bluuebunny/crossref_metadata_2025_split huggingface dataset:
Siep’s test
Authors: Gadavi Binita N , Pai Aditi , Kamath MAtul , Bhosale Dhananjay A , Gohel Devdatta J 
Published: October 2022

Purpose:
This study was conducted to ensure the integrity of surgery wounds.

Methods:
This was a randomized prospective trial of 300 patients who underwent small-incision cataract surgery (SICS) at our hospital over a one-year period. We used 2–3 drops of 5% povidone-iodine at the end of each case, not only to disclose any wound leaks but also to sterilize the surface of the eye.

Results:
Three hundred patients underwent SICS. One hundred ten patients had postoperative wound leak in SICS due to surgical complications. Premature entry comprising 75% (83 cases), followed by floppy iris syndrome comprising 20% (22 cases) and 5% (6 cases) comprising pseudoexfoliation (PXF) syndrome. There was a drop in the number of re-surgeries from 12 to 3 cases since we started implementing this technique.

Conclusion:
The simple procedure is very handy and economical in identifying the leak and can reduce further complications such as endophthalmitis and re-surgeries. Among residents, this can be a boon where povidone-iodine acts as a riverbank for the outflow of aqueous, outlining the speed, location, and quantity of the leak. Siep’s test plays an important role in identifying any postoperative wound leaks and also sterilizing the eye surface post surgery.
Comparison of surgically induced astigmatism in chevron, straight, and frown incisions in manual small-incision cataract surgery
Authors: Rathi Manisha , Dabas Ruchi , Verma Ritesh , Rustagi Inder M , Mathur Satanshu , Dhania Sweety 
Published: October 2022

Purpose:
The study was conducted to calculate and compare the surgically induced astigmatism (SIA) in chevron, frown, and straight incisions in manual small-incision cataract surgery (MSICS).

Methods:
A prospective, hospital-based study was conducted on 90 patients aged 50 years and above with nuclear sclerosis of grade 4 or more. Each group had 30 patients, divided into Group V (chevron incision), Group S (straight incision), and Group F (frown incision). Patients who had with-the-rule (WTR) astigmatism were operated on through a chevron or straight incision superiorly, while patients who had against-the-rule (ATR) astigmatism underwent MSICS through a temporal frown incision. The patients were followed up post-operatively on days 1, 7, 6 weeks, and 12 weeks, and at each visit, the uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and SIA were calculated and compared.

Results:
The mean age of all the patients was 66.22 ± 8.05 years. BCVA of at least 6/18 or better at 12 weeks post-operatively was achieved in 29 patients (97%) in Group V, 28 patients (93%) in Group F, and 29 patients (97%) in Group S. The mean SIA in Group V was 0.34D ± 0.22D, in Group S was 0.97D ± 0.29D, and in Group F was 0.575D ± 0.25D.

Conclusion:
SIA by chevron incision is the least followed by the frown incision and straight incision. The superiorly placed chevron incision in WTR astigmatism provided optimal results for the best UCVA and minimal SIA. The temporal frown incision in ATR astigmatism also had good results.
Comparison of different endophthalmitis prophylactic measures in cataract surgery - An analysis of 2.4 lakh cases
Authors: Reddy Jagadeesh Kumar , Sundaram Vandhana , Dani Samruddhi , Shah Neeraj , Ingawale Ameya , Pooja C M 
Published: October 2022

Purpose:
To compare different endophthalmitis prophylaxis methods adopted in cataract surgery (manual small-incision cataract surgery and phacoemulsification) between the years 2013 and 2021 in the community eye care section of a tertiary eye care hospital in South India and report their outcomes.

Methods:
All cataract surgeries performed from January 2013 to December 2021 (2,46,874 surgeries) at a single center were included in this retrospective study. The different endophthalmitis rates with each regimen were analyzed and evaluated.

Results:
70,081 surgeries were performed from January 2013 to February 2015, where Tobramycin was added to Balanced Salt Solution (BSS) (Group A). From March 2015 to January 2017, 63,245 surgeries were performed when intracameral Moxifloxacin was given (Group B). From February 2017 to December 2021, 1,13,548 surgeries were performed were Amikacin was added to BSS (Group C). In total, 42 cases of postoperative endophthalmitis were reported during the study period (0.02%). There was no significant difference in the endophthalmitis rates between groups A and B (P = 0.4152); however, there was a significant decrease in endophthalmitis rates in group C when compared with group A (P = 0.04) and group B (P = 0.006).

Conclusion:
There was a significant reduction in the rates of endophthalmitis following the addition of amikacin in irrigating BSS. Nocardia was one of the predominant organisms isolated from these endophthalmitis patients. This is the first single-center study to report a comparative analysis of different endophthalmitis prophylactic measures in a community eye care set up with a high incidence of Nocardia endophthalmitis prevented with amikacin in BSS irrigating solution.
Correction of pre-existing astigmatism by on-axis incision size modulation in manual small-incision cataract surgery
Authors: Goel Ruchi , Sontakke Ruchita , Shah Shalin , Nagpal Vaibhav , Kumar Sushil , Koli Omeshwer , Ojha Shweta , Saini Swati , Arya Deepanjali 
Published: October 2022

Purpose:To study the effect of wound size modulation on pre-existing astigmatism by on-axis placement of incision in manual small-incision cataract surgery (MSICS).Methods:In this prospective interventional study conducted at a tertiary care centre, 40 eyes of 40 consecutive senile cataract patients with 1.00–3.00 D corneal astigmatism were enrolled for the study. MSICS by modified Blumenthal’s technique was performed through 6.0, 6.5, and 7.0 mm on-axis incision in 1.0–1.49 D (group A), 1.50–1.99 D (group B), and 2.00–3.00 D (group C) astigmatism, respectively. Surgically induced astigmatism (SIA) was calculated by vector analysis and double angle plots (DAP) at 12 weeks postoperatively.Results:There were 22 males and 18 females with mean age of 58.12 ± 1.18 years. The mean SIA at 12 weeks was 0.85 ± 0.28 D in group A (17 eyes), 1.32 ± 0.65 D in group B (10 eyes), and 1.91 ± 0.69 D in group C (13 eyes). The overall median uncorrected visual acuity was 0.18 (IQR = 0 to 0.2). The mean astigmatism decreased from 1.95 ± 0.74 D to 1.04 + 0.57 D (P= 0.00) in superior incision and from 1.70 + 0.50 D to 0.92 ± 0.45 D (P= 0.00) in temporal incision group with central shift of centroid in all cases.Conclusion:The customization of on-axis external incision size can be used to manage pre-existing corneal astigmatism of less than 3.00 D using both temporal and superior incisions effectively.
Comparative study between conventional and 4 mm manual small-incision cataract surgery
Authors: Chauhan Ravi A , Agrawal Sachin O , Sawarkar Radhika R , Agrawal Sanjay 
Published: October 2022

Purpose:
Comparative study of intraoperative and postoperative complications, visual outcomes, and cost-effectiveness between conventional and 4-mm manual small-incision cataract surgery with MVR blade.

Methods:
In total, 600 patients having nuclear sclerosis grade I–IV were operated under peribulbar anesthesia and were divided into two groups of 300 each. In group A (300), conventional small-incision cataract surgery was done, whereas in group B (300), 4-mm manual small-incision cataract surgery was performed through a 4-mm sclerocorneal tunnel. A wire vectis was passed through the 4-mm incision below the nucleus to stabilize it, and a 20-G MVR blade was introduced from 11o’clock limbus and nucleus was bisected into two halves, which were removed through main incision. Cortical wash was given, and foldable IOL was implanted. Intraoperative and postoperative complications between the two groups were compared. Postoperative visual outcome and surgically induced astigmatism between the two groups was studied.

Results:
The most common intraoperative complication was hyphema (11.33%) and irido-dialysis (8.00%), whereas postoperatively, striate keratopathy (36.33%) and hyphema (19.33%) were common. Short-term complications such as striate keratopathy, hyphema, and irido-dialysis were significantly more in group B, and long-term results in terms of visual outcome and surgically induced astigmatism were significantly less in group B.

Conclusion:
Although intraoperative and short-term postoperative complications were observed more in 4-mm manual small-incision cataract surgery, it was found to be more effective in terms of surgically induced astigmatism and final visual outcome. In addition, it is cost-effective as compared to phacoemulsification.
Incidence of re-surgery after manual small-incision cataract surgery at a tertiary eye-care center in South India
Authors: Shetty Prerana A , Bhalerao Sushank A , Vuyyuru Sowjanya , Thigale Uma Y , Satyanarayana Devara , Mallipudi Rajavardhan 
Published: October 2022

Purpose:
To study the incidence of re-surgery after manual small-incision cataract surgery (MSICS) at a tertiary eye-care center in South India and to compare the re-surgery rate between trainees and experts.

Methods:
A retrospective study was conducted at a tertiary eye-care center in Andhra Pradesh state of South India, which included 19,515 patients who underwent MSICS between 2012 and 2022 with 369 eyes of 369 patients who underwent re-surgery within 1 week of primary surgery. Factors included demographic data, type of re-surgery, that is, wound re-suturing, IOL repositioning, cortical wash, as well as anterior chamber (AC) wash.

Results:
19,515 eyes from the year 2012–2022 were analyzed. Most of the patients undergoing re-surgery belonged to the age group of 61–70 years (40.3%). Wound re-suturing was the more frequently performed re-surgery (47.6%). Wound re-suturing rates were comparable between the trainees and experts, whereas IOL repositioning, cortical wash, and AC wash were higher in the cases performed by trainees though statistically not significant.

Conclusion:
Careful pre-operative assessment, training under supervision, and other measures can be taken to reduce the re-surgery rates. Timely diagnosis and early treatment can give better outcomes and prevent devastating complications like endophthalmitis.
Regurgitation on pressure over the lacrimal sac versus lacrimal irrigation in determining lacrimal obstruction prior to intraocular surgeries
Authors: Kim Usha , Vardhan Ashok , Datta Dipankar , Mekhala Amirtha , Kishore Nanda , Rathi Gunjan , Hildebrand P Lloyd 
Published: October 2022

Purpose:
To determine the diagnostic accuracy of manual regurgitation on pressure over the lacrimal sac (ROPLAS) versus lacrimal irrigation for screening nasolacrimal duct obstruction (NLDO) in adults prior to intraocular surgeries.

Methods:
This cross-sectional study took place in a tertiary eye care hospital in South Tamil Nadu, India. From January to December 2017 and included consecutive patients who presented for routine cataract surgery. Prospective data collection occurred in 8369 eyes of patients who underwent cataract surgery. All patients underwent ROPLAS testing by an ophthalmologist followed by lacrimal irrigation by trained ophthalmic assistants, rechecked or confirmed in equivocal cases by ophthalmologists who were masked to the ROPLAS status. The primary outcome, the sensitivity, specificity, positive, and negative predictive values to detect lacrimal occlusion by ROPLAS compared with lacrimal irrigation with 95% confidence intervals was estimated.

Results:
A total of 8369 eyes underwent cataract surgery during the time periods of the study. ROPLAS and lacrimal irrigation were performed in all eyes. The sensitivity of ROPLAS to diagnose NLDO correctly was 54.5% (95% CI, 44.8%–63.9%) and its specificity was 100% (95% CI, 100%–100%). The positive and negative predictive values were 75.3% (95% CI, 65.6%-83.0%) and 99.4% (95% CI, 99.2%–99.5%), respectively.

Conclusion:
We found that ROPLAS when used alone had very low sensitivity and low positive predictive value in detecting NLDO prior to cataract surgery as compared with lacrimal irrigation. Hence, we recommend performing ROPLAS and lacrimal irrigation in every patient as part of the routine preoperative workup prior to cataract surgery.
Comparison of the outcomes of phacoemulsification and manual small-incision cataract surgery in posterior polar cataract - A retrospective study
Authors: Pathak Madhumallika , Odayappan Annamalai , Nath Manas , Raman Ramalakshmi , Bhandari Sahil , Nachiappan Sivagami 
Published: October 2022

Purpose:
To compare the visual outcomes and intraoperative complications between phacoemulsification and manual small-incision cataract surgery (MSICS) in cases of posterior polar cataract (PPC).

Methods:
A retrospective study was carried out involving 142 patients (164 eyes) with PPC who underwent cataract surgery between January and December 2017. Data collected include the demographic details, preoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), type of cataract, intraocular pressure, anterior and posterior segment findings, type of surgery performed, intraoperative complications, postoperative UCVA on the first day, UCVA and BCVA at 1 month after surgery, complications, and resurgery details.

Results:
In total, 90 patients (107 eyes) underwent phacoemulsification, and 52 patients (57 eyes) underwent MSICS. There was no significant difference in the mean age, sex, and type of PPC between the two groups (P = 0.326, 0.852, and 0.220, respectively). Patients who underwent phacoemulsification had significantly better preoperative BCVA (P = 0.002). The BCVA on first postoperative day and 1 month after surgery was better in the phacoemulsification group than in the MSICS group (P < 0.001 and 0.002, respectively). The overall incidence of posterior capsular rupture (PCR) was 11.6%, which included the 10.3% in phacoemulsification and 14.0% in MSICS. There was, however, no significant difference in the rates of PCR between the two groups (P = 0.506).

Conclusion:
Phacoemulsification delivered better postoperative visual outcomes than MSICS in PPC patients, whereas the complication rates were similar between the two groups.
Stabilization of refraction and timing of spectacle prescription following manual small-incision cataract surgery
Authors: Pattanayak Sabyasachi , Patra S Hari Sankar , Nanda Ashok Kumar , Subudhi Praveen 
Published: October 2022

Purpose:
To determine the stabilization of refraction at 2 weeks following MSICS by comparing the difference in spherical, cylindrical component and also spherical equivalent of refraction of 2 weeks follow-up with that of 6 weeks following surgery.

Methods:
The difference of spherical, cylindrical component and also spherical equivalent of refraction at 2 weeks and 6 weeks follow-up of 194 eyes that underwent uncomplicated MSICS with implantation of PMMA IOL conducted by a single experienced surgeon were compared to find out the amount of change and its significance was statistically tested by Wilcoxon-Signed Rank Test.

Results:
The difference in spherical power (0.04 ± 0.30), cylinder power (0.03 ± 0.40), and spherical equivalent (0.06 ± 0.34) were very small and not significant statistically (P-value ≤0.05).

Conclusion:
Necessary spectacle correction can safely be prescribed after 2 weeks following MSICS as subjective refraction stabilizes by that time without undergoing significant change. However, our observation was applicable in patients who had an uneventful cataract surgery without any risk factor, which can delay wound healing or cause poor visual outcome.
Association between physical activity and serum liver aminotransferases in Southwestern Iran
Authors: Badiei Sajad , Hashemi Seyed Jalal , Masjedizadeh Abdolrahim , Sayyah Jalal , Mohammadi Zahra , Hariri Sanam , Hashemi Farnaz , Rahimi Zahra , Danehchin Leila , Abolnezhadian Farhad , Malihi Reza , Paridar Yousef , Mard Seyyed Ali , Cheraghian Bahman , Poustchi Hossein , Shayesteh Ali Akbar 
Published: October 2022

Background:
The main aim of the present study is to investigate the independent association objectively measured level of physical activity (PA) and serum concentration of liver aminotransferases (alanine aminotransferase [ALT] and aspartate aminotransferase [AST]) among seemingly healthy individuals.

Materials and Methods:
The current secondary study was conducted in the framework of Khuzestan Comprehensive Health Study, a large population-based multicentric cross-sectional study, conducted between 2016 and 2019 on 18,966 individuals living in Khuzestan province, southwestern Iran. International PA Questionnaire was used for evaluating PA levels, and participants were divided into three groups: low, moderate, and high PA, and ALT and AST were compared between these groups.

Results:
The mean ± standard deviation age of participants was 38.65 ± 11.40 years. The majority of participants were female (71%). The mean concentration of ALT in total sample was 18.22 ± 13.06 (male: 23.65 ± 16.26 and female: 15.57 ± 10.06), while the mean concentration of ALT in total sample was 19.61 ± 8.40 (male: 22.44 ± 10.03 and female: 18.23 ± 7.08). A statistically significant inverse correlation was found between AST (r = −0.08, P = 0.02) and ALT (r = −0.038, P < 0.001) with total PA score. The mean concentration of ALT was 19.96 ± 13.63 in people with low PA, 17.62 ± 12.31 with moderate PA, and 18.12 ± 13.47 with high PA (P < 0.001). The mean concentration of AST in total sample was 20.37 ± 8.85 in people with low PA, 19.21 ± 8.83 with moderate PA, and 19.75 ± 8.85 with high PA (P < 0.001). The difference between people in different levels of PA in terms of mean concentration of AST was remained significant (P = 0.003); however, the difference for ALT was not remained significant after adjusting potential confounders.

Conclusion:
The current study based on large sample showed that PA had a statistically negative association with the concentration of liver aminotransferases in the seemingly healthy individuals; however, the observed associations were weak. People in the lowest levels of PA had the highest levels of ALT and AST.
HIV-Associated Dementia: Associated Factors and Characteristics of Cognitive Domain Abnormalities in Elderly People Living with HIV Treated with Highly Active Antiretroviral Therapy
Authors: Boonyagars Lakkana , Kiatsoongsong Nucharee , Winitprichagul Supharat 
Published: October 2022

ABSTRACT.
This study aimed to evaluate the prevalence and associated factors of HIV-associated dementia (HAD) in people living with HIV (PLWH) aged ≥ 60 years who are currently treated with highly active antiretroviral therapy. A cross-sectional study was conducted on adult (age ≥ 60 years) PLWH at the infectious clinic, Vajira Hospital, Navamindradhiraj University, Thailand, between August 2019 and March 2021. We collected the patients’ characteristics and performed Montreal Cognitive Assessment and Instrumental Activities of Daily Living test to determine whether they have HIV-associated neurocognitive disorders (HAND), which we further classified into asymptomatic neurocognitive impairment (ANI), mild neurocognitive disorder (MND), and HAD. Finally, we evaluated the prevalence, associated factors, and characteristics of cognitive domain abnormalities in these patients. We enrolled 84 elderly PLWH patients consisting of 43 (51.2%) males. The mean patient age was 63 years (SD ± 3.9), and the median duration of HIV infection was 13 (SD ± 5.7) years. All the patients had undetectable HIV viral load. Among them, seven (8.3%) had no neurocognitive impairment, 61 (72.6%) had ANI, three (3.6%) had MND, and 13 (15.5%) had HAD. After confounder adjustment, the patient age of ≥ 65 years was found to be significantly associated with dementia (odds ratio = 5.97, 95% CI: 1.51–23.57). Significant difference in the mean score of all cognitive domains was observed between the patients with HAD and those with normal cognitive status. HAND is common in PLWH. Age older than ≥ 65 years is a risk factor of HAD.
Limited Capacity for Aedes aegypti to Mechanically Transmit Chikungunya Virus and Dengue Virus
Authors: Bransfield Angela B. , Misencik Michael J. , Brackney Doug E. , Armstrong Philip M. 
Published: October 2022

ABSTRACT.
Mechanical transmission is an understudied mode of arbovirus transmission that occurs when a biting insect transmits virus among hosts by the direct transfer of virus particles contaminating its mouthparts. Multiple arboviruses have been shown to be capable of utilizing this transmission route, but most studies were conducted 40 to 70 years ago using dated methodologies. To gain a better understanding of this phenomenon, we used molecular techniques to evaluate the efficiency of mechanical transmission by Aedes aegypti mosquitoes for two evolutionarily divergent arboviruses, chikungunya virus (CHIKV) and dengue virus (DENV). Viral RNA and/or infectious DENV could be detected on 13.8% of mosquito proboscises sampled immediately after an infectious bloodmeal, but positivity rates declined within hours. CHIKV RNA and/or infectious virus was detected on 38.8% of proboscises immediately after feeding but positivity rates dropped to 2.5% within 4 hours. RNA copy numbers were low for both viruses, and we were unable to demonstrate mechanical transmission of CHIKV using an established animal model, suggesting that this mode of transmission is unlikely under natural conditions.
Environmental Education in South African Schools: The Role of Civil Society Organizations
Authors: Damoah Benjamin , Adu Emmanuel Olusola 
Published: October 2022

Environmental education (EE) is an integrated component of the South African Curriculum and Assessment Policy Statement (CAPS) document. Pro-EE civil society organisations are actively involved in the implementation of EE policies in schools. The roles played by civil society organisations contribute to the trajectory of practical environmental programmes. This study adopted an interpretive paradigm, a qualitative approach, and a phenomenological design anchored on Bronfenbrenner's philosophical view of human development. One Pro-EE civil society organisation and two respondents were purposefully sampled. Semi-structured interviews and documents were tools employed to collect qualitative data and results were analysed thematically. The study revealed that Pro-EE civil society organisations play a pivotal role which includes; equipping learners to live sustainably, teachers’ professional development, policy formulation, and implementation that actualizes the CAPS document's objectives. The study recommended that the South School Act be amended to make EE policy mandatory. The department of basic education (DBE) should provide sufficient resources to Pro-EE civil society organisations to expand Eco-Schools project-based initiatives in schools regardless of the geographical location.