bluuebunny/crossref_metadata_2025_split huggingface dataset:
Le mur entre deux fossés
Authors: Roquefère Anne-Sophie 
Published: December 2022

Evoquer la modestie, la retenue, n’est-ce pas aussi nommer le doute comme espace de possibles et de flou entre soi et l’autre, et ce qui environne ? Un espace de coexistence de mouvements distincts ? Dans le doute comme dans l’humilité, n’est-on pas agi par cette impression que ce qui fait sens pour soi ne le fait pas nécessairement pour l’autre sans pour autant chercher nécessairement à (s’) imposer ? En l’absence de réserve, de possibilité d’effacement, l’espace semble se réduire, s’accaparer. Il n’y a plus de flou ; tout doit s’entériner. Il ne paraît plus possible d’advenir au contact de…, tout est préalablement constitué. Le texte qui suit s’emploie sans retenue à faire l’éloge du doute et de l’humilité.
Morphological and functional retinal changes in neovascular age-related macular degeneration treated with intravitreal bevacizumab
Authors: Damkondwar Deepali R , Srinivasan Ramyaa , Raman Rajiv , Kulothungan Vaitheeswaran , Sharma Tarun 
Published: December 2022

Purpose:
This study was conducted to determine the morphological and functional retinal changes in patients with neovascular age-related macular degeneration (nAMD) treated with intravitreal bevacizumab 1.25 mg.

Methods:
This was a prospective, nonrandomized, interventional study. Eighteen eyes of 18 subjects with nAMD were treated with intravitreal bevacizumab (1.25 mg) injection. Subjects underwent complete ophthalmic evaluation which included visual acuity, slitlamp examination, tonometry, binocular ophthalmoscopy, optical coherence tomography (OCT), and MP1 microperimetry before the intravitreal injection and the follow-up at 1 and 3 months. Test of significance such as Chi-squared test, paired ttest and oneway analysis of variance (ANOVA) linear trend were used to compare the pre- and post-anti-VEGF outcomes. Intraclass correlation was done to assess the intra observer variability.

Results:
Mean retinal sensitivity had increased from 3.77 ± 3.13 dB at baseline to 4.93 ± 2.42 dB at 3 months (P = 0.05). Visual acuity improved from 0.62 ± 0.36 at baseline to 0.52 ± 0.36 at 1 month and 0.48 ± 0.34 at 3-month followup, but overall change was not significant (P = 0.40). There was a significant reduction in central foveal thickness (CFT) from 274.61 ± 117.95 at baseline to 179.83 ± 84.18 at 1 month and 179.00 ± 126.55 at 3-month follow-up (P = 0.013).

Conclusion:
Intravitreal bevacizumab (1.25 mg) injection in nAMD improves retinal function, quantified by retinal sensitivity, scotoma characteristics, fixation stability by MP 1 microperimetry and morphological parameters quantified by CFT in SDOCT. These changes show the effectiveness of treatment with intravitreal bevacizumab in nAMD.
Clinical outcome and course of Tenon’s patch graft in corneal perforation and descemetocele
Authors: Kusumesh Rakhi , Ambastha Anita , Singh Ankita , Kumari Divya , Mohan Nilesh , Sinha Bibhuti P , Arya Lalan K 
Published: December 2022

Purpose:
To assess the efficacy and clinical outcome of Tenon’s patch graft (TPG) in corneal perforation and descemetocele.

Methods:
In this retrospective study, medical records of 83 patients (85 eyes) who underwent TPG for corneal perforation (58, 68%) or descemetocele (27, 32%) between July 2018 and October 2021 were reviewed. Clinical examination and anterior segment optical coherence tomography (AS-OCT) were performed on every follow-up visit. Anatomical success was considered as the restoration of the structural integrity with the formation of scar and anterior chamber (AC).

Results:
The mean size of the corneal lesions (corneal perforation or descemetocele) was 4.20 ± 1.01 mm. The mean follow-up period was 9.2 ± 5.48 months. The common underlying etiologies were infectious keratitis in 48% and autoimmune disorders in 35% of cases. TPG successfully restored the globe integrity in 74 (87%) eyes (83% in perforation and 96% in descemetocele). Anatomical failure occurred in 11 eyes (13%). The failures were due to graft dehiscence (8 eyes), graft ectasia (1 eye), and scarring with flat AC (2 eyes). The median time to epithelialization and scar formation were 3 and 15 weeks, respectively. Logistic regression analysis showed few predictors for a successful outcome: descemetoceles, noninfective causes, viral keratitis in infectious etiology, and paracentral or peripheral lesions.

Conclusion:
TPG can be considered an effective and inexpensive treatment for restoring the structural integrity in the eyes with perforations and descemetoceles, particularly when the donor tissue is unavailable. AS-OCT is a valuable noninvasive tool for monitoring the graft status.
“Trigger happy” visual field: Ten pointers
Authors: Mansoori Tarannum 
Published: December 2022

Background:
While performing the visual field test, some patients press the response button, at random and not in response to seeing a stimulus, resulting in a classical trigger happy visual field.

Purpose:
This can be identified by 10 pointers as shown in this single field analysis printout of Humphrey visual field (HVF), 24-2, Swedish interactive threshold algorithm (SITA) standard test of the right eye. These points are useful teaching points for the students to recognize.

Synopsis:
The video describes classical 10 points, which can be identified in an HVF 24-2 printout in a patient with high false-positive (FP) error.

Highlights:
The FP index is the most useful of the reliability indices. In SITA strategy, the FP rate is based upon the assessment of patient’s reaction time over the entire course of the test, and hence is not calculated until the test is completed. Therefore, it is important for the perimetrist to be alert to recognize the signs early during the test, such as high fixation los s (despite good fixation as seen on screen monitor) and unusually high retinal sensitivity values (up to 50 dB), and reinstruct the patient. If the test is completed, it should be repeated. This is important as the FP rates >15% are associated with compromised test results and are automatically removed from the glaucoma progression analysis.

Video link:

https://youtu.be/UMVw2vkzdfQ

Key word: HVF, False positive, white scotoma
Three-piece intraocular lens in the sulcus with optic capture in patients with mild to moderate zonular weakness in exfoliation
Authors: Bhaskaran Jayaprasad , Narayanan Smita , Balamurali Rani 
Published: December 2022

Purpose:
To study the use of sulcus placement of a 3-piece intraocular lens (IOL) with optic capture in patients with exfoliation with zonular weakness.

Methods:
Data on all exfoliation patients who had direct or indirect evidence of zonular weakness and had a 3-piece IOL implanted in the sulcus with optic capture over a 5-year period between January 2017 and January 2022 were included in this retrospective case series.

Results:
The study comprised of 35 eyes of 35 patients. The mean age at surgery of the 20 male and 13 female patients was 75.21 years ± 5.74 (standard deviation (SD)). The mean pupillary diameter was 5.77 ± 2.23 mm (range: 10 to 3 mm). A capsular tension ring (CTR) was used in 17 cases and iris hooks as a pupil-expanding device were used in 15 cases. No patients had an increase in inflammation after surgery and there were no late subluxation or dislocation of “in the bag” posterior chamber IOL or major complications. There was a significant improvement in visual acuity.

Conclusion:
The sulcus placement of 3-piece IOL with optic capture is the ideal technique in patients with clinical or intraoperative evidence of mild to moderate zonular weakness. It may also be more appropriate in relatively younger patients (in the fifties or sixties) with exfoliation with no overt zonulopathy to prevent late subluxation or dislocation of “in the bag” IOL.
Snowball-associated ocular injury – An unusual presentation
Authors: Sanjay Srinivasan , Durgalaxmi Modak 
Published: December 2022

Background:
Snow ball associated ocular injuries are rare. We present the 1st case of a snow ball injury reported in India with symptoms occurring after 10 days.

Purpose:
To highlight the fact that symptoms can occur many days after the injury. The injuries can cause structural damage to ocular structures and can be permanent.

Synopsis:
A 25-year-old Asian Indian female presented with increased redness and blurring of vision of a day’s duration. She had been playing in the snow and had an apparent injury to the right eye 10 days earlier. She had no symptoms at that point of time. Her uncorrected visual acuity by Snellen’s chart was 20/20 in both the eyes. Intraocular pressure was normal in both the eyes. On evaluation of the right eye she had traumatic anterior uveitis and mydriasis and the left eye was normal. There was no evidence of posterior segment involvement. She was treated with topical steroids and her anterior chamber inflammation improved but she had persistent mydriasis with no effect on her near vision. She was subsequently lost to follow after a month.

Highlights:
Rare case of ocular injury caused by a hurtling snow ball. Demonstration of anterior chamber inflammation with a video Infrared video imaging of the pupil in bright and dark showing anisocoria worse in bright light. Protective goggles are a must while indulging in these activities.

Video link:

https://youtu.be/FpLbPTVg5Rk

Key words: Snow ball, Ocular injury, Traumatic anterior uveitis, Traumatic mydriasis, Infrared imaging
Dysthyroid optic neuropathy: Demographics, risk factors, investigations, and management outcomes
Authors: Poonam Nisar Sonam , Alam Md. Shahid , Oberoi Prashant , Mukherjee Bipasha 
Published: December 2022

Purpose:
To analyze the clinical presentations, risk factors, and management outcomes in patients presenting with dysthyroid optic neuropathy (DON).

Methods:
This is a retrospective, single-center study carried out on consecutive patients presenting with DON over a period of 4 years (2013–2016). The VISA classification was used at the first visit and subsequent follow-ups. The diagnosis was based on optic nerve function tests and imaging features. Demographic profiles, clinical features, risk factors, and management outcomes were analyzed.

Results:
Thirty-seven eyes of 26 patients diagnosed with DON were included in the study. A significant male preponderance was noted (20, 76.92%). Twenty patients (76.9%, P = 0.011) had hyperthyroidism, and 15 (57.69%, P = 0.02) were smokers. Decreased visual acuity was noted in 28 eyes (75.6%). Abnormal color vision and relative afferent pupillary defects were seen in 24 (64.86%) eyes, and visual field defects were seen in 30 (81.01%) eyes. The visual evoked potential (VEP) showed a reduced amplitude in 30 (96.77%, P = 0.001) of 31 eyes and delayed latency in 20 (64.51%, P = 0.0289) eyes. Twenty-six (70.27%) patients were treated with intravenous methyl prednisolone (IVMP) alone, whereas 11 (29.72%) needed surgical decompression. The overall best-corrected visual acuity improved by 0.2 l logMARunits. There was no statistically significant difference in outcome between medically and surgically treated groups. Four patients developed recurrent DON, and all of them were diabetics.

Conclusion:
Male gender, hyperthyroid state, and smoking are risk factors for developing DON. VEP, apical crowding, and optic nerve compression are sensitive indicators for diagnosing DON. Diabetics may have a more defiant course and are prone to develop recurrent DON.
Suntex
Authors: Van Dongen Pauline , Britton Ellen , Wetzel Anna , Houtman Rogier , Ahmed Ahmed Mohamed , Ramos Stephanie 
Published: December 2022

The key objective of this research project is to “create a new architectural textile, Suntex, by interweaving thin film solar cells and electrically conductive yarn into a structural technical textile, so it can generate energy while it is providing shade, structure or an aesthetic update to a building.”
Textile has strong potential as a sustainable building material because it can be lightweight, material efficiency and low carbon. Moreover, its flexibility provides great design freedom and its transparency makes it very suitable for façade applications, maintaining views to the outside while providing solar shading. Suntex is a solar textile, currently in development, intended for textile architecture applications like textile façades. By combining three qualities, namely providing the building with energy generation, solar shading and a unique aesthetic appearance, which also promotes the acceptance of solar technology, it offers a positive climate impact.
Suntex can be considered as a new type of membrane material for Building Integrated Photovoltaics (BIPV). With this innovative, constructive fabric, enormous surfaces that are still unused can be outfitted with energy-generating potential.
This paper presents a design case to analyse the potential impact of Suntex as a textile façade. Based on insights into the development process and experiment results so far, it evaluates the feasibility and impact from a technical and design perspective.
COMPARISON OF “JUST SEAL” VS “STETHOSCOPE GUIDED” CUFF INFLATION METHOD OF ENDOTRACHEAL TUBE CUFF FOR REDUCTION OF POST OPERATIVE SORE THROAT
Authors: Ali Shah Syed Ali Raza 
Published: December 2022

Objective: To compare the efficacy of “Just seal” method of endotracheal tube cuff inflation versus “stethoscope guided”method for reduction of frequency of post operative sore throat.
Study Design: Prospective observation study.
Place and Duration of study: This study was conducted in Main operation theatre, CMH Kohat from 1st September 2018 to 30th November 2018.
Patients and methods: 44 patients divided in two groups of 22 each were made, Group JS and Group SG. Inj Propofol and atracurium was used for induction of general anaesthesia, and Inj Nalbuphine was used as analgesic. Endotracheal intubation with 7.5 internal diameter ETT, was done after 3 minutes of injecting atracurium. In group JS, ETT cuff was inflated gradually till no leakage was heard. In group SG, ETT cuff was inflated slowly and stethoscope bell was placed over thyroid lamina till harsh sounds stopped. Age, volume used to inflate cuff, cuff pressure generated and complain of sore throat 02 hours after extubation were noted.
Results: Mean age was 30.22 ±4.7 years and 30.13± 4.2 years for Group JS and SG respectively (p=0.946). Mean volume used was 6.81±0.41 ml and 4.95±0.29 ml for Group JS and SG respectively (p=0.000). Mean pressure generated was 34.90±4.48 cmH2O and 28.91±2.37 cmH2O (p=0.000). Frequency of Post operative sore throat was 54.55% (12/22) in JS group and 18.18 % (4/22) in SG group (p= 0.012).
Conclusion: Stethoscope guided technique for inflation of ETT cuff is more effective in reducing frequency of post operative sore throat.
Association of Esophageal Varices with Portal Vein Diameter More Than 13 mm in Chronic Liver Disease Patients
Authors: Muhammad Ali , Khan Andaleeb , Butt Kamil Rehman , Khan Jawad , Akbar Fazal , Zubair Usama Bin 
Published: December 2022

Objective: To determine the frequency and association of esophageal varices with diameter of portal vein more than 13 mm in patients of chronic liver disease (CLD).
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Gastroenterology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Feb to Aug 2018.
Methodology: The study included one hundred and sixty-one patients of chronic liver disease with portal vein diameter more than 13 mm. Patients with the history of variceal bleeding, prior variceal treatment and liver transplantation were excluded. A consultant radiologist performed the hepatobiliary ultrasound in all the patients to measure the portal vein diameter. The presence of esophageal varices was confirmed on upper GI endoscopy performed by the consultant gastroenterologist.
Results: The mean age of the patients was 47.16 ± 9.36 years. Most of the patients included in our study 102 (63.35%) were between 46-65 years of age. Out of the 161 patients, 95 (59.01%) were males and 66 (40.99%) were females. Esophageal varices were found in 128 patients (79.50%) with chronic liver disease with portal vein diameter >13 mm. Age, gender, duration of illness and BMI had no relation with the presence of esophageal varices in our target population.
Conclusion: Patients of CLD with portal diameter greater than 13 mm had more chance for the presence of esophageal varices in our study.
Impact of Sleep Deprivation and Coping Abilities on The Psychological Adjustment of Caregivers of The Elderly
Authors: Naz Iram , Ghumman Mishal Rauf , Shabbir Aliya 
Published: December 2022

Objective: To examine the impact of sleep deprivation and coping abilities on the psychological adjustment of caregivers of elderly.
Study Design: Cross sectional analytical study.
Place and Duration: Department of Psychology, University of Gujrat, Gujrat Pakistan, from Jan to Jul 2018.
Methodology: The caregivers of the elderly were recruited in the study with the caregiving experience of 6 months to 2 years. The respondents with any physical or psychological problems were excluded from the study. The sleep deprivation, coping and psychological adjustment were measured using the Pittsburgh sleep quality index, coping styles scale, scale of adjustment for adults respectively.
Results: The data of 200 caregivers of the elderly was analyzed using structure equation modeling. The model fit was established with the p-value of <0.001. It was found that caregivers' sleep deprivation and coping abilities affected their psychological adjustments. The overall model confirmed that sleep deprivation and coping ability affected the psychological adjustment. The individual relationship between sleep deprivation predicted psychological adjustment with the value of regression estimate as 5.808 (p-value <0.001). Furthermore, the role of coping abilities on psychological adjustment had a regression value of 0.151 (p-value 0.7013).
Conclusion: The sleep deprivation affected the psychological adjustment of caregivers of the elderly, whereas the coping abilities did not affect the psychological adjustment.
Short and long-term follow-up results of soleus muscle rotation flap for coverage of soft tissue defects of proximal and middle leg
Authors: Ali Ghazanfar , Ayaz Saeed Bin , Almas Danish , Adeel Imran , Majid Abdul , Khan Yasser Saeed 
Published: December 2022

Objective:
To observe the short and long-term outcomes of the soleus muscle rotation flap for coverage of soft tissue defects of proximal and middle leg.
Study Design:
Case series
Place and duration of study
Departments of Plastic and Reconstructive Surgery of Bahawal Victoria Hospital Bahawalpur, Combined Military Hospital Bahawalpur, and Combined Military Hospital Quetta from December 2014 to February 2020..
Materials and methods
In total, 36 patients were enrolled for the study through consecutive sampling. Data was processed using SPSS-17. All patients were reviewed at first and second week (early morbidity), and then at six months (late morbidity) from operation. During early follow up, they were examined for hematoma at donor site, wound infection, sural nerve injury, graft loss, and flap necrosis. In late follow-up, patients were examined for reduced knee mobility, muscle weakness, sensory abnormalities, hypertrophic scarring, hyperkeratosis, and soleus muscle contractures.
Results
The studied patients consisted of 30 (90.9%) men and 3 (0.9%) women. The mean age was 35 years (range: 16 to 64) years. Hematoma was the commonest complication. It occurred in 6.1%. Wound infection, partial loss of flap, partial loss of skin graft and wound infection occurred in 3.03% patients. Late follow up revealed reduced knee mobility in 9.09% patients (n=3) and bothersome contraction of soleus muscle in same number of patients.
Conclusion
The soleus flap is reliable, versatile, and very useful for provision of supple soft tissue coverage for defects in upper and middle leg.
Association of Body Composition With Serum Cholesterol and Body Mass Index in Healthy Pakistani Adults
Authors: Ali Ujala , Riaz Bushra , Nadeem Muhammad Sohaib , Alam Amir , Khan Muhammad Alamgir 
Published: December 2022

Objective: To determine the association of serum cholesterol and body mass index with body composition in the healthy Pakistani adults.
Study Design: Cross sectional study.
Place and Duration of Study: Physiology Department, Army Medical College Rawalpindi/National University of Medical Sciences (NUMS), in collaboration with Armed Forces Institute of Rehabilitation Medicine (AFIRM) Rawalpindi and Clinical Pathology Laboratory (CPL), Pak-Emirates Military Hospital, Rawalpindi. (Duration to be asked form the authors).
Methodology: The total study sample of 100 participants was taken, that comprised of two groups. Group-1 included male participants (n=50) while group-2 included female participants (n=50). The participants were healthy adults of ages 18-60 years having same physical activity background. Body composition of the participants was evaluated by bioelectric impedance analysis machine. Measurement of serum cholesterol was carried out by the Bosh Diagnostic Kit. Body Mass Index (BMI) was determined by the formula.
Results: Serum cholesterol was found to be significantly correlated with body fat mass and percent body fat in males (r-value = 0.90 and 0.82, p-value <0.001 and 0.002 respectively) and in females there was significantly positive correlation with the body fat mass (r-value=0.51, p-value 0.007), skeletal muscle mass (r-value = 0.59, p-value 0.005), total body water (r-value=0.67, pvalue 0.006) and fat free mass (r-value=0.47, p-value 0.008).
Conclusion: Serum cholesterol and BMI were associated with the body composition in females but with only fat parameters in the males. .
Effect of Injection Botox in Masseter Muscle on Morphometric Measurements of The Mandible in Sprague Dawley Rats
Authors: Iram Maria , Kiani Muhammad Rizwan Bashir , Qamar Khadija , Saleem Saima , Atta Muhammad Fahad , Zakria Iram 
Published: December 2022

Objective: To study the effects of injection botox in masseter muscle on the morphometric measurement of underlying mandible and total body weight change in Sprague Dawley rats.Study Design: Laboratory-based experimental study.
Place and Duration of Study: Anatomy Department, Army Medical College, Rawalpindi, with collaboration with Military Hospital, Rawalpindi and National Institute of Health (NIH), Islamabad, from Jun to Aug 2020.
Methodology: Female sprague dawley rats, 10 weeks of age, weighing 200-250 gm were selected. They were housed in separate cages in animal house of NIH under standard laboratory conditions and received regular diet and water ad libitum. Animals were divided into three groups. Group-A served as control while group B and C were experimental groups. Group-B was sham injected whilst group-C was injected by injection botox in left masseter muscle. Initial and final weights of the rats were recorded. All the rats were sacrificed after completion of experimental period. Weight of left mandibles was recorded. All the specimens of mandibles were cleaned and the mandibular length, condylar head length and width were measured by Vernier caliper.
Result: Total 30 sprague dawley rats were included in the study. Injection botox decreased the morphometric measurements of the mandible in experimental group-C when compared with control group-A and sham group-B with the statistically significant result (p<0.001).