bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effects of Organic and Conventional Cultivation Systems on the Content of Bioactive Substances in Herbal Plants
Authors: Kazimierczak Renata , Hallmann Ewelina , Kazimierczyk Małgorzata , Sokołowska Oliwia , Rembiałkowska Ewa
Published: February 2012

The Effects of Organic and Conventional Cultivation Systems on the Content of Bioactive Substances in Herbal Plants

Five species of herbs from organic and conventional cultivation (dropsy plant, lovage, mint, thyme and sage) were used for this experiment. The research material consisted of usable parts of fresh herbs, which were harvested in the first ten days of September 2009 and 2010. In order to avoid losses in the content of biologically active compounds in the plant material, the herbs were frozen at -80°C immediately after harvesting, and then subjected to freezedrying; finally, analytical research was conducted. The results of two-year studies indicated that herbal plants from organic production contained a higher level of dry matter, vitamin C and flavonoids, while the conventional ones contained more phenolic acids. Regardless of the cultivation system, dropsy plant and mint were distinguished by the content of phenolic acids, the highest level of flavonoids was found in thyme, while lovage was the raw material containing the most vitamin C. The qualitative analysis of phenolic compounds contained in herbs showed that the most diverse composition of phenolic acids was attributed to sage and thyme, which also contained the largest number of identified flavonoids.
Heart rate and other risk factors in outpatients with stable coronary artery disease in Latvia
Authors: Balode Inga , Jēgere Sanda , Mintāle Iveta , Narbute Inga , Latkovskis Gustavs , Ērglis Andrejs
Published: February 2012

Heart rate and other risk factors in outpatients with stable coronary artery disease in Latvia

The aim of the study was to characterise coronary artery disease (CAD) outpatients in Latvia by risk factors (RF) including heart rate (HR), physical examination data, clinical data and treatment. Twelve practitioners had each examined and questioned 6 to 12 patients with established CAD (n = 120). The most frequent cardiovascular (CV) RF and co-morbidity were dyslipidemia (94.2%) and hypertension (78.3%), respectively. Prevalence of increased resting HR (≥70 bpm) was 35.9% and 33.6%, when measured by pulse palpation and electrocardiography, respectively. Regarding other RFs, prevalence of treated but insufficiently controlled blood pressure 140/90 mmHg, total cholesterol 1 > 5 mmol/l and triglycerides > 1.7 mmol/l was 25.8%, 30.1% and 33.3%, respectively. Aspirin, statins and angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers were used in 96.7%, 94.2% and 85.0% of cases, respectively. Beta blockers were used in 81.7% of cases. Average daily doses of most frequently used β blockers (metoprolol and bisoprolol) were 32% and 53% from target doses, respectively. In three cases β blockers were combined with ivabradin. Our results suggest that practitioners follow guidelines and consider CV prevention by treating CAD patients. Our data identified, however, unused potential for better control of increased HR by higher doses and combinations of HR-reducing agents.
Acoustics of Classrooms in Primary Schools - Results of the Reverberation Time and the Speech Transmission Index Assessments in Selected Buildings
Authors: Mikulski Witold , Radosz Jan
Published: February 2012

The article presents results of our own research regarding acoustic properties of 110 classrooms in five typical primary schools in Warsaw. The target of the research was to assess the classrooms using established criteria. These criteria include the reverberation time and the speech transmission index. The research has shown a large diversity of acoustic properties of classrooms within each of the schools and between the schools, resulting from the classroom equipment and the school building construction. In addition, the assessment has indicated that classrooms in schools researched do not meet the established acoustic criteria (reverberation time and speech transmission index). Because the classroom equipment is different for younger forms (integrated teaching) and for older forms (subject teaching), the results have been analyzed separately for rooms for younger forms (0-III) and for rooms for older forms (IV-VI). Synthetic results prove the advisability of such division. Correlation analysis has been conducted for the speech transmission index STI and reverberation time Tmf, as well as for the speech transmission index STI and the suggested reverberation time Twf defined in a similar manner as Tmf, but in a wider frequency range. The correlation between the speech transmission index STI and Twf is higher than that between the STI index and Tmf. The reverberation time Twf can therefore be used for a more precise assessment of acoustic properties of interiors with regard to verbal communication than Tmf. In addition, the paper presents estimated analysis results of the influence of selected classroom equipment (carpets) on its acoustic properties.
Developing novel correlations for calculating natural gas thermodynamic properties
Authors: Farzaneh-Gord Mahmood , Rahbari Hamid
Published: February 2012

Developing novel correlations for calculating natural gas thermodynamic properties

Natural gas is a mixture of 21 components and it is widely used in industries and homes. Knowledge of its thermodynamic properties is essential for designing appropriate processes and equipment. This paper presents simple but precise correlations of how to compute important thermodynamic properties of natural gas. As measuring natural gas composition is costly and may not be effective for real time process, the correlations are developed based on measurable real time properties. The real time properties are temperature, pressure and specific gravity of the natural gas. Calculations with these correlations are compared with measured values. The validations show that the average absolute percent deviation (AAPD) for compressibility factor calculations is 0.674%, for density is 2.55%, for Joule-Thomson coefficient is 4.16%. Furthermore, in this work, new correlations are presented for computing thermal properties of natural gas such as enthalpy, internal energy and entropy. Due to the lack of experimental data for these properties, the validation is done for pure methane. The validation shows that AAPD is 1.31%, 1.56% and 0.4% for enthalpy, internal energy and entropy respectively. The comparisons show that the correlations could predict natural gas properties with an error that is acceptable for most engineering applications.
A study of performance and emissions of SI engine with a two-stage combustion system
Authors: Jamrozik Arkadiusz , Tutak Wojciech
Published: February 2012

A study of performance and emissions of SI engine with a two-stage combustion system

Lean mixture burning leads to a decrease in the temperature of the combustion process and it is one of the methods of limiting nitric oxide emissions. It also increases engine efficiency. An effective method to correct lean mixture combustion can be a two-stage system of stratified mixture combustion in an engine with a prechamber. This article presents the results of laboratory research on an SI engine (spark ignition) with a two-stage combustion system with a cylinder powered by gasoline and a prechamber powered by propane-butane gas LPG (liquefied petroleum gas). The results were compared to the results of research on a conventional engine with a one-stage combustion process. The test engine fuel mixture stratification method, with a two-stage combustion system in the engine with a prechamber, allowed to burn a lean mixture with an average excess air factor equal to 2.0 and thus led to lower emissions of nitrogen oxides in the exhaust of the engine. The test engine with a conventional, single-stage combustion process allowed to properly burn air-fuel mixtures of excess air factors λ not exceeding 1.5. If the value λ > 1.5, the non-repeatability factorCOVLiincreases, and the engine efficiency decreases, which makes it virtually impossible for the engine to operate. The engine with a two-stage combustion process, working with λ = 2.0, theQin/Qtot= 2.5%, reduced the NOxcontent in the exhaust gases to a level of about 1.14 g/kWh. This value is significantly lower than the value obtained in a conventional engine, which worked at λ = 1.3 with comparable non-repeatability of successive cycles (about 3%) and a similar indicated efficiency (about 34%), was characterised by the emissions of NOxin the exhaust equal to 26.26 g/kWh.
The effects of favouring lower alcohol content beverages: Four examples from Finland
Authors: Österberg Esa
Published: February 2012

Aims

This paper studies the possibility of substituting the consumption of one alcoholic beverage category for another by changing alcohol control measures. It examines four Finnish examples: the waiving in 1952 of the requirement to show a special identity card issued by the alcohol monopoly Alko for buying fortifed wines; again binding the sales of fortifed wines to Alko's identity card in 1958; a 1960s alcohol price policy favouring wines and beer over vodka; and the change in alcohol legislation in 1968, which allowed selling medium beer in grocery stores but left the off-premise sales of all stronger alcoholic beverages to Alko's liquor stores.

Data

Data on recorded consumption of alcoholic beverages in terms of 100 per cent alcohol per capita according to beverage categories will be used together with the numbers of arrests for drunkenness according to beverage categories as well as different data sources on changes in alcohol control measures.

Results & Conclusions

The four examples from Finland show that strong alcoholic beverages can be substituted for lighter drinks, but this seems to work especially when the lighter beverages can be used for the same purposes as the stronger ones. It is much more difficult to persuade consumers to substitute strong alcoholic beverages for light ones by changing relative alcohol availability or by adjusting prices, if the consumers also have to change their drinking habits by, for instance, substituting binging with vodka for drinking light wines with meals. The Finnish examples also make it clear that changing from one beverage category to another does not automatically result in changing the way to use alcoholic beverages or the drinking habits themselves.
In fear of a reversal back to the spirits-drinking era — the 2004 decrease of Finnish alcohol taxes in public discourse
Authors: Hellman Matilda , Karlsson Thomas
Published: February 2012

Aims

The study investigates how the dissimilar tax reductions for different alcoholic beverages (spirits, wine and beer) were debated during the large tax decrease on alcoholic beverages in Finland in 2004.

Design and Data

The material comprises parliamentary proceedings and discussions, as well as daily press items (=105) from 2003–2004. Content analyses, both quantitative and qualitative, were performed.

Results

The parliament's discussion on the unequal treatment of different beverage types concerned mostly the overall framing of a public health perspective, differencing between consumption of “spirits” and “non-spirits”. The mass media framed the question mostly from the industry's point of view. Neither a clear support of the total consumption model (excluding specification of beverage sort), nor a strong liberalisation model for alcohol policy were expressed in the materials. Varying stances were merely motivated within a paradigm of “changing drinking patterns”.

Conclusions

The differing treatment of different beverage types, especially the large reductions in spirits taxes, was crystallised as the fundamental public health concern surrounding the decision to lower alcohol taxes. In the end of the article the authors ask whether the lack of clear stances other than the drinking pattern framing could imply that the Finnish alcohol policy debate has become more heterogeneous, neutralised or resigned in its basic nature.
Recruiting Effective Math Teachers: Evidence From New York City
Authors: Boyd Donald , Grossman Pamela , Hammerness Karen , Lankford Hamilton , Loeb Susanna , Ronfeldt Matthew , Wyckoff James
Published: February 2012

For well over a decade school districts across the United States have struggled to recruit and retain effective mathematics teachers. In response to the need for qualified math teachers and the difficulty of directly recruiting individuals who have already completed the math content required for qualification, some districts, including Baltimore, Philadelphia, Washington, D.C., and New York City, have developed alternative certification programs with a math immersion component to recruit otherwise well-qualified candidates who do not have undergraduate majors in math. This article examines the qualifications, student achievement gains, and retention of Math Immersion teachers in New York City compared to New York City mathematics teachers who began their careers through other pathways.
Non-Alcoholic Fatty Liver Disease (NAFLD) Is it an Emerging Risk Factor for Coronary Artery Disease?
Authors: Shrestha Umar Kumar
Published: February 2012

DOI: http://dx.doi.org/10.3126/jaim.v1i1.5780 Keywords: coronary artery disease; non alcoholic - fatty liver; disease; metabolic syndrome Journal of Advances in Internal Medicine. 2012;01(1)1-2.
Cardiac Electrophysiological Study & Radiofrequency Ablation: Our Experience in Nepal
Authors: Rajbhandari Sujeeb , KC Man Bdr , Raut Roshan , Dhungana Murari , Shaha Rajesh , Shaha Kunal Bikram
Published: February 2012

Background and aim - Cardiac Electrophysiological Study and Radiofrequency ablation is a form of cardiac intervention for diagnosing and treating cardiac arrhythmias. Various catheters are placed in the various parts of the heart to record signals and radiofrequency energy is used for the ablation. Methods - A total of 768 patients with paroxysmal supraventricular arrhythmias underwent the procedure at Shahid Gangalal National Heart Centre, Kathmandu, Nepal in a period between October 2003 to September 2011. Results - The success rate is high (92%) and the complication rate is low (0.8%) which is comparable to the results shown in various literatures. Conclusion - Cardiac Electrophysiological study and Radiofrequency ablation is fairly safe and provides a definitive cure to the patients with paroxysmal supraventricular tachycardia. DOI: http://dx.doi.org/10.3126/jaim.v1i1.5831 Journal of Advances in Internal Medicine. 2012; 1(1): 4-7
Schizophrenia and its Correlation with Parental Age
Authors: Risal Ajay , Tharoor Hema
Published: February 2012

Background and aim - Schizophrenia is considered to be a Neuro developmental disorder with its pathogenesis going back to gestation and early childhood. New mutations secondary to advanced paternal age may operate to increase the risk of this disorder by adversely affecting the brain development. Methods - The study was conducted in the department of psychiatry at Kasturba Hospital, Manipal, India during the period of five years (2004 June to 2009 June). Retrospective study of the hospital based records of the patients diagnosed with Schizophrenia (N=290) was carried out and compared with equal number of patients with non-psychotic illness (excluding organic mental illness & substance abuse) in relation to the maternal and paternal age and duration of marriage of the parents at delivery. Results - Logistic regression study among the patients with Schizophrenia and Non-schizophrenic illness in relation to paternal and maternal age above 40 years and duration of marriage of parents above 15 years at delivery of the patient revealed the odd’s ratio (95% CI) as 1.37 (0.81, 2.33), 1.3 (0.47, 3.5), 2.08 (1.4, 3.79) respectively. The analysis showed statistical significance in relation to duration of marriage of the parents (p<0.05). The patients with Paranoid Schizophrenia showed late age of onset in comparison to non-paranoid type, which was statistically significant (p<0.05). Conclusion - A higher risk of developing schizophrenia was found with a paternal age of above 40 years. Further studies are necessary to establish association between Schizophrenic illnesses and parental age. DOI: http://dx.doi.org/10.3126/jaim.v1i1.5832 Journal of Advances in Internal Medicine. 2012; 1(1): 8-11
Skin Lesions and Lower Extremity Edema in a newly diagnosed HIV patient
Authors: Trotter Andrew B , Poutsiaka Debra D
Published: February 2012

The differential diagnosis of skin lesions in human immunodeficiency virus patients is diverse and includes both infectious and non infectious causes. In this case presentation, a 37 year old male newly diagnosed with HIV presented to a hospital in the United States with skin lesions and worsening lower extremity swelling. After presentation, he developed respiratory distress and was found to have disseminated Kaposi sarcoma with cutaneous and pulmonary involvement. Kaposi sarcoma has decreased in incidence in the era of highly active antiretroviral therapy. However, it remains an important acquired immunodeficiency syndrome defining illness which may be the presenting complaint in a patient with occult HIV infection. Kaposi sarcoma has substantial mortality and morbidity and should be included in the differential diagnosis of skin lesions in a HIV positive patient. DOI: http://dx.doi.org/10.3126/jaim.v1i1.5833 Journal of Advances in Internal Medicine. 2012; 1(1): 12-15
Rituximab Monotherapy for Primary Cutaneous Follicle Center Lymphoma
Authors: Dhakal Ajay , Tretheway David M , Fulton Rebecca , Shah Binay Kumar
Published: February 2012

Primary cutaneous follicle center lymphoma is a rare disorder. Although there are several treatment options, large clinical trials on the treatment of primary cutaneous follicle center lymphoma are lacking. Optimal treatment of this disease is unclear. We describe a case of primary cutaneous follicle center lymphoma treated with systemic rituximab, and review the literature. DOI: http://dx.doi.org/10.3126/jaim.v1i1.5834 Journal of Advances in Internal Medicine. 2012; 1(1): 16-18
Bone Marrow Necrosis - A rare clinicopathologic entity - Picture Question
Authors: Shah Binay Kumar , Tretheway David M
Published: February 2012

DOI: http://dx.doi.org/10.3126/jaim.v1i1.5835 Journal of Advances in Internal Medicine. 2012; 1(1): 19
Picture Question Answer
Authors: Shah Binay Kumar
Published: February 2012

DOI: http://dx.doi.org/10.3126/jaim.v1i1.5836 Journal of Advances in Internal Medicine. 2012; 1(1): 26
Epidemiology, Biology, and Outcome in Multiple Myeloma Patients in different Geographical Areas of the World
Authors: Saraf Santosh , Patel Pritesh , Rondelli Damiano
Published: February 2012

Multiple myeloma has an incidence rate of 102,000 and death rate of 72,000 people per year worldwide. The incidence varies by ethnicity with highest rates observed in African Americans followed by people from industrialized nations. Consistent risk factors for MM include increasing age, male gender, black race, MGUS, and family history with familial aggregates seen globally. Chromosome abnormalities commonly seen include hyperdiploidy, translocations involving the immunoglobulin heavy chain, monosomy of chromosome 13, gains of chromosome 1q, and deletion of 17p. These chromosome abnormalities have also been observed in Asian and South American countries, although mild variability in frequencies has been seen. The International Staging System (ISS) was first validated in MM patients from North America and Europe and has shown significant correlation to survival in cohorts from South America and Asia. High-dose chemotherapy followed by autologous stem cell transplant (ASCT) and the novel agents, thalidomide, lenalidomide, and bortezomib are recent advances that have improved response rates and survival. The original studies proving efficacy were primarily performed in the United States and European countries. Although, African Americans were seen to be 23% less likely to receive chemotherapy, similar response rates and survival were seen when given equal access to care. Recent data from several countries in South America and Asia have also shown similar advances in response rates and survival to ASCT and novel agents. The parallel improvements signify that monitoring adequate and equal access to care is critically important in order to improve the long term outcome of MM globally. DOI: http://dx.doi.org/10.3126/jaim.v1i1.5837 Journal of Advances in Internal Medicine. 2012; 1(1): 20-32
Role of Peroxisome Proliferator Activated Receptor-gamma and its Ligands in Inflammatory Bowel Disease
Authors: Shrestha Umid Kumar , Xia Bing
Published: February 2012

Peroxisome proliferator-activated receptor-gamma (PPAR-γ), a nuclear receptor, is highly expressed in the colonic epithelium in contrast to its impaired expression in the patients with ulcerative colitis (UC). Several natural and synthetic ligands of PPAR-γ with some effects in the colon have been identified. The aim of this review is to provide an overview of the role of PPAR-γ and its ligands in inflammatory bowel disease (IBD). Review of article was done using a PubMed search. Animal model studies have revealed that PPAR-γ is the key receptor for 5-aminosalicylic acid that mediates its main effects in the colon. Moreover, the clinical trials have shown that the PPAR-γ agonist rosiglitazone is effective in the treatment of mild to moderately active UC. PPAR-γ gene therapy, used as an adjunct intervention, may be effective in suppressing inflammation in colitis. Some commensal bacteria and natural ligands present in food may induce PPAR-γ expression and activation in the colon which suggest the possibility of associating a natural regulator and a synthetic ligand of PPAR-γ as drug therapy for IBD patients. Further studies are required for the development of unique and effective therapies with PPAR-γ agonists in IBD patients. DOI: http://dx.doi.org/10.3126/jaim.v1i1.5838 Journal of Advances in Internal Medicine. 2012; 1(1): 33-38
Review paper on Bronchiectasis
Authors: Lohani Sudhir
Published: February 2012

Bronchiectasis is characterized by dilatation of bronchi, airflow limitation and chronic infection/ inflammation. The aetiology, pathology and management are discussed in this review. It is vital that we distinguish bronchiectasis from other obstructive airways disease like Asthma and Chronic obstructive airways disease as management strategies are different. DOI: http://dx.doi.org/10.3126/jaim.v1i1.5839 Journal of Advances in Internal Medicine. 2012; 1(1): 39-42
Allogeneic Stem Cell Transplantation to cure Acute Myeloid Leukemia in elderly patients
Authors: Patel Pritesh , Saraf Santosh , Rondelli Damiano
Published: February 2012

Outcomes for elderly patients with acute myeloid leukemia (AML) remain poor with standard therapies. Historically this age group has been excluded from treatment with allogeneic stem cell transplantation (allo-SCT) due to worries of excessive treatment related morbidity and mortality. However, transplantation outcomes have dramatically improved in the last decade due to the widespread use of less ablative conditioning regimens, improved supportive care, and improved patient selection based on prognostic tools such as the hematopoietic cell transplant specific comorbidity index. These have all led to an increasing acceptance of allo-SCT as a potential treatment modality in elderly patients with AML. This review addresses current strategies for patient selection and efficacy data for allo-SCT in elderly patients with AML. DOI: http://dx.doi.org/10.3126/jaim.v1i1.5840 Journal of Advances in Internal Medicine. 2012; 1(1): 43-49
The burden of glaucoma in Nepal
Authors: Badhu BP
Published: February 2012

DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5841 NEPJOPH 2012; 4(1): 1-2
Guest Editorial: Prevention of ocular firework injuries
Authors: Stilma JS
Published: February 2012

DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5842 NEPJOPH 2012; 4(1): 3-4
Prevalence and correction of near vision impairment at Kaski, Nepal
Authors: Sapkota YD , Dulal S , Pokharel GP , Pant B , Ellwein LB
Published: February 2012

Introduction: Presbyopia is an important cause of avoidable visual disability. Objective: To estimate the prevalence of near vision impairment and spectacle coverage among middle and older-aged adults in rural Nepal. Materials and methods: The surveys was carried out among the people of age 35 and over in randomly-selected cluster samples in rural settings of Kaski district of western Nepal, Near visual acuity, with and without presenting near correction, was measured at 40 cm using a LogMAR near vision tumbling E chart under ambient indoor lighting. Subjects with uncorrected binocular distance vision of 20/40 or worse were refracted and those with near vision of 20/40 or worse tested with plus sphere to obtain the best-corrected binocular near visual acuity. Results: A total of 2,360 persons aged 35 years and over were enumerated and 2,156 (91.3 %) were examined. The age- and gender-standardized prevalence of uncorrected near visual impairment (vision of 20/40 or worse) in study population was found to be 66.1 %. Near vision could not be corrected (>20/40) even after distance and near vision correction in 6.4 % . Using the multiple logistic regression models, uncorrected visual impairment was associated with an older age (odds ratio [OR] = 1.13, P < 0.001) and a lower educational level (OR = 1.11, P = 0.01) was less associated with female gender (OR = 0.72, P = 0.038). Over 90 % of people with near visual impairment did not have spectacles. Conclusion: The prevalence of presbyopia appears to be higher with an earlier onset and over 90 % of people in need of near correction do not have spectacles in this setting. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5845 NEPJOPH 2012; 4(1): 17-22
Atorvastatin in clinically-significant macular edema in diabetics with a normal lipid profile
Authors: Narang S , Sood S , Kaur B , Singh R , Malik A , Kaur J
Published: February 2012

Introduction: Lipid-lowering drugs preserve vision and reduce the risk of hard exudates in clinically-significant macular edema(CSME) in diabetics with an abnormal lipid profile. But their role in reducing CSME in diabetics with a normal lipid profile is not yet known. Objective: To evaluate the role of atorvastatin in CSME in diabetics with a normal lipid profile. Materials and methods: A prospective, randomized clinical trial was carried out. Thirty CSME patients with a normal lipid profile were randomly divided into Group A and B. Atorvastatin had been started in Group A four weeks prior to laser treatement. The main outcome measures were any improvement or deterioration in visual acuity and macular edema and hard exudates at six months follow-up. Statistics: Both the groups were compared using unpaired t test for quantitative parameters and chi-square test for qualitative parameters. A p value of < 0.05 was taken as significant. Results: Visual acuity, macular edema and hard exudates resolution was not significantly different in the two groups (P = 0.14, 0.62, 0.39 respectively). Conclusion: Atorvastatin does not affect treatment outcome in CSME with a normal lipid profile over a short term follow-up. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5846 NEPJOPH 2012; 4(1): 23-28
Epidemiology and laboratory diagnosis of fungal corneal ulcer in the Sundarban Region of West Bengal, eastern India
Authors: Bandyopadhyay S , Das D , Mondal KK , Ghanta AK , Purkait SK , Bhaskar R
Published: February 2012

Introduction: Corneal ulcers are the second most-common cause of preventable blindness after cataract in tropical developing countries. Fungal corneal ulcers constitute 30 to 62 % of the total microbial culture-positive corneal ulcers. Objective: To study the epidemiological characteristics, risk factors and laboratory diagnosis of fungal corneal ulcer in the Sundarban Region, West Bengal, eastern India. Materials and methods: A retrospective review of 399 culture-positive, fungal corneal ulcers out of a total 928 corneal ulcer patients attending a tertiary care hospital in Kolkata, eastern India, over a period of four years from February 2007 to January 2011. Results: Males (246; 61.65 %) were more commonly affected than females (P < .0001). The affected people were mostly (342; 85.71 %) residing in the rural areas (P < .0001). 196 patients (49.12 %) were involved in agricultural activities (P < .0001). The younger people of, 21 - 50 years of age, were particularly prone to this disease (269; 67.41 %). Corneal trauma (354; 88.72 %) was the commonest risk factor (P < .0001) and 261 patients (61.41 %) had a history of trauma with vegetative matter (P< .0001). The use of topical corticosteroids was implicated in 65 (16.29 %) cases. The incidence of the disease was highest in the monsoon season, between June to September (192; 48.12 %). The aspergillus spp was the most common fungal growth (151; 37.84 %), followed by an Fusarium spp (81; 20.3 %). Conclusion: The fungal corneal ulcers are an important cause of ocular morbidity in people residing in the Sundarban Region. The identification of the etiology and the predisposing factors of corneal ulcers in this region are important for the prevention and early treatment of the disease. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5847 NEPJOPH 2012; 4(1): 29-36
Ocular and adnexal rhinosporidiosis : the clinical profile and treatment outcomes in a tertiary eye care centre
Authors: Mithal C , Agarwal P , Mithal N
Published: February 2012

Introduction: Rhinosporidiosis may mimic a burst chalazion or a simple conjunctival polyp. Objective: To study the demography, histopathological evaluation, treatment modalities, their outcomes and recurrence rates in patients clinically and histopathologically diagnosed as ocular and adnexal rhinosporidiosis. Patients and methods: The study was conducted in the Department of Orbit, Oculoplasty and Oncology at a tertiary eye care centre in South India. Fifty patients were included who were diagnosed with ocular and adnexal rhinosporidiosis. The conjunctival and lid mass underwent complete excision. All patients with rhinosporidiosis of the lacrimal system underwent dacryocystectomy (DCT) with care taken to avoid spilling the spores. Diagnosis was confirmed histopathologically. Results: The mean age at presentation was 30.42 years, standard deviation( SD) being 16.89 (1 - 70 years). The mean follow-up was 14.2 months (12 months - 18 months) . The most common site was conjunctiva (n = 26 eyes, 52 %), followed by the lacrimal sac ( n = 13, 26 %) and lids (n = 11, 22 %). All the cases were treated by surgical excision with cautery at the base. There was a single recurrence (2 %) involving the lacrimal sac. Endonasal polypectomy combined with exploration in the sac region was done. There were no further recurrences during subsequent follow-up. Conclusion: Rhinosporidiosis is an ocular disorder with high recurrence rates reported. We recommend histopathological examination in every case following excision biopsy for conclusive diagnosis. Recurrence rates can be very low if a complete meticulous excision coupled with cauterization of the lesion is performed. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5849 NEPJOPH 2012; 4(1): 45-48
Ocular morbidity in the rural areas of Allahabad, India
Authors: Singh A , Dwivedi S , Dabral SB , Bihari V , Rastogi AK , Kumar D
Published: February 2012

Background: Although there has been a considerable reduction in the infective causes of ocular morbidity, the global burden of blindness has not significantly altered for over a decade. Objectives: To find the extent of ocular morbidity in different subgroups of the rural population and to study the factors associated with ocular morbidity. Materials and methods: A cross-sectional study was conducted at the Jasra and Saidabad blocks of Allahabad District. A total of eight villages were selected by multistage random sampling technique. The data were analyzed with SPSS Software. Results: Among 9,736 people surveyed, 931 cases of eye diseases were identified. Ocular morbidity was highest (40.92 %) among those aged above 60 years. A higher morbidity was also observed among females (53.60 %), illiterates (69.50 %) and those belonging to low socioeconomic strata (42.86 %). The main causes of ocular morbidity in the study population were cataract (41.89 %), uncorrected refractive errors (21.59 %), xerophthalmia (10.20 %) and glaucoma ( 4.83 %). Conclusions: Programs for cataract surgery, detection and treatment of glaucoma, correction of refractive errors and vitamin A prophylaxis for xerophthalmia need to be targeted to further reduce the burden of ocular morbidity. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5850 NEPJOPH 2012; 4(1): 49-53
Comparison of astigmatism following manual small incision cataract surgery: superior versus temporal approach
Authors: Malik VK , Kumar S , Kamboj R , Jain C , Jain K , Kumar S
Published: February 2012

Introduction: Now-a-days, all techniques of cataract extraction are meant for giving the best uncorrected visual acuity and early post-operative rehabilitation. Purpose: To compare astigmatism induced by the superior and temporal section in manual small incision cataract surgery (SICS) in the Indian population. Materials and methods: One hundred and ten eyes were taken. Eyes having a steeper vertical keratometry reading were assigned to the superior SICS group whereas eyes with a steeper horizontal keratometry reading were assigned to the temporal SICS group. Eyes with no astigmatism were randomly assigned to either of the two groups. Both the groups had 54 eyes each. Eyes in Group 1 underwent manual SICS with a superior tunnel and eyes in Group 2 underwent manual SICS with a temporal tunnel. The patients were examined on postoperative Day1, 1 week, 45 days, and 3 months. Uncorrected and best-corrected visual acuity was recorded, slit-lamp examination, auto-refracto-meter and keratometry examinations were done. Statistics: All calculations were performed using surgically-induced astigmatism (SIA) Calculator version 1.0, a free software program. Results: In Group 2, only 35 eyes out of 54 completed the follow-up of 90 days. The mean SIA in Group1 was found to be 1.45 ± 0.7387 and in Group 2 it was 0.75± 0.4067. The z score applied was found to be 5.7143. This value was more than the standard value, i.e.2.58. The p value accordingly was < 0.001, which is highly significant. The SIA induced by the superior incision was 48.28 % more than by the temporal incision. Conclusion: SICS with the temporal approach provides a better stabilization of the refraction with a significantly less SIA than superior approach. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5851 NEPJOPH 2012; 4(1): 54-58
Retinal nerve fiber layer thickness in Indian eyes with optical coherence tomography
Authors: Malik A , Singh M , Arya SK , Sood S , Ichhpujani P
Published: February 2012

Introduction: Measuring the thickness of the retinal nerve fiber layer is a potential method of recognizing axon loss prior to the visual field abnormality. Objective: To study normal individuals to quantify peripapillary retinal nerve fiber layer (RNFL) thickness in Asian Indian subjects. Materials and methods: This was a prospective study of 150 normal subjects. Peripapillary RNFL was imaged with Optical Coherence Tomography (OCT3) and the thickness of the RNFL around the disc was determined in four quadrants with a 3.4 mm circle OCT scan. The influence of age and gender was evaluated on various parameters using unpaired t test, Pearson’s correlation coefficient and ANOVA. Results: The sample included 66 males and 84 females. The mean age of the study sample was 42.64 ± 13.63 years. The average RNFL thickness was 101.07 ± 10.13μm with the maximum thickness in the inferior quadrant (127.47±15.57) followed by the superior, nasal and temporal quadrants. The difference between the inferior and superior quadrants was statistically significant (p < 0.001). There was no significant difference in RNFL thickness between males and females. Negative correlation was found between age and average RNFL thickness, superior and temporal average (Pearson’s correlation value = -0.262, - 0.209, - 0.294 respectively and p = 0.02, 0.04, 0.001 respectively). Conclusion: The present study provides additional data on the existing database of RNFL thickness in Asian Indians. It is also evident that RNFL thickness decreases with age but there is no relationship with gender. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5852 NEPJOPH 2012; 4(1): 59-63
Pattern of orbital exenteration at a tertiary eye care centre in North India
Authors: Kaur A , Khattri M , Jaiswal V
Published: February 2012

Objective: To analyze cases undergoing orbital exenteration in terms of demographic and socioeconomic profile of patients, indications for surgery, histopathological diagnosis and to assess the magnitude of eyelid malignancies as indication of orbital exenteration. Materials and methods: A case record analysis of 25 patients who underwent orbital exenteration at a tertiary care centre in India between October 2002 and October 2007 was undertaken. The case records were reviewed to obtain demographic data, presenting symptoms, duration of symptoms, laterality, best-corrected visual acuity (BCVA), and the clinical and histopathological diagnosis. Results: The age group of patients undergoing exenteration ranged from 1 year to 78 years (Mean 46.92 ± 10 years). Proptosis and/or a palpable mass were the main presenting complaints in 80 % of cases. The duration of symptoms was more than 5 years in 80 % cases. Primary orbital malignancies were the commonest indication for exenteration and were diagnosed in 11cases (44 %), followed by lid malignancies in 8 cases (32 %), retinoblastoma in 4 cases (16 %) and conjunctival malignancies in 2 cases (8 %). Sebaceous gland carcinoma was the commonest lid malignancy followed by basal cell carcinoma and squamous cell carcinoma. Conclusion: Lid malignancies contribute the majority of the patients undergoing orbital exenteration in this part of the world, leading to an extreme sacrifice of eyes with good visual acuity. Increase in awareness, early diagnosis and prompt referral may help to overcome this grim scenario. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5853 NEPJOPH 2012; 4(1): 64-67
Effect of mitomycin C-aided trabeculectomy on conjunctival goblet cell density
Authors: Mukhopadhyay S , Thakur SKD , Dutta J , Prakash R , Shaw C , Gangopadhyay DN , Dutta H , Bhaduri G
Published: February 2012

Introduction: Mitomycin C is gaining widespread popularity as an adjunctive with trabeculectomy, as it significantly increases the success rate of the procedure. But it is associated with serious sight-threatening complications. Materials and methods: Twenty eyes planned for trabeculectomy from the glaucoma clinic were enrolled for the study after obtaining an informed consent. The baseline impression cytology was taken. Ten eyes underwent trabeculectomy with mitomycin C (Group A) and the rest underwent trabeculectomy without any antimetabolites (Group B). Impression cytology samples were taken on months 1, 3, 6, 9 and 12. Results: In Group A, the difference between goblet cell density preoperatively and 12 month postoperatively was statistically significant (p < 0.0001). In Group B, the difference was not statistically significant. (p = 0.27). Conclusion: Mitomycin C, though used to augment the success rate of trabeculectomy, has deleterious effect on the conjunctival goblet cell population as is evident from the conjunctival impression cytology. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5854 NEPJOPH 2012; 4(1): 68-72
Causes of sub-optimal cataract surgical outcomes in patients presenting to a teaching hospital
Authors: Kumar Kshitiz , Gupta VP , Dhaliwal U
Published: February 2012

Introduction: Surgical treatment for cataract blindness in India is increasing apace; however, sight restoration after surgery is not always satisfactory. Objective: To evaluate visual outcome after cataract surgery and causes of sub-optimal outcome, if any. Materials and methods: A cross-sectional study including the patients who had undergone cataract surgery six months to ten years ago was carried out. The variables studied were visual acuity, demographic and surgical factors and ocular findings. The causes of subnormal outcome was categorized into cataract surgery-related or unrelated. Statistical analysis: SPSS-17 was used; the Chi-square test was used to determine the association between good outcome and categorical variables; the t-test was used for continuous variables. Multivariate analysis using step-wise logistic regression was done. Results: Among 644 patients (644 eyes), good outcome (presenting visual acuity 6/18 or better) after surgery was seen in 266 (41.3 %) eyes. Good outcome was significantly related to urban residence, presence of an intraocular lens and absence of ocular co-morbidities or posterior capsule opacification. Borderline and poor outcomes were mainly due to surgeryrelated causes; treatable causes included uncorrected refractive errors, and posterior capsule opacification. Intra-operative complications resulting in a pulled-up pupil were frequent. Conclusions: Surgical factors are responsible most often for sub-optimal visual outcome; some, like induced astigmatism and vitreous loss, can be modified with training; actively encouraging follow-up visits can allow treatment of residual refractive errors and capsular opacification. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5855 NEPJOPH 2012; 4(1): 73-79
Bactericidal effect of trypan blue and fluorescein sodium in ophthalmic practice
Authors: Malhotra S , Nirmalijit Kaur , Mehta DK
Published: February 2012

Objective: Trypan blue and fluorescein sodium are two commonly used dyes in ophthalmic practice. The staining of anterior lens capsule is achieved using trypan blue while fluorescein finds its application in fluorescent angiography. We assessed the ‘in vitro’ bactericidal effect of these two agents. Materials and methods: The cidal properties of these two dyes were tested in vitro against thirty representative strains of four commonly isolated bacteria from the eye. The concentration of dyes used were 0.6 mg/ml, 0.1 mg/ml, and 0.05 mg/ml for trypan blue and 20 mg/ml, 10 mg/ml and 5 mg/ml for fluorescein sodium. Result: We found that trypan blue and fluorescein sodium at an optimum concentration of 0.6 mg/ml and 20 mg/ml respectively could produce a significant fall (p < .05) in the bacterial count of representative Gram positive and Gram negative bacteria. Conclusion: The use of prophylactic antibiotics/antiseptic eye drops can be avoided if these two dyes are used at an optimum bactericidal concentration but side effects of the same at these concentrations need to be kept in mind. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5856 NEPJOPH 2012; 4(1): 80-83
Microbial contamination in open globe injury
Authors: Bhala S , Narang S , Sood S , Mithal C , Arya AK , Gupta V
Published: February 2012

Introduction: Endophthalmitis is the most dreaded complication of ocular trauma and knowledge of the microbial contaminants is essential to start empirical antibiotic therapy. Purpose: To determine incidence of contamination after open globe injuries (OGI) in our setup and to identify the spectrum of microorganisms contaminating open globe injuries. Material and methods: A prospective study including 50 consecutive eyes of open globe injury over a period of two years was conducted. Intra-operatively, 4 - 5 samples were taken from the inferior conjunctival sac and anterior chamber at the beginning and end of the open globe injury repair. Any abscised tissue or foreign body was also sent for culture sensitivity. A vitreous tap was taken from eyes with posterior segment trauma with signs of endophthalmitis. Results: Microbial cultures were positive in13 eyes (26 %). The microbial spectrum included Aspergillus species in 45.6 %, Alternaria in 15.2 %, Curvularia in 15.2 %, Staphylococcus aureus in 7.6 %, Bacillus species in 7.6 %, and Streptococcus pneumoniae in 7.6 %. Of these 13 eyes, nine eyes developed clinically evident frank endophthalmitis during follow-up. Overall, endophthalmitis developed in 20 eyes (40 %). There was a significant association between the initial contamination and development of endophthalmitis (p < 0.05). 53 % of culture positive cases achieved ambulatory vision compared to 73 % of culturenegative cases. Conclusion: Initial contamination was seen in 26 % of OGI cases. Aspergillus (fungus) was the commonest contaminant. There was a strong correlation between the initial contamination and development of endophthalmitis. Culture-negative cases had a trend towards better final visual outcome than culture-positive cases. Close follow up of cases showing contamination following OGI is recommended. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5857 NEPJOPH 2012; 4(1): 84-89
The distribution of refractive errors among children attending Lumbini Eye Institute, Nepal
Authors: Rai S KC , Thapa HB , Sharma MK , Dhakhwa K , Karki R
Published: February 2012

Introduction: Uncorrected refractive error is an important cause of childhood blindness and visual impairment. Objective: To describe the patterns of refractive errors among children attending the outpatient clinic at the Department of Pediatric Ophthalmology, Lumbini Eye Institute, Bhairahawa, Nepal. Subjects and methods: Records of 133 children with refractive errors aged 5 - 15 years from both the urban and rural areas of Nepal and the adjacent territory of India attending the hospital between September and November 2010 were examined for patterns of refractive errors. The SPSS statistical software was used to perform data analysis. Results: The commonest type of refractive error among the children was astigmatism (47 %) followed by myopia (34 %) and hyperopia (15 %). The refractive error was more prevalent among children of both the genders of age group 11-15 years as compared to their younger counterparts (RR = 1.22, 95 % CI = 0.66 – 2.25). The refractive error was more common (70 %) in the rural than the urban children (26 %). The rural females had a higher (38 %) prevalence of myopia than urban females (18 %). Among the children with refractive errors, only 57 % were using spectacles at the initial presentation. Conclusions: Astigmatism is the commonest type of refractive error among the children of age 5 - 15 years followed by hypermetropia and myopia. Refractive error remains uncorrected in a significant number of children. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5858 NEPJOPH 2012; 4(1): 90-95
Nd: Yag laser treatment for sub-hyaloid hemorrhage in childhood acute leukemia
Authors: Khadka D , Sharma AK , Shrestha JK , Pant B , Pant S , Shrestha A
Published: February 2012

Introduction: Sub-hyaloid haemorrhage is common in acute leukemia. Objective: To investigate the effects of Nd: YAG Laser hyaloidotomy in 11 eyes of 8 patients with pre-macular haemorrhage in acute childhood leukemia. Materials and methods: Premacular sub-hyaloid haemorrhage is one of the leading causes of visual disability in children with acute leukemia. Eleven eyes of 8 patients attending Kanti Children Hospital and BP Koirala Lions Centre for Ophthalmic Studies from January 2006 to July 2007 with premacular subhyaloid haemorrhage were included in the study and treated with Nd: YAG Laser. The haemorrhage originated from acute myeloid leukemia (AML) in 4 cases (6 eyes) and acute lymphoblastic leukemia (ALL) in 4 cases (5 eyes). Results: Drainage of premacular sub-hyaloid haemorrhage into the vitreous cavity within 3 months succeeded in 9 eyes out of 11 eyes treated. One eye had a dense clotted haemorrhage and the other had a re-bleed. Overall visual improvement was equal in both AML and ALL cases. No obvious epiretinal membrane, retinal breaks and tractional retinal detachment occurred in any eye. Conclusion: Nd: Yag laser hyaloidotomy is a relatively safe, simple and alternative treatment for eyes with a dense premacular sub-hyaloid haemorrhage in acute childhood leukemia. The risks and benefits have to be weighed in randomized clinical trials to establish Nd: YAG hyaloidotomy treatment as a routine procedure in leukemic children. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5860 NEPJOPH 2012; 4(1): 102-107