bluuebunny/crossref_metadata_2025_split huggingface dataset:
Economic Evaluation of First-Line Atezolizumab for Extensive-Stage Small-Cell Lung Cancer in the US
Authors: Wang Yingcheng , Rui Mingjun , Yang Lan , Wang Xintian , Shang Ye , Ma Aixia , Li Hongchao 
Published: April 2021

Introduction: This study evaluated the cost-effectiveness of atezolizumab + chemotherapy vs. chemotherapy as first-line treatment for extensive-stage small-cell lung cancer (SCLC) in the United States (US).Methods: The three health states partitioned survival (PS) model was used over the lifetime. Effectiveness and safety data were derived from the IMpower133 trial. The parametric survival model and mixture cure model were used for the atezolizumab + chemotherapy group to explore the long-term uncertainty of the effect of immunotherapy, and the parametric survival model was used for the chemotherapy group. Costs were derived from the pricing files of Medicare and Medicaid Services, and utility values were derived from previous studies. Sensitivity analyses were performed to observe model stability.Results: If the mixture cure model was considered for the intervention group, compared with chemotherapy alone, atezolizumab + chemotherapy yielded an additional 0.11 quality-adjusted life-years (QALYs), with an incremental cost of US$84,257. The incremental cost-utility ratio (ICUR) was US$785,848/QALY. If the parametric survival model was considered for the intervention group, atezolizumab + chemotherapy yielded an additional 0.10 QALYs, with an incremental cost of US$84,257; the ICUR was US$827,610/QALY. In the one-way sensitivity analysis, progression-free (PF) and postprogression (PP) utilities were the main drivers. In the scenario analysis (PF utility = 0.673, PP utility = 0.473), the results showed that the ICUR was US$910,557/QALY and US$965,607/QALY when the mixture cure model and parametric survival model was considered for the intervention group, respectively. In the PSA, the probabilities that atezolizumab + chemotherapy would not be cost-effective were 100% if the willingness-to-pay threshold was US$100,000/QALY.Conclusions: The findings of the present analysis suggest that atezolizumab + chemotherapy is not cost-effective in patients receiving first-line treatment for extensive-stage SCLC in the US.
La importancia de los elementos descriptivos en el relato de los hechos en Expeditio Persica de Jorge de Pisidia (III. 225-280)
Authors: Silventi María Cristina 
Published: April 2021

En la sociedad bizantina la lectura en público era algo común. Quien estaba a cargo de esta era consciente de su influencia en el auditorio. El texto bien elaborado y la expresividad del orador eran fundamentales. En este trabajo nos enfocamos en el empleo que hace de la ἔκφρασις Jorge de Pisidia (610?-632?) en un fragmento de Expeditio Persica, (vv. 225-280), en donde relata la parte final de la primera campaña del emperador Heraclio (610?-641), con el propósito de cautivar la atención de la elite cortesana que lo rodeaba enalteciendo su figura como representante de la fe cristiana.
Fabrication of slippery liquid-infused porous surfaces for anti-fouling applications
Authors: Atthi Nithi , Suwan Mantana , Sangwong Nuchjarin , Pattamang Pattaraluck , Sripumkhai Witsaroot , Meananeatra Rattanawan , Saengdee Pawasuth , Thongsook Oraphan , Ranron Norabadee , Pankong Krynnaras , Uahchinkul Warinrampai , Jeamsaksiri Wutthinan , Supothina Sitthisuntorn 
Published: April 2021

Abstract
Lubricant-infused textured surfaces have gained much attention as liquid-repellent surfaces owing to high surface stability compared to their superhydrophobic counterparts. In this study, polydimethylsiloxane (PDMS) micro-structures (width: 20 μm, height: 80 μm), were fabricated using soft lithography. Effects of micro-structural geometry, including pillar-type (pillar, discrete ridge) and hole-type (hole, continuous ridge, circular rings with eight stripe supporters), on infiltration capability of the lubricants with different viscosity (Krytox-103; η: 0.131 Pa.s, Krytox-105; η: 0.737 Pa.s, paraffin oil; η: 0.112 Pa.s) were investigated. Partial infiltration was observed on the pillar-type micro-structures, while more completed infiltration was obtained on the hole-type micro-structures. More viscous Krytox-105 resulted in completed infiltration for all micro-structures, thus creating a slippery liquid-infused porous surface (SLIPS). The best SLIPS, signified by a low sliding angle and a fast speed of water droplet, prepared from the hole pattern infused with Krytox-105 exhibited good anti-fouling performance against chlorophyll and milk yogurt.
Clinical Outcome of Pars Plana Vitrectomy With Or Without Intravitreal Bevacizumab As A Pretreatment in Advanced Diabetic Eye Disease
Authors: Gull Ambreen , Ahmad Sairam , Khan Niazi Fuad Ahmad , Raza Ali 
Published: April 2021

Purpose: To find out the clinical outcome of Pars Plana Vitrectomy with and without Intravitreal Bevacizumab as a pretreatment in advanced diabetic eye disease.
Place and Duration of Study: Ophthalmology department of holy family hospital Rawalpindi, from January 2018 to December 2018.
Methods: Sixty patients with advanced proliferative diabeticretinopathy wereincluded. Patients were divided into two groups. In group A, patients had pars plana vitrectomy with pre procedure injection of intravitreal Bevacizumab and group B had vitrectomy without pre procedure intravitreal Bevacizumab. Amount of bleeding during vitrectomy, surgical time and rate of iatrogenic tears were noted in both groups. Outcome measures were post operative best corrected visual acuity at 6 months and post operative recurrent vitreous hemorrhage.
Results: Patients had a mean age of 63.83 ± 7.314. In group A, mild bleeding was seen in 33%, moderate in 6.7% and severe in 0%. In group B, mild bleeding was seen in 13.3%, moderate in 46.7%, and severe bleeding in 40%. After 6 months, 27 (90%) patients in group A showed improvement in best corrected visual acuity while it was seen in 12 (40%) patients in group B. Iatrogenic tearswere seen in 10% in group A and 36% in group B. Mean time of surgery in group A was 59.27 ± 6.823 minutes and in group B was 77.87 ± 9.637 minutes. Rate of recurrent vitreous hemorrhage after vitrectomy was 6.7% in group A and 40% in group B.
Conclusion: Intravitreal injection of Bevacizumab is helpful in reducing surgical time and also decreases intraoperative and post operative bleeding.
Key Words: Bevacizumab, Vitrectomy, Proliferative Diabetic Retinopathy.
Histopathological Features of Group E Retinoblastoma Eyes after Upfront Enucleation
Authors: Viyani Usman , Mughal Jamal , Arshad Muhammad Owais , Javed Anum , Nasir Javeria , Chatni Muhammad Hanif 
Published: April 2021

Purpose: To study histopathological features of eyes with intraocular Group E retinoblastoma primarily treated by enucleation at a tertiary care centre in Karachi, Pakistan.
Study Design: Retrospective histopathological study.
Place and Duration of Study: Department of Ophthalmology, Patel Hospital, Karachi, January 2012 to August 2019.
Methods: Seventy five eyes of children diagnosed with Group E retinoblastoma, on clinical examination, examination under general anaesthesia along with MRI and then enucleated were examined histopathologically after being primarily enucleated. Histological features were enlisted for the presence of choroidal invasion, extent of optic nerve invasion, anterior chamber involvement, scleral and extra-scleral invasion along with tumour differentiation. Demographic variables (age at presentation, gender, laterality of the disease, median follow-up) and the histopathological features of tumour along with high risk features were assessed using SPSS version 24.
Results: Out of 75 eyes, 48 (64%) eyes showed high risk histopathological features including post lamina cribrosa involvement, choroidal invasion, scleral involvement, anterior chamber involvement (angle, iris, ciliary body). All high risk features were significantly more in the poorly differentiated group of tumours. All patients showing high risk features were given post enucleation systemic chemotherapy accordingly.
Conclusion: By identifying the histopathological pattern and high risk features, we can decrease the chances of metastasis, recurrence, mortality and morbidity of these children which pose an overwhelming physical, psychological, social and financial burden on our society as a whole. Further large, multi-centre prospective studies can provide with a better understanding about the high risk features and histopathological patterns of retinoblastoma in our region.
Key Words: Retinoblastoma, Enucleation, Chemotherapy.
Orbital Rhabdomyosarcoma – A Case Series of 12 Patients from North – West Pakistan
Authors: Hussain Ibrar , Khan Tajamul , Shah Zaman , Ali Zulfiqar 
Published: April 2021

Purpose: The purpose of this study is to find out demographic characteristics, clinical behavior and outcome of this neoplasm in North West Pakistan.
Study Design: Retrospective Case series.
Place and Duration of Study: Department of Ophthalmology, Khyber Teaching Hospital Peshawar Pakistan, from 2015 to 2019.
Methods: All patients with Orbital Rhabdomyosarcoma consulting our department were registered and a self-designed proformawas used to document demography, clinical features, management, and follow-up of all cases. At the end of study, the data was analyzed using SPSS version 25 and result compiled.
Results: Twelve patients with “Orbital Rhabdomyosarcoma” were included in the study with mean age of7.2 ± 1.6 years. Majority of patients presented with mass in upper lid with proptosis. On CT-Scan and/or MRI orbit proved that in seven (58.3%) cases the mass was occupying the superior orbit, in 3 (25%) cases inferior orbit and in 2 (16.6%) cases the tumor was advance enough to occupy the whole orbit.Biopsy showed embryonic type (66.7%), alveolar type (25%) and undifferentiated (8.3%). All patients received chemotherapy and radiotherapy with excision of tumor in 16.7% and exenteration in 41.7% patients. The course of follow-up extended from 7 to 24 months. Five (41.7%) patients felt well at the end of last follow-up and four (33.3%) developed recurrence. At the end of follow-up, 3 (25%) patients died of tumor.
Conclusion: In North West Pakistan patients with Orbital Rhabdomyosarcoma present late and the prognosis is poor due to not following the proper protocol for follow-up.
Key Words: Rhabdomyosarcoma, Orbital rhabdomyosarcoma, IRS Staging.
Outcome of Conventional Trabeculectomy in Terms of Intraocular Pressure and Visual Acuity in Primary Open Angle Glaucoma
Authors: Shahid Erum , Fasih Uzma , Shaikh Arshad 
Published: April 2021

Purpose: To determine the outcomes of conventional trabeculectomy in terms of decrease in Intra Ocular Pressure (IOP) and improvement in visual acuity in patients of primary open glaucoma, coming to a tertiary care hospital.
Study Design: Retrospective case series.
Place and Duration of Study: Ophthalmology department of a tertiary care hospital from January 2017 to December 2018.
Methods: Patients undergoing trabeculectomy for Primary open angle glaucoma were included. Patients with repeated trabeculectomy, failed argon laser trabeculoplasty, advance cataract, corneal opacities and absolute glaucoma were excluded. All the trabeculectomies were done under retrobulbar anaesthesia after taking all aseptic measures. Primary outcome measures were preoperative and postoperative visual acuity, intraocular pressure, number of antiglaucoma medications and failed or successful trabeculectomy.
Results: Total 52 patients underwent trabeculectomy. There were 36 (69.2%) males and 16 (30.8%) females. Mean age was 56.73 years ± 10.9 SD. Mean preoperative IOP was 30.96 ± 6.71 mm Hg, post operatively IOP at 1 year it was 15.6 ± 4.2 mm Hg. P value was <.000. Mean number of antiglaucoma medications was 3.03 and 1.19, pre and post-operatively respectively (p value <.000). Improvement in visual acuity after trabeculectomy was seen in 32 (61.5%) patients. Complete Surgical success was seen in 28 (53.8%) and qualified success in 21 (40.4%) patients. Failed trabeculectomy was seen in 3 (5.8%) patients.
Conclusion: Conventional trabeculectomy is effective in lowering IOP in primary open angle glaucoma patients. It maintains IOP within normal range with and without anti-glaucoma medications at 1 year follow-up. Trabeculectomy significantly reduces number of anti-glaucoma medications.
Key Words: Intraocular pressure, Primary open angle glaucoma, Trabeculectomy.
Manual Sutureless Cataract Surgery (MSCS) in Patients with Pseudo-Exfoliation
Authors: Iqbal Yasir , Khan Qaim Ali , Zia Sohail , Arshad Qureshi Muhammad Usman , Hassan Masud-ul- 
Published: April 2021

Purpose: To document the complications of Manual suture-less cataract surgery in eyes with pseudo-exfoliation.
Study Design: Interventional case series.
Place and Duration of Study: Naseer memorial hospital, Dadyal, Azad Jammu Kashmir, from 4 July 2017 to 3 July 2019.
Methods: One hundred and fifty patients with pseudo-exfoliation (PEX) and cataract were selected by convenient sampling. Patients with systemic diseases, history of trauma, intraocular pressure ≥15 mm Hg on Applanation tonometry and any other associated ocular disease for example retinal detachment or retinal disease, previous history of glaucoma or narrow/closed angle on Gonioscopy were excluded from the study. Dark brown cataracts were also excluded. Pseudo-exfoliation was diagnosed on slit lamp on the basis of presence of dandruff like material on the pupil and the anterior lens capsule. The patients underwent manual suture less cataract surgery under local anesthesia Intraoperative and post-operative complications were noted. first day postoperatively. The collected data and analyzed using statistical package for social sciences (SPSS) version 21 for analysis.
Results: The study group consisted of 64% males and 36% females with mean age of 65 ± 15.32 years. The most common difficulty encountered was poor pupil dilatation in 37.3% cases followed by Zonular dehiscence in 7.3%. On the first post-operative day, the most common complication was intraocular lens decentration in 2.6% of the cases.
Conclusion: Pupils of patients with pseudo-exfoliation dilate poorly and makes surgery difficult. With good pupillary dilatation, careful capsulorhexis and minimal stress on the zonules, MSCS can be safely performed in eyes with cataract and PEX.
Key Words: Pseudo-exfoliation, Cataract, Pupil.
Surgical Outcomes of Combined Phacoemulsification and Silicone oil Removal in Post Retinal Detachment Surgery Patients
Authors: Haseeb Uzma , Haseeb Muhammad , Rehman Aziz ur 
Published: April 2021

Purpose: To evaluate the surgical outcomes of Combined Phacoemulsification with IOL implantation and Silicone oil removal in patients with previous retinal surgery.
Study Design: Interventional case series.
Place and Duration of Study: Al-Ibrahim eye Hospital Karachi from January 2019 to December 2019.
Methods: Total 30 eyes of 30 patients between ages of 25 to 65 years, who had retinal detachment surgery with silicone oil used as internal tamponade and later on developed cataract were re-operated once confirming that retinal was attached. The time interval between two surgeries was 8 to 10 months. Phacoemulsification with IOL implantationwas done followed by silicone oil removal by 23-gauge pars plana method. Postoperative follow-ups were done at day 1, 1 month and at 6 months to record visual acuity and retinal status.
Results: Best corrected Visual acuity was recorded pre and post-operatively using Snellen chart. Preoperatively 12 patients had visual acuity of 6/60, 12 with vision 6/95 and 6 with 6/120. There was improvement of 2 lines of visual acuity post operatively as recorded by Snellen chart. Retina was attached in 28 (93.33%) patients and 2 (6.66%) had re-detached retina at the end of 6 months.
Conclusion: Visual outcomes were found to be better with low rate of retinal re-detachment after 6 months follow-up of combined phacoemulsification with IOL implantation and silicone oil removal. Hence, Combined Phacoemulsification with Silicone oil removal is a method that is associated with better visual and anatomical outcomes as well as decrease the chances of patients undergoing third surgery for cataract extraction.
Key Words: Retinal Detachment, Phacoemulsification, Silicon Oil.
Efficacy of Oral Alprazolam and Mefenamic Acid in Relieving Pain During Pan Retinal Photocoagulation
Authors: Haider Muhammad Ali , Sattar Uzma , Ahmad Iftikhar 
Published: April 2021

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Purpose: To find out the efficacy of oral Alprazolam and Mefenamic acid in relieving pain during pan retinal photocoagulation in patients with proliferative diabetic retinopathy.
Study Design: Quasi experimental study.
Place and Duration of Study: Department of Ophthalmology, Al-Ehsan Eye Hospital, Lahore, from January 2018 to December 2018.
Methods: Patients were divided into two groups; groups A received one tablet of Xanax (Alprazolam 0.5 mg) and 2 tablets of Ponston Forte (Mefenamic acid 500 mg) an hour before PRP. In group B no pain relieving medicines were prescribed. Proparacaine hydrochloride 0.5% eye drops were instilled in the eye to achieve corneal anesthesia before the procedure in both the groups. Pain was scored, 15 minutes after PRP, using standard verbal rating scale and results were analyzed. Paired sample t-test was used to measure the mean difference in pain between the two groups. A p value of less than 0.01% was considered significant.
Results: Five hundred and sixty patients with proliferative diabetic retinopathy (PDR) requiring Pan Retinal Photocoagulation (PRP) were enrolled. There were 272 males and 288 females. Mean age of patients was 64.0 ± 6.8 years. Mean pain score for group A was 4.0 ± 0.6 and for group B was 2.1 ± 0.3. Difference in pain score felt by each group was -1.93 ± 0.7 with significant p value of ˂ 0.01%.
Conclusion: Oral administration of Alprazolam and Mefenamic acid one hour before PRP in patients with proliferative diabetic retinopathy was effective in reducing pain and in attaining patient cooperation during the procedure.
Key Words: Pan Retinal Photocoagulation, Pain, Proliferative Diabetic Retinopathy, Alprazolam, Mefenamic acid.
Computer Vision Syndrome (CVS) and its Associated Risk Factors among Undergraduate Medical Students in Midst of COVID-19
Authors: Noreen Khola , Ali Kashif , Aftab Kausar , Umar Muhammad 
Published: April 2021

Purpose: To determine the frequency of computer vision syndrome and its associated risk factors among under graduate medical students.
Study Design: Descriptive Cross–sectional study.
Place and Duration of Study: Gujranwala Medical College and Rawalpindi Medical University, Pakistan from 5th August to 28th August, 2020.
Methods: A validated self-designed questionnaire was used for this study. The survey instrument was tailored from a published questionnaire which comprised of questions on demographics, frequency of symptoms of computer vision syndrome, pattern of computer usage and ergonomic practices.
Results: Final analysis was run on 326 under graduate medical students. Females were 228 (69%) and 98 (30%) were males. Age of the participants ranged between 17 to 25 years. Overall frequency of CVS was found to be 98.7%. Twenty nine percent students experienced extra ocular complaints and 71% had ocular symptoms. Symptoms of CVS were more commonly observed among those using desktop/laptop at less than forearm length (p = 0.001). Distance of < 12 inches from mobile phone was found to be associated with eye irritation and neck shoulder pain (p = 0.001). Frequency of break of more than 60 minutes was found to be significantly associated with eye irritation (p = 0.002) and excessive blinking and light sensitivity (p = 0.001). The students not using ergonomically comfortable chair were found to suffer more with symptoms of CVS as compared to those using ergonomically designed chair (p = 0.049).
Conclusion: Health issues related to excessive use of digital devices has become alarmingly high during COVID-19 pandemic. Symptoms of CVS are significantly associated with distance from digital device and less frequent break intervals.
Key Words: COVID-19, Computer Vision Syndrome, Digital eye syndrome, ergonomics, visual display terminals.
Visual Outcome After Sutureless Scleral Fixation of Intraocular Lens
Authors: Sajid Munir Muhammad , Ramzan Muhammad , Arshad Muhammad , Nazir Shahid , Rizwan Ullah Muhammad 
Published: April 2021

Purpose: To study the results of sutureless scleral fixation of intraocular lens (IOL) in cases of complicated cataract surgery.
Study Design: Interventional case series.
Place and Duration of Study: Niazi Medical and Dental College Sargodha from Jan 2018 to Dec 2019.
Methods: Twenty-five eyes of 25 consecutive patients were selected for this study. Patients of traumatic cataract with zonular dehiscence, patients who had per-operative complications like PC rent with insufficient capsular bag, and children with subluxated lens of Marfan, Ehler Danlos syndrome were included in this study. After routine investigation all patients were operated under local anesthesia except children, who were operated under general anesthesia. Sclerotomies were made at 3 and 9 o’clock positions with MVR blade. Sutureless scleral fixation of intraocular lens was done. The haptics of lenses were buried in the scleral pockets which were already made at 3 and 9 o‘clock position. Post-operative antibiotics and steroids were given for 8 weeks and patients were followed up for two years.
Results: Out of 25, 18 (72%) female patients and 7 (28%) male patients underwent surgery. Most of the patients had previous surgical complications of Posterior capsular rent 15 (60%). Four (16%) patients had eye trauma, three had lens subluxation for pseudo-exfoliation and 3 patients (children) were suffering from Marfan Syndrome. Seventy-two percent patients had visual acuity of more than 6/18, 16% had 6/18 to 6/24 and 12% had 6/24 to 6/60.
Conclusion: Properly done suture-less scleral fixation is a safe technique with little chance of IOL dislocation.
Key Words: Scleral fixation, Intraocular lens, Cataract.
Late within the Capsular Bag Intraocular Lens Dislocation (Ten – Year Experience)
Authors: Baig Munir Amjad , Munir Rabeeya 
Published: April 2021

Purpose: To find out the frequency and causes of within the bag intraocular lens dislocation.
Study Design: Descriptive, retrospective study.
Place and Duration of Study: Federal Government Services Hospital Islamabad, from 2008 to 2018.
Methods: Records of all the patients who underwent uneventful phacoemulsification were studied. Patients with Pseudoexfoliation and glaucoma were excluded. Out-of-the bag IOL dislocations and early dislocations that occurred within first three months after the cataract surgery were also not included. Percentage of patients with dislocated lens within the capsular bag after three months or more was calculated and the cause of dislocation was found. Results were presented in percentages.
Results: Three thousand patients underwent uneventful phacoemulsification. Two thousand nine hundred thirty two (2932) patients fulfilled the inclusion criteria while 68 patients did not return for follow up. Age ranged between 25 and 75 years. There were 1600 males and 1332 were females. One thousand seven hundred and sixty were right eyes and one thousand one hundred and seventy two were left eyes. Sixty one (2.08%) developed late IOL dislocations, 35 (57.3%) males and 26 (42.7%) females. Patients of age group 50 – 75 years had more IOL dislocations. Causes of dislocation included; advanced mature cataract 21.3%, 19.7% with postoperative trauma, uveitis 14.7%, Myopia 9.8%, Silicon plate design in 9.8%, eccentric capsulorhexis 8.1%, small capsulorhexis 6.5%, retinitis pigmentosa 3.2% and in 6.5% no cause was found.
Conclusion: Advanced mature cataract and postoperative trauma were the commonest causes of IOL dislocation.
Key Words: Cataract surgery, Phacoemulsification, Trauma, Capsulorhexis. Intra ocular lens dislocation.