Traumatic 6th Nerve Palsy Managed with Medial Rectus Recession with Hangback Sutures and Hummelsheim Procedure

Traumatic paralytic esotropia due to 6th nerve palsy is not uncommon but difficult to manage. We reported a case of 38‑year‑old male who sustained head injury in road traffic accident 15 years ago and inward deviation of his left eye. His vision in right eye was 20/20 and counting fingers at one foot in the left eye. He had >70 prism diopters esotropia in the left eye with restriction of movements in all directions of gaze except adduction. His forced duction test was positive. Examinations of the anterior and posterior segments of both eyes were within normal limits. Magnetic resonance imaging suggested old traumatic insult in the left eye. Diagnosis of left eye traumatic 6th nerve palsy with medial rectus contracture was made. Left medial rectus recession with hangback sutures and Hummelsheim procedure were performed. Postoperatively, the patient’s vision in the left eye had improved to 20/80 the esotropia had reduced to 15 prism diopters (delta).Keywords: Abducent nerve, esotropia, traum

BUDH IES V:The baryonic Tully-Fisher relation at z = 0.2 based on direct H I detections

We present H I-based B- and R-band Tully-Fisher relations (TFRs) and the Baryonic TFR (BTFR) at z = 0.2 using direct H I detections from the Blind Ultra-Deep H I Environmental Survey (BUDH IES). Deep photometry from the Isaac Newton Telescope was used for 36 out of 166 H I sources, matching the quality criteria required for a robust TFR analysis. Two velocity definitions at 20 and 50 per cent of the peak flux were measured from the global H I profiles and adopted as proxies for the circular velocities. We compare our results with an identically constructed z= 0 TFR from the Ursa Major association (UMa) of galaxies. To ensure an unbiased comparison of the TFR, all the samples were treated identically regarding sample selection and applied corrections. We provide catalogues and an atlas showcasing the properties of the galaxies. Our analysis is focused on the zero points of the TFR and BTFR with their slopes fixed to the z = 0 relation. Our main results are: (1) The BUDH IES galaxies show more asymmetric H I profiles with shallower wings compared to the UMa galaxies, which is likely due to the environment in which they reside, (2) The luminosity-based z= 0.2 TFRs are brighter and bluer than the z = 0 TFRs, even when cluster galaxies are excluded from the BUDH IES sample, (3) The BTFR shows no evolution in its zero point over the past 2.5 billion yr and does not significantly change on the inclusion of cluster galaxies, and (4) proper sample selection and consistent corrections are crucial for an unbiased analysis of the evolution of the TFR

Ultrasound intensification suppresses the need of methanol excess during the biodiesel production with Lipozyme TL-IM

The synthesis of biodiesel from sunflower oil and methanol based on transesterification using the immobilized lipase from Thermomyces lanuginosus (Lipozyme TL-IM) has been investigated under silent conditions and under an ultrasound field. Ultrasound assisted process led to reduced processing time and requirement of lower enzyme dosage. We found for the first time that ratio 1:3 (oil to methanol) was favoured for the ultrasound assisted enzymatic process which is lower as that favoured for the silent process (ratio of 1.4). Our results indicate that intensification provided by ultrasound suppresses the need of the excess of the methanol reactant during the enzymatic biodiesel production. Ultrasound assisted enzymatic biodiesel production is therefore a faster and a cleaner processes.The authors acknowledge Brenntag India Pvt. Ltd. for kindly providing gift sample of lipase enzyme Lipozyme TL IM to carry out the research work. All authors acknowledge the funding of Department of Science and Technology and Portuguese Science Foundation under the Indo-Portuguese collaborative program

BUDHIES IV:Deep 21-cm neutral Hydrogen, optical, and UV imaging data of Abell 963 and Abell 2192 at z ≃ 0.2

In this paper, we present data from the Blind Ultra-Deep H I Environmental Survey (BUDHIES), which is a blind 21-cm H I spectral line imaging survey undertaken with the Westerbork Synthesis Radio Telescope. Two volumes were surveyed, each with a single pointing and covering a redshift range of 0.164 < z < 0.224. Within these two volumes, this survey targeted the clusters Abell 963 and Abell 2192, which are dynamically different and offer unique environments to study the process of galaxy evolution within clusters. With an integration time of 117 × 12 h on Abell 963 and 72 × 12 h on Abell 2192, a total of 166 galaxies were detected and imaged in H I. While the clusters themselves occupy only 4 per cent of the 73 400 Mpc3 surveyed by BUDHIES, most of the volume consists of large-scale structures in which the clusters are embedded, including foreground and background overdensities and voids. We present the data processing and source detection techniques and counterpart identification based on a wide-field optical imaging survey using the Isaac Newton Telescope and deep ultraviolet (UV) Galaxy Evolution Explorer (GALEX) imaging. Finally, we present H I and optical catalogues of the detected sources as well as atlases of their global H I properties, which include integrated column density maps, position-velocity diagrams, global H I profiles, and optical and UV images of the H I sources

Awareness regarding eye donation among stakeholders in Srikakulam district in South India

Background There is a huge need for the availability of transplantable donor corneas worldwide to reduce the burden of corneal blindness due to corneal opacity. Voluntary eye donation depends on the awareness levels of various stakeholders in the community. This study aimed to assess the awareness level regarding eye donation among various stakeholders in Srikakulam district in the state of Andhra Pradesh, India. Methods 355 subjects were selected from the district using multi stage random sampling. A pre tested semi structured questionnaire was used to collect information regarding each individual’s awareness, knowledge, and perception regarding eye donation. Each response was scored individually and a total score was calculated. Univariate and multivariate regression analysis was used to determine the factors associated with willingness towards eye donation and increased awareness levels. Results Of the 355 subjects interviewed, 192 (54%) were male and 163 (46%) were female. The mean age of the stakeholders was 35.9 years (SD ±16.1) and all the study subjects were literate. Ninety-three percent of subjects were aware of the concept of eye donation. Knowledge levels were similar among the teaching community and persons engaged in social service, but lower among students (p < 0.05). Among the stakeholders, there was considerable ambiguity regarding whether persons currently wearing spectacles or suffering from a chronic illnesses could donate their eyes. Older age group (p < 0.001), female gender (p < 0.001) and education (p < 0.001) were associated with increased knowledge levels. 82% of the subjects were willing to donate their eyes and this was unaffected by gender or geographical location (rural vs urban). Conclusions Awareness levels and willingness to donate eyes are high among the stakeholders in Srikakulam district in India. The services of stakeholders could be utilized, in conjunction with other community based eye donation counselors, to promote awareness regarding eye donation among the general population

A Branch and Bound Algorithm for Exact, Upper, and Lower Bounds on Treewidth

In this paper, a branch and bound algorithm for computing the treewidth of a graph is presented. The method incorporates extensions of existing results, and uses new pruning and reduction rules, based upon roperties of the adopted branching strategy. We discuss how the algorithm can not only be used to obtain exact bounds for the treewidth, but also to obtain upper and/or lower bounds. Computational results of the algorithm are presented

An updated systematic review of the cost-effectiveness of therapies for metastatic breast cancer

Purpose: The goal of this systematic review is to provide an update to the review by Pouwels et al. by conducting a systematic review and an assessment of the reporting quality of the economic analyses conducted since 2014. Methods: This systematic review identified published articles focused on metastatic breast cancer treatment using the Medline/PubMed and Scopus databases and the following search criteria: (((cost effectiveness[MeSH Terms]) OR (cost effectiveness) OR (cost-effectiveness) OR (cost utility) OR (cost–utility) OR (economic evaluation)) AND ((“metastatic breast cancer”) OR (“advanced breast cancer”))). The reporting quality of the included articles was evaluated using the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. Results: Of the 256 identified articles, 67 of the articles were published after October 2014 when the prior systematic review stopped its assessment (Pouwels et al. in Breast Cancer Res Treat 165:485–498, 2017). From the 67 articles, we narrowed down to include 17 original health economic analyses specific to metastatic or advanced breast cancer. These articles were diverse with respect to methods employed and interventions included. Conclusion: Although each of the articles contributed their own analytic strengths and limitations, the overall quality of the studies was moderate. The review demonstrated that the vast majority of the reported incremental cost-effectiveness ratios exceeded the typically employed willingness to pay thresholds used in each country of analysis. Only three of the reviewed articles studied chemotherapies rather than treatments targeting either HER2 or hormone receptors, demonstrating a gap in the literature

Blindness in Childhood in Developing Countries: Time for a Reassessment?

Paul Courtright and colleagues argue that the changing patterns of global childhood blindness suggest a need to reassess research, training, and programmatic requirements

Variation of cataract surgery costs in four different graded providers of China

<p>Abstract</p> <p>Background</p> <p>China has the largest population of cataract patients in the world. However, the cataract surgery rate per million remains low in China. We carried out a survey on costs of cataract surgery from four different graded providers in China and analyzed differences in cost among these clinics.</p> <p>Methods</p> <p>1,189 patients were recruited for the study in four eye clinics, located in two provinces, Guangdong province in southern China and Hubei province in central China. The average cost of each cataract surgery episode was calculated including cost of intraocular lens, cost of drugs and facility cost. We also collected information on reimbursement and disposable annual income of local residents.</p> <p>Results</p> <p>Mean total cost per cataract intervention of four different providers varied considerably, ranging from US$1,293 in Union Hospital to US$ 536 in Jingshan County Hospital. In all providers, except for Jingshan County Hospital, the cost exceeded annual disposable income of local rural residents. As to the proportion of patients with reimbursement, the figure for Union Hospital was only 36%, while for other three clinics it was more than 60%. There was a significant difference between mean reimbursement ratios, with the highest ratio in Zhongshan Ophthalmic Center being 71%.</p> <p>Conclusions</p> <p>Significant differences in costs of cataract surgery were found among the 4 different graded providers. A part of the cost was borne by patients. Proportion of patients with reimbursement and mean reimbursement ratios were higher in economically developed regions than in economically developing regions. Much more financial support should be directed into the rural New Cooperative Medical Scheme to raise the reimbursement ratio in rural China.</p

Cardiovascular Effects of Canagliflozin in Relation to Renal Function and Albuminuria

Background: People with type 2 diabetes mellitus (T2DM) have elevated cardiovascular (CV) risk, including for hospitalization for heart failure (HHF). Canagliflozin reduced CV and kidney events in patients with T2DM and high CV risk or nephropathy in the CANVAS (CANagliflozin cardioVascular Assessment Study) Program and the CREDENCE (Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation) trial. Objectives: The aim of this study was to assess the effects of canagliflozin on CV outcomes according to baseline estimated glomerular filtration rate (eGFR) and urine albumin:creatinine ratio (UACR) in pooled patient-level data from the CANVAS Program and CREDENCE trial. Methods: Canagliflozin effects on CV death or HHF were assessed by baseline eGFR (60 mL/min/1.73 m2) and UACR (300 mg/g). HRs and 95% CIs were estimated by using Cox regression models overall and according to subgroups. Results: A total of 14,543 participants from the CANVAS Program (N = 10,142) and the CREDENCE (N = 4,401) trial were included, with a mean age of 63 years, 35% female, 75% White, 13.2% with baseline eGFR 300 mg/g. Rates of CV death or HHF increased as eGFR declined and/or UACR increased. Canagliflozin significantly reduced CV death or HHF compared with placebo (19.4 vs 28.0 events per 1,000 patient-years; HR: 0.70; 95% CI: 0.62-0.79), with consistent results across eGFR and UACR categories (all P interaction >0.40). Conclusions: Risk of CV death or HHF was higher in those with lower baseline eGFR and/or higher UACR. Canagliflozin consistently reduced CV death or HHF in participants with T2DM and high CV risk or nephropathy regardless of baseline renal function or level of albuminuria. (Canagliflozin Cardiovascular Assessment Study [CANVAS], NCT01032629; A Study of the Effects of Canagliflozin [JNJ-24831754] on Renal Endpoints in Adult Participants With Type 2 Diabetes Mellitus [CANVAS-R], NCT01989754; and Evaluation of the Effects of Canagliflozin on Renal and Cardiovascular Outcomes in Participants With Diabetic Nephropathy [CREDENCE], NCT02065791