Novel approach to soft tissue regeneration: in vitro study of compound hyaluronic acid and horizontal platelet-rich fibrin combination

Abstract Objective This study aims to develop a compound biomaterial to achieve effective soft tissue regeneration. Methodology Compound hyaluronic acid (CHA) and liquid horizontal-platelet-rich fibrin (H-PRF) were mixed at a ratio of 1:1 to form a CHA-PRF gel. Human gingival fibroblasts (HGFs) were used in this study. The effect of CHA, H-PRF, and the CHA-PRF gel on cell viability was evaluated by CCK-8 assays. Then, the effect of CHA, H-PRF, and the CHA-PRF gel on collagen formation and deposition was evaluated by qRT‒PCR and immunofluorescence analysis. Finally, qRT‒PCR, immunofluorescence analysis, Transwell assays, and scratch wound-healing assays were performed to determine how CHA, H-PRF, and the CHA-PRF gel affect the migration of HGFs. Results The combination of CHA and H-PRF shortened the coagulation time of liquid H-PRF. Compared to the pure CHA and H-PRF group, the CHA-PRF group exhibited the highest cell proliferation at all time points, as shown by the CCK-8 assay. Col1a and FAK were expressed at the highest levels in the CHA-PRF group, as shown by qRT‒PCR. CHA and PRF could stimulate collagen formation and HGF migration, as observed by fluorescence microscopy analysis of COL1 and F-actin and Transwell and scratch healing assays. Conclusion The CHA-PRF group exhibited greater potential to promote soft tissue regeneration by inducing cell proliferation, collagen synthesis, and migration in HGFs than the pure CHA or H-PRF group. CHA-PRF can serve as a great candidate for use alone or in combination with autografts in periodontal or peri-implant soft tissue regeneration.

Physiology teaching methodology – Perspective of undergraduate medical students

Background: Proper understanding of concepts of physiology forms basis of good clinical practice. To make the lectures in physiology more interesting and understanding, one has to review the teaching methods at regular intervals. Aims and Objectives: This study is designed to get feedback regarding teaching methods in physiology from MBBS students of Government Medical College, Kozhikode, to make teaching more effective. Materials and Methods: Two hundred randomly selected students who successfully completed 1st-year MBBS are included in the study group. The standard questionnaire is shared to study group through Google forms and adequate time is given to record their responses. Descriptive statistics are used. Frequency is expressed in percentage. Results: Most of students prefer interactive teaching methodologies such as group discussion as their preferred mode of learning rather than conventional didactic lectures in whole batch. Students also like to have integration with other subjects and early clinical exposure to understand the concepts precisely. Conclusion: Teaching in small groups with proper integration and alignment with other subjects will make maximum results rather than the traditional teacher centered medical education. Periodic review of teaching methods is very much essential to make the subject more interesting.

Design of Exercise Device for Older Adults / Diseño de Dispositivo para Ejercitación de Adultos Mayores

ABSTRACT Older adults should perform physical activity to improve cardiorespiratory functions. Aerobic exercises improve cardiovascular function, decrease basal heart rate and blood pressure, and improve mood and energy. To facilitate the execution of aerobic physical activity in older adults, the objective of this research was to design an exercise device for older adults. Starting from design specifications such as comfort, size, weight, resistance, and cost, we developed the detailed design of a horizontal bicycle. The designed device, thanks to its horizontally disposed structure, its adequate resistance to pedaling, its dimensioning based on anthropometric measurements of the Chilean population, and the disposition of sensors for heart rate and oxygen saturation, is suitable for older adults. Its weight and size also make it convenient for use inside the home, and the use of materials, components, and manufacturing processes available nationally and within the cheapest options, increases the possibility of access by older adults.

RESUMEN Es fundamental que los adultos mayores realicen actividad física para mejorar las funciones cardiorrespiratorias, particularmente los ejercicios aeróbicos mejoran la función cardiovascular, disminuyen la frecuencia cardíaca basal y la tensión arterial, además de mejorar su estado de ánimo y energía. Con la finalidad de facilitar la ejecución de actividad física del tipo aeróbica en adultos mayores, se planteó el objetivo de este trabajo, centrado en diseñar un dispositivo para su ejercitación. Partiendo de especificaciones de diseño como comodidad, tamaño, peso, resistencia y costo, se desarrolló el diseño de detalle de una bicicleta horizontal. El dispositivo diseñado, gracias a la disposición horizontal de la estructura, la resistencia adecuada al pedaleo, su dimensionamiento con base a medidas antropométricas de población chilena, y la disposición de sensores para heart rate and oxygen saturation, es adecuado para adultos mayores. Además, su peso y tamaño lo hacen conveniente para el uso dentro de las viviendas, del mismo modo, el uso de los materiales, componentes y proceso de manufactura disponibles nacionalmente y dentro de las opciones más económicas, aumentan la posibilidad de acceso por parte de los adultos mayores.

Observation on the curative effect of horizontal rectus transposition combining recess-resect treatment on monocular elevation deficiency with horizontal strabismus

Purpose: To explore the clinical effect of horizontal rectus transposition combining recess and resect treatment on monocular elevation deficiency (MED) with horizontal strabismus. Methods: Ten patients (10 eyes) scheduled to undergo horizontal rectus transposition combining recess?resect surgery to treat MED with horizontal strabismus in the ME Department of Ophthalmology of the First Affiliated Hospital of Guangxi Medical University between July 2016 and February 2022 were included in the study. The degree of vertical and horizontal prism strabismus, the grading of upper movement of the paralyzed eye, and the improvement of binocular vision were evaluated before and after the surgery. Results: Horizontal rectus transposition combined with recess and resect treatment was used to treat 10 patients with MED combined with horizontal strabismus. A good curative effect was seen in eight patients. The differences in the degree of vertical strabismus, the degree of horizontal strabismus, and the movement function of the paretic eyes before and after surgery were significantly different (all P < 0.05). The binocular haplopia function in six patients was reconstructed in the primary position after surgery. Conclusion: Horizontal rectus transposition combining recess?resect is easy to perform, and the number of recti involved in the surgery is small. This approach can effectively correct the eye position, improve eye movement, and reconstruct binocular vision in patients with MED by combining horizontal strabismus

Transient change in the binocular visual function after femtosecond laser-assisted in situ keratomileusis for myopia patients

Purpose: The goal of this study was to compare the difference in binocular visual function for high and low?moderate myopes before and after femtosecond laser?assisted in situ keratomileusis (FS?LASIK). Methods: Thirty?three subjects (17 males and 16 females) were divided into two groups according to their preoperative refractive errors in spherical equivalent (SE): low?moderate myopia group (SE ??6.00 D) and high myopia group (SE <?6.00 D). The binocular visual function including accommodative amplitude (AA), accommodative facility (AF), positive and negative relative accommodation (PRA and NRA, respectively), horizontal phoria measurement, positive and negative fusion vergence, accommodative–convergence over accommodation (AC/A) ratio, and stereopsis were assessed with the best?corrected vision before patients received FS?LASIK and 7 and 30 days after the surgery. Repeated measures analysis of variance (ANOVA) was applied to study the change in binocular visual function. Results: The AF values in both groups were significantly reduced after 7 days of FS?LASIK (baseline vs. day 7 (mean): high myopia group: 7.85 vs. 5.62 cpm, repeated ANOVA, P = 0.01; low?moderate myopia group: 5.95 vs. 4.40 cpm, repeated ANOVA, P = 0.04). This change returned to the baseline level 30 days after the operation. In addition, the horizontal phoria values in both groups were significantly reduced for both distant (P = 0.019 and P = 0.001, respectively) and near (P = 0.003 and P = 0.049, respectively) 7 days after the operation, but they rebound to preoperative state after 30 days. Conclusion: A transient change in binocular visual function was noticed after 7 days of FS?LASIK operation, which could cause symptoms of asthenopia. Our data showed all the binocular visual functions returned to baseline level after 30 days of operation.

A comparative study on efficacy of different dilutions of phenylephrine and tropicamide combination eye drops on pupil dilatation

Background: In ophthalmology (OPD), cycloplegics or mydriatics were needed for doing correct refraction and evaluation of fundus on a daily basis. Aims and Objectives: The objectives of this study were to compare the clinical efficacy and systemic side effects of different dilutions of phenylephrine and tropicamide combinations drops on pupil dilatation and to measure and compare pulse rate and blood pressure before and after giving the drug. Materials and Methods: The present study is a hospital-based interventional study conducted among patients attending to OPD of Regional Eye hospital, Visakhapatnam during April 2012–August 2012. Eighty-one patients randomly allocated to two groups (41 patients in Group 1 and 40 patients in Group 2). Dilution of phenylephrine 5% and Tropicamide 0.8% mixture was applied to patients of Group A in both eyes and dilution of phenylephrine 2.5% and Tropicamide 0.4% mixture was applied to Group B patients in both eyes. Pupil diameter and pulse rate BP were measured and compared. Results: Mean age of Group 1 patients was 55.39 ± 11.47 and Group 2 was 49.95 ± 13.71. Among 36 males, 50% in Group 1 and 50% in Group 2 and among 45 females 51.1% in Group 1 and 48.9% in Group 2. Among both Group 1 and Group 2 patients, both left and right pupil size was significantly increased after application of dilutions, but there was more increase in the pupil size among Group 1 patients compared to Group 2 patients 15 min after and 30 min after application of drug. Conclusions: The combination of 0.8% tropicamide and 5% phenylephrine was effective compared to alternate application of 0.4% tropicamide and 2.5% phenylephrine for rapid and sustainable pupil dilatation for indirect ophthalmoscopy.

Clinical features of 23 neonates infected with Omicron variant of severe acute respiratory syndrome coronavirus 2 / 中国当代儿科杂志

OBJECTIVES@#To summarize the clinical features of neonates infected with Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).@*METHODS@#The medical data of 23 neonates with Omicron variant of SARS-CoV-2 infection admitted to the City North Campus of Urumqi First People's Hospital from October to December 2022 were retrospectively reviewed.@*RESULTS@#All 23 infants had a history of exposure to confirmed caregivers with SARS-CoV-2 infection after birth, and none of them was vertically transmitted. Clinical classification: 5 cases of asymptomatic infection, 18 cases of mild infection, and no cases of moderate, severe, or critically ill. The first symptoms were fever in 13 cases, cough in 3 cases, nasal congestion in 1 case, and diarrhea in 1 case. Blood white blood cell counts decreased in 2 cases, and C-reactive protein increased in 1 case. Seven infants underwent chest X-ray examination due to cough or shortness of breath, and one of which showed focal exudative changes, while the rest showed no abnormal changes. All infants were discharged after symptomatic treatment and the median hospital stay was 6 days. The duration of nucleic acid positivity of SARS-CoV-2 was negatively correlated with N gene Ct values and ORF1ab gene Ct values (rs=-0.719 and -0.699, respectively; P<0.05). One month after discharge, all infants had no symptoms or signs of nucleic acid re-positivity.@*CONCLUSIONS@#The clinical manifestations are usually mild or asymptomatic in neonates infected with SARS-CoV-2 Omicron variant. The lower the Ct values of the N and ORF1ab genes of SARS-CoV-2, the longer the duration of nucleic acid positivity. Neonates infected with SARS-CoV-2 Omicron variant can have a good prognosis after symptomatic treatment.

The influence of additional roll test on the repositioning procedure by SRM-vertigo diagnosis system for horizontal canal benign paroxysmal positional vertigo / 临床耳鼻咽喉头颈外科杂志

Objective:To evaluate the influence of an additional roll test on the repositioning procedure by SRM-vertigo diagnosis system for horizontal canal benign paroxysmal positional vertigo（HC-BPPV）. Methods:A total of 713 patients diagnosed with HC-BPPV in Department of Otolaryngology Head and Neck Surgery，the First Affiliated Hospital of Xi'an Jiaotong University from Jan 2020 to Feb 2022 were enrolled. The patients were divided into two groups by hospital card numbers, in which the number is odd were considered as group A, and the number is even were considered as group B. The group A underwent two circles of Barbecue repositioning procedure by SRM-vertigo diagnosis system, while the group B first performed an additional roll test and then underwent two circles of Barbecue repositioning procedure by SRM-vertigo diagnosis system, to observe the cure rate and compare influence of HC-BPPV by an additional roll test. The quality of life and sleep of patients before and one-month after the treatment were assessed by the dizziness handicap inventory（DHI） and the pittsburgh sleep quality（PSQI）. Results:The cure rate of group A was 63.21%, and the cure rate of group B was 87.68%，the difference between the two groups was statistically significant（P<0.05）; The DHI score of patients after the repositioning was significantly lower than that before the repositioning（P<0.05）. The PSQI score after the repositioning was significantly lower than that before the repositioning（P<0.05）. The DHI and the PSQI scores after the repositioning were significantly lower than that before the repositioning, with a statistically significant difference （P< 0.05）. The total score of DHI in group B after treatment was lower than that in group A, with a statistically significant difference（P<0.05）. The total score of PSQI in group B after treatment was lower than that in group A, with non-statistically significant difference （P< 0.05）. Conclusion:An additional roll test before the repositioning procedure by SRM-vertigo diagnosis system can significantly improve the cure rate of HC-BPPV, relieve anxiety, and improve the quality of life.

Analysis on key points of ethics review of horizontal scientific research projects: Based on the ethics review management system of horizontal scientific research projects in a tertiary hospital / 中华医学科研管理杂志

Objective:This paper aims to promote the standardization of ethics review of horizontal scientific research projects and improve the ethics review quality by analyzing the current ethics review practice in a certain tertiary hospital, identifying common problems during the review process, illustrating relevant causes and proposing corresponding solutions.Methods:Through introducing the current situation of ethics review of horizontal scientific research projects in a tertiary level hospital, the differences between the main points of ethics review of horizontal scientific research projects and government-funded scientific research projects were analyzed, so as to sort out the common problems and possible causes in the process of ethics review of horizontal scientific research projects, and then explore the possible corresponding solutions.Results:Based on the characteristics of horizontal research projects, ethics review should focus on their scientific and social values, potential conflicts of interest, protection of subjects′ rights and interests, and whole-process management and quality assurance. At present, there are still many problems, such as a large number of projects, but not many projects with high research value, inadequate project process management, and ineffective implementation of ethics review opinions.Conclusions:The hospital should further improve the management system of horizontal scientific research project approval, bring in more comprehensive review regarding to both scientific and ethics review, engage more experts at the outset of project funding decision-making, set up ethics specialists, strengthen the process management of horizontal scientific research projects, strengthen ethical publicity and education, and improve the ethical awareness of researchers to fully protect the rights and interests of subjects and promote the high-quality development of clinical research.

Key points to execute internal horizontal mattress suture in tissue augmentation / 口腔疾病防治

@#Ideal sutures can provide great fixation, wound closure and a stable environment for healing of the surgical site. Tension-free apposition sutures are important for tissue regeneration and could tackle insufficient amounts of soft and hard tissue, especially in missing tooth sites that require implantation. The internal horizontal mattress suture, similar to the conventional horizontal mattress suture, forms a rectangle that can be bisected by the incision with both intrusion and extrusion of the needle on each side. On the basis of the rectangle, the internal horizontal mattress suture emphasizes that the suture should be located below the incision, so the eversion of the wound margin is the highlight of this procedure. The internal horizontal mattress suture could stabilize the graft on the targeting tissue, realize the fixation of the collagen membrane, apically repositioned flap and soft tissue graft, reduce the tension on the incision, and further release the tension of the incision margin. Beyond the primary need for fixation and wound closure, internal horizontal mattress sutures can also achieve stress interruption that reduces the interference of the surrounding muscle and can better master wound tension with the assistance of interrupted sutures. Given the above advantages, horizontal internal mattress sutures have great potential in the application of implant-related regenerative surgery. In this review, according to our experience in clinical practice and the literature, we summarize the advantages of internal horizontal mattress sutures in tissue augmentation. In addition, the sites and sequence to insert the needle and the spatial relationship between the suture and incision are clarified with the rationale of the naming pattern, which is conducive to experience exchange and clinical practice.

Study on the influence of Barbecure combined with Epley on residual dizziness of horizontal canal benign paroxysmal positional vertigo by SRM-vertigo diagnosis system / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the influence of Barbecure combined with Epley on residual dizziness of horizontal canal benign paroxysmal positional vertigo（HC-BPPV） by SRM-vertigo diagnosis system. Methods:A total of 406 patients diagnosed with HC-BPPV from Nov 2021 to Nov 2022 were enrolled by rapid axial roll test and Dix-Hallpike in the department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Xi'an Jiaotong University. The patients were divided into two groups by hospital card numbers, in which the numbers that were odd were considered as group A, and the numbers that were even were considered as group B. The group A underwent two circles of Barbecure repositioning procedure by SRM-vertigo diagnosis system, while the group B underwent two circles Barbecure combined with Epley repositioning procedure by SRM-vertigo diagnosis system. The treatment was stopped on the next day when two groups of patients were cured, and those who were not cured will continue treatment with the same method. Results:The cure rate of group A was 83.41%, and the cure rate of group B was 80.51%, the difference between the two groups was not-statistically significant difference（P>0.05）. The rate of residual dizziness of group A was 23.30%, the rate of residual dizziness of group B was 11.46%, the difference between the two groups was statistically significant（P<0.05）. Conclusion:The Barbecure combined with Epley otoliths repositioning maneuver by SRM-vertigo diagnosis system can significantly reduce the rate of residual dizziness after the treatment of HC-BPPV, and improve the quality of life of patients.

Advances in the study of morphological changes of optic nerve and retina in horizontal eye movement / 中华实验眼科杂志

The impairment of optic disc and retinal function caused by intraocular pressure is one of the main causes of irreversible visual impairment.In addition to the effects of intraocular pressure, studies have found that ocular adduction and horizontal abduction movements affect the optic disc and surrounding retinal tissue, which result in mechanical pressure and traction having influences on tissue and this change is related to the rotation angle, speed, and age, etc.Studies have found that horizontal eye movements can cause changes in the nasal and temporal sides of the optic disc, as well as the surrounding retinal and choroidal structures, and these changes vary among different age groups.This paper reviewed the current research on the effects of horizontal eye movements on the morphology of the optic nerve and retina, in order to provide some useful clues for the treatment of relevant diseases in clinical practice.

Different procedures combined with Toric intraocular lens implantation on age-related hard nuclear cataract / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To compare the curative effect of different surgical methods combined with Toric intraocular lens(IOL)implantation on age-related hard nuclear cataract.METHODS:According to retrospective study, 104 patients(104 eyes)with age-related hard nuclear cataract confirmed in the hospital between January 2020 and December 2021 were enrolled. They were divided into phacoemulsification group(52 eyes, phacoemulsification combined with Toric IOL implantation)and small-incision group(52 eyes, small-incision split nuclear technique in horizontal space combined with Toric IOL implantation)according to different surgical methods. The best corrected distance visual acuity(BCDVA), corneal astigmatism, number of corneal endothelial cells, proportion of normal hexagonal cells, tear film function and complications were compared between the two groups.RESULTS:There was no significant difference in BCDVA(LogMAR)between the two groups before and at 3mo after surgery(all P&#x003E;0.05), while BCDVA(LogMAR)was better in small-incision group than phacoemulsification group at 1wk after surgery(0.15±0.04 vs. 0.20±0.05, P&#x003C;0.001). The corneal astigmatism of the patients in both groups was lower at 1wk and 3mo after surgery than that before surgery, and it was lower at 3mo than 1wk after surgery(all P&#x003C;0.05), while there was no significant difference in corneal astigmatism between the two groups before and after surgery(all P&#x003E;0.05). At 1wk and 3mo after surgery, number of corneal endothelial cells in small-incision group was more than that in phacoemulsification group(1wk after surgery: 2363.8±315.3 vs. 2231.4±326.4 cells/mm2, P&#x003C;0.05; 3mo after surgery: 2414.6±245.7 vs. 2322.9±221.0 cells/mm2, P&#x003C;0.05). Before and at 1wk after surgery, there was no significant difference in the proportion of normal hexagonal cells between the two groups(all P&#x003E;0.05). At 3mo after surgery, proportion of normal hexagonal cells in small-incision group was higher than that in phacoemulsification group(21.77%±1.91% vs. 20.59%±1.65%, P&#x003C;0.001). Before and at 3mo after surgery, there was no difference in break up time(BUT)or ocular surface disease index(OSDI)score between the two groups(P&#x003E;0.05). At 1wk after surgery, BUT in small-incision group was longer than that in phacoemulsification group(6.8±0.8 vs. 5.9±1.0s, P&#x003C;0.001)and OSDI score was lower than that in phacoemulsification group(17.62±5.47 vs. 20.34±6.18 points, P&#x003C;0.05). The incidence of postoperative complications in small-incision group was lower than that in phacoemulsification group(3.9% vs. 17.3%, P&#x003C;0.05).CONCLUSION: Small-incision split nuclear technique in horizontal space combined with Toric IOL implantation can significantly improve visual acuity and astigmatism in patients with age-related cataract, with slight damage to corneal endothelium and tear film function.

Estudio de supervivencia de Streptococcus mutans en un tipo de fomite / Survival study of Streptococcus mutans in a type of fomite

Objetivo: Evaluar la supervivencia de Streptococcus mutans (S.mutans)en un tipo de fómite. Método: Se reactivó una cepa de S.mutans ATCC25175 criopre-servada en agar TYCSB. El inóculo se estandarizó en PBS buffer hasta obtener turbidez equivalente al 0,5 de Mc Farland y un OD = 0.01 por espectrofotome-tría. Bloques plásticos de 2cm2/superficie fueron seleccionados como fómites. La descontaminación de los bloques se realizó por inmersión en alcohol etílico 70% v/v durante 10 minutos, los que fueron secados en cabina de seguridad biológica. La conta-minación de los mismos se realizó por inmersión en inóculo estandarizado durante 10 minutos. Los blo-ques contaminados se extrajeron y depositaron so-bre placas de Petri estériles hasta cumplir los tiem-pos propuestos (T0-T4 con intervalos de 30 minutos). A cada tiempo, los bloques fueron eluidos en 20 ml de buffer PBS y agitados en vortex durante 30 segun-dos. 100 µl de cada eluato fueron sembrados por dis-persión en agar TYCSB e incubados en anaerobiosis por 48 horas a 37°C. El recuento de colonias (UFC/ml) se realizó bajo lupa estereoscópica 50X. Resulta-dos: El recuento inicial de S.mutans fue de 7,8 X 106(DS+1,7 X 106) UFC/ml y para cada tiempo de estu-dio fue de: T0=3.25 X 104 (DS+1.9 X 103); T1=2.63X104 (DS+4,50E+03); T2= 1.85 X 104 (DS+9,45E+02); T3=1.93 X103(DS+1,29E+03) y T4=1.2X103 (DS+7,21x102). Conclusión: En los rangos de tiempos establecidos, la cepa de S.mutans ensayada permaneció viable sobre la superficie plástica (AU)

Aim: To evaluate the survival time of Streptococcus mutans (S.mutans) in a type of fomites. Method: A strain of cryopreserved S.mutans ATCC 25175 was reactivated in TYCSB agar. The inoculum was standardized in the PBS buffer to obtain turbidity equivalent to 0.5 Mc Farland and OD = 0.01 by spectrophotometry. Plastic blocks of 2 cm2 /surface were selected as fomites. Decontamination of the blocks was carried out for 10 minutes by immersion in ethyl alcohol 70% v/v, which were dried in a biosafety chamber. Contamination was carried out by immersion in standardized inoculum for 10 minutes. The contaminated blocks were extracted and put on sterile Petri dishes until the proposed times were met (T0-T4 at 30-minute intervals). At each time, the blocks were eluted in 20 ml of PBS buffer and vortexed for 30 seconds. 100 µl of each eluate were dispersed on TYCSB agar and incubated anaerobically for 48 hours at 37°C. Colony count (CFU/ml) was performed under a 50X stereoscopic magnifying glass. Results: The initial S.mutans count was 7,8 X 106 (DS+1,7 X 106) CFU/ml and for each study time was: T0=3.25 X 104 (DS+1.9 X 103); T1=2.63X104 (DS+4,50E+03); T2= 1.85 X 104 (DS+9,45E+02); T3=1.93 X103(DS+1,29E+03) y T4=1.2X103 (DS+7,21x102). Conclusion: Within the established time ranges, the tested S.mutans strain remained viable on the plastic surface (AU))

Complex benign horizontal canal positional vertigo: new perceptual management

Abstract Objective: Horizontal semicircular canal site pathology of benign paroxysmal positional vertigo demonstrating three types of nystagmi on positional test were studied. We have attempted to design a protocol for its diagnosis and treatment. Methods: 320 patients of HSC-BPPV were subjected to two types of positional tests. Of these, patients with bilateral steady apogeotropic nysatgmus were treated with VAV modification of Semont's maneuver. Patients with unsteady or changing apo/geotropic signs were converted into steady geotropic ones by repetitive positional tests; followed by barbecue maneuver with forced prolong positioning. Results: Overall 88% of patients had a total recovery. 92% of patients with geotropic nystagmus showed no symptoms after second maneuveral sitting. 85% of patients with apogeotropic nystagmus recovered fully after third maneuveral sitting. Conclusion: Correct identification of subtypes of HSC-BPPV is based on provoked nystagmus by positional tests. After locating the site and side on the basis of nystagmic pattern, physician can apply the appropriate PRM. Level of evidence: II a.

Effect of age on virtual reality-assisted subjective visual vertical and subjective visual horizontal at different head-tilt angles

Abstract Objective: Subjective Visual Vertical (SVV) and Subjective Visual Horizontal (SVH) values may reflect bilateral utricle asymmetry. Bilateral utricle static tension balance can be used to evaluate bilateral otolith lesions and otolith-related central neuropathy. Few studies have examined Virtual Reality (VR)-assisted SVV and SVH values at various head-tilt angles across age groups. The present study aimed to determine the effects of age on VR-assisted SVV and SVH values at different head-tilt angles. Methods: We divided 180 healthy subjects into 6 age groups (n = 30 in each group). VR-assisted SVV and SVH measurements were performed at 9 head-tilt angles (head held vertically, 0°; head tilted 30°, 45°, 60°, and 90° to the left/right) in the roll plane. Results: SVV and SVH values significantly differed with head-tilt angle (p < 0.05). No significant difference was detected in the SVH and SVV values between different age groups (p = 0.632 and p = 0.810, respectively), and no interaction between the age group and the head-tilt angle was found for the SVH and SVV values (p = 0.670 and p = 0.084, respectively). Conclusion: These results suggest that age may have little effect on VR-assisted SVV and SVH at different head-tilt angles. Therefore, VR-assisted SVV and SVH can be evaluated as an effective, fast, and simple way to evaluate utricle function. Level of Evidence: Level 4.

Comparación de biometría ocular entre adultos jóvenes chinos y cubanos / Comparison of ocular biometry between chinese and cuban young adults

Objetivo: Comparar la biometría ocular entre adultos jóvenes chinos y cubanos pertenecientes al sector salud. Métodos: Estudio observacional descriptivo de corte transversal en 30 chinos y 30 cubanos, residentes de las diferentes especialidades médicas, que acudieron al Instituto Cubano de Oftalmología "Ramón Pando Ferrer" entre septiembre de 2016 y septiembre de 2017. Las variables estudiadas fueron: longitud axial, profundidad de cámara anterior, y diámetro corneal horizontal. Se realizó biometría de no contacto con IOLMaster 500 (Carl Zeiss) en ambos ojos. Resultados: La edad media fue 24,9 años y 25,9 años en cubanos y chinos respetivamente. Los resultados biométricos promedio de ambos ojos para cubanos/chinos fueron: longitud axial 24,10 mm/24,60 mm; amplitud de cámara anterior 3,56 mm/3,46 mm; y diámetro corneal horizontal 11,80 mm/11,60 mm, sin diferencias estadísticamente significativas. El 60 de los ojos chinos fueron largos mientras que en los cubanos fue el 45 . Se reportaron dos ojos chinos con cámara anterior estrecha y el diámetro corneal horizontal fue normal en el 100 por ciento. Conclusiones: Los chinos exhibieron ojos de mayor longitud axial, menor amplitud de cámara anterior y menor diámetro corneal horizontal que los cubanos aunque las diferencias no fueron estadísticamente significativas.(AU)

Objective: To compare ocular biometry between Chinese and Cuban young adults belonging to the health sector. Methods: Descriptive observational cross-sectional study in 30 Chinese and 30 Cubans, residents of different medical specialties, who attended the Cuban Institute of Ophthalmology "Ramón Pando Ferrer" between September 2016 and September 2017. The variables studied were: axial length, anterior chamber depth, and horizontal corneal diameter. Non-contact biometry was performed with IOLMaster 500 (Carl Zeiss) in both eyes. Results: The average age was 24.9 years and 25.9 years in Cuban and Chinese patients respectively. The average biometric results of both eyes for Cuban/Chinese eyes were: axial length 24.10 mm/24.60 mm; anterior chamber width 3.56 mm/3.46 mm; and horizontal corneal diameter 11.80 mm/11.60 mm, with no statistically significant differences. Sixty percent of the Chinese eyes were long, while 45 percent of the Cuban eyes were long. Two Chinese eyes were reported with narrow anterior chamber and horizontal corneal diameter was normal in a 100 percent of them. Conclusions: Chinese exhibited eyes of greater axial length, smaller anterior chamber width and smaller horizontal corneal diameter than Cubans although the differences were not statistically significant(AU)

Outcomes of a simplified, fixed surgical dosage calculation for uncomplicated, horizontal, concomitant strabismus in adults

Purpose: The aim of this study was to evaluate the outcomes of a simplified, fixed surgical dosage calculation for uncomplicated, horizontal, concomitant strabismus in adults. Methods: Outcomes analysis of a fixed?dose calculation method for uncomplicated, horizontal, concomitant strabismus in adults (?18 years) wherein 1?mm recession/resection equals 2 PD for lateral rectus and 3 PD for medial rectus. This was a retrospective case series. Results: The mean age of the patients was 28.50 � 8.43 years, the mean amount of preoperative deviation was 35.16 � 9.97 PD, the mean expected correction was 36.26 � 9.49 PD, and the mean correction achieved was 35.92 � 10.74 PD. There were 22 monocular exotropias, six monocular esotropias, eight alternate divergent squints, and two alternate convergent squints. There were 20 cases of sensory strabismus (54.28%). There was no statistically significant difference between the expected correction and correction achieved (P = 0.519), meaning that our fixed?dose calculation method was effective. Thirty?five out of 38 patients had successful outcomes as per our criteria of less than 10?PD deviations from straight in primary position. Therefore, the success rate achieved by this procedure was 92.10%. There was no statistically significant correlation between age and the amount of deviation (P = 0.611). Conclusion: Our case series had a high postoperative success rate in terms of motor alignment. It is hoped that this simplified, fixed?dosage calculation method would help the numerous novice strabismus surgeons, make their starting steps easier and give them the confidence to do strabismus surgeries. They can modify the dosages later as per their own experiences

Restablecimiento de la estabilidad horizontal en luxaciones acromioclaviculares III-V mediante la reconstrucción anatómica de los ligamentos coracoclaviculares y acromioclaviculares; técnica quirúrgica / Restoring horizontal stability in III-V acromioclavicular dislocations by anatomic reconstruction of the coracoclavicular and acromioclavicular ligaments; surgical technique

Resumen: Introducción: la luxación de la articulación acromioclavicular (AC) es una lesión frecuente que se observa en adultos jóvenes. El objetivo es describir una técnica quirúrgica que pueda restablecer la estabilidad horizontal y vertical de la articulación AC. Material y métodos: se describe una técnica quirúrgica utilizando un aloinjerto para la reconstrucción anatómica de los ligamentos coracoclaviculares (CC) y AC para luxaciones AC grado III-V de acuerdo con la clasificación de Rockwood. Resultados: es una técnica quirúrgica con reconstrucción anatómica y biológica de los ligamentos CC y AC con injerto. Se realizan dos túneles óseos en la clavícula pasando el cabo lateral del injerto por debajo del acromion; posteriormente se fijan los dos cabos con dos tornillos bioabsorbibles, restaurando de esta manera la estabilidad vertical y horizontal. Conclusión: este procedimiento permite restablecer la estabilidad vertical y horizontal de la articulación AC. Se requieren estudios de seguimiento para reportar resultados funcionales y radiológicos con el fin de poder asegurar ventajas en comparación con las técnicas existentes.

Abstract: Introduction: dislocation of the acromioclavicular (AC) joint is a common injury seen in young adults. The objective is to describe a surgical technique that can restore the horizontal and vertical stability of the AC joint. Material and methods: we describe a surgical technique that can restore horizontal and vertical stability using an allograft for the anatomical reconstruction of the CC and AC ligaments, for AC grade III-V dislocations according to the Rockwood classification. Results: this is a surgical technique with anatomical and biological reconstruction of the CC and AC ligaments, using an allograft. Two bone tunnels are made in the clavicle, passing the lateral end of the graft below the acromion; then the two ends are fixed with two bioabsorbable screws, restoring vertical and horizontal stability. Conclusion: this procedure allows to restore the vertical and horizontal stability of the AC joint. Follow up studies are required to report functional and radiological results, in order to ensure advantages compared to existing techniques.