bluuebunny/crossref_metadata_2025_split huggingface dataset:
Breakthrough coronavirus disease 2019 infection among health-care workers at a tertiary care center in Chitradurga district
Authors: Mangasuli Vijayalaxmi , Sidenur Bhagyalaxmi , Amrutha A. M. , Sudharani M. , Vijeth S. B. 
Published: May 2024

Background:
Coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2), spread rapidly leading to a pandemic in March 2020. To combat this, the COVID-19 vaccination drive was conducted in India and had its first recipients as the health-care workers who represent a high-risk population for the same. It included both Covishield and Covaxin. This study draws attention to the COVID-19 attack rate among health-care workers in a teaching Medical hospital, Basaveshwara Medical College and Hospital, in Chitradurga, Karnataka, India.

Objective:
The objective of the study was to assess breakthrough COVID-19 infection after vaccination among health-care workers.

Methodology:
A cross-sectional study was carried out in Basaveshwara Medical College and Hospital in October 2021 and December 2021. The study participants were more than 18 years old. The participants include BMCH staff including doctors, nurses, watchman, and ward boys. A sample size of 200 was obtained.

Results:
Most of the sample lies in the age group of 18–30 years, consisting of more females than males. 191/200, i.e., 95.5% of the population have been vaccinated against COVID-19, of which 69.5% have taken Covishield vaccine and 26% have Covaxin vaccine. Only 9/200 tested positive for COVID-19, postvaccination, whereas 2/200 were hospitalized for complications of COVID-19, postvaccination.

Conclusion:
Breakthrough COVID-19 among BMCH staff members shows that the vaccination has reduced COVID-19 infection.
How common is elder abuse? A cross-sectional study in urban slums of Siliguri, India
Authors: Roychowdhury Papiya , Mukherjee Abhijit , Kar Titas , Bhattacherjee Sharmistha 
Published: May 2024

Background:
Elder abuse is still underreported and unacknowledged despite being a serious social concern linked to significantly higher rates of hospital admission and mortality. Abuse has a profound effect on the victims' physical, mental, and overall quality of life. Abuse can worsen an elderly person's preexisting chronic and incapacitating disease, increasing their dependence, vulnerability, and marginalization.

Objective:
The objective of this study is to evaluate the prevalence and pattern of abuse and identify various factors associated with it among community-dwelling elderly people in slums of Siliguri Municipal Corporation.

Materials and Methods:
A community-based cross-sectional study was conducted among 300 elderly people (60 years and above) in slums of Siliguri Municipal Corporation. A predesigned, pretested, and semi-structured questionnaire was used for data collection. The prevalence and pattern of elder abuse were determined by simple descriptive statistics and binary logistic regression was used to find out the correlates of abuse.

Results:
Abuse was present in 12% of the study population. The elderly above 80 years and females had higher odds of abuse. With respect to the existing property, results showed that ownership of agricultural land is a risk factor of abuse. Most of the study population thought that disrespect accounts for elder abuse, followed by neglect, and verbal abuse. The main perpetrators were daughters-in-law, followed by sons, and spouses.

Conclusion:
The prevalence of geriatric abuse was found to be quite high in the present study. The higher age group and lesser socioeconomic position are just a couple of the causes. Therefore, the continuous issues that make life difficult for the elderly must be addressed.
Application of flipped classroom combined with problem-based learning - An effective learning approach to upgrade learning in medical students: A randomized controlled trial
Authors: Palla Jayasree , Moparthi Sindhura , Kaki Sateesh Babu , Komaram Ravi Babu 
Published: May 2024

Abstract

Background:
As per the recent advancement in medicine, novel learning methodological innovations such as flipped classroom (FC) and problem-based learning (PBL) have earned ample recognition in medical education. The present study was directed with an aim to assess the effectiveness of combined learning method (CLM: FC combined with PBL) over traditional lecture-based classroom (TLC).

Objectives:
The objectives of this study were as follows: to determine whether CLM improves learning outcome among medical students and to determine whether there is any significant difference in students’ perceptions regarding learning method implemented.

Materials and Methods:
A randomized controlled trial (educational interventional study) was conducted with 100 medical students; they were randomly allocated into two equal groups: experimental group (EG) was taught by CLM, whereas control group (CG) was taught by TLC method. Closed- and open-ended questionnaire was used for the collection of data. Statistical analysis was done by applying independent samples t-test and Chi-square test.

Results:
A significant difference in the learning outcome was observed between the mean posttest scores of the two groups (CG = 31.5, EG = 46.2). There was a significant difference in the mean scores of perception between the groups (P ≤ 0.05). Chi-square test showed that students’ satisfaction is associated with the CLM (P = 0.00001).

Conclusion:
FC combined with PBL can be considered a better alternative to the lecture-based classroom for educating medical students on maternal and child health care.
Endophthalmitis Postintravitreal Bevacizumab Injections
Authors: Rizwan Amna , Asghar Asfandyar , Sughra Ume , Yasmin Naila 
Published: May 2024

PURPOSE:
The purpose is to study the incidence, characteristics, management, and visual outcome of endophthalmitis postintravitreal bevacizumab (Avastin®) injections.

METHODS:
Retrospective cohort study conducted at Fauji Foundation Hospital that is a tertiary care center in Rawalpindi, Pakistan. The study duration was from January 1, 2015 to March 31, 2020. A total of 2321 eyes of 1407 patients were treated with Intravitreal bevacizumab (IVB) in a minor operation theater using standard aseptic measures. We studied the incidence, clinical characteristics, treatment, and visual outcomes of endophthalmitis post-IVB.

RESULTS:
Seven eyes (0.30%) out of 2321 eyes developed post-IVB endophthalmitis during the study period. Three eyes (42.8%) were culture positive and four eyes (57.2%) were culture negative. Five eyes (71.4%) showed visual improvement and two eyes (28.6%) did not show visual improvement.

CONCLUSION:
Prompt intravitreal antibiotic along with vitreous tap in cases of postintravitreal endophthalmitis may prevent vision loss which provides a useful alternative to immediate pars plana vitrectomy that requires more expertise, equipment, and an operation theater.
Multipiece posterior chamber intraocular lens as sutureless, glueless scleral fixated intraocular lens
Authors: Mohanty Anuja , Mahapatra Santosh K. , Mannem Navya 
Published: May 2024

PURPOSE:
The purpose of the study is to report the outcomes of sutureless, glueless multipiece posterior chamber intraocular lens (PCIOL) as scleral fixated intraocular lens (SFIOL) implantation in patients with poor or no posterior capsular support.

METHODS:
Medical records of 45 eyes of 42 patients who underwent SFIOL implantation where no suture or glue was used to fixate intraocular lens (IOL) to the sclera from November 2016 to October 2017, with minimum 18 months of follow-up were retrospectively analyzed. The best-corrected visual acuity, indication of surgery, other significant eye examination findings, and complications were analyzed.

RESULTS:
Out of 42 patients, 62% were males and 38% were females. Mean age of subjects was 48.5 ± 16.5 years (range 13–79 years). Mean preoperative and postoperative visual acuity was 1.48 ± 0.6 Logarithm of the Minimum Angle of Resolution (logMAR) units and 0.6 ± 0.3 logMAR units, respectively. Most common complication was vitreous hemorrhage six eyes (13.3%) followed by postoperative hypotony in five eyes (11.11%). Other complications such as transient postoperative intraocular pressure rise, hyphema, tilted IOL, cystoid macular edema, retinal detachment were also noted.

CONCLUSION:
Multipiece PCIOL used as SFIOL without any sutures and glue is a viable, cost-effective method of IOL implantation in eyes with aphakia following surgical complication or trauma, with comparable outcome to other techniques of SFIOL implantation.
Comparison of IOP obtained in different kind of eyes with contact and no contact tonometers
Authors: Sbordone Sandro , Ragucci Adele , Iaccarino Gennarfrancesco , Scognamiglio Gabriele , Leone Angelo , Gironi Carnevale Ugo Antonello , Lanza Michele 
Published: May 2024

BACKGROUND:
The aim of this study is to analyze and compare the intraocular pressure (IOP) values measured in three different kinds of participants such as healthy subjects (HS), keratoconus patients (KP), and those who underwent myopic photorefractive keratectomy (MPRK). The devices used in this study are the Goldmann Applanation Tonometry (GAT), the dynamic contour tonometry (DCT), the ocular response analyzer (ORA), and the Corvis ST (CST).

SUBJECTS AND METHODS:
This research included 92 eyes of 92 h, 63 eyes of 63 KP, and 58 eyes of 58 MPRKM. Each participant underwent a complete ophthalmic evaluation and IOP measurement with GAT, DCT, ORA, and CST. A statistical analysis was conducted to detect possible differences and correlations.

RESULTS:
First, according to the observed data, HS eyes displayed mean IOP values measured with GAT, DCT, ORA, and CST, respectively, 15.82 ± 2.74 mmHg, 17.63 ± 2.28 mmHg, 16.24 ± 3.14 mmHg, and 17.31 ± 3.21 mmHg. Then, KP eyes showed mean IOP values measured with GAT, DCT, ORA, and CST of, respectively, 14.89 ± 1.64 mmHg, 16.97 ± 2.08 mmHg, 13.09 ± 3.12 mmHg, and 13.78 ± 2.11 mmHg. Finally, MPRK eyes showed mean IOP values measured with GAT, DCT, ORA, and CST of, respectively, 13.92 ± 1.34 mmHg, 15.39 ± 2.86 mmHg, 16.63 ± 2.51 mmHg, and 15.06 ± 1.56 mmHg.

CONCLUSION:
According to the observed data, ORA and GAT might be used interchangeably in HS, whereas GAT, ORA, and CST in KP eyes. Moreover, it has been noticed that in those eyes that previously undergone a myopic PRK, GAT provided lower values of IOP in comparison with other devices.
The effect of sustained eye rotation upon eye length in healthy myopic adults
Authors: Alkhaldi Saleh A. , Gray Lyle S. 
Published: May 2024

AIM:
The aim of the study was to determine whether ocular movement can affect the shape of the globe and lead to measurable change in axial and peripheral eye length.

METHODS:
Ten subjects aged 18–30 years (6 M/4 F) participated with informed consent. The mean spherical equivalent refractive error was ≤−1.00 DS with cylindrical refraction <−1.25 DC. One drop of tropicamide hydrochloride 1% was instilled 20 min before measurement to induce mydriasis and mild cycloplegia. Using IOLMaster, eye length was measured centrally and temporally (25° off-axis) in four different positions. Subjects then rotated their eyes 25° in the temporal direction to fixate on a target for 10 min. After that, the same measurements were repeated.

RESULTS:
Before rotation, the group mean peripheral eye length was significantly shorter than the central eye length (P < 0.05). There was no significant variation in central or peripheral eye length due to off-axis fixation, either after the initial eye rotation or after fixation for 10 min at the off-axis point. The difference between central and peripheral eye lengths was maintained after 10 min of temporal fixation (P < 0.05).

CONCLUSION:
Peripheral eye length was shorter than central eye length showing the prolate shape associated with myopia. The action of the extraocular muscles on the globe has no significant effect upon the retinal shape assessed by off-axis eye length measurement in myopic subjects.
Outcomes of canalicular trephination versus canaliculodacryocystorhinostomy in common canalicular blocks
Authors: Vukkadala Tejaswini , Bajaj Mandeep Singh , Pushker Neelam 
Published: May 2024

AIM:
This study aimed to compare the outcomes and efficacy of canalicular trephination with monocanalicular stenting and canaliculodacryocystorhinostomy (canaliculoDCR) with silicone intubation.

MATERIALS AND METHODS:
A prospective comparative study was done in 30 patients (30 eyes) with common canalicular blocks who were randomized into two groups. Fifteen patients underwent canalicular trephination with monocanalicular stenting and 15 patients underwent canaliculoDCR with silicone intubation. Common canalicular obstruction was diagnosed by preoperative syringing and the location of block was confirmed on probing. Stents were kept in both the groups for 3 months and followed up till 6 months postoperatively. Success was defined based on both anatomical and functional outcomes. Anatomical success was defined by the free passage of fluid on syringing with the fluid felt in the throat. Functional success was defined in terms of relief from epiphora based on the subjective opinion and its categorization by Kraft and Crawford's grading and the fluorescein dye disappearance test (FDDT).

RESULTS:
Eighty percent of eyes in canalicular trephination group and 73.3% of eyes in canaliculoDCR group were anatomically patent on syringing at the final follow-up. Sixty-six percent of eyes in trephination group and 53.3% in canaliculoDCR group were reported to have absent epiphora (complete recovery). Ten eyes in both groups had Grade 0 and 1 FDDT indicating a functional success of 66.6% in both groups.

CONCLUSIONS:
Canalicular trephination can produce results comparable to canaliculoDCR with silicone intubation in cases of common canalicular blocks. The average duration of surgery is significantly less in canalicular trephination which gives this procedure an added advantage.
Single-snip paralimbal incision
Authors: Saxena Juhi , Akhtar Naheed , Gupta Yogesh , Amitava Abadan Khan , Kauser Farnaz , Ahmed Shiraz , Raza S. Aisha , Masood Anam 
Published: May 2024

INTRODUCTION:
Less invasive and quicker surgeries have become common. We compared two conjunctival incisional approaches in strabismus, namely Follow standard paralimbal approach for (SPLA) and single-snip paralimbal (SSPLA).

MATERIALS AND METHODS:
Forty-four patients with horizontal strabismus qualifying for uniocular recession–resection surgeries were randomized to SPLA and SSPLA. SSPLA involved a single v-shaped incision, with the apex of the V near the limbus, and the limbs facing away: by pinching up the conjunctiva with a forceps and delivering the single snip with a spring scissors. We compared the postoperative grades of redness, congestion, chemosis, foreign body sensation, and drop intolerance at day 1, 2 weeks, and 6–8 weeks; scar visibility, as yes or no, at 6–8 weeks; success rates, considered to be within 10 prism diopters of orthophoria, at 6–8 weeks; and operation duration in minutes.

STATISTICAL ANALYSIS:
Statistical analysis was done using Mann–Whitney U-test, for inflammatory grades, Chi-square for proportions, and t-test for parametric measures. Statistical significance was set at P < 0.05.

RESULTS:
On postoperative day 1, congestion (P = 0.02), foreign-body sensation (P = 0.04), and total inflammatory score (P = 0.003) were statistically significantly favoring the SSPLA group. While at 2 weeks, only congestion (P = 0.02) was found to be significantly less in the SSPLA group. There were no significant differences in the proportions of scar visibility (5/22 in the SPLA vs. 3/22 in the SSPLA) and success rate: 20/22 vs. 18/22. The SSPLA was quicker on an average by 6 min (P < 0.001, 95% confidence interval: 3.2–8.7).

CONCLUSION:
Compared to the SPLA, the SSPLA is quicker and results in lesser inflammation in the immediate postoperative period.
Accuracy of Barrett versus third-generation intraocular lens formula across all axial lengths
Authors: Solomon Raline , Tamilarasi S , Sachdev Gitansha , Dandapani Ramamurthy 
Published: May 2024

PURPOSE:
The purpose of this study is to evaluate and compare the accuracy of Barrett Universal II versus third-generation formula for different intraocular lens (IOL) powers for Indian eyes with different axial lengths (ALs).

DESIGN:
This is a retrospective, nonrandomized consecutive case series.

METHODS:
This study reviewed 981 eyes from 825 patients who had uneventful cataract surgery and IOL implantation. The eyes were separated into subgroups based on AL as follows: short (<22.0 mm), medium (22.01–23.99 mm), and long (>24.0 mm). The predicted refractive outcome using formulas was calculated and compared with the actual refractive outcome to give the prediction error. The percentage of every refractive error absolute value for each formula was calculated at <±0.50D, 0.50D-0.75D, and >±0.75D.

RESULTS:
In all, 981 eyes were analyzed. There were no significant differences in the median absolute error predicted by Barrett and the third-generation formulae. The Barrett Universal II formula resulted in significantly lowest mean spherical equivalent in short eyes (P = 0.0047) as well as a higher percentage of eyes with prediction errors within <±0.50D, 0.50D-0.75D, and >±0.75D. We found that the Barrett Universal II formula had the lowest predictive refraction error and mean absolute error across all ALs.

CONCLUSION:
The Barrett Universal II formula rendered the lowest predictive error compared with SRK/T, Holladay, and Hoffer Q formulas. Thus, the Barrett Universal II formula may be regarded as a more reliable formula for achieving emmetropia and reducing postoperative refractive surprises across all ALs.
A quantitative evaluation of the effect of meals on macular thickness in diabetic patients with diabetic macular edema
Authors: Sinha Yashika , Trehan Hemant Singh , Kurumkattil Raji , Bhatkoti Bhupesh , Dhar Sanjay Kumar , Sharma Vijay Kumar 
Published: May 2024

PURPOSE:
Central subfoveal thickness measurement is used in a large number of clinical trials to monitor the progression and treatment response of diabetic macular edema (DME) in patients of diabetic retinopathy (DR). Several studies have been carried out to investigate various factors affecting the central subfoveal thickness in order to minimize errors in the testing. We planned a study to investigate the effect of meals on central macular thickness (CMT) in patients with DME and compare that with nondiabetic patients.

METHODS:
In this observational study, 50 patients of diabetes with DME and 50 normal controls were included. Macular thickness was measured after overnight fasting and 2 h postprandial for both the groups. Any changes in morphology and CMT were evaluated.

RESULTS:
Each group had 22 females and 28 males with a mean age of 60.6 ± 6.6 in the diabetic group and of 49.66 ± 11.13 in the control group. Reduction in the CMT was noticed after the meals (mean: −9.78 ± 12.77 μm; P < 0.001) in those with DME as compared to the control group. This was more prominent in those who had intraretinal cystic spaces (17.14 ± 10.33 μm) and neurosensory detachment (66 µ). Patients with high blood sugar levels had higher CMT and a greater reduction in thickness was noticed in them postprandially (r = 0.414; P = 0.0028).

CONCLUSION:
The CMT values in patients with DME are significantly affected by meals. Hence, an attempt should be made to measure CMT during the fasting state for more accurate results.
Review of incidental ocular pathologies detected during the screening of retinopathy of prematurity in preterm infants
Authors: Dabir Supriya , Mohankumar Arthi , Munusamy Sivakumar , Rajan Mohan , Azad Rajvardhan 
Published: May 2024

AIM:
The aim of the study was to report the spectrum of ocular pathologies other than retinopathy of prematurity (ROP) occurring in preterm babies, suggesting the need for universal screening in all babies.

METHODS:
Babies born before 34 weeks of gestational age (GA) and/or weighing <2000 g were screened at around 4 weeks of postnatal age and those born before 28 weeks of GA and weighing <1200 g were examined at 2–3 weeks of postnatal age. Babies between 34 and 36 weeks of GA or birth weight of 1750–2000 g with additional risk factors were also screened. Pupils were dilated using a fixed dose combination of 0.4% tropicamide and 2.5% phenylephrine. The babies underwent retinal imaging using the 3nethra neo camera, Forus, India, by a skilled ophthalmic photographer.

RESULTS:
A total of 1437 preterm babies were screened in an outreach project which spanned 18 hospitals equipped with neonatal intensive care centers (neonatal intensive care units) in an urban setting during the study period. A total of 4339 screening sessions were conducted. Of these infants, 754 (52.47%) were male and 683 (47.52%) were female babies. Among the enrolled infants, 165 (12.16%) had ocular findings other than ROP. Of the 165 cases, 70 (42.42%) were anterior segment and globe pathologies, whereas the remaining 95 (57.57%) were posterior segment pathologies.

CONCLUSION:
Timely screening helps in identifying and managing potentially vision-threatening pathologies including ROP. This will help reduce the burden of childhood blindness worldwide.
Spectacle compliance postcataract surgery significantly improved vision function-related quality of life of adult patients in India: Evidence from a multicenter longitudinal cohort study
Authors: Vishwakarma Pankaj , Sundararaj Lijiraj , Chavan Shobhana , Mondal Amit , Ranpise Dhanaji , Sudhir Rachapalle Reddi , Kumar S. G. Prem , Kurian Elizabeth ,   MFV Qol Study Team
Published: May 2024

BACKGROUND:
Cataract is the leading cause of avoidable blindness globally. This study aims to measure the changes in Vision function-related quality of life (VFQoL) before and after cataract surgery and identify the predictors of an improvement in these outcomes.

METHODS:
A multicenter, longitudinal cohort study was conducted. Patients with first eye cataracts were interviewed before and 6 months after cataract surgery. Multiple classification analysis (MCA) was performed to assess variation in the intensities of mean change scores for general function, psychosocial impact, and visual function with select factors.

RESULTS:
A total of 747 participated in the baseline assessment. The 6-month follow-up rate was 86.5%. The mean general function, psychosocial impact, and visual function scores were 35.3 (±8.6), 12.5 (±3.4), and 8.3 (±3) in the baseline and 17 (±5.3), 6 (±2.2) and 3.8 (±1.3) in the follow-up assessments, respectively. In MCA, patients using spectacles postsurgery (β 0.111) and those having a very good postoperative visual acuity (β 0.098) had the most impact on general function. Patients reporting no ocular complaints postsurgery had a relatively higher effect on the psychosocial impact, (β 0.168) and similarly, patients using spectacles postsurgery and those aged 70 and older had the most impact on the visual function scores (β 0.146 and 0.126), respectively.

CONCLUSION:
Cataract surgery is associated with meaningful improvements in vision and VFQoL in general. The determinants of better VFQoL include the usage of spectacles postsurgery. Strategies to further improve patient participation in postoperative review visits are needed for spectacle provision and patient education regarding spectacle use and compliance is imparted during such visits.