bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does Opioid Addiction Influence Clinical and Angiographic Outcomes in STEMI Patients Undergoing Emergency PCI?
Authors: Amirpour Afshin , Kermani-Alghoraishi Mohammad , Sattar Fereshteh , Roohafza Hamidreza , Shahabi Javad , Zavar Reihaneh , Sadeghi Masoumeh 
Published: February 2023

Background:
Despite recognizing the traditional coronary artery disease (CAD) risk factors, some secondary factors, such as opioid substance abuse, have to be considered. We aimed to assess the relationship between opioid consumption and emergency percutaneous coronary intervention (PCI) revascularization results, according to Thrombolysis in Myocardial Infarction (TIMI) flow and in-hospital survival outcomes in ST-elevation myocardial infarction (STEMI) patients.

Materials and Methods:
This case–control study was conducted on 186 patients (93 patients in each group) with acute STEMI, who were referred to Chamran Heart Center, Isfahan, Iran. Opioid addiction was diagnosed by patients' records and confirmed by conducting an interview based on the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria. Patients in both groups were evaluated and compared for angioplasty results based on the TIMI flow grade and in-hospital cardiovascular events and complications.

Results:
Ninety-one patients (97.84%) of each group were male, and opioid-addicted patients were younger than the non-opioid users (52.95 9.91 vs. 57.90 12.17, P = 0.003). Among the CAD risk factors, prevalence of dyslipidemia was significantly higher in non-opioid users, whereas cigarette smoking was higher in opioid-addicted patients (P < 0.050). There was no significant difference between the two groups regarding pre- and post-procedural myocardial infarction complications as well as mortality rate (P > 0.050). Also, there were no significant differences between the opioid and non-opioid users regarding TIMI flow grading, and successful PCI rate based on achieving TIMI III was 60.21% versus 59.1% in opiate-dependent and non-opioid users, respectively (P = 0.621).

Conclusion:
Opioid addiction has no effects on post-PCI angiographic results and in-hospital survival outcomes in STEMI patients which undergoing emergency PCI.
Quality Assessment of Computed Tomography Images Using a Channelized Hoteling Observer: Optimization of Protocols in Clinical Practice
Authors: Choopani Mohammad Reza , Abedi Iraj , Dalvand Fatemeh 
Published: February 2023

Background:
This study investigated the feasibility of channelized hoteling observer (CHO) model in computed tomography (CT) protocol optimization regarding the image quality and patient exposure. While the utility of using model observers such as to optimize the clinical protocol is evident, the pitfalls associated with the use of this method in practice require investigation.

Materials and Methods:
This study was performed using variable tube current and adaptive statistical iterative reconstruction (ASIR) level (ASIR 10% to ASIR 100%). Various criteria including noise, high-contrast spatial resolution, CHOs model were used to compare image quality at different captured levels. For the implementation of CHO, we first tuned the model in a restricted dataset and then it to the evaluation of a large dataset of images obtained with different reconstruction ASIR and filtered back projection (FBP) levels.

Results:
The results were promising in terms of CHO use for the stated purposes. Comparisons of the noise of reconstructed images with 30% ASIR and higher levels of noise in rebuilding images using the FBP approach showed a significant difference (P < 0.05). The spatial resolution obtained using various ASIR levels and tube currents were 0.8 pairs of lines per millimeter, which did not differ significantly from the FBP method (P > 0.05).

Conclusions:
Based on the results, using 80% ASIR can reduce the radiation dose on lungs, abdomen, and pelvis CT scans while maintaining image quality. Furthermore using ASIR 60% only for the reconstruction of lungs, abdomen, and pelvis images at standard radiation dose leads to optimal image quality.
A Comparative Study of the Effect of Low-Dose Epinephrine and Ketamine on Rapid-Sequence Endotracheal Intubation by the Priming Dose Method of Cisatracurium in Patients Under General Anesthesia
Authors: Hajigholam Saryazdi Hamid , Honarmand Azim , Nazemroaya Behzad , Naderi Afshar Pouyan 
Published: February 2023

Background:
Low-dose ephedrine and ketamine may accelerate the onset time of action of neuromuscular blocking agents. We studied the effect of ephedrine and ketamine and cisatracurium priming on endotracheal intubation conditions and the onset time of action of cisatracurium.

Materials and Methods:
The study was a double-blind clinical trial performed on American Society of Anesthesiologists (ASA) class 1 and 2 patients, who were candidates for general anesthesia. In total, 120 patients were entered into the study and were divided into 4 groups, E, K, E + K, and N. The first group was given 70 mcg/kg ephedrine (E group), the second group was given 0.5 ml/kg ketamine (K group), the third group was given the same amount of ketamine plus ephedrine (E + K group), and the fourth group was given the same volume of normal saline (control group); a single dose of 0.1 mg/kg cisatracurium was given, and intubating conditions were evaluated at 60 seconds after cisatracurium administration.

Results:
The mean Cooper score based on the response to laryngoscopy, the position of the vocal cords, and the movement of the diaphragm of patients in the control group with a mean of 2.53 ± 1.07 was significantly lower than in the three groups of E, K, and E + K with the means of 4.47. 1.17, 4.53 ± 1.14, and 7.63 ± 1.42, respectively (P value < 0.001). In the (E + K) group, it was significantly higher than in the two other drugs alone (P value < 0.001). The two groups of E and K alone were not significantly different from each other (P value = 0.997). The means of hemodynamic parameters were not significantly different in any of the groups (P value > 0.05).

Conclusion:
According to the results of the present study, the use of low-dose ephedrine and ketamine alone can improve intubation conditions. In addition, the combined use of these drugs not only had any Positive effect on patients' hemodynamic parameters but also greatly improved intubation conditions.
Application and validation of a novel inflammatory score in the clinical grading of infectious endophthalmitis: The endophthalmitis management study – Report 2
Authors: Dave Vivek Pravin , Belenje Akash , Dogra Avantika , Das Taraprasad ,   on behalf of the EMS working group
Published: February 2023

Purpose:
This study was conducted to describe and validate a novel inflammatory score (IS) system in the management of infectious endophthalmitis.

Methods:
This was a prospective comparative non-interventional observational study. The study included the patients with clinical signs and symptoms of acute post-cataract surgery endophthalmitis (surgery within 6 weeks) with visual acuity from 6/18 to light perception. IS was scored by the clinical picture at two-levels of four ocular tissues on a scale of 0 (normal) to 4 (severe). Four masked graders of different levels of experience evaluated slit-lamp photographs. The concordance correlation coefficient was assessed between the slit-lamp clinical grading and photographic grading. We measured the concordance correlation coefficient, Pearson’s correlation (indicating precision), and the bias correction factor (indicating the accuracy).

Results:
The study included 43 eyes of 43 patients. The concordance correlation coefficient was 0.99 (95% CI 0.995 to 0.998). Both Pearson’s correlation coefficient and the bias correction were 0.99. The interclass correlation coefficient (ICC) was measured. The intra-rater ICC was 0.833 with good agreement (95% CI, 0.711 to 0.906; P < 0.001). Inter-rater ICC for consistency was 0.92 (95% CI 0.87 to 0.95). Inter-rater ICC for absolute agreement was 0.86 (95% CI 0.66 to 0.93).

Conclusion:
Currently used IS scoring in the study is a reliable, reproducible, and easy-to-apply scale to measure inflammation severity in endophthalmitis. We propose that it can have applications in decision-making for primary treatment and monitoring progression in acute infectious endophthalmitis.
Eye banking and keratoplasty trend analysis during the COVID-19 pandemic: A South Indian observational study
Authors: Madkaiker Aditee , Venugopal Anitha , Ghorpade Aditya , Ravindran Meenakshi , Ragappa Ramakrishnan , Sithiq Mohammed Uduman 
Published: February 2023

Purpose:
To analyze the impact on eye donation and corneal transplantation during the COVID-19 pandemic in a tertiary eye hospital in south India.

Methods:
A retrospective analysis of the donor and recipient records during the study period from January 2020 to May 2021 was conducted and tabulated in Microsoft Excel 2013. Demographic details of the donor, utility rate, cause of death, culture characteristics, storage methods, wet lab usage, and the surgical donor outcomes were evaluated. Additionally, the postoperative workup of the recipients, diagnosis, graft infection and rejection episodes, development of COVID-19 postoperatively, and outcome in terms of visual acuity at one, three, and six months were also noted.

Results:
A total of 466 eyes from 249 donors were received during the study period. The mean age of the donor population was 62.43 years (20.9). The corneal transplantation utility rate was 36.4% (n = 170). Fifty-one percent of the total transplant surgeries were for therapeutic purposes. This was followed by penetrating optical keratoplasty (34%), Descemet’s stripping endothelial keratoplasty (9%), and patch grafts (3%). Seventeen (10%) graft rejection episodes were noted and nine (53%) had complete resolution after medical treatment.

Conclusion:
Proper preventive measures are key to carrying out safe and efficient eye banking activities even during a deadly pandemic, as COVID-19 transmission via transplantation is rare.
Evaluating perspective and quality of life of glaucoma patients during the COVID-19 pandemic in India: Results of a telephone survey
Authors: Roy Avik K , Rao Aparna , Pal Anindita , Mohapatra Shreya , Swain Rubina 
Published: February 2023

Purpose:
The past few years have been difficult in the lives of most glaucoma patients in view of the COVID-19 pandemic. Our aim was to find out patients’ perspective and disruption of their quality of life during the COVID-19 pandemic by conducting a telephone survey among glaucoma patients.

Methods:
This was a cross-sectional study involving the glaucoma patients of a tertiary eye care hospital in India. Patients who had completed at least five years of follow-up before 2020 were randomized by a random number generator. A validated (forward–backward translation and completed pilot analysis) set of 14 questionnaires was administered to the patients, the latter of whom were telephonically interviewed by one of the investigators in February 2022. The entire data was audio-recorded. Statistical Package for the Social Sciences (SPSS) version 26 was used.

Results:
Out of 1141 patients with >5 years of follow-up, 103 were selected by randomization. A large group of 46 patients (44.6%) admitted to glaucoma affecting their daily activities. Only 12 (11.6%) admitted to being irregular with their drops. Thirty-four (33%) patients felt that their glaucoma was deteriorating and 31 (30.1%) had fear of blindness. Ninety-five patients (92.7%) felt that they were safe under the care of the treating doctor. There were 46 (44.6%) out of 103 patients who did not turn up for follow-up for six months or more. Lockdown (36.2%) and travel-expenses (27.6%) were the two most common reasons for the loss to follow-up visits.

Conclusion:
Nearly half of the long-term glaucoma patients were lost to follow-up during the COVID-19 pandemic. Glaucoma affecting daily lives and fear of losing vision turned out to be significant observations in the telephone survey. This fear seemed to be ameliorated by the majority still feeling safe by being in touch with their doctor for continued care even during the COVID-19 pandemic.
Clinical features and visual outcomes of pediatric optic neuritis in the Indian population: A prospective study
Authors: Kowsalya Akkayasamy , Ramalingam Uma , Chaudhary Sameer , Kumar Mahesh 
Published: February 2023

Purpose:
Optic neuritis, defined as inflammation of the optic nerve, is the most common optic neuropathy affecting adults. Various studies in Southeast Asia have shown that the clinical profile of optic neuritis might differ in these regions from that reported in the western literature. Through this study, we evaluate the clinical profile of pediatric optic neuritis (PON) in the Indian population.

Methods:
This was a hospital-based prospective observational study. Patients with optic neuritis younger than 16 years who attended the neuro-ophthalmology clinic from May 2016 to April 2017 were included in the study.

Results:
This study included 54 eyes of 38 patients. The mean age of presentation was 10.6 years. Unilateral disease (58%) was found to be more common, and a slight female preponderance (58%) was noted. The most common feature was visual loss (96.3%). Pupillary light reflex abnormality was seen in most patients. Fundus examination revealed disk edema (77.7%) to be the most common feature. Neuroimaging was performed in 34 patients, and multiple sclerosis was diagnosed in four patients. At 3 months follow-up after treatment, 89% of eyes had best correct visual acuity of 6/9 or better (P < 0.001).

Conclusion:
In our study, we found the clinical profile of PON to be similar to that seen in western studies as well as those done previously in the Indian population, although with a few differences.
Comparison of the effect of audiovisual and verbal instructions on patient performance while performing automated Humphrey visual field testing
Authors: Maheshwari Devendra , Nair Aditi , Tara Techi Dodum , Pawar Neelam , Ramakrishnan Rengappa , Selvi D Ranitha Guna , Uduman Mohammed Sithiq 
Published: February 2023

Purpose:
To compare the effect of audiovisual and verbal instructions on patient performance while performing automated Humphrey visual field testing.

Methods:
This was a prospective study. A total 120 patients divided into groups of 40 each were recruited from the glaucoma outpatient department (OPD). All patients were aged 35–75 years with no previous experience of performing HFA. Patients with hearing impairment, any other cognitive impairment, and best-corrected visual acuity (BCVA) ≤6/36 on Snellen’s visual acuity were excluded. The first two groups were given strict (conservative) and lenient (liberal) verbal instructions. The instructions were adapted from those listed in the manufacturer’s instruction. and the third group was shown a standard video depicting in detail how perimetry was to be performed. A questionnaire was given to each patient before and after the test to assess the patient’s performance.

Results:
Patients diagnosed with glaucoma during testing in each group were 29 (72.50%), 30 (75.0%), and 33 (82.5%) in the video instructed, strictly verbal, and leniently verbal groups, respectively. The overall mean deviation (MD) in the right eye (RE) was of − 3.38 (−4.9 to 1.9) and in the left eye (LE) was − 3.96 (−6.4 to − 1.9). Reliable field was slightly higher for the video instructed group (47.5%) and lowest for the strictly verbal group (22.5%) (P = 0.033). A higher number of patients were very motivated in the video instructed group (27%) (P = 0.041). Post-test questionnaires showed that 40% of patients felt they have performed the test with 100% accuracy in video group with less guessing. A higher number of patients in the video instructed group (85%) felt instruction was helpful in performing the test (P = 0.001).

Conclusion:
The video groups were more motivated and had better confidence to perform the test with less anxiety and stress and with probably better understanding of the procedure due to visual effects enhancing their understanding.
An evaluation of the accuracy of toric intraocular lens power calculation based on measured total corneal refractive power
Authors: Yang Zhi , Zhou Yanwen , Jin Tianru , Li Jingjing 
Published: February 2023

Purpose:
To evaluate a method using measured values of total corneal refractive power (TCRP) for a manufacturer’s online calculator by comparing it with the Barrett toric calculator (BTC) and Kane toric calculator (KTC) combined with simulated keratometry values (SimK).

Methods:
This was a retrospective case series. Patient records were reviewed to identify the patients who had biometry with the IOL Master 700 and Pentacam recorded before toric IOL implantation and refractive follow-up data after implantation. The predicted error in residual astigmatism was calculated by vector analysis according to the calculation methods and the measurements used.

Results:
A total of 70 eyes of 56 patients were included. The mean absolute astigmatism prediction errors were 0.6 ± 0.32, 0.59 ± 0.35, and 0.61 ± 0.35 D for the ATCTCRP, BTCSimK, and KTCSimK calculators, respectively (P = 0.934), and the centroid of the prediction errors were 0.3 D @ 178°, 0.11 D @ 102°, and 0.09 D @ 147°, respectively (P = 0.23). In the with-the-rule subgroup, the centroid of the prediction error was 0.34 D @ 176° for ATCTCRP and was the highest among the three calculation methods (P = 0.046).

Conclusion:
The ATCTCRP, BTCSimK, and KTCSimK calculators had similar performance with regards to their astigmatism prediction accuracy. The ATCTCRP calculator combined with 4.0-mm apex/ring readings of TCRP was slightly intended to result in against-the-rule residual astigmatism.
Role of polymerase chain reaction–based viral detection in pterygia
Authors: Krishnan Janani Madhuravasal , Rajagopal Rama , Lakshmipathy Dhanurekha , Agarwal Shweta , Anand AR , Therese Lily , Thangam Aishwarya , Madhavan Hajib Narahari Rao 
Published: February 2023

Purpose:Pterygium is a fibrovascular disease that originates in the conjunctiva and commonly spreads to the corneal surface, thereby posing a threat to eyesight. Despite intensive research, the pathophysiology of this disease remains unclear. Recent research suggests that oncogenic viruses, such as human papillomavirus (HPV), cytomegalovirus, and Epstein–Barr virus (EBV), may play a role in pterygia development. Although there are questions concerning the function of oncogenic viruses in pterygium pathogenesis, existing research shows a lack of consensus on the subject, demonstrating the heterogeneity of pterygium pathophysiology. Therefore, we aimed to simultaneously detect the three common viral pathogens that have been reported in pterygium tissue obtained after excision.Methods:Thirty-five tissue specimens of pterygium from patients undergoing pterygium surgery (as cases) were analyzed for evidence of viral infection with multiplex polymerase chain reaction (PCR), and virus-specific real-time quantitative PCR was used for the samples that were detected positive by multiplex PCR.Results:Of the 35 patients, one sample was positive for EBV and two samples were positive for HPV. Further PCR-based DNA sequencing of the HPV PCR-positive product showed identity with HPV-16. Real-time quantitative PCR on samples that showed EBV or HPV positivity did not yield any detectable copy number.Conclusion:Our study results confirmed that PCR positivity could be due to transient flora, but it was not quantitatively significant to conclude as the causative factor of pterygium pathogenesis. However, additional studies with larger sample populations are warranted to fully determine the role of the virus in pterygium.
Measurement of change in angle kappa and its correlation with ocular biometric parameters pre- and post-phacoemulsification
Authors: Umesh Y , Saolapurkar Kelini , Joshi Pallavi , Singh Devika 
Published: February 2023

Purpose:
Angle kappa has been considered to play a role in causing glare and haloes despite accurate centration during implantation of multifocal intraocular lenses following phacoemulsification. There is a lack of substantial data regarding whether angle kappa is a constant entity or changes following ocular surgical procedures. To answer this question, in this prospective observational study, we measured change in angle kappa following phacoemulsification, and studied the ocular biometric parameters correlating with this change.

Methods:
Angle kappa was measured objectively using synoptophore. Ocular Biometric parameters (Anterior Chamber Depth, Corneal White-to-White measurement, Lens Thickness, and Axial Length) using LenStar LS 900 Haag Streit Anterior Segment imaging system. outcome measures were a quantitative change in angle kappa from the preoperative value by one degree or more and observation of correlation between change in angle kappa and ocular biometric parameters. The Wilcoxin Signed Rank Test was used to determine the difference between pre-operative and post-operative measurements for angle kappa. A p-value of less than 0.05 was considered statistically significant. Pearson’s correlation coefficient was employed to find the relationship between preoperative ocular biometric parameters and a change in angle kappa. A linear regression model was used to derive an equation considering corneal white-to-white measurement as the predictor and change in angle kappa as the outcome measure.

Results:
A significant change in angle kappa was recorded, and a significant correlation was found with corneal white to white measurements. This change could be predicted preoperatively, for a known corneal white to white measurement using the standard equation y=mx+c.

Conclusion:
This study explains the possible cause of dissatisfaction among seemingly ideal patients who undergo multifocal IOL implantation and the potential for better decision-making during patient selection for multifocal IOL implantation.
Social determinants of diabetic retinopathy and impact of sight-threatening diabetic retinopathy: A study from Pune, India
Authors: Kulkarni Sucheta , Patil Veena , Kashikar Rashmi , Deshpande Rahul , Dole Kuldeep 
Published: February 2023

Purpose:
Diabetes-related retinopathy is the leading cause of blindness in India. The study was carried out with the purpose of studying the association of sight-threatening diabetic retinopathy (STDR) with socioeconomic factors and demonstrating the impact of STDR on the affected individual.

Methods:
A mixed methods (quantitative and qualitative) research design was used. The study participants were divided into two groups for quantitative analysis. The control group consisted of non–sight-threatening diabetic retinopathy, whereas the study group consisted of sight-threatening diabetic retinopathy. Apart from demographics, data on comorbidities, type and duration of diabetes mellitus (DM), health insurance status, and socioeconomic data were collected from each individual. A statistical test (Chi-square) was performed to study the association between socioeconomic (SE) classes and STDR. For the qualitative part, a few people were chosen. Face-to-face interviews were conducted in depth.

Results:
A total of 207 individuals, were recruited, of which 69 had STDR and the remaining 138 had non-STDR. The incidence of STDR was high among patients with lower socioeconomic class (SEC) (upper lower and lower), and univariate analysis revealed a strong association between STDR and SEC, the presence of comorbidities, presence of health insurance, type and duration of DM, and P value <0.05. SEC, in contrast, emerged as an independent risk factor for STDR in multivariate analysis. STDR had a devastating effect on all patients interviewed. The financial impact was most likely the most severe.

Conclusion:
People with lower SEC are more likely to suffer from STDR-related vision loss. The impact of such vision loss on individuals is multifaceted, including a negative impact on social and work life, psychological well-being, and, most importantly, a significant financial impact.