bluuebunny/crossref_metadata_2025 huggingface dataset:
Sensitivity of imaging properties of metal-dielectric layered flat lens to fabrication inaccuracies
Authors: Kotyński R. , Baghdasaryan H. , Stefaniuk T. , Pastuszczak A. , Marciniak M. , Lavrinenko A. , Panajotov K. , Szoplik T.
Published: September 2010

We characterize the sensitivity of imaging properties of a layered silver-TiO2 flat lens to fabrication inaccuracies. The lens is designed for approximately diffraction-free imaging with subwavelength resolution at distances in the order of a wavelength. Its operation may be attributed to self-collimation with a secondary role of Fabry-Perot resonant transmission, even though the first order effective medium description of the structure is inaccurate. Super-resolution is maintained for a broad range of overall thicknesses and the total thickness of the multilayer is limited by absorption. The tolerance analysis indicates that the resolution and transmission efficiency are highly sensitive to small changes of layer thicknesses.
An Application of Low-Order Arma and Garch Models for Sea Level Fluctuations
Authors: Niedzielski Tomasz , Kosek Wieslaw
Published: September 2010

An Application of Low-Order Arma and Garch Models for Sea Level Fluctuations

The paper presents the analysis of geographically-dependent irregular sea level fluctuations, often referred to as residual terms around deterministic signals, carried out by means of stochastic low-order autoregressive moving average (ARMA) and generalised autoregressive conditional heteroscedastic (GARCH) models. The gridded sea level anomaly (SLA) time series from TOPEX/Poseidon (T/P) and Jason-1 (J-1) satellite altimetry, commencing on 10th January 1993 and finishing on 14th July 2003, has been examined. The aforementioned models, limited to low-orders being combinations of 0,1 and 2, have been fitted to the SLA data. The root mean square and the Shapiro-Wilk test for the normal distribution have been used to calculate statistics of the residuals from these models. It has been found that autoregressive (AR) models as well as ARMA ones serve well the purpose of adequate modelling irregular sea level fluctuations, with a successful fit in some patchy bits of the equatorial Pacific. In contrast, GARCH models have been shown to be rather inaccurate, specifically in the vicinity of the tropical Pacific, in the North Pacific and in the equatorial Indian Ocean. The pattern of the Tropical Instability Waves (TIWs) has been noticed in the statistics of AR and ARMA model residuals indicating that the dynamics of these waves cannot be captured by the aforementioned linear stochastic processes.
Practical Use of the HOAC II for Clinical Decision Making and Subsequent Therapeutic Interventions in an Elite Athlete With Low Back Pain
Authors: Thoomes Erik J. , Schmitt Maarten S.
Published: September 2010

Study Design

Resident's case problem.

Background

This case report describes the diagnostic process, based on the Hypothesis-Oriented Algorithm for Clinicians II (HOAC II), and subsequent interventions in an elite athlete with subacute low back pain. It also demonstrates the clinical application of the HOAC II and shows how disablement terms, as used in the World Health Organization's International Classification of Functioning, Disability and Health model, can be integrated into patient management in a manner that we believe enhances clinical practice. It also demonstrates the practical use of validated questionnaires and how these can be used to gather necessary information for the algorithm.

Diagnosis

A structured, evidence-based assessment led to a multifaceted, activity limitation-based diagnosis of being unable to (1) remain in a deep squat position during speed skating, (2) accelerate in turns while speed skating, and (3) rise from a slouched position without pain. We believed that these dysfunctions were due to local limited lumbar segmental mobility, concurrent with an inability to properly and functionally stabilize the lumbopelvic area.

Discussion

The HOAC II requires the therapist to develop an evidence-based strategy for the examination that is based on initial hypotheses developed from the medical history and other data obtained prior to the examination. The examination was tailored to identify and quantify activity limitations and participation restrictions that we believed could help to explain why this patient had his health problem. The case demonstrates how all elements of the HOAC II can be used for what we consider to be relatively common types of patients. We believe that by applying the HOAC II on an individual-patient basis, therapists will be ideally positioned to apply evidence to patient care and to defend their interventions to colleagues and third-party payers.

Level of Evidence

Differential diagnosis, level 4. J Orthop Sports Phys Ther 2011;41(2):108–117, Epub 17 September 2010. doi:10.2519/jospt.2011.3353
Muscle Architecture Predicts Maximum Strength and Is Related to Activity Levels in Cerebral Palsy
Authors: Moreau Noelle G. , Simpson Kit N. , Teefey Sharlene A. , Damiano Diane L.
Published: September 2010

Background

Muscle architecture is known to be predictive of muscle function. However, it is unknown whether this relationship is similar in children and adolescents with and without cerebral palsy (CP).

Objective

The objective of this study was to determine whether the architecture of the rectus femoris (RF) and vastus lateralis (VL) muscles was predictive of maximum voluntary knee extensor torque in children and adolescents with and without CP and whether these measures were related to activity and participation levels.

Design

A case-control design was used.

Methods

Eighteen participants with CP (mean age=12.0 years, SD=3.2) at Gross Motor Function Classification System (GMFCS) levels I through IV and 12 age-matched peers with typical development (mean age=12.3 years, SD=3.9) were evaluated. Muscle thickness, fascicle length, and fascicle angle of the RF and VL muscles were measured with 2-dimensional, B-mode ultrasound imaging. The activity and participation measures used for participants with CP were the Pediatric Outcomes Data Collection Instrument (PODCI) and the Activities Scale for Kids, Performance Version (ASKp).

Results

When age and GMFCS level were controlled for, VL muscle thickness was the best predictor of knee extensor isometric torque in the group with CP (R2=.85). This prediction was similar to the prediction from VL muscle thickness and age in participants with typical development (R2=.91). Rectus femoris muscle fascicle length was significantly correlated with the Sports and Physical Functioning Scale of the PODCI (ρ=.49), and VL muscle fascicle angle was correlated with the Transfers and Basic Mobility Scale of the PODCI (r=.47) and with ASKp Locomotion subdomain (r=.50).

Limitations

A limitation of this study was the small sample size.

Conclusions

Ultrasound measures of VL muscle thickness, adjusted for age and GMFCS level, were highly predictive of maximum torque and have the potential to serve as surrogate measures of voluntary strength (force-generating capacity) in children and adolescents with and without CP.
Potential barriers to the laparoscopic management of ectopic pregnancies: a regional UK study
Authors: Odejinmi Funlayo , Rizzuto Ivana , Ballard Karen D.
Published: September 2010

In this regional UK study across seven hospitals, we examined the potential barriers to undertaking a laparoscopic approach to the surgical management of ectopic pregnancies. Across the region 84% of surgically managed ectopic pregnancies were undertaken laparoscopically, although out of hours operating resulted in a higher rate of laparotomies. Trainees perceived themselves to be competent in carrying out laparoscopy for ectopic pregnancies and reported their training as adequate. Perceived barriers to training were a lack of operating time, service commitments, reduced working hours arising from the European working directive, and a lack of laboratory training facilities. In order to maintain and improve the laparoscopic rate for the management of ectopic pregnancies, it is necessary to ensure that trainees have more supervised operating time and better access to laboratory training facilities.
Massive subchorionic thrombohematoma: a series of 10 cases
Authors: Fung Tak Yuen , To Ka Fai , Sahota Daljit Singh , Chan Lin Wai , Leung Tak Yeung , Lau Tze Kin
Published: September 2010

A retrospective audit identified 10 cases of massive idiopathic subchorionic thrombohematoma. The incidence was 1:3,133. Only six of these pregnancies resulted in a livebirth and only two reached term. In eight cases there were ultrasound abnormalities, including two cases of placentomegaly both of which resulted in a pregnancy loss. There was one placental abruption. Seven of the women were nulliparous. Massive subchorionic thrombohematoma is associated with poor pregnancy outcome. Ultrasound findings of placentomegaly might be a bad prognostic sign.
Risk factors in women 40 years of age and younger with endometrial carcinoma
Authors: Haidopoulos Dimitrios , Simou Maria , Akrivos Nikolaos , Rodolakis Alexandros , Vlachos Georgios , Fotiou Stelios , Sotiropoulou Maria , Thomakos Nikolaos , Biliatis Ioannis , Protopappas Athanasios , Antsaklis Aris
Published: September 2010

Objective. To identify and compare risk factors among endometrial cancer patients ≤40 years of age, postmenopausal women with the same malignancy and women ≤40 years without malignancy. Design. Retrospective case–control study. Setting. Athens University, department of obstetrics and gynecology of a tertiary hospital serving a mainly urban population. Population. Endometrial cancer patients ≤40 years (study group, n = 40), postmenopausal women with the same malignancy (positive controls, n = 40) and women ≤40 (negative controls, n = 40) without endometrial cancer. Methods. Clinical history, treatment and follow‐up of patients were evaluated. Factors studied included age, histology, stage, grade, lymphovascular space involvement, body mass index (BMI), cytology, lymph node status, parity, smoking, family history, hypertension recurrence and survival. Main outcome measures. Differences in risk factors and characteristics. Results. Nulliparity, smoking and hypertension were significantly related with endometrial cancer in the study group compared to positive controls (p = 0.001, p < 0.01 and p < 0.001, respectively). BMI >30 significantly characterized patients in the study group compared to negative controls (p = 0.006). Finally, irregular menstruation and family history of cancer were observed more often in the study group compared to both control groups. Stage, grade, myometrial invasion, lymphovascular space involvement and lymph node status were comparable between the study and positive control groups. Conclusion. Nulliparity, obesity, unstable menstruation, smoking and cancer in the family are strongly correlated with endometrial cancer risk in women ≤40 years.
Paradigms, pragmatism and possibilities: mixed‐methods research in speech and language therapy
Authors: Glogowska Margaret
Published: September 2010

Background: After the decades of the so‐called ‘paradigm wars’ in social science research methodology and the controversy about the relative place and value of quantitative and qualitative research methodologies, ‘paradigm peace’ appears to have now been declared. This has come about as many researchers have begun to take a ‘pragmatic’ approach in the selection of research methodology, choosing the methodology best suited to answering the research question rather than conforming to a methodological orthodoxy. With the differences in the philosophical underpinnings of the two traditions set to one side, an increasing awareness, and valuing, of the ‘mixed‐methods’ approach to research is now present in the fields of social, educational and health research.

Aims: To explore what is meant by mixed‐methods research and the ways in which quantitative and qualitative methodologies and methods can be combined and integrated, particularly in the broad field of health services research and the narrower one of speech and language therapy.

Main contribution: The paper discusses the ways in which methodological approaches have already been combined and integrated in health services research and speech and language therapy, highlighting the suitability of mixed‐methods research for answering the typically multifaceted questions arising from the provision of complex interventions. The challenges of combining and integrating quantitative and qualitative methods and the barriers to the adoption of mixed‐methods approaches are also considered.

Conclusions & Implications: The questions about healthcare, as it is being provided in the 21st century, calls for a range of methodological approaches. This is particularly the case for human communication and its disorders, where mixed‐methods research offers a wealth of possibilities. In turn, speech and language therapy research should be able to contribute substantively to the future development of mixed‐methods research.
Negotiation of identity in group therapy for aphasia: the Aphasia Café
Authors: Simmons‐Mackie Nina , Elman Roberta J.
Published: September 2010

Background: There has been increasing interest in ensuring that aphasia intervention includes attention to the negotiation of a robust identity after the life‐altering changes that often accompany the onset of aphasia. But how does one go about simultaneously improving communication and positive identity development within aphasia therapy? Socially oriented group therapy for aphasia has been touted as one means of addressing both psychosocial and communicative goals in aphasia.

Aims: This article describes the results of a sociolinguistic analysis of group therapy for aphasia in which positive personal and group identity are skilfully negotiated.

Methods & Procedures: Sociolinguistic microanalysis of discourse in a group therapy session was undertaken. The session, described as group conversation therapy, included eight adults with aphasia, a speech–language pathologist and an assistant. The session was videotaped and transcribed, and the data were analysed to identify ‘indices of identity’ within the discourse. This included discourse that exposed members' roles, values or beliefs about themselves or others. The data were further analysed to identify ‘patterns’ of discourse associated with identity. The result is a detailed description of identity‐enhancing discourse within group therapy for aphasia.

Outcomes & Results: The findings included several categories associated with the negotiation of identity in therapy including: (1) discourse demonstrating that group members were ‘being heard’, (2) that the competence of group members was assumed, (3) that ‘solidarity’ existed in the group, (4) that saving face and promoting positive personal identity was important, and (5) that markers of group identity were made visible via discourse that referenced both member inclusion as well as non‐member exclusion.

Conclusions & Implications: The results suggest that it is possible to create identity‐enhancing interactions as part of therapy for aphasia; the analysis demonstrates the potential role of the group leader/clinician in managing identity negotiation in aphasia therapy.
May everybody witness the fruitful events!
Authors: Editor The
Published: September 2010

DOI: 10.3126/nepjoph.v1i1.3665Nep J Oph 2009;1(1):1
Effectiveness of sedation in dacryocystorhinostomy surgery
Authors: Taludhar S , Adhikari S , Bhattarai BK
Published: September 2010

Background: Chronic dacryocystitis is a common ophthalmic problem almost always requiring surgery as the only definitive treatment. Aim: To compare the perioperative outcome of external DCR surgery under local anesthesia with and without sedation. Subjects and methods: One hundred consecutive patients with chronic dacryocystitis undergoing dacryocystorhinostomy (DCR) surgery were randomly divided into two groups using computer generated random table. Group A underwent DCR under local anesthesia (LA) without sedation and group B under LA with sedation. The outcome parameters were intra-operative pain, surgeon's comfort, intra-operative complications and duration of surgery. Statistical analysis: SPSS version 11.5 software was used. Chi square test was used to compare the difference between the groups. Results: There were 50 patients in each group. The mean age ± SD of the patients was 34.4±12.12 years (95% CI=28.89-38.55 years). Sixty-nine percent of them were female. Significantly higher number of patients experienced pain in Group A as compared to Group B (100% vs 50%, P<0.001) Surgeon's discomfort was significantly present in group A as compared to group B (70% vs 10%), (p=0.00001). Blood loss was significantly more in group A than in group B (p=0.017). There was no significant difference in the duration of surgery. The post operative success rate in both the groups was comparable after six months of followup. Conclusion: The use of sedation with LA improves the perioperative outcome of DCR surgery in terms of patient's pain, surgeon's comfort and intra-operative complications. Key words: dacryocystitis; dacryocystorhinostomy; sedation DOI: 10.3126/nepjoph.v1i1.3670 Nep J Oph 2009;1(1):25-31
Post-operative capsular opacification
Authors: Raj SM , Vasavada AR , Johar SR Kaid , Vasavada VA , Vasavada VA
Published: September 2010

Post-operative capsular opacification (PCO) is a multifactorial physiological consequence of cataract surgery. Opacification involving the central posterior capsule has a significant impact on high and low contrast acuity and low contrast sensitivity. The assessment of PCO on cadaver eyes, experimental studies and culture models and in clinical studies has provided an understanding of its pathogenesis. The proliferation, migration and abnormal differentiation of residual lens epithelial cells and fibers in the capsular bag have been implicated in the pathogenesis of PCO. The incidence and severity of PCO correlates to the use of surgical techniques, intraocular lens (IOL) optic edge designs and IOL materials. This article summarizes the clinical studies with recommendations for retarding the development of central PCO. It discusses experiments with pharmacological agents broadly categorized as anti-inflammatory, immuno-modulating, antiproliferative, antiadhering and antitransdifferentiating agents for the prevention of PCO. These studies will remain critical for future endeavors undertaken for the eradication of PCO. Key words: posterior capsular opacification; capsular opacification; cataract; crystalline lens; phacoemulsification DOI: 10.3126/nepjoph.v1i1.3673 Nep J Oph 2009;1(1):43-59
Terson's syndrome
Authors: Sharma R , Shrestha JK
Published: September 2010

Terson's syndrome is rarely encountered in ophthalmic practice. The ophthalmologists should be acquainted with the clinical features and methods of diagnosis of this syndrome. Here we report a middleaged lady with altered sensorium, visual impairment and headache who was diagnosed as having Terson's syndrome after fundoscopy and spinal tap. It was managed conservatively. Key words: vitreous hemorrhage; subarachnoid hemorrhage DOI: 10.3126/nepjoph.v1i1.3678 Nep J Oph 2009;1(1):77-79
VISION 2020: the meaning and the spirit of the right to sight initiative
Authors: Gudlavalleti Murthy VS
Published: September 2010

DOI: 10.3126/nepjoph.v1i2.3679Nep J Oph 2009;1(2):83-84
Gender and wavefront higher order aberrations: Do the genders see the world differently?
Authors: Reilly CD , Blair MA
Published: September 2010

Introduction: Wavefront sensing technology has emerged as a means to advance our understanding of high-order aberrations of the human eye. Purpose: To evaluate the differences in ocular high-order aberrations between males and females and the distribution of high-order aberrations in males and females. Subjects and methods: 3,597 eyes (1,029 female and 2,568 male) of 1,874 patients who obtained wavefront measurements performed using the VISX Wavescan device were included in this study. Mean RMS (root mean square) values of high-order aberrations (HOAs) and the mean of each Zernike polynomial from the second to the sixth order were calculated from multiple scans of each eye. Analysis was performed to assess the association between HOAs and gender, and symmetry of HOAs between eyes in both males and females. Results: Overall HOA did not differ significantly between males and females (p= 0.93). Overall HOA did not differ between left eyes (p=0.852) or right eyes (p=0.76). Individual Zernike polynomials did reveal a significant difference between male and female eyes: Z14 (Tetrafoil x, p=.036); Z16 (Secondary Trefoil y, p=0.015); Z24 (Secondary Spherical, p=0.003); Z25 (Tertiary Astigmatism x, p=0.010); and Z26 (Secondary Tetrafoil x, p=0.004). Conclusion: Overall HOA does not differ between the genders; however, individual HOA Zernike terms do demonstrate statistically significant differences between males and females. This is the first such study to describe these differences. The clinical significance of these differences has yet to be determined. Keywords: refractive surgery; high-order aberrations; cornea; gender DOI: 10.3126/nepjoph.v1i2.3680 Nep J Oph 2009;1(2):85-89
The factors associated with age related macular degeneration and quality of life of the patients in a tertiary-level ophthalmic center in Kathmandu
Authors: Gautam P , Shrestha JK , Joshi SN
Published: September 2010

Introduction:Age-related macular degeneration (ARMD) is a leading cause of blindness in the elderly population. Objective:To frame a profile of patients with ARMD and find out the factors associated with it Materials and methods: A cross-sectional study was carried out including a total of 75 patients with ARMD presenting to the out-patient department of a tertiary level ophthalmic center in Kathmandu. The data pertaining to their demography, ocular and systemic history and the findings of clinical examination and laboratory investigations were analyzed. The quality of life was assessed based on their dependability on the others for daily activity. Results: Mean age of presentation of ARMD was 73 years ±7.93. Of the total, 44 were male and 31 female. Smoking was significantly associated with ARMD (p<0.01). 47 of the subjects had a sedentary lifestyle and 28 a non-sedentary lifestyle. Sedentary life style was significantly associated with ARMD (p=0.028). 48 subjects were hypertensive. Systemic hypertension was significantly associated with ARMD (p = 0.015). 45 had dry ARMD, 21 had wet ARMD and 9 of them had a mixed variety. Thirteen out of the 75 study subjects were leading a normal life while 45 of them had some limitation (self-care only) and 17 of them were dependent on the others for their daily activity. The quality of life was not significantly different between dry and wet ARMD (p = 0.40). Conclusion: Sedentary life style, smoking and hypertension are the modifiable factors that are associated with ARMD. A significant number of people with the ARMD have a compromised quality of life. Keywords: ARMD; associated factors; quality of life; macular degeneration DOI: 10.3126/nepjoph.v1i2.3685 Nep J Oph 2009;1(2):114-117
Xerosis meter-an electro-physiological device for quick screening of dry eyes
Authors: Gupta Y , Gupta M , Maheshwari R , Mittal T
Published: September 2010

Aim: To study the role of ‘Xerosis Meter' in screening of dry eye cases in a large population and compare its results with Schirmer's test and tear break-up time. Materials and method: In a cross sectional study with a control group dry eye was evaluated with Xerosis Meter, Schirmer test and tear film break-up time (TBUT). Cases included in the study were divided into two groups. Group I (Control Group) comprised of asymptomatic patients while Group II (Test Group) had patients showing symptoms and signs of dry eye. The Group II was further divided into two subgroups. Group IIa had cases showing positive result with either of the two tests Schirmer test or TBUT. Group IIb had cases which showed positive results with Xerosis Meter but normal results with the other two tests. Statistics: All the observations were statistically analyzed using SPSS version 11.5 software. The results obtained were compared statistically using unpaired t-test and chi-square test. The p value of < 0.05 was considered as significant. Results: There was a statistically significant difference between the means of Xerosis Meter, Schirmer test and TBUT of the two groups: Group I and Group IIa (p value < 0.001). On comparing Group I and Group IIb the difference was found to be statistically significant with Xerosis Meter (p value < 0.001). The sensitivity and specificity of Xerosis Meter were 85.7% and 80.2% respectively. This was higher than that of the Schirmer's test (81.3% and 74.9%) and TBUT (73.2% and 68.7%). Conclusion: The "Xerosis Meter" is an effective alternate in screening of dry eye cases. It is more effective than the TBUT and as effective as the Schirmer's test in detecting both the normal and dry eye patients. DOI: 10.3126/nepjoph.v1i2.3687 Nep J Oph 2009;1(2):123-128
Alport syndrome
Authors: Karki P , Shrestha JK
Published: September 2010

Alport syndrome is an oculo-renal syndrome characterized by a triad of clinical findings consisting of hemorrhagic nephritis, sensorineural hearing loss and characteristic ocular findings. We report a young male patient who presented with painless diminution of vision associated with hearing loss. The importance of ophthalmic evaluation for suspecting the disease is highlighted. Keywords: Alport syndrome; sensorineural hearing loss; micro-hematuria; oculo-renal syndrome DOI: 10.3126/nepjoph.v1i2.3690 Nep J Oph 2009;1(2):139-140
Management of intra-vitreal cysticercosis
Authors: Yadav SK , Winter I , Singh SK
Published: September 2010

Background: South East Asia is an endemic zone for cysticercosis. Oocular cysticercosis is emerging as a common problem which if untreated can lead to severe visual loss in 3-5 years. Cases: We describe here a case series of three patients with intravitreal cysticercosis and managed by surgical cyst removal by pars plana vitrectomy. Observation: The procedure was successful in all cases to maintain anatomical integrity of the globe with some functional gain of vision. Conclusion: Surgical intervention in ocular intravitreal cysticercosis is an acceptable approach with good results. Key words: cysticercosis; ocular cysticercosis; intravitreal cysticercosis DOI: 10.3126/nepjoph.v1i2.3692 Nep J Oph 2009;1(2):143-145
Management of corneal wounds: some practical tips
Authors: Lee SH
Published: September 2010

Corneal trauma is one of the leading causes of ocular morbidity. This paper aims at providing some practical tips useful for management of corneal wounds. DOI: 10.3126/nepjoph.v1i2.3693 Nep J Oph 2009;1(2):146-150
Visual outcome of conventional extra-capsular cataract extraction with posterior chamber intraocular lens implantation versus manual small incision cataract surgery
Authors: Sharma A , Lavaju P
Published: September 2010

DOI: 10.3126/nepjoph.v1i2.3694 Nep J Oph 2009;1(2):151
Anaesthesia and ophthalmic surgery
Authors: Acharya S
Published: September 2010

DOI: 10.3126/nepjoph.v1i2.3695 Nep J Oph 2009;1(2):152
Ocular manifestations in HIV/AIDS cases in Nepal
Authors: Lamichhane G , Shah DN , Sharma S , Chaudhary M
Published: September 2010

Background: A significant number of patients with HIV/AIDS can have ocular manifestations. Almost every structure in the eyes can be affected in this condition. Objective: To study various ocular manifestations in the cases known to be infected with HIV. Materials and methods: A cross-sectional descriptive study was carried out including 117 subjects positive for HIV using the purposive sampling method. Their demographic pattern and ocular findings were studied. Findings were recorded in the pro forma developed for the study. Statistics: SPSS ver 14.0 was used for data analysis. The p value of <0.05 was considered as significant. Results: A total of 117 HIV infected cases were included in this study. Among them, 76 (64.95 %) were male and 41 (35.05 %) female. The mean age of the subjects was 30.04 ± 11.32 years. The duration of HIV detection ranged from 1-5 years. Ocular complaints were present in 26.49 % of the subjects. Ocular manifestations were present in 56 % of the patients with complaints and in 27.3 % of asymptomatic patients. Ocular involvement was seen in 55 (47 %) patients. The common anterior segment findings were herpes zoster ophthalmicus (4.27 %), anterior uveitis (2.56 %), blepharitis (2.56 %) and conjunctivitis (1.7 %), whereas HIV retinopathy (19.6 %), CMV retinitis (5.1 %), ocular toxoplasmosis (2.5 %) and presumed ocular tuberculosis (0.85 %) were common posterior segment findings. Conclusion: Herpes zoster ophthalmicus, anterior uveitis, HIV retinopathy and CMV retinitis are common ocular manifestations associated with HIV infections. Keywords: HIV/AIDS; anterior and posterior segments; ocular involvement DOI: 10.3126/nepjoph.v2i1.3704 Nep J Oph 2010;2(1) 45-50
Lasers in glaucoma
Authors: Kumar S
Published: September 2010

Use of lasers in the treatment of various types of glaucomas is an important aspect in ophthalmic practice. Both Argon and Yag lasers are now-a-days commonly used in the treatment of angleclosure and open-angle glaucomas. Besides this, more recently, Diode lasers are being used for the treatment of the glaucomas. Lasers are also being used in the management of intractable glaucomas which are not controlled by medication alone. In this review article, all these features have been highlighted. Keywords: Lasers; glaucoma DOI: 10.3126/nepjoph.v2i1.3705 Nep J Oph 2010;2(1) 51-58
A rare case of persistent pupillary membrane associated with high myopia and amblyopia
Authors: Gupta Y , Gupta M , Sambhav K , Mittal T
Published: September 2010

Purpose: To present the management of a rare case of persistent pupillary membrane (PPM) associated with high myopia and amblyopia. Case: A 12-year-old boy presented with progressive diminution of vision in the right eye since childhood. Examination (OD) showed several fine strands of iris attached to the collarette and to the anterior lens capsule with a clump of iris pigment adherent over it. Some of these strands even wrinkled on pupillary contraction. The patient was also examined on slit-lamp.The patient was operated for lens extraction with PCIOL implantation. Results: The patient regained useful vision after surgery. Conclusion: This is a rare case of persistent pupillary membrane associated with high axial myopia. Keywords: persistent pupillary membrane; myopia; amblyopia DOI: 10.3126/nepjoph.v2i1.3708 Nep J Oph 2010;2(1) 68-70
Low vision devices
Authors: Arya SK , Kalia A , Pant K , Sood S
Published: September 2010

A person with low vision has some useful sight. However, low vision usually interferes with the performance of daily activities such as reading or driving. Because low vision cannot be improved by mere traditional methods (i.e., the use of eyeglasses, contact lenses, etc), persons with low vision often rely on the use of a number of different instruments, called low vision devices, and tailored equipment for improved vision. Low vision devices are described in this article. DOI: 10.3126/nepjoph.v2i1.3710 Nep J Oph 2010;2(1) 74-77
Bacteriology and antimicrobial susceptibility of adult chronic dacryocystitis
Authors: Chaudhary M , Bhattarai A , Adhikari SK , Bhatta DR
Published: September 2010

Introduction: Chronic dacryocystitis results in chronic infection and inflammation of the lacrimal sac. Objective: To identify the aetiology of chronic dacryocystitis and to determine their antimicrobial susceptibility pattern. Materials and methods: A cross - sectional study was undertaken including 120 lacrimal swab materials collected from patients aged above 15 years suffering from chronic dacryocystitis. Statistics: Data analysis was done by using software "Win pepi'' ver 7.9. Results: The bacteria of eight different species were isolated from 76.66 % (92/120) culture positive samples. 85.86 % showed a single and 14.13 % showed a mixed growth pattern. Coagulase negative staphylococci were the most common bacteria (P= 0.018) accounting for 33.96 % followed by Staphylococcus aureus (25.46 %), Streptococcus pneumoniae ( 19.81 % ), Streptococci viridans (5.66 %), Escherichia coli (5.66 %), Haemophilus spp ( 4.71 % ), Streptococcus pyogenes (3.77 %) and Bacillus spp (0.94 % ). Staphylococcus aureus were the most predominant bacteria in mixed growth. Rate of infection was higher in males 81.39 % than in females 74.02 %. Infection was higher in the age group of above 31 years. In the antimicrobial susceptibility test, except staphylococcus aureus, all the Gram positive isolates were 100 % sensitive to chloramphenicol and were least sensitive to tobramycin, but Gram negative isolates were equally sensitive to Chloramphenicol and Nalidixic acid. Conclusion: Coagulase negative staphylococci are the most frequently isolated bacteria. Staphylococcus aureus is predominantly found in mixed growth. Chloramphenicol is the most effective drug of choice for chronic dacryocystitis. Key words: chronic dacryocystitis; nasolacrimal duct; lacrimal sac; epiphora; mucopurulent DOI: 10.3126/nepjoph.v2i2.3716 Nep J Oph 2010;2(2) 105-113
Physiological disproportions between un-corrected vision and degree of myopia
Authors: Gupta Y , Rizvi SAR , Gupta M
Published: September 2010

Introduction: Anomalies of the refractive state of the eye are the commonest cause of defective vision. Purpose: To study the relationship between uncorrected visual acuity and refractive error in myopia in children, the prevalence of disparity between them and to find out the possible explanation for it. Materials and methods: 100 eyes of 50 myopic children were studied and analyzed to study relationship between the uncorrected visual acuity (UCVA) and its refractive status. 42 cases were chosen to study disparity, either in the form of uncorrected visual acuity or refractive error. To study these disparities, Keratometery for anterior corneal curvature and A-scan for axial length and anterior chamber depth were also done. Statistics: The results were analyzed statistically using student t-test while the relationship between uncorrected visual acuity (UCVA) and refractive error in myopia was obtained with Spearman's correlation coefficient (R). Results: The strength of association of uncorrected visual acuity and myopia as indicated by the correlation coefficient (0.897, p < 0.001) is a significant one. Out of 42 cases taken to study disparity, 24 (57 %) cases showed discrepancy either in the form of uncorrected visual acuity or refractive error. The reason for this disparity as proven statistically in our study is increased axial length (p value< 0.001). Conclusions: There exists a linear relationship between UCVA and myopia, yet an accurate prediction of uncorrected visual acuity cannot be made on the basis of the refractive error or vice-versa for any single individual, as there exists a disparity either in form of UCVA or refractive error in myopia. Keywords: refractive error; myopia; uncorrected visual acuity; disparity; axial length DOI: 10.3126/nepjoph.v2i2.3721 Nep J Oph 2010;2(2) 138-144
Role of amniotic membrane transplantation in ocular surface disorders
Authors: Arya SK , Bhala S , Malik A , Sood S
Published: September 2010

The advent of amniotic membrane (AM) and limbal stem cell grafts have transformed the treatment of diseases resulting in ocular surface failure. The current success may be attributed to cryopreservation of human AM, which retains its properties and renders the amniotic epithelial cells nonviable and thus nonimmunogenic. Its unique properties have prompted its application in a large number of ocular ailments. The present article reviews the properties of AM and its uses in ophthalmic practice. Keywords: amniotic membrane transplantation; ocular surface disorders; chemical injury; dry eye DOI: 10.3126/nepjoph.v2i2.3722 Nep J Oph 2010;2(2) 145-153
Ocular trauma among children in western Nepal: agents of trauma and visual outcome
Authors: Adhikari RK , Pokhrel H , Chaudhary H , Chaudhary B
Published: September 2010

DOI: 10.3126/nepjoph.v2i2.3726 Nep J Oph 2010;2(2) 164-165
Prevalence of the glaucomas in Nepal
Authors: Sah RP
Published: September 2010

DOI: 10.3126/nepjoph.v2i2.3727Nep J Oph 2010;2(2) 166
Cerebral watershed hypoperfusion in subarachnoid hemorrhage: computed tomography perfusion analysis
Authors: Lanterna Luigi Andrea , Lunghi Alessandro , Martchenko Svetlana , Gritti Paolo , Bonaldi Giuseppe , Biroli Francesco
Published: September 2010

Object

A better understanding of the pathophysiology of vasospasm-induced delayed cerebral ischemia and earlier detection of hypoperfusion before ischemic injury are needed to guide therapy in subarachnoid hemorrhage (SAH). The cerebrovascular physiology of the major arterial territories differs from that of the watershed zones (WZs) in a way that would suggest a differential topographic sensitivity of the brain to vasospasm. The primary end point of the study was to investigate the vasospasm-induced hypoperfusion in relation to cerebrovascular topography and timing from the onset of SAH.

Methods

Forty-one patients were prospectively enrolled and scheduled for perfusion-weighted (PW) CT at 3 time points (≤ 3 days, Days 4–8, and Days 9–15 after SAH). Perfusion-weighted CT maps were visually assessed for side-to-side perfusion asymmetry. The PW CT topographic pattern was categorized into absence of asymmetry, WZ, and vascular territory hypoperfusion. Perfusion-weighted CT revision was performed by investigators blinded to clinical information. The null hypothesis for the primary end point was that there would be no difference in hypoperfusion space-time distribution among the different vascular territories. Multivariate logistic regression and Cox proportional hazards modeling were used for statistical analysis.

Results

Delayed cerebral ischemia occurred in 26 patients and its predicting variables were increasing age (p = 0.045), Fisher grade (p = 0.007), and hypoperfusion on the PW CT performed within the 1st 72 hours after SAH (p = 0.004). The timing of the PW CT with respect to the day of SAH affected the topographic pattern of hypoperfusion: watershed-zone hypoperfusion was more common within the first 3 days after SAH (p = 0.018), while the proportion of territorial hypoperfusion increased subsequently. Among the different covariates, a young age was independently associated with a higher risk of developing hypoperfusion in the WZs (p = 0.02).

Conclusions

This study suggests the existence of a cerebral topographic heterogeneity to the hemodynamic effects of SAH and differential pathogenetic mechanisms of hypoperfusion according to timing, age, and brain topography. Hypoperfusion in the WZs may be an early precursor to more profound ischemic events. The PW CT detection of such brain-sensitive zones could offer a warning signal of the early hemodynamic effects of SAH and cerebral vasospasm.
Morphologically cryptic biological species within the liverwort Frullania asagrayana
Authors: Ramaiya Megan , Johnson Matthew G. , Shaw Blanka , Heinrichs Jochen , Hentschel Jörn , von Konrat Matt , Davison Paul G. , Shaw A. Jonathan
Published: September 2010

• Premise of the study: The Frullania tamarisci complex includes eight Holarctic liverwort species. One of these, F. asagrayana, is distributed broadly throughout eastern North America from Canada to the Gulf Coast. Preliminary genetic data suggested that the species includes two groups of populations. This study was designed to test whether the two groups are reproductively isolated biological species.

• Methods: Eighty‐eight samples from across the range of F. asagrayana, plus 73 samples from one population, were genotyped for 13 microsatellite loci. Sequences for two plastid loci and nrITS were obtained from 13 accessions. Genetic data were analyzed using coalescent models and Bayesian inference.

• Key results: Frullania asagrayana is sequence‐invariant at the two plastid loci and ITS2, but two clear groups were resolved by microsatellites. The two groups are largely reproductively isolated, but there is a low level of gene flow from the southern to the northern group. No gene flow was detected in the other direction. A local population was heterogeneous but displayed strong genetic structure.

• Conclusions: The genetic structure of F. asagrayana in eastern North America reflects morphologically cryptic differentiation between reproductively isolated groups of populations, near‐panmixis within groups, and clonal propagation at local scales. Reproductive isolation between groups that are invariant at the level of nucleotide sequences shows that caution must be exercised in making taxonomic and evolutionary inferences from reciprocal monophyly (or lack thereof) between putative species.
Polymorphic chloroplast microsatellite markers in the octoploid Lepidium meyenii (Brassicaceae) and cross‐species amplification in Lepidium
Authors: Hasan Nabeeh A. , Mummenhoff Klaus , Quiros Carlos F. , Tay C. David , Bailey C. Donovan
Published: September 2010

• Premise of the study: As a crop and medicinal plant, the octoploid Andean endemic Lepidium meyenii suffers from taxonomic uncertainty. Few molecular markers are available to genotype individuals or track gene flow in wild and cultivated material.

• Methods and Results: Using available sequence data, eight cpSSR primer pairs were developed for L. meyenii. Levels of polymorphism checked in 56 individual L. meyenii, including cultivated and wild material, revealed that the number of alleles per locus ranged from three to five, and intrapopulation allele frequencies ranged from 0.071 to 1.0. Polymerase‐chain‐reaction screens using our cpSSR primers in 27 other Lepidium species and three Coronopus species suggested a high degree of interspecific amplification.

• Conclusions: These polymorphic cpSSR markers should prove useful in characterizing genetic variation among cultivated and wild L. meyenii. Additionally, interspecific amplifications suggest that these markers will be useful for the study of related taxa.
Autopsie d'une négociation. Le règlement de la grève d'avril-mai 1947 à la Régie Renault
Authors: Sardais Cyrille
Published: September 2010

Résumé Grâce à la richesse des archives du premier PDG de la Régie Renault, et notamment des comptes rendus inédits des réunions qui ont rassemblé la direction de l’entreprise, la CGT et/ou le gouvernement, cet article rend compte du processus de négociation qui a conduit à résoudre le conflit Renault d’avril-mai 1947. Il montre comment la solution qui fut construite par les acteurs, tout en étant impensable au début du conflit, a finalement rendu compatibles l’ensemble des impératifs posés d’entrée par les différents protagonistes. Parce qu’il se propose d’entrer dans l’univers des principaux acteurs de cette négociation, ce texte éclaire d’une manière originale un processus de négociation particulièrement spectaculaire, ainsi que toute une page de l’histoire de la France de l’après-guerre, page décisive qui a conduit à l’exclusion des ministres communistes du gouvernement et à la rupture du tripartisme.
L'intelligence investie par les familles.
Authors: Lignier Wilfried
Published: September 2010

Résumé En France, depuis les années 1990, un nombre grandissant de parents s'investissent dans la « précocité intellectuelle », c'est-à-dire donnent du sens et du poids dans leurs pratiques et dans leurs conceptions éducatives au fait qu'un ou plusieurs de leurs enfants aient un quotient intellectuel supérieur à 130. Cet article vise à rendre compte des conditions sociales de cet investissement. On montre d'une part que les ressources économiques et culturelles dont disposent les familles importent, mais que jouent sans doute aussi la proximité culturelle à la psychologie et la distance à la nécessité scolaire. On montre d'autre part que l'opportunité de l'« investissement de l'intelligence » est à relier à des stratégies scolaires efficaces, qui sont nécessaires pour donner une véritable consistance sociale au diagnostic de précocité.þ
Fine needle aspiration biopsy of an osteoclast-rich undifferentiated urothelial carcinoma: A cytology case report and review of the literature
Authors: Purohit Chetna N. , Bui Marilyn M. , Hakam Ardeshir
Published: September 2010

Osteoclast-rich undifferentiated carcinoma of urinary bladder (ORUCUB) is a very rare and an unusual variant of high-grade urothelial carcinoma. Here, we report an extraordinary case of metastatic ORUCUB, diagnosed by fine needle aspiration (FNA) biopsy, in a 74-year-old Hispanic male who presented with a palpable, tender left groin mass and a known previous history of high-grade carcinoma of urinary bladder and prostatic cancer. To the best of our knowledge, diagnosis of ORUCUB by FNA is the first case report in FNA cytology to be published to date. A review of the literature is emphasized on the cytological, histological and immunohistochemical features and differential diagnoses of giant cell tumor.
Eosinophilic ascites due to severe eosinophilic ileitis
Authors: Setia Namrata , Ghobrial Peter , Liron Pantanowitz
Published: September 2010

Background:

There is a broad etiology for effusion eosinophilia that includes allergic, reactive, infectious, immune, neoplastic, and idiopathic causes. We report and describe the cytomorphologic findings of a rare case of eosinophilic ascites due to severe eosinophilic ileitis.

Case Presentation:

A 17-year-old male manifested acutely with eosinophilic ascites due to severe biopsy-proven subserosal eosinophilic ileitis. Isolated peritoneal fluid submitted for cytologic evaluation revealed that 65% eosinophils were present in a bloody background. The patient responded to corticosteroids, with complete resolution of his ascites.

Conclusion:

Eosinophilic gastroenteritis with subserosal involvement should be added to the list of causes for eosinophils in peritoneal fluid. The finding of eosinophilic ascites, with appropriate clinical and laboratory findings, may warrant the need to perform laparoscopic intestinal biopsies to confirm the diagnosis.
The Work of David Gottlieb: A Success Story
Authors: Gustafsson Bertil
Published: September 2010

This article is a brief survey of David Gottlieb’s extraordinary research career. It is impossible to give a thorough presentation of all his research and the impact of his work, but we shall describe the main contributions and give examples of the results in some of his papers. David was for many years the dominating person in the development of spectral methods, and we devote much of the space in this article to this field.
Constraint Preserving Schemes Using Potential-Based Fluxes I. Multidimensional Transport Equations
Authors: Mishra Siddhartha , Tadmor Eitan
Published: September 2010

We consider constraint preserving multidimensional evolution equations. A prototypical example is provided by the magnetic induction equation of plasma physics. The constraint of interest is the divergence of the magnetic field. We design finite volume schemes which approximate these equations in a stable manner and preserve a discrete version of the constraint. The schemes are based on reformulating standard edge centered finite volume fluxes in terms of vertex centered potentials. The potential-based approach provides a general framework for faithful discretizations of constraint transport and we apply it to both divergence preserving as well as curl preserving equations. We present benchmark numerical tests which confirm that our potential-based schemes achieve high resolution, while being constraint preserving.