bluuebunny/crossref_metadata_2025 huggingface dataset:
Iris-Claw Anterior Chamber Phakic Intraocular Lens Explantation: A Case Series
Authors: Teixeira Sofia Cunha , Martins Pedro , Pacheco Teresa , Arede Carlos
Published: September 2024

Purpose:

To evaluate indications, clinic characteristics, and outcomes in a series of patients who underwent explantation of phakic intraocular lens (pIOL).

Methods:

Retrospective case series of patients who underwent iris-claw pIOL explantation in our institution from 2018 to 2022. Indications for explantation and visual and refractive outcomes were analyzed.

Results:

Twenty-three eyes of 14 patients underwent pIOL explantation with a mean time to explantation of 11.7 ± 3.4 years. The mean age at explantation was 46.0 ± 3.9 years. Sixteen Artisan and seven Artiflex IOL were explanted. The main indication for explantation was endothelial cell loss (n= 14) and morphometric significant alterations of endothelial cells other than endothelial cell count decline (n= 5). The mean corrected vision after explantation was 0.4 ± 0.4 logMAR, and around 70% of intervened patients achieved visual acuity of at least 0.3 logMAR (0.5 in decimal scale).

Conclusions:

In our group series, the main reason for the removal of pIOL was endothelial cell loss. This complication should be monitored and followed, so that early actions, namely IOL explantation, can be performed to avoid the development of deterioration requiring corneal transplantation. In fact, loss of follow-up, found in several cases for many years, continues to be a serious problem.
Macular Thickness and Volume by Spectral-Domain Optical Coherence Tomography and their Related Factors in the Elderly Population
Authors: Hashemi Hassan , Heydarian Samira , Hashemi Alireza , Khabazkhoob Mehdi
Published: September 2024

Purpose:

To determine the distribution of macular thickness and macular volume in an elderly healthy population 60 years of age and above and their determinants.

Methods:

The sampling was performed using a multistage stratified random cluster sampling method on the geriatric population 60 years of age and above in Tehran, Iran. All participants underwent optometric examinations, slit-lamp examination, and optical biometry. Retinal imaging was performed by spectral-domain optical coherence tomography.

Results:

The means ± standard deviation and 95% confidence interval of central macular thickness (CMT), average macular thickness (AMT), and macular volume were 221 ± 33 (218–223) μm, 267 ± 29 (265–269) μm, and 8.36 ± 0.44 (8.33–8.39) mm3, respectively. The CMT was significantly lower in females than males (β: −5.77; P = 0.002). The AMT was significantly lower in females than males (β = −10.32; P < 0.001) and was significantly directly related to intraocular pressure (β = 0.63; P = 0.038). The macular volume was significantly lower in females than males (β = −0.13; P < 0.001) and decreased with age (β = −0.01; P < 0.001). In addition, the macular volume had a significant inverse and direct relationship with axial length (β = −0.04; P = 0.011) and keratometry (β = 0.03; P < 0.001).

Conclusions:

Macular thickness in the Iranian geriatric population was slightly less than the populations studied in other countries. The role of sex should also be taken into account in the interpretation of macular thickness findings.
Changes in the Optical Corneal Densitometry, Visual Acuity, and Refractive Error after the Annular Intracorneal Inlay Implantation
Authors: Jabbarvand Mahmoud , Khodaparast Mehdi , Jamali Alireza , Ahmadzadeh Hooman , Bordbar Soodeh
Published: September 2024

Purpose:

To investigate the changes in the optical corneal densitometry as an objective method in assessing the corneal light back-scattering before and 1 year after the annular intracorneal inlay (AICI) implantation into the keratoconic corneas.

Methods:

Changes in the optical corneal densitometry, visual acuity, refractive, and tomographical status were assessed before and 1 year after the AICI implantation into the corneas with different stages of keratoconus. Optical corneal densitometry was evaluated using the Pentacam-HR in 0–2, 2–6, 6–10, and 10–12 mm rings in the anterior 120 μ, central layers, posterior 60 μ and also the total value were measured for cornea in the Grey Scale Unit criterion.

Results:

Totally, 34 patients with keratoconus were studied; the uncorrected and best corrected visual acuity were increased after the surgery (0.98 ± 0.25 to 0.53 ± 0.30 logMAR, P < 0.001 and 0.26 ± 0.18 to 0.19 ± 0.14, P = 0.007 logMAR, respectively); the spherical equivalent was decreased from −4.45 ± 2.25 to − 2.06 ± 2.01 D (P = 0.004). AICI implantation led to an increase in the amount of optical corneal densitometry in 0–2 mm central, 2–6 mm central, 6–10 mm central, total central, 2–6 mm posterior, and 2–6 mm total rings (all, P < 0.05); however, a decrease was observed in 0–2 mm anterior ring (P = 0.049). Results of statistical analysis showed that the total optical corneal densitometry, anterior total, and posterior total back-scattering did not change after the AICI implantation (all, P > 0.05).

Conclusions:

Our results revealed a significant improvement in the visual function, including refractive error and visual acuity following the AICI implantation. Changes in the optical corneal densitometry were different in distinct regions and layers however, the total amount did not change after the AICI implantation.
Peripapillary Retinal Nerve Fiber Layer Thickness Changes in Preterm Children with or without Retinopathy of Prematurity History
Authors: Zarei-Ghanavati Siamak , Ostadimoghaddam Hadi , Najjaran Marzieh , Shoeibi Nasser , Ziaei Mohammed
Published: September 2024

Purpose:

To investigate peripapillary retinal nerve fiber layer (pRNFL) thickness changes in preterm children with or without retinopathy of prematurity (ROP) history compared to full-term children.

Methods:

A retrospective comparative cohort study assessing pRNFL thickness was completed in children aged 4–8 years. Four groups of children were included (n = 30 each group): children with a history of ROP who were treated with intravitreal bevacizumab, children with ROP who received no treatment, and preterm children without ROP compared to age- and gender-matched full-term children.

Results:

A total of 120 eyes from 120 children were enrolled in this study. Both treated and regressed ROP children showed a significantly thinner pRNFL in the nasal quadrant compared to full-term children (P = 0.017 and P = 0.008, respectively). The pRNFL in the superior quadrant of treated ROP children was thinner than the preterm and control groups (P = 0.015 and P = 0.023, respectively), whereas the inferior quadrant of treated ROP children was thinner than the preterm group alone (P = 0.008). The pRNFL thickness in the temporal quadrant was comparable between groups (P = 0.129). The average spatial distribution profile of pRNFL thickness in treated ROP children was significantly thinner than in the preterm group (P = 0.041).

Conclusion:

pRNFL thickness is significantly altered in children with a prior history of treated ROP with thinning of the nasal and superior quadrants compared to full-term children.
Physical Characteristics, Clinical Application, and Side Effects of Viscoelastics in Ophthalmology
Authors: Mohammadpour Mehrdad , Asadigandomani Hassan , Aminizade Mehdi , Raeisi Saeed
Published: September 2024

Purpose:

To explain the physical properties of ophthalmic viscoelastic devices (OVDs), covering their structural units, optimal features, existing viscoelastic materials, clinical applications, and potential side effects.

Methods:

This is a narrative review on the OVDs. A literature review was conducted in PubMed, Google Scholar, and Scopus databases. Studies that investigated physical characteristics, clinical applications, OVD commercial products, and their complications were included.

Results:

We included 42 articles from 2010 and discussed physical characteristics, properties of a desirable OVD, structural units of common OVDs, OVD commercial products, clinical applications, and also complications of OVDs.

Conclusions:

Today, viscoelastics hold a distinct and crucial role in intraocular surgery due to their remarkable properties. These materials safeguard the endothelium and epithelium, uphold anterior chamber depth, manage intraocular bleeding, ease tissue handling, and aid intraocular lens placement. Currently, the American market features 12 prevalent viscoelastic types, including 7 sodium hyaluronate derivatives (Healon, Healon-Greater Viscosity, Healon-5, Amvisc, Amvisc Plus, Advanced Medical Optics Vitrax, and Provisc), 2 hydroxypropyl methylcellulose 2% derivatives (OcuCoat and Cellugel), and 3 combinations of sodium hyaluronate and chondroitin sulfate (Viscoat, DisCoVisc, and DuoVisc). Despite the introduction of new viscoelastic materials annually, no single material encompasses all desired properties. Surgeons must select and employ suitable viscoelastics based on surgical conditions and patient requirements. Advancements in material development and understanding of physical properties and clinical applications continue to refine viscoelastic selection.
Overminus Lens Therapy in the Management of Children with Intermittent Exotropia
Authors: Abri Aghdam Kaveh , Zand Amin , Soltan Sanjari Mostafa , Khorramdel Shabnam , Asadi Reza
Published: September 2024

Purpose:

To evaluate the results of overminus lens therapy in the management of children with intermittent exotropia or X(T).

Methods:

In this retrospective study, 163 consecutive patients with X(T) who were treated with overminus spectacles with at least 12 months of follow-up were included in the study. The outcome measures were the level of X(T) control evaluated using the Jampolsky's qualitative assessment method and refractive error changes under overminus lens treatment.

Results:

The mean angle of deviation at the initial visit was 24.7 ± 15.1 prism diopters (PD) that improved to 10.6 ± 4.2 PD with overminus glasses with a median follow-up of 38 months (P = 0.02). One hundred and nine patients (66.8%) achieved good controlled X(T) or orthotropia by overminus lens therapy after 1 year. Three patients progressed to esotropia, which disappeared after discontinuing overminus lens therapy. Overminus lens therapy did not have a statistically significant effect on the mean spherical equivalent of cycloplegic refraction in each eye (right eye: P = 0.13; left eye: P = 0.15).

Conclusions:

Overminus lens therapy can be effective for improving the control of X(T) in young children. It can defer the requirement for surgery or decrease the rate of surgical intervention.
Corneal Endothelial Health after Phacoemulsification Cataract Surgery Without Viscoelastic Substance
Authors: Bianchi Germán Roberto
Published: September 2024

Purpose:

To evaluate corneal endothelial health after cataract surgery without viscoelastic substance (VS).

Methods:

A prospective, non-randomized, case-series study was developed, and phacoemulsification cataract surgery without VS was performed on 1324 eyes between September 2015 and September 2018. As main outcomes, mean endothelial cell density (ECD) and mean central corneal thickness (CCT) were assessed before surgery and then 6 and 12 months after surgery. Data are summarized as mean, standard deviation (SD), and 95% confidence intervals (CI).

Results:

A total of 1324 eyes were operated, and 31 were excluded by intraoperative complications. The mean ECD baseline was 2506 cells/mm2(SD = 215, CI = 2494–2518); 6 months after surgery, it was 2328 cells/mm2(SD = 213, CI = 2316–2340); and 1 year after surgery, it was 2265 cells/mm2(SD = 214, CI = 2253–2277). In terms of percentage differences, the mean ECD decrease was 9.4% after 1 year. The mean preoperative CCT was 531.6 μm (SD = 34.8, CI = 529.7–533.5); 6 months after surgery, it was 537.7 μm (SD = 38.2, CI = 535.6–539.8); and 1 year after surgery, it was 537.9 μm (SD = 37.9, CI = 535.8–540.0). The mean CCT increased 1.2% 1 year after surgery.

Conclusions:

Phacoemulsification cataract surgery can be completely performed without VS, with very low intraoperative complications. The postoperative ECD and CCT changes occurred primarily during the first 6 months, and the changes decreased during the second semester.
Assessment of Corneal Biomechanical Properties using Scheimpflug Camera-Based Imaging in Night Shift Medical Staff
Authors: Shirzadi Keyvan , Makateb Ali , Asadigandomani Hassan , Irannejad Maziyar
Published: September 2024

Purpose:

To evaluate the effect of night shifts on the biomechanical properties of the cornea using Scheimpflug camera-based imaging (Corvis and Pentacam).

Methods:

Thirty-four participants from the medical staff who had at least six night shifts per month as a case group and fifty-two participants as a control group participated in the study. The biomechanical characteristics of the cornea using the Corvis device and the topographical characteristics of the cornea using the Pentacam device were investigated in the participants.

Results:

The main indices of corneal biomechanics including Corvis Biomechanical Index (0.17 ± 0.18 vs. 0.15 ± 0.14; P = 0.66 [adjusted] and 0.66 [unadjusted]) and Tomographic and Biomechanical Index (0.16 ± 0.19 vs. 0.14 ± 0.19; P = 0.78 [adjusted] and 0.63 [unadjusted]) were not significantly different between case and control groups.

Conclusion:

Our study showed that night shifts do not independently affect corneal biomechanical indices.
Comparison between the Efficacy and Tolerability of Polyvinylpyrrolidone-Iodine Eye Drops 0.6% and 1% in Adenoviral Keratoconjunctivitis: A Randomized Clinical Trial
Authors: Makateb Ali , Soleymanzadeh Mahdi , Soleiman-Meigooni Saeed , Asgari Ali , Etemadi Mohammad Reza , Mafi Amir Reza , Mohammadi Nader
Published: September 2024

Purpose:

To investigate the effect of topical Polyvinylpyrrolidone-iodine (PVP-I) 0.6% on the clinical course of adenoviral keratoconjunctivitis compared with PVP-I 1% and artificial tears.

Methods:

We prospectively enrolled all patients over 18 years of age with a polymerase chain reaction (PCR)-confirmed diagnosis of adenoviral keratoconjunctivitis who presented to the hospital between November 2022 and June 2023. Patients were randomized into 3 groups: artificial tears (control), PVP-I 1%, and PVP-I 0.6% eye drops, 4 times daily for 5 days. Clinical signs at presentation and at 6 follow-up visits during the 1st 3 weeks of the acute phase were recorded. Patients were also followed up at 1 and 3 months.

Results:

Ninety-four patients completed the study, of which 30, 31, and 33 were in the control, PVP-I 1%, and PVP-I 0.6% groups, respectively. The mean age of the patients was 37.2 years (interquartile range: 25-46). The PCR result was positive in 75.6% of patients with the clinical suspicion. PVP-I, regardless of the concentration, was superior to the artificial tears in terms of time to resolution of lid swelling, discharge, and incidence of subsequent subepithelial infiltrates (P < 0.05). However, a concentration of 0.6% was equivalent to 1%. No significant adverse events were reported in any group.

Conclusions:

The PVP-I 0.6% topical drops are safe and well tolerated in patients with acute adenoviral keratoconjunctivitis. It can be substituted for the 1% solution as it has comparable effects in improving the clinical course and reducing subsequent complications.
Multiple Bilateral Retinal Pigment Epithelial Detachments in a Patient with Systemic Lupus Erythematosus: A Case Report
Authors: Lemos Renata Diniz , Hamade Ahmad Mohamad Ali , Hall Leangelo Nicholas , Nascimento Maurício Abujamra
Published: September 2024

Purpose:

To report a case of multiple bilateral retinal pigment epithelial detachments (PEDs) in a woman with systemic lupus erythematosus (SLE).

Methods:

Case Report.

Results:

A 28-year-old female with mild blurred bilateral vision in both eyes (OU) without pain or any other symptom was admitted to the hospital due to worsening renal function and uncontrolled high blood pressure (HBP). Best-corrected visual acuity (BCVA) was 20/30 and 20/40, right and left eyes, respectively. She had SLE, glucose-6-phosphate dehydrogenase deficiency, and immune thrombocytopenic purpura. BP was over 150/90 mmHg for more than 1.5 years, and she used corticosteroids at varying doses for more than 4 years. During hospitalization, she was taking prednisone 60 mg daily as Class IV lupus nephritis was diagnosed. On fundoscopy, she had a lacy retinal pattern, remarkably on the macula in OU. Spectral-domain optical coherence tomography revealed multiple bilateral serous PEDs and pachychoroid. Angiofluoresceinography displayed multiple pooling hyperfluorescence areas. Six months afterward, while she was on prednisolone 10 mg daily, and antihypertensive medications, BCVA was improved to 20/25 OU. Nevertheless, she had no retinal or choroidal changes. Her findings could be related to SLE choroidopathy, central serous chorioretinopathy-like disease, and/or hypertensive choroidopathy.

Conclusions:

Ocular involvement affects nearly one-third of SLE patients. The findings are variable and can include nearly any part of the eyeball. Multiple bilateral PEDs have been described in the literature; however, in this case, it is probably multifactorial and not only related to SLE.
Eyedrop Instillation Techniques, Difficulties, and Currently Available Solutions: A Literature Review
Authors: Dadak Rohan , Hatamnejad Amin , Patil Nikhil S. , Qiu Hongbo , Chan Toby Y.B. , Rayat Jaspreet
Published: September 2024

Purpose:

To review current eyedrop instillation techniques, common difficulties faced by patients instilling eyedrops, available eyedrop assistive devices, and patient education regarding eyedrop instillation.

Methods:

PubMed, Embase, and Google Scholar were searched from conception until June 2022 for articles on eyedrop instillation difficulties, techniques, tools, and patient education.

Results:

Instillation involves pulling down the lower eyelids and placing drops on the corneal surface or conjunctival fornix, followed by closing of the eyelids for about 1 min. Examples of techniques include eyelid closure and nasolacrimal obstruction techniques. Patients encounter many difficulties when administering eyedrops, including but not limited to poor visibility, squeezing the dropper bottle, aiming the bottle, and accidentally blinking. However, devices are available that assist with aim and dropper compression-force reduction in eyedrop instillation. These can be particularly useful in patient demographics with diminished manual dexterity or the ability to generate force from their fingers. Furthermore, despite patient education in eyedrop instillation not being a common practice, it has been found that adequate patient education can lead to significant improvement in eyedrop instillation technique.

Conclusions:

While many factors are associated with poor eyedrop instillation technique, there are many solutions available including assistive devices and proper instillation education.
Potential Drug Interactions in Hospitalized Hematologic Cancer Patients: New Update with New Chemotherapy Regimens
Authors: Gholipourshahraki Tahereh , Aria Amir , Sharifi Mehran , Moghadas Ayda , Moghaddas Azadeh
Published: September 2024

ABSTRACT

Objective:

This cross-sectional study aimed to assess the frequency of potential drug–drug interactions (DDIs) and demographic correlates of moderate and major DDIs among patients with hematologic cancer at a referral hematology hospital in Iran.

Methods:

In this study, for 6 months, all patients suffering from hematologic cancers admitted to the tertiary oncology hospital, Omid, Isfahan, were considered. Data from all medications prescribed to patients during hospitalization were analyzed using the online Lexicomp® drug interaction checker, recording all interactions classified by risk level: C, D, or X.

Findings:

A total of 674 DDIs were detected in 109 patients. The prevalence of treatments with at least one clinically relevant interaction was 95%, being 57.9% for those at level C and 31.5% for levels D and X. According to the frequency, the main interaction was between aprepitant and corticosteroids, followed by the interaction between aprepitant and vincristine. The most common interaction between antineoplastic agents was between doxorubicin and cyclophosphamide. In terms of mechanism, most of DDIs (54.9%) were pharmacodynamics. Only the number of administered medications was associated with DDI occurrence.

Conclusion:

Potential DDIs of moderate to major severity are common among patients with hematologic malignancies. This underscores the importance of implementing different strategies to mitigate this clinically significant risk.
Awareness Regarding the Disease and Its Prevention amongst Women with Recurrent Urinary Tract Infection: A Cohort Study
Authors: Thulasi P. , Jamadarakhani Siddappa , Rajani KR. , Sujatha M.
Published: September 2024

Introduction:

Urinary tract infection (UTI) is regarded as the most common bacterial infection in the community. This disease is more common in females and those in the perimenopausal age group are particularly vulnerable. One of the dreaded complications of UTI is its recurrence. Although the use of antibiotics is the primary modality of treatment of UTI, recurrence can be prevented by adopting behavioural and lifestyle changes and other non-antibacterial measures. Awareness regarding this amongst the patients is of paramount importance.

Aims and Objectives:

This study was undertaken to assess the knowledge regarding UTI and its preventive measures in a cohort of women with primary UTI attending various Urological clinics in an urban population.

Methodology:

One hundred and eighty patients with proven UTIs having no comorbid diseases and structural/functional abnormalities in the urinary system were included in the study. A structured questionnaire was prepared to assess the knowledge of patients regarding the basics of UTI and lifestyle modifications, including non-antibacterial measures that could potentially prevent the recurrence of UTI in them. The total scores obtained by patients were categorised into those with inadequate knowledge, moderate knowledge and adequate knowledge. The percentage of patients in each category was calculated.

Results:

While assessing the overall knowledge using the scale, it was observed that 80% of the patients had inadequate knowledge, while 16.67% had moderate knowledge. Only 3.34% had overall adequate knowledge on the questionnaire. The mean percentage of patients having adequate knowledge on the three subsets of questionnaire given was 18.0%, 8.45% and 7.45%, respectively. The overall mean percentage of adequate knowledge level was only 8.97%.

Conclusions:

Poor awareness on UTI and its preventive measures could be an important factor in averting recurrent UTI (RUTI) in the community women, particularly belonging to the perimenopausal age group. Since there is a strong correlation between knowledge and practice, educating these women with UTI regarding preventive measures could significantly reduce the incidence of RUTI.
Sequential Management of Corrosive Esophageal Perforation in a Low-Resource Setting – Case Illustration
Authors: Gold Ikponmwosa , Callise Obi Chukwunyere , Bolaji Akanni Abdulazeez , Onwurah Chukwurah , Akerele Johnbull , Emeruem Nwadinma , Onoh Uchenna , Okwulehie Vincent
Published: September 2024

Corrosive esophageal injury in children usually occurs following accidental ingestion of corrosives. Suicidal or homicidal injury in children is rare. The degree and extent of injury depend on the nature of corrosives, the volume of corrosive ingested, and the duration of contact. Esophageal perforation is a devastating complication following severe corrosive esophageal injury. Delayed esophageal perforation is defined as perforation diagnosed after 24 h. The following case study describes an incident involving the accidental ingestion of “garri” (flour of processed starchy cassava root taken as flakes or cooked) mixed with an organophosphate by a 4-year-old female child with subsequent development of thoracic esophageal perforation. We stress the importance of aggressive emergency surgical intervention against a conservative approach.
The Effectiveness of 1 g Intravenous Tranexamic Acid in Reducing Blood Loss in Total Hip and Knee Replacement Surgeries: A Double-blind Controlled Study in a Regional Hospital
Authors: Ugbeye Michael Ebiyon , Alatishe Kehinde Adesola , Olanrewaju Sulaimon Olatunji , Lawal Wakeel Olaide , Adadevoh Ine Prattson , Akpan Imeh James , Nwose Uche C.
Published: September 2024

Background:

Tranexamic acid (TXA) is one of the pharmacological drugs employed to reduce haemorrhage during total hip replacement (THR) and total knee replacement (TKR), but there is yet to be consensus on the doses and timing of administration during surgery.

Aim:

This is to assess the effectiveness of 1 g intravenous (IV) TXA compared to placebo for reducing blood loss in THR and TKR.

Patients, Materials and Methods:

This was a prospective randomised double-blind study conducted in our regional hospital between January 2016 and June 2017. THR and TKR patients were randomly allocated to placebo and TXA groups. Intraoperative blood loss (IBL), postoperative blood loss (PBL), total blood loss (TBL), haemoglobin (Hb) drop, duration of surgery, and transfusion rates were outcomes compared between the two groups.

Results:

The administration of 1000 mg (15 mg/kg) TXA significantly reduces IBL, PBL, and TBL by 30%, 31%, and 25.8%, respectively, when compared to placebo in patients who had THR. The mean IBL (187.7 ± 46.2 mL), PBL (334.4 ± 85.9 mL), and TBL (574.3 ± 102.1 mL) in the TXA group were significantly lower than those in the placebo group (344.3 ± 89.0 mL, 628.0 ± 197.4 mL, and 946.5 ± 152.3 mL) (P < 001), respectively, in TKR patients. There was a significant reduction in Hb drop in the TXA group when compared to the placebo group in both THR and TKR patients. The number of THR and TKR patients who received blood transfusions was significantly lower in the TXA group. Mean surgical time in the TXA group was reduced by 0.3 h during THR. However, there was no significant difference in the surgical time between TXA and placebo groups in TKR (P = 0.970).

Conclusion:

One gram of IV TXA is effective in reducing perioperative bleeding, Hb loss, and the need for blood transfusion requirements in THR and TKR.
Service-specific Readiness for Hypertension and Diabetes Care and Its Related Factors in Primary Health Facilities in Akwa Ibom State, Nigeria: A Comparative Service Availability and Readiness Assessment Study
Authors: Nwakile Peter C. , Ekanem Uwemedimbuk S. , Uchendu Obioma C. , Odili Augustine N.
Published: September 2024

Background:

According to the global action plan of the World Health Organization (WHO), private and public health facilities (HFs) must possess at least 80% of affordable basic technologies and essential medicines to tackle the rising burden of hypertension and diabetes (H and D) globally. Literature regarding the realisation of this target is scarce in resource-poor settings like Nigeria.

Objective:

The objective of this study was to assess and compare the service-specific readiness for H and D care in selected urban and rural primary health-care (PHC) facilities in Akwa Ibom State, Nigeria.

Materials and Methods:

The WHO’s service availability and readiness assessment tool was adapted and deployed to assess readiness for H and D care in 214 PHCs randomly sampled from the entire 426 government-owned PHCs in the state.

Results:

A total of 214 PHCs were surveyed (urban, 51.4%). Overall, more urban than rural PHCs had essential drugs (4.8% vs. 0.9%), laboratory equipment (81.7% vs. 76.4%), and were ready for H and D care (23% vs. 11%). Availability of drug-revolving funds (odds ratio [OR] = 4.09; 95% confidence interval [CI] = 1.03–1.12) and the number of health workers (OR = 1.08; 95% CI = 1.03–1.33) were significantly associated with readiness.

Conclusion:

The level of readiness for H and D care was low in both urban and rural primary HFs. The correlates found to be associated with the readiness for H and D care are the availability of drug-revolving funds and the number of health workers.
Appraising Haemophilia Caregivers Burden in the Resource-limited Setting: A Nigerian Survey
Authors: Nwagha Theresa Ukamaka , Okoye Helen Chioma , Nonyelu Charles Emeka , Ejezie Chioma Sandra , Obodo Onochie Ikenna , Adediran Megan
Published: September 2024

Background:

Inadequate management of haemophilia in a resource-limited setting may worsen the challenges that haemophilia caregivers face.

Aim:

The aim of the study was to evaluate the effect of the burden of caring for persons with haemophilia (PWH) on the quality of life of the caregivers.

Methods:

This was a cross-sectional national survey carried out among caregivers of PWH. A modified CarerQol-7D Questionnaire was distributed to consenting families with PWH. The association between clinicopathological characteristics of care recipients and these outcome variables was calculated by SPSS version 22.

Results:

One hundred and five families participated. The majority of the caregivers were immediate family members (101, 96.2%) and mothers (75, 71.4%) of patients. Caregivers were five times more likely to experience a lot of personal mental health problems when taking care of a PWH of severe phenotype (odds ratio [OR]: 4.55, 95% confidence interval [CI]: 1.13–18.32) and when rendering care to a recipient that experienced ≥6 serious bleeds a year (OR: 3.94, 95% CI: 1.02–15.18), respectively. Caregivers were also found to be 12 times more likely to experience a lot of physical health problems when taking care of wheelchair-bound PWH (OR: 12.00, 95% CI: 0.89–161.65).

Conclusion:

Improved treatment of haemophilia with the establishment of a support system may be key in easing the burden of caregivers in resource-limited settings.
FK506 contributes to peripheral nerve regeneration by inhibiting neuroinflammatory responses and promoting neuron survival
Authors: Kou Yuhui , Jin Zongxue , Yuan Yusong , Ma Bo , Xie Wenyong , Han Na
Published: September 2024

JOURNAL/nrgr/04.03/01300535-202507000-00031/figure1/v/2024-09-09T124005Z/r/image-tiff

FK506 (Tacrolimus) is a systemic immunosuppressant approved by the U.S. Food and Drug Administration. FK506 has been shown to promote peripheral nerve regeneration, however, its precise mechanism of action and its pathways remain unclear. In this study, we established a rat model of sciatic nerve injury and found that FK506 improved the morphology of the injured sciatic nerve, increased the numbers of motor and sensory neurons, reduced inflammatory responses, markedly improved the conduction function of the injured nerve, and promoted motor function recovery. These findings suggest that FK506 promotes peripheral nerve structure recovery and functional regeneration by reducing the intensity of inflammation after neuronal injury and increasing the number of surviving neurons.
Prolonged intermittent theta burst stimulation restores the balance between A2AR- and A1R-mediated adenosine signaling in the 6-hydroxidopamine model of Parkinson’s disease
Authors: Jovanovic Milica Zeljkovic , Stanojevic Jelena , Stevanovic Ivana , Ninkovic Milica , Ilic Tihomir V. , Nedeljkovic Nadezda , Dragic Milorad
Published: September 2024

JOURNAL/nrgr/04.03/01300535-202507000-00027/figure1/v/2024-09-09T124005Z/r/image-tiff

An imbalance in adenosine-mediated signaling, particularly the increased A2AR-mediated signaling, plays a role in the pathogenesis of Parkinson’s disease. Existing therapeutic approaches fail to alter disease progression, demonstrating the need for novel approaches in PD. Repetitive transcranial magnetic stimulation is a non-invasive approach that has been shown to improve motor and non-motor symptoms of Parkinson’s disease. However, the underlying mechanisms of the beneficial effects of repetitive transcranial magnetic stimulation remain unknown. The purpose of this study is to investigate the extent to which the beneficial effects of prolonged intermittent theta burst stimulation in the 6-hydroxydopamine model of experimental parkinsonism are based on modulation of adenosine-mediated signaling. Animals with unilateral 6-hydroxydopamine lesions underwent intermittent theta burst stimulation for 3 weeks and were tested for motor skills using the Rotarod test. Immunoblot, quantitative reverse transcription polymerase chain reaction, immunohistochemistry, and biochemical analysis of components of adenosine-mediated signaling were performed on the synaptosomal fraction of the lesioned caudate putamen. Prolonged intermittent theta burst stimulation improved motor symptoms in 6-hydroxydopamine-lesioned animals. A 6-hydroxydopamine lesion resulted in progressive loss of dopaminergic neurons in the caudate putamen. Treatment with intermittent theta burst stimulation began 7 days after the lesion, coinciding with the onset of motor symptoms. After treatment with prolonged intermittent theta burst stimulation, complete motor recovery was observed. This improvement was accompanied by downregulation of the eN/CD73-A2AR pathway and a return to physiological levels of A1R-adenosine deaminase 1 after 3 weeks of intermittent theta burst stimulation. Our results demonstrated that 6-hydroxydopamine-induced degeneration reduced the expression of A1R and elevated the expression of A2AR. Intermittent theta burst stimulation reversed these effects by restoring the abundances of A1R and A2AR to control levels. The shift in ARs expression likely restored the balance between dopamine-adenosine signaling, ultimately leading to the recovery of motor control.
Liposomes as versatile agents for the management of traumatic and nontraumatic central nervous system disorders: drug stability, targeting efficiency, and safety
Authors: Zhang Mingyu , Xiang Chunyu , Niu Renrui , He Xiaodong , Luo Wenqi , Liu Wanguo , Gu Rui
Published: September 2024

Various nanoparticle-based drug delivery systems for the treatment of neurological disorders have been widely studied. However, their inability to cross the blood–brain barrier hampers the clinical translation of these therapeutic strategies. Liposomes are nanoparticles composed of lipid bilayers, which can effectively encapsulate drugs and improve drug delivery across the blood–brain barrier and into brain tissue through their targeting and permeability. Therefore, they can potentially treat traumatic and nontraumatic central nervous system diseases. In this review, we outlined the common properties and preparation methods of liposomes, including thin-film hydration, reverse-phase evaporation, solvent injection techniques, detergent removal methods, and microfluidics techniques. Afterwards, we comprehensively discussed the current applications of liposomes in central nervous system diseases, such as Alzheimer’s disease, Parkinson’s disease, Huntington’s disease, amyotrophic lateral sclerosis, traumatic brain injury, spinal cord injury, and brain tumors. Most studies related to liposomes are still in the laboratory stage and have not yet entered clinical trials. Additionally, their application as drug delivery systems in clinical practice faces challenges such as drug stability, targeting efficiency, and safety. Therefore, we proposed development strategies related to liposomes to further promote their development in neurological disease research.
Stepping up after spinal cord injury: negotiating an obstacle during walking
Authors: Frigon Alain , Lecomte Charly G.
Published: September 2024

Every day walking consists of frequent voluntary modifications in the gait pattern to negotiate obstacles. After spinal cord injury, stepping over an obstacle becomes challenging. Stepping over an obstacle requires sensorimotor transformations in several structures of the brain, including the parietal cortex, premotor cortex, and motor cortex. Sensory information and planning are transformed into motor commands, which are sent from the motor cortex to spinal neuronal circuits to alter limb trajectory, coordinate the limbs, and maintain balance. After spinal cord injury, bidirectional communication between the brain and spinal cord is disrupted and animals, including humans, fail to voluntarily modify limb trajectory to step over an obstacle. Therefore, in this review, we discuss the neuromechanical control of stepping over an obstacle, why it fails after spinal cord injury, and how it recovers to a certain extent.
Evaluation of In vitro Antibacterial Activity of Endophytic Bacteria Isolated from Catharanthus roseus
Authors: Bhuvaneswari S
Published: September 2024

Background:

Research on the antimicrobial potential of endophytic bacteria isolated from Catharanthus roseus has gained significant attention due to the increasing need for novel treatment options. The scientific community has explored a wide range of bioactive metabolites in endophytes, such as antiviral, anticancer, antidiabetic, and antibacterial substances, highlighting their potential therapeutic applications. These endophytes play a crucial role in enhancing host fitness and competitive ability by improving nutritional uptake, seed germination success, tolerance to environmental stresses, and resistance to phytopathogens. India, with its rich biodiversity of medicinal plants, offers a vast resource for antimicrobial agents. Plants such as C. roseus have been traditionally used in various medical systems for their therapeutic properties. C. roseus, belonging to the Apocynaceae family, contains beneficial compounds such as antioxidant-rich phenolic chemicals, which contribute to its medicinal properties.

Methods:

The main objective of this investigation was to isolate endophytic bacteria from C. roseus, focusing on various colonies isolated from leaf discs. The isolated organisms were identified using Gram staining techniques. Furthermore, the study assessed the in vitro antibacterial activity of the isolated bacteria against selected human pathogens using the well-diffusion method. In addition, the investigation aimed to determine the minimal inhibitory concentration of leaf extract by employing standard antibiotics.

Results:

The study demonstrated that bacterial isolates from C. roseus exhibited potent antibacterial activity against pathogens such as Staphylococcus and Pseudomonas species. The results indicated that the leaf isolates from C. roseus showed strong inhibitory effects against pathogenic bacteria. The Gram-positive organisms were more susceptible than Gram-negative organisms, reflecting the differences in their cell wall structures.

Conclusion:

While the antibacterial activity of C. roseus showed promising results, it was not as potent as certain common antibiotics. This study contributes to the understanding of the antibacterial potential of endophytic bacteria from C. roseus and lays the groundwork for further research on their therapeutic applications in combating bacterial infections.
SJLA_2024_A17: Use of Perioperative Tamsulosin to Prevent Postoperative Urinary Retention Following Day Case Laparoscopic Inguinal Hernia Repair
Authors: AlGhazal Thabet
Published: September 2024

Postoperative urinary retention is one of the more common complications following laparoscopic inguinal hernia repair (LIHR). We hypothesized that the oral one adrenergic blocker Tamsulosin, (Flomax, Boehringer Ingelheim) could be used to decrease the incidence of urinary retention after LIHR. Data from all patients undergoing laparoscopic total extraperitoneal (TEP) inguinal hernia repair by a single surgeon from June 2012 through June 2017 were collected prospectively. Patients received Tamsulosin (Flomax) 0.4 mg/day orally for a total of 5 days beginning 2 days before surgery. All TEP procedures were done under general anesthesia without a urinary catheter in place. Patients were discharged home after voiding in the recovery area. Data are expressed as mean ± standard deviation; flomax was administered to 30 of 32 consecutive patients undergoing outpatient TEP inguinal hernia repair. The mean patient age was 51.3 ± 10.5 years (28–72 years). Ten (32.2%) patients were operated on for recurrent inguinal hernias, 14 (45.1%) had bilateral hernias repaired, and 4 (12.9%) had concomitant umbilical hernia repair. The average operative time was 60 ± 24 min. The mean amount of intraoperative fluids given was 998 ± 297 ml. Two patients were excluded from the study because they required a urinary catheter in the operating room for other reasons (one requiring concomitant cystoscopy and one with anticipated complicated repair in patients who had three prior open inguinal hernia repairs and did not take Flomax). None of the patients given Flomax perioperatively developed urinary retention and all were discharged home the same day of surgery. In contrast, the two patients undergoing TEP repairs who did not receive Flomax perioperatively both developed urinary retention that required catheter placement.
SJLA_2024_A7: Five Cases of Salvage Thoracoscopic Esophagectomy after Proton Beam Therapy
Authors: Muranami Yuto
Published: September 2024

Introduction:

Proton beam therapy (PBT) has the feature of reducing radiation exposure to surrounding organs compared to conventional X-ray irradiation, so PBT for esophageal cancer is gradually spreading.

Background:

However, there are few reports about salvage esophagectomy after PBT, and its efficacy and safety are unclear.

Methods:

We reviewed the clinical and surgical outcomes of 5 cases who underwent salvage thoracoscopic esophagectomy after PBT from 2010 to 2023.

Results:

Four of five cases were males; the median age was 70 years, and all lesions were in the thoracic esophagus. One case was T2 lesion depth before PBT and 4 cases were T3. The median dose of proton beam radiation was 35.2 (26–60) Gy, and the median total (including X-ray) radiation dose was 66 (40–71.2) Gy. For of them were recurrent and one was remnant lesions. All cases were performed through thoracoscopic esophagectomy (one was converted to open surgery). Median thoracic operation time and blood loss were 217 (213–427) min and 10 (6–565) ml, respectively. Two cases with a preoperative diagnosis of T1-2 showed fibrosis comparable to that seen in conventional salvage esophagectomy, and we underwent R0 resection. However, the others had severe fibrosis and Grade IIIb postoperative complications such as thoracic abscess and cardiac tamponade requiring open chest drainage, and percutaneous pericardial drainage was occurred in two cases who underwent R2 resection.

Discussion:

For the nonlocally advanced cases, the results were comparable to the conventional salvage esophagectomy. However, fibrosis and scarring of the irradiated area were stronger after PBT, especially in advanced lesions, and they were at high risk for non-R0 resection and complications.

Conclusion:

Because the number of cases was small in this study, it is necessary to conduct further studies on a large number of cases, including multicenter collaboration.
Kilka uwag na temat stosunków króla Jana Olbrachta z hospodarem mołdawskim Stefanem do 1495 roku
Authors: Nalewajek Agnieszka
Published: September 2024

The article provides information based on the unpublished royal accounts of John Albert preserved in the Central Archives of Historical Records in Warsaw and concerning the diplomatic relations between the Polish ruler and Stephen, the Voivode (hospodar) of Moldavia, until 1495. After John Albert ascended the throne in 1492, the Polish court was visited by envoys from Moldavia. We know on the basis of the accounts that, for example, an envoy sent by the Voivode visited the king during a session of the Sejm in Piotrków in 1493. Next, from May to November 1493, a brother (frater) of the Voivode of Moldavia was a guest at the royal court during his stay in Poznań. The entries in the accounts also confirm the presence of two envoys from Moldavia during the King’s stay in Cracow at the beginning of 1494. Another envoy from the Voivode of Moldavia arrived in Cracow after the King’s return from the congress in Levoča in the second half of May 1494. At that time, John Albert sent one of his servants on a mission to Voivode Stephen. Towards the end of 1494, an envoy from Moldavia arrived at the royal court during John Albert’s visit to Elbląg. It is also known that the Voivode sent gifts – the King’s brother, i.e. Sigismund Jagiellonian, received “bridles made in Turkey” from him. The royal accounts do not provide any information about diplomatic relations between John Albert and Voivode Stephen after 1495. Therefore, we do not know what these were like in the period preceding the invasion of Moldavia in 1497. These sources were not used in the existing studies analysing King John Albert’s policy towards Moldavia, including those prepared in recent years.
Nauczanie historii Kościoła alumnów obrządku łacińskiego w Instytucie Teologicznym w Przemyślu 1772-1918
Authors: Kapłon Marcin
Published: September 2024

The author of the article – presenting the place of the ecclesiastical history in the curriculum of seminary studies under the Austrian partition on the example of the Przemyśl centre – introduces the history of this institution established in 1687. The following part contains the complicated fate of the Seminary in Przemyśl, which from 1772 had to struggle with the policy of the invader that first involved its closing (1783), then reactivation (1819) and finally functioning under the conditions of severe Austrian supervision. It is this stage of the activity of the discussed institution that constitutes the main interest of the article and shows the place of the ecclesiastical history in the curriculum of theological studies, the organization of lectures and the textbooks used. Particular attention was paid to the teaching staff throughout the discussed century, presenting their struggles with the Austrian bureaucracy and even facing repression by the authorities.
ENSINO EM BRAILLE E FORMAÇÃO DE PROFESSORES
Authors: Oliveira Elineide Cavalcanti de , Santos Beatriz Alves dos , Almeida Evaristo Fernandes de , Mulatti Lorena dos Santos , Figueiredo Suzamary Almira de
Published: September 2024

Este estudo teve como objetivo analisar a importância do ensino em Braille na formação de professores e explorar as percepções de docentes e discentes do ensino superior sobre essa temática. A pesquisa foi conduzida por meio de uma revisão bibliográfica, investigando fontes teóricas e estudos anteriores relacionados ao ensino em Braille e à formação docente. Assim, ao longo do estudo, identificou-se que o domínio do Braille é essencial para a inclusão educacional de estudantes cegos, sendo uma competência fundamental para professores que atuam nessa área. Também se aprendeu durante a edificação deste estudo que tanto docentes quanto discentes reconhecem a importância do Braille na formação acadêmica, mas ainda enfrentam desafios relacionados à falta de recursos e à necessidade de uma formação mais aprofundada. A pesquisa ressaltou, dessa forma, a necessidade de uma maior integração do Braille nos currículos de formação docente para garantir uma educação mais inclusiva e de qualidade.
The branch of Samara State Transport University in Rtishchevo is 55 years old
Authors: Editorial Article
Published: September 2024

In accordance with the instructions of the Ministry of Railways dated June 11, 1969 and the order of the head of the Volga Railway dated June 16, 1969, the Rtishchevsky Railway Transport College with full-time education was organized at the Rtishchevo station.