bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship between central corneal thickness and axial eye length using partial coherence interferometry
Authors: Abdelkhalek Wafaa A.E. , Hegazy Hanan S. , El-Kasaby Mohamed I.
Published: April 2024

Background and aim

Several studies have shown the relationship between axial length (AL) of the eye and central corneal thickness (CCT). Since genetics, ethnicity, and race can affect these factors, their differences between different societies can probably explain refractive error variance. We present the ocular parameter values in 154 eyes of different refractive error groups to investigate the correlation between AL of the eye and CCT in Egyptians with refractive errors.

Patients and methods

In all, 154 patients were classified into emmetropic, hypermetropic, simple myopic, congenital myopic, and malignant myopic groups. Most ocular parameters were achieved using IOLMaster 700 and stratified according to AL and CCT.

Results

The CCT means in the studied groups was 537±34, 523±31, 541±40, 524±40, and 524±27 μm in emmetropic, hypermetropic, simple myopic, congenital myopic, and malignant myopic groups, respectively. The AL was 23±0.76, 22±1.1, 25±1.3, 26±1.4, and 29±1.6 mm, respectively. Regarding the correlation between AL of the eye and CCT (r=−0.01, P=0.92, confidence interval=−0.17 to 0.15).

Conclusion

This study provided valued measurements of ocular parameters of the Egyptians with refractive errors. Besides, there is no significant correlation between AL of the eye and its CCT in Egyptians with errors of refraction.
Thyroid eye disease treated with orbital decompression surgery versus repeated peribulbar injection of triamcinolone
Authors: Elfarouk Nehal O. , Seoud Sabah A. , Atwa Fatma A. , Kamel Rehab M.
Published: April 2024

Background

Thyroid eye disease (TED) is the most common autoimmune disease of the orbit. Management includes conservative measures, medical therapy, surgery, and targeted biologic therapy.

Aim

To compare the efficacy of repeated peribulbar triamcinolone injections with surgical orbital decompression in patients with moderate to severe TED.

Patients and methods

A prospective nonrandomized, noncontrolled comparative interventional study was conducted that included 30 eyes with moderate to severe inactive TED, which were divided into two groups: group A included 15 eyes that were enrolled for surgical orbital decompression and group B included 15 eyes that underwent repeated peribulbar triamcinolone injections. Patients were subjected to preoperative and postoperative ophthalmological examination, including visual acuity, intraocular pressure measurement, and degree of proptosis.

Results

Hertel's exophthalmometer measurements showed mean±SD difference between preoperative and postoperative values in group A of 6.20±1.32, whereas group B had 2.53±0.92, revealing high statistically significant differences between preoperative and postoperative results in each group as well as between both groups. Differences in intraocular pressure values between preoperative and postoperative periods in group A were 1.73±1.39 and in group B were 1.13±0.92, showing a highly statistically significant difference. Concerning refraction, the mean difference between preoperative and postoperative periods in sphere, cylinder, and axis in group A showed a highly statistically significant difference in cylinder and axis, whereas only cylinder and not axis in group B.

Conclusion

Both repeated peribulbar injection of triamcinolone and surgical orbital decompression are effective modalities for management of moderate and severe inactive TED, with surgical orbital decompression having the upper hand in providing better results in reduction of proptosis.
Role of stem cells in the management of acute kidney disease
Authors: Galala Fawzi M.A. , Mohammed Shaaban R.I.
Published: April 2024

Background and aim

Renal failure is usually treated by hemodialysis forever. Renal transplantation is the only curative intervention. However, regenerative therapies are expected to exert a beneficial role in such situations. The aim of this study was to study the role of mesenchymal stem cells (MSCs) in the treatment of acute renal failure (ARF) in an animal model.

Materials and methods

ARF was induced by cisplatin injection in 20 male rats weighing 200–225 g. Rats were allocated into one of two equal groups: group A included 10 rats with ARF and umbilical cord-derived stem cell treatment, and group B included 10 rats with saline treatment. In addition, 10 healthy rats were included as a healthy control group (group C). Both serum urea and creatinine were measured after induction of renal failure and on the 7th and 15th day after MSC treatment. Kidney sections were obtained, stained with hematoxylin and eosin, and examined histologically.

Results

Serum urea and creatinine showed marked elevation after cisplatin injection. These values progressively decreased with MSC treatment significantly. At the end of the second week, the values were near normal. In addition, histological examination of renal section confirms the results obtained by laboratory analysis.

Conclusion

Umbilical cord-derived MSCs could play a regenerative action in ARF.
Sural and medial plantar nerve conduction study in the diagnosis of subclinical diabetic neuropathy
Authors: Hasan Mahmoud M. , Shokry Abd E. , Mohamad Sara K. , El Ali F.
Published: April 2024

Background and Aim

Diabetic peripheral neuropathy is one of the most challenging complications of diabetes mellitus. A large number of patients have subclinical neuropathy at the time of detection of diabetes. Proper detection of subclinical diabetic neuropathy is important to prevent more complications. When the symptoms start, there are not many effective therapeutic treatments. Nerve conduction studies (NCS) are known to be sensitive, reliable, noninvasive, and easy to perform to study diabetic neuropathy. Study of the medial plantar and sural nerves can test the most distal parts of the nerves and can be considered an alternative method for the diagnosis of polyneuropathy in the early stages. The aim of this work is to study the utility of both medial plantar and sural nerve conduction in the early diagnosis of diabetic polyneuropathy.

Patients and methods

Twenty diabetic asymptomatic patients and 20 healthy volunteers of both sexes were included. Their ages ranged between 26 and 44 years and 24 and 46 years, respectively. NCS of the medial plantar and sural nerves for all the patients and control groups is performed using the antidromic method of stimulation for sural nerve and orthodromic stimulation for the medial plantar nerve.

Results

There were significant changes in the sensory study of both medial plantar and sural nerves of neurologically asymptomatic diabetic patients compared with the control.

Conclusion

NCS of both medial plantar and sural nerves aids in the detection of subclinical diabetic polyneuropathy.
Comorbidity in a sample of Egyptian patients with multiple sclerosis
Authors: Elsheshiny Ahmed H. , Rashad Mohamed H.
Published: April 2024

Background

Comorbidities are commonly associated with multiple sclerosis (MS). Not only do they delay the diagnosis of MS but also deteriorate the quality of life, progress the disease, and perhaps increase health care costs. This study was performed to assess the prevalence of comorbidities in Egyptian patients with MS and to evaluate its effect on the cognitive function, disability, and disease relapse.

Patients and methods

All patients were subjected to clinical assessment and cognitive evaluation using the mini-mental state examination and the symbol digit modalities test. The relapse was assessed using the Assessing Relapse in Multiple Sclerosis questionnaire.

Results

The current study included 420 participants. Of them, 310 patients had MS, whereas 110 did not have MS (control group). The most common comorbidities among patients with MS were depression, in 71 (22.9%); anxiety, in 68 (21.9%); and hypertension, in 59 (19.0%). Patients with MS with comorbidities experienced a statistically significant (P<0.001) lower mean of mini-mental state examination (26.61±1.88) and symbol digit modalities test (37.44±9.65), in contrast with those without comorbidity. There was no statistically significant difference between both groups regarding comorbidity count (P=0.507) and individual comorbidities (P>0.05).

Conclusion

Egyptian patients with MS and comorbidities were more vulnerable to develop cognitive dysfunction and disability, relative to those without. However, the negative effect of comorbidities on disease relapse was not established. Employment of such knowledge in MS treatment protocols might reflect considerably on the quality of life and disease outcomes.
T-helper and natural killer cells’ disturbance in active alopecia areata
Authors: Younes Abdel-Khalek H. , Hammad Refaat R. , Othman Mona H.A. , Sobhy Ali
Published: April 2024

Background and aim

Alopecia areata (AA) is a common nonscarring hair disease targeting the hair follicles during the anagen phase, leading to hair loss. The etiology of AA is still unclear; however, evidence revealed the association of this disease with immune disturbance. Therefore, we aimed in this study to evaluate the level of natural killer (NK) and T-helper 1 (Th1) cells in the peripheral circulation of patients with different subtypes of AA during the active stage in comparison with the controls.

Patients and methods

Venous blood samples from 50 female patients and 50 healthy-controls were collected to evaluate the level of Th1 and NK cells using flow cytometry.

Results

Patients with active patchy AA, alopecia totalis, and alopecia universalis were associated with a lower level of circulating Th1 and NK cells when compared with the controls.

Conclusion

The observed reduction in the circulating Th1 and NK cells indicates the autoimmune nature of the disease. Also, we highlight the cellular shift from the peripheral circulation to the lesion site during the active stage; however, more research is required to reveal the exact mechanism for this phenomenon.
Comparing the effect of gonadotropin versus letrozole for induction of ovulation in patients with polycystic ovary syndrome with clomiphene citrate failure
Authors: Ali Ahmed I.A. , Ahmed Abd El-Azeem M. , Elboghdady Adel A.
Published: April 2024

Background and aim

Polycystic ovary syndrome (PCOS) is an endocrinopathy affecting women during the childbearing period, with incidences of between 8 and 13%. PCOS is the main cause of anovulatory infertility with a prevalence of 20% in infertile women. We aimed to compare the ovulation induction effect of letrozole versus gonadotropins in patients with PCOS after clomiphene citrate (CC) failure.

Patients and methods

This is a prospective comparative study held in the El Hussien University Hospital, Al-Azhar University; throughout the duration of 12 months from January 2020 to January 2021. In all, 100 women were enrolled in the study diagnosed with PCOS with an ovulatory infertility and after CC failure, patients were allocated into two groups in a ratio of 1 : 1. The first group included 50 patients and received (letrozole 2.5 mg tablet) twice daily.

Results

There was higher incidence of confirmed ovulation in the gonadotropin group (62%) compared with the letrozole group (58%) with no significance. It also showed a higher incidence of confirmed pregnancy in the gonadotropin group (34%) compared with the letrozole group (30%), but that difference was statistically nonsignificant. The results showed a shorter duration till the day of trigger in the letrozole group (13.48) compared with the gonadotropin group (14.55), the difference was significant. Endometrial thickness on day of trigger was higher in the gonadotropin group (11.3) compared with the letrozole group (10.9) with no significance.

Conclusion

In patients who failed to conceive with CC, gonadotropins have higher pregnancy rates for ovulation induction than letrozole with an insignificant statistical difference.
IJCM_14A: Contraceptive use and its determinents among women in field practice area of rural health and training center of tertiary care hospital -a Cross-Sectional study
Authors: Krishnarao Jumale Shital , Chavan Bharat B.
Published: April 2024

Background:

In reproductive health services contraceptive prevalence rate serves as a proxy measure and is an indicator of health, population, development, and women’s empowerment which is essential for meeting many of Sustainable Development Goals, especially child mortality and maternal related goals. There is increase the use of contraceptive methods in rural area which is influenced by various factors.

Objectives:

1) To estimate the prevalence of use of contraception among reproductive age women in rural area 2) To examine the determinants of contraceptive used of reproductive age women.

Methodology:

This is community based cross sectional study among reproductive age women in field practice area of rural health training center. The sample size was calculated as 208 using 67 percentage prevalence of contraceptive prevalence rate according to NFHS 5 data at 95% confidence interval and 6% error. The study were conducted using prevalidated and pretested questionnaire on sociodemographic variables. The data was analysed using SPSS trial version. Univariate analysis is done and binary logistic regression is applied p value

Results:

The prevalence of contraceptive use was 73.1%. Most commonly used methods among study participant was condom followed by intra uterine device and oral contraceptive pills. In the adjusted analysis of binary logistic regression, contraceptives use was significantly lower (OR=0.21,95%CI=0.07-0.26, P=0.001) upon respondent age 36-49years compaired to those aged 15-35 years. Contraceptive use was significantly lower among migrants (OR=0.34;95%CI=0.13-0.48; p=0.03) compared with non-migrant.

Conclusion:

The contraceptive prevalence was found to be higher in this study population and multiple factors were influencing the contraception use. In addition, family planning programs should target migrants to increase use of contraception in rural areas.
IJCM_171A: A community-based study on awareness of organ donation among in Arang block of Raipur district Chhattisgarh.
Authors: Jacob Sewa Vibhuti , Verma Nirmal , Jain Kamlesh , Jaiswal Prashant
Published: April 2024

Background:

For many of the end-stage organ diseases, organ transplantation is the most preferred treatment. The need for the organ transplantation is higher than the availability. For the transplantation program to be successful, awareness regarding organ donation is needed and people must have a positive attitude toward donating organs.

Objective:

To determine the knowledge, attitudes, and practices regarding organ donation in Arang block of Raipur district Chhattisgarh.

Methodology:

Community based cross-sectional study used in this study. Simple random sampling was used to generate a sample of 100 in Arang block of Raipur district. Face to Face interview was conducted based on a semi structured questionnaire in Arang block of Raipur district. Data was taken from MS Excel sheet and analysed.

Results:

The majority of the study participants belongs to 44.9 year average mean with 15.4 Standard deviation. 65% of respondents were male and 35% were female. The study shows that 64% of respondents studied high school or above. Per capita income of 40% belong to Lower class 5. Majority of respondents have good knowledge and 75% have positive attitude for organ donation.

Conclusion:

The present study concluded there was good knowledge among the community participants. However, there questionnaire were kept distinct keeping in mind to their level of knowledge. Attitude variable didn’t have much disparity.
IJCM_248A: Visual health related to quality of life and visual acuity in cataract patients advised for surgery: A hospital-based cross-sectional study
Authors: Jain Animesh , Rao M Archana , Bhat M Shashank , Soumya  , Shrigiri  , Shalaka R , Anubha A J
Published: April 2024

Background:

Vision plays a pivotal role in daily activities, and its impairment, often caused by cataracts, significantly impacts the quality of life. Cataracts, characterized by cloudiness or opacity in the eye lens, contribute significantly to visual impairment, especially in individuals over 60 years. The prevalence of cataract-induced blindness in India is alarmingly high, with 80.1% of blindness and 58% of senile cataract cases attributed to this condition.

Objectives:

To assess the impact of cataract surgery on the visual health- related quality of life (VHRQoL) among patients.

Methodologyology:

This hospital-based cross-sectional study was conducted at Government Wenlock Hospital and KMC Mangalore Attavar, hospitals affiliated to Kasturba Medical college, Mangalore. The study included cataract patients, both preoperative and postoperative, excluding those with other eye-related disorders. Non-probability (purposive) sampling was employed, determining a sample size of 60 based on a 95% confidence level and 62% prevalence of cataract.

Results:

Patients undergoing cataract surgery exhibited notable improvements in general vision, ocular pain, mental health, and near activities. Enhanced role performance, social life, and reduced dependency were observed. Post-operative visual acuity improved, especially for pre-operative values below 6/18. VFQ-J11 revealed significant associations in 4 out of 7 domains, surpassing VFQ-25 (2 out of 12), making VFQ-J11 a preferred tool for assessing pre- operative and post-operative patients.

Conclusion:

The cataract surgery leads to an overall enhancement in the quality of life for the majority of patients, with a moderate correlation between VHRQoL improvement and visual acuity.
IJCM_27A: To assess consumption of IFA in adolescent girls and pregnant women in selected health blocks of Himachal Pradesh.
Authors: Chauhan Paras , Gandhi Manoj Kumar
Published: April 2024

Background:

In India, anaemia is the most widespread nutritional deficiency disorder occurring primarily due to iron deficiency. Despite implementation of the Weekly Iron & Folic Acid Supplementation (WIFS) Programme under NRHM since 2013, the prevalence of anaemia is high among adolescents and pregnant women (PW)

Objectives:

To assess consumption of IFA in adolescent school going girls and pregnant women in selected health blocks of Himachal Pradesh.

Methodology:

It was a community-based study which was a part of project under WCD department of H.P. PW and school going adolescent girls of age 10-19 years from 9 Community development blocks were selected randomly using PPS. IFA consumption in last one year among adolescent girls and last 1 month among pregnant women was assessed by interviewing them.

Results:

Total participants among PW were 180 with mean age of 26.3±4.13, whereas 720 adolescents with mean age of 15.82±1.19 were enrolled in the study. Out of 180 PWs, 160(88.8%) received IFA where majority (156;97%) of them consumed IFA distributed by ASHA worker. On the other hand, majority of adolescent girls (484/720;67%) did not receive IFA, 196/236 (83%) who received IFA was distributed by ASHAs. Mean Hb level of PW was 11.7±1.47 whereas for adolescents was 12.73±4.85.

Conclusion:

It was observed that most of the pregnant women are utilizing government services, however the services are not being utilized by the school going adolescent girls as WIFS are not provided regularly.
IJCM_299A: Clinical profile of patients with dengue: a cross-sectional study from a tertiary care hospital, Karnataka
Authors: Nivetha S , Kumar Ashwini , Saravu Kavitha , Eshwari K
Published: April 2024

Background:

Dengue fever (DF) are among the most important mosquito- borne diseases of the Indian subcontinent and have become a major global public health concern. Its clinical manifestations of which vary from influenza- like illness (DF) to life-threatening dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS). The purpose of the study was to find out the mode of presentation, biochemical profile and complications of Dengue cases in an apical level.

Objectives:

1. To identify socio-demographic characteristics and clinical features; 2. To document the disease specific management and outcomes

Methodology:

A cross-sectional study of admitted patients was conducted in the department of medicine and Infectious Diseases over a period of 9 months (15/2/2023 -15/11/2023). Patients aged above 18 years with serology proven (nonstructural protein 1 [NS1]/dengue immunoglobulin M [IgM]) DF were included in this study. Their Socio demographic Details, clinical and laboratory data was recorded and analyzed.

Results:

Preliminary Results: Out of 125 cases, - 89 (71.2 %) patients were males and 36 (28.8%) were females. - The most common presentations were fever (96%) followed by Nausea/vomiting (40%), Headache (35%) and myalgia (31%). - Dengue NS1 and IgM antibodies were positive in 87.3% and 88.12% of the patients, respectively. - the incidence of DF, DHF, and DSS was 87.2, 11.2, and 1.6% respectively. - Shock, bleeding, and elevated serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase levels predicted adverse outcome.

Conclusion:

DF can present with a spectrum of clinical manifestations ranging from mild self-limiting illness to severe fatal disease. It can have varied and multi-systemic manifestations which can go unrecognized. Continuous seroepidemiological surveillance is essential to control outbreak and minimize morbidity and mortality.
IJCM_61A: Prevalence of Domestic Violence Among Married Women in urban and rural field practice area of RIMS, Raichur
Authors: Radha K. Jeeva , Neelopant Sushrita , Kirte Rahul C. , Basagoudar Shashidhar. S.
Published: April 2024

Background:

Domestic violence (DV), being a widespread public health issue affecting women globally, is still being neglected and women remain silent sufferers and suffer from physical, mental, sexual and reproductive health consequences which further affects well-being of her family. It also leads to increased risk of child abuse. Women being considered as weaker sex, gender bias and male dominance resulted in mistreating women and victimizing them and remains unreported in many areas.

Objective:

To estimate prevalence of domestic violence among married women. €¢ To compare prevalence of domestic violence in urban and rural areas. €¢ To find out factors associated with prevalence of domestic violence.

Methodology:

Cross sectional study, 3 months duration in married women residing in field practice areas of RIMS, Raichur. Least prevalence found in a study having 28%. Using the formula N = Z2pq/ d2 sample size calculated as 257. Almost population of UHTC, RHTC and PHC are similar, equal number of samples (86) taken from all 3 areas. Community consent obtained from representatives, Home visits were made, informed oral consent obtained, face to face interview done using pre-designed, pre-tested questionnaire. Statistical analysis done using SPSS, means and standard deviations calculated. Chi square test used to calculate the associations.

Results:

Prevalence of DV is 33.3% and 16% of them are currently experiencing domestic violence. 36.4% of rural participants have experienced DV compared to 21.2% in urban participants & these differences were statistically significant as indicated by p value of 0.037. Factors such as religion, caste, type of family, education of female, spousal education, spousal occupation, alcohol consumption by husband, smoking habit of husband, history of parental abuse in spousal family, etc.. are associated with domestic violence.

Conclusion:

We conclude that domestic violence is mostly done by husband followed by mother-in-law and most common solution offered was to advice husband.
Detection of Molecular Variations at Androgen Receptor Gene in 46,XY Differences in Sex Development Cases
Authors: Marzuki Nanis S. , Kartapradja Hannie D. , Coutrier Farah N. , Wahyudi Irfan , Batubara Jose R.L.
Published: April 2024

Introduction:

One of the common causes of 46,XY differences in sex development (DSD) cases is androgen insensitivity syndrome. This X-linked recessive inherited condition is associated with pathological variations of the AR gene, leading to defects in androgen action. Affected 46,XY infants or individuals experience variable degrees of undervirilization and those with severe form will have female-like external genitalia. Therefore, they were more likely assigned and reared as females. The confirmatory molecular test is often needed due to similar clinical manifestations with other conditions causing 46,XY DSD. Since in our country, the molecular test for the AR gene is lacking, the study is conducted as a preliminary study to elaborate on the possibility of developing a molecular test for the AR gene in 46,XY DSD cases.

Methods:

Archived DNAs of 13 46,XY DSD cases were analyzed using polymerase chain reaction and direct sequencing for molecular defects in the AR gene. Clinical and hormonal data were collected and analyzed.

Results:

The study successfully amplified and visualized the eight exons of the AR gene and revealed two subjects carrying AR gene variants at exon 7. In the first case, 1.2-year-old boy carried heterozygous p.Gln825Arg, which has never been reported elsewhere, and the second subject, a 2.1-year-old girl with heterozygous p.Arg841His. Both subjects presented with severe undervirilization of external genitalia with external genitalia masculinization scores (EMS) of 1.5 and 3.

Conclusion:

In this series, two of 13 46,XY DSD cases carried variants at the AR gene, resulting in complete androgen insensitivity syndrome.
Bilateral recurrent choroidal neovascularization in AZOOR
Authors: Sánchez-Quirós Julia , Galletero Lucía , Giralt Lena , Artaraz Joseba , Ruiz-Arruza Ioana , Soto Adriana , Carreño Ester , Fonollosa Alex
Published: April 2024

A 61-year-old man presented with recurrent bilateral peripapillary choroidal neovascularization (CNV), which was treated with intravitreal bevacizumab injections. Fundus autofluorescence revealed the typical acute zonal occult outer retinopathy (AZOOR) trizonal pattern, so the patient was started on immunosuppressive treatment with prednisone and methotrexate, and subsequently with mycophenolate mofetil due to recurrent inflammatory activity. While on immunosuppressive treatment, further CNV showing the “pitchfork sign” appeared in the right eye and required multiple bevacizumab injections due to persistent activity. The complication of CNV in AZOOR is very rare and treatment is a challenge. However, the combination of intravitreal anti-VEGF with immunosuppressive treatment could prevent the progression of the disease.
A surprise error in a phakic IOL
Authors: Mungale Meeta
Published: April 2024

Phakic intraocular lenses (IOLs) have been in clinical use for two and half decades and are an accepted option for extreme ametropia. Incorrect power correction postsurgery could be due to multiple reasons such as improper biometry readings, incorrect IOL placement, or displacement. A manufacturer error is the least expected and unwanted. Herein, a case where an error in labeling from a manufacturer resulted in not only a scare for the operating surgeon but also an equally harassed patient is presented. This case highlights that any checklist followed by the operating surgeons also needs to be implemented at the manufacturer’s end.
Brittle cornea syndrome—A rare genetic disease
Authors: Mohan Leila S , Kannambalath Shabeeba , Maneparambil Vijayalakshmi , Nambiar Soumya , Mohankumar Kavitha , Melarambath Roohi A
Published: April 2024

To report a case of an 8-year-old girl who presented with bluish discoloration of sclera, keratoconus, and progressive high myopia. She had a history of recurrent shoulder dislocation. A general physical examination showed a midfacial hypoplasia, upturned nares, thick and tented upper lip, and hyperextensible joints. The genetic analysis showed ZNF469 mutation suggestive of Brittle cornea syndrome 1 (BCS-1). We aim to highlight the importance of timely diagnosis and early provision of protective glasses seems to be the most important step in treating BCS.
An interesting case of facial en coup de sabre presenting with optic neuritis in the contralateral eye: A rare presentation
Authors: Mishra Avinash , Agrawal Mohini , Bhirud Atul , Tripathi Anchal , Dash Mahashweta
Published: April 2024

Ocular involvement in morphea or en coup de sabre (ECS) is relatively infrequent, observed in approximately 2–3% to 14% of cases. The intricate pathogenesis underlying these ocular manifestations remains elusive. Within this context, we present a rare case in a young female patient, wherein, ECS manifested with optic neuritis in the eye contralateral to the linear scleroderma lesion, a phenomenon, hitherto, unreported in the literature. This unique case affirms the importance of comprehensive ophthalmological evaluations, not only at the initial presentation but also in the ongoing care of ECS patients. The recommendation is particularly emphasized in instances where patients perceive the emergence of new ocular symptoms. This approach aims to enhance our understanding of the ocular complexities associated with ECS and improve the overall management of this intriguing condition.
Bilateral acute retinal necrosis with choroidal detachment
Authors: Sharma Akanksha , Tekchandani Uday , Neupane Swechya , Singh Ramandeep
Published: April 2024

A 42-year-old man with history of topiramate intake presented with sudden diminution of vision. He was diagnosed with bilateral panuveitis with retinitis and serous choroidal detachment, with ultrasound biomicroscopy revealing ciliary body effusion. Systemic investigations were negative for immunosuppression. Topiramate was stopped and the patient was started on oral valacyclovir and oral steroids 48 h after antiviral therapy. The patient responded well to the treatment leading to resolution of retinitis as well as choroidal detachment. This is a unique case of bilateral acute necrotizing retinitis and choroidal detachment, in which early recognition and prompt treatment led to a favorable outcome.
Unveiling rarity: Ocular manifestations of recessive dystrophic epidermolysis bullosa (RDEB) syndrome with localized corneal edema
Authors: Rahman Sharah , Hussain A.H.M. Enayet , Anwar Ishtiaque , Sarker Bipul Kumar De , Malek Mohammad Ibn Abdul , Mahfooz Shahrina
Published: April 2024

This case report illustrates the ocular manifestations of recessive dystrophic epidermolysis bullosa (RDEB) syndrome in a 7-year-old boy from Bangladesh. During his overall examination, the boy exhibited active and chronic bullous lesions associated with black eschar throughout his body. In addition, he presented dental abnormalities, tooth decay, nail dystrophy, and the absence of nails on his fingers and toes. His ocular presentation included localized corneal edema extending from the subepithelium to Descemet’s membrane and blistering of the eyelids, which spared the corneal epithelium and the conjunctiva. We treated the lesion successfully using topical loteprednol and artificial tear (carboxymethyl cellulose) eye drops, resulting in an excellent outcome.
Choroidal osteoma secondary to chronic posterior scleritis: A case report and literature review
Authors: Sun Huixin , Yang Shizhao , Wang Qian , Zhou Xiyuan , Zheng Zheng , Zheng Minming
Published: April 2024

Choroidal osteoma is a rare benign ossifying tumor of the choroid. Posterior scleritis is an uncommon yet potentially sight-threatening inflammation of the sclera. Herein, we report a case of choroidal osteoma secondary to chronic posterior scleritis accompanied by a literature review. Decalcification of the tumor, choroidal neovascularization, and retinal pigment epithelium atrophy can result in blindness. Hence, patients with recurrent posterior scleritis need long-term follow-up; in addition, we need to be alert for complications, such as choroidal osteoma, which can ultimately lead to a poor visual prognosis.
A case of Phialemoniopsis curvata keratitis and literature review
Authors: Yildirim Nilgun , Oz Yasemin , Yaz Yasemin Aydin , Sahin Afsun
Published: April 2024

We reported the case of a keratomycosis caused by an extremely rare filamentous fungus. A patient with a history of phacoemulsification and intraocular lens implantation surgery followed by bullous keratopathy and was wearing a bandage contact lens presented with signs of keratitis. Microbiological examinations revealed a filamentous fungus identified as Phialemoniopsis curvata. Penetrating keratoplasty was performed due to spontaneous corneal perforation during the treatment. P. curvata is an extremely rare agent of fungal keratitis. Although the course of infection is serious, recovery without sequela may be possible with early diagnosis and appropriate treatment.
Glaucoma associated with congenital iris cyst
Authors: Bayoumi Nader H L , El Naggar Hady M
Published: April 2024

Four eyes of four children (mean age 5.5 ± 2.6 months) were operated upon for glaucoma associated with iris cyst (cysts excised 6 weeks earlier). All eyes were subjected to a combined trabeculotomy–trabeculectomy with mitomycin C once, which lowered the mean intraocular pressure (IOP) from 28.8 ± 6.5 to 14.8 ± 12.8 mmHg (mean follow-up of 15.1 ± 9.1 months). Complications included two eyes developing cataract and one eye developing a staphyloma. The eye that developed staphyloma suffered a persistently elevated IOP, was prescribed topical IOP-lowering therapy, and was classified as a failure.
Revisiting open-sky keratoplasty
Authors: Singh Shweta , Acharya Manisha
Published: April 2024

The video depicts a case of regrafting in a severely inflamed post-PK eye, previously grafted for active Pythium keratitis. The video highlights the various intraoperative challenges faced during a penetrating keratoplasty and the principles to tackle them.

Video Link: https://youtu.be/3PWQ9hosAV0
Lymphangioma manifesting as corneoscleral cyst: A rare case report
Authors: Kodavoor Shreesha Kumar , Neemuchwala Tasneem , Dandapani Ramamurthy
Published: April 2024

An 11-year-old male patient reported with whitish, progressively growing swelling in his right eye for 2–3 months. A cystic lesion was present involving the intrastromal layers of the cornea, extending through the limbus into the adjacent sclera. There was no systemic involvement. Surgical excision of the lesion revealed it to be a continuous intracorneal and intrascleral cyst. Histopathology confirmed it to be a benign lymphangioma-capillary hemangiomatous lesion.
Terminal facial nerve palsy – A diagnostic dilemma
Authors: Rao Sonali , Raghunandan Nithya , Shamsi Mariya
Published: April 2024

The pterional or frontotemporal sphenoidal approach to craniotomy is an extensively used neurosurgical technique to expose different structures in cranial fossae. Two middle-aged patients presented to the clinic with loss of forehead creases, and unilateral brow ptosis. This article aims to detail the findings in two patients with selective frontal branch of facial nerve palsy after undergoing craniotomy through the pterional approach. Though facial nerve palsy is classified as upper motor neuron/lower motor neuron palsy, this case scenario highlights the importance of isolated involvement of the frontal branch of the facial nerve. Thus, it is important to highlight these findings to create awareness among ophthalmologists who may come across such a clinical picture while examining neurosurgery patients so that they are better enabled to localize the cause.
Double flaps of internal limiting membrane for chronic optic pit maculopathy with large outer lamellar hole
Authors: Dhananjay Shukla
Published: April 2024

A 24-year-old woman presented with very chronic optic pit maculopathy and outer lamellar hole. During vitrectomy, two internal limiting membrane (ILM) flaps were designed and inverted from the temporal to the nasal side to cover the thin-roofed fovea and the optic pit. Two weeks post vitrectomy, the outer lamellar hole de-roofed into a full-thickness macular hole but remained covered with the inverted ILM flap. The hole edges grew centripetally and re-bridged over the next month. By 9 months, the macular hole had closed, schisis settled, and BCVA improved substantially.
CSCR with full-thickness retinal fold: An atypical presentation
Authors: Sen Ahana , Chowdhury Ruchira , Thounaojam Sanatombi , Kala Urvashi , Bhattacharyya Sampurna , Shambhawi Pragya , Chattree Surabhi , Saurabh Kumar , Roy Rupak
Published: April 2024

We are reporting an atypical presentation of full-thickness retinal fold in central serous chorioretinopathy (CSCR) in a 30-year-old male. Thick retinal folds in the setting of CSCR is not yet described and can pose a diagnostic dilemma. It is important not to misdiagnose CSCR as inappropriate management may lead to severe visual impairment.
Choroidal ganglioneuroma- An exceptionally rare choroidal tumor in a child
Authors: Suryakanth Shwetha , Shanmugam Mahesh P , Ramanjulu Rajesh , Mishra Divyansh Kailashchandra , Agrawal Surbhi
Published: April 2024

A 3-year-old male child presented with decreased vision in the right eye. There was an elevated, white mass lesion with heterogeneous lucent areas and focal pigmentation arising from the choroid with irregular margins and subretinal fluid inferiorly. Infective etiologies were ruled out. There was no tumor elsewhere in the body that could have caused a metastasis to the choroid. In view of the non-resolving subretinal fluid and inconclusive diagnosis, the child underwent choroidal biopsy. Histopathology and immunohistochemistry clinched the rare diagnosis of ganglioneuroma of choroid. The child was genetically negative for Neurofibromatosis.
Congenital lower eyelid entropion with corneal ulcer – A case report
Authors: Nugent Ryan B , Smith James E H , Tumuluri Krishna
Published: April 2024

Congenital entropion is a rare condition affecting the lower eyelid more commonly than the upper eyelid. We describe a case of congenital lower eyelid entropion in a 3-week-old with corneal ulceration, likely present in utero. The child had successful repair of entropion with Quickert everting sutures and reformation of the lower eyelid skin crease. At 3 months post-surgery, the lid position and corneal ulcer have resolved. The use of non-incisional rotational eyelid surgery for the repair of congenital entropion is quick and simple with good surgical outcomes.
Clinical usefulness of nebulized dexmedetomidine for conscious sedation in daycare flexible bronchoscopy in Southern India
Authors: Antony Thomas , Acharya K. Vishak , Acharya Preetam Rajgopal , Kotian Himani , Kamath Sindhu
Published: April 2024

BACKGROUND:

Sedative agents used in bronchoscopy require trained personnel to administer and monitor the patient. This increases the procedure cost, duration, and inpatient stay. Inhalational administration of sedative agents can be a practical solution to the issue. Dexmedetomidine in the inhalational form could give results similar to the intravenous form without significant adverse events.

MATERIALS AND METHODS:

The study is prospective, randomized, and double-blinded study. Patients needing bronchoscopy were randomized to receive the nebulized form of either dexmedetomidine or saline (0.9%) before bronchoscopy. The study parameters are assessed and recorded before, during, and after bronchoscopy. Data collected are analyzed using the SPSS software.

DISCUSSION:

The side effects limit using commonly administered sedation agents in bronchoscopy, such as midazolam, fentanyl, and dexmedetomidine. The nebulized dexmedetomidine is safe with proven efficacy when compared to the placebo. Proceduralist-administered conscious sedation reduces the overall cost and shortens inpatient stays. Attenuation of hemodynamic parameters by dexmedetomidine could be an advantage for the physician in reducing an untoward cardiac event.

CONCLUSION:

Dexmedetomidine in the nebulized form improves the comfort of patients during the procedure. It blunts the pressure response during bronchoscopy and could be a safer and cost-effective agent in its nebulized form for conscious sedation in bronchoscopy. The study is approved by the institutional ethics committee (IEC KMC MLR 10-2021-310).
Neutralization antibody titer and change in 50% protection after the third dose of the COVID-19 vaccine
Authors: Mungmunpuntipantip Rujittika , Wiwanitkit Viroj
Published: April 2024

BACKGROUND:

The new COVID-19 variant outbreak is the present global public health problem. The omicron variant of SARS-CoV-2 has several subvariants and causes outbreaks worldwide. Because of the increasing genetic heterogeneity of SARS-CoV-2, it is expected that using COVID-19 immunization to prevent and control disease will be problematic.

AIM:

The aim of the study was to study neutralization of antibody titer and change in 50% protection after the third dose of the COVID-19 vaccine.

MATERIALS AND METHODS:

In this report, the authors determine the expected neutralization antibody titer against omicron subvariants and the change in 50% protection against infection after the third dose of the immunization.

RESULTS:

The change due to subvariant B.4 or B.5 is substantially higher than that due to the other subvariants. The efficacy of using viral vector vaccine boosters is questionable since viral vector COVID-19 boosters fail to generate enough antibodies to achieve the mean convalescent plasma level.

CONCLUSION:

Higher antibody levels than the typical convalescent level and that needed for half protective property are still possible with the mRNA vaccine booster shot. In addition, compared to the half-dose regimen, the full-dose regimen produces a higher antibody level. As a booster shot, the mRNA COVID-19 vaccine is recommended.
Off-target effect of high-dose sildenafil on adenosine 5’- diphosphate and collagen-induced platelet activation through mitogen-activated protein kinase pathway in treated BALB/C mice and in vitro experiments: A preliminary study
Authors: Balaji Sudharshanan , Patnaik Yash Raj , Surin William Rasican
Published: April 2024

Sildenafil, a common over-the-counter pill often self-administered at high doses for erectile dysfunction, has been reported to rarely cause prothrombotic events and sudden cardiac death in a few case reports. Therefore, we investigated the in vitro and in vivo effect of sildenafil treatment and dosage on platelet activation and mitogen-activated protein kinase (MAPK) phosphorylation. BALB/C mice were segregated into four groups, each having four mice each (control, low [3.25 mg/kg], medium [6.5 mg/kg], and high [13 mg/kg] sildenafil), and after the treatment, blood was drawn from each mouse and washed platelets prepared. Washed platelets were incubated with CD41 PE-Cy7 and Phospho-p38 MAPK PE antibodies and analyzed using a flow cytometer for platelet activation and adenosine 5’- diphosphate (ADP)/collagen-induced MAPK phosphorylation. Washed platelets obtained from the venous blood of 18 human volunteers, were incubated with PAC-1 FITC and Phospho-p38 MAPK PE antibodies, and platelet activation (ADP and collagen), followed by flow cytometry analysis. There was a significant increase in both platelet activation as well as MAPK phosphorylation in the presence of collagen in the high-dose (13 mg/kg) sildenafil group (P = 0.000774). Further, increased platelet activation was observed in samples that were treated with high-dose sildenafil as compared to the untreated samples (P < 0.00001). These studies show the risk of prothrombotic episodes in patients on high-dose sildenafil (100 mg), in those with even mild endothelial dysfunction due to ADP, and collagen-induced platelet activation through MAPK phosphorylation, which was not seen in the low-and intermediate-dose cohorts.
Prescription-based cost analysis of medicines for cardiovascular risk factors at Indian Council of Medical Research-Rational Use of Medicine Centre Hospitals of India
Authors: Chugh Preeta Kaur , Gupta Pooja , Wasan Himika , Tripathi C. D. , Chandy Sujith J. , Ranjalkar Jaya , Bright Heber Rew , Badyal Dinesh Kumar , Samuel Madhulika Peter , Jhaj Ratinder , Banerjee Aditya , Joshi Rupa , Medhi Bikash , Prakash Ajay , Kamat Sandhya , Tripathi Raakhi , Shetty Yashashri , Parmar Urwashi , Dikshit Harihar , Mishra Hitesh , Roy Sukalyan Saha , Kumar Rajiv , Chatterjee Suparna , Bhattacharya Manjari , Samanta Kalyan , Trivedi Niyati , Shah Prashant , Chauhan Janki , Ramasamy Raveendran , Mathaiyan Jayanthi , Gauthaman Jeevitha , Kaushal Sandeep , Jain Samriti , Arora Shalini , Gupta Kanchan , Cherian Jerin Jose , Chatterjee Nabendu Sekhar , Kshirsagar Nilima Arun
Published: April 2024

OBJECTIVES:

India has taken several initiatives to provide health care to its population while keeping the related expenditure minimum. Since cardiovascular diseases are the most prevalent chronic conditions, in the present study, we aimed to analyze the difference in prices of medicines prescribed for three cardiovascular risk factors, based on (a) listed and not listed in the National List of Essential Medicines (NLEM) and (b) generic and branded drugs.

MATERIALS AND METHODS:

Outpatient prescriptions for diabetes mellitus, hypertension, and dyslipidemia were retrospectively analyzed from 12 tertiary centers. The prices of medicines prescribed were compared based on presence or absence in NLEM India-2015 and prescribing by generic versus brand name. The price was standardized and presented as average price per medicine per year for a given medicine. The results are presented in Indian rupee (INR) and as median (range).

RESULTS:

Of the 4,736 prescriptions collected, 843 contained oral antidiabetic, antihypertensive, and/or hypolipidemic medicines. The price per medicine per year for NLEM oral antidiabetics was INR 2849 (2593–3104) and for non-NLEM was INR 5343 (2964–14364). It was INR 806 (243–2132) for generic and INR 3809 (1968–14364) for branded antidiabetics. Antihypertensives and hypolipidemics followed the trend. The price of branded non-NLEM medicines was 5–22 times higher compared to generic NLEM which, for a population of 1.37 billion, would translate to a potential saving of 346.8 billion INR for statins. The variability was significant for sulfonylureas, angiotensin receptor blockers, beta-blockers, diuretics, and statins (P < 0.0001).

CONCLUSION:

The study highlights an urgent need for intervention to actualize the maximum benefit of government policies and minimize the out-of-pocket expenditure on medicines.
Tumor-targeted gypenoside nanodrug delivery system with double protective layers
Authors: Lai Zongqiang , Bai Facheng , Pu Tao , Li Jun , Wu Lining , Zhou Zhou , Yang Nuo
Published: April 2024

Objectives:

Gypenoside (Gyp) is easily degraded in the gastrointestinal tract, resulting in its low bioavailability. We aimed to develop a tumor-targeted Gyp nanodrug delivery system and to investigate its antitumor effect in vitro.

Materials and Methods:

We used Gyp as the therapeutic drug molecule, mesoporous silica (MSN) and liposome (Lipo) as the drug carrier and protective layers, and aptamer SYL3C as the targeting element to establish a tumor-targeted nanodrug delivery system (i.e., SYL3C-Lipo@Gyp-MSN). The characteristics of SYL3C-Lipo@Gyp-MSN were investigated, and its drug release performance, cell uptake, and antitumor activity in vitro were evaluated.

Results:

A tumor-targeted Gyp nanodrug delivery system was successfully prepared. The SYL3C-Lipo@Gyp-MSN was spherical or ellipsoidal; had good dispersion, which enabled it to specifically target and kill the liver tumor cell HepG2; and effectively protected the early leakage of Gyp.

Conclusions:

We have established a tumor-targeted nanodrug delivery system that can target and kill liver cancer cells and may provide a strategy for preparing new nanodrug-loaded preparations of traditional Chinese medicine.