bluuebunny/crossref_metadata_2025 huggingface dataset:
Parental Perception of the Effectiveness of Online Classes for Primary School Children
Authors: Suresh G.  , Naveen Kumara R.  , Sunil M. P.
Published: August 2022

The unprecedented measures to control the spread of COVID19 have affected both students and parents as education institutions have almost overnight shifted to virtual platforms. This study explores the effectiveness of online classes on primary school children's performance and investigates online classes' impact on children's behaviour and holistic development. Besides, it explores the impact of online classes on parents' workload by adopting a sequential research method. The data was collected using Google form and telephonic interviews with randomly selected parent respondents. Results exhibit that online classes are ineffective, and there is an indicative change in children's behaviour. Also, the lack of social interaction with peers and teachers, and minimal physical activities, have made online sessions monotonous for children. Parents have been experiencing an increased workload, as they are expected to be mentors, curators and personal tutors for their children. The study emphasizes a need for exclusive curriculum and pedagogy development suitable for online classes
Emergence of the Tyndale–King James Version tradition in English Bible translation
Authors: Naudé Jacobus A.
Published: August 2022

In this essay, it is demonstrated that the inception of the English Bible tradition began with the oral–aural Bible in Old English translated from Latin incipient texts and emerged through a continuous tradition of revision and retranslation in interaction with contemporary social reality. Each subsequent translation achieved a more complex state by adapting to the emergence of incipient text knowledge (rediscovery of Hebrew and Greek texts), emergence of the (meaning-making) knowledge of the incipient languages (Latin, Hebrew and Greek), language change (Old, Middle and Modern English), mode of communication (hearing-dominant and text-dominant), style (literal or word-for-word) and products (oral-aural Bible, handwritten manuscript Bible and printed Bible). Historical sources indicate that there were translations of portions of the English Bible since 700 CE as handwritten manuscript Bibles in Old and Middle English and in print in Modern English – even before the retranslation associated with Tyndale (1526) and despite ecclesiastical opposition since 1408. This version and its revisions (1530–1531, 1534) are followed by subsequent revisions (Coverdale Bible, Matthew’s Bible, Great Bible, Geneva Bible and Bishop’s Bible). The next revision was the King James Version (1611), which replaced all its predecessors, and which was never replaced for the next four centuries – not even by its revisions.Contribution: Contrary to the fragmentation caused by ordering individual English Bibles either by period (e.g. 20th century) or according to their features (e.g. literal), it is demonstrated that the history of English Bible translation emerged rather as a translation complex, and its history must be understood in this way.
Role of traditional beliefs in the knowledge and perceptions of mental health and illness amongst rural-dwelling women in western Nigeria
Authors: Okafor Ifeoma P. , Oyewale Damilola V. , Ohazurike Chidumga , Ogunyemi Adedoyin O.
Published: August 2022

Background: Globally, the public health importance of mental health has gained significant attention in recent years. In Africa, many traditional belief systems impact the perceptions, attitude and management of mental illness. Women are usually the primary caregivers of mentally ill persons, but they have lower mental health literacy.Aim: To assess rural women’s knowledge, perceptions and attitudes regarding mental illnesses and the role of traditional beliefs in their management.Setting: Epe Local Government Area of Lagos State, Nigeria.Methods: This was a cross-sectional study with a total of 295 rural women recruited through a multistage sampling method. A pretested interviewer-administered questionnaire was used to collect data. Summary and inferential statistics were measured using Epi Info version 7. The level of significance was predetermined at 5%.Results: A total of 253 questionnaires were adequately filled and analysed. Overall, just over one-third (35%) of respondents had good knowledge and only 26% had positive attitudes towards mental health and illness. About 45% reported that mental illness should first be treated in ‘the traditional way’, whilst 47% felt that there was no need for collaboration between orthodox and unorthodox healthcare for mental illness. Sociodemographic variables were significantly associated with knowledge (educational level p = 0.001) and attitude (marital status p = 0.001 and ethnicity p = 0.001).Conclusion: Respondents had poor knowledge of and attitude towards mental health, and traditional beliefs played a role in their perception and management of mental illness. We recommend community-based health education programmes to improve knowledge and help-seeking for mental illness amongst rural women.
Preventing antenatal stillbirths: An innovative approach for primary health care
Authors: Hlongwane Tsakane M. , Botha Tanita , Nkosi Bongani S. , Pattinson Robert C.
Published: August 2022

Background: In South Africa (SA), approximately 16 000 stillbirths occur annually. Most are classified as unexplained and occur in district hospitals. Many of these deaths may be caused by undetected foetal growth restriction. Continuous wave Doppler ultrasound of the umbilical artery (CWDU-UmA) is a simple method for assessing placental function. This screening method may detect the foetus at risk of dying and growth-restricted foetuses, allowing for appropriate management.Methods: A cohort study was conducted across South Africa. Pregnant women attending primary health care clinics at 28–34 weeks gestation were screened using CWDU-UmA. Women not screened at those antenatal clinics served as control group 1. Control group 2 consisted of the subset of control group 1 with women detected with antenatal complications excluded. Women with foetuses identified with an abnormal CWDU-UmA test were referred and managed according to a standardised protocol. A comparison between the study and control groups was performed.Results: The study group consisted of 6536 pregnancies, and there were 66 stillbirths (stillbirth rate [SBR]: 10.1/1000 births). In control group 1, there were 193 stillbirths in 10 832 women (SBR: 17.8/1000 births), and in control group 2, 152 stillbirths in 9811 women (SBR: 15.5/1000 births) (risk ratio: 0.57, 95% confidence intervals: 0.29–0.85 and 0.65, 0.36–0.94, respectively).Conclusion: Screening a low-risk pregnant population identified the low-risk mother with a high-risk foetus, and acting on the information as described was associated with a significant reduction (35% – 43%) in stillbirths. This demonstrates a step-change reduction in stillbirths and warrants screening in SA.
Testicular germ cell cancer in Africa: A survey on patterns of practice
Authors: Burger Henriette , Rick Tara , Spies Pieter , Cassel Ayun , Vanderpuye Verna , Incrocci Luca
Published: August 2022

Background: Testicular germ cell tumours (GCTs) are rare malignancies most prevalent in 15–40-year-old men. Incidence rates of testicular cancer on a global level show marked geographic variation with higher incidence rates reported in predominantly Caucasian populations. African data on GCT management show low incidence rates but an advanced stage at presentation and high mortality rates.Aim: The aim of the study was to explore patterns of practice in the management of testicual GCTs.Setting: The study was conducted in an African oncology care setting.Methods: A cross-sectional web-based survey was distributed to doctors or nurses providing oncology care for patients with testicular GCT in Africa. Data on staging procedures, chemotherapy and radiotherapy (RT) treatment schedules across institutions are reported and discussed in the context of international treatment guidelines and local resources.Results: Eleven African countries contributed data. Epidemiological estimates were received from 20 institutions and management and outcome data from 18 institutions. The estimated ratio of seminoma to non-seminoma was 1:1.3. The stage at presentation was tumour-node-metastases-serum marker (TNM-S) Stage III at half of the institutions surveyed. Chemotherapy regimens mostly followed international guidelines, but certain essential drugs were not consistently accessible at all centres. Radiotherapy services were available to all but one respondent, with three-dimensional planning being widely used. There was marked variation in RT doses and treatment fields.Conclusion: The resources to effectively manage testicular GCT appear to be accessible to most institutions surveyed. Regional management guidelines, sharing of clinical expertise within Africa through online platforms and centralised data collection on epidemiology, management and treatment efficacy are advocated to better allocate resources and improve the outcomes reported in this rare but potentially curable condition.
The experiences of clinical psychologists in treating traumatic stress at a tertiary psychiatric hospital in the Eastern Cape: A qualitative study
Authors: Munishvaran Kuriesha , Booysen Duane D.
Published: August 2022

Background: Qualitative data on the experiences of treating post-traumatic stress disorder (PTSD) in a psychiatric setting in a low-resource context is sparse.Aim: The authors aimed to explore the lived experiences of clinical psychologists who treat patients who are either trauma survivors or perpetrators in a psychiatric hospital.Setting: A public psychiatric hospital in the Eastern Cape, South Africa.Method: A total of six individual semi-structured interviews were conducted with three clinical psychologists. Data were analysed using interpretive phenomenological analysis (IPA).Results: The analysis for each participant identified several significant themes, namely (1) support as a male person, (2) being appreciative, (3) difficult trauma narratives, (4) a mother and a psychologist and (5) fear and hopelessness.Conclusion: Treating traumatic stress amongst clinical psychologists working in a public psychiatric hospital can lead to experiences of vicarious trauma and traumatic stress. In addition, the participants experienced an added danger in treating high-risk state patients, exposing psychologists to traumatic stress. Furthermore, psychologists recognised the influence of gender and race and its impact on their roles in their personal and professional lives as practitioners treating traumatic stress.
Bullous fixed drug eruptions consequent to NSAID usage − a case series
Authors: Kandra Naga V. , Varghese Anjaly M. , Uppala Praveen K. , Vangoori Yakaiah , Uttaravelli Upendra R. , Venkata Saibaba S. , Lavanya Butti
Published: August 2022

Fixed drug eruption (FDE) is a distinct, delayed type-IV hypersensitivity manifesting as recurring cutaneous reaction (on skin or mucosa) in the same locations on re-exposure to the offending drug. This is most commonly due to oral medications, antimicrobials and NSAIDs being the most common culprits. Herein, we discuss six cases of bullous FDE due to diverse NSAIDs. The first case was Naproxen-induced bullous fixed drug eruption (BFDE), the second case was due to Etoricoxib, the third patient had Mefenamic acid-induced BFDE, the fourth was Ibuprofen-induced FDE, the fifth one was Diclofenac-induced BFDE, the sixth was Aceclofenac-induced BFDE, and the seventh was a case of paracetamol-induced BFDE. All these patients noticed skin reactions that were clinically diagnosed by the dermatologist as NSAID-induced BFDE. The mainstay of treatment adopted was to avoid the culprit drug. All the seven patients were treated with oral steroids, followed by antihistaminics for reducing FDE-associated pruritus, ointment soframycin, and topical steroids for hyperpigmented lesions. Prompt diagnosis of BFDE and drug withdrawal at the clinician side may help in rapid resolution of the reaction within days to delayed recovery within few weeks, thus preventing rise in morbidity and mortality.
Laparoscopic Management of Cesarean Scar Pregnancy after Medical Treatment Failure Using Laparoscopic Bulldog Clamps
Authors: Alzamora Maria Claudia , Blosser Stella Lii
Published: August 2022

Cesarean scar pregnancies are a rare complication of pregnancy, with an incidence rate of approximately 1 in 2000 pregnancies. Numerous treatment alternatives have been proposed and published for cesarean scar pregnancies (CSPs), including medical management with local or systemic methotrexate injection, resection through hysteroscopic, vaginal, abdominal or laparoscopic approach, and dilation and curettage. Concomitant strategies for achieving hemostasis/bleeding control have been attempted, including uterine artery embolization, the placement of a Foley balloon catheter, injection of vasopressin, and less commonly reported, the use of vascular clamps. We describe a case of failed medical management of a CSP, followed by laparoscopic resection with the use of vascular clamps to minimize bleeding. This approach can be considered for minimizing blood loss in the laparoscopic management of cesarean ectopic pregnancies.
Cellular Leiomyoma versus Endometrial Stromal Sarcoma
Authors: Agarwal Charu , Pujani Mukta , Chauhan Varsha , Chawla Raina , Agarwal Anu , Menia Reetika
Published: August 2022

Endometrial stromal sarcomas (ESSs) account for approximately 0.2% of all uterine malignancies. Cellular leiomyoma (CL) often simulates low-grade ESS due to similar cytology. We report the case of a 34-year-old female with a mass per abdomen. Frozen sections showed a tumor with many thin- and thick-walled vessels along with hyaline material. A differential diagnosis of CL and endometrial stromal tumor was suggested. The index case was diagnostically challenging to pathologists. Paraffin sections supplemented by immunohistochemistry (smooth muscle actin, CD10, and beta-catenin) favored CL. Frozen section sometimes leads to over/underestimation of tumor in view of small sampling area of tumor.
An experimental study to evaluate the effect of polymixin E (Colistin) alone or in combination with gentamicin in McCarey-Kaufman corneal preservation medium on various drug resistant bacterial and fungal isolates
Authors: Sushmasri K , Joseph Joveeta , Chaurasia Sunita R , Ramachandran Charanya , Roy Sanhita
Published: August 2022

Purpose:

To assess the efficacy of the addition of polymyxin E (colistin) in the McCarey-Kaufman (MK) corneal storage solution against multi-drug resistant strains of Enterobacteriaceae, Staphylococcus aureus, and Candida spp.

Methods:

A standard micro broth dilution test and a checkerboard assay were performed for five multi-drug resistant (MDR) clinical strains of P. aeruginosa and five clinical strains of methicillin-resistant S. aureus (MRSA) and C. albicans against colistin and gentamicin alone and in combination. The minimum inhibitory concentration (MIC) and the fractional inhibitory concentration index (FICI) were calculated to assess the efficacy of each combination.

Results:

The MIC of colistin was in the range of 1–2 µg/mL for P. aeruginosa, whereas it was 256–1024 µg/mL against S. aureus. In comparison, the MIC of gentamicin was found to be 0.5–512 µg/mL and 0.5–8 µg/mL against P. aeruginosa and S. aureus, respectively. All five isolates of C. albicans did not exhibit any susceptibility to either colistin or gentamicin even at a concentration of ≥ 512 µg/mL each. The checkerboard assay was performed to evaluate the nature of the interaction of the combination of colistin and gentamicin. Based on the FICI, it was observed that the colistin and gentamicin combination has a maximum synergistic effect (FIC <0.5) in 80% (4/5) for S. aureus isolates, whereas the maximum additive effect (FIC >0.5–4) was 100% (5/5) for P. aeruginosa and the minimum additive effect was 20% (1/5) for S. aureus isolates. Antagonism (FIC ≥ 4) was not observed in any combination between the strains used in the study. Both colistin and gentamicin alone or in combination were, however, ineffective against Candida spp.

Conclusion:

The addition of colistin has an inhibitory effect on bacterial contamination that could be possibly caused by MDR strains and could potentially be considered as an additional additive in corneal storage media.
Association of primary angle-closure disease in patients with retinal vein occlusion in North Indian population
Authors: Bhoot Madhu , Pegu Julie , Bhumbla Shayana , Dubey Suneeta , Agarwal Manisha , Mukherjee Saptarshi , Harish H S
Published: August 2022

Purpose:

To determine the association of primary angle-closure disease (PACD) in patients with retinal vein occlusion (RVO) at a tertiary eye care center in North India.

Methods:

It is a cross-sectional, observational study. Sixty consecutive patients with retinal vein occlusion within a period of one year from a single tertiary eye care center were enrolled. Detailed history, slit-lamp examination of the anterior segment, intraocular pressure measurement by applanation tonometry, gonioscopy and fundus examination were done. Anterior chamber depth and axial length were also measured.

Results:

Among the 60 patients, 29 were males (48.3%) and 31 females (51.6%). Twenty-seven (45%) of them had central retinal vein occlusion (CRVO) and 33 (55%) had branch retinal vein occlusion (BRVO). Forty percent of patients with RVO had PACD. Relative risk of PACD was 1.71 times in patients with CRVO as compared to BRVO. Risk of glaucoma was 49% more in CRVO than BRVO. Probability of PACD was more in patients of RVO who had diabetes and CAD as comorbidity.

Conclusion:

The association between PACD and RVO is less known. PACD can be one of the risk factors for the development of RVO. A comprehensive examination and detailed angle evaluation of both of the eyes should be done in all cases of RVO, in addition to investigating for systemic risk factors. However, larger population-based studies would be required to prove it as an independent risk factor.
Predominant peripheral lesions in patients with diabetic retinopathy and its association with systemic comorbidities
Authors: Cherian Juhy , Giridhar Anantharaman , Sivaprasad Sobha , Rajalakshmi R , Raman Rajiv , Khan Rehana , Prakash Nimmy , Rodrigues Ann M
Published: August 2022

Purpose:

To determine the associations of predominant peripheral lesions (PPLs) with systemic comorbidities in individuals with diabetic retinopathy.

Methods:

This is a multicenter cross-sectional observational study conducted across three tertiary eye care centers in south India between January 2019 and July 2021. Ultra-widefield fundus images of consecutive patients with varying severity of diabetic retinopathy with data on systemic comorbidities were classified based on the presence or absence of PPL. Systemic comorbidities (hypertension, diabetic kidney disease, coronary artery disease, dyslipidemia, and anemia) were compared between the two groups.

Results:

A total of 879 participants (70.1% males) were included in the study, of which 443 (50.4%) patients had PPL. The mean age of the study participants was 56 ± 10 years, mean age of onset of diabetes was 41.24 ± 11.6 years, and mean duration of diabetes was 15.39 ± 7.6 years. The number of PPL increased with increasing severity of DR. Of all the systemic comorbidities analyzed, we found that coronary artery disease (CAD) had a significant association with PPL (Odds ratio [OR]-1.69; 95% confidence interval [CI], 1.12–2.55; P = 0.013) after adjusting for diabetic retinopathy severity, duration of diabetes, and age of onset of diabetes.

Conclusion:

The presence of PPL is a marker for coronary artery disease and early referral to cardiology is warranted.
Correlation of pattern of visual field loss by perimetry and anterior chamber angle parameters by anterior segment optical coherence tomography in primary angle-closure glaucoma
Authors: Palanisamy Sreeramyaa , Raja Vidya , Senthilkumar Vijayalakshmi A , Mani Iswarya , Krishnadas R
Published: August 2022

Purpose:

To correlate and analyze the pattern of the visual field (VF) defects by perimetry and anterior chamber angle parameters by AS-OCT in primary angle-closure glaucoma (PACG) across varied severity levels on presentation to a tertiary eye care center.

Methods:

This was a cross-sectional study, which included 323 eyes of clinically diagnosed cases of PACG. Glaucoma severity was categorized according to mean deviation (MD) as mild (-6.00 dB or more), moderate (-6.01 to -12.00 dB), and severe (-12.01 to -30.00 dB). AS-OCT measured the nasal (N) and temporal (T) angle opening distance at 500 mm (AOD 500) and 750 mm (AOD 750), anterior chamber angle (ACA), lens vault (LV), and anterior chamber width (ACW). The VF severity was then correlated with the AS-OCT parameters using statistical analysis.

Results:

The mean age ± standard deviation (SD) of the patients included in the study was 56.03 ± 8.6 years, with a 1:1.2 gender ratio. The number of eyes with mild, moderate, and severe VFs were 140 (43.3%), 88 (27.24%), and 95 (29.41%), respectively. There was no statistically significant correlation in the mean anterior chamber angle parameters (AOD 500, AOD 750, ACA 500, ACA 750, LV, ACW, and axial length (AL)) among the groups. However, the correlation between AOD 500 and LV thickness was found to be significant (P = 0.0000) with a negative Spearman’s rank correlation coefficient (r = -0.3329).

Conclusion:

The ACA parameters obtained by AS-OCT along the horizontal axis after elimination of pupillary block by laser peripheral iridotomy do not correlate and cannot be used to assess the disease severity of PACG.
Biometry and intraocular power calculation using a swept-source optical coherence tomography: A repeatability and agreement study
Authors: Hashemi Hassan , Miraftab Mohammad , Panahi Parsa , Asgari Soheila
Published: August 2022

Purpose:

To evaluate the repeatability of biometry and intraocular lens (IOL) power using Galilei G6 and to determine the agreement of its measurements with those of IOL Master 700 and IOL Master 500.

Methods:

Hundred mature cataract eyes were examined twice with Galilei G6 and the results were compared with those of other two devices. Axial length (AL), minimum (K1), maximum (K2), and mean keratometry, anterior chamber depth (ACD), white-to-white (WTW) diameter, lens thickness (LT), and the calculated IOL power were the studied parameters. The correlation coefficient, within-subject standard deviation (Sw), Bland–Altman method, and 95% limits of agreement (LoA) were used for statistical analysis.

Results:

The intraclass correlation coefficient (ICC) was above 0.9 for all indices, and the LoA ranged from a minimum of 0.08 mm for AL to a maximum of 0.50 D for K1. Sw also ranged between a minimum of 0.02 for AL, ACD, and WTW and a maximum of 0.13 for K1. In the Galilei G6–IOL Master 700 pair, the narrowest and widest LoA were calculated for AL (0.07 mm) and K2 (0.49 D), respectively. In the Galilei G6–IOL Master 500 pair, the narrowest and widest widths of LoA were calculated for AL (0.17 mm) and K2 (0.92 D), respectively. In the first pair, the LoA of IOL power (0.57 D) were the best for Haigis formula and in the second pair, the best agreement (LoA: 0.35 D) was observed for Holladay-1.

Conclusion:

Galilei G6 provided repeatable biometric measurements. The agreement between biometry and IOL power calculation was better in the Galilei G6–IOL Master 700 pair compared to the Galilei G6–IOL Master 500.
Efficacy and safety of subliminal transscleral cyclophotocoagulation in uncontrolled glaucoma
Authors: Mohammed Ferzana , Somasundaran Sandhya , Unnikrishnan Suma , Jyothi P T
Published: August 2022

Purpose:

To determine the efficacy of subliminal cyclophotocoagulation in reducing intraocular pressure (IOP) and to assess the safety profile of the procedure.

Methods:

We reviewed the charts of all patients who underwent subliminal cyclophotocoagulation between August 2019 and August 2020. The IOP, number of antiglaucoma medications, and visual acuity were compared at baseline and at 6 months. The post-laser complications were noted. Paired t-test, Wilcoxon rank-sum test, and McNemar test were used for analysis.

Results:

This study included 40 eyes of 40 patients. The most frequent diagnosis was neovascular glaucoma (55%), followed by primary open-angle glaucoma (17.5%). The mean IOP reduced from 32 to 21 mmHg (mean IOP reduction: 32%, 95% confidence interval [CI]: 27%–37%, P < 0.001). Mean number of antiglaucoma medications declined from 3.2 to 1.9 (P < 0.001). Use of oral acetazolamide decreased from 62% to 5% (P < 0.001). The success rate of the procedure at 6 months was 55%. One patient had unexplained visual acuity decline after the procedure.

Conclusion:

Subliminal sub-cyclophotocoagulation is effective in treating refractory glaucoma in the Indian population. It decreases the medication burden. However, subliminal lasers can also cause vision-threatening complications such as hypotony, uveitis, and optic nerve hypoperfusion. So, clinicians should be cautious when using sub-cyclophotocoagulation in patients with good vision.
Comparison of clinical outcomes of trifocal intraocular lens (AT LISA, Eyecryl SERT trifocal) versus extended depth of focus intraocular lens (Eyhance, Eyecryl SERT EDOF)
Authors: Karuppiah Preethi , Varman N V Arulmozhi , Varman Aadithreya , Balakumar Dinesh
Published: August 2022

Purpose:

To compare four different types of intra ocular lenses (IOLs), namely, AT LISA, Eyecryl SERT trifocal, Eyhance, Eyecryl SERT extended depth of focus (EDOF) with respect to their clinical outcomes.

Methods:

This is a retrospective comparative study in which patients who underwent surgery and one of the four types of IOL were implanted. Postoperative evaluation was recorded at one month, postoperatively. The monocular uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) (6 m), uncorrected intermediate visual acuity (UIVA) (60 cm), distance-corrected intermediate visual acuity (CIVA), uncorrected near visual acuity (UNVA) (40 cm), and corrected near visual acuity (CNVA) were assessed postoperatively on post operative day 30, for all four IOL groups. Defocus curve and contrast sensitivity were also compared.

Results:

With regards to UDVA and CDVA, P value was not statistically significant. (P = 0.534 and 0.421, respectively). EDOF group of IOLs had statistically significant better UIVA and CIVA than trifocal IOL group. (P < 0.001, 0.012, <0.001) and EDOF group had statistically significant worse P value pertaining to UNVA and CNVA (P < 0.001, 0.070, <0.001, 0.190). Pertaining to contrast sensitivity, EDOF group had better contrast sensitivity than Trifocal IOL group (P < 0.001).

Conclusion:

All four IOLs compared in this study had good comparable distant visual acuity. Near visual acuity was better with AT LISA and Eyecryl SERT trifocal IOL while intermediate vision was better with Eyhance and Eyecryl SERT EDOF IOL. Contrast sensitivity was better in EDOF IOLs than in both trifocal IOLs.
Updated guidelines for the management of polypoidal choroidal vasculopathy: Recommendations from the Indian Polypoidal Choroidal Vasculopathy Panel and the Vitreoretinal Society of India
Authors: Sheth Jay U , Narayanan Raja , Anantharaman Giridhar , Bhende Muna , Agarwal Aniruddha , Chawla Shobhit , Rajendran Anand
Published: August 2022

In Asians, polypoidal choroidal vasculopathy (PCV) is becoming more widely recognized as a significant cause of exudative maculopathy. The previous set of Indian guidelines on the management of PCV were published in 2018, with a literature search updated up to November 2015. As the treatment of PCV evolves, retinal physicians must constantly modify their current practice. The current guidelines are based on the most up-to-date information on PCV and are an update to the previous set of guidelines. These guidelines were developed by a panel of Indian retinal experts under the aegis of the Vitreoretinal Society of India (VRSI), based on a comprehensive search and assessment of literature up to September 2021. The final guidelines i) provide the updated nomenclature in PCV; ii) discusses the newer diagnostic imaging features of PCV, especially in the absence of indocyanine green angiography (ICGA); and iii) recommends the best possible therapeutic approach in the management of PCV, including the choice of anti-vascular endothelial growth factor (anti-VEGF) agents, treatment regimen, and the role of switching between the anti-VEGF agents. In the face of non-availability of photodynamic therapy (PDT) in India, we constructed practical recommendations on anti-VEGF monotherapy in PCV. The current updated recommendations would provide a broader framework to the treating retinal physician for the diagnosis and management of PCV for optimal therapeutic outcomes.
Preservation of donor corneal epithelium in McCarey-Kaufman medium
Authors: Kaur Amanjot , Priyadarshini Smruti R , Mohanty Amrita , Sahu Srikant K , Das Sujata
Published: August 2022

Purpose:

To evaluate the role of McCarey-Kaufman (MK) medium in maintaining the integrity of donor corneal epithelium.

Methods:

Nineteen corneal buttons were harvested and stored in MK media at 2°C–8°C for four days. Serial photographs were done every day till the 3rd day, and images were then analyzed with ImageJ software (LOCI, University of Wisconsin, USA). The area of exposure and epithelial defect (ED) was calculated every day for each corneal button.

Results:

The average age of the donors was 56.5 ± 22.7 years and mean time from death to preservation of the corneal buttons was 7.7 ± 3.1 hours. The average corneal area was 145.6 ± 18.8 mm2. The total mean area of exposure was 3.6 ± 4.8, 7.2 ± 9.2, and 9.0 ± 11.9 mm2, and ED was 1.7 ± 4.6, 2.8 ± 5.3, and 3.3 ± 5.9 mm2 on days 1, 2, and 3, respectively. The percentage of increase in the area of exposure and ED in MK media was 3.71% and 1.1% from day 1 to day 3, respectively. Six out of 19 corneal buttons (31.57%) were utilized for keratoplasties, of which two were utilized in house and four were distributed outside. Of the two utilized corneas, none had epithelial defect on postoperative day 1. Rest 13 corneas were either used for training and research purposes, stored in glycerol media, or discarded.

Conclusion:

Since the percentage change in area of exposure/ED is not much at the end of day 3, corneas stored in MK media can be safely used even after three days of storage. Hence, MK medium serves as an excellent medium in maintaining the integrity of donor corneal epithelium.
Anterior staphyloma repair following trauma and surgery – A retrospective review of techniques and outcomes over 25 years
Authors: Rajagopal Rama , Matai Hiren D , Gopal Lingam , Susvar Pradeep , Bhende Pramod S
Published: August 2022

Purpose:

To review surgical options, techniques, and outcomes of anterior staphyloma repair done following trauma and surgery.

Methods:

This was a retrospective case study of patients who underwent staphyloma repair with scleral or tibial periosteal patch grafts following trauma and surgery with a minimum follow-up of 3 months postoperatively. Preoperative risk factors, choice of graft materials, surgical details, and outcomes in terms of graft uptake and tectonic integrity were analyzed.

Results:

Seventeen eyes of 17 patients underwent successful staphyloma repair (scleral 15, tibial periosteal two). Mean follow-up was 47.1 months (3–159 months). Postoperative intraocular pressure rise noted in four eyes was controlled medically or surgically. Three patients underwent successful repeat patch grafting (graft melt one and recurrent ectasia two). Tectonic integrity of the eyeball was restored and maintained in all patients at the final follow-up.

Conclusion:

Comprehensive evaluation of the risk factors, control of ocular comorbid conditions, and early and meticulous surgery can optimize results.
New model for the prediction of visual outcomes in young children with mechanical ocular conditions and comparison with other models
Authors: Shah Shreya , Shah Mehul , Gunay Ruhi , Kataria Apeksha , Makhloga Sakshi , Vaghela Mrugesha
Published: August 2022

Purpose:

Herein, we compared the efficacy among the Ocular Trauma Score (OTS), Toddlers Ocular Trauma Score (TOTS), and Pediatric Ocular Trauma Score (POTS) for prognosis prediction in Indian children who had mechanical ocular conditions causing traumatic cataract.

Methods:

This prospective, interventional study recruited consecutive children undergoing operation for traumatic cataracts caused by mechanical eye injuries at Drashti Netralaya. The following details were obtained from their medical files: the circumstance and time of injuries, penetrating injury type, initial and final visual acuity (VA), time of operation, and associated eye diseases. Specific variables were employed to determine the OTS, TOTS, and POTS. For all patients, the final and predicted VA determined using all scores were compared using Fischer’s exact test. Accuracy, specificity, and sensitivity were evaluated for all the scores by using the area under receiver operating characteristic curve.

Results:

We enrolled 124 eyes. Patients’ mean value for age was 4.6 ± 1.29 years; 44 (35.41%) and 74 (64.5%) were female and male patients, respectively. Visual outcomes significantly improved after operation, and the outcomes did not differ between closed- and open-globe injuries (P = 0.162). The actual and predicted VA did not exhibit a statistically significant difference among the three scores. TOTS and POTS were more suitable for evaluating low-risk injuries, whereas the OTS could more efficiently examine high-risk cases.

Conclusion:

TOTS and POTS were more accurate than the OTS in VA prediction after operation in toddlers with traumatic cataracts caused by mechanical globe injury. TOTS and POTS were more suitable for evaluating low-risk injuries, whereas the OTS could more efficiently examine high-risk cases. All the examined scores can be helpful in estimating VA following treatment.
Preferred practice patterns in aphakia management in adults in India: A survey
Authors: Kelkar Aditya S , Kelkar Jai , Bhende Pramod , Narayanan Raja , Maiti Aniruddha , Bolisetty Mounika , Singhvi Priyanka
Published: August 2022

Purpose:

To assess different approaches in the management of aphakia in adults in Indian ophthalmologists via an online survey.

Methods:

A survey-monkey based online questionnaire was fielded to Indian ophthalmologists in accordance with the CHERRIES guidelines. We recorded participants’ demographics, practice settings, and preferred surgical options including the type of intraocular lens (IOL) preferred when encountering a case of aphakia in adults with and without adequate capsular support. Differences between anterior segment (AS) surgeons and vitreoretinal (VR) surgeons as well as differences between surgeons with more or less than 10 years of surgical experience were evaluated using analytic statistics.

Results:

Of the 481 surgeons who responded to the survey, 369 (77%) were AS surgeons and the remaining 112 (23%) were VR surgeons and represented all regions of India. When encountering posterior capsular rent during cataract surgery, a three-piece IOL in the ciliary sulcus was the most preferred (n = 275, 57%) when there was adequate capsular support, while a retrofixated iris-claw IOL (n = 91, 19%) was the commonest choice in eyes without adequate capsular support. With associated nucleus drop, 85% of surgeons preferred to refer the patient to a VR surgeon and left the eye aphakic. Multivariable logistic regression showed that VR surgeons were more than six times likely to prefer a scleral fixated intraocular lens (SFIOLs) [odds ratio (OR) = 6.5, 95% confidence interval (CI) = 3.4–12.5, P < 0.001] and surgeons with >10 years of experience were also twice more likely to prefer an SFIOL (OR = 2.4, 95% CI = 1.2–4.9, P = 0.02).

Conclusion:

The choice of IOL in absence of capsular support in adult eyes differs between AS and VR surgeons and is also influenced by the surgeon’s experience.
A novel, versatile cannula for vitreoretinal surgery: Bapaye aspiration scraper – Initial experience
Authors: Bapaye Maneesh M , Bapaye Charuta M , Bapaye Meenaxi M , Nair Akshay Gopinathan
Published: August 2022

The induction of posterior vitreous detachment (PVD) is an important step in the successful outcome of vitreoretinal surgery for various indications. This may pose a significant challenge intraoperatively in cases of strong adhesion between the posterior hyaloid and retina. Various techniques to achieve intraoperative PVD have been described which involve active aspiration as well as non-aspiration techniques to achieve a plane of separation between the posterior hyaloid and retina. Very frequently, combinations of these techniques might be necessary to achieve successful PVD induction. We describe a novel instrument that combines aspiration as well as non-aspiration techniques for PVD induction, Bapaye aspiration scraper. It is also useful in various vitreoretinal interface procedures due to its design and is compatible with small-gauge vitrectomy systems which are commonly used in modern vitreoretinal surgery.
COVID-19-related bilateral acute de-pigmentation of iris with ocular hypertension
Authors: Gaur Sandhya , Sindhu Narottama , Singh Deependra Vikram , Bhattacharya Mainak , Sharma Ajay , Shinde Dattatraya
Published: August 2022

A 43-year-old male patient presented with acute blurring of vision in both eyes associated with photophobia, redness, and mild pain following coronavirus disease 2019 (Covid-19) infection. Clinical examination revealed extensive pigment dusting in the corneal endothelium and the trabecular meshwork with de-pigmentation bands in the iris periphery. The patient was managed empirically with topical anti-glaucoma medications for high intra-ocular pressure. The patient was prescribed systemic antibiotics including cephalosporins and amoxicillin for respiratory symptoms. A rare condition called bilateral acute de-pigmentation of iris (BADI) was suspected after ruling out common entities, for example, viral kerato-uveitis, pigment dispersion syndrome, and Fuchs iridocyclitis. Covid-19 infection and systemic antibiotics including cephalosporins have shown to cause BADI in the literature. The patient responded well with good outcome.
Exploring the Research Priorities for Occupational Therapy in India
Authors: Kamalakannan Sureshkumar , Sethuraman Lakshmanan , Chockalingam Manigandan , Samuelkamaleshkumar Selvaraj , Moorthy Shobana Devi , Srinivasan MuraliKrishnan , Ramakrishnan Jothikumar , Muthuvel Thirumugam , Mani Karthik
Published: August 2022

Background:

Occupational therapists are considered an important workforce for the rehabilitation of persons with disabilities globally. However, in India, the profession is just beginning to gain recognition within the national and state-level systems for health care. One of the reasons for this could be the paucity of specific research related to the development of occupational therapy (OT) and its benefits to the health systems. Therefore, it is of immense public health importance to explore the priorities and gaps in OT research in India. A vast majority of the OT research in India is promoted and disseminated through the All-India Occupational Therapists Association (AIOTA) and its annual national conference (ANC).

Objectives:

The objective of this study is to descriptively review the conference abstracts of the AIOTA ANC published in the Indian Journal of OT (IJOT), an official publication of the AIOTA, from 2017 to 2021.

Study Design:

The study design was a descriptive, nonsystematic review.

Methods:

Review of the abstracts selected for the AIOTA ANC published in the IJOT from 2017 to 2021. A data extraction form was developed and used to synthesize data related to the clinical and demographic characteristics of OT research in India.

Results:

The search yielded 218 abstracts. State-level trends indicated that close to 85% of the research submissions were from four states and no submissions from the northeastern states until 2020. Nearly 60% of the abstracts were clinical research with OT interventions. About 40% of these research abstracts were related to pediatrics, followed by neurology (17%), musculoskeletal (15%), mental health (10%), and ergonomics and assistive technology (8%). There were 1%–2% of research abstracts submitted related to coronavirus disease-2019 (COVID-19) and geriatrics. About 85% of the research abstracts were related to impairment (39%), activity limitation (26%), and social participation (22%).

Conclusion:

This review highlights the need for diversifying the research in OT in India. This is particularly important in relation to expanding from selected states to pan-India research and development, especially in the northeastern states. Furthermore, the focus of OT research must move beyond impairments and approach disability from the biopsychosocial perspective. It is also very important to diversify the research in OT to areas that are of public health importance such as COVID-19, geriatrics, noncommunicable diseases, and rehabilitation in health systems. Priority setting for research in OT in India is an important implication of this review.
Evaluation of Surface Dose and Commissioning of Compensator-Based Total Body Irradiation
Authors: Pandu Bharath , Khanna D. , Mohandass P. , Ninan Hima , Elavarasan Rajadurai , Jacob Saro , Sunny Goutham
Published: August 2022

Purpose:

The aim of the current study is to commission compensator-based total body irradiation (TBI) and to compare surface dose using percentage depth dose (PDD) while varying the distance between beam spoiler and phantom surface.

Materials and Methods:

TBI commissioning was performed on Elekta Synergy® Platform linear accelerator for bilateral extended source to surface distance treatment technique. The PDD was measured by varying the distance (10 cm, 20 cm, 30 cm, and 40 cm) between the beam spoiler and the phantom surface. Beam profile and half-value layer (HVL) measurement were carried out using the FC65 ion-chamber. Quality assurance (QA) was performed using an in-house rice-flour phantom (RFP). In-vivo diodes (IVD) were placed on the RFP at various regions to measure the delivered dose, and it was compared to the calculated dose.

Results:

An increase in Dmax and surface dose was observed when beam spoiler was moved away from the phantom surface. The flatness and symmetry of the beam profile were calculated. The HVL of Perspex and aluminum is 17 cm and 8 cm, respectively. The calculated dose of each region was compared to the measured dose on the RFP with IVD, and the findings showed that the variation was <4.7% for both Perspex and Aluminum compensators.

Conclusion:

The commissioning of the compensator-based TBI technique was performed and its QA measurements were carried out. The Mayneord factor corrected PDD and measured PDD values were compared. The results are well within the clinical tolerance limit. This study concludes that 10 cm −20 cm is the optimal distance from the beam spoiler to phantom surface to achieve prescribed dose to the skin.
Imatinib-Induced Cardiotoxicity
Authors: Chakravarthy P Sanjay , Kumari Pushpa , Gupta Dipendra Kumar , Bhowmick Mithu , Naik M. Devendra , Priyanka Gudimetla
Published: August 2022

INTRODUCTION:

The success of tyrosine kinase inhibitors in the treatment of chronic myeloid leukemia (CML) has increased the focus on survivorship and late toxicity in oncological care. Cardiovascular (CV) health has emerged as an important consideration in patients of CML. Some studies have shown an increased incidence of CHF with Imatinib therapy. This study was conducted to assess the cardiac functions in patients of CML on Imatinib therapy.

METHODS:

Seventy newly diagnosed CML patients started on Imatinib therapy having normal baseline cardiac functions as assessed by two-dimensional echocardiography and multigated acquisition (MUGA) scan were included in the study. Further assessment of cardiac functions at 3, 6, and 12 months was done by MUGA scan.

RESULTS:

At 3, 6, and 12 months of follow-up, 7.14%, 10%, and 11.43% of patients, respectively, showed evidence of cardiotoxicity in the form of reduced ejection fraction and wall abnormalities on MUGA scan (P = 0.58, 0.013, and 0.006, respectively).

CONCLUSION:

Cardiac dysfunction was seen in 11.43% of patients on Imatinib therapy for CML, though none of them were symptomatic. CML patients on Imatinib therapy must be monitored for cardiac functions, especially if they have other CV risk factors.
Latanoprost-associated cystoid macular edema in a patient with phakic eyes
Authors: Lin Wei-Che , Hsieh Jui-Wen , Tsai Shawn H. , Lan Yu-Wen
Published: August 2022

Here, we report a case of bilateral cystoid macular edema (CME) in a woman with phakic eyes after 22 years of latanoprost use. Optical coherence tomography revealed multiple intraretinal cysts, and fluorescein angiography revealed characteristic petaloid dye leakage from the perifoveal capillaries. A cause-effect relationship was suspected when CME resolved after switching from latanoprost to dorzolamide, as confirmed by positive rechallenge and dechallenge tests. Since prostaglandin analog-induced CME has only been reported in patients with pseudophakic, aphakic, or phakic eyes with retinal conditions predisposing to macular edema, this seems to be the first reported case of latanoprost-induced CME in a patient with phakic eyes without retinal risk factors.
Design of telemedicine information query system based on wireless sensor network
Authors: Gao Qian , Gadekallu Thippa Reddy
Published: August 2022

INTRODUCTION: A wireless sensor network-based remote medical information query system is proposed and designed.
OBJECTIVE: The proposed method aims at improving the throughput of the hospital information remote query system and reducing the response time
METHODS: The system structure is divided into three levels. The presentation layer is responsible for displaying the query operation interface of the function layer. The function layer realizes the query function according to the user instructions. The wireless sensor network is responsible for the transmission of instructions. The data layer starts the query of telemedicine information based on the Top-k query algorithm. In wireless sensor networks, the improved ant colony algorithm is used to optimize it, which improves the information transmission performance of the system.
RESULTS: The experimental results show that the designed system can complete the medical information query according to the needs of users, the system throughput and the residual energy of sink nodes are high, and the maximum response time of the system is always less than 0.5s.
CONCLUSION: It shows that the designed system has strong practical application performance and high application value.
On the number of vertices of Newton–Okounkov polygons
Authors: Roé Joaquim , Szemberg Tomasz
Published: August 2022

The Newton–Okounkov body of a big divisor

D

on a smooth surface is a numerical invariant in the form of a convex polygon. We study the geometric significance of the
shape
of Newton–Okounkov polygons of ample divisors, showing that they share several important properties of Newton polygons on toric surfaces. In concrete terms, sides of the polygon are associated to some particular irreducible curves, and their lengths are determined by the intersection numbers of these curves with

D

.

As a consequence of our description, we determine the numbers

k

such that

D

admits some

k

-gon as a Newton–Okounkov body, elucidating the relationship of these numbers with the Picard number of the surface, which was first hinted at by work of Küronya, Lozovanu and Maclean.