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Balachandran A, Pei H, Beard J, Caspi A, Cohen A, Domingue BW, Eckstein Indik C, Ferrucci L, Furuya A, Kothari M, Moffitt TE, Ryan C, Skirbekk V, Zhang Y, Belsky DW. Pace of Aging in older adults matters for healthspan and lifespan. medRxiv 2024:2024.04.25.24306359. [PMID: 38712264 PMCID: PMC11071564 DOI: 10.1101/2024.04.25.24306359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
As societies age, policy makers need tools to understand how demographic aging will affect population health and to develop programs to increase healthspan. The current metrics used for policy analysis do not distinguish differences caused by early-life factors, such as prenatal care and nutrition, from those caused by ongoing changes in people's bodies due to aging. Here we introduce an adapted Pace of Aging method designed to quantify differences between individuals and populations in the speed of aging-related health declines. The adapted Pace of Aging method, implemented in data from N=13,626 older adults in the US Health and Retirement Study, integrates longitudinal data on blood biomarkers, physical measurements, and functional tests. It reveals stark differences in rates of aging between population subgroups and demonstrates strong and consistent prospective associations with incident morbidity, disability, and mortality. Pace of Aging can advance the population science of healthy longevity.
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Affiliation(s)
- A Balachandran
- Robert N Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
| | - H Pei
- Robert N Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - J Beard
- Robert N Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Health Policy & Management, Columbia University Mailman School of Public Health, New York, NY, USA
| | - A Caspi
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
- Social, Genetic, and Developmental Psychiatry Unit, Institute of Psychiatry, Kings College, University of London, London, UK
| | - A Cohen
- Robert N Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - BW Domingue
- Graduate School of Education, Stanford University, Palo Alto, CA, USA
| | - C Eckstein Indik
- Robert N Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
| | - L Ferrucci
- National Institute on Aging, Bethesda, MD, USA
| | - A Furuya
- Robert N Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - M Kothari
- Robert N Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
| | - TE Moffitt
- Social, Genetic, and Developmental Psychiatry Unit, Institute of Psychiatry, Kings College, University of London, London, UK
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - C Ryan
- Robert N Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
| | - V Skirbekk
- Norwegian Institute for Public Health, Oslo, Norway
| | - Y Zhang
- Robert N Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - DW Belsky
- Robert N Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Health Policy & Management, Columbia University Mailman School of Public Health, New York, NY, USA
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2
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Jenkins V, Matthews L, Solis-Trapala I, Gage H, May S, Williams P, Bloomfield D, Zammit C, Elwell-Sutton D, Betal D, Finlay J, Nicholson K, Kothari M, Santos R, Stewart E, Bell S, McKinna F, Teoh M. Patients' experiences of a suppoRted self-manAGeMent pAThway In breast Cancer (PRAGMATIC): quality of life and service use results. Support Care Cancer 2023; 31:570. [PMID: 37698629 PMCID: PMC10497681 DOI: 10.1007/s00520-023-08002-z] [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: 02/27/2023] [Accepted: 08/16/2023] [Indexed: 09/13/2023]
Abstract
PURPOSE To describe trends and explore factors associated with quality of life (QoL) and psychological morbidity and assess breast cancer (BC) health service use over a 12-month period for patients joining the supported self-management (SSM)/patient-initiated follow-up (PIFU) pathway. METHODS Participants completed questionnaires at baseline, 3, 6, 9 and 12 months that measured QoL (FACT-B, EQ 5D-5L), self-efficacy (GSE), psychological morbidity (GHQ-12), roles and responsibilities (PRRS) and service use (cost diary). RESULTS 99/110 patients completed all timepoints; 32% (35/110) had received chemotherapy. The chemotherapy group had poorer QoL; FACT-B total score mean differences were 8.53 (95% CI: 3.42 to 13.64), 5.38 (95% CI: 0.17 to 10.58) and 8.00 (95% CI: 2.76 to 13.24) at 6, 9 and 12 months, respectively. The odds of psychological morbidity (GHQ12 >4) were 5.5-fold greater for those treated with chemotherapy. Financial and caring burdens (PRRS) were worse for this group (mean difference in change at 9 months 3.25 (95% CI: 0.42 to 6.07)). GSE and GHQ-12 scores impacted FACT-B total scores, indicating QoL decline for those with high baseline psychological morbidity. Chemotherapy patients or those with high psychological morbidity or were unable to carry out normal activities had the highest service costs. Over the 12 months, 68.2% participants phoned/emailed breast care nurses, and 53.3% visited a hospital breast clinician. CONCLUSION The data suggest that chemotherapy patients and/or those with heightened psychological morbidity might benefit from closer monitoring and/or supportive interventions whilst on the SSM/PIFU pathway. Reduced access due to COVID-19 could have affected service use.
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Affiliation(s)
- V Jenkins
- Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, East Sussex, England, UK.
| | - L Matthews
- Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, East Sussex, England, UK
| | - I Solis-Trapala
- School of Medicine, Keele University, University Road, Staffordshire, England, UK
| | - H Gage
- Surrey Health Economics Centre/Department of Clinical and Experimental Medicine, Leggett Building, University of Surrey, Guildford, Surrey, England, UK
| | - S May
- Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, University of Sussex, Falmer, East Sussex, England, UK
| | - P Williams
- Department of Mathematics, University of Surrey, Guildford, Surrey, England, UK
| | - D Bloomfield
- Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, East Sussex, England, UK
- Surrey & Sussex Cancer Alliance, Royal Surrey County Hospital NHS Foundation Trust, Guildford, Surrey, England, UK
| | - C Zammit
- Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, East Sussex, England, UK
- Surrey & Sussex Cancer Alliance, Royal Surrey County Hospital NHS Foundation Trust, Guildford, Surrey, England, UK
| | - D Elwell-Sutton
- Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, East Sussex, England, UK
| | - D Betal
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, Worthing, West Sussex, England, UK
| | - J Finlay
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, Worthing, West Sussex, England, UK
| | - K Nicholson
- Worthing Hospital, University Hospitals Sussex NHS Foundation Trust, Worthing, West Sussex, England, UK
| | - M Kothari
- Ashford & St Peter's NHS Foundation Trust, London Road, Ashford, Surrey, England, UK
| | - R Santos
- Ashford & St Peter's NHS Foundation Trust, London Road, Ashford, Surrey, England, UK
| | - E Stewart
- Ashford & St Peter's NHS Foundation Trust, London Road, Ashford, Surrey, England, UK
| | - S Bell
- Surrey & Sussex Cancer Alliance, Royal Surrey County Hospital NHS Foundation Trust, Guildford, Surrey, England, UK
| | - F McKinna
- Surrey & Sussex Cancer Alliance, Royal Surrey County Hospital NHS Foundation Trust, Guildford, Surrey, England, UK
| | - M Teoh
- Surrey & Sussex Cancer Alliance, Royal Surrey County Hospital NHS Foundation Trust, Guildford, Surrey, England, UK
- Ashford & St Peter's NHS Foundation Trust, London Road, Ashford, Surrey, England, UK
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Waziry R, Ryan CP, Corcoran DL, Huffman KM, Kobor MS, Kothari M, Graf GH, Kraus VB, Kraus WE, Lin DTS, Pieper CF, Ramaker ME, Bhapkar M, Das SK, Ferrucci L, Hastings WJ, Kebbe M, Parker DC, Racette SB, Shalev I, Schilling B, Belsky DW. Author Correction: Effect of long-term caloric restriction on DNA methylation measures of biological aging in healthy adults from the CALERIE trial. Nat Aging 2023:10.1038/s43587-023-00432-y. [PMID: 37161091 DOI: 10.1038/s43587-023-00432-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Affiliation(s)
- R Waziry
- Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
| | - C P Ryan
- Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
| | - D L Corcoran
- Department of Genetics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - K M Huffman
- Duke Molecular Physiology Institute and Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - M S Kobor
- Department of Medical Genetics, Edwin S.H. Leong Healthy Aging Program, Centre for Molecular Medicine and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
| | - M Kothari
- Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
| | - G H Graf
- Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - V B Kraus
- Duke Molecular Physiology Institute and Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - W E Kraus
- Duke Molecular Physiology Institute and Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - D T S Lin
- Department of Medical Genetics, Edwin S.H. Leong Healthy Aging Program, Centre for Molecular Medicine and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
| | - C F Pieper
- Center on Aging and Development, Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | - M E Ramaker
- Duke Molecular Physiology Institute and Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - M Bhapkar
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA
| | - S K Das
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - L Ferrucci
- Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - W J Hastings
- Department of Biobehavioral Health, Pennsylvania State University, State College, PA, USA
| | - M Kebbe
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - D C Parker
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - S B Racette
- Program in Physical Therapy and Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - I Shalev
- Department of Biobehavioral Health, Pennsylvania State University, State College, PA, USA
| | - B Schilling
- Buck Institute for Research on Aging, Novato, CA, USA
| | - D W Belsky
- Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA.
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
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Waziry R, Ryan CP, Corcoran DL, Huffman KM, Kobor MS, Kothari M, Graf GH, Kraus VB, Kraus WE, Lin DTS, Pieper CF, Ramaker ME, Bhapkar M, Das SK, Ferrucci L, Hastings WJ, Kebbe M, Parker DC, Racette SB, Shalev I, Schilling B, Belsky DW. Effect of long-term caloric restriction on DNA methylation measures of biological aging in healthy adults from the CALERIE trial. Nat Aging 2023; 3:248-257. [PMID: 37118425 PMCID: PMC10148951 DOI: 10.1038/s43587-022-00357-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 12/22/2022] [Indexed: 04/30/2023]
Abstract
The geroscience hypothesis proposes that therapy to slow or reverse molecular changes that occur with aging can delay or prevent multiple chronic diseases and extend healthy lifespan1-3. Caloric restriction (CR), defined as lessening caloric intake without depriving essential nutrients4, results in changes in molecular processes that have been associated with aging, including DNA methylation (DNAm)5-7, and is established to increase healthy lifespan in multiple species8,9. Here we report the results of a post hoc analysis of the influence of CR on DNAm measures of aging in blood samples from the Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy (CALERIE) trial, a randomized controlled trial in which n = 220 adults without obesity were randomized to 25% CR or ad libitum control diet for 2 yr (ref. 10). We found that CALERIE intervention slowed the pace of aging, as measured by the DunedinPACE DNAm algorithm, but did not lead to significant changes in biological age estimates measured by various DNAm clocks including PhenoAge and GrimAge. Treatment effect sizes were small. Nevertheless, modest slowing of the pace of aging can have profound effects on population health11-13. The finding that CR modified DunedinPACE in a randomized controlled trial supports the geroscience hypothesis, building on evidence from small and uncontrolled studies14-16 and contrasting with reports that biological aging may not be modifiable17. Ultimately, a conclusive test of the geroscience hypothesis will require trials with long-term follow-up to establish effects of intervention on primary healthy-aging endpoints, including incidence of chronic disease and mortality18-20.
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Affiliation(s)
- R Waziry
- Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
| | - C P Ryan
- Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
| | - D L Corcoran
- Department of Genetics, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
| | - K M Huffman
- Duke Molecular Physiology Institute and Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - M S Kobor
- Department of Medical Genetics, Edwin S.H. Leong Healthy Aging Program, Centre for Molecular Medicine and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
| | - M Kothari
- Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
| | - G H Graf
- Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - V B Kraus
- Duke Molecular Physiology Institute and Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - W E Kraus
- Duke Molecular Physiology Institute and Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - D T S Lin
- Department of Medical Genetics, Edwin S.H. Leong Healthy Aging Program, Centre for Molecular Medicine and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada
| | - C F Pieper
- Center on Aging and Development, Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | - M E Ramaker
- Duke Molecular Physiology Institute and Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - M Bhapkar
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA
| | - S K Das
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - L Ferrucci
- Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - W J Hastings
- Department of Biobehavioral Health, Pennsylvania State University, State College, PA, USA
| | - M Kebbe
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - D C Parker
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - S B Racette
- Program in Physical Therapy and Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - I Shalev
- Department of Biobehavioral Health, Pennsylvania State University, State College, PA, USA
| | - B Schilling
- Buck Institute for Research on Aging, Novato, CA, USA
| | - D W Belsky
- Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, NY, USA.
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
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Matthews L, Teoh M, May S, Zammit C, Bloomfield D, Kothari M, Betal D, Santos R, Stewart E, Finlay J, Nicholson K, Elwell-Sutton D, McKinna F, Gage H, Bell S, Jenkins V. CN61 Patients’ experiences of a suppoRted self-manAGeMent pAThway In breast Cancer (PRAGMATIC): Interview results. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.384] [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: 11/25/2022] Open
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Bajaj S, Venkatraman M, Agarwal N, Kothari M. Cross-sectional observational analysis of the genetic referral practices across pediatric ophthalmology outpatient departments in an urban setting. Indian J Ophthalmol 2022; 70:2564-2569. [PMID: 35791157 PMCID: PMC9426136 DOI: 10.4103/ijo.ijo_2187_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: 11/05/2022] Open
Abstract
Purpose To analyze the genetic referral practices of pediatric ophthalmologists in an urban setting. Methods (1) The first limb of the study: cross-sectional, observational study among children visiting the outpatient department of pediatric ophthalmology across five centers in Mumbai. All pediatric patients were screened separately by pediatric ophthalmologists and a clinical geneticist for their ophthalmic and systemic complaints. Children were marked for referral to genetics (RTG) by both the specialists based on identification of distinctive features (red flag) and were requested to meet a local geneticist. (2a) Twenty-three months later, patients who had been marked for RTG were contacted telephonically to follow-up if they had met the geneticist. (2b) Additionally, the last 20 proformas from each center were checked retrospectively to note the RTG marked by the ophthalmologist alone. Results (1) In the first aspect of the study, 126 patients (male: female = 1.2:1) were included. Forty-nine (38.3%) patients were referred for genetic evaluation, of which three (6.1%), 31 (63.26%), and 15 (30.6%) cases were referred by the ophthalmologist alone, geneticist alone, and by both the specialists, respectively. Glaucoma (100%), nystagmus (86%), and leukocoria (83%) were the most prominent ocular diagnoses in cases referred for genetic evaluation. Facial dysmorphism (55.1%) and neurodevelopmental delays (51%) were among the most common systemic red flags found in patients referred to genetics. (2a) Twenty-three months later, on contacting the 49 patients marked for RTG, only one family had met the geneticist. (2b) Retrospective evaluation of 100 proformas: only three patients were marked for RTG by ophthalmologist alone. Conclusion This study found that the genetic referrals by pediatric ophthalmologist were far lesser than those by geneticist. The study highlights an area of knowledge gap among pediatric ophthalmologists, prompting a need for heightened awareness in this area.
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Affiliation(s)
- Shruti Bajaj
- The Purple Gene Clinic, Mumbai, Maharashtra, India
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7
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Abstract
We report 7 years of follow-up data on ocular findings in a 2-month-old boy who presented with early-onset bilateral granulomatous panuveitis with subsequent development of secondary glaucoma and total cataract, along with multisystem involvement. He was diagnosed with mevalonate kinase deficiency (MKD), with a homozygous missense variant in exon-6 of the mevalonate kinase (MVK) gene on chromosome-12 that resulted in the substitution of aspartic acid for asparagine at codon 205 (p.Asn205Asp). Despite being managed with topical/systemic steroids and immunosuppression therapy with methotrexate and a short course of adalimumab, the patient continued to develop recurrent episodes of uveitis along with multisystem manifestations. The occurrence of early-onset uveitis is rare, as is the diagnosis of MKD.
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Affiliation(s)
- Nidhi Agarwal
- Department of Pediatric Ophthalmology, Jyotirmay Eye Clinic for Children and Adult Squint and Ocular Motility Laboratory, Thane, Maharashtra, India.
| | - Mihir Kothari
- Department of Pediatric Ophthalmology, Jyotirmay Eye Clinic for Children and Adult Squint and Ocular Motility Laboratory, Thane, Maharashtra, India
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8
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Kumar V, Kothari M, Gandhi S, Vastardi M. P050 PROFILE OF URTICARIA AND ANGIOEDEMA CASES IN AN INNER-CITY PEDIATRIC E.D. OVER 12 MONTHS. Ann Allergy Asthma Immunol 2021. [DOI: 10.1016/j.anai.2021.08.085] [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: 10/19/2022]
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9
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Kothari M, Rathod V, Sugathan S, Kothari MM, Sahiba B. Response to comments on: A pilot study on the perspectives of pediatric ophthalmologists and their patients towards online consultation during COVID-19 lockdown in India. Indian J Ophthalmol 2020; 69:164. [PMID: 33323611 PMCID: PMC7926089 DOI: 10.4103/ijo.ijo_3553_20] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Mihir Kothari
- Department of Paediatric Ophthalmology, Jyotirmay Eye Clinic, and Ocular Motility Laboratory, Thane; Department of Paediatric Ophthalmology, Mahatme Eye Hospital, Nagpur, Maharashtra, India
| | - Vivek Rathod
- Department of Paediatric Ophthalmology, Jyotirmay Eye Clinic, and Ocular Motility Laboratory, Thane, Maharashtra, India
| | - Susha Sugathan
- Department of Paediatric Ophthalmology, Jyotirmay Eye Clinic, and Ocular Motility Laboratory, Thane, Maharashtra, India
| | - Megha M Kothari
- Department of Paediatric Ophthalmology, Jyotirmay Eye Clinic, and Ocular Motility Laboratory, Thane, Maharashtra, India
| | - Bedi Sahiba
- Department of Paediatric Ophthalmology, Jyotirmay Eye Clinic, and Ocular Motility Laboratory, Thane, Maharashtra, India
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10
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Solanki M, Jahan S, Kothari M, Abdal MO, Mehta M, Ingle G. Comments on: Comparison of higher order aberrations in amblyopic and non-amblyopic eyes in pediatric patients with anisometropic amblyopia. Indian J Ophthalmol 2020; 68:2328-2329. [PMID: 32971721 PMCID: PMC7728009 DOI: 10.4103/ijo.ijo_353_20] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Meghna Solanki
- Department of Binocular Vision Disorders, Jyotirmay Eye Clinic for Children and Adult Squint and Ocular Motility Laboratory, Thane, Maharashtra, India
| | - Shairin Jahan
- Department of Binocular Vision Disorders, Jyotirmay Eye Clinic for Children and Adult Squint and Ocular Motility Laboratory, Thane, Maharashtra, India
| | - Mihir Kothari
- Department of Binocular Vision Disorders, Jyotirmay Eye Clinic for Children and Adult Squint and Ocular Motility Laboratory, Thane; Department of Pediatric Ophthalmology, Krishna Eye Center, Garodia Nagar, Ghatkopar East; Department of Pediatric Ophthalmology, Mehta Eye Clinic, Ghatkopar, Mumbai, Maharashtra, India
| | - Mohammad Oliullah Abdal
- Department of Pediatric Ophthalmology, Krishna Eye Center, Garodia Nagar, Ghatkopar East, Mumbai, Maharashtra, India
| | - Mansi Mehta
- Department of Pediatric Ophthalmology, Mehta Eye Clinic, Ghatkopar, Mumbai, Maharashtra, India
| | - Gunjan Ingle
- Department of Binocular Vision Disorders, Jyotirmay Eye Clinic for Children and Adult Squint and Ocular Motility Laboratory, Thane, Maharashtra, India
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Kothari M, Rathod V, Sugathan S, Kothari MM. A pilot study on the perspectives of pediatric ophthalmologists and their patients towards online consultation during COVID-19 lockdown in India. Indian J Ophthalmol 2020; 68:1494-1495. [PMID: 32587216 PMCID: PMC7574087 DOI: 10.4103/ijo.ijo_1306_20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Mihir Kothari
- Department of Paediatric Ophthalmology, Jyotirmay Eye Clinic and Ocular Motility Laboratory, Thane; Department of Paediatric Ophthalmology, Mahatme Eye Hospital, Nagpur, Maharashtra, India
| | - Vivek Rathod
- Department of Paediatric Ophthalmology, Jyotirmay Eye Clinic and Ocular Motility Laboratory, Thane, Maharashtra, India
| | - Susha Sugathan
- Department of Paediatric Ophthalmology, Jyotirmay Eye Clinic and Ocular Motility Laboratory, Thane, Maharashtra, India
| | - Megha M Kothari
- Department of Paediatric Ophthalmology, Jyotirmay Eye Clinic and Ocular Motility Laboratory, Thane, Maharashtra, India
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Kothari M, Modak M, Khan H, Jahan S, Solanki M, Rathod V. Convergence excess consecutive esotropia associated with 0.01% atropine eye drops usage in patients operated for intermittent exotropia. Indian J Ophthalmol 2020; 68:653-656. [PMID: 32174596 PMCID: PMC7210838 DOI: 10.4103/ijo.ijo_1243_19] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
To report convergence excess esotropia (CEET) following 0.01% atropine eye drops (Low dose atropine [LDA]). Children who developed CEET that resolved promptly after discontinuation of LDA are described. Three myopes aged 5.3 ± 1.2 years and mean sphere -4.5D were included. All were operated for intermittent exotropia earlier. Mean esotropia was +28.3PD for near and 10.6PD for distance. LDA induced high AC/A ratio and fusion normalized in 3 weeks after discontinuation of LDA. LDA should be used with caution in patients with esophoria or previously operated for intermittent exotropia. Any evidence of the emergence of a CEET should warrant discontinuation of LDA.
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Affiliation(s)
- Mihir Kothari
- Department of Pediatric Refractive Errors, Jyotirmay Eye Clinic for Children and Adult Squint and Ocular Motility Laboratory, Thane; Department of Pediatric Ophthalmology, Mahatme Eye Hospital, Nagpur, Maharashtra, India
| | - Mohini Modak
- Department of Pediatric Refractive Errors, Jyotirmay Eye Clinic for Children and Adult Squint and Ocular Motility Laboratory, Thane, Maharashtra, India
| | - Heena Khan
- Department of Pediatric Ophthalmology, Mehta Eye Clinic, Mumbai, Maharashtra, India
| | - Shairin Jahan
- Department of Pediatric Refractive Errors, Jyotirmay Eye Clinic for Children and Adult Squint and Ocular Motility Laboratory, Thane, Maharashtra, India
| | - Meghna Solanki
- Department of Pediatric Refractive Errors, Jyotirmay Eye Clinic for Children and Adult Squint and Ocular Motility Laboratory, Thane, Maharashtra, India
| | - Vivek Rathod
- Department of Pediatric Refractive Errors, Jyotirmay Eye Clinic for Children and Adult Squint and Ocular Motility Laboratory, Thane, Maharashtra, India
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Kothari M, Bhombal F, Abdal M, Lad S, Nankani G. Effectiveness of combined dichoptic therapy, binocular vision therapy, and part-time patching for the management of amblyopia in adults. Indian J Ophthalmol 2020; 68:257-258. [PMID: 31856546 PMCID: PMC6951202 DOI: 10.4103/ijo.ijo_1184_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Affiliation(s)
- Mihir Kothari
- Department of Pediatric Ophthalmology, Jyotirmay Eye Clinic for Children <16 Years and Adult Squint and Ocular Motility Laboratory, Thane; Department of Pediatric Ophthalmology, Mahatme Eye Hospital, Nagpur, Maharashtra, India
| | - Shairin Jahan
- Department of Pediatric Ophthalmology, Jyotirmay Eye Clinic for Children <16 Years and Adult Squint and Ocular Motility Laboratory, Thane; Department of Pediatric Ophthalmology, Mahatme Eye Hospital, Nagpur, Maharashtra, India
| | - Meghna Solanki
- Department of Pediatric Ophthalmology, Jyotirmay Eye Clinic for Children <16 Years and Adult Squint and Ocular Motility Laboratory, Thane; Department of Pediatric Ophthalmology, Mahatme Eye Hospital, Nagpur, Maharashtra, India
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Kothari M, Bhat D, Khadse N, Jain R, Rathod V. Response to comments on: Changes in pattern electroretinogram after application of 0.01% atropine eye drops. Indian J Ophthalmol 2019; 68:261. [PMID: 31856548 PMCID: PMC6951129 DOI: 10.4103/ijo.ijo_2086_19] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | - Deepak Bhat
- Jyotirmay Eye Clinic, Mumbai, Maharashtra, India
| | - Nitu Khadse
- Jyotirmay Eye Clinic, Mumbai, Maharashtra, India
| | - Rishika Jain
- Jyotirmay Eye Clinic, Mumbai, Maharashtra, India
| | - Vivek Rathod
- Jyotirmay Eye Clinic, Mumbai, Maharashtra, India
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Kothari M, Huang J, Hancock U, Beydoun S, Seth D, Poowuttikul P, Secord E. A203 VISUAL RECOGNITION OF ASTHMA MEDICATIONS IN INNER CITY ASTHMA CHILDREN AND CAREGIVERS. Ann Allergy Asthma Immunol 2019. [DOI: 10.1016/j.anai.2019.08.047] [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: 11/30/2022]
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Kothari M, Jain Y, Verma D, Rathod V, Jain R, Khadse N. Estimation Dynamic Distance Direct Ophthalmoscopy (eDDDO): A novel, objective method for the quantitative assessment of accommodation in young children. Indian J Ophthalmol 2019; 67:1564-1569. [PMID: 31546481 PMCID: PMC6786224 DOI: 10.4103/ijo.ijo_1935_18] [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: 11/04/2022] Open
Abstract
Purpose To describe estimation dynamic distance direct ophthalmoscopy (eDDDO) and compare it with the monocular estimation method of dynamic retinoscopy (eDR) for the assessment of accommodation in children. Methods In this prospective observational cohort study, an ophthalmologist performed eDDDO followed by eDR in children with normal eyes, and then under the partial effects of cyclopentolate and tropicamide to assess performance of eDDDO with eDR under the condition of pharmacologically induced accommodation failure. Only one eye of each child was recruited in the study. To study the inter-observer variation, two masked pediatric ophthalmology fellows performed eDDDO in the similar manner. Results For the comparison of eDDDO with eDR, 60 eyes of 60 patients were recruited. The mean age of the patients was 10.4 years. The mean accommodation on eDDDO was 3.0D, 5.1D, 9.8D, and 11.3D at 40 cm, 25 cm, 10 cm, and 8 cm, respectively and 3.0D, 5.0D, 9.5D, and 11.0D on eDR. The eDDDO overestimated accommodation by a mean 0.17D (95% CL 0-0.48D, P = 0.5). The correlation of eDDDO with eDR was excellent (Pearson r 0.98, T value 76.0). The inter-observer difference with eDDDO was not significant (mean 1D, 95% CL 0-2.6D, P = 0.9) and the correlation between two observers was excellent (Pearson r 0.9, T value 12.7). The eDDDO and eDR were also performed on 12 eyes of 6 children with a mean age of 8.5 years (range 8-12 years) under the partial effect of cyclopentolate and tropicamide, where eDDDO overestimated the accommodation by a mean 0.3D (95% CL 0- 1.2D, P = 0.7) and the correlation was excellent (Pearson r 1.0, T value 45). Conclusion eDDDO is a simple, reliable, quantitative, and objective technique of accommodation assessment for children. Further studies with larger sample are required to assess its performance in disorders of accommodation affecting younger children and in children with ocular comorbidities.
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Affiliation(s)
- Mihir Kothari
- Department of Pediatric Ophthalmology, Jyotirmay Eye Clinic, Thane, Maharashtra; Department of Pediatric Ophthalmology, Mahatme Eye Bank and Eye Hospital, Nagpur, India
| | - Yash Jain
- Johns Hopkins University School of Undergraduates, Baltimore, Maryland, USA
| | - Daneshwar Verma
- Department of Pediatric Ophthalmology, Mahatme Eye Bank and Eye Hospital, Nagpur, India
| | - Vivek Rathod
- Department of Pediatric Ophthalmology, Jyotirmay Eye Clinic, Thane, Maharashtra, India
| | - Rishika Jain
- Department of Pediatric Ophthalmology, Jyotirmay Eye Clinic, Thane, Maharashtra, India
| | - Nitu Khadse
- Department of Pediatric Ophthalmology, Jyotirmay Eye Clinic, Thane, Maharashtra, India
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Kothari M, Bhat D, Khadse N, Jain R, Rathod V, Aru P. Changes in pattern electroretinogram after application of 0.01% atropine eye drops. Indian J Ophthalmol 2019; 67:309-310. [PMID: 30672508 PMCID: PMC6376844 DOI: 10.4103/ijo.ijo_989_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Mihir Kothari
- Department of Pediatric Clinical Optics and Refraction, Jyotirmay Eye Clinic and Ocular Motility Laboratory, 104/105, Kaalika Tower, Kolbad Road, Opp. Pratap Cinema, Khopat, Thane; Department of Pediatric Ophthalmology and Strabismus, Mahatme Eye Bank and Eye Hospital, Chintaman Nagar, Somalwada, Nagpur, Maharashtra, India
| | - Deepak Bhat
- Department of Electrophysiology, UBM Institute - The Institute for High Resolution Ophthalmic Diagnosis, Door No. A1, Ganesh Baug, No. 214, Behind Ruia College, Bhalchandra Road, Dadar East, Mumbai, Maharashtra, India
| | - Nitu Khadse
- Department of Pediatric Clinical Optics and Refraction, Jyotirmay Eye Clinic and Ocular Motility Laboratory, 104/105, Kaalika Tower, Kolbad Road, Opp. Pratap Cinema, Khopat, Thane, Maharashtra, India
| | - Rishika Jain
- Department of Pediatric Clinical Optics and Refraction, Jyotirmay Eye Clinic and Ocular Motility Laboratory, 104/105, Kaalika Tower, Kolbad Road, Opp. Pratap Cinema, Khopat, Thane, Maharashtra, India
| | - Vivek Rathod
- Department of Pediatric Clinical Optics and Refraction, Jyotirmay Eye Clinic and Ocular Motility Laboratory, 104/105, Kaalika Tower, Kolbad Road, Opp. Pratap Cinema, Khopat, Thane, Maharashtra, India
| | - Pallavi Aru
- Department of Pediatric Clinical Optics and Refraction, Jyotirmay Eye Clinic and Ocular Motility Laboratory, 104/105, Kaalika Tower, Kolbad Road, Opp. Pratap Cinema, Khopat, Thane, Maharashtra, India
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Abstract
Purpose To report clinical manifestations of ocular allergy to atropine eye drops used for retardation of progressive myopia in children. Methods Myopic children, who developed bothersome itching that subsided promptly after cessation of atropine eye drops, were included. History of systemic or ocular allergy, preexisting ocular conditions, and clinical features of allergy were noted. Results Six children, age 5-15 years, were included. Four developed allergy to 1% atropine sulfate eye drops and two to 0.01% concentration of atropine sulfate. The onset of allergy was within a month to as late as 4 years after using atropine eye drops. The severity of allergy was higher with 1% concentration. The most common symptoms of atropine allergy were itching and burning. The most common signs were lid swelling and hyperemia. The allergic manifestations promptly reversed with the stoppage of eye drops. Reintroduction was possible in three patients, either by reducing the concentration of atropine or using benzalkonium free formulation. Conclusion Allergy to atropine eye drops in children may develop within a few weeks or after many years of usage. Prompt cessation followed by a reintroduction and continuation of therapy may be possible in few patients.
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Affiliation(s)
- Mihir Kothari
- Department of Pediatric Clinical Optics and Refraction, Jyotirmay Eye Clinic and Ocular Motility Laboratory, Thane; Department of Pediatric Ophthalmology and Strabismus, Mahatme Eye Bank and Eye Hospital, Nagpur, Maharashtra, India
| | - Rishika Jain
- Department of Pediatric Clinical Optics and Refraction, Jyotirmay Eye Clinic and Ocular Motility Laboratory, Thane, Maharashtra, India
| | - Nitu Khadse
- Department of Pediatric Clinical Optics and Refraction, Jyotirmay Eye Clinic and Ocular Motility Laboratory, Thane, Maharashtra, India
| | - Vivek Rathod
- Department of Pediatric Clinical Optics and Refraction, Jyotirmay Eye Clinic and Ocular Motility Laboratory, Thane, Maharashtra, India
| | - Shreyans Mutha
- Department of Dermatology, Avista Clinics, Indore, Madhya Pradesh, India
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Kumar A, Kothari M, Grigoriadis A, Trulsson M, Svensson P. Bite or brain: Implication of sensorimotor regulation and neuroplasticity in oral rehabilitation procedures. J Oral Rehabil 2018; 45:323-333. [DOI: 10.1111/joor.12603] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2017] [Indexed: 02/04/2023]
Affiliation(s)
- A. Kumar
- Division of Oral Diagnostics and Rehabilitation; Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
- Scandinavian Center for Orofacial Neurosciences (SCON); Huddinge Sweden
| | - M. Kothari
- Hammel Neurorehabilitation Centre and University Research Clinic; Aarhus University; Hammel Denmark
| | - A. Grigoriadis
- Division of Oral Diagnostics and Rehabilitation; Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
- Scandinavian Center for Orofacial Neurosciences (SCON); Huddinge Sweden
| | - M. Trulsson
- Division of Oral Diagnostics and Rehabilitation; Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
- Scandinavian Center for Orofacial Neurosciences (SCON); Huddinge Sweden
| | - P. Svensson
- Division of Oral Diagnostics and Rehabilitation; Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
- Scandinavian Center for Orofacial Neurosciences (SCON); Huddinge Sweden
- Section of Orofacial Pain and Jaw Function; Institute for Odontology and Oral Health; Aarhus University; Aarhus Denmark
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Abstract
Purpose: The aim of this study is to assess the efficacy of 1% atropine eye drops for the retardation of progressive axial myopia in Indian eyes. Methods: This prospective interventional cohort study included children aged 5–16 years. Both the eyes of myopic children with progressive increase of ≥−0.5D sphere/year with the best-corrected vision of ≥6/6 were treated with once a day application of 1% atropine eye drops and progressive addition photogray lenses. The progression of myopia after 1-year follow-up was analyzed. Results: Sixty eyes of thirty myopes were included in the study. The mean age was 10 years and 15 were girls. The mean baseline sphere was −5.2D (−2.5D–−13D). Mean duration of follow-up was 23 months (12–36 months). The baseline rate of progression was reduced from −0.6D/year (range −0.5D/year to −3D/year) to −0.2D/year (range 0D/year to −1.5D/year) after atropine therapy. Seventeen patients (57%) had to use the atropine in the daytime to reach the target progression of <−0.5D/year. There was no difference between the efficacy of atropine drops in the boys and girls (P = 0.6). The efficacy of atropine drops did not have a correlation with the age of the patients or the magnitude of baseline myopia (Pearson's r = 0). Conclusion: 1% atropine eye drops was well tolerated and efficacious for the retardation of progressive myopia in Indian eyes. Effectiveness was better with daytime application. Further studies are necessary to assess the role of 1% atropine in the rapid progressors and patients poorly responding to low-dose atropine.
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Affiliation(s)
- Mihir Kothari
- Department of Pediatric Refractive Services, Jyotirmay Eye Clinic for Children and Adult Squint and Ocular Motility Laboratory, Thane; Department of Pediatric Ophthalmology, Mahatme Eye Hospital, Nagpur, Maharashtra, India
| | - Vivek Rathod
- Department of Pediatric Refractive Services, Jyotirmay Eye Clinic for Children and Adult Squint and Ocular Motility Laboratory, Thane, Maharashtra, India
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Kothary AS, Kothari M, Parab S. A double-masked randomized trial of postoperative local anesthetic for pain control in pediatric strabismus surgery. J AAPOS 2017; 21:346-347. [PMID: 28757347 DOI: 10.1016/j.jaapos.2017.07.200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 07/16/2017] [Revised: 07/17/2017] [Accepted: 07/21/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Anar Sanjaykumar Kothary
- Department of Pediatric Strabismus Services, Jyotirmay Eye Clinic And Ocular Motility Laboratory, Thane, Maharashtra, India
| | - Mihir Kothari
- Department of Pediatric Strabismus Services, Jyotirmay Eye Clinic And Ocular Motility Laboratory, Thane, Maharashtra, India
| | - Snehanka Parab
- Department of Pediatric Strabismus Services, Jyotirmay Eye Clinic And Ocular Motility Laboratory, Thane, Maharashtra, India
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Kothari M, Stubbs PW, Pedersen AR, Jensen J, Nielsen JF. Reliability of surface electromyography measurements from the suprahyoid muscle complex. J Oral Rehabil 2017. [PMID: 28644567 DOI: 10.1111/joor.12537] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 11/29/2022]
Abstract
Assessment of swallowing musculature using motor evoked potentials (MEPs) can be used to evaluate neural pathways. However, recording of the swallowing musculature is often invasive, uncomfortable and unrealistic in normal clinical practice. To investigate the possibility of using the suprahyoid muscle complex (SMC) using surface electromyography (sEMG) to assess changes to neural pathways by determining the reliability of measurements in healthy participants over days. Seventeen healthy participants were recruited. Measurements were performed twice with one week between sessions. Single-pulse (at 120% and 140% of the resting motor threshold (rMT)) and paired-pulse (2 ms and 15 ms paired pulse) transcranial magnetic stimulation (TMS) were used to elicit MEPs in the SMC which were recorded using sEMG. ≈50% of participants (range: 42-58%; depending on stimulus type/intensity) had significantly different MEP values between day 1 and day 2 for single-pulse and paired-pulse TMS. A large stimulus artefact resulted in MEP responses that could not be assessed in four participants. The assessment of the SMC using sEMG following TMS was poorly reliable for ≈50% of participants. Although using sEMG to assess swallowing musculature function is easier to perform clinically and more comfortable to patients than invasive measures, as the measurement of muscle activity using TMS is unreliable, the use of sEMG for this muscle group is not recommended and requires further research and development.
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Affiliation(s)
- M Kothari
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark
| | - P W Stubbs
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark
| | - A R Pedersen
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark
| | - J Jensen
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark
| | - J F Nielsen
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark
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Kothari M, Stubbs PW, Figlewski K, Pedersen AR, Jensen J, Baad-Hansen L, Svensson P, Nielsen JF. Effect of transcranial direct current stimulation on neuroplasticity in corticomotor pathways of the tongue muscles. J Oral Rehabil 2017; 44:691-701. [DOI: 10.1111/joor.12529] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2017] [Indexed: 11/29/2022]
Affiliation(s)
- M. Kothari
- Hammel Neurorehabilitation Centre and University Research Clinic; Aarhus University; Hammel Denmark
| | - P. W. Stubbs
- Hammel Neurorehabilitation Centre and University Research Clinic; Aarhus University; Hammel Denmark
| | - K. Figlewski
- Hammel Neurorehabilitation Centre and University Research Clinic; Aarhus University; Hammel Denmark
| | - A. R. Pedersen
- Hammel Neurorehabilitation Centre and University Research Clinic; Aarhus University; Hammel Denmark
| | - J. Jensen
- Hammel Neurorehabilitation Centre and University Research Clinic; Aarhus University; Hammel Denmark
| | - L. Baad-Hansen
- Section of Orofacial Pain and Jaw Function, Department of Odontology and Oral Health; Aarhus University; Hammel
- Scandinavian Center for Orofacial Neurosciences (SCON); Aarhus Denmark
| | - P. Svensson
- Section of Orofacial Pain and Jaw Function, Department of Odontology and Oral Health; Aarhus University; Hammel
- Scandinavian Center for Orofacial Neurosciences (SCON); Aarhus Denmark
- Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
| | - J. F. Nielsen
- Hammel Neurorehabilitation Centre and University Research Clinic; Aarhus University; Hammel Denmark
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Kothari M, Rathod V, Shah K, Shikhangi K, Singhania R. Congenital nasolacrimal duct obstruction: Should we continue lacrimal massage till 1 year or perform an office probing at 6 months? A clinical decision analysis approach. Indian J Ophthalmol 2017; 65:167-169. [PMID: 28345576 PMCID: PMC5381299 DOI: 10.4103/ijo.ijo_245_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Mihir Kothari
- Department of Pediatric Oculoplasty Services, Jyotirmay Eye Clinic and Ocular Motility Laboratory, Thane; Department of Pediatric Ophthalmology, Mahatme Eye Hospital, Nagpur, Maharashtra, India
| | - Vivek Rathod
- Department of Pediatric Oculoplasty Services, Jyotirmay Eye Clinic and Ocular Motility Laboratory, Thane, Maharashtra, India
| | - Kruti Shah
- Department of Pediatric Oculoplasty Services, Jyotirmay Eye Clinic and Ocular Motility Laboratory, Thane, Maharashtra, India
| | - Khushboo Shikhangi
- Department of Pediatric Oculoplasty Services, Jyotirmay Eye Clinic and Ocular Motility Laboratory, Thane, Maharashtra, India
| | - Renu Singhania
- Department of Pediatric Oculoplasty Services, Jyotirmay Eye Clinic and Ocular Motility Laboratory, Thane, Maharashtra, India
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Abstract
Internet is used by many patients to obtain relevant medical information. We assessed the impact of "Google" search on the knowledge of the parents whose ward suffered from squint. In 21 consecutive patients, the "Google" search improved the mean score of the correct answers from 47% to 62%. We found that "Google" search was useful and reliable source of information for the patients with regards to the disease etiopathogenesis and the problems caused by the disease. The internet-based information, however, was incomplete and not reliable with regards to the disease treatment.
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Affiliation(s)
- Mihir Kothari
- Department of Ocular Motility, Jyotirmay Eye Clinic and Ocular Motility Laboratory, Thane, Maharashtra, India
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Kothari M, Joshi V. The perceived personality traits of adults with digitally induced large angle strabismus and the impact of its correction. Indian J Ophthalmol 2016; 62:773-6. [PMID: 25116768 PMCID: PMC4152645 DOI: 10.4103/0301-4738.138617] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Purpose: To ascertain the effect of digitally induced large angle strabismus and its correction on social bias against strabismic adults. Subjects and Methods: This prospective, observational study included 10 orthotropic subjects whose face photographs were digitally altered to produce esotropia, exotropia, and hypertropia. Three batches of non-medical professionals, each consisting of 14 subjects, adjudged personality traits of the altered face photographs on a 10-item questionnaire. The same evaluators effected the appraisal of the orthotropic photographs. The personality score of the strabismic photograph of a subject was compared with its own orthotropic photograph. Subjects and Methods: This prospective, observational study included 10 orthotropic subjects whose face photographs were digitally altered to produce esotropia, exotropia, and hypertropia. Three batches of non-medical professionals, each consisting of 14 subjects, adjudged personality traits of the altered face photographs on a 10-item questionnaire. The same evaluators effected the appraisal of the orthotropic photographs. The personality score of the strabismic photograph of a subject was compared with its own orthotropic photograph. Results: The 10 subjects whose photographs were digitally modified were of the same age (21 years) and had equal gender distribution. The evaluation of the photographs was performed by 42 evaluators aged 38.3 ± 14.9 years, of whom 21 were males. Different personality traits were rated negatively in the strabismic photographs. The statistically significant negative impact was apparent on more number of personality traits for esotropia (7 out of 10) as compared to exotropia (4 out of 10) or hypertropia (3 out of 10). Rating of the strabismic photographs was significantly lower by female evaluators (P = 0.006). However, there was no difference whether the subject evaluating the photograph of the strabismic individual was of the same gender or the opposite gender. Internal consistency of the questionnaire was excellent (Cronbach's Alpha = 0.81). Conclusion: There was a significant negative impact of strabismus on the perceived personality traits of the digitally altered face photographs of the adults when compared to their orthotropic photograph.
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Affiliation(s)
- Mihir Kothari
- Department of Pediatric Ophthalmology and Adult Strabismus, Aditya Jyot Eye Hospital, Wadala, Mumbai, Maharashtra, India
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Kothari M, Baad-Hansen L, Svensson P. Bilateral sensory deprivation of trigeminal afferent fibres on corticomotor control of human tongue musculature: a preliminary study. J Oral Rehabil 2016; 43:656-61. [PMID: 27265155 DOI: 10.1111/joor.12414] [Citation(s) in RCA: 6] [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] [Accepted: 05/16/2016] [Indexed: 12/01/2022]
Abstract
Transcranial magnetic stimulation (TMS) has demonstrated changes in motor evoked potentials (MEPs) in human limb muscles following modulation of sensory afferent inputs. The aim of this study was to determine whether bilateral local anaesthesia (LA) of the lingual nerve affects the excitability of the tongue motor cortex (MI) as measured by TMS. The effect on MEPs after bilateral LA of the lingual nerve was studied, while the first dorsal interosseous (FDI) muscle served as a control in ten healthy participants. MEPs were measured on the right side of the tongue dorsum in four different conditions: (i) immediately prior to anaesthesia (baseline), (ii) during bilateral LA block of the lingual nerve, (iii) after anaesthesia had subjectively subsided (recovery) and (iv) 3 h after bilateral lingual block injection. MEPs were assessed using stimulus-response curves in steps of 10% of motor threshold (T). Eight stimuli were given at each stimulus level. The amplitudes of the tongue MEPs were significantly influenced by the stimulus intensity (P < 0·001) but not by condition (P = 0·186). However, post hoc tests showed that MEPS were statistically significantly higher during bilateral LA block condition compared with baseline at T + 40%, T + 50% and T + 60% (P < 0·028) and also compared with recovery at T + 60% (P = 0·010) as well as at 3 h after injection at T + 50% and T + 60% (P < 0·029). Bilateral LA block of the lingual nerve seems to be associated with a facilitation of the corticomotor pathways related to the tongue musculature.
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Affiliation(s)
- M Kothari
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark
| | - L Baad-Hansen
- Section of Orofacial Pain and Jaw Function, Institute of Odontology and Oral Health, Aarhus University, Aarhus, Denmark.,Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark
| | - P Svensson
- Section of Orofacial Pain and Jaw Function, Institute of Odontology and Oral Health, Aarhus University, Aarhus, Denmark.,Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark
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Kothari M, Rao K, Moolani S. Recurrent progressive anterior segment fibrosis syndrome following a descemet-stripping endothelial keratoplasty in an infant with congenital aniridia. Indian J Ophthalmol 2015; 62:246-8. [PMID: 24618492 PMCID: PMC4005245 DOI: 10.4103/0301-4738.128635] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Progressive anterior segment fibrosis syndrome (ASFS), after intraocular surgery in older children (≥9 years) and adults with congenital aniridia, is described in the literature. In this report, we describe an unique case of ASFS in an infant with congenital aniridia following a combined trabeculotomy-ectomy and its recurrence after a descemet stripping endothelial keratoplasty. The ophthalmologists should be well aware of this entity and warn the parents about its possibilities. Use of immunomodulators or prolonged anti-inflammatory therapy may be considered to prevent its occurrence.
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Affiliation(s)
- Mihir Kothari
- Department of Pediatric Ophthalmology and Adult Strabismus, Department of Cornea Services, Aditya Jyot Eye Hospital, Wadala, Mumbai, Maharashtra, India
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Kothari M, Kothari K, Kadam S, Mota P, Chipade S. Converting a conventional wired-halogen illuminated indirect ophthalmoscope to a wireless-light emitting diode illuminated indirect ophthalmoscope in less than 1000/- rupees. Indian J Ophthalmol 2015; 63:42-5. [PMID: 25686062 PMCID: PMC4363957 DOI: 10.4103/0301-4738.151466] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Aim: To report the “do it yourself” method of converting an existing wired-halogen indirect ophthalmoscope (IO) to a wireless-light emitting diode (LED) IO and report the preferences of the patients and the ophthalmologists. Subjects and Methods: In this prospective observational study, a conventional IO was converted to wireless-LED IO using easily available, affordable electrical components. Conventional and the converted IO were then used to perform photo-stress test and take the feedback of subjects and the ophthalmologists regarding its handling and illumination characteristics. Results: The cost of conversion to wireless-LED was 815/- rupees. Twenty-nine subjects, mean age 34.3 ± 10 years with normal eyes were recruited in the study. Between the two illumination systems, there was no statistical difference in the magnitude of the visual acuity loss and the time to recovery of acuity and the bleached vision on photo-stress test, although the visual recovery was clinically faster with LED illumination. The heat sensation was more with halogen illumination than the LED (P = 0.009). The ophthalmologists rated wireless-LED IO higher than wired-halogen IO on the handling, examination comfort, patient's visual comfort and quality of the image. Twenty-two (81%) ophthalmologists wanted to change over to wireless-LED IO. Conclusions: Converting to wireless-LED IO is easy, cost-effective and preferred over a wired-halogen indirect ophthalmoscope.
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Affiliation(s)
- Mihir Kothari
- Department of Clinical Optics and Biomedical Engineering, Jyotirmay Eye Clinic, Ocular Motility Laboratory, Thane, India
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Affiliation(s)
- Mihir Kothari
- Department of Pediatric Ophthalmology, Aditya Jyot Eye Hospital, Wadala, Mumbai, Maharashtra, India
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Kothari M, Baldua S. Parental perspectives on surgical fees of pediatric squint surgeries. J Clin Ophthalmol Res 2014. [DOI: 10.4103/2320-3897.122633] [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: 11/04/2022] Open
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Jog S, Sable S, Patel D, Kapadnis N, Rajhans P, Akole P, Pawar B, Bhurke B, Kothari M, Gururaj S. Comparison of HFOV and conventional ventilation in H1N1 influenza ARDS. Crit Care 2014. [PMCID: PMC4069430 DOI: 10.1186/cc13483] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Kothari M, Svensson P, Jensen J, Kjærsgaard A, Jeonghee K, Nielsen J, Ghovanloo M, Baad-Hansen L. Training-induced cortical plasticity compared between three tongue-training paradigms. Neuroscience 2013; 246:1-12. [DOI: 10.1016/j.neuroscience.2013.04.040] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 04/18/2013] [Accepted: 04/18/2013] [Indexed: 02/08/2023]
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Abstract
Part time occlusion therapy is not reported to cause occlusion (reverse) amblyopia. However, when combined with high dose oral levodopa, an increase in the plasticity of the visual cortex can lead to occlusion amblyopia. In this case report, we describe a six year old child who developed occlusion amblyopia following part time patching combined with oral levodopa.
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Affiliation(s)
- Mihir Kothari
- Department of Pediatric Ophthalmology, Aditya Jyot Eye Hospital, Wadala, Mumbai, India
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Kothari M, Mehta L. Scope and limitations of therapies: a neomillennial epistemological evaluation for helping medical practices. J Postgrad Med 2013; 58:309-13. [PMID: 23298934 DOI: 10.4103/0022-3859.105465] [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] [Indexed: 11/04/2022] Open
Abstract
Medical practice is in crisis - the sophistications are enormous and expensive, and the outcomes leave much to be desired. An epistemologic evaluation that weighs the scope and limitations of any -pathy or any procedure seems to be the need of the day. As an example, described herein is the logic of such an exercise; and a sample of the exercise itself, taking cancer as an example.
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Affiliation(s)
- M Kothari
- Seth GS Medical College, Parel, Mumbai, India
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Kothari M, Shukri N, Quayyum A. Transient superior oblique paresis after injection of Botulinum Toxin A for facial rejuvenation. Indian J Ophthalmol 2012; 60:77-8. [PMID: 22218260 PMCID: PMC3263261 DOI: 10.4103/0301-4738.90496] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Valecha N, Krudsood S, Tangpukdee N, Mohanty S, Sharma SK, Tyagi PK, Anvikar A, Mohanty R, Rao BS, Jha AC, Shahi B, Singh JPN, Roy A, Kaur P, Kothari M, Mehta S, Gautam A, Paliwal JK, Arora S, Saha N. Arterolane Maleate Plus Piperaquine Phosphate for Treatment of Uncomplicated Plasmodium falciparum Malaria: A Comparative, Multicenter, Randomized Clinical Trial. Clin Infect Dis 2012; 55:663-71. [DOI: 10.1093/cid/cis475] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Kothari M, Balankhe S, Paralkar S, Nar D, Bhagat S, Ranade S. Dynamic distance direct ophthalmoscopy, a novel technique to assess accommodation in children. Indian J Ophthalmol 2012; 60:109-14. [PMID: 22446905 PMCID: PMC3339069 DOI: 10.4103/0301-4738.94051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Aim: To describe and compare dynamic distance direct ophthalmoscopy (DDDO) with dynamic retinoscopy (DR) in assessment of accommodation in children. Materials and Methods: This prospective observational study had four components. Component 1: to understand the characteristic digital images of DDDO. Component 2: to compare DDDO with DR for detection of accommodative defects in children (1–16 years). Component 3: to compare DDDO with DR for the detection of completeness of pharmacologically induced cycloplegia in children (5–16 years) and Component 4: to assess which one of the two techniques was more sensitive to detect onset of cycloplegia after instillation of 1% cyclopentolate eye drops. Results: Component 1: image analysis of DDDO on two subjects (7 years and 35 years) demonstrated superior pupillary crescent that progressively disappeared with increasing accommodation. Concurrently an inferior crescent appeared that became bigger in size with increasing accommodation. Component 2: the prevalence of defects in accommodation was 3.3% (33/1000 children). Three had unilateral accommodation failure. Sensitivity of DDDO was 94%, specificity 100%, positive predictive value 100%, negative predictive value 99%, and clinical agreement (kappa) 0.97. Component 3: in the detection of completeness of pharmacologically induced cycloplegia (n=30), the sensitivity of DDDO was 94%, specificity 96%, positive predictive value 97%, negative predictive value 93% and kappa 0.9. DR had two false positives. DDDO had one false negative. Component 4: DDDO detected onset of pharmacologically induced cycloplegia 5 min earlier than DR (n=5). Conclusion: DDDO is a novel, simple, clinical and reliable method to assess accommodation in young children. This test can assess the accommodative response of both eyes simultaneously.
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Affiliation(s)
- Mihir Kothari
- Department of Pediatric Ophthalmology, Pediatric Neuroophthalmology and Adult Strabismus of Jyotirmay Eye Clinic, Thane, Maharashtra, India.
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Kothari M. Author reply. Indian J Ophthalmol 2012. [PMCID: PMC3339090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Mihir Kothari
- Jyotirmay Eye Clinic and Pediatric Low Vision Center, Thane West, Maharashtra, India,Correspondence to: Dr. Mihir Kothari, Jyotirmay Eye Clinic, 205 Ganatra Estate, Khopat, Thane West 400601, Maharashtra, India. E-mail:
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Kothari M, Menon R. Authors’ reply. Indian J Ophthalmol 2012. [PMCID: PMC3339088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Mihir Kothari
- Department of Pediatric Ophthalmology, Pediatric Neuroophthalmology and Adult Strabismus, Aditya Jyot Eye Hospital Pvt. Ltd., Wadala, Mumbai, India,Correspondence to: Dr. Mihir Kothari, Jyotirmay Eye Clinic, 205 Ganatra Estate, Khopat, Thane – 400 601, Maharashtra, India. E-mail:
| | - Ricky Menon
- Department of Pediatric Ophthalmology, Pediatric Neuroophthalmology and Adult Strabismus, Aditya Jyot Eye Hospital Pvt. Ltd., Wadala, Mumbai, India
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Kothari M, Menon R. Authors′ reply. Indian J Ophthalmol 2012. [DOI: 10.4103/0301-4738.94067] [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: 11/04/2022] Open
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Kothari M. Author reply. Indian J Ophthalmol 2012. [DOI: 10.4103/0301-4738.94069] [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: 11/04/2022] Open
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Kothari M, Svensson P, Basic A, Christiansen B, Vigsø M, Truc L, Baad-Hansen L. Influence of the ability to roll the tongue and tongue-training parameters on oral motor performance and learning. Arch Oral Biol 2011; 56:1419-23. [DOI: 10.1016/j.archoralbio.2011.04.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2011] [Revised: 04/01/2011] [Accepted: 04/28/2011] [Indexed: 10/18/2022]
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Abstract
This cohort study included children with esotropia and hypermetropia of ≥ +2.0 diopters (D). The deviation was measured at presentation, under atropine cycloplegia and 3 months after full refractive correction. Of 44 children with a mean age of 5.2 ± 2.4 years, 25 were males. Eighteen (41%) had fully refractive accommodative esotropia (RAE), 10 (23%) had partial accommodative esotropia (PAE), and 5 (11%) had nonaccommodative esotropia (NAE). Eleven (25%) had convergence excess (CE). Under cycloplegia, all with RAE and RAE with CE had orthotropia. There was no significant change in the deviation in the patients with NAE. The deviation under cycloplegia and that with full refractive correction in PAE and PAE with CE (with +3.0 D addition) were not different. The intraclass correlation coefficient for deviation under cycloplegia and after full refractive correction (+3.0 D addition for CE) was 0.89. It was concluded that ocular deviation under cycloplegia can help to predict the accommodative component in esotropia with hypermetropia.
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Affiliation(s)
- Mihir Kothari
- Aditya Jyot Eye Hospital, Plot 53, Road 9, Wadala, Mumbai - 400 031, Maharashtra, India.
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Abstract
The aim of the study was to know the response of the relatives attending the squint surgery of their ward. A trained secretary administered an eight item questionnaire by live / telephonic interview. Of the 44 attendees, two left the Operation Theater before completion of the surgery. Mean age of the patients was 7.2 years ± 7.8 and that of the attendees was 36.1 years ± 8.5. Forty patients had a surgery under general anesthesia and four under local anesthesia. Eleven (25%) attendees experienced an increase in anxiety. Thirty-six (82%) attendees reported increased transparency, 38 (86%) reported increased confidence, and 43 (98%) reported increased awareness. None found any disadvantage. Twenty-seven (61%) recommended this practice for all and 16 (36%) recommended the practice selectively. The internal validity of the questionnaire was fair (Cronbach's Alpha = 0.6). It was concluded that the presence of relatives in the Operation Theater during the surgery could bring in more transparency, accountability, confidence, awareness, and trust.
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Affiliation(s)
- Mihir Kothari
- Jyotirmay Eye Clinic and Pediatric Low Vision Center, Khopat, Thane, Maharashtra, India.
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Kothari M, Balankhe S. Inferior trabeculotomy and trabeculectomy for refractory pediatric glaucomas. Indian J Ophthalmol 2011; 59:323. [PMID: 21666325 PMCID: PMC3129764 DOI: 10.4103/0301-4738.82007] [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: 11/30/2022] Open
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