bluuebunny/crossref_metadata_2025 huggingface dataset:
The Development of Future School Psychology Counselors' Technology Integration Skills
Authors: Kulaksız Taibe , Alkan Özge Kelleci , Geris Ali
Published: February 2025

This book chapter examines the technology integration skills of future school psychology counselors and their implementation process in real-world instructional technology settings. Using a convergent parallel mixed-method design, 36 first-year Guidance and Psychological Counseling students participated. Data collection tools included the demographic information and course expectations form, the TPACK-P scale, and material development reports. Both qualitative and quantitative analyses were conducted. Results revealed that participants' expectations focused on acquiring technological knowledge. Pre- and post-test scores showed significant improvements in their technology integration knowledge and skills. Participants also shared insights on the implementation process, feedback from students, and challenges faced during implementation. These findings highlight the necessity of equipping future school psychology counselors with hands-on training in instructional technologies to ensure effective and meaningful professional integration.
Protecting Generations: Sri Lanka's triumph in ending Mother-to-Child Transmission (EMTCT) of HIV
Authors: Somatunga Lakshmi C.
Published: February 2025

No abstract available
Rethinking the Medicalisation of Milder Symptoms in Sri Lanka: An Evidence-Based Approach to Rational Health Practices
Authors: Ferdinando Ruwan , Somathunga Lakshmi C. , Samaraweera Sudath , Wijesinghe Millawage Supun Dilara
Published: February 2025

No abstract available
Enhancing Resurrection Practices for Unusable Surgical Inventory Items at District General Hospital, Negombo
Authors: Malalasekara L. I. , Wijemanne W. M. U. S.
Published: February 2025

Background: Effective management and maintenance of surgical inventory items are vital for ensuring uninterrupted healthcare services and optimizing resource utilization in hospitals. In resource-poor settings where financial and technical constraints limit the availability of new equipment, enhancing resurrection practices plays a critical role in sustaining healthcare delivery and maximizing existing resources.Objective: The primary aim of this study was to enhance the resurrection practices of selected surgical inventory items at  District General Hospital (DGH) Negombo through tailored interventions and involvement of volunteer technical support.Methods: This implementation science study with pre- and post-assessments conducted at DGH Negombo from August 2022 to November 2023 focused on collaborating with unit heads managing surgical inventory items and condemned items identified by the Biomedical Engineering Division. Data collection involved key informant interviews to gather qualitative insights, self-administered questionnaires distributed to unit heads for quantitative data on repair processes, and a desk review of hospital records to identify frequently malfunctioning items. Statistical analysis included content analysis for qualitative data and descriptive statistics for quantitative data, helping to prioritize items for repair based on urgency and feasibility.Results: Pre-intervention assessments highlighted several inefficiencies including prolonged repair times, poor coordination with the Biomedical Engineering Division, and inadequate infrastructure for managing surgical inventory items. Post-intervention evaluations demonstrated marked improvements, with repair times decreasing by 32%, enhanced coordination with Biomedical Engineering units, and increased stakeholder satisfaction, as indicated by the higher SAQ scores. Additionally, 60% of condemned multipara monitors, 76% of oxygen regulators, and 78% of suction apparatus were successfully restored, underscoring significant efficiency gains in equipment availability and resource utilization. Conclusion and Recommendations: The tailored interventions implemented during this study significantly improved efficiency and effectiveness in managing surgical inventory items at DGH Negombo, enhancing equipment availability, and achieving cost savings. Similar approaches emphasizing systematic assessments, stakeholder collaboration, and volunteer technical support are recommended for sustainable improvements in comparable healthcare settings.
Assessment of Drug Supply Chain Management Effectiveness in Selected Tertiary Care Hospitals in The Western Province of Sri Lanka
Authors: Jeyassuthan K. , Roshan G. Paul , Gandharupan N. , Kayalvizhi B.
Published: February 2025

Background: Access to essential medicines is crucial for effective healthcare delivery, particularly in tertiary care hospitals where complex medical cases are managed. However, challenges in the supply chain management of drugs persist, leading to shortages and inefficiencies in healthcare delivery. In Sri Lanka, despite substantial investments and regulatory frameworks, deficiencies in drug supply chain management have been observed, impacting the availability and quality of medications in hospitals.Objective: To assess the effectiveness of drug supply chain management in selected tertiary care hospitals within the Western Province of Sri Lanka.Methods: A cross-sectional descriptive study was conducted in selected tertiary care hospitals in the Western Province, utilizing purposive sampling. Data were collected through self-administered questionnaires, document reviews, and observations of drug stores.Results: The study revealed significant gaps in supply chain management practices in tertiary care hospitals. Factors such as inadequate training, poor inventory management, and substandard storage facilities were identified as contributors to inefficiencies. Despite efforts, none of the hospitals met the expected standards in drug availability or quality management.Conclusion: This study highlighted areas for improvement such as drug availability and estimation accuracy, alongside successes in mitigating drug wastage and maintaining inventory. Despite limitations in existing literature, the study provided valuable insights into enhancing drug management practices. Urgent interventions are needed to address challenges and ensure uninterrupted access to essential medications, emphasizing the importance of targeted interventions in tertiary care settings.
Perceived Bureaucratic Red Tape in Hospital Administration: A Case Study from a District General Hospital in Sri Lanka
Authors: Wijekoon W. M. C. R. , Hewage R. A. , Ratnasekare W. A. P. P.
Published: February 2025

Background: Public Hospitals are hierarchical organizations characterized by the features of bureaucracy described by Max Weber. Tiring rules and regulations, endless paperwork, and strict legal requirements are some of the adverse outcomes of bureaucracy, termed bureaucratic Red Tape. They have detrimental effects on organizational performance. Objective: To assess employees’ perceptions of bureaucratic Red Tape in the administrative section of the District General Hospital, Kalutara.Methods: This study utilized a case study approach employing mixed methods. Office employees were selected using purposive sampling, and a semi-structured questionnaire that featured a ten-point scale to measure Red Tape with close-ended and open-ended questions was used to explore the causes. Key informant interviews with managers and focus group discussions with office employees were conducted to obtain management perspectives on the causes and suggestions to alleviate Red Tape. Potential solutions for the Red Tape were discussed at a stakeholder meeting. In addition to descriptive analysis, inferential statistical analysis was performed for demographic variables and operational factors to explore any correlation with Red Tape. Thematic analysis was performed using  qualitative data.Results: The mean perceived bureaucratic red tape score was 5.03 (95% CI: 4.25–5.81), slightly above the midpoint of the scale, indicating inefficiencies in existing rules or procedures, as the literature suggests that even such levels of perceived red tape are significant and warrant attention. Key factors contributing to Red Tape include deficient technology for information management; problematic procedural formats; insufficient in-service training; lack of modern infrastructure; and challenges in rules, regulations, and procedures. Stakeholder suggestions to alleviate Red Tape included training; establishing a committee to investigate, review, and seek suggestions; technology integration; supporting managers; job rotation; increasing access to information on procedures; and streamlining the documentation process.Conclusions and Recommendations: The employee-perceived Red Tape was slightly above the expected level in the administrative section, primarily due to inefficient administrative practices and outdated technology, highlighting the need for targeted interventions. The study identified enhancing employee training in administrative processes, streamlining procedures, integrating advanced information technologies, and fostering a supportive leadership culture to mitigate the effects of bureaucratic Red Tape. Continuous feedback mechanisms are also recommended to ensure the adaptability and effectiveness of administrative processes.
Neurotoxic snake bite mimicking brain death
Authors: Nanayakkara Chathura , Lasika Rukshani , Kuruppu Lakmini
Published: February 2025

Neurotoxic snake bites are common in tropical countries, leading to hospital admissions due to symptoms ranging from mild ptosis to severe neuromuscular paralysis with respiratory failure. Among these, krait bites stand out for their potent neurotoxins, which can lead to a deceptive clinical picture mimicking brain death.We present a case of krait envenomation where the patient presented to the emergency care unit, in a state of pseudo-coma, with fixed dilated pupils and absent brain stem reflexes, resembling brain death. Diagnosing such cases in emergency settings is challenging without proper history and diagnostic tests, often necessitating a high level of suspicion. By recognizing this mimicry, timely administration of antivenom and supportive measures can improve patient outcomes.
A case of anti-Ku myositis mimicking limb girdle muscular dystrophy
Authors: Jayawardena Janya , Weerasinghe Nipuna , Hordagoda Hemal , Peiris Janaka
Published: February 2025

Anti-Ku is a myositis associated antibody. Histopathology of anti-Ku myositis shows significant muscle fibre necrosis imitating immune mediated necrotising myositis as well as muscular dystrophies. A presentation of isolated proximal muscle weakness with muscle biopsy evidence of muscular dystrophy could mislead the clinician. We present a case of anti-Ku myositis with lower limb predominant weakness, absent extra-muscular manifestations and with an equivocal Anti-Nuclear antibody titre, whose muscle biopsy report came as muscular dystrophy. We would like to highlight the importance of considering anti-Ku myositis as an important differential in biopsies showing significant muscle destruction.
Treatment of Alzheimer’s disease: a critical appraisal
Authors: Gunatilake Saman B.
Published: February 2025

No abstract available
Intramuscular Botulinum Neurotoxin Injections for Infantile Esotropia: A Durban Academic Hospital Review
Authors: Khan Mohammed , Kritzinger Anine
Published: February 2025

Background: Infantile esotropia is characterised by a constant, large-angle strabismus present before 6 months of age. Botulinum neurotoxin (BNT) injections offer a potential alternative to surgical correction.Aim: To evaluate the effectiveness and safety of bilateral medial rectus BNT injections in managing infantile esotropia in children younger than 2 years.Setting: The study was conducted at a quaternary hospital in KwaZulu-Natal, South Africa.Methods: A retrospective chart review was performed for patients who received bilateral medial rectus BNT injections over a 7-year period. The primary outcome was the change in the angle of deviation from baseline to 6 months post-treatment. Success was categorised as complete, partial or qualified. Secondary outcomes included complications and demographic factors.Results: The study assessed 41 patients. Most patients were African (90.20%) with large-angle esotropia (85.20%). The mean pre-treatment angle of deviation in the study population was 64.00 prism dioptres (PD). This decreased to a mean post-treatment angle at 6 months of 31.40 PD. There were 28 successes (68%) at 6 months, which comprised 18 patients (43.9%) who had complete or partial success and 10 patients (24.4%) with qualified success.Conclusion: Botulinum neurotoxin injections can be considered as a first-line treatment for infantile esotropia in patients under 2 years, regardless of the initial angle of deviation and are effective and safe.Contributions: Botulinum neurotoxin injections offer a viable alternative to surgery in resource-constrained settings where theatre time may be limited.
Novel bi-allelic variants in DNAH10 lead to multiple morphological abnormalities of sperm flagella and male infertility
Authors: Shoaib Muhammad , Zubair Muhammad , Shah Wasim , Uddin Meftah , Hussain Ansar , Mustafa Ghulam , Rahim Fazal , Zhang Huan , Ali Imtiaz , Abbas Tanveer , Raza Yousaf , Fan Sui-Xing , Shi Qing-Hua
Published: February 2025

Multiple morphological abnormalities of sperm flagella (MMAF) is a severe form of asthenoteratozoospermia, characterized by morphological abnormalities and reduced motility of sperm, causing male infertility. Although approximately 60% of MMAF cases can be explained genetically, the etiology of the remaining cases is unclear. Here, we identified two novel compound heterozygous variants in the gene, dynein axonemal heavy chain 10 (DNAH10), in three patients from two unrelated Pakistani families using whole-exome sequencing (WES), including one compound heterozygous mutation (DNAH10: c.9409C>A [p.P3137T]; c.12946G>C [p.D4316H]) in family 1 and another compound heterozygous mutation (DNAH10: c.8849G>A [p.G2950D]; c.11509C>T [p.R3687W]) in family 2. All the identified variants are absent or rare in public genome databases and are predicted to have deleterious effects according to multiple bioinformatic tools. Sanger sequencing revealed that these variants follow an autosomal recessive mode of inheritance. Hematoxylin and eosin (H&E) staining revealed MMAF, including sperm head abnormalities, in the patients. In addition, immunofluorescence staining revealed loss of DNAH10 protein signals along sperm flagella. These findings broaden the spectrum of DNAH10 variants and expand understanding of the genetic basis of male infertility associated with the MMAF phenotype.
Knowledge, attitude and practices about influenza vaccines amongst hospital staff in a tertiary care hospital
Authors: Sharma Harsh Vardhan , Sharma Sushil , Gupta Abhinav , Patil Yogeshwari Himmatsing , Gupta Ravinder Kumar
Published: February 2025

Background:

People working in health care are particularly vulnerable to catching influenza infection as they are always exposed to probable cases in hospital settings. Influenza is a communicable disease that transmits from patients to healthcare workers (HCWs) and vice versa. Contrary to most of the recommendations, influenza vaccination coverage among HCWs is low.

Aims:

This study intends to assess the knowledge, attitude and practices towards influenza vaccination in a group of HCWs.

Materials and Methods:

In this cross-sectional study conducted, 128 HCWs participated. Institutional ethical committee clearance was obtained before starting the study. It was conducted from April 2023 to May 2023. A set of 20 questions were sent in a single Google sheet to all participating HCWs affiliated with the institution. Data collected were tabulated using MS Excel and analysed using proper statistical tools.

Results:

Amongst the aggregate of 250 HCWs approached, 128 (51.2%) replied to the questionnaire. Of these, 71 (55.5%) responses were from female participants and 51 (44.5%) were from male participants. The maximum respondents belonged to the age group of 25–39 years (40.6%), followed by the age group of 50–59 years (25%). Most respondents were paramedics who comprised about 40.6% of the total study population, followed by nurses (28.9%). Amongst the total study population of 128, only 44 (34.4%) have had the influenza vaccine at the minimum once in their lifespan, the most common reason for acceptance was that it was recommended at their workplace (38.6%) and it protects high-risk patients (22.7%). Whereas 84 (65.6%) have not received an influenza vaccine ever in their lifetime, the reasons being their mistrust in vaccines preventing influenza disease (35.7%) and their belief that they are not at risk for influenza (28.6%).

Conclusion:

There is an unsatisfactory rate of influenza vaccination amongst HCWs. Maximum HCWs believe that the vaccine is safe and protects from influenza. Vaccine coverage needs to be improved by making all the stakeholders put more effort into the same.
Awareness of paediatric surgical conditions amongst practicing paediatricians in Northern India
Authors: Singh Gurmeet , Pandey Anand , Verma Sanjeev Kumar , Kumar Piyush , Pant Nitin , Rawat Jiledar
Published: February 2025

Background:

Surgical conditions in the paediatric age group are a common condition encountered routinely by Paediatricians. Delays in consulting a paediatrician or inaccuracies in their assessments can lead to postponed management of conditions that require surgical intervention.

Aims:

To assess the exposure of practicing paediatricians to paediatric surgical conditions in Northern India and to assess any limitation in this regard.

Material and Methods:

This was a prospective cohort study with an online questionnaire as per Checklist for Reporting Results of Internet E-Surveys (CHERRIES) guidelines consisting of twenty questions related to demographic data, diagnosis and management aspects of various paediatric surgical conditions.

Result:

Of 221 responses, 193 were included in the study. The majority of responders were under the age of 35. Of all, only 42.2% were exposed to paediatric surgery during their undergraduate course. A notable proportion of pediatricians (49.4%) regularly encountered paediatric surgical patients in their practice. There were differences of opinion on diagnosis and management of common paediatric surgical conditions, such as abdominal wall defects, oesophageal atresia, congenital diaphragmatic hernia, etc. The ideal timing of surgical intervention in conditions, such as undescended testis and inguinal hernia, etc. were also debatable.

Conclusion:

Despite its importance, many pediatricians are not exposed to paediatric surgery during their formative years due to the absence of this department in the respective medical institutes. A proper exposure of the pediatrician to the work and spectrum performed by the paediatric surgeons will help to improve the paediatric surgical care of the children in need.
Application of Digitalization in Dental Education - A Systematic Review
Authors: Das Spandita , Jha Kunal , Menon Ipseeta , Kumar Gunjan , Singh Arpita , Barman Diplina
Published: February 2025

The use of digital technologies in education play a crucial role in providing new and innovative forms of delivering education to teachers and students as well as broadening the learning process. The aim of this systematic review is to summarize existing evidence in order to evaluate the application of digitalization in undergraduate and postgraduate dental education. A literature review was completed using PubMed, SCOPUS and DOAJ search engines, following the search strategy using the PICO criteria, to identify English-language articles published between January 2013 and June 2023 that reported the use of digitalization in dental education. Following thorough research, 1721 articles were identified from e-databases. However, only 14 articles were added to this study after they were screened for eligibility. Quality assessment was performed by a checklist of important parameters using the National Institute of Health (NIH) assessment tool. Two studies focused on the knowledge regarding the utilization of digitalization in dental education, two studies examined the implementation of digitalization in dental education, two studies explored the user experience of utilizing digital dentistry, and eight studies investigated the perception and attitude towards digital dental education. The goal of incorporating digitalization in dental education should be to maximize the effectiveness of the many different digital technologies functioning together in patient care and dental education. The most significant advantage of understanding digital technology is its noteworthy benefits, which include compliance from patients, quick and prompt results and aesthetic outcomes.
Comparative Outcomes of Different Surgical Techniques for the Removal of Impacted Mandibular Third Molars
Authors: Shinde Swapnil U. , Peswani Khushboo C. , Sharma Abhilasha , Rai Swarna , Dangi Raj K. , Choudhary Neelam , Tiwari Rahul
Published: February 2025

ABSTRACT

Introduction:

Impacted mandibular third molar removal is a common oral surgery procedure, often associated with postoperative complications. The choice of surgical technique may influence outcomes such as pain, swelling, and healing time. This study aims to compare different surgical techniques to evaluate their impact on clinical outcomes.

Methods:

A retrospective analysis of patients undergoing impacted mandibular third molar removal was conducted. Three techniques were evaluated: traditional rotary instruments, piezosurgery, and laser-assisted surgery. Postoperative outcomes, including pain, edema, and healing time, were recorded.

Results:

Patients who underwent piezosurgery reported significantly less postoperative pain and swelling compared to those treated with rotary instruments. Laser-assisted surgery showed a comparable reduction in pain but extended healing time.

Conclusion:

Piezosurgery is the most favorable technique in terms of minimizing postoperative discomfort and swelling, while laser-assisted surgery may be beneficial in certain clinical scenarios.
Spinal cord injury and inflammatory mediators: role in “fire barrier” formation and potential for neural regeneration
Authors: Zhou Mi , Xu Zhengyu , Zhong Hao , Ning Guangzhi , Feng Shiqing
Published: February 2025

Traumatic spinal cord injury result in considerable and lasting functional impairments, triggering complex inflammatory and pathological events. Spinal cord scars, often metaphorically referred to as “fire barriers,” aim to control the spread of neuroinflammation during the acute phase but later hinder axon regeneration in later stages. Recent studies have enhanced our understanding of immunomodulation, revealing that injury-associated inflammation involves various cell types and molecules with positive and negative effects. This review employs bibliometric analysis to examine the literature on inflammatory mediators in spinal cord injury, highlighting recent research and providing a comprehensive overview of the current state of research and the latest advances in studies on neuroinflammation related to spinal cord injury. We summarize the immune and inflammatory responses at different stages of spinal cord injury, offering crucial insights for future research. Additionally, we review repair strategies based on inflammatory mediators for the injured spinal cord. Finally, this review discusses the current status and future directions of translational research focused on immune-targeting strategies, including pharmaceuticals, biomedical engineering, and gene therapy. The development of a combined, precise, and multitemporal strategy for the repair of injured spinal cords represents a promising direction for future research.
Sclerotomy port suturing in microincisional vitrectomy surgery
Authors: Lambat Sarang P , Khanna Neha N , Nangia Vinay B
Published: February 2025

Despite the advantages of self-sealing wounds in microincisional vitrectomy surgery (MIVS), wound leak can occur, leading to hypotony and increased risk of choroidal detachment and endophthalmitis. Inappropriate wound construction is the major cause of wound leaks, apart from failure to detect and manage wound leaks. Few techniques of wound construction have been described to prevent wound leaks and enhance appropriate closure, but wound leaks can still happen. It is challenging to address it due to compromised visibility because of the oozing of blood or vitreous substitute and swelling of the conjunctiva and tenons. The use of an inverted surgical contact lens to detect port leakage has been documented. Still, it fails to address the issue of passing the suture to close the sclerotomy. Our approach addresses both issues. It has been reported that more than one-third of ports in MIVS require suturing. In our technique, we start suturing the port at the conclusion of surgery while withdrawing the cannula itself. We did 30 consecutive cases of MIVS for various indications where suturing the ports was done with this new technique. The mean postoperative intraocular pressure on day one was 18.82 ± 12.24 mmHg. Our technique ensures proper identification of the port and facilitation of suturing of the port, especially in cases where we decide to suture the sclerotomy in anticipation of a leak.
A novel surgical technique: “Ab interno” autologous lamellar scleral patch for a large traumatic scleral defect at the posterior pole
Authors: Doganay Selim , Kiristioglu Mehmet Omer , Gunduz Gamze Ucan
Published: February 2025

This case report presents the case of a 60-year-old man who underwent autologous lamellar scleral patch graft (SPG) repair for a large posterior pole scleral defect during pars plana vitrectomy (PPV). Initially, the patient experienced a perforating air rifle pellet injury, necessitating suturing of the entry wound. Six days later, lensectomy and PPV were performed for traumatic cataract, removal of an intraocular foreign body, dense vitreous hemorrhage, and retinal detachment. During PPV, a significant full-thickness scleral defect was found at the posterior pole and repaired using a 3.5 mm × 4.5 mm autologous lamellar SPG sourced from the superotemporal superficial sclera. Postoperatively, the graft fully adhered to the adjacent sclera without complications such as silicone oil leakage or inflammation. This case marks the first instance of utilizing an autologous lamellar SPG for such a large posterior pole defect during PPV, showcasing its effectiveness and safety for such challenging conditions.
Clinical outcome of eplerenone in the management of acute central serous chorioretinopathy
Authors: Sharma Pramod Kumar , Padhan Bhagyashree , Khuntia Ipsita , Naik Madhumita , Satpathy Biswambara
Published: February 2025

OBJECTIVES:

To evaluate the clinical outcomes of eplerenone in the management of acute central serous chorioretinopathy (CSCR).

MATERIALS AND METHODS:

This case–control study involved 52 eyes of 52 cases of acute CSCR divided between treatment (26) and control (26) groups. Cases in the treatment group were managed by tablet eplerenone 50 mg/d. During the scheduled visits, serum electrolytes and an ophthalmic evaluation, including optical coherence tomography, were conducted. The control group was subject to observation and a similar follow-up. The Statistical Programme for Social Sciences, version 23 was used for statistical tests.

RESULTS:

The mean age in the treatment and control group was 39.15 ± 12.1 years and 36.1 ± 8.09 years, respectively. In the treatment group, 46.15% of right eyes and 53.8% of left eyes, and in the control group, 61.5% of right eyes and 38.5% of left eyes were evaluated. Visual acuity improved to 6/6 in 96.2% of treated cases and 19.2% of controls in the 2nd month of follow-up. Subretinal fluid resolved completely in 61.52% of treated cases and 38.46% of controls at 12-week follow-up. No adverse events were reported, and by the 12th week of follow-up, the mean serum K+ was 4.80 ± 0.157 mEq/L.

CONCLUSION:

Acute CSCR cases managed with oral eplerenone can attain faster resolution with significant functional improvement. Eplerenone may serve as a first-line therapeutic option for acute CSCR with a better safety profile.
Quantifying pupillary dilation-induced alterations in intraocular pressure, angle, and anterior segment parameters in pseudoexfoliation syndrome using Scheimpflug imaging
Authors: Boshra Maria N. , Moharram Hossam M. , Khairat Yehia M. , Moustafa M. Tarek A.
Published: February 2025

PURPOSE:

The aim of the study is to compare the effects of three mydriatic agents on anterior segment parameters and intraocular pressure (IOP) in pseudoexfoliation (PEX) patients and compare the results with healthy controls.

PATIENTS AND METHODS:

This cross-sectional study involved 25 PEX and 16 control patients. Each received three dilating drops (phenylephrine, tropicamide, and cyclopentolate) with eye examinations before and after (over 3 weeks). The measured parameters included IOP, gonioscopy grading, and Scheimpflug imaging analysis of anterior chamber depth, anterior chamber volume, anterior chamber angle, pupillary diameter (PD), central corneal thickness (CCT), and corneal volume.

RESULTS:

The mean age was 66.12 years in the PEX group and 55 years in the control group. There were no significant differences between the groups in baseline parameters, except for CCT being significantly thicker in the control group (P = 0.049). After 2 h of using the dilating drops, the PEX group showed no change in CCT and gonioscopy measurement while all the other tested parameters showed a significant increase. Phenylephrine caused the greatest increase in pupil diameter. Correlation analysis of PD versus other parameters in both groups showed only a negative significant correlation between PD and IOP when using tropicamide on the PEX patients.

CONCLUSION:

All three dilating drops are effective in dilating PEX patients. Phenylephrine is the most effective and ideal for both clinics and surgeries. Cyclopentolate is the least effective dilator in PEX patients compared to healthy controls. Tropicamide 1% provides a good balance between pupil dilation and minimal IOP elevation, making it safer for PEX patients.
Efficacy and outcome safety of capsular tension segment combined with capsular tension ring in children with ectopia lentis
Authors: Barliana Julie Dewi , Rhendy Rio , Casey Anthea , Farandy Rayhan
Published: February 2025

This study aimed to report the efficacy and outcome safety of capsular tension segment (CTS) combined with capsular tension ring (CTR) in ectopia lentis in children. This retrospective case series included patients with nontraumatic ectopia lentis under 18 years old who underwent intraocular lens (IOL) implantation with CTS and CTR combined between 2022 and 2023. The primary outcomes were best-corrected visual acuity (BCVA), IOL centration, and postoperative complications. Four patients, aged 6, 9, 10, and 13, had bilateral subluxated lenses and underwent the surgery. Ectopia lentis with a suspicion of Marfan syndrome was established as the diagnosis. Improvement of the BCVA and IOL centration was seen in all the patients. Posterior capsular opacification occurred in one patient, who was then treated with Nd: YAG capsulotomy. IOL implantation with a combination of CTS and CTR showed a promising visual outcome in children with ectopia lentis.
An acute posterior multifocal placoid pigment epitheliopathy with presumed systemic lupus erythematosus etiology
Authors: Abdullah Omer Othman
Published: February 2025

This case report describes a patient with acute posterior multifocal placoid pigment epitheliopathy, presumed to be the initial manifestation of systemic lupus erythematosus (SLE), who responded to oral immunotherapy. The clinical, hematological, serological, and imaging examinations were carried out on the 28-year-old female who presented with bilateral multifocal central creamy lesions. The imaging modalities’ findings and the overall visual improvement led us to diagnose acute posterior multifocal placoid pigmented epitheliopathy. This is the second time SLE has been presented as acute posterior multifocal placoid pigmented epitheliopathy, and before declaring it is idiopathic, we must investigate it thoroughly.
Assessment of central and peripheral contrast sensitivity in myopes using Spaeth/Richman contrast sensitivity
Authors: Ichhpujani Parul , Parmar Uday Pratap Singh , Singh Rohan Bir , Kumar Suresh
Published: February 2025

BACKGROUND:

Assessing central and peripheral contrast sensitivity (CS) in myopic patients with varying degrees of refractive error using Spaeth/Richman contrast sensitivity test (SPARCS) and compared it with emmetropic individuals.

MATERIALS AND METHODS:

CS of 50 consecutive myopic individuals of varying severity was matched with emmetropes using an online CS test, SPARCS, and Pelli-Robson test. Group comparisons for continuously distributed data were made using analysis of variance (ANOVA) when comparing the groups. A post hoc analysis was also done to compare pairs of each group. SPARCS scores were correlated with age and gender.

RESULTS:

Data of 126 eyes, 96 eyes from 50 myopes and 30 eyes from 15 emmetropes, were analyzed. The total SPARCS scores of Groups 1, 2, 3, and 4 were 75.15 ± 9.59, 76.48 ± 7.74, 74.55 ± 7.48, and 86.43 + 5.3, respectively. Univariate ANOVA analysis revealed a statistically significant difference in total SPARCS score distribution in the three subgroups with myopia (P = 0.048) and between all the groups (P = 0.000). No statistically significant difference was seen between the groups when comparing the individual SPARCS scores with either age or gender.

CONCLUSION:

The study concludes that there is a significant difference in the CS in patients with varying severity of myopia and assessing peripheral CS is an important adjunct to central CS.
Fluorescein-free detection of focal leak in a patient with acute central serous chorioretinopathy
Authors: Mohan Sashwanthi , Sugathan Geethu
Published: February 2025

Fundus fluorescein angiography (FFA) is considered the gold standard for identifying focal leaks in central serous chorioretinopathy (CSCR). However, there are situations where FFA cannot be performed, and alternative noninvasive investigations are required to pinpoint area of focal leaks. We present a case of a 36-year-old female patient with bilateral steroid induced acute CSCR with three distinct fluorescein-free signs converging in the same area indicating presence of focal leak.
Unilateral chorioretinitis in early latent syphilis
Authors: Dhoot Sanjeev Kumar
Published: February 2025

An interesting and unusual case of a 42-year-old Indian male with unilateral chorioretinitis, optic disc inflammation, and positive syphilis serology is presented, highlighting the need for a high index of suspicion in diagnosing this “great masquerader” with diverse manifestations.
Pediatric endophthalmitis-associated penetrating ocular trauma: A single-center retrospective study
Authors: Dehghani Alireza , Ghanbari Heshmatollah , Akhlaghi Mohammadreza , Kianersi Farzan , Fazel Farhad , NabaviNejhad Samin , Mohammadbeigy Iman , Pourazizi Mohsen
Published: February 2025

BACKGROUND:

Penetrating ocular trauma is a severe form of eye injury in children. The purpose of this study is to describe the clinico-epidemiological features of endophthalmitis-associated penetrating ocular trauma in children.

MATERIALS AND METHODS:

In this single-center retrospective study, the medical records of children diagnosed with endophthalmitis-associated ocular penetrating trauma were reviewed during the 5-year study period.

RESULTS:

From 375 cases of children with penetrating ocular injuries, 13 cases (3.5%) of endophthalmitis following penetrative ocular trauma were identified. The patients’ ages ranged from 4 to 18 years. The majority of children were male (69.2%) in preschool age. The most common source of penetration was wood, which accounted for 5 of 13 cases (38.5%), followed by knife and then wire. An intraocular foreign body was detected in three cases of endophthalmitis. Most patients had visual acuity of hand motion or count fingers.

CONCLUSIONS:

Most open-globe injuries and associated endophthalmitis in this study are related to accidental events. More consideration should be taken in attempting to prevent perforating ocular injuries and the consequence of endophthalmitis in children.
Ophthalmic and periocular management of facial nerve palsy
Authors: Yao Anthony , Malhotra Raman
Published: February 2025

Facial nerve palsy (FNP) can be a highly distressing condition with sight-threatening sequelae. However, major advances in ophthalmic and oculoplastic management have been achieved in recent decades, guided by a better understanding of clinical manifestations and an ever-expanding armamentarium of surgical and nonsurgical therapies. Ophthalmologists should be aware of the contemporary approach to FNP, its periorbital complications, and the broad range of treatment options now available.
Adequacy and Distribution of the Health Workforce in Indonesia
Authors: Muharram Farizal Rizky , Sulistya Hanif Ardiansyah , Swannjo Julian Benedict , Firmansyah Fikri Febrian , Rizal Muhammad Masrur , Izza Alifina , Isfandiari Muhammad Atoillah , Ariningtyas Ninuk Dwi , Romdhoni Achmad Chusnu
Published: February 2025

Background:

Indonesia faces the challenges in distributing its health workforce across its diverse geographic barriers, leading to disparities in health status. By examining the distribution patterns and identifying the areas of critical need, the study seeks to inform policy interventions that can more effectively address the health worker (HW) distribution.

Methods:

We conducted a descriptive analysis of healthcare workforce data across all 514 districts in Indonesia. The study focused on five categories of HWs: General practitioners (GPs), medical specialists, dentists, nurses, and midwives. We calculated the HW-to-population ratio to quantify the availability of healthcare workers. We employed the Gini Index as a measure of distribution equality. In addition, we conducted a comparative metric approach to assess the quantity and the equity of healthcare worker distribution across the districts.

Results:

In Indonesia, the current HW ratio stands at 3.84 per 1000 people, falling short of the World Health Organization’s threshold of 4.45 for achieving 80% universal health coverage. This shortfall translates to a need for an additional 166,000 HWs. While midwives show a relatively equitable distribution, specialists and dentists exhibited significantly unequal distribution, especially at the district level. There were greater disparities at the district than at the provincial level. There has been notable progress in the distribution of medical specialists across provinces, with the between-provinces Gini Index for specialists decreasing from 0.57 in 1993 to 0.44 in 2022. However, the inter-district Gini Index remains high at 0.53 in 2022, signifying a concentration of specialists in major cities and provincial capitals.

Conclusion:

This study shows that human resources for health in Indonesia are both inadequate in terms of quantity, and unevenly distributed. Our finding underscores the importance of considering inter-province and inter-district disparities to tailor policies to tackle each region’s unique problems.
Situation Analysis of Maternal Near-miss in Bhutan from 2018 to 2020: Using the World Health Organization Approach
Authors: Tshomo Tashi , Zangmo Kencho , Tshering Karma , Dem Dago , Tshering Sangay
Published: February 2025

Background:

In Bhutan, the maternal mortality rate has drastically decreased over the years. In situations where maternal mortality is not a public health concern anymore, severe maternal conditions have been used as an alternative to maternal health quality indicators.

Aims and Objectives:

This study aimed to report the prevalence, underlying causes, and outcomes of maternal near-miss (MNM) cases in Bhutan.

Materials and Methods:

The study involved a secondary analysis of routine data on MNM cases recorded in three referral hospitals in Bhutan from 2018 to 2020. The World Health Organization MNM, 2011 approach guided the investigation.

Results:

The incidence of potentially life-threatening conditions was 12.8 and MNM was 6.7 per 1000 live births. Obstetric hemorrhage, pregnancy with abortive outcomes, and hypertensive disorders in pregnancy were some of the leading conditions, which had led to women experiencing near-miss complications. About 68.5% of women had received blood products, 20.2% had undergone laparotomy, and 5.9% required intensive care unit admission.

Conclusion:

An audit of MNM cases, which occur more frequently than maternal deaths, could provide better insights into the existing quality of care.
Simulation of Turing machines with analytic discrete ODEs: Polynomial-time and space over the reals characterised with discrete ordinary differential equations
Authors: Bournez Olivier
Published: February 2025

We prove that functions over the reals computable in polynomial time can be characterised using discrete ordinary differential equations (ODE), also known as finite differences. We also provide a characterisation of functions computable in polynomial space over the reals.While existing characterisations could only cover time complexity or were restricted to functions over the integers, here we deal with real numbers and also cover space complexity. Furthermore, we prove that no artificial sign or test function is needed even for time complexity.At a technical level, this is obtained by proving that Turing machines can be simulated with analytic discrete ordinary differential equations. We believe this result opens the way to many applications, as it opens the possibility of programming with ODEs, with an underlying well-understood time and space complexity.
On plus-one generated conic-line arrangements with simple singularities
Authors: Măcinic Anca , Pokora Piotr
Published: February 2025

In this paper, we study plus-one generated arrangements of conics and lines in the complex projective plane with simple singularities. We provide several degree-wise classification results that allow us to construct explicit examples of such arrangements.
Feasibility of a Mobile Application for Self and Assisted Reporting of Coronavirus Disease 2019 Self-Testing Results in Tanzania: A Pilot Study
Authors: Msuya Hajirani M. , Ali Ali M. , Mrisho Mwifadhi , Lweno Omar N. , Temu Silas G. , Msuya Ibrahim , Kalabamu Frank , Milando Florence A. , Rashid Mohammed , Said Ali H. , Tumbo Anneth M. , Jongo Said A. , Kassim Kamaka R. , Abdallah Gumi , Mbarak Hussein , Mbarak Hassan A. , Berenge Hassan T. , Mshana Prosper , Awadh Khamis , Mmbaga Selemani , Ndanzi Tunu , Nyaulingo Gloria D. , Iddy Lathma , Bajaria Shraddha , Kao Kekeletso , Mwangoka Grace W. , Abdulla Salim , Mkopi Abdallah
Published: February 2025

A critical impediment to efficient outbreak response is the availability of timely and complete data on cases and their linkage to care. To inform solutions to this issue, this study investigated the utility of self-testers reporting their coronavirus disease 2019 results using a mobile health platform. Our study has demonstrated that the mobile health platform is feasible; it achieved a 74.5% reporting rate, indicating a strong likelihood of data entry into the unstructured supplementary service data platform. Support from community health workers (CHWs) and healthcare professionals, particularly nurses, contributed to this success, especially among users with limited digital literacy. Specifically, 44.9% of self-test results were submitted by study participants themselves, 24.7% were submitted with the assistance of healthcare professionals, and 30.4% were submitted with the assistance of CHWs. The platform broadens the population base by increasing access and equity, allowing participation even among users without smartphones. Additionally, it integrates rapid antigen diagnostic tests with digital reporting, simplifying data processing and enabling standardized screening, real-time data capture, and effective patient follow-up. This technology also lays a foundation for pandemic preparedness in low- and middle-income countries by demonstrating the feasibility of fully integrating response loops for disease management and interventions. Future response loops could leverage artificial intelligence, machine learning, and integration with existing health surveillance systems, directly benefiting users through enhanced support.
Exploring Routes of Infection of Severe Fever with Thrombocytopenia Syndrome Virus Using Experimentally Infected Animals
Authors: Marano Jeffrey M. , Bosco-Lauth Angela M.
Published: February 2025

Reports from endemic regions in Asia indicate that severe fever with thrombocytopenia syndrome virus (SFTSV), a canonically tick-borne virus, can be directly transmitted from infected humans and animals to naïve hosts. To understand this process, using a feline infection model, we observed that both intramuscular inoculation and oral inoculation resulted in adult cats developing viremia, with cats inoculated intramuscularly shedding virus orally. We also observed a potential organ tropism associated with the route of inoculation. Using an immunodeficient murine model, we further demonstrated that noncanonical routes of inoculation can result in lethal infections. However, we could not replicate the organ tropism seen in cats, possibly because of the immunodeficient nature of the mice. Like cats, mice shed SFSTV orally. These results indicate that SFTSV can exist in a vector-free cycle, highlighting a need for increased surveillance and precautions when handling potentially infected animals.
Sample Reduction for Physiological Data Using Principal Component Analysis in Artificial Neural Network
Authors:   , Adolfo Cid Mathew
Published: February 2025

In the realm of biomedical applications, the analysis of big data holds immense promise, particularly in aiding medical practitioners with crucial interpretations. However, ensuring the integrity of multi-dimensional datasets and achieving high classification accuracy are paramount challenges. The quality of data sources presents a significant threat, with issues like abnormal, random and biased sampling posing obstacles, especially in machine learning contexts. Addressing these challenges is essential, particularly in biomedical applications reliant on accurate classification and prediction, such as physiological signal analysis utilizing Artificial Neural Networks (ANNs). This study proposes a novel approach, utilizing Principal Component Analysis–Sample Reduction Process (PCA-SRP), to preprocess datasets and enhance ANN model accuracy. We discuss the theoretical underpinnings of this methodology, followed by empirical validation using publicly available physiological and L/R Motor Movement (MM)EEG datasets. The analysis demonstrates the efficacy of PCA-SRP in cleansing datasets and improving ANN classification performance, with significant enhancements observed across various performance metrics. Notably, our approach achieves up to a 7% increase in accuracy in classifying L/R motor movement EEG signals, as validated through Python implementation.