bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hearing Evaluations in Children With Retinoblastoma Treated With Intra-arterial Carboplatin Chemotherapy: A Single Institution Review
Authors: Davis Mary Elizabeth , Guarini Edith , O'Connor Kerri , Francis Jasmine H. , Abramson David H. 
Published: September 2024

Purpose
To determine whether the administration of intra-arterial carboplatin affected the hearing of children with retinoblastoma.

Methods
Children with retinoblastoma who were treated with intra-arterial carboplatin chemotherapy were included. Hearing tests before chemotherapy including tympanometry, distortion product otoacoustic emissions, and audiogram (if achievable) were performed and repeated 3 to 9 months after concluding intra-arterial therapy. The study was approved by the institutional review board. Patients were identified from the retinoblastoma clinic when the treatment plan included intra-arterial carboplatin chemotherapy. Children were excluded if they had previous intra-arterial carboplatin or preexisting hearing loss but were included if they had systemic carboplatin and dosing was available. Tympanometry was performed to rule out inner ear fluid. All examinations were performed by a certified audiologist with the same equipment, calibrated regularly by a certified technician.

Results
Twenty-two children (32 eyes) were evaluable. Because most children are diagnosed at a young age and are unable to participate in an audiogram, distortion product otoacoustic emission measurement was the primary measurement. No child displayed hearing loss.

Conclusions
Intra-arterial chemotherapy with carboplatin did not cause ototoxicity in any child by distortion product otoacoustic emission measurement in contrast to systemic chemotherapy where ototoxicity is common. Distortion product otoacoustic emission levels were essentially unchanged from before to after intra-arterial chemotherapy in children with retinoblastoma. These findings suggest that intra-arterial carboplatin does not affect outer hair cell function, and distortion product otoacoustic emission tests can provide useful information when monitoring children at risk of developing carboplatin ototoxicity.

[
J Pediatr Ophthalmol Strabismus
. 2025;62(1):27–32.]
Effect of Posterior Keratometry and Corneal Radius Ratio on the Accuracy of Intraocular Lens Formulas After Myopic LASIK/PRK
Authors: Zheng Yuxing , Zhang Jiaqing , Han Xiaotong , Huang Ruoxuan , Wen Ling , Ye Jinfeng , Huang Yiguo , Qiu Xiaozhang , Chen Xiaoyun , Tan Xuhua , Luo Lixia 
Published: September 2024

Purpose:
To investigate the impact of back-to-front corneal radius ratio (B/F ratio) and posterior keratometry (PK) on the accuracy of intraocular lens power calculation formulas in eyes after myopic laser in situ keratomileusis (LASIK)/photorefractive keratectomy (PRK) surgery.

Methods:
A retrospective, consecutive case series study included 101 patients (132 eyes) with cataract after myopic LASIK/PRK. Mean prediction error (PE), mean absolute PE (MAE), median absolute error (MedAE), and the percentage of eyes within ±0.25, ±0.50, and ±1.00 diopters (D) of PE were determined.

Results:
The Barrett True K-TK formula exhibited the lowest MAE (0.59 D) and MedAE (0.48 D) and the highest percentage of eyes within ±0.50 D of PE (54.55%) in total. In eyes with a B/F ratio of 0.70 or less and PK of −5.70 D or greater, the Potvin-Hill formula displayed the lowest MAE (0.46 to 0.67 D).

Conclusions:
The Barrett True-TK exhibited the highest prediction accuracy in eyes after myopic LASIK/PRK overall. However, for eyes with a low B/F ratio and flat PK, the Potvin-Hill performed best.

[
J Refract Surg
. 2024;40(9):e635–e644.]
Misclassification of Eyes With Progressive Keratoconus Using the KISA% Index
Authors: Hammoud Bassel , Dupps William J. , Scarcelli Giuliano , Randleman J. Bradley 
Published: September 2024

Purpose:
To determine the misclassification rate of the keratoconus percentage (KISA%) index efficacy in eyes with progressive keratoconus.

Methods:
This was a retrospective case-control study of consecutive patients with confirmed progressive keratoconus and a contemporaneous normal control group with 1.00 diopters or greater regular astigmatism. Scheimpflug imaging (Pentacam HR) was obtained for all patients. KISA% index and inferior-superior (IS) values were obtained from the Pentacam topometric/keratoconus staging map. Receiver operating characteristic curves were generated to determine the area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity values.

Results:
There were 160 eyes from 160 patients evaluated, including 80 eyes from 80 patients with progressive keratoconus and 80 eyes from 80 control patients. There were 20 eyes (25%) with progressive keratoconus misclassified by the KISA% index, with 16 eyes (20%) of the progressive keratoconus cohort classified as normal (ie, KISA% < 60). There were 4 eyes (5%) with progressive keratoconus that would classify as having “normal topography” using the published criteria for very asymmetric ectasia with normal topography of KISA% less than 60 and IS value less than 1.45. All controls had a KISA% index value of less than 15. The optimal cut-off value to distinguish cohorts was 15.31 (AUROC = 0.972, 93.75% sensitivity). KISA% index values of 60 and 100 achieved low sensitivity (80% and 73.75%, respectively).

Conclusions:
The KISA% index misclassified a significant proportion of eyes with progressive keratoconus as normal. Although highly specific for clinical keratoconus, the KISA% index lacks sensitivity, does not effectively discriminate between normal and abnormal topography, and thus should not be used in large data analysis or artificial intelligence–based modeling.

[
J Refract Surg
. 2024;40(9):e614–e624.]
Association Between Systemic Levels of Vascular Endothelial Growth Factor and Optical Coherence Tomography Biomarkers in a Non-Neovascular Age-Related Macular Degeneration Cohort
Authors: Lisker-Cervantes Andres , Gill Zafar , Patnaik Jennifer L. , Gnanaraj Ramya , Lynch Anne M. , Palestine Alan G. , Mathias Marc , Manoharan Niranjan , Mandava Naresh , de Carlo Forest Talisa E. 
Published: September 2024

Background and Objective
Investigate associations between systemic vascular endothelial growth factor (VEGF) and optical coherence tomography (OCT) biomarkers in eyes with complete retinal pigment epithelium and outer retina atrophy (cRORA) secondary to non-neovascular age-related macular degeneration.

Patients and Methods
Cross-sectional study of patients with cRORA. OCT images and blood samples were collected at study enrollment. OCT images were evaluated for biomarkers. Systemic VEGF levels were measured using a standard multiplex assay.

Results

Study included 187 eyes from 96 patients. Lower levels of systemic VEGF were significantly associated with retinal pseudocysts (RPs) and sub-retinal hyper-reflective material (SHRM), a median of 7.7 pg/mL and 6.1 pg/mL for patients with the imaging biomarkers compared to those without (10.3 pg/mL [
P
= 0.004] and 9.3 pg/mL [
P
= 0.02], respectively).

Conclusion
This novel study shows that lower systemic VEGF levels were associated with SHRM and RP, which was shown to correspond to an intermediate stage of the atrophic process in age-related macular degeneration. Systemic VEGF could be a useful biomarker and therapeutic target for eyes with cRORA.

[
Ophthalmic Surg Lasers Imaging Retina
2025;56:23–29.]
A novel homozygous splicing mutation in AK7 causes multiple morphological abnormalities of sperm flagella in patients from consanguineous Pakistani families
Authors: Hussain Ansar , Zhang Huan , Zubair Muhammad , Shah Wasim , Khan Khalid , Ali Imtiaz , Raza Yousaf , Zeb Aurang , Abbas Tanveer , Ahmed Nisar , Rahim Fazal , Mustafa Ghulam , Uddin Meftah , Ullah Nadeem , Abbas Musavir , Khan Muzammil Ahmad , Ma Hui , Yang Bo , Shi Qing-Hua 
Published: September 2024

Abstract
Multiple morphological abnormalities of the flagella (MMAF) represent a severe form of sperm defects leading to asthenozoospermia and male infertility. In this study, we identified a novel homozygous splicing mutation (c.871-4 ACA>A) in the adenylate kinase 7 (AK7) gene by whole-exome sequencing in infertile individuals. Spermatozoa from affected individuals exhibited typical MMAF characteristics, including coiled, bent, short, absent, and irregular flagella. Transmission electron microscopy analysis showed disorganized axonemal structure and abnormal mitochondrial sheets in sperm flagella. Immunofluorescence staining confirmed the absence of AK7 protein from the patients’ spermatozoa, validating the pathogenic nature of the mutation. This study provides direct evidence linking the AK7 gene to MMAF-associated asthenozoospermia in humans, expanding the mutational spectrum of AK7 and enhancing our understanding of the genetic basis of male infertility.
Evaluation of Anal Position Indexes from Anal Dimple and Neoanus at Sphincter Muscle Complex in Children with High Anorectal Malformations in Kano, Nigeria
Authors: Liman Bilyaminu Ibrahim , Mohammed Muhammad Aminu , Anyanwu Lofty-John Chukwuemeka , Abdullahi Lawal Barau , Aji Sani Ali , Aliyu Muhammad Salele , Sa’ad Bashir , Jalo Rabiu Ibrahim , Mamuda Atiku , Hassan Mujahid Muhammad , Usman Abubakar Nagoma 
Published: September 2024

Abstract

Background:
Anorectal malformations (ARMs) comprise a spectrum of congenital anomalies that continue to present a challenge to patients, caregivers and paediatric surgeons. The main objective of this study was to determine the anal position index (API) from anal dimple and neoanus at the sphincter muscle complex in children with high ARM.

Methods:
Using a cross-sectional study design, the API was assessed from anal dimple and neoanus at the sphincter muscle complex in children with high ARM. All eligible children with high ARM who presented to AKTH during the study period were recruited into the study.

Results:
Forty eligible patients with an age range of 8 months to 108 months were recruited. Twenty-five were males (62.5%) with a male: female ratio of 1.7:1. The mean pre-operative API using anal dimple was 0.47 ± 0.05, while that of the post-operative API using neoanus was 0.53 ± 0.04. There was a statistically significant difference between the two indices (t = −11.8, P < 0.01). There was also a statistically significant difference amongst male and female indices P < 0.05, but there were no significant differences between different age groups.

Conclusion:
This study has shown that there was a statistically significant difference between the pre-operative API and post-operative API; thus, the position of the anal dimple does not significantly predict the central position of the sphincter muscle complex.
COVID-19 pandemic impact on mental and professional cognition: A questionnaire survey on a sample of GP trainees and GPs
Authors: Zhang Haiyan , Huang Jiabao , Zhang Kouxing 
Published: September 2024

ABSTRACT

Background:
Since the outbreak of 2019 coronavirus disease (COVID-19), general practitioners (GPs) have been working in the frontline under psychological and physical pressure. This study aims to evaluate the psychological health, career prospective, attitudes toward educational mode changes, and knowledge about COVID-19.

Methods:
An online anonymous questionnaire survey was carried out on GP trainees and GPs from June 2022 to September 2022. The survey mainly consisted of four parts: 1) general information; 2) level of knowledge about COVID-19; 3) psychological and physical health impact; and 4) changes in professional perception.

Results:
The total knowledge score of 43 GP trainees and 38 GPs was 334 and 283, respectively, without significant difference (z = -0.839, P = 0.402). There was no statistical difference between the scores of GP trainees and GPs for each subindicator of mental and physical disorders. Eleven GP trainees and four GPs had severe psychological disorder subindexes. Severe somatization disorder subindexes were found in eight GP trainees and five GPs. Also, 67.44% of GP trainees and 52.63% of GPs had a positive attitude toward GP career. Moreover, 62.79% of GP trainees and 52.63% of GPs considered the epidemic had no impact on their professional cognition. Among GP trainees, 62.8% and 32.6% considered the epidemic had no or slight impact on their academic activities, respectively. Also, 53.5% and 44.2% of GP trainees partially and fully approved online teaching, respectively. The most popular forms were live and recorded courses.

Conclusions:
COVID-19 pandemic had no noticeable impact on their physical and mental health and their attitude toward GP career.
Surviving the storm: Wave-wise comparison of the pandemic’s impact on mental health dynamics, sleep patterns, and preventive behaviors among coronavirus patients in Northern India
Authors: Yadav Jaivinder , Sharma Rajni , Kumar Krishan , Rana Devender , Yadav Suman , Sharma Akhilesh , Saini Lokesh , Sharma Divyansh , Saxena Aryan , Patra Pratap , Sexena Muskaan , VikasSuri  
Published: September 2024

ABSTRACT

Background:
Different clinical manifestations were revealed by the distinct waves of the coronavirus. The pandemic had a multifaceted impact on mental health, sleep patterns, and associated fear.

Materials and Methods:
It was an observational online survey using by using Google Forms in the city of Chandigarh between April 2020 and April 2021 across three waves of the coronavirus outbreak (first wave from March 2020 to May 2020, second wave from June 2020 to January 2021, and third wave from February 2021 to April 2021). Fear of coronavirus disease (COVID), preventive behaviors, insomnia-related problems, and impact of the event were assessed by using standardized scales.

Results:
The participants who were infected during the first phase exhibited significantly higher levels of distress, loss of control over their reactions, increased fear of coronavirus and sleep problems, and also greater adherence to preventive behaviors compared to those who were infected during the second and third waves. A tendency to emerge post-traumatic stress disorder (PTSD) was seen in 68 (58.1%) of the participants (Peritraumatic Distress Inventory (PDI) score >14) and 34 (29.1%) of all the participants (PDI score >23). Overall, 66 (56.4%) participants reported having insomnia. About 24 people (20.5%) had clinical concerns about PTSD, 20 people (17.1%) had probable PTSD diagnoses, and 16 people (13.7%) experienced a severe coronavirus disease 2019 (COVID-19) pandemic impact on their lives.

Conclusion:
The first wave of COVID-19 had a greater psychological impact than subsequent waves. Further research must fill important gaps in our knowledge of the clinical range and long-term effects.
Blended learning: An innovative teaching strategy to teach dermatology to the family medicine residents of a teaching hospital
Authors: Masood Sadia , Bhombal Swaleha Tariq , Ghulam Unzela 
Published: September 2024

ABSTRACT

Context:
Medical educators face different challenges in this digital era with the pressure for clinical practice as well as teaching. In blended learning Internet technologies are used along with face-to-face teaching to deliver learning methodologies.

Objective:
To assess the efficacy of the blended learning dermatology course on Family Medicine residents at a teaching hospital. Methodology: It was interventional (pre and post) study with purposive sampling. All the Family Medicine residents enrolled at The Aga Khan University Hospital participated in the study after giving consents. The course covered most common skin conditions. Multiple slide sessions, online lectures, clinical presentations, case-based scenarios, and quizzes were included in the course. Knowledge was assessed through pre- test by multiple choice questions. Post tests were taken after completion of the modules to assess the improvement in the knowledge of residents about basic dermatological conditions by multiple choice questions. After completion of sessions a survey questionnaire was administered to evaluate the perception of participants about blended learning strategy.

Results:
The tests scores were significantly higher in the post test. The majority of the residents were satisfied with the course delivery. A statistically significant difference was found between pre and post test results with a P value 0.000.

Conclusions and Recommendation:
Blended learning is an effective and innovative teaching strategy that helped family medicine residents to enhance their learning more effectively. We recommend that this method of teaching strategy should be used in other clinical disciplines in different contexts.didifferent contexts.
Effectiveness and safety of intravenous labetalol in severe pre-eclampsia and eclampsia at a teaching institution in Chhattisgarh
Authors: Jain Rachna , Jogi Sangeeta Raman 
Published: September 2024

ABSTRACT

Introduction:
Severe hypertension in pregnancy deserves prompt recognition and urgent effective reduction in order to reduce the risk of complications such as eclampsia and HELLP syndrome and to achieve desirable neonatal outcomes. There is a need for effective and safe parenteral antihypertensive treatment.

Subjects and Methods:
We studied the effectiveness and safety of intravenous labetalol use in severe hypertension in pregnancy and post-partum period in a teaching hospital in Chhattisgarh in 101 women. IV labetalol was given as bolus doses till the blood pressures were controlled. Neonatal outcomes were recorded, and adverse effects such as hypotension, hypoglycemia, and neonatal asphyxia were documented.

Results:
Intravenous labetalol given as a single bolus of 20 mg was efficacious in controlling blood pressures in 93 out of 101 (93%) women, and the rest were controlled with 1 or 2 additional doses in 1–3 hours. No neonatal deaths happened beyond the 13 intrauterine fetal deaths at presentation. No women developed any episodes of hypotension, tachycardia of more than 100, or nausea or vomiting on labetalol.

Conclusion:
Intravenous labetalol, even as a single bolus dose, is highly efficacious and is free of any major adverse effects.
Primary care perspectives on leptin and adiponectin in north Indian families with metabolic syndrome
Authors: Singhal Arjun Kumar , Singh Gaurav , Singh Shravan Kumar , Karunanand Busi , Siddique Merajul Haque , Kumar Naveen 
Published: September 2024

ABSTRACT

Background:
Urbanization, sedentary lifestyles, and dietary changes have all contributed to an increase in the prevalence of metabolic syndrome (MetS) in Indian populations during the past 10 years. Numerous markers have been investigated to determine if a person is at risk for developing MetS, with the bulk of them having to do with adipose tissue. Recently, adiponectin and leptin, two biomarkers with a high correlation to cardiometabolic health or disease, are of particular interest.

Methods:
In the general population of India, 100 persons were included. Body mass index (BMI), waist circumference, systolic and diastolic blood pressure, fasting blood glucose, plasma lipids, adiponectin, leptin, insulin, and the homeostasis model were measured to assess insulin resistance. We used binary logistic regression analysis to determine the connection between the researched factors and MetS and Spearman’s analyses to evaluate correlations.

Results:
In all, 200 participants (100 men and 100 women) were enrolled in the study. Men’s and women’s median ages were 53 and 48, respectively (P < 0.05). Men had significantly greater WHR, SBP, and DBP (P < 0.05, respectively). Women had significantly higher levels of triglycerides, LDL, insulin, adiponectin, leptin, and HOMA-IR (P < 0.05, respectively). Leptin-to-adiponectin ratio was significantly and positively correlated with BMI (r = 0.597, P < 0.001), waist circumference (r = 0.576, P < 0.001), triglycerides (r = 0.190, P = 0.001), insulin levels (r = 0.329, P < 0.000), and HOMA-IR (r = 0.301, P < 0.000).

Conclusion:
In this study, higher levels of LAR, together with higher levels of leptin and lower levels of adiponectin, were found to be significantly linked with MetS. To properly determine whether LAR can be a predictor of MetS, independent of confounding factors, research with adequate design must be conducted.
Effectiveness of a training program in improving knowledge and skills about selected common neurological disorders among primary healthcare doctors: The Karnataka Brain Health Initiative (KaBHI) in India
Authors: Mailankody Pooja , Parthasarathy Rajani , Randeep D , Rao Girish N. , Paplikar Avanthi , Johnson Annie Nithiya Vathani , Varghese Feba , Govindaraj Sarath , Shahed Rehan , Vasudev Aparna , Boopalan Deenadayalan , Kulkarni Girish B. , Kalkonde Yogeshwar , Sinha Sanjib , Alladi Suvarna ,   on behalf of the Karnataka Brain Health Initiative (KaBHI) Consortium
Published: September 2024

ABSTRACT

Introduction:
Neurological disorders are the leading causes of death and disability globally. In low-middle-income countries such as India, there is a wide treatment gap for neurological disorders. To address this gap, an initiative known as the Karnataka Brain Health Initiative (KaBHI) was developed in collaboration with the public health system of the state of Karnataka in India.

Method:
A structured hybrid training program was conducted for 120 medical doctors working in the Primary Health Centers (PHCs) in the public health system in three districts of Karnataka. Pre- and post-training evaluation was conducted to assess physicians’ knowledge and skills for evaluating patients with common neurological conditions.

Results:
Of 120 PHC doctors, 111 (92%) scored below the passing score of 50 points out of 100 before the training program. After the training, all trainees scored above this cut-off. The study found a significant improvement in knowledge and skills after the training (before training: 40.48 ± 7.92, after training: 66.28 ± 8.98 (P < 0.001) mean difference = 25.81), and was comparable among the PHC doctors in all three districts.

Conclusions:
Our study shows the feasibility of training primary care doctors in the public health system to manage selected common neurological disorders. The training program can potentially help to reduce the treatment gap for neurological disorders in India.
Comparison of quality-adjusted life years (QALYs) of end-stage patients with gastrointestinal cancers receiving conventional therapies with recipients of supportive-palliative care package
Authors: Vaziri Samira , Esfehani Kourosh Javdani , Hamidi Reza , Amiri Hassan , Naghshbandi Mobin , Rezai Mahdi , Mohammadi Fatemeh 
Published: September 2024

ABSTRACT

Objective:
This study aimed to compare the quality-adjusted life years (QALYs) of patients with gastrointestinal (GI) cancer after receiving palliative and supportive care.

Materials and Methods:
Conducted at Firoozgar Hospital in Tehran, Iran, this observational study included 500 end-stage gastrointestinal cancer patients. The study divided these patients into two groups: 250 utilized palliative medicine services, while the remaining 250 did not. The study compared the conditions of patients in both groups.

Results:
Among those receiving palliative care, only 21% underwent chemotherapy, significantly lower than the 55% in the non-palliative care group (P < 0.001). Hospital mortality rates were considerably reduced in the palliative care group, with 115 patients (46%) compared to 200 patients (80%) in the non-palliative group (P < 0.001). The average hospital stay for patients receiving palliative care was 25.11 ± 5.12 days, significantly shorter than the 96.42 ± 14.15 days in the non-palliative group (P < 0.001). The EuroQol 5-Dimensions 3-Levels (EQ-5D-3L) questionnaire scores showed that patients in the palliative care group experienced significantly better outcomes in pain and mood symptoms, but no significant difference was observed in physical function compared to the non-palliative group.

Conclusion:
Palliative medicine is recommended for gastrointestinal cancer patients as it can significantly reduce unnecessary hospital referrals and length of hospitalization.