bluuebunny/crossref_metadata_2025 huggingface dataset:
The The Effects of Massage Therapy on a Patient with Migraines and Cervical Spondylosis: a Case Report
Authors: Rostron, RMT Sarah
Published: September 2021

Background: Migraines involve moderate- to-severe neck and face pain that lasts four to 72 hours, and are followed by fatigue and stiffness. Migraines are treated using medications, massage therapy (MT), and non-pharmacological alternatives. Cervical spondylosis (CS) is characterized by degeneration of the intervertebral discs, neck pain, and involvement of soft tissues in the cervical area. CS is treated using medications and manual therapy, including MT.

Objective: To determine the effects of MT on cervical range of motion and daily function in a patient with migraines and CS.

Case Presentation: The patient was an active 56-year-old female diagnosed with migraines and CS. Initial evaluation included cervical range of motion (ROM), goniometry, reflexes, myotomes, dermatomes, local sensation testing and orthopedic tests. Assessment was followed by five MT treatments. Swedish massage, myofascial trigger point release, and proprioceptive neuromuscular facilitation (PNF) stretching were applied to the back, neck, head, and face. The Headache Disability Index (HDI) was administered on the initial and final visits to evaluate patient function. Cervical ROM was measured pre- and posttreatment using a universal goniometer. Treatment was conducted by a second-year MT student at the MacEwan Massage Therapy Teaching Clinic in Edmonton, Alberta.

Results: All cervical ranges of motion improved. The Headache Disability Index score decreased, but was not considered significant. The patient reported decreased stiffness in the upper back and shoulders, reduced migraines, and better sleeping patterns after the MT intervention.

Conclusion: MT was effective in increasing cervical ROM, but had no significant effect on daily function. Further research is warranted on effects of MT on CS and migraines.
Numerical Study of Two Injection Methods for the 2007 November 15 Coronal Mass Ejection in the Inner Heliosphere
Authors: Zhang Man , Feng Xueshang , Shen Fang , Yang Liping
Published: September 2021

In this paper, we use two injection methods, i.e., coronal mass ejection (CME) with and without radial compression, to investigate the propagation of the 2007 November 15 CME in the inner heliosphere with a three-dimensional, time-dependent, numerical magnetohydrodynamic model. In order to reproduce the large-scale interplanetary magnetic field associated with the CME, the spheromak model is used to provide the intrinsic magnetic field structure of the CME. The modeled results also suggest that the CME without radial compression propagates in interplanetary space with a lower velocity and arrives at 1 au later. We interpret these differences as a result of different Lorentz forces acting on the two injection methods, which lead to different CME expansions in the heliosphere. Additionally, the model of a CME without radial compression tends to overestimate the radial extension at 1 au due to an overestimation of the CME radial size in the simulation and the modeled magnetic fields at 1 au are lower compared to the model of a CME with radial compression. The above results are all useful in understanding the dynamic process occurring between the CME and the solar wind.
Brown Dwarfs are Violet: A New Calculation of Human-eye Colors of Main-sequence Stars and Substellar Objects
Authors: Cranmer Steven R.
Published: September 2021

There has always been interest in the perceived colors of stars. They were key to the development of the Hertzsprung–Russell diagram, and they are also used widely in educational and public-outreach imagery. Thus, it is useful to develop tools to compute these colors from spectral energy distributions. This paper presents a collection of objective (CIE coordinate) and subjective (RGB triple) colors for main-sequence stars and brown dwarfs, as well as links to related codes and tables. Using the proposed conversion from CIE to RGB colors, O and B stars are bluer than equivalent blackbodies because of Paschen continuum absorption, and M dwarfs tend to be less red and more beige. Although brown dwarfs over a wide range of effective temperatures (400–2000 K) emit most of their flux in the infrared, their visible spectra are dominated by short wavelengths. Thus, they may appear violet to human eyes.
Family Experience during Patient Assistance Process in General Intensive Care Unit: A Phenomenology Study
Authors: Safitri Dwi , Kurnia Anna , Al Jihad Much
Published: September 2021

BACKGROUND: Intensive care unit (ICU) treatment can lead to fear, anxiety, depression, panic, and tension in the family. Place of the family as active presence, guardian, facilitator, historian, and coaching of the family cannot be separated from the recovery process. During the assistance of ICU patients, the family is faced with a strange environment, strict rules, emotional stress, and everyday life changes that have caused them to encounter psychological and physiological concerns.
AIM: This study aims to describe and interpret of the family’s experience during assistance patient in the ICU.
METHODS: A phenomenological methodology is used to explore experience of family. In-depth interviews were conducted on nine participants who were selected using purposive sampling. Data were analyzed by Colaizzi techniques, began with read transcripts, look for phenomenon, formulated data, organized, and verified to the participants.
RESULTS: The result is presented in three themes; physically and psychologically tired; good language is a medicine, strengthens each other’s companion.
CONCLUSION: The support of the patient in the ICU helps the family face a number of stressful circumstances. Adaptive coping and psychosocial help from health care workers and friends build a supportive family to cope with the difficulties when supporting patients in the ICU.
Clinique éducative et bienveillance
Authors: Royer Anne-Marie
Published: September 2021

L’auteure décrit avec une grande précision clinique le cas d’une adolescente aux prises avec une mère à forte emprise sur ses enfants, elle notamment. Elle subit également de mauvais traitements dans sa famille et adopte un comportement passif, ne suivant plus de scolarité, fuguant de son foyer et ne parlant guère aux éducateurs qui la suivent. Le changement interviendra avec le confinement dû au Covid. Son éducatrice acceptera de la prendre au téléphone chaque jour et le temps qu’il convient pour écouter sa demande de prise en charge affective. Pour A.-M. Royer, il convient de marquer la différence entre la bientraitance qui relève de normes comportementales éthiques et la bienveillance, qui part d’une générosité et d’une position de contre-transfert positif qui donnera à la jeune fille apathique l’assurance dont elle a manqué pendant sa période de maternage.
Burn-out et Anesthésie-Réanimation
Authors: Arzalier Ségolène
Published: September 2021

Les anesthésistes-réanimateurs se préoccupent de leur santé au travail et de son impact sur la sécurité des soins. Les risques psycho-sociaux font l’objet de travaux au sein de la spécialité d’anesthésie-réanimation pour sensibiliser les médecins et les infirmiers sur les déterminants et les conséquences de la souffrance au travail, et proposer des outils pratiques pour faire face individuellement ou collectivement.
France-Algérie : l’héritage colonial
Authors: Khalfoune Tahar , Stora Benjamin , Euvé François , Sarthou-Lajus Nathalie
Published: September 2021

Le rapport rédigé par l’historien Benjamin Stora, rendu public le 20 janvier 2021, à propos des questions mémorielles portant sur la colonisation et la guerre d’Algérie, répond à une mission que lui a confiée le président de la République. Lors d’une conversation avec Tahar Khalfoune, l’historien et le juriste reviennent sur la réception de ce rapport en France et en Algérie, ainsi que sur les controverses que suscitent ces questions mémorielles. Ils proposent enfin une analyse sur la manière dont cet héritage colonial et cette culture de guerre structurent de part et d’autre l’imaginaire national.
Traduire, un savoir-faire avec les différences
Authors: Cassin Barbara , de Launay Marc
Published: September 2021

« Lorsqu’on comprend qu’on ne se comprend pas, on commence à se comprendre. » La philosophe Barbara Cassin montre comment la traduction, ce « savoir-faire avec les différences », est un geste philosophique fondamental au service de la vie en commun.
Soi-même comme un avatar. Comment l’identité se construit aujourd’hui
Authors: Tordo Frédéric
Published: September 2021

L’auteur présente, en Cyberpsychologie, un modèle de relation entre un individu et un avatar numérique (incarnation de soi sur Internet, ou dans les jeux vidéo). Cette relation dépend d’un processus, la cyber-empathie , qui comprend deux boucles d’interactions. Dans la première, pré-réflexive, l’avatar est modélisé dans le cerveau. En l’internalisant, le cerveau simule un double virtuel des propriétés de l’avatar. Simultanément, la personne externalise son schéma corporel dans l’objet, conduisant à une modification de ce même schéma dans le cerveau. C’est ce qui permet à l’avatar d’apparaître, progressivement, comme un double virtuel du corps . Dans une seconde boucle réflexive, l’avatar est intégré comme une partie du psychisme même, c’est-à-dire comme un double virtuel du psychisme . Dans un premier temps, une extension de la surface du Moi à la technologie se manifeste. Elle s’accompagne d’une projection de l’image du corps, et de la subjectivité. Dans un second temps, un dédoublement virtuel du Moi opère, permettant une empathie avec sa propre vie psychique. Enfin, une intégration se présente, consistant à faire de l’avatar une partie de soi. Elle est permise par le Moi-cyborg , qui intervient comme une figuration (inconsciente) dont le sujet se sert pour se représenter la technologie comme une partie de lui-même . Aussi, la personne noue avec l’avatar une relation semblable à celle qui se déroule à l’intérieur de son propre psychisme, en influençant en retour ses conduites, et en modelant potentiellement son identité.
Image du double et clinique du corps à l’adolescence
Authors: Maïdi Houari
Published: September 2021

Le sentiment d’inquiétante étrangeté est particulièrement intense à l’adolescence, une période marquée notamment par les métamorphoses pubertaires, le travail de subjectalisation et de création de l’image du moi-corps. La question du narcissisme, du double, de l’image, de l’étrangeté, et la clinique du corps à l’adolescence dans son expression hypocondriaque sont étudiés et analysés d’un point de vue clinique et théorique dans cet article.
The beneficial effects of physical exercise on visuospatial working memory in preadolescent children
Authors: Serra Laura ,   Neuroimaging Laboratory, Fondazione Santa Lucia, IRCCS, Rome, Italy, Raimondi Sara , di Domenico Carlotta , Maffei Silvia , Lardone Anna , Liparoti Marianna , Sorrentino Pierpaolo , Caltagirone Carlo , Petrosini Laura , Mandolesi Laura ,   Department of Motor Sciences and Wellness, University “Parthenope”, Naples, Italy,   Institute de Neurosciences Des Systèmes, Aix-Marseille University, Marseille, France Department of Engineering, University “Parthenope”, Naples, Italy,   Department of Clinical and Behavioural Neurology, Fondazione Santa Lucia, IRCCS, Rome, Italy.,   Laboratory of Experimental and Behavioural Neurophysiology, Fondazione Santa Lucia, IRCCS, Rome, Italy,   Department of Humanities, University of Naples Federico II, Naples, Italy
Published: September 2021

The relationship between physical exercise and improvement in specific cognitive domains in children and adolescents who play sport has been recently reported, although the effects on visuospatial abilities have not yet been well explored. This study is aimed at evaluating in school-age children practicing artistic gymnastics the visuospatial memory by using a table version of the Radial Arm Maze (table-RAM) and comparing their performances with those ones who do not play any sport. The visuospatial performances of 14 preadolescent girls practicing artistic gymnastics aged between 7 and 10 years and those of 14 preadolescent girls not playing any sport were evaluated in the table-RAM forced-choice paradigm that allows disentangling short-term memory from working memory abilities. Data showed that the gymnasts obtained better performances than control group mainly in the parameters evaluating working memory abilities, such as within-phase errors and spatial span. Our findings emphasizing the role of physical activity on cognitive performances impel to promote physical exercise in educational and recreational contexts as well as to analyse the impact of other sports besides gymnastics on cognitive functioning.
Distribution and changes in the sbGnRH system in Rastrelliger brachysoma males during the breeding season
Authors: Senarat Sinlapachai , Kettratad Jes , Jiraungkoorskul Wannee , Kangwanrangsan Niwat , Amano Masafumi , Shimizu Akio , Plumley F. Gerald , Tipdomrongpong Sasipong
Published: September 2021

Rastrelliger brachysoma is a mariculture candidate species, but reproduction in captive fish has been problematic. This report examines the difference in the HPG axis, the neuroendocrine system and the development of reproductive tissues between captive vs. wild male R. brachysoma. The gonadosomatic index (GSI) of sexually mature male wild R. brachysoma was 1.12±0.34 and 1.94±0.26 during the non-breeding and breeding seasons, respectively. Captive R. brachysoma had a GSI of 1.88±0.17. All wild R. brachysoma were in the late spermatogenic stage irrespective of seasons. Immunostaining results showed that sbGnRH-immunoreactive neurons were distributed in three areas of the brain, namely the nucleus periventricularis, nucleus preopticus and nucleus lateralis tuberis. Follicle stimulating hormone and luteinizing hormone immunoreactivities were also observed in the pituitary gland. The levels of brain sbGnRH and GtH mRNA were not significantly different between the non-breeding and breeding seasons, but captive fish displayed (times or percent difference) lower mRNA levels than wild fish. These results suggest that these hormones control the testicular development in R. brachysoma and that the impaired reproduction in captivity may be due to their relative lower expression levels of follicle stimulating hormone and luteinizing hormone genes.
Blow-up. Une enquête dans le fonds Roquefort des archives municipales de Marseille
Authors: Gouffran Laure-Hélène
Published: September 2021

Cette contribution revient sur les recherches menées entre 2009 et 2015 autour de la figure de Bertrand Rocafort, marchand provençal du début du XVe siècle, dont l’étude a débuté par l’exploration d’un fonds d’archives éponyme conservé aux archives municipales de Marseille. D’agrandissement et agrandissement, l’analyse des pièces rares qui composent ce fonds a progressivement ouvert les portes vers d’autres questionnements et a également conduit à étendre le corpus ainsi que le sujet même de la recherche. Ainsi la progression dans cette enquête biographique s’est révélée avant tout constituer un cheminement à travers les archives. Ce parcours permet aujourd’hui de s’interroger sur les enjeux relatifs à la constitution d’un corpus destiné à la réalisation d’une biographie historique.
L’inventaire d’un petit monde. Étudier un groupe socio-professionnel à la fin du Moyen Âge
Authors: Troadec Cécile
Published: September 2021

Comment constituer, ou reconstituer, le corpus documentaire propre à l’étude d’un groupe socio-professionnel ? C’est tout l’enjeu de l’enquête prosopographique lorsqu’elle s’intéresse à une profession. Plutôt que de se demander selon quels critères l’historien peut définir les contours du groupe, afin d’y inclure, ou d’en exclure, les multiples individus rencontrés au cours des dépouillements, il s’agit ici de prendre en compte le groupe tel qu’il est constitué par l’archive et les pratiques de l’écrit. À travers l’exemple des bouchers de Rome, connus grâce aux archives de la douane du xve siècle, on se propose de réfléchir sur la « cohésion de cet ensemble flou » qu’est le groupe socio-professionnel, pour reprendre une analyse de Luc Boltanski dans son essai sur les cadres.
De la formalisation des savoirs à la cartularisation
Authors: Bretthauer Isabelle
Published: September 2021

Le manuel de Guillaume Flambart (c. 1470) contient des textes réglementaires sur la justice et un formulaire d’actes passés devant des juridictions normandes (1395-1469). Dans le formulaire, deux familles apparaissent, les Flambart et les Mustel. Partie d’un recueil juridique construit par un individu dans le cadre de pratiques professionnelles, l’étude traite du registre à la manière d’un cartulaire familial (activités des membres de la famille, réseaux), en croisant avec le chartrier d’une des seigneuries de la famille Flambart. L’historien est amené à analyser plusieurs corpus : celui du formulaire, celui du chartrier, l’ensemble construit à partir des deux. La démarche interroge le poids du biais des sources dans l’étude du statut d’une famille et de la diversité de la production écrite.
La mobilité des Pieds‑noirs entre l’Espagne et la France depuis 1962
Authors: Sempere‑Souvannavong Juan‑David , Dominguez Villaverde Mariana
Published: September 2021

This article studies the presence of Pieds-noirs in Alicante (Spain) from a new approach that allows us to consider it as not as the result of a migration but as the origin of a type of mobility developed between Spain and France for fifty years.
The impact of digital divide for first-year students in adoption of social media for learning in South Africa
Authors: Mphahlele Mohube I. , Mokwena Sello N. , Ilorah Appolonia
Published: September 2021

Background: Social media comprise technologies that facilitate learning in higher education institutions. However, many first-year students at tertiary education institutions are not taking advantage of social media for their learning because of environmental and personal factors related to the digital divide (DD).Objectives: The objective of this research study was to investigate the impact of the DD factors on first-year students in using social media for learning in tertiary education institutions.Method: A survey method was used to conduct the study. Social cognitive theory was employed as a theory underpinning this research. A questionnaire technique was used to collect data from 600 first-year students of a multi-campus university. Three hundred students came from each of the two campuses. Regression analysis was performed with the purpose of testing the hypotheses of the study.Results: The result of the analysis revealed a low computer access and usage but a high percentage of mobile devices usage by students from disadvantaged backgrounds. Personal factors were found to have an impact on the behaviour of students in adopting social media for their studies. The study also found that the prevalence of social media nullifies the lack of computer resources and connection to the Internet in disadvantaged areas.Conclusion: This study demonstrated that the DD was more complex than hitherto envisaged. The study recommends that ownership of computers and devices connected to the Internet needs to be promoted, especially in disadvantaged areas.
Central retinal vein occlusion secondary to varicella zoster retinal vasculitis in an immunocompetent individual during the COVID-19 pandemic - A case report
Authors: Sarpangala Shailaja , George Neenu M , Kamath Yogish S , Kulkarni Chidanand
Published: September 2021

We report the occurrence of unilateral central retinal vein occlusion (CRVO) in a young yoga enthusiast who presented amidst the COVID-19 pandemic. Subtle signs of uveitis when systemically investigated revealed a multitude of causes, but ocular fluid polymerase chain reaction was positive for varicella zoster virus (VZV). The prompt initiation of antivirals resulted in a good visual outcome. Our case describes the rare presentation of VZV retinal vasculitis as CRVO in a young healthy individual and highlights the importance of early antiviral therapy for favorable outcomes.
Exudative retinal detachment in COVID-19 - associated rhino-orbital mucormycosis – A rare clinical finding
Authors: Sarkar Sandip , Gokhale Tanmay , Kaliaperumal Subashini , Singh Rakesh , Begam R Benazir , Deb Amit Kumar
Published: September 2021

Rhino-orbital-cerebral mucormycosis is a life-threatening, opportunistic invasive fungal infection. Patients with moderate to severe coronavirus disease 2019 (COVID-19) infection are more vulnerable to it. Varied clinical presentations can be seen in patients with orbital mucormycosis starting from conjunctival chemosis, proptosis, ptosis, restriction of extraocular movements, exposure keratitis, neurotrophic keratitis, and central retinal artery occlusion. Exudative retinal detachment in a patient with orbital mucormycosis is a rare clinical entity. We, hereby, report a case of orbital mucormycosis with exudative retinal detachment in a patient post-COVID-19 infection.
Evaluation of various preservation media for storage of donor corneas
Authors: Sharma Namrata , Shaikh Farin , Nagpal Ritu , Manumuraleekrishna  , Maharana Prafulla K , Agarwal Tushar , Sinha Rajesh , Satpathy Gita , Velpandian Thirumurthy , Titiyal Jeewan S
Published: September 2021

Purpose:

To compare the physical and microbiological characteristics of McCarey-Kaufman (MK), Cornisol, and Optisol-GS media and evaluate the outcomes of keratoplasty performed using corneas stored in these three media.

Methods:

The study involved 60 donor corneas which were distributed in 3 groups: MK, Cornisol, and Optisol-GS. Corneas in these groups were further analyzed based on the type of keratoplasty performed (full thickness versus endothelial keratoplasty). At baseline, the endothelial cell density and death to preservation time of donor corneas were recorded. Following keratoplasty, patients were evaluated on day 1, at 1 month, 3 months, and 6 months follow-up. Outcomes were assessed in terms of corrected distance visual acuity (CDVA), endothelial cell density, percentage endothelial cell loss, and corneal thickness. The storage media were also assessed for their physical quality and their microbiological characteristics.

Results:

Physical characteristics of all three media were found to be within normal limits. Mean CDVA was comparable among the 3 groups at 6-month follow-up. The absolute endothelial cell count values were significantly lower for corneas stored in MK medium (1873.7 ± 261.1 cells/mm2) compared to the Cornisol (2085.0 ± 230.3 cells/mm2) and Optisol-GS media [(2180.3 ± 217.2 cells/mm2) (P = <0.001)]. Corneas stored in Optisol-GS medium were significantly thinner at 1-month follow-up with no significant difference at 6 months (P = 0.66).

Conclusion:

Optisol-GS and Cornisol media were found to preserve endothelial cell density better and stabilize corneal thickness earlier as compared to the MK medium. However, the functional outcomes were comparable among the three groups.
Topical interferon – A novel treatment for pseudophakic macular edema
Authors: Kawali Ankush , Snehith Ram , Singh Vivek , Sanjay Srinivasan , Mahendradas Padmamalini , Shetty Rohit
Published: September 2021

Purpose:

The aim of this study was to evaluate the efficacy of topical interferon (IFN) therapy in pseudophakic cystoid macular edema (P-CME).

Methods:

This is a prospective, interventional case series of patients with P-CME. Patients presenting with P-CME were given the option of topical IFN therapy against conventional treatment with oral, topical, intravitreal, and periocular steroid therapy and antivascular growth factors. Patients who consented for the same were advised to use the IFN drops four times/day. Commercially available injection IFN alfa-2b was reconstituted to prepare the eye drops (1 MIU/ml). Optical coherence tomography (OCT) was done at the baseline and on each review visit until complete resolution of P-CME.

Results:

Eight eyes of eight patients diagnosed with P-CME were studied. Mean central macular thickness (CMT) on OCT at the presentation (n = 8) and at 4 weeks post topical IFN therapy (n = 6) was 560.1 μm (range: 349–702 μm) and 344.33 μm (range: 250–390 μm), respectively. All eyes except one had posterior capsular rent (PCR). Five patients had regular follow-up until resolution. The mean duration of complete first resolution of P-CME was 5 weeks (range: 4–7.1 weeks) in those patients. Relapse was seen in three patients who responded after resuming or continuing the therapy. Case 1 had 9 months follow-up after completion of IFN therapy, and no recurrence was noted. No ocular or systemic side effects related to the topical IFN therapy were noted clinically, except papillary conjunctivitis in one patient.

Conclusion:

Topical IFN therapy can be a noninvasive, economical, and effective choice of treatment for P-CME, especially in the case of PCR, and where steroids are contraindicated.
A novel indigenous technique for corneal tattooing using self-prepared do-it-yourself carbon soot pigment
Authors: Ravindra M S , Meda Deepthi R
Published: September 2021

Purpose:

To evaluate the cosmetic efficacy and safety of an indigenous novel corneal tattooing technique using a self-prepared candle soot pigment.

Methods:

This pilot observational study involved 22 eyes of patients at a Bengaluru-based ophthalmology setting. The study considered only eyes with nil or low visual potential. Eyes with active ocular inflammation, nasolacrimal obstruction, severe hypotony, and shrunken globe due to phthisis bulbi were excluded. The surgery was carried out under aseptic conditions using a self-prepared carbon soot pigment. Different methods such as lamellar, surface needle micropuncture, machine-assisted surface tattooing, or a combination were used for pigment application.

Results:

Ten eyes underwent combined lamellar and surface tattooing; lamellar tattooing was performed for 11 eyes, and surface tattooing for one eye. Nineteen patients underwent limbus-to-limbus corneal tattooing and three patients had undergone focal tattooing to cover nasal pterygium scar, inferior iridectomy, and leukocoria due to calcific cataract. Nearly 91% were subjectively satisfied with the tattooing technique and 82% had excellent cosmetic coverage along with subjective satisfaction. None of the subjects required a repeat surgery or augmentation of tattooing. There was no reported case of corneal inflammation, epithelial erosions, infiltrations, infections, nonhealing areas, stromal melting, or any other complications.

Conclusion:

This novel procedure, involving self-prepared carbon soot pigment tattooing, provides excellent cosmetic results and high patient satisfaction. It is relatively safe, easy to perform, and the conventional steps of tattooing such as pigment procurement, storage, and sterilization can be avoided, as the carbon pigment is freshly prepared under aseptic conditions.
Experimental evaluation of safety and efficacy of plasma-treated poly-ε-caprolactone membrane as a substitute for human amniotic membrane in treating corneal epithelial defects in rabbit eyes
Authors: Ravani Raghav D , Yadav Saumya , Takkar Brijesh , Sen Seema , Kashyap Seema , Gupta Deepika , Jassal Manjeet , Agrawal Ashwini , Mohanty Sujata , Tandon Radhika
Published: September 2021

Purpose:

To evaluate biocompatibility and safety of plasma-treated poly-ε-caprolactone (pPCL) membrane compared to the human amniotic membrane in the healing of corneal epithelial defects in an experimental model.

Methods:

This is a prospective, randomized animal study including 12 rabbits. Circular epithelial injury measuring 6 mm in diameter was induced over the central cornea of one eye in twelve rabbits. The rabbits were randomized into two groups; in group A, the defect was covered with human amniotic membrane, while in group B, an artificial membrane made of bio-polymer plasma-treated poly-ε-caprolactone was grafted. Six rabbits were euthanized after 1 month and the other six after 3 months and the corneal epithelium was evaluated histopathologically and with immunohistochemistry.

Results:

Light microscopy of the corneal tissue performed after 1 month and 3 months demonstrated similar findings with no significant complications in either group. Immunohistochemistry with anti-CK-3 antibody showed characteristic corneal phenotype in the healed epithelium. In eyes grafted with pPCL membrane, epithelial healing as estimated by a decrease in size of the defect was significantly better than the group treated with the human amniotic membrane at all time periods monitored (P < 0.05), except day 1 (P = 0.83). The percentage reduction in the size of the epithelial defect was also significantly more in the pPCL membrane group as compared to the human amniotic membrane at all time periods (P < 0.05 at all observations) post-implantation except day 1 (P = 0.73).

Conclusion:

Plasma-treated poly-ε-caprolactone membrane is safe, biocompatible, and effective in the healing of corneal epithelial defects in rabbits.
Initial experience with phacoemulsification and goniotomy using the Kahook dual blade in advanced open-angle glaucoma: Six-month outcomes in Indian eyes
Authors: Krishnamurthy Rashmi , Senthil Sirisha , Choudhari Nikhil
Published: September 2021

Purpose:

The aim of this study was to report our initial experience on the outcomes of phacoemulsification in combination with goniotomy using the Kahook Dual Blade (KDB) in eyes with advanced open-angle glaucoma (OAG).

Methods:

The outcomes of phaco-goniotomy with KDB in advanced OAG in Indian eyes were retrospectively analyzed. Based on the Hodapp-Anderson-Parrish criteria of visual field defects, severe glaucoma (mean deviation on standard automated perimetry worse than 12 dB) was considered as advance glaucoma. Preoperative, intraoperative, and postoperative data were collected through 6 months of follow-up. Outcome measures included antiglaucoma medications (AGM), the proportion of eyes achieving >1AGM reduction, intraocular pressure (IOP), and visual acuity.

Results:

Median (interquartile range) number of AGM in eyes that underwent phaco-KDB goniotomy reduced from 2 (2,3) at baseline to 1 (0,1) at 6 months (P = 0.002). Median IOP reduced from 20 (20,26) mmHg at baseline to 14 (12,15) mmHg at 6 months (P = 0.02). The proportion of eyes achieving >1 medication reduction was 88% eyes (8/9). Adverse events noted were IOP spike (22 mmHg) in 2 eyes and intra-op hyphema in 1 eye on postoperative day-1, both resolved in a week with conservative management. Except one eye with central corneal scar due to prior pterygium surgery, 8 eyes had 20/20 vision at 1 week which was maintained till last follow-up.

Conclusion:

Phacoemulsification with KDB Goniotomy significantly lowered the need for AGM with moderate IOP reduction in advanced OAG eyes. There were no serious complications and the visual recovery was good and early.
Incidence of presumed steroid response in contralateral eye of patients who underwent glaucoma filtration surgery
Authors: Pandit Rinal , George Ronnie J , Lingam Vijaya , Balekudaru Shantha
Published: September 2021

Purpose:

The aim of this study was to report the incidence of presumed steroid response in contralateral eye of patients who underwent glaucoma filtration surgery.

Methods:

We reviewed records of 298 glaucoma patients (147 PACG [primary angle-closure glaucoma], 129 POAG [primary open-angle glaucoma], and 22 JOAG [juvenile open-angle glaucoma]) who underwent either trabeculectomy alone or trabeculectomy with cataract extraction. All patients received prednisolone acetate 1% eye drop postoperatively in the operated eye for up to 6 to 8 weeks. The contralateral eye received the same antiglaucoma medications as before. Information collected included age, sex, number of antiglaucoma medications in the fellow eye preoperatively, and VFI (visual field index). The preoperative intraocular pressure (IOP) in the contralateral eye was taken as the baseline. The maximum IOP recorded postoperatively up to a follow-up period of 6 to 8 weeks was noted. A steroid response was defined as rise in the IOP by ≥6 mmHg.

Results:

In this study, 298 eyes of 298 glaucoma patients were included. The mean age of patients was 60.1 ± 13.7 years. The mean number of antiglaucoma medications in the fellow eye pre-operatively was 2.4 ± 1.2. Mean preoperative and postoperative IOP in the fellow eye were 17.46 ± 7 and 19.37 ± 7.1 mmHg, respectively. Sixty-three eyes out of 298 eyes (21.14%) showed a rise in IOP by 6 mmHg. The maximum IOP difference noted was 15 mmHg. The average time interval to the defined steroid response was 16.13 days. The majority showed a steroid response within 19 days.

Conclusion:

Steroid response is a significant factor leading to elevated IOP postoperatively in the contralateral eye as well.
A questionnaire-based assessment of Safe Eye Examination (SEE) technique
Authors: Mishra Divyansh , Shanmugam Mahesh P , Chaitanya E Vivek , Murali Kaushik , Ramanjulu Rajesh , Kulkarni Mayur , Nair Sukanya
Published: September 2021

Purpose:

This study aims to assess the novel and innovative method of Safe Eye Examination (SEE) technique using the model eye for the purpose of teaching, training, and resident examination.

Methods:

A questionnaire-based study (Descriptive Data) with 53 participants, including ophthalmology residents, fellows in various subspecialties, and trainee optometrists was used. In our study, we used the Reti Eye model, but instead of the usual retina template sheet, we used prominent pathological fundus photographs loaded into the model eye. The study participants were asked to view prominent pathological fundus images printed on a matte finish paper. A circular image was cut and was placed in the Reti Eye model. The candidates were made to perform indirect ophthalmoscopy with a + 20D lens and to fill up a Google image assessment scale questionnaire with characteristics, including pixelation, sharpness, contrast, reflexes, blotchy appearance, and diagnostic confidence, which were then analyzed and depicted. Association between categorical variables was analyzed using Fisher exact test and Chi-square test. A P value of less than 0.05 was considered statistically significant. All data were analyzed with a statistical software package (SPSS, Version 16.0 for Windows).

Results:

The number of positive responses (>90%) obtained for the pixelation, sharpness, contrast, reflexes, blotchy appearance, and diagnostic confidence of the image viewed were statistically more significant than the negative responses (P < 0.05).

Conclusion:

The SEE technique of using the model eye can be incorporated for teaching, training, and skill assessment in the examinations in these difficult times of COVID-19 (coronavirus disease 2019) pandemic.
Effect of pupil size on posterior chamber phakic intraocular lens vault measurements
Authors: Srirampur Arjun , Pesala Veerendranath , Mansoori Tarannum , Gadde Aruna Kumari , Kola Pravalika
Published: September 2021

Purpose:

The aim of this study was to measure the implantable collamer lens (ICL) vault changes with anterior segment optical coherence tomography (AS-OCT) after the implantation of the Visian posterior chamber phakic ICL with a central hole (V4c) in relation to the pupil size.

Methods:

This retrospective observational pilot study included 32 eyes of 16 patients, who underwent V4c ICL implantation. ICL vault was measured with AS-OCT in undilated and fully dilate state of the pupil. Primary outcome measure was the change in the vault of V4c ICL at the maximum and minimum pupil size.

Results:

Median (IQR) undilated and post-dilated vault measurement was 393.00 (335.50–493.50) microns and 421.00 (338.50–503.75) microns, respectively, which was not statistically significant (P = 0.44).

Conclusion:

No statistically significant difference was observed between the undilated and post-dilated ICL vault measurements. Hence, the postoperative vault can be measured either in resting, undilated state or fully dilated state of the pupil and would be similar irrespective of the pupil size.
Demographics and clinical profile of patients with ocular Calotropis poisoning in India
Authors: Rathi Varsha M , Das Anthony Vipin , Mahajan Mayank , Khanna Rohit C
Published: September 2021

Purpose:

To describe the clinical profile of patients with ocular Calotropis poisoning presenting to a multitier ophthalmology hospital network in India.

Methods:

This cross-sectional hospital-based study included 2,047,360 new patients presenting between August 2010 and March 2020. Patients with a clinical diagnosis of Calotropis poisoning in at least one eye were included. The data were collected using an electronic medical record system. Descriptive statistics using mean ± standard deviation and median with inter-quartile range (IQR) were used to elucidate the demographic data. Chi-square test was done for univariate analysis.

Results:

Overall, 362 (0.018%) new patients were diagnosed with ocular Calotropis poisoning during the study period. The mean age of the patients was 44.10 ± 18.61 years. The incidence rates were 0.013% in children and 0.018% in adults. Males were 57.46% and 87.29% had unilateral affliction. A significant number of patients presented from the rural geography (59.67%) and were from the higher socioeconomic class (72.65%). About a fourth of the patients were homemakers (23.48%) followed by agriculture workers (18.23%). Of the 408 affected eyes, 49.26% had mild visual impairment (<20/70) followed by moderate visual impairment (>20/70 to ≤ 20/200) in 23.28%. The most common clinical signs were conjunctival congestion (61.03%), descemet membrane folds (57.35%), stromal edema (30.39%), and corneal epithelial defect (24.51%).

Conclusion:

Calotropis poisoning in individuals seeking eye care in India is very rare. It is commonly unilateral and occurs more in the rural geography. It is common in middle-aged males and may affect vision due to involvement of the cornea.
Accuracy of the Barrett Universal II formula integrated into a commercially available optical biometer when using a preloaded single-piece intraocular lens
Authors: Mieno Hiroki , Hieda Osamu , Ikeda Toshihide , Hayashi Shino , Hashida Masatsugu , Urabe Kimiaki , Sotozono Chie
Published: September 2021

Purpose:

To compare the commonly used formulas for intraocular lens (IOL) selection using IOLMaster®700 (Carl Zeiss Meditec) and to evaluate the Barrett Universal II (BU-II) formula accuracy when using the Vivinex™ iSert® XY1 IOL (Hoya Corporation Medical Division).

Methods:

A retrospective chart review was performed that included patients who underwent uneventful cataract surgery with in-the-bag insertion of Vivinex™ iSert® XY1 IOL. Prediction errors at 3 months postoperative of IOLMaster® 700 with Haigis, Holladay 1, SRK/T, and BU-II formulas were compared. As a subgroup analysis, we focused on the axial length (AL) and IOL power. AL subgroup analysis was based on the following AL subgroups: short (<22.5 mm), medium (22.5–25.5 mm), and long (>25.5 mm). IOL power subgroup analysis was based on the following IOL power subgroups: low (≤18.0 diopters [D]), medium (18.5–24.0 D), and high (≥24.5 D).

Results:

This study included 590 eyes of 590 patients. Overall, the four IOL calculation formulas appeared to be similarly accurate. In the long AL subgroup, the BU-II formula had a significantly lower absolute error (AE) than the Holladay 1 formula. In the low-power subgroup, the BU-II formula had a significantly lower AE than the Holladay 1 and SRK/T formulas. On the other hand, in the high-power subgroup, the BU-II formula was significantly less accurate than the SRK/T formula and also appeared to be worse than the Holladay 1 formula (P = 0.052).

Conclusion:

The BU-II formula might be less accurate when using a Vivinex™ iSert® XY1 IOL of 24.5 D or greater.
Exploring the barriers for eye care among transgenders and commercial sex workers in Pune, Maharashtra
Authors: Kulkarni Sucheta , Lawande Devika D , Dharmadhikari Sheetal , Deshpande Col. Madan
Published: September 2021

Purpose:

To explore all possible barriers faced by transgenders (TG) and commercial sex workers (CSW) in accessing eye care in Pune city in western India.

Methods:

This qualitative study was conducted at a tertiary eye care center in Pune. Interview topic guides for face-to-face interviews and focused group discussions were developed. Comprehensive eye check-up was organized in the residential localities of TG and CSW communities in Pune. Those with severe visual impairment or blindness were identified. A sample of TGs and CSWs from this group was purposively selected and invited to participate in this study. Face-to-face interviews were conducted with each TG and CSW. A group of health care providers and NGO workers serving these communities were invited to participate in focused group discussions. All interviews/discussions were audio recorded, transcribed, and translated into English. A qualitative software (N vivo 12, QRS International, Australia) was used to identify various themes and subthemes under each domain of barriers.

Results:

A total of 24 people (6 each from TGs, CSWs, health care provider, and NGO worker groups) participated in this study. The most common barriers reported were social stigma, discrimination, poverty, financial exclusion, and mental health factors. Non availability of gender-neutral facilities in clinics was a unique barrier reported by TGs.

Conclusion:

Marginalized communities of TGs and CSWs in Pune face several previously unexplored and unique barriers for access to eye care despite the availability of services in the vicinity.
Effect of complicated ocular surgery in stress-related parameters: A novel outlook into surgeon’s health
Authors: Kaushik Jaya , Pannu Anju , Chaitanya YVK , Kumar Ashok , Parihar Jitendra Kumar Singh , Jain Vaibhav K , Chaturvedi Piyush , Manumala Lalita K , Singh Ankita , Kochhar Divya
Published: September 2021

Purpose:

To assess the stress-related physiological parameters of ophthalmic surgeons during complicated cataract surgery and compare them with uncomplicated routine cataract surgery.

Methods:

In this cross-sectional observational study, 110 patients of various types of cataract were divided into two groups: Group 1 included 55 patients with simple cataract (Grade ≤3) with no ocular or systemic comorbidities, whereas Group 2 included 55 patients with complicated cataracts (Grade >3) and ocular/systemic comorbidities. All patients underwent phacoemulsification with intraocular lens implantation in the right eye only. The outcome measures were systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and saturation of peripheral oxygen (SpO2).

Results:

The average SBP, DBP, MAP, and HR were significantly higher in the surgeon operating Group 2 (complicated cataract) compared with Group 1 (uncomplicated cataract; P < 0.05). The average SBP of the surgeon while operating Group 1 patients preoperatively and postoperatively was 125.42 ± 2.49 mmHg and 122.45 ± 2.10 mmHg, respectively, whereas in Group 2, the average SBP of the surgeon taken preoperatively and postoperatively was 145.98 ± 3.80 mmHg and 137.44 ± 3.45 mmHg, respectively (P < 0.05). The surgeon’s SpO2 showed no significant difference between the two groups.

Conclusion:

There is a significant level of increase in stress-related parameters of operating surgeons while doing complicated cataract surgery.
Case series of scleral patch grafts during COVID-19 pandemic
Authors: Siva Jyothi E Lalitha , Gopala Krishna O , Lakshmana Rao P , Raja Sekhar P
Published: September 2021

Scleral graft is done for clinical conditions as scleral melt post pterygium surgery, immune or infection related scleral melt, for covering the tubes of Ahmed glaucoma valve implant, for covering the orbital implants post enucleation, etc. A review of literature revealed the use of sclera for corneal perforations in the past, but became obsolete after the cornea being used for patch grafts. Now in this COVID-19 time, due to scarcity of corneal tissue, this technique of scleral patch grafts can be considered as an alternative to corneal patch grafts, which serves well the tectonic/therapeutic purpose and helps salvage the eye.
Evaluating the presence of SARS-CoV-2 in the intraocular fluid of COVID-19 patients
Authors: Hada Maya , Khilnani Kamlesh , Vyas Nitya , Chouhan Jugal Kishore , Dharawat Kulveer S , Bhandari Sudhir , Tripathy Koushik
Published: September 2021

Purpose:

To detect the presence of SARS-CoV-2 in aqueous and vitreous humor of COVID-19 patients in a pilot study.

Methods:

Consecutive patients planned for emergency ophthalmic surgeries after ocular trauma were subjected to naso-oropharyngeal RT-PCR test for SARS-CoV-2. Laboratory-confirmed cases were enrolled for the study. During surgery, 0.1 mL aqueous and vitreous each was aspirated. The vitreous tap was collected on clinical suspicion of endophthalmitis. RT-PCR test was used to detect SARS-COV-2 nucleotide in the samples. Cycle threshold (Ct) for E gene of ≤35 along with confirmatory results on one of the two target genes (RdRp or ORF1b) was considered as positive.

Results:

One hundred and thirty two patients were found positive on naso-oropharyngeal RT-PCR test for SARS-CoV-2 preoperatively. Seven patients with ocular trauma were studied. The mean age was 31.8 years. There were six male and one female patient. Two patients had symptoms of mild COVID-19 disease and the rest were asymptomatic. The mean Ct value of the E gene on naso-oropharyngeal RT-PCR was 23.14 ± 4.7. Corneal and corneoscleral laceration repair was done in five patients, intracorneal wooden foreign body was removed in one patient, and injection of intravitreal antibiotics was done in one patient. Aqueous and vitreous tap was collected in 7 and 5 patients, respectively. None of the aqueous or vitreous samples was found positive for SARS-CoV-2.

Conclusion:

SARS-CoV-2 was not detected by RT-PCR in aqueous or vitreous humor in this pilot study. Future studies with a larger sample size are needed to further explore the presence of SARS-CoV-2 in intraocular fluids.
Porokeratosis and mycosis fungoides
Authors: Eldarouti Mohammad Ali , Rasheed Hoda , Eltawdy Amira , Mostafa Pakinam Ibrahim Nabil
Published: September 2021

Mycosis fungoides (MF) is a great imitator. It can resemble more than 50 different clinical disorders. Porokeratosis is the rarest of the disorders and has been reported only in three cases. Herein, we present three cases of porokeratosis occurring in MF patients. The first case proved to be MF lesions upon histopathological examination, whereas the second case showed a classic porokeratosis occurring in association with MF in the same lesion. Finally, the third case was presented with classic porokeratosis that developed in a longstanding MF case undergoing treatment with Methotrexate and PUVA.
Clinical and histopathological assessment of botulinum toxin-A injection for treatment of hypertrophic scars and keloids
Authors: Elfiky Seif-Allah M. , Shokeir Hisham , Elbasiouny Mahmoud S. , Samy Nevien
Published: September 2021

Background

Various treatments for hypertrophic scars (HTS) and keloids are available. Not all treatment modalities have been adequately tested. Recently, it has been shown that botulinum toxin type A (BTX) positively affects wound healing, so it might contribute in treating HTS and keloids.

Objective

To assess the effect of BTX intralesional injection as a monotherapy for the treatment of HTS and keloids clinically and histopathologically.

Patients and methods

A total of 30 patients with HTS and keloids were treated by intralesional injection of BTX as a monotherapy. Each lesion was injected with BTX (5 IU/cm2 once every 4 weeks for four sessions). Immunohistochemical evaluation of the lesions before and after treatment was done. Moreover, Vancouver scar scale and clinical imaging were taken before and after treatment.

Results

There was a highly significant difference after treatment with BTX intralesional in both the epidermal thickness (P=0.001) and area% of fibroblast dermis (P=0.001). Additionally, there was a significant decline in Vancouver scar scale after treatment (P<0.001).

Conclusion

BTX injection of HTS and keloids can be considered as a promising effective and well tolerated therapeutic option acting on fibroblast activity of HTS and keloids.