bluuebunny/crossref_metadata_2025_split huggingface dataset:
Corneal Endothelial Health after Phacoemulsification Cataract Surgery Without Viscoelastic Substance
Authors: Bianchi Germán Roberto 
Published: September 2024

Purpose:To evaluate corneal endothelial health after cataract surgery without viscoelastic substance (VS).Methods:A prospective, non-randomized, case-series study was developed, and phacoemulsification cataract surgery without VS was performed on 1324 eyes between September 2015 and September 2018. As main outcomes, mean endothelial cell density (ECD) and mean central corneal thickness (CCT) were assessed before surgery and then 6 and 12 months after surgery. Data are summarized as mean, standard deviation (SD), and 95% confidence intervals (CI).Results:A total of 1324 eyes were operated, and 31 were excluded by intraoperative complications. The mean ECD baseline was 2506 cells/mm2(SD = 215, CI = 2494–2518); 6 months after surgery, it was 2328 cells/mm2(SD = 213, CI = 2316–2340); and 1 year after surgery, it was 2265 cells/mm2(SD = 214, CI = 2253–2277). In terms of percentage differences, the mean ECD decrease was 9.4% after 1 year. The mean preoperative CCT was 531.6 μm (SD = 34.8, CI = 529.7–533.5); 6 months after surgery, it was 537.7 μm (SD = 38.2, CI = 535.6–539.8); and 1 year after surgery, it was 537.9 μm (SD = 37.9, CI = 535.8–540.0). The mean CCT increased 1.2% 1 year after surgery.Conclusions:Phacoemulsification cataract surgery can be completely performed without VS, with very low intraoperative complications. The postoperative ECD and CCT changes occurred primarily during the first 6 months, and the changes decreased during the second semester.
Assessment of Corneal Biomechanical Properties using Scheimpflug Camera-Based Imaging in Night Shift Medical Staff
Authors: Shirzadi Keyvan , Makateb Ali , Asadigandomani Hassan , Irannejad Maziyar 
Published: September 2024

Abstract

Purpose:
To evaluate the effect of night shifts on the biomechanical properties of the cornea using Scheimpflug camera-based imaging (Corvis and Pentacam).

Methods:
Thirty-four participants from the medical staff who had at least six night shifts per month as a case group and fifty-two participants as a control group participated in the study. The biomechanical characteristics of the cornea using the Corvis device and the topographical characteristics of the cornea using the Pentacam device were investigated in the participants.

Results:
The main indices of corneal biomechanics including Corvis Biomechanical Index (0.17 ± 0.18 vs. 0.15 ± 0.14; P = 0.66 [adjusted] and 0.66 [unadjusted]) and Tomographic and Biomechanical Index (0.16 ± 0.19 vs. 0.14 ± 0.19; P = 0.78 [adjusted] and 0.63 [unadjusted]) were not significantly different between case and control groups.

Conclusion:
Our study showed that night shifts do not independently affect corneal biomechanical indices.
Comparison between the Efficacy and Tolerability of Polyvinylpyrrolidone-Iodine Eye Drops 0.6% and 1% in Adenoviral Keratoconjunctivitis: A Randomized Clinical Trial
Authors: Makateb Ali , Soleymanzadeh Mahdi , Soleiman-Meigooni Saeed , Asgari Ali , Etemadi Mohammad Reza , Mafi Amir Reza , Mohammadi Nader 
Published: September 2024

Abstract

Purpose:
To investigate the effect of topical Polyvinylpyrrolidone-iodine (PVP-I) 0.6% on the clinical course of adenoviral keratoconjunctivitis compared with PVP-I 1% and artificial tears.

Methods:
We prospectively enrolled all patients over 18 years of age with a polymerase chain reaction (PCR)-confirmed diagnosis of adenoviral keratoconjunctivitis who presented to the hospital between November 2022 and June 2023. Patients were randomized into 3 groups: artificial tears (control), PVP-I 1%, and PVP-I 0.6% eye drops, 4 times daily for 5 days. Clinical signs at presentation and at 6 follow-up visits during the 1st 3 weeks of the acute phase were recorded. Patients were also followed up at 1 and 3 months.

Results:
Ninety-four patients completed the study, of which 30, 31, and 33 were in the control, PVP-I 1%, and PVP-I 0.6% groups, respectively. The mean age of the patients was 37.2 years (interquartile range: 25-46). The PCR result was positive in 75.6% of patients with the clinical suspicion. PVP-I, regardless of the concentration, was superior to the artificial tears in terms of time to resolution of lid swelling, discharge, and incidence of subsequent subepithelial infiltrates (P < 0.05). However, a concentration of 0.6% was equivalent to 1%. No significant adverse events were reported in any group.

Conclusions:
The PVP-I 0.6% topical drops are safe and well tolerated in patients with acute adenoviral keratoconjunctivitis. It can be substituted for the 1% solution as it has comparable effects in improving the clinical course and reducing subsequent complications.
Multiple Bilateral Retinal Pigment Epithelial Detachments in a Patient with Systemic Lupus Erythematosus: A Case Report
Authors: Lemos Renata Diniz , Hamade Ahmad Mohamad Ali , Hall Leangelo Nicholas , Nascimento Maurício Abujamra 
Published: September 2024

Purpose:
To report a case of multiple bilateral retinal pigment epithelial detachments (PEDs) in a woman with systemic lupus erythematosus (SLE).

Methods:
Case Report.

Results:
A 28-year-old female with mild blurred bilateral vision in both eyes (OU) without pain or any other symptom was admitted to the hospital due to worsening renal function and uncontrolled high blood pressure (HBP). Best-corrected visual acuity (BCVA) was 20/30 and 20/40, right and left eyes, respectively. She had SLE, glucose-6-phosphate dehydrogenase deficiency, and immune thrombocytopenic purpura. BP was over 150/90 mmHg for more than 1.5 years, and she used corticosteroids at varying doses for more than 4 years. During hospitalization, she was taking prednisone 60 mg daily as Class IV lupus nephritis was diagnosed. On fundoscopy, she had a lacy retinal pattern, remarkably on the macula in OU. Spectral-domain optical coherence tomography revealed multiple bilateral serous PEDs and pachychoroid. Angiofluoresceinography displayed multiple pooling hyperfluorescence areas. Six months afterward, while she was on prednisolone 10 mg daily, and antihypertensive medications, BCVA was improved to 20/25 OU. Nevertheless, she had no retinal or choroidal changes. Her findings could be related to SLE choroidopathy, central serous chorioretinopathy-like disease, and/or hypertensive choroidopathy.

Conclusions:
Ocular involvement affects nearly one-third of SLE patients. The findings are variable and can include nearly any part of the eyeball. Multiple bilateral PEDs have been described in the literature; however, in this case, it is probably multifactorial and not only related to SLE.
Eyedrop Instillation Techniques, Difficulties, and Currently Available Solutions: A Literature Review
Authors: Dadak Rohan , Hatamnejad Amin , Patil Nikhil S. , Qiu Hongbo , Chan Toby Y.B. , Rayat Jaspreet 
Published: September 2024

Purpose:To review current eyedrop instillation techniques, common difficulties faced by patients instilling eyedrops, available eyedrop assistive devices, and patient education regarding eyedrop instillation.Methods:PubMed, Embase, and Google Scholar were searched from conception until June 2022 for articles on eyedrop instillation difficulties, techniques, tools, and patient education.Results:Instillation involves pulling down the lower eyelids and placing drops on the corneal surface or conjunctival fornix, followed by closing of the eyelids for about 1 min. Examples of techniques include eyelid closure and nasolacrimal obstruction techniques. Patients encounter many difficulties when administering eyedrops, including but not limited to poor visibility, squeezing the dropper bottle, aiming the bottle, and accidentally blinking. However, devices are available that assist with aim and dropper compression-force reduction in eyedrop instillation. These can be particularly useful in patient demographics with diminished manual dexterity or the ability to generate force from their fingers. Furthermore, despite patient education in eyedrop instillation not being a common practice, it has been found that adequate patient education can lead to significant improvement in eyedrop instillation technique.Conclusions:While many factors are associated with poor eyedrop instillation technique, there are many solutions available including assistive devices and proper instillation education.
Potential Drug Interactions in Hospitalized Hematologic Cancer Patients: New Update with New Chemotherapy Regimens
Authors: Gholipourshahraki Tahereh , Aria Amir , Sharifi Mehran , Moghadas Ayda , Moghaddas Azadeh 
Published: September 2024

ABSTRACT

Objective:
This cross-sectional study aimed to assess the frequency of potential drug–drug interactions (DDIs) and demographic correlates of moderate and major DDIs among patients with hematologic cancer at a referral hematology hospital in Iran.

Methods:
In this study, for 6 months, all patients suffering from hematologic cancers admitted to the tertiary oncology hospital, Omid, Isfahan, were considered. Data from all medications prescribed to patients during hospitalization were analyzed using the online Lexicomp® drug interaction checker, recording all interactions classified by risk level: C, D, or X.

Findings:
A total of 674 DDIs were detected in 109 patients. The prevalence of treatments with at least one clinically relevant interaction was 95%, being 57.9% for those at level C and 31.5% for levels D and X. According to the frequency, the main interaction was between aprepitant and corticosteroids, followed by the interaction between aprepitant and vincristine. The most common interaction between antineoplastic agents was between doxorubicin and cyclophosphamide. In terms of mechanism, most of DDIs (54.9%) were pharmacodynamics. Only the number of administered medications was associated with DDI occurrence.

Conclusion:
Potential DDIs of moderate to major severity are common among patients with hematologic malignancies. This underscores the importance of implementing different strategies to mitigate this clinically significant risk.
Awareness Regarding the Disease and Its Prevention amongst Women with Recurrent Urinary Tract Infection: A Cohort Study
Authors: Thulasi P. , Jamadarakhani Siddappa , Rajani KR. , Sujatha M. 
Published: September 2024

Abstract

Introduction:
Urinary tract infection (UTI) is regarded as the most common bacterial infection in the community. This disease is more common in females and those in the perimenopausal age group are particularly vulnerable. One of the dreaded complications of UTI is its recurrence. Although the use of antibiotics is the primary modality of treatment of UTI, recurrence can be prevented by adopting behavioural and lifestyle changes and other non-antibacterial measures. Awareness regarding this amongst the patients is of paramount importance.

Aims and Objectives:
This study was undertaken to assess the knowledge regarding UTI and its preventive measures in a cohort of women with primary UTI attending various Urological clinics in an urban population.

Methodology:
One hundred and eighty patients with proven UTIs having no comorbid diseases and structural/functional abnormalities in the urinary system were included in the study. A structured questionnaire was prepared to assess the knowledge of patients regarding the basics of UTI and lifestyle modifications, including non-antibacterial measures that could potentially prevent the recurrence of UTI in them. The total scores obtained by patients were categorised into those with inadequate knowledge, moderate knowledge and adequate knowledge. The percentage of patients in each category was calculated.

Results:
While assessing the overall knowledge using the scale, it was observed that 80% of the patients had inadequate knowledge, while 16.67% had moderate knowledge. Only 3.34% had overall adequate knowledge on the questionnaire. The mean percentage of patients having adequate knowledge on the three subsets of questionnaire given was 18.0%, 8.45% and 7.45%, respectively. The overall mean percentage of adequate knowledge level was only 8.97%.

Conclusions:
Poor awareness on UTI and its preventive measures could be an important factor in averting recurrent UTI (RUTI) in the community women, particularly belonging to the perimenopausal age group. Since there is a strong correlation between knowledge and practice, educating these women with UTI regarding preventive measures could significantly reduce the incidence of RUTI.
Sequential Management of Corrosive Esophageal Perforation in a Low-Resource Setting – Case Illustration
Authors: Gold Ikponmwosa , Callise Obi Chukwunyere , Bolaji Akanni Abdulazeez , Onwurah Chukwurah , Akerele Johnbull , Emeruem Nwadinma , Onoh Uchenna , Okwulehie Vincent 
Published: September 2024

Abstract
Corrosive esophageal injury in children usually occurs following accidental ingestion of corrosives. Suicidal or homicidal injury in children is rare. The degree and extent of injury depend on the nature of corrosives, the volume of corrosive ingested, and the duration of contact. Esophageal perforation is a devastating complication following severe corrosive esophageal injury. Delayed esophageal perforation is defined as perforation diagnosed after 24 h. The following case study describes an incident involving the accidental ingestion of “garri” (flour of processed starchy cassava root taken as flakes or cooked) mixed with an organophosphate by a 4-year-old female child with subsequent development of thoracic esophageal perforation. We stress the importance of aggressive emergency surgical intervention against a conservative approach.
The Effectiveness of 1 g Intravenous Tranexamic Acid in Reducing Blood Loss in Total Hip and Knee Replacement Surgeries: A Double-blind Controlled Study in a Regional Hospital
Authors: Ugbeye Michael Ebiyon , Alatishe Kehinde Adesola , Olanrewaju Sulaimon Olatunji , Lawal Wakeel Olaide , Adadevoh Ine Prattson , Akpan Imeh James , Nwose Uche C. 
Published: September 2024

Abstract

Background:
Tranexamic acid (TXA) is one of the pharmacological drugs employed to reduce haemorrhage during total hip replacement (THR) and total knee replacement (TKR), but there is yet to be consensus on the doses and timing of administration during surgery.

Aim:
This is to assess the effectiveness of 1 g intravenous (IV) TXA compared to placebo for reducing blood loss in THR and TKR.

Patients, Materials and Methods:
This was a prospective randomised double-blind study conducted in our regional hospital between January 2016 and June 2017. THR and TKR patients were randomly allocated to placebo and TXA groups. Intraoperative blood loss (IBL), postoperative blood loss (PBL), total blood loss (TBL), haemoglobin (Hb) drop, duration of surgery, and transfusion rates were outcomes compared between the two groups.

Results:
The administration of 1000 mg (15 mg/kg) TXA significantly reduces IBL, PBL, and TBL by 30%, 31%, and 25.8%, respectively, when compared to placebo in patients who had THR. The mean IBL (187.7 ± 46.2 mL), PBL (334.4 ± 85.9 mL), and TBL (574.3 ± 102.1 mL) in the TXA group were significantly lower than those in the placebo group (344.3 ± 89.0 mL, 628.0 ± 197.4 mL, and 946.5 ± 152.3 mL) (P < 001), respectively, in TKR patients. There was a significant reduction in Hb drop in the TXA group when compared to the placebo group in both THR and TKR patients. The number of THR and TKR patients who received blood transfusions was significantly lower in the TXA group. Mean surgical time in the TXA group was reduced by 0.3 h during THR. However, there was no significant difference in the surgical time between TXA and placebo groups in TKR (P = 0.970).

Conclusion:
One gram of IV TXA is effective in reducing perioperative bleeding, Hb loss, and the need for blood transfusion requirements in THR and TKR.
Service-specific Readiness for Hypertension and Diabetes Care and Its Related Factors in Primary Health Facilities in Akwa Ibom State, Nigeria: A Comparative Service Availability and Readiness Assessment Study
Authors: Nwakile Peter C. , Ekanem Uwemedimbuk S. , Uchendu Obioma C. , Odili Augustine N. 
Published: September 2024

Abstract

Background:
According to the global action plan of the World Health Organization (WHO), private and public health facilities (HFs) must possess at least 80% of affordable basic technologies and essential medicines to tackle the rising burden of hypertension and diabetes (H and D) globally. Literature regarding the realisation of this target is scarce in resource-poor settings like Nigeria.

Objective:
The objective of this study was to assess and compare the service-specific readiness for H and D care in selected urban and rural primary health-care (PHC) facilities in Akwa Ibom State, Nigeria.

Materials and Methods:
The WHO’s service availability and readiness assessment tool was adapted and deployed to assess readiness for H and D care in 214 PHCs randomly sampled from the entire 426 government-owned PHCs in the state.

Results:
A total of 214 PHCs were surveyed (urban, 51.4%). Overall, more urban than rural PHCs had essential drugs (4.8% vs. 0.9%), laboratory equipment (81.7% vs. 76.4%), and were ready for H and D care (23% vs. 11%). Availability of drug-revolving funds (odds ratio [OR] = 4.09; 95% confidence interval [CI] = 1.03–1.12) and the number of health workers (OR = 1.08; 95% CI = 1.03–1.33) were significantly associated with readiness.

Conclusion:
The level of readiness for H and D care was low in both urban and rural primary HFs. The correlates found to be associated with the readiness for H and D care are the availability of drug-revolving funds and the number of health workers.
Appraising Haemophilia Caregivers Burden in the Resource-limited Setting: A Nigerian Survey
Authors: Nwagha Theresa Ukamaka , Okoye Helen Chioma , Nonyelu Charles Emeka , Ejezie Chioma Sandra , Obodo Onochie Ikenna , Adediran Megan 
Published: September 2024

Abstract

Background:
Inadequate management of haemophilia in a resource-limited setting may worsen the challenges that haemophilia caregivers face.

Aim:
The aim of the study was to evaluate the effect of the burden of caring for persons with haemophilia (PWH) on the quality of life of the caregivers.

Methods:
This was a cross-sectional national survey carried out among caregivers of PWH. A modified CarerQol-7D Questionnaire was distributed to consenting families with PWH. The association between clinicopathological characteristics of care recipients and these outcome variables was calculated by SPSS version 22.

Results:
One hundred and five families participated. The majority of the caregivers were immediate family members (101, 96.2%) and mothers (75, 71.4%) of patients. Caregivers were five times more likely to experience a lot of personal mental health problems when taking care of a PWH of severe phenotype (odds ratio [OR]: 4.55, 95% confidence interval [CI]: 1.13–18.32) and when rendering care to a recipient that experienced ≥6 serious bleeds a year (OR: 3.94, 95% CI: 1.02–15.18), respectively. Caregivers were also found to be 12 times more likely to experience a lot of physical health problems when taking care of wheelchair-bound PWH (OR: 12.00, 95% CI: 0.89–161.65).

Conclusion:
Improved treatment of haemophilia with the establishment of a support system may be key in easing the burden of caregivers in resource-limited settings.
Evaluation of In vitro Antibacterial Activity of Endophytic Bacteria Isolated from Catharanthus roseus
Authors: Bhuvaneswari S 
Published: September 2024

Abstract

Background:
Research on the antimicrobial potential of endophytic bacteria isolated from Catharanthus roseus has gained significant attention due to the increasing need for novel treatment options. The scientific community has explored a wide range of bioactive metabolites in endophytes, such as antiviral, anticancer, antidiabetic, and antibacterial substances, highlighting their potential therapeutic applications. These endophytes play a crucial role in enhancing host fitness and competitive ability by improving nutritional uptake, seed germination success, tolerance to environmental stresses, and resistance to phytopathogens. India, with its rich biodiversity of medicinal plants, offers a vast resource for antimicrobial agents. Plants such as C. roseus have been traditionally used in various medical systems for their therapeutic properties. C. roseus, belonging to the Apocynaceae family, contains beneficial compounds such as antioxidant-rich phenolic chemicals, which contribute to its medicinal properties.

Methods:
The main objective of this investigation was to isolate endophytic bacteria from C. roseus, focusing on various colonies isolated from leaf discs. The isolated organisms were identified using Gram staining techniques. Furthermore, the study assessed the in vitro antibacterial activity of the isolated bacteria against selected human pathogens using the well-diffusion method. In addition, the investigation aimed to determine the minimal inhibitory concentration of leaf extract by employing standard antibiotics.

Results:
The study demonstrated that bacterial isolates from C. roseus exhibited potent antibacterial activity against pathogens such as Staphylococcus and Pseudomonas species. The results indicated that the leaf isolates from C. roseus showed strong inhibitory effects against pathogenic bacteria. The Gram-positive organisms were more susceptible than Gram-negative organisms, reflecting the differences in their cell wall structures.

Conclusion:
While the antibacterial activity of C. roseus showed promising results, it was not as potent as certain common antibiotics. This study contributes to the understanding of the antibacterial potential of endophytic bacteria from C. roseus and lays the groundwork for further research on their therapeutic applications in combating bacterial infections.
SJLA_2024_A7: Five Cases of Salvage Thoracoscopic Esophagectomy after Proton Beam Therapy
Authors: Muranami Yuto 
Published: September 2024

Introduction:
Proton beam therapy (PBT) has the feature of reducing radiation exposure to surrounding organs compared to conventional X-ray irradiation, so PBT for esophageal cancer is gradually spreading.

Background:
However, there are few reports about salvage esophagectomy after PBT, and its efficacy and safety are unclear.

Methods:
We reviewed the clinical and surgical outcomes of 5 cases who underwent salvage thoracoscopic esophagectomy after PBT from 2010 to 2023.

Results:
Four of five cases were males; the median age was 70 years, and all lesions were in the thoracic esophagus. One case was T2 lesion depth before PBT and 4 cases were T3. The median dose of proton beam radiation was 35.2 (26–60) Gy, and the median total (including X-ray) radiation dose was 66 (40–71.2) Gy. For of them were recurrent and one was remnant lesions. All cases were performed through thoracoscopic esophagectomy (one was converted to open surgery). Median thoracic operation time and blood loss were 217 (213–427) min and 10 (6–565) ml, respectively. Two cases with a preoperative diagnosis of T1-2 showed fibrosis comparable to that seen in conventional salvage esophagectomy, and we underwent R0 resection. However, the others had severe fibrosis and Grade IIIb postoperative complications such as thoracic abscess and cardiac tamponade requiring open chest drainage, and percutaneous pericardial drainage was occurred in two cases who underwent R2 resection.

Discussion:
For the nonlocally advanced cases, the results were comparable to the conventional salvage esophagectomy. However, fibrosis and scarring of the irradiated area were stronger after PBT, especially in advanced lesions, and they were at high risk for non-R0 resection and complications.

Conclusion:
Because the number of cases was small in this study, it is necessary to conduct further studies on a large number of cases, including multicenter collaboration.