bluuebunny/crossref_metadata_2025 huggingface dataset:
A Survey on IoT Authentication Security Service
Authors: Mehta Mihir , Patel Kajal
Published: February 2022

Internet of things is becoming the most important technology now a days and it is next era of communication. By the use of IOT, various physical things can create, send and receive the data seamlessly. Different IoT applications' main focus is to automate the maximum tasks so with minimum human intervention efficiency and productivity can be increased. "Things" are directly connected with the Open Web, so any intruder can easily become the part of the network and can launch different attacks. So, to increase the level of comfort and efficiency, high security policy in terms of the authentication is required. Existing authentication methods can not be deployed on "Things" as they require high amount of resources and because of that life span of the network will be decreased. In this paper, we have discussed different security threats present at each IoT layer, existing research done in this domain, research gap in existing identity validation methods and also we have find out the future work directions to enhance IoT Security in terms of accurate validation of device identity.
Learning to Teach
Authors: Phan Anh Ngoc Quynh
Published: February 2022

Microteaching is a learning activity from which preservice teachers (PSTs) learn to teach either individually, in pairs or in groups. Thanks to its merits, it has been widely used in teacher education. The paper investigates a specific case of four PSTs conducting microteaching in groups of three as an obligatory component of an English language teacher education programme in a leading higher education institution in Vietnam. Informed by activity theory within the sociocultural perspective, the paper elucidates the learning process of these four PSTs through reflection on their microteaching sessions in their third year to shed light on the application and development of teaching knowledge and skills, peer scaffolding, contradictions within the activity system of the PSTs and their teacher identity construction. The last aspect is considered the contribution of the current study to fulfill a research gap since identity construction through microteaching has rarely been studied before.
What Are the Key Principles of Lesson Study?
Authors: Burrows Stuart
Published: February 2022

While there are success stories, the literature on lesson study indicates that the practice has often been implemented outside of Japan in a superficial and ineffective manner. This review attempts to explore the nature of authentic Japanese lesson study and to establish a set of principles that can be used to inform and guide future transfer efforts. The analysis shows that authentic lesson study consists of five main stages, each with its own purpose and principles. Crucially, this paper emphasises that in order to be effective, lesson study must be viewed by its participants as a process of research, the fundamental aim of which is to generate fresh insights into student learning.
Consumer Green Consumption Behavior
Authors: Gupta Anu , Jain Vijay Kumar , Arya Vikas , Verma Hemraj
Published: February 2022

The objective of the current study is to assess research activities in green consumption behavior where the flow of information is helping consumers to mold their minds towards green consumption. Bibliometric analysis has been applied for the current study using 1447 research papers on green consumption behaviors from Scopus Indexed journals for the 2015 to 2020 period. The document with the maximum citation “Predicting green products consumption using the theory of planned behavior and reasoned action” is the article with the highest citation of 338. Further, the keywords co-occurrence analysis indicates that the maximum occurring keywords are “Green Consumption”, “Sustainability”, “Sustainable Development”, “Green Consumption Behavior”. This research adds to the current literature on the behavior of green consumption in the edge where information is floating in many ways. The current study will provide the first baseline data on this subject, which will be used for future comparisons and policymakers to develop green consumption plans.
Immunity against hepatitis B in a selected child population in Gampaha district, Sri Lanka, ten years after vaccination at two, four and six months of age
Authors: Perera PJ , Fernando MD , Hapugoda M , Udayanga L
Published: February 2022

Background: Hepatitis B (HB) infections are a global public health concern, which carry high morbidity and mortality. Immunization is the safe and effective intervention to prevent transmission. Currently, the Hepatitis B vaccine is given to children at two, four and six months of age in Sri Lanka. However, the capability of this regimen in providing long term protection up to adolescence and beyond remains a concern. The current study was conducted to assess the HB immune status of children, ten years after vaccination during infancy.
Methods: Antibody status of 150 children who received HB vaccine at two, four and six months of age was assessed 10 years after the last dose of vaccination. Some of these children had received liquid monovalent HB vaccine, while others were vaccinated with the Hexavalent vaccine. Children with HB antibody levels below the protective level were given a booster dose of monovalent recombinant HB vaccine, and antibody levels were reassessed in one month.
Results: At the initial assessment, 128 children (85%) had protective levels of antibodies. Type of vaccine and gender had no significant effect on the prevalence of HB antibody levels (p>0.05). All children who received the booster dose developed protective levels of antibodies.
Conclusions: Most of the children immunized against HB during infancy maintain protective antibody levels at 10 years of age. Children with antibody levels below protective levels produced a rapid anamnestic response following a booster dose.
Development of a Nanoparticle Multiepitope DNA Vaccine against Virulent Infectious Bronchitis Virus Challenge
Authors: Qin Yifeng , Teng Qingyuan , Feng Delan , Pei Yu , Zhao Ye , Zhang Guozhong
Published: February 2022

To develop a safe and effective nanoparticle (NP) multiepitope DNA vaccine for controlling infectious bronchitis virus (IBV) infection, we inserted the multiepitope gene expression box SBNT into a eukaryotic expression vector pcDNA3.1(+) to construct a recombinant plasmid pcDNA/SBNT. The NP multiepitope DNA vaccine pcDNA/SBNT-NPs were prepared using chitosan to encapsulate the recombinant plasmid pcDNA/SBNT, with a high encapsulation efficiency of 94.90 ± 1.35%. These spherical pcDNA/SBNT-NPs were 140.9 ± 73.2 nm in diameter, with a mean ζ potential of +16.8 ± 4.3 mV. Our results showed that the chitosan NPs not only protected the plasmid DNA from DNase degradation but also mediated gene transfection in a slow-release manner. Immunization with pcDNA/SBNT-NPs induced a significant IBV-specific immune response and partially protected chickens against homologous IBV challenge. Therefore, the chitosan NPs could be a useful gene delivery system, and NP multiepitope DNA vaccines may be a potential alternative for use in the development of a novel, safe, and effective IBV vaccine.
Determination of phytoplankton in water samples, algal biotoxins, microbiological parameters and microplastics in Mediterranean mussels (Mytilus galloprovincialis Lamarck, 1819) from an experimental pilot farm in the Calich Lagoon (Sardinia, Italy)
Authors: Mudadu Alessandro Graziano , Bazzoni Anna Maria , Melillo Rita , Lorenzoni Giuseppa , Piras Gabriella , Salza Sara , Cau Simona , Soro Barbara , Vodret Bruna , Tedde Tiziana , Fois Nicola , Serra Simonetto , Virgilio Sebastiano , Meloni Domenico
Published: February 2022

The aims of this paper were to collect and analyse preliminary data of phytoplankton in the water, biotoxins, Escherichia coli, Salmonella spp., Vibrio spp. and microplastic eventually present in farmed mussels, and to acquire information about the production capability from an experimental pilot farm of the Calich Lagoon. Two sampling sessions were carried out, in February and in May 2019, also monitoring the water condition (pH, temperature, salinity, dissolved oxygen, chlorophyll a). No potentially toxic algae were detected, and moreover no biotoxins (Paralytic Shellfish Poison, Diarrheic Shellfish Poison, Amnesic Shellfish Poison) were found in mussels. E.coli was present with the highest concentration in February (16000 MPN/100g e.p.). Salmonella and Vibrio spp. have not been detected. Almost a microplastic per grams was found, mainly fiber of different colours. Further studies, carried out for several months, will allow to better understand the possible problems related to the production of mussels in a lagoon not yet classified as a shellfish production area.
Ultrastructural and enzymatic alterations in the ovary of Rhodnius prolixus infected with Trypanosoma rangeli
Authors: Machado Guilherme S. , Lopes Rosane L. , Oliveira Simone S. C. , Freitas Simone P. C. , Santos-Mallet Jacenir R. , Santos André L. S. , Feder Denise , Gomes Suzete A. O.
Published: February 2022

Objective:

To investigate the morphological structure of ovarian follicular cells and biochemical parameters of both ovaries and fat bodies (sites of vitellogenesis) from Rhodnius (R.) prolixus infected with Trypanosoma (T.) rangeli.

Methods:

Adult virgin females of R. prolixus were fed upon a membrane apparatus containing heat-inactivated citrated rabbit blood and a suspension of T. rangeli epimastigotes (Macias strain). Females from the control group and all the males received parasite- free blood. Transmission electron microscopy was used to reveal the morphological aspects of ovarian follicle cells in both control and parasite-infected groups. Protein profile, proteolytic activities and Western blotting analyses were performed in either ovary or fat body samples of control and parasite-infected groups.

Results:

According to the ultrastructural data, T. rangeli infection elicited a degeneration process in the ovarian follicular cells of R. prolixus. Proteolytic assays indicated a reduction in the activity of aspartic peptidases in the ovary and fat body from parasite-infected group, while a significant increase in the cysteine peptidase activity was measured in both insect organs. Additionally, immunoblotting revealed that vitellogenin was overexpressed in the ovary of parasite-infected insects.

Conclusions:

T. rangeli infection seems to elicit an early programmed cell death in the ovarian follicle cells as well as induces the modulation on the activities of different peptidase classes in either ovaries or fat bodies and the overexpression of the vitellogenin in the ovary of R. prolixus.
Osteogenic Differentiation from Mouse Adipose-Derived Stem Cells and Bone Marrow Stem Cells
Authors: Huang Cheng-Pu , Hsu Keng-Chia , Wu Chean-Ping , Wu Hsi-Tien
Published: February 2022

Mesenchymal stem cells (MSCs) have been successfully cultured and proliferated in vitro and can differentiate into a variety of specific cell types, such as adipocytes or osteocytes, through chemical stimulation. One of the major applications of MSCs is in regenerative medicine research. MSCs can be collected from many adult tissues. In this experiment, an 8-week-old expresses green fluorescent protein (EGFP) transgenic mouse, FVB/NCrl-Tg(Pgk1-EGFP)01Narl, was used to obtain adipose-derived stem cells (ADSCs) from abdominal adipose tissue and bone marrow stem cells (BMSCs) from femur bone marrow. We compared the differences in the growth rate and differentiation ability of ADSCs and BMSCs. The growth curves of different generations (P1 and P3) of the stem cells showed that the proliferation rate of ADSCs was significantly higher than that of BMSCs. The purity of stem cells was measured by the number of colony-forming unit fibroblast. The results show that the number of colonies of ADSCs at different generations (P1 and P3) was significantly higher than that of BMSCs and that the purity of ADSCs was greater than that of BMSCs. Comparing the ability of ADSCs and BMSCs to induce osteogenic differentiation and the expression of Runx2 and Opn genes, the results show that ADSCs had a higher rate of osteogenic differentiation than BMSCs. In summary, mouse ADSCs display similar osteogenic differentiation ability to BMSCs but have a better capacity than BMSCs in terms of stem cell purity and cell proliferation in vitro.
Age and Training Intensity Differently Affect Male Runners' Endocrine and Sexual Parameters
Authors: Passavanti Giandomenico , Paoli Antonio , Rizzato Alex , Ceccarelli Ilaria , Fiorenzani Paolo , Casini Ilenia , Aloisi Anna M
Published: February 2022

Physical activity is widely recognized to improve health and its inclusion in daily life at all ages is highly recommended. Gonadal hormones are known to be affected by physical activity. The exercise-induced effects on male runners of different ages were investigated by dividing 31 runners by age (Young, Y, 30–55 years; Old, O, 56–70 years) and amount of training (Light, L, <50 km/week; Heavy, H, 50 or more km/week). To test the somatic, sexual, and psychological health aspects, the Aging Male's Symptoms Scale (AMS) and the International Index of Erectile Function-6 (IIEF-6) questionnaires were administered and blood samples were drawn for adrenocorticotropic hormone, testosterone (Total-TT), free testosterone (Free-T), cortisol (C), dihydrotestosterone (DHT), estradiol, and sex hormone-binding globulin determinations. Clinical evaluations and questionnaire results showed the presence in all groups of some subclinical symptoms and “Light” dysfunctions. TT in the old-heavy (OH) group was significantly lower than in the OL group (2.38 ± 0.18 ng/mL vs. 3.36 ± 0.44 ng/ml, P = 0.05). The TT/DHT ratio was significantly higher in YH than in OH (3.64 ± 0.16 vs. 2.92 ± 0.23, P < 0.05). TT was positively correlated with AMS sexual subscale and negatively correlated with IIEF-6. Physical activity can significantly affect andrological health and testosterone levels in runners at all ages. Thus, due to the important testosterone-mediated vital functions in men, the evaluation of these parameters would be indicated in old as well as in young subjects.
Carbohydrate Mouth Rinsing Decreases Fatigue Index of Taekwondo Frequency Speed of Kick Test
Authors: Chiu Chih-Hui , Chen Che-Hsiu , Yang Tsung-Jen , Chou Kuei-Ming , Chen Bo-Wei , Lin Zong-Yan , Lin Yung-Chih
Published: February 2022

Carbohydrate mouth rinsing (CMR) potentially affects the interval training performance of taekwondo athletes. This study explored the effect of CMR on vertical jump, kicking speed, and fatigue index before and after simulated taekwondo competition. In a crossover experimental design, 13 trained taekwondo athletes were randomly divided into the CMR and control trials. After warming up, the participants used 6.6% maltodextrin (CMR trial) or mineral water (control trial) to rinse their mouth. Next, the participants underwent tests of vertical jump, kicking speed, and maximum number of kicks. After the tests, the participants rinsed their mouth again, followed by using Wingate testing bikes for 5-s sprint and 25-s rest to simulate taekwondo competitions. Four repetitions were performed in each round for 2 min for a total of three rounds. The results revealed that the fatigue index of the participants in the CMR trial before and after the simulated competition was significantly lower than that of the control trial. However, the two trials differed nonsignificantly in their performance in vertical jump, kicking speed, and the simulated competition. Overall, the study results indicated that CMR reduces the fatigue index but no change was observed in performance for vertical jump, kicking speed, and the simulated competition of trained taekwondo athletes.
Refractive changes during off-the-axis retinoscopy in myopia
Authors: Chaurasiya Ritesh Kumar
Published: February 2022

Purpose:

To analyze the refractive shift during off-the-axis retinoscopy under cycloplegic drugs in myopic patients during ocular examination.

Methods:

Prospective cross-sectional study was carried out among 10 myopic patients having refractive errors of −3.00 D or less. All the subjects underwent cycloplegic refraction by a single examiner at 0°, 10°, and 20°. Descriptive data were analyzed as mean and standard deviation. Paired t-test was used to compare the mean differences between on-axis (0°) and off-axis (10° and 20°) retinoscopy.

Result:

The mean spherical equivalent refraction of 10 myopic patients showed an increase in myopic shift with approximately 7% and 18% for 10° and 20° of eccentricity, respectively. Similarly, the mean spherical equivalent measure on axis (0°) and off axis (10° and 20°) were -2.5495, −2.737, and −3.0265, respectively. The mean spherical equivalent differences between on-axis (0°) and off-axis (10° and 20°) showed statistically significant differences with P < 0.05.

Conclusion:

This study concluded that a greater degree of eccentricity will induce a greater amount of errors in retinoscopy.
Assessment of dry eye disease in N95 versus surgical face mask wearers during COVID-19
Authors: Azzam Shirin Hamed , Nama Amir , Badarni Hanan , Asael Helena , Dahoud Wadie Abu , Mimouni Michael , Zayyad Hiba
Published: February 2022

Purpose:

Investigating the effect of different face masks on dry eye disease (DED) among healthcare workers during the COVID-19 pandemic.

Methods:

This was a comparative, cross-sectional study. Participants were included into two groups: group 1 (n = 30) wore surgical masks, and group 2 (n = 30) wore N95 masks with face shields. Demographic and ocular surface disease index questionnaires (OSDI) were performed. In addition, Tear break-up time (TBUT), corneal and conjunctival fluorescein staining, and meibography to assess meibomian gland loss (MGL) were performed on all participants. Independent T-test was used to compare continuous parameters and Chi-square test for categorical variables. The relationship between continuous variables was tested using bivariate Pearson correlation.

Results:

Sixty healthcare workers participated in this study (36 females and 24 males). The mean (±SD) age of the surgical mask and N95 groups was 35.33 (±14.94) and 36.63 (±10.64) years, respectively. Both masks caused dryness according to TBUT, MGL, and OSDI scores. DED per DEWS II definition was observed in 14 (46.7%) and 16 (53.3%) patients in groups 1 and 2, respectively. Comparing the two groups, N95 mask caused significantly more dryness according to TBUT (P = 0.042) and fluorescein staining (P = 0.038 for the right eye and P = 0.015 for the left eye).

Conclusion:

Physicians should be aware of the potential dry eye signs secondary to face mask wear during the COVID-19 pandemic. Further attention should be taken in patients who suffer from preexisting dry eye syndrome and in patients who undergo intraocular operations.
Development of age appropriate vision function questionnaire for children with visual impairment (CHVI-VFQ)
Authors: Wadhwani Meenakshi , Vashist Praveen , Singh Suraj S , Gupta Vivek , Saxena Rohit , Kalaivani Mani , Tandon Radhika
Published: February 2022

Purpose:

To develop a new age-appropriate visual function questionnaire for visually impaired children.

Methods:

The study was conducted in north India in 20,955 (97.3%) children ≤15 years who underwent visual acuity examination. Of these 20,955 children, a total of 722 children were referred with unaided visual acuity less than 6/12 in any eye. Among these referred children, parents in the age group of 5–9 years and children between 10 and 15 years underwent interviews using LV Prasad Functional Visual Questionnaire-20 (LVP FVQ 20) and Indian Visual Functioning Questionnaire-33 (IND VFQ-33). Following this, multiple steps were undertaken that involved expert opinion for the removal of items on basis of zero variance and factor analysis along with calculation of Cronbach’s alpha.

Results:

A Cronbach’ alpha of 0.834 was calculated for the younger age group and 0.931 for the higher age group of children.

Conclusion:

A new robust age-appropriate questionnaire was developed and it was observed that there was a significant change in median score (that was derived for various domains after calculating the median for the items in various domains asked pre- and post-intervention in the form of glasses or surgery) for quality of visual function in the visually impaired children. A significant change in functional vision of visually impaired children (P < 0.005) was observed in both age groups.
Optimization of surgeon ergonomics with three-dimensional heads-up display for ophthalmic surgeries
Authors: Gupta Yogita , Tandon Radhika
Published: February 2022

Purpose:

To describe the variables that may be utilized in the optimization of three-dimensional heads-up surgeries (3D-HUS) for achieving better ergonomics among ophthalmic surgeons.

Methods:

A cross-sectional study was conducted at the operating room of a tertiary eye care center, equipped with an ARTEVO 800 3D surgical microscope and display monitor. The parameters noted were monitor height (MH), surgeon eye-to-floor distance (ETFD), surgeon eye-to-monitor distance (ETMD) and viewing tilt (VT) angle. The neck and eye strain of the surgeon and assistant were scored as per Borg’s CR-10 scale, before and after surgeries.

Results:

Thirty (13 right, 17 left) eye surgeries were analyzed. The minimum ETMD was 51 inches (in) and the eye strain reduced with shorter ETMD (within the range 51 inches to 83 inches). The VT and ETFD were higher for right eye surgeries. The optimum MH was between 50 and 55 in. Overall, the neck strain and eye strain were in the range of 0–3 and 0–1, respectively.

Conclusion:

The various parameters affecting the 3D image quality, neck and eye strain are chair height, VT angle, eye centration, monitor distance, laterality of the eye, and room illumination.
Fibrin glue assisted amniotic membrane graft reconstruction of conjunctival fornix and canthus following excision of conjunctival tumours
Authors: Harley Umiya , Salvi Sachin M
Published: February 2022

Conjunctival tumors involving non-limbal locations, such as the fornix and canthus, are typically excised using a “non-touch” technique, often with a wide surgical margin. Reconstruction of these large defects can be difficult due to the contour of the ocular surface and are often complicated by shortening of the fornix, symblepharon formation, and restriction of eye movements. In our experience, the use of amniotic membrane grafts combined with the sealant properties of fibrin glue such as Tisseel® has improved our surgical outcomes during the reconstruction phase. We would like to highlight and describe our surgical technique using fibrin glue and squint hooks to aid amniotic membrane graft reconstruction for surgically challenging locations in the fornix and canthus following excision of conjunctival lesions, with excellent surgical outcomes.
Trends in teleconsultations for uveitis during the COVID-19 lockdown
Authors: Mahendradas Padmamalini , Sethu Swaminathan , Jayadev Chaitra , Anilkumar Aaditi , Kawali Ankush , Sanjay Srinivasan , Mishra Sai Bhakti , Shetty Rohit , Shetty Bhujang K
Published: February 2022

Purpose:

To study the use of teleophthalmology as a tool to manage patients with uveitis and to describe the experience of teleconsultation for uveitis at a tertiary eye care hospital in India during the two waves of the COVID-19 pandemic.

Methods:

A prospective observational case series of uveitis patients seeking teleconsultations during the first (March 25–May 2020) and second lockdown (April 27 to June 21, 2021) in a tertiary eye care center were analyzed.

Results:

There were 79 teleconsultations in the first and 89 teleconsultations in the second lockdown. A majority of the patients presented in the age group of 41–60 years in both the lockdowns. There were both new or primary consultations and follow-up patients (6% vs. 94%) in the first lockdown, and similarly in the second lockdown (8% new vs. 92% follow-up). The majority of patients resided in Bengaluru city (78% in the first and 76% in the second lockdown). After evaluation through video consultation, only 15% required a hospital referral in the first lockdown, whereas in the second lockdown, 21.3% were referred to the hospital. During the second lockdown, 20% presented with COVID-19 infection-related ailments.

Conclusion:

Based on our preliminary experience using a customized smartphone-based application for teleconsultation, we found it to be an alternative option to provide continuation of ophthalmic care to uveitis patients. Given the current COVID-19 situation, it can help avoid physical visits of uveitis patients to the hospital.
Pars plana Aurolab aqueous drainage implantation for refractory glaucoma: Outcome of a new modified technique
Authors: Kader Mohideen A , Dabke Shylesh B , Shukla Aakriti G , Reddy Venugopal , Abdul Khadar Syed M , Maheshwari Devendra , Ramakrishnan Rengappa
Published: February 2022

Purpose:

To report the outcomes of pars plana insertion of Aurolab aqueous drainage implant (AADI) in adults with refractory glaucoma by the novel technique of making scleral tunnel instead of patch graft to cover the tube to prevent its migration.

Methods:

A retrospective study was done between April 2016 and April 2018 on patients with ≥12 months of follow-up. The main outcome measure was a surgical failure at 12 months. The failure was defined as intraocular pressure (IOP) >18 mmHg or IOP ≤5 mmHg on two consecutive follow-up visits after 3 months, reoperation for glaucoma, loss of light perception vision, or implant explantation. Alternate definitions of failure including IOP >21 and IOP >15 mmHg were also considered.

Results:

The study included 32 eyes of 32 patients. The mean age was 46.2 ± 17.5 years. The most common etiology is traumatic glaucoma (12 eyes, 37.5%). The mean preoperative IOP and anti-glaucoma medications were 43.3 ± 10.3 and 3.4 ± 0.5 mmHg, respectively; both the parameters at the final follow-up were reduced to 15.2 ± 8.1 and 1.6 ± 0.5 mmHg. The Kaplan–Meier survival estimates demonstrated that the cumulative probability of failure was 15.6% (95% CI; 6.8–33.5%) at 3 months, 18.7% (95% CI; 8.9–37.0%) at 6 months, and 25.0% (95% CI; 13.4–43.8%) at 12 months.

Conclusion:

Pars plana AADI implantation with a newer modification technique is a useful procedure in reducing IOP and the number of anti-glaucoma medications in the eyes with refractory glaucoma. The visual acuity may be stabilized with the concurrent treatment of posterior segment pathology.
Jet stream related iatrogenic retinal breaks during vitreo-retinal surgery
Authors: Belenje Akash , Takkar Brijesh , Agarwal Komal , Tyagi Mudit , Aggarwal Vinod , Padhi Tapas R , Narayanan Raja
Published: February 2022

Purpose:

To evaluate the causes of jet stream injury (JSI)-related iatrogenic retinal breaks (IRBs) during vitreoretinal surgery (VRS).

Methods:

The precise surgical environment, which includes the indication and type of surgical procedure, retina status, details of instrumentation and fluidic parameters, and characteristics of the jet responsible for the IRB, was noted from case records. The nature of IRB and its healing and impact on anatomical and visual outcomes were analyzed.

Results:

Five eyes of five patients with complete documentation of both the JSI and the IRB were included. Two cases were operated for macular hole, and one each for vitreous hemorrhage, retinal detachment, and endophthalmitis. One case had infusion-fluid-related JSI, while four developed it because of injection of surgical adjuncts (drugs, PFCL, and dye). JSI developed in two cases when the vitreous cavity was filled with fluid, while it was air-filled in three cases. In four cases, the fluid migrated into subretinal space, necessitating further maneuvers following which the breaks healed, but were directly responsible for vision loss in two cases.

Conclusion:

JSI related IRBs are rare but may be directly responsible for vision loss if they impact the macula. The balance between jet stream velocity, its distance from the retinal surface, the intervening media (vitreous cavity), and retinal health play an important role. It can occur because of both infusion as well as injection jets. Precautions must be taken in cases vulnerable to complications with suggested modifications in the surgical technique.
A glued technique of external dacryocystorhinostomy
Authors: Rizvi Syed Ali Raza , Sabah Mehnaz , Mehmood Faizan , Maheshwari Rakesh , Alam Md. Shahid
Published: February 2022

Purpose:

Fibrin glue was used for anastomosis of lacrimal sac and nasal mucosal flaps and was compared with the conventional suture technique in external dacryocystorhinostomy.

Methods:

A prospective interventional randomized control study in which 50 consecutive patients of primary acquired nasolacrimal duct obstruction (PANDO) were equally allocated into two groups. The case group underwent glued technique of external dacryocystorhinostomy (Ext DCR) in which fibrin glue was used for the apposition of the anterior lacrimal sac and nasal mucosal flaps. In the control group, conventional technique of Ext DCR was used to suture the flaps. Functional success was assessed by improvement in epiphora and fluorescein dye disappearance test (FDDT), whereas anatomical success was assessed by lacrimal irrigation and endoscopic view of the osteotomy site.

Results:

The anatomical success in both the groups was 92%, whereas the functional success was 92% in the case group and 88% in the control group. The difference in the success rates between the two groups was statistically non-significant.

Conclusion:

Glued technique of Ext DCR is a simple and easy alternative to suturing of the flaps. Though the final outcome was comparable in both the groups, glue can be especially useful in uncooperative cases, in cases of excessive bleeding, or in situations where the flaps are very thin or have become friable.
Evaluation of macular and peripapillary vascular parameter change in healthy subjects after caffeine intake using optical coherence tomography angiography
Authors: Yilmaz Tugan Busra , Subasi Sevgi , Pirhan Dilara , Karabas Levent , Yuksel Nursen , Demirci Kucuk Kubra
Published: February 2022

Purpose:

To observe the effects of caffeine intake on vessel densities in macular and peripapillary regions and to analyze the correlations of vascular properties of these two interlinked regions in healthy volunteers using optical coherence tomography angiography (OCTA).

Methods:

In this prospective randomized, double-masked, placebo-controlled study, 120 participants were grouped into two groups: sixty subjects as a study group, which received caffeine and sixty subjects as a placebo group, which received a placebo. OCTA imaging was performed at baseline and 1 h after drug intake. Changes in macular and radial peripapillary capillary (RPC) vessel densities (VD) and foveal avascular zone (FAZ) parameters and correlation of these parameters were analyzed.

Results:

Baseline macular and RPC VD and FAZ parameters showed no significant difference between study and placebo groups (P > 0.05 for all). VD parameters in all segments of superficial and deep macular regions and peripapillary region showed a statistically significant decrease after caffeine intake (P < 0.001 for all). All macular superficial VD parameters showed a positive correlation with deep perifovea VD (P < 0.05 for all). Also, superficial perifovea VD was positively correlated with all deep macular VD parameters except deep fovea VD (P < 0.05 for all).

Conclusion:

We show that caffeine causes a decrease in macular and peripapillary vessel densities in healthy subjects, and correlations were observed between macular and peripapillary VD parameters. We believe that future studies are needed to support the effect of caffeine on peripapillary VD and the idea of using deep perifovea VD as the main parameter to estimate superficial macular parameters.
Funduscopy-guided fluorescein angiography-free focal laser photocoagulation for central serous chorioretinopathy
Authors: Mohanty Anuja , Mahapatra Santosh K
Published: February 2022

Purpose:

To identify and correlate hypopigmented spots on fundoscopy with the leakage points on fluorescein angiography (FA) in patients with central serous chorioretinopathy (CSCR) to provide criteria for FA-free focal laser photocoagulation (FLP).

Methods:

Fifty consecutive patients of acute CSCR were evaluated between March and October 2019 confirming the inclusion and exclusion criteria. Colocalization of leakage points with discrete hypopigmented spots on clinical fundoscopy was evaluated using FA. Positive predictive value (PPV) was calculated to identify the status of association between these to formulate criteria for FA-free FLP of CSCR patients in future.

Results:

Out of the 50 eyes, 38 (76%) had a discrete hypopigmented spot on fundoscopy which coincided with the leakage point on FA. The PPV of finding a leakage point at the area of discrete hypopigmented spot is 95%. Colocalization with a pigment epithelial detachment was found in 25 (65.7%) of these 38 eyes. Retinal pigment epithelial irregularities were found associated in all of these 38 eyes. Subretinal homogenously hyperreflective material was found in 8 (21.05%) of 38 eyes. optical coherence tomography following FLP of leakage point in all cases showed complete resolution of CSCR in 47 (94%) eyes.

Conclusion:

This study demonstrates that hypopigmented spots on clinical fundus examination in CSCR patients, when present, coincide with the leakage point of FA. This may aid to undergo FA-free FLP treatment in CSCR patients.
Flanged intraocular lens (IOL) implantation with scleral pockets - A modification of flanged IOL technique (E-Flanged IOL) for secondary lens implantation
Authors: Agrawal Hitesh K , Tyagi Mudit , Agarwal Komal , Rani Padmaja K
Published: February 2022

The current technique for implanting flanged intraocular lens (IOL) suffers from complications like haptic exposure and tilting of the implanted IOL. We describe a modification of the currently described technique to obviate its shortcomings. Five eyes of five patients with a minimum of 1 year of follow-up were included. In this technique, two scleral pockets were made nasal and temporal to embed the flanged haptics. The primary outcome measure was the improvement in visual acuity (VA) postoperatively and the secondary outcome measures were postoperative complications. The primary objective of this current modification is to simplify the surgical technique for secondary IOL implantation and make it more replicable and predictive. The mean age of the patients was 19.44 years. The mean preoperative VA was 0.44 logMAR which improved to 0.26 logMAR at the 6-week postoperative visit. The mean follow-up was 496+/- 80 days. The maximum follow-up was 647 days. There were no postoperative complications such as haptic exposure, hypotony, or IOL tilt in any cases. The new E-flanged IOL technique has good visual outcomes and does not have postoperative complications. It has less intraoperative manipulation and complications.
Clinical profile and management of sixth nerve palsy in pediatric patients (0–15 years) in Southern India – A hospital-based study
Authors: Kalita Iva Rani , Veena K , Mouttappa Fredrick , Sundaralakshmi Priya , Singh Harsh Vardhan
Published: February 2022

Purpose:

This study was done to evaluate the clinical profile in pediatric patients (0–16 years) presenting with acute onset esotropia due to sixth nerve palsy and its management options in a tertiary care set up of Southern India.

Methods:

A total of 12 patients presenting to our OPD with acute onset esotropia due to sixth nerve palsies were included in this retrospective study. All patients were observed for 6 months and managed with prism and/or patching while waiting for spontaneous resolution and later managed surgically. Neuroimaging was done in all cases.

Results:

The mean deviation of esotropia at presentation was 30.17 ± 5.7 Prism Diopter (range 12–50 Prism Diopter 95% CI, SD 10.11). Mean age of the patients during presentation was 8.6 ± 2.4 years (range: 1–15 years, SD 4.27). Among the common causes of sixth nerve palsy in our study population were trauma and idiopathic intracranial hypertension followed by tumor and miscellaneous causes. Only three patients underwent surgical correction of residual deviation after a waiting period of 6 months for self-resolution. Spontaneous resolution was observed in 41.6% patients, and surgical correction (unilateral resection–recession) was done in 25% of the patients with good surgical outcome.

Conclusion:

At 1-year follow up, the motor outcome was satisfactory except for one patient who had diffuse pontine glioma and had worsening neurological symptoms on follow-up.
Resource maximization during COVID-19 crunch – A novel graft marking technique to use one cornea for two recipients for either Descemet membrane endothelial keratoplasty or deep anterior lamellar keratoplasty
Authors: Narayanan Niveditha , Dubey Amber
Published: February 2022

During pandemic, eye banks worldwide faced drastic reduction of corneal retrieval. Since precut tissues are uncommon in India, the onus is on corneal surgeons to maximize the donor corneal usage. The stumbling block making the stromal part unusable in the graft preparation of the Descemet membrane endothelial Keratoplasty is the stromal window creation to place the orientation mark on the stromal side of the folded graft. To overcome this, we simply marked directly on the folded Descemet graft, after partly stripping it from the donor cornea. Then, we unfolded, punched, and created two grafts after completely stripping it, retaining the Descemet part for the endothelial Keratoplasty and the stromal part for lamellar Keratoplasty. Initially, we used a special F marker, and later we marked an L using just a spatula. This simple technique needing no extra donor tissue or instrumentation maximizes the tissue utility with proper patient selection.
Outcome of transcutaneous retrobulbar injection of liposomal amphotericin B in post-COVID-19 rhino-orbito-cerebral mucormycosis: Our experience
Authors: Ramamurthy Lakshmi B , Bhandari Ridhi , Kanakpur Savitha , Thejaswini P
Published: February 2022

Purpose:

To assess the outcome and response of transcutaneous retrobulbar injection of amphotericin B (TRAMB) in post-coronavirus disease of 2019 (COVID-19) rhino-orbito-cerebral mucormycosis (ROCM) and to establish a scoring system in guiding treatment modalities.

Methods:

An interventional, prospective study was done on 82 eyes of post-COVID-19 ROCM from May 2021 to July 2021. A comprehensive multi-departmental evaluation along with detailed ophthalmic examination, laboratory investigations, and radiological examination was done. Scoring points were given to each symptom, sign, and radiological features of orbit and the total score was taken. Based on these scores, severity of disease was grouped into A, B, and C corresponding to mild, moderate, and severe orbital ROCM. One milliliter of reconstituted liposomal amphotericin B was given to all patients every alternate day as three doses. Efficacy of these injections was assessed in all groups, even though other treatment modalities like orbital debridement and exenteration were considered for moderate and severe cases. Patients were followed up for a period of 8 weeks.

Results:

Out of 82 eyes, symptomatic improvement was seen in a major proportion (72%) of patients. A statistically significant improvement in scores was noted in group A (93% improved) with a P value of 0.002, while 68.4% showed improvement in group B (P-value- 0.0001). Group C with severe disease showed minimal improvement in post-injection scores of 41% (P-value 0.086), necessitating surgical intervention. No serious adverse effect of the drug or procedure was noted.

Conclusion:

Significant improvement in scores of groups A and B highlights TRAMB as an effective and safe treatment modality in mild to moderate ROCM. It is an effective adjunct in severe cases, along with other interventions. Also, the scoring system helps in assessing the severity and guiding in management strategies.
Comparison of once daily dose of 0.3% nepafenac alone and three times dose of 0.1% nepafenac alone in pain and inflammation control after phacoemulsification
Authors: Bardoloi Narayan , Sarkar Sandip , Burgute Pankaj Suresh , Deb Amit Kumar , Dholkawala Roshni , Aggarwal Priyal , Gokhale Tanmay
Published: February 2022

Purpose:

To compare the efficacy of a once-daily dose of 0.3% nepafenac and three times daily dose of 0.1% nepafenac in controlling pain and inflammation following phacoemulsification.

Methods:

In this prospective randomized control single-blind study. patients who underwent uneventful phacoemulsification were divided into two groups. Group A received 0.1% nepafenac eye drops three times/day for 4 weeks and group B received 0.3% nepafenac eye drops once daily for 4 weeks following phacoemulsification. All the patients received moxifloxacin 0.5% eye drops four times/day for 2 weeks. None of the patients in any group received any form of corticosteroids.

Results:

The mean age of the patients in group A was 63.55 ± 8.5 years, while in group B, it was 60.05 ± 7.76 years. There was no significant result in the preoperative baseline demographics and intraoperative parameters between both the groups. The results were statistically insignificant in terms of inflammatory markers between both groups on day 1. But, on day 7, group B showed better results in terms of lid edema, conjunctival congestion, and anterior chamber cells. The patients in group B also perceived significantly less pain on day 1 (P = 0.02) and day 7 (P < 0.001). The central macular thickness was also significantly lower in group B at day 30 (P < .001) and day 90 (P < .001), respectively.

Conclusion:

Once-daily dose of higher concentrated nepafenac (0.3%) is equally effective and shows better results than 0.1% nepafenac for pain and inflammation control.
iSMART Contoura laser-assisted in situ keratomileusis: A new planning software
Authors: Khatib Zain
Published: February 2022

Background:

Topography guided laser-assisted in situ keratomileusis (LASIK) has always been some sort of an enigma in terms of its understanding and interpretation. Contoura LASIK is one such form of FDA approved topography guided LASIK on the Wavelight platform for virgin eyes. Inspite of promising so much, its complete application has not yet been fully understood and cannot be applied for all cases.

Purpose:

The iSMART Contoura LASIK is a software designed by the author, aimed to specifically to plan and treat eyes with Contoura LASIK.

Synopsis:

This is computer based software which studies the higher order aberrations being treated by the machine, and applies geometry and vector mathematics to appropriately modify the final treatment refraction so as to completely correct the refractive error. The software guides almost everything related to LASIK planning including safety parameters like percent tissue altered and residual stromal bed, the ring and stop size for microkeratome needed, femto flap diamter and Contoura planning. This software will be a useful tool for all Wavelight EX500 Contoura LASIK users.

Highlights:

This video demonstrates briefly the overview, working and utility of the iSMART LASIK software along with a quick understanding of how Contoura LASIK planning is done using it.

Online Video Link:

https://youtu.be/5x7jWmr08O4
Rescue of photoreceptor with human mesenchyme stem cell and human mesenchyme stem cell expressing erythropoietin in total degeneration of retina animal model
Authors: Abd Rashid Munirah , Chenshen Lam , Ee Hwan Avin Koh , AlSaeedy Hiba , Mok Pooi Ling , Subbiah Suresh Kumar , Md Isa Hazlita , Yong Then Kong , Nizam Harun Mohd Hairul , B S Mohamad Syed Mohamed Suhail , Ng Min Hwei Angela , Luu Chi D , Bastion Mae-Lynn Catherine
Published: February 2022

Purpose:

This study aimed to investigate the efficacy of human-derived umbilical cord mesenchymal stem cells (HDUMSC) and human-derived umbilical cord mesenchymal stem cells expressing erythropoietin (HDUMSC-EPO) to rescue total degenerated retina in a rat model.

Methods:

The study included four treatment groups, namely negative control using normal saline (HBSS) injection, positive control using sodium iodide 60 mg/kg (SI), SI treated with HDUMSC, and SI treated with HDUMSC-EPO given via subretinal and intravenous routes, to test the efficacy of retinal regeneration following SI-induced retinal degeneration. Retinal function in both phases was tested via electroretinography (ERG) and histological staining examining the outer nuclear layer (ONL).

Results:

There was a statistically significant result (P < 0.05) in the SI treated with HDUMSC-EPO only when comparing day 11 (mean = 23.6 μv), day 18 (mean = 25.2 μv), day 26 (mean = 26.3 μv), and day 32 (mean = 28.2 μv) to the b-wave ERG on day 4 rescue injection day (mean = 12.5 μv). The SI treated with HDUMSC-EPO showed significant improvement in b-wave ERG readings in the Sprague–Dawley (SD) rat but did not restore baseline readings prior to degeneration (day 0). Both treated groups’ ONL thicknesses did not show significant changes compared to the negative control group (HBSS) following rescue therapy.

Conclusion:

Total retinal degeneration following intravenous SI injection was observed at 60 mg/kg. SI treated with HDUMSC and HDUMSC-EPO showed no regenerative potential compared to baseline in SI-induced total retina degeneration on ERG or histology, whereas SI treated with HDUMSC-EPO group showed a substantial increase in b-wave ERG amplitude over time.
Accuracy of intraocular lens power calculation formulae in short eyes: A systematic review and meta-analysis
Authors: Shrivastava Ankur K , Nayak Swatishree , Mahobia Ashish , Anto Mary , Pandey Pranay
Published: February 2022

This review article attempts to evaluate the accuracy of intraocular lens power calculation formulae in short eyes. A thorough literature search of PubMed, Embase, Cochrane Library, Science Direct, Scopus, and Web of Science databases was conducted for articles published over the past 21 years, up to July 2021. The mean absolute error was compared by using weighted mean difference, whereas odds ratio was used for comparing the percentage of eyes with prediction error within ±0.50 diopter (D) and ±1.0 D of target refraction. Statistical heterogeneity among studies was analyzed by using Chi-square test and I
2 test. Fifteen studies including 2,395 eyes and 11 formulae (Barrett Universal II, Full Monte method, Haigis, Hill-RBF, Hoffer Q, Holladay 1, Holladay 2, Olsen, Super formula, SRK/T, and T2) were included. Although the mean absolute error (MAE) of Barrett Universal II was found to be the lowest, there was no statistically significant difference in any of the comparisons. The median absolute error (MedAE) of Barrett Universal II was the lowest (0.260). Holladay 1 and Hill-RBF had the highest percentage of eyes within ±0.50 D and ±1.0 D of target refraction, respectively. Yet their comparison with the rest of the formulae did not yield statistically significant results. Thus, to conclude, in the present meta-analysis, although lowest MAE and MedAE were found for Barrett Universal II and the highest percentage of eyes within ±0.50 D and ±1.0 D of target refraction was found for Holladay 1 and Hill-RBF, respectively, none of the formulae was found to be statistically superior over the other in eyes with short axial length.