bluuebunny/crossref_metadata_2025_split huggingface dataset:
Language of actions: The effects of teacher's kinesics on student learning and learning environment
Authors: Sajjad Taliya , Khan Humaira Fayyaz , Yasmeen Rahila , Waqas Arfaa 
Published: May 2024

BACKGROUND:
A teacher's appropriate use of nonverbal communication skills, mainly kinesics, can play a crucial role in the success of the students. Medical educators are unaware of the effective use of nonverbal communication as an instructional skill that can be used to engage learners, balance learners' participation by controlling the classroom environment, and motivate them to have a passion for learning. The purpose of the study was to explore the students' perceptions regarding the effect of teachers' kinesics on students' learning and their learning environment. This can be helpful for teachers in modifying their teaching styles and delivering quality education.

MATERIALS AND METHODS:
A qualitative study with an exploratory design was conducted at a private medical institute in 2021 for a duration of 6 months. Fourteen medical students volunteered to participate in the study. Focus group discussions were conducted with the students to explore the experiences of the medical students regarding the use of nonverbal communication skills by their teachers and its effect on their learning in the classroom. The data collected was analyzed manually.

RESULTS:
The results of the study revealed that teachers' nonverbal behaviors in the classroom significantly influence students' motivation, engagement, and learning in the classroom. Students preferred interaction with the teachers who were friendly and confident and used their nonverbal communication skills (eye contact, facial expressions, hand gestures) effectively, compared to strict and judgmental teachers.

CONCLUSION:
Teachers need to motivate their students by improving their teaching styles and incorporating nonverbal behaviors positively in the classroom. By creating an impactful learning environment, students' participation and learning will increase, which will, in turn, improve their academic performance.
Generalized peritonitis secondary to a ruptured schistosoma appendix: A case series
Authors: Bello Bashir M , Umar Ibrahim Abubakar , Emetuma Faruk 
Published: May 2024

Abstract
Schistosoma peritonitis is a rare cause of acute abdomen. Similarly, schistosoma appendicitis is also a rare entity. We present a case series of few patients, who presented with clinical features of generalized peritonitis due to a ruptured appendix. Subsequently, a histopathologic examination revealed schistosoma peritonitis. We had two young patients who presented with clinical features of generalized peritonitis due to a ruptured schistosoma appendix; they were resuscitated, and both had laparotomy with histology of the resected appendix revealing schistosoma appendicitis. We presented this article to highlight the fact that even though rare, schistosomal peritonitis secondary to ruptured schistosoma appendicitis is still possible.
Concurrent Sarcina ventriculi infection in a patient with Helicobacter pylori-associated chronic gastritis: A case report
Authors: Awolola Nicholas Awodele , Akinjo Dolapo , Cookey Kalanne Cara , Haruna Muibat , Arhere Ejiroghene Pauline , Onyekwere Charles Asabamaka , Abdulkareem Fatimah Biade 
Published: May 2024

Abstract

Sarcina ventriculi is a Gram-positive, nonmotile, chemo-organotrophic anaerobic organism, which is rare in humans. Although its role as a pathogen in humans remains poorly characterized, it has been associated with delayed gastric emptying, emphysematous gastritis, and gastric perforation in existing literature. The index case was a 34-year-old male who presented with a history of abdominal pain, 1-month history of frequent vomiting, bloating, and abdominal distension. He was evaluated for gastric-outlet obstruction secondary to a possible gastric tumor. Upper gastrointestinal endoscopy showed a stomach that is filled with food debris, hyperemia, and deformed pylorus but no mass was seen. Histology of a mucosal biopsy sample showed active antral predominant gastritis with concurrent H. pylori and S. ventriculi infections. A repeat endoscopy following antibiotic treatment showed the absence of H pylori and S. ventriculi and the patient reported a cessation of symptoms. S. ventriculi was found in association with H. pylori infection.
The efficacy of the EncephalApp in diagnosing minimal hepatic encephalopathy (MHE) among patients with liver cirrhosis in Jos Nigeria
Authors: David Nyam Paul , Duguru Mary John , Davwar Pantong Mark , Omaiye Patience One , Okeke Edith Nonyelum , Ojonugwa Alufiya Ameh , Umejiaku Crystal Chikor , Kenis Shedrack Felangu , Makpu Jireh Dan , Bitrus Sekat Nenman 
Published: May 2024

Background and Objectives:
Minimal hepatic encephalopathy is a condition in which patients with liver cirrhosis with normal mental and neurological status on clinical examination show cognitive dysfunction detectable on psychometric or neurophysiologic tests. Routine detection of this condition is not commonly carried out despite the high prevalence among patients with liver cirrhosis and a high risk of progression to overt hepatic encephalopathy. We compared the smartphone based EncephalApp with the standard psychometric hepatic encephalopathy score (PHES) in diagnosing MHE in patients with liver cirrhosis in Jos University Teaching Hospital.

Materials and Methods:
Fifty healthy subjects and 42 patients with liver cirrhosis who did not have overt hepatic encephalopathy and who fulfilled other study criteria were recruited in this cross-sectional analytical study. Both healthy subjects and patients were tested with the EncephalApp, and with the paper-pencil PHES test. Data analysis was done using Statistical Package for the Social Sciences (SPSS) 23.0. A value of P < 0.05 was considered statistically significant.

Results:
The mean age of the control group was 35.9 ± 8.7 years, whereas that of the patient group was 38.9 ± 8.7, P = 0.099. The mean number of years in school for the control group was 16.5 ± 3.4 years, whereas that of the patients was 16.1 ± 3.1, P = 0.471. The prevalence of MHE by PHES was 40.5%. The prevalence of MHE by EncephalApp was 51.4% based on the cutoff of 241.8 s, sensitivity = 54.1% and specificity = 90.0%, AUROC = 0.77.

Conclusion:
The prevalence of MHE in patients with liver cirrhosis in Jos, Nigeria, is about the same with values documented in other parts of the world. The EncephalApp was shown to be a reliable screening tool with good sensitivity, specificity and AUROC in our patients with liver cirrhosis.
Six months' follow-up of combined phacoemulsification–kahook dual blade excisional goniotomy
Authors: Mechleb Nicole , Tomey Karim , Cherfan Daniel , Nemr Antony , Cherfan Georges , Dorairaj Syril , Khoueir Ziad 
Published: May 2024

PURPOSE:
This study reports on the combination of excisional goniotomy and cataract extraction in the management of glaucoma in terms of intraocular pressure (IOP) and glaucoma medication reduction.

METHODS:
This is a retrospective case series. Twenty-eight eyes of 22 patients with the diagnosis of cataract and ocular hypertension or glaucoma of any stage underwent combined phacoemulsification and Kahook Dual Blade (KDB) goniotomy, between March 2019 and September 2020. The parameters evaluated were postoperative best-corrected visual acuity, mean IOP reduction, number of IOP-lowering medications, and the surgical success rate defined as IOP reduction >20% and/or reduction in glaucoma medications >1.

RESULTS:
The mean IOP reduction at 6 months was 4.5 mmHg (P = 0.0007), which translates to 24.9% reduction from preoperative IOP. The mean preoperative number of glaucoma medications was 2.9 ± 1.0 (median of 3). It was reduced to 1.1 ± 1.1 (median of 1.5), 1.46 ± 1.17 (median of 2), 1.44 ± 1.28 (median of 2), and 1.56 ± 1.28 (median of 2) at 1 week, 1 month, 3 months, and 6 months, respectively. Twenty-nine percent (8/28) of the patients were off glaucoma medications at 6 months and 46% (13/28) had a reduction of more than 50% of their glaucoma medications.

CONCLUSION:
Combined phacoemulsification–KDB excisional goniotomy may be an effective and safe alternative to more invasive filtering surgery in glaucoma patients of any stage.
Effect of eyeliner and mascara use on tear film and meibomian glands
Authors: Ercan Zeynep E. 
Published: May 2024

PURPOSE:
This study was conducted to see whether eyeliner, mascara, or combined eyeliner and mascara (EM) use affects tear production, tear film stability, and meibomian gland (MG) loss.

METHODS:
Two hundred and twenty healthy women underwent noninvasive tear break-up time (NTBUT) measurement, meibography, and Schirmer testing. Study groups were no makeup (NM) group, eyeliner-only group, mascara-only group, and those who used both EM. The one-way analysis of variance test was used for group comparisons. Chi-square test was used for meiboscale comparison.

RESULTS:
NTBUT (seconds) results were 11.5 ± 4.8 (no makeup), 21.3 ± 69 (eyeliner only), 21.8 ± 6.5 (mascara only), and 22.5 ± 7.0 (eyeliner–mascara). The differences between groups were significant (P < 0.0001). All makeup groups (eyeliner only, mascara only, eyeliner–mascara) had significantly diminished values compared with NM group (P < 0.001, P < 0.001 and P = 0.003, respectively). Schirmer test (millimeters) results were 22.7 ± 6.4 (NM group), 21.3 ± 6.9 (eyeliner only), 21.8 ± 6.5 (mascara only), and 22.5 ± 7.0 (eyeliner–mascara) with no significant differences between groups (P = 0.66). Meiboscale grading revealed that NM group had significantly lower values of MG loss compared with eyeliner-only (EO) (P = 0.01), mascara-only (MO) (P = 0.002), and eyeliner-mascara groups (P = 0.007). There were no significant differences between EO and MO (P = 0.31), EO and eyeliner–mascara (P = 0.39), or MO and eyeliner-mascara groups (P = 0.91).

CONCLUSION:
None of the makeup groups had changes in Schirmer wetting. All eye cosmetic groups have significant changes of NTBUT and meibography compared with NM subjects, and yet combined use of EM does not affect ocular surface more adversely than their separate use.
Intraocular lens power calculation after excimer laser corneal refractive surgery
Authors: Said Reeda B. , Ghorayeb Ralph , Akiki Dany , Wakim Elias , Sukkarieh Georges , Sfeir Joseph , Cherfan George , Jarade Elias 
Published: May 2024

PURPOSE:
Our article aims to assess the accuracy of modified and commonly used formulas of intraocular lens (IOL) power calculation after excimer laser corneal refractive surgery.

METHODS:
This is a retrospective study, with data retrieved for 50 eyes of 32 patients who underwent uncomplicated cataract surgery after excimer laser corneal refractive surgery. The expected spherical equivalent was calculated using the American Society of Cataract and Refractive Surgeons (ASCRS) IOL power calculator for Shammas and Barrett True-K, using three-fourth generation formulas (Haigis-L, Barrett True-K no history, and Holladay 2), and using three-third generation formulas (SRKT, Holladay 1, and Hoffer Q) with single k, as a reference, and adjusting these formulas by calculating the keratometry readings by two methods (Jarade's index and formula). The mean refractive error and mean absolute refractive error (MARE) were calculated at the 1 postoperative month.

RESULTS:
When all data was available (eight eyes), 13 formulas were compared. Holladay 1 as modified by Jarade's index and formula, and Hoffer Q as modified by Jarade's formula resulted in MARE <0.75D (P < 0.05). In the group of 25 eyes with only ablation available, the formulas with MARE <0.75D were Haigis L, Barrett TK (from ASCRS), Hoffer Q, and the three conventional formulas in Jarade's index (P < 0.001). In the group of 17 eyes with no available prerefractive data, only Haigis-L and Barret TK (no history) had a MARE <0.75 D.

CONCLUSION:
The use of Hoffer Q or Holladay 1, when prerefractive data are available, gives reliable results with Jarade's index.
Clinical experience with an anti-dysphotopic intraocular lens
Authors: Rupnik Zsófia , Elekes Ágnes , Vámosi Péter 
Published: May 2024

PURPOSE:
Report experience regarding an anterior capsulotomy fixated intraocular lens (IOL) designed to prevent negative dysphotopsia (ND).

METHODS:
A prospective, nonrandomized clinical study was done at Péterfy Sándor Street Hospital-Clinic, and Jenő Manninger National Trauma Institute, Budapest, Hungary. The Morcher (Masket) 90S IOL has a circumferential groove on the optic that captures the anterior capsulotomy. Thus, part of the optic projects over and anterior to the capsule edge, while the bulk of the IOL is fixated within the capsular bag. We implanted the first version of the 90S IOL into the 40 eyes of 38 patients. These 40 eyes made up the primary investigational cohort. An additional 22 eyes received a modified version of the 90S IOL. The main outcome measure was the presence of ND. There was also a control group of 40 patients who received a single-piece monofocal aspheric hydrophobic acrylic IOL (877 FAB, Medicontur, Budapest, Hungary).

RESULTS:
None of our 66 test patients experienced ND during the follow-up period. After specific questioning, six patients reported nondebilitating PD that improved or disappeared completely in 5 cases. For the 40 eyes of the control group, there were 10 cases of ND on the first postoperative day and in 2 cases ND persisted for more than 1 year postoperatively.

CONCLUSION:
The 90S IOL can be used successfully to prevent ND. Since it is fixated by the anterior capsulotomy, additional advantages such as prevention of anterior capsule contraction, limited tilt, stable toric axis, perfect centration on the visual axis, and a more predictable lens position, among others, may be expected, and are under investigation.
Effectiveness of 0.15% hylan A eye drops in ameliorating symptoms of severe dry eye patients in Saudi Arabia
Authors: Alsheikh Osama , Alzaaidi Sultan , Vargas Jose M. , Al-Sharif Eman , Alrajeh Mohammed , AlSemari Mohammad A. , Alhommadi Abdulrahman , Alsaati Anoud , Aljwaiser Nouf , Alshahwan Eman , Abdulhafiz Mona , Elsayed Rashad , Müller-Lierheim Wolfgang G. K. 
Published: May 2024

PURPOSE:
The aim of the HYLAN A study was to investigate if symptoms and/or signs of patients suffering from severe dry eye disease (DED) in Saudi Arabia can be improved by substituting individually optimized artificial tear therapy by high molecular weight hyaluronan (HMWHA) eye drops.

METHODS:
The HYLAN M study, a multicenter prospective randomized open-label study, was performed in 11 centers in eight countries. Patients suffering from severe DED were electronically randomized in two parallel arms. patients with symptoms of at least ocular surface disease index (OSDI) 33 and corneal fluorescein staining (CFS) of at least Oxford grade 3 were included . The patients in the control group continued with their individual optimized therapy as by the time of inclusion. The patients in the hylan A group replaced their individual lubricant eye drops by preservative-free eye drops containing 0.15% hylan A. The total OSDI scores as well as the OSDI subscores for pain and for visual disturbances of each patient at baseline, at 4 weeks, and at 8 weeks of treatment was used to analyse the improvement of symptoms. We focus and report the results obtained at the two study centers in Riyadh, Saudi Arabia (King Khaled Eye Specialist Hospital and Riyadh Military Hospital).

RESULTS:
A total of 13 patients were included in the study. The majority of the study participants were middle aged (40-65 years). Overall, female patients accounted for 76.9% of all study participants. At the initiation of the study, both hylan A and control groups had relatively similar total OSDI scores together with pain and vision subscores. At 4-week follow-up, both groups demonstrated a noticeable decrease in all study variables. Nevertheless, the OSDI scores improved significantly in the group of patients treated with hylan A eye drops at 8 weeks, whereas the scores increased in the control group.

CONCLUSION:
Saudi Arabia has a very high prevalence of patients with severe dry eye disease. Ethnicity, climate, and a high incidence of diabetes mellitus may contribute to this situation. Lubricant eye drops frequently do not provide adequate relief from ocular pain and instable vision in severe chronic ocular surface disease. High molecular weight hyaluronan (HMWHA) eye drops provide superior relief of symptoms of patients suffering from severe DED. This includes ocular pain as well as unstable vision.
Retinopathy of prematurity screening
Authors: Tan Zachary , Isaacs Michael , Zhu Zhuoting , Simkin Samantha , He Mingguang , Dai Shuan 
Published: May 2024

PURPOSE:
Neonatal care in middle-income countries has improved over the last decade, leading to a “third epidemic” of retinopathy of prematurity (ROP). Without concomitant improvements in ROP screening infrastructure, reduction of ROP-associated visual loss remains a challenge worldwide. The emergence of teleophthalmology screening programs and artificial intelligence (AI) technologies represents promising methods to address this growing unmet demand in ROP screening. An improved understanding of current ROP screening programs may inform the adoption of these novel technologies in ROP care.

METHODS:
A critical narrative review of the literature was carried out. Publications that were representative of established or emerging ROP screening programs in high-, middle-, and low-income countries were selected for review. Screening programs were reviewed for inclusion criteria, screening frequency and duration, modality, and published sensitivity and specificity.

RESULTS:
Screening inclusion criteria, including age and birth weight cutoffs, showed significant heterogeneity globally. Countries of similar income tend to have similar criteria. Three primary screening modalities including binocular indirect ophthalmoscopy (BIO), wide-field digital retinal imaging (WFDRI), and teleophthalmology were identified and reviewed. BIO has documented limitations in reduced interoperator agreement, scalability, and geographical access barriers, which are mitigated in part by WFDRI. Teleophthalmology screening may address limitations in ROP screening workforce distribution and training. Opportunities for AI technologies were identified in the context of these limitations, including interoperator reliability and possibilities for point-of-care diagnosis.

CONCLUSION:
Limitations in the current ROP screening include scalability, geographical access, and high screening burden with low treatment yield. These may be addressable through increased adoption of teleophthalmology and AI technologies. As the global incidence of ROP continues to increase, implementation of these novel modalities requires greater consideration.
Eight-years Egyptian experience of Boston type I keratoprosthesis following failed penetrating keratoplasty or ocular surface disease
Authors: Othman Ihab S. , Gharieb Hesham M. , Ibrahim Hani M. G. 
Published: May 2024

PURPOSE:
To evaluate the outcome and complications after implantation of the Boston type I keratoprosthesis (Kpro) in two groups of eyes.

METHODS:
We retrospectively reviewed records of 28 eyes with failed Penetrating keratoplasty (PKP) (Group A) and 31 eyes with severe ocular surface diseases who implanted Kpro. Follow-up was performed for a mean 37 months. Primary outcomes were Kpro retention and visual improvement, secondary outcomes included the occurrence of complications as endophthalmitis, retro-prosthesis membrane (RPM), intraocular pressure (IOP) abnormalities, posterior capsule opacification (PCO), graft thinning and extrusion.

RESULTS:
Visual improvement was achieved in 20 eyes in Group A, and in 19 eyes in Group B. In group A, the prosthesis was retained in 25 eyes, while prosthesis retention in Group B was in 26 eyes. Group A had higher rates of PCO, high IOP, soft IOP, and graft thinning. Group B had higher risk of RPM, and endophthalmitis. Two eyes in Group A, and Five eyes in Group B required redo procedure.

CONCLUSION:
The Boston Kpro type I is an effective procedure in eyes with high risk of keratoplasty failure and in severe ocular surface diseases, it has a high retention rate, higher in cases following failed PKP.
Dry eye disease and ocular surface characteristics in patients with keratoconus
Authors: Mirza Enver , Oltulu Refik , Oltulu Pembe , Mirza Gunsu D. , Okka Mehmet 
Published: May 2024

PURPOSE:
The purpose of this study is to investigate the ocular surface alterations in patients with mild or severe keratoconus (KC).

METHODS:
A total of 80 participants were included in the study. The corneal topography was performed on each participant using Pentacam and the grouping was done accordingly. The patients with Kmax ≥52.0 D (severe KC) were considered Group 1 (n = 28), the patients with Kmax ≥47.2 and <52.0 D (mild KC) were considered Group 2 (n = 30). Healthy control participants with Kmax <47.2 D were considered Group 3 (n = 22). Tear breakup time (TBUT), Schirmer-I test, ocular surface disease index (OSDI) questionnaire, and conjunctival impression cytology (CIC) were evaluated among the groups.

RESULTS:
The mean values of TBUT and Schirmer-I test were significantly lower (P = 0.012, P = 0.012) and the mean scores of OSDI and CIC were significantly higher (P = 0.006, P < 0.001) in Group 1 and Group 2 than in Group 3. The mean values of TBUT and Schirmer-I test were lower and the mean scores of OSDI and CIC were higher in Group 1 than in Group 2 but the differences were insignificant (P > 0.05 for all).

CONCLUSION:
These results indicated that the tests associated with dry eye disease are correlated with KC. Tear film alterations and goblet cell loss are higher in severe KC.
Etiology, clinical profile, and treatment outcome of peripheral ulcerative keratitis
Authors: Kochhar Sonal , Singh Shwetambari , Desai Beena , Purohit Dipali 
Published: May 2024

PURPOSE:
To assess the etiology, clinical features, and treatment outcome in patients with peripheral ulcerative keratitis (PUK).

METHODS:
In this retrospective, observational study, forty-eight eyes of 32 consecutive patients with PUK were included. Demographic profile, etiology, clinical features, treatment history, and outcome were documented.

RESULTS:
Of the 32 patients, 19 (59%) were male and the mean age at presentation was 54.72 ± 14.92 years. Sixty-eight percent of patients were from rural backgrounds. Half of the patients had bilateral involvement. Fifty percent of patients presented after 4 weeks of the onset of symptoms. Of 48 eyes at presentation, 11 had mild disease, 9 had moderate disease and 28 had severe disease. At presentation, best-corrected visual acuity <3/60 was found in 26 (54%) eyes. Mooren's ulcer (40% eyes) was the most common etiology for PUK. Rheumatoid factor was positive in 8 of 32 patients (25%). Of 32 patients, 19 (59%) required systemic immunosuppression for the control of disease activity. Surgical intervention to maintain anatomical integrity was required in 27 (56%) eyes. No significant change in vision was seen in pretreatment and posttreatment groups. Four eyes failed to heal after 4 weeks of initiation of treatment due to noncompliance of the patient. None of our patients died during follow-up.

CONCLUSION:
PUK is an indicator of occult systemic autoimmune disease. Mooren's ulcer is the most common cause of PUK. Prompt and adequate immunosuppression is not only eye saving but also lifesaving for patients with PUK of autoimmune origin.