bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Stay Back Technique” of scleral fixation of decentred intraocular lensbag complex
Authors: Shekhar Madhu , P Ramya Menon 
Published: July 2022

Background:
Even though rare, posterior chamber intraocular lens (IOL)-bag complex dislocation is a serious complication following cataract surgery. Preoperative trauma or zonular weakness, capsule contraction syndrome, and surgical or postoperative trauma to the zonules have been proposed as the causative mechanism. Various risk factors have been described such as pseudoexfoliation (PXF), aging, high myopia, uveitis, trauma, previous vitreoretinal surgery, retinitis pigmentosa, diabetes mellitus, and connective tissue disorders, among which PXF is the most common risk factor. The management of late IOL-bag complex dislocation poses a challenge even for an experienced surgeon.

Purpose:
To demonstrate the “stay back technique” of scleral fixation of decentered IOL-bag complex.

Synopsis:
We demonstrate three cases of scleral fixation of anteriorly dislocated IOL-bag complex. The first two cases are traumatic subluxation of IOL-bag complex and the third case is late decentration of both the haptics in a case of PXF. A scleral flap/groove is made along the area of haptic dislocation. Dislocated haptic is allowed to stay in the same position and one arm of 9-0 prolene suture is passed between the optic-haptic junction and docked in a 26-gauge needle passed beneath the scleral flap, 2 mm from the limbus. Haptic is then repositioned beneath the iris and the second arm of prolene suture is passed above the haptic. Sutures are pulled underneath the scleral flap and secured with 5 to 6 knots.

Highlights:
This is a simplified approach of scleral fixation of anteriorly dislocated IOL-bag complex. This novel technique gives better visualization of the optic-haptic junction during the passage of prolene suture.

Online Video Link:

https://youtu.be/vKQCR0fow68
Genetic testing in four Indian families with suspected Stickler syndrome
Authors: Kandeeban Suganya , Kandale Kaustubh , Periyasamy Porkodi , Bhende Muna , Bhende Pramod , Mathavan Sinnakaruppan , Sarangapani Sripriya 
Published: July 2022

Purpose:
Stickler syndrome is associated with the development of rhegmatogenous retinal detachment (RRD), and often presents with ocular, auditory, skeletal, and orofacial abnormalities. Molecular analysis has proven effective in diagnosis, confirmation and classification of the disease. We aimed to describe the utility of next-generation sequencing (NGS) in genetic analysis of four Indian families with suspected Stickler syndrome.

Methods:
The index cases presented with retinal detachment with family history. Genetic analysis in the index case was performed by next-generation sequencing of inherited retinal degeneration genes, and validated by Sanger sequencing followed by co-segregation analysis in the other family members.

Results:
Twenty patients were included for the genetic analysis (15 males and 5 females from four families). Clinical details were available for 15 patients (30 eyes). Fourteen eyes (11 patients) developed RRD. In the 16 eyes without RRD, 8 underwent barrage laser to lattice degeneration and 8 were under observation. Disease segregating heterozygous mutations with pathogenic/likely pathogenic effect was identified in COL2A1 (c.4318-1G>A, c.141G>A, c.1221+1G>A for 3 families) and COL11A1 (c.1737+1 G>A for 1 family) gene. In addition to the mutation in the COL2A1 gene, a pathogenic heterozygous variant associated with risk for arrhythmogenic right ventricular cardiomyopathy (ARVC) was identified in one member.

Conclusion:
NGS testing confirmed the presence of the causative gene for Stickler syndrome in the index case followed by evaluation of family members and confirmation of genetic and ocular findings. We believe that this may be the first such report of families with RRD from India.
Clinical and visual electrophysiological characteristics of vitelliform macular dystrophies in the first decade of life
Authors: Padhy Srikanta Kumar , Parameswarappa Deepika C , Agarwal Komal , Takkar Brijesh , Behera Shashwat , Panchal Bhavik , Ramappa Muralidhar , Padhi Tapas Ranjan , Jalali Subhadra 
Published: July 2022

Purpose:
To evaluate patterns of pediatric vitelliform macular dystrophy (PVMD).

Methods:
This is a retrospective analysis of Indian children with vitelliform macular dystrophy (VMD) presenting within the first decade of life. Records were evaluated for clinical findings, family screening, and investigative findings including optical coherence tomography (OCT), fundus autofluorescence (FAF), full-field electroretinogram (ERG) and electrooculogram (EOG). Electrophysiology was scrutinized and audited for acquisition and interpretation errors. Findings on follow-up were also recorded.

Results:
46 eyes of 24 patients were included. Mean age at presentation was 7.17 ± 2.17 years. Mean follow-up duration was 1.55 ± 1.69 years. Best disease was the commonest type of VMD detected (21 patients), while autosomal recessive bestrophinopathy was seen in three cases. Mean logMAR BCVA was 0.364 which decreased to 0.402 on follow-up. Hyperopia was noted in 29 out of 46 eyes (mean being +3.87 D, range ebing +0.75 to +8.75 D). Four eyes of four children had choroidal neovascular membrane at presentation, while another child developed while in follow-up. Solid type subretinal deposit was the commonest OCT finding (n = 29/38) and central hyper FAF was the commonest pattern (n = 18/32). EOG was available for review in 32 eyes, but was unreliable in 11 eyes. Seven eyes demonstrated complete absence of light rise on EOG.

Conclusion:
PVMD can present in advanced forms. Progression to complications with loss of visual acuity can happen within the first decade of life. EOG shows grossly suppressed waveforms in the light phase in a large number of such children.
Retinitis pigmentosa in Laurence-Moon-Bardet-Biedl syndrome in India: Electronic medical records driven big data analytics: Report II
Authors: Parameswarappa Deepika C , Das Anthony V , Thakur Pratima S , Takkar Brijesh , Multani Prabhjot K , Padhy Srikant K , Doctor Mariya B , Agarwal Komal , Jalali Subhadra 
Published: July 2022

Purpose:
To describe the clinical presentation and demographic distribution of retinitis pigmentosa (RP) in Laurence–Moon–Bardet–Biedl (LMBB) syndrome patients.

Methods:
This is a cross-sectional observational hospital-based study wherein 244 patients with RP in LMBB syndrome presenting to our hospital network between March 2012 and October 2020 were included. An electronic medical record database was used for data retrieval.

Results:
There were 244 patients in total, with a hospital-based prevalence rate of 0.010% or 1000/100,000 population. The mean and median age of patients was 15.22 ± 7.56 and 14 (IQR: 10–18.5) years, respectively, with the majority being in the age group of 11–20 years (133/244 patients; 54.50%). Males were more commonly affected (164 patients; 67.21%), and the majority (182 patients; 74.59%) were students. All 244 patients (100%) complained of defective central vision at presentation. More than one-fourth of the patients had severe visual impairment to blindness at presentation. Prominent retinal feature at presentation was diffuse or widespread retinal pigment epithelial degeneration in all patients.

Conclusion:
Patients with RP in LMBB syndrome present mainly in the first to second decade of life with severe visual acuity impairment to blindness early in life. It is important to rule out LMBB syndrome in early-onset RP with central visual acuity impairment. On the contrary, all patients diagnosed or suspected with LMBB syndrome systemic features at physician clinic should also be referred for ophthalmic evaluation, low vision assessment, rehabilitation, and vice versa.
Retinitis pigmentosa in Usher syndrome in India: Electronic medical records driven big data analytics: Report III
Authors: Parameswarappa Deepika C , Das Anthony Vipin , Doctor Mariya Bashir , Natarajan Ramya , Agarwal Komal , Jalali Subhadra 
Published: July 2022

Purpose:
To describe the clinical presentation and demographic distribution of retinitis pigmentosa (RP) in patients with Usher syndrome (USH).

Methods:
This is a cross-sectional observational hospital-based study including patients presenting between March 2012 and October 2020. In total, 401 patients with a clinical diagnosis of USH and RP in at least one eye were included as cases. The data were retrieved from the electronic medical record database. For better analysis, all 401 patients were reclassified into three subtypes (type 1, type 2, and type 3) based on the USH criteria.

Results:
In total, there were 401 patients with USH and RP, with a hospital-based prevalence rate of 0.02% or 2/10,000 population. Further, 353/401 patients were subclassified, with 121 patients in type 1, 146 patients in type 2, and 86 patients in the type 3 USH group. The median age at presentation was 27 years (IQR: 17.5–38) years. There were 246 (61.35%) males and 155 (38.65%) females. Males were more commonly affected in all three subtypes. Defective night vision was the predominant presenting feature in all types of USH (type 1: 43 (35.54%), type 2: 68 (46.58%), and type 3: 40 (46.51%) followed by defective peripheral vision. Patients with type 2 USH had more eyes with severe visual impairment.

Conclusion:
RP in USH is commonly bilateral and predominantly affects males in all subtypes. Patients with USH and RP will have more affection of peripheral vision than central vision. The key message of our study is early visual and hearing rehabilitation in USH patients with prompt referral to otolaryngologists from ophthalmologists and vice versa.
Coloboma associated retinal detachment: Anatomical and functional results in the era of microincision vitrectomy surgery with an evaluation of risk factors for a recurrence
Authors: Shenoy Pratik , Katre Prashant S , Kohli Gaurav M , Sen Alok , Agarwal Manisha 
Published: July 2022

Purpose:
To analyze the anatomical and visual outcomes of microincision vitrectomy surgery (MIVS) with silicone oil tamponade in eyes having coloboma-related retinal detachment (RD) and evaluate the risk factors for recurrence of RD.

Methods:
This was a retrospective, multicentric analysis of eyes having coloboma RD undergoing MIVS with silicone oil tamponade between March 2010 and July 2018.

Results:
We evaluated 148 eyes of 144 patients. The mean age of presentation was 17.4 ± 9.8 years (range: 2–65 years) and the mean follow-up duration was 13.1 ± 13.8 months (range: 3–84 months). The single operation success rate was 88.5% (131 eyes), with an overall successful outcome achieved in 90.5% (134 eyes). Recurrence of RD occurred in 17 eyes (11.5%) over a mean duration of 2.59 ± 3 months. The risk of recurrence was found to be higher in eyes where relaxing retinectomy (RR) was performed (odds ratio [OR]: 3.22; P = 0.05). A statistically significant improvement in vision was noted in the majority of cases from logMAR 1.85 ± 0.34 preoperatively to logMAR 1.33 ± 0.6 post-surgery (P = 0.002).

Conclusion:
MIVS with silicone oil tamponade provided an anatomical success rate of 90.5% in eyes with coloboma RD with a significant improvement in visual acuity. Eyes in which RR was performed were susceptible to higher rates of re-detachment.
A bibliometric analysis of research on genetic retinal diseases done in India
Authors: Kumaragurupari Ravichandran , Mishra Chitaranjan 
Published: July 2022

Purpose:
To conduct a bibliometric analysis of research on genetic retinal diseases (GRD) done in India published from 2011 to 2020 in peer-reviewed journals, and assess the productivity, trends in journal choice, publication types, research funding, and collaborative research.

Methods:
We searched PubMed for articles indicating both vision-related content and author affiliation with an Indian research center. We identified research collaborations and classified articles as reporting basic science, clinical science, or clinically descriptive research. Impact factors were determined from Journal Citation Reports for 2015.

Results:
The total number of published articles that were retrieved from 2011 to 2021 was 341. During the 10 years of study, the annual output of research articles has nearly doubled, that is, from 21 in 2011 to 44 in 2021. A total of 298 (87%) articles were published in international journals, and 149 (42%) articles in vision-related journals had an impact factor. A total of 224 (65%) articles came from six major eye hospitals. Clinical science articles were most frequently (86%) published, whereas basic science was the least (14%). The diseases on which the maximum and the minimum number of articles were published were retinoblastoma (n = 82,24%) and Stargardt disease (n = 3, 0.9%), respectively.

Conclusion:
This bibliometric study provides a broad view of the current status and trends in the research on GRD done in India and may help clinicians, researchers, and policymakers to better understand this research field and predict its dynamic directions.
An Analysis of Proposed Etiological Factors for Sudden Spike in Mucormycosis Infection During COVID-19 Pandemic at a Tertiary Hospital of North India
Authors: Singh Akhil Pratap , Agrawal Prabhat , Kumar Vikas 
Published: July 2022

Aim:
The aim is to analyze various possible etiological factors for the sudden outbreak of mucormycosis.

Methods:
A prospective observational study involving consecutive individuals with proven mucormycosis was undertaken at a tertiary care teaching hospital in North India from May 2021 to July 2021. A total of 88 patients with mucormycosis were studied for the demographic profile, COVID-19 status, various risk factors, COVID-19 immunization status, clinical staging of disease, and outcome of patients.

Results:
Out of 88 patients, 54 (61%) were males and 34 (39%) were females. The mean age of male patients was 50.5 ± 13.8 and female patients was 52.1 ± 14.1. Most of the patients were in stage two, i.e., 45 (51.1%) and 26 (29.5%) in stage three of the disease. Past history of diabetes was present in 49 (55%) patients. Forty-one (46.6%) patients had documented Reverse Transcription Polymerase Chain Reaction (RTPCR) reports in favor of COVID-19 and others had clinical features consistent with COVID-19. Only 1% of patient took COVID-vaccination. Of the total 88 patients, 42 (47%) were on oxygen therapy, 72 (81%) had history of blood transfusion, and 48 (54%) were given steroids.

Conclusions:
No conclusive etiological factor was identified although few recommendations are suggested for prevention, early diagnosis, and prompt management of mucormycosis in hospitalized COVID-19 patients.
Leiomyosarcoma causing obstructive uropathy and acute renal failure
Authors: Radhika Y. , Reddy Pranathi , Rewatkar Nitin Ashok 
Published: July 2022

Abstract
A 41-year-old nulliparous woman presented to the hospital with lower abdominal pain for 15 days and constipation since 1 week and acute retention of urine for 3 days. Ultrasound revealed enlarged uterus with a large posterior wall fibroid with degenerative changes and bilateral mild hydro ureteronephrosis and MRI pelvis with contrast showed 17 × 10 × 12 cm pelvic mass along the posterior wall of the uterus with cystic degeneration and necrosis minimal haemorrhage with multiple fibrotic strands. Enlarged bilateral external internal, right iliac and lymph nodes noted. Laboratory evaluation revealed an elevated urea 101 mg/dl and creatinine levels 9.4 mg/dL with normal myoglobin levels (39 ng/mL). The patient was haemodynamically stable with serum electrolytes and ABG normal. After taking a nephrologist and urologist opinion and proper counselling for exploratory laparotomy +/- hysterectomy, proceeded with total abdominal hysterectomy. Immediate improvement of renal parameters and reversal of renal failure was noted and
Prevalence of COVID-19 Infection Among Asymptomatic Ophthalmic Surgical Patients Undergoing Ophthalmic Procedures at University of Abuja Teaching Hospital, Gwagwalada, Abuja
Authors: Muhammad Rilwan Chiroma , Bisiriyu Oluwatosin Emmanuel 
Published: July 2022

Purpose:
The aim of this article is to determine the prevalence of COVID-19 infection among asymptomatic ophthalmic patients undergoing ophthalmic procedures at University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria.

Materials and Methods:
A retrospective review of records of all consecutive ophthalmic patients who had pre-operative reverse transcriptase–polymerase chain reaction testing for COVID-19 screening before an elective surgical procedure between July 2020 and January 2021 was done. A semi-structured questionnaire was used to extract the following information from eligible patients’ case records: age, gender, results of COVID-19 tests, type of ophthalmic surgical procedure done, and ocular examination findings and diagnosis.

Results:
Out of the 150 patients scheduled for surgical procedures within the study period, only 14 (9.3%) returned a positive test result. These patients had their surgeries postponed and were asked to return with negative results 2 weeks later. No association was found between gender, age, or type of surgical procedure and the prevalence of COVID-19 infection.

Conclusion:
This study found that 1 in 11 patients scheduled for elective ophthalmic procedure was a carrier of COVID-19 infection, highlighting the need for regular pre-operative testing in order to reduce the risk of spread of infection to healthcare workers and other hospitalized patients.
Prevalence and Antifungal Susceptibility of Candida Species Isolated from HIV Seropositive Women Attending Gynecological Clinic in Kaduna, Nigeria
Authors: Taingson Matthew C. , Ige Oluwafemi , Adze Joel , Bature Stephen , Durosinlorun Amina Mohammed , Mohammed Caleb , Abubakar Amina , Airede L. R. 
Published: July 2022

Context:
Candidal vulvovaginitis causes discomfort and increased HIV infectivity because viral shedding is increased among these women.

Aim:
To determine the prevalence of Candida infections among HIV seropositive women in the special treatment (STC) and the gynecological clinics of Barau Dikko Teaching Hospital and the antifungal susceptibility patterns of the isolates.

Study Design:
We conducted a cross-sectional study among HIV-positive women accessing care in our hospital.

Methods and Materials:
A total of 312 high vaginal swabs (HVS) were collected from HIV seropositive women with clinical features of vulvovaginitis between February and July 2019. Wet mount preparations in potassium hydroxide (KOH) and Gram stained smears were performed directly on specimens. Cultures for Candida species were performed using Sabouraud dextrose agar (SDA) (Oxoid, UK) at room temperature (28°C) and in the incubator at 37 °C. Antifungal susceptibility of the Candida species to amphotericin B, clotrimazole, fluconazole, and miconazole was assessed using the ATB FUNGUS 4 test kits (bioMerieux, Marcy l'Etoile, France).

Statistical Analysis Used:
Data collected were analyzed using SPSS, Version 23.

Results:
Out of the 312 HVS cultured, 40 yielded Candida species giving a point prevalence of 12.8% in the study population. Candida species isolated from HVS specimens were Candida tropicalis (n = 14, 4.5%), Candida glabrata (n = 13, 4.2%), Candida krusei (n = 11, 3.5%), Candida dubliniensis (n = 1, 0.3%), and others C. glabrata/C. tropicalis (n = 1, 0.3%). Susceptibility of the isolates to antifungal agents ranged from 27.5% to 52.5%. Amphotericin B was the best performing antifungal agent with a sensitivity of 52.5%.

Conclusion:
The prevalence from our study was low compared to other studies among HIV seropositive women.
Diphtheria Outbreak During Covid-19 Pandemic in Katsina, North-Western Nigeria
Authors: Ibrahim Olayinka R. , Lawal Ibrahim M. , Mohammed Bashir , Abdullahi Suleiman Bello , Bello Surajudeen O. , Issa Amudalat , Sanda Abdallah , Suleiman Bello M. , Ibrahim Mu'uta 
Published: July 2022

Context:
The impact of coronavirus disease 2019 (COVID-19) pandemic on vaccine-preventable diseases, including diphtheria, may hamper the previous gains made in the eradication of the disease.

Aims:
We report the epidemiological profile, clinical features, laboratory findings, and hospitalization outcomes amongst cases of diphtheria managed at Federal Medical Centre, Katsina, Nigeria during the first wave of COVID-19 pandemic.

Settings and Design:
This was a retrospective review of cases of diphtheria managed between July and December 2020.

Methods and Material:
We extracted the clinical (socio-demographics, clinical features, and hospitalization outcomes) and laboratory findings (full blood counts, electrolytes, urea and creatinine) from the record of the children.

Statistical Analysis Used:
Using SPSS, we carried out a descriptive analysis and applied binary logistic regression to determine factors associated with death. Level of statistical significance was set at P < 0.05.

Results:
A total of 35 cases of diphtheria were admitted and managed from 1 July to 31 December 2020. The mean age of the children was 7.6 ± 3.1 years. Males were 15 (42.9%). There were 24 deaths (case fatality of 68.6%). Clinical findings were comparable between survivors and non-survivors except the bull neck, which was more common among non-survivors (P = 0.022). The median duration of hospitalization was shorter in those that died (P = 0.001). The age, sex, immunization status, leukocytosis, and biochemical features of renal impairments were not predictive of deaths. Prescence of bull neck was predictive of death (adjusted odds ratio 2.115, 95% CI 1.270, 3.521).

Conclusions:
The study shows a high number of cases of diphtheria over a short period of six months with high mortality. Amongst the clinical and laboratory variables, only presence of bull neck was predictive of death.
Efficacy of Ultrasonography in the Diagnosis of Dento-Maxillofacial Swellings among an Urban Population in Nigeria
Authors: Adamu Yahuza Mansur , Hassan Maryam Olaitan , Abba Mohammed , Amole Olushola , Garba Idris , Dare Akintade 
Published: July 2022

Context:
Ultrasonography as an imaging modality in dentistry has been explored in recent years. It is particularly useful in the examination of superficial structures where the use of a high frequency linear transducer produces clearer sonographic images.

Aim:
To evaluate the efficacy of ultrasound when compared with other known diagnostic examinations.

Materials and Methods:
This was a prospective cross-sectional study involving patients with maxillofacial swellings in Aminu Kano Teaching Hospital. They were classified as malignant neoplasms, benign cysts, abscesses and infections and lymphoma, according to clinical, radiographic and ultrasound and diagnosis independently. The findings from these methods were then compared to the gold standard histologic findings. Chi-square test, Pearson contingency coefficient, and 2 x 2 contingency table were used in evaluating the diagnostic accuracy, sensitivity as well as the specificity of the examinations.

Results:
A total of 36 patients comprising 21 males and 15 females with mean age of 34.97 years were recruited. Diagnostic accuracy of ultrasound was 50% in the diagnosis of malignant tumors, 95.8% in benign cystic swellings, 50% in abscesses and infections, and 100% in lymphoma. Significant relationship exists between ultrasonography with histology, clinical and radiographic diagnosis with a contingency coefficient of 0.833, 0.759, and 0.798, respectively. Overall, the accuracy, sensitivity and specificity of ultrasound was 86.1%, 90.3%, and 60%, respectively.

Conclusion:
Ultrasonography provides accurate imaging of the maxillofacial region and provides information about the pathological characteristic of lesion, its extent, and relationship with the surrounding structures. Inclusion of ultrasonography to the clinical and histopathological examinations increases the accuracy of orofacial swelling diagnosis.