bluuebunny/crossref_metadata_2025 huggingface dataset:
Hormone receptor status, Her 2- neu amplification and their correlation with prognostic indices in patients with invasive ductal carcinoma of breast in Jaffna
Authors: Rajendra S.
Published: January 2021

Knowing the tumour biology can help to stratify patients for prognostic and therapeutic purposes. Expression of estrogen and progesterone receptors (ER, PR), amplification of human epidermal growth factor receptor 2 (Her 2 neu), size and histological grading of tumour , axillary lymph node state and NPI ( Nottingham Prognostic Index) are well established parameters that have influence on prognosis and treatment of breast carcinoma. It is an institutional based retrospective cross sectional analytic study.181 female patients who underwent primary mastectomy and axillary clearance for invasive ductal carcinoma of breast in Teaching Hospital Jaffna from 2014 to 2018 were included in this study.ER/PR status and amplification of Her 2 neu in the infiltrating ductal carcinoma of breast and the prognostic indices were recorded. SPSS was used for statistical analysis and correlation between the receptor status and prognostic indices were calculated using Spearman’s correlation, chi-square and Kruskal- Wallis tests. Of the 181 patients with invasive ductal carcinoma of breast, 132 patients (72.9%) were above 45 years old. A total of 87 patients had ER + (48.1%), 76 had PR + (41.9%) and, 62 had Her 2-neu + (34.3%). The mean ages of patients with expression of ER, PR and Her 2-neu amplification were 56.43, 54.36 and 52.95 years respectively. Triple negative tumour was found in 38 patients (21%). NPI 1 indicating good prognosis, NPI 2 with moderate and NPI 3 with poor prognostic categories were seen in 57 (31.5%), 74 (40.9%) and 50 (27.6%) patients respectively. Stage T2 sized tumour was identified in 88 patients (48.6%).A total of 110 patients (60.8%) had grade 2 tumours. 89 patients (49.1%) had axillary lymph node involvement. Statistically significant correlation was found between the expression of ER and PR (Spearman’s correlation coefficient (r) = 0.136, p value < 0.0001). Statistically significant inverse correlation existed between the expression of hormone receptors (ER&PR) and Her 2-neu amplification (chi square=12.93, p value < 0.0001). Kruskal-Wallis test revealed statistically significant association between the expression of ER and the favourable NPI groups and also with low grade tumours ((p value 0.046 and 0.006) and a statistically significant association between Her2-nue amplification and axillary lymph node involvement (p value = 0.0001).
Prevalence and influencing factors of BMI and effect of school based intervention among the Grade 8 Schoolchildren in Jaffna district
Authors: Surenthirakumaran R. , Coonghe P. A. D. , Kumaran S.
Published: January 2021

Overweight and obesity are becoming a global issue. In contrast, children living in developing countries like Sri Lanka are having problems with wasting . Understanding the status of wasting, overweight and obesity and underlying factors may help to address the issue. The study aimed to determine the prevalence of wasting, overweight and obesity and the underlying socio-demographic and school-related correlate and effect pf school-level intervention to manage wasting, overweight and or obesity among Sri Lankan school children A school based descriptive cross-sectional study was conducted among 836 students aged between 13-15 years studying at government schools in Jaffna district from June 2016 to November 2017. Anthropometric measurements obtained using electronic height weight machine with the precision of the instrument for height is ≤±0.1cm, and for weight is ≤±0.1kg, and the Body Mass Index (BMI) for age calculated and compared with WHO (2007) standards. Chi-square analyses performed, and odds ratios calculated in SPSS 21. ResultsSlightly males students (51.4%) were more than the female students. Majority of the students were Hindus (91.1%), and living with both parents (87.2%). The prevalence of wasting, overweight and obesity was 38.6%, 6.8% and 2.4% respectively. Having abnormal BMI was not significantly affected the participation in extracurricular activities. High prevalence of abnormal BMI observed, and none of the school-level interventions for abnormal BMI were not useful. Hence, periodical assessment and monitoring of the school-based program might improve the outcome.
Histopathological study of cervical lesions: a hospital based study in teaching hospital Batticaloa, Sri Lanka
Authors: Thirukumar M. , Ahilan S.
Published: January 2021

The uterine cervix is prone for infections and malignancies. The cervical cancer is fourth most common cancer in the world and second common female cancer in Sri Lanka. This hospital based retrospective study was done on 586 cervical specimens. This study was aimed for the histomorphology patterns of cervical lesions. Results; There were 10.2% malignant cases and 68.90% were non-neoplastic cervical specimens. Majority of the non- neoplastic cervical lesions were inflammation and polyp, constitute 37.2% and 17.7% of the total study samples. Majority of patients with cervical carcinoma (36.5%) presented with blood-stained, whitish per vaginal discharge and it is followed by (32.7%) abnormal uterine bleeding. The peak age incidence of cervical cancer was 50-59 years. Squamous cell carcinoma was by far the most common histological type accounting for 84.6%, followed by adenocarcinoma 11.5%. Squamous cell cervical carcinoma classified according to Broder’s grading system into well, moderately and poorly differentiated at the time of initial diagnosis and constituting cases as 20%, 71.1% and 8.9% respectively. The chronic nonspecific cervicitis was the most common inflammatory lesion constituting 86.2% of nonneoplastic cases. The main presenting complaints of blood-stained vaginal discharge or abnormal uterine bleeding, especially in the age group of 50-59 years, should be investigated to exclude malignancy. Public health education should be intensified to encourage early health seeking behavior in order to diagnose cervical malignancy at an early age especially when they have clinical symptoms of blood-stained vaginal discharge or abnormal uterine bleeding.
Bee stings an unusual cause of severe rhabdomyolysis: A case report and literature review
Authors: Seelarathna R. M. M. , Navakumaran M. , Kumanan T.
Published: January 2021

Wasp and bee stings are common among the rural population of Sri Lanka. It is known to cause local reaction and rarely anaphylaxis. Bee sting associated rhabdomyolysis leading to acute kidney injury (AKI) is a rare complication and was not reported from Northern Sri Lanka. This case report illustrates a patient who developed rhabdomyolysis following multiple bee stings and made a complete clinical recovery with prompt and optimal supportive care.
Tricuspid valve endocarditis following peripheral venous cannulation – an unusual aetiology
Authors: Kumara D. M. , Peranantharajah T. , Guruparan M. , Rajanthi R.
Published: January 2021

Isolated tricuspid valve endocarditis is rarely seen without intravenous drug abuse, invasive cardiac procedure or previous valvular disease. Another often overlooked but rarely seen risk factor is peripheral intravenous cannulation. In such cases poor cannula line care and unhygienic practices predispose patients to right sided infective endocarditis. The patient in this case developed tricuspid valve endocarditis following treatment for Dengue Hemorrhagic fever. He had pulmonary involvement as well. Blood culture was positive with MRSA and he was treated with prolonged course of IV antibiotics without surgical interventions. Eventually, he recovered completely and was discharged after 8 weeks of hospital stay.
Pheochromocytoma - an unusual cause of broken heart syndrome
Authors: Thineskaran P. , Suganthan N. , Kumanan T. , Selvaratnam G. , Guruparan M.
Published: January 2021

Takotsubo cardiomyopathy or stress induced cardiomyopathy is a recently emerged clinical entity though it was known as broken heart syndrome for sometime. Here we report a 47-year- old female with type 2 diabetes mellitus who presented with an episodic chronic headache and excessive sweating of face and head. She had an acute coronary syndrome leading to cardiogenic shock, respiratory failure and needed assisted ventilation during the hospital stay while being evaluated for headache. She had marked haemodynamic instability as well. A coronary angiogram confirmed normal epicardial vessels and the 2D echocardiogram revealed antero-septal and apical hypokinesia with poor systolic function. Considering the clinical picture, a presumptive diagnosis of pheochromocytoma was made and a right supra renal mass was detected by ultrasonography and subsequently confirmed by a CT scan. However, the urinary Vanillin Mandalic Acid (VMA) and metanephrine levels were repeatedly within normal limits. Once she recovered from the acute cardiac event, she under went a laparoscopic adrenalectomy and the histology of the tumour and subsequent immunohistochemical studies confirmed a pheochromocytoma. All her symptoms completely disappeared, and she was normotensive with stable blood pressure recordings after the surgery.
A prospective clinical audit evaluating the incision angle at mediolateral episiotomy for vaginal delivery
Authors: Patabendige M. , Gobi U. , Jayawardane A.
Published: January 2021

Background: Increasingly, the angle at which the episiotomy is performed has come under scrutiny. The current recommendation is that because of distortion of the anatomy at crowning of the head, the incision should be at an angle of at least 60° from the midline to ensure that a post-delivery angle of 43° is achieved. Method: A prospective clinical audit was performed in Castle Street Hospital for Women, Colombo, Sri Lanka, evaluating the post-delivery angle after suturing of episiotomy in a sample of consecutive vaginally delivered women. The angle after repair was defined as the angle formed by the suture line and the midline is measured at the end of the suturing. OASI Care Bundle, recently developed by the RCOG was used as the gold standard reference. Results: A total of 105 consecutive vaginal deliveries with mediolateral episiotomy were evaluated. Mean age (SD) was 27.9 (6.0) years. Mean gestational age (SD) was 39.3 (1.7) and mean birthweight (SD) was 3.0 (0.5) kg. There were 97 (92.4%) spontaneous vaginal deliveries and 21 (20.0%) were diabetic. Majority, 48 (45.7%) had their first delivery. There were 6 (5.7%) third degree perineal tears and 24 (22.9%) had additional second degree perineal tears. Out of 105, 91 (86.7%) women had post-delivery angle of less than 45° and 33 (31.4%) of them were less than 30°. Only 14 (13.3%) episiotomies were having the correct post-delivery angle (45°). Majority (55.2%) had not been started from the midline. Conclusion: Current practice of incision angle at medio-lateral episiotomy is not satisfactory. Training using ‘Episiotomy angle-cutter demonstrator’ in the OASI Care Bundle has been planned before the re-audit.
Acute colonic pseudo-obstruction in a patient following total abdominal hysterectomy and bilateral salpingo-oophorectomy (Ogilvie syndrome)
Authors: Weerasekera D. S. , De Silva W. D. D. , Rodrigo N. K. , Nanayakkara T. K. I. N.
Published: January 2021

A 50-year-old woman underwent total abdominal hysterectomy and bilateral salphingo-oophorectomy for heavy menstrual bleeding due to a uterine fibroid. On second post-operative day she developed progressive abdominal distention, tachycardia, and fever. An intra-abdominal pathology was suspected and she was re-opened on the third postoperativeday. At laparotomy a distended colon was found with serosal tears due to distention with no distal colonic obstruction. Bowel decompression was done and a diagnosis of acute colonic pseudo-obstruction (ACPO) was made. Since her abdominal distention was persisting after the laparotomy she was treated with intravenous neostigmine. She responded immediately with passage of flatus and bowel opening. Subsequent recovery was uneventful. ACPO is a clinical entity characterized by severe colonic distention in the absence of mechanical obstruction. It can result in bowel ischaemia and perforation if left untreated. Therapeutic importance of neostigmine is discussed in the management ofthis potentially fatal condition.
Economic Inequality in Unmet Refractive Error Need in Deprived Rural Population of Iran
Authors: Yekta Abbasali , Hashemi Hassan , Pakzad Reza , Aghamirsalim Mohamadreza , Ostadimoghaddam Hadi , Doostdar Asgar , Khoshhal Fahimeh , Khabazkhoob Mehdi
Published: January 2021

Purpose:

To determine economic inequality in unmet refractive error (RE) need and its determinants in deprived rural population of Iran.

Methods:

In this population-based study, two villages were randomly selected from among underserved villages of Iran. After selecting the participants, optometric examinations, including uncorrected and corrected visual acuity and subjective and manifest refraction, were done for all the participants. Then, unmet need for glasses was determined. Concentration index (C) was used to assess inequality, and Oaxaca–Blinder decomposition method was applied to decompose the gap between the two groups based on the determinants.

Results:

Of 3851 samples, 3314 participated in the study (response rate = 86.05%). The data of 3255 participants were used for analysis. The value of C and 95% confidence interval (CI) was −0.088 (−0.157 to −0.020), indicating a pro-poor inequality in unmet need. The prevalence (95% CI) of unmet need was 11.74% (9.25–14.22) in the poor and 6.51% (4.96–8.06) in the rich, with a gap of about 5% in favor of the rich (P < 0.001). A marked percentage of the gap was due to the explained portion (b = 5.73; P = 0.031). In the explained portion, the variable of economic status (b = 3.48; P = 0.004) and myopia (b = 0.88; P = 0.031) caused inequality in favor of the rich and against the poor, respectively. In the unexplained portion (b = −0.51; P = 0.372), the variables of education (P = 0.002) and place (P = 0.001) had statistically significant effects on inequality.

Conclusions:

There is a significant pro-poor economic inequality in the prevalence of unmet need in rural areas of Iran. Although part of this inequality is related to variables such as education and myopia, a major portion (two thirds) of this inequality may be due to the direct effect of economic inequality.
Intravitreal Injections of Bevacizumab Plus Methotrexate Versus Bevacizumab Alone for the Treatment of Diabetic Macular Edema
Authors: Fazel Farhad , Oliya Behrooz , Mirmohammadkhani Majid , Fazel Mohammadreza , Yadegarfar Ghasem , Pourazizi Mohsen
Published: January 2021

Purpose:

To evaluate the efficacy of intravitreal bevacizumab (IVB) combined with intravitreal methotrexate (IVM) in the treatment of diabetic macular edema (DME).

Methods:

In this prospective, interventional contralateral eye study, patients with bilateral DME were randomly allocated to receive three monthly injections of IVB (1.25 mg/0.05 mL) plus IVM (400 μg; 0.16 cc) or IVB alone. The outcome measure was changes in the best corrected visual acuity (BCVA), central macular thickness (CMT), and central macular volume (CMV).

Results:

Thirty-six treatment-naive eyes of 18 patients with a mean age of 62.38 ± 6.2 years were included in the study. BCVA logMAR changed from 0.95 ± 0.53 at baseline to 0.75 ± 0.53 in the combination group and from 0.72 ± 0.57 to 0.49 ± 0.50 in the IVB alone group at 1 month after the 3rd injection. BCVA improvement in both groups was not statistically significant compared with the baseline value (P > 0.99). Compared with the baseline values, mean CMT and CMV were reduced in both groups; however, these changes did not reach a significant level. The differences of CMT changes between the groups were not statistically significant at month 1 (P = 0.82), month 2 (P = 0.21), and month 3 (P = 0.10). Furthermore, the differences of CMV changes between the groups were not statistically significant at month 1 (P = 0.76), month 2 (P = 0.82), and month 3 (P = 0.11).

Conclusions:

This pilot study demonstrated no significant therapeutic effects for IVB combined with IVM compared to IVB alone in treatment-naive DME patients over a 3-month course.
Management of Upside-Down Descemet Membrane Endothelial Keratoplasty
Authors: Bardan Ahmed Shalaby , Goweida Mohamed B , El Goweini Hesham F , Liu Christopher SC
Published: January 2021

Purpose:

To present the management of upside-down Descemet membrane endothelial keratoplasty (DMEK) following combined phacoemulsification with DMEK (phaco-DMEK) in cases of Fuchs endothelial dystrophy (FED).

Methods:

This is a comparative interventional case series extracted from a prospective interventional case series (clinical outcome of DMEK combined with phacoemulsification for FED). We report five cases of upside-down DMEK. Two cases of upside-down DMEK were managed with re-orientation and the other two with repeat DMEK. The 5th case underwent an initial re-orientation and then a subsequent repeat graft. Graft re-orientation and repeat surgery were performed 9–20 days after initial phaco-DMEK. All the five cases were followed up over a 6-month period, and the following outcomes were assessed: best corrected visual acuity (BCVA), contrast sensitivity (CS), central corneal thickness, endothelial cell density (ECD), and central macular thickness.

Results:

At the final 6-month postoperative follow-up, all the five cases achieved good outcomes in terms of BCVA and CS. Overall, the results were comparable to 32 control cases. One case of re-orientation and the case of re-orientation with subsequent repeat DMEK performed slightly less well than control cases in terms of postoperative ECD.

Conclusions:

Re-orientation of the original DMEK scroll in cases of upside-down DMEK can be a safe and cost-effective alternative to repeat DMEK. If re-orientation does not result in corneal deturgescence, a repeat DMEK may be done subsequently.
A Drop in Hemoglobin as An Association with Pegylated Interferon Retinopathy
Authors: Berkenstock Meghan , Patel Shaivi , Ackert Jessica
Published: January 2021

Purpose:

To describe the association of change in the baseline hemoglobin levels with the development of interferon (INF) retinopathy after the start of pegylated INF (PEG INF) and ribavirin for hepatitis C virus treatment.

Methods:

This was a retrospective chart review conducted on 12 patients on PEG INF and ribavirin with baseline examination and follow-up during the treatment regimen: 6 developed INF-induced retinopathy and 6 patients were without retinopathy. Serial hemoglobin values for both the groups were recorded at the time of the retinopathy diagnosis in affected patients and the nadir in those without retinopathy. The total percent reduction of hemoglobin was calculated for both the groups.

Results:

Hemoglobin concentration levels between control and INF retinopathy patients tended to be slightly lower in the group that developed retinopathy. There was no threshold hemoglobin concentration under which the rate of developing retinopathy significantly increased. Greater than 25% drop in hemoglobin conferred a statistically significant risk in the development of INF-associated retinopathy.

Conclusion:

Patients starting PEG INF and ribavirin require baseline testing and subsequent follow-up based on the rapidity of the decrease in hemoglobin levels to identify the development of retinopathy with treatment.
The Effect of Topical Bromfenac on Intraretinal and Subretinal Fluid in Neovascular Age-Related Macular Degeneration
Authors: Abdolrahimzadeh Solmaz , Fameli Valeria , Tizio Federico Di , Staso Federico Di , Fenicia Vito , Scuderi Gianluca
Published: January 2021

Purpose:

To report the effect of topical bromfenac, a non-steroidal anti-inflammatory drug (NSAID), in a case of neovascular age-related macular degeneration (AMD).

Methods:

An 85-year-old woman presented with a complaint of visual acuity reduction in the right eye. Comprehensive ophthalmological examination and retinal imaging were performed.

Results:

Best corrected visual acuity was 2/100. Fundus examination showed reticular pseudodrusen and a small hemorrhage in the fovea. Fluorescein angiography showed an active neovascular membrane. Spectral-domain optical coherence tomography (SD-OCT) confirmed diagnosis and revealed subretinal and intraretinal fluid. The patient refused recommended intravitreal anti-vascular endothelial growth factor treatment and received topical bromfenac 0.09% twice daily. Follow-up with SD-OCT showed subretinal followed by intraretinal fluid reduction at 16 weeks after treatment.

Conclusion:

Short-term reduction of subretinal and intraretinal fluid was observed with topical bromfenac monotherapy in neovascular AMD.
Presumed Intraocular Lymphoma Masquerading as Age-Related Macular Degeneration
Authors: Riazi-Esfahani Hamid , Hassanpoor Narges , Ghassemi Fariba , Zarei Mohammad
Published: January 2021

Purpose:

To describe a case of primary vitreoretinal lymphoma (PVRL) that initially presented and managed as dry type age-related macular degeneration (AMD).

Methods:

A 69-year-old male was referred to us by decreased vision.

Results:

On funduscopy, a few small hard drusen at the posterior pole of the right eye and many large confluent drusen in the left eye were observed. Optical coherence tomography findings included the hyperreflective drusenoid materials in the subretinal pigment epithelium (sub- RPE) space which was similar to previous imaging records except for decreased area and height of pigment epithelial detachments and RPE and ellipsoid zone attenuation in some areas appeared. The thickness of the retina was normal, but the choroid appeared to be slightly decreased compared to the left eye. Patient has been followed up with the diagnosis of AMD for 1 year. After the right hemiparesis presentation, he underwent craniotomy and biopsy that made the diagnosis evident.

Conclusion:

PVRL/primary central nervous system lymphoma may be one of the most important masquerades of AMD, but a significantly waxing and waning course may help to make correct diagnosis.
Swept-Source Optical Coherence Tomography Angiography Shows Choriocapillaris Flow Reduction in Multiple Evanescent White Dot Syndrome
Authors: Khochtali Sana , Dridi Tarek , Abroug Nesrine , Ksiaa Imen , Lupidi Marco , Khairallah Moncef
Published: January 2021

Purpose:

To report two cases of typical multiple evanescent white dot syndrome (MEWDS), in which swept-source optical coherence tomography angiography (SS-OCTA) revealed transient areas of flow deficit at the level of the choriocapillaris.

Methods:

The SS-OCTA images of two female patients with typical MEWDS were analyzed at the onset of the disease and during follow-up.

Results:

The patients were aged 24 and 25 years, respectively. Previous medical history was unremarkable in both cases. The diagnosis of MEWDS was made on the basis of typical clinical findings and results of fundus autofluorescence, fluorescein angiography, and optical coherence tomography. At presentation, SS-OCTA showed a few small hypointense areas of flow deficit at the level of the choriocapillaris in both cases. During follow-up, SS-OCTA showed complete resolution of choriocapillaris flow voids.

Conclusion:

Both our patients with typical acute MEWDS showed SS-OCTA multifocal small areas of flow reduction at the level of the choriocapillaris, with full recovery during the follow-up. This finding supports the hypothesis of transient, primary, or secondary choriocapillaris hypoperfusion in typical MEWDS.
Characteristics and Recurrence of Primary Eyelid Basal Cell Carcinoma in Central Spain
Authors: Galindo-Ferreiro Alicia , Sanchez-Tocino Hortensia , Diez-Montero Cecilia , Belani-Raju Minal , Garcia-Sanz Raquel , Diego-Alonso Miguel , Llorente-Gonzalez Ines , Perez Patricia Callejo , Khandekar Rajiv , Schellini Silvana
Published: January 2021

Purpose:

To define the incidence, characteristics, and management of eyelid basal cell carcinoma (BCC) in Central Spain.

Methods:

This retrospective study investigates the characteristics and the outcome of eyelid BCC from 2000 to 2016 in a central region of Spain. Data were collected on demographics, skin phenotype, location of the eyelid lesion, clinical and histological diagnosis, surgery, commitment of surgical margins, and recurrence rate.

Results:

Primary eyelid BCC occurred in a mean of 20.6 lesions a year or 9.4/100,000 inhabitants/year. The mean age of BCC carriers was 69.4 ± 16.2 years, with no gender difference (P = 0.479), predominantly affecting Fitzpatrick II–III skin (81.3%) (P < 0.001). The most common location was the inner canthus (154/45.7%) (P < 0.001) and type nodular (215 cases/63.8%) (P < 0.001). The surgical margins were affected in 69 (20.5%) individuals, and the recurrence rate was 5.6 (95% confidence interval, 3.2–8.3) significantly higher in affected margins (P < 0.001). The most common location for recurrence was the inner canthus (P = 0.003), and the most common histological type for recurrence was sclerosing (16.7%), then multinodular (12.5%), and infiltrating (10.4%) with no significant difference (P = 0.27).

Conclusions:

The frequency of occurrence of eyelid BCC is much less than the estimated crude incidence for skin tumors involving all areas of the body in the Spanish population. Eyelid BCC is more common in the seventh decade of life, with no predilection for gender. Nodular histological type is the most common. The recurrence rate is 5.6%, depending on site and affected margins, even though clear free margins also can present with recurrence.
The Short-Term Effects of Intravitreal Injection of Bevacizumab on the Plasma Levels of Vascular Endothelial Growth Factor, Insulin-Like Growth Factor-1, and Growth Parameters in Infants with Retinopathy of Prematurity
Authors: Sedaghat Ahad , Abdolalizadeh Parya , Parvaresh Mohammad Mehdi , Ghorbanizadeh Sajad , Mohagheghi Parisa , Aghdam Kaveh Abri
Published: January 2021

Purpose:

To determine the changes in serum levels of free vascular endothelial growth factor (VEGF), insulin-like growth factor-1 (IGF-1), and growth parameters in infants with retinopathy of prematurity (ROP) who received intravitreal injection of the bevacizumab (IVB).

Methods:

A prospective interventional case series study, including 10 infants with Type 1 ROP was conducted. Using the enzyme-linked immunosorbent assay, serum levels of VEGF and IGF-1 were measured before, 1 month and 2 months after treatment with IVB in both eyes. Growth parameters, including weight, length, and head circumference and their Fenton's z-score, were also measured.

Results:

Serum VEGF levels were suppressed 1 month after IVB (P = 0.007) and then increased between 1 and 2 months (P = 0.064). Z-scores of all growth parameters except weight z-score decreased in the 1st and 2nd months.

Conclusion:

Serum VEGF levels showed a transient reduction after IVB which lasted at least 2 months. Growth velocity of premature infants may be affected by anti-VEGF therapy and should be followed with particular attention.
The Surgical Outcomes of Limbal Allograft Transplantation in Eyes Having Limbal Stem Cell Deficiency
Authors: Ozer Muhammet Derda , Altınkurt Emre , Yilmaz Yusuf Cem , Gedik Ali Ceyhun , Alparslan Nilufer
Published: January 2021

Purpose:

To report the limbal allograft transplantation and penetrating keratoplasty (PK) results in limbal stem cell deficiency (LSCD)-developed eyes because of chemical or thermal injury.

Methods:

Medical records of 18 eyes of 14 patients who had undergone keratolimbal allograft (KLAL) or living-related conjunctival limbal allograft (lr-CLAL) with or without PK and followed up at least 1 year postoperatively were evaluated retrospectively. The preoperative LSCD grade was noted in all patients. Rejection incidents, recurrence of LSCD, and corneal graft clarity along with a visual improvement during the follow-up were noted. The complications rate due to surgery or injury itself, for instance, glaucoma and cataract, were evaluated. The limbal allograft tissue survival analysis and corneal allograft survival analysis were done to reveal the differences in both the procedures. The existence of normal corneal epithelium and improvement in visual acuity were accepted as the surgical success criteria.

Results:

In the limbal allograft transplantation group, the survival rates of the allograft tissue were 65 ± 10.7% at 1 year and 36.6 ± 11.4% at 3 years in lr-CLAL and 66.7 ± 15.7% at 12 months and 53.3 ± 17.3% at 18 months in KLAL-transplanted eyes. The survival rate of corneal allograft at the 5th postoperative year was lower in the simultaneous procedure compared to the staged procedure, but it was not statistically significant (25.7 ± 25.8% vs. 62.5 ± 17.1%, P = 0.75). The ambulatory vision was achieved in 10 eyes (56%) after a mean follow-up time of 93.8 ± 37.8 months. The visual acuity level has increased in 12 eyes (67%) in which the limbal allograft transplantation was applied. The ambulatory visual acuity level was achieved (≤1.0 logMar [20/200]) in 10 eyes (56%). In addition, two or more Snellen lines' gain in the best corrected visual acuity was observed in 12 eyes of 18 (67%) at the last follow-up, and there was not any significant difference between the KLAL and lr-CLAL.

Conclusions:

Ocular surface integrity was longer in KLAL than in lr-CLAL transplantation, but it was not statistically significant. The staged procedure was more convenient than the simultaneous procedure in terms of corneal allograft clarity maintenance in limbal allograft-employed eyes.
Surgical Outcomes of Retropupillary-Fixated Iris-Claw Intraocular Lens
Authors: Mansoori Tarannum , Gooty Agraharam Satish , Sannapuri Sravanthi , Manwani Sunny , Balakrishna Nagalla
Published: January 2021

Purpose:

To assess the visual outcome and complications following retropupillary-fixated iris-claw intraocular lens (IOL) implantation.

Methods:

For this retrospective, non-comparative study, chart review of patients who underwent retropupillary iris-claw IOL implantation for the correction of aphakia from July 2014 to October 2018 and had a minimum postoperative follow-up of 2 months was carried out. Postoperative corrected distance visual acuity (CDVA), intraocular pressure (IOP), and complications were noted.

Results:

One hundred and twenty-two eyes of 122 patients (mean follow-up: 7.48 ± 5.2 months, range, 2 months-3.5 years) were enrolled in the study. The mean logMAR CDVA improved from 1.36 ± 0.52 preoperatively to 0.5 ± 0.42 postoperatively, at the last follow-up visit (P < 0.0001). The final CDVA improved in 110 eyes (90.2%), remained unchanged in 8 eyes (6.6%), and worsened in 4 eyes (3.3%). In cases of pre-existing cystoid macular edema (CME) or excessive intraoperative manipulations, 0.05 ml of 4 mg intravitreal triamcinolone acetonide (IVTA) was injected at the end of the surgery. Twenty eyes (16.4%) had transient ocular hypertension (OHT), 6 eyes (4.9%) had persistent OHT, and 2 eyes (1.6%) progressed to glaucoma. Choroidal detachment was noted in 2 eyes (1.6%), CME in 6 eyes (4.9%), 2 eyes (1.6%) had retinal detachment, 20 eyes (16.4%) had significant ovalization of pupil, 8 eyes (6.6%) had one haptic disenclavation, 1 eye (0.8%) had corneal decompensation, and 1 eye (0.8%) had endophthalmitis.

Conclusions:

Retropupillary iris-claw IOL provides good visual rehabilitation with a few complications. Its ease of insertion and short surgical time makes it a good option to correct aphakia in patients with an inadequate capsular support.
Vision-Related Quality of Life after Corneal Transplantation
Authors: Amiri Fardin , Ghiyasvandian Shahrzad , Haghani Hamid
Published: January 2021

Purpose:

To determine the vision-related quality of life (VR-QoL) and its dimensions in corneal transplant recipients.

Methods:

This cross-sectional study was carried out on 100 patients who underwent penetrating keratoplasty. Data collection tools included a demographic questionnaire, satisfaction questionnaire, and Persian version of the 39-item National Eye Institute Visual Functioning Questionnaire (NEI-VFQ 39).

Results:

The composite score of VR-QoL in corneal transplant recipients was 54.39 ± 9.22 (32.9–71.01). The highest mean score among subscales was related to color vision (74.75 ± 27.63) and the lowest related to dependency (31.06 ± 31.02). The results showed that there is a reverse correlation between VR-QoL with both age (r = −0.364;P < 0.001) and the numbers of years after the transplantation (r = −0.362;P < 0.001). However, there was a correlation between satisfaction and VR-QoL (r = 0.679;P < 0.001). Furthermore, the results showed that there is a significant difference in VR-QoL between men and women (P < 0.001) and also a significant difference in VR-QoL between unilateral and bilateral graft recipients (P < 0.001).

Conclusions:

The corneal transplant has the highest impact on color vision and the lowest on dependency. Moreover, the results of this study provide a comprehensive picture for the state of vision and overall health status of patients for health-care providers to enhance the patient care.
Multimodal Imaging in Retinitis Pigmentosa
Authors: Falfoul Yousra , Elleuch Issam , El Matri Khaled , Ghali Hela , Hassairi Asma , Chebil Ahmed , Chaker Nibrass , El Matri Leila
Published: January 2021

Purpose:

To analyze microvascular changes in patients with retinitis pigmentosa (RP) with relatively preserved visual acuity (VA), using swept source optical coherence tomography (SS-OCT) angiography to correlate results to macular function and structure.

Methods:

This was a case–control study conducted over 70 eyes of 35 RP patients with relatively preserved VA. All patients underwent a complete ophthalmic examination, including SS-OCT, OCT angiography (OCT-A), fundus autofluorescence (FAF), and multifocal electroretinogram (mfERG). Thirty-four eyes of 34 healthy controls of age-, sex-, and axial length-matched (control group), were also analyzed. The main outcome measures were foveal and parafoveal vascular densities (FVDs and PFVDs) in the superficial capillary plexus (SCP) and deep capillary plexus (DCP), foveal avascular zone (FAZ) and its enlargement coefficient and their correlation with macular function (by means of VA and mfERG), and structure (by means of FAF and SS-OCT).

Results:

In the RP group, PFVD was 25.99 ± 5.2% in the SCP and 34.47 ± 2.37% in the DCP and were significantly lower as compared to control group (P < 0.0001; P = 0.0026, respectively). Enlargement coefficient of FAZ was 1.78 ± 0.79. We found a statistically significant correlation between VA and PFVD in the DCP (P < 0.0001), FAZ disruption in the SCP (P = 0.006) and enlargement coefficient of FAZ (P = 0.01). The parafoveal DCP density was significantly correlated with P1 amplitude (P = 0.005) in rings 2, 3, 4, and 5 of the mfERG. We found a statistically significant correlation between parafoveal density in the DCP, thickness of ganglion cell complex (GCC) (P = 0.001), and the width of ellipsoid band (P = 0.041). Parafoveal SCP density was also correlated to GCC (P = 0.033).

Conclusions:

We showed that vascular alteration in RP begins at the level of the DCP, which affects the outer retina and leads to a narrowing of the ellipsoid. The alteration of the SCP would occur later in the evolution of the disease. Vascular changes occur early during RP and were highly correlated to retinal function and structure. OCT-A seems to be a good tool to quantify vascular network loss and could play a central role in staging, prognosis, and monitoring disease progression.
Synthesis, characterization, structure determination from powder X-ray diffraction data, and biological activity of azo dye of 3-aminopyridine and its complexes of Ni(II) and Cu(II)
Authors: S. Mohammed H.
Published: January 2021

In the present work azo dye ligand of 3-aminopyridine (L) and its complexes of NiII and CuII were synthesized, characterized and evaluated for antibacterial and antifungal activities in vitro. The L ligand was synthesized by reacting diazonium ion of 3-aminopyridine with 1-naphthole in presence of sodium acetate. The ligand (L) and its complexes were characterized by elemental analysis (CHN), magnetic susceptibility, molar conductivity, UV-Vis spectra, and infrared technique. The (L) azo dye exhibited high sensing for the pH changes. The color of L dye changed from red in basic medium to yellow color in acidic medium. The data of CHN, UV-Vis and magnetic susceptibility indicate that the complexes [Ni(L)2Cl2] and [Cu(L)2Cl2] are tetrahedral. The complexes of Ni(II) and Cu(II) exhibited potent activity against growth of Staphylococcus aureus and Escherichia Coli as well as against Penicillium Sp. And Aspergillus niger. Under visible irradiation (395 nm), the (L) azo dye of pyridine exhibited a significant change in the spectra under irradiation.

                   

KEY WORDS: Pyridine, Photoisomerization, Pyridylazo, Biological activity, pH sensor

 

Bull. Chem. Soc. Ethiop. 2020, 34(3), 523-532.

DOI: https://dx.doi.org/10.4314/bcse.v34i3.8
Determination the Modes Characteristics in the Complex Cross-Section Waveguides
Authors: AL-Gawagzeh Mohammed Yousef
Published: January 2021

In this research the Expressions that determine the eigenfunctions and modes eigenvalues in waveguides with a composite sectorial cross-section are obtained. The possibility of characteristics changing for eigenvalues by changing the parameters that characterizing the cross-sectional shape was studied. The field modes of waveguide based on Ritz method was analyzed.it was determined the characteristics of the quasi – H_mn modes in a cruciform sector waveguide, and quasi – H_mn modes in a composite sector waveguide with an arbitrary number of sectors.it was also shown the advantage of using the cross-section waveguide in single mode optical fiber wavelength range. The eigenvalues (χ) and the normalized coefficients (a )for quasi – H_mn modes in terms of Bessel functions (Q_m,P_m ) and their combinations was obtained.
Pengembangan Watak Kristen Melalui Pengampunan
Authors: Siregar Jundo Parasian
Published: January 2021

The character of forgiveness is the struggle of the lives of believers who must always be present in every believer's life. Forgiveness is the essence of the faithful, where forgiveness shows that Christians have truly felt and are grateful for the forgiveness given by God. True forgiveness changes the lives of believers and impacts themselves and others. This paper describes forgiveness as a basis or reference for believers in the development of life character.

Abstrak

Karakter pengampunan merupakan pergumulan hidup orang beriman yang senantiasa harus ada dalam setiap kehidupan orang percaya. Mengampuni adalah hakikat orang beriman, dimana pengampunan menunjukkan bahwa orang Kristen sudah benar-benar merasakan dan mensyukuri pengampunan yang diberikan oleh Allah. Pengampunan yang sejati mengubahkan kehidupan orang percaya dan memberi dampak bagi diri sendiri dan orang lain. Tulisan ini menguraikan pengampunan sebagai dasar atau acuan orang percaya dalam pengembangan watak atau karakter hidup.
Penggunaan Media Teknologi Informasi dalam Pembelajaran Pendidikan Agama Kristen di Masa Pandemi Covid-19
Authors: Sihotang Hermanto
Published: January 2021

Christian religious education has a strategic role in the inheritance of the values of Christian life and faith as taught by the Bible, the Word of God, which can take place in families, churches and schools. The complaint that is often heard from the school and teachers is the lack of interest in learning PAK by students, which can be caused by traditional learning strategies such as the use of one-way and monotonous lecture methods. In order to overcome this the teacher must implement a variety of learning strategies, including those that allow the use of information technology media in it. In addition, the covid-19 phenomenon is a new challenge, especially in the world of education - learning that cannot be done face-to-face. Therefore, teachers as educators in schools must optimize their insights and skills in information technology to be able to answer the challenges in question. Parents who are responsible for their children's education should create a good climate at home and facilitate children's learning facilities. Children as students are obliged to optimize gadgets as a source of learning, and develop skills in the field of information technology (computers, internet) as a means of learning during the Covid-19 pandemic. In this paper, descriptive qualitative methods or library research are used to obtain and analyze data regarding the use of information technology in the learning process of Christian religious education during the pandemic. The findings obtained are that the use of information technology in Christian religious education has basically become a demand for Christian religious education teachers, especially in the era of disruption. During the Covid-19 pandemic, these demands were far different, and made Christian religious education teachers even more motivated and inevitably had to adjust to online learning, master and apply this educational technology so that in the end it resulted in learning Christian religious education in schools
Desain Bahan Pembinaan Suami-Istri Kristen untuk Ketahanan Keluarga Warga Gereja
Authors: Sihombing Herdiana , Sitopu Elisamark , Sitorus Herowati , Sipahutar Roy Charly HP , Harianja Bintahan M.
Published: January 2021

The high divorce rate in Indonesia, including among Christian families, has in recent years been a struggle together. Divorce itself is the mouth of a variety of pressures faced by Christian families that are not properly resolved. Not a few Christian families have a vulnerable resilience due to their inability to manage conflicts that occur. On the other hand, the Church must recognize that it has an ethical and theological responsibility to maintain the resilience of the family members of its congregation. However, the fact is that most churches do not have a programmed mission to nurture husband and wife members of their congregations in order to maintain family resilience. In fact, many churches do not have documented teaching material for cultivating Christian families. This article is a summary of development research that seeks to create a design for Christian husband and wife formation materials that can later be used by church leaders for the survival of the family of church members. The research method used is Research and Development (R & D), which is used to produce certain products, and test their effectiveness. In this research, the design of Christian husband and wife guidance materials for the family resilience of church members is produced.
Kunci Keberhasilan Seorang Anak Dalam Pemaparan Alkitab
Authors: Nainupu Astrid Maryam Yvonny , Emiyati Ayang
Published: January 2021

Every parent definitely wants the children to succeed in their life. However, most parents do not understand the true key of success. On the other hand, they are not able to accompany and educate their children to be success. The purpose of this study is to search the exposure of the Bible about the concept of success, the way a child raised by the parent or adults based on the examples from the Bible. The method used in this study is a literature review research and the exegesis of Bible. Based on the Bible success promised by God is a success in wealth and an ability to have wisdom needed to manage the daily problems. Besides, the important thing for a child to be success based on the exposure of the Holy Bible, is by reading, meditating and being careful to do everything written in the Scripture.  AbstrakSetiap orang tua pasti ingin agar anak – anaknya berhasil di dalam hidupnya. Tetapi belum tentu semua orang tua memahami kunci keberhasilan yang sejati. Di sisi lain, belum tentu juga semua orang tua dapat mendampingi anak – anak mereka dan mendidik mereka sehingga menjadi berhasil. Penelitian ini bertujuan meneliti pemaparan Alkitab tentang konsep keberhasilan, bagaimana seorang anak dapat berhasil dalam didikan orang tua atau orang dewasa lainnya berdasarkan contoh – contoh dari Alkitab. Metode yang dipakai dalam penulisan ini adalah penelitian studi pustaka dan eksegese Alkitab. Berdasarkan pemaparan Alkitab ditemukan bahwa keberhasilan yang dijanjikan Allah bagi umat-Nya adalah keberhasilan yang meliputi kesuksesan secara materi dan kemampuan untuk mendapatkan hikmat yang dibutuhkan dalam menangani masalah – masalah kehidupan. Selain itu kunci agar seorang anak dapat mencapai keberhasilan dalam pemaparan Alkitab adalah dengan membaca, merenungkan dan bertindak hati – hati sesuai yang dituliskan di dalam Firman Tuhan.
Implikasi Ulangan 5:16 Dalam Pendidikan Keluarga
Authors: Mary Eirene
Published: January 2021

God is the God who wants to reveal Himself to humans. God also revealed what He wanted humans to do in the 10 Commanments. The law provides for the things that humans must do in relation to God and with others. The first law in human relations is the law concerning parents and children. Children must respect their parents. In fact, there are many events that show the fading of the values of respecting parents. This paper tries to reexamine the fifth law regarding respect for parents by analyzing Deuteronomy 5:16.  The analysis is done by looking for the meaning of the word "honor" and synthesizing several interpretations of the meaning of honoring parents.From this analysis it was found that through parents, a child is born into the world. Parents are God's representatives. The relationship between parent and child is the highest relationship in human relations. God gives orders for children to respect their parents. Respecting parents can be done in the form of submitting to parents, obeying parents and caring for parents in their old age. This has implications in the process of family education where parents are responsible for educating their children, children must be taught about things that God has done and submit to authority.  AbstrakAllah adalah Allah yang mau menyatakan diri-Nya kepada manusia.  Allah juga menyatakan apa yang dikehendaki-Nya untuk dilakukan oleh manusia dalam hukum Taurat.  Hukum Taurat memberikan hal-hal yang harus dilakukan oleh manusia dalam hubungannya dengan Allah dan dengan sesama.  Hukum pertama dalam hubungan dengan manusia adalah hukum tentang orang tua dan anak.  Anak harus menghormati orang tuanya. Kenyataan yang terjadi saat ini, banyak kejadian yang menunjukkan lunturnya nilai-nilai menghormati orang tua. Tulisan ini mencoba meneliti kembali hukum Taurat yang kelima mengenai menghormati orang tua dengan menganalisis Ulangan 5:16.  Analisis yang dilakukan adalah dengan mencari makna kata “hormat” dan mensintesakan beberapa penafsiran mengenai makna menghormati orang tua.  Dari analisis tersebut ditemukan bahwa melalui orang tua, seorang anak dilahirkan ke dalam dunia.  Orang tua adalah wakil Allah.  Hubungan orang tua dan anak adalah hubungan yang tertinggi dalam hubungan antar manusia.  Allah memberikan perintah agar anak menghormati orang tua.  Menghormati orang tua dapat dilakukan dalam bentuk tunduk kepada orang tua, taat kepada orang tua dan memelihara orang tua pada masa tuanya.  Hal ini berimplikasi dalam proses pendidikan keluarga dimana orang tua bertanggung jawab dalam mendidik anak-anaknya, anak-anak harus diajarkan tentang hal-hal yang sudah dilakukan Allah dan tunduk pada otoritas.