bluuebunny/crossref_metadata_2025 huggingface dataset:
Determinants and Functional Significance of Renal Parenchymal Volume in Adults
Authors: Johnson Samuel , Rishi Rahul , Andone Andreea , Khawandi Wassim , Al-Said Jafar , Gletsu-Miller Nana , Lin Edward , Baumgarten Deborah A. , O'Neill W. Charles
Published: September 2010

Background and objectives

The significance of renal parenchymal volume and the factors that influence it are poorly understood.

Design, setting, participants, & measurements

Renal parenchymal volume (RPV) was measured on contrast-enhanced CT scans after exclusion of sinus fat and vessels in 224 healthy subjects evaluated as kidney donors and in a separate cohort of 22 severely obese individuals before and after 6 months of weight loss. GFR was measured by iohexol clearance in 76 of the transplant donors. RPV was correlated with age, GFR, and various anthropometric parameters.

Results

In potential transplant donors, RPV correlated with body surface area (BSA; r = 0.68) and was 7% larger in men but did not vary with age or race. Gender and body size were independent determinants of RPV. RPV correlated well with GFR (r = 0.62) and accounted for almost all of the variability in a model of GFR that included age, race, gender, and body surface area. GFR correlated more strongly with RPV than with creatinine-based equations. The same relationship between RPV and BSA was observed in obesity, and RPV decreased with weight loss.

Conclusions

In healthy adults younger than 65 years, renal parenchymal volume is governed by body size and gender but not age or race and is strongly correlated with GFR. This indicates that renal parenchymal volume varies to meet metabolic demand and is closely linked to renal function.
Influence of internal reflections of light on spectral characteristics of photoacoustic signal
Authors: Maliński M.
Published: September 2010

The aim of this paper is to present the formula, and its derivation, for a photoacoustic (PA) signal in the front configuration in the case when the effect of multiple reflections of light in a sample is taken into account. The formula derived in the paper was next used for theoretical investigations of the influence of multiple reflections of light on series of PA spectral characteristics.
Empirical Hydrologic Predictions for Southwestern Poland and Their Relation to Enso Teleconnections
Authors: Niedzielski Tomasz
Published: September 2010

Empirical Hydrologic Predictions for Southwestern Poland and Their Relation to Enso Teleconnections

Recent investigations confirm meaningful but weak teleconnections between the El Niño/Southern Oscillation (ENSO) and hydrology in some European regions. In particular, this finding holds for Polish riverflows in winter and early spring as inferred from integrating numerous geodetic, geophysical and hydrologic time series. The purpose of this study is to examine whether such remote teleconnections may have an influence on hydrologic forecasting. The daily discharge time series from southwestern (SW) Poland spanning the time interval from 1971 to 2006 are examined. A few winter and spring peak flows are considered and the issue of their predictability using empirical forecasting is addressed. Following satisfactory prediction performance reported elsewhere, the multivariate autoregressive method is used and its modification based on the finite impulse response filtering is proposed. The initial phases of peak flows are rather acceptably forecasted but the accuracy of predictions in the vicinity of local maxima of the hydrographs is poorer. It has been hypothesized that ENSO signal slightly influences the predictability of winter and early spring floods in SW Poland. The predictions of flood wave maxima are the most accurate for floods preceded by normal states, less accurate for peak flows after La Niño episodes and highly inaccurate for peak flows preceded by El Niño events. Such a finding can be interpreted in terms of intermittency. Before peak flows preceded by El Niño there are temporarily persistent low flows followed by a consecutive melting leading to a considerable intermittency and hence to difficulties in forecasting. Before peak flows preceded by La Niño episodes there exist ENSO-related positive temperature and precipitation anomalies in SW Poland causing lower, but still considerable, intermittency and thus better, but not entirely correct, predictability of hydrologic time series.
Primary Care Physical Therapy in People With Fibromyalgia: Opportunities and Boundaries Within a Monodisciplinary Setting
Authors: Nijs Jo , Mannerkorpi Kaisa , Descheemaeker Filip , Van Houdenhove Boudewijn
Published: September 2010

Despite the fact that people with fibromyalgia syndrome (FMS) frequently are seen by primary care physical therapists, guidelines for the management of FMS are based primarily on outcomes from multidisciplinary and tertiary care treatment studies. Few data addressing the treatment of patients with FMS in primary care currently are available. The evidence-based guidelines on the management of FMS are based, in part, on evidence from studies examining physical therapy treatment components alone (eg, aerobic exercise, education). Thus, the recommendations can be applied to primary care physical therapy. Primary care physical therapy for patients with FMS should include education, aerobic exercise, and strengthening exercise. For other treatment components such as passive treatments, activity management, and relaxation, less evidence currently is available to advocate their use in primary care physical therapy. Superior results are to be expected when various treatment components are combined.
Assessing Neighborhood Racial Segregation and Macroeconomic Effects in the Education of African Americans
Authors: Johnson Odis
Published: September 2010

The “underclass” debate of the 1980s often concerned the relative importance of neighborhood racial and economic isolation to the educational challenges facing many African Americans. This review organizes the neighborhood effects research that has emerged since that time according to these differing perspectives. The review’s triangulated approach assesses (a) the association of a neighborhood’s racial segregation and low level of economic resources to less academic success, (b) whether certain neighborhood social processes lower children’s educational performance, and (c) if residential opportunity leads to improvements in educational performance after children leave impoverished and segregated neighborhoods for integrated and middle-class areas. The analysis reveals that the education of African Americans appears less affected by neighborhood conditions than the two perspectives suggest, at least as they are currently conceptualized and measured. The results are contextualized with the author’s identification of areas in the field where more research is needed, the problems and promise associated with particular analytical strategies, and other social, school-based, and human development dynamics that complicate the estimation of neighborhood influences in education.
Teaching pelvic examination technique using professional patients: a controlled study evaluating students' skills
Authors: Wånggren Kjell , Fianu Jonassen Aino , Andersson Sonja , Pettersson Gunilla , Gemzell‐Danielsson Kristina
Published: September 2010

Objective. To compare the skills in pelvic examination technique between students who have had training with professional patients and a control group of students trained using clinical patients. Design. Prospective controlled study. Setting. University hospital. Population. Students attending three consecutive courses in obstetrics and gynecology at Karolinska University Hospital. Methods. A study group of 53 students received training in pelvic examination with professional patients and was compared with a control group of 34 students who were trained using clinical patients. Main outcome measures. The students' skills in pelvic examination technique were examined by teachers in a practical test. Students' skills were also evaluated by the students themselves and by the patients who participated in the examination. Results. Students who had training with professional patients were more skilled in performing a pelvic examination and better prepared to examine their own patients than students trained using clinical patients. Conclusions. Training with professional patients is more effective in teaching pelvic examination technique than training with clinical patients. We recommend that the use of professional patients is considered in the training of medical students.
Hormonal and metabolic characteristics of premenopausal women with a history of preeclamptic pregnancy
Authors: Tuuri Anna , Tiitinen Aila , Hiilesmaa Vilho , Hämäläinen Esa , Turpeinen Ursula , Tikkanen Matti J. , Kaaja Risto
Published: September 2010

Objective. To investigate whether women with a history of preeclampsia have more signs of hyperandrogenism and insulin resistance in the premenopausal period than women with history of normotensive pregnancies. Design. Case–control study. Setting. University Hospital. Sample. Eighteen women with a history of preeclamptic first pregnancy and 19 women with prior normotensive first pregnancy studied 23–24 years after delivery. Methods. Diagnosis of metabolic syndrome was based on the International Diabetes Federation (IDF) criteria. Matsuda's whole‐body insulin sensitivity index, serum concentrations of follicle‐stimulating hormone (FSH), sex hormone‐binding globulin, and total and free calculated testosterone were assessed. Polycystic ovary syndrome (PCOS) phenotype was defined using Rotterdam criteria. Main outcome measures. Insulin sensitivity, metabolic syndrome and signs of hyperandrogenism. Results. Insulin sensitivity and total and free testosterone were similar in the two groups. However, in women with prior preeclampsia and FSH below the median, calculated free testosterone levels were higher than in women with prior preeclampsia and FSH above the median (median 13.4 range (8.0–22.5) vs. 7.1 (5.1–20.5), p = 0.03). Of the women with previous preeclampsia, 17% (3/18) had metabolic syndrome and 11% (2/18) PCOS, versus 11% (2/19) and 0% of the controls, respectively. Conclusions. In women with prior preeclampsia, premenopause was not associated with insulin resistance, but signs of hyperandrogenism were present if FSH was within a premenopausal level.
Prenatal course and outcome in 103 cases of fetal spina bifida: a single center experience
Authors: Amari Feriel , Junkers Wiebe , Hartge David , Beyer Daniel Alexander , Axt‐Fliedner Roland , Weichert Jan
Published: September 2010

Objective. To investigate the prenatal course and functional outcome for fetuses with spina bifida according to the level of the spinal lesion at prenatal ultrasound examination.Design. Retrospective, descriptive study.Setting. Tertiary referral center, Germany.Population. A total of 103 fetuses with spina bifida identified between 1993 and 2008.Methods. The antenatal course and postnatal outcome for affected fetuses were reviewed. The relation of relevant outcome domains to the anatomical level was assessed using Fisher's exact test and theχ2‐test.Main outcome measures. Level and type of spinal lesion, pregnancy outcome, psychomotor development, bladder and bowel function.Results. Our cohort included a total of 31 live born infants, 68 terminated pregnancies, four intrauterine fetal deaths and five postnatal deaths. Four cases were excluded from follow‐up. Twenty of the remaining 22 infants had normal or only slightly impaired mental development (91%). Thirteen children (59%) were able to walk, but nine (41%) needed wheelchairs or were paraplegic. The rate of poor motor outcome varied strongly in dependence on the level of the lesion (22.2% at lower lumbosacral levels to 80% at thoracic level). The majority of the affected children (16/22, 72.7%) suffered from impairment of bladder function. In 36% of cases (8/22) anal incontinence was documented.Conclusion. Spina bifida can result in a spectrum of disabilities that frequently lead to an impairment of bladder, bowel and motor function. The motor function depended on level of the lesion.
Unresolved grief in women and men in Sweden three years after undergoing unsuccessful in vitro fertilization treatment
Authors: Volgsten Helena , Svanberg Agneta Skoog , Olsson Pia
Published: September 2010

Objective. To explore the experience of undergoing unsuccessful in vitro fertilization (IVF) treatment and of remaining childless 3 years after IVF in both women and men. Design. Qualitative‐approach study. Sample. Ten women and nine men who had attended a public fertility clinic in Sweden. Methods. Individual qualitative semi‐structured interviews were conducted with qualitative content analysis guiding the analysis. Results. Three years after the end of IVF treatment, most men and women were still processing and had not adapted to childlessness, indicating that the grieving process was unresolved. Unsuccessful IVF was experienced by women in terms of grief, whereas men took upon themselves a supportive role and did not express grief. A need for professional support and counseling in how to handle grief was described. An unstructured end after IVF treatment left unanswered questions. Conclusions. The grieving process after unsuccessful IVF treatment was hampered among both men and women. The provision of additional individual support during IVF is recommended as men and women experienced childlessness differently. Support and counseling concerning grief reactions following IVF failure, and a structured final consultation after IVF may facilitate the grieving process after undergoing unsuccessful IVF treatment.
Visual outcome of conventional extracapsular cataract extraction with posterior chamber intraocular lens implantation versus manual small-incision cataract surgery
Authors: Gurung A , Karki DB , Shrestha S , Rijal AP
Published: September 2010

Background: An effective method for cataract surgery should be identified to combat cataract blindness. Aim: To study the surgical outcome of conventional extracapsular cataract extraction versus manual small-incision cataract surgery. Materials and methods: A randomized clinical trial was carried out including one hundred eyes (88 patients) which were divided into two groups using systematic randomization: groups of conventional extracapsular cataract extraction with posterior chamber intraocular lens (ECCE with PCIOL) implantation and manual small-incision cataract surgery (MSICS). The postoperative parameters/variables studied were the unaided and best-corrected visual acuity and astigmatism. Statistics: Epi info 2000 version statistical software was used for data analysis and calculation of relative risk, 95% CI and p value. The p value of less than 0.05 was considered as significant. Results: In the immediate postoperative period, unaided visual acuity of =/> 6/18 was achieved in 24 subjects in MSICS group versus 7 in ECCE with PCIOL group (RR=2.05, 95% CI=1.44 - 2.94, p = 0.0002), whereas the same at 6 - 8 weeks postoperatively was found in 28 and 22 subjects in those groups respectively (RR=1.27, 95% CI=0.86-1.89, p=0.23). The astigmatism of =/> 2 at 6 - 8 weeks was found in 35 and 17 subjects from the conventional and MSICS groups respectively ( R=2.28, 95% CI = 1.39-3.73, p=0.0002). Conclusion: Both MSICS and conventional ECCE with PCIOL are safe and effective techniques for treatment of cataract patients. A more rapid recovery of good vision can be achieved with MSICS than with conventional ECCE with PCIOL in the immediate postoperative period. Key words: ECCE; MSICS; visual acuity; astigmatism DOI: 10.3126/nepjoph.v1i1.3668 Nep J Oph 2009;1(1):13-19
Preliminary experiences with limbal relaxing incision for treatment of astigmatism during phacoemulsification
Authors: Sharma BR , Kumar A
Published: September 2010

Introduction: This small study relates our early experiences with the Limbal Relaxing Incision (LRI) for management of astigmatism in patients undergoing cataract surgery. Aims: To evaluate the efficacy of LRI in the management of primary astigmatism when combined with phacoemulsification. Subjects and methods: Limbal relaxing incisions were performed to correct primary astigmatism in 12 eyes of 12 cataract patients who underwent phacoemulsification as the primary procedure. The length and number of incisions were determined using the AMO LRI calculator software programme using Donnenfield and NAPA nomograms. Keratometric astigmatism was measured preoperatively and postoperatively on day 1 and after 3 weeks or more. Surgically-induced astigmatism (SIA) and the intended angle of error were evaluated by the vector analysis method. Preoperative and postoperative uncorrected visual acuity (UCVA) and best spectacle corrected visual acuity (BSCVA) were evaluated in each visit. Results: The mean age of patients was 52.92 ±10.91 years. There were 75 % male and 25 % female patients. The mean keratometric preoperative astigmatism was 2.08 ±1.05 diopter. The mean 1st postoperative day keratometric astigmatism was 1.74 ±1.32 diopter and the mean final keratometric astigmatism at 3 weeks postoperatively was 1.05± 0.68 diopter. The mean SIA on the 1st postoperative day was 2.97 ±1.72 diopter at 103.25±56.57 degree with intended angle of error 6.53±9.61 degree. The mean SIA on the 3rd postoperative week was 2.26±0.87 Diopter at 107.08±49.96 degrees with intended angle of error 2.90±7.87 degrees. Conclusion: Limbal relaxing incisions are effective method to reduce postoperative astigmatism with good predictability of intended angle. Keywords: limbal relaxing incision (LRI); uncorrected visual acuity (UCVA); surgically induced astigmatism (SIA); angle of error; target astigmatic treatment (TAT) DOI: 10.3126/nepjoph.v1i2.3681 Nep J Oph 2009;1(2):90-94
Hospital-based community cataract surgery: comparison of visual outcomes between conventional extra-capsular cataract extraction and small incision cataract surgery
Authors: Karki P , Shrestha JK , Shrestha JB
Published: September 2010

Introduction: The small-incision cataract surgery is gaining popularity among the ophthalmic surgeons. Objective: To compare the visual outcome of conventional extra-capsular cataract extraction (ECCE) and small-incision cataract surgery (SICS) in a hospital based community cataract program. Materials and methods: A prospective interventional study without randomization was carried out including the patients undergoing cataract surgery by either conventional ECCE or manual SICS. They were followed up for 6 weeks postoperatively. The visual outcomes were compared between the two groups. Statistics: The statistical program Epi-Info version 2000 was used to analyze the data. Mean values with standard deviations, 95% CI and p value were calculated. The p value of <0.05 was considered significant. Results: Of 85 patients, 44 (M: F=10:34) underwent ECCE and 41 (M: F=15:26) SICS (RR= 0.71, 95% CI=0.42-1.2, p value=0.16). Unaided visual acuity on the 1st postoperative day in the ECCE group was e"6/ 18 in 22.7%,<6/18-6/60 in 63.6 %,< 6/60 in 13.7%, whereas in the SICS group, the same was e"6/18 in 70.7%,<6/18-6/60 in 22 %,< 6/60 in 7.3% (95% CI = 0.23 - 0.48, p=0.001). Best corrected visual acuity on the 6th week follow-up in the ECCE group was e"6/18 in 79.5%,<6/18-6/60 in 18.2 %,< 6/60 in 2.3% and in the SICS group the same was 6/18 in 90.5% and <6/18-6/60 in 4.9% (95% CI=0.44 - 0.73; p=0.0012). Conclusion: Both ECCE and SICS are good procedures for hospital based community cataract surgery but within the 6 weeks postoperative period SICS gives better visual outcome. Remarkably higher number of female patients can be provided service in a hospital based community cataract programme as compared to males. Keywords: cataract; small incision; extra-capsular DOI: 10.3126/nepjoph.v1i2.3686 Nep J Oph 2009;1(2):118-122
Association between Helicobacter pylori and open angle glaucoma: current perspective
Authors: Zaidi M , Jilani FA , Gupta Y , Umair S , Gupta M
Published: September 2010

Helicobacter pylori is a Gram negative, spiral-shaped, strictly micro-aerophilic and flagellate human pathogen that can inhabit many areas of stomach. H. pylori infection leads to the generation of oxygen free radicals. H. pylori infection might also aggravate the course of glaucoma by increasing the levels of nitric oxide, endothelin-1 and free radicals indirectly. This article briefly reviews the current perspectives on this issue. Keywords: Helicobacter pylori; glaucoma; free radicals DOI: 10.3126/nepjoph.v1i2.3688 Nep J Oph 2009;1(2):129-135
Profile of the glaucomas and intervention in a large eye care centre in South-East Nepal
Authors: Sarkar S , Mardin C , Henning A
Published: September 2010

Introduction: Glaucoma is the second leading cause of blindness worldwide. Objective:To estimate the prevalence and risk factors of glaucoma and modes of therapeutical intervention in a rural population of a developing country. Patients and methods: A single centre-based cross-sectional study was carried out over a seven-month period in Sagarmatha Choudhary Eye Hospital (SCEH), Lahan/NEPAL, including the patients with glaucoma. Outcome measurement: The patients' demography, type of the glaucomas, visual acuity, vertical cup-disc ratio, intra-ocular pressure and visual field findings were the parameters studied. Results: A total of 3986 eyes with suspected glaucoma were identified. 53.7 % of the patients were between 41- 60 years of age. 53.9 % were male. 26.5 % were blind or severely visually impaired. 37.2 % had IOP more than 35 mmHg. 46.4 % had vertical cup-disc ratio (VCDR) higher than 0.8. Severe visual field defects were found in 28.4 % eyes. 35.3% eyes had primary angle-closure glaucoma, 22.6 % eyes primary open-angle glaucoma, and 14.6 % eyes normaltension glaucoma. 10.2 % eyes suffered from lens induced glaucoma. Only in 9 eyes was pseudoexfoliation syndrome with glaucoma diagnosed. 25.7 % eyes were advised for trabeculectomy. 11.5 % eyes underwent extra-capsular cataract surgery. IOP lowering medication was prescribed in 5.9 % patients. Conclusions: The most common glaucoma seen in the out-patient department of a large eyecare centre in South-East Nepal is primary angle-closure glaucoma. 25 % of the glaucoma patients are visually impaired or blind at the time of presentation. In more than one-fourth of the patients, trabeculectomy is the therapy of choice. Keywords: glaucoma; South-East Nepal; North-East India; Bihar; blindness. DOI: 10.3126/nepjoph.v2i1.3697 Nep J Oph 2010;2(1):3-9
Effectiveness of intra-operative and post-operative use of 5-Fluorouracil in trabeculectomy – a randomized clinical trial
Authors: Malla P , Karki P , Das H
Published: September 2010

Introduction: The success rate of trabeculectomy is limited by postoperative scarring. Objective: To evaluate the effectiveness of intra-operative and post-operative use of 5- Fluorouracil (5-FU) in trabeculectomy Materials and methods: Thirty consecutive eyes undergoing trabeculectomy were randomized systematically into 3 groups of ten patients each. Group A served as a control; in Group B intraoperative 5-FU was used, whereas Group C received post-operative sub-conjunctival 5-FU. The variables studied were pre- and post-operative intraocular pressure, post-operative bleb characteristics and complications. Statistics: Data were evaluated using the SPSS ver 10.0 program. ANOVA, paired t test and chi2 tests were performed. Results: The means of age in years of patients in group A, B and C were 49 ± 9.23, 56.50 ± 8.39 and 52.10 ± 8.96 respectively (p = 0.222). The means of pre-operative IOP in groups A, B and C were 37.80 ±10 mmHg, 42.00 ± 11.22 mmHg and 29.40 ± 12.82 mmHg respectively. The medians of pre-operative anterior chamber depth (ACD) in groups B and C were 3 and 2 in group A according to van Herrick's grading. The mean values of final IOP were 11.90± 3.50, 11.70 ± 4.24, 11.00 ± 2.83 mmHg (p=0.841). The median post-operative anterior chamber depth in all the groups was similar compared to the pre-operative anterior chamber depth (p= 0.510). The final bleb scores in all the groups were similar (p=0.873). Conclusion: The intra-operative and post-operative use of 5-FU in trabeculectomy is almost equally effective in terms of IOP control and bleb characteristics. Keywords: trabeculectomy; 5-Fluorouracil; glaucoma DOI: 10.3126/nepjoph.v2i1.3699 Nep J Oph 2010;2(1):16-25
Association between pregnancy-induced hypertensive fundus changes and fetal outcomes
Authors: Karki P , Malla P , Das H , Uprety DK
Published: September 2010

Background: Ocular involvement in pregnancy-induced hypertension (PIH) is common. Objective: To study the association between pregnancy-induced hypertensive fundus changes and fetal outcomes. Subjects and methods: A prospective cohort study was carried out including 153 subjects with the diagnosis of PIH. The subjects were evaluated for hypertensive fundus changes. Fetal outcomes were assessed in terms of gestational age, birth weight, 1 minute Apgar score, stillbirth and neonatal death. Statistics: The chi 2 test was used to evaluate the association between the various fundus changes and fetal outcomes using SPSS version 10 software program. Results: Fundus changes were found in 13.7 % of the subjects. The means of systolic and diastolic BP of the subjects with hypertensive fundus changes were 182.86 ± 33.64 and 125.24 ± 21.36 respectively, whereas those values without fundus changes were 150.72 ± 12.86 and 100.07 ± 9.51.Vitreous hemorrhage, serous retinal detachment and macular star were not found in this study. Fetal outcomes in PIH patients with vascular changes alone were similar to those with no fundus changes. Retinal and optic nerve head changes were found to be associated (p =0.016) with low birth weight (<2.5 kg). Choroidal changes and optic nerve head changes were associated with low Apgar score. Conclusion: Retinal and optic nerve head changes are associated with low birth weight. Choroidal changes and optic nerve head changes are associated with low Apgar score. Fundus evaluation in patients with PIH is an important procedure to predict adverse fetal outcomes. Keywords: PIH; retinopathy; choroidopathy; optic neuropathy; fetal outcomes. DOI: 10.3126/nepjoph.v2i1.3700 Nep J Oph 2010;2(1):26-30
Surgical treatment and histopathological analysis of proptosis
Authors: Rizvi SAR , Gupta Y , Gupta M
Published: September 2010

Introduction: Inflammations and tumors of the orbit and para-orbital regions may present as proptosis. Management depends on clinical, radiological, histo-pathological and biochemical evaluation. Objective: To analyze the clinical and histopathological profile of the lesions causing proptosis and to report the outcome of their surgical management. Materials and methods: In a retrospective study, 25 cases of proptosis due to orbital and paraorbital tumours were analyzed in relation to their age, sex, and clinical and histopathological profiles. CT Scan was considered as the first line investigation modality. According to location and type of tumour, different surgical options like anterior orbitotomy, lateral orbitotomy and medial orbitotomy were considered. Results: The majority of the patients were of the age group 50-59 years (28 %). Primary orbital tumors were encountered in 15 cases (60 %) and para-orbital in 10 (40 %). Of 15 primary orbital tumors, 7 (46.66 %) were excised by lateral orbitotomy, another 7 (46.66 %) were approached via anterior orbitotomy, whereas 1 (6.67%) was removed by medial orbitotomy. Pediatric orbital tumors were quite common {7(46.66%)}. Three cases of rhabdomyosarcoma, 3 cases of dermoid cyst and 1 case each of optic nerve glioma were found in pediatric age group. The most common benign adult tumor found in our study was pleomorphic adenoma of the lacrimal gland {3(20%)}. Conclusion: The majority of the patients with proptosis are of the age group 50-59 years. Proptosis due to primary orbital tumors is more common than para-orbital tumors. Early diagnosis and timely surgical intervention provide good functional and cosmetic results. Keywords: orbit; proptosis; tumors; orbitotomy. DOI: 10.3126/nepjoph.v2i1.3701 Nep J Oph 2010;2(1):31-34
A profile and treatment outcome of seasonal hyper-acute panuveitis
Authors: Shrestha E
Published: September 2010

Introduction: Seasonal hyper-acute panuveitis (SHAPU) is a sight-threatening disease and its management is challenging. Objective: To study the profile and evaluate the visual outcome of the patients of clinicallydiagnosed cases of SHAPU after treatment. Subjects and methods: A retrospective interventional hospital-based study was carried out involving 21 subjects with clinically-diagnosed SHAPU. The data were retrieved from the record section of the hospital and analyzed. The variables studied were demographic pattern, clinical condition, duration of presentation and visual acuity before and after the treatment. Statistics: The data were analyzed using Epi Info version 2000. Percentage prevalence, mean values with standard deviation, relative risk, 95% CI and p value were calculated. P value of < 0.05 was considered to be significant. Results: Among the 21 cases, the numbers of male and female were 11 (52.4 %) and 10 (46.7 %) respectively. A comparative analysis of gender in children and adults did not show any significant difference (RR=0.47, 95% CI = 0.22 - 1.01, Fisher exact test: p = 0.14). The mean for all ages was 7 ± 12.68 years, while the mean age in pediatric cases was 4.5 ± 3.91 years. Thirteen (61.9%) cases occurred in children below fifteen years. Fifteen (71.4 %) cases reported during September and October. Presenting visual acuity of all cases was less than 3/60. All of them received medical treatment. By the end of the 4th week, seven (33.3 %) patients regained vision to 6/18. Conclusion: SHAPU is more prevalent in pediatric age group. It is equally prevalent among males and females. The visual acuity can improve with early medical treatment. Keywords: SHAPU; panuveitis; steroid; phthisis bulbi DOI: 10.3126/nepjoph.v2i1.3702 Nep J Oph 2010;2(1) 35-38
Orbital rhabdomyosarcoma in an adult
Authors: Lavaju P , Das H , Malla P , Tiwari A , Sinha A , Upadhyaya P
Published: September 2010

Introduction: Rhabdomyosarcoma is the most common primary orbital malignant tumor in children. Orbital lesions represent about 10 % of all the cases of rhabdomyosarcoma. Rhabdomyosarcoma is a rare cause of proptosis in adults. Objective: To report a case of primary orbital rhabdomyosarcoma in a 45-year-old female. Design: Interventional case report. The main outcome measures are a rare cause of proptosis in an adult, discussion on treatment options and prognosis of rhabdomyosarcoma. Result: The patient underwent total orbital exenteration and was referred for radiotherapy and chemotherapy. Conclusion: Rhabdomyosarcoma is a rare cause of proptosis in adults. It should be suspected in a case of rapidly-progressive proptosis in adults. DOI: 10.3126/nepjoph.v2i1.3707 Nep J Oph 2010;2(1) 64-67
Peripheral ulcerative keratitis triggered by bacterial conjunctivitis
Authors: Pokharel A , Subedi S , Bajracharya M
Published: September 2010

Background: Peripheral ulcerative keratitis (PUK) is a disorder consisting of a crescent-shaped destructive inflammation of the perilimbal corneal stroma. Case: We present a case of PUK following acute bacterial conjunctivitis in a 60-year-old lady with a history of on-and-off joint pain for two years. After admission to the hospital, she underwent conjunctival resection and was given topical and oral steroids. She was prescribed hydroxychloroquine after confirming the diagnosis of rheumatoid arthritis with a positive RA factor. Conclusion: This report highlights the role of infection as a triggering agent in the induction of PUK in an otherwise quiescent cornea. Keywords: conjunctivitis; peripheral ulcerative keratitis; rheumatoid arthritis DOI: 10.3126/nepjoph.v2i1.3709 Nep J Oph 2010;2(1) 71-73
PRK vs LASEK vs Epi-LASIK: A comparison of corneal haze, postoperative pain and visual recovery in moderate to high myopia
Authors: Reilly CD , Panday V , Lazos V , Mittelstaedt BR
Published: September 2010

Introduction: The field of refractive surgery continues to evolve amid continued concerns as to which surgical technique minimizes the risk of inducing ectasia. Purpose: To compare clinical outcomes between PRK, LASEK and Epi-LASIK in moderately to highly myopic eyes (-4.00 D to -8.00 D). Materials and methods: A retrospective chart review of 100 PRK eyes, 100 LASEK eyes (with alcohol) and 97 Epi-LASIK eyes was performed. Post-operative pain, uncorrected visual acuity, and corneal haze data was recorded and analyzed at post-op days 1, 4 and 7 and at post-op months 1, 3, 6 and 12. Results: In all groups surgical corrections ranged from -4.00 D to -8.00 D. There was less pain associated with the epi-LASIK procedure especially early (post-op days 1 and 4). Visual recovery was superior within the PRK group during the first post-operative week but by post-op week 4 all three were equal. Haze scores were similar but a trend for less haze was demonstrated with epi-LASIK at 6 and 12 months. Conclusion: Epi-LASIK has a slight advantage over PRK and LASEK early on in the post-op course with regards to pain. Visual recovery is similar by 4 weeks and is better with PRK early. In addition, epi-LASIK trends toward less significant haze. Keywords: LASIK; epi-LASIK; LASEK; PRK; haze DOI: 10.3126/nepjoph.v2i2.3715 Nep J Oph 2010;2(2) 97-104
The patterns of refractive errors among the school children of rural and urban settings in Nepal
Authors: Pokharel A , Pokharel PK , Das H , Adhikari S
Published: September 2010

Introduction: The uncorrected refractive error is an important cause of childhood blindness and visual impairment. Objective: To study the patterns of refractive errors among the urban and rural school going children of Nepal. Subjects and methods: A total of 440 school children of urban and rural schools within the age range of 7-15 years were selected for this study using multi-stage randomization technique. Results: The overall prevalance of refractive error in school children was 19.8 %. The commonest refractive error among the students was myopia (59.8 %), followed by hypermetropia (31.0 %). The children of age group 12-15 years had the higher prevalence of myopia as compared to the younger counterparts (42.5 % vs 17.2 %). The prevalence of myopia was 15.5 % among the urban students as compared to 8.2 % among the rural ones (RR = 1.89, 95 % CI = 1.1-3.24). The hypermetropia was more common in urban students than in rural ones (6.4 %) vs 5.9 %, RR = 1.08 (95 % CI: 0.52-2.24). Conclusion: The prevalence of refractive error in the school children of Nepal is 19.8 %. The students from urban settings are more likely to have refractive error than their rural counterparts. DOI: 10.3126/nepjoph.v2i2.3717 Nep J Oph 2010;2(2) 114-120
Conjunctival rhinosporidiosis presenting as a cystic mass-an unusual presentation
Authors: Lavaju P , Arya SK , Kumar B , Upadhaya P
Published: September 2010

Rhinosporidiosis is endemic in India and Sri Lanka and parts of East Africa and South America. Cases of ocular rhinosporidiosis have also been reported from Nepal. Ocular rhinosporidiosis usually involves the conjunctiva and the lacrimal sac. It usually presents as a polypoidal mass. Cystic mode of presentation has not yet been reported in the literature. We herein report an unusual mode of presentation of ocular rhinosporidiosis presenting as a huge conjunctival cystic mass. Key words: conjunctival cyst; oculosporidiosis; rhinosporidiosis; Rhinosporidiosis seeberi DOI: 10.3126/nepjoph.v2i2.3724 Nep J Oph 2010;2(2) 157-159
A report on a rare case of Kearns Sayre-like syndrome
Authors: Gupta Y , Gupta M , Sambhav K , Phougat A , Varshney A
Published: September 2010

Purpose: To report the presentation of a rare case of Kearns-Sayre-like syndrome (KSS) Case: A 14-year-old boy presented with progressive drooping of both upper eyelids for 10 years. Past history of right sided hemi-plegia and left facial nerve palsy was present. Examination (OU) showed total external ophthalmoplegia, ptosis and pigmentary retinopathy. The patient also had a short stature (height 121.9 cm) for his age. Keywords: Kearns Sayre syndrome; total external ophthalmoplegia; ptosis DOI: 10.3126/nepjoph.v2i2.3725 Nep J Oph 2010;2(2) 160-163
Pitfalls in the publication of scientific literature: a road map to manage conflict of interest and other ethical challenges
Authors: Patel Alpesh A. , Whang Peter G. , White Andrew P. , Fehlings Michael G. , Vaccaro Alexander R.
Published: September 2010

The process of publishing scientific research can be hampered by potential pitfalls for journals and researchers alike; the definition and determination of authorship, legal documentation, data accuracy, and disclosure of financial conflicts of interest are all examples. In the current article, the authors discuss the challenges related to scientific medical writing and provide updated recommendations for both the prevention and management of these issues.
Natural Philosophy and the Use of Causal Terminology: A Puzzle in Reid's Account of Natural Philosophy
Authors: Cobb Aaron D.
Published: September 2010

Thomas Reid thinks of natural philosophy as a purely nomothetic enterprise but he maintains that it is proper for natural philosophers to employ causal terminology in formulating their explanatory claims. In this paper, I analyze this puzzle in light of Reid's distinction between efficient and physical causation – a distinction he grounds in his strict understanding of active powers. I consider several possible reasons that Reid may have for maintaining that natural philosophers ought to employ causal terminology and suggest that the underlying rationale for his views is his understanding of the aims of explanation and their connection to the interests of human agents. The ultimate aim of knowing the causes of phenomena is to mollify the natural intellectual curiosity of human inquirers and provide guidance that insures successful action. The discovery of laws governing phenomena fulfills this aim and, as such, it is appropriate for natural philosophers to employ causal terminology.
Identity of Persons and Objects: Why Hume Considered Both as Two Sides of the Same Coin
Authors: Waldow Anik
Published: September 2010

By investigating one of the major inconsistencies that Hume's parallel treatment of the identity of persons and objects issues, this essay offers an unconventional account of what it needs to avoid a dualist picture of mind and world. It will be argued that much hinges on the question of whether or not one is willing to allow the principally unperceivable to enter into one's concept of reality. Hume, as will be shown, rejects this approach: he denies that we have reason to think that there are substances that divide the world into two separate realms. The strategic value of this move is that it enables us to think of minds in terms similar to those underlying our conception of physical objects without urging us to engage in reductionist or eliminativist projects.
Le « patron » MGEN : un exemple de gestion salariale syndicalo-mutualiste (1946-1991)
Authors: Siney-Lange Charlotte
Published: September 2010

Résumé Cet article traite de la politique salariale élaborée par la Mutuelle générale de l’Éducation nationale (MGEN) depuis sa création en 1946. Aujourd’hui première mutuelle de France en termes d’effectifs, la MGEN a connu une croissance sans précédent au cours des Trente Glorieuses, tant au plan des effectifs d’adhérents, du nombre de salariés, que du nombre d’établissements médico-sociaux créés. En conséquence, les administrateurs de la Mutuelle, anciens militants syndicalistes, ont affaire à un personnel de plus en plus nombreux et diversifié. En vertu de leur origine syndicaliste, ces derniers estiment devoir organiser des relations particulières avec leurs salariés. Mais malgré cette bonne volonté affichée, ces « patrons sociaux » ne sont pas épargnés par des conflits sociaux parfois violents, en particulier durant la décennie 1970. Il paraît donc judicieux d’analyser la politique salariale mise en œuvre par la MGEN, l’évolution des relations entre les administrateurs mutualistes et leurs salariés, ainsi que la portée et les retombées des mouvements sociaux qui secouent l’institution.
Le Matin, les affaires et la politique, 1884-1897
Authors: Pinsolle Dominique
Published: September 2010

Résumé Fondé par le journaliste new-yorkais Samuel Chamberlain en 1884, Le Matin est censé révolutionner la presse d’information française en important les méthodes du journalisme américain. Treize ans plus tard, le journal, qui est devenu une feuille officieuse et un instrument de chantage, doit être vendu suite à son échec commercial. Cet article a pour but d’analyser le rapport entre la dépendance du Matin à l’égard des milieux d’affaires, d’une part, et les liens qu’entretiennent le journal et ses bailleurs de fonds avec le monde politique, d’autre part. Lancé grâce au soutien financier d’un richissime industriel américain, Le Matin , dont la formule semble prometteuse, attire des bailleurs de fonds avant tout mus par l’appât du gain. Le journal, trop peu rentable, déçoit rapidement les premiers actionnaires américains, ce qui permet au journaliste Alfred Edwards d’en prendre le contrôle. Ce dernier, de plus en plus confronté à des difficultés financières, transforme Le Matin en une feuille de chantage au service de ses intérêts personnels. Les relations qu’Edwards entretient avec le monde politique sont ainsi subordonnées à des impératifs d’ordre économique.
Responsabilités en souffrance. Les conflits autour de la souffrance psychique des salariés d'EDF-GDF (1985-2008)
Authors: Benquet Marlène , Marichalar Pascal , Martin Emmanuel
Published: September 2010

Résumé L'article analyse le traitement de la souffrance psychique des salariés au sein des entreprises Électricité de France-Gaz de France entre 1985 et 2008, à partir d'un dépouillement exhaustif des procès-verbaux d'une instance nationale. Il entend montrer que l'émergence et les problématisations du thème de la souffrance psychique sur la période ne peuvent être comprises sans tenir compte des débats préexistants sur la responsabilité des accidents, de l'identité des personnes qui le mobilisent, et des argumentations qu'il permet.
A Robust WENO Type Finite Volume Solver for Steady Euler Equations on Unstructured Grids
Authors: Hu Guanghui , Li Ruo , Tang Tao
Published: September 2010

A recent work of Li et al. [Numer. Math. Theor. Meth. Appl., 1(2008), pp. 92-112] proposed a finite volume solver to solve 2D steady Euler equations. Although the Venkatakrishnan limiter is used to prevent the non-physical oscillations nearby the shock region, the overshoot or undershoot phenomenon can still be observed. Moreover, the numerical accuracy is degraded by using Venkatakrishnan limiter. To fix the problems, in this paper the WENO type reconstruction is employed to gain both the accurate approximations in smooth region and non-oscillatory sharp profiles near the shock discontinuity. The numerical experiments will demonstrate the efficiency and robustness of the proposed numerical strategy.
An FFT Based Fast Poisson Solver on Spherical Shells
Authors: Huang Yin-Liang , Liu Jian-Guo , Wang Wei-Cheng
Published: September 2010

We present a fast Poisson solver on spherical shells. With a special change of variable, the radial part of the Laplacian transforms to a constant coefficient differential operator. As a result, the Fast Fourier Transform can be applied to solve the Poisson equation with operations. Numerical examples have confirmed the accuracy and robustness of the new scheme.
Semi-Eulerian and High Order Gaussian Beam Methods for the Schrödinger Equation in the Semiclassical Regime
Authors: Jin Shi , Wu Hao , Yang Xu
Published: September 2010

A novel Eulerian Gaussian beam method was developed in [8] to compute the Schrödinger equation efficiently in the semiclassical regime. In this paper, we introduce an efficient semi-Eulerian implementation of this method. The new algorithm inherits the essence of the Eulerian Gaussian beam method where the Hessian is computed through the derivatives of the complexified level set functions instead of solving the dynamic ray tracing equation. The difference lies in that, we solve the ray tracing equations to determine the centers of the beams and then compute quantities of interests only around these centers. This yields effectively a local level set implementation, and the beam summation can be carried out on the initial physical space instead of the phase plane. As a consequence, it reduces the computational cost and also avoids the delicate issue of beam summation around the caustics in the Eulerian Gaussian beam method. Moreover, the semi-Eulerian Gaussian beam method can be easily generalized to higher order Gaussian beam methods, which is the topic of the second part of this paper. Several numerical examples are provided to verify the accuracy and efficiency of both the first order and higher order semi-Eulerian methods.
Numerical Simulation of Time-Harmonic Waves in Inhomogeneous Media using Compact High Order Schemes
Authors: Britt Steven , Tsynkov Semyon , Turkel Eli
Published: September 2010

In many problems, one wishes to solve the Helmholtz equation with variable coefficients within the Laplacian-like term and use a high order accurate method (e.g., fourth order accurate) to alleviate the points-per-wavelength constraint by reducing the dispersion errors. The variation of coefficients in the equation may be due to an inhomogeneous medium and/or non-Cartesian coordinates. This renders existing fourth order finite difference methods inapplicable. We develop a new compact scheme that is provably fourth order accurate even for these problems. We present numerical results that corroborate the fourth order convergence rate for several model problems.
Extrapolation-Based Acceleration of Iterative Solvers: Application to Simulation of 3D Flows
Authors: Grinberg Leopold , Karniadakis George Em
Published: September 2010

We investigate the effectiveness of two extrapolation-based methods aiming to approximate the initial state required by an iterative solver in simulations of unsteady flow problems. The methods lead to about a ten-fold reduction in the iteration count while requiring only negligible computational overhead. They are particularly suitable for parallel computing since they are based almost exclusively on data stored locally on each processor. Performance has been evaluated in simulations of turbulent flow in a stenosed carotid artery and also in laminar flow in a very large domain containing the human intracranial arterial tree.
The Debt-Growth Nexus in Poor Countries: A Reassessment
Authors: Presbitero Andrea F.
Published: September 2010

The paper investigates the relationship between external debt and economic growth, focusing on the role played by the policy and institutional framework. Results for a panel of 114 developing countries show that the debt-growth nexus depends on institutions and policies. The Debt-Laffer curve looses statistical significance once institutional quality is controlled for and debt overhang seems to be at work exclusively in countries with sound institutions. On the contrary, external debt proves to be irrelevant for countries with weak institutions. A policy implication is that efficient debt relief policies should be tailored to country-specific characteristics and conditional to a certain level of institutional quality.
Price-Concentration Analysis in Merger Cases with Differentiated Products
Authors: Beckert Walter , Mazzarotto Nicola
Published: September 2010

This paper considers the empirical assessment of the relationship between prices and number of firms in local markets in geographic or, more generally, characteristic space and its use as evidence in merger cases. It outlines a structural, semi-nonparametric econometric model of competition in such markets, examines its testable implications in terms of price-concentration relationships, and demonstrates that the model is non-parametrically identified. This general approach to price-concentration analysis in differentiated product markets is illustrated in a small-scale application to cinemas in the UK. The application highlights the main decision points faced by an authority when assessing the weight that can be attached to this type of analysis as evidence.