Pediatric ocular trauma score as a prognostic tool in the management of pediatric traumatic cataracts.

OBJECTIVE: To introduce and validate the pediatric ocular trauma score (POTS) - a mathematical model to predict visual outcome trauma in children with traumatic cataract METHODS: In this retrospective cohort study, medical records of consecutive children with traumatic cataracts aged 18 and below were retrieved and analysed. Data collected included age, gender, visual acuity, anterior segment and posterior segment findings, nature of surgery, treatment for amblyopia, follow-up, and final outcome was recorded on a precoded data information sheet. POTS was derived based on the ocular trauma score (OTS), adjusting for age of patient and location of the injury. Visual outcome was predicted using the OTS and the POTS and using receiver operating characteristic (ROC) curves. RESULTS: POTS predicted outcomes were more accurate compared to that of OTS (p = 0.014). CONCLUSION: POTS is a more sensitive and specific score with more accurate predicted outcomes compared to OTS, and is a viable tool to predict visual outcomes of pediatric ocular trauma with traumatic cataract.

Innovative method for wound debridement in open globe injury.

Background: Open globe injury is a serious sight threatening condition. Full-thickness, non-selfsealing corneal lacerations require repair in the operating room. During repair, debridement of the wound is an important step. Incarceration of the intraocular structures in the wound eg. Iris, lens capsule, vitreous leads to improper healing if not removed properly. Purpose: To demonstrate the technique of wound debridement in open globe injury. Synopsis: : Manual removal of incarcerated tissue contents leads to incomplete cleaning & enormous traction on intra ocular contents. In this video, we have tried vitrectomy cutter with higher vacuum for cleaning the edges of the wound especially in the posterior aspect and debri removal, followed by easy suturing. All tissue in the wound edges are removed effectively without any traction on intraocular contents. Highlights: : Vitrectomy cutter is a very useful and effective tool to clean wound edges and good apposition & suturing of wound. Video link: https://youtu.be/y_kCxLdwhuQ.

Stress-strain relation in the collapse of Langmuir monolayer of a dimer of disk shaped moiety.

Langmuir monolayer of a novel molecule containing dimer of disk shaped moiety, viz., terephtalic acid bis-[6-(3,6,7,10,11-pentahexyloxy-triphenylen-2-yloxyl)-hexyl] ester (tp-dimer), was studied at air-water interface. The monolayer of the tp-dimer at air-water interface exhibited the coexistence of condensed and gas phases at large area per molecule which on compression transformed to a uniform condensed phase at lower area per molecule (1.80 nm(2)) and then collapsed at 1.67 nm(2). The monolayer film transferred by Langmuir-Blodgett technique onto a hydrophilic silicon substrate was studied using an atomic force microscope. The topography image showed the film to be of height of about 1.5 nm corresponding to the edge-on configuration of the triphenylene moieties. We have studied the collapse of monolayer at air-water interface as a function of compression rate and temperature. We find that the collapse pressure increased with increase in the compression rate. The surface pressure of the monolayer is considered as stress and compression as strain. The strain rate is related to the collapse pressure by a power law similar to that found in the dendrimers. Our studies on the effect of temperature on the collapse pressure of tp-dimer monolayer showed that the collapse pressure decreased with increase in temperature. We have considered the Arrhenius temperature dependence of the strain rate and calculated the activation energy for the collapse of monolayer. Our analysis of the relative area loss as a function of time in the collapse region suggests that the monolayer collapses by the formation of nuclei of three-dimensional crystallites.

Comparative study of visual outcome between open- and closed-globe injuries following surgical treatment of traumatic cataract in children.

OBJECTIVE: To compare final visual outcomes of surgically treated traumatic cataract between open-globe and closed-globe injuries in children, as classified by the Birmingham Eye Trauma Terminology system. METHODS: This is an observational cohort study with permission from Hospital Ethical Committee. We enrolled children meeting specific inclusion criteria, examined their eyes to review any co-morbidities due to trauma, performed surgery for traumatic cataracts, and implanted lenses. The patients were re-examined postoperatively. We classified the cases of traumatic cataract as either open-globe (Group 1) or closed-globe (Group 2) according to the Birmingham Eye Trauma Terminology system and compared visual acuity. RESULT: Our study cohort of 1076 eyes with traumatic cataracts included 405 eyes in Group 1 and 671 in Group 2. Postoperatively, the visual acuity was >20/60 in 223 (55.3%) and 377 (56.3%) operated eyes in Groups 1 and 2, respectively ( p < 0.001, analysis of variance). With further follow-up, >20/60 vision was significantly higher in Group 2 as compared to Group 1 (odds ratio = 1.61; 95% confidence interval = 0.85-3.02). Overall, 600 eyes (55.7%) regained final visual acuity >20/60. CONCLUSION: Closed-globe injury has more favourable prognosis for the satisfactory (>20/60) visual recovery after effective management of traumatic cataracts in children.

TRAK App Suite: A Web-Based Intervention for Delivering Standard Care for the Rehabilitation of Knee Conditions.

BACKGROUND: Standard care for the rehabilitation of knee conditions involves exercise programs and information provision. Current methods of rehabilitation delivery struggle to keep up with large volumes of patients and the length of treatment required to maximize the recovery. Therefore, the development of novel interventions to support self-management is strongly recommended. Such interventions need to include information provision, goal setting, monitoring, feedback, and support groups, but the most effective methods of their delivery are poorly understood. The Internet provides a medium for intervention delivery with considerable potential for meeting these needs. OBJECTIVE: The objective of this study was to demonstrate the feasibility of a Web-based app and to conduct a preliminary review of its practicability as part of a complex medical intervention in the rehabilitation of knee disorders. This paper describes the development, implementation, and usability of such an app. METHODS: An interdisciplinary team of health care professionals and researchers, computer scientists, and app developers developed the TRAK app suite. The key functionality of the app includes information provision, a three-step exercise program based on a standard care for the rehabilitation of knee conditions, self-monitoring with visual feedback, and a virtual support group. There were two types of stakeholders (patients and physiotherapists) that were recruited for the usability study. The usability questionnaire was used to collect both qualitative and quantitative information on computer and Internet usage, task completion, and subjective user preferences. RESULTS: A total of 16 patients and 15 physiotherapists participated in the usability study. Based on the System Usability Scale, the TRAK app has higher perceived usability than 70% of systems. Both patients and physiotherapists agreed that the given Web-based approach would facilitate communication, provide information, help recall information, improve understanding, enable exercise progression, and support self-management in general. The Web app was found to be easy to use and user satisfaction was very high. The TRAK app suite can be accessed at http://apps.facebook.com/kneetrak/. CONCLUSIONS: The usability study suggests that a Web-based intervention is feasible and acceptable in supporting self-management of knee conditions.

Novel benzene-bridged triphenylene-based discotic dyads.

We report the synthesis and characterization of two series of novel triphenylene-based benzene-bridged symmetric discotic dimers. Two triphenylene discotics have been connected to a rigid benzene ring via flexible methylene spacers. In one series, triphenylene moiety was tethered with benzene via an ester linkage, while in the second series it is via an ether linkage. Within each series, the orientation of the linkage of the triphenylene core around the benzene core has been changed by substituting the benzene ring at o-, m-, and p-positions. These materials have been characterized from their spectral and elemental analysis. The thermotropic liquid crystalline properties were investigated by polarizing optical microscopy, differential scanning calorimetry, and X-ray diffraction studies. All the virgin compounds do not display any mesomorphism; however, their charge transfer complexes with trinitrofluorenone, an electron acceptor, exhibited columnar mesophases. The direct current (dc) conductivity of charge transfer complexes at two ratios has been studied at variable temperature. The small conductivity value demonstrates that long spacers as well as connectivity to the rigid benzene ring dilute the column packing, hence making pi-pi interaction less efficient for the entire column length. A hexagonal assembly of triphenylene-benzene dimer 12 on a highly oriented pyrolytic graphite (HOPG) surface has been visualized with scanning tunneling microscopy (STM).