Category: Nevin Manimala

Drugs Context. 2023 Aug 8;12:2022-10-5. doi: 10.7573/dic.2022-10-5. eCollection 2023.

ABSTRACT

BACKGROUND: This study investigates the efficiency of two different types of immunomodulators for the treatment of non-severe community-acquired pneumonia (CAP) and assesses their long-term effects.

METHODS: The study included 55 patients with non-severe CAP. Group 1 (control) received only standard CAP therapy; the other two groups received immunomodulators simultaneously with the standard therapy: bacterial lysate for group 2 and azoximer bromide (AzB) for group 3. TNF and IL-6 concentrations were determined on the day of hospitalization as well as on days 13 and 60 of follow-up. For 2 years, we monitored the incidence of low respiratory tract infections (LRTIs) in the same patients with CAP (n=55).

RESULTS: The overall duration of all symptoms was lower in the immunomodulator groups compared with the control group. During treatment, TNF and IL-6 concentrations decreased on days 13 and 60 in all patients; in patients who received immunomodulators, TNF and IL-6 were reliably lower than in control patients. IL-6 concentration decreased on day 60 in the bacterial lysate and AzB treatment groups and did not differ (p=0.72). The odds ratio for the development of LRTIs in the AzB group was 0.15 (0.02-0.93) (p=0.04), suggesting its protective effect.

CONCLUSION: Inclusion of immunomodulators in the basic treatment of non-severe CAP reduces the duration of symptoms and is associated with improvement of the pro-inflammatory cytokine profile. In 2 years of follow-up, the long-term effects of the immunomodulatory therapy showed a statistically significant lower incidence of LRTIs in the AzB group only. However, given the small sample size of this study, further clinical studies are needed.

PMID:37602358 | PMC:PMC10435266 | DOI:10.7573/dic.2022-10-5

Int J Ophthalmol. 2023 Aug 18;16(8):1287-1292. doi: 10.18240/ijo.2023.08.15. eCollection 2023.

ABSTRACT

AIM: To determine the effects of change in light conditions on refractive error and visual functions including visual acuity, stereopsis and contrast sensitivity.

METHODS: This cross-sectional study was conducted in the optometry clinic of the Shahid Beheshti School of Rehabilitation on 48 students in 2021-2022. All of them had eye health and normal visual function and could have refractive errors or not. Light intensity of 4 lx was considered equivalent to photopic light condition and light intensity of 1 lx was considered to be equivalent to mesopic light condition. The amount of refractive error was checked by auto refractometer and its changes in mesopic light condition were subjectively measured. Also, visual acuity, stereopsis and contrast sensitivity (in five spatial frequencies of 1.5, 3, 6, 12, and 18 cycles per degree), were measured first in photopic light condition and then in mesopic light condition, by Snellen control vision chart, stereo butterfly test and the M&S technology monitor test respectively.

RESULTS: In the 48 student subjects with an average age of 22.69±3.56y, mean of refractive error as sphere equivalent, visual acuity and stereopsis were -1.25±1.74 diopters, 0 logMAR, 44.37±13.03 seconds of arc, respectively in photopic light condition while in mesopic light was equal to -1.56±1.75 diopters, 0.12±0.09 logMAR and 50.62±33.35 seconds of arc, respectively. The mean of contrast sensitivity measured at spatial frequencies of 1.5, 3, 6, 12, and 18 cycles per degree in photopic condition was equal to 2.38±0.04, 2.37±0.07, 2.04±0.21, 1.27±0.32, 0.82±0.27 logarithm of contrast sensitivity, respectively and in mesopic lighting condition was equal to 2.34±0.12, 2.30±0.16, 1.84±0.28, 1.02±0.28, 0.63±0.24 logarithm of contrast sensitivity, respectively. Statistical analysis showed a significant difference between the two lighting conditions in all evaluated variables [refractive error (P<0.001), visual acuity (P<0.001), stereopsis (P=0.008) and contrast sensitivity (P<0.001)].

CONCLUSION: The refractive error of the student subjects in mesopic light condition change towards myopia, and its amount is clinically significant. Also, the examination and comparison of the factors of visual acuity, stereopsis and contrast sensitivity in these two lighting conditions show that the decrease in brightness level to the mesopic level causes a decrease in the aforementioned visual functions.

PMID:37602349 | PMC:PMC10398513 | DOI:10.18240/ijo.2023.08.15

Int J Ophthalmol. 2023 Aug 18;16(8):1243-1249. doi: 10.18240/ijo.2023.08.09. eCollection 2023.

ABSTRACT

AIM: To evaluate whether latanoprost/timolol fixed combination (LTFC) dosed twice daily may provide further intraocular pressure (IOP) reduction and evaluate the safety profile at this dose.

METHODS: This is an open-labeled, randomized, prospective crossover study on fourty primary open angle glaucoma patients. Two weeks of washout period were followed by randomization to either once daily (OD, group A) or twice daily dosing (BD, group B) of LTFC for 4wk. After another 2-week washout period, the patients’ treatment dose was crossed-over for another 4wk. IOP reduction alongside ocular and systemic side effects were evaluated.

RESULTS: Mean baseline IOP was 18.57±2.93 and 17.8±3.01 mm Hg before OD and BD dose respectively, (P=0.27). Mean IOP after BD dose was statistically lower (12.49±1.59 mm Hg) compared to OD (13.48±1.81 mm Hg, P=0.017). Although IOP reduction after BD dose was more (5.32±3.24 mm Hg, 29.89%) than after OD dosing (5.04 mm Hg, 27.14%), it did not reach statistical significance (P=0.68). Patients switched from OD to BD (group A) showed mean IOP reduction by 0.69 mm Hg [95% confidence interval (CI): -0.09 to 1.48 mm Hg, P=0.078]; but patients switched from BD to OD (group B) had significantly higher mean IOP by 1.25 mm Hg (95%CI: -2.04 to -0.46 mm Hg, P=0.006). BD dose had more ocular side effects albeit mild.

CONCLUSION: Mean IOP after LTFC dosed twice daily is statistically lower, with additional mild side effects.

PMID:37602343 | PMC:PMC10398532 | DOI:10.18240/ijo.2023.08.09

Int J Ophthalmol. 2023 Aug 18;16(8):1260-1267. doi: 10.18240/ijo.2023.08.11. eCollection 2023.

ABSTRACT

AIM: To explore the correlation between diabetic retinopathy (DR) and Helicobacter pylori (Hp) infection, based on data from a physical examination population.

METHODS: This cross-sectional retrospective analysis included data of 73 824 health examination participants from December 2018 to December 2019. Participants were divided into the diabetic group and non-diabetic group, non-diabetic retinopathy (NDR) group, non-proliferative diabetic retinopathy (NPDR) group, proliferative diabetic retinopathy (PDR) group, and Hp infection group. Gender, age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (FPG), glycated hemoglobin A1c (HbA1c), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and Hp data were recorded to compare the degree of DR lesions and Hp infection. Logistic regression analysis was used to evaluate the correlation between DR and Hp infection.

RESULTS: There was a statistically significant difference between the diabetic and non-diabetic group (χ²=94.17, P<0.0001). Logistic regression analysis showed that male sex, age, BMI, SBP, TG, LDL-C, and Hp infection were independent risk factors for DR. There was no correlation between the degree of DR lesions and Hp infection (ρ=-0.00339, P=0.7753). Age [odds ratio (OR)=1.035, 95%CI: 1.024, 1.046, P<0.0001] and SBP (OR=1.009, 95%CI: 1.004, 1.015, P=0.0013) were independent risk factors for the degree of DR.

CONCLUSION: There is a significant correlation between DR and Hp infection in the physical examination population. Hp infection is a risk factor for DR, and there is no significant difference between Hp infection and DR of different pathological degrees. Actively eradicating Hp may be of help to prevent DR.

PMID:37602340 | PMC:PMC10398527 | DOI:10.18240/ijo.2023.08.11

Int J Ophthalmol. 2023 Aug 18;16(8):1326-1336. doi: 10.18240/ijo.2023.08.20. eCollection 2023.

ABSTRACT

AIM: To assess the efficacy versus the adverse effects of various concentrations of atropine in the prevention of myopia in Asian children.

METHODS: Databases (PubMed, EMBASE, the Cochrane Library and Web of science) were comprehensively searched from inception to April 2022. Types of studies included were randomized clinical trials (RCTs). The published languages were limited to English. Two researchers assessed the quality of included studies independently using Cochrane risk of bias tool based on the Cochrane Handbook for Systematic Reviews of Interventions. Funnel plots and Egger’s test were used for detection of publication bias. Meta-analyses were conducted using STATA (version 15.0; StataCorp).

RESULTS: A total of 15 RCTs involving 2268 patients were included in the study. In the atropine group, spherical equivalent progressed at a significantly lower rate [weighted mean difference (WMD)=0.39, 95% confidence interval (CI): 0.23, 0.54] than in the control group. A WMD of 0.15 mm was associated with less axial elongation (95%CI -0.19, -0.10). Different doses showed statistically significant differences (P<0.05) and an improved effect could result from a higher concentration. Changes in photopic pupil size and mesopic pupil size in atropine group is 0.70 mm (95%CI: 0.33, 1.06) and 0.38 mm (95%CI: 0.22, 0.54) more than the control group. In the present Meta-analysis, no changes in accommodative amplitude (AA) were associated with atropine administration. Atropine administration increased the risk of adverse effects by 1.37 times.

CONCLUSION: Concentrations of less than 1% atropine are able to effectively retard diopter and axis growth of myopia in Asian children in a dose-dependent manner. Meanwhile, it caused pupil enlargement, but induced no change in the AA within this range. Further study is required to determine the dosage needed to achieve maximum efficacy and minimal side effects.

PMID:37602338 | PMC:PMC10398521 | DOI:10.18240/ijo.2023.08.20

Int J Ophthalmol. 2023 Aug 18;16(8):1280-1286. doi: 10.18240/ijo.2023.08.14. eCollection 2023.

ABSTRACT

AIM: To evaluate the effectiveness, safety, predictability, precision and changes of higher-order aberrations (HOAs) on corneal front surface of selective corneal wavefront aberration-guided femtosecond laser-assisted in situ keratomileusis (CW-FS-LASIK) in patients with high myopia 1-year postoperatively.

METHODS: Totally 74 eyes of 37 patients with high myopia or myopic astigmatism in both the eyes who underwent the CW-FS-LASIK procedure in Xi’an Gaoxin Hospital from January 2021 to June 2021 were included. The changes of uncorrected distance visual acuity (UDVA), best corrected visual acuity (BCVA), spherical equivalent refraction (SER), astigmatism, HOAs and Strehl ratio (SR) on the anterior surface of the cornea after 1y of the surgery were analyzed.

RESULTS: At postoperative 1y, the UDVA (logMAR) of 74 eyes (100%) reached 0 or better, including 0 in 8 eyes (10.81%), -0.1 in 45 eyes (60.81%), and -0.2 in 21 eyes (28.38%). The effectiveness index was 1.29±0.134. There was no decrease in postoperative BCVA compared with preoperative BCVA in all patients. Postoperative BCVA was the same in 44 eyes (59.46%) as preoperative BCVA, increased by 1 line in 23 eyes (31.08%) and increased by 2 lines in 7 eyes (9.46%) compared with preoperative BCVA. The safety index was 1.11±0.159. The estimated corrected SER before surgery was (-7.76±1.21) D, and the actual corrected SER was (-7.83±1.25) D (Y=0.9811X+0.2156, R²=0.9084). There was a high correlation between the estimated corrected SER and the actual corrected SER. The postoperative SER in 74 eyes (100%) was within ±0.75 D. The postoperative astigmatism of all was within -0.75 D to 0. Root mean square (RMS) HOAs of spherical aberration and SR within 5 mm of the corneal front surface were all increased compared with those before operation (P<0.01). The total coma, horizontal coma and vertical coma were all decreased compared with those before operation (P<0.01). There was no statistically significant difference in horizontal trefoil and vertical trefoil compared with preoperative ones (P>0.05).

CONCLUSION: Selective CW-FS-LASIK for correction of high myopia is effective, safe, predictive, and accurate. For patients with preoperative RMS HOAs over 0.25 defocus equivalent, postoperative coma aberration can be significantly reduced, and SR value can be increased, thus corneal imaging quality can be improved.

PMID:37602337 | PMC:PMC10398522 | DOI:10.18240/ijo.2023.08.14

Int J Ophthalmol. 2023 Aug 18;16(8):1268-1273. doi: 10.18240/ijo.2023.08.12. eCollection 2023.

ABSTRACT

AIM: To investigate thickness characteristics and vascular plexuses in retinas with reticular pseudodrusen (RPD) as an early detection strategy for age-related macular degeneration (AMD).

METHODS: This retrospective study included 24 subjects (33 eyes) with RPD and 25 heathy control subjects (34 eyes). The superficial capillary plexus (SCP) and the deep capillary plexus (DCP) of the retinal posterior poles were investigated with optical coherence tomography angiography (OCTA). Retinal thicknesses and vessel densities were analyzed statistically.

RESULTS: The general retinal thicknesses of RPD eyes were significantly decreased (95%CI -14.080, -0.655; P=0.032). The vessel densities of DCP in RPD eyes were significantly increased in the global (95%CI 1.067, 7.312; P=0.027), parafoveal (95%CI 0.417, 5.241; P=0.022), and perifoveal (95%CI 0.181, 6.842; P=0.039) quadrants. However, the vessel densities of the SCP were rarely increased in the eyes with RPD.

CONCLUSION: The thinning of retinas in the RPD group suggests a reduction in the number of cells. Additionally, the increased vessel density of the DCP in retinas with RPD indicates a greater demand for blood supply, possibly due to the hypoxia induced RPD compensation caused by RPD in the outer retina. This study highlights the pathological risks associated with RPD and emphasizes the importance of early intervention to retard the progression of AMD.

PMID:37602336 | PMC:PMC10398519 | DOI:10.18240/ijo.2023.08.12

Int J Ophthalmol. 2023 Aug 18;16(8):1350-1355. doi: 10.18240/ijo.2023.08.22. eCollection 2023.

ABSTRACT

AIM: To assess metrics of diffusion tensor imagining (DTI) in evaluating microstructural abnormalities of horizontal extraocular muscles (EOM) in esotropia.

METHODS: Six adult concomitant esotropia patients, 5 unilateral abducent paralysis patients and 2 healthy volunteers were enrolled. Conventional magnetic resonance imaging (MRI) and DTI were performed on all subjects using 3T MR scanner. Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) of medial and lateral rectus muscles were measured and compared between patients group and control group.

RESULTS: Medial rectus MD and RD within the adducted eye of concomitant patients was significantly greater than that in unilateral abducent paralysis patients (0.259×10^-2 mm²/s vs 0.207×10^-2 mm²/s, P=0.014; 0.182×10^-2 mm²/s vs 0.152×10^-2 mm²/s, P=0.017). Both strabismus patients showed a significantly decreased MD and AD than that obtained in normal controls for lateral rectus muscles (P<0.05). Medial rectus MD of the adducted eye in concomitant strabismus patients was significantly decreased than that in healthy controls (0.259×10^-2 mm²/s vs 0.266×10^-2 mm²/s, P=0.010). Lateral rectus AD of the adducted eye in concomitant strabismus patients was significantly decreased as compared with that in healthy controls (0.515×10^-2 mm²/s vs 0.593×10^-2 mm²/s, P=0.013). No statistically significant differences were present between the adducted and fixating eyes in concomitant strabismus patients.

CONCLUSION: DTI represents a feasible technique to assess tissue characteristics of EOM. The effects of eye position changes on DTI parameters are subtle. Decreased MD and RD could be evidence for remodeling of the medial rectus muscle contracture. Lower medial and lateral recuts MD of concomitant esotropia patients indicates a thinner fibrous structure of the EOM. Lower MD and AD should be general character of esotropia.

PMID:37602335 | PMC:PMC10398516 | DOI:10.18240/ijo.2023.08.22

Int J Ophthalmol. 2023 Aug 18;16(8):1224-1230. doi: 10.18240/ijo.2023.08.06. eCollection 2023.

ABSTRACT

AIM: To observe the imaging features of color Doppler ultrasound (CDU) and computed tomography (CT) or computed tomography dacryocystography (CT-DCG) in different types of lacrimal sac space-occupying lesions (SOLs).

METHODS: This retrospective case series study included 21 patients with lacrimal sac SOLs who underwent lacrimal sac surgery between January 2018 and March 2022. The imaging features of CDU and CT or CT-DCG in these patients were extracted from the examination cloud system. The images were observed and analyzed.

RESULTS: The detection rate of lacrimal SOLs between CDU (21/21, 100%) and CT or CT-DCG (20/21, 95.2%) had no statistically significant difference (P=1.0). CDU could detect the blood flow signals in all SOLs except mucocele and mucopeptide concretion. Among them, polyps had characteristic imaging changes on CDU and CT-DCG. The mucoceles and mucopeptide concretions had characteristic imaging changes on CDU, which could provide more information for differential diagnosis.

CONCLUSION: The morphology and internal blood flow signals of lacrimal sac SOLs can be observed using CDU. CT or CT-DCG has advantages in observing structural damage around the lacrimal sac mass. Therefore, CDU may be used as a routine examination to exclude lacrimal sac SOLs before dacryocystorhinostomy in the absence of preoperative CT or CT-DCG.

PMID:37602333 | PMC:PMC10398530 | DOI:10.18240/ijo.2023.08.06

Front Mol Biosci. 2023 Aug 3;10:1222133. doi: 10.3389/fmolb.2023.1222133. eCollection 2023.

ABSTRACT

Introduction: Acute aortic dissection (AAD) often leads to the development of acute lung injury (ALI). However, the early detection and diagnosis of AAD in patients with ALI pose significant challenges. The objective of this study is to investigate distinct metabolic alterations in the plasma samples of AAD patients with ALI, AAD patients without ALI, and healthy individuals. Method: Between September 2019 and September 2022, we retrospectively collected data from 228 AAD patients who were diagnosed with ALI through post-surgery chest X-ray and PaO₂/FiO₂ assessments. Univariate analysis was employed to identify pre-surgery risk factors for ALI. Additionally, we conducted high-throughput target metabolic analysis on 90 plasma samples, comprising 30 samples from AAD patients with ALI, 30 from patients with AAD only, and 30 from healthy controls. After LC-MS spectral processing and metabolite quantification, the recursive feature elimination with cross-validation (RFECV) analysis based on the random forest was used to select the optimal metabolites as a diagnostic panel for the detection of AAD patients with ALI. The support vector machines (SVM) machine learning model was further applied to validate the diagnostic accuracy of the established biomarker panel. Results: In the univariate analysis, preoperative β-HB and TNF-α exhibited a significant association with lung injury (OR = 0.906, 95% CI 0.852-0.965, p = 0.002; OR = 1.007, 95% CI 1.003-1.011, p < 0.0001). The multiple-reaction monitoring analysis of 417 common metabolites identified significant changes in 145 metabolites (fold change >1.2 or <0.833, p < 0.05) across the three groups. Multivariate statistical analysis revealed notable differences between AAD patients and healthy controls. When compared with the non-ALI group, AAD patients with ALI displayed remarkable upregulation in 19 metabolites and downregulation in 4 metabolites. Particularly, combining citric acid and glucuronic acid as a biomarker panel improved the classification performance for distinguishing between the ALI and non-ALI groups. Discussion: Differentially expressed metabolites in the ALI group were primarily involved in amino acids biosynthesis, carbohydrate metabolism (TCA cycle), arginine and proline metabolism, and glucagon signaling pathway. These findings demonstrate a great potential of the targeted metabolomic approach for screening, routine surveillance, and diagnosis of pulmonary injury in patients with AAD.

PMID:37602331 | PMC:PMC10434778 | DOI:10.3389/fmolb.2023.1222133