Exploring the interwoven relationship: Property rights, financial freedom, government regulation, and stock market fluctuations in emerging economies - A novel system GMM perspective.

This study delves into the impact of formal institutions on stock market volatility within a selection of emerging economies. Specifically, it examines the role that formal institutions play in shaping this volatility. To accomplish our goal, we analyze panel data from 46 emerging nations spanning the years 2000-2019, utilizing system generalized method of moments (GMM), as well as random and fixed effect models for our estimations. The findings of this research validate the existence of a significant association between formal institutions and stock market volatility. Likewise, through dynamic panel estimation, we discover that formal institutions such as property rights, financial freedom, and government regulations have a notable negative effect on stock market volatility. Consequently, this study implies that formal institutions play a crucial role in reducing stock market volatility in emerging economies, fostering their development. The insights gained from this research encourage policymakers to view formal institutions as key influencers of stock market volatility. These results offer valuable guidance for emerging nations.

Inequities Along the Human Immunodeficiency Virus (HIV) Pre-exposure Prophylaxis Services Continuum for Black Women in the United States, 2015-2020.

OBJECTIVE: To estimate the number of women who received human immunodeficiency virus (HIV) and sexually transmitted infection (STI) testing and HIV pre-exposure prophylaxis (PrEP) services by race and ethnicity in seven THRIVE (Targeted Highly Effective Interventions to Reverse the HIV Epidemic)-funded jurisdictions and to estimate associations of age and syphilis and gonorrhea diagnoses with receipt of HIV PrEP services. METHODS: We analyzed data collected from 2015 to 2020 in Birmingham, Alabama; Baltimore City, Maryland; Washington, DC, New Orleans, Louisiana; Brooklyn, New York; Philadelphia, Pennsylvania; and Hampton Roads, Virginia. We compared Black women and women of additional racial and ethnic groups by age, HIV status at enrollment, receipt of STI testing and test positivity, and steps in the PrEP continuum (screened, eligible, referred, linked, and prescribed). We also examined the association of age, syphilis, or gonorrhea with the following steps in the PrEP continuum: screened, referred, linked, and prescribed. RESULTS: Black women made up 69.2% (8,758/12,647) of women served in THRIVE. Compared with non-Black women, Black women were more likely to have a positive test result for syphilis (3.3% vs 2.1%), gonorrhea (4.9% vs 3.5%), chlamydia (5.1% vs 1.9%), or more than one STI (1.4% vs 0.3%). Among women with negative HIV test results or unknown HIV status, Black women were more likely to be screened for PrEP eligibility (88.4% vs 64.9%). Among Black women, the proportion screened for PrEP was higher among those diagnosed with syphilis (97.3%) or gonorrhea (100%) than among those without an STI (88.1% and 87.8%, respectively). Among 219 Black women who presented with syphilis, only 10 (4.6%) were prescribed PrEP; among 407 with gonorrhea, only 11 (2.7%) were prescribed PrEP. CONCLUSION: Although most Black women seeking services received STI testing, the proportion of Black women who were eligible for PrEP and prescribed PrEP was low. To achieve national HIV-prevention goals, it is imperative that Black women have access to PrEP information and services.

Computational analysis of control of hepatitis B virus disease through vaccination and treatment strategies.

Hepatitis B disease is an infection caused by a virus that severely damages the liver. The disease can be both acute and chronic. In this article, we design a new nonlinear SVEICHR model to study dynamics of Hepatitis B Virus (HBV) disease. The aim is to carry out a comprehensive mathematical and computational analysis by exploiting preventive measures of vaccination and hospitalization for disease control. Mathematical properties of proposed model such as boundedness, positivity, and existence and uniqueness of the solutions are proved. We also determine the disease free and endemic equilibrium points. To analyze dynamics of HBV disease, we compute a biologically important quantity known as the reproduction number R0 by using next generation method. We also investigate the stability at both of the equilibrium points. To control the spread of disease due to HBV, two feasible optimal control strategies with three different cases are presented. For this, optimal control problem is constructed and Pontryagin maximum principle is applied with a goal to put down the disease in the population. At the end, we present and discuss effective solutions obtained through a MATLAB code.

The Emulsification of Silicone Oil 5000 cs in Patients With Retinal Detachment.

Background The emulsification of silicone oil is a significant concern for those with rhegmatogenous retinal detachment (RRD) following surgery. The aim of the study was to assess the frequency of emulsification in the patients who underwent primary vitrectomy and were administered 5000 cs silicone oil. Methodology The Layton Rahmatullah Benevolent Trust in Lahore conducted an ophthalmology study from January 2022 to March 2023. The patients who had primary vitrectomy for RRD with silicone oil tamponade were included regardless of age or gender. Those on anti-inflammatory or steroid medications prior to surgery were excluded. Retinal attachment was examined 8-12 weeks post operation to assess silicone oil removal eligibility. Emulsification occurrence was reported. Data on emulsification time, visual acuity (pre- and post-removal), mean intraocular pressure (IOP), and clinical outcomes were collected and analyzed using the Statistical Package for Social Sciences (SPSS) software (IBM SPSS Statistics, Armonk, NY). The results were graphically presented with mean, standard deviations, frequencies, and proportions. Results A total of 158 patients underwent silicone oil removal after undergoing primary vitrectomy for RRD with silicone oil. The mean age of the patients was 45.90 ± 17.8 years. The mean preoperative intraocular pressure (IOP) among the patients was 16.28 ± 2.97 mmHg. Post removal of silicone oil, the IOP was reduced to 12.66 ± 3.02 mmHg. In 11 out of 158 cases (6.9%) of RRD, emulsification had occurred with silicone oil 5000 cs. We found that out of 11 cases of emulsification, eight (72.73%) were 40 years or older in age. Seven (63.64%) patients had tamponade duration of 10 weeks or longer. However, the difference was not statistically significant. Conclusion In conclusion, our study found that the incidence of emulsification of 5000 cs silicone oil in the patients who underwent primary vitrectomy for the treatment of RRD was 6.9%. We observed that emulsification was more frequent in patients aged 40 years or older and those with a tamponade duration of 10 weeks or longer, although the difference was not statistically significant. Further investigation with bigger sample sizes and extended follow-up periods is required to verify our findings and explore potential factors that could lead to emulsification in this group of patients.

Comparison Of Different Methods Of Controlling Pain During Debonding Of Orthodontic Brackets.

Objective: To compare the efficacy of finger pressure and plastic wafers in terms of pain control during debonding. METHODS: This cross sectional study was conducted at the Department of Orthodontics, Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from January to June 2020, and comprised patients of either gender aged 13-21 years who had completed fixed orthodontic treatment with 0.022 brackets of Roth prescription and required debonding. The patients was divided into two equal groups. In group A, teeth were stabilised with finger pressure with cotton between the finger and teeth, and then debonding was done using open mouth technique. In group B, teeth were stabilised using a plastic wafer between maxillary and mandibular teeth, and then debonding was done using closed mouth technique. Pain was assessed using a visual analogue scale VAS. Data was analysed using SPSS 23. RESULTS: Of the 110 patients, each of the 2 groups had 55(50%) subjects. Overall, there were 35(32%) males and 75(68%) females. The mean age of the sample was 16±2.4 years. Mean pain scores among the males was 32.0±7.68 compared to 34.067±12.59 among the females (p>0.05). Subjects in group B had significantly less pain than those in group A (p<0.05). Conclusion: Plastic wafer was found to be more effective in terms of controlling pain during debonding compared to finger pressure.

Benefits of Frequent HIV Testing in the THRIVE Demonstration Project: United States, 2015-2020.

Objectives. To describe HIV testing among clients in the Targeted Highly Effective Interventions to Reverse the HIV Epidemic (THRIVE) demonstration project and evaluate testing frequency. Methods. We identified factors associated with an average testing frequency of 180 days or less compared with more than 180 days using adjusted Poisson regression models. We performed the Kaplan-Meier survival analysis to compare time to diagnosis by testing frequency. Results. Among 5710 clients with 2 or more tests and no preexposure prophylaxis (PrEP) prescription, 42.4% were tested frequently. Black/African American clients were 21% less likely and Hispanic/Latino clients were 18% less likely to be tested frequently than were White clients. Among 71 Black/African American and Hispanic/Latino cisgender men who have sex with men and transgender women with HIV diagnoses, those with frequent testing had a median time to diagnosis of 137 days, with a diagnostic testing yield of 1.5% compared with those tested less frequently, with 559 days and 0.8% yield. Conclusions. HIV testing at least every 6 months resulted in earlier HIV diagnosis and was efficient. Persons in communities with high rates of HIV who are not on PrEP can benefit from frequent testing, and collaborative community approaches may help reduce disparities. (Am J Public Health. 2023;113(9):1019-1027. https://doi.org/10.2105/AJPH.2023.307341).

Giant Meckel's Diverticulum as a Cause of Post-traumatic Hemoperitoneum in a 25-Year-Old Male: An Extremely Rare Phenomenon.

Following the "rule of 2", Meckel's Diverticulum (MD) is 2 inches or 5cm long. However, we report the case of an extremely large MD. To the best of our elucidated literature search, it is the first case of Giant Meckel's Diverticulum (GMD) from Pakistan presenting with post-traumatic hemoperitoneum. A 25-year-old Pakistani male presented to a surgical emergency with a two-hour history of generalized abdominal pain after blunt abdominal trauma. An exploratory laparotomy was carried out due to the deranged hemodynamic parameters and free fluid in the abdominopelvic cavity, revealing a 35 centimeters long MD with a bleeding vessel on its tip. Diverticulectomy with the repair of a small intestinal defect was performed after the evacuation of 2.5 liters of clotted blood. Histologic evaluation revealed ectopic gastric tissue. He had an uneventful post-operative stay and was discharged home. The current English scientific literature has adequate case reports documenting the complications of perforation, intestinal obstruction, and diverticulitis of Meckel's Diverticulum (MD) of normal length. However, this case report highlights the significance of an MD with an abnormal length which put the patient's life at risk of death in the setting of normal intra-operative anatomy of all other abdominal organs.

HIV Prevention Services for Hispanic/Latino Persons in THRIVE, 2015-2020.

INTRODUCTION: Hispanic/Latino men who have sex with men (MSM) and transgender women (TGW) are disproportionately affected by HIV in the U.S. This study evaluated HIV prevention services and outcomes among Hispanic/Latino MSM and TGW in the Targeted Highly Effective Interventions to Reduce the HIV Epidemic (THRIVE) demonstration project and consider lessons learned. METHODS: The authors described the THRIVE demonstration project services provided to Hispanic/Latino MSM and TGW in 7 U.S. jurisdictions from 2015 to 2020. HIV prevention service outcomes were compared between 1 site with (2,147 total participants) and 6 sites without (1,129 total participants) Hispanic/Latino-oriented pre-exposure prophylaxis clinical services, and Poisson regression was used to estimate the adjusted RR between sites and pre-exposure prophylaxis outcomes. Analyses were conducted from 2021 to 2022. RESULTS: The THRIVE demonstration project served 2,898 and 378 Hispanic/Latino MSM and TGW, respectively, with 2,519 MSM (87%) and 320 TGW (85%) receiving ≥1 HIV screening test. Among 2,002 MSM and 178 TGW eligible for pre-exposure prophylaxis, 1,011 (50%) MSM and 98 (55%) TGW received pre-exposure prophylaxis prescriptions, respectively. MSM and TGW were each 2.0 times more likely to be linked to pre-exposure prophylaxis (95% CI=1.4, 2.9 and 95% CI=1.2, 3.6, respectively) and 1.6 and 2.1 times more likely to be prescribed pre-exposure prophylaxis (95% CI=1.1, 2.2 and 95% CI=1.1, 4.1), respectively, at the site providing Hispanic/Latino-oriented pre-exposure prophylaxis clinical services than at other sites and adjusted for age group. CONCLUSIONS: The THRIVE demonstration project delivered comprehensive HIV prevention services to Hispanic/Latino MSM and TGW. Hispanic/Latino-oriented clinical settings may improve HIV prevention service delivery to persons in Hispanic/Latino communities.

Decreased Human Immunodeficiency Virus Diagnosis Rates Among Black and Hispanic or Latino Men Who Have Sex With Men in US Jurisdictions Supported by the THRIVE Demonstration Project, 2014-2019.

BACKGROUND: Black and Hispanic/Latino men who have sex with men (MSM) are disproportionately affected by human immunodeficiency virus (HIV). In the Targeted Highly Effective Interventions to Reverse the HIV Epidemic (THRIVE) demonstration project, 7 community collaboratives were developed to provide comprehensive HIV prevention services for these populations. METHODS: We analyzed National HIV Surveillance System data to determine the number of HIV diagnoses for each year from 2014 to 2019 among Black, Hispanic/Latino, and White MSM in 7 THRIVE-eligible Metropolitan Statistical Areas (MSAs) that were awarded funding and 12 THRIVE-eligible MSAs that were not awarded funding. We used generalized linear Poisson regression models to estimate adjusted estimated annual percentage changes (EAPCs) with 95% confidence intervals for HIV diagnosis rates controlling for HIV prevalence, viral suppression, HIV testing rates, preexposure prophylaxis (PrEP) prescription rates, poverty, education, and insurance status. RESULTS: We found larger estimated decreases in HIV diagnosis rates in THRIVE jurisdictions compared with non-THRIVE jurisdictions. The adjusted EAPC among Black MSM was -8.2 (-11.7 to -4.6) in THRIVE MSAs compared with -4.2 (-7.8 to -0.4) in non-THRIVE MSAs. The adjusted EAPC among Hispanic/Latino MSM was -8.6 (-12.2 to -4.8) in THRIVE MSAs compared with -2.6 (-5.1 to -0.1)in non-THRIVE MSAs. The adjusted EAPC among White MSM was -7.6 (-12.0 to -3.1) in THRIVE MSAs compared with 5.9 (1.8-10.1) in non-THRIVE MSAs. CONCLUSIONS: The THRIVE community collaborative model was associated with a decrease in HIV diagnoses among Black and Hispanic/Latino MSM. To achieve the goals of the US Ending the HIV Epidemic initiative, effective interventions aimed to increase PrEP use need to be focused on Black and Hispanic/Latino MSM.

HIV Pre-exposure Prophylaxis Services for Black and Hispanic or Latino Gay, Bisexual, and Other Men Who Have Sex With Men and Transgender Women in THRIVE, 2015-2020.

BACKGROUND AND SETTING: From 2015 to 2020, the THRIVE project supported 7 US health departments to improve HIV prevention services for Black or African American (Black) and Hispanic or Latino gay, bisexual, and other men who have sex with men (GBM) and transgender women (TGW). METHODS: We described services provided in the THRIVE PrEP continuum. Using Poisson regression models, we estimated associations between race or ethnicity and age and PrEP screening, linkage, and prescription. We examined associations between colocation of services and PrEP linkage and prescription for 2 sites. RESULTS: THRIVE served 12,972 GBM without HIV; 37% of PrEP-eligible GBM were prescribed PrEP. THRIVE served 1185 TGW without HIV; 45% of PrEP-eligible TGW were prescribed PrEP. Black and Hispanic or Latino GBM were 29% (RR = 0.71, 95% CI: 0.66-0.77) and 19% (RR = 0.81, 95% CI: 0.75-0.87) less likely, respectively, to be prescribed PrEP than White GBM. GBM aged 18-24 years and 55 years or older were 19% (RR = 0.81, 95% CI: 0.75-0.87) and 22% (RR = 0.78, 95% CI: 0.67-0.9) less likely, respectively, to be prescribed PrEP compared with those aged 35-44 years. Colocated services were associated with a 54% (RR = 1.54, 95% CI: 1.44-1.64) and a 31% (RR = 1.31, 95% CI: 1.19-1.43) greater likelihood of PrEP linkage and prescription, respectively, compared with services at different locations. CONCLUSIONS: THRIVE provided PrEP to higher proportions of PrEP-eligible persons than current national estimates; however, PrEP use disparities persist. Colocation of services may be a useful component of jurisdictional strategies to increase PrEP coverage.

The Effect of Navigation on Linkage to a PrEP Provider Among PrEP-Eligible Men who have Sex with Men in a U.S. Demonstration Project.

Our objective is to evaluate the effect of navigation on linkage to a PrEP provider among PrEP-eligible men who have sex with men (MSM) in THRIVE, a demonstration project in seven U.S. public health jurisdictions during 2015-2020. We describe PrEP linkage and navigation use among MSM in THRIVE. We performed multivariable probit regression modeling, controlling for demographic covariates, to estimate the association between navigation and linkage to a PrEP provider among MSM and to assess for disparities in linkage to PrEP among MSM who used navigation. Among 9538 PrEP-eligible MSM, 51.3% used navigation and 53.8% were linked to PrEP. From the three sites where navigation was optional and the main form of PrEP support, MSM who used navigation were 16.69 times (95% CI 13.07-21.32) more likely to link to PrEP compared with MSM who did not use navigation. Among 4895 MSM who used navigation from all seven sites, Black MSM were 21% less likely to link to PrEP compared with White MSM (aRR 0.79; 95% CI 0.74-0.83). Navigation is a promising strategy for improving uptake of PrEP among U.S. MSM, but disparities persist. Addressing the underlying causes of inequities will be important to end the HIV epidemic.

Epidemiologic Features of the Monkeypox Outbreak and the Public Health Response - United States, May 17-October 6, 2022.

On May 17, 2022, the Massachusetts Department of Health announced the first suspected case of monkeypox associated with the global outbreak in a U.S. resident. On May 23, 2022, CDC launched an emergency response (1,2). CDC's emergency response focused on surveillance, laboratory testing, medical countermeasures, and education. Medical countermeasures included rollout of a national JYNNEOS vaccination strategy, Food and Drug Administration (FDA) issuance of an emergency use authorization to allow for intradermal administration of JYNNEOS, and use of tecovirimat for patients with, or at risk for, severe monkeypox. During May 17-October 6, 2022, a total of 26,384 probable and confirmed* U.S. monkeypox cases were reported to CDC. Daily case counts peaked during mid-to-late August. Among 25,001 of 25,569 (98%) cases in adults with information on gender identity,† 23,683 (95%) occurred in cisgender men. Among 13,997 cisgender men with information on recent sexual or close intimate contact,§ 10,440 (75%) reported male-to-male sexual contact (MMSC) ≤21 days preceding symptom onset. Among 21,211 (80%) cases in persons with information on race and ethnicity,¶ 6,879 (32%), 6,628 (31%), and 6,330 (30%) occurred in non-Hispanic Black or African American (Black), Hispanic or Latino (Hispanic), and non-Hispanic White (White) persons, respectively. Among 5,017 (20%) cases in adults with information on HIV infection status, 2,876 (57%) had HIV infection. Prevention efforts, including vaccination, should be prioritized among persons at highest risk within groups most affected by the monkeypox outbreak, including gay, bisexual, and other men who have sex with men (MSM); transgender, nonbinary, and gender-diverse persons; racial and ethnic minority groups; and persons who are immunocompromised, including persons with advanced HIV infection or newly diagnosed HIV infection.

Triple-combination therapy for cutaneous leishmaniasis using detergent-free, hyaluronate-coated elastic nanovesicles.

Aim: To develop and evaluate detergent-free, triple-drug-loaded, hyaluronate-coated elastic nanovesicles (H-ENVs) for the topical treatment of cutaneous leishmaniasis. Materials & methods: H-ENVs were developed and evaluated for vesicle size, entrapment efficiency, skin permeation and antileishmanial potential. Results: A 15.7 and 28.6% decrease in the cytotoxicity of paromomycin and amphotericin B, respectively, was observed in detergent-free ENVs compared with conventional ENVs. H-ENVs improved the efficacy of paromomycin against promastigote and amastigote models of leishmaniasis by 4- and 7.5-fold, respectively. In vivo investigation of H-ENVs demonstrated efficient topical management of cutaneous leishmaniasis. Conclusion: The results indicate the potential of H-ENVs as a safe topical treatment choice for cutaneous leishmaniasis.

Application of topical gel is an attractive alternative to oral or intravenous administration of drugs and is likely to deliver a higher dose of the drug to the target site with only rare systemic adverse effects. Nanotechnology-based topical drug delivery is an attractive aspect of pharmaceutical sciences that expresses interest in the topical treatment of cutaneous leishmaniasis. The authors' research focuses on the development and evaluation of novel multidrug-loaded, detergent-free nanovesicles for the simple and effective topical treatment of cutaneous leishmaniasis.

Optimal control strategies for the reliable and competitive mathematical analysis of Covid-19 pandemic model.

To understand dynamics of the COVID-19 disease realistically, a new SEIAPHR model has been proposed in this article where the infectious individuals have been categorized as symptomatic, asymptomatic, and super-spreaders. The model has been investigated for existence of a unique solution. To measure the contagiousness of COVID-19, reproduction number R 0 is also computed using next generation matrix method. It is shown that the model is locally stable at disease-free equilibrium point when R 0 < 1 and unstable for R 0 > 1 . The model has been analyzed for global stability at both of the disease-free and endemic equilibrium points. Sensitivity analysis is also included to examine the effect of parameters of the model on reproduction number R 0 . A couple of optimal control problems have been designed to study the effect of control strategies for disease control and eradication from the society. Numerical results show that the adopted control approaches are much effective in reducing new infections.

Core Technological Competence and Competitive Advantage: A Study on Chinese High-Tech SMEs.

The purpose of this study was to examine the effect of core technology competence on the competitive advantage of high-tech SMEs (small- and mid-sized enterprises in China). Based on the 379 valid responses collected from a survey, structural equation modeling (SEM) was employed to examine the research model. Infrastructure and technology, state-of-the-art technology, innovative research and development (R&D) capability, and organizational flexibility all have a significant impact on the competitive advantage, while infrastructure and technology, state-of-the-art technology, and innovative R&D capability have a significant effect on organizational flexibility. Organizational flexibility plays a mediating role between innovative R&D capability's effect and competitive advantage. Under the continuous influence of COVID-19, we should promote development from the perspective of strengthening enterprise infrastructure and technology and improving organizational flexibility to gain a competitive advantage. This study reveals the internal relationship between core technology competence, organizational flexibility, and competitive advantage. The results of this study will help us to fully understand the survival status and competitive advantage of high-tech SMEs under COVID-19.

How Did Work-Related Depression, Anxiety, and Stress Hamper Healthcare Employee Performance during COVID-19? The Mediating Role of Job Burnout and Mental Health.

The study objective was to examine the psychological impact of the COVID-19 pandemic on the performance of healthcare employees. The study was informed by a theoretical framework that incorporates different psychological issues (i.e., stress, depression, and anxiety) that influence healthcare workers' performance through the mediating roles of job burnout and mental health. The study data was gathered through structured questionnaires from 669 participants working in the healthcare sector in Pakistan. A structured equation modeling (SEM) technique was used for data analysis and hypothesis development. It was found that stress, depression, and anxiety positively affected healthcare employees' job performance during COVID-19. Psychological factors had a positive and significant impact on job burnout and mental health. Job burnout and mental health mediated the relationship between stress, anxiety, depression, and employee performance. The ongoing repercussions of COVID-19 include their impact on employee performance in the healthcare sector. Healthcare worker performance is critical to fostering industrial economic growth. Elevated levels of stress, depression, and anxiety have profoundly exacerbated employee mental health issues. COVID-19 has created challenging working conditions in organizations requiring that they address the growing psychological issues which impact negatively on worker performance.

Psychosis resulting from trimethoprim-sulfamethoxazole treatment for preseptal cellulitis.

Trimethoprim-sulfamethoxazole (TMP-SMX) is a commonly used antimicrobial agent because of its low cost, diverse antimicrobial profile, and minimal severe adverse effects. A rare side effect is psychosis, a complication that has not been published in the ophthalmology literature. A 53-year-old female presented to the ophthalmology office with left upper eyelid erythema, focal tenderness, and discharge. She was diagnosed with preseptal cellulitis of the left upper lid and started on TMP-SMX. The next day, the patient's condition improved with reduced swelling and no discharge. However, 2 days later, she experienced visual hallucinations whereby worms were growing out of her left eye accompanied by theme-congruent tactile hallucinations. TMP-SMX was discontinued and substituted for clindamycin, and she reported resolution of her symptoms 8 h later. TMP-SMX has extensive cerebrospinal fluid penetration and causes a folic acid deficiency, which may explain the rare occurrence of neuropsychiatric side effects. This patient had a substance-induced psychosis, in which visual and tactile hallucinations began 3 days after taking TMP-SMX and resolved 8 h after discontinuation, a timeline consistent with the literature. Central nervous system toxicity is rare in nonelderly immunocompetent patients, with only three such cases reported in the literature. While visual and auditory hallucinations have been described previously, this is the first reported case of TMP-SMX-induced tactile hallucinations and unilateral visual hallucinations. Moreover, because TMP-SMX is a first-line agent commonly used to treat orbital and preseptal cellulitis, it is important for ophthalmologists to be aware of this atypical side effect, as it can be life threatening.

Incidence of Rhegmatogenous Retinal Detachment (RRD) in a Tertiary Care Center of Pakistan.

Background Regardless of the advancements in ophthalmology, rhegmatogenous retinal detachment (RRD) remains a substantial issue for physicians. The present study assessed the incidence of RRD among our population. Methodology A cross-sectional study was performed at the Layton Rehmatullah Benevolent Trust (LRBT) between June 2020 and May 2021. All the patients of RRD, irrespective of gender, within the age bracket of 20 years or more and diagnosed by a consultant ophthalmologist were included in the research study. Patients with serous retinal or tractional detachment and RRD with vitreous leakage were excluded from the study. A slit lamp and dilated fundus examination was performed preoperatively to assess the type of retinal detachment and associated factors as mentioned above. All data were collected on predesigned pro forma. Results About 25,000 individuals were presented to the outpatient department during the study period. Out of these, 100 patients were diagnosed with RRD. The incidence rate of the RRD in our center was 0.4%. There were a majority of the males. The mean age of patients did not vary significantly with respect to gender (p < 0.797). The most common type of RD was the total RD with a frequency of 53 cases followed by inferior RD with 19 cases. The majority of those with total RRD were males, i.e., 37%; however, the difference was statistically insignificant (p = 0.476). The study revealed that most of the RRD was diagnosed in patients < 45 years of age; however, the difference was not statistically significant (p < 0.227). Conclusion The present study highlighted the incidence of RRD and explored the sociodemographic and other clinical features in the Pakistani population. However, it is possible that the RRD condition is still under-diagnosed in our hospital settings. Further exploration is warranted to study comprehensively the risk factors associated with RRD.

On implementation of a semi-analytic strategy to develop an analytical solution of a steady-state isothermal tube drawing model.

In this paper, we consider an isothermal glass tube drawing model consisting of three coupled nonlinear partial differential equations. The steady-state solution of this model is required in order to investigate its stability. With the given initial and boundary conditions, it is not possible to determine an analytical solution of this model. The difficulty lies in determining the constants of integrations while solving the second order ordinary differential equation analytically appearing in the steady-state model. To overcome this difficulty, we present a numerical based approach for the first time to develop an analytical solution of the steady-state isothermal tube drawing model. We use a numerical technique called shooting method to convert the boundary value problem into a set of initial value problems. Once the model has been converted into a system of differential equations with initial values, an integrating technique is implemented to develop the analytical solution. The computed analytical solution is then compared with the numerical solution to better understand the accuracy of obtained solution with necessary discussions.

The outcomes and usefulness of Intraoperative Optical Coherence Tomography in vitreoretinal surgery and its impact on surgical decision making.

Objective. To evaluate the utility of intraoperative OCT and its influence on the surgeon's decision during vitreoretinal surgery. Methods. This was a pilot, prospective case series conducted at a tertiary care ophthalmology department in Lahore, Pakistan. Sixteen patients undergoing vitreoretinal surgeries were included using the Leica Enfocus microscope integrated intraoperative optical coherence tomography (IOCT). We also investigated the changes in surgical decision making based on the findings revealed by IOCT using a questionnaire. Results. 16 patients with a mean age of 40.6 ± 19.0 (range: 11-66) years, were included in the study; one case of acute postoperative endophthalmitis could not be imaged. The surgeon had to modify surgical decisions in four (26.7%) cases. IOCT clearly delineated various tissue planes for efficient and safe surgical dissection in pathologies such as posterior vitreous detachment, vitreomacular traction and epiretinal membranes. Furthermore, it also helped identifying perfluorocarbon-retina interface. Conclusions. The intraoperative OCT modality is a feasible and useful intraoperative imaging technique for various kinds of vitreoretinal disorders. The decision making of the surgeon was modified in a quarter of the cases after the use of this newer modality.