bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relation between Cardiometabolic Risk Factors and Obesity Differs in Children and Adults
Authors: Haq Tahniyah , Tohfa-E-Ayub  , Fariduddin Md. , Sutradhar Palash Chandra , Aurpa Nishat Nayla , Hasanat Md. Abul 
Published: March 2023

Background:
Obesity is a harbinger of cardiovascular disease. It is affecting individuals from an early age.

Aim:
The aim of the study was to compare cardiometabolic risk factors (CRFs) in obese children and adults; and to see their relationship with obesity.

Materials and Methods:
Two hundred and thirty-nine overweight and obese individuals (189 ≤20 and 50 >20 years) without secondary causes of obesity were included and data on their CRFs (blood pressure, plasma glucose, glycated hemoglobin, and lipid profile) were obtained from clinic records.

Results:
Mean age and body mass index (BMI) of ≤20 years of group were 13.77 ± 2.32 years and 33.29 ± 8.45 kg/m2, respectively. The mean age and BMI of >20-year group were 39 ± 1.41 years and 36.81 ± 2.40 kg/m2, respectively. Participants in the ≤20-year group had a lower rate of abnormal glucose tolerance (28.9% vs. 61.9%, P < 0.001) and hypertension (3.6% vs. 15.4%, P < 0.001), but a higher rate of dyslipidemia (98.8% vs. 97.5%, P < 0.001) than the ≤20 years of group. After adjusting for all cardiovascular risk factors, diastolic blood pressure was significantly related to obesity (BMI β = 0.380, P = 0.001; waist circumference β = 0.499, P < 0.001; fat mass index β = 0.407, P = 0.001; waist height ratio β = 0.356, P = 0.004) in the ≤20-year group, while fasting plasma glucose was related to BMI (β = 1.086, P = 0.001) in the >20-year group.

Conclusion:
There is a high rate of dyslipidemia in young obese individuals. Blood pressure is associated with obesity at a younger age, while dysglycemia is associated with increasing BMI in adults.
Determination of hematological response to iron and folic acid supplementation among the expectant mothers attending Kakamega County Referral Hospital, Kenya
Authors: Dennis Kirui , Marera Dominic , Were Tom 
Published: March 2023

Background
Despite iron and folic acid supplementation program among expectant mothers while attending antenatal care clinic at Kakamega County, the rates of maternal and fetal morbidity and mortality due to anemia complications are still high.

Aim
First, we determined changes in hematological profiles following iron and folic acid supplementation. Second, we determined association between hematological changes with demographic and clinical characteristics in response to iron and folic acid supplementation.

Patients and methods
Full hemogram and reticulocyte profiles of 127 expectant mothers were determined at baseline and endpoint after 1 month of iron and folic acid supplementation. Full hemogram profiles were measured using a Maxim 3010 fully automated hematology analyzer, whereas reticulocyte profiles were examined microscopically at ×100 magnification. Demographic data were collected using pretested structured questionnaires.

Results
The end point measures of red blood cells, hemoglobin (Hb), hematocrit, mean cell volume, reticulocyte count, reticulocyte production index, and absolute reticulocyte number among the anemic mothers were significantly higher relative to baseline levels. Among nonanemic mothers, Hb and mean cell volume levels differed significantly between baseline and end point of the study. The change in erythropoietic response and adequate Hb response was significantly associated with adherence to iron and folic acid supplement.

Conclusion
Hematological profiles significantly changed especially among anemic mothers following iron and folic acid supplementation. Adherence to supplement is associated with positive erythropoietic response and adequate Hb response.
Tyrosine kinase inhibitors reduce myeloid-derived suppressor cells in patients with chronic myeloid leukemia with better outcome
Authors: Refaat Youmna , Rahman Youseria A. , Mohammed Saleh Mostafa F. , Sayed Douaa M. , Elzohri Mona H. 
Published: March 2023

Background and objectives
Myeloid-derived suppressor cells (MDSCs) are increased in several hematologic malignancies. We looked at the effect of imatinib and nilotinib (tyrosine kinase inhibitors) on MDSCs in patients with chronic myeloid leukemia (CML) and how those cells could affect prognosis in CML.

Patients and methods
A randomized controlled trial was conducted that enrolled 103 patients with newly diagnosed chronic phase CML who were randomly subgrouped into group I, which included patients treated with oral imatinib (n=58) 400 mg/day, and group II, which included patients treated with oral nilotinib (n=45) 600 mg/day. Follow-up of BCR/ABL transcript was measured by quantitative PCR every 3 months. Moreover, detection of the percentages of granulocytic-MDSCs and monocytic (M-MDSCs) in the peripheral blood (HLA-DR/CD11b//CD33/CD14) by flow cytometry was done at baseline and during follow-up.

Results
Both groups had insignificant difference regarding baseline laboratory and clinical data. Both groups showed significant reduction in MDSCs but with insignificant differences between both of them. Patients did not achieve major molecular response (MMR) and had significantly higher M-MDSCs at baseline. Moreover, baseline M-MDSCs were a predictor for MMR (odds ratio=0.78, 95% confidence interval=0.66–0.93) and for loss of MRR (odds ratio=2.17, 95% confidence interval=1.22–3.87). For prediction of MMR, baseline M-MDSCs had 89.2% accuracy at cutoff point less than 8.9% and had 89.5% accuracy for prediction of loss of MMR at a cutoff point more than 8.5%.

Conclusion
Both imatinib and nilotinib are effective in reducing MDSCs in patients with CML. Baseline M-MDSCs are predictors of MMR and loss of response in patients with CML. The study was registered on clinicaltrials.gov with NCT03214718.
Orthokeratology compliance, digital device use, and myopia control among children with myopia during COVID-19 home confinement in Taiwan
Authors: Chang Li-Chun , Sun Chi-Chin , Liao Li-Ling 
Published: March 2023

Purpose:
The coronavirus disease 2019 (COVID-19) pandemic profoundly impacts lifestyle habits and myopia control in children worldwide. This study investigated the changes in eyecare habits, orthokeratology compliance, axial length, and time interval of follow-up visits during home confinement in the COVID-19 pandemic in Taiwan.

Methods:
This investigation was part of a prospective study undertaken to evaluate the effectiveness of a mobile application. A semi-structured telephone interview was conducted with parents retrospectively to document eyecare habits and myopia control during the COVID-19 home confinement.

Results:
Thirty-three children with myopia participated in the follow-up of orthokeratology lenses for 2 years. The children’s time viewing digital devices such as tablets and televisions significantly increased during the COVID-19 pandemic (P < 0.05). An analysis using McNemar’s test found that the proportional growth of axial length <0.2 mm in 2021 was significantly higher than that in 2020 (77.42% vs. 58.06%, P < 0.05). In the multivariate logistic regression analysis, onset <10 years of age (P = 0.001) and parents with high myopia (P < 0.001) were independent risk factors for the growth of axial length ≥0.2 mm in 2021.

Conclusion:
The suspension of face-to-face classes and after-school tutorials benefited myopic axial elongation in children during COVID-19 home confinement. The use of digital devices and staying indoors may not be the exclusive reasons for myopia progression. Educating parents about the influence of extra learning classes after school on myopia progression would be prudent.
Clinical outcome of diffractive multifocal lens versus monofocal lens in post-laser in situ keratomileusis patients: A retrospective, comparative study
Authors: Cheng Anny M S , Yin Han Y , Davenport Connor , Walter Keith 
Published: March 2023

Purpose:
To compare the clinical outcomes of diffractive multifocal and monofocal lenses in post-laser in situ keratomileusis (LASIK) patients who underwent cataract surgery.

Methods:
This was a retrospective, comparative study of clinical outcomes that was conducted at a referral medical center. Post-LASIK patients who underwent uncomplicated cataract surgery and received either diffractive multifocal or monofocal lens were studied. Visual acuities were compared at baseline and postoperatively. The intraocular lens (IOL) power was calculated with Barrett True-K Formula only.

Results:
At baseline, both groups had comparable age, gender, and an equal distribution hyperopic and myopic LASIK. A significantly higher percentage of patients receiving diffractive lenses achieved uncorrected distance visual acuity (UCDVA) of 20/25 or better (80 of 93 eyes, 86% vs. 36 of 82 eyes, 43.9%, P = 1.0 x 105) and uncorrected near vision of J1 or better (63% vs. 0) compared to the monofocal group. The residual refractive error had no significant difference (0.37 ± 0.39 vs. 0.44 ± 0.39, respectively, P = 0.16) in these two groups. However, more eyes in the diffractive group achieved UCDVA of 20/25 or better with residual refractive error of 0.25–0.5 D (36 of 42 eyes, 86% vs. 15 of 24 eyes, 63%, P = 0.032) or 0.75–1.5 D (15 of 21 eyes, 23% vs. 0 of 22 eyes, P = 1.0 x 10−5) compared to the monofocal group.

Conclusion:
This pilot study shows that patients with a history of LASIK who undergo cataract surgery with a diffractive multifocal lens are not inferior to those who receive monofocal lens. Post-LASIK patients with diffractive lens are more likely to achieve not only excellent near vision, but also potentially better UCDVA, regardless of the residual refractive error.
Distribution of corneal densitometry in different grades of keratoconus
Authors: Mounir Amr , Awny Islam , Yousef Hassan S , Mostafa Engy M 
Published: March 2023

Purpose:
To evaluate the use of Scheimpflug tomography in corneal densitometry (CD) in comparing the stages of keratoconic eyes.

Methods:
Keratoconic (KC) corneas (stages 1–3 classified according to the topographic parameters) were examined using the Scheimpflug tomographer (Pentacam, Oculus) using the CD software. CD was measured over three different depths (anterior stromal layer [120 μm], posterior stromal layer [60 μm], and middle stromal layer between these two layers), and concentric annular zones (0.0 to 2.0, 2.0 to 6.0, 6.0 to 10.0, and 10.0 to 12.0 mm diameter area).

Results:
The study participants were divided into three groups: keratoconus (KC) stage 1 (KC1) with 64 participants, keratoconus stage 2 (KC2) with 29 participants, and keratoconus stage 3 (KC3) with 36 participants. Comparing CD of all three layers (anterior, central, and posterior) of the cornea over different circular annuli (0–2, 2–6, 6–10, and 10–12 mm) revealed a significant difference in the 6–10 mm annulus between all groups and in all layers (P = 0.3, 0.2, and 0.2, respectively). Area under curve (AUC) was done. It revealed that the central layer showed the highest specificity (93.8%) in comparing KC1 and KC2, whereas CD in the anterior layer between KC2 and KC3 had the highest specificity (86.2%).

Conclusion:
CD showed increased values in the anterior corneal layer and in the annulus 6–10 mm more than other locations in all stages of KC.
Comparison of conjunctiva-related complications between scleral and corneal patch grafts in Ahmed glaucoma valve implantation
Authors: Panda Smita , Khurana Mona , Vijaya Lingam , George Ronnie , Balekudaru Shantha 
Published: March 2023

Purpose:
Comparison of the conjunctiva related complication rates and success rates among eyes with Ahmed glaucoma valve (AGV) implantation in which eye bank derived scleral and corneal patch grafts had been used to cover the tube.

Methods:
Retrospective comparative study. Patients who underwent AGV implantation between January 2000 to December 2016 were included. Demographic, clinical data, intra and post operative data was obtained from electronic medical records. Conjunctiva related complications were divided into two groups: with and without implant exposure. Conjunctiva related complication rates, success rate, risk factors among eyes with corneal and scleral patch graft were compared.

Results:
Three hundred and twenty three eyes of 316 patients underwent AGV implantation. Scleral patch graft was used in 214 eyes of 210 patients (65.9%) and corneal patch graft was used in 109 eyes of 107 patients (34%). Median follow up was 14 months. There was no significant difference in the conjunctiva related complication rate (7.3 % in corneal patch graft versus 7.0% in scleral patch graft;p=0.5) and conjunctival dehiscence rate (3.7% versus 4.6%, P = 0.7) among the two groups. Success rate was significantly higher in the corneal patch graft group versus the scleral patch graft group (98% versus 72%; p=0.001). Eyes with corneal patch graft had a higher survival rate (P = 0.01).

Conclusion:
There was no significant difference in the rate of conjunctiva related complications following corneal and scleral patch grafts used to cover the AGV tube. Eyes with corneal patch graft had a higher success rate and survival rate.
Strabismus in pediatric orbital wall fractures
Authors: Bhate Manjushree , Adewara Bolajoko , Bothra Nandini 
Published: March 2023

Purpose:
To assess the clinical profiles and outcomes of strabismus in pediatric patients with orbital wall fractures.

Methods:
A retrospective interventional study of all consecutive children of age ≤16 years who presented with traumatic orbital wall fractures with and without resultant strabismus was conducted. The details of patient demographics, clinical features, interventions, and outcomes were obtained.

Results:
Forty-three children presented with traumatic orbital fractures to a tertiary care center. The mean age at presentation was 11 years and there was a male predominance (72.09%). Isolated floor fracture involvement was the most common (n = 24, 55.81%), and almost half of the children had a white-eyed or trapdoor fracture (n = 21, 48.83%). Twenty-six (60.46%) children had surgical repair of fracture(s). Manifest strabismus following orbital fracture was documented in 12 children (27.90%). Of these, an exotropia was noted in seven (58.33%), hypotropia in two (16.67%), hypertropia in one (8.33%), and esotropia in one patient (8.33%), while an exotropia with hypotropia was noted in one patient (8.33%). Restrictive nature of strabismus due to either muscle entrapment or local trauma was more commonly observed in 11/12 patients (91.66%). Primary position diplopia before orbital wall fracture repair was observed in four children and after repair was observed in two children with manifest strabismus. Four children underwent strabismus surgery post-fracture repair.

Conclusion:
An improvement in strabismus and ocular motility was noted in majority of the patients after fracture repair. The few that underwent strabismus surgery had a restrictive nature of strabismus. Trapdoor fractures and the nature of trauma in children vary compared to adults. Persistence of strabismus may be due to an excessive time interval between trauma and fracture repair or the extensive nature of trauma.
Cataract surgical training among residents in India: Results from a survey
Authors: Nair Akshay Gopinathan , Mishra Deepak , Prabu A 
Published: March 2023

Purpose:
To assess the quantum of cataract surgical training opportunities for trainees enrolled in ophthalmology residency programs in India.

Methods:
An anonymous online survey was sent across to resident ophthalmologists across India through various social media platforms. The results were tabulated and analyzed.

Results:
A total of 740 resident ophthalmologists participated in the survey. In all, 40.1% (297/740) were independently performing cataract surgeries. Of those who were not performing independent cataract surgeries, 62.5% (277/443) were in the third year of residency. A significantly higher proportion of trainees who were not operating independent cataract surgeries were enrolled in MD/MS programs as compared with DNB courses (65.6% vs. 43.7%; P < 0.0001). Of those who were operating independent cases; 97.1% had exposure to manual small incision cataract surgery (MSICS), whereas only 14.1% performed phacoemulsification. It was noted that 31.3% of residents reported that on an average a trainee in their training program performed less than 100 independent cataract surgeries throughout the residency. Apart from cataract surgery, the most performed surgeries by residents were pterygium excision (85.3%), followed by enucleation/evisceration (68.1%). When it came to training aids, 47.2% (349/740) of the respondents reported no access to wet lab, animal/cadaver eyes, or surgical simulators for training.

Conclusion:
The amount of surgical exposure in terms of cataract surgery across residency programs in India is low with most of the ophthalmology residents who participated in this survey not operating cataracts independently; even in their final year of residency. Exposure to phacoemulsification in residency programs is very limited across the country. Although some programs do provide well-rounded surgical exposure to trainees, such centers are scarce; the stark variations in infrastructure, training opportunities, and surgical numbers warrant an overhaul in the structure and curriculum of residency programs in India.
Predictive factors and visual outcomes after immediate pars plana vitrectomy for posteriorly dislocated lens fragments during complicated phacoemulsification surgery
Authors: Kelkar Aditya S , Kelkar Jai A , Mondal Sukanya , Bolisetty Mounika , Amrute Trupti , Jain Harsh H 
Published: March 2023

Purpose:
To investigate the prognostic factors for visual outcome in patients undergoing immediate pars plana vitrectomy (PPV) for posteriorly dislocated lens fragments during phacoemulsification surgery.

Methods:
This was a single-center, retrospective, cross-sectional study of 37 eyes of 37 patients undergoing immediate PPV for posteriorly dislocated lens fragments from 2015 to 2021. The primary outcome measure was changes in the best-corrected visual acuity (BCVA). Additionally, we analyzed the predictive factors for poor visual outcomes (BCVA <20/40) and perioperative complications.

Results:
The mean (±standard deviation [SD]) age of the patients was 66.57 (±10.86) years, with an almost identical gender profile (M: F = 18/19 [48.64%:51.36%]). The median (interquartile range [IQR]) log of minimum angle of resolution (logMAR) BCVA improved significantly from the baseline (1 [0.6–1.48], ~20/200) to the final visit (0.3 [0.2–0.6], ~20/40) (P < 0.0001) after a mean (±SD) follow-up of 6.35 (±6.32) months. The final BCVA was 20/40 or better in 59.5% of the eyes. Poor final BCVA (<20/40) was associated with small preoperative pupillary size (P = 0.02), presence of preoperative ocular pathology (P = 0.02) including uveitis, glaucoma, and clinically significant macular edema (CSME), intraoperative displacement of >50% of lens matter into the vitreous (P < 0.001), use of iris-claw lens (P < 0.001), and postoperative cystoid macular edema (CME; P = 0.007). The postoperative complications included CME (13.51%), retinal detachment (10.81%), chronic uveitis (8.11%), glaucoma (8.11%), iritis (2.7%), posterior chamber IOL (PCIOL) dislocation (2.7%), and vitreous hemorrhage (2.7%).

Conclusion:
For retained lens fragments in complicated phacoemulsification surgery, immediate PPV is a viable approach with the potential for a good visual outcome. The important predictors for poor visual outcomes include a small preoperative pupil size, preexisting ocular pathology, displacement of significant volume of lens matter (>50%), use of an iris-claw lens, and CME.
A clinical trial on phakic intraocular lens for the treatment of refractive amblyopia in children and adolescents
Authors: Morya Arvind Kumar , Kaur Kirandeep , Gurnani Bharat , Janti Siddharam S , Shrivastava Ankur Kumar , Tejaswini Antarvedi , Sinha Aprajita , Venkatesh Dharavath 
Published: March 2023

Purpose:To analyze the demographics and clinical outcomes of posterior chamber phakic intraocular (IOL) implantation for refractive amblyopia in children and adolescents.Methods:A prospective interventional study was performed on children and adolescents with amblyopia at a tertiary eye care center from January 2021 to August 2022. Twenty-three eyes of 21 anisomyopic and isomyopic amblyopia patients operated for posterior chamber phakic IOL (Eyecryl phakic IOL) as a treatment for amblyopia were included in the study. Patient demographics, pre- and postoperative visual acuity, cycloplegic refraction, anterior and posterior segment examination, intraocular pressure, pachymetry, contrast sensitivity, endothelial count, and patient satisfaction scores were evaluated. Patients were followed up at day 1, 6 weeks, 3 months, and 1 year after surgery, and visual outcomes and complications were documented.Results:The mean age of patients was 14.16 ± 3.49 years (range: 10–19 years). The mean intraocular lens power was − 12.20 diopter spherical (DS) in 23 eyes and − 2.25 diopter cylindrical (DC) in four patients. The mean unaided distant visual acuity (UDVA) and best-corrected visual acuity (BCVA) were 1.39 ± 0.25 and 0.40 ± 0.21 preoperatively on the log of minimum angle of resolution (logMAR) chart. Postoperatively, the visual acuity improved by 2.6 lines in 3 months period and maintained till 1 year. Postsurgery, contrast sensitivity in the amblyopic eyes significantly improved, and the average endothelial loss recorded was 5.78% at 1 year, which was statistically insignificant. Patient satisfaction score was statistically significant, with 4.736/5 recorded on the Likert scale.Conclusion:Posterior chamber phakic IOL is a safe, effective, and alternative method for treating amblyopia patients who are noncompliant with glasses, contact lenses, and keratorefractive procedures.
Role of artificial intelligence in determining factors impacting patients’ refractive surgery decisions
Authors: Kundu Gairik , Virani Imranali , Shetty Rohit , Khamar Pooja , Nuijts Rudy M M A 
Published: March 2023

Purpose:To create a predictive model using artificial intelligence (AI) and assess if available data from patients’ registration records can help in predicting definitive endpoints such as the probability of patients signing up for refractive surgery.Methods:This was a retrospective analysis. Electronic health records data of 423 patients presenting to the refractive surgery department were incorporated into models using multivariable logistic regression, decision trees classifier, and random forest (RF). Mean area under the receiver operating characteristic curve (ROC-AUC), sensitivity (Se), specificity (Sp), classification accuracy, precision, recall, and F1-score were calculated for each model to evaluate performance.Results:The RF classifier provided the best output among the various models, and the top variables identified in this study by the RF classifier excluding income were insurance, time spent in the clinic, age, occupation, residence, source of referral, and so on. About 93% of the cases that did undergo refractive surgery were correctly predicted as having undergone refractive surgery. The AI model achieved an ROC-AUC of 0.945 with an Se of 88% and Sp of 92.5%.Conclusion:This study demonstrated the importance of stratification and identifying various factors using an AI model which could impact patients’ decisions while selecting a refractive surgery. Eye centers can build specialized prediction profiles across disease categories and may allow for the identification of prospective obstacles in the patient’s decision-making process, as well as strategies for dealing with them.