Training ambidexterity – A survey-based analysis on the dexterity of ophthalmologists in performing standard ophthalmic procedures

Purpose: Our study was designed to determine ophthalmologists’ dexterity in performing standard ophthalmic procedures at various levels of expertise via a structured questionnaire. Methods: A structured questionnaire was administered via the Google platform from August 20 to September 19, 2022, to assess the perspectives and preferences of ophthalmologists concerning their proficiency in using their right hand, left hand, or both hands to perform routine tasks required in the practice of ophthalmic medicine and surgery. Results: Two hundred and three participants took part in the survey. A majority (n = 162, 79.8%) of the clinicians considered themselves right?handed, nine (4.4%) considered themselves left?handed, and 32 (15.7%) considered themselves ambidextrous. Also, 86% (n = 174) of the participants considered ambidexterity an essential trait in the practice of ophthalmic medicine and surgery. The number of cataract surgeries performed had an impact on the comfort of using both hands for performing anterior vitrectomy (P < 0.001), injection of viscoelastic (P < 0.001), and toric marking (P < 0.05), but not on the performance of capsulorhexis and switching of foot pedals. The number of procedures carried out had an impact on the comfort of using both hands in gonioscopy (P < 0.001), 90 D evaluation (P < 0.001), and 20 D evaluation (P < 0.05). More years of experience had an impact on skills involving the use of both hands for slit lamp joystick usage (P < 0.05) and laser procedures (P < 0.001). Conclusion: Irrespective of a person’s handedness, trained ambidexterity in the required fields is achievable and has a significant impact on one’s ability to perform the required skill optimally and appropriately.

Under lock and key: Incorporation of blockchain technology in the field of ophthalmic artificial intelligence for big data management - A perfect match?

Big data has been a game changer of machine learning. But, big data is a form of centralized version of data only available and accessible to the technology giants. A way to decentralize this data and make machine learning accessible to the smaller organizations is via the blockchain technology. This peer?to?peer network creates a common database accessible to those in the network. Furthermore, blockchain helps in securing the digital data and prevents data tampering due to human interactions. This technology keeps a constant track of the document in terms of creation, editing, etc., and makes this information accessible to all. It is a chain of data being distributed across many computers, with a database containing details about each transaction. This record helps in data security and prevents data modification. This technology also helps create big data from multiple sources of small data paving way for creating a well serving artificial intelligence model. Here in this manuscript, we discuss about the usage of blockchain, its current role in machine learning and challenges faced by it

Utilizing human intelligence in artificial intelligence for detecting glaucomatous fundus images using human-in-the-loop machine learning

Purpose: For diagnosing glaucomatous damage, we have employed a novel convolutional neural network (CNN) from TrueColor confocal fundus images to conquer the black box dilemma in artificial intelligence (AI). This neural network with CNN architecture with human?in?the?loop (HITL) data annotation helps not only in diagnosing glaucoma but also in predicting and locating detailed signs in the glaucomatous fundus, such as splinter hemorrhages, glaucomatous optic atrophy, vertical glaucomatous cupping, peripapillary atrophy, and retinal nerve fiber layer (RNFL) defect. Methods: The training was done on a well?curated private dataset of 1,400 high?resolution confocal fundus images, out of which 1,120 images (80%) were used exclusively for training and 280 images (20%) were used exclusively for testing. A custom trained You Only Look Once version 5 (YOLOv5)?based object detection methodology was used to identify the underlying conditions precisely. Twenty?six predefined medical conditions were annotated by a team of humans (comprising two glaucoma specialists and two optometrists) by using the Microsoft Visual Object Tagging Tool (VoTT) tool. The 280 testing images were split into three groups (90,100, and 90 images) for three test runs done once every 15 days. Results: Test results showed consistent increments in the accuracy, from 94.44% to 98.89%, in predicting the glaucoma diagnosis along with the detailed signs of the glaucomatous fundus. Conclusion: Utilizing human intelligence in AI for detecting glaucomatous fundus images by using HITL machine learning has never been reported in the literature before. This AI model not only has good sensitivity and specificity in accurate glaucoma predictions but is also an explainable AI, thus overcoming the black box dilemma.

Clinico-Epidemiological Profile of Scorpion Sting in a Tertiary Care Centre in South Tamil Nadu

Introduction: Venomous scorpion sting is a medicalemergency. The clinical manifestations vary widely betweenthe children and adult group. Current research aimed to studythe epidemiological profile of Scorpion Stings and to study theclinical profile and prevalence of complications of Scorpionstings.Material and methods: 82 cases of Scorpion sting admittedin Toxicology unit of Tirunelveli Medical College werestudied. Detailed history was taken, and a thorough clinicalexamination was done in all patients. All patients were givenPrazosin except in cases with hypotension.Results:Scorpion sting was more common in monsoonfollowed by Summer season. The sting was more prevalent inthe lower limb. Commonest symptom was pain followed bynumbness and tingling. Dyspnea and perspiration were lesscommon. 60.9% had grade1 envenomation followed by 25.7%patients with grade 2 envenomation. Severe envenomationwas less common. Tachycardia was frequently noted (62.2%)whereas only 3 patients developed pulmonary edema. Allpatients recovered well, and there was nil mortality.Conclusion:Prazosin had good outcome in all patients withscorpion sting. The study throws light on the common clinicalfeatures and complications of scorpion sting.

Pattern of adverse drug reactions in paediatric patients reported to adverse drug reaction monitoring centre in a tertiary care hospital

Background: Adverse drug reactions (ADRs) are an important cause of morbidity and mortality across the world and contribute to a significant economic burden on healthcare resources and community. In children, monitoring ADRs is essential as adequate clinical trials are lacking in this group. So, this study was undertaken to assess the ADR pattern in a paediatric population in a tertiary care hospital.Methods: A cross sectional, retrospective study was done at ADR monitoring centre (AMC) for a period of 3 years in a tertiary care hospital. All the ADRs reported by the Department of Paediatrics to AMC were collected and analyzed for age group affected, demographic profile, ADR pattern, drug group, systems affected, causality and severity of the ADR.Results: During the study period, a total of 102 ADRs were reported to the AMC from the paediatric department. Out of 102 ADRs reported, males represented 60.8% and females represented 39.2%. Maximum number of ADRs were seen in the age group of 1-5 years (43.3%). Most common ADR reported was maculopapular rash (27.5%) followed by diarrhoea (14.7%). The most common drug class causing ADRs are antibiotics (36.3%) followed by anticonvulsants (18.6%). Vaccines contributed to 14.7% of all reported ADRs. Majority of the ADRs were of probable (70.6%) causality and moderate (52%) in severity.Conclusions: ADRs were reported more among under 5 years of age and antibiotics were the common implicated causative agents. Most of the reactions were of moderate severity. Information acquired through ADR reporting may be useful in identifying and minimizing preventable ADRs and augmenting the knowledge of the prescribers to deal with ADRs more efficiently.

Applicability of Pont's index in orthodontics

To investigate the applicability of Pont's index in estimating the maxillary arch width depending on the sum of mesiodistal dimensions of maxillary incisors. Cross-sectional, comparative study. Dental Clinics, The Aga Khan University Hospital, Karachi, from January 2006 to December 2008. A total of 150 subjects were included. All measurements were taken on maxillary study casts by a digital caliper. The premolar arch width was taken from the first premolar of the left side to the right side at the distal end of its occlusal groove. The molar arch width was taken from the maxillary left permanent molar to the same of the right at its mesial pit on the occlusal surface. The combined width of the maxillary incisors was taken at their greatest mesiodistal widths. The predicted arch widths were estimated with the Pont's formula: Premolar width [P] = Sum of Incisor widths/80 x 100 Molar width [M] = Sum of Incisor widths/64 x 100 Incisor diameters and arch widths were described in terms of mean values, standard deviations, and coefficients of variation. Correlation coefficients were computed between observed arch widths and those predicted according to Pont's M and P indices. The mean age was 15.8 +/- 1.6 years. Low correlations existed between observed and Pont's predicted arch widths in both premolar [r = 0.364] and molar [r = 0.238] regions. Twenty two percent of interpremolar arch widths and 18% of intermolar arch widths showed differences between -1 mm to 1 mm. Low correlations were found between observed and Pont's predicted arch widths. Pont's index is unlikely to be clinically useful as a true predictor of arch width.

Extra-gonadal secretion of an inhibin-like substance in the laboratory albino rat.

Acetone powder preparations of ventral prostates of adult albino rat exhibit an inhibin-like activity. In vitro cultured ventral prostate explants secrete a substance possessing similar activity which appears to be independent of testicular androgens for its elaboration.