bluuebunny/crossref_metadata_2025 huggingface dataset:
Mitogen-activated protein kinase phosphatase 1 regulates bone mass, osteoblast gene expression, and responsiveness to parathyroid hormone
Authors: Mahalingam Chandrika D , Datta Tanuka , Patil Rashmi V , Kreider Jaclynn , Bonfil R Daniel , Kirkwood Keith L , Goldstein Steven A , Abou-Samra Abdul B , Datta Nabanita S
Published: August 2011

Parathyroid hormone (PTH) signaling via PTH 1 receptor (PTH1R) involves mitogen-activated protein kinase (MAPK) pathways. MAPK phosphatase 1 (MKP1) dephosphorylates and inactivates MAPKs in osteoblasts, the bone-forming cells. We previously showed that PTH1R activation in differentiated osteoblasts upregulates MKP1 and downregulates pERK1/2–MAPK and cyclin D1. In this study, we evaluated the skeletal phenotype ofMkp1knockout (KO) mice and the effects of PTHin vivoandin vitro. Microcomputed tomography analysis of proximal tibiae and distal femora from 12-week-oldMkp1KO female mice revealed osteopenic phenotype with significant reduction (8–46%) in bone parameters compared with wild-type (WT) controls. Histomorphometric analysis showed decreased trabecular bone area in KO females. Levels of serum osteocalcin (OCN) were lower and serum tartrate-resistant acid phosphatase 5b (TRAP5b) was higher in KO animals. Treatment of neonatal mice with hPTH (1–34) for 3 weeks showed attenuated anabolic responses in the distal femora of KO mice compared with WT mice. Primary osteoblasts derived from KO mice displayed delayed differentiation determined by alkaline phosphatase activity, and reduced expressions ofOcnandRunx2genes associated with osteoblast maturation and function. Cells from KO females exhibited attenuated PTH response in mineralized nodule formationin vitro. Remarkably, this observation was correlated with decreased PTH response of matrix Gla protein expression. Expressions of pERK1/2 and cyclin D1 were inhibited dramatically by PTH in differentiated osteoblasts from WT mice but much less in osteoblasts fromMkp1KO mice. In conclusion, MKP1 is important for bone homeostasis, osteoblast differentiation and skeletal responsiveness to PTH.
"O Brasil não é só doença": o programa de saúde pública de Juscelino Kubitschek
Authors: Hochman Gilberto
Published: August 2011

Analisa o programa de saúde do candidato à Presidência da República Juscelino Kubitschek e seu diálogo com interpretações que identificavam o Brasil como 'país doente' a ser recuperado pela medicina. Os contextos nacional e internacional são marcados pela ideia de desenvolvimento e pelo otimismo sanitário do pós-Segunda Guerra Mundial. Aborda o modo como Kubitschek elaborou, no contexto de seu projeto de desenvolvimento, os temas da centralidade das endemias rurais e do abandono do trabalhador rural, caros ao movimento sanitarista da década de 1910, e indica a articulação de saúde e desenvolvimento nesse programa setorial, bem como a introdução de agendas sanitárias emergentes.
Assessment of Scar Quality after Cleft Lip Closure
Authors: Frans Franceline A. , van Zuijlen Paul P.M. , Griot J.P.W. Don , van Der Horst Chantai M.A.M.
Published: August 2011

Objective

To assess scar quality after cleft lip repair.

Design

The linear scars of patients with cleft lip with or without cleft palate were evaluated in a prospective study using the Patient and Observer Scar Assessment Scale. Linear regression was performed to identify which scar characteristics were important according to patients and observer.

Setting

Regular outpatient follow-up visit with the cleft palate teams of two tertiary centers.

Patients

All consecutive patients were asked to participate in this study after informed consent, minimally 1 year postsurgery.

Main Outcome Measure

Scar characteristics influencing patient and observer opinion after cleft lip repair.

Results

A total of 86 patients with cleft lip with or without cleft palate were included, resulting in evaluation of 99 scars. Two scar characteristics, itching and pain, were seldom a concern for the patients. Linear regression showed that scars assessed longer after surgery had a better outcome.

Conclusion

Scar itching and pain did not seem to have an effect on patient opinion of the quality of the scar, and the majority of the patients were more satisfied with the outcome of their scar than the observer was.
Briefing: Human impact of Cairo Metro line 2
Authors: Massoud Omar W.
Published: August 2011

This briefing investigates the human impact of metro projects cutting through densely populated metropolises in developing countries, taking Cairo Metro line 2 (CML2) as its case study.
Modelling and monitoring towards ‘ecologically good' status
Authors: Hartnett Michael , Dabrowski Tomasz , McGovern Joseph
Published: August 2011

Ambitious goals set for all EU states in the water framework directive call for the development of appropriate tools that support the implementation of the directive. Mathematical modelling can be utilised for devising the methodologies that address its many aspects, from evaluation of management alternatives to design of operational monitoring programmes. A major difficulty is the lack of detail in the directive regarding the implementation of monitoring programmes. This paper reviews and discusses the role of modelling in the implementation of the directive, with particular emphasis on integration of modelling into directive monitoring systems. New approaches, such as the Bayesian maximum entropy method, are discussed. The method utilises models in the processes of waterbody mapping and assessment and optimisation of water quality monitoring programmes; the authors are currently implementing the method to Irish coastal waterbodies. It is concluded that one of the main difficulties in implementing the directive is the lack of a structured approach in the development and management of monitoring programmes; mathematical models are recommended tools to help overcome these difficulties.
Umbilical Cord Blood: Information for Childbirth Educators
Authors: Waller-Wise Renece
Published: August 2011

Umbilical cord blood was once thought of as a waste product. Now, years after the first successful umbilical cord blood transplant, more families seek information about whether or not to save their newborn’s cord blood. Childbirth educators may be one of the main sources that an expectant family depends on to gain more knowledge about cord blood banking in order to make an informed decision. Preserving umbilical cord blood in public banks is advisable for any family; however, it is recommended that expectant families only consider private cord blood banking when they have a relative with a known disorder that is treatable by stem cell transplants. The childbirth educator is encouraged to be well versed on the topic of cord blood banking, so that as questions from class participants arise, the topic can be explored and addressed appropriately.
Finding Our Way
Authors: Bauer Amy
Published: August 2011

Long before I got pregnant, my husband and I began to prepare for the kind of birth I had always imagined for myself: peaceful, normal, and without medication or unnecessary medical intervention. In the fall of 2008, I got pregnant. At that same time, I started a new career as a labor and delivery nurse in a hospital that specializes in high-risk labor and birth. My daughter’s journey into this world turned out to be the beautiful normal experience we had always imagined. This special experience also helped shape the kind of care I offer as a new labor and delivery nurse.
Answering Questions About Herpes in Pregnancy
Authors: Wood Stacey
Published: August 2011

Herpes during pregnancy is a common concern. Because one in every five women is infected with the herpes virus, it is likely that herpes may be a topic that will be raised during a prenatal class, or afterward in private. An expectant mother who has a history of herpes may have concerns about protecting her baby from this virus. She may also have concerns about her own health, relationship issues including the support of her husband and family, or how to communicate with her health-care provider and make the best choices for a safe birth experience. Her childbirth educator can be a source of support and empowerment.
Grand Multiparous Women’s Perceptions of Birthing, Nursing Care, and Childbirth Technology
Authors: Fleming Susan E. , Smart Denise , Eide Phyllis
Published: August 2011

This qualitative descriptive study explored grand multiparous women’s perceptions of the evolving changes in birthing, nursing care, and technology. A purposive sample of grand multiparous women (N = 13) from rural, eastern Washington State were interviewed as they shared their 105 birth stories. Eight themes were identified: (1) providing welcome care, (2) offering choices, (3) following birth plans, (4) establishing trust and rapport, (5) being an advocate, (6) providing reassurance and support, (7) relying on electronic fetal monitors and assessments versus nursing presence, and (8) having epidurals coupled with loss of bodily cues. Results from this study may be used to educate women, intrapartum nurses, and childbirth educators on nursing care and on the evolving use of technology to better manage intrapartum care in hospitals. The results can also add to the extant knowledge of childbirth nursing practices.
Role Models for Pregnancy, Birth, and Breastfeeding
Authors: Budin Wendy C.
Published: August 2011

In this column, the editor of The Journal of Perinatal Education discusses how the media provide role models—good and bad—for pregnancy, birth, and breastfeeding. There is a critical need for more positive role models that promote natural, safe, and healthy pregnancy and birth. The editor also describes the contents of this issue, which offer a broad range of resources, research, and inspiration for childbirth educators in their efforts to promote natural, safe, and healthy birth.
The Value of Listening to Grandmothers’ Infant-Feeding Stories
Authors: Grassley Jane S. , Eschiti Valerie
Published: August 2011

The purpose of this study was to examine the usefulness of storytelling as a foundation for communicating with grandmothers about breastfeeding. The benefits of storytelling are applied to an analysis of infant-feeding stories that grandmothers told during a focus group study conducted by the authors. Thirty-five grandmothers participated in the study. A qualitative content analysis of the interview transcripts revealed that grandmothers’ infant-feeding stories provided insights into the people (characters) and circumstances (setting) that affected their early experiences of infant feeding. By asking grandmothers to tell their stories, health-care professionals may understand the personal and cultural context grandmothers bring to their support of new mothers and facilitate a place for grandmothers’ voices to be heard.
Teaching in a Patient-Centered Medical Home
Authors: Hotelling Barbara A.
Published: August 2011

Teaching Lamaze International classes in a patient-centered medical home allows the childbirth educator the best environment for giving evidence-based information and empowering parents to give birth their way. Patient-centered medical home facilities and providers practice evidence-based care and adhere to the principles of family-centered maternity care. In patient-centered medical homes, women can expect to give birth using the Lamaze Healthy Birth Practices and to fully participate in their care with appropriate interventions and the right to informed consent and informed refusal.
Functions of the Spleen and their Evaluation
Authors: Vasilescu Catalin
Published: August 2011

The spleen receives 5% of the total cardiac output every minute and less than 10% of the blood in the
arterial capillaries is emptied directly in the venous sinuses. It is also a major site for the synthesis of tuftsin and
properdin, two proteins which serve as opsonins. This organ is the largest lymphoid tissue of the body. Most of
the splenic functions of fight against pathogens may be taken over by other organs. The major known functions of
spleen are removal of aging erythrocytes and recycling of iron, elicitation of immunity, and supply of
erythrocytes after hemorrhagic shock and removes intraerythrocyte inclusions. Up to 30% of platelets are stored
within the average spleen and can be released in response to specific stimuli such as epinephrine. Splenic function
can be assessed most simply by searching for Howell-Jolly bodies. The spleen can be visualized and its size
estimated by scintillation scanning following injection of isotope-labelled, autologous, heat-damaged red cells,
which are selectively removed by functional splenic tissue.
Robotic Splenectomy
Authors: Vasilescu Catalin
Published: August 2011

While laparoscopic splenectomy has become the standard procedure for the surgical treatment of
hematologic splenic disorders, the role of robotic splenectomy is still a matter of debate. The robotic equipment is
expensive, still bulky and the surgical team needs special training. However, there are some limitations of
laparoscopy in difficult splenectomies (massive splenomegaly, portal hypertension, partial/subtotal splenectomy
and splenic malignancies) which can be overcome by the robotic system by means of better visualization,
maneuverability and motion control allowing a better dissection of the splenic vessels and precise and timeefficient
intracorporeal maneuvers.
Modeling Mass Transfer Kinetics and Mass Diffusivity During Osmotic Dehydration of Blanched Carrots
Authors: Sutar Parag P , Prasad Suresh
Published: August 2011

Osmotic dehydration of 3.5 mm thick blanched carrot slices was carried out in order to study the effect of sucrose concentration, solution temperature and time on mass transfer kinetics and mass diffusivity. The experiments were conducted at the combinations of four sucrose concentration (30, 40, 50 and 60% w/w) and four solution temperatures (25, 37.5, 50 and 62.5°C). At each combination, nine time intervals (10, 20, 30, 40, 50, 60, 80, 100 and 120 min) were selected to determine the moisture loss and sucrose gain. Sample-to-solution ratio was kept 1:10 w/w through all the experiments. It was found that sucrose concentration and time of osmosis increased mass transfer whereas; solution temperature showed effect only on solid gain. Azuaras models were used to determine the mass transfer kinetics and variable mass diffusivity coefficients. The average moisture diffusivity and solid diffusivity values were in the range 2.23×10-8 to 12.85×10-8 m2/s and 1.20×10-8 to 7.64×10-8 m2/s, respectively. Also, at each concentration, the values of activation energies for moisture loss and solid gain were found to be in the range 12.46 to 24.98 kJ K-1 mol-1 and 9.68 to 31.27 kJ K-1 mol-1, respectively.
Twin-Screw Extrusion of Pre-Germinated Brown Rice: Physicochemical Properties and ?-Aminobutyric Acid Content (GABA) of Extruded Snacks
Authors: Chanlat Nirandorn , Songsermpong Sirichai , Charunuch Chulaluck , Naivikul Onanong
Published: August 2011

Pre-germinated brown rice (PGBR) from non-glutinous (KDML 105) and glutinous (RD 10) varieties was produced by a soaking method in cool water at 25°C for 48 h. After germination, increased crude fiber, reducing sugar (P ? 0.05) and the ?-aminobutyric acid (GABA) content (P ? 0.01) and decreased fat were observed. The extrusion was carried out in a twin-screw extruder by a central composite design (CCD) which studied the effect of feed moisture (15.6-22.3%), screw speed (264-434 rpm) and pre-germinated glutinous brown rice flour level (0-63.6%) on the physicochemical properties of extruded snacks (expansion ratio, density, hardness, brittleness, water absorption index (WAI), water solubility index (WSI)) and GABA content. Second-order polynomial models were computed and used to generate surface plots. Increasing the feed moisture increased the density (P ? 0.01) hardness and WAI, and decreased the expansion ratio, brittleness (P ? 0.01) and WSI (P ? 0.05). Increasing the screw speed increased the expansion ratio, brittleness, WAI and WSI, and decreased the density and hardness. Increasing the levels of pre-germinated glutinous brown rice flour increased the expansion ratio (P ? 0.01), brittleness, WSI (P ? 0.01) and the GABA content (P ? 0.01), and decreased the density, hardness (P ? 0.01) and WAI (P ? 0.01), while the feed moisture content and screw speed had no significant effect on the GABA content (P > 0.05). This knowledge can be used in the design of customer-oriented extruded PGBR products.
Comparative Study on Drying of Selected Marine Products: Bombay Duck (Herpodon nehereus) and Prawn (Penaeus indicus)
Authors: Visavale Ganesh Lotanrao , Sutar Parag P , Thorat Bhaskar Narayan
Published: August 2011

A study on drying of two types of fish, viz., Bombay duck and Prawn, using the open sun, a solar cabinet, hot air and freeze drying was carried out. The fish were dried to 56% moisture content. The drying rates were calculated and drying data were fitted to the Page model, and on the basis of R2 and RMSE values it was found that the Page model describes satisfactorily the drying behavior of Bombay duck and Prawn. Also, effective moisture diffusivity values were calculated during fish drying by different methods. The values of the average effective moisture diffusivity of Bombay duck and Prawn were in the range of 1.01 × 10-9 to 1.51 × 10-9 m2 s-1and 0.21 × 10-9 to 0.31 × 10-9 m2 s-1, respectively. Freeze drying was found to provide the best quality of dehydrated product, which was as expected. Solar cabinet drying was found to be a low-energy intensive process compared to freeze and hot air drying, resulting in a dehydrated product with acceptable quality.
Contribution study of the thermodynamics properties of the ammonia-water mixtures
Authors: Kherris Sahraoui , Makhlouf Mohammed , Zebbar Djallel , Sebbane Omar
Published: August 2011

The full thermodynamic study of the absorption refrigeration units requires
the knowledge of the thermodynamic properties of the used mixture. The
present work deals with the mathematical modeling of the thermodynamic
properties of ammonia-water mixtures using various models. The presented
model covers high vapor-liquid equilibrium pressures up to 110 [bar] and
temperatures from 230 to 600 [K]. Furthermore, the calculation of the
thermodynamic properties of the ammonia-water mixtures and their pure
components was carried out. The obtained results were compared with results
given in the literature. This shows a good concordance.

 This article has been corrected. Link to the correction 10.2298/TSCI180624196E
Thyrocyte morphomethric analysis significance in differential diagnosis of thyroid carcinoma
Authors: Kuzmic-Jankovic Snezana , Andjelkovic Zoran , Cerovic Snezana , Milosavljevic Ivica
Published: August 2011

Backgraund/Aim. Conventional cytomorphology of thyroid cell aspirates is
limited in preoperative differential diagnosis of follicular adenomas (FA)
and hyperplastic adenomatoid nodular goiters from well differentiated thyroid
follicular carcinoma (FTC) and follicular variant of thyroid papillary
carcinoma (PTC). This is the reason of inaccurate presurgical differential
diagnosis and in the same cases of inadequate operative managament. The aim
of the study was to evaluate the role of quantitative estimation of
thyreocite nuclear features (cariomorphometry) in thyroid aspirated smears in
preoperative differential diagnosis of benign from malignant thyroid lesions.
Methods. A total of 48 patients with thyroid nodular disease underwent fine
needle aspiration biopsy for cytomorphology, cariomorphometric analysis of
the aspirates, and histopathologic explorations conducted fully
postoperatively. On the basis of cytomorphology classification the patients
were divided into three groups: benign (B), n = 8; malignant (M), n = 15, and
suspicious for malignancy (S), n = 25. Using a microscope connected to a
computerized video system, mean nuclear area, the nuclear area coefficient of
variation (NACV) and anisocariosis ratio were measured and calculated.
Results. In all the 15 patients with cytologically malignant results the
diagnosis of PTC was confirmed histopathologically. All cytologically benign
lesions were confirmed histopathologically. Thyroid carcinoma was found in 15
out of 25 patients with suspicious lesions. The highest mean values of
nuclear area were in the PCT (90.74 ? 26.71 ?m2), and were significantly
different from all other groups (p < 0.001). The mean nuclear area in FTC was
69.20 ? 27.31 ?m2 and was significantly higher than in the benign adenomatous
group (p < 0.01). There was no significant difference in mean nuclear area
between FTC and FA, but there was a significant difference in NACV between
these two groups (FTC: 39.46 % vs FA: 23.42%, p < 0.001). In 27 out of 30
patients with thyroid carcinoma higher values of NACV than 18% were found.
Conclusion. Preoperatively cariomorphometry is a useful method in
differential diagnosis of thyroid carcinoma from benign lesions, as a
complementary method to convencional cytodiagnostics. The NACV showed highest
sensitivity as a parameter of malignant thyroid cell transformation.
Does Blood Glucose Monitoring Increase Prior to Clinic Visits in Children With Type 1 Diabetes?
Authors: Driscoll Kimberly A. , Johnson Suzanne Bennett , Tang Yuanyuan , Yang Fang , Deeb Larry C. , Silverstein Janet H.
Published: August 2011

OBJECTIVE

To assess the occurrence of white coat adherence in families with children who have type 1 diabetes.

RESEARCH DESIGN AND METHODS

Blood glucose data were downloaded from meters of 72 children, aged 2–11 years, with type 1 diabetes at four consecutive clinic visits. Generalized estimating equations were used to analyze patterns of blood glucose monitoring (BGM) during the 28 days before each clinic visit.

RESULTS

More frequent BGM was associated with better glycemic control. Evidence of a white coat adherence effect, with BGM frequency increasing before a clinic visit, was found only among children with low A1C levels.

CONCLUSIONS

Highly motivated families who frequently monitor their child’s blood glucose increased the frequency of BGM before the child’s clinic visit. The additional monitoring may benefit the child by providing the physician with a wealth of blood glucose information to guide recommendations.
Obesity in Adults Is Associated With Reduced Lung Function in Metabolic Syndrome and Diabetes
Authors: Yeh Fawn , Dixon Anne E. , Marion Susan , Schaefer Carl , Zhang Ying , Best Lyle G. , Calhoun Darren , Rhoades Everett R. , Lee Elisa T.
Published: August 2011

OBJECTIVE

The purposes of this study were to investigate whether reduced lung function is associated with metabolic syndrome (MS) and diabetes (DM) in American Indians (AIs) and to determine whether lower pulmonary function presents before the development of DM or MS.

RESEARCH DESIGN AND METHODS

The Strong Heart Study (SHS) is a multicenter, prospective study of cardiovascular disease (CVD) and its risk factors among AI adults. The present analysis used lung function assessment by standard spirometry at the SHS second examination (1993–1995) in 2,396 adults free of overt lung disease or CVD, with or without DM or MS. Among MS-free/DM-free participants, the development of MS/DM at the SHS third examination (1996–1999) was investigated.

RESULTS

Significantly lower pulmonary function was observed for AIs with MS or DM. Impaired pulmonary function was associated with MS and DM after adjustment for age, sex, abdominal obesity, current smoking status, physical activity index, hypertension, and SHS field center. Both forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were negatively associated with insulin resistance or DM severity and with serum markers of inflammation (P < 0.05). FVC and FEV1-to-FVC ratio both predicted DM in unadjusted analyses but not when adjusted for covariates, including waist circumference. In the adjusted model, abdominal obesity predicted both MS and DM.

CONCLUSIONS

Reduced lung function is independently associated with MS and with DM, and impaired lung function presents before the development of MS or DM; these associations may result from the effects of obesity and inflammation.
The stability of an additive functional equation in menger probabilistic φ-normed spaces
Authors: Miheţ D. , Saadati R. , Vaezpour S.
Published: August 2011

We establish a stability result concerning the functional equation: $\sum\limits_{i = 1}^m {f\left( {mx_i + \sum\limits_{j = 1,j \ne i}^m {x_j } } \right) + f\left( {\sum\limits_{i = 1}^m {x_i } } \right) = 2f\left( {\sum\limits_{i = 1}^m {mx_i } } \right)} $ in a large class of complete probabilistic normed spaces, via fixed point theory.
Physical Activity Benefits of Learning to Ride a Two-Wheel Bicycle for Children With Down Syndrome: A Randomized Trial
Authors: Ulrich Dale A. , Burghardt Amy R. , Lloyd Meghann , Tiernan Chad , Hornyak Joseph E.
Published: August 2011

Background

People with Down syndrome (DS) display consistent patterns of physical inactivity. If these sedentary behaviors continue over extended periods of time, there will be negative health consequences.

Objective

The objective of this study was to investigate the physical activity and health-related outcomes of teaching children with DS to ride a 2-wheel bicycle.

Design

This study was a randomized intervention in which the control group waited 1 year to receive the intervention.

Setting

This intervention study was conducted in a community setting.

Participants

The participants were children who were 8 to 15 years of age and who had been diagnosed with DS.

Intervention

The participants were randomly assigned to an experimental group (bicycle intervention) or a control group (no intervention).

Measurements

Measurements were obtained in the month before the intervention (preintervention), at 7 weeks after the intervention, and at 12 months after the preintervention measurement for all participants.

Results

The results indicated no group differences at the preintervention session. Fifty-six percent of the participants in the experimental group successfully learned to ride a 2-wheel bicycle during the 5-day intervention. Analysis showed that participants who learned to ride spent significantly less time in sedentary activity at 12 months after the preintervention measurement and more time in moderate to vigorous physical activity than participants in the control group. Body fat appeared to be positively influenced over time in participants who learned to ride.

Limitations

It is unknown how frequently the children in the experimental group rode their bicycles after the intervention.

Conclusions

Most children who are 8 to 15 years of age and who have been diagnosed with DS can learn to ride a 2-wheel bicycle. Learning to ride can reduce time spent in sedentary activity and increase time spent in moderate to vigorous physical activity, which may influence the health and functioning of these children.
Characteristics of Suicide Attempts in Young People Undergoing Treatment for First Episode Psychosis
Authors: Fedyszyn Izabela E. , Harris Meredith G. , Robinson Jo , Edwards Jane , Paxton Susan J.
Published: August 2011

Objectives: Understanding the characteristics of suicide attempts in people undergoing treatment for first episode psychosis (FEP) may have implications for risk management at a service level and local suicide prevention strategies. Although studies have focused on identifying individual-level risk factors for suicide attempts in this patient group, none have yet conducted an in-depth profile of suicide attempts. The aim of the present study was to examine the characteristics of suicide attempts in young people during the initial 18 months of treatment for FEP.

Method: A retrospective medical record audit study of a cohort of patients accepted for treatment at a specialist FEP service between 1/12/2002 and 30/11/2005.

Results: Of 607 patients, 73 (12%) attempted suicide during treatment. Of these 73, most (72.6%) attempted suicide on one occasion. The majority of attempts (85.3%) occurred when patients were treated as outpatients and were in regular contact with the service. Suicide attempts tended to be impulsive (77.6%), triggered by interpersonal conflict or distress due to psychotic symptoms. Two thirds involved self-poisoning, usually by overdose of prescribed medications. All inpatient suicide attempts were by hanging or strangulation. Individuals infrequently sought help immediately before or after the attempt; if help-seeking occurred, informal sources of support were contacted.

Conclusions: To reduce the number of suicide attempts among individuals treated for FEP, psychiatric services could consider: restricting the amount of medication prescribed per purchase; individualised suicide risk management plans for all newly admitted patients, including those who do not appear to be at risk; stringent reviews of inpatient psychiatric units for potential ligature points; providing information and psycho-education for significant others in recognition and response to suicide risk; fostering patients' problem solving and conflict resolution skills; and regular risk assessment and close monitoring of patients, particularly during the high risk period of 3 months after a suicide attempt.
Clinical profile and visual outcome following pars plana vitrectomy in acute post-operative endophthalmitis
Authors: Thapa R , Paudyal G
Published: August 2011

Introduction: Endophthalmitis following cataract surgery is a rare but devastating ocular complication where delay in treatment not only results in vision loss but also in difficulty to save the eye ball. Objective: To explore the clinical profile and visual outcome following pars plana vitrectomy (PPV) in acute endophthalmitis after cataract surgery. Materials and methods: This is a retrospective interventional case series study conducted at Tilganga Institute of Ophthalmology (TIO), Nepal. All consecutive cases of acute endophthalmitis following cataract surgery treated with PPV from January 2005 to August 2010 were included in the study. Results: There were a total of 34 cases (34 eyes) treated with PPV. The age range was 8 - 93 years with mean age of 56.9 ± 19.5 years. The mean duration of presentation and duration following cataract surgery was 7.7 ± 8.1days and 13 ± 11.6 days respectively. Small incision cataract surgery was done in 75 % of cases followed by phacoemulsification (15.6 %). The mean duration of the last follow -up was 4.3 months. Vision was improved in two-thirds of cases (67.67 %) with a good vision of 6/18 or better in 17.6 %. Among the available vitreous samples of 22 cases, 36.36 % had an abnormality in Gram and Giemsa stains and culture was positive in 13.6 % of cases. Conclusion: Despite the late presentation, the majority of eyes were salvaged with improvement of vision in 67.67 %, with a good vision of 6/18 or better in 17.6 4 % of cases following PPV in acute post operative endophthalmitis. Key words: Endophthalmitis, vitrectomy, cataract surgery, visual outcome DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5260 Nepal J Ophthalmol 2011; 3(2): 102-108
Scleral buckle surgery for pseudophakic and aphakic retinal detachment in western Nepal
Authors: Byanju RN , Bajimaya S , Kansakar I , Melamud A
Published: August 2011

Introduction: Retinal detachment remains one of the most serious complications of cataract surgery. Treatment of this condition has represented a challenge for vitreoretinal surgeons. Scleral buckle (SB) surgery is one of the treatment options in pseudophakic and aphakic retinal detachment (RD). Aims: To find out the anatomical and visual outcome of SB in pseudophakic and aphakic RD. Subjects and methods: Retrospective case series of 46 consecutive eyes of 46 patients with RD (38 pseudophakic and 8 aphakic eyes) that had undergone conventional SB surgery were reviewed from patient files. Postoperative retinal status at 3 weeks, 6 weeks and 3 months were recorded to see the anatomical success rate after retinal reattachment surgery. Best corrected visual acuity (BCVA) at 3 months follow-up was noted. Results: The mean age of the patients was 54.28 ± 13.49 years. Forty eyes (86.9 %) had primary attachment by 6 weeks duration. Five eyes had undergone repeat surgery within a six-week duration (pars plana vitrectomy). Forty patients had follow-up visit to 12 weeks, achieving retinal attachment in 37 eyes (80.5 %). Best corrected visual acuity (BCVA) at 3 months was better than 6/60 in 18 eyes (39.1%), BCVA better or equal to 1/60 but less than 6/60 in 18 eyes (39.1%) and BCVA less than 1/60 in 4 eyes (8.7 %). Conclusion: Conventional scleral buckling has good outcome for pseudophakic and aphakic RD and can be useful for patients in peripheral eye hospitals where patients cannot afford high cost surgeries. Keywords: scleral buckle, pseudophakia, retinal detachment DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5261 Nepal J Ophthalmol 2011; 3(2): 109-117
Pattern of fungal isolates in cases of corneal ulcer in the western periphery of Nepal
Authors: Ganguly S , Salma KC , Sharma M , Bastola P , Pradhan R
Published: August 2011

Purpose: To find out the epidemiologic features in 686 consecutive cases of fungal keratitis presenting in a tertiary eye hospital in the western region of Nepal. Materials and methods: A prospective hospital - based study was carried out on 1880 consecutive patients presenting with corneal ulcer in the outpatient department and cornea clinic of Lumbini Eye Institute, Bhairawa, Nepal. The socio-demographic data, predisposing risk factors, prior treatment modalities, laboratory results and the distribution pattern of fungus species were analyzed. Results: Diagnosis of fungus keratitis was established in 686 (36 %) out of the total study group of 1880 cases. The spectrum of fungi isolated were Fusarium species (Fusarium spp.) in 219 (31.9 %), followed by unidentified dematiaceous 151 (22 %), curvularia 122 (17.7 %) and unidentified hyaline in 111 cases (16.1 %). Men (59.3 %) were more commonly affected than women (40.6 %). The young adults age group of 31-40 years was most commonly involved (26.6 %). Corneal trauma (58 %) and topical steroids (12 %) were the most common predisposing risk factors noted. Conclusion: In contrast to the other studies done in Nepal, we found Fusarium to be the most common fungal isolate causing corneal ulcer followed by unidentified dematiaceous, unidentified hyaline and curvularia. Corneal trauma was the commonest predisposing risk factor in causing fungal keratitis. Keywords: cornea, fungal ulcer, fusarium, unidentified dematiaceous fungus DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5262 Nepal J Ophthalmol 2011; 3(2): 118-122
Glaucoma at a tertiary referral eye hospital in Nepal
Authors: Paudyal I , Thapa SS , Paudyal G , Gurung R , Ruit S
Published: August 2011

Background: Glaucoma is an important cause of blindness. Objective: To report the distribution of various types of glaucoma among patients presenting to a tertiary eye hospital in Nepal. Materials and methods: All new patients visiting the hospital between March 2007 and February 2008 underwent a comprehensive eye examination. Whenever glaucoma was suspected, patients were referred to fellowship-trained glaucoma specialists. Patients received a comprehensive glaucoma workup including applanation tonometry, stereoscopic examination of the optic nerve head performed by the glaucoma specialists, and a Humphrey visual field analysis (SITA 24 - 2). Results: 447 patients were newly diagnosed with glaucoma. 171 (38.2 %) patients had primary open-angle glaucoma (POAG), while 143 (32 %) had primary angle-closure glaucoma (PACG). The average age of presentation of patients with POAG was 65.78 ± 9.1 years, while the average age for PACG patients was 54.6 ±12.8 years. 30 (21 %) patients with PACG had acute angle-closure on presentation, while 113 (79 %) had chronic angle closure glaucoma. 107 (75 %) of these patients with PACG had visual acuity of less than 3/60 (20/ 400) in the worse eye at presentation. The most common form of secondary glaucoma was lens-induced (5.3 %), followed by neovascular (3.2 %) and uveitic glaucoma (3.2 %). Conclusion: The most common glaucoma seen in a tertiary referral eye hospital of Nepal is primary open-angle glaucoma. Among the angle-closure glaucoma, chronic angle-closure is the most common. Lens-induced glaucoma is still the commonest cause of secondary glaucoma. Keywords: glaucoma, open-angle, angle-closure, lens-induced DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5263 Nepal J Ophthalmol 2011; 3(2): 123-127
A comparative bacteriological profile and antibiogram of dacryocystitis
Authors: Shah CP , Santani D
Published: August 2011

Introduction: Dacryocystitis is an infection and an inflammation of the lacrimal sac and is an important cause of ocular morbidity in India. Objective: To isolate and identify the bacterial patterns associated with dacryocystitis and to determine their antibacterial sensitivity pattern. Materials and methods: A total of 100 lacrimal swab materials were subjected to bacaterial analysis. Children less than 8 years were not included in the study. Results: The chances of chronic dacryocystitis were more than acute dacryocystitis and were commonly found in the age group of 41 - 50 years. Females were more vulnerable to the infection than males. From a 100 samples a total of 122 bacterial isolates were obtained. Both Gram positive and Gram negative bacteria were equally distributed in the study. The most common organism associated with the infection was S. aureus. The antibacterial sensitivity showed more effectiveness towards Gram positive isolates than Gram negative isolates. Conclusion: Both Gram positive and Gram negative organism are associated with with chronic dacryocystitis. Knowledge of the bacteriology of dacryocystitis and the susceptibility of the bacteria towards antibiotics will better guide a clinician in the choice of the medication for the most appropriate drug for the treatment. Keywords: Acute dacryocystitis, chronic dacryocystitis, lacrimal sac, nasolacrimal duct DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5265 Nepal J Ophthalmol 2011; 3(2): 134-139
Evaluation of tear film stability before and after laser in situ keratomileusis
Authors: Shrestha GS , Wagh S , Darak A
Published: August 2011

DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5266 Nepal J Ophthalmol 2011; 3(2): 140-145
Pterygium surgery with conjunctival limbal autograft with fibrin glue under topical anaesthesia with lignocaine 2% jelly
Authors: Mithal C , Agarwal P , Mithal N
Published: August 2011

Objective: To evaluate the efficacy of lignocaine 2 % jelly as topical anesthesia in pterygium surgery with conjunctival limbal autograft using fibrin glue. Materials and methods: A non-randomized interventional study was carried out including twenty-one patients who presented with primary pterygium. Under 2% lignocaine jelly, surgical dissection of the pterygium, scraping of corneal bed with crescent blade, excision of Tenon’s capsule, harvesting conjunctival limbal autograft superiorly, and securing it with respect to limbus and stromal orientation with fibrin glue were done. Postoperatively, the patients’ discomfort and pain were evaluated by Wongs pain scoring system. Results: The mean pain score was 0.70 ± 0.97. Only one patient (4.76%) out of the whole series experienced pain who rated more than three on the visual analog scale of 5. Thirteen patients (61.9%) had pain score of zero, that is, no pain. The surgeon’s evaluation of the technique in terms of surgical ease and complications was favorable. There were no dislodged grafts and no cases required suturing. There were no cases of infection, significant inflammation, epithelial problems and reduction in visual acuity. There was a single case of recurrence (4.76%) five months postoperatively which was managed conservatively. Conclusions: Topical anesthesia with lignocaine 2% jelly using fibrin sealant is safe and effective in pterygium surgery allowing for short operative times. It results in low pain and good aesthetic and functional outcomes. Key words: fibrin glue, pterygium, topical anaesthesia, conjunctival autograft DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5268 Nepal J Ophthalmol 2011; 3(2): 151-154
Presbyopia and its anatomical and physiological variants
Authors: Gupta M , Sukul RR , Gupta Y , Dey M , Phougat A , Bhardwaj U , Dixit S
Published: August 2011

Aim: To study the various ocular anatomical and physiological parameters in presbyopia. Materials and methods: We studied the various ocular anatomical and physiological parameters like corneal curvature (keratometry readings: K1 and K2), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT) and axial length (AL) in 100 presbyopic patients between 35 - 55 years of age. The patients were divided into two age groups: I (35 – 44 years) and II (45-55 yrs). ACD, AL and LT were measured using an Ascan. CCT was measured with ultrasonic pachymetry. Results: The CCT decreased (BE), LT increased and ACD decreased (RE) significantly with increasing age (p < 0.05). There was no significant difference in males and females. Nearly 3/4th of the total increase in lens thickness was responsible for the decrease in the anterior chamber depth and the rest, 1/4th , goes posteriorly. Corneal curvature and AL showed no significant change with age. Conclusions: The mean of CCT decreased significantly with advancing age. As age increased, the mean value of lens thickness increased and anterior chamber depth decreased. Nearly 3/ 4th of total increase in LT was anteriorly, decreasing the ACD. Corneal curvature and AL has no relation with age. Key words: Presbyopia, central corneal thickness, anterior chamber depth, lens thickness, axial length DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5269 Nepal J Ophthalmol 2011; 3(2): 155-158
Cataract surgery in camp patients: a study on visual outcomes
Authors: Pai SG , Kamath SJ , Kedia V , Shruthi K , Pai A
Published: August 2011

Aim: To assess the complications and visual outcomes associated with cataract surgery in camp patients operated at a tertiary centre. Materials and methods: In a retrospective study, 206 outreach camp patients had undergone cataract surgeries with posterior chamber intraocular lens implantation under peribulbar anesthesia over a period of 6 months. Post-operative complications on Day 1 were graded as per Oxford Cataract Treatment and Evaluation Team (OCTET) definitions. One month postoperative complications, best corrected visual acuity and refractive errors were assessed. Results: 206 eyes underwent cataract extraction with PCIOL implantation. Small incision cataract surgery (SICS) was the commonest method (78.6%) used. The most common first post-operative day complication was mild iridocyclitis (26.2%). The complications were based on OCTET definitions, and showed that 33 % had Grade I and 3.4 % had Grade II complications. The major post-operative complication after 4 weeks of surgery was posterior capsular opacity. 89.8 % of the eyes had a 4 week-post-operative best corrected visual acuity of e” 6/24. The commonest refractive error was myopia with against the rule astigmatism, seen in 86 out of 150 cases. Conclusion: High quality cataract surgery with a low rate of intra-operative complications and good visual outcome can be attained in camp patients operated in the base hospitals, thus justifying more similar screening camps to clear the vast cataract backlog. Key words: cataract surgery, eye camp, visual outcomes DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5270 Nepal J Ophthalmol 2011; 3(2): 159-164
Endothelial cell loss after small incision cataract surgery
Authors: Thakur SKD , Dan A , Singh M , Banerjee A , Ghosh A , Bhaduri G
Published: August 2011

DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5273Nepal J Ophthalmol 2011; 3(2): 177-180
Sympathetic ophthalmia: Enucleation or evisceration?
Authors: Manandhar A
Published: August 2011

The purpose of this review is to find out the risk of sympathetic ophthalmia after evisceration and enucleation particularly in a case of penetrating ocular (non-surgical or surgical) injury and to know about the cosmetic outcome of evisceration and enucleation. Ophthalmologists around the world, whenever dealing with a case of penetrating ocular (non-surgical or surgical) injury, might thus be helped in deciding whether to keep the traumatized eye or remove it. And if they finally decide to remove it, they will be able to choose between evisceration and enucleation for the best cosmetic outcome, and to minimize the risk of sympathetic ophthalmia. The results of the review are the following. Enucleation is not found to be the best protective measure against development of sympathetic ophthalmia, as it was thought to be, since there are ample reports of sympathetic ophthalmia occurring not just after evisceration but also after enucleation. The cosmetic outcome of evisceration as opposed to enucleation is found to be better. Key words: sympathetic ophthalmia, enucleation, evisceration DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5274 Nepal J Ophthalmol 2011; 3(2): 181-187
Alport Syndrome: case report and review of ocular manifestations
Authors: Jain Charu , Malik VK , Kamboj Reny , Kumar Sanjeev , Kumar Sandeep , Jain Kirti
Published: August 2011

Background: Alport Syndrome is an uncommon disease. Case: We report a case of a young Indian male who presented with the characteristic ocular findings and systemic features of Alport Syndrome. Conclusion: Any young patient with a chronic renal disease should have a careful ophthalmologic examination for Alport Syndrome. Key words: Alport Syndrome, hereditary nephritis, lenticonus, deafness, retinopathy DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5275 Nepal J Ophthalmol 2011; 3(2): 188-190
An unusual case of anisocoria in a child with bleeding aneurysm of posterior communicating artery and idiopathic thrombocytopenic purpura (ITP)
Authors: Mahapatra NC , Bandyopadhyay A , Samanta SK , Dolui S , Fariduddin K
Published: August 2011

Background: It can give rise to bleeding episodes in different parts of the body including the central nervous system with various systemic manifestations. Case: An eight-year old female child, diagnosed as a case of chronic ITP for last two years, developed intense headache and vomiting for a few days before admission. This was associated with right sided mid dilated pupil with brisk reaction to light. MRI-angiography showed a bleeding aneurysm of posterior communicating artery. The features of raised intra cranial tension subsided with conservative management but the anisocoria persisted. Conclusion: A bleeding aneurysm can manifest with anisocoria as a sign of partial third cranial nerve palsy. Key words: ITP, children, leaking aneurysm, anisocoria DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5276 Nepal J Ophthalmol 2011; 3(2): 191-192
Ophthalmomyiasis in humans
Authors: Chakraborti C , Mukhopadhya U , Mondal M , Giri D , Khan M
Published: August 2011

Background: Ophthalmomyiasis in humans is a rare phenomenon. Objectives: To create awareness among the ophthalmologists regarding larval conjunctivitis. Cases: We report two cases of ophthalmomyiasis, which came to a tertiary care centre with features of unilateral acute catarrhal conjunctivitis. Observations: Fly larvae were detected on slit-lamp examination and removed after immobilizing them with topical 4 % lignocaine. Topical antibiotics and steroid drops were prescribed for 2 weeks. The samples were identified as Oestrous ovis by the entomology department of the Institute of Tropical Medicine, Kolkata. The signs and symptoms regressed within 48 hours. Conclusion: The ocular myiasis can manifest as a unilateral catarrhal conjunctivitis. Key words: Ophthalmomyiasis, Oestrous ovis, conjunctivitis DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5277 Nepal J Ophthalmol 2011; 3(2): 193-195
Cavernous lymphangioma of eyelid - a rare case report
Authors: Kumar Sanjiv , Kumar Sandeep , Malik VK , Jain K , Jain C , Kamboj R , Bansal R
Published: August 2011

Background: Lymphangioma is a lymphatic malformation, a benign proliferation of lymph vessels. Case: We hereby present a case of eyelid lymphangioma of cavernous type in a twelve year old male patient. This is a very uncommon site for this type of lymphangioma. Key words: lymphangioma, eyelid, cavernous type DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5278 Nepal J Ophthalmol 2011; 3(2): 196-198