bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute kidney injury
Authors: Singh Krishan , Yadav Arun Kumar , Aggarwal Rashmi , Alam Aftab
Published: May 2024

Background:

Coronavirus disease-2019 (COVID-19) has protean clinical presentation, influencing almost every organ. The number of COVID-19 patients with acute kidney injury (AKI) is expanding, and the incidence of kidney injury in COVID-19 patients with severe disease is higher than in patients with mild disease.

Objectives:

The objective of the study is to find out the association of AKI with COVID-19 deaths.

Methods:

A case–control study was designed with a total of 172 patients. This included 92 death cases and 80 discharged cases in a dedicated COVID-19 hospital, critical care and fully intensive care unit equipped, in the peak of the second wave of COVID pandemic. Various biochemical parameters and inflammatory markers were studied to find out the mortality indicators in these severe COVID-19 cases.

Results:

Significantly elevated AKI markers such as urea (mean 58.5 vs. 37.1, P < 0.05), uric acid (mean 5.67 vs. 4.18, P < 0.05), and blood urea nitrogen (mean 26.9 vs. 17.3, P < 0.05) were detected in the death group compared to discharge group. This was accompanied by significantly elevated markers of inflammation such as total leukocyte count (TLC) (mean 16082 vs. 12100, P < 0.05), interleukin (IL-6) (mean 194.9 vs. 58.7, P < 0.05), C-reactive protein (mean 28.45 vs. 9.73, P < 0.05), and ferritin (mean 761.4 vs. 608.2, P < 0.05) in the death group.

Conclusion:

Significant AKI was noticed in the death group and AKI was further positively correlated with inflammatory markers C-reactive protein, ferritin, IL-6, d-dimer, and TLC levels.
Seroprevalence of syphilis in human immunodeficiency virus patients with special reference to diagnostic utility of rapid plasma reagin test
Authors: Lakshminarayan Divya , Vodapalli Akshay Kumar , Kolla Sri Harsha , Nakka Annie Ratnam
Published: May 2024

Background:

Syphilis is a sexually transmitted infection caused by Treponema pallidum. High prevalence of syphilis was observed among human immunodeficiency virus (HIV)-positive patients. Atypical serological responses such as high antibody titers leading to frequent false-negative reactions have been reported with nonspecific treponemal tests. Simultaneous infection of syphilis and HIV in pregnant women increases the risk of HIV transmission from mother-to-child.

Aim:

The aim of the study was to assess the seroprevalence of syphilis in HIV patients including pregnant women and to know the efficiency of serological tests in detecting syphilis among HIV patients.

Materials and Methods:

The present study was a hospital-based cross-sectional study conducted among 500 HIV-reactive patients, including 100 HIV-reactive pregnant women attending the Outpatient Department of Dermatology, Venereology and Leprosy in a tertiary care center were enrolled in the study and were tested for the presence of syphilis using rapid plasma reagin (RPR) and T. pallidum hemagglutination assay (TPHA).

Results:

Among 500 samples, 58 (11.65%) were positive for syphilis. The most common age group was 30–39 years. Both RPR and TPHA were reactive in 25% of cases, TPHA reactive in 60.2% of cases, and only RPR reactive in 14.7% of cases. Seropositivity among pregnant women was 7%. The sensitivity and specificity of RPR test was 29.3% and 97.7%, respectively, in comparison with TPHA. Positive and negative predictive values of the same were found to be 62.9% and 91.3%, respectively, compared to TPHA.

Conclusion:

In all symptomatic and asymptomatic cases of syphilis, both RPR and TPHA should be performed for laboratory diagnosis of syphilis. It is advocated that all patients with newly diagnosed HIV should be suggested for syphilis serology and vice versa.
Determinants of out-of-pocket health care expenditures and financial coping strategies among beneficiaries of a state-run health insurance scheme in South India
Authors: John Anugraha , Avirneni Hari Teja , Swaminathan Sinthu Sarathamani , Abhina Sivakumar
Published: May 2024

Background:

The household spending for health care in terms of out-of-pocket expenditures (OOPEs) in India remains one of the highest in the world at around 55% of current health expenditures and 48% of total health expenditures. Hence, it becomes extremely important to explore the determinants, i.e., the factors leading to OOPE.

Objectives:

To explore the determinants of OOPE and the financial strategies undertaken by the households to cope up with OOPE.

Methodology:

A longitudinal study was conducted among chronic kidney disease (CKD) patients who availed care at a Tamil Nadu Chief Ministers Comprehensive Health Insurance Scheme empanelled health care facility. They recorded their OOPE over a period of 6 months in the hand-book provided to them. An interview schedule was administered at the end of 6 months, to explore the determinants of OOPE and coping strategies.

Results:

Among the sociodemographic characteristics, age and gender had an impact on OOPE. Females had higher OOPE (INR 10,100) when compared to that of males (INR 9360) and with increased age of more than 60 years, there was a dip in OOPE (<60-INR 11,072; >60-INR 10,100). The duration of current treatment has been another important determinant, whereas borrowings were the most predominant financial strategy to cope up with OOPE.

Conclusion:

Despite having the health insurance coverage sponsored by government, CKD patients had OOPE pertaining to the various aspects such as age, gender, comorbidities, and number of members in the household utilizing the scheme and the coverage amount under the scheme.
Torus occipitale and occipital bun
Authors: Shamsundara Manaswi , Paramesh Nikil Sanaba , Kulkarni Vasudha
Published: May 2024

Nonmetric characteristics, epigenetic traits, and cranial distinct traits are indicated by tubercles, ossicles, bony protuberances, foramina/notches, and other features on the human skull. For decades, they have piqued the interest of anatomists and anthropologists by supporting and providing evidence for human evolution. Torus occipitale is one such cranial nonmetric variation which is the projection/prominence of inion (midpoint of external occipital protuberance). According to studies, it is caused by the ossification of the ligamentum nuchae's connection to the external occipital protuberance. Yet another nonmetric trait, occipital bun is the posterior projection of the squamous part of the occipital bone below internal occipital protuberance. This case series reports how autapomorphic traits such as torus occipitale and occipital bun are helpful to determine race and the relationship between living taxa and paleontology. These tiny qualitative differences can be used as phenotypic connection markers between groups. We hereby report four types of torus occipitale and cases of occipital bun with their clinical and anthropological relevance.
Role of deferred retinal laser following intravitreal injection of bevacizumab in treatment of severe retinopathy of prematurity
Authors: Bhat Vishalakshi , Patil Shankargouda H.
Published: May 2024

PURPOSE:

The purpose is to determine the advantages and role of supplemental deferred retinal laser treatment following intravitreal bevacizumab (IVB) monotherapy in cases of severe retinopathy of prematurity (ROP) requiring treatment.

MATERIALS AND METHODS:

This is a retrospective study involving preterm infants diagnosed with treatment requiring ROP, treated initially with bevacizumab monotherapy who subsequently received deferred laser treatment during the study period from April 2019 to March 2021. Deferred laser treatment was done when recurrence of ROP or plus disease was noted or nonprogression of retinal vasculature was noted on two consecutive examinations over 2 weeks. The main outcomes measured were the ability of the treatment to prevent ROP progression or recurrence and anatomic outcome at the last follow-up visit.

RESULTS:

Twenty-three eyes of 14 neonates were treated with a deferred laser treatment following the initial intravitreal injection of Bevacizumab. The mean postmenstrual age at which IVB was given was 34+6 ± 1+3 weeks. The mean duration between IVB and retinal laser was 5+3 ± 3+4 weeks. The mean weight at the time of injection was 1317.8 ± 231.8 g. The mean weight of the infants at the time of the laser was 2050 ± 813.9 g. None of the eyes developed recurrence or adverse anatomical outcomes following laser till the last available follow-up.

CONCLUSIONS:

In our small number of subjects, blinding complications of ROP were prevented by using a deferred laser treatment protocol following initial bevacizumab therapy in treatment requiring ROP. It is better suited in cases where compliance for long-term follow-up after bevacizumab therapy cannot be ensured.
Human immune deficiency virus conundrum
Authors: Kochar Anju , Farooq Shaheen
Published: May 2024

BACKGROUND:

Human immune deficiency virus (HIV) causes a wide spectrum of diseases worldwide and has the capability to affect every organ system in the body. Ocular manifestations have been reported in up to 70% of individuals infected with HIV and the ocular manifestations reflect systemic disease and maybe the first sign of disseminated infection.

PURPOSE:

To study the pattern of ocular manifestations related to HIV in seropositive patients with the objective of identifying its spectrum in highly active antiretroviral therapy (HAART) era and to emphasize on the role of ophthalmologists in fighting the battle against HIV.

MATERIALS AND METHODS:

A cross sectional study was undertaken on 300 HIV positive patients. Data were collected, tabulated and analyzed using MSTAT software. Chi-square test was applied and P < 0.05 was considered significant.

RESULTS:

Ocular lesions were observed in 50.33% of patients. Conjunctival microvasculopathy being the most common finding seen in 27 (9%) patients, followed by retinal microvasculopathy and trichomegaly in 20 (6.66%) patients each. Herpes zoster ophthalmicus and cytomegalovirus retinitis were observed in four (1.33%) and three (1%) patients respectively. In the study 78.33% patients were on ART.

CONCLUSION:

HAART has reduced serious ocular opportunistic infections and ocular malignancies, but HAART mediated visually disabling immune recovery uveitis has emerged as a clinical challenge for ophthalmologists. Improved communication between the two broad specialties of HIV medicine and ophthalmology will definitely go a long way in the battle against this dreadful disease.
Maximal levator resection versus Gore-Tex® sling for congenital blepharoptosis with poor levator function
Authors: Dawood Ahmed Said , Hassan Omar Abdelghany , El Sayed Mohamed Othman
Published: May 2024

BACKGROUND:

Treating congenital blepharoptosis is often mandatory to clear the visual access and avoid amblyopia; however, when the levator function is poor, achieving a satisfactory long-term outcome is challenging. This study aimed to compare the outcomes of maximal levator resection (MLR) with those of frontalis suspension (FS) using Gore-Tex ®, in the treatment of congenital blepharoptosis with poor levator function.

PATIENTS AND METHODS:

The study included 102 eyelids of 66 patients of mean age 4.3 ± 1.6 standard deviation (SD) years, randomly divided into two groups (51 eyes each). Group A: FS using Gore-Tex ®, Group B: MLR. Postoperative outcomes were evaluated at 1, 6 and 12 months. Patients' ophthalmic examination including margin-reflex distance (MRD1) before and after surgery and postoperative complications were recorded.

RESULTS:

At the end of the follow-up, the mean MRD1 increased from 0.3 ± 0.7 SD mm in Group A, 0.4 ± 0.8 SD mm in Group B preoperatively, to 2.7 ± 0.5 SD mm and 2.9 ± 0.7 SD mm, respectively (P < 0.001 in both groups). Results of Group B were significantly higher than Group A (P = 0.047). Success was achieved in 77 eyelids (75.4%), distributed as follows: 36 eyelids (70.6%) in Group A, and 41 eyelids (80.1%) in Group B. The total recurrence rate was 6.9% (seven eyes), while other complications were recorded in 23 eyes (22.5%).

CONCLUSION:

MLR, compared to FS with Gore-Tex® sling, can be a more efficient surgical option to correct congenital blepharoptosis with poor levator excursion. Prominent postoperative lagophthalmos warrants close ocular surface observation in early follow-up weeks.
Acute reversible bilateral hearing loss after retrobulbar anesthesia
Authors: Kiristioglu Mehmet Omer , Gunduz Gamze Ucan , Doganay Selim
Published: May 2024

This is the first reported case who had bilateral reversible hearing loss after regional anesthesia (RA) without a procedural sedoanalgesia. Furthermore, 20% lipid emulsion infusion (LEI) was first used in the treatment of a patient with hearing loss as an indicator of impending brainstem anesthesia. The ophthalmologist had performed a retrobulbar block without any difficulties to a 55-year-old the patient who undergone pars plana vitrectomy. A combination of lidocaine and bupivacaine was injected slowly through a 23G, 1.5-inch needle. Few minutes later, the patient experienced sudden bilateral hearing loss and, subsequently, mental confusion and mild respiratory distress. Local anesthetic toxicity to the predominantly brainstem was the diagnosis. Consequently, 20% LEI was administered, and his hearing loss gradually improved within a few hours. Prompt intervention is crucial in case of severe systemic complications of RA. LEI might be beneficial to halt the deepening of brainstem toxicity.
Systematic review
Authors: Pérez-Peralta Liliana , Sauceda-Valenzuela Alma L. , La Parra David Rivera-de , Suarez-Ajoleza Angela Abril , Beauregard-Escobar Ana Maria , Torres-Dominguez Juan Alejandro
Published: May 2024

The disease, which originated from the SARS-CoV-2 virus, is primarily transmitted by direct contact with infected individuals. Visual healthcare professionals perform clinical practices that pose a significant risk of infection due to their proximity with patients during the examination. This systematic review aims to identify preventive measures that will aid in reducing the risk of infection during standard appointments between patients and visual health professionals. A systematic review was done for articles published in indexed journals from December 2019 to December 2020. The search for these articles was done in 3 electronic databases. As part of the search criteria, articles were selected if they had the keywords (SARS-CoV-2), (COVID-19), and coronavirus combined with ophthalmology, optometry, eye care, and the eye. Once duplicated and unrelated items were eliminated, 36 articles of interest were selected. Seven sections were described in detail: telephone screening, (COVID-19) triage, decreasing transmission within shared spaces, hand washing, use of personal protective equipment Personal Protective Equipment (PPE), cleaning of diagnostic instruments, and use of telemedicine. This paper helps healthcare professionals to better understand the context of the “new normal” clinical practice. Visual health professionals and their patients must adhere to norms and use the indicated PPE during the consultation to safeguard each other.
Presumed herpes simplex virus ulcerative nodular episcleritis treated by topical acyclovir alone
Authors: Hoshing Abhishek , Seth Atul , Subramaniam Abhay
Published: May 2024

A 7-year-old female child was referred to the cornea clinic with a painless, ulcerated, and inflamed nodule near the limbus which did not respond to 1-week antibiotic therapy and worsened on starting topical steroids. Clinical examination showed ulcerative nodular episcleritis and raised a suspicion of herpes simplex virus etiology. The patient responded well and resolved completely on topical antiviral therapy alone.
Cornea plana in a family from Pakistan: Case series and literature review on the principles of management
Authors: Khan Taimoor Ashraf , Zameer Sheharyar , Janjua Teyyeb Azeem , Zahid Muhammad Abdullah , Akram Amjad , Mallick Naafiah Khalid
Published: May 2024

Cornea plana (CP) is a rare ocular condition existing in two distinct clinical and hereditary forms: a milder, autosomal dominant type I and a more severe, autosomal recessive type II. The condition is more commonly found in Finnish, Saudi, and Czech families. We report three brothers from a consanguineous marriage that presented with complaints of decreased vision of varying degrees. All three of them have blue, thick, and hazy corneas with shallow anterior chamber depths. The additional features of CP type II were seen in the older two brothers including arcus lipoids, ill-demarcated limbus, and an accommodative squint. They were managed by the correction of refractive errors through spectacles and detailed counseling with follow-up visits to look for progressive complications. The management is mainly centered around optically or surgically correcting the developmental anomalies. This is complimented with proper genetic counseling and regular follow-up visits to look for and manage complications. There are, however, novel therapies that can be considered in these patients including corneal transplants or corneal stromal stem cellular therapies.
Dacryocystitis in a patient with Samter's triad
Authors: Abdel-Aty Ahmad , Jin Andrew , Manes R Peter , Khan Mohammad , Pointdujour-Lim Renelle
Published: May 2024

Samter's triad, also known as aspirin-exacerbated respiratory disease, is characterized by nasal polyposis, bronchial asthma, and aspirin intolerance. Here, we present a case of a 36-year-old woman with a history of Samter's triad and recurrent dacryocystitis. After combined dacryocystorhinostomy and endoscopic sinus surgery, pathological specimens of the lacrimal sac showed respiratory fibrosis with chronic inflammation and eosinophilic infiltration. Our case demonstrates that Samter's triad is a potential etiology for inflammatory nasolacrimal duct obstruction.
Twelve month outcome of manual small-incision cataract surgery in Assiut, Egypt
Authors: Shehata Mohamed , M. Aly Mohamed Omar , A. Saleh Mohamed Gamal , Abdel-Radi Mahmoud
Published: May 2024

BACKGROUND:

To assess the visual outcome of manual small-incision cataract surgery (MSICS) as well as safety, cost, and time of the procedure.

PATIENTS AND METHODS:

A retrospective study involving candidates for cataract surgery with baseline-corrected distance visual acuity (CDVA) ≤20/120. Visual acuity (VA) was the primary outcome measure while surgical complications, cost, and time of surgery were the secondary outcome measures. Follow-up visits were scheduled at 1 day, 1 week, 1 month, and at 6 and 12 months following surgery.

RESULTS:

The study enrolled 3007 patients with a mean age of 66.45 ± 17.3 years. Out of 3007 patients, 2774 (92.2%) were legally blind before surgery (CDVA <20/200) which was significantly reduced to 55 patients (1.9%) by 1 month following surgery. Uncorrected distance visual acuity was 20/60 or better in 2098 eyes (69.8%) at 1 month, in 2035 eyes (67.7%) at 6 months, and in 2017 eyes (67.1%) at 12 months. The posterior capsular rupture was the most common intraoperative complication. Corneal edema was the most common immediate postoperative complication while the development of posterior capsular opacification was the leading cause for later impaired VA. The mean cost was approximately equivalent to 20 US dollars. The median duration of surgery was 10 min.

CONCLUSION:

MSICS is a safe, cost-effective, and time-saving technique for improving the vision of cataract patients in areas with high cataract surgery volume and limited facilities.
Advanced Coats' disease
Authors: Shukla Dhananjay
Published: May 2024

An 8-year-old child with Stage 3A Coats' disease and severe submacular lipid exudation was initially treated with intravitreal injections of bevacizumab followed by triamcinolone. The exudative retinal detachment was then treated by scleral buckling, cryotherapy of persistent telangiectasia, and subretinal fluid drainage. The residual telangiectasia on the reattached retina was finally ablated by photocoagulation. The patient had a near-total resolution of submacular hard exudates without macular fibrosis. The peripheral telangiectasia and exudative detachment also regressed, with the sustained recovery of excellent visual acuity.
Mitigation of photoreceptors abnormalities after low-level laser therapy and chia seeds supplementation in experimental diabetic retinopathy
Authors: Hassan Mahmoud Abdel Rahman , Abdelkawi Salwa Ahmed , Ghoneim Dina Fouad , Hassan Aziza Ahmed , Morsy Mona Ebrahim
Published: May 2024

BACKGROUND:

This study aimed to assess the effect of low-level laser therapy (LLLT) and chia seeds on the mitigation of photoreceptors abnormalities in experimental diabetic retinopathy (DR).

MATERIALS AND METHODS:

A total of 65 female Wistar rats, 5 rats were served as a control group and 60 rats were injected intraperitoneally with one dose of 55 mg/kg of streptozotocin (STZ) to induce DR after 6–8 weeks. The rats were divided into (n = 20 rats each): (a) DR group: did not receive any treatment, (b) DR+ LLLT group was exposed to 670-nm LLLT for 6 weeks (two sessions/week), and (c) DR+ LLLT+ chia seed group, in which rats were exposed to LLLT and administrated with 250 mg/kg/day of chia seeds flour for 2 weeks before STZ injection and continued to the end of the experiment. Blood glucose (BG) levels and retinal histological examination were employed after 1, 2, 4, and 6 weeks.

RESULTS:

The BG level in the DR group and the treated groups were significantly higher (P < 0.001) than in the control group after the four-time periods. Chia seeds group exhibited BG levels less than the DR and the DR+ LLLT groups after 6 weeks (P < 0.01). LLLT improved the degeneration of the photoreceptors after 6 weeks of treatment, while LLLT+ chia seeds supplementation showed early photoreceptors improvement after 2 weeks.

CONCLUSION:

The early improvement in the photoreceptors after LLLT+ chia seed may be attributed to the potent antioxidant properties of chia seeds. Therefore, the combination between LLLT and chia seeds should be employed to protect the retinal photoreceptors against DR.
Suprachoroidal hemorrhage postintracameral bevacizumab injection
Authors: Mahalingam Karthikeyan , Angmo Dewang , Neupane Swechya Madhukar , Azad Shorya Vardhan
Published: May 2024

Suprachoroidal hemorrhage (SCH) is a dreaded complication of intraocular surgery. We report a case of a 65-year-old male with left eye primary angle-closure glaucoma and idiopathic elevated episcleral venous pressure with neovascularization of the iris. Due to uncontrolled intraocular pressure even after maximum medical therapy, trabeculectomy with mitomycin C was planned. Preoperative intracameral bevacizumab was given to avoid intraoperative bleeding. Postinjection, localized SCH was noted, which settled spontaneously on conservative management. A combination of ocular and systemic risk factors, such as arteriosclerosis and idiopathic elevated episcleral venous pressure accentuated by intraoperative hypotony during intracameral injection, led to SCH. There are no previous reports of a localized SCH following intracameral bevacizumab.
Bilateral optic disc edema with subconjunctival hemorrhage
Authors: Sen Saswati , Nayak Bhagabat , Parija Sucheta
Published: May 2024

A 15-year-old female patient presented with complaints of headache, blurring of vision, and redness of both eyes for 15 days and fever for 20 days. Her best-corrected visual acuity (BCVA) was 20/40 in both eyes. Anterior segment examination was normal except for subconjunctival haemorrhage in both eyes. Examination of the posterior segment showed disc oedema in both eyes. Her blood investigations revealed platelet count to be 1.5 lakhs per cubic mm, and leucocyte count to be10,700 per cubic mm. CSF culture showed seven cells per microlitre,76% lymphocytes and CSF samples negative for gram stain, acid-fast bacilli, and culture. Further investigation for IgM titre for scrub typhus was positive. She was treated with oral doxycycline. On follow up after three weeks, both the subconjunctival haemorrhage and bilateral disc oedema resolved with BCVA of 20/20 in both eyes. She was kept on follow up and has not presented with any fresh complaints until six months after the initial presentation.”
Co occurrance of Macular Telangiectasia type 2 with hemorrhagic polypoidal choroidal vasculopathy and response to anti-vascular endothelial growth factor
Authors: Shah Shreyas , Manayath George J. , Gajula Shruthi , Narendran Venkatapathy
Published: May 2024

We report the case of a 57-year-old female patient who presented with defective vision in the right eye due to large hemorrhagic pigment epithelial detachment with subretinal hemorrhage near the arcades with scattered retinal pigment epithelium (RPE) alteration at the macula and minimal vitreous hemorrhage inferiorly. The left eye showed right angle perifoveal dipping venule with RPE alteration temporal to the fovea, intraretinal RPE stellate plaque at the macula area. Multimodal imaging features including color fundus photo, red-free photograph, optical coherence tomography (OCT), enhanced depth imaging OCT, fundus fluorescein angiography, indocyanine green angiography, and OCT angiography were studied along with treatment response. One eye showed features of macular telangiectasia Type 2 (MacTel 2) with polypoidal choroidal vasculopathy (PCV) (hemorrhagic type) and the other eye showed features of MacTel 2 with pachychoroid pigment epitheliopathy. This report highlights the hitherto undescribed co-occurrence of MacTel 2 with bilateral pachychoroid and with unilateral hemorrhagic PCV in one eye and its favorable outcome with anti-vascular endothelial growth factor therapy.
Splitting of retinal pigment epithelium and Bruch’s membrane due to a focal choroidal excavation
Authors: Ratra Dhanashree , Ratra Vineet , Raviselvan Munispriyan
Published: May 2024

We report an unusual finding of a split between the Bruch’s membrane (BM) and retinal pigment epithelium (RPE) due to a focal choroidal excavation (FCE) in a healthy young girl with sudden onset visual disturbance. She was followed up regularly for over a year with serial optical coherence tomography (OCT) scans which revealed a parafoveal conforming type of FCE. Initial retinal edema subsided in a month. No associated pathology, such as a choroidal neovascular membrane, was seen. A split was seen between the RPE and the BM on one side of the FCE, which remained unchanged. We postulate this novel finding of the split between the RPE and BM to be due to the inelasticity of the BM, causing it to separate from the RPE due to the sudden outward force exerted during the formation of an FCE.
Cytomegalovirus keratitis in acute myeloblastic leukemia
Authors: Daryabari Seyed-Hashem , Mosavi Seyed Aliasghar , Moghtaderi Mohsen
Published: May 2024

A 58-year-old woman presented with acute myeloblastic leukemia (AML) developed a bilateral dendritic epithelial keratitis without retinitis. The patient was initially treated with oral acyclovir with a possible diagnosis of herpes simplex virus (HSV) keratitis. Polymerase chain reaction (PCR) was performed on ocular discharge specimens collected by soft-tipped applicators reported as cytomegalovirus (CMV). Then, acyclovir was discontinued and bilateral CMV keratitis was treated with IV ganciclovir and her epithelial lesions gradually disappeared. The current case report confirms that CMV is capable of generating corneal epithelial engagement without retina involvement and demonstrated that CMV keratitis is an emergent problem of AML. Therefore, in any case with bilateral corneal herpes keratitis, the patient should be evaluated for immune system deficiency.
Management of acute hydrops with pre-Descemet's deep anterior lamellar keratoplasty
Authors: Mohan Sujatha , Mohan Madhuvanthi , Danasekar Sujitha , Mohan Sashwanthi
Published: May 2024

This case report describes a 23-year-old female patient who had bilateral keratoconus and a history of right eye penetrating keratoplasty who presented with acute hydrops in the left eye which did not respond to conservative management. Pre-Descemet's deep anterior lamellar keratoplasty was performed in the acute stage for management of the impending perforation with good visual outcomes.
A novel case of limbal stem cell deficiency in a patient with acrodermatitis enteropathica
Authors: Sundareswaran Gayatri , Arora Neha , Sankarasubramaniam Anandan
Published: May 2024

An 18-year-old male diagnosed with acrodermatitis enteropathica (AE) since early childhood presented with worsening of dermatitis along with photophobia and watering in both eyes. Systemic evaluation by dermatology and gastroenterology specialists confirmed a diagnosis of acute exacerbation of AE, and oral zinc supplements were initiated. A best-corrected visual acuity of 20/20 was documented in both eyes. Slit-lamp examination revealed bilateral subepithelial corneal opacities in a radial fan-like pattern extending from the superior limbus toward the center. A whorled appearance of fluorescein staining and small epithelial erosions was noted in both eyes. Ocular involvements in AE such as blepharitis, cataracts, and radial corneal opacities have been reported previously. We report a new association of AE with limbal stem cell deficiency with its classical features of linear subepithelial corneal opacities with a whorling uptake of fluorescein stain and corneal erosions.
Glaucoma drainage device implantation in a pregnant woman with axenfeld–rieger syndrome
Authors: Ramesh Prasanna Venkatesh , Krishnadas Subbaiah R. , Senthilkumar Vijayalakshmi A. , Rajasekaran Ramesh , Ramesh Shruthy Vaishali , Parthasarathi Sathyan
Published: May 2024

Axenfeld–Rieger syndrome (ARS) is a rare disease characterized by anterior segment anomalies with or without glaucoma. A 28-year-old antenatal female diagnosed with ARS presented with uncontrolled intraocular pressures (IOPs) and advanced glaucoma despite maximal medical therapy and progressive vision loss during her third trimester. The refractory and progressive nature of the disease, with useful vision in one eye, necessitated immediate surgical intervention, following which there was successful control of IOP, lasting till the final follow-up at 18 months. We discuss the role of glaucoma surgery, for an ARS patient with refractory glaucoma during the third trimester with a comprehensive review of literature.
Management of odontogenic cutaneous sinus tract referred from dermatology and ENT clinics using cone-beam computed tomography
Authors: Merdad Khalid
Published: May 2024

An odontogenic cutaneous sinus tract (OCST) is an uncommon finding caused by prolonged periapical inflammation. Patients typically seek treatment from dermatology and ENT clinics due to a lack of intraoral symptoms and the presence of a cutaneous lesion. Misdiagnosis in certain circumstances may result in ineffective treatment. This current article describes four cases of recurrent OCST that were initially misdiagnosed and treated with surgical excision and orally administered antibiotics, without healing. These cases were referred to the endodontic clinic and diagnosed noninvasively using cone-beam computed tomography. The cases were managed by nonsurgical endodontic treatment, followed by dermatologic treatment protocol to prevent scar formation and healing was observed with a 3-year follow-up. These cases emphasize the importance of considering dental infection as a primary etiologic factor in OCST. Referral for dental care management is essential for diagnosis, treatment, and follow-up.
Dental health-care professionals' awareness and knowledge of sterilization and disinfection practices for new, unused endodontic files and gutta-percha in Jeddah, Saudi Arabia
Authors: Merdad Khalid , Alnaffaie Maram , Balbaid Rawan , Nakity Asmaa , Alghamdi Faisal , Sabbahi Dania , Al Nazhan Saad
Published: May 2024

Introduction:

The proper protocol for the sterilization of instruments is essential in dental practice; especially because some clinicians think that new files directly from the manufacturers are already sterile and can be used directly on patients without the standard sterilization. Therefore, the aim of this study is to analyze the dental levels of professionals and their auxiliary staffs concerning awareness, knowledge, attitudes, and behaviors about sterilizing endodontic instruments and gutta-percha.

Materials and Methods:

This cross-sectional study was conducted in Jeddah, Saudi Arabia, using an online, randomly distributed survey for dental health-care practitioners. The survey questions were about the participants' demographics, knowledge, attitudes, and behaviors about sterilization techniques for endodontic files and gutta-percha. Data analysis consisted of simple descriptive statistics presented in frequency tables and percentages.

Results:

Of the 197 dental health-care practitioners surveyed, the majority (84.7%) stated that they use files directly from the manufacturer's packages, while only 15.3% reported sterilizing the new endodontic files before using them with patients. As for gutta-percha, 23.4% of the participants answered that they disinfected it before obturation. About 60% of the participants were unaware that the sterilization's expiry date was printed on the endodontic file packages.

Conclusions:

The results indicated that the majority of dental practitioners and students do not practice an effective sterilization protocol for endodontic files and gutta-percha. Based on these results, this study recommends that more education about sterilization protocols should be added to the infection control curriculum.
Elucidating the pathogenicity, diagnosis, treatment, and prevention of COVID-19 – Part II
Authors: Khatri Monisha Parshotam , Mahalaxmi Sekar
Published: May 2024

Introduction:

After throwing light on COVID-19 infection, its transmission, available treatment options in Part I, this article has focused on various preventive measures proposed to deal with the disease.

Aim:

The Part II of this review article aimed to provide the different measures advocated to prevent COVID-19.

Methods:

An electronic search was performed in PubMed and Google Scholar databases with the keywords "Corona virus, COVID-19, World Health Organization, Severe Acute Respiratory Syndrome, SARS-CoV-2, Prevention, Vaccines" from January 2017 to August 2022.

Results:

A total of 42 articles were included in the current review.

Conclusion:

The theoretical evidence does advocate the use of vaccines to be good candidates, but practically, no guarantee can be given that an individual will never be infected. One needs to take personal precautions such as hand sanitizing, wearing a mask in public places, and maintaining social distancing till a permanent cure is procured.
Enhancing recombinant antibody yield in Chinese hamster ovary cells
Authors: Yang Chee-Hing , Li Hui-Chun , Lo Shih-Yen
Published: May 2024

ABSTRACT

A range of recombinant monoclonal antibodies (rMAbs) have found application in treating diverse diseases, spanning various cancers and immune system disorders. Chinese hamster ovary (CHO) cells have emerged as the predominant choice for producing these rMAbs due to their robustness, ease of transfection, and capacity for posttranslational modifications akin to those in human cells. Transient transfection and/or stable expression could be conducted to express rMAbs in CHO cells. To bolster the yield of rMAbs in CHO cells, a multitude of approaches have been developed, encompassing vector optimization, medium formulation, cultivation parameters, and cell engineering. This review succinctly outlines these methodologies when also addressing challenges encountered in the production process, such as issues with aggregation and fucosylation.
Time-global existence of generalized BV flow via the Allen–Cahn equation
Authors: Tashiro Kiichi
Published: May 2024

We show that a mean curvature flow obtained as the limit of the Allen–Cahn equation is not only a Brakke flow but also a generalized BV flow proposed by Stuvard and Tonegawa (2024).
Dietary mercury intake, the IL23R rs10889677 polymorphism, and the risk of gastric cancer in a Korean population: a hospital-based case-control study
Authors: Kim Ji Hyun , Gunathilake Madhawa , Lee Jeonghee , Choi Il Ju , Kim Young-Il , Kim Jeongseon
Published: May 2024

OBJECTIVES: Mercury can stimulate immune responses through T helper 17 (Th17). The gene IL23R is a key factor in Th17 function, which may also contribute to digestive tract diseases. The aim of this study was to identify the associations between dietary mercury and gastric cancer (GC) and to investigate whether the IL23R rs10889677 polymorphism modifies those associations.METHODS: This case-control study included 377 patients with GC and 756 healthy controls. Dietary mercury intake (total mercury and methylmercury) was assessed using a dietary heavy metal database incorporated into the food frequency questionnaire. IL23R genetic polymorphism rs10889677 (A>C) was genotyped. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using unconditional logistic regression models with adjustments for potential confounders.RESULTS: A higher dietary methylmercury intake was associated with an elevated risk of GC (OR for the highest vs. lowest tertile [T3 vs. T1], 2.02; 95% CI, 1.41 to 2.91; p for trend <0.001). The IL23R rs10889677 reduced the risk of GC in individuals who carried at least 1 minor allele (OR, 0.62; 95% CI, 0.46 to 0.83; p=0.001; AC/CC vs. AA). Individuals with a C allele exhibited a lower susceptibility to GC through methylmercury intake than those with the AA genotype (OR for the T3 of methylmercury and AA carriers, 2.93; 95% CI, 1.77 to 4.87; and OR for the T3 of methylmercury and AC/CC genotype, 1.30; 95% CI, 0.76 to 2.21; p-interaction=0.013).CONCLUSIONS: Our findings suggest that a genetic polymorphism, rs10889677 in IL23R, plays a role in modifying the association between dietary methylmercury intake and the risk of GC.
Inequality in dental flossing behavior among Korean adults based on household income levels
Authors: Wang Zi-Lan , Choi Eun-Jae , Ryu Seung-Hee , Kim Seon-Jip , Cho Hyun-Jae
Published: May 2024

OBJECTIVES: The aim of this study was to estimate the association between household income and dental flossing.METHODS: This cross-sectional study investigated the impact of household income on flossing among 9,391 adults aged 30+ with ≥20 natural teeth, utilizing data from the seventh Korea National Health and Nutrition Examination Survey (2016-2018). Outcome measures included flossing (yes/no), with income categorized into 4 levels: lowest, medium to low, medium to high, and highest. Logistic regression, adjusted for age, gender, brushing frequency, recent dental exams, periodontitis, smoking, and alcohol use, was employed to evaluate the influence of socioeconomic status on oral hygiene practices.RESULTS: In the highest income group, flossing was 62.6% more prevalent than in the lowest income group (adjusted odds ratio [aOR], 1.63; 95% CI, 1.27 to 2.08). The strongest association between income levels and flossing was observed in individuals aged ≥70 years (aOR, 3.64; 95% CI, 1.86 to 7.11), with a decreasing strength of association in the 60s (aOR, 1.72; 95% CI, 1.05 to 2.84) and 50s age groups (aOR, 1.69; 95% CI, 1.07 to 2.68). Higher-income women demonstrated a higher frequency of flossing than their lower-income counterparts (aOR, 1.67; 95% CI, 1.24 to 2.23). Higher-income individuals without periodontitis were more likely to floss (aOR, 1.64; 95% CI, 1.23 to 2.18), and among those with periodontitis, flossing was significantly associated only with the highest income category (aOR, 1.64; 95% CI, 1.10 to 2.44).CONCLUSIONS: The findings of this study indicate a significant correlation between higher household income levels and an increased prevalence of flossing.
Comparison of factors influencing the decision to withdraw life-sustaining treatment in intensive care unit patients after implementation of the Life-Sustaining Treatment Act in Korea
Authors: Kim Claire Junga , Hong Kyung Sook , Cho Sooyoung , Park Jin
Published: May 2024

Background: The decision to discontinue intensive care unit (ICU) treatment during the end-of-life stage has recently become a significant concern in Korea, with an observed increase in life-sustaining treatment (LST) withdrawal. There is a growing demand for evidence-based support for patients, families, and clinicians in making LST decisions. This study aimed to identify factors influencing LST decisions in ICU inpatients and to analyze their impact on healthcare utilization.Methods: In this retrospective study, we examined medical records of ICU patients with neurological disorders, infectious disorders, or cancer who were treated at a single university hospital between January 1, 2019 and July 7, 2021. Factors influencing the decision to withdraw LST were compared between those who withdrew LST and those who did not.Results: Among 54,699 hospital admissions, LST was withdrawn from 550 patients (1%). Cancer was the most common disease, followed by pneumonia, and cerebral infarction. Among patients admitted to the ICU, LST was withdrawn from 215 (withdrawal group). The withdrawal group was older (78 vs. 75 years, P=0.05) and had longer total hospital stays (16 vs. 11 days, P<0.001) and higher ICU readmission rates than control patients (ICU patients for whom LST was not withdrawn). When healthcare costs were compared, there was no significant difference in the cost of ICU stay between the two groups. The family played a crucial role in the LST decision (86% of LST decisions).Conclusions: The decision to withdraw LST of ICU patients was influenced by age, readmission, and disease category. ICU costs were similar for patients who withdrew from LST treatment and those who did not. Further research is need to help patients and families tailor LST decisions in the ICU.
O naukowych sympatiach i antypatiach Leona Pinińskiego
Authors: Skrzywanek-Jaworska Dagmara
Published: May 2024

This article delves into Leon Piniński’s academic sympathies and aversions, as manifested in his contributions to Przegląd Polski through the posthumous memoirs of Rudolf von Jhering and Bernhard Windscheid. A shared interest in Roman law and possession as a subject of research interest served as a common ground between Piniński and the memoir protagonists during a certain phase of their academic careers. The 19th-century German legal landscape witnessed a polarization of perspectives on possessio, with Savigny and his followers (including Windscheid) on one side and Jhering on the other. This dichotomy captivated Piniński, leading to his exploration of the subject and the development of his unique concept of possessio. During his foreign sojourns, Piniński wrote a German-language monograph titled Der Thatbestand des Sachbesitzerwerbs nach gemeinem Recht, a work yet to be translated into Polish. The evaluations of Jhering’s and Windscheid’s scholarly output were primarily based on Piniński’s views on the nature of possessio. Additionally, the article paints an intellectual tableau of an era whose accomplishments in the realm of legal research continue to hold relevance in contemporary discourse.
Przestępstwo czynu nierządnego z nieletnim w kodeksach karnych państw zaborczych i kodeksie karnym z 1932 roku. Przyczynek do badań
Authors: Siemaszko Karol
Published: May 2024

The crime of pedophilia, as a separate type of prohibited act, appeared in Poland together with the criminal codes of the partitioning countries. These provisions were in many cases very casuistic, providing a different standard of protection for minors. The Criminal Code of 1932 introduced a uniform standard of protection through the provision of Article 203 penalizing the act of fornication with a minor. The author discusses not only the provisions of the partitioning codes and the Polish Criminal Code of 1932 relating to the crime of pedophilia, but also points to the conflict of these provisions with the provisions of the marriage law in force in Poland, which in some cases allowed children under 15 years of age to marry.
Materialne dziedzictwo prawne i jego wykorzystanie w edukacji prawniczej. Walory wykładu z polskiej archeologii prawnej
Authors: Janicka Danuta
Published: May 2024

Legal archaeology is a relatively young scientific field. Its subject of research concerns objects which once fulfilled specific functions in everyday legal life of the society. Legal archaeology has been the subject of lectures at Polish universities for many decades. The author attempted to define the scope of teaching this subject, taking into account the experience of different historians of law who conduct such lectures. The author analyzed selected conceptions of teaching legal archaeology. As a result, she indicated which old buildings, devices, tools, and other items, including official uniforms, insignia, and attributes of public authority, are best suited to the presentation of old places and methods of lawmaking and law enforcement. She concluded that lectures on legal archaeology serve to broaden the general humanistic and social knowledge of students, as well as shape their civic and patriotic behaviors.
Konstytucyjne prawo równego dostępu do służby publicznej a instytucja podwójnego obywatelstwa
Authors: Bodnar Adam , Ploszka Adam
Published: May 2024

The “Law and Justice” government in Poland in 2016–2020 conducted a controversial “judicial reform”. As a result, access to the profession of judge and prosecutor for people with dual citizenship was initially denied and eventually significantly restricted. In this piece, we analyze these legislative changes through the lens of their conformity with the Polish Constitution, in particular with the constitutional right of access to public service, as well as with Poland’s binding international law. We are also critically examining the arguments raised to justify these regulations and identifying the effects of their implementation. We argue that depriving people of multiple citizenship of access to the judge or prosecutor profession violates the Polish Constitution, as well as international law.
Status prawny komisarza wyborczego jako organu administracji wyborczej
Authors: Radajewski Mateusz
Published: May 2024

The subject of this article is the legal status of an election commissioner as an authority of election administration. The starting point for further analyses is the reconstruction of the basic aspects of an electoral commissioner’s status. In this respect, it is pointed out, among other things, the consequences of defining him as a “plenipotentiary of the State Electoral Commission” and the necessity to understand this phrase in a non-civilist way. The following part discusses the issue of tasks and competences of election commissioners. The author notes the unconstitutionality of entrusting election commissioners with the creation of polling districts and electoral districts in local government elections. A further subject of analysis is the procedure for appointing election commissioners. The participation of the minister responsible for internal affairs in it is criticised. The author also reflects on issues related to the conditions of performing the function of commissioner, such as remuneration or temporary inability to perform the function. In this respect, among other things, it is pointed out that the election commissioner does not perform his/her function within the framework of an employment relationship, but within the framework of a non-employee employment relationship of a constitutional nature. A separate issue discussed in the article is the question of premature termination of the function of the election commissioner. The author draws attention, inter alia, to the problems related to the legislator’s provision that the function expires by operation of law in the event of the fulfilment of an unspecified condition of carrying out unacceptable activities. It is also emphasised that an electoral commissioner who has been removed from office before the expiry of his or her term of office has the right to lodge a complaint on this matter with the administrative court. The article ends with the most important final conclusions concerning the analysed issues.