bluuebunny/crossref_metadata_2025_split huggingface dataset:
Phenotypic variations in ocular features among siblings with oculocutaneous albinism
Authors: Bhate Manjushree , Lalwani Sakshi , Chakrabarti Subhabrata 
Published: July 2022

Purpose:
To assess the clinical profiles, presenting ocular features, and variations in the phenotypic features in siblings with oculocutaneous albinism (OCA).

Methods:
Electronic medical records of consecutive siblings diagnosed with albinism from January 2016 to December 2020 were reviewed to identify the affected siblings. The variations in their phenotypic characteristics were studied.

Results:
Significant variations were observed in the clinical features between the siblings (n = 42). A difference of >2 lines in visual acuity was observed in 50% (n = 21) of the sibling pairs. Compound hyperopic astigmatism was the commonest refractive error. The refractive status was different in 80.95% (n = 34) pairs. Although individually strabismus and abnormal head posture were observed in one-third and one-fourth of individual children, respectively, both siblings with similar strabismus were seen in only 16.67% (n = 7) and with a similar abnormal head posture in 13.33% (n = 5). Nystagmus was the most consistent finding across these siblings with a similar nature of horizontal jerk or pendular in 65% of sibling pairs.

Conclusion:
This study observed significant variations in phenotypic presentations among siblings with OCA. Such differences in clinical manifestations and severity would be helpful in appropriate counseling of these families as the need for rehabilitation services is likely to vary across siblings.
A safer alternative approach to penetrating keratoplasty in opaque corneas
Authors: Venugopal Anitha , Chandratreya Madhura P , Ghorpade Aditya S 
Published: July 2022

Background:
This video demonstrates a useful technique of keratoplasty which can be routinely undertaken by all surgeons when imaging modalities such as anterior segment optical coherence tomography are not available and prior patient history is not forthcoming.

Purpose:
To demonstrate a technique of lamellar separation and layer by layer removal of host cornea when dealing with keratoplasty in perforated corneal ulcers, adherent leucomas, dense corneal opacities, which obscure visualization of the iris and anterior chamber details.

Synopsis:
In this video, we demonstrate penetrating keratoplasty in a failed opacified graft with iridocorneal adhesions, with no visualization of anterior chamber details. Lamellar dissection of the host cornea is done starting at its periphery and moving centrally, with gentle peeling of the superficial layers, the epithelium and bulk of stroma, following which, the deeper portion of the cornea is dissected and separated from underlying adherent iris tissue. Layer by layer separation allows better visualization through the remaining thin layers of the cornea. This permits fine dissection and layered removal of the cornea, thereby avoiding injury to iris and lens. Debulking of the host cornea decreases the force that is needed to be applied to separate adherent iris tissue from the host cornea, and reduces the chances of sudden entry into the anterior chamber and subsequent damage to the iris or lens. This also reduces the chance of iris tears, iridodialysis and bleeding from the iris and helps maintain iris integrity, which is essential intraoperatively for protection of lens and anterior chamber formation, and to avoid glare and photophobia postoperatively. Preventing iris damage also reduces the chances of formation of peripheral anterior synechiae (PAS), which can predispose to graft rejection, graft failure and secondary glaucoma.

Highlights:
Layer by layer corneal separation beginning inside the graft host junction, careful separation of iridocorneal adhesions and PAS is a helpful technique to optimally preserve the anterior segment anatomy during difficult cases of penetrating keratoplasty.

Online Video Link:

https://youtu.be/ZmQQhuOnAh4
A 28-mm intraocular foreign body removal: The vitreoretinal surgeon’s dilemma
Authors: Gangwe Anil , Barwar Gulshan 
Published: July 2022

Background:
Intraocular foreign body (IOFB) removal becomes tricky if its large and impacted in the ocular coats. When confronted with such a combination, the vitreoretinal surgeon will need to modify the surgical plan. This surgical video describes one of such situation encountered during removal of a long wooden IOFB impacted in the ocular coats.

Purpose:
The video describes a scenario when the surgeon becomes aware that injury to ocular structure is inevitable due to inherent length of the IOFB. However, a careful assessment of the situation helps the surgeon to identify how he could minimize the damage to the eye and not put vision at risk.

Synopsis:
A young boy presented with painful loss of vision in left eye since 15 days. Examination showed BCVA of 20/32 and limitation movement in up gaze. Fundus showed hazy media and an IOFB in superior quadrant. It was noted that IOFB was moving with eye movement. The impaction in sclera and extraocular extension was suspected. After pars plana vitrectomy, it was observed that IOFB was longer than what was measured by the scan and it was impacted in the coats. Removal using IOFB forceps further pulled the IOFB into vitreous cavity. A rectangular scleral window was created, IOFB was pushed towards opposite pars plana region to avoid injury to macula, optic nerve, lens and peripheral retina. The IOFB was then removed.The retinal tears were lasered. Three months following the surgery, he developed cataract, which needed surgery. His BCVA at the last follow up visit was 20/25 with attached retina.

Highlights:
1. Limitation of movement in presence of linear IOFB shall raise a suspicion of IOFB being impacted in coats and possibility of its extraocular extension; 2.An oblique IOFB posterior to limbus, can have length more in transverse diameter of the eyeball. Though rarely used, an ab-externo approach can be a viable option in such a case to minimise injury to vital structure of the eye, particularly if the IOFB is severely impacted in sclera.

Online Video Link:

https://youtu.be/2bF3WLd812o
Structural and functional phenotypic features and molecular analysis of Indian patients with Bietti crystalline dystrophy
Authors: Ratra Dhanashree , Chattree Surabhi , Raviselvan Munispriyan , Pradhan Arkaprava , Giridhar Sneha 
Published: July 2022

Purpose:
Bietti crystalline dystrophy (BCD) is a rare retinal dystrophy, uncommon in Indians. This study describes the various phenotypic features seen in the Indian population.

Methods:
In this retrospective, descriptive case series, records of patients with either clinical or molecular diagnosis of BCD from 2009 to 2020 were perused. Phenotypic and genotype information was collected and analyzed.

Results:
This study included 58 patients of BCD (31 males) aged 21–79 years (mean: 47 ± 14 years). The age at onset ranged from 7 to 41 years (mean: 28.8 ± 5.1 years). Vision ranged from 20/20 to counting fingers. There were 18 (31%) patients with stage 1 with crystals and mild retinochoroidal atrophy, 22 (38%) with stage 2 with atrophy extending beyond arcades, and 18 (31%) with absent crystals and extensive atrophy of stage 3. Choroidal neovascular membrane was seen in four patients. The optical coherence tomography showed retinochoroidal thinning (84.6%), outer retinal tubulations (71.8%), and paradoxical foveal thickening with interlaminar bridges (7.7%). Electrophysiology and visual fields showed reduced responses in advanced retinochoroidal changes. Molecular confirmation was available in five patients; five mutations were seen in the CYP4V2.

Conclusion:
A wide variation is seen in the phenotypic picture of BCD. A molecular diagnosis is helpful in differentiating from other retinal dystrophies. The OCT shows the peculiar feature of the interlaminar bridge in early cases with photoreceptor loss. Further investigations into this OCT feature may provide insights into the pathogenesis of BCD. A genotype–phenotype correlation could not be done.
North India Childhood Cataract Study - The real scenario and causes of surgical delay of pediatric cataract
Authors: Khokhar Sudarshan , Gupta Yogita , Rani Deeksha , Rathod Aishwarya , Moharana Sikshya 
Published: July 2022

Purpose:
The study sought to describe the clinical presentation pattern of pediatric cataracts and factors leading to delay in surgery at a tertiary care center in North India.

Methods:
A cross-sectional, interview-based study was conducted from January 2020 to October 2020, that included pediatric patients <12 years, with unilateral or bilateral congenital or developmental cataract. A pre-validated questionnaire was used to record data. The parameters recorded were age at first symptoms, age at diagnosis of cataract, age at surgery, laterality of cataract, first symptom, first family member noticing the abnormality, the morphology of cataract, association of perinatal complications, family history, systemic diseases, and cause (s) of delay in surgery.

Results:
A total of 89 patients were included. The mean age of subjects was 4.75(±3.51) years. A white pupil was the most common symptom (64.04%) and appeared in infancy in 30.3% of cases. Parents first detected the problem in 60.67%, and the pediatrician was the first medical contact in 11.23% of cases. The median (IQR) delay period between diagnosis of cataract and cataract surgery was 4 (3–6) months, the major causes were long GA waiting (30.33%), and delay due to systemic ill health (14.61%).

Conclusion:
Parental education on cataract detection is recommended to help in the timely detection and hence, improved outcomes of pediatric cataract surgery. Pediatricians, consulted for any systemic illness, have the role of the second most important contact in the detection of pediatric cataract.
Posterior corneal morphological changes in primary congenital glaucoma
Authors: Gupta Shikha , Mahalingam Karthikeyan , Singh Abhishek , Selvan Harathy , Somarajan Bindu I , Gupta Viney 
Published: July 2022

Purpose:To compare posterior corneal morphology between older treated and younger untreated children with primary congenital glaucoma (PCG) using anterior segment optical coherence tomography (ASOCT) and intraoperative OCT (iOCT), respectively.Methods:In this comparative study, ASOCT of older PCG children were compared with iOCT of younger untreated PCG patients. Differences between the two groups with respect to posterior corneal morphology were studied.Results:Observed morphological patterns within posterior cornea in older treated (age: 72–300 months) children (87 eyes) included Descemet’s membrane (DM) excrescences (70%), thickened DM (35%), intracameral twin protuberances (92%), and DM detachment (26%). Changes within pre-Descemet’s layer (PDL) (28%) included thickening, breaks, and detachments. Extent of Haab’s striae was associated with thickness of DM/PDL complex (P= 0.008) when analyzed in the treated group. In contrast, in the untreated group (n= 53 eyes, age 1–63 months), posterior corneal changes were limited to diffuse hyper-reflectivity of the DM/PDL complex, with absence of DM tears.Conclusion:Posterior cornea thickens and Haab’s striae become more circumscribed in eyes of older treated children compared to untreated PCG eyes, probably reflecting a healing response of posterior cornea over time.
Effectiveness of a modified therapeutic protocol for the management of vernal keratoconjunctivitis based on Bonini’s graded clinical severity
Authors: Pradhan Anuradha , Pattanayak Sabyasachi , Dora Jayashree , Subudhi Praveen 
Published: July 2022

Purpose:
To evaluate the effectiveness of a modified therapeutic protocol used for vernal keratoconjunctivitis (VKC) based on severity as per Bonini grading system.

Methods:
This was a prospective observational clinical study conducted with 123 eyes of 63 patients. A meticulous clinical examination was performed, and data was documented in all the cases. Patients on known systemic atopy and antiallergic therapy were excluded from the study. Eyes with a clinical diagnosis of VKC were segregated based on Bonnini’s grading system. A treatment protocol was created depending on the grade of VKC. Therapeutic responses were documented at 3 weeks, 3 months, 6 months, 12 months, and 24 months. Grading of the eyes was performed in each visit.

Results:
The mean age of the patients was 8.85 years with a standard deviation of 4.48 years. Males were predominant, and 95.24% had bilateral manifestation. The palpebral component was the most common form of manifestation. Itching was the most common manifestation, followed by congestion, discharge, and papillae in a decreasing order. Also, 68% of patients were in grade 2, 14% in grade 3, 12% in grade 1, and the rest were in grade 4. Following the treatment protocol, 70% showed signs of significant improvement in grade by the end of 6 weeks, reaching 90% at the end of 6 months (P = 0.074) and 92% at the end of 12 months (P = 0.002). Also, 52.4% versus 77.8% of patients had no recurrence in the pre- versus posttreatment protocol and it was statistically significant (P = 0.001).

Conclusion:
Grading of VKC gives a clear evaluation of the severity and progression of the condition. Besides, significant improvement in the grades was observed with fewer incidences of recurrences following execution of the therapeutic protocol. Hence, it is essential to maintain a treatment protocol in our clinical practice to provide grade-based therapy and monitor accurate changes in the clinical condition.
Relationship between Aedes aegypti indices with perception and practices of dengue in an urban community of Mysore
Authors: Sunil B. C. , Kulkarni Praveen , Renuka N. , Murthy M. R. Narayana 
Published: July 2022

Background:
Dengue is one of the major public health problems in the world. Currently, dengue is endemic in more than 100 countries of Asian pacific region. Prevention and control of dengue is largely influenced by the level of awareness and the preventive practices people undertake. In this background, the present study was conducted to find out the relationship between Aedes aegypti indices and perception and practices regarding dengue and its prevention.

Materials and Methods:
This cross-sectional study was conducted in an urban slum for the period of 1 year among 270 households selected by probability proportionate to size technique. Data were collected by structured questionnaire with details on sociodemographic characteristics, perception, and practices adopted by people toward dengue and its prevention. Larva survey was conducted by observing for the A. aegypti larvae in the containers within and outside the households.

Results:
Among 270 households included in the present study, overall, 70 (25.9%) and 96 (35.6%) of the study respondents were having poor and average levels of perception. 22 (8.1%) and 163 (60.4%) of respondents had poor and average levels of dengue prevention practices, respectively. Household index, container index, and Bretau's index (BI) were 5.52%, 6.05%, and 8.51%, respectively. Median perception and practice scores among the respondents of households with larva breeding were significantly lower as compared to the ones without larva breeding.

Conclusion:
Majority of the study participants had poor to average levels of perception and practices regarding dengue and its prevention. These scores were significantly lower among households with active larva breeding.
A retrospective analysis of characteristics and perioperative outcomes of rhino-orbital-cerebral mucormycosis in COVID-19 patients posted for surgical debridement under general anaesthesia in a tertiary care hospital
Authors: Sreehari K. G. , Jamuna T. , Gouripeddi Sreenivas , Sunil N. , Venkataramanaiah C. 
Published: July 2022

Abstract

Background:
Rhino-orbital-cerebral mucormycosis (ROCM) has increasingly been reported in patients with severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) disease-2019 (COVID-19) from India.

Methods:
A retrospective study was done to analyse the demographic and clinical characteristics, treatment received for COVID-19 during the hospital stay, perioperative outcomes in ROCM patients posted for surgical debridement under general anaesthesia from May 2021 to July 2021 at our tertiary care teaching hospital in Tirupati, southern India.

Results:
Overall, 350 patients with ROCM and COVID-19 had undergone surgical debridement under general anaesthesia Mucormycosis was predominantly seen in males (65.7%). Majority of the cases (40%) were in the age group between 41-50 years. Common comorbidities were: pre-existing diabetes mellitus (DM) (70%), hypertension (32%), new-onset DM/hyperglycaemia (22%) and cardiac disease (8%). The most common sites involved in mucormycosis were the nose and paranasal sinuses (100%) followed by rhino-orbital (63.1%). A history of hospital admission for COVID-19 management was evident in 89.7%; 40.7% of the patients had received oxygen therapy during their hospital stay. The use of corticosteroids for the treatment of COVID-19 was noted in 73.2%. The types of surgical procedures done were: functional endoscopic sinus surgery (FESS) (98.5%) and neurosurgery procedures (3.4%). Revision surgery was performed in 18.5% of the cases. Perioperative complications observed were anticipated difficult intubation during pre-operative airway assessment 35.7%, intraoperative hypertension 8.5%. A patient had developed intraoperative cardiac arrest, post-operative-delayed recovery and needed ventilator requirement. Outcomes of ROCM patients associated with COVID-19 were: discharged 91.7%, death 8.3%.

Conclusions:
Diabetes mellitus, rampant use of corticosteroids in the treatment of COVID-19 appear to have contributed to the development of ROCM. Early diagnosis, a thorough pre-operative evaluation, surgical debridement are likely to result in better prognosis in COVID-19 patients with ROCM.
Orthodontic Treatment Needs of Adolescents in North-Western Nigeria Using the Index of Orthodontic Treatment Needs
Authors: Adeyemi T. E. , Aikins E. A. , Yemitan T. A. 
Published: July 2022

Introduction:
Orthodontic treatment planning within a public health system needs information on the need for orthodontic treatment within the population. It is imperative to have epidemiological data from which the need for orthodontic care in any region can be estimated. The present study, therefore, aimed to determine the orthodontic treatment need of adolescents in North-Western Nigeria.

Materials and Methods:
A descriptive cross-sectional study was conducted of 200, 12–15-year-old schoolchildren in Northern Nigeria using the Dental Health Component (DHC) and Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN). A structured interview and clinical examination were used to assess the subjects. Descriptive statistics and χ2 tests were used for data analysis with statistical significance set at P < 0.05.

Results:
There were 19.5% with definite need (DHC 4 or 5) for orthodontic treatment and 15.5% borderline need (DHC 3). The AC scores demonstrated that 1% of the studied subjects had a definite need (AC 8–10) for orthodontic treatment and 24% borderline need (AC 5–7). A statistically significant relationship between AC and DHC of IOTN among the study population (P < 0.05) was observed.

Conclusion:
Using the DHC of the IOTN, the proportion of subjects estimated to have great and very great treatment needs (grades 4 and 5) was 19.5%. However, only 1% of individuals were in need (grades 8–10) of orthodontic treatment according to the AC. Awareness about orthodontic treatment should be a part of public health planning for this region.
Burden and Management of Urolithiasis in a Newly Established Urology Unit of a Tertiary Hospital
Authors: Abdullahi Muzzammil , Kura Muhammed Mustapha , Salihu Makama Baje 
Published: July 2022

Background:
Urolithiasis is the third most common affliction of the urinary tract that constitutes a significant burden on the practice of urology. The incidence and prevalence of urolithiasis are increasing globally.

Objective:
To assess the burden, presentation, and management of urolithiasis in our hospital.

Materials and Methods:
It was a retrospective descriptive study of patients who were managed for urolithiasis at the urology unit of our hospital between January 2015 and December 2019. Ethical approval was obtained. Patients' bio-data, clinical features, treatment, and complications were extracted from their medical records and entered into the proforma. The generated data were analyzed using SPSS version 21.0.

Results:
Complete medical records of 68 patients were retrieved. This constituted about 40.6% of urologic patients managed within the period. Their age ranged from 9 to 86 years with the mean age of 43.2 years ± 8.8 standard deviation (SD). The M F was 1.8:1. Students were predominant (29.4%). Others were traders, housewives, civil servants, and farmers. The majority of the patients presented with flank pain (64.7%) and mostly had renal pelvis stone (35.3%). Others had bladder stone (16.2%) and stag horn calculus (11.8%). Nearly all our patients were treated by open surgeries (98.5%) and most (72.1%) did not have any postoperative complication.

Conclusion:
Urolithiasis constitutes significant workload for urologists in our environment predominantly affecting young and middle-age males. The stones were predominantly in the upper urinary tract with a significant number of stag horn calculi. Despite the non-availability of uroendoscopic facilities, the majority of our patients had good outcome.
Competencia oral y ansiedad: entrenamiento y eficacia en estudiantes universitarios
Authors: Maldonado Miguel A. , García García Andrés , Armada Crespo José Manuel , Alós Francisco José , Moreno Osella Eliana M. 
Published: July 2022

Introducción: la importancia de las competencias comunicativas y el manejo de la expresión oral en la formación Universitaria viene recogida en distintos planes de estudios y asignaturas dentro del Espacio Europeo de Educación Superior. Estas competencias son prioritarias para el desarrollo profesional en distintos campos e implican el aprendizaje de una serie de habilidades que van desde el manejo de vocabulario adecuado, la organización del discurso y de la información, hasta la regulación de la ansiedad que suele provocar el hecho de hablar en público. Los objetivos del presente estudio son; 1 favorecer el aprendizaje de competencias orales y disminuir la ansiedad a hablar en público en estudiantes universitarios; 2. comprobar y comparar los efectos de las estrategias educativas y psicoeducativas aplicadas. Metodología: para ello se aplicó un experimento (pre-post) en el que se implementaron tres estrategias diferentes en una muestra de 51 participantes divididos en tres grupos, (grupo de intervención mediante taller; grupo de intervención mediante debate; grupo control). Resultados: se observan resultados positivos y eficaces en la mejora de competencias orales y confianza para hablar en público, así como una reducción de la ansiedad tras las distintas intervenciones. Discusión: estos hallazgos son relevantes para su implementación en programas específicos de mejora de las competencias comunicativas en el alumnado. Conclusiones: las intervenciones educativas y psicoeducativas mejoran la competencia oral y la ansiedad, siendo la aplicación de un taller de comunicación más efectiva que otras estrategias, consiguiendo generar un clima de participación activa en el aula.