Assessing the impact of a program for late surgical intervention in early-blind children

OBJECTIVE

Many blind children in the developing world are unable to obtain timely treatment due to lack of financial and medical resources. Can public health programs that identify and treat such children several years after the onset of blindness enhance their quality of life? The notion that visual development is subject to an early 'critical period' argues against this possibility. However, there are inadequate empirical data from humans on this issue. To address this need, we examined the quality of life of children living in India and who were treated for early-onset blindness (before one year of age), due to cataracts or corneal opacities.

STUDY DESIGN

Survey study.

METHODS

As part of an ongoing scientific effort named Project Prakash, we screened over 40,000 children in rural northern India to identify those suffering from early-onset blindness. They were provided eye surgeries in a tertiary care ophthalmic center in New Delhi. We subsequently surveyed 64 Prakash children, ranging in age from 5 to 22 years and obtained their responses on a multi-dimensional quality of life questionnaire.

RESULTS

Nearly all of the subjects indicated that their quality of life had improved after treatment. Children reported marked enhancement in their mobility, independence, and safety, and also in social integration. Surprisingly, we found no significant correlations between quality of life metrics and factors such as age at treatment, gender, time since treatment, and pre-surgery and post-surgery acuity.

CONCLUSIONS

A key question for public health policy makers is whether a program of surgical intervention for older blind children is likely to be beneficial, or if the resources are better spent on rehabilitation via vocational training and assistive devices. The marked improvements in quality of life we find in our data strongly argue for the provision of surgical care regardless of a child's age.

Performance study of a laboratory model shallow solar pond with and without single transparent glass cover for solar thermal energy conversion applications

The thermal performance of a shallow solar pond with and without the single transparent glass cover has been investigated experimentally. This experiment has been performed during the summer season of 2014 under the operational condition for five different storage volumes of water upto a maximum of 10liter. The pond performance is investigated in terms of the rate of energy collected and its collection efficiency. A Low Density Polyethylene (LDPE) black sheet liner of 200μm thickness was laid on all the interior sides of the pond for solar energy absorption. A clear transparent PVC plastic sheet of 150μm thickness was laid over the water surface as evaporation suppressing membrane. Calibrated Copper constantan thermocouples were used to measure the temperatures of the system. A highest temperature of 81.5°C has been achieved for the stored volume of 2liter of water, when the pond was used with a single transparent glass cover of 5mm thickness. When the shallow solar pond was used without the transparent glass cover the system attained a maximum temperature of 62°C for the same stored volume of 2liter. A comparison between the two conditions of with and without the transparent glass cover, on the thermal performance of the SSP has been reported. A shallow solar pond system of the present type could be used us a source of warm water, of desired temperature, below 10°C which are required for the domestic and industrial utilities. The global warming is increased day by day; inorder to reduce global warming a typical method of small scale shallow solar pond has been used to absorb the radiation from the sun to convert it to useful heat energy by the source of water. The SSP is an eco friendly way to generate energy without polluting our environment and in an environment safety manner. Based on environmental safety this study has experimentally investigated the thermal performance of the shallow solar pond.

Chilling requirements for hatching of a New Zealand isolate of Nematodirus filicollis

The eggs of some species of the parasitic nematode Nematodirus require a period of chilling before they can hatch; N. filicollis is one such species. This study investigated this requirement for chilling in a New Zealand strain of this species. Eggs of N. filicollis were extracted from lamb's faeces and incubated at 20°C to allow development to the third stage larvae within the egg. These eggs were then placed into tissue culture plates and incubated at: 2.7°C (±0.99), 3.6°C (±0.90), 4.7°C (±0.35), 6.4°C (±0.37), 8.0°C (±1.54) or 9.9°C (±0.14) for up to 224 days. At 14day intervals until day 84, then every 28 days, one plate was removed from each temperature and placed at 13.1°C (±0.44) for 14 days. Eggs were then assessed for hatching. From this data, chill units were calculated by subtracting the culture temperature from a constant threshold of 11°C and multiplying by the number of days for which the sample was cultured; then the Gompertz model fitted. Even though hatching overall was low, a greater proportion of eggs hatched with chill accumulation. Maximum hatching of eggs required 800-1000 chill units. Consequently in the field, more than one season of chilling would be required before hatching. As such a generation time could take more than one year to complete. This is different to the hatching dynamics of N. spathiger, the other main species found in New Zealand sheep, which does not display this requirement for chilling and hatches immediately once the third stage larvae are developed.

Dynamic Magnetic Resonance Imaging- a sensitive tool in managing consecutive exotropia

Background: Proper evaluation and accurate diagnosis are crucial in managing a case of strabismus. Objective: Report a case of prolonged large angle complicated consecutive exotropia where dynamic Magnetic Resonance Imaging helped us to diagnose and simplify the management plan. Case: A 19-year-old male presented with outward deviation of both eyes for last 16 years with right face turn, without diplopia and trauma. However, he had history of two consecutive squint surgeries, a month apart, at the age of 3 years. Observation: Visual acuity (best corrected) in the right and left eye was 6/36 and 6/6 respectively. Extraocular movements revealed minus (-) 4 adduction deficits in the left eye with right eye suppression. Prism Alternate Cover Test (PACT) showed 65 prism diopter (PD) base in (BI), for primary and near gazes with lateral incommitance and without any pattern. Forced Duction Test (FDT) showed restriction of the left lateral rectus. Dynamic Magnetic Resonance Imaging revealed posterior insertion of the left medial rectus with thinning of the tendinous insertion of the left lateral and medial rectus in neutral position. On adduction of left eye, there was slight increased bulk of the left medial rectus. Medial Rectus (MR) advancement 5.5 mm and Lateral Rectus (LR) recession 9mm was done. Repeat FDT showed improvement in resistance. After 3 month, the patient had excellent outcome with 5 PD primary position exotropia and 2 units of improvement in left eye adduction. Conclusion: Precise workup and appropriate investigation decreases the undue interventions with excellent outcome in a case of large angle consecutive XT. 

Study of Outcome of an Implanted Autologous Auricular Cartilage: A Preliminary Experimental Research in Rabbits

To investigate the viability of the implanted crushed and uncrushed auricular cartilage graft with intact perichondrium with respect to macroscopic and microscopic parameters. Cartilage grafts from 8 white New Zealand rabbits were harvested from the right auricle, with intact perichondrial layers. There were two categories Pre implant and Post-implant and two types, mildly crushed and uncrushed cartilage graft. The cartilage grafts were implanted into the subcutaneous pockets over the right upper paraspinal area. At the end of 2 months, implanted grafts were retrieved and examined histopathologically. There was a difference among the both types of cartilages in both the categories with respect to chronic inflammation, fibrosis, cartilage mass viability and vascularization. The mildly crushed auricular autologous cartilage with intact perichondrium does not lose the viability and maintains the structural integrity and thus increasing the clinical predictability for cosmetic correction of nose in rhinoplasty.

Production benefits from pre- and post-lambing anthelmintic treatment of ewes on commercial farms in the southern North Island of New Zealand

AIMS

To measure the magnitude and variability in production responses to anthelmintic treatments administered to adult ewes around lambing.

METHODS

Ewes carrying twin lambs, from sheep and beef farms (eight in Year 1 and six in Year 2) in the Wairarapa region of New Zealand, were enrolled in 14 trials (part of an experiment carried out on one farm in one year). Experiment 1 compared ewes treated 2-4 weeks pre-lambing with a controlled release capsule (CRC) containing abamectin, albendazole, Se and Co, to ewes injected pre-lambing with a long-acting Se plus vitamin B12 product, and to untreated ewes. Experiment 2 included these treatments, plus a CRC administered at pregnancy scanning. Experiment 3 included the same treatments as Experiment 1, plus administration of a CRC containing albendazole, Se and Co, injectable moxidectin or oral derquantel plus abamectin, all administered pre-lambing, or oral derquantel plus abamectin administered 4-6 weeks after lambing. Variables compared were ewe liveweight at weaning and pre-mating, lamb liveweight at weaning, total weight of lamb weaned per ewe and ewe dag score at weaning.

RESULTS

Ewes treated with a CRC pre-lambing were heavier than untreated ewes (mean 3.2 kg) at weaning in 12/14 trials, and pre-mating (mean 2.8 kg) in 9/14 trials (p<0.001). Compared with mineral-treated ewes the mean difference was 2.8 kg pre-lambing (9/14 trials) and 1.7 kg pre-weaning (6/14 trials). Lambs reared by treated ewes were heavier (mean 1.55 kg) at weaning in 6/14 trials (p<0.001), but there was no effect of CRC treatment on total weight of lambs weaned per ewe (p=0.507). Variation in weight of lamb weaned per ewe was largely explained by differences in lamb survival from birth to weaning (p<0.001), with no effect of CRC treatment (p>0.65). Treatment of ewes with a CRC at pregnancy scanning was neither better nor worse than a pre-lambing treatment (p=0.065). There was no difference in the response from treatment with either of the two CRC or moxidectin. Treatment with short-acting oral anthelmintics resulted in no consistent benefit.

CONCLUSIONS

Anthelmintic treatments administered to ewes around lambing resulted in variable responses between farms and years, which in some trials were negative for some variables, and some of the variability was due to the mineral component of the CRC. The widespread perception amongst farmers and veterinarians that anthelmintic treatment of ewes around lambing will always result in positive benefits is not supported.

Measurement of bremsstrahlung-induced reaction cross-section for 93Nb using electron Linac

Cross sections for (γ, n) reaction at bremsstrahlung end point energies of 10 and 12.5MeV on niobium have been measured by the activation technique. Induced activities were measured by a high-resolution γ-ray spectrometer with a high-purity germanium (HPGe) detector. Theoretically the (γ, n) cross-section of 93Nb as a function of photon energies were also calculated using TALYS 1.4 computer code. We compared the measured data with the flux weighted average values from the available literature data based on experiments with mono-energetic photons and the theoretical calculation by the model code TALYS 1.4. The experimental values are found to be in good agreement with the theoretical value from TALYS 1.4 but are slightly higher than the flux-weighted values from mono-energetic photons

Evaluation of Physical Properties of Tissue Conditioning Materials as used in Functional Impression - A Lab Study

BACKGROUND

The purpose of this study was to identify the basic physical properties of 3 commonly available tissue-conditioning materials to gain knowledge for their clinical use as impression materials.

MATERIALS & METHODS

A total of 60 samples were prepared and each sample was mixed and prepared according to manufacture direction. Finally five specimens of each tissue conditioners were subjected for each of the above test at different time duration.

RESULTS & CONCLUSION

The study showed that all the materials underwent water loss from the time of mixing to 24 hr & became hard. The plasticity of coecomfort & viscogel decreased from the time of mixing upto 1hr & 2hr respectively & again increased after that till 24 hrs, but the softone showed decreased plasticity after 30 min till 24hrs. Softone & coecomfort at 30 min showed better flow & more plasticity than that of viscogel. The dimensional accuracy of softone & viscogel at 30min is better than that of coecomfort. Thus softone at 30 min after mixing has better Dimensional accuracy, Plasticity and Flow; suitable for making functional impression then that of Coe-comfort and Viscogel. How to cite this article: Shylesh K B S, Hallikerimath R B, Rajeev V V, Ganesh S, Meenakshi S. Evaluation of Physical Properties of Tissue Conditioning Materials as used in Functional Impression - A Lab Study. J Int Oral Health 2013; 5(3):20-27.

Comparative Study to Assess the Effectiveness of Various Disinfecta- nts on two Microorganisms and the effect of same on Flexural Strength of Acrylic Denture Base Resin - An In Vitro Study

BACKGROUND

To evaluate and compare the effectiveness of various disinfectants on Candida albicans (C.albicans) and Staphylococcus aureus (Staph.aureus) inoculated on acrylic denture base resin and effect of disinfectants on flexural strength of denture base resin.

MATERIALS & METHODS

A total of 130 acrylic denture base resin specimens were fabricated and processed according to manufacturer instructions. 82 sterile specimens were used for microbiological study. 2 specimens were cultured for organism growth to ensure sterility. 40 sterile specimens each were inoculated by immersing in Sabouraud & Nutrient broth containing microorganisms for 45 minutes each. Then the specimens were immersed in chlorhexidine, glutaraldehyde & distilled water (control) for 4 & 8 minutes. Then the specimens were neutralized. After neutralization the specimens were cultured onto Sabouraud's broth for C.albicans and Nutrient broth for Staph.aureus incubated for 72 h and observed for turbidity. At the end of 72 h subculture were made onto Sabourads dextrose agar media for C.albicans, Blood agar media for Staph.aureus and incubated for 48 h to observe growth. For flexural strength testing, 8 specimens each was immersed in the above mentioned disinfectants and distilled water for 8 & 16 minutes. Each of which was then subjected to 3 point flexural load in Lloyd's Universal testing machine. The peak load was recorded and flexural strength values were calculated.

RESULTS

The microbiological study revealed that both disinfectants were equally effective at 4 minutes against C.albicans & Staph.aureus microorganisms. Flexural strength test revealed no significant difference between test and control groups.

CONCLUSION

Chlorhexdine and Glutaraldehyde disinfectans are equally effective against C.albicans and Staph.aureus microorganisms. Heat polymerized acrylic denture base resin did not demonstrate any significant change in flexural strength between control and test specimens. How to cite this article: Ganesh S, Gujjari A K, Shylesh K B S, Ravi M B, Sowmya S, Meenakshi S.Comparative Study to Assess the Effectiveness of Various Disinfectants on two Microorganisms and the effect of same on Flexural Strength of Acrylic Denture Base Resin - An In Vitro Study. J Int Oral Health 2013; 5(3):55-62.

Electron irradiation effects on optical properties of semiorganic antimony thiourea tetra chloride single crystals

Antimony thiourea tetra chloride single crystals were grown by solution growth technique at room temperature. The UV-visible, fourier transform infrared and fluorescence spectra were recorded and electron irradiation effects on these properties were studied. The optical absorption edge of the UV-visible spectrum slightly shifts towards longer wavelength with the increase of irradiation dose. The fluorescence quantum yield is decreased for electron irradiated antimony thiourea tetra chloride crystals. The presence of functional group of the as-grown and electron irradiated complex was confirmed by fourier transform infrared spectral study.

Correlation of glutathione S-transferases with overall survival in patients with gastric carcinoma

Glutathione S-transferases (GST) are enzymes involved in the detoxification of xenobiotics and are divided into four subclasses, Alpha, Mu, Pi, and Theta. Most human gastrointestinal tumors contain increased amounts of GST Pi and GST enzyme activity. The relationship between GST parameters and tumor and patient characteristics, including overall survival, were studied retrospectively in normal and malignant gastric tissue from 49 patients with primary gastric carcinoma. Twelve patients (24%) were alive at the end of the study with a mean follow-up time of 4.1+/-0.4 years. Levels of GST Alpha, Mu, Pi and GST enzyme activity were not related to tumor stage, localization and diameter of the tumor, number of eosinophils in the tumor, presence of intestinal metaplasia in normal gastric mucosa, or gender and age of the patient. Optimal dichotomization and uni- and multivariate analyses were done with the Cox proportional hazard model. None of the clinicopathological parameters were associated with survival, except the number of eosinophils in the tumor. In contrast, high levels of GST Pi in both normal mucosa (Hazard ratio 3.0, p=0.02) and in gastric carcinoma (HR 2.2, p=0.05) and the presence of GST Mu in normal (HR 0.4, p=0.05) and malignant (HR 0.3, p=0.009) gastric tissue were found to have a significant prognostic value, independent from the clinicopathological parameters, when added separately to a Cox model. In conclusion, the levels of GST Mu and Pi in both normal or carcinomatous gastric tissue have an independent prognostic impact on overall survival.

High acceptability of a vaginal ring intended as a microbicide delivery method for HIV prevention in African women

Vaginal rings (VRs) are new methods for continuous delivery of microbicides. This is the first study to quantitatively and qualitatively explore the acceptability of rings in Africa: 157 HIV-negative, sexually active women aged 18-35 used a placebo silicone elastomer ring for 12 weeks. They completed product acceptability questionnaires every 4 weeks. We conducted 6 exit focus group discussions with a subset of 48 women and 19 in-depth interviews with male partners. Retention in the study was high (97 %). Initial insertion at the clinic was successful on first attempt for 81 % of participants. Most women were comfortable using the ring, and very few (≤2 %) could feel it during daily activities or had ring-related physical or emotional problems. In the qualitative interviews many participants reported that they initially had concerns about using the ring. However, only a minority of women actually reported concerns with the ring during the study. The most frequent concern was that the ring would get lost inside the body (20 %), and this was significantly correlated with study site, frequently thinking about the ring and reporting that the ring was not very easy to remove. Qualitative data suggest that informants grew to like the ring because it felt securely placed, was unnoticeable during daily activities, and felt "normal" during sex. The ring appeared to be highly acceptable for women and men. Initial concerns with this novel method suggest a need for enhanced product counseling when VRs are introduced.

Accommodative spasm with bilateral vision loss due to untreated intermittent exotropia in an adult

Background: Intermittent exotropia (IXT) is an exodeviation intermittently controlled by fusional mechanisms. Patients with IXT may present with asthenopic symptoms, blurred vision, headaches, diplopia or visual confusion and reading difficulties; especially after prolonged periods of near work. Objective: To report the presentation and management of a young adult with intractable accommodative spasm secondary to long standing intermittent exotropia. Case: The patient was found to have bilateral accommodative spasm with high pseudomyopia and severe impairment of vision. There was a tendency for recurrence with discontinuation of cycloplegics.Conclusion: A total relief of symptoms was noticed after strabismus surgery was undertaken for the exotropia. A detailed orthoptic evaluation with emphasis on recognizing accommodative spasm as an unusual presentation of IXT, could aid in appropriate diagnosis and treatment of such cases.DOI: http://dx.doi.org/10.3126/nepjoph.v4i2.6552 Nepal J Ophthalmol 2012; 4 (2): 319-322