bluuebunny/crossref_metadata_2025 huggingface dataset:
Toronto clinical scoring system
Authors: Dalimunthe Dina Arwina , Sinambela Duma Wenty Irene , Lubis Syahril Rahmat
Published: October 2022

Mycobacterium leprae causes leprosy and can impair peripheral nerves. If nerve function is damaged and is not treated immediately and effectively, it can cause disability. Hence, early detection of peripheral neuropathy is critical. Toronto Clinical Scoring System (TCSS) is a simple neuropathy assessment instrument for diabetic neuropathy, chemotherapy-induced peripheral neuropathy, and human immunodeficiency virus neuropathy. Therefore, TCSS is expected to be an alternative tool for diagnosing leprosy neuropathy. This study aims to determine the diagnostic value of TCSS in leprosy neuropathy. This is a cross-sectional observational study with 40 participants. The TCSS and Semmes–Weinstein Monofilament tests were used to assess neuropathy. The diagnostic analysis showed that the sensitivity was 85.7%, specificity was 84.2%, positive predictive value was 85.7%, negative predictive value was 84.2%, positive likelihood ratio (LR+) was 5.42, negative (LR-) was 0.17, accuracy was by 85%, and area under curve value of 93.2%. The optimal cut-off point score of TCSS is ≥6. It can be concluded that TCSS is an alternative diagnostic tool with a high accuracy value and can be used as a routine examination for the early detection of leprosy neuropathy.
Diversity of coronaviruses in wild and domestic birds in Vietnam
Authors: Marchenko Vasily Y. , Kolosova Natalia P. , Danilenko Alexey V. , Bragina Maria K. , Nhai Tran Thi , Ryzhikov Alexander B.
Published: October 2022

Objective:

To investigate the genetic diversity of coronaviruses in wild and domestic birds in the bird park and live poultry markets of Ca Mau province in Vietnam in 2020.

Methods:

A total of 228 samples (121 from wild birds and 107 from poultry) were collected in the territory of Ca Mau province of Vietnam in 2020. The avian samples were tested for the presence of the four genera of coronaviruses using reverse transcription and nested PCR. Molecular genetic analysis using targeted NGS sequencing of RdRp gene was performed for 29 representative samples (12 samples from wild birds and 17 from poultry). Phylogenetic analysis was performed using the neighbour joininig method with 1000 bootstrap replications using MEGA X software.

Results:

Among wild birds, 21.5% samples were positive for the genetic material of coronaviruses and 38.3% samples were positive for coronaviruses among poultry. Genetic analysis of the partial sequence of RdRp gene from representative samples revealed that wild birds were carriers of gammacoronaviruses and deltacoronaviruses. Among poultry, three genotypes of infectious bronchitis virus (QX, Mass and Q1) were detected in chickens, with QX genotypes being predominant, and viruses of DCoV group were detected in domestic ducks. There was no detection of alphacoronaviruses or betacoronaviruses in the studied birds.

Conclusions:

Coronaviruses of genera Gammacoronavirus and Deltacoronavirus were detected in wild birds. A high percentage of infectious bronchitis virus was detected in poultry. Thus, there is a need for broader surveillance of coronaviruses in birds, which can be used for evaluation of diversity, evolution and distribution of coronaviruses in Vietnam. Continuous surveillance of coronaviruses circulation in wild and domestic animals is necessary for implementing strategic measures for poultry and domestic animal protection and for evaluation of possible risk of circulating coronaviruses to human health.
Sympathetic ophthalmia following radiation-induced scleral necrosis in choroidal melanoma
Authors: Chen Yen-Cheng , Chao Yu-Jang , Tsai Chieh-Chih , Chen Shih-Jen , Hwang De-Kuang
Published: October 2022

Sympathetic ophthalmia (SO) is a bilateral granulomatous panuveitis. We report a rare case of SO presenting after scleral necrosis as a late complication of Gamma Knife radiotherapy for choroidal melanoma. A 55-year-old woman presented with primary choroidal melanoma in the right eye and has been treated with Gamma Knife radiotherapy with stable tumor size. Five years after radiotherapy, a pigmented protrusive uveal mass was visibly noted over the superior sclera of the same eye, corresponding to periocular soft tissue enhancement on computed tomography. Biopsies of the pigmented mass showed the absence of malignancy. One month later, acute blurred vision with signs of sympathetic ophthalmia developed in the left eye. The patient received high-dose systemic corticosteroids and immunomodulatory therapy. The intraocular inflammation in the left eye subsided with improving vision, and the uveal mass in the right eye flattened after the anti-inflammatory therapy. Scleral necrosis is a rare complication following radiotherapy for choroidal melanoma and may incite sympathetic ophthalmia, for which prompt and aggressive treatment is important to save vision, especially for the fellow eye.
Concomitant Avascular Necrosis of the Lunate and Proximal Pole of the Scaphoid in a Thalassemia Minor Patient
Authors: Afshar Ahmadreza , Shariyate Mohammad Javad , Tabrizi Ali
Published: October 2022

Avascular necrosis (AVN) of multiple carpal bones is a very rare condition. This case report presents a patient with concomitant AVN of the lunate and proximal pole of the scaphoid that had led to severe joint space narrowing and degenerative arthritis in the radiocarpal and distal radioulnar joints (DRUJs). She was known to have thalassemia minor hemoglobinopathy. Wrist arthrodesis and distal ulna hemiresection-interposition arthroplasty (Bowers technique) for a DRUJ were offered and performed. The patient was satisfied with the clinical outcomes.
The Pros and Cons of Using Elderberry (Sambucus nigra) for Prevention and Treatment of COVID-19
Authors: Asgary Sedigheh , Pouramini Alireza
Published: October 2022

Background:

The novel severe acute respiratory syndrome coronavirus 2 emerged in 2019. Health-care systems around the world are looking for alternative prevention and treatment remedies. Herbal supplements are popular among consumers as a complementary method to prevent and treat illnesses. One of them is Sambucus nigra.

Methods:

We searched for related articles in Scopus, Web of Science, PubMed, Google Scholar, and the Directory of Open Access Journals using the following keywords: elderberry, S. nigra, and COVID-19.

Results:

Elderberry has antiviral properties due to its ability to modulate inflammatory cytokines. The current evidence suggests elderberry is appropriate for the prevention and initial treatment of viral disease. Concerns have been raised that elderberry may overstimulate the immune system, increasing the risk of a cytokine storm. There is not yet enough evidence to support this claim.

Conclusions:

For COVID-19 patients, further research is required since elderberry may provoke a cytokine storm if administered therapeutically.
Higher Dose of Dexmedetomidine Infusion Provides Better Oxygenation and Lung Mechanics in Obese Patients Undergoing Laparoscopic Cancer Surgeries
Authors: Hassan Mohamed Elsayed , Wadod Mohamed Alfattah
Published: October 2022

Background:

As a result of the growing international prevalence of overweightness, following then, the proportion of obese people undergoing major surgery increased. Both obesity and laparoscopic cancer surgeries had physiological effect on the respiratory system. Various studies have shown that Dexmedetomidine improves both lung compliance and oxygenation. The goal of the work to compare the effect of two various doses of dexmedetomidine infusion intraoperative on the oxygenation and lung mechanics in obese underwent laparoscopic cancer surgeries.

Materials and Methods:

This randomized double-blinded, trial was performed on 70 cases who underwent laparoscopic pelviabdominal cancer surgery. Cases were categorized into 2 equal groups. Group A: was given 1 μg/kg body weight dexmedetomidine then 0.5 μg/kg/hour, and group B: received 0.5 μg/kg body weight then 0.3 μg/kg/hour. Dexmedetomidine was administered as a bolus following intubation, then infusion till the end of surgery. Arterial blood gases and lung mechanics were measured at baseline, 30, 60, 90,120 min, and end of surgery.

Results:

PaO2/FiO2 ratio at 90min, 120min, and the end of surgery and delta PaO2/FiO2 were significantly increased in group A than in group B (P = 0.045, 0.048, and 0.047, respectively). Dynamic compliance at 120 min and at end of surgery were significantly increased in group A in comparison to group B (P = 0.047 and 0.04, respectively).

Conclusions:

Dexmedetomidine at a higher dose provides better oxygenation, dynamic compliance, lower dead space in obese laparoscopic cancer patients.
Discrepancy between admission diagnosis in emergency and final diagnosis in ward and its correlation with length of hospital stay and mortality
Authors: Nabi Umer Un , Rafi Asma , Maqbool Muzaffar , Shah Parvaiz Ahmad
Published: October 2022

Background:

Inception of emergency medicine as a specialty in India is on a rise. Data on the accuracy of diagnosis made in emergency rooms in India is scarce and with varied results with especially no such data available from our part of the country.

Aim:

The aim of this study was to evaluate the discrepancy between admission diagnosis in emergency and final diagnosis in ward and its correlation with length of hospital stay and outcome. This study was an observational prospective study.

Materials and Methods:

Patients were categorised as per the International Classification of Diseases – Version 10. A total of 2000 patients were enrolled in the study. The patients were followed from admission to discharge. Data were categorised into two major groups – 'Concordant' diagnosis and 'Discordant' diagnosis. Univariate analysis was performed using SPSS version 20.0.

Results:

Five hundred and fifty-three (27.65%) patients had a final diagnosis in ward discordant from the initial diagnosis in the medical emergency room. The frequency of discrepancy was highest for the genitourinary system (39%) and relatively low for neoplasm (16%). The average length of hospital stay in the concordant group of patients was 5.15 days, whereas it was 7.05 days in the discordant group (P = 0.003). There was a statistically significant increase in percentage mortality in patients when initial and final diagnoses did not match (P = 0.0005).

Conclusions:

A diagnostic discrepancy of 27.65% occurred between admission diagnosis in the medical emergency room and final diagnosis in ward. The diagnostic discrepancy resulted in a significant increase in the length of hospital stay and mortality.
Factors affecting surgically induced astigmatism in manual small-incision cataract surgery
Authors: Gupta Smriti Nagpal , Goel Ruchi , Kumar Sushil
Published: October 2022

Cataract is the most common cause of avoidable blindness in the world. While cataract surgery is continually evolving, manual small-incision cataract surgery (MSICS) still remains highly relevant, especially with the threat of the coronavirus disease 2019 (COVID-19) still looming large over the world. MSICS today has a renewed significance, since it does not involve the use of any advanced machinery and relies mainly on easily sterilizable instruments, thereby making it a safe and inexpensive option. A self-sealing valvular tunnel entry forms the basis of MSICS, and proper positioning and construction of the tunnel is imperative to the success of the surgery. With more and more people demanding spectacle independence after surgery, it becomes important to have a thorough understanding of the factors that may influence surgically induced astigmatism in MSICS. These include the incision location, size and shape, configuration of the sclero-corneal tunnel, pre-existing ocular pathology, role of sutures, amongst others. With proper knowledge, many of these factors can be modulated to achieve best results.
Study of changes in pre-existing against-the-rule astigmatism after temporal manual small-incision cataract surgery using frown, straight, and smile incisions
Authors: Soumya H V , Yadav Prashansa , Prabhakar S K
Published: October 2022

Purpose:

To assess the change in the amount of astigmatism caused by frown, straight, and smile incision in patients with pre-existing against-the-rule (ATR) astigmatism of more than and equal to 1 diopter

Methods:

This is a prospective, comparative study conducted over 18 months on 60 patients. Twenty patients were allocated to each incision using simple random sampling. Demographic details, best-corrected visual acuity (BCVA), intraocular pressure (IOP), anterior and posterior segment evaluation, and A-scan were done. An average of three measurements of K horizontal (Khavg), K vertical (Kvavg), and difference between the two (Khavg − Kvavg) were taken using manual keratometry. All surgeries were performed by a single surgeon. All the data analyses were performed by using IBM Statistical Package for the Social Sciences (SPSS) version 20 software. Frequency distribution and cross tabulation were performed to prepare the tables.

Results:

In frown incision, Khavg − Kvavg was significantly decreased on day 45 from the preoperative value (P < 0.001), followed by straight incision (P < 0.001), and smile incision (P < 0.001). Maximum decrease was observed in frown incision (49.15%) followed by straight (37.75%) and smile (28.57%) incisions.

Conclusion:

Our results are consistent with reduction of pre-existing ATR astigmatism with temporal incisions, and frown incision seems to be the best approach.
Customized incision cataract surgery
Authors: Boramani Jagannath , Bali Jatinder , Boramani Priyanka , Bali Ojasvini
Published: October 2022

Advanced instrumentation and intraocular lenses (IOL) allow great refractive and visual outcome control to permit excellent correction of refractive aberrations. Residual astigmatism can be modified to provide depth of focus using an appropriate incision in the steepest meridian in manual small-incision cataract surgery (MSICS). The authors describe the nomogram for surgically correcting astigmatism (SCA). This technique can handle preoperative astigmatism of about 2.25 DCyl with the standard incisions—straight incision of 5, 6, and 7 mm in length, the minimally curved frown incision, the frown incision, the frown incision with an accentuated frown, and the U incision placed on the steep axis in the superior or the temporal quadrant depending on the axis of pre-operative astigmatism.
Technique modifications in manual small-incision cataract surgery for left-handed cataract surgeons
Authors: Mukherjee Amrita , Kalamkar Charudutt , Rao Rohit , Patel Bhavin
Published: October 2022

Learning manual small-incision cataract surgery (SICS) is essential for ophthalmic surgeons as it provides an alternative to phaco-emulsification in complicated cases. Nearly 10% of ophthalmic surgeons are left-handed. Left-handed surgeons do face more difficulties because of their laterality, which have been highlighted in various surveys even in other surgical specialities. Surgical training programs, residency programs, and fellowships have traditionally been designed considering the right hand as the dominant hand. Left-handed surgeons (LHSs) are at disadvantage as they are trained by right-handed surgeons (RHSs), which may result in more initial intra-operative errors. Intra-ocular lenses are also designed such that dialing into the bag is relatively difficult for LHSs. Developing customized training modules for LHSs can help them overcome the laterality challenges and enhance their surgical capabilities. In this article, we herein present a brief description of the SICS technique for LHSs, elaborating the crucial steps and customized maneuvers that, if performed differently, may make surgeries easier for them.
Long-term outcomes of small-incision cataract surgery in patients with uveitis
Authors: Bhargava Rahul , Pandey Kankambari , Mehta Bhavya
Published: October 2022

Purpose:

To evaluate the long-term outcomes of manual small-incision cataract surgery (MSICS) in eyes with uveitis.

Methods:

Patients who underwent MSICS for uveitic cataract from 2009 to 2019 were retrospectively evaluated. Visually significant cataract and presence of less than five cells per high-power field in the anterior chamber for a minimum of 3 months were the prerequisites for surgery. Patients with follow-up less than 9 months were excluded.

Results:

After exclusion, 283 eyes of 264 patients were evaluated. The mean age of patients was 44.3 ± 11.3 years. The mean follow-up duration was 22 ± 11.5 months. The mean surgical time was 11.2 ± 3.2 min. One hundred and seventy-two eyes (60.8%) had anterior uveitis, 78 (27.5%) had posterior uveitis, and 33 (11.7%) had panuveitis. At the final follow-up, 253 eyes (88.4%) had corrected distance visual acuity (CDVA) better than 0.6 log of minimum angle of resolution (LogMAR) unit. The final endothelial cell counts were significantly (analysis of variance [ANOVA], P = 0.001) lower in eyes with human leukocyte antigen (HLA)-B27–associated uveitis and in eyes with idiopathic anterior uveitis. Patients on systemic corticosteroids had significantly better (P = 0.031) final visual acuity than those without preoperative corticosteroids. Recurrent uveitis (43.8%), Posterior capsule opacification (PCO) (19.4%), glaucoma (8.5%), cystoid macular edema (CME; 13.5%), and Epiretinal membrane (ERM) (5.6%) were the frequent complications. A significantly worse (ANOVA, P = 0.001) visual prognosis was seen in patients with Vogt–Koyanagi–Harada disease (VKH), sarcoidosis, acute posterior multifocal placoid pigment epitheliopathy (APMPPE), and serpiginous choroiditis.

Conclusion:

MSICS is safe in most cataracts due to uveitis and results in improvement in CDVA at 9 months. Posterior capsule opacification, macular edema, persistent uveitis, etiology of uveitis, and use of preoperative steroids significantly influenced the visual outcome.
Siep’s test
Authors: Gadavi Binita N , Pai Aditi , Kamath MAtul , Bhosale Dhananjay A , Gohel Devdatta J
Published: October 2022

Purpose:

This study was conducted to ensure the integrity of surgery wounds.

Methods:

This was a randomized prospective trial of 300 patients who underwent small-incision cataract surgery (SICS) at our hospital over a one-year period. We used 2–3 drops of 5% povidone-iodine at the end of each case, not only to disclose any wound leaks but also to sterilize the surface of the eye.

Results:

Three hundred patients underwent SICS. One hundred ten patients had postoperative wound leak in SICS due to surgical complications. Premature entry comprising 75% (83 cases), followed by floppy iris syndrome comprising 20% (22 cases) and 5% (6 cases) comprising pseudoexfoliation (PXF) syndrome. There was a drop in the number of re-surgeries from 12 to 3 cases since we started implementing this technique.

Conclusion:

The simple procedure is very handy and economical in identifying the leak and can reduce further complications such as endophthalmitis and re-surgeries. Among residents, this can be a boon where povidone-iodine acts as a riverbank for the outflow of aqueous, outlining the speed, location, and quantity of the leak. Siep’s test plays an important role in identifying any postoperative wound leaks and also sterilizing the eye surface post surgery.
Comparison of surgically induced astigmatism in chevron, straight, and frown incisions in manual small-incision cataract surgery
Authors: Rathi Manisha , Dabas Ruchi , Verma Ritesh , Rustagi Inder M , Mathur Satanshu , Dhania Sweety
Published: October 2022

Purpose:

The study was conducted to calculate and compare the surgically induced astigmatism (SIA) in chevron, frown, and straight incisions in manual small-incision cataract surgery (MSICS).

Methods:

A prospective, hospital-based study was conducted on 90 patients aged 50 years and above with nuclear sclerosis of grade 4 or more. Each group had 30 patients, divided into Group V (chevron incision), Group S (straight incision), and Group F (frown incision). Patients who had with-the-rule (WTR) astigmatism were operated on through a chevron or straight incision superiorly, while patients who had against-the-rule (ATR) astigmatism underwent MSICS through a temporal frown incision. The patients were followed up post-operatively on days 1, 7, 6 weeks, and 12 weeks, and at each visit, the uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and SIA were calculated and compared.

Results:

The mean age of all the patients was 66.22 ± 8.05 years. BCVA of at least 6/18 or better at 12 weeks post-operatively was achieved in 29 patients (97%) in Group V, 28 patients (93%) in Group F, and 29 patients (97%) in Group S. The mean SIA in Group V was 0.34D ± 0.22D, in Group S was 0.97D ± 0.29D, and in Group F was 0.575D ± 0.25D.

Conclusion:

SIA by chevron incision is the least followed by the frown incision and straight incision. The superiorly placed chevron incision in WTR astigmatism provided optimal results for the best UCVA and minimal SIA. The temporal frown incision in ATR astigmatism also had good results.
Comparison of different endophthalmitis prophylactic measures in cataract surgery - An analysis of 2.4 lakh cases
Authors: Reddy Jagadeesh Kumar , Sundaram Vandhana , Dani Samruddhi , Shah Neeraj , Ingawale Ameya , Pooja C M
Published: October 2022

Purpose:

To compare different endophthalmitis prophylaxis methods adopted in cataract surgery (manual small-incision cataract surgery and phacoemulsification) between the years 2013 and 2021 in the community eye care section of a tertiary eye care hospital in South India and report their outcomes.

Methods:

All cataract surgeries performed from January 2013 to December 2021 (2,46,874 surgeries) at a single center were included in this retrospective study. The different endophthalmitis rates with each regimen were analyzed and evaluated.

Results:

70,081 surgeries were performed from January 2013 to February 2015, where Tobramycin was added to Balanced Salt Solution (BSS) (Group A). From March 2015 to January 2017, 63,245 surgeries were performed when intracameral Moxifloxacin was given (Group B). From February 2017 to December 2021, 1,13,548 surgeries were performed were Amikacin was added to BSS (Group C). In total, 42 cases of postoperative endophthalmitis were reported during the study period (0.02%). There was no significant difference in the endophthalmitis rates between groups A and B (P = 0.4152); however, there was a significant decrease in endophthalmitis rates in group C when compared with group A (P = 0.04) and group B (P = 0.006).

Conclusion:

There was a significant reduction in the rates of endophthalmitis following the addition of amikacin in irrigating BSS. Nocardia was one of the predominant organisms isolated from these endophthalmitis patients. This is the first single-center study to report a comparative analysis of different endophthalmitis prophylactic measures in a community eye care set up with a high incidence of Nocardia endophthalmitis prevented with amikacin in BSS irrigating solution.
Correction of pre-existing astigmatism by on-axis incision size modulation in manual small-incision cataract surgery
Authors: Goel Ruchi , Sontakke Ruchita , Shah Shalin , Nagpal Vaibhav , Kumar Sushil , Koli Omeshwer , Ojha Shweta , Saini Swati , Arya Deepanjali
Published: October 2022

Purpose:

To study the effect of wound size modulation on pre-existing astigmatism by on-axis placement of incision in manual small-incision cataract surgery (MSICS).

Methods:

In this prospective interventional study conducted at a tertiary care centre, 40 eyes of 40 consecutive senile cataract patients with 1.00–3.00 D corneal astigmatism were enrolled for the study. MSICS by modified Blumenthal’s technique was performed through 6.0, 6.5, and 7.0 mm on-axis incision in 1.0–1.49 D (group A), 1.50–1.99 D (group B), and 2.00–3.00 D (group C) astigmatism, respectively. Surgically induced astigmatism (SIA) was calculated by vector analysis and double angle plots (DAP) at 12 weeks postoperatively.

Results:

There were 22 males and 18 females with mean age of 58.12 ± 1.18 years. The mean SIA at 12 weeks was 0.85 ± 0.28 D in group A (17 eyes), 1.32 ± 0.65 D in group B (10 eyes), and 1.91 ± 0.69 D in group C (13 eyes). The overall median uncorrected visual acuity was 0.18 (IQR = 0 to 0.2). The mean astigmatism decreased from 1.95 ± 0.74 D to 1.04 + 0.57 D (P= 0.00) in superior incision and from 1.70 + 0.50 D to 0.92 ± 0.45 D (P= 0.00) in temporal incision group with central shift of centroid in all cases.

Conclusion:

The customization of on-axis external incision size can be used to manage pre-existing corneal astigmatism of less than 3.00 D using both temporal and superior incisions effectively.
Comparative study between conventional and 4 mm manual small-incision cataract surgery
Authors: Chauhan Ravi A , Agrawal Sachin O , Sawarkar Radhika R , Agrawal Sanjay
Published: October 2022

Purpose:

Comparative study of intraoperative and postoperative complications, visual outcomes, and cost-effectiveness between conventional and 4-mm manual small-incision cataract surgery with MVR blade.

Methods:

In total, 600 patients having nuclear sclerosis grade I–IV were operated under peribulbar anesthesia and were divided into two groups of 300 each. In group A (300), conventional small-incision cataract surgery was done, whereas in group B (300), 4-mm manual small-incision cataract surgery was performed through a 4-mm sclerocorneal tunnel. A wire vectis was passed through the 4-mm incision below the nucleus to stabilize it, and a 20-G MVR blade was introduced from 11o’clock limbus and nucleus was bisected into two halves, which were removed through main incision. Cortical wash was given, and foldable IOL was implanted. Intraoperative and postoperative complications between the two groups were compared. Postoperative visual outcome and surgically induced astigmatism between the two groups was studied.

Results:

The most common intraoperative complication was hyphema (11.33%) and irido-dialysis (8.00%), whereas postoperatively, striate keratopathy (36.33%) and hyphema (19.33%) were common. Short-term complications such as striate keratopathy, hyphema, and irido-dialysis were significantly more in group B, and long-term results in terms of visual outcome and surgically induced astigmatism were significantly less in group B.

Conclusion:

Although intraoperative and short-term postoperative complications were observed more in 4-mm manual small-incision cataract surgery, it was found to be more effective in terms of surgically induced astigmatism and final visual outcome. In addition, it is cost-effective as compared to phacoemulsification.
Incidence of re-surgery after manual small-incision cataract surgery at a tertiary eye-care center in South India
Authors: Shetty Prerana A , Bhalerao Sushank A , Vuyyuru Sowjanya , Thigale Uma Y , Satyanarayana Devara , Mallipudi Rajavardhan
Published: October 2022

Purpose:

To study the incidence of re-surgery after manual small-incision cataract surgery (MSICS) at a tertiary eye-care center in South India and to compare the re-surgery rate between trainees and experts.

Methods:

A retrospective study was conducted at a tertiary eye-care center in Andhra Pradesh state of South India, which included 19,515 patients who underwent MSICS between 2012 and 2022 with 369 eyes of 369 patients who underwent re-surgery within 1 week of primary surgery. Factors included demographic data, type of re-surgery, that is, wound re-suturing, IOL repositioning, cortical wash, as well as anterior chamber (AC) wash.

Results:

19,515 eyes from the year 2012–2022 were analyzed. Most of the patients undergoing re-surgery belonged to the age group of 61–70 years (40.3%). Wound re-suturing was the more frequently performed re-surgery (47.6%). Wound re-suturing rates were comparable between the trainees and experts, whereas IOL repositioning, cortical wash, and AC wash were higher in the cases performed by trainees though statistically not significant.

Conclusion:

Careful pre-operative assessment, training under supervision, and other measures can be taken to reduce the re-surgery rates. Timely diagnosis and early treatment can give better outcomes and prevent devastating complications like endophthalmitis.
Regurgitation on pressure over the lacrimal sac versus lacrimal irrigation in determining lacrimal obstruction prior to intraocular surgeries
Authors: Kim Usha , Vardhan Ashok , Datta Dipankar , Mekhala Amirtha , Kishore Nanda , Rathi Gunjan , Hildebrand P Lloyd
Published: October 2022

Purpose:

To determine the diagnostic accuracy of manual regurgitation on pressure over the lacrimal sac (ROPLAS) versus lacrimal irrigation for screening nasolacrimal duct obstruction (NLDO) in adults prior to intraocular surgeries.

Methods:

This cross-sectional study took place in a tertiary eye care hospital in South Tamil Nadu, India. From January to December 2017 and included consecutive patients who presented for routine cataract surgery. Prospective data collection occurred in 8369 eyes of patients who underwent cataract surgery. All patients underwent ROPLAS testing by an ophthalmologist followed by lacrimal irrigation by trained ophthalmic assistants, rechecked or confirmed in equivocal cases by ophthalmologists who were masked to the ROPLAS status. The primary outcome, the sensitivity, specificity, positive, and negative predictive values to detect lacrimal occlusion by ROPLAS compared with lacrimal irrigation with 95% confidence intervals was estimated.

Results:

A total of 8369 eyes underwent cataract surgery during the time periods of the study. ROPLAS and lacrimal irrigation were performed in all eyes. The sensitivity of ROPLAS to diagnose NLDO correctly was 54.5% (95% CI, 44.8%–63.9%) and its specificity was 100% (95% CI, 100%–100%). The positive and negative predictive values were 75.3% (95% CI, 65.6%-83.0%) and 99.4% (95% CI, 99.2%–99.5%), respectively.

Conclusion:

We found that ROPLAS when used alone had very low sensitivity and low positive predictive value in detecting NLDO prior to cataract surgery as compared with lacrimal irrigation. Hence, we recommend performing ROPLAS and lacrimal irrigation in every patient as part of the routine preoperative workup prior to cataract surgery.
Embracing technology in cataract surgical training – The way forward
Authors: Lansingh Van C , Ravindran Ravilla D , Garg Prashant , Fernandes Merle , Nair Akshay Gopinathan , Gogate Parikshit J , Natarajan Sundaram , Swaminathan Meenakshi , Bachhav Ashish E , Gandhi Rashmin A
Published: October 2022

While ophthalmology as a surgical branch itself has evolved technologically with newer instruments, techniques and procedures; ophthalmic surgical training appears to have stagnated in terms of how it is delivered and how trainees’ learning and performance are assessed. This collaborative editorial attempts to identify the lacunae in ophthalmic residency training and highlight how technological tools such as surgical simulators can be incorporated into ophthalmic training even in limited-resource settings with good results.
Comparison of the outcomes of phacoemulsification and manual small-incision cataract surgery in posterior polar cataract - A retrospective study
Authors: Pathak Madhumallika , Odayappan Annamalai , Nath Manas , Raman Ramalakshmi , Bhandari Sahil , Nachiappan Sivagami
Published: October 2022

Purpose:

To compare the visual outcomes and intraoperative complications between phacoemulsification and manual small-incision cataract surgery (MSICS) in cases of posterior polar cataract (PPC).

Methods:

A retrospective study was carried out involving 142 patients (164 eyes) with PPC who underwent cataract surgery between January and December 2017. Data collected include the demographic details, preoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), type of cataract, intraocular pressure, anterior and posterior segment findings, type of surgery performed, intraoperative complications, postoperative UCVA on the first day, UCVA and BCVA at 1 month after surgery, complications, and resurgery details.

Results:

In total, 90 patients (107 eyes) underwent phacoemulsification, and 52 patients (57 eyes) underwent MSICS. There was no significant difference in the mean age, sex, and type of PPC between the two groups (P = 0.326, 0.852, and 0.220, respectively). Patients who underwent phacoemulsification had significantly better preoperative BCVA (P = 0.002). The BCVA on first postoperative day and 1 month after surgery was better in the phacoemulsification group than in the MSICS group (P < 0.001 and 0.002, respectively). The overall incidence of posterior capsular rupture (PCR) was 11.6%, which included the 10.3% in phacoemulsification and 14.0% in MSICS. There was, however, no significant difference in the rates of PCR between the two groups (P = 0.506).

Conclusion:

Phacoemulsification delivered better postoperative visual outcomes than MSICS in PPC patients, whereas the complication rates were similar between the two groups.
Stabilization of refraction and timing of spectacle prescription following manual small-incision cataract surgery
Authors: Pattanayak Sabyasachi , Patra S Hari Sankar , Nanda Ashok Kumar , Subudhi Praveen
Published: October 2022

Purpose:

To determine the stabilization of refraction at 2 weeks following MSICS by comparing the difference in spherical, cylindrical component and also spherical equivalent of refraction of 2 weeks follow-up with that of 6 weeks following surgery.

Methods:

The difference of spherical, cylindrical component and also spherical equivalent of refraction at 2 weeks and 6 weeks follow-up of 194 eyes that underwent uncomplicated MSICS with implantation of PMMA IOL conducted by a single experienced surgeon were compared to find out the amount of change and its significance was statistically tested by Wilcoxon-Signed Rank Test.

Results:

The difference in spherical power (0.04 ± 0.30), cylinder power (0.03 ± 0.40), and spherical equivalent (0.06 ± 0.34) were very small and not significant statistically (P-value ≤0.05).

Conclusion:

Necessary spectacle correction can safely be prescribed after 2 weeks following MSICS as subjective refraction stabilizes by that time without undergoing significant change. However, our observation was applicable in patients who had an uneventful cataract surgery without any risk factor, which can delay wound healing or cause poor visual outcome.
Association between physical activity and serum liver aminotransferases in Southwestern Iran
Authors: Badiei Sajad , Hashemi Seyed Jalal , Masjedizadeh Abdolrahim , Sayyah Jalal , Mohammadi Zahra , Hariri Sanam , Hashemi Farnaz , Rahimi Zahra , Danehchin Leila , Abolnezhadian Farhad , Malihi Reza , Paridar Yousef , Mard Seyyed Ali , Cheraghian Bahman , Poustchi Hossein , Shayesteh Ali Akbar
Published: October 2022

Background:

The main aim of the present study is to investigate the independent association objectively measured level of physical activity (PA) and serum concentration of liver aminotransferases (alanine aminotransferase [ALT] and aspartate aminotransferase [AST]) among seemingly healthy individuals.

Materials and Methods:

The current secondary study was conducted in the framework of Khuzestan Comprehensive Health Study, a large population-based multicentric cross-sectional study, conducted between 2016 and 2019 on 18,966 individuals living in Khuzestan province, southwestern Iran. International PA Questionnaire was used for evaluating PA levels, and participants were divided into three groups: low, moderate, and high PA, and ALT and AST were compared between these groups.

Results:

The mean ± standard deviation age of participants was 38.65 ± 11.40 years. The majority of participants were female (71%). The mean concentration of ALT in total sample was 18.22 ± 13.06 (male: 23.65 ± 16.26 and female: 15.57 ± 10.06), while the mean concentration of ALT in total sample was 19.61 ± 8.40 (male: 22.44 ± 10.03 and female: 18.23 ± 7.08). A statistically significant inverse correlation was found between AST (r = −0.08, P = 0.02) and ALT (r = −0.038, P < 0.001) with total PA score. The mean concentration of ALT was 19.96 ± 13.63 in people with low PA, 17.62 ± 12.31 with moderate PA, and 18.12 ± 13.47 with high PA (P < 0.001). The mean concentration of AST in total sample was 20.37 ± 8.85 in people with low PA, 19.21 ± 8.83 with moderate PA, and 19.75 ± 8.85 with high PA (P < 0.001). The difference between people in different levels of PA in terms of mean concentration of AST was remained significant (P = 0.003); however, the difference for ALT was not remained significant after adjusting potential confounders.

Conclusion:

The current study based on large sample showed that PA had a statistically negative association with the concentration of liver aminotransferases in the seemingly healthy individuals; however, the observed associations were weak. People in the lowest levels of PA had the highest levels of ALT and AST.
Индекс Маслова на симплектических многообразиях.
С дополнением А. Т. Фоменко
"Построение обобщенного класса Маслова
для тотального пространства $W=\mathbb{T}^*(M)$ кокасательного расслоения"
Authors: Mishchenko Alexandr Sergeevich
Published: October 2022

Мы обсуждаем геометрические свойства индекса Маслова
на симплектических многообразиях.
Индекс Маслова строится как гомологический инвариант
на лагранжевом подмногообразии
некоторого симплектического многообразия. В простейшем случае
лагранжево подмногообразие $\Lambda\subset \mathbb{R}^{2n}\approx
\mathbb{R}^{n}\oplus\mathbb{R}^{n}$ - это подмногообразие
в симплектическом пространстве $\mathbb{R}^{n}\oplus\mathbb{R}^{n}$,
симплектическая структура в котором задается невырожденной формой
$\omega=\sum_{i=1}^n dx^{i}\wedge dy^{i}$,
а $\Lambda\subset\mathbb{R}^{2n}$ - это подмногообразие,
$\dim\Lambda=n$, на котором форма $\omega$ тривиальна.
В общем случае рассматривается симплектическое многообразие
$(W,\omega)$ и расслоение лагранжевых грассманианов
$\mathcal{LG}(\mathbb{T}W)$. Вопрос, который нас интересует
заключается в следующем: когда индекс Маслова,
заданный на индивидуальном лагранжевом многообразии
как одномерный класс когомологий, является образом
некоторого одномерного класса когомологий тотального пространства
$\mathcal{LG}(\mathbb{T}W)$ расслоения лагранжевых грассманианов.
Дается ответ для различных классов расслоений
лагранжевых грассманианов.
Библиография: 6 названий.
Pivotal Weak Turaev $\pi$-Coalgebras
Authors: Xiaohui Zhang , Shuangjian Guo , Shengxiang Wang
Published: October 2022

In this paper, we first introduce the notion of the
$\pi$-pivotal elements in a weak
Turaev
$\pi$-coalgebra
$H$
and show that the representation category of
$H$
is a pivotal crossed category if and only
if there is a
$\pi$-pivotal element in
$H$.
Also we discuss the relation between
$\pi$-pivotal elements and
$\pi$-ribbon elements of
a quasitriangular weak Turaev
$\pi$-coalgebra.
Finally, we obtain a generalized Deligne Type theorem.
HIV-Associated Dementia: Associated Factors and Characteristics of Cognitive Domain Abnormalities in Elderly People Living with HIV Treated with Highly Active Antiretroviral Therapy
Authors: Boonyagars Lakkana , Kiatsoongsong Nucharee , Winitprichagul Supharat
Published: October 2022

This study aimed to evaluate the prevalence and associated factors of HIV-associated dementia (HAD) in people living with HIV (PLWH) aged ≥ 60 years who are currently treated with highly active antiretroviral therapy. A cross-sectional study was conducted on adult (age ≥ 60 years) PLWH at the infectious clinic, Vajira Hospital, Navamindradhiraj University, Thailand, between August 2019 and March 2021. We collected the patients’ characteristics and performed Montreal Cognitive Assessment and Instrumental Activities of Daily Living test to determine whether they have HIV-associated neurocognitive disorders (HAND), which we further classified into asymptomatic neurocognitive impairment (ANI), mild neurocognitive disorder (MND), and HAD. Finally, we evaluated the prevalence, associated factors, and characteristics of cognitive domain abnormalities in these patients. We enrolled 84 elderly PLWH patients consisting of 43 (51.2%) males. The mean patient age was 63 years (SD ± 3.9), and the median duration of HIV infection was 13 (SD ± 5.7) years. All the patients had undetectable HIV viral load. Among them, seven (8.3%) had no neurocognitive impairment, 61 (72.6%) had ANI, three (3.6%) had MND, and 13 (15.5%) had HAD. After confounder adjustment, the patient age of ≥ 65 years was found to be significantly associated with dementia (odds ratio = 5.97, 95% CI: 1.51–23.57). Significant difference in the mean score of all cognitive domains was observed between the patients with HAD and those with normal cognitive status. HAND is common in PLWH. Age older than ≥ 65 years is a risk factor of HAD.
Limited Capacity for Aedes aegypti to Mechanically Transmit Chikungunya Virus and Dengue Virus
Authors: Bransfield Angela B. , Misencik Michael J. , Brackney Doug E. , Armstrong Philip M.
Published: October 2022

Mechanical transmission is an understudied mode of arbovirus transmission that occurs when a biting insect transmits virus among hosts by the direct transfer of virus particles contaminating its mouthparts. Multiple arboviruses have been shown to be capable of utilizing this transmission route, but most studies were conducted 40 to 70 years ago using dated methodologies. To gain a better understanding of this phenomenon, we used molecular techniques to evaluate the efficiency of mechanical transmission by Aedes aegypti mosquitoes for two evolutionarily divergent arboviruses, chikungunya virus (CHIKV) and dengue virus (DENV). Viral RNA and/or infectious DENV could be detected on 13.8% of mosquito proboscises sampled immediately after an infectious bloodmeal, but positivity rates declined within hours. CHIKV RNA and/or infectious virus was detected on 38.8% of proboscises immediately after feeding but positivity rates dropped to 2.5% within 4 hours. RNA copy numbers were low for both viruses, and we were unable to demonstrate mechanical transmission of CHIKV using an established animal model, suggesting that this mode of transmission is unlikely under natural conditions.
Historical and contemporary factors that influenced the emergence and continuity of WANEL: Lessons for sustainable HPSR network formation in LMICs
Authors: Defor Selina , Lehmann Uta , Godt Sue , Sombie Issiaka , A. Agyepong Irene
Published: October 2022

Objectives: To explore historical and contemporary factors and processes that influenced the emergence of WANEL and analyse how the formation process has influenced the network’s continued existence and sustainability and lesson for sub-regional health policy and systems research (HPSR) networking in Low –and –Middle –Income Countries (LMICs)Design: Qualitative explanatory case study which used process tracing to chart the formation and development of WANEL.Methods: Data was obtained through document reviews, semi-structured interviews, group discussions, and partici-pant observation. Data was analysed using thematic content analysis.Results: The emergence of WANEL was made possible by several factors, including support from a network of senior HPSR champions and institutions across West Africa; sustained funding from IDRC Canada, a reputable funder with a track record in supporting research capacity development in LMICs; learning and networking opportunities provided by CHEPSAA Emerging Leaders and the Institute of Tropical Medicine Antwerp Emerging Voices for Global Health initiative. Its formation followed a mix of emergent and engineered processes.Conclusion: WANEL is the first and currently the only sub-regional network for early and mid-career health policy and systems researchers and practitioners in West Africa. To ensure its long-term sustainability, the network needs to put in place mechanisms to constantly attract and develop the next generation of early and mid-career researchers, maintain links with senior researchers, strengthen its capacity for coordination and facilitation, and develop a plan for its long-term financial sustainability.
Sexual behaviours and their associated factors among young people in the Dodowa Health and Demographic Surveillance Site (DHDSS) in Ghana
Authors: P. Agyekum Mary , O. Agyekum Enoch , Adjei Alexander , Asare Kwabena , E. Akpakli David , Asiamah Sabina , Tsey Irene , Amankwah Georgina , K. Manyeh Alfred , E. O. Williams John , A. Ross David
Published: October 2022

Objective: This paper describes sexual behaviours and their associated factors among young people.Design: The study design is cross-sectional.Setting: Dodowa Health and Demographic Surveillance Site (DHDSS) in Ghana’s Shai-Osudoku and Ningo Prampram districts.Participants: Young people aged 10 to 24 years, median age 17 years.Outcome measures: Self-reported to have ever had sex, non-use of a condom at last sex, and ever been pregnant or gotten someone pregnant.Results: Of the 1689 young people; 42% reported having ever had sex, not using a condom at last sexual activity (64%), and ever been pregnant or gotten someone pregnant (41%). The proportion of non-use of condoms at last sex was high across all age groups but was highest (93%) in a small proportion of 10 to 14-year-olds who have ever had sex. Higher proportions of females than males; were reported to have ever had sex (46%), not using a condom at their last sex (66%) and ever been pregnant or getting someone pregnant (56%). Age group (20 to 24), females, primary or junior high school, living alone and lower household socio-economic status were risk factors associated with all three outcome measures.Conclusion: Risky sexual behaviour is high among young people in the Dodowa HDSS. Therefore, interventions that promote safer sexual practices and help young people make timely decisions on their sexual and reproductive health care needs are required.
Let the precious hidden values shine brightly: A collective project with high school boys
Authors: Ahmadi Fariba
Published: October 2022

This paper documents collective narrative practice in an Australian high school with students from refugee backgrounds and their families. Teachers were concerned about the students’truancy and their behaviour in class. I met with a group of boys to develop a counter story of their knowledge about respect. Drawing on their family and cultural backgrounds, the boys shared rich understandings about ways of demonstrating respect, and about its value. The documents they developed will be shared with their school community and with young people at other schools.
Environmental Education in South African Schools: The Role of Civil Society Organizations
Authors: Damoah Benjamin , Adu Emmanuel Olusola
Published: October 2022

Environmental education (EE) is an integrated component of the South African Curriculum and Assessment Policy Statement (CAPS) document. Pro-EE civil society organisations are actively involved in the implementation of EE policies in schools. The roles played by civil society organisations contribute to the trajectory of practical environmental programmes. This study adopted an interpretive paradigm, a qualitative approach, and a phenomenological design anchored on Bronfenbrenner's philosophical view of human development. One Pro-EE civil society organisation and two respondents were purposefully sampled. Semi-structured interviews and documents were tools employed to collect qualitative data and results were analysed thematically. The study revealed that Pro-EE civil society organisations play a pivotal role which includes; equipping learners to live sustainably, teachers’ professional development, policy formulation, and implementation that actualizes the CAPS document's objectives. The study recommended that the South School Act be amended to make EE  policy mandatory. The department of basic education (DBE) should provide sufficient resources to Pro-EE civil society organisations to expand Eco-Schools project-based initiatives in schools regardless of the geographical location.