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Nazir A, Rath S, Tibrewal S, Ganesh S. Amblyopia treatment outcomes in patients with neurodevelopmental disorders. J AAPOS 2024; 28:103824. [PMID: 38246311 DOI: 10.1016/j.jaapos.2023.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 11/10/2023] [Indexed: 01/23/2024]
Affiliation(s)
- Arshi Nazir
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr Shroff's Charity Eye Hospital, Daryaganj, New Delhi, India
| | - Soveeta Rath
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr Shroff's Charity Eye Hospital, Daryaganj, New Delhi, India
| | - Shailja Tibrewal
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr Shroff's Charity Eye Hospital, Daryaganj, New Delhi, India
| | - Suma Ganesh
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr Shroff's Charity Eye Hospital, Daryaganj, New Delhi, India
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Sabherwal S, Adhisesha Reddy P, Siddiqui Z, Sood I, Singh BP, Ganesh S, Majumdar A, Bassett KL. Visual Acuity Screening in North Indian Schools: Testing Accuracy and Cost of Alternate Screening Models. Ophthalmic Epidemiol 2024; 31:70-77. [PMID: 36880784 DOI: 10.1080/09286586.2023.2187069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 02/28/2023] [Indexed: 03/08/2023]
Abstract
PURPOSE Our study compares the sensitivity, specificity and cost of visual acuity screening as performed by all class teachers (ACTs), selected teachers (STs) and vision technicians (VTs) in north Indian schools. METHODS Prospective cluster randomized control studies are conducted in schools in a rural block and an urban-slum of north India. Consenting schools, with a minimum of 800 students aged 6 to 17 years, within a defined study region in both locations, were randomised into three arms: ACTs, STs or VTs. Teachers were trained to test visual acuity. Reduced vision was defined as unable to read equivalent of 20/30. Optometrists, who were masked to results of initial screening, examined all children. Costs were measured for all three arms. RESULTS The number of students screened were 3410 in 9 ACT schools, 2999 in 9 ST schools and 3071 in 11 VT schools. Vision deficit was found in 214 (6.3%), 349 (11.6%) and 207 (6.7%), (p < .001) children in the ACT, ST and VT arms, respectively. The positive predictive value of VT screening for vision deficit (81.2%) was significantly higher than that of ACTs (42.5%) and STs (30.1%), (p < .001). VTs had significantly higher sensitivity of 93.3% and specificity of 98.7%, compared to ACTs (36.0% and 96.1%) and STs (44.3% and 91.2%). The cost of screening children with actual visual deficit by ACTs, STs and VTs, was found to be $9.35, $5.79 and $2.82 per child, respectively. CONCLUSION Greater accuracy and lower cost favours school visual acuity screening by visual technicians in this setting, when they are available.
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Affiliation(s)
- Shalinder Sabherwal
- Department of Community Ophthalmology and Public Health Research, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Priya Adhisesha Reddy
- Centre for Public Health, Royal Victoria Hospital, Queen's University Belfast, Belfast, UK
- Seva Canada, Vancouver, BC, Canada
| | - Zeeshan Siddiqui
- Department of Projects and Marketing, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Ishaana Sood
- Department of Community Ophthalmology and Public Health Research, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Birendra P Singh
- Department of Optometry, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Suma Ganesh
- Department of Pediatric Ophthalmology, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Atanu Majumdar
- Department of Bio-statistics, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Ken L Bassett
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
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Sharma P, Tibrewal S, Singh PK, Ganesh S. Efficacy of anti-suppression therapy in improving binocular vision in children with small-angle Esotropia. J Optom 2023; 17:100490. [PMID: 38061140 PMCID: PMC10750105 DOI: 10.1016/j.optom.2023.100490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 08/21/2023] [Accepted: 08/30/2023] [Indexed: 12/29/2023]
Abstract
PURPOSE To evaluate the efficacy of anti-suppression exercises in children with small-angle esotropia in achieving binocular vision. METHODS A retrospective review of patients aged 3-8 years who underwent anti-suppression exercises for either monocular or alternate suppression between January 2016 and December 2021 was conducted. Patients with esotropia less than 15 prism diopters (PD) and visual acuity ≥ 6/12 were included. Patients with previous intra-ocular surgery or less than three-month follow-up were excluded. Success was defined as the development of binocular single vision (BSV) for distance, near, or both (measured clinically with either the 4 prism base out test or Worth four dot test) and maintained at two consecutive visits. Qualified success was defined as the presence of diplopia response for both distance and near. Additionally, improvement in near stereo acuity was measured using the Stereo Fly test. RESULTS Eighteen patients with a mean age of 5.4 ± 1.38 years (range 3-8 years) at the time of initiation of exercises were included in the study. The male female ratio was 10:8. The mean best corrected visual acuity was 0.18 LogMAR unit(s) and the mean spherical equivalent was +3.8 ± 0.14 diopters (D). The etiology of the esotropia was fully accommodative refractive esotropia (8), microtropia (1), post-operative infantile esotropia (4), partially accommodative esotropia (1), and post-operative partially accommodative esotropia (4). Patients received either office-based, home-based, or both modes of treatment for an average duration of 4.8 months (range 3-8). After therapy, BSV was achieved for either distance or near in 66.6 % of patients (95 % CI = 40.03-93.31 %). Binocular single vision for both distance and near was seen in 50 % of children. Qualified success was observed in 38.46% of patients. Persistence of suppression was observed in one patient (5.5 %). Near stereopsis improved to 200 s of arc or more in 60% of the patients. The mean esotropia reduced from 5.7 ± 4.0 PD for distance and 6.2 ± 4.66 PD for near to 2.7 ± 2.4 PD and 3.38 ± 4.7 PD respectively, at the last follow-up (p-value 0.004 and 0.006). Failure of therapy was noticed after six months of follow-up in the child with infantile esotropia. CONCLUSION Anti-suppression exercises may be beneficial to improve binocular vision functions in children with small-angle esotropias of variable etiologies. Recurrence of suppression after cessation of therapy is possible, warranting regular follow up.
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Affiliation(s)
- Preeti Sharma
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr. Shroff's Charity Eye Hospital, Daryaganj, New Delhi 110002, India.
| | - Shailja Tibrewal
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr. Shroff's Charity Eye Hospital, Daryaganj, New Delhi 110002, India
| | - Prem Kumar Singh
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr. Shroff's Charity Eye Hospital, Daryaganj, New Delhi 110002, India
| | - Suma Ganesh
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr. Shroff's Charity Eye Hospital, Daryaganj, New Delhi 110002, India
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Sharma R, Tibrewal S, Majumdar A, Rath S, Ganesh S. Acquired comitant esotropias - comparison of surgical outcomes of accommodative vs non-accommodative types. Strabismus 2023; 31:293-305. [PMID: 38086747 DOI: 10.1080/09273972.2023.2281979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Purpose: To compare the motor and sensory outcomes of strabismus surgery and the factors affecting surgical success in acquired acute non-accomodative esotropia (ANAET) and partially accommodative refractive esotropia (pARET). Methods: A retrospective chart review of patients with ANAET and pARET who underwent unilateral or bilateral horizontal rectus muscle surgery between January 2020 and December 2021 was conducted. Patients with postoperative follow-up of at least six weeks were included. Patients with pattern deviation, lateral incomitance, and near-distance disparity were excluded. Motor success was defined as a postoperative deviation within eight prism diopters of orthophoria. Sensory success was defined as presence of binocular single vision (BSV) for both distance and near (Worth four dot test). The effect of factors like age at onset, age at surgery, amblyopia before surgery, duration of squint before treatment, presence or absence and magnitude of vertical deviation, preoperative angle of deviation, and spherical equivalent on the motor and sensory success in each group were analyzed and compared. Results: 38 patients with ANAET and 33 patients with pARET were included. The mean age of onset of esotropia was 8.55 ± 4.65 years and 4.39 ± 2.27 years (p < .001) and the mean age at surgery was 10.62 ± 4.99 years and 7.89 ± 2.84 years (p = .006) in the ANAET and the pARET group respectively. The mean duration of the final follow-up was 38.51 weeks in the ANAET and 48.68 weeks in the pARET group (p = .089). Patients were successfully aligned for both distance and near in 81.5% of patients in the ANAET and 78.9% of patients in the pARET group at the final follow-up (p. 0.775). A BSV for both distance and near at the final follow-up was seen in 81.2% vs 66.6% of patients in the ANAET and the pARET group respectively (p = .25). A good near stereoacuity (<120 arcsecs) was seen in 60.6% and 41.9% of the ANAET and the pARET groups respectively (p = .175). The percentage of patients in the ANAET group who had orthophoria, any esodeviation, and any exodeviation for distance at the final follow-up was 63.1%, 34.2% and, 2.6%. The percentage of patients in the pARET group in similar categories was 36.3%, 42.4% and, 21.2%. None of the demographic and preoperative factors were found to affect the surgical outcomes in the two groups. Conclusions: The motor and sensory outcomes were similar in the two groups. A higher proportion of ANAET patients remained orthophoric during the follow-up. The patients in the pARET group showed a tendency toward exodrift.
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Affiliation(s)
- Richa Sharma
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr Shroff's Charity Eye Hospital, New Delhi
| | - Shailja Tibrewal
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr Shroff's Charity Eye Hospital, New Delhi
| | - Atanu Majumdar
- Department of Biostatistics, Dr Shroff's Charity Eye Hospital, New Delhi
| | - Soveeta Rath
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr Shroff's Charity Eye Hospital, New Delhi
| | - Suma Ganesh
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr Shroff's Charity Eye Hospital, New Delhi
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Gore J, Rath S, Ganesh S. Clinical profile of childhood exotropia in a tertiary eye care center in North India. Indian J Ophthalmol 2023; 71:3637-3641. [PMID: 37991296 PMCID: PMC10788762 DOI: 10.4103/ijo.ijo_29_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 06/21/2023] [Accepted: 07/17/2023] [Indexed: 11/23/2023] Open
Abstract
PURPOSE To identify different types of exotropia in children less than 16 years and their clinical presentation. The secondary objective is to identify the age of onset, age of presentation, birth history, and ocular and systemic associations as well as to evaluate their motor and sensory status. METHODS This hospital-based descriptive observational study was conducted from September 2018 to December 2019. Patients with a clinical diagnosis of exotropia of age less than 16 years, and exotropia of ≥ 10 PD were included in the study. Data were collected using a structured proforma. All statistical calculations were performed using Microsoft Excel Office version 2016 and R version 4.0.2. RESULTS Two hundred eighty-six (286) consecutive children with exotropia were analyzed. Intermittent exotropia (72%) was the most common form of exotropia, followed by exotropia with a neurological association (11%), infantile (8%), sensory (6%), restrictive (2%), and paralytic (1%) types. Exotropia with neurological association had a significantly earlier age of presentation (median = 42months) as compared to other types (P = 0.039). CONCLUSION We recorded a huge amount of cases of exotropia associated with neurological abnormalities and this group of patients had significantly more number of preterm and low birth weight children. This study has its limitations as it is not a population-based study and prevalence rates could not be calculated.
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Affiliation(s)
- Jinal Gore
- Department of Pediatric Ophthalmology and Strabismus and Neuro-ophthalmology, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Soveeta Rath
- Department of Pediatric Ophthalmology and Strabismus and Neuro-ophthalmology, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Suma Ganesh
- Department of Pediatric Ophthalmology and Strabismus and Neuro-ophthalmology, Dr. Shroff's Charity Eye Hospital, New Delhi, India
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Baldev V, Tibrewal S, Ganesh S, Majumdar A, Chandna A. Measures and variability with age of low contrast acuity and near stereoacuity in children. Clin Exp Optom 2023; 106:759-768. [PMID: 36031926 DOI: 10.1080/08164622.2022.2113735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 10/15/2022] Open
Abstract
CLINICAL RELEVANCE Low contrast acuity (LCA) and near stereoacuity (NS) testing are integral to the comprehensive assessment of sensory visual function in children. However, routine ophthalmological evaluations seldom take these measures into consideration. Additionally, there is limited literature regarding the normative values of these parameters in children. BACKGROUND This study investigated LCA and NS measures and their variability in children with normal visual acuity. The aim was to provide a benchmark for distinguishing normal measures from abnormal ones. METHODS A prospective observational study was conducted in primary and secondary schools across North India. The participants numbered 240 children, aged between 3 and 15 years. They were split into 12 smaller groups of 20 participants in each age group. Only participants with normal monocular uncorrected visual acuity, no refractive error, normal birth history, and no systemic ailments, were recruited. All the participants underwent a complete ophthalmic examination and non-cycloplegic retinoscopy. LCA was measured, using the low contrast Lea number chart at three metres. NS was measured using the Randot® stereo test at 40 cm. RESULTS The percentages of males and females, were found to be 55%, and 45%, respectively (p = 0.093). The mean NS was found to be 38.7 ± 11.5 arcsecs in the 3-9-year age group, and 26.7 ± 5.6 arcsecs in the 9-15-year age group (p-value <0.001). The mean NS showed an increasing trend up to 9 years of age. The mean LCA was 64.4 ± 20.1 in the age group of 3-8 years, and 76.38 ± 11.39 in the age group of 8-15 years (p-value <0.001). Considerable variability was noted in the LCA in the younger age group (p-value = 0.000). CONCLUSIONS LCA and NS mature gradually during childhood. LCA stabilises after the age of 8, while NS stabilises after the age of 9.
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Affiliation(s)
- Vibha Baldev
- Department of Pediatric Ophthalmology, Dr Om Parkash Eye Institute, Amritsar, Punjab, India
| | - Shailja Tibrewal
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr Shroff's Charity Eye Hospital, Daryaganj, New Delhi, Delhi, India
| | - Suma Ganesh
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr Shroff's Charity Eye Hospital, Daryaganj, New Delhi, Delhi, India
| | - Atanu Majumdar
- Department of Biostatistics, Dr Shroff's Charity Eye Hospital, Daryaganj, New Delhi, Delhi, India
| | - Arvind Chandna
- Smith-Kettlewell Eye Research Institute, SEELAB, San Francisco, USA
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Sharma M, Ganjoo S, Ganesh S. Occurrence and subsequent development of vertical deviations in patients treated surgically for infantile esotropia. Indian J Ophthalmol 2023; 71:2835-2840. [PMID: 37417130 PMCID: PMC10491062 DOI: 10.4103/ijo.ijo_2777_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 02/26/2023] [Accepted: 03/29/2023] [Indexed: 07/08/2023] Open
Abstract
Purpose The purpose of this study was to evaluate the onset of dissociated vertical deviation (DVD) and inferior oblique overaction (IOOA), their subsequent development, and their correlation with pre and postoperative parameters. Methods Medical records of patients with infantile esotropia who underwent surgery between 2005 and 2017 were retrospectively reviewed. DVD and IOOA were measured before and after surgery. Patients were divided into two groups based on horizontal and vertical deviation at the time of presentation: those with infantile esotropia only (group A) and patients with infantile esotropia who developed vertical deviation (group B). Results Out of a total of 102 patients, DVD occurrence was seen in 53 patients (51.9%) and IOOA was seen in 50 patients (48.04%). DVD was seen in 22 patients at the time of initial examination and in 31 patients postoperatively. IOOA at presentation was seen in 45 patients (44.1%) and 5 patients (8.8%) postoperatively. No statistical difference was found in the age of surgery, angle of deviation, mean follow-up, and mean refractive error within both groups. The postoperative motor outcome was statistically comparable between the two groups (P = 0.29). Sensory outcomes of fusion (P = 0.048) and stereopsis (P-value = 0.00063) were better in group A. Conclusion No correlation was found between the age of occurrence and development of vertical deviation with refractive error, angle of deviation, age, or type of surgery. We found that motor outcomes are not affected but sensory outcomes are affected in patients with vertical deviations. This indicates that DVD and IOOA are developed due to inherent disruption of fusion and stereopsis.
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Affiliation(s)
- Manasvini Sharma
- Pediatric Ophthalmology and Strabismology Services, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Sharika Ganjoo
- Pediatric Ophthalmology and Strabismology Services, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Suma Ganesh
- Pediatric Ophthalmology and Strabismology Services, Dr. Shroff's Charity Eye Hospital, New Delhi, India
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Tibrewal S, Sharma P, Rath S, Ganesh S. Sutureless Cataract Surgery in the Pediatric Age Group: Is It Advisable? J Pediatr Ophthalmol Strabismus 2023; 60:302. [PMID: 37478194 DOI: 10.3928/01913913-20230616-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/23/2023]
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Gupta S, Rahman M, Tibrewal S, Gaur A, Ganesh S, Sangwan VS. Evaluation of dry eyes in children with vernal kerato-conjunctivitis using clinical tests and ocular surface analysis. Indian J Ophthalmol 2023; 71:1488-1494. [PMID: 37026288 PMCID: PMC10276721 DOI: 10.4103/ijo.ijo_2836_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
Purpose To evaluate dry eyes in children with vernal kerato-conjunctivitis (VKC) and correlate it with symptoms, clinical findings, and ocular surface analysis (OSA) parameters. Methods Children with clinically diagnosed VKC underwent complete ophthalmological examination, Schirmer's testing, modified ocular surface disease index (OSDI) scoring, Bonini grading, fluorescein tear-film break-up time (TBUT), VKC - Collaborative Longitudinal Evaluation of Keratoconus (CLEK) scoring, and OSA. Children with a TBUT of < 10 s were defined to have dry eyes. The above-mentioned parameters were compared between dry eye and non-dry eye VKC children. Results The mean age of the 87 children included in the study was 9.1 ± 2.9 years. Dry eyes were seen in 60.9% [95% confidence interval (CI); 51% to 71%]. The mean TBUT was 13.4 ± 3.8 and 5.9 ± 1.9 s in non-dry and dry eye groups, respectively (P < 0.001). The mean value of Schirmer's test was 25.9 ± 9.8 and 20.8 ± 8.6 mm in the non-dry and dry eye groups, respectively (P = 0.01). The two groups did not differ in their OSDI scores, Bonini grading, and CLEK scores. The OSA parameter of non-invasive break-up time (NIBUT) was 8.3 ± 3.2 s in non-dry eye group and 6.4 ± 2.9 s in dry eye group, P = 0.008. The lower lid Meibomian gland (MG) loss was 7.4% in non-dry eye group and 12.2% in dry eye group, P = 0.028. Other OSA parameters did not differ significantly among the two groups. Conclusion Dry eyes are seen in two-thirds of pediatric VKC. Evaluation of dry eyes should be incorporated in their clinical evaluation. Among OSA parameters, NIBUT and lower lid MG loss are associated with dry eyes in pediatric VKC patients.
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Affiliation(s)
- Shalini Gupta
- Department of Paediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Mahmooda Rahman
- Department of Paediatric Ophthalmology, OSB Eye Hospital and Institute, Dhaka, Bangladesh
| | - Shailja Tibrewal
- Department of Paediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Abha Gaur
- Department of Cornea and Anterior Segment Services, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Suma Ganesh
- Department of Paediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Virender Singh Sangwan
- Department of Cornea and Anterior Segment Services, Dr. Shroff's Charity Eye Hospital, New Delhi, India
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Sabherwal S, Sharma M, Majumdar A, Singh B, Siddiqui Z, Sood I, Tibrewal S, Ganesh S. Photoscreener: An effective tool for vision screening of preschool children in community setting. J Clin Ophthalmol Res 2023. [DOI: 10.4103/jcor.jcor_15_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
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Sengupta S, Ganesh S, Meenakshi S, Bettahalli AS, Rao RM, Swamy KNR. Comparative evaluation of the antibacterial activity of red diode laser therapy and 0.2% chlorhexidine against Aggregatibacter actinomycetemcomitans on implant healing abutments: An ex vivo study. J Indian Prosthodont Soc 2023; 23:12-20. [PMID: 36588370 PMCID: PMC10088439 DOI: 10.4103/jips.jips_158_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/28/2022] [Accepted: 06/17/2022] [Indexed: 12/31/2022] Open
Abstract
Aims The intraoral microbiota has a high potential to undergo dysbiosis, causing inflammatory changes with respect to the tissues surrounding either a natural tooth or an implant. Thus, the longevity of implant prosthesis depends on a thorough implant decontamination protocol. Among all the techniques available for doing so, laser is garnering increasing popularity, owing to minimal bleeding, high efficiency, and faster healing. However, limited literature exists regarding the superiority of lasers over chlorhexidine (CHX), the indisputable gold standard antibacterial chemical agent. The aim of this study was to compare the percentage of bacterial reduction of Aggregatibacter actinomycetemcomitans from implant healing abutments post red diode laser therapy versus 0.2% CHX treatment. Settings and Design The current study had an ex vivo, observational, case-control design. Materials and Methods Patients reporting for the second stage of the implant surgery were taken as the source of data and the healing abutments, the clinical samples. Eleven patients were chosen with one intraoral implant serving as the test site for laser treatment and another, the control site for CHX treatment. Microbiological analysis was performed via quantitative real time polymerase chain reaction to compare the bacterial reduction percentage after each treatment. Statistical Analysis Used Repeated measures ANOVA and independent sample t test were used. Results The mean bacterial viability of the test group (laser) was 1.2%-1.6%, and 0.6%-1.4% for the control group (CHX). The former caused a mean bacterial reduction of 96.1% while the latter, 96.3%. Both the treatments caused a highly statistically significant reduction of viable bacterial counts (P = 0.001). However, when compared, there was no statistically significant difference in the bacterial reduction, when compared in between the two (P = 0.902). Conclusion Laser treatment is at par with chemical implant surface decontamination. It can help bypass the complications of CHX and revolutionize the protocols for implant surface decontamination.
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Affiliation(s)
- Soumee Sengupta
- Department of Prosthodontics and Crown and Bridge, JSS Dental College and Hospital, JSSAHER, Mysore, Karnataka, India
| | - S. Ganesh
- Department of Prosthodontics and Crown and Bridge, JSS Dental College and Hospital, JSSAHER, Mysore, Karnataka, India
| | - S. Meenakshi
- Department of Prosthodontics and Crown and Bridge, JSS Dental College and Hospital, JSSAHER, Mysore, Karnataka, India
| | - Avinash Singh Bettahalli
- Department of Periodontology, JSS Dental College and Hospital, JSSAHER, Mysore, Karnataka, India
| | - Raghavendra M. Rao
- Department of Microbiology, JSS Dental College and Hospital, JSSAHER, Mysore, Karnataka, India
| | - K. N. Raghavendra Swamy
- Department of Prosthodontics and Crown and Bridge, JSS Dental College and Hospital, JSSAHER, Mysore, Karnataka, India
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Gupta P, Shah P, Shrestha S, Gilad-Gutnick S, Ganesh S, Gandhi T, Sinha P. Vulnerability of facial attractiveness perception to early and multi-year visual deprivation. Dev Sci 2023; 26:e13258. [PMID: 35340087 DOI: 10.1111/desc.13258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 02/28/2022] [Accepted: 03/09/2022] [Indexed: 12/15/2022]
Abstract
Judgments of facial attractiveness invariably accompany our perception of faces. Even neonates appear to be capable of making such judgments in a manner consistent with adults. This suggests that the processes supporting facial attractiveness require little, if any, visual experience to manifest. Here we investigate the resilience of these processes to several years of early-onset visual deprivation. Specifically, we study whether congenitally blind children treated several years after birth possess the ability to rate facial attractiveness in a manner congruent to normally sighted individuals. The data reveal significant individual variability in the way each newly sighted child perceives attractiveness. This is in marked contrast to data from normally sighted controls who exhibit strong across-subject agreement in facial attractiveness ratings. This variability may be attributable, in part, to atypical facial encoding strategies used by the newly sighted children. Overall, our results suggest that the development of facial attractiveness perception is likely to be vulnerable to early visual deprivation, pointing to the existence of a possible sensitive period early in the developmental trajectory.
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Affiliation(s)
- Priti Gupta
- Amarnath and Shashi Khosla School of Information Technology, Indian Institute of Technology, New Delhi, India
| | - Pragya Shah
- Institute of Human Behaviour and Allied Sciences, New Delhi, India
| | - Swochchhanda Shrestha
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Sharon Gilad-Gutnick
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Suma Ganesh
- Department of Pediatric Ophthalmology, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Tapan Gandhi
- Department of Electrical Engineering, Indian Institute of Technology, New Delhi, India
| | - Pawan Sinha
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
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Mohapatra M, Rath S, Agarwal P, Singh A, Singh R, Sutar S, Sahu A, Maan V, Ganesh S. Cerebral visual impairment in children: Multicentric study determining the causes, associated neurological and ocular findings, and risk factors for severe vision impairment. Indian J Ophthalmol 2022; 70:4410-4415. [PMID: 36453355 PMCID: PMC9940545 DOI: 10.4103/ijo.ijo_801_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose To evaluate the causes, associated neurological and ocular findings in children with cerebral visual impairment (CVI), and to identify risk factors for severe vision impairment. Methods A multicenter, retrospective, cross-sectional analysis was carried out from January 2017 to December 2019 on patients less than 16 years of age with a diagnosis of CVI. Results A total of 405 patients were included of which 61.2% were male and 38.8% were female. The median age at presentation was 4 years (range 3 months to 16 years). Antenatal risk factors were present in 14% of the cases. The most common cause of CVI was hypoxic-ischemic encephalopathy (35.1%), followed by seizure associated with brain damage (31.3%). The most common neurological finding was seizure (50.4%), followed by cerebral palsy (13.6%). Associated ophthalmological findings were significant refractive error (63.2%), esotropia (22.2%), exotropia, (38%), nystagmus (33.3%), and optic nerve atrophy (25.9%). Severe visual impairment (<20/200) was associated with optic atrophy (odds ratio: 2.9, 95% confidence interval: 1.4-6.0; P = 0.003) and seizure disorder (odds ratio: 1.9, 95% confidence interval: 1.2-3.3; P = 0.012). Conclusion The various ophthalmic, neurological manifestations and etiologies could guide the multidisciplinary team treating the child with CVI in understanding the visual impairment that affects the neuro development of the child and in planning rehabilitation strategies.
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Affiliation(s)
- Monalisa Mohapatra
- Department of Pediatric Ophthalmology, MGM Eye Institute, Raipur, Chattisgarh, India,The Bodhya Eye Consortium, a. MGM Eye Institute, Raipur, Chhattisgarh, India, b. Dr. Shroff’s Charity Eye Hospital, New Delhi, India, c. CL Gupta Eye Institute, Moradabad, Uttar Pradesh, India,Correspondence to: Dr. Monalisa Mohapatra, Department of Pediatric Ophthalmology, MGM Eye Institute, 5th Mile, Vidhan Sabha Road, Saddu, Raipur, Chhattisgarh - 493 111, India. E-mail:
| | - Soveeta Rath
- Department of Pediatric Ophthalmology, Dr. Shroff’s Charity Eye Hospital, New Delhi, India,The Bodhya Eye Consortium, a. MGM Eye Institute, Raipur, Chhattisgarh, India, b. Dr. Shroff’s Charity Eye Hospital, New Delhi, India, c. CL Gupta Eye Institute, Moradabad, Uttar Pradesh, India
| | - Pradeep Agarwal
- Department of Pediatric Ophthalmology, CL Gupta Eye Institute, Moradabad, Uttar Pradesh, India,The Bodhya Eye Consortium, a. MGM Eye Institute, Raipur, Chhattisgarh, India, b. Dr. Shroff’s Charity Eye Hospital, New Delhi, India, c. CL Gupta Eye Institute, Moradabad, Uttar Pradesh, India
| | - Abhishek Singh
- Department of Pediatric Ophthalmology, MGM Eye Institute, Raipur, Chattisgarh, India,The Bodhya Eye Consortium, a. MGM Eye Institute, Raipur, Chhattisgarh, India, b. Dr. Shroff’s Charity Eye Hospital, New Delhi, India, c. CL Gupta Eye Institute, Moradabad, Uttar Pradesh, India
| | - Rupali Singh
- Department of Pediatric Ophthalmology, Dr. Shroff’s Charity Eye Hospital, New Delhi, India,The Bodhya Eye Consortium, a. MGM Eye Institute, Raipur, Chhattisgarh, India, b. Dr. Shroff’s Charity Eye Hospital, New Delhi, India, c. CL Gupta Eye Institute, Moradabad, Uttar Pradesh, India
| | - Sameer Sutar
- Department of Pediatric Ophthalmology, CL Gupta Eye Institute, Moradabad, Uttar Pradesh, India,The Bodhya Eye Consortium, a. MGM Eye Institute, Raipur, Chhattisgarh, India, b. Dr. Shroff’s Charity Eye Hospital, New Delhi, India, c. CL Gupta Eye Institute, Moradabad, Uttar Pradesh, India
| | - Anupam Sahu
- Department of Pediatric Ophthalmology, MGM Eye Institute, Raipur, Chattisgarh, India,The Bodhya Eye Consortium, a. MGM Eye Institute, Raipur, Chhattisgarh, India, b. Dr. Shroff’s Charity Eye Hospital, New Delhi, India, c. CL Gupta Eye Institute, Moradabad, Uttar Pradesh, India
| | - Veenu Maan
- Department of Pediatric Ophthalmology, CL Gupta Eye Institute, Moradabad, Uttar Pradesh, India,The Bodhya Eye Consortium, a. MGM Eye Institute, Raipur, Chhattisgarh, India, b. Dr. Shroff’s Charity Eye Hospital, New Delhi, India, c. CL Gupta Eye Institute, Moradabad, Uttar Pradesh, India
| | - Suma Ganesh
- Department of Pediatric Ophthalmology, Dr. Shroff’s Charity Eye Hospital, New Delhi, India,The Bodhya Eye Consortium, a. MGM Eye Institute, Raipur, Chhattisgarh, India, b. Dr. Shroff’s Charity Eye Hospital, New Delhi, India, c. CL Gupta Eye Institute, Moradabad, Uttar Pradesh, India
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Rath S, Ganesh S, Goyal P, Molinari A. Modified Nishida's procedure in a case of medial rectus hypoplasia. Strabismus 2022; 30:200-203. [PMID: 36469556 DOI: 10.1080/09273972.2022.2136212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Introduction: We report a case of large angle exotropia in a child with limitation of adduction in the left eye with a radiological finding of hypoplastic medial rectus. Methods: A 3- year- old male child presented with left eye large angle exotropia, left face turn, -4 adduction limitation and severe amblyopia. Orbital imaging revealed hypoplasia of the medial rectus and intraoperatively a thin medial rectus was noted. The surgical procedure planned was lateral rectus recession combined with Modified Nishida's technique in the left eye. In this technique the superior and inferior recti were transposed medially by inserting non-absorbable sutures in the sclera posteriorly, closer to the upper and lower borders of the medial rectus muscle. Result: There was improvement in adduction of left eye and reduction of original deviation following maximal lateral rectus recession and a modified Nishida's approach. The early and optimal correction of exotropia also improved the compliance to patching with subsequent gain in visual acuity of the amblyopic eye. Conclusion: Modified Nishida's technique has the advantage of no muscle splitting and no tenotomy, remains a less invasive surgical procedure to correct large deviations. The modification of placing the bellies closer to medial rectus augments the effect and further improves adduction in cases with severe limitation of adduction. This technique can thus be considered as a possible surgical approach in young children with large angle exotropia due to hypoplastic medial rectus.
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Affiliation(s)
- Soveeta Rath
- Department of Pediatric Ophthalmology and Strabismus and Neuro-ophthalmology, Dr Shroff's Charity Eye Hospital Delhi, New Delhi, India
| | - Suma Ganesh
- Department of Pediatric Ophthalmology and Strabismus and Neuro-ophthalmology, Dr Shroff's Charity Eye Hospital Delhi, New Delhi, India
| | - Priya Goyal
- Department of Pediatric Ophthalmology and Strabismus and Neuro-ophthalmology, Dr Shroff's Charity Eye Hospital Delhi, New Delhi, India
| | - Andrea Molinari
- Department of Ophthalmology, Hospital Metropolitano, Quito Ecuador
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Ganesh S, Ganesh SB, Jayalakshmi S. Effect of carbonated beverages on flexural strength property of restorative glass ionomer cement. J Adv Pharm Technol Res 2022; 13:S186-S189. [PMID: 36643106 PMCID: PMC9836160 DOI: 10.4103/japtr.japtr_265_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/17/2022] [Indexed: 01/17/2023] Open
Abstract
Glass ionomer cement (GIC) releases fluorides and has good biocompatibility, carbonated drinks, sometimes known as fizzy drinks, are carbonated liquids that contain dissolved carbon dioxide, sweeteners, and natural or artificial flavoring. The aim of our study is to determine the flexural strength of GIC after immersing in carbonated beverages. Twelve samples of GIC filling material were used among which six samples prepared were from the Dtech brand and six were prepared from the Shofu brand for the in vitro study. Bar-shaped specimens were prepared from each group with the dimension of 2 mm × 2 mm × 25 mm. They were immersed in Sprite, fizz drinks, and in distilled water as a control group. The immersion period was 7 days. Then, the determination of maximum force and displacement was done using INSTRON E3000 (ElectroPuls) universal testing machine, then the collected data were used to determine flexural strength. The mean flexural strength of Dtech GIC was 24.84 ± 6.523 Mpa. The mean flexural strength of Dtech GIC was 18.57 ± 11.60 Mpa. The independent sample t-test showed that P = 0.247 (>0.05) which was statistically not significant. The flexural strength of GIC material decreased after being immersed in Sprite and fizz drinks.
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Affiliation(s)
- S. Ganesh
- Undergraduate Student, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - S. Balaji Ganesh
- White Lab - Material Research Centre, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India,Address for correspondence: Dr. S. Balaji Ganesh, White Lab - Material Research Centre, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai - 600 077, Tamil Nadu, India. E-mail:
| | - S. Jayalakshmi
- White Lab - Material Research Centre, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
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Sabherwal S, Sood I, Siddiqui Z, Majumdar A, Singh BP, DasGupta S, Ganesh S. Door-to-door Screening as a New Model Augmenting School Eye Screening: Reaching Out to School Age Children in the Midst of a Pandemic. Ophthalmic Epidemiol 2022:1-9. [PMID: 36121011 DOI: 10.1080/09286586.2022.2123003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
PURPOSE Explore door-to-door eye screening in India as a model to reach school age children in need of eye care, especially during school closures due to the Covid-19 pandemic. METHODS Children between 5 and 18 years were screened in an urban-slum of Delhi from September 2020 to March 2021. Screening included capturing ocular complaints, visual acuity and conducting a torchlight examination. Children with any eye-related complaints, gross abnormality or a LogMAR acuity of more than 0.2 in either eye were referred to the nearby vision centre. Data were disaggregated by gender and age group. Reporting after referral and proportion of true positives referrals were used to assess the model. RESULTS 32,857 children were screened. 55% were boys. Only 917 children (2.8%) had previous eye examinations. 1814 (5.5%) children were referred. Overall compliance rate amongst those referred was 59% (1070 of 1814) and compliance was significantly higher (72%) amongst those referred with poor vision as compared to those with only ocular morbidities (38%). Overall compliance was significantly higher amongst older age group (64% vs 50%) and amongst girls than boys (61% vs 56%). 3.9% children were detected with refractive error (RE) and 2.5% with uncorrected RE which was significantly higher in girls and in older age group. Of 1070 children reporting after referral, 85% had confirmed diagnosis for RE or other ocular pathology. CONCLUSION Door-to-door screening had good referral compliance and positive predictive value. We recommend this model as a supplement to school screening especially in regions with low enrolment and high absenteeism in schools.
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Affiliation(s)
- Shalinder Sabherwal
- Department of Community Ophthalmology and Public Health Research, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Ishaana Sood
- Department of Community Ophthalmology and Public Health Research, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Zeeshan Siddiqui
- Department of Community Outreach, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Atanu Majumdar
- Biostatistician, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Birendra Pratap Singh
- Department of Community Ophthalmology and Public Health Research, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Shantanu DasGupta
- Department of Community Operations and Strategic Planning, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Suma Ganesh
- Department of Pediatric Ophthalmology, Strabismus and Neuro-Ophthalmology, Dr. Shroff's Charity Eye Hospital, New Delhi, India
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Baldev V, Tibrewal S, Rath S, Ganesh S. Correction of horizontal and torsional compensatory head posture in infantile nystagmus syndrome using horizontal rectus muscle recession and resection with vertical transposition. Strabismus 2022; 30:139-143. [PMID: 35815464 DOI: 10.1080/09273972.2022.2097704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Infantile nystagmus syndrome (INS) is often characterized by an identifiable null zone. When the null zone is not in the straight-ahead gaze, a compensatory head posture (CHP) is adopted by the patient to achieve best possible vision. Various surgical procedures have been recommended to correct a CHP which is clinically predominant in one dimension of yaw (lateral rotation), pitch (anterior or posterior flexion/extension) or roll (lateral flexion). However, the presence of a complex CHP which is clinically evident in more than one dimension, warrants either a combination of multiple techniques or a stepwise approach. We report the case of a 26-year-old male with INS with an eccentric null and a multi-dimensional complex CHP of 30º left face turn, 20º right head tilt and 10º chin depression. The patient was managed by all four horizontal rectus muscle recession and resection with full tendon vertical transposition to address the face turn and head tilt. He underwent lateral rectus muscle (LR) recession with upward transposition and medial rectus muscle (MR) resection with downward transposition in the right eye. MR recession with upward transposition and LR resection with downward transposition were performed in the left eye. Postoperatively. the head posture improved significantly for both distance and near viewing. The chin depression also reduced after the procedure. He developed transient diplopia due to a small vertical deviation after the surgery, which was managed by prisms and fusional exercises. Thus, horizontal rectus muscle recession and resection combined with vertical transposition may be helpful to simultaneously improve the head tilt associated with the face turn, obviating the need for vertical rectus muscle or oblique muscle surgery.
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Affiliation(s)
- Vibha Baldev
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr. Om Parkash Eye Institute, Amritsar
| | - Shailja Tibrewal
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr. Shroff's Charity Eye Hospital, New Delhi
| | - Soveeta Rath
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr. Shroff's Charity Eye Hospital, New Delhi
| | - Suma Ganesh
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr. Shroff's Charity Eye Hospital, New Delhi
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Abstract
Purpose To analyze the efficacy of fusional vergence therapy (FVT) in management of consecutive esotropia with diplopia after intermittent exotropia (IXT) surgery. The current study is carried on how FVT affects the duration of treatment, sensory fusion, and exotropic drift. Methods This was a retrospective study for the medical record of 11 patients with consecutive esotropia after IXT surgery of 543 patients over the period of 5 year, with mean surgery age of 9.5 (range: 4-33 y). FVT was planned after minimum 6 weeks of surgery and was considered for maximum 24 weeks. Patients underwent a combination of office-based and home-based FVT. Successful outcome of therapy was considered where diplopia resolves in free space and achieves sensory fusion, stereopsis with no manifest deviation. Results Record of 543 patients who had horizontal muscle surgery for IXT were identified and reviewed. Records of 11 patients who showed consecutive esotropia of 10 prism diopter (PD) or more with normal retinal correspondence, with or without diplopia complaint, after 6 week of surgery and had undergone vision therapy management were reviewed. A successful outcome of binocular single vision with good sensory and motor fusion with no manifest deviation or prism requirement was achieved with in the mean duration of 4.8 month of therapy. With a mean duration of 4 weeks of therapy, the mean angle of deviation reduced by 53% for distance (17 PD to 8 PD) and 27% for near (11 PD to 8 PD) and mean stereopsis improvement by 80% with 94% patients demonstrating sensory fusion on Bagolini test and 94% of patients having no symptoms of diplopia or squint. Conclusion With nonsurgical management involving refractive error correction, FVT, and prism, consecutive esotropia was resolved in 74% cases. Management of consecutive esotropia with FVT can result in satisfactory sensory fusion and successful motor alignment.
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Affiliation(s)
- Prem Kumar Singh
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Preeti Sharma
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Sonia Sharma
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Suma Ganesh
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr. Shroff's Charity Eye Hospital, New Delhi, India
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Tibrewal S, Ratna R, Gour A, Agarkar S, Dubey S, Ganesh S, Kekunnaya R, Sangwan V, Liu Y, Vanita V. Clinical and molecular aspects of congenital aniridia - A review of current concepts. Indian J Ophthalmol 2022; 70:2280-2292. [PMID: 35791108 PMCID: PMC9426064 DOI: 10.4103/ijo.ijo_2255_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Congenital aniridia is a pan ocular disorder characterized by partial or total loss of iris tissue as the defining feature. Classic aniridia, however, has a spectrum of ocular findings, including foveal hypoplasia, optic nerve hypoplasia, nystagmus, late-onset cataract, glaucoma, and keratopathy. The latter three are reasons for further visual compromise in such patients. This entity is often due to mutations in the PAX6 (Paired box protein Pax-6) gene. Recently, aniridia-like phenotypes have been reported due to non-PAX6 mutations as in PITX2, FOXC1, FOXD3, TRIM44, and CYP1B1 as well wherein there is an overlap of aniridia, such as iris defects with congenital glaucoma or anterior segment dysgenesis. In this review, we describe the various clinical features of classic aniridia, the comorbidities and their management, the mutation spectrum of the genes involved, genotype-phenotype correlation of PAX6 and non-PAX6 mutations, and the genetic testing plan. The various systemic associations and their implications in screening and genetic testing have been discussed. Finally, the future course of aniridia treatment in the form of drugs (such as ataluren) and targeted gene therapy has been discussed.
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Affiliation(s)
- Shailja Tibrewal
- Department of Ocular Genetics; Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr Shroff's Charity Eye Hospital, Daryaganj, New Delhi, India
| | - Ria Ratna
- Department of Ocular Genetics, Dr Shroff's Charity Eye Hospital, Daryaganj, New Delhi, India
| | - Abha Gour
- Department of Cornea and Anterior Segment, Dr Shroff's Charity Eye Hospital, Daryaganj, New Delhi, India
| | - Sumita Agarkar
- Department of Pediatric Ophthalmology and Strabismus, Medical Research Foundation, Sankara Netralaya, Chennai, Tamil Nadu, India
| | - Suneeta Dubey
- Department of Glaucoma, Dr Shroff's Charity Eye Hospital, Daryaganj, New Delhi, India
| | - Suma Ganesh
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr Shroff's Charity Eye Hospital, Daryaganj, New Delhi, India
| | - Ramesh Kekunnaya
- Child Sight Institute, Jasti V Ramanamma Children's Eye Care Centre, L V Prasad Eye Institute, KAR Campus, Hyderabad, Telangana, India
| | - Virender Sangwan
- Department of Cornea and Anterior Segment, Dr Shroff's Charity Eye Hospital, Daryaganj, New Delhi, India
| | - Yutao Liu
- Department of Cellular Biology and Anatomy, Center for Biotechnology and Genomic Medicine, Augusta University, Augusta, USA
| | - Vanita Vanita
- Department of Human Genetics, Guru Nanak Dev University, Amritsar, Punjab, India
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Ben-Ami S, Gupta P, Yadav M, Shah P, Talwar G, Paswan S, Ganesh S, Troje NF, Sinha P. Human (but not animal) motion can be recognized at first sight - After treatment for congenital blindness. Neuropsychologia 2022; 174:108307. [PMID: 35752267 DOI: 10.1016/j.neuropsychologia.2022.108307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 05/27/2022] [Accepted: 06/13/2022] [Indexed: 11/24/2022]
Abstract
The long-standing nativist vs. empiricist debate asks a foundational question in epistemology - does our knowledge arise through experience or is it available innately? Studies that probe the sensitivity of newborns and patients recovering from congenital blindness are central in informing this dialogue. One of the most robust sensitivities our visual system possesses is to 'biological motion' - the movement patterns of humans and other vertebrates. Various biological motion perception skills (such as distinguishing between movement of human and non-human animals, or between upright and inverted human movement) become evident within the first months of life. The mechanisms of acquiring these capabilities, and specifically the contribution of visual experience to their development, are still under debate. We had the opportunity to directly examine the role of visual experience in biological motion perception, by testing what level of sensitivity is present immediately upon onset of sight following years of congenital visual deprivation. Two congenitally blind patients who underwent sight-restorative cataract-removal surgery late in life (at the ages of 7 and 20 years) were tested before and after sight restoration. The patients were shown displays of walking humans, pigeons, and cats, and asked to describe what they saw. Visual recognition of movement patterns emerged immediately upon eye-opening following surgery, when the patients spontaneously began to identify human, but not animal, biological motion. This recognition ability was evident contemporaneously for upright and inverted human displays. These findings suggest that visual recognition of human motion patterns may not critically depend on visual experience, as it was evident upon first exposure to un-obstructed sight in patients with very limited prior visual exposure, and furthermore, was not limited to the typical (upright) orientation of humans in real-life settings.
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Affiliation(s)
- Shlomit Ben-Ami
- MIT Department of Brain and Cognitive Sciences, Cambridge, MA, USA; Sagol School of Neuroscience, School of Psychological Sciences, Tel-Aviv University, Tel-Aviv, Israel; Minducate Science of Learning Research and Innovation Center, Tel-Aviv University, Tel Aviv, Israel.
| | - Priti Gupta
- The Project Prakash Center, Delhi, India; Amarnath and Shashi Khosla School of Information Technology, Indian Institute of Technology, Delhi, India
| | | | | | | | - Saroj Paswan
- The Project Prakash Center, Delhi, India; Department of Ophthalmology, Dr. Shroff's Charity Eye Hospital, Delhi, India
| | - Suma Ganesh
- Department of Ophthalmology, Dr. Shroff's Charity Eye Hospital, Delhi, India
| | | | - Pawan Sinha
- MIT Department of Brain and Cognitive Sciences, Cambridge, MA, USA
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Shanmugam K, Nirmala A, Parthiban P, Pitchiah Kumar M, Dhanam C, Ganesh S, Babu K, Salaikarthikaiyan T. Safety and Efficacy of Siddha Medicine preparation in the management of COVID-19: A Prospective Randomised Open Label Study. J Ayurveda Integr Med 2022; 13:100597. [PMID: 35677618 PMCID: PMC9163045 DOI: 10.1016/j.jaim.2022.100597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/16/2021] [Accepted: 05/27/2022] [Indexed: 10/26/2022] Open
Abstract
Background The use of complementary and alternative medicine (CAM) therapies has surged since the spread of COVID-19 pandemic. However, the efficacy and safety of these CAM therapies remains majorly unexplored. Objective of the current study is to understand the efficacy and safety of one such traditional CAM therapy of South India, known as 'Siddha' system of medicine, in the management for the COVID-19 patients. Methods We conducted a randomised, controlled, open label trial in patients hospitalized with SARS-CoV-2 infection who had an oxygen saturation of 90% or more while breathing ambient air. Patients were randomized into two groups in a 1:1 ratio to either intervention group, receiving seven days of siddha medicine (Intervention group; n=50) or standard care (control group; n=50). The primary end point was clinical markers and patient recovery status on day 8. Results A total of 100 patients with confirmed COVID-19 with average age of 37 yrs (interquartile range, 28-49) participated in the study. There was no statsistically difference between groups at baseline (P>0.05). After intervention, patients in the intervention group had statistically (P<0.05) significant reduction in the symptoms when compared to standard care. By end of the intervention period, 6 patients (12%) were hospitalized in the control group and none of them were reported for intervention group. Conclusion Among patients with mild to moderate COVID-19, 7 days of siddha medicine showed a significant reduction in the clinical sysmptoms and requirement of hospitalisation, with no adverse events. Therefore, the particular siddha medicine preparation could be used safely and effectively for the management of COVID-19 patients. Clinical Trial Registration CTRI/2020/08/026999.
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Affiliation(s)
- K Shanmugam
- Department of Indian Medicine & Homeopathy, Govt of Tamilnadu, India
| | - A Nirmala
- Govt.Medical college & ESI Hospital, Singanallur, Coimbatore
| | - P Parthiban
- Department of Indian Medicine & Homeopathy, Govt of Tamilnadu, India
| | - M Pitchiah Kumar
- Department of Indian Medicine & Homeopathy, Govt of Tamilnadu, India
| | - C Dhanam
- Department of Indian Medicine & Homeopathy, Govt of Tamilnadu, India
| | - S Ganesh
- Department of Indian Medicine & Homeopathy, Govt of Tamilnadu, India
| | - K Babu
- Department of Indian Medicine & Homeopathy, Govt of Tamilnadu, India
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Ninawe P, Ganesh S, Sai Karthik P, Chandrasekhar S, Vijay R. Microstructure and mechanical properties of spark plasma sintered austenitic ODS steel. ADV POWDER TECHNOL 2022. [DOI: 10.1016/j.apt.2022.103584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gupta P, Shah P, Gutnick SG, Vogelsang M, Vogelsang L, Tiwari K, Gandhi T, Ganesh S, Sinha P. Development of Visual Memory Capacity Following Early-Onset and Extended Blindness. Psychol Sci 2022; 33:847-858. [PMID: 35533319 PMCID: PMC9343893 DOI: 10.1177/09567976211056664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
It is unknown whether visual memory capacity can develop if onset of pattern vision is delayed for several years following birth. We had an opportunity to address this question through our work with an unusual population of 12 congenitally blind individuals ranging in age from 8 to 22 years. After providing them with sight surgery, we longitudinally evaluated their visual memory capacity using an image-memorization task. Our findings revealed poor visual memory capacity soon after surgery but significant improvement in subsequent months. Although there may be limits to this improvement, performance 1 year after surgery was found to be comparable with that of control participants with matched visual acuity. These findings provide evidence for plasticity of visual memory mechanisms into late childhood but do not rule out vulnerability to early deprivation. Our computational simulations suggest that a potential mechanism to account for changes in memory performance may be progressive representational elaboration in image encoding.
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Affiliation(s)
- Priti Gupta
- Amarnath and Shashi Khosla School of Information Technology, Indian Institute of Technology
| | - Pragya Shah
- Department of Neurology, Institute of Human Behaviour and Allied Sciences
| | - Sharon Gilad Gutnick
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology
| | - Marin Vogelsang
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology.,School of Computer and Communication Sciences, École Polytechnique Fédérale de Lausanne
| | - Lukas Vogelsang
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology.,Brain Mind Institute, École Polytechnique Fédérale de Lausanne
| | - Kashish Tiwari
- Dr. R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences
| | - Tapan Gandhi
- Department of Electrical Engineering, Indian Institute of Technology
| | - Suma Ganesh
- Department of Pediatric Ophthalmology, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Pawan Sinha
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology
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Tibrewal S, Rath S, Ganesh S. Anomalous insertion of the superior oblique tendon onto the superior rectus muscle causing congenital superior oblique palsy. J AAPOS 2022; 26:89-91. [PMID: 35131481 DOI: 10.1016/j.jaapos.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/23/2021] [Accepted: 10/12/2021] [Indexed: 11/18/2022]
Abstract
Congenital superior oblique (SO) palsy is often associated with anomalies of its tendon, increased tendon laxity being the most common. Rarely, the tendon lies in an abnormal location nasal to the superior rectus (SR) muscle, either attaching to the sclera or to Tenon's capsule. We describe a case of a child who presented with abnormal head posture and exotropia. The orthoptic evaluation revealed a left hypertropia and V-pattern exotropia. The motility pattern and the Parks three-step test were suggestive of left-sided SO palsy. Intraoperatively, the left SO tendon was very lax and was absent from its usual insertion. Further exploration revealed it to be inserted entirely to the nasal border of the SR muscle, with no scleral attachment. This tendon was advanced to its normal attachment to the sclera, and 11 mm inferior oblique recession was also performed. Postoperative alignment was satisfactory.
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Affiliation(s)
- Shailja Tibrewal
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr Shroff's Charity Eye Hospital, New Delhi, India.
| | - Soveeta Rath
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Suma Ganesh
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr Shroff's Charity Eye Hospital, New Delhi, India
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Raghu S, Devendrappa H, Ganesh S, Matteppanavar S. Modification of PEO-based polymer electrolytes by electron beam irradiation for energy storage applications. Polym Bull (Berl) 2022. [DOI: 10.1007/s00289-021-03977-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Vanita V, Goyal S, Tibrewal S, Ganesh S. Molecular diagnosis of autosomal dominant congenital cataract in two families from North India reveals a novel and a known variant in GJA8 and GJA3. Front Pediatr 2022; 10:1003909. [PMID: 36533234 PMCID: PMC9755747 DOI: 10.3389/fped.2022.1003909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/11/2022] [Indexed: 12/05/2022] Open
Abstract
AIMS The study aims to detect the underlying genetic defect in two autosomal dominant congenital cataract (ADCC) families. METHODS A detailed family history was collected, pedigrees were drawn, and slit-lamp examination and lens photography were performed. Mutation screening was carried out in the genes for crystallins and connexins by PCR and Sanger sequencing. Ethnically matched controls were tested for the identified variants. Different bioinformatics tools were used to assess the pathogenicity of the observed variants. RESULTS In an ADCC family with total cataract, a novel change (c.166A > G) (p.Thr56Ala) in GJA8 was identified. In another ADCC family with nuclear cataract, c.134G > C (p.Trp45Ser) in GJA3 has been detected. These variants co-segregated completely in patients in their respective families and were neither observed in unaffected family members nor in ethnically matched 100 controls, excluding them as polymorphisms. CONCLUSIONS The present study identifies a novel variant c.166A > G (p.Thr56Ala) in GJA8 in an ADCC family having total cataract and a previously known mutation c.134G > C (p.Trp45Ser) in GJA3 in another ADCC family. Thr56 in GJA8 seems to be a mutation hotspot, as previously an ADCC Mauritanian family harbored a different substitution (p.Thr56Pro) at the same codon, although for a different phenotype (nuclear cataract). Similarly, Trp45 in GJA3 appears as a mutation hotspot, as p.Trp45Ser has previously been reported for nuclear cataract in a Chinese ADCC family. p.Thr56 (GJA8) and p.Trp45 (GJA3) are in the extracellular loop 1 (EL1) in their respective connexin proteins, which, along with EL2, are essential for gap junction formation, hemichannel docking, and regulating the voltage gating of the channels. Hence, residues in these regions seem crucial for maintaining eye lens transparency.
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Affiliation(s)
- Vanita Vanita
- Department of Human Genetics, Guru Nanak Dev University, Amritsar, India
| | - Shiwali Goyal
- Department of Human Genetics, Guru Nanak Dev University, Amritsar, India
| | - Shailja Tibrewal
- Department of Pediatric Ophthalmology, Strabismus and Neuro-Ophthalmology, Dr. Shroff's Charity Eye Hospital, Daryaganj, India.,Department of Ocular Genetics, Dr. Shroff's Charity Eye Hospital, Daryaganj, India
| | - Suma Ganesh
- Department of Pediatric Ophthalmology, Strabismus and Neuro-Ophthalmology, Dr. Shroff's Charity Eye Hospital, Daryaganj, India
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Sushmitha TJ, Rajeev M, Sriyutha Murthy P, Ganesh S, Toleti SR, Karutha Pandian S. Bacterial community structure of early-stage biofilms is dictated by temporal succession rather than substrate types in the southern coastal seawater of India. PLoS One 2021; 16:e0257961. [PMID: 34570809 PMCID: PMC8476003 DOI: 10.1371/journal.pone.0257961] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 09/15/2021] [Indexed: 01/04/2023] Open
Abstract
Bacterial communities colonized on submerged substrata are recognized as a key factor in the formation of complex biofouling phenomenon in the marine environment. Despite massive maritime activities and a large industrial sector in the nearshore of the Laccadive Sea, studies describing pioneer bacterial colonizers and community succession during the early-stage biofilm are scarce. We investigated the biofilm-forming bacterial community succession on three substrata viz. stainless steel, high-density polyethylene, and titanium over 15 days of immersion in the seawater intake area of a power plant, located in the southern coastal region of India. The bacterial community composition of biofilms and peripheral seawater were analyzed by Illumina MiSeq sequenced 16S rRNA gene amplicons. The obtained metataxonomic results indicated a profound influence of temporal succession over substrate type on the early-stage biofilm-forming microbiota. Bacterial communities showed vivid temporal dynamics that involved variations in abundant bacterial groups. The proportion of dominant phyla viz. Proteobacteria decreased over biofilm succession days, while Bacteroidetes increased, suggesting their role as initial and late colonizers, respectively. A rapid fluctuation in the proportion of two bacterial orders viz. Alteromonadales and Vibrionales were observed throughout the successional stages. LEfSe analysis identified specific bacterial groups at all stages of biofilm development, whereas no substrata type-specific groups were observed. Furthermore, the results of PCoA and UPGMA hierarchical clustering demonstrated that the biofilm-forming community varied considerably from the planktonic community. Phylum Proteobacteria preponderated the biofilm-forming community, while the Bacteroidetes, Cyanobacteria, and Actinobacteria dominated the planktonic community. Overall, our results refute the common assumption that substrate material has a decisive impact on biofilm formation; rather, it portrayed that the temporal succession overshadowed the influence of the substrate material. Our findings provide a scientific understanding of the factors shaping initial biofilm development in the marine environment and will help in designing efficient site-specific anti-biofouling strategies.
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Affiliation(s)
- T. J. Sushmitha
- Department of Biotechnology, Alagappa University, Karaikudi, Tamil Nadu, India
| | - Meora Rajeev
- Water and Steam Chemistry Division, Bhabha Atomic Research Centre Facilities, Kalpakkam, Tamil Nadu, India
| | - P. Sriyutha Murthy
- Water and Steam Chemistry Division, Bhabha Atomic Research Centre Facilities, Kalpakkam, Tamil Nadu, India
| | - S. Ganesh
- Department of Chemistry, Scott Christian College, Nagercoil, Tamil Nadu, India
| | - Subba Rao Toleti
- Water and Steam Chemistry Division, Bhabha Atomic Research Centre Facilities, Kalpakkam, Tamil Nadu, India
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Balamurugan R, Ram J, Ganesh S, Kaur S, Gupta PC, Behera R. Jagat and Bala intraocular lens supporting system: An artificial platform for intraocular lens implantation in an aphakic patient with inadequate capsular support. Indian J Ophthalmol 2021; 69:1618-1622. [PMID: 34011755 PMCID: PMC8302291 DOI: 10.4103/ijo.ijo_3240_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
We describe a novel device, Jagat and Bala Intraocular lens Supporting System (JBISS), an artificial Intraocular lens (IOL) platform that facilitates IOL fixation in an aphakic patient with poor capsular support and also facilitates IOL exchange in case of myopic shift or refractive surprise. Implantation of JBISS along with IOL was carried out in four patients and results are promising without any adverse events.
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Affiliation(s)
- R Balamurugan
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Jagat Ram
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - S Ganesh
- Medical Device, Intraocular Lens Division, Appasamy Associates (P) Ltd., Chennai, Tamil Nadu, India
| | - Savleen Kaur
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Parul Chawla Gupta
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ranjan Behera
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Goyal P, Tibrewal S, Rath S, Ganesh S. Good Long-term Motor and Sensory Outcomes of Infantile Esotropia: A Strabismus Surgeon's Goal. J Pediatr Ophthalmol Strabismus 2021; 58:202. [PMID: 34039164 DOI: 10.3928/01913913-20210315-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Gupta N, Singla P, Ganesh S. Usefulness of high definition sialoendoscope for evaluation of lacrimal drainage system in congenital nasolacrimal duct obstruction. Eur J Ophthalmol 2021; 32:11206721211008047. [PMID: 33827297 DOI: 10.1177/11206721211008047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE Sialoendoscope was used as a dacryoendoscope, high- definition images of the lacrimal drainage system (LDS) were captured and its performance in congenital nasolacrimal duct obstruction (CNLDO) is reported. METHODS Nasal endoscopy was done as the first in all the cases using a 0°, 2.7 mm nasal endoscope (Karl Stroz Tutlingan Germany). This was followed by Dacryoendoscopy (DEN) of the lacrimal drainage system from puncta till the valve of Hasner. DEN was performed under general anaesthesia in 26 children (including 17 primary and 9 failed probing cases). All cases were examined using 0.8 mm sialoendoscope (Karl Storz, Tuttlingen, Germany) with fibreoptic light transmission with a side port for irrigation. RESULTS We were able to obtain high-definition images of canaliculi, lacrimal sac, sac duct junction, proximal, mid and distal segments of nasolacrimal duct in all the children with CNLDO.In 17 primary cases 16 had distal membranous obstruction and I case had proximal canalicular obstruction. In nine children with history of failed probing, five had membranous obstruction, two had dacryoliths, two had NLD malformation at different levels. An overall success rate of 88.4% was achieved. CONCLUSION Sialoendoscope can be used as high-definition dacryoendoscope for diagnostic and therapeutic use in CNLDO. Useful information can be obtained on dacryoendoscopy in complex CNLDO cases.
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Affiliation(s)
- Nishi Gupta
- Dr Shroff's Charity Eye Hospital, New Delhi, India
| | | | - Suma Ganesh
- Dr Shroff's Charity Eye Hospital, New Delhi, India
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31
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Murali R, Ganesh S, Desigan N, Augustine E, Rajeev R, Pandey N. Kinetics of simultaneous stripping of U(VI) and nitric acid from tri-n-butyl phosphate. Progress in Nuclear Energy 2021. [DOI: 10.1016/j.pnucene.2021.103678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Stephen SK, Ganesh S, Varghese T. Modifications of structural and optical properties of nanophase BaWO4 phosphors: Dose dependent effect of high energy electron beam irradiation. Radiat Phys Chem Oxf Engl 1993 2021. [DOI: 10.1016/j.radphyschem.2020.109317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Roberts R, Borley A, Hanna L, Dolan G, Ganesh S, Williams EM. Identifying Risk Factors for Anthracycline Chemotherapy-induced Phlebitis in Women with Breast Cancer: An Observational Study. Clin Oncol (R Coll Radiol) 2020; 33:230-240. [PMID: 33308947 DOI: 10.1016/j.clon.2020.11.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 10/25/2020] [Accepted: 11/25/2020] [Indexed: 11/15/2022]
Abstract
AIMS Anthracycline chemotherapy administered via a peripheral cannula results in severe anthracycline chemotherapy-induced phlebitis (ACIP) in about 20-30% of patients. Administering chemotherapy via a central venous catheter (CVC) prevents ACIP. However, CVCs are associated with an increased risk of thrombosis and sepsis. Our aim was to identify risk factors associated with severe ACIP and to provide evidence about the individual risk of developing symptoms. MATERIALS AND METHODS A prospective observational study of 263 women with breast cancer receiving peripheral administration of anthracycline chemotherapy at a UK cancer centre was conducted between May 2016 and January 2018. Data were collected at baseline and every 3 weeks following each chemotherapy treatment, using both healthcare professional- and participant-reported symptom assessments. RESULTS After three cycles of chemotherapy, 27% of participants experienced severe ACIP. Factors associated with symptom severity were identified as: arm used for chemotherapy administration, epirubicin dose, age, pre-existing hypertension, comorbidity, ethnic group and pain during chemotherapy administration. The sequence of arm used for chemotherapy administration was the single most significant factor (P < 0.001). When alternating arms were used no other risk factor was influential. Where alternating arms were not used, younger age and higher dose were associated with higher-grade symptoms, with age being more influential than dose. The cumulative effect of increasing symptom severity with repeated cycles was also identified (P < 0.001). CONCLUSION It is recommended that a CVC is not routinely required for women with breast cancer who have not undergone an axillary node clearance and receive chemotherapy in alternate arms. The need for a CVC for women who are planned to receive all anthracycline chemotherapy cycles in the same arm should be assessed in the light of peripheral venous access assessment and the key risk factors of age, dose and number of cycles.
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Affiliation(s)
- R Roberts
- Velindre Cancer Centre, Whitchurch, Cardiff, UK.
| | - A Borley
- Velindre Cancer Centre, Whitchurch, Cardiff, UK
| | - L Hanna
- Velindre Cancer Centre, Whitchurch, Cardiff, UK
| | - G Dolan
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - S Ganesh
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - E M Williams
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
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Tibrewal S, Rath S, Ganesh S, Sangwan VS. Lateral Rectus Muscle Injury During Double-Headed Pterygium Surgery: A Rare Complication. J Pediatr Ophthalmol Strabismus 2020; 57:e96-e99. [PMID: 33320270 DOI: 10.3928/01913913-20201103-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 08/24/2020] [Indexed: 11/20/2022]
Abstract
A 43-year-old man developed double vision, esotropia, and abduction limitation after excision of a doubleheaded pterygium. Exploration during strabismus surgery 4 months later revealed a partially severed lateral rectus muscle and extensive conjunctival scarring. Direct injury to the lateral rectus muscle during pterygium surgery is extremely rare. Prevention and management strategies are discussed. [J Pediatr Ophthalmol Strabismus. 2020;57:e96-e99.].
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Tibrewal S, Subhedar K, Sen P, Mohan A, Singh S, Shah C, Nischal KK, Ganesh S. Clinical spectrum of non-syndromic microphthalmos, anophthalmos and coloboma in the paediatric population: a multicentric study from North India. Br J Ophthalmol 2020; 105:897-903. [PMID: 32829301 DOI: 10.1136/bjophthalmol-2020-316910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/10/2020] [Accepted: 06/23/2020] [Indexed: 11/04/2022]
Abstract
AIMS To describe the clinical features, visual acuity and causes of ocular morbidity in children (0-18 years) with microphthalmos, anophthalmos, and coloboma (MAC) from North India. METHODS A retrospective study conducted between October 2017 and September 2018 in three tertiary eye institutes, part of the Bodhya Eye Consortium with consensus led common pro formas. Children with complete clinical data and without syndromic/systemic involvement were included. The clinical phenotype was divided into isolated ocular coloboma (CB), coloboma with microcornea (CBMC), colobomatous microphthalmos (CBMO), non-colobomatous microphthalmos (MO) and anophthalmos (AO). RESULTS A total of 532 children with MAC were examined. Seventeen records were excluded due to incomplete data (0.2%). 515 children (845 eyes) were included: 54.4% males and 45.6% females. MAC was unilateral in 36% and bilateral in 64%. CB, CBMC, CBMO, MO and AO were seen in 26.4%, 31%, 22%, 8% and 12.5% of eyes, respectively. Nystagmus was found in 40%, strabismus in 23%, cataract in 18.7% and retinal detachment in 15%. Best-corrected visual acuity (BCVA) of <3/60 was seen in 62.4% eyes. Blindness (BCVA <3/60 in better eye) was seen in 42.8% of bilateral patients. Those with microcornea or microphthalmos with coloboma had worse BCVA (p<0.001). There were regional differences in the type of MAC phenotype presenting to the three institutes. CONCLUSION The MAC group of disorders cause significant ocular morbidity. The presence of microcornea or microphthalmos with coloboma predicts worse BCVA. The variation of the MAC phenotype with the district of origin of the patient raises questions of aetiology and is subject to further studies.
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Goodson AMC, Parmar S, Ganesh S, Zakai D, Shafi A, Wicks C, O'Connor R, Yeung E, Khalid F, Tahim A, Gowrishankar S, Hills A, Williams EM. Printed titanium implants in UK craniomaxillofacial surgery. Part I: access to digital planning and perceived scope for use in common procedures. Br J Oral Maxillofac Surg 2020; 59:312-319. [PMID: 33280946 DOI: 10.1016/j.bjoms.2020.08.087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 08/13/2020] [Indexed: 11/28/2022]
Abstract
This first part of a two-part study examines perceived applications for and barriers to using printed titanium in light of current caseloads, funding pathways, and use of digital planning. It aims to demonstrate the scope for printed titanium in modern practice and to guide industry about the needs of UK surgeons. A cross-sectional study over 14 weeks was performed electronically with support from the British Association of Oral and Maxillofacial Surgeons (BAOMS) and a national trainee-led recruitment team. Ethics approval was obtained at the lead centre. A total of 132 participants joined the study (70% consultants, 25% specialty registrars, and 5% other), approximating a 29% response rate from consultant/registrar BAOMS members throughout mainland UK. Eighty-eight per cent used CAD-CAM design, with highly variable funding/access, design/manufacturing workflows (in-house/outsourced). Eighty-eight per cent were involved with trauma, 61% with orthognathic, and 52% with oncology-reconstruction surgery. Favourite applications for printed titanium were orbital floor repair (89%) and free-flap jaw reconstruction (87%). Most participants also cited maxillary/zygomatic osteotomies and cranioplasty (range 61%-73%). Although a popular application (78%), the evidence base in temporomandibular joint surgery is limited. Those performing orthognathic surgery perceived more indications than those who did not (p=0.013). Key barriers included cost, turnaround time and logistics, and the need to be trained in traditional techniques. Printed titanium was useful for both common and niche procedures, but was specifically limited in emergency trauma. Most surgeons had experience in CAD-CAM surgery but technical understanding appeared unclear. Limiting factors included variable funding and production pathways, perceived costs, and logistics, but in-house design can minimise them. In part II, we quantify perceived benefits and limitations and whether surgeons' understanding and knowledge are sufficient to rationalise them.
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Affiliation(s)
- A M C Goodson
- Faculty of Life Sciences and Education, University of South Wales, Cemetery Road, Glyntaff, Pontypridd, CF37 4BD, United Kingdom.
| | - S Parmar
- University Hospital Birmingham NHS Trust, Queen Elizabeth Hospital, Birmingham B15 2TH, United Kingdom.
| | - S Ganesh
- Faculty of Life Sciences and Education, University of South Wales, Cemetery Road, Glyntaff, Pontypridd, CF37 4BD, United Kingdom.
| | - D Zakai
- Health Education England (West Midlands), 213 Hagley Road, Edgbaston, Birmingham, B16 9RG, United Kingdom.
| | - A Shafi
- NHS Education for Scotland, Westport 102, West Port, Edinburgh, EH3 9DN, United Kingdom.
| | - C Wicks
- Health Education England (South West), Park House, Newbrick Rd, Stoke Gifford, Bristol BS34 8YU, United Kingdom.
| | - R O'Connor
- Health Education England (East Midlands), Westbridge Place, 1 Westbridge Close, Leicester, LE3 5DR, United Kingdom.
| | - E Yeung
- Health Education England (South London), 4, Stewart House, 32 Russell Square, Bloomsbury, London WC1B 5DN, United Kingdom.
| | - F Khalid
- Health Education England (North West), 3 Piccadilly Place, Manchester, M1 3BN, United Kingdom.
| | - A Tahim
- Health Education England (North Central and East London, North West London), 4, Stewart House, 32 Russell Square, Bloomsbury, London WC1B 5DN, United Kingdom.
| | - S Gowrishankar
- Health Education England (Thames Valley), Chancellor Court, John Smith Drive, Oxford Business Park, Oxford, OX4 2GX, United Kingdom.
| | - A Hills
- Health Education England (Kent, Surrey & Sussex), 7 Bermondsey Street, London, SE1 2DD, United Kingdom.
| | - E M Williams
- Faculty of Life Sciences and Education, University of South Wales, Cemetery Road, Glyntaff, Pontypridd, CF37 4BD, United Kingdom.
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Goodson AMC, Parmar S, Ganesh S, Zakai D, Shafi A, Wicks C, O'Connor R, Yeung E, Khalid F, Tahim A, Gowrishankar S, Hills A, Williams EM. Printed titanium implants in UK craniomaxillofacial surgery. Part II: perceived performance (outcomes, logistics, and costs). Br J Oral Maxillofac Surg 2020; 59:320-328. [PMID: 33280945 DOI: 10.1016/j.bjoms.2020.08.088] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 08/13/2020] [Indexed: 11/30/2022]
Abstract
This second part explores perceptions and understanding of clinical performance, turnaround, and costs for printed titanium implants or plates in common procedures, evaluating both 'in-house' and 'outsourced' CAD-CAM pathways. A cross-sectional study, supported by the British Association of Oral and Maxillofacial Surgeons (BAOMS) and a national trainee-led recruitment team, was conducted over 14 weeks. A total of 132 participants took part (demographic data is reported in Part I). For fibular-flap mandibular reconstruction, most participants (69% - 91%) perceived printed titanium as superior to intraoperatively or preoperatively hand-bent plates for surgical duration, accuracy, dental restorability, and aesthetics. There was less agreement about complications and plate-failure risks. Most perceived printed plates to be superior to traditional wafer-based maxillary osteotomy for surgical duration (61%) and maxillary positioning (60%). For orbital floor repair, most perceived improvements in surgical duration (83%, especially higher-volume operators p=0.009), precision (84%), and ease of placement (69%). Rarely (less than 5%) was any outcome rated inferior to traditional techniques for any procedure. Perceived turnaround times and costs were variable, but the greatest consensus was for two-segment fibular-flap reconstructions and orbital floor repair. Industry estimates were generally consistent between two company representatives, but manufacturing-only costs differed when using in-house (departmental) designers. Costs and turnaround times are questionable barriers since few understand 'real-world' figures. Designing in-house can dramatically alter costs. Improved accuracy and surgical duration are common themes but biomechanical benefits are less-well understood. This study paints a picture of the potentially routine applications and benefits of printed titanium, capacity for uptake, understanding amongst surgeons, and areas for improvement.
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Affiliation(s)
- A M C Goodson
- Faculty of Life Sciences and Education, University of South Wales, Cemetery Road, Glyntaff, Pontypridd, CF37 4BD, United Kingdom.
| | - S Parmar
- University Hospital Birmingham NHS Trust, Queen Elizabeth Hospital, Birmingham B15 2TH, United Kingdom.
| | - S Ganesh
- Faculty of Life Sciences and Education, University of South Wales, Cemetery Road, Glyntaff, Pontypridd, CF37 4BD, United Kingdom.
| | - D Zakai
- Health Education England (West Midlands), 213 Hagley Road, Edgbaston, Birmingham, B16 9RG, United Kingdom.
| | - A Shafi
- NHS Education for Scotland, Westport 102, West Port, Edinburgh, EH3 9DN, United Kingdom.
| | - C Wicks
- Health Education England (South West), Park House, Newbrick Rd, Stoke Gifford, Bristol BS34 8YU, United Kingdom.
| | - R O'Connor
- Health Education England (East Midlands), Westbridge Place, 1 Westbridge Close, Leicester, LE3 5DR, United Kingdom.
| | - E Yeung
- Health Education England (South London), 4, Stewart House, 32 Russell Square, Bloomsbury, London WC1B 5DN, United Kingdom.
| | - F Khalid
- Health Education England (North West), 3 Piccadilly Place, Manchester, M1 3BN, United Kingdom.
| | - A Tahim
- Health Education England (North Central and East London, North West London), 4, Stewart House, 32 Russell Square, Bloomsbury, London WC1B 5DN, United Kingdom.
| | - S Gowrishankar
- Health Education England (Thames Valley), Chancellor Court, John Smith Drive, Oxford Business Park, Oxford, OX4 2GX, United Kingdom.
| | - A Hills
- Health Education England (Kent, Surrey & Sussex), 7 Bermondsey Street, London, SE1 2DD, United Kingdom.
| | - E M Williams
- Faculty of Life Sciences and Education, University of South Wales, Cemetery Road, Glyntaff, Pontypridd, CF37 4BD, United Kingdom.
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Rath S, Ganesh S, Mathur U, Sharma M. Necrotizing scleritis after strabismus surgery in Treacher Collins syndrome. GMS Ophthalmol Cases 2020; 10:Doc20. [PMID: 32676265 PMCID: PMC7332715 DOI: 10.3205/oc000147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objective: To describe a case of surgically induced scleral necrosis in Treacher Collins syndrome after strabismus surgery. Methods: A 19-year-old girl underwent bilateral squint surgery. Two weeks postoperatively, she presented with subconjunctival abscess in the left eye. The surrounding conjunctiva was markedly inflamed with raised edges. Surgical debridement, microbiological evaluation and medical management were started immediately. Screening for autoimmune and vasculitic conditions did not provide any positive results. Results: On subsequent follow-up, conjunctival retraction and an area of scleral necrosis with thinning was noted. Significant healing with antibiotics and steroids was noted within one week. The integrity of the globe was well maintained and no further procedure for tectonic support was performed. Conclusion: Surgically induced scleral necrosis can be immune-mediated or following surgical site infection. Pre-existing scleral thinning due to neuroectodermal apoptosis in Treacher Collins syndrome remains a possible explanation for the accelerated necrotising scleritis in our case.
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Affiliation(s)
- Soveeta Rath
- Department of Pediatric Ophthalmology and Strabismus, Dr. Shroff's Charity Eye Hospital, Daryaganj, New Delhi, India
| | - Suma Ganesh
- Department of Pediatric Ophthalmology and Strabismus, Dr. Shroff's Charity Eye Hospital, Daryaganj, New Delhi, India
| | - Umang Mathur
- Department of Cornea and Anterior Segment Services, Dr. Shroff's Charity Eye Hospital, Daryaganj, New Delhi, India
| | - Manasvini Sharma
- Department of Pediatric Ophthalmology and Strabismus, Dr. Shroff's Charity Eye Hospital, Daryaganj, New Delhi, India
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Sabherwal S, Sood I, Siddiqui Z, DasGupta S, Ganesh S, Basset K. Out-of-School Vision Screening in North India: Estimating the Magnitude of Need. Ophthalmic Epidemiol 2020; 27:449-452. [DOI: 10.1080/09286586.2020.1766513] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Shalinder Sabherwal
- Department of Community Ophthalmology, Dr Shroff’s Charity Eye Hospital, New Delhi, India
| | - Ishaana Sood
- Department of Community Ophthalmology, Dr Shroff’s Charity Eye Hospital, New Delhi, India
| | - Zeeshan Siddiqui
- Department of Community Ophthalmology, Dr Shroff’s Charity Eye Hospital, New Delhi, India
| | - Shantanu DasGupta
- Department of Community Ophthalmology, Dr Shroff’s Charity Eye Hospital, New Delhi, India
| | - Suma Ganesh
- Department of Pediatric Ophthalmology, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Ken Basset
- Department of Ophthalmology, University of British Columbia and Program Director, SEVA Canada
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Sharma M, Ganesh S, Tibrewal S, Sabharwal S, Sachdeva N, Adil M, Chaudhary J, Siddiqui Z. Accuracy of noncycloplegic photorefraction using Spot photoscreener in detecting amblyopia risk factors in preschool children in an Indian eye clinic. Indian J Ophthalmol 2020; 68:504-509. [PMID: 32057013 PMCID: PMC7043179 DOI: 10.4103/ijo.ijo_701_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose: To evaluate the accuracy of Spot photoscreener (PS) as a noncycloplegic photorefractor in detecting amblyopia risk factors (ARFs) in preschool children in an Indian eye clinic setting. Also, to derive appropriate cutoff values for screening to obtain maximum sensitivity and specificity of the device in detecting ARF. Methods: This was a cross-sectional study conducted in the outpatient pediatric eye clinic at a tertiary eye care institute. A Spot PS was used to screen all the children between the ages of 6 months and 5 years that presented to the eye clinic from August 2018 to October 2018. This screening was followed by a complete eye examination, including cycloplegic refraction by a masked examiner. The 2013 American Association for Pediatric Ophthalmology and Strabismus (AAPOS) guidelines were considered the standard cutoff values for clinically significant refractive error in children younger than 5 years of age. Results: The study comprised of 219 children. The Spot PS diagnosed 135 (61.64%) children with ARF as compared with 124 (56.62%) children detected by clinic examination. For ARF detection, the Spot photoscreeneer had 85.48% sensitivity, 69.47% specificity, 78.52% positive predictive value and 78.57% negative predictive value. The sensitivity for detection of strabismus and hypermetropia was very low (42% and 36%, respectively). The 95% limits of agreement ranged from −5.48 to +5.59 diopters (D) with a bias of 0.06 D for spherical equivalent between noncycloplegic photorefraction and cycloplegic refraction. Conclusion: The Spot PS may be used as a screening tool to detect ARF in children younger than 5 years of age keeping its limitations in consideration. However, the performance can be improved by modifying the cutoff values for the referral.
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Affiliation(s)
- Manasvini Sharma
- Department of Pediatric Ophthalmology and Strabismus, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Suma Ganesh
- Department of Pediatric Ophthalmology and Strabismus, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Shailja Tibrewal
- Department of Pediatric Ophthalmology and Strabismus, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Shalinder Sabharwal
- Department of Community Outreach Services, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | | | - Mohd Adil
- Department of Pediatric Ophthalmology and Strabismus, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Jyotsana Chaudhary
- Department of Pediatric Ophthalmology and Strabismus, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Zeeshan Siddiqui
- Department of Community Outreach Services, Dr Shroff's Charity Eye Hospital, New Delhi, India
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Baldev V, Tibrewal S, Rath S, Ganesh S. Microvascular changes in amblyopic eyes detected by optical coherence tomography angiography. J AAPOS 2020; 24:59. [PMID: 31586583 DOI: 10.1016/j.jaapos.2019.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 09/19/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Vibha Baldev
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr Shroff Charity Eye Hospital, New Delhi, India
| | - Shailja Tibrewal
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr Shroff Charity Eye Hospital, New Delhi, India
| | - Soveeta Rath
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr Shroff Charity Eye Hospital, New Delhi, India
| | - Suma Ganesh
- Department of Pediatric Ophthalmology, Strabismus and Neuro-ophthalmology, Dr Shroff Charity Eye Hospital, New Delhi, India
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Affiliation(s)
- Shailja Tibrewal
- Department of Pediatric Ophthalmology and Strabismus, Dr Shroff Charity Eye Hospital, New Delhi
| | - Manasvini Sharma
- Department of Pediatric Ophthalmology and Strabismus, Dr Shroff Charity Eye Hospital, New Delhi
| | - Soveeta Rath
- Department of Pediatric Ophthalmology and Strabismus, Dr Shroff Charity Eye Hospital, New Delhi
| | - Suma Ganesh
- Department of Pediatric Ophthalmology and Strabismus, Dr Shroff Charity Eye Hospital, New Delhi
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Rath S, Varma D, Tibrewal S, Ganesh S, Gupta N. A flower in the brain: Planum sphenoidale meningioma. Indian J Ophthalmol 2020; 68:2514-2516. [PMID: 33120663 PMCID: PMC7774206 DOI: 10.4103/ijo.ijo_618_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Tibrewal S, Baldev V, Rath S, Ganesh S. Isolated abducens nerve palsy following temporal bone fracture in a child. Taiwan J Ophthalmol 2020; 10:306-308. [PMID: 33437607 PMCID: PMC7787089 DOI: 10.4103/tjo.tjo_75_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 10/19/2019] [Indexed: 11/04/2022] Open
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Gupta N, Ganesh S, Singla P, Kumar S. A rare association of blepharophimosis-ptosis-epicanthus inversus case with congenital nasolacrimal duct obstruction. Eur J Ophthalmol 2019; 31:NP8-NP11. [PMID: 31752537 DOI: 10.1177/1120672119886427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The aim of reporting this case is to describe a rare combination of blepharophimosis-ptosis-epicanthus inversus syndrome with congenital nasolacrimal duct obstruction. A variety of lacrimal anomalies have been seen in blepharophimosis-ptosis-epicanthus inversus syndrome but the occurrence of nasolacrimal duct obstruction is rare. METHOD The blepharophimosis-ptosis-epicanthus inversus syndrome is an autosomal dominant rare genetic defect with clinical manifestation of dysplasia of the eyelids, palpebral fissures, flat nasal bridge, and ptosis. A 20-month-old boy was referred with the complaints of watering and discharge from his right eyes since birth. On examination, the child had all the features of blepharophimosis-ptosis-epicanthus inversus syndrome with right congenital nasolacrimal duct obstruction in line with the published reports. RESULT On endoscopic probing and irrigation, the probe could not be visualized into the inferior meatus. On dacryoendoscopy, the membranous part of the nasolacrimal duct was found to be completely obliterated with no light transmission into the nose indicating a malformed nasolacrimal duct. The child was managed by endoscopic dacryocystorhinostomy. We could find only one case report published so far on the combination of congenital nasolacrimal duct obstruction with blepharophimosis-ptosis-epicanthus inversus syndrome. This study adds one more case of blepharophimosis-ptosis-epicanthus inversus syndrome with congenital nasolacrimal duct obstruction and adjuvant use of dacryoendoscopy.
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Affiliation(s)
- Nishi Gupta
- Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | - Suma Ganesh
- Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | | | - Sunil Kumar
- Dr. Shroff's Charity Eye Hospital, New Delhi, India
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Mohan S, Jarhyan P, Ganesh S, Nikhil SV, Khatkar R, Rao BM, Reddy KS, Tandon N, Prabhakaran D. P1945High levels of unawareness and suboptimal management of hypertension in India: data from a large community based study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Hypertension is the most common cause of the rising cardiovascular disease (CVD) epidemic in India. However, despite availability of proven therapies management remains sub-optimal.
Purpose
To determine the hypertension control rates and associated factors among adults with known hypertension in urban and rural India.
Methods
We conducted a representative population based cross-sectional survey among 12243 participants aged ≥30 years residing in rural and urban North and South India. Participants were selected using a multistage cluster random sampling technique. Trained personnel collected the data using an interviewer administered questionnaire, measured blood pressure, conducted anthropometry and collected bio-samples. Hypertension was defined as known hypertension (self-report of physician diagnosis) or systolic blood pressure (SBP) ≥140 mmHg or diastolic blood pressure (DBP) ≥90 mmHg. Control was defined as SBP <140 mmHg and DBP <90 mmHg among those with known hypertension. The associations were measured using logistic regression.
Results
The mean (±SD) age of participants was 47.7 (±12.5) years, women comprised 54%. The age-standardized prevalence of hypertension was 29.0% (95% CI: 28.2- 29.8) and known hypertension was 14.0% (13.4- 14.6). Among all hypertensives 38.6% (37.0–40.2) were on treatment and 26.2% (24.6–28.0) had their blood pressure controlled, while among known hypertensives 79.8% (77.8–81.7) were on treatment and 55.7% (53.3–58.1) had their blood pressure controlled. In multivariate analysis, participants from North Indian site [OR: 1.9 (1.6–2.3)], urban residents [1.3 (1.1–1.6)], younger participants [1.5 (1.2–1.8)], men [2.0 (1.5–2.6)], those with low socio-economic status [1.6 (1.1–2.3)], without comorbidities and those without a family history hypertension were more likely to be unaware about their hypertensive status and less likely to take treatment. Hypertension control was significantly higher in participants from South Indian site [1.5 (1.2–1.0)], the highly educated [1.6 (1.1–2.4)], those without heart diseases [1.8 (1.1–3.1)], those without central obesity [1.4 (1.1–1.9)], physically active individuals [1.5 (1.1–2.0)] and current non-alcohol users [1.9 (1.3–2.6)].
Conclusions
Many individuals with hypertension remain unaware and sub-optimally managed. This warrants the implementation of tailored public education to raise awareness, complemented by active screening for the early detection and effective management of hypertension, in order to stem the rising tide of preventable CVD in India.
Acknowledgement/Funding
Unrestricted educational grant from Eli Lilly under the Lilly NCD Partnership
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Affiliation(s)
- S Mohan
- Public Health Foundation of India, Gurgaon, India
| | - P Jarhyan
- Public Health Foundation of India, Gurgaon, India
| | - S Ganesh
- Public Health Foundation of India, Gurgaon, India
| | - S V Nikhil
- Public Health Foundation of India, Gurgaon, India
| | - R Khatkar
- Public Health Foundation of India, Gurgaon, India
| | - B M Rao
- KIMS ICON, Cardiology, Visakhapatnam, India
| | - K S Reddy
- Public Health Foundation of India, Gurgaon, India
| | - N Tandon
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Gupta N, Singla P, Kumar S, Ganesh S, Dhawan N, Sobti P, Aggarwal S. Role of dacryoendoscopy in refractory cases of congenital nasolacrimal duct obstruction. Orbit 2019; 39:183-189. [PMID: 31552767 DOI: 10.1080/01676830.2019.1668434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Purpose: To highlight the importance of dacryoendoscopy in recognizing the factors responsible for failure with successful recanalization obviating the need for dacryocystorhinostomy in a few selective cases.Method: A retrospective study of 13 children undergoing dacryoendoscopy for refractory congenital nasolacrimal duct obstruction (CNLDO) was carried out during a period of 3 years from 2016 to 2018. Children with single or multiple failed probings were included in the study.Results: Out of the total 13 cases included in the study there 9 males and 4 females. The age ranged from 9 months to 36 months with the involvement of the right side in 7 cases and the left side in 6 cases. Four cases had dysgenesis of bony nasolacrimal duct (NLD), 4 cases had dacryolith, 3 cases had an intact membrane at the lower end of NLD and 2 cases had fibrosis of the lower end of NLD and the surrounding area in the inferior meatus (IM) following multiple interventions, (Table 1). Dacryoendoscopic recanalization was done in 7 cases while the endoscopic dacryocystorhinostomy (DCR) was done in 6 cases. Asuccessful outcome was achieved in all the cases and at the end of 6 months, all the children remained asymptomatic.Conclusions: Dacryoendoscopy (DEN) facilitates direct examination of the nasolacrimal system and thus has an added advantage over nasal endoscopy assisted probing in the refractory cases of CNLDO.
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Affiliation(s)
- Nishi Gupta
- Department of ENT, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Poonam Singla
- Department of ENT, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Sunil Kumar
- Department of ENT, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Suma Ganesh
- Department of Ophthalmology, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Nidhi Dhawan
- Department of ENT, Dr Shroff's Charity Eye Hospital, New Delhi, India
| | - Parul Sobti
- Department of ENT, Dr Shroff's Charity Eye Hospital, New Delhi, India
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Raja S, Gilad-Gutnick S, Ben-Ami S, Gupta P, Shah P, Tiwari K, Ganesh S, Sinha P. Characterizing Global Motion Perception Following Treatment for Bilateral Congenital Cataracts. J Vis 2019. [DOI: 10.1167/19.10.285c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Sruti Raja
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology
| | - Sharon Gilad-Gutnick
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology
| | - Shlomit Ben-Ami
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology
| | | | | | | | - Suma Ganesh
- Department of Ophthalmology, Dr. Shroff’s Charity Eye Hospital
| | - Pawan Sinha
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology
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Gilad-Gutnick S, Kurian G, Gupta P, Tiwari K, Shah P, Raja S, Ben-Ami S, Gandhi T, Ganesh S, Sinha P. Development of facial expression recognition following extended blindness: The importance of motion. J Vis 2019. [DOI: 10.1167/19.10.21a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Sharon Gilad-Gutnick
- Department of Brain and Cognitive Sciences Massachusetts Institute of Technology
| | - Grace Kurian
- Faculty of Medicine, University of Geneva, GE, Switzerland
| | | | | | | | - Sruti Raja
- Department of Brain and Cognitive Sciences Massachusetts Institute of Technology
| | - Shlomit Ben-Ami
- Department of Brain and Cognitive Sciences Massachusetts Institute of Technology
| | - Tapan Gandhi
- Department of Electrical Engineering, Indian Institute of Technology Delhi
| | | | - Pawan Sinha
- Department of Brain and Cognitive Sciences Massachusetts Institute of Technology
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Ganesh S, Khurana R, Sharma S, Rath S. Predisposing Factors, Ophthalmic Manifestations, and Radiological Findings in Children With Cerebral Visual Impairment. J Pediatr Ophthalmol Strabismus 2019; 56:313-318. [PMID: 31545865 DOI: 10.3928/01913913-20190610-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 05/22/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To describe predisposing factors, ophthalmic manifestations, and magnetic resonance imaging (MRI) findings in children with cerebral visual impairment. METHODS A retrospective cross-sectional analysis of patients younger than 16 years with neuroradiological and clinical evidence of retrogeniculate visual pathway pathology was performed. Detailed histories, ophthalmic examinations, and MRI findings were compiled and analyzed. RESULTS Of the 88 cases included in the study, the median age was 32 months (range: 1 to 180 months). Ante-natal history and preterm delivery was positive in 25.0% and 37.5% of patients, respectively. A simple myopic astigmatism was the most common refractive error. Accommodative anomalies were noted in 6 children. CONCLUSIONS The demographic trends found in the study were similar to those of developed nations, but the frequency of the predisposing factors varied. A comprehensive knowledge of cerebral visual impairment in the developing world can aid an earlier diagnosis, appropriate management, and the development of better rehabilitation teams. [J Pediatr Ophthalmol Strabismus. 2019;56(5):313-318.].
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