bluuebunny/crossref_metadata_2025 huggingface dataset:
Elevated Urinary CD80 Excretion in Children with Steroid-Responsive Nephrotic Syndrome
Authors: Hooman Nakysa , Otukesh Hasan , Hosseini Rozita , Nickavar Azar , Dastan Farzaneh , Sarouei Mahboubeh Jafari , Honarpisheh Parisa
Published: October 2022

Background:

Idiopathic nephrotic syndrome (INS) is one of the most common glomerular diseases in children with different pathological types and different responses to corticosteroids. A definitive diagnosis is essential for planning the treatment and determining the prognosis of these patients and currently, kidney biopsy is the only method for definitive diagnosis. However, this is an invasive procedure. In addition, in some cases, the biopsy is contraindicated or tissue obtained on biopsy is insufficient and may not represent the underlying disease. According to the recent hypothesis about the role of circulating permeability factors in the pathogenesis of INS, urine protein analysis as a noninvasive method to determine the specific biomarkers of the disease is of great interest to nephrologists and can be useful.

Methods:

In this case − control study, we analyzed urinary CD80 (uCD80) levels in 51 patients with INS using a special CD80 enzyme-linked immunosorbent assay kit and were compared between different groups of patients.

Results:

The highest urine CD80/creatinine ratio was found in patients with active minimal change disease and steroid-responsive nephrotic syndrome in the relapse stage of the disease.

Conclusion:

A significant level of uCD80 is correlated with better renal function and a more favorable response to steroids in patients with INS. Therefore, it can be concluded that a high level of uCD80 is correlated with a good prognosis in these patients.
Designing a Circular Coil of Repetitive Transcranial Magnetic Stimulation at Frequencies of 0.5 and 1 Hz using CST Studio Suite Software and Comparison of Results with Theoretical Calculations
Authors: Tavakoli Hassan , Heidarpanah Arsalan
Published: October 2022

Context:

Since the 1990s, repetitive transcranial magnetic stimulation (rTMS) has been used as a noninvasive method to diagnose and manage the treatment of many neurological disorders. The circular coil is one of the most common coils in rTMS devices. This study presents the design documentation of a circular coil for use in the rTMS device and examines the consistency of the magnetic field intensity (H) and the magnetic flux density (B) obtained from the simulation of its use with the theoretical values.

Aims:

This study aimed to design a rTMS circular coil at frequencies of 0.5 and 1 Hz using CST Studio Suite software and compare the intensity of the B- and H-fields with theoretical calculations.

Materials and Methods:

After designing a circular coil, we measured B and H by simulation with CST Studio Suite software and compared the results with theoretical calculations.

Results:

The magnetic field intensity and the magnetic flux density obtained from the circular coil simulation we designed had an acceptable consistency with the theoretical values.

Conclusions:

The B- and H-field intensity whether on the body or in the air, or on the antenna, is fairishly consistent with theoretical calculations.
Evaluation of Immunoglobulin G Level Among Subjects Vaccinated with Different Types of COVID-19 Vaccines in the Karbala Population, Iraq
Authors: Hassan Rawaq Taleb , Mohammed Suhad H.
Published: October 2022

Background:

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccines represent the only way in combating the COVID-19 pandemic. Studying the differences in immune response to different types of vaccines is considered an important tool for optimizing vaccine selection and dosage required. The aim of this study was to evaluate the immunoglobulin G (IgG) concentration following vaccination with Pfizer, AstraZeneca, and Sinopharm vaccines. A cross-sectional study was conducted between November 2021 and April 2022.

Methods:

A blood sample was obtained from 174 vaccinated persons, IgG levels were detected using the SARS-COV-2 IgG II Quant assay on the ARCHITECT I system. Statistical analysis used IBM SPSS VERSION 24 software. Quantitative results are indicated as mean ± standard deviation. The statistical significance level was set at P < 0.05.

Results:

Out of 60.3%, 33.9%, and 5.7% had received Pfizer, Sinopharm, and AstraZeneca vaccines, respectively. Ninety participants were men and 84 were women with ages ranging from 18 to 70 years. IgG concentrations were higher in participants vaccinated with Pfizer's vaccine. There were significant differences among the three types of vaccine within age groups. The mean IgG concentration was higher in male participants vaccinated with Pfizer and AstraZeneca. No significant variation was observed between the first and second doses for each type of the three vaccines. The IgG concentration for a vaccination with Pfizer varied significantly among the weeks after vaccination, the maximum concentration was seen between the 6th and 7th weeks.

Conclusions:

Participants vaccinated with the Pfizer vaccine produce the highest antibody concentration as compared to other vaccines, especially in male participants. Younger participants produce higher amount of antibody response.
Pseudomonas Aeruginosa a Tenacious Uropathogen
Authors: AL-Khikani Falah Hasan , Ayit Aalae Salman
Published: October 2022

No population in the world can be cleared from urinary tract infections (UTIs) that considered the most common bacterial infection globally, every year more than 150 million people suffering from acute or chronic UTI caused by various bacteria. It is among the most frequent health care-associated diseases. In patients with UTI, Pseudomonas
aeruginosa deserves special attention since it can affect patients with serious underlying conditions. P.
aeruginosa is a multidrug-resistant pathogen causing numerous chronic infections including urinary tract disorders. Infection caused by this organism is difficult to treat because of the presence of its innate resistance to many antibiotics and its ability to acquire further resistance mechanism to multiple classes of antibiotics, including beta-lactams, aminoglycosides, and fluoroquinolones; thus, the treatment option for these drug resistance pseudomonas are very limited. P.
aeruginosa-induced UTIs continue to be linked with substantial mortality and morbidity. This adverse consequence is owing to our failure to create effective disease-prevention treatment methods, which is related to a lack of knowledge of resistance mechanisms. This study alerts researchers to the need to better understand the mechanisms of resistance in P.
aeruginosa-caused UTIs to develop viable treatment options. The microbiological perspectives, virulence factors, epidemiology, mechanisms beyond antibiotic resistance, and antimicrobial sensitivity of P.
aeruginosa in UTI are discussed in this review as well as future strategies to build basic information and clear vision to other researchers for more studies regarding this tenacious bacterium.
Immunoinformatics-based Identification of Highly Conserved Cytotoxic T-Cell Epitopes in Polyprotein pp220 of African Swine Fever Virus
Authors: Juan Aiman Kiara Atienza , Palma Keana Milen Calara , Suarez Marianne Bermudez , De Mesa Herrera-Ong Leana Rich
Published: October 2022

Background:

High mortality rate of pigs peaked in 2020 due to the re-emergence of a deadly African swine fever virus (ASFV) which has led to transcontinental outbreaks in Europe, reportedly from 2014 to 2019, and in Asia and the Pacific from 2018–2020. Given the huge socioeconomic consequences of the disease, vaccines that will prime the immunity of swine against this pathogen is a dire necessity.

Methods:

Insilicoidentification and characterization of highly conserved cytotoxic T-cell (CD8+) epitopes derived from one of its structural proteins, pp220, were analyzed. Protein sequences of pp220 were retrieved and clustered to obtain highly conserved sequences. Cross-reactive epitopes were filtered out, and the remaining epitopes were docked with swine leukocyte antigen-1*0401 (SLA-1*0401). Furthermore, the epitope stability was determined by comparing binding energy, dissociation constant, and eigenvalues of the epitopes with the values of positive control, influenza-epitope complex.

Results:

This study showed that 20 highly conserved epitopes promiscuously bind to two or more SLAs and 9 of which epitopes (ALDLSLIGF, QIYKTLLEY, FLNKSTQAY, IADAINQEF, IINPSITEY, AINTFMYYY, SLYPTQFDY, RSNPGSFYW, and RLDRKHILM) that were validated exhibit potential immunogenicity based on the acceptable binding energy, dissociation constant, and eigenvalues.

Conclusion:

This study has identified epitopes that show high conservancy, reducing the chance of epitope immune evasion. It is anticipated that the identified epitopes must be further evaluated as a potential immunotherapeutic agent in developing an epitope-based vaccine against ASFV.
Role of Atrial Natriuretic Peptide in Abrogated Cardio Protective Effect of Ischemic Postconditioning in Diabetic Rat Heart
Authors: Gupta Garima , Varshney Vibhav , Goyal Ahsas , Gupta Jeetendra K. , Yadav H. N.
Published: October 2022

Background:

Diabetes decreased cardioprotective potential of ischemic postconditioning (IPOC), atrial natriuretic peptide (ANP) induced the cardioprotection against ischemic-reperfusion (I/R) injury. The present study has been designed to investigate the role of ANP induced postconditioning in diabetic rat heart.

Methods:

Isolated Langendorff perfused normal and diabetic rat hearts were stabilized for 10 min proceed by global ischemia further followed by four cycles of IPOC, each cycle comprised 5 min of reperfusion and 5 min of ischemia at onset of 120 min of reperfusion. Perfusion of ANP (0.1μM/l) with Krebs–Henseleit Buffer solution in isolated diabetic rat heart for four-cycle of IPOC significantly decreased I/R-induced myocardial infarct size and release of CK-MB and lactate dehydrogenase (LDH) level in coronary effluent.

Results:

Four cycles of IPOC-induced cardioprotection noted by decreased in infarct size and also in release of LDH and CK-MB in normal rat heart. However, IPOC-induced cardioprotection was completely attenuated in isolated heart obtained from diabetic rat. Perfusion of ANP (0.1μM/L) significantly restored the attenuated cardioprotection in diabetic rat heart, which was completely blocked by perfusion of L-NAME (100μM/L), an eNOS inhibitor.

Conclusion:

So that, ANP restored cardioprotective affect in diabetic rat heart, which was completely abolished by the perfusion of L-NAME (100μM/L), an eNOS inhibitor.
Development and Validation of Chemometric-Assisted Spectrophotometric Method for the Simultaneous Estimation of Aceclofenac, Paracetamol, and Chlorzoxazone with Impurities
Authors: Gunjal Rajshree , Gajbhar Arti , Vichare Vijaya , Sutar Abhijeet , Deshmukh Minal , Choudhari Vishnu
Published: October 2022

Background:

Analysis of tertiary mixtures of analytes along with their impurities with simple and cost effective manner is always of interest. Utility of chemometric techniques are growing in pharmaceuticals, it improve speediness in the analysis and also provide analytical solutions with reduce the number of steps in the analytical method. In this study UV-Visible spectrophotometry coupled with principle component regression (PCR) and partial least square (PLS) multivariate methods was applied for estimation of three drugs in their formulation.

Method:

The calibration and validation sets were prepared in linear concentration range of three drugs and major impurities of paracetamol and aceclofenac. The series of sets were prepared using multilevel multifactorial design. Leave- One-Out (LOO) cross validation technique was employed to get essential number of Latent variables (LVs) that provides the greatest predictive ability. The developed method was studied for qualitative and quantitative analysis of titled drugs and validated as per regulatory guidelines.

Results:

The results showed the values of coefficient of determination (R2) for all drugs and impurities was higher than 0.99 indicating high acceptability. The obtained RMSE values were relatively low. Coefficient of determination and RMSE values indicate good accuracy and precision, respectively.

Conclusion:

Proposed method was successfully used for analysis of aceclofenac, paracetamol and chlorzoxazone in tablet dosage form and major impurities of aceclofenac, paracetamol in bulk.
Immunocytochemical Expression of AE1/AE3 and Cytokeratin 20 in the Urinary Cells of Cigarette Smokers in South-West Nigeria
Authors: Ajileye Ayodeji Blessing , Akinbo Frederick Olusegun
Published: October 2022

Background:

Cigarette smoking has been identified as the most important risk factor for some cancers and the second leading risk factor for death in the world. This study was conducted to evaluate the immunocytochemical expression of AE1/AE3 and cytokeratin 20 (CK20) in the urinary cells of cigarette smokers in South-West, Nigeria.

Methods:

Urine samples were collected from 250 cigarette smokers and 200 noncigarette smokers in South-West, Nigeria. A questionnaire was administered to subjects before specimen collection. About 10 ml of urine samples were collected from every subject into a clean sterile universal bottle, thereafter transferred into a clean test tube and spun with a cytocentrifuge for the use of staining with immunocytochemical biomarkers (AE1/AE3 and CK20).

Results:

Immunocytochemical staining carried out on the urine smears of cigarette smokers revealed that 2.8% of the samples expressed AE1/AE3, while 1.1% expressed CK20. None of the urinary smears of nonsmokers expressed AE1/AE3 and CK20. Furthermore, being cigarette smokers did not strongly influence the expression of AE1/AE3 and CK20 in the urine of cigarette smokers.

Conclusion:

Based on the outcome of this study, cigarette smoking has been seen to be one of the leading causes of renal diseases and one of the major causes of cancer among cigarette smokers.
Biological Liquefaction and Dehairing of Tannery Hides Using Protease Crude Extract from Bacillus Safensis
Authors: Nachimuthu Saranya , Nehru Lavanya , Kathirvel Preethi
Published: October 2022

Background:

The contemporary usage of leather products has established large number of tanneries worldwide and increased the production of leather goods, releasing huge solid and liquid tannery waste. The amount of firm waste from the unprocessed skins and hides generated from tannery is increased day by day posing a solemn threat to the health and environment. It was reported to account 5-7% of the total solid wastes. This study aims for the biological approach of utilizing tannery hide waste for the production of bacterial enzymes. Proteases produced by the microbes have multiple commercial and industrial applications.

Methods:

The physiochemical property of raw trimming of bovine tannery hides was analyzed for the segregation of protease constructing bacteria. Seven bacterial isolates from the raw trimming bovine tannery hides were isolated and screened for their protease production and activity. The isolated bacterial strains were documented through morphological, biochemical tests and confirmed by MALDI-TOF and 16S rRNA sequencing as Bacillus safensis.

Results:

Among the seven isolates, Bacillus safensis established better proteolytic action. The culture conditions and media requirements were optimized for the maximum growth of the chosen bacteria. The crude proteolytic enzyme from Bacillus safensis was extracted, analyzed for its application in tannery hide dehairing activity through microbial fermentation. Further, the antibacterial and antioxidant properties displayed by the protease crude extract from Bacillus safensis could be explored for potential industrial and pharmaceutical applications.

Conclusion:

The verdict of the present study reveals a novel source of protease enzyme with the superior dehairing activity. Further, the research shed light on the strategies to reduce environmental pollution by the conversion of tannery waste into economically important products.
Feasibility and Safety of Laparoscopic Surgery in Large Ovarian Masses
Authors: Kinay Tugba , Kizilkaya Yasemin , Altinbas Sadiman Kiykac , Tapisiz Omer Lutfi , Ustun Yaprak Engin
Published: October 2022

Objectives:

To evaluate the feasibility and safety of laparoscopic surgery for large ovarian masses with benign features.

Materials and Methods:

Women who underwent laparoscopic surgery for an ovarian mass with benign features between 2017 and 2019 at a tertiary referral center were included in the retrospective study. Based on the size of the ovarian mass, the women were divided into the case and control groups of ≥10 cm and <10 cm, respectively. Clinical characteristics, operative findings, histopathological results, and complication rates of the groups were compared.

Results:

A total of 260 women, 64 women with large masses and 196 with small masses were included in the study. The operation time, intraoperative cyst rupture rate, complication rate, and hospital stay were similar in the case and control groups (P > 0.05). The cyst aspiration rate (29.7% vs. 5.1%, P < 0.001) and the unexpected malignancy rate (7.8% vs. 0.0% P = 0.001) were significantly higher in the case group than in the control group.

Conclusion:

Laparoscopic surgery was found feasible for the treatment of women with large ovarian masses. However, a higher unexpected malignancy rate requires the careful patient selection and appropriate counseling preoperatively in these cases.
Septic Shock Following Operative Hysteroscopy in a Menopausal Woman
Authors: Belouad Moad , Benlghazi Abdelhamid , Belkouchi Lina , Bouhtouri Yassine , Benali Saad , Kouach Jaouad
Published: October 2022

Minimally invasive gynecologic surgery such as hysteroscopy has a low risk of complications. Infections, however, are more common in the presence of risk factors such as smoking, history of pelvic inflammatory disease, and endometriosis. We report the case of a patient who underwent operative hysteroscopy without immediate complications and was admitted 2 days later to the emergency department in a severe state of septic shock. With multiple organ failures requiring admission to an intensive care unit, the patient died despite extensive antibiotic therapy and vasoactive drugs. Ascending infection can be a potentially fatal complication of hysteroscopy, even in the absence of known risk factors.
Ulipristal Acetate in Adenomyosis
Authors: Gonçalves-Henriques Manuel , de Pinho António , Freixo Marília , Liz-Coelho Maria , Castro Fabiana , Ceschin Nathan , Brandão Pedro
Published: October 2022

Adenomyosis is defined as the invasion of the basal endometrium (stroma and glands) into the underlying myometrium. It may lead to abnormal uterine bleeding (AUB), pelvic pain, and infertility. The definitive treatment is hysterectomy. Some conservative measures have been used in patients willing to procreate. Ulipristal acetate is a selective progesterone receptor modulator used to treat AUB caused by leiomyomas. This is a systematic review on the use of ulipristal to treat adenomyosis. Eight eligible articles were retrieved from PubMed, SCOPUS, and Cochrane Library. Only one randomized clinical trial was published until date concerning this matter. It seems that ulipristal acetate induces partial or complete remission of AUB caused by adenomyosis, but the evidence concerning its effect on pelvic pain and the radiologic findings of the disease is conflicting. Nevertheless, given the paucity of data, it is still preliminary to draw any conclusion about the subject.
It is time for more colors!
Authors: Jayanna Sushma , Shanmugam P Mahesh
Published: October 2022

Retinal drawing with a color-coding system brings uniformity in representation of fundus findings so that clinician can decipher various lesions on a two-dimensional drawing. Existing color coding addresses most of the common retinal pathologies including preretinal, intraretinal, and subretinal lesions. However, with the advent of various imaging modalities there is deeper understanding of microanatomy of retina and associated pathologies. With this, there appears further need of newer set of color coding to include the minute details of fundus findings clinically. Through this article, we discuss few common pathologies at different levels of retina layers with color-coding dilemma which calls for a better preciseness in its clinical representations.
Gonioscopy-assisted transluminal trabeculotomy: Passing the right way decoding suture
Authors: Maheshwari Devendra , Gupta Shivam , Tara Techi D , Pillai Madhavi Ramanatha , C Drishti , Ramakrishanan Rengappa
Published: October 2022

Background:

Trabeculectomy is still the most frequently performed glaucoma surgery. But being an invasive procedure, it has numerous vision-threatening complications along with bleb-related complications like cystic bleb, overhanging bleb blebitis, or endophthalmitis. The choice of therapy between medical laser and filtering surgery is now bridged by minimally invasive glaucoma surgeries (MIGS), which are conjunctiva-sparing procedures with adequate intraocular pressure (IOP)-lowering effects and good safety profiles. Among the armamentarium of MIGS procedures, gonioscopy-assisted transluminal trabeculotomy (GATT) is a frontrunner safe procedure. The procedure is a blebless and sutureless procedure in which a readily available Prolene suture is used to cleave the entire trabecular meshwork. An ab interno approach also allows direct visualization of a so-called trabecular shelf that, when present, indicates an open, cleaved collector system commonly associated with a positive postoperative outcome. Thus, it not only saves the eye from various postoperative complications of other previous penetrating procedures, but is also an effective glaucoma surgery that can be performed with very low costs, which would have big economic implications for glaucoma care in developing countries.

Purpose:

The purpose of this video is to illustrate transluminal novel trabeculotomy technique and video-based skill transfer to a novice surgeon.

Synopsis:

This video depicts detailed steps of GATT surgery in a patient with primary open angle glaucoma and in a case of silicon oil induced secondary open angle glaucoma. The authors also share their experience regarding possible intraoperative problems and solutions with some tips and tricks to make the surgery easy.

Highlights:

GATT can be performed with cataract surgery with minimal patient morbidity and a short recovery time with preserving healthy conjunctiva. There is no risk of post op hypotony or bleb related complications, with a short surgical learning curve.

Online Video Link:

https://youtu.be/gk1of38EX1g

Key words: Gonioscopy-assisted transluminal trabeculotomy, minimally invasive glaucoma surgery, trabecular meshwork
Intraoperative optical coherence tomography-guided donor corneal tissue assessment and preparation
Authors: Agarwal Rinky , Shakarwal Chetan , Sharma Namrata , Titiyal Jeewan Singh
Published: October 2022

Purpose:

To evaluate the role of intraoperative optical coherence tomography (i-OCT) in donor grading, selection, and preparation during different types of keratoplasty.

Methods:

Seventy-one consecutive donor corneas collected over 6 months, after clinical grading, were observed by an experienced corneal surgeon under an i-OCT equipped microscope. The donor preparation (manual/automated) for different types of keratoplasty procedures was also undertaken under i-OCT.

Results:

The mean central corneal thickness of optical and nonoptical grade tissues was 533 ± 19 and 662 ± 52 mm, respectively. The i-OCT-based grading matched with clinical grading in 98.5% cases. Irregular thickness, anterior stromal hyperreflectivity, and previous scars were appreciated in 1.4, 1.4, and 7.04% donors, respectively. During Descemet stripping automated endothelial keratoplasty, i-OCT facilitated selection of appropriate microkeratome head for automated donor preparation in all cases, besides allowing manual dissection of partially dissected lenticule, identification of site of inadvertent perforation, and eccentric trephination in one case each. During Descemet membrane endothelial keratoplasty, i-OCT-based assessment of preexisting scar (five cases) guided careful tissue selection (2/5) and preparation. During predescemetic endothelial keratoplasty, precise needle advancement allowed successful type-1 bubble formation in all cases. All manually punched donors demonstrated an extra endothelial ledge, while those with automated preparation showed tapering donor margins.

Conclusion:

i-OCT might serve as a useful imaging tool for objective assessment of donor characteristics. The modality may complement clinical evaluation for donor grading, selection, and preparation.
Central retinal artery occlusion after vaccination with whole virion inactivated SARSCoV- 2 vaccine Covaxin
Authors: Thakar Meenakshi , Bhattacharya Shruti
Published: October 2022

Coronavirus disease 2019 (COVID-19) vaccinations have been associated with a higher risk of thromboembolic events. There have been no reports of central retinal artery occlusion (CRAO) after vaccination with the indigenously developed Covaxin, and worldwide, there has been only one such isolated case after administration of the AstraZeneca vaccine. We report a case of a 44-year-old healthy man who presented with sudden painless vision loss in his left eye 10 days after receiving Covaxin. His best-corrected visual acuity was minimal perception of light, with a relative afferent pupillary defect. Fundus examination revealed arterial attenuation and macular cherry red spot, suggesting an acute CRAO. Optical coherence tomography showed macular swelling and disorganization of the inner layers due to ischemic sequelae. Blood work was normal and cardiovascular examination was unremarkable. The patient was kept on follow-up. To our knowledge, this is the first case of an isolated CRAO after Covaxin administration, but further studies are needed to evaluate this potential association.
Irrational ophthalmic fixed-dose combinations for dry eye syndrome
Authors: Kshirsagar Nilima A , Munshi Renuka , Bavdekar Sandeep B , Saxena Rohit
Published: October 2022

Dry eye syndrome (DES) is a common disorder with rising incidence due to increased use of digital devices. While multiple treatment options are available, some are not efficacious or sometimes even safe for use in DES. This is particularly true for Fixed Dose Combinations (FDCs) that may contain ingredients having no rational for their use or may actually be harmful. Various committees appointed by the Government have reviewed several FDCs marketed in India and found some of them to be irrational and recommended for their removal. This paper discusses the contents of some of these FDCs marketed for DES with an aim to ensure that prescribers are mindful of their ingredients and whether there is adequate data about their efficacy and safety and prescribe them only if they consider them necessary for managing the patient.
Do static and dynamic pupillary parameters differ according to childhood, adulthood, and old age? A quantitative study in healthy volunteers
Authors: Yıldırım Biçer Gamze , Zor Kürşad Ramazan , Küçük Erkut
Published: October 2022

Purpose:

We aimed to evaluate the normative pupillometry values and mean pupil dilatation speed in healthy individuals in different age groups in our study.

Methods:

The study group included 180 eyes of 90 healthy volunteers in different age groups. Group 1 consisted of 30 participants between the ages of 6 and 18, group 2 consisted of 30 participants aged 19–40, and group 3 consisted of 30 participants aged 41–75. Scotopic, mesopic, photopic, and dynamic measurements were taken with automatic pupillometry of Sirius Topographer (CSO, Firenze, Italy). The mean pupil dilation speed at the 18th second was calculated according to dynamic measurements.

Results:

Group 1 had a significantly larger pupil diameter than groups 2 and 3 in all static and dynamic parameters, and the mean pupil dilation speed was the highest among the groups (P < 0.001 for all static and dynamic parameters). In addition, group 2 had a significantly larger pupil diameter than group 3 (P < 0.001 for all static and dynamic parameters) and the mean pupil dilation speed was faster than group 3 (P = 0.027).

Conclusion:

We have presented the static and dynamic parameters and the mean speed of pupil dilatation at the 18th second with automatic pupillometry in healthy individuals in childhood, adulthood, and old age. More studies with higher participants and younger age children are needed.
Candida Albicans Sub-Retinal Abscess following COVID-19
Authors: Ramamurthy Srishti , Joseph Joveeta , Dave Vivek Pravin
Published: October 2022

A 42-year-old male post-renal transplantation presented with sudden diminution of vision in the left eye. The right eye was lost following a failed vitreoretinal surgery 5 years ago. The patient had been hospitalized 4 months prior for coronavirus disease 2019 infection with a good recovery. The presenting visual acuity was 20/600 in the right eye and 20/250 in the left eye. Fundus examination revealed a sub-macular sub-retinal abscess in the left eye. Sub-retinal aspiration of the abscess revealed Candida albicans. The patient was managed with repeated intravitreal amphotericin B injections, following which the abscess resolved with scarring and vision improving to 20/60.
Unilateral Purtscher-like retinopathy post-COVID-19
Authors: Shroff Daraius , Kumar Sandeep , Naidu Anushree , Gupta Charu
Published: October 2022

A 32-year-old male with no known systemic illness presented with unilateral Purtscher-like retinopathy in his left eye 2 weeks after recovering from a severe COVID-19 infection. Fundus examination revealed areas of intraretinal whitening and few cotton wool spots. Multimodal imaging findings were consistent with embolic occlusion of capillaries seen in Purtscher-like retinopathy. The case highlights the effect of virus-directed coagulation cascade activation leading to unilateral microvasculopathy in our patient. The case adds to the spectrum of COVID-19 retinopathy and presses that retina screening strategies should be established for patients suffering from or recovering from severe COVID-19 infection.
Scleral cut-down technique of subretinal fluid drainage in scleral buckle surgery for rhegmatogenous retinal detachment
Authors: Varma Shobhit , Mohan Sashwanthi , Ratra Dhanashree , Nadig Ramya R , Kashyap Rengappa
Published: October 2022

Background:

The art of scleral buckle (SB) surgery is being largely forgotten. However, it still remains a good option for selected cases of rhegmatogenous retinal detachment. Drainage of subretinal fluid (SRF) is one of the most crucial steps of the surgery. When performed correctly, it gives the advantage of immediate retinal reattachment, and it hastens recovery. However, it has its own set of complications.

Purpose:

To demonstrate, step by step, the scleral cut-down technique of SRF drainage in SB surgery for rhegmatogenous retinal detachment (RRD) and to discuss its indications, contraindications, and complications.

Synopsis:

Longstanding RRDs with bullous detachments, old age, inferior breaks, or multiple breaks are indications of SRF drainage. In shallow RDs or young patients, a non-drainage procedure may be preferred. It is safer to drain at the bed of the buckle. After the sclera is cut and dissected, it is essential to inspect the choroid for the presence of large vessels. Choroidal vessels are avoided from getting injured while perforating. The release of pigments indicates the end of the drainage. Various possible complications can be prevented by being careful in the surgical technique.

Highlights:

Diagrammatic illustrations explain the steps of the surgical technique. Intraoperative complications have been explained in an easy-to-understand manner with tips to manage such conditions and their prevention. The video highlights the correct way of performing SRF drainage.

Online Video Link:

https://youtu.be/L0TrdkCwk20

Key words: Scleral buckle, scleral cut-down technique, sub-retinal fluid drainage
When the savior becomes a demon: Silicon oil synechia-induced glaucoma
Authors: Agarwal Amar , Narang Priya , Narang Rhea
Published: October 2022

Background:

Silicon oil is an important adjunct for achieving internal tamponade in the treatment of retinal detachment. Silicone oil tamponade often leads to narrowing of the angle and development of adhesions between the iris and anterior chamber angle structures, with consequential elevation of the intraocular pressure. The video showcases the management of these challenging scenarios.

Purpose:

To highlight the management of early synechial closures due to silicon oil tamponade.

Synopsis:

The video highlights the management of early synechial closure following silicon oil tamponade. Surgical pupilloplasty has been demonstrated to break the peripheral anterior synechias on intraoperative gonioscopy as well as on anterior segment optical coherence tomography (AS-OCT). Performing pupilloplasty in the early phase of development of peripheral anterior synechias (PAS) helps to break the existing synechias and prevent angle closure and sequential deterioration of vision.

Highlights:

Surgical pupilloplasty helps to relieve the post silicon oil-induced secondary angle closure glaucoma by breaking the peripheral anterior synechias and significantly opening the anterior chamber angles.

Online Video Link:

https://youtu.be/xe2NGlhPBF4

Key words: Angle Closure Glaucoma, glaucoma, retinal detachment, silicon oil, PAS, peripheral anterior synechias, pupilloplasty
Clinical characteristics in the misdiagnosis of cytomegalovirus retinitis: A retrospective analysis of eight patients
Authors: Du Kui-Fang , Huang Xiao-Jie , Chen Chao , Kong Wen-Jun , Xie Lian-Yong , Wei Wen-Bin
Published: October 2022

Purpose

To highlight characteristics in the misdiagnosis of cytomegalovirus retinitis (CMVR).

Methods

Misdiagnosed cases related to CMVR were analyzed retrospectively at the Department of Ophthalmology, Beijing Youan Hospital, from July 2017 to October 2019. The medical records were reviewed by two independent senior ophthalmologists and the patients’ clinical characteristics were analyzed.

Results

Eight patients (16 eyes) were identified with misdiagnoses related to CMVR. Six of the patients with CMVR were previously unaware of their human immunodeficiency virus (HIV) infection; one patient with CMVR concealed their history of HIV infection. The cases were initially misdiagnosed as diabetic retinopathy (1/7, 14.3%), branch retinal vein occlusion (1/7, 14.3%), ischemic optic neuropathy (1/7, 14.3%), Behçet’s disease (1/7, 14.3%), iridocyclitis (2/7, 28.6%), and progressive outer retinal necrosis (1/7, 14.3%). One patient with binocular renal retinopathy and chronic renal insufficiency was misdiagnosed with CMVR. Four eyes (4/16, 25%) presented with pan-retinal involvement. Fourteen eyes (14/16, 87.5%) had optic disc or macular area involvement. At the final diagnosis, one patient was blind, and two patients had low vision. Seven AIDS patients showed an extremely low level of CD4+ T lymphocytes (median of 5 cells/ml; range 1–9 cells/ml).

Conclusion

CMVR may be misdiagnosed in the absence of known immune suppression. CMVR and HIV screening cannot be overlooked if a young male patient presents with yellowish-white retinal lesions. These misdiagnosed patients had severe retinitis associated with poor vision.
Retinal venous occlusion in a child following Corbevax COVID-19 vaccination
Authors: Nangia Purna , Prakash V Jaya , Dutta Majumder Parthopratim
Published: October 2022

A 13-year-old boy developed painless diminution of vision in left eye 15 days after taking first dose of coronavirus disease 2019 (COVID-19) vaccine (Corbevax). Fundus and fluorescein angiography revealed central retinal vein occlusion in the left eye. Blood investigations were noncontributory. He was administered three doses of pulse corticosteroids followed by a tapering dose of oral corticosteroids. Retinal vascular occlusion can occur following COVID-19 vaccination in children, and early and aggressive systemic anti-inflammatory therapy can be helpful.
Relationship between refractive outcomes and quantitative retinal vascularization and severity of plus disease in eyes treated with intravitreal bevacizumab
Authors: Bayramoglu Sadik Etka , Sayin Nihat
Published: October 2022

Purpose:

The study aimed to investigate the relationship between refractive outcomes with the extent of retinal vascularization and severity of the plus disease in infants treated with intravitreal bevacizumab (IVB).

Methods:

Pre-IVB fundus images (PFIs), final fundus images (FFIs), and refractive outcomes of the 93 infants who underwent IVB monotherapy for type 1 and aggressive retinopathy of prematurity (A-ROP) were retrospectively evaluated. Quantitative measurements were performed on PFIs and FFIs. Pre-IVB plus severity was scored on a five-leveled scale. Correlation between spherical equivalent (SE) with pre-treatment and final extent of the temporal retinal vascularization and pre-treatment severity of plus disease was analyzed.

Results:

There was a linear and low positive correlation between the extent of pre-IVB and final temporal retinal vascularization with final SE (p = 0.000, r = 0.267; P = 0.002, r = 0.274, respectively). There was a low negative correlation between the pre-IVB plus severity score with final SE (p = 0.012, r = -0.192). Gestational age (GA), birth weight (BW), IVB dose, presence of additional IVB, or laser treatments were not correlated with refractive outcome. Out of 171 eyes, 38 eyes had >1 D myopia. In the univariate logistic analyses, pre-IVB retinal zone and pre-IVB and final extent of the temporal retinal vascularization were found to be related to the development of >1 D myopia (p = 0.002, odds ratio (OR) = 0.298; P = 0.000, OR = 0.281; P = 0.001, OR = 0.317; respectively).

Conclusion:

Our study indicates that the pre-treatment and final extent of retinal vascularization were the main parameters that were related to final refractive outcomes in IVB-treated eyes for type 1 and A-ROP.
An insight into the altered ophthalmic dynamics during the COVID-19 pandemic
Authors: Kaushik Jaya , Riyaz Eram , Chaitanya YVK , Nair Renu , Kumar Ashok , Singh Ankita , Parihar JKS , Srikant S , Shetty Rakesh
Published: October 2022

Purpose

The objective of this survey-based study was to examine the effects of personal protective measures taken at the level of instrument and surgeon during the pandemic on the optics in ophthalmology.

Methods

The study involved an online questionnaire of 24 questions which was distributed to ophthalmologists practicing in several hospitals, including residents and fellows undergoing training in ophthalmology in India. The responses were collected through an online data collection tool (Google forms). The participants could choose from multiple options provided to them in each question.

Results

A total of 285 participants out of 296 had used modified methods for examining and performing surgical procedures during the pandemic, while 78.7% (265) of the participants acknowledged having encountered difficulty in interpreting the ocular findings of patients while examining in personal protective equipment. Moreover, 58.7% (198) of our study respondents also reported that there was significant worsening of the quality of ophthalmological examination with pandemic-appropriate measures and 84.8% (286) of our study participants also felt that these measures have significantly added to the time of examination, hence increasing the risk of exposure to both patient and doctor.

Conclusion

The workplace study has highlighted the crucial aspects of optics in ophthalmology during the pandemic. The protective measures taken during the pandemic have significantly worsened the quality of ophthalmological examination and increased the time taken to perform outpatient department-based and surgical procedures in ophthalmology.
Evaluation of ocular pulse amplitude changes after the retinal detachment repair
Authors: Jeremic Miroslav , Kovacevic Igor , Vasilijevic Jelena , Kalezic Tanja , Bozic Marija
Published: October 2022

Purpose

The study was conducted to determine the ocular pulse amplitude (OPA) changes, measured with a dynamic contour tonometer (DCT), after surgical retinal detachment repair.

Methods

This was a prospective and comparative study. Thirty patients (30 eyes) who had undergone uncomplicated unilateral scleral buckling and encircling procedures for quadrant or half-retinal rhegmatogenous retinal detachment were referred for DCT one day before the surgery was performed, on the 1st, 7th, and 30th postoperative day. Methods of descriptive (arithmetical mean, standard deviation) and analytical statistics (analysis of variance) were used to analyze the data and evaluate the significance of the difference. A value of P less than 0.05 was considered statistically significant. The data were evaluated for normality with the single-sample Kolmogorov–Smirnov test.

Results

OPA values decreased significantly after scleral buckling procedures (p < 0.0001), but regained near to preoperative values one month after the surgery.

Conclusion

OPA tends to decrease after retinal detachment surgery. Restoring patients’ vision with scleral buckling and encircling procedures gives early changes in blood supply to the choroid and ocular nerve, and since OPA is an indirect parameter of choroidal vascularization, measuring these values can help make an insight into ocular hemodynamics.
Implementing competency-based medical education in post-graduate ophthalmology training: Understanding key concepts and methodologies and overcoming challenges
Authors: Sud Rouli , Khanduja Sumeet
Published: October 2022

The National Medical Council (NMC) has mandated that all post-graduate training shall be competency-based, following the principles of Competency. Based Medical Education (CBME). This aims to serve the dual purpose of standardizing ophthalmology post-graduate training and to overcome the shortcomings of the traditional curriculum by employing innovative and interactive teaching–learning and assessment techniques to produce competent ophthalmologists well equipped with clinical, surgical, and professional skills relevant to current times. CBME marks a paradigm shift from traditional curriculum methodologies and involves the introduction of several new concepts. This article aims to highlight the key principles of CBME and the various teaching–learning and assessment technique methodologies which can be employed for post-graduate training. It also highlights the various challenges that are likely to be faced in its implementation and measures to overcome them.
Comparison of measurements between manual and automated eyetracking systems in patients with strabismus – A preliminary study
Authors: Rajendran Janani , Rai Kshama , Shetty Shashikant , Mathangi V
Published: October 2022

Purpose:

The main objective is to test the measurements made by an automated eye-tracking system in the presence of strabismus and to compare the data with manual measurements of deviation.

Methods:

A prospective observational cross-sectional masked double-blinded study was conducted in a tertiary eye care center with 39 participants included in our study, aged 3–41 years. Initial screening of all participants was performed by an ophthalmologist. Ocular deviations were evaluated and compared between manual measurements and an automated eye-tracking system. The device is based on eye-tracking technology. The participants had either a congenital or acquired type of manifest or latent strabismus. Children less than 3 years of age, visual acuity <6/36, and abnormal configuration of the anterior segment were excluded from the study.

Results:

The prism alternate cover test (PACT) manual measurements and the automated alternate cover test for measuring horizontal deviation, the manual measurement, and the automated eye track system showed a highly positive correlation (r = 0.932, P < 0.001). The Bland Altman plot analysis shows good agreement between the two measurements, with the mean difference between the two measurements being 1.55 PD, and the 95% limit of agreement was ± 10 PD.

Conclusion:

The results obtained with an automated eye-tracking system correlate well with manual strabismus measurements with PACT in terms of diagnosis, precision, and accuracy, with an added benefit of lesser time consumption in performing the test in cooperative/motivated patients. Considering these aspects, patients above the age of 3 years could be assessed with the equipment.
Prospective evaluation of wipe-out after glaucoma filtration surgery in eyes with split fixation
Authors: Bhadra Tania Ray , Ghosh Rudra Prosad , Saurabh Kumar , Mitra Ankita , Ghosh Asim Kumar , Bhadra Tanmoy
Published: October 2022

Purpose:

To assess the incidence and cause of idiopathic, irreversible loss of vision (“wipe-out”) in the early post-operative period after glaucoma-filtration surgery in advanced glaucoma.

Methods:

It was a prospective, interventional cohort study. Patients with advanced glaucoma and macular split fixation underwent either only trabeculectomy (group A) or combined phaco-emulsification with trabeculectomy (group B). The incidence and cause of visual loss, changes in intra-ocular pressure, visual acuity, and visual field indices during 2 months post surgery were assessed.

Results:

Thirty patients (30 eyes) were divided in two groups. No significant difference was noted between the pre-operative and post-operative mean deviations in both groups (P = 0.41, P = 0.65). Two eyes in group A and one eye in group B had visual loss of two lines or more at the end of 2 months because of cataract and choroidal detachment. None of the eyes showed “wipe-out”.

Conclusion:

“Wipe-out” is a rare phenomenon after surgery in advanced glaucoma.
Ophthalmology as a career choice among medical students in Eastern India – A cross-sectional study
Authors: Parija Sucheta , Gupta Ashna , Nayak Saurav , Banerjee Aparajita , Poddar Chanchal
Published: October 2022

Purpose:

Several factors influence medical students to choose a specialty branch for post-graduate training, and it is important to understand them so that strategies can be made to make it more attractive and hence the shortage in the workforce can be addressed. This study aimed to identify the factors that influenced under-graduate medical students to choose ophthalmology as their specialty for post-graduate training.

Methods

It was a descriptive, cross-sectional, questionnaire-based study, carried out among medical students at a tertiary academic institute in eastern India. In this survey tool, 25 questions were divided into different sections: demographic data, factors influencing the choice and perceptions about ophthalmology as a career option, and the impact of rotatory internship posting on the choice of subject. The various factors were then scored and indexed appropriately.

Results

There were 515 participants. The median age was 23 years. The major influencing factor for choosing ophthalmology was “adequate time” (52.04%), and the discouraging factor was “steep learning curve” (58.64%). Age had an odds ratio of 0.781, showing that the lower the age, the higher the chances of being positively inclined toward ophthalmology as a career choice. Similarly, major deciding factors, perceptions, and experiences in ophthalmology had odds ratios of 1.841, 1.725, and 2.057, respectively, showing a positive inclination.

Conclusion

The study states that a steep learning curve, personal attitudes, and misconceptions may dissuade the students from taking this subject, but adequate clinical exposure and experience, as well as role models during the internship, can create a positive impact on career choice.