training across India. It indicates that the simulator is extremely helpful to fellows and if adopted, VR surgical simulators with organized, directed, and supervised sessions will considerably improve the surgical training experience.
An ophthalmology professionalism survey tool: Outcomes from a multi-center study in Central India
Authors: Joltikov Katherine A , Khandekar Rajiv , Shenoy Pratik , Jain Sashi , Kumar Kavita , Tiwari Uma Sharan , Kochar Shipli , Sood Devendra , Edward Deepak P , Sen Alok
Published: August 2023

Purpose:

To describe a professionalism survey tool and its use to assess knowledge of medical professionalism in ophthalmology training programs in Central India.

Settings and Design:

Multi-center survey study.

Methods:

A validated 33-question, scenario-based survey addressing professionalism attributes was administered at five centers in central India. The attributes tested included “personal characteristics,” “physician–patient relationships,” “workplace practice and relationships,” and “socially responsible behaviors.” A mean attribute score (%) was calculated and compared to “gold standard” responses by a group of expert senior ophthalmologists (100% agreement for responses).

Results:

A total of 225 participants completed the survey; 124 residents, 47 fellows, and 54 consultants (98.4% response rate). The total mean attribute score was 80.7 ± 9.1 (min 16.67, max 100). There was variation in the mean attribute score by professionalism attribute (P< 0.001), and a trend toward higher mean attribute scores for consultants compared to trainees across all attribute groups. The scores for “personal characteristics” (93 ± 9.7) and “physician-patient relationship” (82 ± 15.8) were the highest, whereas scores for “socially responsible behaviors” (73.9 ± 18.6) and “workplace practices” were low (72 ± 13).

Conclusions:

There is a generally high level of professionalism knowledge among ophthalmologists in central India. The results suggest that experience does impact knowledge of professionalism. Potential for improvement in professionalism exists in around “workplace practices”, and around “socially responsible behaviors”. These findings may serve as a valuable discussion starter and teaching tool to enhance professionalism in ophthalmology training programs.
Preparation and uses of amniotic membrane for ocular surface reconstruction
Authors: Gera Pratik , Kasturi Nirupama , Behera Geeta , Jayasri P , Jayaseelan Jagadeeswari
Published: August 2023

Background:

The use of human amniotic membrane transplantation is rapidly increasing for the management of various ocular surface disorders. Despite its numerous advantages, amniotic membrane is not widely available due to the lack of awareness among ophthalmologists regarding its preparation and preservation techniques.

Purpose:

To provide an instructional video demonstrating the technique of harvesting, preparation, preservation of human amniotic membrane, and its uses in the management of ocular surface diseases.

Synopsis:

The amniotic membrane is the innermost layer of the human placenta. Properties of the amniotic membrane, like the presence of various growth factors, anti-inflammatory and anti-angiogenic factors, and its low immunogenicity, contribute to its ability to promote epithelial growth and differentiation with the reduction in fibrosis during healing. To harvest amniotic membrane, informed consent is obtained from a patient undergoing an elective caesarian section, and the donor is screened to exclude the risk of infections. Under sterile precautions, the amniotic membrane is separated from the chorion and washed free of blood clots. With the epithelial surface up, the amniotic membrane is spread uniformly without folds or tears on individually sterilized 0.22 μm nitrocellulose filter papers of the required sizes. The prepared filter paper with the adherent amniotic membrane is placed in freshly prepared Dulbecco’s Modified Eagle’s Medium and stored at −80°C. The amniotic membrane can be used for surgical procedures like symblepharon release, pterygium or dermoid excision, perforated ulcers, nonhealing epithelial defects, etc.

Highlights:

Instructional videos demonstrating the preparation and preservation of amniotic membrane are very sparse. This video clearly explains how any ophthalmologist can learn to prepare and preserve the human amniotic membrane and gives a glimpse of its properties, advantages, and scope of use.

Video Link:
https://youtu.be/8HfSjXUKoiY

Key words: Amniotic membrane, AMT, harvesting, ocular surface, preparation
Lifting the White Walker’s curse–Management of Coats’ disease
Authors: Kelkar Aditya , Bolisetty Mounika
Published: August 2023

Background:

Coats’ disease, described by George Coats in the early 1900s, is an idiopathic unilateral retinal vascular abnormality with exudation occurring in young males. It is characterized by retinal telangiectasia with intraretinal or subretinal exudation. Coats’ disease is mostly diagnosed in the first to the second decade of life, with a common presentation of leukocoria. Younger patients have a more severe presentation and are associated with poor visual prognosis. Management of Coats’ disease varies from observation, cryotherapy with anti-VEGFs (Vascular Endothelial Growth Factor), and surgery to enucleation. The mode of treatment depends on the age of presentation, the severity of the disease, and the stage of the disease. Through this video, we describe the clinical features, pathology, and surgical management of a 2-year-old child with grade 3B of Coats’ disease.

Purpose:

To demonstrate successful surgical management of grade 3B of Coats’ disease in a 2-year-old boy.

Synopsis:

Coats’ disease mostly presents with a diagnostic dilemma due to its varied presentation. Early detection and treatment are the keys to salvaging the eye as well as the vision, hence, avoiding dreadful complications such as neovascular glaucoma or phthisis bulbi. We demonstrate successful surgical management of a child who presented with grade 3B of Coats’ disease.

Highlights:

Through this video, we aim to describe the clinical features, pathology, and surgical management of a 2-year-old child with grade 3B of Coats’ disease. Combination of external drainage with vitrectomy, challenges faced, and the importance of visual rehabilitation postoperatively.

Video Link:
https://youtu.be/0obpVTOkKKs

Key words: Coats’ disease, leukocoria, phthisis bulbi, surgical management
Juvenile Temporal Arteritis with Hypereosinophilic Syndrome Masquerading as An Epidermal Inclusion Cyst of the Scalp
Authors: Deshpande Maheshri , Bhuyan Geet
Published: August 2023

A 34-year-old man came to the outpatient department with subcutaneous nodules in the temporal area. He did not complain of any other symptoms. Computed tomography scan revealed a nodule of 40.5 HU in the temporal region of the scalp. A possibility of an epidermal inclusion cyst was given. The lesion was excised and the biopsy revealed vasculitis with eosinophilia without giant cell formation. A final diagnosis of juvenile temporal arteritis with hypereosinophilic syndrome was given based on the clinical, radiological, and histopathological findings.
The Importance of Perioperative Flow Evaluation and Prevention of Steal Syndrome in Arteriovenous Fistula Surgery Using Transit-Time Flow Measurement
Authors: Colak Abdurrahim , Jalalzai Izatullah
Published: August 2023

Aim:

Our aim is to evaluate the relationship between the survival time of arteriovenous (AV) fistula whose flows are measured with flow meter in patients with chronic renal failure who were operated for AV fistula (AVF) and present the results.

Materials and Methods:

In our clinic, we evaluated the flow meter measurement results with patency rates and usability after 6 months of AVF in 100 patients who underwent AVF operation due to chronic renal failure.

Findings:

In February 2012, transit-time flow measurement was put into use in our clinic. The last 50 consecutive patients with the same characteristics before this date constituted the control group (Group A) and the first 50 consecutive patients after this date constituted the study group. Radiocephalic fistula was made the most common (Group A, n = 50; Group B, n = 50). Nondominant upper extremity was selected when planning AVF for patients. First radiocephalic, then brachiocephalic AVF was performed. Fistulas flow was measured with an intraoperative flow meter. Those with bad flow were revised during the operation. Embolectomy was performed in one patient at the 2nd month due to fistula thrombosis, but it was not successful in one patient, and an AVF was opened with a graft.

Results:

While creating AVF, our aim is to use it effectively for a long time. By evaluating the fistula flows with the flow meter and make an intraoperative revision if necessary we ensure to extend the lifespan of a fistula.
Vascular Plug as Adjunct in the Treatment of Giant Serpentine Splenic Artery Aneurysm
Authors: Nagarajan Krishnan , Sabarish Sekar , Yadav Ankusha , Vishnu Prasad Nelamangala Ramakrishnaiah
Published: August 2023

Splenic artery aneurysms (SAAs) are commonly related to high flow in the splenic artery and can remain asymptomatic for a long time. However, their natural course is a progressive increase in size, so treatment is always indicated if their size is >2 cm and even if they are asymptomatic. Endovascular treatment of these aneurysms is successful and safe either as an alternative to or as an adjunct to surgery. We present a case of SAA in a patient of noncirrhotic portal hypertension treated successfully by an endovascular Amplatzer plug followed by surgery.
Arteriovenous Grafts: Still a Viable Option? A 5-Year Study
Authors: Thomas Ashita Elizabeth , Desai Sanjay C , Ramswamy Chandrashekar Anagavalli
Published: August 2023

Background:

Hemodialysis patients require a vascular access that is both reliable and long lasting. Several variables, including population changes and comorbidities, have impacted patency rates. This study analyzes multiple parameters and estimates the patency rates and complications of brachioaxillary arteriovenous (AV) prosthetic grafts used for dialysis access in a single center.

Materials and Methods:

This was a prospective single-center study conducted at the Ramaiah Medical College Hospital in Bengaluru. This study comprised 92 patients with chronic renal failure who had brachioaxillary AV prosthetic graft surgery for dialysis access between 2018 and 2022. We monitored cases for up to 2 years for complications, and the primary and secondary graft patency rates were reported.

Results:

Seventy-five percent of the participants were male, with a mean age of 60. Diseases including hypertension (72.9% prevalence), diabetes (38.2%), and coronary artery disease (20.7% prevalence) were also very common. The present investigation found that thrombosis was the most frequent problem, followed by stenosis. In this study, the primary graft patency rates after 1 year and 2 years were 60.5% and 48%, respectively, whereas the secondary graft patency rates at 1 year and 2 years were 69% and 58%, respectively.

Conclusion:

The outcomes of this study regarding graft patency and complication rates compare favorably with other published data. Therefore, the authors consider brachioaxillary AV to be the optimal HD route when no acceptable forearm veins are available for creating AV fistulas.
Psychological impact of COVID-19 on health-care workers
Authors: Mousavi Mohammad , Ahmadi Najmeh , Seyedhosseini Ghaheh Hooria , Vaezi Atefeh , Javanmard Shaghayegh Haghjooy
Published: August 2023

Background:

Health-care workers (HCWs) as frontline soldiers are involved in the war against COVID-19. Not only their protection from COVID-19 is important but also their mental health is a concern. This study aimed to measure the psychological distress among HCWs in the time of COVID-19 in Isfahan, Iran.

Materials and Methods:

A cross-sectional study was conducted in the 2nd month of the spread of COVID-19 in Isfahan, Iran (March 16 to April 3). A total of 321 HCWs participated in an online survey and answered the General Health Questionnaire, the Insomnia Severity Index, and the Medical Outcomes Study Social Support Survey. t-test and ANOVA were used for comparing variables between groups. Multiple linear regression was used to evaluate the predictive factors of psychological distress.

Results:

About 34% of our HCWs suffer from some levels of psychological distress. The result of multiple linear regression (R
2: 0.41) shows that the predictive variables with the highest value were insomnia, working as a medical resident, and lack of social support (standardized coefficient of beta: 0.51, 0.25, and 0.16, respectively; P < 0.05).

Conclusion:

The result of our study shows that about one-third of HCWs in COVID-19 special hospitals have some psychological problems. Being a medical resident, suffering from insomnia, and lack of social support are predictive variables.
Transcultural adaptation and validation of the Persian version of the Brief Emotional Intelligence Scale
Authors: Hadadian-Chaghaei Fateme , Haghani Fariba , Feizi Awat , Taleghani Fariba , Alimohammadi Nasrollah
Published: August 2023

Background:

Increasing the level of emotional intelligence (EI) is seen as a strategy for improving both relational quality and efficiency at work. As of today, there was no validated Persian brief instrument for evaluating EI. To fill this gap, this article was aimed to investigate the validity and reliability of the Persian version of the Brief Emotional Intelligence Scale (BEIS-10).

Materials and Methods:

A methodological cross-sectional study was conducted among 201 Persian-speaking individuals. These individuals were selected from different parts of Iran using the convenience sampling method. Translation of the BEIS-10 was conducted by employed forward–backward method. Internal consistency was evaluated by Cronbach's α, and for test–retest reliability, the intraclass correlation coefficient (ICC) was employed. The construct validity was investigated by confirmatory factor analysis (CFA).

Results:

The Persian version of BEIS-10 indicates a good test–retest reliability (ICC = 0.612, 95% confidence interval: 0.384 and 0.769) as well as internal consistency (Cronbach's alpha = 0.748, ranging from 0.359 to 0.868 for different domains). The construct validity was evaluated by CFA and five factors from ten items were confirmed and all goodness-of-fit-indices were in acceptable levels.

Conclusion:

The article concludes that the Persian version of BEIS-10 in five factors from ten items was a reliable and valid instrument for measuring EI in the general population. As well, the article was suggesting that the Persian version of BEIS-10 may stand as a suitable alternative to time-consuming tools for EI measurement since this scale appears to be time-saving and applicable to Iranian society.
Evaluation of the predictive value of body mass index (BMI), waist circumference, and visceral fat to differentiate non-alcoholic fatty liver (NAFLD) in women with polycystic ovary syndrome
Authors: Eslami Bita , Aletaha Najmeh , Maleki-Hajiagha Arezoo , Sepidarkish Mahdi , Moini Ashraf
Published: August 2023

Background:

Our objective was to determine the overall prevalence of nonalcoholic fatty liver disease (NAFLD) in women with polycystic ovarian syndrome (PCOS) in our sample population. The second aim was to evaluate the predictive value of body mass index (BMI), waist circumference (WC), and visceral fat for the onset of NAFLD in these patients.

Materials and Methods:

This cross-sectional study was performed on 71 women with PCOS who were referred to Arash Women's Hospital in Tehran. Demographic and clinical information and anthropometric and biomedical indices were collected by a trained nurse. Liver ultrasonography was performed for all participants by a radiologist.

Results:

NAFLD was identified in 53.5% (n = 38) of subjects and the frequency of mild, moderate, and severe grades were 65.8%, 31.6%, and 2.6%, respectively. BMI and visceral fat of patients with NAFLD were significantly higher than non-NAFLD (P < 0.001). Receiving operating characteristic (ROC) curve analysis revealed that BMI was the best indicator of predicting NAFLD (cutoff = 25.5 kg/m2, sensitivity 75%, and specificity 75%), whereas visceral fat (cutoff = 5.5%, sensitivity 79%, and specificity 67%) and WC (cutoff = 89.5 cm, sensitivity 73%, and specificity 64%) were inferior for predicting NAFLD in PCOS patients.

Conclusion:

The prevalence of NAFLD in the study population is high. Our findings supported the use of BMI as a simple and practical predictive factor for the NAFLD onset, with a cutoff level of 25.5. The use of this cutoff level will enable physicians to identify PCOS patients at risk for NAFLD.
Chronic recurrent multifocal osteomyelitis in a 3.5-year-old boy
Authors: Tahririan Mohamad Ali , Nodushan Seyed Mohamad Hossein Tabatabaei , Farrokhi Mehrdad
Published: August 2023

We report an extremely rare case of multifocal bone disorder in a 3.5-year-old boy who appeared for left forearm and arm pain and multiple periods of fever with an unusual presentation of lymphoma/leukemia and highlight diagnostic challenges leading to a misdiagnosis, which was then diagnosed and treated for chronic recurrent multifocal osteomyelitis (CRMO). Based on a left arm biopsy and whole-body scans, he was eventually diagnosed with CRMO. Taken together, in this case, we noticed a notable amelioration after a 5-month treatment with nonsteroidal anti-inflammatory drugs on multiple bone pains.
Epidemiology of COVID-19
Authors: Halaji Mehrdad , Heiat Mohammad , Faraji Niloofar , Ranjbar Reza
Published: August 2023

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a zoonotic infection, is responsible for COVID-19 pandemic and also is known as a public health concern. However, so far, the origin of the causative virus and its intermediate hosts is yet to be fully determined. SARS-CoV-2 contains nearly 30,000 letters of RNA that allows the virus to infect cells and hijack them to make new viruses. On the other hand, among 14 detected mutations in the SARS-CoV-2 S protein that provide advantages to virus for transmission and evasion form treatment, the D614G mutation (substitution of aspartic acid [D] with glycine [G] in codon 614 was particular which could provide the facilitation of the transmission of the virus and virulence. To date, in contrary to the global effort to come up with various aspects of SARS-CoV-2, there are still great pitfalls in the knowledge of this disease and many angles remain unclear. That's why, the monitoring and periodical investigation of this emerging infection in an epidemiological study seems to be essential. The present study characterizes the current epidemiological status (i.e., possible transmission route, mortality and morbidity risk, emerging SARS-CoV-2 variants, and clinical feature) of the SARS-CoV-2 in the world during these pandemic.
Evaluation of methicillin-resistant Staphylococcus virulence genes and antibiotics susceptibility in Iranian population
Authors: Armin Shahnaz , Karimi Abdollah , Pourmoghaddas Zahra , Azimi Leila , Fallah Fatemeh , Tahbaz Sahel Valadan
Published: August 2023

Background:

Methicillin resistance Staphylococcus aureus (MRSA) is one most important pathogens for human health. The ability of this organism for producing different kinds of disease is related to its virulence gene. The frequency of hemolysin alpha (hla), hemolysin beta (hlb), and exfoliative toxin A (eta) virulence genes of MRSA was evaluated, and the association of these genes with antibiotics susceptibility was investigated.

Materials and Methods:

In a cross-sectional study, a total of 695 Staphylococcus clinical samples from seven different provinces of Iran were evaluated. MRSA was detected by cefoxitin disk. Virulence genes were detected by polymerase chain reaction. Susceptibility to clindamycin and ciprofloxacin was evaluated according to the Clinical and Laboratory Standards Institute guideline.

Results:

From a total of 695 samples, 170 (24.46%) were found to be MRSA. 142, 82, and 132 samples of MRSA were hla, hlb, and eta positive, respectively. hla gene was significantly found more frequently in patients at least 18 years (P = 0.02). 105 (68.6%) and 93 (59.6%) of MRSA samples were resistance to ciprofloxacin and clindamycin, respectively. hlb gene was significantly more resistant to clindamycin (P = 0.04) and ciprofloxacin (P = 0.01). Logistic regression analysis displayed hlb-positive MRSA strains were significantly associated with ciprofloxacin (odds ratio [OR]: 3.6, 95% confidence interval [CI] = 1.637–8.00) and clindamycin (OR: 1.93, 95% CI 1.00–3.68).

Conclusion:

MRSA strains from Staphylococcus aureus which isolated from hospitalized Iranian patients are significantly resistant to clindamycin and ciprofloxacin and it is may be because of hlb virulence gene. These samples consist of both community-acquired MRS) and health-care associated MRSA, so we could not use this finding as a guide for local antibiotics usage.
Effect of different protein diets on weight loss, inflammatory markers, and cardiometabolic risk factors in obese women
Authors: Yılmaz Sevil Karahan , Eskici Günay , Mertoǧlu Cuma , Ayaz Aylin
Published: August 2023

Background:

Reducing and maintaining body weight has become more important than ever as obesity is becoming increasingly common worldwide. This study was aimed to investigate the effects of diets with different protein contents administered to obese women on anthropometric measurements, inflammatory markers, and cardiometabolic risk factors.

Materials and Methods:

This randomized controlled trial was conducted with sixty volunteering obese women aged between 20 and 45 years. The subjects were divided into two groups in equal numbers. The high-protein (HP) group (n = 30) was administered an iso-caloric HP diet (25% protein, 30% fat, and 45% carbohydrate), and the control group (n = 30) an isocaloric low-protein diet (15% protein, 30% fat, and 55% carbohydrate), and both groups were followed up for 8 weeks. The subjects' descriptive data, anthropometric measurements, homeostatic model assessment-insulin resistance (HOMA-IR), lipid profiles, and high-sensitive C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) levels were analyzed.

Results:

There was no significant difference at baseline (except for low-density lipoprotein cholesterol [LDL-C]), and end-of-study (except for IL-6, systolic blood pressure [SBP], and diastolic blood pressure) values of parameters between the two groups; after adjusted for baseline measurements, a significant difference was observed between the groups for body weight, body mass index, waist circumference, HOMA-IR, LDL-C, hs-CRP, TNF-α, IL-6, and SBP (P = 0.004, P = 0.001, P = 0.003, P = 0.029, P = 0.004, P = 0.016, P = 0.004, P = 0.010, and P = 0.000, respectively) and were greater in the HP group than in the control group (P < 0.05).

Conclusion:

The HP diet was effective on improvement in HOMA-IR, SBP, LDL-C, hs-CRP, TNF-α, IL-6, and resulted in body weight loss.
Antibiotic resistance pattern of Helicobacter pylori strains isolated from patients in Isfahan, Iran
Authors: Sadeghi Hajarsadat , Narimani Tahmineh , Tabesh Elham , Shafiee Fatemeh , Soltani Rasool
Published: August 2023

Background:

The objective of this study was to evaluate the antibiotic resistance pattern of Helicobacter pylori strains isolated from patients in Isfahan province.

Materials and Methods:

Gastric antrum biopsy specimens of patients undergoing endoscopy were cultured. The samples with the growth of H. pylori underwent antibiotic susceptibility test by disk diffusion method.

Reaults:

Of 96 samples, 50 samples (53%) were positive for H. pylori. The rates of antibiotic resistance were as follows: amoxicillin, 6%; azithromycin, 20%; furazolidone, 22%; levofloxacin, 16%; metronidazole, 20%; rifampin, 12%; and tetracycline, 22%.

Conclusion:

H. pylori strains in our area have high rates of resistance to azithromycin, levofloxacin, metronidazole, tetracycline, and furazolidone.
Malus domestica reduces chemotherapy-induced nausea and vomiting
Authors: Darvishpour Sharareh , Avan Razieh , Azadbakht Mohammad , Maham Monireh , Akbari Jafar , Janbabaei Ghasem , Zaboli Ehsan , Amirabadizadeh Ali Reza , Salehifar Ebrahim
Published: August 2023

Background:

Chemotherapy-induced nausea and vomiting (CINV) is considered as the most common complications of chemotherapy which has a detrimental influence on the quality of life of patients with cancer. We assessed the efficacy of Apple (Malus domestica) syrup for reducing CINV.

Materials and Methods:

This study was a randomized, double-blind, placebo-controlled trial carried out in a Hematooncology Clinic affiliated to Mazandaran University of Medical Sciences, Sari, Iran (from October 2017 to August 2018). Subjects were randomly allocated to receive apple syrup or placebo along with their previous antiemetic treatment and chemotherapy regimen, three times a day. Thirty-four patients received apple syrup (n = 16) or placebo (n = 18). Statistical analysis was conducted using SPSS software Version 21® (SPSS Inc., Chicago, IL, USA). A P < 0.05 indicated statistical significance.

Results:

Both acute and delayed nausea grades were significantly lower in M. domestica syrup in comparison to placebo syrup (P = 0.001 and 0.001, respectively). The duration of nausea (P = 0.04) was lower in intervention group compared to placebo group.

Conclusion:

These findings demonstrated that M. domestica syrup can reduce the severity and duration of nausea in cancer patients who received chemotherapy.
A Comparison of 30-, 50-, and 60-mL Foley Catheter Balloon Volume and Time to Achieve Cervical Ripening for Labor Induction: A Triple-Blind Randomized Controlled Trial
Authors: Cousin KO , Ebeigbe PN
Published: August 2023

ABSTRACT

Background:

Cervical ripening is one of the most important determinants of the outcome of induction of labor. The findings of studies on the most efficacious inflatable catheter balloon volume for pre-induction cervical ripening have been inconclusive.

Aim:

To compare the efficacy of the use of different intracervical Foley catheter balloon volumes (30-, 50-, and 60-mL) on cervical ripening.

Subjects and Methods:

This study was a triple-blind randomized controlled trial. Two hundred and sixteen women with a Bishop score ≤5 at term were randomly assigned into three groups (1:1:1) to receive an intracervical single size eighteen Foley balloon catheter inflated either with 30-mL (control arm) or 50-mL and 60-mL (intervention arm) of sterile saline which was retained for a duration of 12 h. The primary outcome measures were the mean change in Bishop score and achieving a Bishop score of ≥6 at the twelfth-hour post-Foley catheter balloon insertion.

Results:

In the total study population and among nulliparous women, the 50-mL and 60-mL balloons compared with the 30-mL Foley catheter balloon achieved a statistically significantly greater mean change in Bishop scores at the twelfth hour\post-insertion (P = 0.005 and P = 0.001), while the 60-mL balloon compared with the 30-mL and 50-mL balloons achieved statistically significant higher mean change in Bishop scores among multiparous women (P = 0.047 and P = 0.003) and cervical dilatation irrespective of parity (P = 0.003 and P = 0.002), at the twelfth-hour post-insertion. The larger catheter balloons were also associated with a statistically significant greater chance of having an induction to delivery interval of <12 h in nulliparous women P = 0.003.

Conclusion:

The findings of this study showed that the larger single Foley catheter balloon volumes (50-mL and 60-mL) aside from being well tolerated and acceptable have the ability to induce faster changes in Bishop score, produce higher cervical dilation, and thus likely reduce significantly the total labor induction process compared to the 30-mL single catheter balloon volume irrespective of parity.
What is the Margin of Error of Surgeons and Radiological Imaging in Diagnosing Acute Appendicitis?
Authors: Aziz O , Nevin S , Serhan Y , Hakan B , Abdulkadir A
Published: August 2023

ABSTRACT

Background:

Acute appendicitis is the most common emergency requiring surgical intervention in general surgery. Negative appendectomy is defined as the removal of a pathologically normal appendix. Aim: In this study, we aimed to show our negative appendectomy rate.

Materials and Methods:

This study was carried out among 2990 patients who were operated on for appendicitis between 2015-2020 at the Health Sciences University, İstanbul Kanuni Sultan Suleyman Training, and Research Hospital. Accrual and historical records of the patients were analyzed using NCSS (Number Cruncher Statistical System) 2007 Statistical Software (Utah, USA) package program. The results were evaluated at the significance level of P < 0.05.

Results:

The mean age of all patients was 33. Of the patients, 1011 were women and 1979 were men. 27 of the women patients were pregnant. We requested a blood test (WBC count) and an abdominal ultrasound for all our patients who came with the complaint of abdominal pain in the right lower quadrant. Negative appendectomy was performed with ultrasonography in 622 patients with pathological diagnoses of lymphoid hyperplasia and fibrous obliteration (20.8%). We had abdominal computerized tomography (CT) for 285 patients and abdominal magnetic resonance imaging (MRI) for 16 of 27 pregnant women (59.25%) due to unclear clinical picture. Diagnostic laparoscopy was performed in 36 of the patients who underwent CT and 4 of the patients who underwent MRI since the diagnosis could not be made. We performed unnecessary appendectomy in 21.2% of the patients.

Conclusion:

With the increasing clinical follow-up experience of surgeons and developing technology in radiology, our aim is to minimize the negative appendectomy rate as much as possible.
Prevalence and Patterns of Intimate Partner Violence among Antenatal Clinic Attendees at Federal Medical Center, Abuja
Authors: Ekweani JC , Umeh YB , Ucha JN , Okoro C
Published: August 2023

ABSTRACT

Background:

Intimate partner violence (IPV) has been a source of increasing concern to the government of nations as well as their citizens despite measures taken to reduce it. This is supported by recent data published by the World Health Organization and other development partners. In health care facilities, intimate partner violence in pregnancy has not been screened routinely. Community-based findings have been the source of most data informing policies for decisions.

Objectives:

These were to determine the prevalence and patterns of IPV among antenatal clinic attendees at the Federal Medical Center (FMC), Abuja.

Materials and Methods:

Following ethical clearance, a health facility-based cross-sectional study was conducted at the FMC, Abuja to determine the prevalence and correlates of IPV during pregnancy among attendees of antenatal clinics. It was conducted between 26th June and 17th September 2021. A total of 450 questionnaires were administered among consecutive consenting clients and 407 were returned filled giving a non-response rate of 9.6%. The questionnaire collected data on respondents’ sociodemographics; experience of and types of IPV; and health problems arising from IPV. Results were presented in tables and charts and analysis was done using IBM SPSS (International Business Machines’ Statistical product and service solutions) version 25 software.

Results:

The mean age was 29.37 ± standard deviation 4.43 years and the predominant ethnic group was Igbo (46.5%); 96.56% were married; 68.06% had tertiary education and 49.14% were in their third trimesters. The combined incidence of intimate partner violence among the participants was 17.69% with physical violence contributing 3.19%; the head region (40%) being the most affected body part. While 34% experienced intrauterine foetal death in the past following IPV. In Miller’s landmark study, 27 of 1300 sexually active young women, one in five reported partner pregnancy non promoting behaviors, such as intimidation, threats to leave the relationship if the woman did not become pregnant or actual violence. The two most significant factors for IPV were age and marital status both at P values of P = 0.0001.

Conclusion:

Medical doctors should feel more open discussing issues around IPV with their clients during antenatal visits.
Relationship Between Health Literacy and Maternal Bonding: A Prospective Cross-Sectional Study
Authors: Büyükdereli Atadağ Y , Akdaş S , Keten HS , Kaya E
Published: August 2023

ABSTRACT

Background:

Maternal bonding has an effect on the baby throughout its life. The effective and complete occurrence of the mother-baby bond depends on many factors which can be individual or environmental. Health literacy plays an important role in the health behaviors of individuals, the prevention of diseases, and the improvement of health. Health literacy is a key determinant of medical-related issues.

Objectives:

This study was conducted to examine the relationship between health literacy and mother-infant attachment in infancy. It was aimed to predict the biopsychosocial impact of the mother’s health literacy level on the baby’s life indirectly.

Materials and Methods:

The sample of this descriptive and cross-sectional study included 202 mothers. Data were collected using the Personal Information Form, Health Literacy Scale-Short Form (HLS-SF), and Maternal Attachment Inventory (MAI).

Results:

There were no statistical correlations between HLS-SF scores and MAI scores. In addition, the mothers with a statistically significant higher MAI score were those whose partners had a higher education level, had a planned pregnancy, worked in the prenatal period, never breastfed, and had earlier skin-to-skin contact with their baby. (P < 0.05).

Conclusion:

Factors that may affect maternal bonding, which affects a baby’s entire life, should be addressed by the authorities and necessary improvements would be useful. We believe that this previously unexplored study will pave the way for multicenter similar studies.