bluuebunny/crossref_metadata_2025_split huggingface dataset:
An experimental study to evaluate Gunasankarya (combination of properties)
Authors: Nair Jiji U. , Vyas Hitesh A. , Nariya Mukesh B. 
Published: May 2023

Introduction:

Gunasankarya implies the combination or admixture of different Guna (properties) in a Dravya (substance). Every Dravya in this world is composed of different Guna varying in their quantity and potency. The final resultant action of the Dravya depends on the combination of Guna and their interaction with each other.

Aim:
The present study was aimed to explain the manifestation of Karma (action) of a Dravya through its Guna (properties) and to evaluate the effect of the combination of Sheeta Guna (cool property) with different other Guna on digestion and metabolism in an animal model.

Materials and methods:
The test drugs Usheera (Vetiveria zizanioides Linn.) and Bala (Sida cordifolia Linn.) were dried and powdered. A total of 18 adult healthy male and female Wistar strain albino rats were grouped randomly into three groups out of which the first was the control group and administered with distilled water. The second and third groups were fed with powder of Usheera and Bala, respectively, in the suspended form in distilled water. Test drugs were administered daily for 12 consecutive days. During the experimental phase, relative food intake, relative water intake, relative urine output, relative stool output, and food conversion ratio were recorded on the 3rd, 6th, 9th, and 12th day among which the 3rd day was considered as the initial day for the assessment, whereas body weight was measured from the 1st day of the study. Throughout the study, the main focus was on how these parameters change in Usheera and Bala-treated rats which are having different combinations of Guna with reference to the control group.

Results:
Both Usheera and Bala groups showed a nonsignificant increase in relative food and water intake, nonsignificant increase in relative urine output, significant decrease in relative stool output, and significant increase in food conversion ratio. Body weight was nonsignificantly increased in Usheera group, whereas it was nonsignificantly decreased in Bala group. This study aimed to show how the Guna are interacting and resulting in Karma either by dominating or suppressing or giving a combined effect of Guna. This study provides initial data regarding the concept of Gunasankarya (combination of properties).

Conclusion:
The study concludes that all the Guna in a Dravya interact and exhibit their resultant action, i.e., Karma based on Gunasankarya, with emphasis on example of assessment of the effects of Sheeta Guna Dravya, namely, Usheera and Bala on physiological parameters (digestion and metabolism) have been assessed experimentally in animal models to evaluation of the combination of Guna.
Modified FOLFIRINOX compared to Gemcitabine & nab-Paclitaxel in advanced pancreatic ductal adenocarcinoma - results of a match-pair analysis
Authors: Ramaswamy Anant , Shah Darshit , Bhargava Prabhat , Srinivas Sujay , Kannan Sadhana , Shah Minit , Suman Mannavi , Das Shasanka , Trikha Mehak , Ostwal Vikas 
Published: May 2023

Background & objectives:
FOLFIRINOX and gemcitabine plus nab-paclitaxel (GN) are the most commonly used regimens in advanced pancreatic ductal adenocarcinomas (PDACs). As there is limited data on comparison of these two regimens, the present study was aimed to compare survivals and tolerance for both regimens through a match-pair analysis.

Methods:
The data of 350 patients with metastatic and locally advanced PDAC, treated between January 2013 and December 2019, were retrieved. A 1:1 matching, using age and performance status, without replacement was performed by using nearest neighbour matching method.

Results:
A total of 260 patients (130 modified FOLFIRINOX and 130 GN) were matched. The median overall survival (OS) was 12.98 months [95% confidence interval (CI) 7.257-8.776 months] in modifications of FOLFIRINOX (mFOLFIRINOX) cohort and 12.06 months (95% CI 6.690-8.88 months) in GN group (P=0.080). The incidence of grade 3 and 4 infections, diarrhoea, oral mucositis, and fatigue was higher with mFOLFIRINOX. Patients who received second line therapy had improved OS as compared to those who did not (14.06 vs. 9.07 months, P<0.001).

Interpretation & conclusions:
GN and mFOLFIRINOX appear to have similar survival outcomes in an unselected match paired patient population with advanced PDAC. A markedly increased incidence of non-myelosuppressive grade 3 and grade 4 side-effects and lack of survival improvements suggest a need for nuanced use of the mFOLFIRINOX regimen. Administration of second-line chemotherapy improves OS in patients with advanced PDAC.
Outcomes of accelerated collagen cross linking in progressive paediatric keratoconus
Authors: Preethi B , Kumar Kiran K , Babu G Suresh , Sridhar Sriya , Srinivasa K H 
Published: May 2023

Purpose:
To determine the efficacy and safety of pediatric accelerated cross linking (CXL).

Methods:
A prospective study on progressive keratoconus (KC) cases under ≤18 years of age. Sixty four eyes of thirty nine cases underwent epithelium-off accelerated CXL protocol. Visual acuity (VA), slit-lamp examination, refraction, pentacam reading of keratometry (K), corneal thickness, and thinnest location pachymetry were noted. Cases were followed up on days 1, 5, and at 1st, 3rd, 6th, and 12th-month post procedure.

Results:
Statistically, significant improvement of the mean aided VA, K, and mean corneal astigmatism (p < 0.0001) was noted. Mean Kmax reading reduced from 55.5 ± 5.64 (47.4–70.4) diopter (D) preoperatively to 54.41 ± 5.51 (46–68.3) D at 12 months postaccelerated CXL. Two cases had progression. Complications encountered were sterile infiltrate and persistent haze.

Conclusion:
Accelerated CXL is effective and efficacious in pediatric KC.
Efficacy and safety analysis of intravitreal bio-similar products of bevacizumab in patients with macular edema because of retinal diseases
Authors: Agarwal Ruchi , Gupta Sanjiv K , Agrawal Siddharth 
Published: May 2023

Purpose:
The purpose of this study was to evaluate retrospectively the efficacy and safety profile of intravitreal injection of bevacizumab bio-similar product Zybev(Z) for macular edema because of retinal diseases.

Methods:
A retrospective analysis was conducted on patients with macular edema because of retinal diseases, who had been administered intravitreal injections of bio-similar bevacizumab at a tertiary eye care center. Changes in the retinal thickness and visual acuity were evaluated to judge the efficacy, and adverse events were noted for the safety profile over a period of 6 weeks.

Results:
A total of 104 patients were included in the study. The mean age of the patients was 53 ± 13.5 years. The mean pre-injection best corrected visual acuity (BCVA) was 1.32 ± 0.70 log minimum angle of resolution (logMAR) with a central subfield thickness (CST) of 429.26 ± 204.30 μm, and the post-injection BCVA at 6 weeks was 1.13 ± 0.71 logMAR with a CST of 302.26 ± 104.50 μm; this change was statistically significant (P < 0.05) for all groups. The mean average cube thickness (μm) decreased from 11.85 ± 1.96 pre-injection to 10.52 ± 1.75 post-injection, and the mean average cube volume (mm3) decreased from 329.30 ± 54.35 to 302.23 ± 49.56 (P < 0.05). During the follow-up period after injection, no patient had inflammation, endophthalmitis, an increase in intra-ocular pressure, or systemic side effects.

Conclusion:
This short-term retrospective analysis provides evidence regarding the efficacy and safety of intravitreal injection of bio-similar products of bevacizumab for the treatment of macular edema because of retinal diseases.
Reutilization of disposable rebound tonometer probes: Risk or return?
Authors: Enders Christian , Klante Pia , Hessling Martin , Wolf Armin , Werner Jens Ulrich 
Published: May 2023

Purpose:
An advantage of rebound tonometry (RT) is its ease of use so that it can also be operated by health care technicians. However, the cost of the disposable measuring probes is high and their reuse carries the risk of infection. Therefore, this study aims to objectify the potential risk of bacterial transmission by RT.

Methods:
Our experimental setting consisted of two experiments. The first aimed to quantify the number of bacteria on a tonometer probe after immersion in a bacterial suspension in vitro. The experiment was carried out with two different bacteria and compared with results from a Goldmann tonometer probe. The second experiment tested whether bacteria could be transmitted by simulating reuse of a nondisinfected rebound tonometer probe.

Results:
First experiment: After immersion of the rebound tonometer probe, we measured a bacterial count of 2.43 × 106
Escherichia coli (EC) and 1.12 × 106
Pseudomonas fluorescens. In total, 1.09 × 107 bacteria for EC and 2.61 × 106 for Pseudomonas fluorescens (PF) were measured on the Goldmann tonometer probe. Second experiment: A bacterial transmission could be detected in 36% of cases in which reuse of nondisinfected tonometer probes was simulated.

Conclusion:
These results show that despite the small surface of the rebound tonometer probe, there is a clear risk of bacterial transmission. Thorough disinfection according to general standards should be mandatory if the tonometer probes are to be reused.
Impact of color vision deficiency on the quality of life in a sample of Indian population: Application of the CVD-QoL tool
Authors: Male Shiva Ram , Shamanna BR , Bhardwaj Rishi , Gandhi Rashmin , Bhagvati Chakravarthy , Theagarayan Baskar 
Published: May 2023

Purpose:
To investigate the quality of life (QoL) in a sample of color vision deficit (CVD) patients in India and how color vision deficiency affects them psychologically, economically, and in productivity related to their work and occupation.

Methods:
A descriptive and case–control study design using a questionnaire was conducted on N = 120 participants, of whom 60 were patients of CVD (52 male and eight female) who visited two eye facilities in Hyderabad between 2020 and 2021 and 60 were age-matched normal color vision participants who served as controls. We validated English–Telugu adapted version of CVD-QoL, developed by Barry et al. in 2017 (CB-QoL). The CVD-QoL consists of 27 Likert-scale items with factors (lifestyle, emotions, and work). Color vision was assessed using the Ishihara and Cambridge Mollen color vision tests. A six-point Likert scale was used, with lower scores indicating poor QoL (from 1 = severe issue to 6 = no problem).

Results:
The CVD-QoL questionnaire’s reliability and internal consistency were measured, including Cronbach’s a (a =0.70–0.90). There was no significance between the group in age (t = −1.2, P = 0.67) whereas the Ishihara colour vision test, scores showed a significant difference (t = 4.50, P < 0.001). The QoL scores showed a significant difference towards lifestyle, emotions and work (P = 0.001). The CVD group had a poorer QoL score than the normal color vision group odds ratio [OR] =0.31, 95% confidence interval [CI], (P = 0.002, CI = 0.14–0.65, Z = 3.0) . In this analysis, a low CI indicated that the OR was more precise.

Conclusion:
Color vision deficiency affects Indians’ QoL, according to this study. The mean scores of lifestyle, emotions, and work were lower than the UK sample.Since CVD is underreported and possibly affects developing countries more, advocacy for a new health care plan on CVD is essential. Increasing public understanding and awareness could also help diagnosing the CVD population.
Age-related cataract - Prevalence, epidemiological pattern and emerging risk factors in a cross-sectional study from Central India
Authors: Sarkar Deepayan , Sharma Ria , Singh Priti , Verma Vidhya , Karkhur Samendra , Verma Sunil , Soni Deepak , Sharma Bhavana 
Published: May 2023

Purpose:
To study the epidemiological pattern, prevalence, types, and correlates of age-related cataracts in a tertiary care center in central India.

Methods:
This hospital-based single-center cross-sectional study was conducted on 2,621 patients diagnosed with cataracts for 3 years. Data pertaining to demography, socio-economic profile, cataract grading, cataract types, and associated risk factors were evaluated. Statistical analysis using unadjusted odds ratio (OR) and multivariate logistic regression was performed, with P-value <0.05 considered significant with the power of the study being 95%.

Results:
The commonest age group affected was 60–79 years, closely followed by the 40–59 years age group. The prevalence of nuclear sclerosis (NS), cortical (CC), and posterior subcapsular cataract (PSC) was found to be 65.2% (3,418), 24.6% (1,289), and 43.4% (2,276), respectively. Among mixed cataracts, (NS + PSC) had the highest prevalence of 39.8%. Smokers were found to have 1.17 times higher odds of developing NS than non-smokers. Diabetics had 1.12 times higher odds of developing NS cataracts and 1.04 times higher odds of developing CC. Patients with hypertension showed 1.27 times higher odds of developing NS and 1.32 times higher odds of developing CC.

Conclusion:
The prevalence of cataracts in the pre-senile age group (<60 years) was found to have increased significantly (35.7%). A higher prevalence of PSC (43.4%) was found in studied subjects, as compared to the data of previous studies. Smoking, diabetes, and hypertension were found to have a positive association with a higher prevalence of cataracts.
Comparative evaluation of intraoperative aberrometry and Barrett’s toric calculator in toric intraocular lens implantation
Authors: Mukhija Ritika , Vanathi Murugesan , Verma Meena , Raj Nimmy , Gupta Noopur , Tandon Radhika 
Published: May 2023

Purpose:
Barrett toric calculator (BTC) is known for its accuracy in toric IOL (tIOL) calculation over standard calculators; however, there is no study in literature to compare it with real-time intraoperative aberrometry (IA). The aim was to compare the accuracy of BTC and IA in predicting refractive outcomes in tIOL implantation.

Methods:
This was an institution-based prospective, observational study. Patients undergoing routine phacoemulsification with tIOL implantation were enrolled. Biometry was obtained from Lenstar-LS 900 and IOL power calculated using online BTC; however, IOL was implanted as per IA (Optiwave Refractive Analysis, ORA, Alcon) recommendation. Postoperative refractive astigmatism (RA) and spherical equivalent (SE) were recorded at one month, and respective prediction errors (PEs) were calculated using predicted refractive outcomes for both methods. The primary outcome measure was a comparison between mean PE with IA and BTC, and secondary outcome measures were uncorrected distance visual acuity (UCDVA), postoperative RA, and SE at one month. SPSS Version-21 was used; P < 0.05 considered significant.

Results:
Thirty eyes of 29 patients were included. Mean arithmetic and mean absolute PEs for RA were comparable between BTC (−0.70 ± 0.35D; 0.70 ± 0.34D) and IA (0.77 ± 0.32D; 0.80 ± 0.39D) (P = 0.09 and 0.09, respectively). Mean arithmetic PE for residual SE was significantly lower for BTC (-0.14 ± 0.32D) than IA (0.001 ± 0.33D) (−0.14 ± 0.32D; P = 0.002); however, there was no difference between respective mean absolute PEs (0.27 ± 0.21 D; 0.27 ± 0.18; P = 0.80). At one-month, mean UCDVA, RA, and SE were 0.09 ± 0.10D, -0.57 ± 0.26D, and -0.18 ± 0.27D, respectively.

Conclusion:
Both IA and BTC give reliable and comparable refractive results for tIOL implantation.
Choroidal lesions in varicella zoster virus uveitis
Authors: Kawali Ankush , Khanum Aayesha , Mahendradas Padmamalini , Sanjay Srinivasan , Mishra Sai-Bhakti , Shetty Rohit 
Published: May 2023

Purpose:
To evaluate choroidal lesions with spectral domain optical coherence tomography (SD-OCT) scan in varicella zoster virus (VZV) uveitis.

Methods:
VZV-uveitis cases which underwent OCT scan for choroidal lesions were studied. SD-OCT scan passing through these lesions was studied in detail. Subfoveal choroidal thickness (SFCT) during active and resolved stages was studied. Angiogaphic features were studied where available.

Results:
Thirteen out of 15 cases had same-sided herpes zoster ophthalmicus skin rashes. All except three patients had old or active kerato-uveitis. All eyes demonstrated clear vitreous and a single or multiple hypopigmented orangish-yellow choroidal lesions. The number of lesions remained unchanged during the follow-up on clinical examination. SD-OCT over lesions (n = 11) showed choroidal thinning (n = 5), hyporeflective choroidal elevation during active inflammation (n = 3), transmission effects (n = 4), and ellipsoid zone disruption (n = 7). The mean change in SFCT (n = 9) after resolution of the inflammation was 26.3 μm (range: 3–90 μm). Fundus fluorescein angiography showed iso-fluorescence over lesions in all (n = 5), but indocyanine green angiography (n = 3) showed hypofluorescence at lesions. Mean follow-up was 1.38 years (range: 3 months–7 years). De-novo appearance of choroidal lesion during the first relapse of VZV-uveitis was captured in one case.

Conclusion:
VZV-uveitis can cause focal or multifocal hypopigmented choroidal lesions with thickening or scarring of choroidal tissue, depending on the disease activity.
Medical student competence in ophthalmology assessed using the Objective Standardized Clinical Examination
Authors: Patil Nikhil S , Bal Manpartap , Khan Yasser 
Published: May 2023

Purpose:
To assess pre-clerkship and clerkship medical student performance in an ophthalmology Objective Standardized Clinical Examination (OSCE) station.

Methods:
One hundred pre-clerkship medical students and 98 clerkship medical students were included in this study. The OSCE station consisted of a common ocular complaint – blurry vision with decreased visual acuity – and students were asked to take an appropriate history, provide two or three differential diagnoses to explain the symptoms, and perform a basic ophthalmic examination.

Results:
Generally, clerks performed better than pre-clerks in the history taking (P < 0.01) and ophthalmic examination (P < 0.05) sections, with few specific exceptions. In the history-taking section, more pre-clerkship students asked about patient age and past medical history (P < 0.00001) and for the ophthalmic examination, more pre-clerkship students performed the anterior segment examination (P < 0.01). Interestingly, more pre-clerkship students were also able to provide two or three differential diagnoses (P < 0.05), specifically diabetic retinopathy (P < 0.00001) and hypertensive retinopathy (P < 0.00001).

Conclusion:
The performance of both groups was generally satisfactory; however, many students in both groups had scores that were unsatisfactory. Notably, pre-clerks also outperformed clerks in certain areas, which emphasizes the importance of revisiting ophthalmology content through clerkship. Awareness of such knowledge can allow medical educators to incorporate focused programs into the curriculum.
An observational study on the presence of perilimbal conjunctival pigmentation in vernal keratoconjunctivitis
Authors: Dubbaka Srujana , Agrawal Mohini , Sati Alok , Vats Sumedha , Mahajan Saurabh 
Published: May 2023

Purpose:
To evaluate presence of perilimbal pigmentation (PLP) in Indian patients with vernal keratoconjunctivitis (VKC).

Methods:
A cross sectional study was conducted from 2019 to 2020 at a tertiary eye care center in Western Maharashtra, India. In this study, 152 cases of VKC were identified. The presence, type, color, and extent of PLP were recorded. The incidence of presence of PLP was calculated. Its correlations with severity and duration of VKC were analyzed using Wilcoxon–Mann–Whitney U test and Chi square test.

Results:
Of 152 cases, 79.61% were males. Mean age at presentation was 11.4 ± 5.6 years. The characteristic PLP was present in 81 cases (53.29%; 95% confidence interval [CI]: 45.03%–61.42%; P < 0.001), of which 15 cases (18.5%) had this pigmentation in all the four quadrants. There was a significant difference between the groups with respect to quadrants involvement in terms of the extent of PLP in clock hours (Χ2 = 73.85, P < 0.001). However, the extent did not correlate with age (rho = 0.08, P = 0.487), sex (P = 0.115), time since onset in months (rho = 0.03, P = 0.77), duration of VKC and type or color of PLP (P = 0.12).

Conclusion:
Perilimbal pigmentation seems to be a consistent clinical finding seen in a significant number of VKC cases. It may benefit ophthalmologists in treating VKC cases when the palpebral/limbal signs are elusive.
The impact of COVID-19 on compliance to amblyopia treatment in a tertiary eye care center
Authors: Hegde Namratha , Vidya C , Bandamwar Kalika , Murali Kaushik , Murthy Sowmya Raveendra 
Published: May 2023

Purpose:
To investigate the impact of the coronavirus disease 2019 (COVID-19) outbreak on compliance to amblyopia therapy from the perspective of parents of amblyopic children.

Methods:
The participants for the qualitative study were enrolled from the medical records of a tertiary eye care center during the COVID-19 pandemic. The trained researcher conducted telephonic interviews consisting of validated 15 open-ended questions for 15 min. The questions were related to patients’ compliance toward amblyopia treatment and the date of follow-up with their practitioners. The data collected were entered on Excel sheets in the participant’s own words and later converted to a transcript for analysis.

Results:
A total of 217 parents of children with amblyopia who were due for follow-up were contacted through telephone. The response rate for willingness to participate was only 36% (n = 78). Of these, 76% (n = 59) of parents reported that their child was compliant toward the treatment during the therapy period and 69% reported that their child was currently not on treatment for amblyopia.

Conclusion:
In the current study, we have observed that although reported compliance by parents during the therapy period was good, around 69% of patients had discontinued amblyopia therapy. The main reason for the discontinuation of therapy was the failure to visit the hospital during the scheduled follow-up with the eye care practitioner.
Evaluation of optical coherence tomography angiography changes in nonarteritic anterior ischemic optic neuropathy
Authors: Phuljhele Swati , Sharma Sumant , Chawla Rohan , Saxena Rohit , Sharma Pradeep 
Published: May 2023

Purpose:
To study the long-term microvasculature changes at the macula and the optic disk in eyes with nonarteritic anterior ischemic optic neuropathy (NAION).

Methods:
Patients with acute NAION of less than 6 weeks duration were included. Optical coherence tomography angiography (OCTA) of the macula and the optic disk was performed at baseline, 3 and 6 months and compared with the controls.

Results:
The mean age of 15 patients was 52.25 (±9.06) years. The whole image superficial peripapillary density (42.49 ± 5.28) was significantly low when compared to that of control eyes (46.36 ± 2.09); similarly, radial peripapillary capillary density (49.35 ± 5.64) was also significantly reduced when compared to controls (53.45 ± 1.96, P < 0.05). These parameters showed significant progressive decrease at 3 and 6 months (P < 0.05). At the macula, both superficial (41.83 ± 3.64) and deep macular vasculature densities (47.30 ± 2.04) were significantly reduced when compared to control eyes (52.15 ± 4.84 and 55.13 ± 1.81, respectively). The vascular density at the macula remained stable at 3- and 6-months period.

Conclusion:
The study shows that the microvasculature in case of NAION is significantly reduced both in peripapillary area and in macular area.