Lacrimal gland enlargement in inactive thyroid eye disease: a case series and literature review

ABSTRACT Purpose: This study aimed to evaluate the morphometric and volumetric dimensions of the lacrimal gland in patients with inactive thyroid eye disease and compare them with the values reported in the literature. Methods: This case series evaluated consecutive patients with inactive thyroid eye disease treated at a tertiary eye hospital from 2015 to 2020. The patients' baseline demographics and clinical characteristics were obtained. The axial and coronal length, width, and volume of the lacrimal gland were measured on computed tomography scan images, and the results were statistically analyzed. Results: A total of 21 patients (42 orbits) with inactive thyroid eye disease were evaluated. Their mean age was 49.0 ± 14.6 years, and 12 (57.1%) of them were men. The main complaint was dryness, and the majority of the patients had good vision and mild proptosis. The mean axial length and width of the lacrimal gland were 19.3 ± 3.9 mm and 7.5 ± 2.1 mm, respectively; coronal length and width, 20.4 ± 4.5 mm and 7.5 ± 2.1 mm, respectively; and lacrimal gland volume, 0.825 ± 0.326 mm3. Age, sex, or laterality were not found to be determinants of lacrimal gland enlargement. Conclusion: Patients with thyroid eye disease have enlarged lacrimal gland even in the nonactive phase of the disease multifactorial aspects influence the lacrimal gland in thyroid eye disease, making it difficult to establish a clear correlation with predisposing factors. Further studies are warranted to better understand the association between thyroid eye disease and the lacrimal gland.

A study to assess the prevalence of substance abuse and its impact among medical students in a medical college

Background: Psychoactive drug is an emerging global problem. This is a disturbing matter, especially in the case of medical students, affecting their health and academic performance, which in turn affects the health outcomes of patients. The objectives of our study were to assess the prevalence and impact of substance abuse among medical students. Methods: This was cross-sectional study conducted in tertiary care center. A pretested semi structured questionnaire was used to collect the data. Medical students who were available during the study period and who were willing to participate were included in the study. A total of 301 students were interviewed. Data was entered and analysed in SPPSS version 22.0. Descriptive statistics and inferential statistics were used for the statistical analysis. Results: We had a total of 301 responders. Among them, only 70(23.3%) have been a subject to substance abuse. Alcohol was the most abused substance (19.3%). The most common reason for starting these substances was out of curiosity (15.6%). 24.6% of the students have either thought of or tried stopping, however majority of them have not. Out of these students, 10 (3.3%) have experienced withdrawal symptoms. Conclusions: The substance abuse among youngsters in medical colleges is a highly alarming situation. Proper counselling with planned policies should be implemented to root out this evil among the future doctors which will help in providing better health care services to the people.

Response of Capsicum (Capsicum annuum L.) Hybrids to Micro-nutrients under Protected Conditions

The field experiment was carried out during rabi season of 2021-22 and 2022 at Vegetable Research Farm of Chandra Shekhar Azad University of Agriculture and Technology, Kanpur to find out the response of capsicum hybrids to micronutrients under protected conditions. The experiment was laid out in Split Plot Design (SPD) with 15 treatment combinations and replicated thrice. The experiment comprised three hybrids viz., Indira, Swarna and Bomby and five levels of micronutrients viz., control (no micronutrients application), soil application of Zn, Fe & B, fertigation of EDTA of Zn & Fe and solubor at 15 days interval, foliar application of vegetable special @ 5g/lit at 15 days interval and foliar application of chelated combo micronutrients @ 1g/lit at 15 days interval. Recommended package of practices for the crop were followed except treatments. Results of the experiment revealed that the hybrid Indira recorded significantly highest plant height (91.30 and 94.89 cm), number of branches (11.87 and 12.30), stem girth (4.31 and 4.60 cm), number of leaves (102.94 and 106.43), internode length (13.82 and 14.01 cm), number of flowers per plant (38.22 and 38.36), fruit set (55.10 and 55.44%), no. of fruits per plant (20.99 and 21.22), fruit weight per plant (3.69 and 3.74 kg) and fruit yield per 1000 m2 (70.36 and 71.35 q) while fruit length (11.45 and 11.71 cm), fruit diameter (10.54 and 10.66 cm), weight of placenta (18.51 and 18.71g) and average weight of fruit (193.31 and 195.90g) were significantly highest in Swarna. In case of micronutrients, foliar application of vegetable special @ 5g/at 15 day recorded significantly highest value of plant height (93.72 and 96.77cm), no. of branches (12.66 and 13.39), stem girth (4.75 and 5.12 cm), no. of leaves (105.52 and 108.68), internode length (14.75 and 15.04cm), no. of flowers per plant (41.34 and 41.95), fruit set (56.66 and 57.45%), no. fruits per plant (20.56 and 20.73), fruit length (11.85 and 12.07cm), fruit diameter (10.62 and 10.80cm), weight of placenta (18.31 and 18.46g), average fruit weight (189.03 and 191.33g), fruit weight per plant (4.12 and 4.17 kg) and fruit yield (78.64 & 79.60q/1000 m2). Hence, hybrid Indira and foliar application of vegetable special @ 5g/at 15 days may be recommended for higher productivity from capsicum crops under protected conditions.

Effect of Weed Management Practices on Growth, Yield of Vegetable Cowpea (Vigna unguiculata (L.) Walp.) cv. Kashi Kanchan

The present investigation contains seven different treatments viz., weedy check (control), weed free check (3 hand weeding) (first hand weeding at 25 DAS), pre-emergence application of Pendimethalin @ 6ml/L, pre-emergence application of Pendimethalin @ 6ml/L + one hand weeding, pre- emergence application of Pendimethalin @ 6ml/L + post emergence @ 40-50 g/ha at 25 DAS, post-emergence application of Metribuzin @ 525g/ha at 25DAS and post-emergence spray of Imazethapyr @ 100 g ai/ha at 25 DAS replicated thrice. The cowpea variety ‘Kashi Kanchan’ was used in experiment. Results of the experiment revealed that though, the weed free check (T2) recorded zero weed population and slightly higher values of growth and yield parameters but among tested treatments, pre-emergence application of Pendimethalin @ 6ml/L + one hand weeding (T4) and pre-emergence application of Pendimethalin @ 6ml/L + Quizalofop ethyl @ 40-50 g/ha at 25 DAS(T5) significantly reduced weed number (48.12 and 52.18/m2) and produced significantly highest plant height (47.30 and 45.98 cm), pod length (21.64 and 20.86 cm), number of pods/plant (35.94 and 34.18), average pod weight(11.18 and 11.06 g), green pod weight/plant (367.84 and 348.63g), green pod weight/plot (11.24 and 10.54 kg) and green pod yield per hectare(118.96 and 111.55q). However, these three treatments (T2, T4 and T5) were statistically at par with each other in terms of growth and yield parameters.Hence, these two weed management practices (T4 and T5) may serve as alternative of manual weeding and may be recommended for farmers of the central plain zone of Uttar Pradesh for higher returns from vegetable cowpea crop.

An ophthalmology professionalism survey tool: Outcomes from a multi-center study in Central India

Purpose: To describe a professionalism survey tool and its use to assess knowledge of medical professionalism in ophthalmology training programs in Central India. Settings and Design: Multi?center survey study. Methods: A validated 33?question, scenario?based survey addressing professionalism attributes was administered at five centers in central India. The attributes tested included “personal characteristics,” “physician–patient relationships,” “workplace practice and relationships,” and “socially responsible behaviors.” A mean attribute score (%) was calculated and compared to “gold standard” responses by a group of expert senior ophthalmologists (100% agreement for responses). Results: A total of 225 participants completed the survey; 124 residents, 47 fellows, and 54 consultants (98.4% response rate). The total mean attribute score was 80.7 ± 9.1 (min 16.67, max 100). There was variation in the mean attribute score by professionalism attribute (P < 0.001), and a trend toward higher mean attribute scores for consultants compared to trainees across all attribute groups. The scores for “personal characteristics” (93 ± 9.7) and “physician?patient relationship” (82 ± 15.8) were the highest, whereas scores for “socially responsible behaviors” (73.9 ± 18.6) and “workplace practices” were low (72 ± 13). Conclusions: There is a generally high level of professionalism knowledge among ophthalmologists in central India. The results suggest that experience does impact knowledge of professionalism. Potential for improvement in professionalism exists in around "workplace practices", and around "socially responsible behaviors". These findings may serve as a valuable discussion starter and teaching tool to enhance professionalism in ophthalmology training programs.

Efficacy of deep learning-based artificial intelligence models in screening and referring patients with diabetic retinopathy and glaucoma

Purpose: To analyze the efficacy of a deep learning (DL)?based artificial intelligence (AI)?based algorithm in detecting the presence of diabetic retinopathy (DR) and glaucoma suspect as compared to the diagnosis by specialists secondarily to explore whether the use of this algorithm can reduce the cross?referral in three clinical settings: a diabetologist clinic, retina clinic, and glaucoma clinic. Methods: This is a prospective observational study. Patients between 35 and 65 years of age were recruited from glaucoma and retina clinics at a tertiary eye care hospital and a physician’s clinic. Non?mydriatic fundus photography was performed according to the disease?specific protocols. These images were graded by the AI system and specialist graders and comparatively analyzed. Results: Out of 1085 patients, 362 were seen at glaucoma clinics, 341 were seen at retina clinics, and 382 were seen at physician clinics. The kappa agreement between AI and the glaucoma grader was 85% [95% confidence interval (CI): 77.55–92.45%], and retina grading had 91.90% (95% CI: 87.78–96.02%). The retina grader from the glaucoma clinic had 85% agreement, and the glaucoma grader from the retina clinic had 73% agreement. The sensitivity and specificity of AI glaucoma grading were 79.37% (95% CI: 67.30–88.53%) and 99.45 (95% CI: 98.03–99.93), respectively; DR grading had 83.33% (95 CI: 51.59–97.91) and 98.86 (95% CI: 97.35–99.63). The cross?referral accuracy of DR and glaucoma was 89.57% and 95.43%, respectively. Conclusion: DL?based AI systems showed high sensitivity and specificity in both patients with DR and glaucoma; also, there was a good agreement between the specialist graders and the AI system

Effect of Mutation on Seed Yield per Plant and Chlorophyll Content in M3 Generation of Green Gram [Vigna radiata (L.) R. Wilczek]

Aims: Mutation breeding used to induce quantitative variability in M3 generation of green gram of two excellent variety GM-4 and Meha with a view to study effect various mutagen and for the estimation of genetic variability parameters like GCV, PCV, Heritability and Genetic advance percent of mean for characters like as seed yield per plant and chlorophyll content.Place and Duration of Study: The Field experiment was conducted at Instructional Farm, COA, Junagadh Agricultural University, Junagadh during the Summer-2015.Methodology: The experimental material consisted of M2 derived M3 seeds which consists of sixty-six M3 progeny lines (64 mutant + 2 controls). The progeny lines were selected on the basis of yield and its associated characters from M2 generation.Results: The analysis of variance between family revealed that families differed significantly for chlorophyll content while non-significant for seed yield per plant. GCV and PCV were higher in all the mutagenic family with respect to control for both the characters as well as for both the variety. For both characters, phenotypic coefficient of variation was higher than genotypic coefficient of variation indicating that there was environmental influence on these traits. Heritability exhibited higher in all the mutagenic families and also higher genetic advance was observed. The combined results for heritability showed that the high estimates of heritability and genetic advance were scored for seeds per plant indicating that these characters were under the control of additive genetic effects.Conclusion: Mutagenic progenies with additive gene effect can be selected for improvement of desirable traits in mungbean.

Distance and near vision changes after intravitreal anti-vascular endothelial growth factor injection in eyes with center-involving diabetic macular edema

Purpose: To elucidate distance and near vision changes after intravitreal injections in center?involving diabetic macular edema (CIDME) in phakic and pseudophakic groups. Methods: A retrospective study was done on 148 eyes (72 phakic and 76 pseudophakic) with center?involving DME. All eyes were treated with intravitreal anti?vascular endothelial growth factor (VEGF) injection. All patients underwent distance best?corrected visual acuity (BCVA) testing, near BCVA testing, dilated fundus examination, and optical coherence tomography (OCT) at baseline and follow?up visits. Eyes that could not improve after the first injection were given 2nd, 3rd, and more injections in the subsequent visits. Results: On follow?up, post injections in the phakic group (n = 72), there were 65 eyes (90.3%) with stable/improved near vision and 59 eyes (81.9%) with stable/improved distance vision, whereas in the pseudophakic group (n = 76), 63 eyes (82.9%) and 60 eyes (78.9%), respectively. Both in phakic and pseudophakic eyes, 7.7%–13% of the cohort showed only near vision improvement. Conclusion: In DME, besides the changes in distance vision, there are also changes in near vision. These changes should be taken into account while determining the response to anti?VEGF in DME treatment.

RANKING THE ACCEPTABILITY OF READY TO USE FOOD (RTU): A STUDY OF INDIAN BRANDED QSR OUTLETS

Consumers of Indian fast food chains today's care not only about the quality and flavor of their meals, but also about how quickly they can get their orders at table. Managers at these Indian-branded quick-service outlets have been training their staffs and improving other aspects of operations in order to keep up with the rising demand. The purpose of this study is to make an effort to analyse the acceptance of convenience food among managers and chefs working in Indian branded quick service restaurants (QSR) and to rank the perceptions that affect these individuals to employ convenience food in day-to-day operations. The present study was conducted in various Indian branded QSR outlets in North India. The results reveal that Majority Indian Branded QSR Outlets operators warmly accept the usage of RTU food in their respective outlets. Convenience food plays an important role in overall performance of these outlets especially in context to quality and service time.

Teplizumab: a new glimmer of hope for type 1 diabetic patients

Teplizumab is the first monoclonal antibody used to delay the onset of stage 3 type 1 diabetes mellitus (DM). It is a highly selective, a CD3-directed monoclonal antibody, given parenterally that was approved in November 2022, for delaying the onset of Stage 3 type 1 diabetes in adults and paediatric patients aged 8 years and older with stage 2 type 1 Diabetes. It binds to the immune cells that destroy the insulin producing pancreatic beta cells and inactivates them thereby leading to decreased rate of reduction in insulin production and subsequently delay in the onset of stage 3 type 1 diabetes.

Compliance with follow-up in patients with diabetic macular edema: Eye care center vs. diabetes care center

Purpose: The study was conducted to compare the compliance to intravitreal injection treatment and follow?up in patients with center?involving diabetic macular edema (CI?DME) and treatment outcomes between a tertiary eye care facility and a tertiary diabetes care center. Methods: A retrospective review was conducted on treatment naïve DME patients who had received intravitreal anti?vascular endothelial growth factor (anti?VEGF) injections in 2019. Participants were people with type 2 diabetes who were under regular care at the eye care center or the diabetes care center in Chennai. The outcome measures were noted at months 1, 2, 3, 6, and 12. Results: A review of 136 patients treated for CI?DME (72 from the eye care center and 64 from a diabetes care center) was carried out. The severity of diabetic retinopathy (DR) was similar in both centers. There was no statistically significant (P > 0.05) difference in the choice of initial intravitreal drug in the two centers. At 12?month follow?up, only 29.16% came for a follow?up in the eye center vs. 76.56% in a diabetes care center (P = 0.000). The multivariate logistic regression showed increasing age was associated with non?compliance in both the groups (eye care center: odds ratio [OR] 0.91; 95% confidence interval [CI] 0.82–1.21; P = 0.044) and diabetes care center (OR 1.15; 95% CI 1.02–1.29; P = 0.020). Conclusion: The follow?up rate between eye care and diabetic care center with DME showed a significant disparity. By providing comprehensive diabetes care for all complications under one roof, compliance with follow?up can be improved in people with DME

Next-generation sequencing-based genetic testing and phenotype correlation in retinitis pigmentosa patients from India

Purpose: Inherited retinal dystrophies (IRD) are a heterogeneous group of retinal diseases leading to progressive loss of photoreceptors through apoptosis. Retinitis pigmentosa (RP) is considered the most common form of IRD. Panel?based testing in RP has proven effective in identifying the causative genetic mutations in 70% and 80% of the patients. This is a retrospective, observational, single?center study of 107 RP patients who had undergone next?generation sequencing?based targeted gene panel testing for IRD genes. These patients were inspected for common phenotypic features to arrive at meaningful genotype–phenotype correlation. Methods: Patients underwent complete ophthalmic examination, and blood was collected from the proband for DNA extraction after documenting the pedigree. Targeted Next Generation Sequencing (NGS) was done by panel?based testing for IRD genes followed by co?segregation analysis wherever applicable. Results: Of the 107 patients, 72 patients had pathogenic mutations. The mean age of onset of symptoms was 14 ± 12 years (range: 5–55). Mean (Best Corrected Visual Acuity) BCVA was 6/48 (0.9 logMAR) (range 0.0–3.0). At presentation, over one?third of eyes had BCVA worse than 6/60 (<1 logMAR). Phenotype analysis with the gene defects showed overlapping features, such as peripheral well?defined chorioretinal atrophic patches in patients with CERKL, PROM1, and RPE65 gene mutations and large macular lesions in patients with RDH12 and CRX gene mutations, respectively. Nummular or clump?like pigmentation was noted in CRB1, TTC8, PDE6A, and PDE6B. Conclusion: NGS?based genetic testing can help clinicians to diagnose RP more accurately, and phenotypic correlations can also help in better patient counselling with respect to prognosis and guidance regarding ongoing newer gene?based therapies.

Phenotypic heterogeneity in family members of patients with retinitis pigmentosa

Purpose: To describe the phenotypic variations in family members of patients with retinitis pigmentosa (RP) with different modes of inheritance and to assess the ocular abnormalities in RP families. Methods: A descriptive analysis of three types of inheritance of RP was carried out, where 64 family members were examined at a tertiary eye care center, South India. They underwent comprehensive eye examination, fundus photography, fundus autofluorescence (FAF), full?field electroretinogram (FFERG), and spectral domain optical coherence tomography (SD?OCT). Analysis was performed between mild and severe forms of abnormalities to delineate retinal structural and functional defects in RP families. Results: The mean age was 38.55 ± 17.95 years. Males were 48.4%. In autosomal recessive and X?linked recessive groups, 74.2% and 77.3%, respectively, were asymptomatic, whereas in autosomal dominant group, 27.3% were asymptomatic. The proportion of the cases with abnormalities in all three groups was higher on ERG (59.6%), followed by OCT (57.5%), visual acuity (43.7%), peripheral FAF (23.5%), and macular FAF (11.8%). However, these abnormalities and the clinical pictures of the family members had no statistical difference across the three groups of inheritance. Conclusion: Structural and functional retinal alterations were noted in four out of five asymptomatic members, suggesting the need for careful screening of RP families and the pressing need for pre?test (genetic) counseling

Choosing the Correct?Sized Adult Double?Lumen Tube: Quest for the Holy Grail

Appropriate size selection of double?lumen tubes (DLTs) for one?lung ventilation (OLV) in adults is still a humongous task. Several important factors are to be considered like patient height, gender, tracheal diameter, left main bronchial diameter, and cricoid cartilage transverse diameter. In addition to radiological assessment of the airway diameters, the manufacturing details of the particular DLT being used also play a significant role in size selection. Optimal positioning of the appropriately sized DLT is indispensable to avoid complications like airway trauma, cuff rupture, hypoxemia, and tube displacement. It is imperative to know whether the one?size?fits?all dictum holds for DLT size selection as claimed by certain studies. Further randomized studies are required for crystallizing standard protocols ascertaining the correct DLT size. This systematic review article highlights the various parameters employed for DLT size selection and explores the newer DLTs used for adult OLV.

Assessment of the Agroforestry System on Farmers Socioeconomic Status in Azamgarh District, Uttar Pradesh, India

The study investigated that the Socioeconomic status and use of an agroforestry system, 20 farmers from one district, four blocks, and four villages per block were randomly selected. The socioeconomic condition of the agroforestry system in the Azamgarh districts of Uttar Pradesh is based on preliminary study. According to the size of their holdings, the respondents were divided into Palhani, Bilariyaganj, Mehnagar, and Jahanaganj block farmers, and observations were made about their socioeconomic profiles. Farmers ranged in age from middle-aged to elderly; the majority had completed middle school, whereas large farmers were more likely to have completed high school; most of them were nuclear families with semi-cemented or cemented homes and had more than 10 years of expertise in agriculture and agroforestry. Their family sizes ranged from medium to big, or over 5 individuals. In the three categories of farmers, the risk orientation ranged from low to medium; the scientific orientation was of a medium degree. The large farmers were found to be more exposed to the media, and most farmers were found to attend group meetings. Smallholder farmers, especially in developing nations, contribute significantly to local, regional, and economies as a result of socioeconomic and environmental constraints. About 75% of the world's agricultural land is used by smallholders.

Single-bolus dexmedetomidine in prevention of emergence delirium in pediatric ophthalmic surgeries: A randomized controlled trial

Purpose: Emergency delirium (ED), a common postoperative neurologic complication, causes behavioral disturbances leading to self?traumas and also has long?term adverse effects in children. Our aim was to investigate the efficacy of a single?bolus dose of dexmedetomidine in reducing the incidence of ED. Additionally, pain relief, number of patients who needed rescue analgesia, hemodynamic parameters, and adverse events were assessed. Methods: One hundred and one patients were randomly allocated into two groups: 50 patients received 15 mL of dexmedetomidine 0.4 ?g/kg (group D) and 51 patients received volume?matched normal saline (group C). Hemodynamic parameters such as heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were monitored regularly throughout the procedure. ED was assessed with Pediatric Anesthesia Emergence Delirium Scale (PAEDS), and pain was measured using the modified Objective Pain Score (MOPS). Results: The incidences of ED and pain were higher in group C than group D (P < 0.0001 and P < 0.0001, respectively). Group D showed significant decrease in MOPS and PAEDS values at 5, 10, 15, and 20 min (P < 0.05), HR at 5 min (P < 0.0243), and SBP at 15 min (P < 0.0127). There was no significant difference in DBP between the two groups at any time point. The mean blood pressure (MBP) at 10 min was significantly less in group D than group C (P < 0.001). Conclusion: Dexmedetomidine 0.4 ?g/kg as a single bolus over 10 min immediately after intubation is effective for the prevention of ED and significantly reduces the need of rescue analgesia without compromising the hemodynamic parameters in children undergoing ophthalmic surgery.

Percutaneous Suspensory Stabilization of Chronic Distal Radioulnar Joint (DRUJ) Dislocation Using an Adjustable Loop Endobutton Construct: Case Report / Fixação suspensiva percutânea de luxação crônica da articulação radioulnar distal (ARUD) usando um dispositivo de endobutton de laço ajustável: Relato de caso

Abstract Chronic distal radioulnar joint (DRUJ) dislocation has been treated historically with complex osteotomies and reconstructive procedures, often resulting in intractable stiffness and loss of function. It is desirable to use a technique of fixation that will not only restore the wrist biomechanics but also be cosmetically appealing to the individual. We present a novel technique of reduction and fixation of a chronically dislocated DRUJ in a 26-year-old male using a minimally invasive approach, with successful restoration of DRUJ function and no postoperative complications.

Resumo Luxação crônica da articulação radioulnar distal (ARUD) foi tratada historicamente com osteotomias complexas e procedimentos reconstrutivos, geralmente resultando em rigidez intratável e perda de função. É desejável usar uma técnica de fixação que não apenas restaure a biomecânica do punho, mas também seja esteticamente atraente para o indivíduo. Apresentamos uma nova técnica de redução e fixação de uma ARUD deslocada cronicamente em um homem de 26 anos, usando uma abordagem minimamente invasiva, com restauração bem-sucedida da função da ARUD e sem complicações pós-operatórias.

Pattern, knowledge and attitude regarding substance use among youth (11-24 years): findings from an exploratory survey

Background: Substance use disorders are becoming a serious public health concern with its slow but gradual increase among adolescents and young adults. The study aimed to assess the knowledge, attitude and practices of youth about substance use. Methods: A cross-sectional study was conducted among youth visiting various outpatient departments of a tertiary care teaching hospital. 270 youth participated in the study and were interviewed using pre-tested and pre-structured proforma entailing information on knowledge, attitude and practices about substance use disorders. Results: Out of 270 study subjects, 54 (51 males and 3 females) had ever used drugs. Among male users, 96.07% used drugs for joy seeking whereas among females 66.66% used drugs due to teenager curiosity. All the respondents had information about drug use, with friends being the major source of information (85.18%) followed by electronic media (81.85%) and school curriculum (48.51%). 97.03% of the respondents knew that anxiety, euphoria, depression, happiness and aggressiveness can occur with substance abuse. Both males (98.64%) and females (97.91%) expressed a positive attitude towards helping a friend who is into drug abuse. Age at first use for tobacco (4%), alcohol (6.38%) and inhalants (12.5%) was found to be as young as 12-15 years. Conclusions: The study participants were found to be knowledgeable about substance use disorders and had a positive attitude on majority of the attitude items. No current user and only 20% ever users in the study may be underreporting.

Changes in visual acuity using low vision devices in patients with Leber hereditary optic neuropathy: A retrospective study

Purpose: This study was conducted to estimate the visual acuity improvement in patients with Leber hereditary optic neuropathy (LHON) with the help of low vision devices (LVDs) and to analyze the types of distant and near LVDs prescribed to the patients with LHON. Methods: A retrospective case review of 74 subjects with LHON who were referred to a low vision care clinic at a tertiary eye center from 2016 to 2019 were recruited. The reason for referral was assessed from the patients’ electronic medical records (EMR). Demographic data of the patients, visual acuity status, type of LVD prescribed, and visual acuity improvement with LVD were documented. Results: Out of 74 patients, 91.9% (n = 68) were male, and the median age of patients was 21 (16) years. A 4× monocular telescope was prescribed for 2.7% of patients (n = 2) and SEETV binocular telescope for 1.4% (n = 1) was advised for distance. The most commonly prescribed near LVD was the 6× cutaway stand magnifier for 22 patients (29.7%). Four patients (5.4%) were prescribed with Notex, the most commonly prescribed non?optical LVD. Niki CCTV (12.2%, n=9) was the most commonly prescribed assistive device. The subjects were divided into three groups based on age: group I consisted of those <18 years of age, group II 18–40 years, and group III >40 years for the interpretation of visual improvement. There was a statistically significant improvement (group I: P < 0.001, group II: P < 0.0001, group III: P < 0.003) in near vision with help of LVDs in all three groups. Conclusion: The use of LVDs and rehabilitation can help patients with LHON to lead a better life and will be more beneficial

Artificial intelligence and machine learning in ocular oncology: Retinoblastoma

Purpose: This study was done to explore the utility of artificial intelligence (AI) and machine learning in the diagnosis and grouping of intraocular retinoblastoma (iRB). Methods: It was a retrospective observational study using AI and Machine learning, Computer Vision (OpenCV). Results: Of 771 fundus images of 109 eyes, 181 images had no tumor and 590 images displayed iRB based on review by two independent ocular oncologists (with an interobserver variability of <1%). The sensitivity, specificity, positive predictive value, and negative predictive value of the trained AI model were 85%, 99%, 99.6%, and 67%, respectively. Of 109 eyes, the sensitivity, specificity, positive predictive value, and negative predictive value for detection of RB by AI model were 96%, 94%, 97%, and 91%, respectively. Of these, the eyes were normal (n = 31) or belonged to groupA (n=1), B (n=22), C (n=8), D (n=23),and E (n=24) RB based on review by two independent ocular oncologists (with an interobserver variability of 0%). The sensitivity, specificity, positive predictive value, and negative predictive value of the trained AI model were 100%, 100%, 100%, and 100% for group A; 82%, 20 21 98%, 90%, and 96% for group B; 63%, 99%, 83%, and 97% for group C; 78%, 98%, 90%, and 94% for group D, and 92%, 91%, 73%, and 98% for group E, respectively. Conclusion: Based on our study, we conclude that the AI model for iRB is highly sensitive in the detection of RB with high specificity for the classification of iRB