bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of spectral domain optical coherence tomography in the diagnosis and prognosis of papilledema
Authors: Panyala Rakesh , Sharma Pradeep , Sihota Ramanjit , Saxena Rohit , Prasad Kameshwar , Phuljhele Swati , Gurrala Sneha , Bhaskaran Karthika 
Published: September 2021

Purpose:
The study of papilledema with a novel noninvasive technique such as spectral domain-optical coherence tomography (SD-OCT) provides minute and detailed cross-sectional changes thus giving an insight into the application of biomechanical principles and pathophysiology of disc edema.

Methods:
We measured average retinal nerve fiber layer (RNFL) thickness and the retinal pigment epithelium/Bruch’s membrane (RPE/BM) angle at the temporal and nasal borders of the neural canal opening (NCO) in 30 eyes with papilledema, 30 eyes with papillitis, and 80 control eyes. The inward angulation was considered as positive and the outward as negative. Follow-up was done at 1, 2, 3, and 6 months. The main outcome measures are the average RNFL thickness and the RPE/BM angle.

Results:
29 eyes (96.6%) with papilledema had a positive RPE/BM angle (+8.11 ± 3.13). 29 eyes (96.6%) with papillitis had a negative RPE/BM angle (−1.04 ± 3.27). On follow-up at 1 month, both RNFL thickness (P = 0.01) and RPE-BM angle (P = 0.001) reduced significantly in eyes with papilledema; in eyes with papillitis, there was a significant reduction in the RNFL thickness (P = 0.02), but not in the RPE-BM angle (P > 0.05). RNFL thickness in papilledema cases normalized at 3 months whereas RPE/BM normalized at 6 months of follow-up. To detect papilledema, OCT has a sensitivity of 96.66% and specificity of 99.09% on both nasal and temporal sides.

Conclusion:
After appropriate treatment, the RPE/BM angle in papilledema decreased much later than the RNFL thickness. Hence, the RPE/BM angle in papilledema (positive) can be used to differentiate it from papillitis (negative) and also to monitor the activity of the disease.
Whole-exome sequencing identifies multiple pathogenic variants in a large South Indian family with primary open-angle glaucoma
Authors: Shah Mohd Hussain , Kumaran Manojkumar , Chermakani Prakash , Kader Mohideen Abdul , Ramakrishnan R , Krishnadas Subbiah R , Devarajan Bharanidharan , Sundaresan Periasamy 
Published: September 2021

Purpose:
To identify the pathogenic variants associated with primary open-angle glaucoma (POAG) using whole-exome sequencing (WES) data of a large South Indian family.

Methods:
We recruited a large five-generation South Indian family (n = 84) with a positive family history of POAG (n = 19). All study participants had a comprehensive ocular evaluation. We performed WES for 16 samples (nine POAG and seven unaffected controls) since Sanger sequencing of the POAG candidate genes (MYOC, OPTN, and TBK1) showed no genetic variation. We used an in-house pipeline for prioritizing the pathogenic variants based on their segregation among the POAG individual.

Results:
We identified one novel and five low-frequency pathogenic variants with consistent co-segregation in all affected individuals. The variant c.G3719A in RPGR-interacting domain of RPGRIP1 that segregated heterozygously with the six POAG cases is distinct from variants causing photoreceptor dystrophies, reported affecting the RPGR protein complex signaling in primary cilia. The cilia in trabecular meshwork (TM) cells has been reported to mediate the intraocular pressure (IOP) sensation. Furthermore, we identified a novel c.A1295G variant in Rho guanine nucleotide exchange factors Gene 40 (ARHGEF40) and a likely pathogenic variant in the RPGR gene, suggesting that they may alter the RhoA activity essential for IOP regulation.

Conclusion:
Our study supports that low-frequency pathogenic variants in multiple genes and pathways probably affect Primary Open Angle Glaucoma’s pathogenesis in the large South Indian family. Furthermore, it requires larger case-controls to perform family-based association tests and to strengthen our analysis.
Outcomes of 25-gauge pars plana vitrectomy for cytomegalovirus retinitis-related retinal detachment
Authors: Moharana Bruttendu , Dogra Mohit , Tigari Basavaraj , Singh Simar Rajan , Katoch Deeksha , Arora Atul , Singh Ramandeep 
Published: September 2021

Purpose:
The purpose of this study is to evaluate the anatomical and functional outcomes of 25-gauge (G) pars plana vitrectomy (PPV) in patients with cytomegalovirus retinitis (CMVR)-related rhegmatogenous retinal detachment (RRD).

Methods:
Single-center retrospective consecutive case series of patients who underwent 25-G PPV for CMVR-related RRD repair with a minimum follow-up of 3 months. Complete anatomic success was defined as the complete attachment of retina including the periphery. Best-corrected visual acuity (BCVA) of ≥20/400 was defined as functional success.

Results:
Sixteen eyes of 15 patients were included in the study. Eleven patients were human immunodeficiency virus positive, three patients had hematological malignancies, and one patient suffered from dyskeratosis congenita. The mean follow-up was 20.5 ± 17.4 months (range 3–60 months). Complete anatomical success was seen in 15 eyes (93.75%). One eye had a residual inferior detachment with attached macula. Silicone oil was used as tamponade in 15 eyes and C3F8 gas in one eye. The mean change in BCVA was statistically significant, preoperative LogMAR BCVA was 2.05 ± 0.94 while the final follow-up postoperative LogMAR BCVA was 1.03 ± 0.61 (P < 0.001). Thirteen eyes (81.25%) had final BCVA ≥20/400.

Conclusion:
Microincision vitrectomy surgery can achieve excellent retinal reattachment rates in post-CMVR RRDs without significant intraoperative and postoperative complications. The visual outcome varies depending on the status of the optic disc and macula. Majority of the patients maintained functional vision.
Slit-lamp measurement of anterior chamber depth and its agreement with anterior segment optical coherence tomography and Lenstar LS 900 in pseudoexfoliation and normal eyes
Authors: Pathak Ray Vanita , Ramesh Smitha B , Rathi Varsha 
Published: September 2021

Purpose:
There is a considerable lack of awareness of slit-lamp measurement of anterior chamber depth (ACD) by the Redmond Smith method (SACD) in present day-to-day clinical practice, which may provide rapid assessment in pseudoexfoliation (PXF) when assessing for angle closure and planning for cataract surgery. This assumes importance not only in outreach clinics but also in the ongoing pandemic caused by the highly contagious novel coronavirus, where social distancing is advocated to contain the spread. We aimed to compare the axial ACD in PXF and normal patients by SACD, and its agreement with the anterior segment optical coherence tomography (ASOCT) and LenstarLS-900.

Methods:
A prospective comparative observational study was done at a tertiary eye care hospital. A PXF group and a normal group of controls were recruited. All eyes were phakic with normal cornea. Any eye with previous intraocular/refractive surgery and cause of other secondary or uncontrolled glaucoma was excluded. SACD was measured clinically via slit-lamp method and also via ASOCT and Lenstar; agreement between the methodologies was plotted.

Results:
Fifty patients were recruited in each group. Mean age was 66.82 ± 4.88 years in PXF patients and 65 ± 5.46 years in controls (P = 0.2). ACD was found to be greater in controls compared with the PXF patients; this difference was statistically significant (P < 0.001) across all methodologies. A good agreement with narrow 95% limits of agreement was found between these methodologies.

Conclusion:
Redmond Smith slit-lamp methodology of estimating the axial ACD is recommended as a rapid, quantifiable, noncontact screening technique during routine examination, especially in primary outreach centers, and is also advantageous during the ongoing pandemic by reducing expendable investigations.
Three-year outcomes of alcohol delamination of corneal epithelium for recurrent corneal erosions of traumatic etiology
Authors: Teh Boon Lin , Chua Paul Y S , Reddy Aravind R 
Published: September 2021

Purpose:
Alcohol delamination of the corneal epithelium (ADCE) is a therapeutic option for patients with recurrent corneal erosion (RCE) who do not respond to nonsurgical management of lubricants and extended wear contact lens. The aim of the study is to report on three-year efficacy and safety of ADCE for RCE of traumatic etiology.

Methods:
This is a retrospective review of consecutive patients who underwent ADCE for traumatic RCE in a local hospital between January 2010 and January 2020. The outcomes at a 3-year follow-up review are included. Nonsurgical therapy used; intra- and postoperative complications were recorded. ADCE was only offered to those who remained symptomatic despite maximum topical lubrications and/or extended wear contact lens. Success was defined as the absence of recurrence of corneal erosion.

Results:
Twenty-six eyes of 26 patients with RCE caused by trauma underwent ADCE. The mean age of patients was 39 years. The follow-up period was a minimum of 36 months. Three eyes (11.5%) had recurrence of corneal erosion after ADCE at the 3-year follow-up. Recurrence was noted at months 2, 23, and 36 postoperatively in these patients. All patients reported significant improvement in symptoms associated with recurrent erosion. Ten eyes (38.5%) stopped all topical lubricants postoperatively. No intra- or postoperative complications were noted in our study.

Conclusion:
This study documents the long-term safety and efficacy of alcohol delamination of corneal epithelium at 3 years for patients with RCE of traumatic origin.
Effect of melanocyte keratinocyte transplantation procedure, using ablative CO2 laser and followed by NB-UVB phototherapy, on the expression of E-Cadherin and matrix metalloproteinase-2 in acral vitiligo
Authors: Esmat Samia , Assaf Magda , Kadry Dina , El Hawary Marwa , Halim Dalia A. , Saleh Marwa , Bassiouny Dalia , Saad Heba , El-Hanafy Ghada 
Published: September 2021

Background
Melanocyte keratinocyte transplantation procedure (MKTP) is a multi-procedural intervention that could hypothetically alter the environment surrounding grafted epidermal cells, helping melanocytes’ migration and adherence to keratinocytes in their basal position.

Objective
To evaluate the effect of MKTP in acral vitiligo skin prepared by total ablative CO2 laser resurfacing and followed by narrow-band ultraviolet B (NB-UVB) phototherapy on matrix metalloproteinase-2 (MMP2) and E-Cadherin expression and the reflection of these changes on repigmentation.

Patients and methods
Acral lesions in 20 stable nonsegmental vitiligo patients were prepared by full CO2 ablation down to the papillary dermis followed by MKTP and NB-UVB sessions. Two 4 mm punch biopsies were taken: the first at baseline and the second after the onset of repigmentation or after 6 months of phototherapy if no repigmentation occurred. Immunohistochemical staining for evaluation of E-Cadherin and MMP2 expression was performed.

Results
Eight patients (40%) achieved repigmentation ranging from 10 to 90% with a median of 62.5%. E-Cadherin intensity was significantly increased after treatment (P<00.1). There was also a significant total increase in epidermal (P<0.001) and dermal (P<0.001) MMP2 with diffuse nuclear pattern of staining. In lesions showing repigmentations, the percentage change in dermal MMP2 was significantly higher (P=0.012), while no such difference was present in epidermal MMP2 and E-Cadherin expression.

Conclusion
MKTP with recipient site prepared by full CO2 laser ablation followed by NB-UVB phototherapy increased the expression of E-Cadherin and MMP2 in acral vitiliginous skin. The increase of dermal MMP2 could play a favorable role in repigmentation.
Circulating ghrelin and apelin levels in nonobese psoriasis vulgaris patients
Authors: Farag Azza G.A. , Abdallah Heba M. , Ibrahem Reda A.L. , Elshaib Mustafa E. , Shehata Wafaa A. 
Published: September 2021

Background
The metabolism and immune system are linked via a network of many mediators known as adipokines. Ghrelin and apelin-36 are unique adipokines; however, their role in psoriasis, an immune-mediated disease, remains unclear.

Objective
To detect the serum levels of ghrelin and apelin-36 in psoriasis vulgaris patients in comparison with controls and to correlate their levels with severity of psoriasis, BMI, lipid profile, and glycated hemoglobin (HbA1c).

Patients and methods
The present case–control study included 70 nonobese psoriasis vulgaris patients and 70 controls. The severity of psoriasis was assessed using the psoriasis area and severity index score. The ghrelin and apelin-36 serum levels, cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, and HbA1c were measured.

Results
Psoriatic patients had significantly higher ghrelin (P<0.001), HbA1c (P<0.001), cholesterol (P<0.001), triglycerides (P<0.001), and low-density lipoprotein (P=0.001) levels and a lower apelin-36 (P<0.001) serum level than controls. Serum ghrelin was negatively correlated with psoriasis area and severity index score (r=−0.75; P<0.001), whereas serum apelin-36 was negatively correlated with HbA1c mean values (r=−0.44; P=0.004) and was found to be a good predictor of prediabetes in psoriatic patients (P=0.012). Nonsignificant correlation between ghrelin and apelin-36 serum levels was observed in psoriatic patients.

Conclusion
Ghrelin and apelin-36 are dynamic adipokines that might play a role in psoriasis vulgaris pathogenesis. The role of ghrelin and apelin-36 in psoriasis might be mediated through dyslipidemia and impaired glucose metabolism in psoriatic patients, respectively. Targeting both ghrelin and apelin-36 may be of value in management of metabolic syndrome associated with psoriasis. Serum apelin-36 assessment can predict prediabetic state in psoriatic patients.
Elderly Abuse and Quality of Life
Authors: Joshi Mahendra Raj , Chalise Hom Nath 
Published: August 2021

Background:
The abuse and neglect of older people in the family context are emerging as a significant social, as well as a public health concern that is affecting the overall quality of life (QOL) of the elderly.

Aims:
The main objective of this paper was to study the experience of abuse and its relation with QOL of older people in rural Nepal.

Methods:
This is a cross-sectional, community-based survey carried out in the Kailali district of Nepal. The total sample size for this study was 547 people aged 60 years and older selected randomly. QOL was measured using the World Health Organization QOL scale popularly known as WHOQOL-BREF. Elderly abuse was measured by asking questions related to elderly abuse in the last 1 month. The descriptive technique is used to analyse the data. Descriptive, chi-square tests and F-test was used to analyze the data.

Results:
The findings show that about one-sixth of males (15.6%) and one in every seven females (14.3%) have faced any type of abuse in the last 1 month. This study found that overall QOL score of the Nepalese elderly was moderate (12.92 ± 1.75). The mean scores of the overall QOL index of people experiencing abuse were observed significantly low (12.28 ± 1.74) compared to those who did not experience any abuse (13.04 ± 1.73).

Conclusions:
Elderly experiencing abuse have significantly low QOL compared to not abused elderly in Nepal. The experience of abuse was elicited in the last 1 month. This study was carried out in specific rural area and cannot be generalised to all Nepali older people. Local activities and awareness to discourage older person's abuse should be encouraged that may help to enhance the QOL of older people.
Prevalence of Hypertensive Disorders of Pregnancy in India
Authors: Dhinwa Manisha , Gawande Kanchan , Jha Nishu , Anjali M. , Bhadoria Ajeet Singh , Sinha Smita 
Published: August 2021

Background:
Pregnancy-induced hypertension is one of the major health problems leading to maternal mortality. Globally, one woman dies every 7 min due to hypertensive disorders of pregnancy (HDOP). Pre-eclampsia and eclampsia contribute majority of maternal, perinatal morbidity and mortality. The objective of this meta-analysis was to estimate the pooled prevalence of pregnancy-induced hypertension in India.

Methods:
A systematic search was done through PubMed, Google Scholar, MEDLINE, EMBASE and Scopus for studies conducted on HDOP. All studies that met inclusion criteria published till January 2020 were included and analysed. The analysis was done using STATA 20.0 software (STATA Version 20.0 is sufficient). The pooled prevalence of hypertension in pregnancy was estimated using both mixed-effects and random-effects models.

Results:
A total of 18 studies with 92,220 study participants (pregnant women) were included in this review. The estimated overall pooled prevalence of HDOP in India was found to be 11% (95% confidence interval, 5%–17%). Most of the included studies were cross sectional and from the southern zone of India.

Conclusions:
The overall pooled estimate shows high prevalence, i.e., 1 out of 11 women suffers from pregnancy-induced hypertension. High prevalence of hypertension in the study population demands the attention of policymakers and healthcare professionals. Better implementation of early screening of hypertension during pregnancy should be undertaken.
Impact of COVID-19 Pandemic on Individual Hand Hygiene Infection Control Practices Among Healthcare Workers
Authors: Sharma Prakhar , Gangakhedkar Mihir Raman , Bahurupi Yogesh Arvind , Gupta Puneet Kumar , Prakash Vipul , Dua Ruchi , Sharma Kashmi , Saini Lokesh Kumar 
Published: August 2021

Background:
COVID-19 is primarily transmitted by droplets, aerosols and fomites. While adequate hand hygiene (HH) practice has already been proven to reduce transmission of pathogens and prevent infection, its role in checking cross-contamination with SARS-CoV-2 appears paramount.

Aim:
To assess the impact COVID 19 has had on individual HH practices among health care workers (HCW) at a tertiary health care center.

Patients and Methods:
A cross-sectional survey was conducted among HCWs for a period of 15 days from May to June 2020. The survey was distributed online via Google Forms after acquiring permission from Institutional Ethics Committee.

Results:
Two hundred and three completed survey questionnaires were received, primarily from nursing officers (42.4%) and residents (38.9%). Comparison of pre- and post-COVID-19 habits revealed a significant change in awareness regarding hand washing steps (87%–100%), practicing all steps of hand washing (66%–99%), washing hand before and after touching patient (55%–92% and 77%–100%, respectively), washing hands before going home (30%–91%), washing hands despite wearing gloves (21%–80%) and after touching patient's surroundings (46%–92%). Another significant finding observed was that almost 72% of the respondents took time to educate someone close by in HH and washing steps.

Conclusion:
The pandemic has seen an improvement in practices of HH. This change will not only impact the transmission of SARS-CoV-2, but every infectious disease spread similarly. Moreover, educating the general public would help in curbing the spread of COVID-19.
Factors Influencing the Success of Faculty Development Programme
Authors: Vathulya Madhubari , Rao Shalinee , Kathrotia Rajesh , Naithani Manisha , Bisht Manisha , Varshney Saurabh , Negi Gita , Mohan Latika , Gupta Pratima , Kant Ravi 
Published: August 2021

Background:
The success of any training program is influenced by factors such as the course facilitator, learner and learning environment. Faculty Development Programs are conducted in institutes from time to time to train the trainer.

Aims:
The article aims to evaluate two Faculty Development Programs conducted at a tertiary care institute and address the concerns and suggestions as educationists.

Subjects and Methods:
Data generated from the 4-day workshop on Faculty Development Course conducted in two subsequent programmes in the year 2019 were reviewed. The performance of participants was analyzed based on their performance in pre-test and post-test administered through a set of pre-validated questionnaires. Participant feedback as well as their response to facilitatory and hindering factors was evaluated.

Results:
A total of 57 participants attended the workshop (cumulative both FDP). Pre-test post-test scores were 7.55 ± 2.2 and 12.5 ± 1.87, and improvement in knowledge was statistically significant with P < 0.0001. Overall, FDP was rated very good to good by 97% of the participants. Interactive sessions, group activity and discussions facilitated learning, while prolonged and hurried up sessions as well as non-availability of prior reading material were major hindrances.

Conclusion:
A low baseline knowledge of participants emphasizes the need for an early introduction to FDP with interactive sessions, good time management and a non-threatening environment to maintain the interest of learner and facilitates learning. The article in addition also discusses about the inadequacies and lacunae of the existing programme.
Internal derangement of the temporomandibular joint
Authors: Shah Omair Ashraf , Shera Tahleel Altaf , Bhat Mudasir , Choh Naseer Ahmad , Gojwari Tariq Ahmad 
Published: September 2021

Purpose:
To evaluate the role of magnetic resonance imaging (MRI) in the diagnosis of internal derangement and to assess the complimentary role of MRI and clinical assessment in prognostication. To assess the role of MRI in demonstrating disc displacement and reduction.

Methods:
A total of 34 patients (28 cases and 6 controls) with clinical features of temporomandibular joint (TMJ) internal derangement underwent a dedicated MRI at our institution. MRI was assessed for disc displacement, morphology, and reduction on open-mouth imaging. For analysis, the patients were divided into those with disc displacement with reduction (WR) and those without reduction (WOR). Clinical and MRI grading of internal derangement were done in all patients and correlated with each other. Prognostication was attempted using the clinical and MRI features, and patients were followed up over a mean period of 6 months.

Results:
Most of the patients were females (n = 20 71%) in the child-bearing age group (third decade). MRI demonstrated disc displacement in all but two patients in whom disc was not visible. Fourteen (54%) patients were placed in WR group, whereas 10 (38%) were in WOR group. In two (8%) patients, stuck disc was diagnosed. Patients in WR group responded to conservative treatment alone while those in WOR group needed conservative management in some (n = 8 57%) and surgical intervention in others (n = 6 43%). Both patients with stuck disc failed conservative management.

Conclusion:
MRI is an essential component of TMJ evaluation and helps in diagnosing and staging internal derangement together with disc assessment. Patients with disc displacement WOR and those with higher grades of derangement on MRI including stuck disc require surgical intervention if conservative management fails.