Effect of Spectacle Centration on Stereoacuity

To determine the percentage of decentered spectacles ,the possible relationship of decentration of spectacles on stereoacuity,the difference between interpupillary distance (IPD) and optical centration distance (OCD), the relationship between decentration of spectacles and asthenopic symptoms, magnitude of prismatic effect and the direction of base of prism in decentered spectacles. Methods:A hospital based cross-sectional study conducted on the 100 students, with the age range of 18 to 26 years.Horizontal decentartion of spectacles was assessed by taking the difference between the interpupillary distance and the optical centration distance. Vertical decentration was assessed by difference between the optical centre of the spectacles and the centre of the pupils. Direction of decentration determines the prism base direction and stereoacuity was assessed by titmus fly test.Results: All individuals were using decentered spectacles in both horizontal and vertical direction. Decentration was highest (33%) in the range of 0 – 1.49 (mm) horizontally in both eyes. Vertical decentration in the range of 3 – 5 (mm) was highest, 39% in right eye and 48% in the left eye of the individuals. 56% of the individuals have horizontal prismatic effect in their spectacles in right and left eye within the range of 0 – 0.49 prism diopters. Vertical prismatic effect was within range of 0 – 0.99 prism diopters in maximum number of individuals. Majority (76%) had base-in prisms induced in their spectacles in both right and left eyes. Vertically induced prism was in the base-up direction in 87% and 90% of the individuals in their right and left eyes respectively and 8% and 7% base-down prisms in their right and left eyes respectively. Difference between IPD (inter-pupillary distance) and OCD (optical centration distance) of individuals was quite significant with p-value 0.000. The mean difference between IPD and OCD was -3.57000. Mean IPD was less than the mean OCD. Horizontal prismatic effect in right eye caused decline in the stereo-acuity with p-value 0.019. Highest number of individuals (42) had reduction of stereo-acuity within the range of 20 – 100 minutes of arc having horizontal prismatic effect in the range of 0 – 1.49 in their right eyes.Conclusions: Due to improper dispensing of the spectacles, prismatic effect is induced in the spectacles that shifts the image position formed on the retina and results in the reduction of the stereoacuity of the individuals

Recent advances in the synthesis of triazole derivatives

Triazole ring system has attracted a continuously growing interest of synthetic organic chemists and those dealing with the medicinal compounds due to its versatile potential to interact with biological systems. The triazole compounds possess a wide range of biological activities and are especially focused for antifungal behavior. In thisreview article, we have summarized the recent developmentsin the synthetic methodologies of this ring system. The main focus was on the methodologies which deal with the facile and convenient synthesis

Metaplastic breast carcinoma: Clinicopathological parameters and prognostic profile

Introduction: Metaplastic breast carcinoma (MBC) is defined as breast cancer with a heterologous non-glandular component. MBC is considered a special type of breast cancer with a prognosis that is worse than invasive ductal carcinoma (IDC) of the breast. MBC is the most common breast cancer with a triple-negative profile. Therefore, in this study, we evaluated the clinicopathological parameters, recurrence and survival of MBC in our population.Methods: We conducted a retrospective observational study in the Department of Histopathology at Prince Faisal Oncology Centre, Buraidah, Saudi Arabia, over a period of five years. All cases diagnosed as MBC were included in the study. Estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2/neu) immunohistochemistry (IHC) was performed on representative tissue blocks.Results: Total 183 cases of MBCs were included in the study, out of which 120 cases were excision specimens. The mean age of the patients was 48.84±12.99 years, and the most common age group was between 36 and 50 years of age. Most of the cases were tumor (T) stage T3 (50%), and nodal metastasis was present in 40% of cases. Most cases were grade III (78.7%). ER, PR and HER2/neu positivity was noted in 15.8%, 13.1%, and 9.8% cases, respectively. Follow-up data were available for 70 cases, with a median follow-up period of 4 (1-7) years. Tumor recurrence was noted in 31.4% cases, with a survival rate of 71.4%. Squamous, chondroid, spindle cell differentiation, and matrix production were noted in 70.5%, 7.1%, 13.7%, and 2.2% cases, respectively. A significant association of squamous differentiation was noted with HER2/neu positivity. An inverse association of spindle cell differentiation was seen with axillary metastasis. Survival analysis by Kaplan-Meier revealed a significant association of survival with tumor recurrence.Conclusion: MBC is an important subtype of breast cancer, histopathological identification of which is challenging, owing to varied histological differentiation. We found squamous differentiation to be the most common in MBC, which was associated with HER2/neu positivity. A high recurrence rate of MBC was also observed in our study that was significantly associated with survival

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Literacy, Poverty and Trade Openness in Pakistan: An Empirical Investigation

Purpose: Education plays a vital role in improving the standard of living of the masses by providing them with better job opportunities and future earnings. This study has attempted to investigate the impact of the literacy rate on poverty in Pakistan. Methodology: This study is based on secondary data and has employed the Johansen Cointegration and VECM technique for empirical investigation. Headcount ratio is a dependent variable, employed as a proxy for poverty. In the present study, explanatory variables are literacy rate, trade openness, FDI and inflation rate. Findings: The empirical findings from the study show that literacy rate and trade openness show a negative relationship with poverty in Pakistan. However, inflation shows a positive relationship with poverty. Policy Implications: The study suggests that policymakers should initiate suitable measures to improve the education system in Pakistan. There is a dire need of increasing the enrolment rate at the primary level and special check on the drop-out ratio in public schools

Investigating the Impact of Corruption on Poverty in Pakistan

Purpose: Corruption is one of the mega issues faced by developing countries like Pakistan. It not only erodes the macroeconomic performance of a country but also widens the gap between rich and poor by accelerating income inequality and poverty level. The present tries to examine the effects of corruption on poverty in Pakistan. Design/Methodology/Approach: The present research based on the secondary data from the Transparency International and World Bank database, from the period 1997 to 2019. The study has applied the Johanson Cointegration and Vector Error Correction Method (VECM) as an econometric technique.  Findings: The empirical findings conclude that corruption and inflation are significantly and positively associated with poverty in Pakistan. However, the employed labor force shows a negative relationship with the poverty rate. Implications/Originality/Value: Based on the results, the study suggested that for the reduction and eradication of corruption the present judiciary system should be improved. Supremacy of Law should be implemented

Region-Based Segmentation and Wiener Pilot-Based Novel Amoeba Denoising Scheme for CT Imaging

Computed tomography (CT) is one of the most common and beneficial medical imaging schemes, but the associated high radiation dose injurious to the patient is always a concern. Therefore, postprocessing-based enhancement of a CT reconstructed image acquired using a reduced dose is an active research area. Amoeba- (or spatially variant kernel-) based filtering is a strong candidate scheme for postprocessing of the CT image, which adapts its shape according to the image contents. In the reported research work, the amoeba filtering is customized for postprocessing of CT images acquired at a reduced X-ray dose. The proposed scheme modifies both the pilot image formation and amoeba shaping mechanism of the conventional amoeba implementation. The proposed scheme uses a Wiener filter-based pilot image, while region-based segmentation is used for amoeba shaping instead of the conventional amoeba distance-based approach. The merits of the proposed scheme include being more suitable for CT images because of the similar region-based and symmetric nature of the human body anatomy, image smoothing without compromising on the edge details, and being adaptive in nature and more robust to noise. The performance of the proposed amoeba scheme is compared to the traditional amoeba kernel in the image denoising application for CT images using filtered back projection (FBP) on sparse-view projections. The scheme is supported by computer simulations using fan-beam projections of clinically reconstructed and simulated head CT phantoms. The scheme is tested using multiple image quality matrices, in the presence of additive projection noise. The scheme implementation significantly improves the image quality visually and statistically, providing better contrast and image smoothing without compromising on edge details. Promising results indicate the efficacy of the proposed scheme