bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accuracy of Topometric Indices for Distinguishing between Keratoconic and Normal Corneas
Authors: Lopes Bernardo , Ramos Isaac C , Valbon Bruno F , Salomao Marcella Q , Guerra Frederico P , Jordao Livia F , Canedo Ana Laura C , Correa Rosane 
Published: February 2014

ABSTRACT

Purpose
To evaluate the sensitivity and specificity of the Pentacam topometric indices derived from the corneal surface curvature to distinguish between normal and keratoconic corneas.

Methods
The study consisted of 226 normal corneas from 113 patients and 88 keratoconic eyes from 44 patients. Eyes were defined as keratoconus based on comprehensive ocular examination, including Placido-disk-based corneal topography (Atlas Corneal Topography System; Humphrey, San Leandro, California) and rotating Scheimpflug corneal tomography (Pentacam HR; Oculus, Wetzlar, Germany). Corneal Topometric indices ISV, IVA, KI, CKI, IHA and IHD, along with the TKC (Topometric Keratoconus Classification) score were calculated from the Pentacam HR exam. Statistical analysis were accomplished using BioEstat 5.0 (Instituto Mamiraua, Amazonas, Brazil) and MedCalc 12.0 (MedCalc Software, Mariakerke, Belgium) using unpaired nonparametric Mann Whitney test (Wilcoxon ranked-sum). ROC curves were calculated for each topometric parameter to determine the best cut off values from the significantly different parameters. A logistic regression analysis was performed to provide a combined parameter for optimizing accuracy.

Results
Statistical significant differences were found between keratoconic and normal corneas for all topometric indices (Mann Whitney, p < 0.05). There were four false negative cases among the keratoconic cases on the TKC classification (4.54%) and 16 false positive cases among normal (7.08%), so that the sensitivity and specificity of the TKC were 95.54 and 92.92% respectively. The areas under the ROC curves (AUC) for the individual topometric indices varied from 0.843 (CKI) and 0.992 (ISV). The sensitivity and specificity of the most accurate ISV were 97.7 and 96.5% respectively. The calculated parameter from logistic regression had AUC of 0.996, with sensitivity of 97.7% and specificity of 98.7%.

Conclusion
Pentacam topometric indices were useful for distinguishing between normal and keratoconic corneas. The TKC classification should be expected to have false positives and negatives and should not be considered alone. TKC had more false positives and false negatives than some individual topometric parameters. A novel combined parameter based on logistic regression analysis may improve accuracy for the diagnosis of keratoconus. Further studies are necessary to evaluate if adding other curvature derived indices is beneficial for the regression analysis, as well as for testing the sensitivity of such parameters for the diagnosis of milder forms of ectasia and for testing correlations with severity of the disease.

How to cite this article
Salomao MQ, Guerra FP, Ramos IC, Jordao LF, Canedo ALC, Valbon BF, Luz A, Correa R, Lopes B, Ambrósio Jr R. Accuracy of Topometric Indices for Distinguishing between Keratoconic and Normal Corneas. J Kerat Ect Cor Dis 2013;2(3):108-112.
Corneal Collagen Crosslinking for Keratectasia after Laser in situ Keratomileusis: A Review of the Literature
Authors: Spadea Leopoldo , Verboschi Francesca , Valente Stefano , Vingolo Enzo Maria 
Published: February 2014

ABSTRACT
Corneal ectasia is a serious vision-threatening complication of laser in situ keratomileusis (LASIK). It is associated with progressive corneal steepening, an increase in myopia and astigmatism, and decrease in uncorrected visual acuity. Before LASIK presence of risk factors (corneal thickness, refractive error, presence of clinical and subclinical corneal pathologies) should be studied so patients should be risk-stratified. Forme fruste keratoconus or marginal pellucid degeneration should be investigated before LASIK in order to inform the patients of the possibility to develop a corneal complication. Management of post-LASIK ectasia enlists crosslinking, INTACTS, contact lenses and, in the most serious cases, lamellar keratoplasty and corneal transplantation. Crosslinking is a technique to treat and even prevent post-LASIK corneal ectasia. LASIK is a technique that reduces the corneal strength and stability. Crosslinking increases the number of collagen interfibrillar covalent bonds, using ultraviolet A and riboflavin. This result increases stability in corneal strength, reducing the risk to develop corneal ectasia (if performed simultaneously with LASIK) or it treats ectasia (if performed after LASIK keratectasia).

How to cite this article
Spadea L, Verboschi F, Valente S, Vingolo EM. Corneal Collagen Crosslinking for Keratectasia after Laser in situ Keratomileusis: A Review of the Literature. J Kerat Ect Cor Dis 2013;2(3):113-120.
Intacs Intracorneal Ring Segments Complications in Patients Suffering from Keratoconus
Authors: Barbara Ramez , Barbara Adel 
Published: February 2014

ABSTRACT
Intacs, intrastromal corneal rings are widely used to reduce myopia, astigmatism, keratometry readings and high order aberrations in patients suffering from keratoconus, almost 15 years have passed from the first procedure which was performed in the eye of a patient with unsatisfactory visual acuity and contact lenses intolerance.
Many publications including book chapters, retrospective studies, case reports and literatures reviews have been published on this issue.
In this review, we are reporting on the complications of Intacs implanted in keratoconic eyes, we are reporting on intraoperative and postoperative complications. The review although focusing on complications of the does not contradict the positive results of the procedure on the quality of life of the patients suffering from keratoconus and the its safety.

How to cite this article
Barbara A, Barbara R. Intacs Intracorneal Ring Segments Complications in Patients Suffering from Keratoconus. J Kerat Ect Cor Dis 2013;2(3):121-128.
Case of Corneal Perforation as a Complication after Uneventful CXL without Infection
Authors: Demirci Goktug , Ozdamar Akif 
Published: February 2014

ABSTRACT

Purpose
To demonstrate that UVA/riboflavin crosslinking (CXL) can cause corneal melting in some unpredictable cases.

Materials and methods
We will present a case report of 25-year-old male patient referred for emergency keratoplasty which is due to corneal melting and perforation developed after uneventful CXL procedure for the treatment of keratoconus.

Results
We performed uncomplicated penetrating keratoplasty of the left eye in our hospital.

Conclusion
CXL is gradually becoming the standard treatment procedure for progressive keratoconus and the only major safety concerns associated with CXL are ocular surface damage and endothelial cell damage. This case has shown, however, that even if CXL seems to have been successful, there is still a risk of adverse outcomes. Our report suggests that further research is necessary regarding the safety of corneal collagen crosslinking in corneas with keratoconus.

How to cite this article
Demirci G, Ozdamar A. Case of Corneal Perforation as a Complication after Uneventful CXL without Infection. J Kerat Ect Cor Dis 2013;2(3):139-142.
Long-term Improvement after the Athens Protocol for Advanced Keratoconus with Significant Ectasia Progression in the Fellow Eye
Authors: Santos Rodrigo , Siqueira Jorge Augusto , Dias Luis Claudio , Siqueira Renata , Valbon Bruno , Dawson Daniel 
Published: February 2014

ABSTRACT
To describe the long-term result of the Athens protocol (custom topography-guided advanced surface ablation followed by riboflavin-UVA collagen crosslinking in the same day) for progressive advanced keratoconus in the left eye, while the fellow right eye first presented with relatively mild keratoconus that was treated with a more conservative therapeutic approach of continuous contact lenses use with the goal for ectasia stabilization. Five years after the Athens protocol, a regression of over 10 D (diopters) was observed on the sagittal curvature with significant regularization of corneal shape and improvement of distance corrected visual acuity (DVCA) in the left eye. The right eye, which was treated more conservatively, had an over 12 D increase on sagittal curvature along with significant distortion of the corneal shape and reduction of DCVA.

How to cite this article
Siqueira JA, Dias LC, Siqueira R, Valbon B, Santos R, Dawson D, Ambrósio Jr R. Longterm Improvement after the Athens Protocol for Advanced Keratoconus with Significant Ectasia Progression in the Fellow Eye. J Kerat Ect Cor Dis 2013;2(3):143-146.
Comparative Study of Low Dose Conjugate Equine Estrogen 0.3 mg vs Standard Dose Conjugate Equine Estrogen 0.625 mg as Hormone Replacement Therapy
Authors: Gupta Meeta , Yadav Poonam , Kumar Sarvesh 
Published: February 2014

ABSTRACT

Introduction
Since menopause was related to variety of genitourinary, vasomotor, psychological and musculoskeletal changes, conjugated equine estrogen (CEE) was introduced for all menopause-related symptoms in various doses.

Materials and methods
It is a comparative study in which 100 postmenopausal women were selected (natural or surgical menopause) with one or more menopausal symptoms. All patients were randomly divided in two groups. Group A received 0.3 mg CEE and group B received 0.625 mg CEE, and both groups were compared with each other in various aspects.

Results
Both the groups were comparable to each other with respect to mean age, residence, type of menopause, total duration of menopause. Both the groups show comparable improvement in vasomotor, genitourinary and psychological symptoms and p > 0.05 which is not significant. On evaluation of bone mineral density (BMD), the group B showed significant improvement than group A (p < 0.001). Effect on endometrium was not significant.

Conclusion
Because of the complications of estrogen ± progestin, it should be prescribed at the lowest effective doses and for the shortest duration consistent with treatment goals and risk for individual women.

How to cite this article
Yadav P, Singh R, Kaur H, Gupta M, Kumar S. Comparative Study of Low Dose Conjugate Equine Estrogen 0.3 mg vs Standard Dose Conjugate Equine Estrogen 0.625 mg as Hormone Replacement Therapy. J South Asian Feder Menopause Soc 2013;1(2):45-49.
Relation of Ethnicity and Menopausal Symptoms in Nepal
Authors: Rajbhandari Swaraj , Amatya A , Giri Kanti 
Published: February 2014

ABSTRACT
A cross-sectional study was conducted among women of different ethnic groups aged 40 to 60 years and health workers in different parts of Nepal using focus group discussions (FGDs), key informant interviews (KIIs) and clinical examinations to determine the symptoms and complains related to menopause.
The mean age at menarche was 15 years and the mean age of menopause was 47. The highest menarche and menopause (50 years) was found to be among the Gurung women. Mean age of menopause was found to be higher among currently older women (52 years among 60+ women vs 41 years among <45 years women) and unmarried women. Tharu perimenopausal women and Sarki, Gurung and Tharu postmenopausal women were found to have relatively more regular menstrual cycles. However, Tharu perimenopausal women were found to have excess bleedings during the menstrual cycle.
Most of the women had heard about menopause but did not have detailed knowledge on it. Loss of sexual interest (95.3%), decreased visual activity (58%), joint pain (31.3%) and body pain (31.3%) were the most commonly reported menopausal symptoms. Mean body mass index (BMI) was highest among the Gurung women (both perimenopausal and postmenopausal). Pap smear was normal in all 138 women but around 50% had some cervical and vaginal-related problems. One-third of Tharu postmenopausal women had atropic labia and onethird of Tamang women had leukoderma.
Since, very little knowledge is known about the postmenopausal symptoms and problems in Nepal, this study can serve as the basis for further researches in this area with an increased sample size.

How to cite this article
Rajbhandari S, Amatya A, Giri K. Relation of Ethnicity and Menopausal Symptoms in Nepal. J South Asian Feder Menopause Soc 2013;1(2):50-55.
A Study of Coronary Heart Disease in Postmenopausal Women and Identification of Major Modifiable Determinant Risks for its Prevention
Authors: Pradhan P , Upadhya AV 
Published: February 2014

ABSTRACT
This is a retrospective study of postmenopausal women admitted with myocardial infarction (MI) in five hospitals (Nepal Medical College, Bir Hospital, Institute of Medicine, Norvic International Hospital, Medicare Hospital) having coronary care unit (CCU) in Kathmandu, Nepal, in 1 year period, from 1st Jan 2001 to 31st Dec 2001. Out of 210 cases admitted in CCU,147 (70%) were suffering from acute MI. Two of the three following criteria were used for the diagnosis of MI: characteristic substernal pain of recent origin more than 30 minutes, elevated cardiac enzymes (creatinine kinase, lactate dehydrogenase, aspirate transaminase), ECG: evidence of infarction (pathological Q waves, ST elevation more than 1 mm in standard lead 1/Avl and/or ST elevation more than 2 mm in precordial leads V1-6 followed by T wave inversion. The major identifiable modifiable risks identified are hypertension in 111 (53.8%), smoking 73 (35.0%), diabetes mellitus in 47 (23.03%), hyperlipidemia in 17 (8.1%), previous coronary heart disease (CHD) in 32 (15.2%) and family history of CHD was present in 2% of the cases. Twenty-two patients (10%) died during treatment and six patients (3%) were readmitted with repeat Ml within 6 months of the 1st Ml and all recovered well.

How to cite this article
Pradhan P, Upadhya AV. A Study of Coronary Heart Disease in Postmenopausal Women and Identification of Major Modifiable Determinant Risks for its Prevention. J South Asian Feder Menopause Soc 2013;1(2): 56-62.
Is There any Difference of Climacteric Symptoms between Natural and Surgical Menopause?
Authors: Nasreen Shaikh Zinnat Ara , Shahreen Shafinaz , Rahman Shahnaz 
Published: February 2014

ABSTRACT

Objective
To compare the effects of the natural and the surgical menopause (SM) on climacteric condition.

Materials and methods
This prospective study was conducted from Jan 2008 to Jan 2013 in ZHSWMCH. Initially, 4,000 women were enrolled but finally 1,743 of natural menopause (NM) and 554 of SM were analyzed. All women were aged between 45 and 50 years, and they were of menopause for 1 to 5 years. Ethical and patient's permission was taken. Once enrolled, they were asked questions. The questions were related to menopausal symptoms (MS). Data was collected and analyzed by SPSS software.

Results
Hot flushes, (535 vs 290, p < 0.001), sweating (344 vs 122, p < 0.001), poor memory (99 vs 65 p < 0.001), feeling depressed (335 vs 126, p < 0.001), dry skin/mucosa (229 vs 91, p < 0.001), decreased libido (289 vs 117, p < 0.001), dry vagina (99 vs 65, p < 0.001) and urinary complains (59 vs 42, p < 0.001) were found in SM vs NM. Hypertension or cardiovascular disease was more (191 vs 92, p < 0.01), blood sugar were more (90 vs 32, p ≤ 0.001) and metabolic syndrome are also more (48 vs 26, p < 0.07) in SM than NM but this did not reach the significance.

Conclusion
Menopausal symptoms are common in both NM and SM. These MS were significantly higher in surgically menopause women and they were troubled more, so we need to be cautious about oophorectomy, and ovarian preservation should be the aim in all benign cases. Of course, we need to assess the risks and benefit where there is risk of ovarian cancer during the time of total abdominal hysterectomy. Both hormone replacement therapy (HRT) (following a risk/benefit analysis) and treatment of osteoporosis may be recommended after surgery to decrease the climacteric symptoms and osteoporosis in women with menopausal symptoms.

How to cite this article
Nasreen SZA, Shahreen S, Rahman S. Is There any Difference of Climacteric Symptoms between Natural and Surgical Menopause? J South Asian Feder Menopause Soc 2013;1(2):63-65.
Analysis of Genital Tract Malignancies in Postmenopausal Indian Women
Authors: Joshi Sulabha , Jain Sheela , Kawthalkar Anjali , Somalwar Savita A , Somalwar Ashutosh 
Published: February 2014

ABSTRACT

Introduction
Genital malignancies in women varies widely from developed to developing countries. Postmenopausal women are at risk of developing various genital malignancies.

Objectives
(1) To determine frequency of genital tract malignancies in postmenopausal women, (2) to determine the type and stage of genital tract malignancies, (3) to create awareness of screening in women.

Materials and methods
This descriptive cross-sectional study was carried out over a period of 2 years from March 2010 to Feb. 2012. It included 200 postmenopausal women admitted with complaints like mass or fullness of abdomen, bleeding or discharge per vaginal and ulcer over vulva. They were evaluated clinically followed by relevant investigations. Malignancy was confirmed by histopathology report.

Results
Out of 200 postmenopausal women admitted during study period, malignancy was confirmed in 55 women (27.5%). The type of malignancy was cervical carcinoma (30, 54.54%), ovarian carcinoma (18, 32.72%), carcinoma endometrium (5, 9.09%), carcinoma vulva (1, 1.81%) and carcinoma vagina (1, 1.81%). Majority of carcinoma cervix and ovarian carcinoma were in advanced stage.

Conclusion
Carcinoma cervix was commonest genital malignancy found our study followed by carcinoma ovary. Importance of routine gynecological check-up in postmenopausal women was emphasised.

How to cite this article
Somalwar SA, Joshi S, Kawthalkar A, Bhalerao A, Jain S, Somalwar A. Analysis of Genital Tract Malignancies in Postmenopausal Indian Women. J South Asian Feder Menopause Soc 2013;1(2):66-69.
Menopause and Gynecological Malignancy
Authors: Ferdous Jannatul , Khatun Sabera 
Published: February 2014

ABSTRACT
Menopause is a consequence of biological aging. Menopause does not cause cancer, but the risk of developing cancer increase as a woman ages. Treatment of cancer can also cause premature menopause. Among the gynecological cancer, cervical cancer tops the list of common cancer. Postmenopausal women are prone to have persistent human papillomavirus (HPV) infection. There is no role of primary prevention of cervical cancer by vaccination in postmenopausal women. Secondary prevention by Paps smear only may provide false negative result as the cervix is often flushed with the vagina. So, scraping by Ayres spatula and using endometrial brush is necessary in these women. Unfortunately, symptoms of cervical cancer in postmenopausal women are nonspecific and associated with comorbidities. So, any symptom of cervical cancer in postmenopausal women should be properly evaluated. Ovarian cancer is the number one cancer of death among all gynecologic malignancies. Majority of the ovarian cancer in postmenopausal women present with vague symptom and have the advance stage at prevention. Currently, no reliable screening test is available. Yearly routine pelvic examination, transvaginal ultrasonography and serum CA-125 can be performed in selective high-risk women only. Endometrial cancer is the most common gynecologic cancer in the USA. Most endometrial carcinomas are diagnosed at an early stage and have a good prognosis. Though vulvar and vaginal cancer are rare malignancies, yet these are prevalent in postmenopausal women. Any postmenopausal women with long-term intense itching, pervaginal discharge or any ulcer of vulva or vagina should be evaluated properly.

How to cite this article
Khatun S, Ferdous J. Menopause and Gynecological Malignancy. J South Asian Feder Menopause Soc 2013;1(2):75-79.
Role of Transesophageal Echocardiography in Management of Thoracic Stab Wound
Authors: Sandhu Navparkash S , Capan Levon M 
Published: February 2014

ABSTRACT
Transesophageal echocardiography (TEE) is useful in diagnosing cardiac and aortic injuries. A case of stab chest is described in which TEE ruled out cardiac injury, located the knife in the left lung and had potential to change the surgical plan.

How to cite this article
Sandhu NS, Capan LM. Role of Transesophageal Echocardiography in Management of Thoracic Stab Wound. J Perioper Echocardiogr 2014;2(1):32-33.
TEE Effects of CO2 Insufflation during Video-Assisted Thoracoscopic Thymectomy
Authors: Murray Andrew W 
Published: February 2014

ABSTRACT
Thymectomies have traditionally been performed via a midline sternotomy but are now increasingly being conducted via a thoracoscopic approach. Insufflation of CO2 into the hemithorax during this procedure can create severe compression of the right atrium and ventricle with resultant hemodynamic instability as well as lead to hypercapnia with possible pulmonary vasoconstriction and right heart strain. Transesophageal echocardiography allows monitoring of both the effects of CO2 insufflation on the heart and the efficacy of interventions to restore hemodynamic stability.

How to cite this article
Murray AW, McHugh SM. TEE Effects of CO2 Insufflation during Video-Assisted Thoracoscopic Thymectomy. J Perioper Echocardiogr 2014;2(1):34-37.
Assessment of Pulmonary Valve and Pulmonary Stenosis
Authors: Subramanian A , Malik V , Sreedhar R 
Published: February 2014

ABSTRACT
The Fellow's Corner is a short treatise on material relevant for the learning of trainees in cardiac anesthesia. The first in this series is on the TEE assessment of the pulmonary valve.

How to cite this article
Subramanian A, Malik V, Sreedhar R. Assessment of Pulmonary Valve and Pulmonary Stenosis. J Perioper Echocardiogr 2014;2(1):40-41
A Tomb with a View
Authors: Silva Fabio 
Published: February 2014

AbstractThe orientations of European prehistoric structures have been studied independently by landscape archaeologists and archaeoastronomers. Despite their similar interests, the two fields have failed to converge primarily because of their differing epistemologies. This paper argues that archaeology has much to gain by integrating the two fields to provide a fuller and more balanced exploration and understanding of the location and orientation of the European megaliths. It is suggested that prehistoric archaeoastronomy needs to become more grounded on the archaeological record and context of the prehistoric structures it studies. If it is to generate knowledge of value to archaeology it needs to become a “skyscape archaeology.” This paper looks at current archaeoastronomical approaches through the lens of archaeological practice. It identifies some limitations and discusses how landscape archaeology can inform archaeoastronomy on overcoming them. A methodology that attempts this necessary cross-fertilization, by shedding unfounded assumptions and developing a more phenomenological approach to pattern-recognition, is proposed. This methodology is applied to a case study in central Portugal. The emergent narrative, linking a cluster of dolmens to a local mountain range and the star Aldebaran, not only fits the archaeological record, but is mirrored by local folklore, lending further support to the validity of this methodology.