A comparative study of verbal IQ, performance IQ and verbal IQ-performance IQ disparity among Turner syndrome patients and patients with primary amenorrhoea due to other aetiologies

Background: Assessing disparity in IQ is important in selecting an occupation and thus helping people lead a productive life. In Turner syndrome patients, this shall be more important as assessment of verbal IQ- and performance IQ disparity could be used in helping them select an occupation so that productivity and quality of life is not grossly compromised.Methods: Based on karyotyping, 30 patients with turner syndrome and 30 patients with primary amenorrhoea due to other aetiologies were selected for the study. Cytogenetic analysis was done for every case using G-banding technique. Assessment of intellectual functions was done using Wechsler Adult Intelligence Scale (WAIS).Results: Mean value of PIQ of X0 (turner) was 74.67 and that of XX (other amenorrhoea patients) was 90.30. Mean value of VIQ of X0 (turner) was 93.67 and that of XX (other amenorrhoea patients) was 93.60. Mean value of VIQ and PIQ disparity of X0 (turner) was 18.67 and that of XX (other amenorrhoea patients) was 3.Conclusions: Turner syndrome patients have high VIQ-PIQ disparity when compared to other primary amenorrhoea patients

A Three Level Model of SOA Maturity: Toward Achieving Sense and Respond

Service Oriented Architecture (SOA) has been proposed as both a technical and managerial solution in making firms more agile in addressing ever changing business needs. This conceptual paper identifies 3 levels of SOA implementation maturity: 1. Stability, 2. Flexibility, 3. Sense and Respond. A process and governance strategy on how to achieve each level is theorized and supported by case examples. The highest level conceptualized, Level 3, holds promise whereby SOA intelligence informates business activities and decisions. A case illustration concerning the use of a Customer Priority Index (CPI), derived from Level 3 SOA, outlines how a customer focused Sense and Respond capability might be achieved

Comparison of vitamin D levels in obese and non obese patients with polycystic ovarian syndrome in a South Indian population

Polycystic ovary syndrome (PCOS) is the most common metabolic abnormality occurring in young women of reproductive age. Low vitamin D levels were found to be associated with the development of obesity and insulin resistance in young women with PCOS. The study was conducted as a prospective observational study involving 121 women with PCOS. The diagnosis of PCOS cases were based on the revised Rotterdam consensus criteria. Vitamin D levels were compared in the obese and non obese PCOS groups and also with the controls. In the PCOS group, sixty subjects were obese with BMI of ≥25 kg/m2 and forty seven subjects were found to be non obese. In the control group, sixteen subjects were obese and sixty five subjects were non obese. The mean vitamin D level in the PCOS group was 15.45±7.88 ng/ml and in the control group was 12.83±5.76ng/ml. The mean vitamin D levels in the obese and non obese group with PCOS were 16.11±8.9ng/ml and 14.61±6.1ng/ml respectively. Majority of the patients and controls had vitamin D deficiency and there was no difference in the vitamin D levels in PCOS group and controls as well as obese and non obese groups

The relationship between dietary patterns and ophthalmic disease

There is a rising interest in the impact of diet on the pathogenesis of common ophthalmic conditions. The purpose of this review is to summarize the potential preventive and therapeutic power of dietary interventions described in recent basic science and epidemiological literature.Basic science investigations have elucidated a variety of mechanisms by which diet may impact ophthalmic disease, particularly through its action on chronic oxidative stress, inflammation and macular pigmentation. Epidemiologic investigations have shown the real-world influence of diet on the incidence and progression of a number of ophthalmic diseases, particularly cataract, age-related macular degeneration (AMD) and diabetic retinopathy. A large observational cohort study found a 20% reduction in the incidence of cataract among vegetarians compared with nonvegetarians. Two recent systematic reviews found that higher adherence to Mediterranean dietary patterns was associated with a decreased risk of progression of AMD to later stages. Finally, large meta-analyses found that patients following plant-based and Mediterranean diets had significant reductions of mean haemoglobin A1c scores and incidence of diabetic retinopathy as compared with controls.There is a significant and growing body of evidence that Mediterranean diet and plant-based diets - those that maximize fruits, vegetables, legumes, whole grains and nuts; and that minimize animal products and processed foods - help prevent vision loss from cataract, AMD and diabetic retinopathy. These diets may hold benefits for other ophthalmic conditions, as well. Nevertheless, there is a need for further randomized, controlled and longitudinal studies in this area

A comparison of the efficacy of intercostal nerve block and peritubal infiltration of ropivacaine for post-operative analgesia following percutaneous nephrolithotomy: A prospective randomised double-blind study

Background and Aims: Intercostal nerve blockade (ICNB) and peritubal infiltration of the nephrostomy tract are well-established regional anaesthetic techniques for alleviating pain after percutaneous nephrolithotomy (PCNL). This prospective study compared the efficacy of ICNB and peritubal local anaesthetic infiltration of the nephrostomy tract in providing post-operative analgesia following PCNL. Methods: Sixty American Society of Anesthesiologist physical status 1 and II patients scheduled for PCNL requiring nephrostomy tube were randomised to receive either peritubal infiltration or ICNB. At the completion of the procedure, patients in Group P received peritubal infiltration and those in Group I received ICNB at 10, 11, 12th spaces using fluoroscopy guidance. Postoperatively, patients were followed for 24 h for pain using Visual Analogue Scale (VAS) and Dynamic VAS. Rescue analgesia was inj. tramadol 1 mg/kg IV when pain score exceeded 4. Time to first rescue analgesia, number of doses and patient's satisfaction were noted in all patients. Results: Pain scores were lower in the group I at all points of measurement than group P. The mean time to first demand for rescue analgesia was higher in Group I (13.22 ± 4.076 h vs 7.167 ± 3.92 h P - 0.001). The number of demands and the amount of analgesics consumed were less in Group I. Conclusion: ICNB provided superior analgesia as evidenced by longer time to first demand of analgesic, reduced number of demands and consumption of rescue analgesic. Peritubal infiltration, although less efficacious, may be a safe and simple alternative technique

Infectious and Non-infectious Corneal Ulcers in Ocular Graft-Versus-Host Disease: Epidemiology, Clinical Characteristics and Outcomes

To evaluate the incidence, clinical characteristics, microbiological profile, and therapeutic outcomes of corneal ulcers in individuals with chronic ocular graft-vs-host disease (coGVHD). Retrospective clinical cohort study Review of individuals diagnosed with coGVHD following hematopoietic stem cell transplantation (HSCT) who were seen at the Bascom Palmer Eye Institute between May 2010 and November 2021. Baseline demographics, clinical characteristics, microbiological profile, risk factors for corneal ulceration, and treatment outcomes were collected. Etiology was deemed infectious in individuals with a positive culture or appropriate clinical scenario (presence of stromal infiltrate or hypopyon); otherwise, ulcers were presumed to be non-infectious. Treatment success was defined as re-epithelialization with infiltrate resolution, and treatment failure as progression to corneal perforation or keratoplasty. Kaplan-Meier survival analysis estimated the incidence of ulceration. Cox regression analyses examined demographic and risk factors. Infectious and non-infectious ulcer groups were compared using two-way independent t-tests, one-way analysis of variances (ANOVAs), and Chi-squared tests, as appropriate. 173 individuals were included (53.7±14.4 years old; 59.0% male). Thirty-three individuals developed an ulcer 74.5±54.3 months after HSCT, with estimated 5- and 10-year incidences of 14% and 30%, respectively. Twenty-two (66.6%) ulcers were deemed infectious (15 microbiologically confirmed, 7 clinically) and 11 (33.3%) were deemed non-infectious. Risk factors for corneal ulceration included black race (hazards ratio [HR] 2.89, 95% CI 1.30-6.42, p<0.01), previous ocular surgery (HR 9.16, 95% CI 3.86-21.72, p<0.01), lid margin abnormalities (HR 3.44, 95% CI 1.69–6.99, p<0.01), and topical steroid use (HR 2.74, 95% CI 1.33–5.62, p<0.01). Conversely, contact lens use reduced the risk of corneal ulceration (HR 0.29, 95% CI 0.13–0.66, p<0.01). Infectious ulcers had a significantly higher frequency of treatment failure than non-infectious ulcers (57.1% vs 20.0%, p=0.04). Corneal ulceration is a potential complication of coGVHD, with several clinical features identified as risk factors. Infectious ulcers had worse outcomes than non-infectious ulcers

Intraocular Lens Power Calculations in Keratoconus Eyes Comparing Keratometry, Total Keratometry, and Newer Formulae

•IOL calculations in keratoconus (KCN) eyes are difficult compared with non-KCN eyes.•Recently, new formulae and corneal power methods have been suggested for KCN eyes.•In severe KCN eyes, KCN specific formulas using total keratometry (TK) perform favorably, and the Barrett Universal True K KCN: M-PCA performs best.•In moderate KCN eyes, TK improves the accuracy of new formulae such as the EVO 2.0 formula.•Classical formulae other than SRK/T should be avoided in KCN eyes.To compare the utility of keratometry vs total keratometry (TK) for intraocular lens power calculations in eyes with keratoconus (KCN) using KCN and non-KCN formulae.Retrospective cohort study.This study was conducted at 2 academic centers and included 87 eyes in 67 patients who underwent cataract surgery between 2019 and 2021. Biometry measurements were obtained using a swept-source optical coherence tomography biometer (IOL Master 700). Refractive prediction errors, including root mean square error (RMSE), were calculated for 13 formulae. These included 4 classical formulae (Haigis, Hoffer Q, Holladay 1 [H1], and SRK/T), 5 new formulae (NF) (Barrett Universal II [BU2], Cooke K6, EVO 2.0, Kane, and Pearl-DGS), 3 KCN formulae (BU2 KCN: M-PCA, BU2 KCN: P-PCA, and Kane KCN), and H1 with equivalent keratometry reading values (H1-EKR). Formulae were ranked by RMSE. Friedman analysis of variance with post hoc analysis and H-testing was used for statistical significance testing.KCN formulae had the lowest RMSEs in all eyes, and BU2 KCN:M-PCA performed the best among KCN formulae in all subgroups. In eyes with severe KCN, if TK values are unavailable, the BU2 KCN: P-PCA performed better than the top-ranked non-KCN formula (SRK/T). In eyes with nonsevere KCN, if TK values are unavailable, EVO 2.0 K was statistically superior to the next competitor (Kane K). H1-EKR had the highest RMSE.KCN formulae and TK are useful for intraocular lens power calculations in KCN eyes, especially in eyes with severe KCN. The BU2 KCN: M-PCA using TK values performed best for eyes with all severities of KCN. For eyes with nonsevere KCN, the EVO 2.0 TK or K can also be used

Intracameral Enoxaparin for Descemet Membrane Endothelial Keratoplasty: A Pilot Safety Study

Purpose: The purpose of this study was to investigate the safety and outcomes of Descemet membrane endothelial keratoplasty (DMEK) performed with intracameral enoxaparin. Methods: Two arms were used: a clinical multicenter retrospective cohort arm (CA) and an ex vivo basic science arm (BSA). In CA, DMEKs were performed by 6 experienced corneal surgeons at multiple sites. Intracameral enoxaparin (40 mg/500 mL) was added to the irrigation fluid for all cases. Primary outcomes were measured at 6 and 12 months. In BSA, mated graft pairs were randomized to control or enoxaparin exposure (0.8 mg/mL × 1 hour) and assessed for endothelial cell death count at 0-, 1-, and 24-hour intervals and cellular stress by ELISA Annexin V protein quantification. Results: In the cohort arm, the mean age of 159 eyes of 134 patients was 69.3 years with Fuchs dystrophy as the primary diagnosis. Mean BCVA improved from 0.42 ± 0.3 logMAR preoperatively to 0.13 ± 0.1 logMAR postoperatively at 6 months ( P < 0.001) and to 0.1 ± 0.1 logMAR at 12 months ( P < 0.001). At 6 months, 58.4% of patients achieved a final BCVA of 20/25 or better and 91% improved to 20/40 or better. Rebubble rate was 13% (n = 21), with 6 of these 21 eyes requiring more than 1 rebubble. One total graft detachment was noted with no reports of intraoperative or postoperative hemorrhage. PGF occurred in 0 of 159 eyes. In BSA, enoxaparin had no significant effect on endothelial cell death count or cellular apoptosis compared with control. Conclusions: Enoxaparin can safely be used in DMEK surgery without apparent increased risk of intraoperative hemorrhage, graft detachment/failure, or endothelial cell toxicity