Ocular effects of eye cosmetic formulations.

OBJECTIVE: To study the ocular effects seen among eye cosmetic wearers in the Indian Population. METHODS: This cross-sectional study was conducted on female participants who had fulfilled the inclusion and exclusion criteria. A detailed history was obtained and thorough ophthalmic evaluation was done. Mann Whitney U test was used. Statistical analysis was done using IBM SPSS. p < .05 was taken as the level of statistical significance. RESULTS: Among a total of 225 participants in our study, the mean age was 24.23 ± 1.8, which comprised of young student females. Majority of the females used one eye cosmetic with Kajal (n = 156) being the most predominant. Most frequently encountered symptom upon using eye cosmetics was watering from eyes and ocular pain was the least encountered symptom. Anterior segment examination showed- allergic conjunctivitis and meibomian gland dysfunction being the most and least predominant, respectively. Our study highlights that Kajal predisposes the eyes to significant ocular morbidity with p = .039 for dry eye disease, p = .041 for allergic conjunctivitis, p = .036 for conjunctival pigmentation. Prolonged use of such formulations for more than 4 times a week (p = .046) or even daily (p = .031) for a duration of either 1-5 years (p = .033) or greater than 5 years (p = .027) was found to be statistically significant in causing ocular signs. Non removal of eye cosmetics at the end of the day was significant in causing allergic conjunctivitis (p = .035) and conjunctival pigmentation (p = .021). Plain tap water has been found to be the least effective technique in the removal of such ocular cosmetics with a statistical significance of p = .031 in causing ocular signs. CONCLUSIONS: Eye cosmetics are a significant contributor to the development of ocular surface diseases. Removal of products along with decreased usage seems to be a significant contributor in dampening unwanted adverse effects.

Improved rank-based recursive feature elimination method based ovarian cancer detection model via customized deep architecture.

BACKGROUND: Ovarian cancer is often considered the most lethal gynecological cancer because it tends to be diagnosed at an advanced stage, leading to limited treatment options and poorer outcomes. Several factors contribute to the challenges in managing ovarian cancer, namely rapid metastasis, genetic factors, reproductive history, etc. This necessitates the prompt and precise diagnosis of ovarian cancer in order to carry out efficient treatment plans and give patients who are all impacted by OC the care and support they need. METHODS: This CCLSTM model is suggested under four essential stages including preprocessing, feature extraction, feature selection and detection. Initially, the input data is preprocessed using Improved Two-step Data Normalization. Subsequently, features such as statistical, modified entropy, raw features and mutual information are extracted from the normalized data. Next, obtained features undergo the Improved Rank-based Recursive Feature Elimination method (IR-RFE) to select the most suitable features. Finally, the proposed CCLSTM model takes the selected features as input and provides a final detection outcome. RESULTS: Furthermore, the performance of the proposed CCLSTM technique is examined through a thorough assessment using diverse analyses Additionally, the CCLSTM schemes show a sensitivity value of 0.948, whereas the sensitivity ratings for ALO-LSTM + ALOCNN, Bi-GRU, LSTM, RNN, KNN, CNN, and DCNN are 0.808, 0.893, 0.829, 0.851, 0.765, 0.872, and 0.893, respectively. CONCLUSION: In the end, the development of CNN and the addition of LSTM technique have produced an ovarian cancer detection technique that is more accurate and consistent compared to other existing strategies.

A study on knowledge, attitude, and practices toward ophthalmic emergencies among fresh medical graduates in India.

PURPOSE: The purpose of this study was to evaluate and estimate the knowledge, attitude, and practices of Indian fresh medical graduates with respect to ophthalmic emergencies. MATERIALS AND METHODS: This cross-sectional study was conducted on 1300 participants who had completed compulsory rotatory residential internship with the help of a questionnaire distributed through social platforms. The Chi-square and Pearson's coefficient relation tests were used. Statistical analysis was done using IBM SPSS. P <0.05 was taken as the level of statistical significance. RESULTS: Good knowledge proportionately corresponded to a good attitude with statistical significance (P = 0.000). Participants with good practice also had a good attitude with significance (P = 0.001). Good knowledge participants who managed ophthalmic emergencies were statistically significant than that of participants with poor knowledge and managed ophthalmic emergencies, 15.72%. (χ2 = 16.653, P = 0.000). Attitude toward confidence in the management of ophthalmic emergencies and their willingness in undergoing training was significant (χ2 = 43.8, P = 0.000). CONCLUSION: Educating and training fresh medical graduates can help in the management and mitigation of ophthalmic emergencies to reduce ocular morbidity and prevent blindness to a greater degree.

Sighting Dominance, Biometric Parameters, and Refractive Status Analyzing the Role of Ocular Dominance.

Objectives: The purpose was to study the association between ocular dominance, refractive status, and biometric parameters. Methods: Ocular dominance was assessed on consenting participants with non-pathological eyes using "hole-in-the-card test." The participants were then examined for visual acuity, biometric measurements, and refraction. Data were analyzed using IBM SPSS software. Results: Among a total of 660 participants in our study, right eye dominance was found in 508 (76.97%) participants. We found that horizontal keratometry readings (K1) were greater in the dominant eye compared to the non-dominant eye, showing a statistically significant difference in emmetropes (p<0.001) and hyperopes (p<0.001). The axial length was found to be longer but not significantly greater in dominant eye among while it was significant among myopes (p<0.001) and hyperopes (p<0.001). In myopic anisometropes, the axial length was significantly longer and more myopic in the dominant eye (24.0±0.7 mm) than non-dominant eye (23.9±0.4 mm) while the non-dominant eye was more hyperopic in anisometropic hyperopes. Conclusion: Right eye was dominant in majority of participants. The dominant eye was more myopic and had greater axial length in anisometropes. The dominant eye was more astigmatic than the non-dominant eye. Visual acuity was not affected by ocular dominance. The mean difference in biometric measurements was significantly greater in hyperopic eyes. The assessment of ocular dominance could improve patient satisfaction in refractive surgeries and monovision treatments. Treatment protocols could be fine-tuned based on ocular dominance. Normative data in various biometric measurements could take into consideration laterality in terms of dominance.

Digital Survey Assessment of Individual and Occupational Factors Associated with Musculoskeletal Disorders among Indian Ophthalmologists.

Purpose: To study the prevalence of musculoskeletal disorder (MSD) and the associated occupational risk factors among Indian ophthalmologists, including residents and fellows. Methods: A cross-sectional survey was conducted among ophthalmologists in India using a semi-structured questionnaire in a web-based survey. The questionnaire was prepared in English after extensive literature research and consulting with subject experts. It was pretested on ten ophthalmologists and after confirming that there were no ambiguities, the questionnaire was circulated. After providing informed consent online and ensuring the confidentiality of information, respondents could fill out the questionnaire containing questions to assess demographic details, risk factors, and musculoskeletal symptoms. Results: We received 551 valid responses, out of which 74.77% reported musculoskeletal symptoms since starting practice in ophthalmology. We found a statistically significant association of work-related MSD with greater hours of practice, a higher number of hours of surgery, and a larger patient load. The self-reported symptoms were maximum in lower back (56.55%), followed by neck (49.03%), upper back (38.59%), and shoulder (23.79%). As a remedial measure, 58.98% resorted to rest while only 8.98% consulted orthopedist. Only 46% were aware of good ergonomic practices. Surgery (74.5%), indirect ophthalmoscopy (51.69%), and slit-lamp examination (50.73%) were reported as the major culprits. Respondents declared an interference with personal life (39.56%), with work (33.74%) as well as having caused psychological stress (43.2%) due to work-related MSD. Conclusion: A vast majority of our respondents reported work-related MSD. Major risk factors were hours of practice, hours of surgery, higher body mass index, sedentary lifestyle, and higher patient load. The awareness of ergonomic practices was low.

Quantitative Analysis of Tear Film in Patients on Atypical Antipsychotics.

PURPOSE: To evaluate and compare the prevalence and severity of dry eye disease (DED) among patients on atypical antipsychotics with controls. METHODS: This cross-sectional study was conducted on patients who were on atypical antipsychotic therapy (study group) and matched controls (control group). Prevalence of DED was assessed using tear break up time. Statistical analysis was done using SPSS. Chi-square test and t-test were used. p < 0.05 was taken as the level of statistical significance. RESULTS: Prevalence of DED was significantly more in study group. Polytherapy group has significantly high DED compared with monotherapy. Among monotherapy, clozapine had highest prevalence of DED (p-0.013) and among the polytherapy, clozapine-quetiapine had highest prevalence of dry eye. CONCLUSION: Prevalence of DED was higher among antipsychotics than the normal population, and in polytherapy than monotherapy group. The patients on clozapine (monotherapy) and clozapine with quetiapine (polytherapy) had highest prevalence of DED.

Study of retinal nerve fiber layer thickness in diabetic patients using optical coherence tomography.

Purpose: This study aimed to assess and compare the changes in peripapillary retinal nerve fiber layer (RNFL) thickness in nondiabetics and diabetics with various stages of diabetic retinopathy (DR). Methods: The study subjects were divided into four groups based on their diabetic status and findings, namely, controls (normal subjects without diabetes [NDM]), diabetics without retinopathy (NDR), nonproliferative DR (NPDR), and proliferative DR (PDR). Peripapillary RNFL thickness was assessed using optical coherence tomography. One-way analysis of variance (ANOVA) with the post-Tukey HSD test was done to compare RNFL thickness in different groups. The Pearson coefficient was used to determine the correlation. Results: There was statistically significant difference in measured average RNFL (F = 14.8000, P < 0.05), superior RNFL (F = 11.7768, P < 0.05), inferior RNFL (F = 12.9639, P < 0.05), nasal RNFL (F = 12.2134, P < 0.05), and temporal RNFL (F = 4.2668, P < 0.05) across the different study groups. Pairwise comparison showed that there was a statistically significant difference in RNFL measured (average and all quadrants) in patients with DR (NPDR and PDR) and the NDM control group (P < 0.05). In diabetics without retinopathy, the RNFL measured was reduced compared to controls, but it was statistically significant only in the superior quadrant (P < 0.05). Average RNFL and RNFL in all quadrants showed a small negative correlation with the severity of DR and it was statistically significant (P < 0.001). Conclusion: In our study, peripapillary RNFL thickness was reduced in diabetic retinopathy compared to normal controls and the thinning increased with the severity of DR. This was evident in the superior quadrant even before the fundus signs of DR set in.

A study on the perception, knowledge, attitude, and practices of eye donation among fresh medical graduates in India.

OBJECTIVE: The objective of the study was to assess the perception, knowledge, attitude, and practices of eye donation among fresh medical graduates in India. MATERIALS AND METHODS: Responses to a semi-structured questionnaire were collected from 410 respondents using an online Google Form which were analyzed using IBM SPSS software version 21. RESULTS: First information source about eye donation was textbooks (31%), while ophthalmologists accounted for 10.7%. Forty-two respondents had pledged their eyes, 116 were willing to pledge their eyes. Majority had "adequate" knowledge (74.1%). The knowledge levels were directly related to the practice of motivation for eye donation (P = 0.032). Around 62% had "poor" eye donation practices. Significant relationship between practice and knowledge levels (P = 0.004) was noted. Participants who graduated from institutions with eye banks were more likely to have good practice (P = 0.005). CONCLUSIONS: A curriculum focusing on practical exposure to eye donation and eye banking services would address the current deficits in eye donation. Reinforcing knowledge of eye banking among non-ophthalmologist doctors can enhance the eye donation trend. Timely counseling of patients and bystanders by well-informed sensitized doctors is hence of utmost importance.

Comparison of smartphone application-based visual acuity with traditional visual acuity chart for use in tele-ophthalmology.

PURPOSE: The aim of this study was to compare the visual acuity (VA) by smartphone-based applications - EyeChart and the Peek Acuity to the standard Snellen chart to explore the possibility of using them as an alternative in tele-ophthalmology in the current COVID-19 pandemic. MATERIALS AND METHODS: An analytical type of observational study was done on 360 eyes of 184 patients above 18 years of age. Patients with VA <6/60 and gross ocular pathology were excluded from the study. VA measured by these three methods was converted to logMAR scale for ease of statistical analysis. One-way analysis of variance with post Tukey HSD was used to compare the VA measured by these three methods. RESULTS: There was no statistically significant difference between VA measured using the smartphone-based apps (EyeChart and Peek Acuity) and the Snellen chart (F = 2.5411, P = 0.7925) in 360 eyes assessed. VA measured by Peek Acuity (P = 0.5225) was more comparable to Snellen chart than EyeChart (P = 0.4730). Intraclass correlation coefficient (ICC) demonstrated a strong positive correlation for EyeChart (ICC: 0.982, P < 0.001) and Peek Acuity (ICC: 0.980, P < 0.001) with Snellen chart. A Bland-Altman difference plot showed good limits of agreement for both EyeChart and Peek Acuity with Snellen chart. In subgroup analysis, VA measured by Peek Acuity was not statistically different from Snellen in any subgroups, but in EyeChart, it was statistically different in emmetropes. CONCLUSION: VA measured by smartphone apps (EyeChart and Peek Acuity) was comparable with traditional Snellen chart and can be used as an effective, reliable, and feasible alternative to assess VA in tele-ophthalmology.

Evaluation of post-COVID health status using the EuroQol-5D-5L scale.

SARS-CoV-2 has had a lasting effect on the overall health of recovered patients, called 'long COVID'. Currently, there is a lack of a validated standard questionnaire to assess post-COVID health status. A retrospective observational study involving the recovered COVID patients admitted to a secondary care hospital in India between June to December 2020 (n = 123), was conducted using the EuroQol-5D-5L scale at discharge, 4 weeks and 8 weeks post-discharge. A significant difference in anxiety/depression scores was found (χ2 = 65.6, p < 0.000) among the 3 categories of time (discharge, 4 weeks and 8 weeks). The anxiety/depression dimension scores showed a significant change (p < 0.0001) between discharge and 8 weeks, using paired t-test. Age had a significant relationship with the anxiety/depression dimension at 4 weeks (OR = 5.617, 95% CI = 1.0320-30.5746, p < 0.05). A significant difference was found using Kruskal-Wallis rank-sum test on mean index scores (χ2 = 60.0, p < 0.000) among the three categories of time (discharge, 4 weeks and 8 weeks). There was a statistically significant difference of time on EQ Index scores as determined by one-way repeated measures ANOVA (F(2,375) = 18.941, p = <0.00001). Our study found time to have a statistically significant impact on the mean index scores, level sum scores and dimension scores. Smoking was found to be significantly associated with usual activity scores at 4 weeks. The most remarkable changes occurred in the anxiety/depression dimension. Overall, there was a general trend of health improvement.

Ipsilateral floating hip and knee, or floating lower limb - A rare case report.

INTRODUCTION: Ipsilateral floating hip and knee injuries at the same time are very rare injuries, occurring due to high velocity trauma. With a small number of such case reports, the treatment guidelines regarding surgical fixation are yet to be formulated. CASE REPORT: We report an interesting case of hip dislocation, comminuted acetabular fracture, intertrochanteric and shaft of femur fracture and both bones leg fracture ipsilaterally. Open reduction of hip, antegrade femoral nailing with recon nail and closed tibial nailing was done in a single setting. Acetabular fracture was treated non-operatively. CONCLUSION: Patient's general condition, co-morbid status, fracture pattern and the surgical expertise of the trauma team should guide the definitive treatment and its sequence. Early fixation of long bones is warranted and acetabular fixation can be done in second stage.

Dentigerous Cyst Associated with Adenomatoid Odontogenic Tumour.

Adenomatoid odontogenic tumour (AOT), a tumour composed of odontogenic epithelium, is an uncommon tumour of odontogenic origin that accounts for only 2.2- 7.1% of all odontogenic tumours. Very few cases of AOT associated with Dentigerous cyst (DC) have been reported till date, most cases are in females and have a striking tendency to occur in the anterior maxilla. The present case is that of a 14-year-old female who revealed a large radiolucent lesion associated with the crown of an unerupted canine located in the left maxillary anterior region. The microscopic examination revealed the presence of AOT in the fibrous capsule of a DC. In this paper, we describe the importance of grossing, sectioning and complete examination of the slide to diagnose such hybrid lesions.