Emerging artificial intelligence-aided diagnosis and management methods for ischemic strokes and vascular occlusions: A comprehensive review.

Large-vessel occlusion (LVO) stroke is a promising field for the use of AI, especially machine learning (ML) because optimal results are highly dependent on timely diagnosis, communication, and treatment. In order to better understand the current state of artificial intelligence (AI) in relation to LVO strokes, its efficacy, and potential future applications, we searched relevant literature to perform a comprehensive evaluation of the topic. The databases PubMed, Embase, and Scopus were extensively searched for this review. Studies were then screened using title and abstract criteria and duplicate studies were excluded. By using pre-established inclusion and exclusion criteria, it was decided whether or not to include full-text papers in the final analysis. The studies were analyzed, and the relevant information was retrieved. In recognizing LVO on computed tomography, ML approaches were very accurate. There is a shortage of AI applications for thrombectomy patient selection, despite the fact that certain research accurately evaluates individual patient eligibility for endovascular therapy. Machine learning algorithms may reasonably predict clinical and angiographic outcomes as well as associated factors. AI has shown promise in the diagnosis and treatment of people who have just suffered a stroke. However, the usefulness of AI in management and forecasting remains restricted, necessitating more studies into machine learning applications that can guide decision making in the future.

The German guideline "Obesity in pregnancy": comparison with the international approach.

BACKGROUND: Obesity is an increasing problem, even in young women of reproductive age. Obesity has a negative impact on conception, the course of pregnancy, and neonatal outcomes. Caring for obese pregnant women has becoming an important aspect of standard prenatal care. The Guideline "Obesity and Pregnancy" of the German Society of Gynecology and Obstetrics aims to create evidence-based recommendations which can be used to improve the care of obese pregnant women. As obesity is a worldwide problem, many societies for obstetrics and gynecology have created national guidelines. METHODS: We reviewed the following guidelines for obesity and pregnancy: American College of Obstetricians and Gynecologists (ACOG) 2021, Royal College of Obstetrics and Gynecology (RCOG) 2018; AND Society of Obstetricians and Gynecologists of Canada (SOGC) 2019. These guidelines were compared to the German guideline. RESULTS: There are some variations between the guidelines, though no major contradictions exist. Disparities were found regarding the recommendations for substitution of high folic acid and Vitamin D. Furthermore, the recommended time for screening for gestational diabetes and the methods to control fetal growth differ between the guidelines. Regarding place of birth, RCOG allows delivery in midwifery-led units in the absence of other high-risk circumstances, while others request facility of care by neonatologists and medical staff trained in care of obese women. Induction of labor at term due to increased risk of intrauterine demise is mostly limited to women with a body mass index of 40 kg/m2. Only one guideline considers induction of all obese women. For intrapartum management, the majority allows tolerating of longer labor times to delivery if fetal monitoring is sufficient and fetal stress is excluded. Special encouragement of breastfeeding and healthy lifestyle is commonly recommended; only in the Canadian guideline, postpartum depression evaluation is requested due to the overall high prevalence of depression and anxiety in obese women. CONCLUSION: All guidelines consider pregnancies in obese women as high-risk pregnancies and emphasize the need for preconception counseling. There are special needs in pregnancy care and in the intrapartum and postpartum management to be observed.

Dynamical behavior of solitons of the (2+1)-dimensional Konopelchenko Dubrovsky system.

Utilizing nonlinear evolution equations (NEEs) is common practice to establish the fundamental assumptions underlying natural phenomena. This paper examines the weakly dispersed non-linear waves in mathematical physics represented by the Konopelchenko-Dubrovsky (KD) equations. The [Formula: see text]-expansion method is used to analyze the model under consideration. Using symbolic computations, the [Formula: see text]-expansion method is used to produce solitary waves and soliton solutions to the [Formula: see text]-dimensional KD model in terms of trigonometric, hyperbolic, and rational functions. Mathematica simulations are displayed using two, three, and density plots to demonstrate the obtained solitary wave solutions' behavior. These proposed solutions have not been documented in the existing literature.

Biofilm-forming ability, antibiotic resistance and phylogeny of Escherichia coli isolated from extra intestinal infections of humans, dogs, and chickens.

Escherichia coli (E. coli) causes various infections in humans and animals. The biofilm-forming ability of E. coli has increased antimicrobial resistance and capacity to cause recurrent and chronic infections. This study determined the biofilm-forming ability of E. coli isolated from extraintestinal infections of humans, chickens, and dogs in relation to the phylogroup, type of infection, and antibiotic resistance. Isolates from chickens showed significantly higher biofilm-forming ability compared to those causing urinary tract infections in humans (p = 0.0001). Further, isolates belonging to phylogroup B1 displayed a higher likelihood to form biofilms. Resistance to ciprofloxacin and trimethoprim-sulfamethoxazole was positively correlated with biofilm-forming ability. Harbouring plasmid-mediated quinolone resistance gene, qnrS was also positively correlated with biofilm formation. This study provides insight into factors such as phylogroup and the type of infections that could enhance biofilm formation, as well as genotypic and phenotypic antibiotic resistance that could correlate with the ability to form biofilms.

Central-line-associated bloodstream infection burden among Dutch neonatal intensive care units.

BACKGROUND: The establishment of an epidemiological overview provides valuable insights needed for the (future) dissemination of infection-prevention initiatives. AIM: To describe the nationwide epidemiology of central-line-associated bloodstream infections (CLABSI) among Dutch Neonatal Intensive Care Units (NICUs). METHODS: Data from 2935 neonates born at <32 weeks' gestation and/or with a birth weight <1500 g admitted to all nine Dutch NICUs over a two-year surveillance period (2019-2020) were analysed. Variations in baseline characteristics, CLABSI incidence per 1000 central-line days, pathogen distribution and CLABSI care bundles were evaluated. Multi-variable logistic mixed-modelling was used to identify significant predictors for CLABSI. RESULTS: A total of 1699 (58%) neonates received a central line, in which 160 CLABSI episodes were recorded. Coagulase-negative staphylococci were the most common infecting organisms of all CLABSI episodes (N=100, 63%). An almost six-fold difference in the CLABSI incidence between participating units was found (2.91-16.14 per 1000 line-days). Logistic mixed-modelling revealed longer central line dwell-time (adjusted odds ratio (aOR):1.08, P<0.001), umbilical lines (aOR:1.85, P=0.03) and single rooms (aOR:3.63, P=0.02) to be significant predictors of CLABSI. Variations in bundle elements included intravenous tubing care and antibiotic prophylaxis. CONCLUSIONS: CLABSI remains a common problem in preterm infants in The Netherlands, with substantial variation in incidence between centres. Being the largest collection of data on the burden of neonatal CLABSI in The Netherlands, this epidemiological overview provides a solid foundation for the development of a collaborative platform for continuous surveillance, ideally leading to refinement of national evidence-based guidelines. Future efforts should focus on ensuring availability and extraction of routine patient data in aggregated formats.

Prevalence and pattern of psychiatric morbidity among people living with human immunodeficiency virus in Kano

Background:Human immunodeficiency virus/ Acquired immunodeficiency syndrome (HIV/AIDS), has remained a disease of public health concern, with the largest burden being found in sub Saharan Africa. The advent of anti-retroviral therapy (ART) has significantly reduced the mortality of the disease, thereby transforming it to a chronic disorder, with significant co-morbid psychiatric sequalae.Objectives:To determine the prevalence and pattern of psychiatric morbidity among PLWHAattending Aminu Kano Teaching Hospital, Kano.Materials and methods:This was a cross sectional study of adult patients with HIV/AIDS attending outpatient clinic at the S.S. Wali Virology Centre of Aminu Kano Teaching Hospital who gave informed consent. Systematic random sampling technique was used.Patients aged 18years and above who had been on ARVdrugs for at least one year were included, while those who had a medical emergency and needed immediate attention were excluded.Socio demographic characteristics were obtained using a socio-demographic questionnaire and psychiatric morbidity was assessed with the MINI International Neuropsychiatry Interview.Results:Atotal of 420 participants were recruited in the study with a male to female ratio of 1:1.5 and mean age of 40.4±10.0 years. The prevalence of a psychiatric disorder was 22.1% out of whom 5.0% had more than one psychiatric diagnosis. Major depression was the most common (11%) psychiatric disorder. Generalized Anxiety disorder, substance abuse, post-traumatic stress disorder and alcohol abuse accounted for 7.6%, 5.5%, 2.4% and 1.7% of psychiatric disorders respectively.Conclusion:Psychiatric disorders are common in PLWHA, with major depression being the commonest.

Testing a Method for Evaluation of the Viability of Biofilm-Forming Bacteria after Exposure to Disinfectants.

A method for determining the viability of opportunistic pathogenic bacteria at the stage of biofilm formation after exposure to disinfectants with different active components was tested. The method is based on oxidation of tetrazolium salts by metabolically active cells with the formation of colored formazan derivatives and their quantitative spectrophotometry. The cell viability in the biofilm decreased after exposure to quaternary ammonium compounds and chlorine-containing disinfectants, but their effect was reversible. Dissemination of cells that had retained viability from the biofilm occurred after 24 h. The algorithm of testing, necessary controls, counting, and data interpretation are specified. The method can be recommended for use in laboratory diagnostics and clinical practice.

Evaluation of variable new antigen receptors (vNARs) as a novel cathepsin S (CTSS) targeting strategy.

Aberrant activity of the cysteine protease Cathepsin S (CTSS) has been implicated across a wide range of pathologies. Notably in cancer, CTSS has been shown to promote tumour progression, primarily through facilitating invasion and migration of tumour cells and augmenting angiogenesis. Whilst an attractive therapeutic target, more efficacious CTSS inhibitors are required. Here, we investigated the potential application of Variable New Antigen Receptors (vNARs) as a novel inhibitory strategy. A panel of potential vNAR binders were identified following a phage display panning process against human recombinant proCTSS. These were subsequently expressed, purified and binding affinity confirmed by ELISA and SPR based approaches. Selected lead clones were taken forward and were shown to inhibit CTSS activity in recombinant enzyme activity assays. Further assessment demonstrated that our lead clones functioned by a novel inhibitory mechanism, by preventing the activation of proCTSS to the mature enzyme. Moreover, using an intrabody approach, we exhibited the ability to express these clones intracellularly and inhibit CTSS activity whilst lead clones were also noted to impede cell invasion in a tumour cell invasion assay. Collectively, these findings illustrate a novel mechanistic approach for inhibiting CTSS activity, with anti-CTSS vNAR clones possessing therapeutic potential in combating deleterious CTSS activity. Furthermore, this study exemplifies the potential of vNARs in targeting intracellular proteins, opening a range of previously "undruggable" targets for biologic-based therapy.

AWARENESS AND PRACTICES TOWARDS PREVENTION OF MOTHER-TO-CHILD TRANSMISSION OF HIV AMONG MARRIED MEN ATTENDING THE ANTIRETROVIRAL CLINIC IN AMINU KANO TEACHING HOSPITAL, KANO, NIGERIA.

Background: The prevention of mother-to-child transmission (PMTCT) of HIV programme was introduced as a comprehensive package of interventions with the aim of reducing mother-to-child transmission (MTCT) of HIV. The programme offers an opportunity to capture pregnant women and their partners in order to prevent the transmission of HIV to the baby. This study is aimed at assessing the awareness and practices of married HIV-positive male partners towards PMTCT. Methodology: A descriptive cross-sectional study that interviewed 220 HIV-positive male partners using an interviewer-administered questionnaire. Results: The study revealed that more of the respondents 145 (65.9%) were between the age group of 31 to 40 years. More than half 130 (59%) of the respondents were aware of PMTCT while 135 (61.4%) of the respondents had good practice of PMTCT. Respondents with formal education were 1.5 times more likely to be aware of the PMTCT programme than those having informal education [p=0.03, AOR=1.53, 95%CI=(1.98-4.54)]. Similarly, respondents with formal education were 2.5 times more likely to practice PMTCT programme than those having informal education [p=0.03, AOR=2.53, 95%CI= (1.63-4.54)].In addition, Male partners who were above 30 years of age were 3 times more likely to participate in PMTCT activities compared to those who were less than 30 years [p=0.02, AOR=2.17, 95%CI=(0.01-4.12)]. Conclusion: Raising awareness about the need for male partners' involvement in the PMTCT programme as well as encouraging male partners to partake in PMTCT activities will further increase its uptake.

Identification of Host Factors for Rift Valley Fever Phlebovirus.

Rift Valley fever phlebovirus (RVFV) is a zoonotic pathogen that causes Rift Valley fever (RVF) in livestock and humans. Currently, there is no licensed human vaccine or antiviral drug to control RVF. Although multiple species of animals and humans are vulnerable to RVFV infection, host factors affecting susceptibility are not well understood. To identify the host factors or genes essential for RVFV replication, we conducted CRISPR-Cas9 knockout screening in human A549 cells. We then validated the putative genes using siRNA-mediated knock-downs and CRISPR-Cas9-mediated knock-out studies. The role of a candidate gene in the virus replication cycle was assessed by measuring intracellular viral RNA accumulation, and the virus titers were analyzed using plaque assay or TCID50 assay. We identified approximately 900 genes with potential involvement in RVFV infection and replication. Further evaluation of the effect of six genes on viral replication using siRNA-mediated knock-downs revealed that silencing two genes (WDR7 and LRP1) significantly impaired RVFV replication. For further analysis, we focused on the WDR7 gene since the role of the LRP1 gene in RVFV replication was previously described in detail. WDR7 knockout A549 cell lines were generated and used to dissect the effect of WRD7 on a bunyavirus, RVFV, and an orthobunyavirus, La Crosse encephalitis virus (LACV). We observed significant effects of WDR7 knockout cells on both intracellular RVFV RNA levels and viral titers. At the intracellular RNA level, WRD7 affected RVFV replication at a later phase of its replication cycle (24 h) when compared with the LACV replication, which was affected in an earlier replication phase (12 h). In summary, we identified WDR7 as an essential host factor for the replication of two different viruses, RVFV and LACV, both of which belong to the Bunyavirales order. Future studies will investigate the mechanistic role through which WDR7 facilitates phlebovirus replication.

Histological Chorioamnionitis and Funisitis as New Risk Factors for Retinopathy of Prematurity: A Meta-analysis.

OBJECTIVE: The role of placental inflammation in neonatal morbidities is underestimated due to lack of placental examination. This meta-analysis aims to assess the association between histological chorioamnionitis (HCA) with and without funisitis (FUN) and risk of retinopathy of prematurity (ROP). STUDY DESIGN: Forty-five studies reporting (unadjusted) data on HCA without FUN and HCA with FUN in neonates with ROP were included. Primary outcomes were any stage ROP and severe ROP. Potential confounders explored were gestational age (GA) at birth, birthweight, maternal steroid use, necrotizing enterocolitis, sepsis (suspected/proven) and mechanical ventilation duration. RESULTS: Neonates with HCA had increased risk for any stage ROP (odds ratio [OR] 1.8; 95% confidence interval [CI] 1.3-2.4) and severe ROP (OR 1.5; 95% CI 1.2-1.8) compared with neonates without HCA. The rates of any stage ROP (OR 1.8; 95% CI 1.4-2.2) and severe ROP (OR 1.4; 95% CI 1.1-1.6) were higher in neonates with FUN compared with neonates without FUN. Multivariate meta-regression analysis suggests that lower GA increases the effect size between FUN and severe ROP. CONCLUSION: This meta-analysis confirms that presence of HCA and FUN are risk factors for any stage ROP and severe ROP. Structured histological placental examination of HCA and FUN may be a tool to further refine the ROP risk profile. KEY POINTS: · This systematic review confirms that HCA is a risk factor for ROP.. · This meta-analysis reveals that FUN results in an even higher risk for developing ROP.. · Placental examination of HCA/FUN may be a tool to further refine the ROP risk profile..

Identification of host factors for Rift Valley Fever Phlebovirus.

Background: Rift Valley fever phlebovirus (RVFV) is a zoonotic pathogen that causes Rift Valley fever (RVF) in livestock and humans. Currently, there is no licensed human vaccine or antiviral drug to control RVF. Although multiple species of animals and humans are vulnerable to RVFV infection, host factors affecting susceptibility are not well understood. Methodology: To identify the host factors or genes essential for RVFV replication, we conducted a CRISPR-Cas9 knock-out screen in human A549 cells. We then validated the putative genes using siRNA-mediated knockdowns and CRISPR-Cas9-mediated knockout studies, respectively. The role of a candidate gene in the virus replication cycle was assessed by measuring intracellular viral RNA accumulation, and the virus titers by plaque assay or TCID50 assay. Findings: We identified approximately 900 genes with potential involvement in RVFV infection and replication. Further evaluation of the effect of six genes on viral replication using siRNA-mediated knockdowns found that silencing two genes (WDR7 and LRP1) significantly impaired RVFV replication. For further analysis, we focused on the WDR7 gene since the role of LRP1 in RVFV replication was previously described in detail. Knock-out A549 cell lines were generated and used to dissect the effect of WRD7 on RVFV and another bunyavirus, La Crosse encephalitis virus (LACV). We observed significant effects of WDR7 knock-out cells on both intracellular RVFV RNA levels and viral titers. At the intracellular RNA level, WRD7 affected RVFV replication at a later phase of its replication cycle (24h) when compared to LACV which was affected an earlier replication phase (12h). Conclusion: In summary, we have identified WDR7 as an essential host factor for the replication of two relevant bunyaviruses, RVFV and LACV. Future studies will investigate the mechanistic role by which WDR7 facilitates Phlebovirus replication.

[Comparative aspect of normative (reference) values of indicators of length and weight of children living in the region of the Far North (part 1 - body length indicators)].

PURPOSE OF THE STUDY: to analyze the differences in the normative (reference) values of the body length indicators of children and adolescents living in four ecological and geographical zones of the Republic of Sakha (Yakutia). MATERIALS AND METHODS: Statistical data processing was carried out on 24,123 schoolchildren who do not have chronic diseases belonging to health groups I and II. Statistical, analytical, mathematical and sociological methods were used. RESULTS: Among boys, the highest level of statistically significant differences in body length was observed in the age groups of 12, 13 and 15-17 years, among girls - in the age groups of 13, 14 and 16 years. Higher reference values of body length indicators for boys and girls living in the industrial regions of the Republic of Sakha (Yakutia), lower - for those living in the Arctic zone of the Far North and rural areas of the Republic of Sakha (Yakutia), where the population is represented mainly by the indigenous peoples of the Far North.

[Comparative aspect of normative (reference) values of indicators of length and weight of children living in the region of the Far North. Part 2. Body weight indicators].

PURPOSE OF THE STUDY: to analyze the differences in the normative (reference) values of the body weight indicators of children and adolescents living in four ecological and geographical zones of the Republic of Sakha (Yakutia). MATERIALS AND METHODS: Statistical data processing was carried out on 24,123 schoolchildren who do not have chronic diseases belonging to health groups I and II. Statistical, analytical, mathematical and sociological methods were used. RESULTS: The analysis showed that the greatest differences in this indicator were recorded in groups of children of primary school age, both among boys and girls. The highest values of reference indicators for body weight were determined in the younger age groups of boys and girls living in Yakutsk, and in older age groups - in those living in the industrial regions of the Republic of Sakha (Yakutia). The lowest values of these indicators were determined in children in rural areas of the region.

Safety of antenatal predniso(lo)ne and dexamethasone on fetal, neonatal and childhood outcomes: a systematic review.

CONTEXT: Due to ethical considerations, antenatal dose finding for prednisolone and dexamethasone in pregnant women is limited, leading to a knowledge gap. In order to guide the clinician in weighing benefits versus risks, the aim is to systematically review the current literature on the side-effects of antenatal predniso(lo)ne and dexamethasone use on the foetus, newborn and (pre)pubertal child and to review whether there is a relationship between the dose and risk of these side-effects. EVIDENCE ACQUISITION: The search was performed in PubMed/MEDLINE and EMBASE using prespecified keywords and Medical Subject Headings (MeSH). This systematic review investigated studies published until August 2022 with the following inclusion criteria: studies were conducted in humans and assessed side-effects of long-term antenatal predniso(lo)ne and dexamethasone use during at least one of the trimesters on the child during the foetal period, neonatal phase and during childhood. Exclusion criteria were 1) studies not conducted in humans, 2) abstracts, 3) reviews, 4) retracted papers and 5) papers not written in English. Critical appraisal tools of the Joanna Briggs Institute (JBI) were used to assess bias. EVIDENCE SYNTHESIS: In total, 328 papers in PubMed and 193 in EMBASE were identified. Fifteen studies were eligible for inclusion. Seven records were added through references. Antenatal predniso(lo)ne use may be associated with lower gestational age, but was not associated with miscarriages and stillbirths, congenital abnormalities, differences in blood pressure or low blood glucose levels at birth, or with low bone mass, long-term elevated cortisol and cortisone or high blood pressure at prepubertal age. Increased risks of antenatal dexamethasone use include association with miscarriages and stillbirths, and from age sixteen years, associations with disturbed insulin secretion, higher glucose and cholesterol levels. The quality of reporting of the studies was high. However, part of the cohort studies lack of a control group. CONCLUSIONS: Based on the limited evidence found in this systematic review, predniso(lo)ne may have less side-effects compared to dexamethasone in short- and long-term outcomes. Current literature shows minimal risk of side-effects in the newborn by administration of a prenatal predniso(lo)ne dose of up to 10 mg per day.

[The content of zinc and selenium in local food products of Yakutia].

Deficiency of the necessary complex of micronutrients under abnormal nutrition structure creates a problem for the preservation of health and performance of the population. In this regard, it is very relevant to develop a science-based strategy for the consumption of traditional Yakut national food that have a high nutritional value and are able to satisfy the requirements of the human body in micronutrients. The purpose of the research was to investigate the content of selenium and zinc in the local foods which are most commonly consumed by the population of Yakutia. Material and methods. The objects of study were meat (7-9 cuts each) and offal (9-11 species each) of the Yakut cattle breed (2 bulls at the age of 2.5 years), of the Yakut horse foals (3 heads at the age of 6 months), northern domestic deer (3 heads), and whitefish (Coregonus muksun), Yakut crucian carp (Carassius carassius jacuticus), lake minnow [Phoxinus percnurus (Pallas)] (3 kg each). The trace elements, zinc and selenium, were determined by infrared spectroscopy. Results. The greatest amount of zinc in the meat of farm animals was noted in the meat of Yakut cattle (6.8±0.3 mg/100 g) and Yakut horse foals (6.7±0.2 mg/100 g), and the lowest - in the meat of domestic reindeer (1.5±0.1 mg/100 g). In terms of selenium content, the meat of domestic reindeer had the highest indicators (37.0±1.0 µg/100 g), and the meat of Yakut cattle had the lowest (19.0±0.8 µg/100g). The highest concentration of zinc and selenium was found in by-products of reindeer: zinc level in the heart and liver was 12.8 mg/100 g, in the small intestine and rennet - 19.0-20.4 mg/100 g, selenium level in the colon and rennet was 41.0-46.7 µg/100 g. The content of zinc and selenium in the fresh-water muksun belly (2.14±0.08 mg and 45.0±1.8 µg in 100 g) was 32.3-37.2% higher than in the fillet of muksun, and selenium level was 3 fold higher than in the Yakut carp and in the lake minnow. The consumption of 100-200 g of meat or by-products of Yakut cattle, Yakut horse foals, by-products of reindeer or Yakut crucian carp can fully cover the daily requirement of an adult in zinc. The consumption of 200 g of venison or muksun completely covers the daily need for selenium, while the portion of the other studied products contains about half or more of recommended daily intake of this trace element. Conclusion. The data presented in the article show that the population of Yakutia, with a rational diet with local products, can meet the requirements in selenium and zinc in accordance with physiological needs.

Effects of Ayurveda interventions on acute pain and quality of life of a trigeminal neuralgia patient - A case report.

Classical trigeminal neuralgia (CTN) is a disease characterized by severe pain in the facial area related to the trigeminal nerve. CTN occurs due to neurovascular compression of the Trigeminal nerve presenting with recurrent pain episodes. This case reports the effect of Ayurveda interventions on CTN. Thirty-nine-year-old male patient with pain on the right side of the face for two years presented to the National Institute of Ayurveda, Hospital, Jaipur, Rajasthan, India. The pain was distributed on the right side of the upper lip, cheek, and chin. Paroxysms of pain appeared at the interval of 1-2 h and were lasting of 1-2 min. The case was diagnosed with the help of magnetic resonance imaging (MRI) as right-side classical trigeminal neuralgia due to indentation of the vascular loop of the right superior cerebellar artery. The patient had a treatment history of two years with allopathic medicine, and he sought Ayurveda treatment due to recurrence and excessive pain. The patient was given Ayurvedic interventions (oral medication, Nasya, Kavalagraha, and Gandusha) for three months. The improvement were observed on the visual analogue scale (VAS) for pain, hospital anxiety and depression scale (HADS), and Short Form -36 questionnaire (SF-36) for quality of life. After three months of the treatment, the VAS scale for pain and the HADS scale for anxiety and depression showed marked improvement. Improvement in all the domains of SF-36 was observed, with a total percentage improvement from 10.7% to 83.2%. Observations of this case highlight the usefulness of Ayurveda interventions, i.e., Oral medication, Nasya, Kavalagraha, and Gandusha, in reducing the acute paroxysms of pain in Classical TN and improving the quality of life of CTN patients.

Visual impairment due to retinopathy of prematurity and concomitant disabilities in the Netherlands.

AIM: Determine incidence of visual impairment due to retinopathy of prematurity (ROP) and concomitant disabilities between 2009 and 2018 in the Netherlands and compare data to four former similar studies. Secondly, monitor if infants were missed for ROP-screening since the adoption of stricter, risk factor guided criteria (2013). METHODS: Retrospective inventory on anonymous data of infants diagnosed with ROP from Dutch visual impairment-institutes. Data including: best corrected visual acuity, ROP-treatment and concomitant disabilities: bronchopulmonary dysplasia, behavioral abnormalities, epilepsy, hearing deficit, developmental delay, cerebral palsy and cerebral visual impairment. During the study period, lower age limit for neonatal life support (2010) and higher oxygen saturation targets (2014) were implemented. RESULTS: Records of 53 infants were analyzed. Visual impairment incidence due to ROP was 2.02 per 100.000 live births (2000-2009: 1.84, p = 0.643). Compared to earlier periods (1975-2000), a significant decrease was observed. The incidence of concomitant disabilities remained stable. Mean gestational age (GA) continued to decrease to 26.6 ± 1.9 weeks (2000-2009: 27.4 ± 2.0 weeks, p = 0.047). All patients met the screening inclusion criteria. CONCLUSION: The incidence of visual impairment due to ROP and concomitant disabilities between 2009 and 2018 has not increased, despite lower GA and higher oxygen saturation targets. None of the infants were missed for ROP screening following introduction of more restricted screening inclusion criteria.