bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of pseudoexfoliation in diabetic patients with senile cataract: A hospital-based study in Kashmir, India
Authors: Thakur Sidra Javaid , Lone Imtiyaz Ahmad , Kitab Ifrah Shafat 
Published: August 2023

Purpose:
To study the prevalence of pseudoexfoliation syndrome (PEX) in diabetics with senile cataracts and compare it to the prevalence in nondiabetic control group.

Methods:
Two hundred and fifty diabetics and 250 nondiabetics (age and sex matched) were evaluated for PEX deposition.

Results:
Chi-squared test was employed, and a P value < 0.05 was considered significant. In the PEX group, most patients belonged to the age group of 60–70 years (55.17%). Out of 18 patients with PEX, 11 (61.1%) showed bilaterality. There was a higher frequency of raised intraocular pressure (IOP; >20 mmHg) in PEX eyes (10.3%) than in the non-PEX eyes (5.9%). The PEX group had a higher number of eyes with cup-to-disc ratio (CDR) >0.6 (11.12%) than the non-PEX group (4.32%). Nuclear cataracts were more frequent in PEX eyes than non-PEX eyes, whereas PSC and mature cataracts were more prevalent in the non-PEX group. Most eyes had PEX deposition on the anterior lens capsule and pupillary margin. Of the 500 study eyes corresponding to the diabetic group, 418 had cataracts (rest pseudophakic), of which 28 had pseudoexfoliation, accounting for 6.7% of the total. In the nondiabetic control group comprising 500 eyes, 430 had senile cataracts (rest pseudophakic), of which 105 had PEX deposition, accounting for 24.4% of the total.

Conclusion:
According to our findings, diabetics have a lower prevalence of PEX than nondiabetics. Few such studies have been conducted so far, and none have been conducted in the Indian population.
Refractive outcomes of toric intra-ocular lens implantation in cases of high posterior corneal astigmatism
Authors: Jin Tianru , Yu Lan , Li Jingjing , Zhou Yanwen 
Published: August 2023

Purpose:
To evaluate whether the toric intra-ocular lens (IOL) power calculation based on total corneal astigmatism (TCA) in eyes with high posterior corneal astigmatism (PCA) could result in a systematic over-correction or under-correction after operation.

Methods:
The present study included a mono-centric retrospective study design. The data were collected from 62 consecutive eyes during uncomplicated cataract surgery by a single surgeon with a measured PCA of 0.50 diopters (D) or higher. Toric IOL calculations were made using TCA measurements. The eyes were grouped as either “with-the-rule” (WTR) or “against-the-rule” (ATR) on the basis of the steep anterior corneal meridian. The post-operative refractive astigmatic prediction error was analyzed 1 month post-operatively using the vector analysis by the Alpins method and double-angle plots method.

Results:
The correction indexes were 1.14 ± 0.29 in the ATR eyes and 1.25 ± 0.18 for the WTR eyes, indicating a tendency toward over-correction. The mean over-correction was 0.22 ± 0.52D in the ATR group and 0.65 ± 0.60D in the WTR group. The magnitude of error (ME) values were significantly different from the ideal value of zero in both groups (ATR: P = 0.03; WTR: P = 0.00). No significant difference in mean absolute error (MAE) in predicted residual astigmatism was found between ATR and WTR groups (0.61 ± 0.42 D versus 0.64 ± 0.39 D; P = 0.54). The ATR group yielded better results, with 48% <0.50D prediction error in the main analysis.

Conclusions:
The results suggested that in cases of high PCA, the toric IOL calculation, which was performed using TCA, may cause a potential over-correction in the ATR and WTR eyes. For ATR eyes, over-correction led to slight disruption of post-operative visual quality because of the “with-the-rule” residual astigmatism after operation. Therefore, we suggested using TCA for toric IOL calculation in ATR eyes.
A comparative study of vision-related quality of life (VRQoL) among glaucoma and nonglaucoma patients at a tertiary care center of North India
Authors: Tripathi Alka , Agarwal Richa , Kharya Pradip , Dwivedi Priyanka , Khan Imran 
Published: August 2023

Purpose:
Glaucoma influences vision-related quality of life (VRQoL) of an individual in various ways. There are very limited studies on the Indian population and the northern part of India. Therefore, we conducted the present study to evaluate VRQoL in glaucoma patients as well as the association between the severity of glaucoma and VRQoL.

Methods:
An institution-based, cross-sectional, analytical study was conducted from August 2022 to October 2022 involving 190 participants (95 glaucoma patients and 95 controls). The glaucoma quality of life-15 (GQL-15) questionnaire was explained in their vernacular language by the interviewer. The scoring was given according to the validated scoring algorithm for the questionnaire.

Results:
Mean GQL score in the control group was 19.66 ± 5.5 and in glaucoma cases was 32.8 ± 10.2, whereas the mean score of mild glaucoma cases was 22.3 ± 4.83, moderate glaucoma cases was 36.3 ± 4.09, and severe glaucoma cases was 47.24 ± 3.03. Therefore, as the severity of glaucoma increases, the GQL score also increases, indicating poorer quality of life. Visual field loss was strongly positively correlated (correlation coefficient = 0.759, P < 0.01) with the GQL-15 score, while a weaker positive correlation was found with best corrected visual acuity (BCVA), cup disc ratio, and duration of treatment.

Conclusion:
Besides controlling or reducing intraocular pressure (IOP) to the target level, the goal of glaucoma treatment should be to provide an individual with good functional vision to maintain an acceptable quality of life. It would also help in providing patients with the best possible treatment, not only in terms of good vision but also in maintaining or improving their overall quality of life.
Peering into the eye: A comprehensive look at ultrasound biomicroscopy (UBM) and its diagnostic value in anterior segment disorders
Authors: Kapoor Rohan , Parameswarappa Deepika C , Dhurandhar Deven , Peguda Hari K , Rani Padmaja K 
Published: August 2023

Background:
Ultrasound biomicroscopy (UBM) is a noninvasive imaging modality that enables in-vivo visualization of the structures of the anterior segment of the eye. Unlike routine ophthalmic diagnostic ultrasound which uses frequencies of 5–10 MHz, UBM utilizes ultrasound frequencies in the range of 50–100 MHz. The high-frequency probes in UBM allows for higher resolution and better visualization of subsurface ocular structures, even in the presence of anatomic or pathological obscuration. UBM has qualitative as well as quantitative applications in various disorders affecting the anterior segment of the eye. Despite its huge importance, many clinicians lack in knowledge about the technique and its clinical usefulness. The current educational video aims to address this gap in knowledge by highlighting the technique and various clinical indications of UBM.

Purpose:
The purpose of this video is to demonstrate the technique of UBM and showcase its quantitative and qualitative implications and importance through various clinical cases.

Synopsis:
UBM is an imaging technique that assesses the depth of tissue structures by measuring the time delay of the returning ultrasound signal. This modality is capable of measuring the size of various structures within the eye, such as the cornea, iris, ciliary body, sclera, and the depth of the anterior and posterior chamber. To perform a UBM, a transducer is inserted into a specially designed eye cup filled with distilled water, creating a water bath environment. Axial and longitudinal scans can be performed in a similar fashion as in routine diagnostic B-scan ultrasound. Quantitative indications for UBM depicted in this video include measurements of corneal thickness, depth of the anterior chamber, and the width of the angle. The video also showcases how UBM can aid in the diagnosis and management of various anterior segment disorders like angle-closure glaucoma, plateau iris configuration, secondary glaucoma, and anterior uveitis with complicated cataract. Qualitative indications for UBM highlighted in this video include its role in intermediate uveitis, ocular hypotony, ocular surface tumors, cystic lesions of iris, and identifying the location and type of intraocular foreign bodies in the anterior segment based on the type of artifact seen. Additionally, the video shows the applications of UBM in scleral and episcleral pathologies.

Highlights:
This video will educate clinicians about the technique of UBM and showcase a bouquet of UBM findings in various case scenarios, helping one to better understand the potential of this modality in clinical practice.

Video link:
https://youtu.be/F626TMbJXoU

Key words: Anterior segment and glaucoma, diagnostic modality, indications, ultrasound biomicroscopy
Leptospiral uveitis- “Transition ‘from epidemic to endemic form” difficulties in laboratory confirmation
Authors: Rathinam SR. , Kohila G. Jeya , Gowri P Chidambaranathan , Balagiri KS. 
Published: August 2023

Purpose:
Leptospirosis is a waterborne zoonotic disease that primarily causes systemic illness, followed by uveitis. After heavy flooding in Madurai district, an epidemic outbreak of systemic and ocular leptospirosis occurred in 1994. Our data shows a transition to endemicity after each epidemic.

Aim:
The aim of this study is to report the clinical signs, epidemic outbreaks, and persistent endemicity of leptospiral uveitis, as well as the diagnostic dilemmas associated with it.

Methods:
A retrospective analysis of clinical signs was conducted using medical records of leptospiral uveitis patients over a period of 27 years (1994–2020) in a tertiary care eye hospital. The clinical workup of uveitis included a detailed clinical history, systemic, and ophthalmic examination. Microagglutination tests (MATs) was done at the Centers for Disease Control and Prevention (CDC) in Atlanta and later in our regional laboratory. Serum samples were collected from human systemic leptospirosis cases and a small group of animals in and around Madurai.

Results:
The first epidemic outbreak resulted in 200 seropositive patients. Subsequent epidemic outbreaks occurred in 1997, 1998, 2001, 2005, and 2012, with Madurai experiencing multiple outbreaks. However, the disease remained endemic, with 25–50 patients being observed per year in between the peaks. Ocular examination revealed acute non-granulomatous uveitis (94.9%), pan uveitis (59.8%), vitreous inflammatory reaction (55.4%), retinal vasculitis (29.5%), disc hyperemia (20.9%), and hypopyon. (16.2%). New serovars emerged every year, resulting in decreased sensitivity of the MAT. Over time, the MAT started to miss diagnoses.

Conclusion:
The persistent endemicity of leptospiral uveitis emphasizes the need for accessible diagnostic tests. The low performance of the MAT can be attributable to the use of an older panel. The incorporation of new isolates in the MAT by a national laboratory will improve the accuracy of diagnosis.
Prepapillary vascular loops – A new classification
Authors: Subramanian Vishnu , Govindaraj Indu , Rajendran Anand 
Published: August 2023

Background:
Prepapillary vascular loops are a type of congenital vascular anomaly seen on or around the optic disk. Patients with this condition are usually asymptomatic and are detected incidentally on routine fundus examinations. Differential diagnosis for this condition includes neovascularization of the disk and collaterals on the disk. Prepapillary capillary loops are not associated with any systemic condition. They are usually unilateral in presentation, but can rarely be bilateral.

Purpose:
To discuss the new proposed classification of prepapillary capillary loops.

Synopsis:
Prepapillary capillary loops are classified based on their location around the disk, loop characteristics such as elevation, shape, and covering, and presence of vitreoretinal traction.

Highlights:
The most common vascular loops are arterial in origin and rarely venous in origin. They can sometimes be associated with spontaneous and recurrent vitreous hemorrhage, branch retinal artery or vein occlusion, and subretinal hemorrhage. It is an important differential diagnosis in spontaneous vitreous hemorrhage. Treatment is symptomatic.

Video link: https://youtu.be/gbq_oP7Y2q4

Key words: Branch retinal artery occlusion, prepapillary vascular loops, vitreous hemorrhage
Drill from Military to Operating Theater and Safe Reuse of Single-Use Items to Combat the Cost of Optical Fibers and Consumables in Endovenous Laser Ablation of Varicose Veins
Authors: Rajapaksha Keerthi 
Published: August 2023

Introduction:
Can the tandem arrangement of operating theater setup to perform a surgical drill similar to military, together with safe reuse of single-use items combat the cost of consumables of endovenous laser ablation (EVLA)?

Methods:
Operation pathway of EVLA consisted of cleaning and draping of patient (step 1), access to the affected vein and infiltration of tumescent local anesthesia (step 2), endovenous ablation (step 3), ultrasound-guided microfoam sclerotherapy (step 4), and chemical sterilization of consumables (step 5). Dedicated theater lists for EVLA were arranged to treat several patients per session in a prearranged operating theater. When the step 5 is completed on the first patient, the step 1 on the next patient was performed using sterilized optical fiber (OF) as a cycle while minimizing patient changeover time. Number of patients treated with each session of OF and time taken for step 1 to step 4 was recorded and analyzed.

Results:
A total of 140 patients treated using eight OFs during December 2019 to December 2022. Average number of patients treated with a single OF and during a single session of fiber is 17.5 (9–23) and 4.2 (3–7), respectively. Average time taken for step 1 was 7.83 min, step 2 was 7.95 min, step 3 was 1.57 min, and step 4 was 6.36 min. All the procedures were performed using four chemically re-sterilized guidewires and introducer sheaths.

Conclusion:
Tandem arrangement of operating theater to perform EVLA procedure similar to military drill can optimize the utilization of OFs and consumables.
Usefulness of Off-Label Use of Coronary Drug-Eluting Stents as Bailout for Patients with Critical Limb Ischemia and Infrapopliteal Arterial Occlusive Disease
Authors: Sekar Natarajan , Jagan Jithin , Sima Rahul Ralph , Archana Rajan 
Published: August 2023

Background:
Infrapopliteal arterial disease is the most common finding in patients presenting with critical limb-threatening ischemia (CLTI) majority of whom also present with tissue loss. Vein bypass has been the gold standard of treatment in these patients. Nowadays, because of high peri-operative mortality and morbidity in these high-risk patients, endovascular treatment is offered first. Vascular restenosis, caused by intimal hyperplasia due to vessel injury during percutaneous transluminal angioplasty (PTA), remains the main limitation of infrapopliteal PTA and bare metal stent with clinical relapse and reinterventions. Drug-eluting stents (DES) are considered a possible solution to the problem of restenosis by reducing neointimal hyperplasia, after promising results in coronary arteries.

Materials and Methods:
Coronary DES was used as a bail out in patients undergoing below the knee (BTK) angioplasty. Those who developed dissection or recoil were stented with coronary stents. Multiple stents were used in patients with a long segment recoil of the artery. None of the stents were placed 2 or 3 cm beyond the origin of the tibial artery. The primary patency at 6 and 12 months, defined as absence of restenosis (≥50% stenosis) or occlusion based on clinical assessment and duplex scan, limb salvage and time taken to complete wound healing were assessed.

Results:
A total of 26 patients underwent drug-eluting stenting of the infra-popliteal vessels for CLTI during a period of 32 months. Technical success was possible in 92.3% patients (n = 24), however two patients had on table thrombosis of the stent. These two patients went on to have surgical bypass and their limbs could be salvaged. Wound healing was seen in 13 of 18 (72.2%) patients at 6 months and 11/12 (91.6%) patients at 1 year. Most patients took an average of 5 months to heal. Limb salvage was 11/12 (91.6%) at 1 year. Two patients underwent below-knee amputation for severe worsening sepsis due to uncontrollable foot infection. In both these patients’ stents were patent at the time of amputation. Primary patency was 92.3% at 6 months and at 1 year. None of the patients required re-intervention. Mortality was 15.3% at 1 year.

Conclusion:
Off-label use of cardiac stents in the infra-popliteal segment seems a viable bailout option in patients undergoing revascularization. DES helps to achieve early technical success, longer patency, better wound healing, and improves limb salvage in these patients.
Evaluation and Identification of Macrovascular Complications in Patients with COVID-19 – Original Study
Authors: Hassani Mohammad , Khanabadi Binazir , Tavallaei Mehdi , Mehdizadeh Mahshid , Mahmoud Abadi Farzad Dehghani , Mirabootalebi Fatemeh Sadat 
Published: August 2023

Background:
Coronavirus disease 2019 (COVID-19) is a pandemic that has affected many patients worldwide. Infection with this virus appears to be associated with a high risk of macrovascular complications.

Methods:
In this descriptive study, we examined the clinical and demographic information of 67 patients in whom COVID-19 was confirmed in terms of vascular complications.

Results:
The results of this study showed that 65.6% of COVID-19 patients had venous complications and 34.4% had arterial complications. In the patients who had more severe symptoms caused by COVID-19 such as fever, cough, sore throat, nausea and vomiting, diarrhea, anorexia, shortness of breath, joint pain, and fatigue, they had more severe venous complications.

Conclusions:
Better and more accurate understanding of the pathophysiological mechanisms causing severe disease of COVID-19, as well as identifying the prevalence of macrovascular complications and possible disorders resulting from them in patients with COVID-19 in different ethnicities and populations to develop new treatment, is needed.
Prognostic Value of the Pre-Procedural Six Minute Walk Test in Patients Undergoing Open Abdominal Aortic Aneurysm Repair – A Prospective Observational Study
Authors: Pandey Ashutosh Kumar , Manchikanti Sriram , Sun Neelamjingbha , Gupta Aditya , Pitchai Shivanesan , Pillai Vivek 
Published: August 2023

Objective:
Open surgery for aortic aneurysm is associated with significant morbidity and mortality. Preoperative functional status is one of the key predictors of adverse outcomes in the postoperative period. This study investigated the role of 6-min walk test (6MWT) in predicting the outcomes after open surgery in abdominal aortic aneurysm (AAA).

Methods:
A prospective cohort study was conducted in patients scheduled to undergo open repair of AAA. The preoperative 6-min walk distance (6MWD) was calculated for patients, followed by postoperative monitoring of all patients who underwent surgery. Walking performance was classified with 300 m as a cutoff, and patients were divided into two groups with 6MWD- <300 m and >300 m. The results of 6MWT were analyzed with respect to cardiopulmonary complications, intensive care unit (ICU) stay, ventilatory or inotropic support, length of hospital stay, and mortality.

Results:
A total of 52 patients were included in the study, and 49 patients were able to complete the 6MWT. The patients with <300 m 6MWD had a longer stay in the ICU and an increased duration of ventilatory and inotropic support (P < 0.001). The <300-m group had an increased incidence of cardiopulmonary complications (47%, P = 0.001). The <300-m group had a higher duration of hospital stay (10.6 vs. 8.4 days; P = 0.01). All the patients who died in the perioperative period had a 6MWD <300 m (n = 3, P = 0.03). The 6MWD was the only strong predictor of adverse outcomes in the cohort.

Conclusion:
6MWT can be safely performed in patients with AAA. A low walking distance correlates directly with increased perioperative morbidity and length of hospital stay. A distance of <300 m in patients with aortic aneurysm is predictive of perioperative morbidity and mortality.
A Study of Treatment Outcomes on the Basis of Revised Venous Clinical Severity Score in Patients of Varicose Veins Undergoing Surgical Management
Authors: Chowdhry Shreyansh , Jaiswal Shyam Sunder , Dwivedi Surjeet 
Published: August 2023

Background:
Chronic venous disease is a prevalent and progressive disease. There has been a tremendous increase in venous technologies and procedural volumes over the past decade, but still, there is a great deficiency in available clinical data. Reporting of clinical outcomes in a standard fashion is the need of the hour required to compare devices and other therapeutic methods intended to improve clinical outcomes.

Materials and Methods:
This is a prospective observational study carried out between November 2016 and October 2018 on 200 consecutive cases that underwent surgical management for varicose veins.

Results:
Revised venous clinical severity score (RVCSS) scores reduced significantly after surgical intervention and subsequent follow-up; however, when comparing the scores between the two groups, there was no significant statistical difference.

Conclusion:
RVCSS coupled with Clinical-Etiology-Anatomy-Pathophysiology provides a standard clinical language to report and compare different approaches to cardiovascular diseases management. Ligation and stripping (L and S) are the gold standard for the treatment of varicose veins, endovascular procedures are expensive and have similar efficacy as L and S, however, are preferred in the present era due to better cosmetic and faster recovery.
The effect of symbiotic in the treatment of infantile colic
Authors: Khoshnevisasl Parisa , Sadeghzadeh Mansour , Kamali Koorosh , Hasanlo Masoumeh 
Published: August 2023

Background:
This study aims to evaluate the effect of symbiotic (Pedilact) on the treatment of infantile colic.

Materials and Methods:
In this randomized clinical trial in Zanjan, Iran, 76 infants with infantile colic were assigned to two groups of 38 cases using block randomization. The intervention group received 5 drops of Pedilact, a symbiotic containing Lactobacillus reuteri and simethicone (20 mg twice daily), and the control group received placebo in addition to simethicone for 4 weeks. Daily crying time, number of crying attacks per day, and sleep duration were recorded on days 1, 7, 14, 21, and 28, and the results were compared.

Results:
Thirty-three infants in the intervention group and 35 infants in the control group were enrolled. There was no significant difference between the two groups in terms of age, gender, gestational age, maternal age, type of delivery, type of feeding, and weight at the beginning and the end of the study (all P > 0.05). Daily crying time in the control and intervention groups decreased from 240 and 210 min/day, respectively, to 0 min/day in both the groups. Daily crying attacks decreased from 5 and 4/day in the control and intervention groups, respectively, to 0/day. Sleep duration in both the groups increased from 720 to 840 and 930 min/day in the control and intervention groups, respectively, but the changes were not significant (P = 0.56, P = 0.52, and P = 0.13, respectively).

Conclusion
We did not find a significant improvement in colic symptoms in infants receiving symbiotic compared to placebo.