bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Biobased Surfactants on Hygrothermal Behaviour of Gypsum Foams
Authors: Mortada Nourhan , Phelipot-Mardele Annabelle , Lanos Christophe
Published: January 2022

Reduce the impact of the building sector has become a key point of sustainable development. The production of lightweight materials for the building industry is therefore a must. To produce such materials, foaming is a process commonly used to trap air bubbles and achieve a range of low densities. A sufficient low thermal conductivity and an acceptable ability to regulate humidity variations in order to limit overall energy consumption are the sought properties. In this study, a direct foaming method is applied to formulate gypsum foams using a commercial Plaster and two biobased foaming agents based on proteins. An anionic surfactant (α-olefin sulphonate sodium salt) is used as a reference surfactant. Varying the mixing time, protein content and water content, gypsum foams were produced. The foam volume is measured continuously during the mixing step and the foam homogeneity is controlled. The densities of fresh foams and of the hardened foams are used to identify the links between formulation and foams properties. Gypsum foam specimens with different densities ranging from 300 to 750 kg/m3 are produced. The thermal conductivity and the Moisture Buffer Value measurements are performed. Such properties appear directly linked to the porosity and pore connection of the foams. The obtained results highlight the contribution of biobased surfactant to the performance of gypsum foams.
Shear Behavior of Bamboo Reinforced Concrete Beams
Authors: Khatib J. , Jahami Ali Hussein , Sonebi Mohammed , Elkordi Adel
Published: January 2022

This research work aimed to study the usage of Bamboo strips as shear reinforcement in reinforced concrete (RC) beams. Four beams were considered in this study. The flexural reinforcement for all beams was the same. As for shear reinforcement, one beam was reinforced with conventional shear reinforcement with spacing (s=180 mm), while the other three beams were reinforced with bamboo strips with three different spacings (s=180 mm, s= 90 mm, and s=60 mm). The beams were subjected to a four-point bending test to plot the load-deflection curve for each beam. Results showed that the beam reinforced with bamboo strips spaced at 180 mm has 30% higher shear capacity than the beam with conventional shear reinforcement at the same spacing. Also, as the spacing of bamboo strips decreased, the shear capacity of beams increased nonlinearly.
Development of Animal Fibres Composites for Construction Applications
Authors: Alfocea-Roig Anna , Huete-Hernandez Sergio , Maldonado-Alameda Alex , Giro-Paloma Jessica , Chimenos-Ribera Josep Maria , Formosa-Mitjans Joan
Published: January 2022

Climate change has become one of the world’s leading threats. Currently, the construction industry has a high environmental footprint. For this reason, the scientific and technological sector is looking for new materials to reduce the environmental consequences of this division. It is well known that the valorisation of different by-products can contribute to the reduction of the energy global consumption and CO2 emissions. Magnesium Phosphate Cement (MPC) can be obtained by using Low Grade Magnesium Oxide (LG-MgO) as a by-product from the industrial process of magnesite calcination. In this research, a Sustainable MPC (Sust-MPC) for different construction purposes is developed by using LG-MgO along with monopotassium phosphate KH2PO4 (MKP) as raw materials. The increasing use of synthetic fibres in clothing, as well as China’s competitive prices on Animal Fibres (AF) market, have led to a commercial interest fibre decrease for wool-like AF in Spain. This study aims to formulate a Sust-MPC cement with Animal Fibre (AF) to reduce the cost of the new material (Sust-MPC-AF) and to increase the thermal insulation, allowing the use of Sust-MPC-AF in several potential applications. Besides, it should be emphasized that the final pH of Sust-MPC is neutral, which allows containing natural fibres. To develop Sust-MPC-AF, some properties such as thermal conductivity, density, Modulus of Elasticity (MoE), flexural strength, and economic cost were evaluated using the Design of Experiments (DoE). The DoE studies allowed obtaining a model for further optimization considering minimum thermal conductivity and cost dosages. The formulation 30L-25EW presents the minimum conductivity (λ=0.140 W·m-1·K-1). Therefore, two optimal dosages (36L-25EW and 24L-22EW) are obtained by considering mixing variables such as AF/Cement ratio (AF/C) and AF/Extra Water ratio (AF/EW).
Comprehensive Characterization of Agricultural By-Products for Bio-Aggregate Based Concrete
Authors: Ratsimbazafy Herinjaka Haga , Laborel-Préneron Aurélie , Magniont Camille , Evon Philippe
Published: January 2022

The valorization of available agricultural by-products is important for the development of bio-aggregate based concretes as eco-friendly solutions for building materials. However, their diversity requires to assess their potential of use in vegetal concretes. This study aims to propose simple and relevant multi-physical characterization methods for plant aggregates. Basic and complementary characterizations were carried out on hemp shiv as a reference plant aggregate, and nine by-products available in the South-West part of France, i.e., oleaginous flax shiv, sunflower pith and bark, coriander straw, wheat straw, wheat chaff, corn shuck, miscanthus stem and vine shoot. The basic characterizations performed were those recommended by the TC-RILEM 236 BBM, i.e., particle size distribution, bulk density, water absorption and thermal conductivity. Complementary characterizations have also been proposed, taking into account the possible environment of the binder and the vegetal concrete manufacturing method. The additional tests developed or adapted from previous research assess the following properties: the content of water-soluble compounds at pH 7 and 12, the dry density of plant aggregates compacted in wet state, the real water absorption after compaction and the compression behavior of these compacted aggregates. This complete characterization highlights the distinct behavior of the different agroresources and allows to correlate these characteristics to the use properties of hardened composites.
Fire Behavior of Raw Earth Bricks: Influence of Water Content and Cement Stabilization
Authors: Abdallah Rafik Isaam , Perlot Céline , Carré Hélène , La Borderie Christian , El Ghoche Haissam
Published: January 2022

This study focus on the effects of both water content and cement stabilization on the fire behavior of earth bricks. To observe the effect of cement stabilization, two materials are formulated: raw earth with only soil and water, and stabilized bricks with soil, water and cement (3.5% by mass of soil). Since the material’s mechanical strength can strongly influence its fire behavior, the raw bricks were compacted at 50 MPa to reach a compressive strength similar to the one of stabilized bricks. Four different water contents were tested; dry state obtained with oven drying and three others achieved through equalization at 50%, 75% and 100% of relative humidities. Bricks are then subjected to an ISO 834-1 standard fire. Results show that water content has caused a thermal instability behavior on the raw earth bricks after equalization at 50% and 75% relative humidities. Thermally stable bricks displayed a noticeable diffusion of cracks on their heated face. Furthermore, cement stabilization helps to prevent from thermal instabilities.
Influence of Fibre Treatment and Matrix Modification on Mechanical Properties of Flax Fibre Reinforced Mortars after Freeze/Thaw Cycles
Authors: Poletanovic Bojan , Kopecsko Katalin , Merta Ildikó
Published: January 2022

The aim of this study was to examine the influence of flax fibre protection with the linseed oil and a matrix modification with cement substitution with metakaolin (in 10wt% and 15wt%) on the mechanical properties of cement-based mortars under severe environmental conditions of freeze/thaw cycles. Cement-based mortars (with the dimension of 40x40x160 mm3) were reinforced by 10mm long discrete flax fibres (Linumusitatissimum) and exposed to 51 freeze/thaw cycles under laboratory condition. Their compressive and flexural strengths, as well as specific energy absorption capacity were measured after freeze/thaw cycles and compared to the results of mortars cured for same time in water. Under freeze/thaw cycles mortars reinforced with linseed oil-treated fibres showed the same range of degradation of the compressive and flexural strengths, however, a more pronounced degradation of energy absorption capacity compared to non-treated fibre reinforced mortars was observed. The matrix modification, by partial cement substitution with metakaolin showed optimistic results under freeze/thaw cycles. The compressive strength when cement was partially substituted with metakaolin (in both dosages) increased whereas the flexural strength was slightly lower in case of 10wt% substitution and markedly lower under higher (15wt%) cement substitution. The most relevant is that the decrease of the energy absorption capacity of the fibre reinforced mortar was completely prevented when cement was substituted with metakaolin. It is shown that the energy absorption of the non-treated fibre reinforced mortars increases by 27% when cement was substituted with metakaolin (both 10wt% and 15wt%).
Mortar to Repair Rammed-Earth Walls’ Surfaces: Do we still Need it?
Authors: Abuorf Hazem , Wafi Sulaiman
Published: January 2022

A rammed-earth technique has been echoed worldwide due to being conceived not only as an environment-friendly method of construction but also standing as an alternative method to arguably replacing cement. The technique however shows several pitfalls. One concerns the lengthy process of curing upon erecting the rammed-earth walls due to the low process of a chemical reaction occurred throughout the curing stage. A second bias followed from the slow curing and concerns the degradation accentuated at the outer wall’s texture, particularly at the edges, due to effects of the weather cycle. These drawbacks have been observed while accomplishing a funded research project. This article has at its stake remedying the above pitfalls. A natural sandy limestone shows a low percentage of calcium carbonate needed for a cohesive mixture. The method suggested here is based on an experiment that uses minerals of the fruits’ and vegetables’ waste as a binding substance. Curing time in this method has been reduced to the half. It is also suggested here that each stage has its importance, including mixing the soil particles dry and wet, compacting the moistened soil mixture, a well-made formwork and curing, towards remedying the above pitfalls.
Durability of Bamboo Bio-Concretes Exposed to Natural Aging
Authors: Andreola Vanessa Maria , da Gloria M’hamed Yassin Rajiv , Toledo Filho Romildo Dias
Published: January 2022

In recent years, several studies on the durability of cementitious materials combined with vegetable fibers have been developed. In order to understand the properties of these materials in different environmental conditions, they can be subjected to accelerated aging through several cycles of controlled variations of humidity-temperature, wetting-drying, freezing-thawing. However, analyzes that expose such materials to real conditions of use during their useful life are scarce. As a result, this study analyzed the physical, thermal and mechanical behavior of bamboo bio-concretes produced with different volumes of bio-aggregates, which were exposed to the natural aging of the summer in the city of Rio de Janeiro (Brazil). The cementitious binder was is composed, by mass, of cement (30%), metakaolin (30%) and fly ash (40%). The water-to-cement ratio was as 0.30. The mixtures were produced with bamboo volumetric fraction of 30%; 40% and 50%. After 3 months of natural aging during the Brazilian summer (from December to March), the property determined in the hardened state was the compressive strength. In addition, a visual analysis by photograph was also realize. The results revealed that higher the volumetric fraction, higher the decrease of compressive strength. The visual analysis showed several changes of the external aspect of the bio-concretes.
Flax Fibers Composite Made up by 3D Printing
Authors: Anwar Chems , Benamara Abdeslam , Kaci Abdelhak
Published: January 2022

This preliminary work deals with potential use of additive manufacturing to print a bio-based composite. For this, mixture of clay and flax fibers was used. First, we proceeded to the optimization of the printability conditions by ensuring that the water dosage allows a good extrusion with a continuous volume flow rate. Moreover, the yield stress obtained must allow to deposit several layers without loss of stability. This criterion was verified and then we printed a square element of 20 cm length where 4x4x16cm3 specimens were cut and used to evaluate bending strength. We have shown that under some conditions we are able to print with different layers this composite. To improve the limit height of a printed element, additional tests are necessary to increase the resistance of this type of composite. This study will be continued by Optimizing mix design using other additives and introducing of reinforcement.
Sensitivity Study on the Parameters of a Hygrothermal Transfer Model of Air, Heat and Mass Transfer
Authors: Ouldboukhitine Salah , Amziane Sofiane , Benkhaled Maroua
Published: January 2022

The energy performance of buildings represents a major challenge in terms of sustainable development. The buildings and buildings construction sectors combined are responsible for over one-third of global final energy consumption and nearly 40% of total direct and indirect CO2 emissions. In order to reduce the energy consumption of buildings and their harmful impact on the environment, special attention has been paid in recent years to the use of bio-based materials. Several works have been carried out in the last decades in order to model the coupled heat, air and moisture transfers in the building envelope but the difficulties lies in the identification of numerous parameters that the HAM proposed models use. In the present paper, a sensitivity study regarding the HAM parameters is implemented in order to apprehend the most determining parameters during the transfer processes. A reduced model based on these parameters is then determined.
Bamboo Connection Technology for Lightweight Structures
Authors: Aguilar Larrinaga Roberto , Haurie Ibarra Laia , Lacasta Palacio Ana Maria , Tous Coll Marc
Published: January 2022

Bamboo construction is often related to traditional and vernacular architecture, which is found mostly in rural areas, where, for the construction, local people apply diverse techniques learned in an empirical way and passed on from generation to generation. However, in the last years, many modern constructions with bamboo have been developed around the world. At the same time, many connections have been designed for permanent and ephemerals lightweight structures. However, most of them do not have standardization and mechanical testing, because it is expensive or there are no means to do it. Therefore, it is required to create a technology classification for the most used existing connections, starting with the traditional way to join canes until the contemporary connections developed with high technology. In this context, connections are a challenge to be developed, as currently there is no normative in bamboo to follow and create standardization.
Natural Fibers vs. Synthetic Fibers Reinforcement: Effect on Resistance of Mortars to Impact Loads
Authors: Saad Mahmoud , Sabathier Vincent , Turatsinze Anaclet
Published: January 2022

Given their specific properties, their natural and renewable sources and their low environmental impact in production, natural fibers offer an opportunity for the development of eco-friendly cement-based composites. The main objective of this experimental work is to evaluate the resistance to the impact load of mortars incorporating natural fibers or polypropylene fibers at 28 days. The assessment was carried out according to an experimental protocol developed in our laboratory. The method consists in dropping a metallic ball on a square shaped specimen of 30x30x2 cm3 to determine the energy supported by each sample. For each specimen, the number of blows required for the first crack initiation and for the total collapse of specimen are detected using a device allowing to measure the speed of ultrasonic waves. The device was fixed on the specimen itself. In order to fulfill the mechanical identity card of the composites, flexural and compression tests were also carried out at 28 days. In this experimental protocol, the pozzolanic binder was considered with different fiber percentages of polypropylene (0.25% and 0.5% by mass of binder) and of natural fibers (0.5% and 1% by mass of binder). All fibers have a length of 12 mm. Results show that natural fiber reinforcement could be considered as an ecological alternative to polypropylene fiber one to improve the resistance of mortars to impact loads.
Gender Differences Among Patients Hospitalized with Acute Heart Failure in a Tertiary Care Teaching Hospital
Authors: Dsa Preema , Umesh Soumya , Kamath Deepak
Published: January 2022

Background:

Heart failure (HF) prevalence in India is about 1% which is about 8–10 million, and significant gender differences exist.

Aims:

This study was done to investigate the differences in modes of presentation, cardiac etiology, comorbidities, and inhospital outcomes between both genders and to identify predictors of prolonged hospital stay.

Settings and Design:

We conducted a cross-sectional descriptive study from November 2016 in the coronary care unit.

Materials and Methods:

Consenting adult patients admitted with the primary diagnosis of acute HF were included. Patients with reversible noncardiac circulatory failure and malignancies were excluded. Their clinical details and inhospital outcomes were recorded.

Results:

Out of 150 patients, 86 (57.33%) were males and 64 (42.6%) females. More women were admitted with Stage 4 New York Heart Association (59 [92.2%],P= 0.002), cardiogenic shock (10 [15.6%],P= 0.04), or with hypertensive emergency (23 [35.9%],P= 0.027). The mean duration of stay in males was 6.17 ± 2.21 days and 7.23 ± 2.69 days in females (P = 0.009). Multivariate analysis showed that the adjusted risk of prolonged hospital stay (≥7 days) was 4.6 (95% confidence interval: 1.96, 10.82), with the risk being almost five times greater among patients with the presence of cardiorenal syndrome (CRS), compared to those who did not have it (P < 0.001).

Statistical Analysis:

Chi-square, Student's t-test, and logistic regression were used in the study.

Conclusion:

Our study highlighted that women were more vulnerable, and came in with advanced HF or hypertensive emergency and stayed in the hospital for a longer duration. CRS was the crucial predictor of prolonged hospital stay.
Wintergreen Oil
Authors: Deepak S. , Harsha N. S. , Suraj B. M. , Kanakavidu Supreeth S. , Mayuka G. G. , Monisha R.
Published: January 2022

”All things are poison and nothing is without poison, only the dose permits something not be poisonous” – Paracelsus. Some substances are so toxic that small amounts can be harmful. Here is a case detail about a 58-year-old male who consumed a small quantity of methyl salicylate, mistaking it to Indian blackberry juice. He ended up undergoing six cycles of hemodialysis and critical care polyneuropathy.
Wallenberg Syndrome with Ipsilateral Upper Motor Neuron Facial Palsy
Authors: Sardana Vijay , Jain Pallav
Published: January 2022

Lateral medullary syndrome presents with features of ipsilateral Horner syndrome, ipsilateral ataxia, and contralateral hyperalgesia. Patients can have ipsilateral lower motor neuron-type of facial palsy if there is rostral extension of the infarct as it involves the facial nucleus. Presence of ipsilateral upper motor neuron facial palsy is rare, which is due to the involvement of the corticofacial fibers which ascend in the dorsal medulla to reach the facial nerve nucleus. Our case supports the presence of this hypothetical neuroanatomical loop of supranuclear corticofacial fibers.
Can a Patient or Physician Refuse Cardio Pulmonary Resuscitation?
Authors: Ravindran G. D.
Published: January 2022

ICMR released guideline “Do not attempt resuscitation” in the month of April 2020. This article explores the ethical principles that underlie this guideline. The ethical principles involved are autonomy, futility, ordinary/extraordinary means, principle of double effect, and principle of Good Samaritan and the legal provisions are discussed. It summarizes the process of implementing the guidelines and problems that are involved in its implementation.
Diagnostic yield of one-pore versus two-pore ultrasound-guided tru-cut needle pleural biopsy
Authors: Abdelaal Gehan A. , Abdel Tawab Asmaa M.
Published: January 2022

Background

Ultrasound (US)-guided tru-cut pleural biopsy is a rapid technique that is cheap, has low complication, provides real-time visualization of the biopsy needle, and is without radiation.

Aim

To increase diagnostic yield of US-guided tru-cut pleural biopsy by taking biopsy from two different sites and to study factors increasing this yield for an effective, safe, and noninvasive substitute of thoracoscopy.

Patients and methods

Randomly chosen 80 patients with undiagnosed pleural effusion were scanned by US and classified into two groups: one-pore group where tru-cut US-guided pleural biopsy was done using one opening in the most safe, accessible, thick nodular pleura and the other group is the two-pore group, taking the biopsy from two different site, making two pores instead of one.

Results

The two groups were comparable to each other in diagnostic yield, with no significant difference, and the factors affecting this yield were the more thickness of pleura, presence of nodularity or masses, and the caliber of the cutting needle.

Conclusion

There is no need for more than one pore for taking US-guided tru-cut pleural biopsy, and diagnostic yield depends on more needle caliber and the thickness of the pleura.
Comparison of two questionnaires measuring the health-related quality of life in patients with idiopathic interstitial pulmonary fibrosis
Authors: Abdelaziz Amal A. , Azab Nourane Y. , Elwahsh Rabab A. , Elsheikh Amr A.
Published: January 2022

Objectives

To compare two questionnaires that measure health-related quality of life (HRQL) in idiopathic pulmonary fibrosis (IPF) patients.

Background

IPF is a disease with a progressive course as it is associated with high rates of mortality and a median survival rate of 3–4 years, so it severely affects the patient’s quality of life. General and disease-specific questionnaires are available to assess HRQL.

Patients and methods

HRQL was measured in 30 previously diagnosed IPF patients using a general questionnaire [short form 36 and specific questionnaires − St George’s Respiratory Questionnaire (SGRQ)]. Pulmonary function tests and 6-min walking distance test (6MWDT) were used to assess the patients’ functional status. Dyspnea at rest was evaluated by baseline dyspnea index and after exercise by the modified Borg scale.

Results

Pulmonary function tests showed a restrictive pattern, a decline in the exercise capacity of the patient (6MWDT), and higher scores of dyspnea at rest and following exercise. Both questionnaires showed a good correlation with some of patients’ functional parameters but all of the SGRQ domains showed a strong correlation with all functional status parameters. Also, a good correlation with HRQL was presented by 6MWDT and baseline dyspnea index.

Conclusion

Specific SGRQ is a more suitable instrument for HRQL assessment in IPF patients than the general questionnaire (short form 36).
Hypovitaminosis D in pediatric tuberculosis
Authors: Kashyap Bineeta , Gupta Neha , Dewan Pooja , Hyanki Puneeta , Singh Narendra Pal
Published: January 2022

Background

Vitamin D boosts innate immune response to mycobacteria. Hypovitaminosis D may lead to impaired clearance of tubercle bacilli and an increased risk of tuberculosis (TB). This study aimed to correlate hypovitaminosis D with clinical and microbiological profile in pediatric TB.

Materials and methods

A case–control study was conducted on 60 clinically diagnosed (clinical findings and radiography and/or contact history and/or Mantoux test) or microbiologically confirmed (smear and/or culture and/or cartridge-based nucleic acid amplification test positive) pediatric TB cases up to 12 years. Serum vitamin D levels were estimated using enzyme-linked immunosorbent assay in the cases and 60 healthy children. Hypovitaminosis D was categorized as insufficient at 20–29 ng/ml, deficient at less than 20 ng/ml, and sufficient at least 30 ng/ml levels.

Results

Hypovitaminosis D was significantly associated with pediatric TB (P=0.027). Of the cases, 33% were deficient for vitamin D, while 21.67% had insufficient levels. The levels of vitamin D inversely correlated with age (P=0.047) among the cases. There was no significant difference in the levels of vitamin D on the basis of sex, site of TB, presence of dissemination, or microbiological diagnosis.

Conclusion

Pediatric TB is associated with lower median serum levels of vitamin D. Diet modification to maintain optimum vitamin D levels may reduce the risk of the disease. Screening of healthy children for vitamin D levels with a strong history of close contact with an active TB case may predict the risk of developing TB disease.
Airway pressure release ventilation versus pressure-controlled ventilation in acute hypoxemic respiratory failure
Authors: Ibrahim Rafaat Talaat , Mohamed Yaser Ahmed , Abd El-kader Mohamed Saad , Azouz Ahmed Metwally
Published: January 2022

Background

Airway pressure release ventilation (APRV) is defined as ventilation modality with triggered time, limited pressure, and cycled time. In this mode, the pressure altered from a high level applied for a prolonged time to maintain adequate lung volumes and alveolar recruitment, to a low level for a short period of time that allows efficient ventilation and CO2 removal.

Patients and methods

Patients with acute hypoxemic respiratory failure were mechanically ventilated, and then, shifted to either synchronized intermittent mandatory ventilation, pressure control (group I) or to APRV (group II). The following parameters were monitored and compared: arterial blood gas measurements, hemodynamic, respiratory mechanics, peak pressure, plateau pressure, mean airway pressure, compliance, minute ventilation, indices of hemodynamic, and tissue perfusion.

Results

This study involved 60 mechanically ventilated patients. Our study demonstrated no significant difference between both groups regarding demographic data. We found that APRV group have better hemodynamic, better oxygenation, lower need for sedation and vasopressors, higher cardiac index, and higher estimated glomerular filtration rate. ICU scores were comparable in both groups, whereas lung injury score significantly decreased with APRV mode in APRV group. Decreased duration of mechanical ventilation, ICU stay, hospital stay, less complication risk, and less mortality rate were seen with APRV mode.

Conclusion

The early application of APRV in patients with acute severe hypoxemic respiratory failure was associated with better hemodynamic, better oxygenation, better respiratory mechanics, less sedation use, better perfusion, lower risk of complication, and a shorter duration of ICU stay. Future research should compare APRV strategies to assign the best management approach.
Peripheral cemento-ossifying fibroma – A rare case report
Authors: Kaushik Noopur , Srivastava Nikhil , Rana Vivek , Suhane Chirag
Published: January 2022

Peripheral cemento-ossifying fibroma (PCOF) is a relatively rare tumor classified between fibro-osseous lesions. PCOF is an osteogenic neoplasm that ordinarily presents as an epulis-like growth with uncertain pathogenesis. It predominantly affects young adults, with peak prevalence between the first and second decades of life. We present here the case report of a 15-year-old girl, which was previously surgically excised twice and had recurred both the times. The disease duration was 2 years and a follow-up of 1-year was done. Clinical, radiographic, and histological characteristics are discussed with recommendations regarding the treatment is provided.
Disseminated malignant phyllodes: Presentation after a decade
Authors: Sherin S. Binitta , Joseph Leena Dennis , Pavithra V. , Manickavasagam M.
Published: January 2022

Phyllodes tumors are rare biphasic fibroepithelial lesions of the breast and account for 0.3%–0.5% of primary breast tumors. Malignant phyllodes tumor has a 10%–26% risk of distant metastasis. The most common site of metastasis is lungs followed by bone and soft tissue. This is a rare case of a 42-year-old female with a previous history of malignant phyllodes tumor breast. She presented after 10 years with metastases to multiple sites including lung, abdominal wall, retroperitoneum, bone, and brain. These tumors have a poor overall survival. Accurate diagnosis and aggressive management of malignant phyllodes tumors can help in effective treatment at diagnosis and for close follow-up of the patients.
Dextroversion and D-Transposition of the Great Arteries, Left-Handed Ventricular Topology Related to Multiple Ventricular Septal Defects, and Left Juxtaposition of Atrial Appendage in a 1-Year-Old Child
Authors: Caruso Elio , Farruggio Silvia , Raciti Maria Vittoria , Agati Salvatore
Published: January 2022

We present a 1-year-old female infant case in natural history, affected by D-transposition of the great arteries with multiple ventricular septal defects in dextroversion, left juxtaposition of atrial appendages, and persistent left superior caval vein draining into coronary sinus. This is an uncommon case, and its particularity is due to clinical and anatomical findings diagnosed late in a setting of a complex cardiac malformation. After the diagnosis, the patient underwent palliative arterial switch operation without complications.
Incidence and Risk Factors for Intraocular Pressure Rise after the Scleral Buckle Surgery for Retinal Detachment
Authors: Mansoori Tarannum , Mohan Gandrapu Poojitha , Agraharam Satish Gooty , Balakrishna Nagalla , Pesala Veerandranath
Published: January 2022

Purpose:

To determine the incidence and risk factors for intraocular pressure (IOP) rise after the scleral buckle (SB) procedure for retinal detachment (RD).

Methods:

A retrospective chart review of the medical records of patients, who underwent RD repair by SB performed by a single surgeon and had a minimum follow-up of 6 months was carried out. The outcome measures were the incidence of IOP rise in the operated eyes and the associated risk factors.

Results:

Fifty-two eyes of 52 patients with a median postsurgical follow-up of 18 months (interquartile range: 6, 36, range: 6–60 months) were included. Seven eyes had encircling buckle, 23 eyes had encircling buckle and 1 quadrant segmental buckle, and 22 eyes had encircling buckle and 2 quadrant segmental buckle. IOP rise was seen in 15/52 eyes (28.85%), within 1 month of the SB surgery. Nine out of 15 eyes (60%) of patients <40 years of age had a rise in IOP as compared to 6/37 eyes (16.2%) of patients >40 years of age (P = 0.002). Patients <40 years had a significant increased risk of developing IOP rise, compared to those above 40 years of age (adjusted odds ratio: 7.246 with 95% confidence interval of 1.641–31.986, P = 0.009). None of the fellow eyes had a rise in IOP during the follow-up period. None of the operated eyes with raised IOP progressed to glaucoma.

Conclusions:

Elevated IOP is a common complication after the SB procedure, and age <40 years is associated with a greater risk of development of increase in the IOP. Hence, IOP monitoring after the SB surgery is of paramount importance to detect early rise during follow-up.
Five-Year Experience in Treatment of Retinoblastoma with Intra-Arterial Chemotherapy
Authors: Ghassemi Fariba , Dehghani Shima , Mahmoudzadeh Raziyeh , Khodabandeh Alireza , Ghanaati Hossein , Termehchi Gholamreza
Published: January 2022

Purpose:

To report our 5-year experience in treating retinoblastoma (RB) with intra-arterial chemotherapy (IAC) as a primary or secondary therapy, without adjuvant intravitreal chemotherapy.

Methods:

A retrospective study was conducted on 70 eyes with intraocular RB that were treated with primary or secondary IAC from December 2010-2015. Demographic characteristics, clinical features, tumor control, and treatment complications were compared and reported.

Results:

Thirty-seven eyes had received IAC as a secondary therapy after failed/incomplete response to systemic chemotherapy, and 33 eyes had received IAC as a primary treatment. The mean age of patients was 25 ± 8.9 months, and the patients were followed for a mean of 24.5 ± 16.26 months. Overall, enucleation rates were significantly higher in advanced tumors (Group D and E) in both groups (both P < 0.05). The main reason for enucleation in this study group was being unresponsive to treatment (27.4%), with 76% of latter patients having vitreous seeds at the time of enucleation. Enucleation rates did not differ significantly between patients receiving primary (18/33, 54%) or secondary IAC (18/37, 48%) (P = 0.06). In addition, recurrence and complication rates did not differ significantly between eyes receiving IAC as their primary or secondary treatment (P > 0.05).

Conclusion:

In primary and secondary treatment of RB with IAC, the main findings that are globe salvage, recurrence, and complication rates were comparable when no adjuvant intravitreal chemotherapy was used.
Ocular Abnormal Head Posture
Authors: Akbari Mohamad Reza , Khorrami-Nejad Masoud , Kangari Haleh , Akbarzadeh Baghban Alireza , Ranjbar Pazouki Mehdi
Published: January 2022

Purpose:

To provide a comprehensive review on different characteristics of abnormal head postures (AHPs) due to different ocular causes, its measurement, and its effect on facial appearance.

Methods:

In this review article, PubMed, Scopus, and Google Scholar search engines were searched for the scientific articles and books published between 1975 and September 2020 based on the keywords of this article. The selected articles were collected, summarized, classified, evaluated, and finally concluded.

Results:

AHP can be caused by various ocular or nonocular diseases. The prevalence of ocular causes of AHP was reported to be 18%–25%. 1.1% of patients presenting to ophthalmology clinics has AHP. The first step in evaluating a patient with AHP is a correct differential diagnosis between nonocular and ocular sources by performing comprehensive eye examinations and ruling out other causes of orthopedic and neurological AHP. Ocular AHP occurs for a variety of reasons, the most important of which include nystagmus, superior oblique palsy, and Duane's retraction syndrome. AHP may be an essential clinical sign for an underlying disease, which can only be appropriately treated by the accurate determination of the cause. Long-standing AHP may lead to facial asymmetry and secondary muscular and skeletal changes.

Conclusion:

In conclusion, a proper differential diagnosis between nonocular and ocular causes, knowledge of the different forms of AHP and their measurement methods, accurate diagnosis of the cause, and proper and timely treatment of ocular AHP can prevent facial asymmetry and secondary muscular and skeletal changes in the patients.
Postoperative Blepharoptosis after Trabeculectomy Versus Ahmed Glaucoma Valve Implantation
Authors: Nilforushan Naveed , Es'haghi Acieh , Jafari Samira , Abdolalizadeh Parya , Miraftabi Arezoo , Chaibakhsh Samira , Kashkouli Mohsen Bahmani
Published: January 2022

Purpose:

To investigate the frequency of persistent postoperative ptosis (PP) following trabeculectomy or Ahmed glaucoma valve (AGV) implantation and to analyze the associated factors.

Methods:

It is a prospective observational study on glaucoma patients who underwent trabeculectomy or AGV implantation from October 2015 to June 2017 in a tertiary center. Margin reflex distance 1 and 2 (MRD1 and 2) and levator function were measured before and at least 6 months, postoperatively. Clinically significant ptosis was defined as ≥2 mm drop of MRD1.

Results:

One hundred and fourteen patients (124 eyelids) including 76 patients (87 eyelids) with trabeculectomy and 35 patients (37 eyelids) with AGV implantation were included. The mean age was 55.50 (standard deviation = 17.54) years. Most of the surgeries were performed under general anesthesia (87.9%, 109/124) between 30 and 60 min (53.2%, 66/124) by residents (39.5%, 49/124). Trabeculectomy and AGV groups did not differ in terms of pre, intra, and postoperative variables (0.1≤ P ≤0.9) except duration of surgery (P = 0.01) and sex (P = 0.04). Clinically significant persistent PP was observed in 12.9% (16/124) in total, 13.7% (12/87) in the trabeculectomy group, and 10.8% (4/37) in the AGV group (P = 0.6). Male gender (ß coefficient = 2.56, 95% confidence interval (CI) = 4.76–0.36, P = 0.02) and a higher preoperative MRD1 (ß coefficient = 1.24, 95% CI = 0.52–1.95, P = 0.001) were the only factors affecting the frequency of clinically significant PP.

Conclusions:

Postoperative blepharoptosis occurred in 12.9% of eyes after glaucoma procedures. Male gender and higher preoperative MRD1 were significantly associated with a higher frequency of postglaucoma surgery blepharoptosis.
Quantitative Analysis of Microvascular Network with Optical Coherence Tomography Angiography and Its Correlation with Visual Acuity in Retinal Vein Occlusion
Authors: Ouederni Meriem , Khalifa Mohamed Ben , Sassi Hela , Nefaa Fehmy , Ayed Oumaima , Cheour Monia
Published: January 2022

Purpose:

To analyze the macular microvascular network and the correlations between visual acuity and quantitative parameters using optical coherence tomography angiography (OCTA) in eyes with retinal vein occlusion (RVO).

Methods:

We conducted a prospective cross-sectional study including patients with unilateral RVO. We performed 4.5 mm × 4.5 mm macular OCTA angiograms for assessment of quantitative parameters in both superficial and deep capillary plexuses (SCP, DCP). Area of foveal avascular zone (FAZ), vascular density (VD), skeleton density (SD), fractal dimension (FD), vessel diameter index (VDI), and lacunarity (LAC) were analyzed.

Results:

Seventy eyes of 35 patients were enrolled. As compared to fellow eyes, OCTA analysis in eyes with RVO showed larger FAZ, lower VD, lower SD, lower FD, higher VDI, and increased LAC in both plexuses (All P < 0.05). The enlargement of FAZ in the SCP was associated with visual loss (P = 0.025, r = 0.378). In the DCP, visual acuity was negatively correlated with parafoveal VD, SD, and FD (P = 0.004, r = −0.472; P = 0.003, r = −0.482 and P = 0.036, r = −0.308, respectively). Stepwise multivariate regression analysis showed that lower SD and lower FD in the DCP remained correlated with poorer visual acuity (P = 0.04, r = −0.261 and P = 0.032, r = −0.264, respectively).

Conclusions:

OCTA provides quantitative parameters to analyze retinal microvasculature in eyes with RVO. These OCTA biomarkers could be used to predict the impact of macular ischemia and capillary dropout on visual acuity in RVO.
Thyroid Dysfunction as a Modifiable Risk Factor for Wet Type Age-Related Macular Degeneration
Authors: Farvardin Mohsen , Mousavi Seyed Esmaeil , Zare Kamran , Bazdar Somaye , Farvardin Zahra , Johari Mohammadkarim
Published: January 2022

Purpose:

To investigate possible links between thyroid dysfunction and prevalence of wet age-related macular degeneration (AMD).

Methods:

The present case–control study enrolled a total number of 90 patients with wet AMD and 90 sex-, and age-matched controls through a convenient sequential sampling method. Thyroid hormones were profiled in serum assay. Statistical measures were done to compare means between groups.

Results:

Our findings showed a significant difference in free T4 levels between wet AMD and control groups (P = 0.002), but the mean values of total T3 and Thyroid-stimulating hormone levels were similar between the two groups. In addition, there were no differences in serum lipid profile between groups. Although no significant difference in the history of hypertension and hyperlipidemia between wet AMD and control groups was found, the history of smoking was higher in controls (P = 0.039).

Conclusion:

Thyroid hormone abnormalities may be associated with wet AMD.
Initial Power of Rigid Gas Permeable Contact Lenses in Patients with Keratoconus
Authors: Birjandi Fereshteh , Ostadimoghaddam Hadi , Yekta Abbasali , Mahjoob Monireh
Published: January 2022

Purpose:

To simplify the fitting process, this study was designed to predict the initial power of contact lenses using the regression model based on manual Javal keratometry data and refractive errors.

Methods:

In this retrospective study, 121 eyes of 69 patients with keratoconus (KCN) were fitted with a specific trial set of rigid gas permeable contact lenses based on the standard criterion of “three-point touch” over a 7-year period. Power of the cornea was measured using Javal keratometer. Refractive errors and over refraction of patients were diagnosed using Topcon autorefractometer (RM-A2000) and confirmed by Heine beta 2000 retinoscope.

Results:

The results of multiple linear regression showed the following equation: power of contact lens = −14.368 (constant of the final multiple regression model), +0.475 (spherical refraction), and +0.275 (flatter corneal power).

Conclusions:

The results of this study revealed that lens power has a significant relationship with the power of the flat corneal meridian and spherical refractive error in KCN patients. The obtained regression model can be used to shorten patients' chair time and optometric examination for predicting the power of contact lens.
Epiretinal Membrane Peeling as the Treatment for Macular Edema Associated with Isolated Retinal Astrocytic Hamartoma
Authors: Cuadros Sanchez Carlos , de Luis Eguileor Beatriz , Sacristán Egüén Cristina , Arce Soto Ana , Martínez Alday Nerea
Published: January 2022

Purpose:

To report a case of macular edema and an epiretinal membrane in an isolated astrocytic hamartoma treated surgically.

Methods:

Case report.

Results:

We describe the case of a 37-year-old woman whose first symptoms were blurred vision and metamorphopsia. Optical coherence tomography revealed macular edema together with an epiretinal membrane secondary to an isolated retinal astrocytic hamartoma. We performed a pars plana vitrectomy (PPV) with membrane peeling. Both visual and structural outcomes were satisfactory. Complete resolution of symptoms was obtained, and visual acuity was preserved after a 7-month follow-up.

Conclusion:

Although rare, epiretinal membrane may be present in isolated retinal astrocytic hamartomas, PPV and epiretinal membrane peeling may be a good treatment option in glial tumors with macular edema associated with an epiretinal membrane.
Monocanalicular Intubation in Children with Incomplete Complex Congenital Nasolacrimal Duct Obstruction Older Than Five Years of Age
Authors: Eshraghi Bahram , Jamshidian Tehrani Mansooreh , Tayebi Fereshteh , Momenaei Bita
Published: January 2022

Purpose:

To evaluate the role of monocanalicular intubation (MCI) in congenital nasolacrimal duct obstruction (CNLDO) in children older than 5 years of age.

Methods:

A retrospective case series study was done on children over 5 years of age diagnosed with CNLDO who underwent MCI. Success rates were evaluated subjectively by asking their parents about persistent symptoms and objectively using the dye disappearance test in clinical examination.

Results:

A total of 43 eyes of 37 patients with a mean age of 7.42 ± 2.33 (range, 5–15 years of age) were included. The success rate was 60.46%, and the rate of secondary surgical intervention was 25% of all cases (61.11% of failed cases).

Conclusion:

Primary MCI maintains a reasonable success rate in incomplete complicated CNLDO regardless of age.
The Influence of Topical Cyclopentolate Instillation on Peripapillary and Macular Microvasculature Measured by Optical Coherence Tomography Angiography in Healthy Individuals
Authors: Elbeyli Ahmet , Kurtul Bengi Ece
Published: January 2022

Purpose:

To investigate the influence of topical cyclopentolate 1%, as an anti-muscarinic mydriatic agent, on the peripapillary and macular microvasculature by optical coherence tomography angiography (OCT-A) in healthy adults.

Methods:

A total of 41 healthy adults without any systemic or ocular disease were enrolled for this prospective consecutive study. All patients underwent OCT-A measurements (OptoVue Inc., Freemont, CA, USA) to assess optic disc status for radial peripapillary capillary network (whole image, inside disc, and peripapillary capillary densities), and superficial and deep capillary plexus whole, foveal, parafoveal and perifoveal densities, and foveal avascular zone (FAZ) densities. Foveal retinal thicknesses and all quadrant retinal fiber layer thicknesses were also assessed. The 4.5 mm × 4.5 mm peripapillary and 6 mm × 6 mm macular OCT-A images were undertaken before and 30 min after instillation of topical cyclopentolate 1% to the right eyes.

Results:

The mean age of subjects was 38.14 ± 14.10 years. All macular, optic disc, and FAZ densities, foveal retinal thicknesses, average, and all quadrant retinal fiber layer thicknesses were statistically similar between baseline and after administration of topical cyclopentolate 1% (P > 0.05).

Conclusion:

The current study demonstrated that pupillary dilation with topical cyclopentolate 1% seems to have no statistical effect on macular and peripapillary OCT-A measurements of healthy adults.
A Rare Case of Fahr's Syndrome with Bilateral Vocal Cord Palsy
Authors: Goutham M. K. , Varghese Sherin , Bhat Vadisha Srinivas , Aroor Rajeshwary , Kumar Bhandary B. Satheesh
Published: January 2022

Fahr's syndrome is a rare neurodegenerative condition characterized by the deposition of calcium in various parts of the brain, mostly the basal ganglia. Fahr's disease is an idiopathic condition, whereas Fahr's syndrome is secondary to systemic conditions, including endocrine and autoimmune causes. Hypoparathyroidism is an important cause of this condition. Clinical features of Fahr's syndrome depend on the site of involvement and are usually neurological.
Neonatal Giant Cell Hepatitis Secondary to Extrahepatic Biliary Atresia Associated with Choledochal Cyst
Authors: Hidangmayum Abena , Bhat Shubha P. , Teerthanath S. , Prasad H. L. Kishan , Sajitha K.
Published: January 2022

Neonatal hepatitis (NH) and biliary atresia (BA) are the most common causes of cholestasis in infancy. NH is a nonobstructive type of neonatal cholestatic syndrome manifesting with hepatitis. BA is an obstructive inflammatory syndrome of the extrahepatic biliary tract. BA accounts for 40% of cholestasis in infancy, and NH accounts for 10%–15% cases of neonatal cholestasis. Choledochal cyst is a congenital abnormality characterized by cystic dilatation of the biliary tree. The clinical presentation of these two conditions is very much similar and hence poses a challenge for diagnosis. Radiological studies are beneficial for the preliminary diagnosis of BA and choledochal cyst. BA and choledochal cyst are amenable to surgical treatment, while NH is not. Histopathological examination of the liver biopsy helps differentiate BA from NH.