PASCAL laser platform produces less pain responses compared to conventional laser system during the panretinal photocoagulation: a randomized clinical trial

Background: Most of patients experience pain during the panretinal photocoagulation(PRP). Laser photocoagulation delivery has advanced with the introduction of pattern-scanning laser systems (PASCAL). Shorter pulse duration and less choroidal penetration believed to reduce pain during the laser treatment.Objectives: To compare the severity of expressed pain scores in patients with PDR who underwent PRP either with PASCAL laser or conventional laser.Methods: A total of 28 patients with a diagnosis of PDR who were scheduled for bilateral PRP therapy were enrolled into the prospective study. Both eyes were treated within the same session and while one eye was treated with PASCAL the other was treated with conventional laser randomly. Pulse duration was adjusted to 100-ms in conventional laser and 30 ms in PASCAL. The severity of pain was graded using a verbal scale and a visual analog scale (VAS).  Results: Mean age was 61.36±9.10 years. Mean verbal and VAS scores were 1.32±0.47 and 2.86±1.21 in the PASCAL laser and 2.39±0.49 and 5.75±1.35 in the conventional laser group, respectively. Differences between expressed pain scores obtained by both two scales were statistically significant (p<0.001).Conclusion: PASCAL laser significantly alleviates pain levels possibly due to the shorter laser pulse duration and lower intensity. Keywords: Panretinal photocoagulation, PASCAL, pain

PASCAL laser platform produces less pain responses compared to conventional laser system during the panretinal photocoagulation: a randomized clinical trial

Background: Most of patients experience pain during the panretinal photocoagulation(PRP). Laser photocoagulation delivery has advanced with the introduction of pattern-scanning laser systems (PASCAL). Shorter pulse duration and less choroidal penetration believed to reduce pain during the laser treatment. Objectives: To compare the severity of expressed pain scores in patients with PDR who underwent PRP either with PASCAL laser or conventional laser. Methods: A total of 28 patients with a diagnosis of PDR who were scheduled for bilateral PRP therapy were enrolled into the prospective study. Both eyes were treated within the same session and while one eye was treated with PASCAL the other was treated with conventional laser randomly. Pulse duration was adjusted to 100-ms in conventional laser and 30 ms in PASCAL. The severity of pain was graded using a verbal scale and a visual analog scale (VAS). Results: Mean age was 61.36\ub19.10 years. Mean verbal and VAS scores were 1.32\ub10.47 and 2.86\ub11.21 in the PASCAL laser and 2.39\ub10.49 and 5.75\ub11.35 in the conventional laser group, respectively. Differences between expressed pain scores obtained by both two scales were statistically significant (p<0.001). Conclusion: PASCAL laser significantly alleviates pain levels possibly due to the shorter laser pulse duration and lower intensity

Comparison of pain scores between patients undergoing panretinal photocoagulation using navigated or pattern scan laser systems

ABSTRACT Purpose: To compare the pain responses of patients with proliferative diabetic retinopathy (PDR) undergoing panretinal photocoagulation (PRP) using either pattern scan laser (PASCAL) or navigated laser photocoagulation (NAVILAS). Methods: Patients diagnosed with PDR were randomly assigned to undergo either PASCAL or NAVILAS photocoagulation treatment. PRP was performed using the multi-shot mode with a spot size of 200-400 µm and a pulse duration of 30 ms to obtain a white-grayish spot on the retina. Parameters were identical in both procedures. After 30 min of PRP application, patients were asked to verbally describe their pain perception as either "none," "mild," "moderate," "severe," or "very severe" using a verbal rating scale (VRS) and visual analog scale (VAS) by indicating a score from "0" to "10," representing the severity of pain from "no pain" to "severe pain." Results: A total of 60 eyes of 60 patients (20 females and 40 males) diagnosed with PDR were treated. The mean age of patients was 62.22 ± 9.19 years, and the mean diabetes duration was 195.47 ± 94.54 months. The mean number of laser spots delivered during PRP was 389.47 ± 71.52 in the NAVILAS group and 392.70 ± 54.33 in the PASCAL group (p=0.57). The difference in pain responses between patients in the NAVILAS and PASCAL groups was significant with regard to the mean VRS (1.10 ± 0.67 and 1.47 ± 0.69, respectively; p=0.042) and mean VAS (2.13 ± 1.17 and 2.97 ± 1.35, respectively; p=0.034) scores. Conclusions: Pain responses in patients undergoing PRP with a 30-ms pulse duration were significantly milder in the NAVILAS group than in the PASCAL group

Teaching Evolution Self-Efficacy Scale: The Development, Validation and Reliability Study

Bu çalışma ile biyoloji öğretmen adaylarının evrim öğretimi öz yeterlik inanç düzeylerini belirlemeye yönelik bir ölçek geliştirmek amaçlanmıştır. Likert tipi olarak geliştirilen ölçeğin güvenirlik ve geçerlik çalışmaları rapor edilmiştir. Araştırmanın örneklemini biyoloji alan derslerini tamamlamış 212 biyoloji öğretmen adayı oluşturmaktadır. Ölçeğin kapsam geçerliğini sağlamak için ilgili alan yazın taranmış ve uzman görüşlerine başvurulmuştur. Yapı geçerliği için Açımlayıcı Faktör Analizi (AFA) ve Doğrulayıcı Faktör Analizi uygulanmıştır. Ölçeğin güvenirlik çalışması için Cronbach Alfa iç tutarlık katsayısı, madde toplam korelasyonu ve faktörler arasında anlamlı bir ilişki bulunup bulunmadığını belirlemek amacıyla pearson çarpım moment korelasyonları hesaplanmıştır. Ölçeğin geneli için Cronbach Alfa güvenirlik katsayısı 0.87; genel evrim bilgisi öz yeterliği için 0.83; evrim öğretimi öz yeterliği için 0.81 olarak bulunmuştur. Yapılan tüm analizler sonucunda ölçeğin, biyoloji öğretmen adaylarının evrim öğretimine yönelik öz yeterlik inanç düzeylerini ölçmede güvenilir ve geçerli bir ölçme aracı olduğu saptanmıştır.The purpose of this study is to develop a valid and reliable instrument for measuring prospective biology teachers' self efficacy beliefs about teaching evolution. The research was conducted on a study group consisted of 212 prospective biology teachers. Content validity was established through review of related literature and expert opinions. Exploratory Factor Analysis and Confirmatory Factor Analysis are performed in order to establish the scale's construct validity. The scale's reliability coefficient and item-total correlations are calculated. Cronbach alpha coefficient of the scale is 0,87. Internal consistency coefficients for the sub-scales varied between 0,81 and 0,83 and found to be within admissible limits. In light of these results, it could be argued that the scale is reliable and valid instrument and can be used in identifiying prospective biology teachers’ self efficacy beliefs about teaching evolution

Retinal ultrastructural, electrophysiological and microvascular morphological outcomes in diabetic macular edema treated with intravitreal Bevacizumab

Purpose: To investigate retinal ultrastructural, electrophysiological, and microvascular morphological changes, as well as correlations between these changes and visual outcome in naïve diabetic macular edema (DME) patients after intravitreal bevacizumab therapy Design: A prospective interventional study Methods: A total of 31 DME patients’ eyes had monthly intravitreal bevacizumab injections for three consecutive months. Best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were measured, and fundus fluorescein angiography, optical coherence tomography (OCT), microperimetry (MP), as well as optical coherence tomography angiography (OCTA) were performed before and after therapy. Patients were then grouped based on BCVA improvement after three consecutive intravitreal injections: group 1- >10 letters, group 2- ≤5 letters, and group 3- between 6 and 10 letters. Results: Mean BCVA increased significantly after therapy, rising from 34.2 to 39.9 letters (p<0.001). The central macular thickness (CMT) decreased significantly from baseline 335.1 μm to 276.4 μm (p<0.001). Fixation stability, mean retinal sensitivity, and mean local deficit all improved significantly after therapy (p<0.001 for all). There was no statistically significant change in IOP before and after therapy (p=0.665). While OCTA parameters did not change significantly, patients with lower foveal avascular zone area, higher FD-300 and deep plexus vascular density showed better improvements in mean BCVA, retinal sensitivity, and local defect. Also, there were no significant intergroup differences in gender, age, baseline BCVA, HbA1c, IOP, phakic/pseudophakic lens ratio, presence of concomitant hypertension, and superficial capillary plexus vascular density. Conclusions: Intravitreal bevacizumab therapy was associated with significantly improved BCVA, retinal ultrastructural integrity, and electrophysiological patterns in naive DME patients. Improvements in retinal electrophysiology correlated with ultrastructural improvements, which could be predicted using OCTA

Retinal ultrastructural, electrophysiological and microvascular morphological outcomes in diabetic macular edema treated with intravitreal Bevacizumab

Purpose: To investigate retinal ultrastructural, electrophysiological, and microvascular morphological changes, as well as correlations between these changes and visual outcome in naïve diabetic macular edema (DME) patients after intravitreal bevacizumab therapy Design: A prospective interventional study Methods: A total of 31 DME patients’ eyes had monthly intravitreal bevacizumab injections for three consecutive months. Best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were measured, and fundus fluorescein angiography, optical coherence tomography (OCT), microperimetry (MP), as well as optical coherence tomography angiography (OCTA) were performed before and after therapy. Patients were then grouped based on BCVA improvement after three consecutive intravitreal injections: group 1- >10 letters, group 2- ≤5 letters, and group 3- between 6 and 10 letters. Results: Mean BCVA increased significantly after therapy, rising from 34.2 to 39.9 letters (p<0.001). The central macular thickness (CMT) decreased significantly from baseline 335.1 μm to 276.4 μm (p<0.001). Fixation stability, mean retinal sensitivity, and mean local deficit all improved significantly after therapy (p<0.001 for all). There was no statistically significant change in IOP before and after therapy (p=0.665). While OCTA parameters did not change significantly, patients with lower foveal avascular zone area, higher FD-300 and deep plexus vascular density showed better improvements in mean BCVA, retinal sensitivity, and local defect. Also, there were no significant intergroup differences in gender, age, baseline BCVA, HbA1c, IOP, phakic/pseudophakic lens ratio, presence of concomitant hypertension, and superficial capillary plexus vascular density. Conclusions: Intravitreal bevacizumab therapy was associated with significantly improved BCVA, retinal ultrastructural integrity, and electrophysiological patterns in naive DME patients. Improvements in retinal electrophysiology correlated with ultrastructural improvements, which could be predicted using OCTA

Our clinical experience in pelvic magnetic resonance imaging with vaginal contrast

Objectives: Magnetic resonance imaging (MRI) is an important modality for pelvic imaging. Vaginal distension is provided by the use of vaginal contrast in pelvic MRI, and it plays an important role in staging especially cervical and vaginal cancer. The aim of this study is to show whether the use of vaginal contrast material contributes to the diagnosis in pelvic examination. Material and methods: Between October 1, 2016 and December 30, 2020, a total of 57 patients who underwent pelvic magnetic resonance imaging with vaginal contrast in the radiology clinic were included in the study and evaluated retrospectively. Results: Cervical cancer was detected in 38 of the 57 patients included in the study, and when the vaginal pre- and post-contrast staging of the patients was performed, the pre-contrast stage was found to be high in six patients (15%). Eight of 38 patients diagnosed with cervical cancer underwent surgery. When the pathological and radiological staging of the patients who underwent surgery were compared, they were 100% compatible. Conclusions: The use of vaginal contrast material increases the diagnostic value of MRI in various pelvic pathologies, especially in cervical cancer staging

The interrelations of radiologic findings and mechanical ventilation in community acquired pneumonia patients admitted to the intensive care unit: a multicentre retrospective study

BACKGROUND: We evaluated patients admitted to the intensive care units with the diagnosis of community acquired pneumonia (CAP) regarding initial radiographic findings. METHODS: A multicenter retrospective study was held. Chest x ray (CXR) and computerized tomography (CT) findings and also their associations with the need of ventilator support were evaluated. RESULTS: A total of 388 patients were enrolled. Consolidation was the main finding on CXR (89%) and CT (80%) examinations. Of all, 45% had multi-lobar involvement. Bilateral involvement was found in 40% and 44% on CXR and CT respectively. Abscesses and cavitations were rarely found. The highest correlation between CT and CXR findings was observed for interstitial involvement. More than 80% of patients needed ventilator support. Noninvasive mechanical ventilation (NIV) requirement was seen to be more common in those with multi-lobar involvement on CXR as 2.4-fold and consolidation on CT as 47-fold compared with those who do not have these findings. Invasive mechanical ventilation (IMV) need increased 8-fold in patients with multi-lobar involvement on CT. CONCLUSION: CXR and CT findings correlate up to a limit in terms of interstitial involvement but not in high percentages in other findings. CAP patients who are admitted to the ICU are severe cases frequently requiring ventilator support. Initial CT and CXR findings may indicate the need for ventilator support, but the assumed ongoing real practice is important and the value of radiologic evaluation beyond clinical findings to predict the mechanical ventilation need is subject for further evaluation with large patient series

In a real-life setting, direct-acting antivirals to people who inject drugs with chronic hepatitis c in Turkey

Background: People who inject drugs (PWID) should be treated in order to eliminate hepatitis C virus in the world. The aim of this study was to compare direct-acting antivirals treatment of hepatitis C virus for PWID and non-PWID in a real-life setting. Methods: We performed a prospective, non-randomized, observational multicenter cohort study in 37 centers. All patients treated with direct-acting antivirals between April 1, 2017, and February 28, 2019, were included. In total, 2713 patients were included in the study among which 250 were PWID and 2463 were non-PWID. Besides patient characteristics, treatment response, follow-up, and side effects of treatment were also analyzed. Results: Genotype 1a and 3 were more prevalent in PWID-infected patients (20.4% vs 9.9% and 46.8% vs 5.3%). The number of naïve patients was higher in PWID (90.7% vs 60.0%), while the number of patients with cirrhosis was higher in non-PWID (14.1% vs 3.7%). The loss of follow-up was higher in PWID (29.6% vs 13.6%). There was no difference in the sustained virologic response at 12 weeks after treatment (98.3% vs 98.4%), but the end of treatment response was lower in PWID (96.2% vs 99.0%). In addition, the rate of treatment completion was lower in PWID (74% vs 94.4%). Conclusion: Direct-acting antivirals were safe and effective in PWID. Primary measures should be taken to prevent the loss of follow-up and poor adherence in PWID patients in order to achieve World Health Organization’s objective of eliminating viral hepatitis