bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative study to assess the lifestyle disease risk factors among high school students of government and private schools in Tirupati
Authors: Guthi Visweswara Rao , Monika C. V. , Kondagunta Nagaraj 
Published: May 2024

Background:
Adolescence is a transitional period of life between childhood and adulthood characterized by marked acceleration of growth both physically and mentally.

Objectives:
The objective of the study was to assess the lifestyle disease risk factors among high school students of government schools as compared to high school students of private schools.

Materials and Methods:
This was a cross-sectional study conducted among high school students of both government and private schools for a period of 2 months in Tirupati. Among 4 government and 4 private schools, 884 high school students were included in the study. A pretested semi-structured questionnaire was used to collect information from students. This includes sociodemographic details, and lifestyle disease risk factors related to knowledge and practices were assessed. Weight and height were measured and body mass index (BMI) was calculated. Systolic blood pressure and diastolic blood pressure were measured with manual sphygmomanometer.

Results:
Eight hundred and eighty-four students of age between 12 and 16 years were included in the study. Among them, 438 (49.5%) were in private schools and 446 (50.5%) were in government schools. Among all students, 1.1% (9/884) reported that they smoke tobacco products in the past 30 days and 2.3% (20/884) reported smoke tobacco products at any time in life. Most of the private school students (66.4%) were doing regular exercise compared to government school students (56.3%). The mean BMI was significantly high among private school students (18.9 ± 4.3) compared to government school students (18.1 ± 3.9).

Conclusions:
School is an important place where adolescent behavior was developed and provides environment that influences the development of behavior. The study shows that both government and private school students are equally exposed to risk factors of lifestyle diseases. Therefore, it is recommended that combined and coordinated efforts of health and education departments were required for the primary and primordial prevention of lifestyle diseases.
Challenges faced by accredited social health activist workers in delivering health-care services during COVID-19 lockdowns
Authors: Mohiuddin Syed Ahmed , Butool Shadan , Kenche Bhavani 
Published: May 2024

Background:
COVID-19 pandemic has impacted every aspect of life. Health-care workers and health-care delivery were affected the most. Accredited Social Health Activist (ASHA) workers are the backbone of health-care system in India as they are involved in grass root level activities. They have been at the forefront of India's emergency health response system. Lockdowns disrupted day-to-day activities, and delivery of health-care services became a huge challenge.

Objective:
The objective of this study is to identify the challenges faced by ASHA workers while delivering health-care services during the COVID-19 lockdowns.

Subjects and Methods:
A qualitative study in the form of focus group discussion (FGD) was carried out among the ASHA workers of urban and rural field practice areas. Two FGDs-one each in urban and rural area were conducted. Discussions were about 50–60 min.

Results:
The collected data were analyzed by translation and transcription. The transcripted data was divided into topics and subtopics using NVivo version 12. Topics were fear and social stigma, job-related concerns, difficulties in the community, issues in reaching the center, and financial worries.

Conclusion:
The present study found that the paucity of transport, workload, late payment, and overtime are the biggest hindrances and challenges for ASHA workers in carrying out their work efficiently. Challenges faced by ASHA workers can be solved within the existing framework of the health-care system. However, addressing the issues they have faced will help combat future epidemics and pandemics.
A cross sectional study on awareness about risk factors of cancer cervix among women of reproductive age in the rural field practice area of a medical college
Authors: Naaz Rabiha , Gorantla Misha , Kenche Bhavani 
Published: May 2024

Abstract

Background:
Cervical cancer is the fourth most common cancer in women with an estimated. 6,04,000 new cases in 2020 representing 66% of all female cancers. It is the leading cause of cancer-related death among women.

Objectives:
To assess the awareness about risk factors of cancer cervix and factors associated with it.

Subjects and Methods:
This is a community-based cross-sectional study done in rural field practice area of a Medical College, Hyderabad, Telangana from March to June, among all consenting women in reproductive age group. Data were collected using a predesigned semi-structured questionnaire which contains questions on sociodemographic factors, reproductive risk factors such as age at marriage, prolong use of OCPs, and multiple births.

Results:
Out of the 270 females, respondents belonged majorly to 25 − 34 years age group. About 76.2% of the respondents (206/270) had heard about cervical cancer, of the 76.2% of the study subjects who had heard about cancer cervix, none of them were aware about pap test and vaccination for human papilloma virus (HPV) which is meant to prevent cancer cervix.

Conclusion:
The study showed that women had a fair knowledge about risk factors and symptoms of cancer cervix. Awareness on screening tests, i.e., pap test, HPV vaccinations was poor.
Prevalence and determinants of refractive error and related ocular morbidities among Saudi adolescence population in Riyadh, Saudi Arabia
Authors: Yasir Ziaul Haq , Basakran Fatimah Abdullah , Alhumaid Nora Ali , Balous Malek Abdulrahman , Banaeem Abdulrahman Salem , Al-Shangiti Ahmad Khaled , Khandekar Rajiv 
Published: May 2024

PURPOSE:
The purpose of this study was to determine the magnitude and determinants of refractive error (RE) and related ocular morbidities among preparatory and secondary Saudi students in Riyadh.

METHODS:
This study was conducted in 2017–2018 at preparatory (12–14 years) and secondary (15–18 years) schools. A “Spot Screener” was used to determine if the child passed or failed a refraction test. Fail test meant RE ≥ ± 0.50 D. Data were collected on refractive status in each eye, anisometropia, and strabismus. The type of RE was estimated and analysis was performed for an association to gender, age, and education levels. The use of spectacle while screening defined the compliance of spectacle wear.

RESULTS:
The study sample was comprised of 708 Saudi students. There were 59.5% of boys. The prevalence of RE was 43.6% (95% confidence interval [CI]: 40.0, 47.3). The prevalence of RE in preparatory and secondary students was 44.5% and 43.2%, respectively. The proportion of myopia (≥ −0.5 D) and hyperopia (≥ +0.5 D) among students with RE was 82.2% and 17.8%, respectively. Family history of RE was positively associated to RE in students (odds ratio: 1.8 [95% CI: 1.3, 2.5]). The current screening initiative identified 45 (6.4%) new cases of RE who required spectacles. The compliance rate for using visual aid among students with RE was 74.6%. The prevalence of anisometropia and strabismus was 3.0% and 4.1%, respectively.

CONCLUSIONS:
A high proportion of Saudi adolescence in Riyadh have RE. Periodic ophthalmic assessment and refractive services are recommended as part of school health screening initiatives.
Correlation between retinal nerve fiber layer thickness and anterior segment parameters in patients with pseudoexfoliation: A cross-sectional comparative study
Authors: Rathinam Nithya , Kasturi Nirupama , Kaliaperumal Subashini , Jayaseelan Venkatachalam 
Published: May 2024

PURPOSE:
The purpose of this study was to assess the retinal nerve fiber layer (RNFL) thickness in patients with pseudoexfoliation (PXF) and to correlate it with anterior segment parameters such as intraocular pressure (IOP), central corneal thickness (CCT), pigments in angle structures, and grades of PXF.

METHODOLOGY:
This was a cross-sectional comparative study in a tertiary care center. Patients having unilateral PXF were categorized as group 1. Age- and sex-matched healthy controls were categorized as group 2. All subjects underwent IOP measurement, CCT measurement, and retinal nerve fiber thickness measurement. Subjects in group 1 also underwent gonioscopy and perimetry. Data were entered and analyzed using the IBM-SPSS program (version 20.0); Chicago, IL.

RESULTS:
Mean RNFL thickness in group 1 was 85.91 ± 22.237 μ and in group 2 was 106.65 ± 6.1 μ. The mean RNFL thickness in patients with PXF syndrome was 103.38 ± 5.815 μ and in patients with PXF glaucoma was 67.82 ± 17.984 μ. The mean CCT in patients with PXF syndrome was 516.41 ± 23.03 μ and in patients with PXF glaucoma was 507 ± 33.05 μ and control group was 526.6 m. The mean IOP in patients with PXF syndrome was 8 ± 6.01 mmHg; in patients with PXF glaucoma was 17.21 ± 7.33 mmHg; and in the control group was 14.12 ± 2.693 mmHg. There was a negative correlation between IOP and RNFL thickness, and a positive correlation between CCT and RNFL thickness, but it was not statistically significant. A statistically significant correlation was found between grades of PXF and RNFL thinning with a correlation coefficient of 0.437 (P = 0.001).

CONCLUSION:
Patients with PXF have a lower CCT, higher mean IOP, and RNFL thinning compared to normal subjects. The presence of grade 3 PXF (on the lens surface edge) showed a statistically significant correlation with RNFL thinning.
Ocular cysticercosis at a teaching hospital in Northern India
Authors: Maurya Rajendra P. , Mishra C. P. , Roy Meghna , Singh Virendra P. , Singh Mahendra K. , Yadav Mahima , Al-Mujaini Abdullah S. 
Published: May 2024

BACKGROUND:
Ocular cysticercosis (OC) is common in tropical countries. This study aimed to analyze the clinical presentation patterns, management and treatment outcomes of OC cases seen at a teaching hospital in North India.

METHODS:
This study took place between March 2014 and February 2019. A total of 36 patients with OC were analyzed to determine clinical presentation and outcomes.

RESULTS:
Of the 36 patients, 13 (36.11%) were male and 23 (63.89%) were female. The most frequently affected age group was 10–29 years (n = 22; 61.11%). All of the patients had unilateral lesions, with involvement of the left eye in 22 (61.11%) and the right in 14 (38.89%). The majority of cases were isolated to the ocular region; however, five (13.89%) demonstrated neural involvement as well. In terms of cyst location, 15 (41.67%) were orbital, 13 (36.11%) were subconjunctival and four each (11.11%) were intraocular or on the eyelid. The most common clinical presentations were subconjunctival masses or proptosis in 13 each (36.11%) and periorbital swelling in 12 (33.33%). Most patients received medical treatment (n – 23; 63.89%), while the others required surgical excision. Recurrence was noted in seven patients (19.44%), of which three underwent surgery while the rest were treated medically. Two patients (5.56%) developed phthisis.

Conclusions:
In this study, OC cysts were more often orbital or subconjunctival compared to findings reported from Western countries. In addition, a female preponderance was noted in contrast to previously reported findings. Advanced radioimaging is crucial to ensure early diagnosis and treatment.
Outcomes of Descemet stripping endothelial keratoplasty in cases of corneal endothelial dysfunction
Authors: Srujana Dubbaka , Bista Nabaratna , Agrawal Mohini 
Published: May 2024

BACKGROUND:
Automated microkeratome is commonly used to get donor lenticules for Descemet stripping endothelial keratoplasty (DSEK); however, manual dissection of donor lenticules is also being done with good outcomes.

AIM:
The aim of this study was to describe the results of manual DSEK performed in cases of corneal endothelial dysfunction caused due to pseudophakic bullous keratopathy, iridocorneal endothelial syndrome, and postpenetrating keratoplasty graft failure.

MATERIALS AND METHODS:
This was a retrospective observational study. The medical records of all patients with corneal decompensation who underwent DSEK at a tertiary care center performed by the same surgeon were reviewed. A standard DSEK with manually dissected donor lenticules was performed in all cases with the exception of the Descemet membrane not being removed in two cases. A comprehensive ophthalmic examination was performed preoperatively and at each postoperative visit in all patients.

RESULTS:
Eight eyes of seven patients (four males and three females) were included. The mean age was 64.8 years (range, 49–74 years). The average follow-up was 10.9 months (range, 5–22 months). There was one case of primary graft failure which was managed by repeat DSEK. In the rest, corneas remained clear at the last follow-up. No rebubbling was done as none of the cases showed graft detachment. The preoperative best-corrected visual acuity (BCVA) was 20/2000 or less, and postoperatively, BCVA attained was 20/30 in four eyes and one eye achieved 20/80.

CONCLUSIONS:
Manual DSEK performed in eyes with corneal decompensation allowed rapid restoration of corneal clarity while minimizing intraoperative and postoperative complications.
Optical density changes of subretinal hyperreflective material in age-related macular degeneration after switching therapy from ranibizumab to aflibercept
Authors: Filik Armagan , Gungel Hulya 
Published: May 2024

BACKGROUND:
Subretinal hyperreflective material (SHRM) is a hyperrefiective material seen on optical coherence tomography (OCT) and located under the retina and above the retinal pigment epithelium. This study aims to examine the effect of SHRM on the functional prognosis of age-related macular degeneration (AMD) patients who switched from intravitreal ranibizumab to intravitreal aflibercept treatment.

MATERIALS AND METHODS:
This is a retrospective, nonrandomized clinical study. AMD patients meeting the switching criteria underwent a complete ophthalmic examination, including spectral-domain OCT and fundus fluorescein angiography. The best-corrected visual acuity and OCT parameters were measured at the switch and 3, 6, 12, and 24 months after. SHRM(+/−), maximum SHRM thickness, and subjective and objective reflectivity stages of SHRM (grades 1–3) were evaluated.

RESULTS:
SHRM was observed in 24/48 (50.0%) of eyes at the time of the switch. The differences in maximum SHRM thicknesses were not statistically significant. SHRM's mean subjective reflectivity stages at the switch and subsequent examinations were 2.37, 2.75, 2.75, 2.74, and 2.81; SHRM's objective reflectivity staging also confirmed them. Functional changes after the switch showed a significant VA loss in the SHRM(+) group and significant gain in the SHRM(−) group.

CONCLUSION:
This study showed that the presence of SHRM and higher optical reflectivity at the switch from ranibizumab to aflibercept caused a poor prognosis after the switch. On the other hand, SHRM(−) patients achieved good functional results after the switch.
Indications for penetrating keratoplasty in Iranian patients
Authors: Eidizadeh Mojtaba , Ebadi-Soflou Leila , Khoushabi Aashkan Safarzadeh 
Published: May 2024

BACKGROUND:
The outcome of penetration into keratoplasty (PK) related to corneal disease is responsible for corneal blindness. The aim of this study is to evaluate the indications and visual outcome of PK in Imam Khomeini Hospital in Kermanshah from March 2017 to March 2019.

MATERIALS AND METHODS:
Data were reviewed from the medical records of 115 PK done in the Department of Ophthalmology, Imam Khomeini Hospital, Kermanshah, from March 2017 to March 2019. Data analysis done using paired Student's t-test for hypothesis testing of grouped values of preoperative and the last follow-up best-corrected visual acuity in cases of optical and therapeutic grafts. P <0.05 was considered statistically significant.

RESULTS:
In this study, the data of 115 eyes of 108 patients were reviewed. The most common indication for keratoplasty was corneal scarring including adherent leucoma, 34 (29.56%). Therapeutic keratoplasty was done for 26 patients. One case of tectonic graft was included in therapeutic keratoplasty group for analysis. There was statistically significant difference (P = 0.0001) in best-corrected visual acuity improvement from 1.36 logMAR + 0.024 (standard deviation [SD]) preoperatively to 0.357 logMAR + 0.42 (SD) postoperatively and 1.4 logMAR + 0.000 (SD) preoperatively to 0.15 logMAR + 0.55 (SD) postoperatively for optical and therapeutic grafts, respectively.

CONCLUSION:
Active or treated infectious keratitis was one of the most important indications for keratoplasty. Symptoms of poor prognosis were more pronounced in this part of the country. Patients' vision after corneal transplantation was encouraging, especially in cases of optical keratoplasty.
Comparative evaluation of diabetic retinopathy screening programs in regular ophthalmology clinics versus integrated diabetic clinics within rural health-care services
Authors: Amritanand Anika , Arthur Anupriya , Horo Saban , Obed Prathibha , Ramamurthy Prashanth , Rebekah Grace , Abraham Vinod Joseph , Paul Padma 
Published: May 2024

BACKGROUND:
Robust integration of diabetic retinopathy (DR) screening within health systems is essential to prevent DR-related blindness. This, however, remains a challenge in the developing world. The aim of this study was to evaluate two models of DR screening programs within rural general health-care services.

MATERIALS AND METHODS:
This was a retrospective observational study from two rural health centers. Demographic and clinical data of patients completing DR screening were analyzed. Patients were screened in regular ophthalmology clinics (ROC) or integrated diabetic clinics (IDC). Referral and treatment completion data were retrieved from the clinical charts at the base hospital.

RESULTS:
A total of 2535 DR screenings were conducted for 2296 patients. The total population prevalence for any DR was 14.2% (95% confidence interval [CI]: 12.8%–15.6%) and vision-threatening DR (VTDR) was 4.7% (95% CI: 3.8%–5.6%). In the ROC and IDC groups, respectively, the prevalence of any DR was 20.4% and 8.2%, VTDR, 7.8% and 1.7%, and blindness, 1.4% and 0.4% (all P < 0.001). Referral completion rates were higher in the ROC group (44.8% vs. 25.2%, P < 0.001), while treatment completion in both was similar (69.6% vs. 70.6%). Referral and treatment completion rates for referable DR were 61.2% and 48.2%, and for VTDR, 62% and 38.8%, respectively. Only 11.45% of patients completed the repeat screening follow-up.

CONCLUSIONS:
Patients attending IDCs had a significantly lower prevalence of any DR, VTDR, and blindness demonstrating the advantages of integrated diabetic care in a rural setting. However, referral uptake and DR treatment completion need strengthening.
Peripapillary nerve fiber layer in patients with iron deficiency anemia: A cross-sectional study in a tertiary eye care center in Central India
Authors: Joshi Rajesh Subhash , Ingle Rajesh Namdeo 
Published: May 2024

AIMS:
The aim of this study is to evaluate the effect of iron-deficiency anemia (IDA) on peripapillary retinal nerve fiber layer (RNFL) thickness using spectral-domain optical coherence tomography (SD-OCT).

SETTINGS:
The study was conducted at tertiary eye care center in Central India.

DESIGN:
This study was a prospective, cross-sectional, case–control, and observational study.

MATERIALS AND METHODS:
In the present study, 58 eyes of patients with IDA were compared with 58 eyes of healthy individuals. All individuals underwent a thorough hematological, clinical, and ophthalmic examination, followed by peripapillary RNFL analysis using SD-OCT.

RESULTS:
A total of 116 eyes were included in the study. The average RNFL thickness (RNFLT) in the cases was 97.26 ± 5.96, and 102.32 ± 6.26 (P = 0.005) in controls. There was a significant RNFL loss in the temporal (66.76 ± 6.1, P = 0.02), superior (119.66 ± 10.47, P = 0.01), nasal (73.59 ± 9.52, P = 0.003), and inferior (129.05 ± 10.96, P = 0.001) quadrants in the cases and controls. Serum hemoglobin, iron, ferritin, total iron-binding capacity, and transferrin saturation were lower in the cases (P < 0.05). A positive correlation was observed between average RNFLT and hemoglobin (r = 0.321), iron (r = 0.122), ferritin (r = 0.152), and transferrin (r = 0.190) levels.

CONCLUSIONS:
In patients with IDA, RNFLT was decreased in all quadrants compared to normal healthy individuals. The inferior and nasal RNFL showed a significant decrease in thickness. The presence of myopia, glaucoma, and diabetic and hypertensive retinopathy can exert an additive effect in the thinning of RNFLs and cause significant visual loss; hence, the correction of anemia is essential. There is a pressing need to raise public and health professional awareness of these problems and their prevention, diagnosis, and management.
Digital contrast sensitivity chart with varying visual acuity: Development and validation
Authors: Hegde Prateeksha G , Rao Diwakar , Prudhvi B. , Hegde Namratha 
Published: May 2024

BACKGROUND:
Contrast sensitivity (CS) evaluation is very much necessary for the diagnosis and management of eye conditions. Several disadvantages seen in the traditionally used Pelli-Robson (PR) chart persuaded us to develop a novel digital device for the evaluation of CS at various levels of visual acuity (VA) for early detection of deteriorating vision.

MATERIALS AND METHODS:
The new chart was constructed on the Debian software. Letters were constructed at each level of VA from 6/60 to 6/6 with a contrast of 0–2.25 logCS. The newly constructed chart was validated against the PR chart. The data were analyzed on the SPSS software version 23. The Pearson’s correlation test was used to find out the correlation between the digital CS chart (DCSC) and PR charts.

RESULTS:
On successful construction of a DCSC with varying VA, 56 participants were examined with a mean age of 20.43 ± 1.44 years. The mean CS with PR was 1.84 ± 0.13 logCS, whereas DCSC was 2.09 ± 0.14 logCS. The correlation between the two charts was moderate having r = 0.489 with P = 0 (confidence interval 95%).

CONCLUSION:
A newly developed CS chart is efficient in examining the CS in clinical practice and has good repeatability; it may help in the early detection and monitoring of ocular diseases.
Bilateral enucleation for retinoblastoma
Authors: Machakuri Khaleel , Kaliki Swathi 
Published: May 2024

PURPOSE:
To study the clinical profile of patients who underwent bilateral enucleation for retinoblastoma (RB).

METHODS:
Retrospective study of 14 cases.

RESULTS:
Of >3000 RB cases, 14 (<1%) underwent bilateral enucleation for treatment of RB. The mean age at diagnosis of RB was 26 months (median, 24 months; range, 5–72 months). All patients had bilateral RB at presentation. Intraocular RB was evident in 23 (82%) eyes and orbital tumor extension was noted in 5 (18%) eyes. Based on the International Classification of Intraocular RB, tumors were classified as Group B (n = 1; 4%), D (n = 4; 14%), or E (n = 14; 50%) at presentation. Based on the International RB Staging System, tumors were classified as Stage 1 (n = 23; 82%) or Stage 3 (n = 5; 18%). Two patients (four eyes with intraocular RB) had undergone prior treatment before presenting to us and thus could not be classified. Primary treatment included systemic chemotherapy (n = 27; 96%) or enucleation (n = 1; 4%). Five patients were lost to follow-up for a mean duration of 15 months (median, 12 months; range, 7–24 months) during treatment and presented with the orbital extension of RB in one (n = 4; 29%) or both (n = 1; 7%) eyes. Secondary enucleation was performed in 27 (96%) eyes. Over a mean follow-up period of 49 months (median, 29 months; range, 3–340 months), there was no evidence of metastasis and 1 (7%) child died due to pneumonia.

CONCLUSION:
Bilateral enucleation is rare in the treatment of RB. Advanced tumor presentation or noncompliance to treatment necessitates bilateral enucleation.