bluuebunny/crossref_metadata_2025 huggingface dataset:
Ophthalmology practice during COVID-19 pandemic: A survey of Indian ophthalmologists
Authors: Sahay Pranita , Sharma Namrata , Sinha Rajesh , Sachdeva Mahipal S
Published: November 2021

Purpose:

To assess the ophthalmic practice pattern among ophthalmologists in India amidst the COVID-19 pandemic.

Methods:

An online questionnaire-based analysis was performed among members of the All India Ophthalmological Society (AIOS) and results were analyzed using SPSS software version 20.

Results:

A total of 2253 responses were received. The majority of the participants (72.6%) were between 30 and 60 years of age and were into private practice (64.7%). During the lockdown, over one-third of participant ophthalmologists reported not attending any OPD patients, whereas a majority (64%) provided only emergency ophthalmic services. During the COVID-19 pandemic, <15% surgeries were performed compared to the pre-COVID-19 era by 81% of participants, whereas elective surgeries were performed by only 4.3%. The proportion of participants utilizing telemedicine in ophthalmology showed a two-fold rise from the pre-COVID-19 era (21.9%) to the COVID-19 pandemic (46%). Over half of the participants reported following the AIOS guidelines, reducing clinic hours, use of screening questionnaires, minimizing staff, and use of breath shield on a slit lamp as precautionary measures to reduce the exposure. Over 95% of ophthalmologists were satisfied (score > 5/10) by the AIOS guidelines for ophthalmic practice during COVID-19.

Conclusion:

COVID-19 pandemic has adversely affected the ophthalmic care services across India with telemedicine emerging as a major rescue. The majority of practicing ophthalmologists are satisfied with guidelines provided by AIOS for ophthalmic care during the COVID-19 pandemic and have implemented the same in their setup.
Year one of COVID-19 pandemic in India: Effect of lockdown and unlock on trends in keratoplasty at a tertiary eye centre
Authors: Das Anthony V , Chaurasia Sunita , Vaddavalli Pravin K , Garg Prashant
Published: November 2021

Purpose:

To describe the impact of lockdown and unlock phases of the COVID-19 pandemic on keratoplasty trends at a tertiary eye care center in India.

Methods:

This cross-sectional hospital-based study included 6,277 patients presenting between March 25, 2017 and March 31, 2021. The data of the patients who underwent keratoplasty during the lockdown and unlock phases were compared with the respective periods in the previous three years before COVID-19.

Results:

During the year one of pandemic, there was a 29.46% decline in the total number of keratoplasty performed at the institute compared to previous year’s annual numbers. The patients undergoing keratoplasty decreased by 90.28% (28/288) of pre-COVID-19 volumes during the lockdown phase. This was mainly because of a 40.6% reduction in the proportion of patients requiring interstate travel. There was complete recovery in the number of patients undergoing keratoplasty to 129.27% (184/142) of pre-COVID-19 volumes by March 2021. This gradual incremental trend was seen across all types of keratoplasty in Descemet stripping endothelial keratoplasty (135.29%), penetrating keratoplasty (117.6%), therapeutic keratoplasty (122.22%), anterior lamellar keratoplasty (150%), and Descemet membrane endothelial keratoplasty (141.18%) by March 2021 with the gradual ease of lockdown regulations. The eye bank affiliated to the institute saw a 55.44% decline in donor cornea collection and an increase in utilization rate from 58.12% in previous years to 83.78% in year one of the pandemic. The overall eye bank donor cornea collection recovered to 86.96% (627/721) and tissue utilization increased by 109.99% (455/414) by March 2021.

Conclusion:

The first year of the COVID-19 pandemic saw an overall reduction of 29.46% of the patients undergoing keratoplasty at the institute. There was a gradual and incremental increase in all types of keratoplasty in the unlock phase, which surpassed the preceding years’ monthly numbers in February and March.
Prevalence and effectiveness of innovative techniques in ophthalmic surgical training during COVID-19 pandemic in India
Authors: Kaushik Jaya , Chaitanya YVK , Kumar Ashok , Jakhar Pushpendra , Shetty Rakesh , Singhal Aanchal , Parihar JKS , Singh Ankita
Published: November 2021

Purpose:

This study aimed to determine the various innovative surgical training techniques prevalent among ophthalmology residents in India during the COVID-19 pandemic.

Methods:

This was a prospective cross-sectional study. An online survey questionnaire was completed by ophthalmology residents from different parts of the country. The survey consisted of questions related to the impact of the pandemic on training, innovative training techniques adapted during the pandemic and their effectiveness, and COVID-19 duty-related information.

Results:

A total of 147 responses were obtained. The mean age was 29.3 years (range: 24–40 years, SD: ±3.82). Of which, 87 (59.2%) respondents were females. A total of 61 (41.5%) respondents reported practicing steps of ocular surgeries on goat eye, 69 (46.9%) on model eye/vegetables/fruits, 30 (20.4%) on surgical simulators, and 26 (17.7%) utilized 3-D virtual images and videos. In addition, 22 (15%) respondents reported never using any such techniques. Furthermore, 130 (88.4%) respondents reported practicing steps of cataract surgery, 52 (35.4%) practiced steps of open globe repair, and steps of trabeculectomy were reported by 24 (16.3%). The steps that were reported to be practiced most are incision or tunnel construction by 108 (73.5%), suturing by 92 (62.6%), capsulorrhexis by 91 (61.9%), primary wound repair by 82 (55.8%), and conjunctival peritomy by 75 (51%).

Conclusion:

The present study demonstrates that residents across the country are adapting to the present scenario by utilizing several innovative methods to sharpen their surgical acumen. The current pandemic situation can serve as an impetus to emphasize upon the institutes and medical regulatory bodies to appropriately remodel the residency curriculum.
Acute bilateral retrobulbar optic neuritis - An atypical sequela of COVID-19
Authors: Sainath Dipika , Paul Anujeet , Krishnagopal Srikanth , Kumar Ashok
Published: November 2021

Coronavirus disease 19 (COVID-19) and its ophthalmic manifestations have been variably portrayed. We report a case of a 56-year-old female presenting with sudden-onset vision loss associated with painful extraocular muscle movements in both eyes following COVID-19. Visual acuity was counting fingers close to face. Color perception tested was inaccurate. Ocular examination revealed sluggishly reacting pupils and an otherwise unremarkable fundus picture in both eyes, giving us an impression of bilateral retrobulbar neuritis. Magnetic resonance imaging of the brain and orbit were unremarkable, while blood investigations revealed nothing suggestive. The patient dramatically improved with steroid therapy with full visual recovery and a color vision defect. This presentation of bilateral retrobulbar neuritis as a sequela of COVID-19 is presented for its rarity.
Mitomycin C application after photorefractive keratectomy in high, moderate, or low myopia: Systematic review and meta-analysis
Authors: Ouerdane Yassamine , Zaazouee Mohamed Sayed , Mohamed Moaiad Eldin Ahmed , Hasan Mohammed Tarek , Hamdy Mohamed , Ghoneim Abdallah Magdy , Gbreel Mohamed Ibrahim , Ibrahim Ahmed Mohamed , Ragab Khaled Mohamed , Nourelden Anas Zakarya
Published: November 2021

Photorefractive keratectomy (PRK) is considered a safe approach laser procedure with a clinical significance in correcting myopia results. PRK requires removing the whole superficial epithelium. The integrity of the epithelial basement membrane and the deposition of abnormal extracellular matrix can put the cornea in a probable situation for corneal haze formation. Mitomycin C (MMC) is applied after excimer laser ablation as a primary modulator for wound healing, limiting corneal haze formation. We aim to summarize the outcomes of MMC application after laser ablation. We searched Scopus, PubMed, Cochrane CENTRAL, and Web of Science till December 2020 using relevant keywords. The data were extracted and pooled as mean difference (MD) or risk ratio (RR) with a 95% confidence interval (CI), using Review Manager software (version 5.4). Our analysis demonstrated a statistically significant result for MMC application over the control group in terms of corneal haze formation postoperatively (RR = 0.29, 95% CI: [0.19, 0.45], P < 0.00001). Regarding corrected distance visual acuity (CDVA), no significant difference was observed between the MMC group and the control group (MD = 0.02; 95% CI: [-0.04, 0.07]; P = 0.56). Regarding the uncorrected distance visual acuity (UDVA), the analysis favored the MMC application with (MD -0.03, 95% CI: [-0.06, -0.00]; P = 0.05). There was no statistically significant increase in complications with MMC. In conclusion, MMC application after PRK is associated with a lower incidence of corneal haze formation with no statistically significant side effects. The long term effect can show improvement regarding UDVA favoring MMC. However, there is no significant effect of MMCs application regarding CDVA, and SE.
Efficacy of topical cyclosporine 0.05% and osmoprotective lubricating eye drops in treating dry eye disease and inflammation
Authors: Mullick Ritika , Annavajjhala Sriram , Thakur Prashansa , Mohapatra Ayushi , Shetty Rohit , D’Souza Sharon
Published: November 2021

Purpose:

To evaluate the effect of topical cyclosporine 0.05% and osmoprotective lubricating eye drops on patients with dry eye disease (DED) with inflammation as measured by raised tear matrix metalloproteinases (MMP-9).

Methods:

This prospective study included 106 eyes of 53 patients diagnosed with DED based on any of the following DED criteria (Ocular Surface Disease Index [OSDI] score >12, tear film breakup time [TBUT] <10 s, Schirmer’s I test result <10 mm/5 min, ocular surface staining). Ocular surface inflammation was assessed by assessing MMP-9 positivity from tears of the patients in the study (Inflammadry kit Quidel corporation). Patients were prescribed osmoprotective lubricating eye drops (Osmodrops, Cipla Ltd) four times a day and cyclosporine A 0.05% eye drops (Imudrops, Cipla Ltd) twice a day for 6 months. Efficacy of the formulations was evaluated by OSDI scores, Schirmer’s test, TBUT change, reduction in ocular surface staining, and reduction in MMP-9 levels after 6 months of usage. Check P value and add from results

Results:

After 6 months of topical therapy, improvement was observed in OSDI scores (mean pretreatment: 25.7 ± 12.8, and mean posttreatment: 15.2 ± 8.4), P < 0.001. There was also reduction number of patients who were MMP-9 positive. Out of 75 eyes that tested MMP-9 positive, 70.66% showed reduction in MMP-9 levels P < 0.0001). Ocular surface staining also improved.

Conclusion:

Topical osmoprotective lubricating eye drops and cyclosporine A 0.05% reduce inflammation in cases of DED, which correlates with improvement in OSDI scores, ocular surface staining, and reduction in inflammation as measured by levels of tear MMP-9.
Sequence of events leading to diagnosis of keratoconus and its impact on quality of life
Authors: Dudeja Lakshey , Chauhan Tulika , Vohra Sanchi
Published: November 2021

Purpose:

Early diagnosis of keratoconus (KCN) and corneal collagen cross-linking can ensure that best-corrected visual acuity is preserved. We report the sequence of events leading to the diagnosis of KCN, as well as its impact on quality of life.

Methods:

This survey-based study included patients diagnosed with KCN for the first time at our center. Their corneal tomography was analyzed, and they were provided with a proforma and the NEI-VFQ-25 questionnaire and were asked to answer the given set of questions.

Results:

The study included 328 eyes of 164 patients. At the time of diagnosis, 112 (68.3%) patients were not aware of a disease called “keratoconus.” VKC was present in 56 patients, and 92 patients were not aware of the need to avoid eye rubbing. In total, 101 patients gave a history of sleeping more often on the side with worse KCN. The preferred primary point of contact was an optometrist for 45.1% of patients; 51.2% of patients reported never having visited an ophthalmologist. Sixty-four (39%) patients were advised a screening test to rule out KCN before presenting to our center; 42 (71.8%) of these patients did not get it done. Vision-targeted score showed a significant negative correlation with grade of KCN (r value: −0.471) and positive correlation (r value: 0.534) with LogMAR vision.

Conclusion:

KCN is a disease of the young and severely affects the quality of life. Improving awareness of the general public, ensuring timely referral by optometrists, and keeping a high index of suspicion is emphasized.
A novel method of tunnel creation using intraoperative optical coherence tomography-guided deep anterior lamellar keratoplasty
Authors: Singh Bhupesh , Sharma Sourabh , Bharti Neha , Bharti Sudhank
Published: November 2021

The big bubble technique has become the technique of choice for performing deep anterior lamellar keratoplasty (DALK) since its inception in 2002. The main challenge with this technique is in achieving a big bubble while preventing inadvertent perforation of the Descemet’s membrane. Although femtosecond lasers have increased the safety, accuracy, and predictability of corneal dissection in DALK, the challenge of achieving a big bubble still exists. To overcome this challenge, Zeimer Z8 Femto LDV has launched a new software module for DALK, which has an added advantage of real-time optical coherence tomography–assisted femtosecond tunnel creation for achieving a big bubble.
Assessment of the lamina cribrosa in attention-deficit hyperactivity disorder
Authors: Akkaya Serkan , Ulusoy Döndü M , Doğan Hatice , Arslan Mahmut E
Published: November 2021

Purpose:

The aim of this study was to determine the usefulness of the lamina cribrosa thickness (LCT) and lamina cribrosa depth (LCD) in adolescence with attention-deficit hyperactivity disorder (ADHD) and compare with those receiving methylphenidate (MPH) and healthy controls.

Methods:

Fifty-five children with ADHD (9.23 ± 1.92 years, mean ± standard deviation), 41 children with ADHD given MPH (9.24 ± 1.84 years), and 86 healthy controls (9.95 ± 2.16 years) were recruited for the study. All subjects were subjected to a complete eye exam and optical coherence tomography (OCT) was used to assess LCT and LCD. The severity of ADHD symptoms was evaluated by using parent-report measures, including Conners’s Parent Rating Scale–Revised: Short Form (CPRS-R: S) and the Strengths and Difficulties Questionnaire: Parent Form (SDQ: P).

Results:

The study showed a significant finding between the research groups with regard to LCT. LCT was shown to be significantly increased in ADHD subjects given MPH compared with the controls. However, LCD was not significantly different between cohorts. Also, a significant inverse correlation was found between the SDQ: P–Emotional Problems Subscale and LCT (r = −0.253; P = 0.030) in ADHD patients.

Conclusion:

Changes in lamina cribrosa (LC) in ADHD children receiving MPH suggest that the mechanism of action for MPH may target developing LC structures. More studies to define the relationship between MPH medications and the LC variations are defensible.
Tuck-and-pull technique for posterior chamber phakic intraocular lens explantation
Authors: Coskunseven Efekan , Kayhan Belma , Jankov Mirko R
Published: November 2021

The tuck-and-pull technique was developed for practical and safe explantations of posterior chamber phakic intraocular lenses (PCPIOLs). In this technique, after the creation of a side port, viscoelastic (or OVD [ophthalmic viscosurgical device]) is initially injected behind the PCPIOL to widen the space between PCPIOL and the crystalline lens. The old incisions can be used after recent implantations rendering the enlargement of the main incision unnecessary. After additional OVD over and under the PCPIOL, the haptic is tucked by a chopper and pulled through the main incision with a single maneuver. The haptic is grasped by two suture forceps and explanted with a “hand-to-hand” maneuver. The tuck-and-pull technique provided high protection of the corneal endothelium, crystalline lens, anterior chamber structures, and the PCPIOL itself. This technique is a practical, easy, and safe approach for explantations of all PCPIOL types, whatever the reason for its explantation may be.
Role of Scheimpflug imaging for assessment of posterior lens capsule in pediatric traumatic cataract
Authors: Sen Pradhnya , Kumar Naveen , Mohan Amit , Shah Chintan , Jain Elesh , Sen Alok
Published: November 2021

Purpose:

To find the accuracy of Scheimpflug imaging for the evaluation of posterior lens capsule and to assess the incidence of pre-existing posterior capsular tear (PCT) in pediatric traumatic cataracts.

Methods:

It was a prospective, non-randomized, and interventional study. Scheimpflug imaging was done preoperatively to detect pre-existing PCT in pediatric traumatic cataracts after blunt trauma. All patients underwent cataract extraction with intraocular lens implantation. Intraoperatively, the posterior capsule status was noted and compared with the preoperative Scheimpflug images.

Results:

Forty-seven eyes of 47 children having traumatic cataracts following closed-globe injury were included. There were 32 males and 15 females with a mean age of 10.91 ± 2.75 years. The mean duration of performing the Scheimpflug imaging from injury was 41.7 ± 7.78 days. Preoperative Scheimpflug imaging showed intact posterior lens capsule in 36 eyes and PCT in 11 eyes. Intraoperative, 37 eyes had an intact posterior lens capsule and 10 eyes had PCT. The Scheimpflug imaging did not detect the PCT in three eyes (false-negative), and in four eyes, PCT was detected falsely on Scheimpflug imaging (false-positive). The sensitivity and specificity of the Scheimpflug imaging were 70 and 89.18%, respectively. The accuracy of the technique was 85.11%.

Conclusion:

Scheimpflug imaging is a useful modality for the detection of PCT preoperatively in cases with doubtful posterior lens capsule integrity.
Firework related ocular injuries in Eastern India - A clinico-epidemiological analysis
Authors: Parija Sucheta , Chakraborty Koyel , Ravikumar S R
Published: November 2021

Purpose:

Ocular trauma is one of the major preventable causes of ocular morbidity and blindness in children and young adults. Firework injuries account for 20% of ocular trauma. The purpose of this study was to describe the clinical profile and assess the severity of the ocular injuries sustained from fireworks in Eastern India mainly during the festive season.

Methods:

This was a retrospective, hospital-based case study of patients with ocular injuries sustained from fireworks during the year 2017–2020. The study was conducted at a tertiary care hospital in Eastern India. Demographic details, type of injury, duration of injury, visual status, diagnostic tests, and management were recorded.

Results:

Sixty-five patients were reported to suffer from firework-related ocular injuries. The majority of cases were male (51/78.5%). The mean age was 21.78 ± 16.82 years (range: 0–90 years). Children and young adult males were mostly affected (n = 40, 61.5%). Most common offending agent was the bottle rockets (n = 23, 35.4%), followed by bomb and crackers in (n = 18, 27.7%). Majority of the injuries occurred at home environment (n = 37, 56.9%), followed by street (n = 15, 23.1%). About (n = 39, 60%) of the injuries occurred among bystanders. About 40 cases (61.5%) hailed from rural areas. The majority of the cases (n = 46, 70.8%) suffered from closed globe injuries and surgical intervention was required in (n = 40, 61.5%) of the cases. The mean length of hospital stay of fewer than 5 days was required in (n = 42, 64.6%). The final visual acuity of 6/18 or better was achieved in 41 cases (63.1%).

Conclusion:

Ocular injuries from fireworks remain a public health problem. Awareness among the masses, preventive measures, and strict implementation of government legislation may help in bringing down the incidence of firework-related ocular morbidity and blindness.
Simple and novel technique of using lampblack soot as a corneal tattoo for disfiguring corneal opacities
Authors: Srirampur Arjun , Kalwad Anupama , Mansoori Tarannum , Kola Pravalika
Published: November 2021

The aim of this study was to report a series of corneal tattooing in three eyes of three patients with disfiguring corneal scar and no visual potential, which underwent the procedure using the lampblack prepared in the operating room (OR), and to describe the novel technique of lampblack preparation for the surgery. The depth of corneal opacity was carefully assessed and a superficial lamellar pocket was made by lamellar separation using corneal dissectors, following which the prepared lampblack soot using materials available in the OR was deposited in the pocket. At a mean follow-up of 6 months, all the eyes had a stable corneal surface with an acceptable cosmetic outcome. Corneal tattoo using lampblack gives a satisfactory cosmetic result with good patient satisfaction and improved quality of life in the eyes with disfiguring corneal scar.
Acute work-related hazardous eye exposures in a health care environment – An observational study from a tertiary care hospital in South India
Authors: Obed Prathibha , Amritanand Anika , Antipas Obed J H , Rebekah Grace , Kirupakaran Henry , Alex Reginald , Paul Padma
Published: November 2021

Purpose:

Healthcare workers (HCW) are exposed to numerous occupation-related eye hazards. We studied the epidemiological distribution, risk factors, and severity of acute work-related hazardous exposure/infection (WRHEI) to the eyes of HCW in a tertiary healthcare institution in Southern India.

Methods:

In this prospective observational study, we included HCW who reported acute WRHEI between February 15, 2017 and August 14, 2017 from a total 11,628 HCWs (staff and students). Each HCW underwent a comprehensive eye examination. Information regarding WRHEI was collected by a structured questionnaire. Statistical analysis was performed using SPSS Version 20.0.

Results:

Cumulative incidence of acute WRHEI in 6 months was 0.8%, 95% CI (0.64–0.96). Among the 94 reporting WRHEI, 82 (87.2%) were staff and 12 (12.8%) students. Mean age was 31.53 ± 8.39 years and 65 (69%) were females. Exposures were reported more commonly among nurses (25.5%), followed by technicians (18%), and housekeeping staff (15.9%). Infectious eye hazards accounted for 50%. Noninfectious eye hazards included exposure to chemicals (28%) and blood and body fluid (8%). Among them, awareness regarding personal protective equipment (PPE) and its usage was present in 44.6 and 27.6%, respectively. Multivariable logistic regression analysis showed that HCWs working in clinical areas (adjusted odd’s ratio (AOR): 3.23, 95% CI: 1.12–9.34) and not wearing glasses (AOR: 3.72, 95% CI: 1.33–10.34) had a significantly higher risk of acute WRHEI.

Conclusion:

Cumulative Incidence of WRHEI eye was 8 per 1000 in 6 months. Infectious conjunctivitis is half the burden followed by chemical exposures. Awareness regarding eye safety and usage of PPE was low.
Ectrodactyly–Ectodermal Dysplasia–Clefting Syndrome
Authors: Gayen Khooshbu , Bag Anisha , Shirolkar Supreet , Sikdar Rajib , Mukhopadhyay Santanu , Sarkar Subir
Published: November 2021

Ectrodactyly–ectodermal dysplasia–clefting (EEC) syndrome is a rare hereditary congenital defect characterized by a triad of disorders such as ectodermal dysplasia, malformed extremities, and cleft lip and/or palate. We report the case of a 3-month-old girl child with clinical signs of EEC syndrome and offer valuable information into current knowledge about this syndrome. The symptoms of EEC display diversity in both extension and expression. Early diagnosis and management of clinical manifestations associated with this syndrome presents a unique challenge due to the paucity of documents in the literature.
Vascular Endothelial Growth Factor Levels in the Gingival Crevicular Fluid of Type II Diabetes Mellitus Patients with and without Chronic Periodontitis – A Clinico-Biochemical Study
Authors: Rujuta Patil , Pradeep A. R. , Chougule Purva , Swathika S.
Published: November 2021

Background:

Vascular endothelial growth factor (VEGF) is a multifunctional angiogenic cytokine that plays a central role in inflammation and wound healing. The role of this angiogenic factor in periodontal destruction could be significant, and VEGF could act as a potent marker of periodontal disease progression. Its role in diabetes mellitus-related complications has been evaluated, and diabetes mellitus may be a potent modulator of VEGF in periodontal disease.

Objective:

The objective of this study is to evaluate and compare gingival crevicular fluid (GCF) VEGF levels of systemically healthy, chronic periodontitis, and Type II diabetes mellitus participants with and without chronic periodontitis and to investigate the role of VEGF in periodontal disease progression.

Materials and Methods:

Eighty participants were divided into four groups based on the gingival index, plaque index, probing pocket depth, and clinical attachment level: (Group 1) healthy, (Group 2) chronic periodontitis, (Group 3) Type II diabetes mellitus without chronic periodontitis, and (Group 4) Type II diabetes mellitus with chronic periodontitis. GCF samples collected from each subject were quantified for VEGF levels using an enzyme-linked immune sorbent assay. Further, the correlation between VEGF levels within groups and with the clinical parameters was analyzed in all groups. The statistical analysis was performed using the SPSS software.

Results:

The mean concentration of VEGF in GCF was the highest in Group 4 (2179.24 pg/ml) followed by Group 3 (1948.32 pg/ml), Group 2 (1776.83 pg/ml), and the least in Group 1 (1266.80 pg/ml). Further, GCF VEGF levels showed a positive correlation with all of the clinical parameters.

Conclusions:

VEGF concentrations increased from health to disease. Type II diabetes mellitus may affect VEGF concentrations in periodontal disease. These data indicate that VEGF plays a key role in periodontal disease progression and can be considered a biomarker of periodontal disease progression.
Effect of Short-term Preoperative Dutasteride and Finasteride on Bleeding after Transurethral Resection of the Prostate
Authors: Kumar Nitesh , Palve Sunil K. , Marripeddi Karthik , Thantla Sanath
Published: November 2021

Purpose:

Transurethral resection of the prostate (TURP) is the standard surgical treatment for patients with benign prostatic hyperplasia (BPH). Among the many complications of TURP, the most prevalent and serious complication is hemorrhage. The aim of the study was to compare the effect of short-term (2–4 weeks) pretreatment of BPH with dutasteride and finasteride on bleeding after TURP.

Methods:

A prospective randomized double-blinded study was conducted in Osmania General Hospital, a tertiary care center for a period of 2 years. Two hundred and forty patients who were planned for TURP were included and randomized into four groups; D2: 2 weeks of dutasteride, F2: 2 weeks of finasteride, P2: 2 weeks of placebo, and D4: 4 weeks of dutasteride. The primary outcome was to evaluate the volume of blood loss.

Results:

The baseline variables were comparable among the groups. Statistically significant differences were seen in total volume of blood loss (183.4 vs. 172.7 vs. 288.5 vs. 173.2 ml, P = 0.01), blood loss per minute of operating time (3.80 vs. 3.65 vs. 5.71 vs. 3.61 ml/min, P = 0.02), and blood loss per gram of resected prostatic tissue (7.61 vs. 7.43 vs. 11.57 vs. 7.21 ml/g, P = 0.008). Blood transfusion requirement was significantly more in the placebo group (11.8%) compared to other groups (P = 0.02).

Conclusion:

Short-term preoperative dutasteride and finasteride for 2 weeks are equally effective, and they significantly reduce the perioperative blood loss during TURP. Four weeks of dutasteride has no significant advantage when compared to its 2-week course.
О линейной разложимости функции $p$-значной логики в произведение функций
Authors: Cheremushkin Aleksandr Vasil'evich
Published: November 2021

Пусть $p$ - простое число, $p\ge 3$. Рассматривается множество разложений функции $p$-значной логики в произведение функций от не пересекающихся множеств переменных при различных линейных преобразованиях аргументов. Каждому такому разложению соответствует разложение векторного пространства в прямую сумму подпространств. Приведены условия, при которых такое разложение определяется однозначно с точностью до перестановки подпространств. Также дается критерий сбалансированности такого произведения.
Предельная теорема для сглаженного варианта спектрального критерия равновероятности двоичной последовательности
Authors: Savelov M P
Published: November 2021

Рассматривается задача о проверке гипотезы о том, что тестируемая последовательность является последовательностью независимых случайных величин, равновероятно принимающих значения $1$ и $-1$. Для решения этой задачи в спектральном критерии пакета NIST используется статистика $T_{Fourier}$, точное предельное распределение которой неизвестно. В настоящей статье предложена новая статистика, которая является незначительной модификацией статистики $T_{Fourier}$, и установлено ее предельное распределение. Сформулирована гипотеза о предельном распределении $T_{Fourier}$, которая согласуется с результатами численных экспериментов, проведенных Pareschi F., Rovatti R. и Setti G.
Дифференциальная игра сближения-уклонения: альтернативная разрешимость и релаксации задачи сближения
Authors: Chentsov Alexander Georgievich
Published: November 2021

Исследуется дифференциальная игра сближения-уклонения на конечном промежутке времени. Предполагаются заданными два множества в пространстве позиций: целевое множество (ЦМ) игрока, заинтересованного в гарантированном осуществлении наведения (сближения), и множество, определяющее фазовые ограничения (ФО). Рассматривается вопрос об условиях альтернативной разрешимости: показано, что для замкнутого в обычном смысле ЦМ и множества с замкнутыми сечениями, определяющего ФО, имеет место некоторый аналог теоремы об альтернативе Н.Н. Красовского и А.И. Субботина. В случае, когда оба упомянутых множества замкнуты, исследуются постановки с ослаблением условий окончания игры сближения. При этом допускается различная степень ослабления требований в части приведения на ЦМ и соблюдения ФО. Построена функция позиции, значения которой имеют смысл наименьшего размера окрестностей упомянутых множеств, при котором игрок, заинтересованный в сближении, гарантирует его реализацию. В основе построения находится вариант метода программных итераций.
Об оценке степени невыпуклости множеств достижимости управляемых систем
Authors: Ushakov Vladimir Nikolaevich , Ershov Aleksandr Anatol'evich , Matviychuk Aleksandr Rostislavovich
Published: November 2021

Изучаются свойства множеств достижимости управляемых систем, линейных относительно управления. Получена оценка роста с течением времени меры невыпуклости $\alpha $ для множеств достижимости из одного класса таких систем. В качестве вспомогательного результата установлена взаимосвязь между $\alpha $-множествами и слабо выпуклыми по Виалю множествами.
Теорема о неявной функции в окрестности анормальной точки
Authors: Arutyunov Aram Vladimirovich , Salikhova Kariia Ilshatovna
Published: November 2021

Исследуется существование неявной функции, заданной уравнением $G(x,\sigma )=0$, в окрестности анормальной точки $(x_0,\sigma _0)$. Доказано, что если некоторое $\lambda $-укорочение отображения $F(x) = G(x,\sigma _0)$ регулярно по некоторому направлению, то искомая неявная функция существует.
Окрестность особого режима второго порядка в задачах с управлением из круга
Authors: Ronzhina Mariya Igorevna , Manita Larisa Anatol'evna , Lokutsievskiy Lev Vyacheslavovich
Published: November 2021

Рассмотрены гамильтоновы системы, аффинные по двумерному управлению из круга. Исследована структура оптимального синтеза в окрестности особой экстремали второго порядка. Найдено семейство решений в виде логарифмических спиралей, которые совершают счетное число оборотов вокруг особой точки и попадают в нее за конечное время.
Абстрактные уравнения Маккина-Власова и Гамильтона-Якоби-Беллмана, их дробные аналоги и связанные с ними системы прямых и обратных уравнений на римановых многообразиях
Authors: Kolokoltsov Vassili Nikitich , Troeva Marianna Stepanovna
Published: November 2021

Вводится класс абстрактных нелинейных дробных псевдодифференциальных уравнений в банаховых пространствах, который включает в себя как уравнения типа Маккина-Власова, описывающие нелинейные марковские процессы, так и уравнения стохастического управления Гамильтона-Якоби-Беллмана-Айзекса. Это позволяет провести единый анализ таких уравнений и приводит к эффективной теории спаренных систем прямых и обратных уравнений (прямая эволюция Маккина-Власова и обратная эволюция Гамильтона-Якоби-Беллмана-Айзекса). Такие системы занимают центральное место в современной теории игр среднего поля.
О минимизации вырожденных интегральных квадратичных функционалов
Authors: Dmitruk Andrei Venediktovich , Manuilovich Nataliya Andreevna
Published: November 2021

Рассматривается метод нахождения нижней грани вырожденного интегрального квадратичного функционала, состоящий в переходе от данного функционала к другому квадратичному функционалу, невырожденному относительно некоторого нового управления. Точку минимума для последнего можно найти путем несложной процедуры. Этой точке соответствует минимизирующая последовательность для исходного функционала. Преимущество данного метода по сравнению с известным методом регуляризации (добавлением малого невырожденного члена) состоит в том, что последний требует решения не одной задачи, а параметрической серии задач с исчезающим добавком.
Усиленное включение Эйлера-Лагранжа для одной задачи оптимального управления с разрывным интегрантом
Authors: Aseev Sergey Mironovich
Published: November 2021

Изучается задача оптимального управления для дифференциального включения со свободным временем и функционалом смешанного типа, содержащим в интегральном члене характеристическую функцию заданного открытого множества "нежелательных" состояний системы. Постановка данной задачи может рассматриваться как ослабление постановки классической задачи оптимального управления с фазовым ограничением. При помощи метода аппроксимаций получены необходимые условия оптимальности первого порядка в форме усиленного включения Эйлера-Лагранжа. Приведены достаточные условия их невырожденности и поточечной нетривиальности. Рассмотрен иллюстрирующий пример.
A PROPELLER BLADE MANUFACTURING BY HYBRID ADDITIVE MANUFACTURING SYSTEM
Authors: EYERCİOĞLU Ömer , ALADAĞ Mehmet
Published: November 2021

Hybrid Additive Manufacturing (Hybrid-AM) describes multi-operational or multi-functional additive manufacturing systems. In industry, the increasing tendency in applications of Hybrid-AM brings up the challenge of improving novel methods for the manufacturing of new or hybrid parts. Hybrid AM can produce fully functional assemblies without any assembly operation. In this study, the hybrid additive manufacturing system means that an object is to be designed partly made from prefabricated or off-the-shelf parts and added by the WAAM process. For this purpose, a prototype Hybrid-AM system using the pulsed TIG-Wire-Arc technique was designed and constructed. The constructed SMD system has three drivers on the x, y, and z-axes and an additional rotary driver (fourth axis). Using the Hybrid-AM machine the wire form material can be deposited on an existing primitive profile i.e., a rod, pipe, a profile, or any 3D surfaces with reducing production time. In this way, spiral-shaped features or twisted blade shapes can be added to cylindrical parts. In this study, a stainless- steel propeller blade was deposited on a pipe by using the developed prototype Hybrid AM machine. A non-planar toolpath was used to deposition the subsequent layers and the surface of the propeller blade was finished using 4-axis CNC machining.
FİZİK, KİMYA VE BİYOLOJİ ÖĞRETMENLERİNİN 3-BOYUTLU KATI MODEL TASARIM VE KULLANIM İHTİYAÇLARINA GENEL BİR BAKIŞ
Authors: ASLAN Ayşegül , DURUKAN Ümmü Gülsüm , BATMAN Demet
Published: November 2021

Bu çalışma ile fizik, kimya ve biyoloji öğretmenlerinin 3B katı model tasarımına ve tasarlayacakları modellerin öğretim süreçlerinde kullanımına yönelik ihtiyaçlarının belirlenmesi amaçlanmaktadır. Tarama yöntemi ile yürütülen bu çalışmanın örneklemini 16 farklı ilde görev yapan 27 fizik, 36 kimya ve 40 biyoloji olmak üzere toplamda 103 öğretmen (66’sı kadın, 37’si erkek) oluşturmaktadır. Veri toplama aracı olarak, araştırmacılar tarafından geliştirilen çevrimiçi “Fen Öğretiminde 3-Boyutlu Modellerin Tasarımı ve Kullanımı Formu” kullanılmıştır. Veriler betimsel olarak analiz edilmiştir. Elde edilen bulgular doğrultusunda; öğretmenlerin çoğunun (%86’sının), derslerinde hazır öğretim materyali veya modeli kullandığı, buna karşılık; %95’inin bu zamana kadar 3B baskı aracı ile kendilerinin geliştirdiği herhangi bir modeli derslerinde kullanmadıkları ve %97’sinin 3B katı model tasarlama deneyiminin olmadığı belirlenmiştir. Bununla birlikte, öğretmenlerin %83’ünün öğretim materyali olarak 3B katı model tasarlamak istediği tespit edilmiştir. Tüm bu sonuçlar, fizik, kimya ve biyoloji öğretmenlerinin 3B katı model tasarlama ve kullanma deneyimlerinin yetersiz olduğunu fakat gereken desteğin verilmesi neticesinde bu sürecin aktif bir şekilde yürütülebileceğini göstermektedir. Bu kapsamda, üniversiteler ile Milli Eğitim Bakanlığı işbirliğinde gerçekleştirilecek proje çalışmalarının ve hizmet içi eğitim programlarının öğretmenlere dijital yetkinlik kazandırma da etkili olacağı, bu sayede 3B öğretim modellerinin öğretmenler tarafından geliştirilerek öğretim süreçlerinde kullanımının artacağı düşünülmektedir.
HOW COGNITIVE APPRAISALS AND MALADAPTIVE COPING EXPLAIN THE BEHAVIOURAL INTENTION OF HEALTH TOURISTS?
Authors:   Universiti Tunku Abdul Rahman, Ai Na Seow , Chee Keong Choong ,   Universiti Tunku Abdul Rahman, Yuen Onn Choong ,   Universiti Tunku Abdul Rahman
Published: November 2021

The main purpose of this paper is to understand the behavioural intention of health tourists through cognitive appraisals and maladaptive coping. A research model is proposed. A field study was conducted in Malaysia’s various international airports. 718 international tourists were approached to partake in the paper survey. The data collected was analysed using SmartPLS software version 3 with partial least square structural equation modelling (PLS-SEM). This study’s findings show that only response severity is not significant related to maladaptive coping, which is defined as a compulsive behaviour individuals use to soothe themselves when feeling anxious. Perceived vulnerability and response cost are positively related to maladaptive coping, whereas response efficacy and self-efficacy are negatively significant to maladaptive coping. This study’s abstract consists of seven main elements: purpose and background, methodology, findings, conclusion, contribution/practical implications, references, and keywords.
PETROGRAPHIC FEATURES AND MODELLING OF SOME WATERFALL ROCKS IN KENYIR LAKE, TERENGGANU: A MICROSCOPIC PERSPECTIVE APPROACH IN SUSTAINABLE GEOTOURISM
Authors:   Universiti Malaysia Terengganu, Abdul Rahman Muhd Nur Ismail , Roslan Ahmad Norzaimie ,   Universiti Malaysia Terengganu, Baharim Nor Bakhiah ,   Universiti Malaysia Terengganu, Abdul Ghani Azman ,   University of Malaya, Ali Che Aziz ,   Universiti Kebangsaan Malaysia
Published: November 2021

Waterfalls around Kenyir Lake, Terengganu naturally serve as an iconic symbol of amazing rock bounded formation amidst the wilderness, which stores a hidden story for millions of years. The waterfalls feeding the Kenyir Lake have become tourists’ main attractions since they are located separately on a different island. There are three naturally picturesque waterfalls worth seeing in the study area, namely Sungai Buweh Waterfall, Lasir Waterfall, and Saok Waterfall, which are made up of granitic rock body that emerged in the Eastern Belt during the Late Triassic (~251.2 Ma). To date, the waterfall landscape in any area concerned with geotourism focusses more on outcrop architecture and geomorphological features, but has only limited accessibility to rock records. This study was carried out to evaluate the geo heritage features, of the waterfall landscape as well as its rock-forming minerals. Three rock samples were carefully collected from the waterfalls and subsequently prepared for optical thin section petrography analysis using a polarised light microscope. The optical thin section petrography further revealed precise mineral compositions, fabrics, and microstructures. A photomicrograph of the thin sections was also taken at low and high magnification levels in plane polarised light (PPL) and cross polarised light (XPL). Additionally, petrographic modelling was constructed using optical microscopic data to help identify a microscopic mineral (a hidden material in rock) in detail so that the mineral becomes clear to both geologists and the public at large. Generally, this modelling will enlighten the public on the material embedded in the rocks and illustrate the importance of learning about rock-forming minerals as well as to embed the idea of making the waterfall a Sustainable Development Goal (SDG). Besides making geology an interesting field to embark on, this mineral find affirms the beauty of the waterfalls for tourism purposes, thereby connecting geotourism and nature. The minerals from various constituents are also useful for scientific heritage purposes and may benefit the economy by serving as sustainable tourism while being part of a geopark.
SUSTAINABLE DEVELOPMENT OF THE ENVIRONMENTAL SUPPLY IN THE NATIONAL PARK: A CASE FROM PHA TAEM NATIONAL PARK, THAILAND
Authors:   Mahasarakham University, Nasa Khan Mayuree , Khan Mongkol ,   Mahasarakham University, Boongthong Taraton ,   Mahasarakham University, Hassan Fatimah ,   Universiti Sains Malaysia, Surawood Wassana ,   Universiti Sains Malaysia
Published: November 2021

This paper aims to present the sustainable development of the environment in the Pha Taem national park in Thailand. It is in the context of the environmental supply for Eco-tourism and nature-based tourism. The study is in the area of the Pha Team National Park (PTNP) in Thailand, which consists of natural and historical features. PTNP has a distinctive geomorphological appearance. The uniqueness of the national park makes it more valuable as a site for not only establishing a national park but a geo-park as well. The PTNP is located on the edge east of Thailand’s territory. The boundary of the PTNP is along with Thailand and the Lao PDR border across the Mekong River. This study employed a semi-structured interview with the national park staff and superintendent. Fifteen questions ranging from the perspective of sustainable tourism development goals to environmental supply were posed to the respondents. The findings demonstrated that to successfully manage the national park and achieve its sustainable tourism development goals the national park should be careful with its management plan and deal cautiously with stakeholders. The national park tourism management plan should include the stakeholder in the planning process to avoid potential conflicts. Moreover, it is necessary for effective tourism management that the park staff enhance their expertise and skills with regard to the tourism operations and tour management aspects of the park.
AN ANALYSIS OF COMPETITIVE CAPABILITIES AND ACCOMMODATION PERFORMANCE FOR SMALL AND MEDIUMSIZED ACCOMMODATIONS (SMSAs) IN EAST-COAST OF MALAYSIA DURING THE COVID-19 PANDEMIC
Authors:   Universiti Malaysia Terengganu, Zulkiffli Siti Nur ‘Atikah , Padlee Siti Falindah ,   Universiti Malaysia Terengganu, Zaidi Nur Farah Zafira ,   Universiti Malaysia Terengganu, Hussin Noor Zatul Iffah ,   Universiti Malaysia Terengganu
Published: November 2021

The COVID -19 pandemic has posed an unprecedented threat to the hospitality industry. Numerous hospitality firms have been impacted by strategies used to flatten the COVID-19 curve. Hospitality firms are required to significantly alter their operations in the COVID-19 business climate in order to secure industry survival and to mitigate the impact of the pandemic. As a result, this study focuses on small and medium-sized accommodations (SMSAs) on Malaysia’s East Coast, which are particularly hard hit by the pandemic. The study of SMSAs on Malaysia’s East Coast discovered that marketing and human resource management contribute significantly to accommodation performance, while the other two factors have a negligible effect on accommodation performance during this pandemic, as determined by multiple regression analysis.
MODELLING FACTORS AFFECTING RELIGIOUS TOURISM FLOWS TO SAUDI ARABIA
Authors:   Victoria University, Australia, Alanzi Eman , Kulen Nada ,   Victoria University, Australia, Huong Nguyen Thu ,   Victoria University, Australia
Published: November 2021

Religious tourism demand is one of the major contributors to Saudi Arabia economy and considered to play an important role in the “Vision 2030”, which seeks to diversify Saudi Arabia’s economy reliance on oil revenues. As the country has undergone structural changes in international tourism and removed travel restrictions in the past few years, there is a need to identify the determinant factors that influence international tourists to plan and manage their trips. Therefore, this current study aims to investigate the effects of economic and noneconomic factors on international tourist flows by using A panel data gravity model for the period 2000-2019. The empirical evidence is based on the Generalized Method of Moments (GMM) and the Panel Regression technique. The findings of the regression show that the traditional gravity variables are important to explain Saudi Arabia’s religious tourism demand. The study also has found that habit persistence, the Pandemic Index, GDP per capita of Saudi and the original countries, human rights and investments in the tourist sector have a significant and positive impact on religious tourism demand. While political risks, transport costs, and tourism price have a statistically significant and negative effect on religious tourists’ arrivals. This study will contribute largely to the tourism demand literature by introducing country characteristics factors which include human rights issues as security proxies, pandemics, and quality of life and by measuring the impact of these variables in tourism demand in the context of an oil-based economy that under the transition to a diversified economy with a new vision. The findings of this study may assist in the development of Saudi Arabia’s tourism sector and economic development by providing knowledge to policymakers, investors, and other tourism stakeholders.