bluuebunny/crossref_metadata_2025 huggingface dataset:
Red cell alloimmunization in multitransfused hepatobiliary patients at hospital Selayang
Authors: Nahendran Prasanthini , Budin Siti Balkis , Saat Nur Zakiah Mohd , Yusop Mohd Faeiz , Yazid Tengku Norita Tengku , Anuar Nur Najmi Mohamad
Published: December 2024

BACKGROUND:

Transfusion support is vital for the management of patients with hepatobiliary disease. Repeated blood transfusions increase the risk of alloimmunization, i.e., the development of alloantibodies, which might lead to difficulties in blood crossmatching.

AIMS:

This study aims to: (1) determine the incidence of red blood cell (RBC) alloimmunization and (2) evaluate the associations between antibody development and demographic factors among hepatobiliary patients.

METHOD:

ABO blood grouping, antibody screening, antibody identification and crossmatch were done on all patients samples included in the study.

SETTINGS AND DESIGN:

A cross-sectional study was conducted from February 2021 to September 2021, with a total of 132 samples from hepatobiliary patients. The relationships between RBC alloimmunization in transfused hepatobiliary patients and demographic factors (gender, age, and history of transfusion) were assessed by binary logistic regression.

RESULTS:

Overall, 67.4% of the patients developed alloimmunization. The majority had a single alloantibody (75.2%) and the most frequently identified antibody specificities were anti-E (37.6%), anti-c (12.8%), anti-Mia (14.4%), and anti-Kidd (11.2%). The predominant antibodies were those against the Rh system (58.4%). Female patients recorded the highest incidence of alloimmunization (69.8%). Female patients also demonstrated a higher tendency to produce both anti-E + anti-c than male patients.

CONCLUSION:

The prevalence of RBC alloimmunization is high among hepatobiliary patients and it may cause complications requiring multiple transfusions. The number of transfused packed cells has been clearly shown to be proportionally significant with the risk for alloimmunization in hepatobiliary patients. Hence, this study highlights the importance of immunohematology tests before blood transfusion.
Implantation Cyst – A Rare Occurrence after Strabismus Surgery
Authors: Vankireddi Mahathi , Katta Divya Bhargavi , Yerra Sowjanya
Published: December 2024

A conjunctival epithelial cyst is a rare occurrence poststrabismus surgery, with incidence ranging from 0.25% to 0.4%. This can occur when the conjunctival wound is not closed meticulously. Conjunctival epithelial cells buried beneath the conjunctival surface multiply over time creating a retention cyst. Risk factors include recessions, fornix incisions, and simple apposition of the conjunctival wound without sutures. When left untreated these cysts can enlarge and result in complications such as limitation of ocular movements, proptosis, and compression of ocular structures. This rare occurrence is underreported, and no specific management protocols have been established. Hereby, we present a case of implantation cyst developed after squint surgery. Despite meticulous surgical procedure, a retention cyst developed within 1 month of surgery. Cyst excision in toto with cauterization of the base was performed to avoid any recurrences. This case describes a rare complication of strabismus surgery and its management.
Trial of Steroids in Retinal Assault: A Case Series
Authors: Krishnamoorthy Sharanyaa , Senthamizh Tharini , Vaithiyanathan Vanaja , Kumar M. Ashok
Published: December 2024

Blunt trauma to the eye can present with transient or permanent visual loss. Mere observation might lead to improvement of vision in cases of transient visual loss whereas those with photoreceptor and optic nerve damage, permanent loss of vision is inevitable. Early intervention might be needed in treatable cases to prevent such morbidity. We present two cases of blunt trauma, one with Sub macular haemorrhage (SMH) and the other with Commotio retinae(CR) with myopic shift. First case presented with SMH following stick injury in Left eye with VA of 5/60. He was given a trial of intravitreal anti-VEGF & topical steroids. Second one presented with CR with myopic shift following cricket ball injury with VA of 4/60, treated with intra-venous Methyl Prednisolone for three days followed by oral prednisolone. Both patients showed rapid visual improvement within a week. Non-surgical interventions like intravitreal anti-VEGF and steroids are alternative option for faster recovery and prevention of complications.
Oculodentodigital Dysplasia
Authors: Sahu Sumit Kumar
Published: December 2024

Oculodentodigital dysplasia is a rare genetic disorder caused by mutation in gap junction alpha gene that encodes connexin 43 protein. It has been diagnosed in <300 people worldwide, and the incidence is 1 in 10 million populations. It is a multisystem disorder, affects many parts of the body, particularly eye (oculo), teeth (dental), fingers, and toe (digital), and less commonly involves skin appendages, brain, and spinal cord. Early recognition can prevent blindness, dental problems, and learning disabilities, and management is multidisciplinary.
Idiopathic Hypertrophic Pachymeningitis Presenting with Unilateral Diminution of Vision and Papilloedema
Authors: Namrata  , Ranjan Rahul Sidheshwar , Agarwal Ruchika , Singh Anil Kumar , Varun Kumar
Published: December 2024

Idiopathic hypertrophic pachymeningitis (IHP) is a rare condition characterized by a chronic fibrosing inflammatory process usually involving either the intracranial or spinal dura matter and rarely both. Neurological symptoms are mostly nonspecific. Patients commonly present with long-standing headache and/or progressive neurologic deficits, multiple cranial nerve palsies or blindness. In this case report, we present a case of IHP in a 19-year-old male with unilateral diminution of vision and papilledema due to the involvement of intracranial duramater.
A Clinical Study of Isolated Third, Fourth, and Sixth Cranial Nerve Palsy at a Tertiary Eye Care Center
Authors: Agrawal Smriti , Karanam Sairani , Vanikireddi Mahathi , Kakumanu Anuradha , Katta Divya Bhargavi
Published: December 2024

Aim:

To study the clinical profile and etiology of isolated third, fourth, and sixth cranial nerve palsy at a tertiary eye care center.

Objectives:

To study the clinical profile, risk factors, etiology, recovery rate, and role of neuroimaging in the diagnosis of isolated third, fourth, and sixth ocular cranial nerve palsy.

Methodology:

It is a hospital-based, prospective, observational study from November 2020 to March 2022.

Statistical Analysis Used:

The analysis was done using the descriptive statistics. The Chi-square test/Fisher’s exact tests were used to assess the differences between the categorical variables. P < 0.05 was considered statistically significant. A statistical package SPSS version 23.0 was used to do the analysis.

Results:

A total of 37 patients were studied. The mean age of onset was 49.46 ± 17.59 years. The most common cranial nerve palsy was the 6th cranial nerve constituting 54.05% of cases. The most common risk factor was vasculopathic constituting 70.27% of cases. The most common etiology was microvascular ischemia constituting 67.56% of cases. 57.58% of patients showed partial recovery, 24.24% of patients showed full recovery, and 18.2% of cases showed no recovery at 3 months’ follow-up.

Conclusion:

In our study, we found that early neuroimaging has a role in the diagnosis, evaluation, and treatment of patients and should be done in all patients presenting with acute ocular motor nerve palsy. The most common etiology seen in our study was microvascular ischemia. Eighty-one percent of patients showed partial or full recovery within 3 months. 88.88% of patients with ischemia or infarct showed full or partial recovery within 3 months.
Correlate Ocular Surface Disease Index with Convergence Insufficiency Symptom Score Among Optometry Students
Authors: Mehta Niravkumar , Desai Rupam , Ajudiya Jainisha
Published: December 2024

Background:

With the increasing prevalence of digital gadget usage, there has been a noticeable impact on ocular health, including conditions such as dry eye attributed to prolonged digital device use and issues related to binocularity or convergence insufficiency. The objective of our research was to conduct a comparative analysis and correlate between scores obtained from the ocular surface disease index (OSDI) and the convergence insufficiency symptom score (CISS).

Methods:

This study was a prospective, cross-sectional, quantitative approach through a questionnaire-based study conducted in various optometry institutes from August 2022 to May 2023. The participants comprised students from optometry colleges in Gujarat, with a total of 329 individuals included in the study. Two validated questionnaires, namely the OSDI and the convergence insufficiency symptoms score (CISS), were administered. Data collection utilized a Digital Google form. Subsequently, groups were formed based on digital usage, CISS symptom scores, and OSDI scores.

Results:

Among the total of 329 participants, 31% were male, and 69% were female, with a mean age of 20.26 ± 1.86. The average duration of digital device usage was 4.08 ± 1.95 h. The overall OSDI score was 17.72 ± 17.04, and the CISS score was 11.23 ± 11.27. The study identified a significant and positive correlation between OSDI and CISS scores (r = 0.719, P < 0.01). The one-way analysis of variance indicated a notable increase in OSDI scores corresponding to CISS scores, F (3, 325) = 71.45, P < 0.05. On the normal ocular surface, the mean CISS score was 5.54 ± 6.57, while on the mild OSDI score, it was 11.16 ± 8.89, on the moderate OSDI score, it was 17.51 ± 9.26, and on the severe OSDI score, it was 24.96 ± 13.66.

Conclusion:

We conclude that OSDI and CISS questionnaire is simple, efficient, and affordable treatment for screening. The study concludes there is increase in CISS score with severe OSDI score or vice versa. The current study suggests evaluating both dry eye and binocular vision assessment where students use digital usage for more than 3 h. Awareness campaign to be carried out on limited use of digital devices.
Relevance of Tissue Glue in Cornea Practice
Authors: Jain Pooja , Jain Parul , Nair Zakhara Moh M.R , Murthy Vinay R. , Matada Roopashri
Published: December 2024

Suturing is not only time-consuming but is associated with complications such as infection, irritation of ocular tissues, and suture granulomas. To circumvent these complications, the use of tissue glues is advocated in select corneal and ocular surface conditions. Two types of tissue glues, synthetic (cyanoacrylate derivatives) and biological (fibrin-based derivatives) are presently available. Cyanoacrylate derivatives have high tensile strength and antibacterial properties and are primarily used to seal small corneal perforations. They are nonbiodegradable, induce inflammatory reaction and neovascularization if left in
situ, and are toxic to endothelium and iris. The fibrin-based derivatives on the other hand have low tensile strength, induce minimal inflammation, and are biodegradable. The latter are nontoxic and are well tolerated by ocular tissue but carry a risk of viral transmission. In this review, we discuss in detail the types of tissue glues, their mechanism of action, indications in cornea practice, and newer alternatives.
Demystifying Corneal Examination: A Guide for Post Graduates
Authors: Hariani Avani , Gupta Isha , Jain Parul
Published: December 2024

It is said that to study the phenomena of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all. Anterior segment examination may appear to be easy at the outset to a post graduate, however it is more intriguing than it seems. To arrive at differentials based on age old examination techniques without the ancillary investigations is a skill that can be acquired by practice. This article aims to briefly describe the basic examination skills that are required for during post-graduation.
Oculoplasty Evaluation for Postgraduates
Authors: Thomas Rwituja , Vaishya Aman
Published: December 2024

Clinical examination and evaluation of Oculoplastics patients as a postgraduate can be daunting, either due to a paucity of patients with oculoplastic conditions or lack of exposure to the sub-specialty. This article aims to concisely provide an examination template for post-graduates along with clinical images of examination findings and techniques, in order to simplify this process. We have divided the evaluation into proptosis, eyelids, lacrimal, trauma, socket and ocular surface examination.
Cutting-Edge Care: Innovative Approaches to Cataract Surgery Counseling
Authors: Wagh Akshay , Tagare Shivraj , Upadhaya Swati , Venkatesh Rengaraj
Published: December 2024

Counselling is an essential part of patient care, especially during the post-operative period, which can be challenging for patients. Cataract surgery patients require adequate counselling to understand the post-operative instructions, medications, and potential complications. However, one-on-one counselling can be time-consuming, especially in high-volume centers. To address this issue, a new approach called “Coffee with Counselling” has been introduced, which involves daily group counselling sessions for patients who have undergone surgery and their caregivers. The sessions include a 4-minute video that explains post-operative advice and instructions, displayed on a TV monitor while patients can drink coffee. After the video, a sister explains post-operative medications, and patients can ask questions and clear their doubts. The approach has several advantages over one-on-one counselling, including reduced counselling time, patients’ ability to ask questions in a group setting, creating a sense of community, and allowing family members to understand post-operative instructions and medications. The Coffee with Counselling approach is an innovative and practical way to provide patients with the necessary information and support during their recovery in a group setting. Healthcare professionals should consider adopting this approach to improve patient care and support.
Clinical Profile of Patients with Nonglaucomatous Optic Atrophy
Authors: Verma Nakul , Tuli Rajeev , Sharma Gaurav , Bhardwaj Amit
Published: December 2024

Aim:

The aim of the study was to study the clinical profile of patients with nonglaucomatous optic atrophy (OA).

Materials and Methods:

This study was a cross-sectional study conducted in a tertiary care center. The study duration was 1 year. Forty-one subjects presenting with nonglaucomatous OA were studied.

Results:

Eighty-two eyes of 41 subjects were studied. Sixty-three eyes were detected to have OA. The most common cause of OA was found to be trauma (17.1%). The other causes were, raised intracranial tension (14.6%), vascular causes (14.6%), intracranial space-occupying lesions (14.6%), optic neuritis (7.3%), orbital lesions (4.9%), hereditary causes (4.9%), radiation (2.4%), drug toxicity (2.4%), snake bite (2.4%), and postinfectious (2.4%). Etiology could not be detected in 12.2% of the cases. Average retinal nerve fiber layer thickness and central macular thickness of the eyes with OA were 69.3 µm (69.3 ± 16.0) and 229.5 µm (229.5 ± 27.8), respectively.

Conclusion:

Visual disability due to OA is not uncommon. Varied etiologies for OA have been observed in this study.
The Role of Pedigree Charting and Analysis in Ophthalmology
Authors: Ratna Ria , Tibrewal Shailja
Published: December 2024

In the age of fast-evolving medicine, as we understand disease pathology and the role of genetic mutations in causation more clearly, advancement in treatment methodologies such as gene therapy is gaining pace. Most eye disorders, especially in the pediatric population are attributable to a genetic etiology. In the current scenario, apart from the clinical assessment and management, an ophthalmologist is expected to provide genetic counseling and appropriate testing for the above. This includes the provision of an accurate diagnosis, prognostication of the course of the disease, estimating the risk to the family members, and outlining the systemic implications if any. However, to understand the genetic etiology of any disorder, careful analysis of generations of family history, their medical records, and deducing patterns of inheritance called “pedigree analysis” remains at the core of these discoveries. Although genetic disorders account for most of the diseases encountered in ophthalmic practice, the familial inheritance pattern is seldom sought. This article aims to deliver a basic introduction to pedigree charting and analysis with specific examples in ophthalmology. It sheds light on the symbols used to create a pedigree chart and step-by-step instructions for its construction. It also aims to teach the art of deducing inheritance patterns with important tips and tricks for easy interpretation. Nonspecific and atypical pedigrees that are hard to deduce have also been discussed while highlighting various advantages and shortcoming of using this method.
Impact of Coronavirus-2019 Pandemic on Medical Graduates Posted in Coronavirus-2019 Care Facility in India
Authors: Singh Kirti , Shrivastava Shraddha Raj , Sahay Pranita , Singh Arshi , Barmi Bhavna , Gupta Diksha , Frank Arthur L. , Arora Ritu
Published: December 2024

Objective:

The aim of the study was to assess the professional impact of coronavirus-2019 (COVID-19) pandemic on medical graduates of India.

Methods:

An online questionnaire-based cross-sectional study was conducted among final-year medical students and interns providing COVID-19 care during the pandemic. The psychological impact of the pandemic and its influence on career choices was assessed.

Results:

The response rate was 40.9% (676/1650). The majority (67.3%) of participants wished to continue in the medical field and 87% to join a clinical specialty postgraduation. The common factors for stress were due to changes in teaching pattern to virtual classes (66%) and risk of acquiring and transmitting infection to their family (50%). Positive coping ability was noted in 93%, with 62% willing to serve as front-line warriors.

Conclusion:

Final-year medical students and interns contributing to COVID-19 care had stress due to virtual teaching patterns and premature exposure to traumatic clinical scenarios. Good coping ability documented high resilience in the medical graduates.
Artifacts in Visual Fields
Authors: Sharma Anugya , Garg Prerna , Goel Priyasha , Dubey Suneeta , Gandhi Monica , Pegu Julie
Published: December 2024

Visual field (VF) examination, as is well known, forms the key stone of management in glaucoma. However, this modality of investigation is not free of errors and artifacts. These artifacts may be patient dependent or maybe dependent on the perimetrist conducting the test. These artifacts are commonly seen in day-to-day clinical practice and lack of familiarity with these errors may lead to misdiagnosis or incorrect staging of the disease, thereby significantly impacting patient management. This highlights the importance of awareness of these artifacts while reading a VF print out. With this article, we aim to describe the common VF artifacts seen in clinical practice with examples.
Analysis of Retinal Nerve Fiber Layer Thickness in Glaucoma Suspects and Glaucoma by Spectral Domain Optical Coherence Tomography and its Correlation with Visual Field Parameters
Authors: Chanekar Samruddhi N. , Usgaonkar Ugam P. S. , Akarkar Shekhar O.
Published: December 2024

Purpose:

The purpose of the study was to quantitatively assess the retinal nerve fiber layer (RNFL) using spectral-domain optical coherence tomography (SD-OCT) and compare with standard automated perimetry in eyes with primary open-angle glaucoma patients and glaucoma suspects.

Materials and Methods:

RNFL thickness measurement by SD-OCT and visual fields (VFs) parameters assessment was done in 160 eyes of 80 patients who were divided into three categories as 80 glaucomatous eyes, 40 glaucoma suspects, and 40 age- and gender-matched normal controls. RNFL thickness values were analyzed and compared with perimetric results. One-way analysis of variance was used for the mean comparison analysis between the groups. The relationship between VF parameters and the average RNFL thickness was analyzed with the help of receiver operating characteristic curves.

Results:

The mean average RNFL thickness in normal controls, glaucoma suspects, and glaucoma patients was 101.58 ± 5.24, 92.35 ± 5.56, and 79.00 ± 7.97 μ, respectively (P < 0.001). There was a direct significant correlationship between average RNFL thickness and VF parameters of mean deviation and pattern standard deviation in glaucoma suspects and glaucoma patients. There was a significant association between average RNFL thickness and VF defects associated with glaucoma in glaucoma patients’ group.

Conclusion:

Patients with glaucoma had significantly lower RNFL quadrant measurements when compared with glaucoma suspects and normal controls. Analysis of RNFL is an excellent means for the early diagnosis of glaucoma and also aids in monitoring the progression of disease.
Role of Optical Coherence Tomography-angiography in Diagnosis and Monitoring Activity of Macular Telangiectasia-associated Choroidal Neovascular Membrane
Authors: Quraishi Mohd Azaz , Shenoy Pratik , Pirdankar Onkar H. , Nene Amit S. , Badole Pushpanjali , Shah Smitesh
Published: December 2024

We report the case of a 62-year-old female diagnosed with Type 2A, Stage 5 macular telangiectasia (MacTel). The right eye showed a scarred choroidal neovascular membrane (CNVM) while the left eye had an active CNVM, confirmed with optical coherence tomography-angiography (OCT-A). She was treated with three doses of monthly intravitreal ziv-aflibercept in the left eye. Sequential OCT-A of the left eye showed regression of the neovascular complex with an improvement in visual acuity. OCT-A can be a useful imaging modality in the diagnosis and monitoring in cases of MacTel with CNVM.
Clinical Profile and Management of Neovascular Glaucoma in North India
Authors: Rajurkar Ketaki , Dubey Suneeta , Gandhi Monica , Gurav Prachi , Pegu Julie
Published: December 2024

Purpose:

To report the etiology, clinical features, treatment and outcomes of neovascular glaucoma (NVG) in a tertiary care ophthalmic center.

Background:

NVG is a devastating ocular disease often leading to loss of vision. The current standard of care includes retinal phtocoagulation and control of increased intraocular pressure with medical and surgical therapy like trabeculectomy, Ahmed Glaucoma Valve (AGV) and Trans scleral cyclophotocoagulation (TSCPC) with studies comparing them showing varied results. We compared these treatment modalities to find out which is better for IOP control.

Methods:

Retrospective file review.

Results:

230 eyes of 217 patients with NVG were studied. Mean age of the population was 56.99 ± 13.8 years. Venous occlusion (37.4%) was the commonest cause of NVG followed by diabetic retinopathy (35.2%). All the patients were managed medically to begin with. Ninety one patients underwent surgical management. Pan retinal photocoagulation was done for 68.75% patients. Anti- vascular endothelial growth factor (VEGF) was given intravitreally for 56.25% patients prior to surgery. Thirty six patients underwent trabeculectomy with Mitomycin C (MMC), eleven patients underwent AGV implantation and thirty three underwent TSCPC. Best corrected visual acuity at baseline was 2.24 ± 0.99. Final visual acuity was 2.67 ± 1.1. Best corrected visual acuity (BCVA) was either stable or improved from baseline in 46.25% patients and deteriorated in 53.5%. All three modalities were equally effective in reducing IOP from baseline (p = 0.00) and there was no statistically significant difference between them taking IOP into consideration as success criteria (p = 0.60). Hyphaema was the commonest complication (22.5%).

Conclusion:

Venous occlusion was the commonest cause of NVG in our setup. All three modalities of treatment, AGV, trabeculectomy with MMC and TSCPC are effective in controlling the disease process. The visual prognosis however remains poor despite surgical treatment due to late presentation and fast progression.
Micropulse Laser Transscleral Cyclophotocoagulation (MP-TSCPC) for Glaucoma Management: An Overview
Authors: Sehgal Vineet
Published: December 2024

The article describes the efficacy and safety of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in glaucoma patients. It also describes the pearls of doing this technique. The rare side effects, complications, and future challenges in the use of this technology are also discussed.
Managing Extramacular Circumscribed Choroidal Hemangioma with Green Laser and Anti-Vascular Endothelial Growth Factor Injection in Times of the Unavailability of Photodynamic Therapy
Authors: Shah Dhaivat , Agrawal Deepanshu , Gangawar Maradula , Porwal Amit C. , Sukhwal Rini
Published: December 2024

Circumscribed choroidal hemangioma (CCH), an orange–red, well-circumscribed benign neoplasm of choroidal vasculature. Ancillary tests for diagnosis are fundus fluorescein angiography, indocyanine green angiography, optical coherence tomography (OCT), OCT angiography, and ultrasound or magnetic resonance imaging. It is usually associated with cystoid macular edema, subretinal fluid (SRF), subretinal fibrosis, or retinoschisis. Choroidal hemangioma needs treatment, when it is associated with visual symptoms and exudative retinal detachment. Photodynamic therapy is the first-line treatment, but currently, there is an unavailability of verteporfin dye. We are reporting an interesting case of a 37-year-old male diagnosed with CCH at our center, who presented with significant visual symptoms due to associated SRF at the macula. He was managed with high-duration low-power green laser photocoagulation and anti-vascular endothelial growth factor injection yielding to the resolution of SRF and an improvement in visual outcome.
Subluxation: The Mother of Innovation: A Literature Review
Authors: Raina Nupur , Goel Madhav , Goel Sonu , Priya Nidhi
Published: December 2024

Partial displacement of the lens from its normal anatomical position, while remaining within the pupillary area, is called subluxation. It can be spontaneous, or can be caused due to certain heritable diseases, trauma and during surgery. Mild- to moderate subluxations can be managed conservatively, however severe subluxations need surgical intervention. The various options available include capsule tension ring and its modifications, capsule tension segments, capsular hooks and capsule anchoring devices. In this article, we aim not only to review the previously available techniques, but also present a novel new technique to manage these cases, called the “Lasso technique”.
Newer Nuances in Orbital Surgery
Authors: Bhattacharjee Kasturi , Venkatraman Vatsalya
Published: December 2024

Purpose:

This article comprehensively compiles the latest technological and surgical advances in the realm of orbital surgery and their application in the pre-operative, intraoperative and post-operative periods.

Methods:

A detailed literature research supplemented by a manual search for the functions of image guidance, three-dimensional printing using computer-assisted manufacturing and ultrasonic surgical aspirator in orbital surgery was conducted and the pearls and pitfalls of the aforementioned tools have been enlisted and elaborated.

Results:

Navigation guided orbital surgery has grown to play a pivotal role in various orbital surgeries such as orbital decompression for thyroid eye disease, post-traumatic orbital fracture repair, and reconstruction, orbital tumor resection, optic canal decompression for traumatic optic neuropathy, extraction of orbital foreign body and endoscopic and lacrimal procedures, by offering enhanced surgical precision. Three-dimensional printing smoothens the potholed road to structural and functional orbital restoration post trauma or surgery. Ultrasonic aspirator is a handy addition, which sophisticates bone and soft tissue removal during decompression or tumor debulking and minimizes the drawbacks of its predecessor technologies.

Conclusion:

The role of image guidance, three-dimensional printing and ultrasonic surgical aspirator in orbital surgeries still bears the scope for further investigation and holds the future of digitally advanced surgical operation within the orbit at its helm.
Emerging Innovations in Cataract Surgery
Authors: Kasturi Nirupama , Jacob Ninan , Jossy Ajax , Chakrabarti Arup
Published: December 2024

Cataract surgery is one of the most commonly performed ophthalmic surgeries worldwide and has evolved to improve patient safety and better visual outcomes.1 Several technological innovations include advanced biometry, viscosurgical devices, pupil expansion devices, newer phaco machines, and techniques like Femtosecond laser assistance, intraoperative optical coherence tomography imaging, intraoperative aberrometry, and three-dimensional heads-up visualization paved the way for this new era in cataract surgery. Newer intraocular lenses have emerged to address issues beyond merely refractive status, like accommodation, U.V. protection, and dysphotopsia. This article reviews the emerging innovations in cataract surgery.
Looping Vessels: Misleading Disc Suspicions
Authors: Mamtani Nidhi , Snehi Sagarika , Hingorani-Bang Puja , Iyer Vandana
Published: December 2024

A 58-year-old hypertensive male presented with grade II nuclear sclerosis and grade III hypertensive retinopathy, alongside congenital prepapillary vascular loops in the left eye. Optical coherence tomography (OCT) revealed twisted vessels at the optic nerve head. This case highlights the significance of identifying prepapillary vascular loops, a rare, benign congenital anomaly of the retinal vasculature, often mistaken for other retinal pathologies. These loops typically present asymptomatically and are discovered incidentally. While intervention is not usually necessary, regular follow-ups are essential to monitor for rare complications such as retinal artery occlusion or hemorrhage.
Innovations to Make Glaucoma Surgery Safer
Authors: Singh Kirti
Published: December 2024

The holy grail of a long surviving and safe trabeculectomy is still awaited. Modifications in the conventional trabeculectomy are required to increase the efficacy of the procedure, reduce the complications and minimize the bleb induced discomfort. Three of the innovations successfully used for over a decade are described in this paper, namely modified conjunctival incision, novel manual SICS trabeculectomy scleral incision and use of amniotic membrane as an anti-fibrotic adjunct in trabeculectomy.
Correlation of urinary glutathione S-transferase with serum creatinine in sepsis-induced acute kidney injury: A prospective and observational study
Authors: Kumari Nidhi , Parashar Samiksha , Giri Manoj , Tripathi Manoj , Kumar Virendra , Kumar Suraj
Published: December 2024

Background:

Sepsis-induced acute kidney injury (AKI) is difficult to prevent because most patients are diagnosed after they develop it. Standard serum and urine creatinine levels are insensitive and nonspecific for detecting kidney injury in its early stages. Glutathione S-transferase (GST) has received little attention as a biomarker in AKI.

Methods:

This study included 65 adult patients with sepsis who developed oliguria within 72 h of admission. Baseline serum creatinine values were recorded at least 1 month before or after intensive care unit (ICU) admission. The clinical endpoints were defined as the occurrence of advanced AKI stages 2 or 3 according to the KDIGO classification. Serum creatinine and urinary GST levels were measured every 6 h from admission until 72 h postoliguria development. The primary objective was to assess the correlation between urinary GST and serum creatinine levels in patients with sepsis-induced AKI.

Results:

Among the 65 patients, 13 (20%) progressed to AKI Grade I, while 52 (80%) progressed to AKI Grade II or III. Both groups exhibited an increasing trend in serum creatinine and urinary GST levels up to 72 h. Significant mean differences between the two AKI groups were observed at 48 and 72 h for serum creatinine (P = 0.021 and P = 0.007, respectively) and at 18 h for urinary GST levels (P = 0.044).

Conclusion:

Urinary GST levels demonstrated an earlier elevation than serum creatinine levels in critically ill sepsis patients, underscoring their utility as a valuable tool for the early diagnosis and predicting AKI following admission to the ICU.
A Study on Quantification of the Effects of Heartfulness Meditation Intervention in Healthcare Professionals by Anchor-Based Method in Occupational Health Psychology
Authors: Sharma Deepak B. , Sharma Himanshu
Published: December 2024

Background:

It’s more important to measure the subjective perception of change after undergoing any behavioral or psychological intervention. Global rating of change method—anchor item-based is a method by which the change can be quantified and “minimum subjective perceived effect” (MSPE) can be calculated.

Aim:

The current study was planned to quantify the effects of heartfulness meditation intervention in healthcare professionals by anchor-based method and compare the result with the pre-post-difference.

Methods and Material:

The current study was done using multimethod study design among the healthcare professionals. These were 1. Cross-sectional study design. 2. Quasi-experimental—Solomon four-nonequivalent control group study design for intervention.

Results:

Cohens’ d for perceived stress scale (PSS) in “Much less negative” category was -.96.

Conclusion:

The study highlights the use of anchor-based method to estimate the minimal subjective perceived difference, and it can also be compared with the groups pre-post-difference for academic purposes.
Driving into Diabetes: Risk Assessment among Interstate Truck Drivers in West Bengal
Authors: Jaiswal Aditi A. , Paul Bobby , Bandyopadhyay Lina
Published: December 2024

Diabetes mellitus has led to a huge increase in its number over recent decades. Due to their occupation, truck drivers are predisposed to higher risk of lifestyle disorders. Hence, this study intended to assess their risk of developing diabetes mellitus with respect to IDRS (Indian Diabetes Risk Score). A cross-sectional study was conducted in a selected logistic company for 3 months, where 160 interstate truck drivers were selected by simple random sampling. The collected data were analyzed using descriptive and inferential statistics using SPSS 16 version. The mean age of study participants was 38.4 ± 10.7 years. Of the total, 49.5% of the participants had a high IDRS. A significant increase in IDRS was associated with the occupational variables. Strict monitoring of government guidelines on fair working hours for truck drivers is required. They, being a high-risk group due to their occupation, require periodic health checkups, and appropriate measures should be taken to minimize the detrimental effects on their health.
Polymorphisms in DNA Repair Genes as Biomarkers of Susceptibility for Pesticide-Induced DNA Damage among Agricultural Workers: A Review
Authors: Kaur Rupinder , Kaur Karashdeep
Published: December 2024

Pesticides induce oxidative DNA damage and genotoxic effects such as DNA single-strand breaks (SSBs), double-strand breaks (DSBs), DNA adducts, chromosomal aberrations, and enhanced sister chromatid exchanges. Such DNA damage can be repaired by DNA repair mechanisms. In humans, single nucleotide polymorphisms (SNPs) are present in DNA repair genes involved in base excision repair (BER) (OGG1, XRCC1, and APE1), nucleotide excision repair (NER) (XPC, XPD, XPF, XPG, and ERCC1), and double-strand break repair (DSBR) (XRCC4 and RAD51). This systematic review intends to provide information about occupational pesticide exposure, genotoxic effects of pesticides as well as association of DNA repair gene polymorphisms with the risk of pesticide-induced DNA damage. Polymorphisms present in DNA repair genes may influence interindividual variation in DNA repair capacity (DRC) by altering the functional properties of DNA repair enzymes and thus modulate DNA damage. The mechanisms of oxidative damage and disrupted DNA repair caused by the pesticides explain the link between pesticide exposure and adverse health outcomes. These polymorphisms in DNA repair genes could be used as biomarkers of susceptibility for pesticide-induced DNA damage among agricultural workers. It could also be useful as a preventive measure by identifying the genetic susceptibility of agricultural workers to pesticide-induced oxidative stress as well as pesticide poisoning.
Prevalence and Risk Factors of Medication Errors in Enteral Tube Feeding Among ICU Patients: A Comprehensive Cross-Sectional Analysis
Authors: Asghari-Varzaneh Mansooreh , Badri Shirinsadat , Farsaei Shadi
Published: December 2024

ABSTRACT

Objective:

Most of the patients who are admitted to the intensive care unit (ICU) are forced to feed and use nutrition and medicine through an implanted tube. When administering medication through enteral feeding tubes, it is essential to be cautious, as some drugs may not be suitable due to interactions with feeding formulas or adverse effects when crushed. Some errors during drug gavage can lead to feeding tube blockage, reduced drug effectiveness, or drug toxicity. This study aimed to assess medication errors (MEs) in ICU patients using enteral feeding tubes and identify factors that affect ME incidents.

Methods:

This descriptive and analytical study was conducted for 9 months in the special care department of hospitals affiliated with Isfahan University of Medical Sciences. It involved 257 patients in the ICU receiving oral medication through an implanted gastric tube. The study assessed the method of oral drug administration, verified the correctness of drug prescriptions, investigated errors in drug provision and administration, and monitored patients for possible side effects of these errors. Demographic information and details about the prescribing physician and relevant nurses were also recorded.

Findings:

Our findings show that not washing the tube before gavage was the most frequent error (99.6%). However, different factors, whether the patient or the nurse, did not affect them. The other most common errors included mixing drugs simultaneously (75.6%) and not cleaning the tube after administering medication (78.6%). These errors were influenced by factors such as the number of drugs received by the patient, the hospital, and specific shifts.

Conclusion:

In this study, we found that polypharmacy, the multiplicity of underlying diseases, and nurses’ gender are the most critical factors that increase the number of MEs during the gavage of drugs in patients hospitalized in ICUs.
Carbapenem-resistant Acinetobacter baumannii and Ventilator-associated Pneumonia; Epidemiology, Risk Factors, and Current Therapeutic Approaches
Authors: Najafabadi Malihe Kazemi , Soltani Rasool
Published: December 2024

ABSTRACT

Acinetobacter baumannii is one of the primary pathogens responsible for healthcare-associated infections. It is related to high rates of morbidity and mortality globally, mainly because of its high capacity to develop resistance to antimicrobials. Nowadays, carbapenem-resistant A. baumannii (CRAB) has increased and represents a significant concern among carbapenem-resistant organisms. It is also a key pathogen associated with ventilator-associated pneumonia. CRAB was placed on the critical group of the universal priority list of the World Health Organization for antibiotic-resistant bacteria, to mention the importance of research development and the urgency of new antibiotics. Patients with severe CRAB infections currently face significant treatment challenges. Some approaches have been taken to deal with CRAB, such as combination therapy and the synergistic effect of certain antibiotics, but the best antibiotic regimen is still unknown. In this narrative review, we attempt to clarify the issues, including epidemiology, risk factors, and current treatment options for CRAB.
Human induced pluripotent stem cell–derived therapies for regeneration after central nervous system injury
Authors: Vidman Stephen , Ma Yee Hang Ethan , Fullenkamp Nolan , Plant Giles W.
Published: December 2024

In recent years, the progression of stem cell therapies has shown great promise in advancing the nascent field of regenerative medicine. Considering the non-regenerative nature of the mature central nervous system, the concept that “blank” cells could be reprogrammed and functionally integrated into host neural networks remained intriguing. Previous work has also demonstrated the ability of such cells to stimulate intrinsic growth programs in post-mitotic cells, such as neurons. While embryonic stem cells demonstrated great potential in treating central nervous system pathologies, ethical and technical concerns remained. These barriers, along with the clear necessity for this type of treatment, ultimately prompted the advent of induced pluripotent stem cells. The advantage of pluripotent cells in central nervous system regeneration is multifaceted, permitting differentiation into neural stem cells, neural progenitor cells, glia, and various neuronal subpopulations. The precise spatiotemporal application of extrinsic growth factors in vitro, in addition to microenvironmental signaling in vivo, influences the efficiency of this directed differentiation. While the pluri- or multipotency of these cells is appealing, it also poses the risk of unregulated differentiation and teratoma formation. Cells of the neuroectodermal lineage, such as neuronal subpopulations and glia, have been explored with varying degrees of success. Although the risk of cancer or teratoma formation is greatly reduced, each subpopulation varies in effectiveness and is influenced by a myriad of factors, such as the timing of the transplant, pathology type, and the ratio of accompanying progenitor cells. Furthermore, successful transplantation requires innovative approaches to develop delivery vectors that can mitigate cell death and support integration. Lastly, host immune responses to allogeneic grafts must be thoroughly characterized and further developed to reduce the need for immunosuppression. Translation to a clinical setting will involve careful consideration when assessing both physiologic and functional outcomes. This review will highlight both successes and challenges faced when using human induced pluripotent stem cell-derived cell transplantation therapies to promote endogenous regeneration.
A multi-sectoral approach to antimicrobial resistance containment: Insights from One Health
Authors: Cheng Yan , Wang Xueting , Ma Yingying , Chen Tao , Xiong Luying , Chen Pan , Lu Ping , Zhang Erjia , Xiao Yonghong
Published: December 2024

Antimicrobial resistance (AMR) has become a serious threat to global public health. By 2050, AMR is estimated to cause 1.91 million deaths annually, with related mortality reaching 8.22 million. The challenges posed by AMR extend beyond the healthcare system to include animal health and environmental factors such as livestock farming, urbanization, and climate change. The “One Health” approach, an interdisciplinary and cross-regional collaborative strategy, integrates the management of human, animal, and environmental health. It is considered a crucial framework for addressing complex public health challenges and providing both scientific and preventive strategies to combat AMR. From October 12 to 13, 2024, the Second One Health Conference of Antimicrobial Resistance Containment was successfully held in Hangzhou, Zhejiang Province, China, under the theme “Hand in Hand with One Health to Contain AMR”. The conference brought together experts from various fields to engage in in-depth discussions on AMR control, reaching a consensus to take action towards advancing the global health community. This conference strengthened multi-sectoral collaboration, promoted cross-departmental and cross-national cooperation, enhanced public awareness of AMR, explored control mechanisms, and provided both theoretical and practical guidance for mitigating AMR. It also called for increased investment and research and development efforts on AMR containment.
A rare case of Kearns–Sayre syndrome in a 19-year-old North Indian male
Authors: Kaur Rajwinder , Kour Mandeep , Sandhu Ravi Kaur
Published: December 2024

Kearns–Sayre syndrome (KSS) is a rare neuromuscular condition characterized by a combination of chronic progressive external ophthalmoplegia (CPEO), pigmentary retinopathy, atrioventricular block, and cerebellar ataxia. We report a rare case of a 19-year-old young male of north Indian origin with KSS. He has a history of bilateral ptosis, progressive restricted ocular movements, decreased vision in both eyes, and difficulty walking. He was diagnosed with CPEO, a form of KSS, along with retinal pigmentary abnormalities. Early detection of these cases is critical for saving the patient’s life as they may lead to atrioventricular block.
Review on the etiopathogenesis, clinical features, and management of pseudo-tumor cerebri
Authors: Periyandavan Jayasri , Stephen Mary , Kasturi Nirupama , Sahi Arun
Published: December 2024

Pseudotumor cerebri is an idiopathic disease characterized by elevated intracranial pressure with associated symptoms and signs. Headache is often the initial presentation, and other associated findings include papilledema, vision loss, and sixth nerve palsy. Numerous risk factors have been proposed to be causative, including obesity, use of oral contraceptive pills, and vitamin A toxicity. Neuroimaging, especially magnetic resonance imaging (MRI) with venography, is crucial for diagnosing and ruling out any other organic pathology that could lead to papilledema. The cerebrospinal fluid opening pressure will be high. Treatment involves lifestyle modification with weight reduction, use of oral acetazolamide, and symptomatic treatment for headache. Patients with vision-threatening presentations may need surgical intervention with optic nerve sheath fenestration surgery. In this brief review, the authors describe the basics of disease etiopathogenesis, clinical features, and management of benign intracranial hypertension.
Spontaneous absorbed cataract: A rare presentation
Authors: Stephen Mary , Temkar Shreyas , Agarwal Disha , Periyandavan Jayasri
Published: December 2024

Spontaneous absorption of the clear or cataractous crystalline lens is a rare phenomenon associated with a history of trauma, uveitis, maternal rubella, and other hereditary conditions. We describe a case of spontaneous aphakia in a lady in her 80s, likely due to blunt trauma. Capsular bag and zonules were intact. With aphakic correction, the vision improved to 20/40. The patient was planned for a sulcus intraocular lens (IOL) placement. At 1-month post-surgery, she had a vision of 20/20 with well-centered IOL.