Dry eye symptoms and digital eyestrain - Emerging epidemics among university students due to online curriculum amid the COVID-19 pandemic. A cross-sectional study

Purpose: Increased screen time has been a major concern among the students who have adopted the online curriculum amid the pandemic. The study was conducted to shed light on the changing trends of symptoms pertaining to dry eye disease and digital eyestrain due to the online curriculum and its negative implications on the ocular health of students. Methods: A cross?sectional study was conducted among students of Manipal Academy of Higher Education who are currently following the E?learning curriculum amid the COVID?19 pandemic the participants were surveyed using a pre?validated structured questionnaire. Results: The mean age of study participants was 23.33 ± 4.604 years. In total, 97.9% (321/352) of the respondents experienced at least three symptoms associated with the usage of digital devices. 88.1% of the participants were exposed to an average screen time of more than 4 hours per day. An increased number of hours of digital device usage was found to be associated with higher total symptom scores (P = 0.04). The total symptom scores were found to be considerably higher for those with continuous contact with the screen (P = 0.02). Headache (69.9%, n = 246) is the most commonly reported symptom followed by neck pain (65.3%, n = 230), tearing (44.6%, n = 157), eye pain (40.9%, n = 144), and burning sensation (40.1%, n = 141). Conclusion: This study highlights a tremendous increase in the prevalence of symptoms related to dry eye and digital eyestrain among students attending online classes during the COVID?19 pandemic. Eye care professionals need to be aware of this emerging public health threat and the appropriate measures for its prevention

Fish hook technique for nucleus management in manual small-incision cataract surgery: An Overview

Manual small-incision cataract surgery (MSICS) preserves its utility as a cost-effective and efficient strategy for mitigating cataract-associated blindness. Numerous techniques of nucleus delivery in MSICS have been described in the literature. The fish hook technique of nucleus extraction was advocated in 1997 and has been popular for high-volume surgery in limited pockets of the world. This article describes in detail the steps involved in the construction of a fish hook, tips of nucleus extraction with the help of a fish hook, and the pros and cons of fish hook-based MSICS through text, diagram, and video supplement.

Diagnostic dilemma in hyperechoic breast masses

Hyperechoic breast lesions are relatively uncommon, constituting only 0.6–6% of all breast masses and 0.6% of all biopsied lesions. The majority of these lesions are benign. There are rare malignancies that can present as hyperechoic masses and careful ultrasonographic assessment must be employed to avoid misdiagnosis.[1] We discuss the case of a 67-year-old female patient with a strong family history of breast and ovarian cancer, who presented with one such rare breast cancer in a hyperechoic mass.

Cost analysis of pediatric cataract surgery in a tertiary eye care hospital in Western India

Purpose: To assess the cost of pediatric cataract surgery in a tertiary eye care hospital from a provider’s perspective. Methods: Retrospective review of direct costs incurred for pediatric cataract surgery for the financial year April 1, 2018, to March 31, 2019. The cost analysis was done by standard costing methods. The fixed cost included the cost of land, buildings, construction, maintenance, personnel, operation theater (OT), and Out patient department (OPD) equipment. The variable cost included the cost of consumables used during surgery. The indirect costs were not considered. Results: The per?patient fixed facility cost was INR 1.52 ($0.02), maintenance cost was INR 39.06 ($0.55), OPD equipment and consultation were INR 19.64 ($0.28), OT equipment was INR 467.95 ($6.61), the cost for personnel was INR 5,300.33 ($74.92), and the cost of consumables varied between INR 16,418 ($314.44) and INR 22,313 ($397.76), with the choice of intraocular lenses (IOL) being the main determining factor. The net average cost for a pediatric cataract surgery varied between INR 22,246.50 ($ 314.44) and INR 28,141.50 ($ 397.76). Conclusion: Pediatric cataract surgeries are cost?intensive. High?volume surgeries and an increase in the number of patients in OPD reduce the fixed facility cost. But there is an overall increase in human resource (HR) and consumable cost owing to economic and technological reforms. However, the impact of operating a child, thereby, increasing his/her blindness?free years probably outweighs the cost and justifies it. High patient inflow, increased number of surgeries, and bulk purchase of consumables help in decreasing the cost.

An Engineering Approach to Roof Top Gardening

With the growing demand for vegetables and fruits in this world of urbanisation roof top gardening finds an insignificant place. The study focuses on identifying and suggesting remedies for effective management of the engineering components involved in roof top gardening. They majorly include design of roof, irrigation management, arrangement of pots, waste management, moisture proofing etc. These factors contribute significantly in designing an effective roof top garden. Various problems faced in the engineering intervention were identified and suitable remedies were suggested in the research using a case study approach of roof top gardens in Bangalore. A well maintained roof top garden is a positive sign of a healthy household.

Comparison of optical coherence tomography angiography and fundus fluorescein angiography features of retinal capillary hemangioblastoma

The aim of this study is to compare the optical coherence tomography angiography (OCTA) and fundus fluorescein angiography (FFA) features of retinal capillary hemangioblastoma (RCH). This is an observational case series of three patients with von Hippel朙indau (VHL) disease and one patient with juxtapapillary RCH. All patients underwent FFA with a mydriatic fundus camera and OCTA with swept-source angio OCT. The FFA and OCTA characteristics of tumors were compared. In our series, FFA could identify tumors as small as the width of a third-order retinal artery, which was missed on clinical examination. OCTA identified these tiny tumors, but only those closer to the posterior pole. Both FFA and OCTA could identify the intrinsic vasculature and feeder vessel in juxtapapillary RCH. On OCTA, the tumors were better defined than in FFA. The depth of the lesion can be identified on OCTA. Feeder and the draining vessels could be identified precisely in OCTA than FFA, particularly in small tumors. OCTA can identify tumors in VHL missed on clinical examination. It can identify the feeder vessel and intrinsic vasculature of sessile juxtapapillary RCH and aids in its diagnosis. Tumors are better defined in OCTA than FFA due to the absence of leakage. However, FFA can identify nearly all the early tumors, but OCTA fails to image the peripheral tumors due to its smaller field and prolonged acquisition time. Technological advances and the development of wide-field OCTA in the future can be helpful in identifying all the unsuspected tumors in VHL disease.

Evaluation of microalgae’s (Chlorella sp. and Synechocystis sp.) pollutant removal property: Pig effluent as a live stock discharge.

The ability of microalgae to remove nitrogen and phosphorus from wastewater has been used in recent years as an alternative treatment for discharges from livestock slurry, which generate a negative environmental impact on vulnerable ecosystems. With this background and the feasibility of using microalgae, we have evaluated the effect of Chlorella sp. and Synechocystis sp., in removing contaminants from the pig manure collected from El Prado ESPE. Slurry samples were collected, filtered and autoclaved, and the supernatant was further diluted to three different concentrations of 40%, 60% and 80%. The microalgal growth and pollutants removal property was evaluated up to 15 days in batch culture. The cell density was determined by counting in a Neubauer hemocytometer, and the pollutants removal was analyzed by standard colorimetric methods. The microalgae Chlorella sp. showed a maximum cell growth of 1.70 ± 0.09 x107 cells/mL at 60% effluent concentration on day 6. While Synechocystis sp. showed a maximum growth of 1.04 ± 0.05 x107 cells/mL, at 60% concentration on day 9. On the other hand, there exists a competition when microalgae used as a consortium. The cell growth of Chlorella sp. was higher at all concentrations compared to Synechocystis sp.. Overall, efficiency of pollutant removal were between 40% and 90%, which demonstrate the feasibility of using microalgae in tertiary swine wastewater treatment.

Effect of Azospirillum spp. and Azotobacter spp. on the growth and yield of strawberry (Fragaria vesca) in hydroponic system under different nitrogen levels.

It is well established fact that bacterial species promotes plant growth. This growth enhancing activity was believed to be through different mechanisms such as synthesis of phytohormones, nitrogen-fixing, and biological control. For this reason, in this present investigation we have isolated and identified Azotobacter spp. and Azospirillum spp. through macromorphologically and micromorphologically in order to assess its effect on growth and yield of strawberry (Fragaria vesca) an Albion variety in hydroponic system. The inoculation and co-inoculation of bacterial culture was performed in combination with three nitrogen levels (50, 100 and 150 ppm), growth parameters such as plant height, root length, fresh and dry weight of root and aerial parts, leaf area, chlorophyll content, nutrient content, solid soluble, caliber, yield/plant. It is observed that in T8 (co-inoculation in100 ppm N) group showed significantly increase in plant height (18.57cm), chlorophyll content (48.57 Soil Plant Analysis Development-SPAD), fresh root weight (25.82g) and dry root weight (5.93g), while in treatment group T5 (Azotobacter spp. 100ppm of Nitrogen) and T6 (Azotobacter spp. 150ppm of Nitrogen) showed significant increase in root length, leaf area, dry and fresh weights of aerial parts. The N content of leaf for all treatments was in the ranges of 2.42 - 2.83 % that is suitable for cultivation. Similarly, the treatment group T5 and T6 showed increase in yield per plant and soluble solids content. So, Azotobacter and Nitrogen treatment has growth related benefits in strawberries under hydroponic system.

Classification of Flying Insects with high performance using improved DTW algorithm based on hidden Markov model

ABSTRACT Insects play significant role in the human life. And insects pollinate major food crops consumed in the world. Insect pests consume and destroy major crops in the world. Hence to have control over the disease and pests, researches are going on in the area of entomology using chemical, biological and mechanical approaches. The data relevant to the flying insects often changes over time, and classification of such data is a central issue. And such time series mining tasks along with classification is critical nowadays. Most time series data mining algorithms use similarity search and hence time taken for similarity search is the bottleneck and it does not produce accurate results and also produces very poor performance. In this paper, a novel classification method that is based on the dynamic time warping (DTW) algorithm is proposed. The dynamic time warping algorithm is deterministic and lacks in modeling stochastic signals. The dynamic time warping (DTW) algorithm is improved by implementing a nonlinear median filtering (NMF). Recognition accuracy of conventional DTW algorithms is less than that of the hidden Markov model (HMM) by same voice activity detection (VAD) and noise-reduction. With running spectrum filtering (RSF) and dynamic range adjustment (DRA). NMF seek the median distance of every reference of time series data and the recognition accuracy is much improved. In this research work, optical sensors are used to record the sound of insect flight, with invariance to interference from ambient sounds. The implementation of our tool includes two parts, an optical sensor to record the "sound" of insect flight, and a software that leverages on the sensor information, to automatically detect and identify flying insects.

Unconventional techniques of fundus imaging: A review.

The methods of fundus examination include direct and indirect ophthalmoscopy and imaging with a fundus camera are an essential part of ophthalmic practice. The usage of unconventional equipment such as a hand‑held video camera, smartphone, and a nasal endoscope allows one to image the fundus with advantages and some disadvantages. The advantages of these instruments are the cost‑effectiveness, ultra portability and ability to obtain images in a remote setting and share the same electronically. These instruments, however, are unlikely to replace the fundus camera but then would always be an additional arsenal in an ophthalmologist’s armamentarium.

Molar Distalisation By Palatal Implants- A Case Report.

Palatal implants have been used to establ ish stat ionary anchorage. The stability of a palatal implant for distalization of molars bodily and for anchorage maintenance was assessed. The implant was a stepped screw titanium (4.5 mm diameter x 8.5 mm length), and it was placed in the palatal region. A surgical template containing a metal drill housing was prepared. Angulation of the drill housing was controlled according to the radiologic tracing of the maxilla transferred to a plaster cast section in the paramedian plane. The implant was placed using a noninvasive technique and left transmucosally to facilitate the surgical procedure and to reduce the number of operations. The paramedian region was selected (1) to avoid the connective tissues of the palatine suture and (2) because it is considered to be a suitable host site for implant placement. After three months of healing, the implant was osseointegrated and orthodontic treatment was initiated. The results showed that the molars were distalized bodily at five months, and no anchorage loss was observed. At the end of the treatment, the smile was improved, and an ideal Class I molar and canine relationship, an ideal overbite, and an ideal overjet were all achieved. In conclusion, palatal implants can be used effectively for anchorage maintenance and in space-gaining procedures. Use of a three-dimensional surgical template eliminated implant placement errors, reduced chair time, minimized trauma to the tissues, and enhanced osseointegration. This method can be used effectively to achieve distalization of molars bodily without anchorage loss.

Hepatitis B - Methods of Sterilization And Disinfection.

Hepatitis b is a slow killer and hence its potence is knowingly ignored. India has the second largest pool of HBV carriers. Hepatitis B causes health threat to dentists and orthodontic patients. In this article we would be describing the various methods of sterilization and disinfection of orthodontic clinic and instruments which protects both patient and orthodontist.

Combination 20 and 23-gauge transconjunctival vitrectomy: A new approach.

The advent of smaller gauge instrumentation allows for minimally invasive vitreoretinal surgery (MIVS) as compared to conventional pars plana vitrectomy. Sutureless posterior segment surgery has the advantages of faster wound healing, minimal surgical trauma, decreased convalescence period besides reduced postoperative astigmatism; however, slower gel removal and limited peripheral vitreous dissection are disadvantages with smaller gauge systems. We herein describe a new technique combining 23-gauge and 20-gauge vitrectomy to improve the effectiveness and outcomes of vitreoretinal surgery.

Simultaneous spectrophotometric estimation of bisoprolol fumarate and hydrochlorothiazide in tablet dosage form

Two analytical methods have been developed for simultaneous quantification of bisoprolol fumarate and hydrochlorothiazide in combined pharmaceutical dosage form using spectrophotometer. Excellent simplicity, accuracy, precision and economy were achieved by the assay. The 'method I' was based upon 'simultaneous equations' whereas the 'method II' was based upon 'multicomponent mode of analysis' of the instrument. For both these methods, 0.1 N NaOH was used as solvent. In this solvent, bisoprolol fumarate showed absorbance at 224 nm and hydrochlorothiazide at 273 nm. Linearity lies in the concentration range of 3 - 21 microg/ml for bisoprolol fumarate and 3 - 18 microg/ml for hydrochlorothiazide. The methods were validated statistically and by recovery studies

Identification of active principles of manihot esculenta and cerbera odallum by thin layer chromatography: The potential for misinterpretation in forensic cases.

The main aim of this study was to perform thin layer chromatography on plant extracts of Cerbera odallum and Manihot esculenta, and ascertain as to whether similar patterns are obtained in the results. Most forensic science laboratories in India perform TLC assays for detecting active principles of Cerbera odallum, which is a common suicidal agent in some parts of the country. There have been instances where a positive report for Cerbera odallum was furnished, where no such history of ingestion was available. In some of these cases there was history of ingestion of cassava (Manihot esculenta), which is a staple food in some communities. The suspicion naturally arose as to whether the active principles of these two plants (one edible, the other poisonous) exhibit similar TLC profiles leading to the confusion. In this study the TLC patterns of the glycosides present in Cerbera odallum and Manihot esculenta were studied, which revealed that this was indeed the case. This makes it imperative that alternative methods must be used in suspected poisoning with Cerbera odallum, in order to avoid confusion in medicolegal cases. It is clear that the glycosides present in both odallum and cassava cross-react with each other giving similar TLC results.

Polyglandular autoimmune syndrome-type I.

Polyglandular autoimmune syndrome type I is a rare disorder characterized by mucocutaneous candidiasis (MC), hypoparathyroidism (HP) and adrenal insufficiency , requiring regular follow up as the components of the syndrome appear at different age groups. We report a six and half year boy having this syndrome and presenting with MC, HP and ectodermal dystrophy.

Etiology and clinical profile of ambiguous genitalia an overview of 10 years experience.

One hundred nine patients presenting with ambiguous genitalia over the past 10 years (year 1995 to 2004) to Pediatric Endocrine Service of our hospital were reviewed. On the basis of clinical and investigative evaluation like hormonal and biochemical estimations, imaging studies, karyotype and invasive techniques like genitoscopy, laproscopy, open exploration and biopsy of gonads when indicated, these cases could be categorised as Genetic females with virilisation or FPH (n = 30 cases, 27.5 % Genetic males undervirilised or MPH (n = 57 cases, 52.3 %), Disorders of gonadal differentiation (n = 11, 10.1 %) Nine patients with gonadal dysgenesis and 2 with true hermaphroditism and the syndromic form of ambiguous genitalia (n = 2, 1.8 %). Congenital adrenal hyperplasia (CAH) was the underlying cause in all cases of FPH, the salt wasting form in 23/30 and simple virilising form in 7. Major categories in MPH group were Androgen insensitivity syndrome in 28 % (16/57) and 5a reductase deficiency in 23% (13/57).