bluuebunny/crossref_metadata_2025 huggingface dataset:
Perioperative nuances of cataract surgery in ocular surface disorders
Authors: Agarwal Shweta , Srinivasan Bhaskar , Harwani Ankit Anil , Fogla Rajesh , Iyer Geetha
Published: October 2022

Ocular surface disorders (OSDs) constitute a varied spectrum of conditions that could be associated with dryness, compromised limbal status, varying grades of forniceal obliteration, corneal scars, and a possible underlying immune etiology. These associations adversely impact surgical outcomes in the eye. One of the treatable causes of decreased vision in these eyes is cataracts which could be secondary to the disease, its treatment, or age-related. The compromised ocular surface status can interfere with decision-making regarding the technique of cataract surgery, preoperative biometry for intraocular lens (IOL) power calculation, and intraoperative visibility, increasing the possibility of complications and compromising the final visual outcome. The postoperative course can be affected by complications, including melt and infection. Stabilization of the ocular surface by medical or surgical means, and appropriate management of underlying immune etiology, if any, helps improve and maintain a healthy ocular surface, optimizing cataract outcomes. With the help of pre, intra, and postoperative tools and means, such as punctal occlusion, ocular surface reconstruction, systemic immunosuppression, illuminators, capsule staining dyes, optical iridectomy, prosthetic replacement of the ocular surface ecosystem (PROSE) lenses, and others, the visual outcome post-cataract surgery in these eyes can be maximized. This article highlights the nuances of performing cataract surgery in various OSDs and the need to have a comprehensive stepwise approach is emphasized.
Vector analysis of astigmatic correction after single-step transepithelial photorefractive keratectomy and femtosecond-assisted laser in-situ keratomileusis for low to moderate myopic astigmatism
Authors: Sun Lixia , Jhanji Vishal , Li Senmao , Li Jinyu , Ji Ruifeng , Zeng Hongqiang , Ng Tsz Kin , Zhang Mingzhi , Zhang Riping
Published: October 2022

Purpose:

This study aimed to evaluate the outcomes of astigmatic correction by single-step transepithelial photorefractive keratectomy (TransPRK) and femtosecond-assisted laser in-situ keratomileusis (Femto-LASIK) surgeries.

Methods:

A total of 218 subjects received TransPRK or Femto-LASIK surgery for the treatment of myopia and astigmatism (−2.25 to −0.25 D). Refraction errors and uncorrected (UDVA) and corrected distance visual acuity (CDVA) were examined before and at 3 months after surgery. Astigmatism changes were assessed by vector analysis.

Results:

Preoperative parameters of the TransPRK group were similar to the Femto-LASIK group. UDVA and CDVA at 3 months were similar between both groups. Manifest refraction (MR) spherical equivalent in the TransPRK group (0 ± 0.20 D) was slightly lower compared with the Femto-LASIK group at 3 months (0.11 ± 0.25 D, P = 0.001). MR cylinder was -0.06 ± 0.19 D in the TransPRK group and -0.02 ± 0.15 D in the Femto-LASIK group at 3 months (P = 0.135). The index of success (IS) was 0.15 ± 0.36 in the TransPRK group and 0.06 ± 0.17 in the Femto-LASIK group (P = 0.125). The correction index (CI) was 1.03 ± 0.19 in the TransPRK group and 1.01 ± 0.11 in the Femto-LASIK group (P = 0.815).

Conclusion:

For low to moderate myopic astigmatism, TransPRK provided a comparable astigmatic treatment effect as Femto-LASIK. Myopic astigmatism was both slightly overcorrected after TransPRK and Femto-LASIK surgeries.
Complications in deep anterior lamellar keratoplasty – A retrospective interventional analysis in a large series
Authors: Kodavoor Shreesha Kumar , Rathi Neha , Dandapani Ramamurthy
Published: October 2022

Purpose:

To analyze the complications in patients managed with deep anterior lamellar keratoplasty (DALK) for diseases of the anterior corneal stroma.

Methods:

This is a retrospective analysis of all the patients who underwent DALK in a tertiary care center in South India from 2010 to 2020. A total of 474 eyes in 373 patients were included in the study. Patients who underwent DALK for advanced keratoconus, keratoconus with Bowman’s membrane scar, healed hydrops, macular corneal opacity, macular corneal dystrophy, granular corneal dystrophy, spheroidal degeneration, pellucid marginal degeneration, post–laser-assisted in situ keratomileusis ectasia, descematocele, post-collagen cross-linking aborted melt and dense scar, and post-radial keratotomy were included in the study. The patients were followed up for 17.2 +/- 9.2 months (1–9 years).

Results:

Complications noted in the surgery were intra-operatively Descemet’s membrane perforation in 31 eyes (6.54%), post-operatively secondary glaucoma in 16 eyes (3.37%), cataract in seven eyes (1.47%), suture-related complications in five eyes (1.05%), graft rejection in three eyes (0.63%), traumatic dehiscence in two eyes (0.42%), filamentary keratitis in two eyes (0.42%), interface infiltrate in one eye (0.21%), and recurrence of disease in four eyes (7.14%) out of 57 eyes with corneal dystrophy.

Conclusion:

DALK as an alternative to penetrating keratoplasty for anterior corneal stromal diseases. It has become an automatic choice for diseases of the anterior cornea requiring keratoplasty. Complications can occur at any stage of surgery; however, if identified and managed early, they can result in optimal outcome.
Outcomes of ab-interno irrigating goniectomy with trabectome in primary and secondary glaucoma from a single center in India
Authors: Dubey Suneeta , Bansal Tanima , Garg Prerna , Hegde Aparna , Das Ranajit , Rekha PD
Published: October 2022

Purpose:

This study was done to report intermediate-term outcomes of irrigating goniectomy with trabectome (trabectome) surgery among different types of glaucoma eyes from a single center in India using a cross-sectional, longitudinal, observational study design.

Methods:

Fifty-three patients (58 eyes) with glaucoma who underwent irrigating goniectomy with trabectome between January 2019 and February 2020 were included. Pre-operative data included age, gender, eye laterality, specific diagnosis, number of anti-glaucoma medications (AGMs), prior glaucoma surgeries, visual acuity, and intraocular pressure (IOP) on medical treatment. Post-operative data included IOP changes during the follow-up till 1-year, number of AGMs, any complications, or additional surgical intervention required. Success was defined as IOP ≤ 21 mmHg and ≥ 20% reduction of IOP from pre-operative IOP with no additional glaucoma surgery.

Results:

The cohort included 58 eyes (male 53.4% and female 46.6%) ranging from 0.6 to 81 years of age. The average baseline IOP was 23.4 ± 10.2 mmHg and reduced significantly with surgery to 14.1 ± 5.3 mmHg at 1-year follow-up. The AGMs reduced from 2.4 ± 1.4 pre-surgery to 1.6 ± 1.4 at 1-year follow-up. Four eyes required additional glaucoma surgeries for IOP control. The success rate of trabectome with phacoemulsification (88%) was discernibly higher than with trabectome alone (67%). Intra-operatively, significant blood reflux was noticed in 27 eyes, of which only one required tamponading with a viscoelastic agent.

Conclusion:

This study concludes that irrigating goniectomy with trabectome has good efficacy and safety in both pediatric and adult cases of glaucoma in terms of IOP control, reduction in AGMs, and low incidence of complications in the Indian population.
Acremonium keratitis: Risk factors, clinical characteristics, management, and outcome in 65 cases
Authors: Priyadarshini Smruti Rekha , Soni Tanvi , Sahu Srikant Kumar , Mohanty Amrita , Sharma Savitri , Mitra Sanchita , Ali Mohammad Hasnat , Das Sujata
Published: October 2022

Purpose:

To study the risk factors, clinical presentation, management options, and outcomes in cases of culture-proven Acremonium keratitis.

Methods:

Medical and microbiology records of culture-proven Acremonium keratitis from Jan 2007 to Dec 2019 at a tertiary eye care center were reviewed. Details of clinical findings on each visit and operating notes were reviewed from the medical records. All cases were subjected to corneal scraping at the first visit for microbiological investigation consisting of direct smear examination and culture. Topical natamycin 5% was the mainstay of medical treatment. Surgical treatment was considered for nonresponding patients.

Results:

During the 13-year study period, 65 cases of culture-proven Acremonium keratitis were identified out of 1605 cases of fungal keratitis. Trauma was the most common predisposing factor in 32 cases (49.2%). The average area of the corneal stromal infiltrate was 24.8 mm2 at the initial presentation. Hypopyon at the time of presentation was evident in 28 (43.1%) cases. Staphylococcus spp. was the most common (n = 22, 33.8%) organism coexistent with Acremonium. Direct microscopy of corneal scraping was positive for fungal filaments in 57/65 (87.6%) cases. Medical management alone was given in 44 patients (67.6%). Age (>50 years) and treatment delay (>15 days) were found to be independent risk factors for the poor final visual outcome (VA <20/60).

Conclusion:

When treated early, Acremonium keratitis responds well to medical therapy with currently available topical antifungals. However, advanced and nonresponding cases require surgical intervention for resolution of the infection.
Recommendations for management of peripheral retinal degenerations
Authors: Venkatesh Ramesh , Sharief Shama , Thadani Atul , Ratra Dhanashree , Mohan Sashwanthi , Narayanan Raja , Narula Ritesh , Asad Yusra , Roy Rupak , Jayadev Chaitra , Yadav Naresh K.
Published: October 2022

Some degenerations involving the peripheral retina can result in a rhegmatogenous retinal detachment. Currently, there are no clear guidelines for retinal screening and/or management of these peripheral retinal degenerations in patients with or without recent onset posterior vitreous detachment or in those prior to refractive surgery or intraocular procedures. This article aims to provide a set of recommendations for the screening and management of peripheral retinal degenerations based on a common consensus obtained from an expert panel of retinal specialists.
Knowledge, awareness and attitude of eye donation among non-clinical staff of a tertiary eye hospital in South India
Authors: Narendran Venkatapathy , Padmavathi Sivakumar , Sangeetha Shanmugam , Karthik Natarajan
Published: October 2022

Purpose:

This study aimed to evaluate the knowledge, awareness and attitude of eye donation among non-clinical staff of tertiary eye hospitals and to convey a positive attitude toward eye donation by enhancing their awareness and knowledge.

Methods:

An online cross-sectional study was conducted among the non-clinical staff from all centers of a tertiary eye care hospital across Tamil Nadu. Quiz link was emailed to non-clinical staff of all the centers. On completion of the quiz, the participants viewed their respective scores and the correct answers to all questions. This activity was presumed to subsequently improve their knowledge and clear up the myths on eye donation.

Results:

Two hundred twenty-eight non-clinical staff from 11 hospitals participated in the quiz. Mean age was 35.3 ± 9.8 years and 130 were female staff (57.05%). One hundred eighty-one participants (79.39%) scored over 50% of the total 17 queries. One hundred eighty-six (81.58%) and 142 (62.28%) participants scored over 50% in the awareness section and knowledge section, respectively. Eye bank volunteers (73, 32.02%) were the main source of information. Twenty-four (10.53%) had already taken pledge for eye donation and 175 (76.75%) were willing to pledge, 29 (12.72%) were not willing to pledge. Twenty-two out of these 29 (75.86%) had no specific reason for not pledging. Family, religious reasons, lack of clarity and fear were least cited reasons (13.79%).

Conclusion:

Non-clinical staff of an eye hospital are easily approachable and are expected to be more knowledgeable by the general public around them. They might act as primary motivators in raising awareness within their family, friends, relatives and neighbors.
A hybrid 26G needle drainage technique in scleral buckling: A mini scleral cut-down
Authors: Markan Ashish , Dogra Mohit , Ayyadurai Nikitha , Singh Ramandeep
Published: October 2022

Purpose

To evaluate the efficacy and safety of hybrid 26-gauge needle drainage in scleral buckling for rhegmatogenous retinal detachment (RRD).

Methods

In this retrospective study, we included patients who underwent scleral buckling surgery along with subretinal fluid (SRF) drainage using the ‘Hybrid 26G needle drainage technique’. Pre-operative assessment included the best corrected visual acuity (BCVA), lens status, and extent of retinal detachment. Intra-operative surgical details such as the height of retinal detachment, number of attempts required to drain the fluid, amount of fluid drained, adequacy of break buckle relationship, and any intra-operative or post-operative complications were noted. Post-operatively, the final visual outcome and retina status were assessed at 3 months of follow-up.

Results

A total of 10 eyes with primary RRD and proliferative vitreoretinopathy C1 or less were included. Pre-operatively, the mean BCVA was 2.43 ± 1.01 logMAR units, which improved significantly to 0.679 ± 0.45 logMAR units (p value < 0.05) at 3 months of follow-up. Regarding the extent of RRD, five eyes (50%) had a total detachment, two eyes (20%) had a sub-total detachment, and three eyes (30%) had an inferior detachment. Four eyes had shallow detachment, four had a moderate detachment, and two eyes had bullous detachment. Complete drainage of SRF (>75%) was achieved in five patients, and a partial but adequate drainage (50–75%) was achieved in the rest of the five patients. In none of the patients, inadequate or dry tap was encountered. No intra-operative complications were encountered. The retina was attached in eight out of ten eyes at 1 week and at a 1-month follow-up period. Two patients required pars plana vitrectomy for persistent SRF. The retina was attached in all the patients at 3 months of follow-up.

Conclusion

The ‘Hybrid needle drainage’ technique is a safe and effective technique for SRF drainage in scleral buckling surgery.
Presence and development of strabismus in children with telecanthus, epicanthus and hypertelorism
Authors: Mooss Vidya S , Kavitha V , Ravishankar HN , Heralgi Mallikarjun M , Aafreen Saba
Published: October 2022

Purpose

To study the presence and development of strabismus in children with telecanthus, epicanthus, and hypertelorism.

Methods

This is a prospective, longitudinal, and observational study. Sixty children aged between 6 months and 18 years with telecanthus, epicanthus, and hypertelorism in isolation or in combination were recruited. A detailed analysis of the history, determination of best corrected visual acuity, complete evaluation of strabismus, and ocular examination were carried out. The presence of telecanthus, epicanthus, and hypertelorism and associated strabismus, if any, was noted. All children were followed up for a minimum and maximum period of 12 and 18 months, respectively, to analyze the strabismus (previously present) and for detection of strabismus in those who did not have. The data were analyzed descriptively with mean and standard deviation. Chi square test and Fishers exact test were used to analyze the data between the groups. A P value less than 0.05 was considered to be statistically significant.

Results

Telecanthus was the most common lid feature (55%). At baseline, ten (16.66%) children had strabismus (six: esotropia; four: exotropia). Two (3.33%) children underwent surgery. One child developed exotropia at the third follow-up (18 months). At the end of the study, 11 (18.33%) children had strabismus. No significant association was seen between lid characteristics and the type of strabismus.

Conclusion

Children with telecanthus, epicanthus, and hypertelorism in isolation or in combination may or may not have associated strabismus. These features can pose difficulty in strabismus diagnosis, which mandates a careful examination, especially in younger age groups and small-angle strabismus. On the other hand, children without strabismus need longer follow-up to detect the development of strabismus and to initiate further management at the earliest.
Peripapillary and fovea avascular zone optical coherence tomography angiography parameters in exfoliation glaucoma versus primary open-angle glaucoma versus healthy eyes
Authors: Zloto Ofira , Veksler Ronel , Moroz Iris , Goldberg Hila , Levkovitch-Verbin Hani
Published: October 2022

Purpose:

To examine the differences in the peripapillary vascular parameters and foveal-avascular-zone (FAZ) vascularity parameters between primary open-angle-glaucoma (POAG) patients versus exfoliation-glaucoma (XFG) patients versus healthy subjects.

Methods:

This is cross-sectional study and a comparative clinical study. POAG and XFG patients and healthy subjects underwent a comprehensive ophthalmic examination, including visual field optical coherence tomography (OCT) and OCT angiography (OCTA) of the optic disc and FAZ. Differences in peripapillary vessel density (VD), perfusion density (PD), and FAZ area and circularity were examined between all groups, as well as correlations between clinical parameters and vascularity parameters for each glaucoma group.

Results:

A total of 109 subjects (one eye for each patient) were analyzed, including 45 with POAG, 30 with XFG, and 34 controls. The average peripapillary VDs were the lowest among the XFG patients and the highest among the controls (P < 0.05, ANOVA). The average peripapillary PD of the central ring was the lowest in the XFG group and the highest in the control group (P = 0.02, ANOVA). A significant negative correlation was found between the average peripapillary VDs and PDs of the inner ring and full ring and disease severity of the POAG patients. There was a significant positive correlation between the average peripapillary PDs of the central rings and full ring and the central macular thickness of the XFG patients (P < 0.01 and P < 0.04, respectively, Pearson correlation).

Conclusion:

The peripapillary vascular parameters of the POAG and XFG patients were lower compared to those of normal participants. A correlation between clinical characteristics of POAG and XFG patients and PD was found. This may hint to a vascular mechanism in glaucoma either primary or secondary to intra-ocular pressure/OAG damage.
A randomized control trial on the role of tranexamic acid in preventing intraoperative bleeding during external dacryocystorhinostomy
Authors: Alam Md Shahid , Barh Atanu , Kundu Debi
Published: October 2022

Purpose

To evaluate the role of tranexamic acid in controlling intra-operative and immediate post-operative bleeding during external dacryocystorhinostomy.

Methods

This was a double-blinded randomized placebo-controlled trial. All patients diagnosed with primary acquired nasolacrimal duct obstruction presenting between June 2018 to December 2019 were included in the study. All patients in the study group received a single dose of 1 gm tranexamic acid injection intravenously 30 minutes before the surgery, whereas the patients from group B (placebo) received normal saline. The effect of the injection was measured in terms of duration of the surgery, surgical field grading, amount of total blood loss during the surgery, and the need for postoperative nasal packing.

Results

A total of 96 patients were included, of whom 45 were males and 51 were females. The study group (Group A) included 51 patients (27 males and 24 females) and the control group (Group B) included 45 patients (18 males and 27 females). There were no statistically significant differences between the two groups in terms of the duration of surgery (48.43 ± 20.01 minutes vs. 53.38 ± 19.8 minutes, P = 0.228), view of the surgical field (P = 0.084), the amount of intraoperative blood loss (88.63 ± 69.34 mL vs. 88.89 ± 51.93 mL, P = 0.984) and requirement of postoperative nasal packing (54.9% vs 62.2%, P = 0.471).

Conclusion

There seems to be little to justify the role of preoperative intravenous tranexamic acid injection in controlling intra-operative and immediate postoperative bleeding during external dacryocystorhinostomy.
Exploring the globe salvaging treatment options in patients of COVID-19-associated mucormycosis with orbital involvement
Authors: Khare Praveen , Chaurasia Yogita , Bhatnagar Shweta
Published: October 2022

Purpose

To explore the various globe salvaging treatment strategies for patients with coronavirus disease 2019-associated mucormycosis (CAM).

Methods

This was a prospective interventional analytical study conducted at a Medical College in rural India. A total of 84 patients of CAM admitted between May 2021 and August 2021 were enrolled for the study. Patients with histologically proven CAM with clinical and/or radiological evidence of orbital involvement were divided into three treatment categories based on the site and extent of the lesion. Re-assessment was performed after 7 days. For patients who worsened with the primary approach, orbital exenteration was considered based on a Sion Hospital Scoring System. A novel approach to intra-orbital anti-fungal therapy, site-centered peri-bulbar injection of amphotericin B (SCPeriAmB), was also explored. All the patients were followed up for at least 3 months. Convenience sampling with descriptive statistics was used.

Results

Six patients had to finally undergo exenteration by the end of the study period. The rest of the patients were reported to be stable or improved. No mortalities were reported on delaying the exenteration. No adverse events were noted in patients who were given SCPeriAmB.

Conclusion

Globe salvaging treatment options should be advocated as a primary approach in patients with CAM. Site-centered peri-bulbar injections can be considered as an approach for delivering intra-orbital anti-fungal therapy in selected patients.
Growth and Development in Children with Rheumatic Diseases: Maintaining a Balance between Drugs and Disease Activity
Authors: Bhattad Sagar , Mohite Rachna Shanbhag , Singh Neha
Published: October 2022

Rheumatic diseases are autoimmune disorders that affect the bones, skin, and muscles, and they contribute to a significant burden of chronic illnesses in children throughout the world, the most common of them being juvenile idiopathic arthritis (JIA). Symptoms begin at a young age and last throughout maximum growth potential in these children. Long-term consequences usually follow delayed diagnosis and contribute to increasing disease burden, joint damage, deformity, and delayed growth and development. Children with systemic arthritis with uncontrolled disease, and/or prolonged use of corticosteroids have an increased risk of growth impairment. Uveitis associated with JIA has a significant impact on academic competence and social development. On the other hand, newer diseases such as autoinflammatory diseases not only pose a challenge in diagnosis but also in management due to the lack of easy availability of targeted therapy. Rheumatic disease in adolescents has more pronounced effects on the development of self-identity, self-confidence, and sexual development. Therefore, there is a need to establish psychosocial and educational interventions targeted at improving social support, resolving insecurities, and building confidence among these adolescents. Drugs used in the treatment of rheumatic illnesses such as glucocorticoids, disease modifying anti-rheumatic drugs (DMARDs), and biologics have both short-term and long-term effects on growth and overall development. A treat-to-target approach and use of various disease activity monitoring tools are efforts in the direction of standardizing treatment and achieving and maintaining prolonged disease remission. Finally in order to provide a holistic care, we need to ease the access to pediatric rheumatologists, increase the awareness of these diseases among the medical fraternity and community, build financial and social systems to support both patients and their families. In this article, we highlight the various aspects of rheumatic diseases in childhood and their possible effects on the overall growth and development in children.
Steroid-Free Management and Recent Advances in Antineutrophil Cytoplasmic Antibody-Associated Vasculitis
Authors: Malik Hassan , Sitram Renuka , Mahmood Waqas , Bhutta Salman , Adeeb Fahd
Published: October 2022

Antineutrophil cytoplasmic antibody-associated vasculitis (AAV) represents one of the most challenging and potentially life-threatening conditions faced by rheumatologists. Part of the challenge has been the limited therapeutic options available and the substantial concern related to their toxicity, which are time dependent and dose dependent. Systemic glucocorticoids (GC) have been the cornerstone of AAV therapy since the 1950s; however, the extensive list of risks associated with its use are well described. Cyclophosphamide and rituximab have become the standard therapy for remission induction in organ or life-threatening AAV but not all patients achieve or sustain remission and many remain on long-term GC therapy. Recent attention focuses on achieving sustainable steroid-free induction and remission maintenance through transformative innovation of novel drug development or repurposing. This review sheds light on the significant advances made in similar or more effective novel innovative steroid-sparing or reduction strategies in AAV.
A 5-year evaluation of early-and late-onset sporadic colorectal cancer screening in Central Saudi Arabia
Authors: Zacharakis Georgios , Almasoud Abdulaziz , Arahmaner Omar , Aldossary Khaled , Alzahrani Jamaan , Al-Ghamdi Sameer , AlShehri Abdullah , Nikolaidis Pavlos , Bawazir Abdullah , Alfayez Talal , Daadour Moataz , Alslimah Faisal , Altamimi Mohammed , Alshalawi Sami
Published: October 2022

Background:

The Al-Kharj colorectal cancer (CRC) screening program was implemented for five years (2017-2022) in a central urban area of Riyadh Province, Saudi Arabia, to assess the participation and impact of the program in average-risk individuals.

Methods:

The high sensitivity-guaiac based-fecal occult blood test (HSgFOBT) was used as a first-line investigation to identify asymptomatic patients, aged 45–75 years, requiring CRC screening using colonoscopy. The program was run in three tertiary hospitals in the area.

Results:

The five-year participation rate was 73% (35,640/48,897). The average age was 53 years (range 45–75), 49% were female (17,464/35,640), all were asymptomatic, and 77% had adequate bowel preparation. The HSgFOBT (+) rate was 6.3% (n = 2245), and 76% (n = 1701) of these underwent colonoscopy. The prevalence of findings were as follows: CRC, 4.8% (81/1701); advanced adenoma, 9.5% (162/1701); adenoma, 15.9% (270/1701); non-adenomatous polyps, 7.9% (135/1701); and no polyps or tumors, 25.4% (432/1701). Among participants aged 45–50 years, early onset-CRC had female predominance, while those ≥50 years with late onset-CRC were predominantly male. CRC was more prevalent in the left colon (P < 0.005).

Conclusions:

Approximately one-third of the participants diagnosed with CRC had early-onset CRC. Screening participation was desirable for the defined target population. Public education is necessary along with expanded colonoscopy resources to continue further citizen participation.
Population immunity in residents of the Kaliningrad region to current antigenic variants of influenza viruses over 2018-2021
Authors: Goncharov A. G. , Egorenkova O. A. , Shupletsova V. V.
Published: October 2022

The article presents the results of population immunity assessment in residents of the Kaliningrad region to current antigenic variants of influenza viruses over the period of 2018 to 2021. To assess spectrum of influenza types circulating in Kaliningrad region, the real-time PCR method was used using AmpliSense reagent kits. The biological material for the study was obtained from oropharyngeal swabs from the persons who applied to polyclinics with inflammatory diseases of upper respiratory tract, or underwent treatment at the out- or inpatient basis in a healthcare facilities of Kaliningrad region. Humoral immunity was assessed by testing blood sera obtained from healthy residents of Kaliningrad region during periodic prophylactic examinations at the city and regional polyclinics. The study of residents covered all age groups. For the period of 2018-2021, more than 14,000 studies have been carried out. Determination of specific serum antibody titers was carried out by staging the hemagglutination suppression reaction using local influenza antigens (LLC PPDP, St. Petersburg). Antibody titers of 1/40 and higher were considered sufficient to reduce the risk of disease by 50%. During the study period, 2165 cases of influenza were confirmed in the region by laboratory tests. Over the study period, the A(H1N1) pdm serotype proved to be the major strain causing influenza, its proportion reached 57.5%. However, along with A(H1N1) pdm, a significant contribution was also made the A(H3N2) strain to the epidemic process, being the etiological cause of influenza infection in 2019 (42.2%), type B influenza strains being actual in 2020 (42.5%). Over the period of 2018-2021, 420 samples of blood sera from vaccinated and non-vaccinated individuals were tested for specific antibodies. The sera were taken 1-2 months after vaccination and between epidemic rises of influenza (April-May). In vaccinated individuals, the antibody titer was protective in 58.3-64.5%. In this group of persons, the titer sufficient to produce immunity was maintained over the spring/summer period. Among those persons who refused vaccination, a protective antibody titer in the pre-epidemic period was noted in 41.2% of the examined, and during the off-season it was detected in 37.4% of the volunteers. Thus, the A(H1N1) pdm strain was the main etiological factor of influenza in Kaliningrad Region in 2018-2021. The protective level of antibodies in vaccinated population over the period preceding the epidemic peak, was observed 30% more often than in unvaccinated individuals. High incidence of influenza B strains noted in 2020 appears to require a change of specific vaccine preparation.
Cytokines of the IL-6 family, adiponectin and leptin levels in patients with metabolic syndrome during the post-COVID period
Authors: Radaeva O. A. , Simbirtsev A. S. , Kostina Yu. A. , Negodnova E. V. , Besheynov D. D. , Mashnina S. V. , Eremeev V. V.
Published: October 2022

COVID-19 is a multisystem disease, but the extent of its consequences is currently poorly understood, especially in the persons with metabolic disorders. The aim of the present study was to evaluate the special changes in the cytokines of IL-6 family (IL-6 and sIL-6, LIF and sLIFr), adiponectin and leptin within 360 days after SARS-CoV-2 infection in the patients with metabolic syndrome (MetS), to discern features of immunopathogenesis depending on previous vaccination against COVID-19.

We have classified the patients in two groups: (1) patients with MetS who underwent COVID-19 6-12 months after full-course vaccination with a vector vaccine (n = 32); (2) patients with MetS who underwent COVID-19 without story of vaccination (n = 29). Control group included conditionally healthy individuals without MetS: (3) vaccinated, and (4) non-vaccinated, who also had COVID-19. The levels of IL-6 and sIL-6, LIF and sLIFr, leptin and adiponectin, NO, ADMA, SDMA were determined by ELISA technique.

In patients with MetS, changes in cytokine regulation towards proinflammatory reactions were revealed (an increase in blood IL-6 and leptin levels), which was most pronounced in MetS within first 30 days post-COVID, but with a number of changes which remained for 12 months (e.g., increased leptin concentration in blood). Vaccination against COVID-19 reduced the severity of pro-inflammatory changes in the sIL- 6r/ IL-6 and leptin/adiponectin systems towards protective adiponectin. However, the persistent increase in leptin was not canceled. When interpreting these results, no negative differences were revealed in the group of once vaccinated individuals with MetS, concerning the mentioned cytokine regulations of MetS over 1 year after COVID-19. The univariate, and then multifactorial correlation analysis between serum contents of sIL- 6r/ IL- 6, LIF/ sLIFr, adiponectin and leptin and the levels of vasoactive substances (NO, ADMA and SDMA), glycated hemoglobin, LDL has shown that the increased ratio of sIL-6r/IL-6 is an independent factor for the NO reduction of (r = 0.74, p 0.01); an increase in sLIFr positively correlates with increase in glycated hemoglobin (r = 0.69, p 0.01), and an association with increase of ADMA (r = 0.82, p 0.001), leptin (in this model) are shown to be an independent factor of LDL increase (r = 0.69, p 0.05).

Influence of pre-COVID modifiable factors, in particular, vaccination, is relevant in terms of reducing the likelihood of progression of pre-existing chronic diseases (hypertension, atherosclerosis, diabetes mellitus) in the persons with MetS after COVID-19 and has prospects for implementation into clinical practice.
Evaluation of anti-TNF treatment efficiency in children with immune-dependent diseases by means of testing the NF-κB activity in lymphocyte populations
Authors: Petrichuk S. V. , Radygina T. V. , Kuptsova D. G. , Kurbatova O. V. , Semikina E. L. , Murashkin N. N. , Potapov A. S. , Fisenko A. P.
Published: October 2022

Nuclear transcription factor B (NF-B) regulates innate and adaptive immunity functions and mediates inflammatory responses by activating proinflammatory cytokine gene transcription. TNF inhibitors block the NF-B signaling pathway, thus reducing inflammatory activity. The aim of the study was to evaluate the informativity of NF-kB transcription factor determination in the lymphocyte populations in children with inflammatory bowel disease (IBD) and psoriasis to assess the efficacy of anti-TNF therapy. We have examined 124 children with IBD and 55 children with psoriasis vulgaris administered maintenance anti-TNF therapy, and 30 healthy children. Stratification into the study groups was carried out according to PCDIA, PUCAI, PASI indices ( 10, remission). The number of cells with NF-B translocation was determined by flow cytometry with vusualization (Amnis ImageStreamX Mk II). Statistical evaluation was performed using Statistica 10.0 and SPSS 16.0. The highest number of cells with NF-B translocation was detected in B-lymphocytes and NK cells, thus being significantly higher than in T helper cells and cytotoxic T lymphocytes (p = 0.000). The percentage of cells with translocation of NF-B in populations of NK cells, T helper, cytotoxic T lymphocytes, Th17 lymphocytes, cytotoxic Th17 lymphocytes (Tc17) and Treg was increased in the patients at the acute disease stage against the comparison group. In the remission state, NF-B activity in lymphocyte populations was lower than in acute stage. In remission of psoriasis, NF-B activity in B lymphocytes, NK cells, and cytotoxic T lymphocytes was significantly lower than in comparison group. In IBD remission state, the NF-B activity was elevated only in T-helper cells. The level of NF-B translocation in the NK-cell population differed in children with IBD and psoriasis, both in acute phase (IBD, 46.2% (34-58); psoriasis, 36.5% (29-48), p = 0.041), and remission of disease (IBD, 25.4% (22-35); psoriasis, 19.1% (17-22), p = 0.000). ROC analysis of the data from exacerbation/remission states assessed as the NK cell numbers with NF-B translocation showed a good quality of the stratification model (AUC 0.8): The cut-off value in IBD was 41% (Se = 65.4; Sp = 89.1), and in psoriasis it was 23% (Se = 85.2; Sp = 94.7). The informativity of NF-B translocation level in lymphocyte populations in children with IBD and psoriasis was shown to correlate with efficacy of anti-TNF therapy. Exacerbation the disease with decreased therapeutic response is characterized by NF-B activation in lymphocyte populations in the children with IBD and psoriasis.
Content of PD-1+ and PD-L1+ peripheral blood lymphocytes in individuals with pollen sensitization before and after allergen-specific immunotherapy
Authors: Barkovskaya M. Sh. , Sevastyanov P. V. , Demina D. V. , Kozlov V. A.
Published: October 2022

The available data on the contribution of the PD-1 and its ligands to immunoregulatory processes suggest their involvement into development of tolerance during immunotherapy. Currently, allergen-specific immunotherapy (ASIT) is the single treatment option that can influence the outcome of allergic diseases. Our purpose was to evaluate the PD-1/PD-L1 expression on the immune cells in patients with confirmed sensitization to plant pollen allergens in comparison with healthy controls before and after ASIT. The patients with bronchial asthma (BA) (n = 5, age 33.82.7), allergic rhinitis (AR) (n = 7, age 31.62.8), and healthy donors (n = 12, age 32.81.8) were included. Venous blood samples were obtained from the patients three times: before starting ASIT, upon completion of the ASIT course, and during the period of seasonal exacerbation. In patients with AR, the number of B lymphocytes was decreased, and the expression of PD-L1 by B lymphocytes increased after ASIT in comparison with donor parameters. At the same time, B lymphocyte counts were increased in BA patients before ASIT and returned to normal after ASIT. In AR, the CD8+PD-1+T lymphocyte count was reduced before ASIT, however, returning to normal values after ASIT was completed. Meanwhile, the reduced number of CD4+PD-1+T lymphocytes returned to normal only during the pollination season following ASIT. In BA patients, both before or after ASIT, PD-1 and PD-L1 expression on CD4+ and CD8+T lymphocytes did not differ from the donor parameters. The PD-1 expression in the T regulatory cells (Tregs) was decreased comparing with donors before ASIT in BA, and in the patients with AR, both before and after treatment. It was shown earlier that low PD-1 expression in the circulating CD4+ T cells is associated with high specific IgE concentrations. Thus, low PD-1 levels on CD4+ and CD8+T lymphocytes and regulatory T cells may indicate their functional disorders in allergic pathology. In summary, our results show a regulatory role of PD-1/PD-L1 axis in the immune response during ASIT and reflect differences in pathogenesis of allergic disorders, which are associated with imbalance of the cell activation and suppression. Further studies are required to establish the role of PD-1/PD-L1 interactions in the process of ASIT-induced modification of allergic responses.
Gastrointestinal manifestations of allergy in the presence of Helicobacter pylori infection
Authors: Barilo A. A. , Smirnova S. V. , Feizer Albina A.
Published: October 2022

Association of Helicobacter pylori infection with gastrointestinal tract disorders is one of the most common problems in the modern medicine. There are conflicting data in the literature on the role of H. pylori infection in development of allergic diseases and its effect on the course of gastrointestinal disorders in allergic conditions. There is currently no conclusive evidence about the role of H. pylori in etiology and pathogenesis of allergic states. Hence, the studies of gastrointestinal disorders in allergic conditions in the presence of H. pylori infection are of sufficient relevance. Our aim was to study the features of sensitization spectrum and clinical course of gastrointestinal manifestations in allergic disorders in the children infected with H. pylori.

We have carried out a retrospective analysis of medical histories of the children with gastrointestinal manifestations of allergies (n = 29) aged from 1 to 18 years (middle age, 110.7 years), living in Eastern Siberia. The presence of H. pylori infection was determined with enzyme immunoassay technique, by measuring concentrations of total antibodies to the CagA H. pylori antigen. Depending on the carriage of H. pylori infection, 2 groups were discerned: HP-infected (n = 8), and HP-non-infected patients (n = 21). The spectrum of sensitization was determined by evaluating skin-prick tests for the non-infectious allergens. Gastrointestinal tract evaluation was based on the results of anamnesis, complaints, objective examination and data of esophagogastroduodenoscopy.

It was found that, in most cases, gastrointestinal manifestations of allergy were combined with dermatorespiratory syndrome (41.3% of total group). The incidence of H. pylori infection in the patients with gastrointestinal manifestations of allergies was 27.5% of the group. Among the gastrointestinal manifestations of allergies, inflammatory diseases of the esophagus, stomach, and intestines, e.g., gastroesophageal reflux, gastritis, and duodenitis were most common. In the group of HP-infected children the incompetence of cardia was more often, being statistically significant. In the group of HP-noninfected children, esophagitis, bulbitis, erosive lesions of the stomach and duodenum were more common, however, the difference did not reach statistical significance. The spectrum of sensitization in the patients with gastrointestinal manifestations of allergies showed some features depending on the presence of HP infection. E.g., sensitization to birch and meadow grass mixture was found to be significantly more often in the group of HP-infected children, Among the HP-noninfected children, sensitization to house dust mite, cat wool, and dog wool was more often detected. Hence, when examining children with gastrointestinal manifestations of allergies it is necessary to exclude the presence of H. pylori infection, which can modify the course of a genuine allergic pathology.
A highly contiguous, scaffold-level nuclear genome assembly for the fever tree (Cinchona pubescens Vahl) as a novel resource for Rubiaceae research
Authors: Canales Nataly Allasi , Pérez-Escobar Oscar A. , Powell Robyn F. , Töpel Mats , Kidner Catherine , Nesbitt Mark , Maldonado Carla , Barnes Christopher J. , Rønsted Nina , Przelomska Natalia A. S. , Leitch Ilia J. , Antonelli Alexandre
Published: October 2022

The Andean fever tree (Cinchona L.; Rubiaceae) is a source of bioactive quinine alkaloids used to treat malaria. C. pubescens Vahl is a valuable cash crop within its native range in northwestern South America, however, genomic resources are lacking. Here we provide the first highly contiguous and annotated nuclear and plastid genome assemblies using Oxford Nanopore PromethION-derived long-read and Illumina short-read data. Our nuclear genome assembly comprises 603 scaffolds with a total length of 904 Mbp (∼82% of the full genome based on a genome size of 1.1 Gbp/1C). Using a combination of de novo and reference-based transcriptome assemblies we annotated 72,305 coding sequences comprising 83% of the BUSCO gene set and 4.6% fragmented sequences. Using additional plastid and nuclear datasets we place C. pubescens in the Gentianales order. This first genomic resource for C. pubescens opens new research avenues, including the analysis of alkaloid biosynthesis in the fever tree.
Análisis bibliométrico de la producción científica de una universidad pública peruana en la base de datos Scopus
Authors: Estrada Araoz Edwin Gustavo , Quispe Aquise Jhemy , Ttito Vilca Sara Agripina , Pilco Arraya Kharla Madelinth
Published: October 2022

El objetivo de la presente investigación fue analizar la producción científica en la base de datos Scopus de una universidad pública peruana. La investigación fue de tipo bibliométrica y retrospectiva, donde se describió la producción científica de la Universidad Nacional de Educación Enrique Guzmán y Valle (UNE) a través del análisis de los documentos indizados en Scopus. De acuerdo a los resultados, se ubicaron 106 documentos indizados, siendo los autores con más publicaciones Bustamante, A. (24 documentos y un Índice H de 7), Morales-Romero, G. (18 documentos y un Índice H de 2) y Trinidad-Loli, N. (11 documentos y un Índice H de 1). En cuanto a las características de los documentos, se halló que la mayor parte de las revistas donde se publicaron fueron extranjeras, predominaron los artículos originales y en idioma inglés, hubo una mayor participación de los investigadores con filiación a la UNE como coautores y en la mayoría de trabajos de investigación no se declaró recibir financiamiento. Finalmente, se encontró que se publicaron más documentos en las áreas de Ciencias Sociales, Negocios, Administración y Contabilidad y Medicina. Se concluyó que en los últimos años la producción científica de la UNE en Scopus se ha incrementado de manera significativa, sin embargo, resulta limitada e insuficiente en comparación a las universidades más competitivas del país, por lo que es necesario que las autoridades universitarias desarrollen políticas institucionales que promuevan la publicación de las investigaciones realizadas por la comunidad universitaria en revistas científicas de alto impacto e indizadas, preferentemente, en bases de datos como Scopus.
Beet sugar subcomplex of Kazakhstan: the role of natural and geographical resource potential
Authors:   Abai Kazakh National Pedagogical University, Almaty, Kazakhstan, Zhandosova G. , Abulgaziev A. ,   Abai Kazakh National Pedagogical University, Almaty, Kazakhstan, Beikitova A. ,   Abai Kazakh National Pedagogical University, Almaty, Kazakhstan
Published: October 2022

Aim – the article reveals the problems of import dependence of sugar products in Kazakhstan, shows state programs for cultivation of sugar beets. Sugar factorie s are characterized by an annual decrease in the share of processing of domestic raw materials with a predominant predominance of sugar cane imported from abroad (Brazil, Cuba and Malaysia). Methods – statistical, cartographic, systemic and comparative analysis. Results – the authors note that according to official statistics, the share of sugar in domestic market is 58%, of which only 3% is locally produced. The main economic indicators of sugar beet subcomplex were determined: the level of productivity, gross harvest, production volumes of white refined sugar, production capacities of sugar industry, which have a high degree of depreciation, requiring modernization of technological equipment, which, in turn, requires large investments. The main reasons hindering the development of this industry were identified: reduction of sown areas in the southern regions of the republic, insufficient degree of use of Kazakh elite seeds and, accordingly, dependence on imported ones, high costs, low profitability at a low purchase price, problems with moisture supply, technical equipment for farmers. There is a positive experience of beet sowing in the northern r egions of the country (North Kazakhstan, Pavlodar, Akmo la regions) in order to reduce import d ependence on raw material base, which is due to the fact that natural and geographical potential of the country allows the effective development of sugar beet production in these regions. Conclusions – analyzing natural and climatic conditions, the authors state that the black soil zone in the north of Kazakhstan is favorable for cultivation of this crop, which is of particular importance during the period of acute shortage of granulated sugar and refined sugar. The de mand for it as the most important social product in the republic is increasing.