11†Convergence insufficiency: are we making a difference in patients' lives or is it a waste of time!

Convergence insufficiency (CI) is a common condition that can impair visual performance and comfort during close visual work. This prospective study evaluated the effectiveness of interventions on clinical outcomes and quality-of-life using the adult strabismus quality-of-life questionnaire (AS20) in patients with CI.Data was extracted from a database collected at first consultation from 2015 to 2022. Demographics, interventions and outcomes of 84 patients with CI (mean age 47.0±24.9 years) were analysed.Orthoptic exercises were prescribed to 56% of patients, 32% received prisms, 15% received no treatment, with 3 discharged on the same day. At latest follow-up review, 22.6% were recommended to continue exercises, 28.6% had prisms, 1 underwent bimedial resection and 2 had botox. The median follow-up was 5.5(5.0-55)months, 88.1% were discharged with 29.8% following failure to attend and 9.5% deceased. Near-point of convergence (NPC) improved from a median of 15(6-50)cm to 10(6-30)cm. The median AS20 score at presentation were 100(30-100) and 47.5(0-100), and post-intervention were 100(80-100) and 77.5(12.5-97.5) for psychosocial and functional components, respectively.At the latest follow-up, the attendance failure rate was higher for exercises (36%) than for prisms (15%). Improvement was noted in NPC (33%) and mean AS20 scores was 9% higher psychosocially and 32.8% functionally, highlighting the benefits of intervention on patients' quality-of-life.This cohort provides valuable insights into the clinical management of CI, as evidenced by improvements in NPC and AS20 scores. However, the study also found that long-term compliance with treatment is intrinsically challenging, emphasising the importance of disease education.

Using Convolutional Neural Network with Cheat Sheet and Data Augmentation to Detect Breast Cancer in Mammograms.

The American Cancer Society expected to diagnose 276,480 new cases of invasive breast cancer in the USA and 48,530 new cases of noninvasive breast cancer among women in 2020. Early detection of breast cancer, followed by appropriate treatment, can reduce the risk of death from this disease. DL through CNN can assist imaging specialists in classifying the mammograms accurately. Accurate classification of mammograms using CNN needs a well-trained CNN by a large number of labeled mammograms. Unfortunately, a large number of labeled mammograms are not always available. In this study, a novel procedure to aid imaging specialists in detecting normal and abnormal mammograms has been proposed. The procedure supplied the designed CNN with a cheat sheet for some classical attributes extracted from the ROI and an extra number of labeled mammograms through data augmentation. The cheat sheet aided the CNN through encoding easy-to-recognize artificial patterns in the mammogram before passing it to the CNN, and the data augmentation supported the CNN with more labeled data points. Fifteen runs of 4 different modified datasets taken from the MIAS dataset were conducted and analyzed. The results showed that the cheat sheet, along with data augmentation, enhanced CNN's accuracy by at least 12.2% and enhanced the precision of the CNN by at least 2.2. The mean accuracy, sensitivity, and specificity obtained using the proposed procedure were 92.1, 91.4, and 96.8, respectively, while the average area under the ROC curve was 94.9.

Breast Cancer Diagnosis in Digital Mammography Images Using Automatic Detection for the Region of Interest.

BACKGROUND: One of the early screening methods of breast cancer that is still used today is mammogram due to its low cost. Unfortunately, this low cost accompanied with low performance rate also. METHODS: The low performance rate in mammograms is associated with low capability in determining the best region from which the features are extracted. Therefore, we offer an automatic method to detect the Region of Interest in the mammograms based on maximizing the area under receiver operating characteristic curve utilizing Genetic Algorithms. The proposed method had been applied to the MIAS mammographic database, which is widely used in literature. Its performance had been evaluated using four different classifiers; Support Vector Machine, Naïve Bayes, K-Nearest Neighbor and Logistic Regression classifiers. RESULTS & CONCLUSION: The results showed good classification performances for all the classifiers used due to the rich information contained in the features extracted from the automatically selected Region of Interest.

Methods Used in Computer-Aided Diagnosis for Breast Cancer Detection Using Mammograms: A Review.

According to the American Cancer Society's forecasts for 2019, there will be about 268,600 new cases in the United States with invasive breast cancer in women, about 62,930 new noninvasive cases, and about 41,760 death cases from breast cancer. As a result, there is a high demand for breast imaging specialists as indicated in a recent report for the Institute of Medicine and National Research Council. One way to meet this demand is through developing Computer-Aided Diagnosis (CAD) systems for breast cancer detection and diagnosis using mammograms. This study aims to review recent advancements and developments in CAD systems for breast cancer detection and diagnosis using mammograms and to give an overview of the methods used in its steps starting from preprocessing and enhancement step and ending in classification step. The current level of performance for the CAD systems is encouraging but not enough to make CAD systems standalone detection and diagnose clinical systems. Unless the performance of CAD systems enhanced dramatically from its current level by enhancing the existing methods, exploiting new promising methods in pattern recognition like data augmentation in deep learning and exploiting the advances in computational power of computers, CAD systems will continue to be a second opinion clinical procedure.

Potential of natural repellents methylanthranilate and anthraquinone applied on maize seeds and seedlings against house sparrow (Passer domesticus) in captivity / Potencial de repelentes naturais, metilantranilato e antraquinona aplicados em sementes de milho e mudas contra o pardal (Passer domesticus) em cativeiro

Abstract Various bird pests caused severe economic losses to valuable crops and fruit orchards all over the world. Among the birds, house sparrow is also considered to cause heavy plunder, not only to seeds of crops but also seedlings especially in organic farming. In present study two bird repellents, methylanthranilate and anthraquinone tested against house sparrows on maize seeds and seedlings in aviary conditions. Trial group in aviary-I, the treated maize seeds and seedlings with different doses of both bird repellents, control group in aviary-II, untreated seeds and seedlings were provided for three hours in the early morning. In each aviary, two closed circuit cameras were also installed to monitor the behavioral responses against different concentrations of both chemical repellents. Statistical analysis showed that there existed highly significant (P<0.01) variations among the trial and control groups for seeds and seedlings. By comparing both repellents, significant (P<0.05) differences were detected and anthraquinone showed better efficacy when compared to methylanthranilate, but in maize seedlings both repellents equal repellent properties. Non-significant (P>0.05) differences were observed in different grading of both natural chemical repellents for maize seeds while significant (P<0.05) variations were noticed for maize seedlings when provided to sparrows. By videotaped behavior sparrows presented manifest head juddering and feather upsetting activities by consumption of treated seeds and seedlings with higher concentrations of both natural bird repellents.

Resumo Várias pragas de aves causaram graves perdas econômicas para cultivos valiosos e pomares de frutas em todo o mundo. Entre os pássaros, o pardal da casa também é considerado um grande saqueo, não só para as sementes das culturas, mas também para as mudas, especialmente na agricultura orgânica. No presente estudo, dois repelentes de aves, metilantranilato e antraquinona testados contra pardais de casa em sementes de milho e mudas em condições de aviário. O grupo de ensaio em aviary-I, as sementes de milho tratadas e as mudas com diferentes doses de repelentes de aves, grupo de controle em aviary-II, sementes não tratadas e mudas foram fornecidas por três horas no início da manhã. Em cada aviário, duas câmeras de circuito fechado também foram instaladas para monitorar as respostas comportamentais contra diferentes concentrações de ambos os repelentes químicos. A análise estatística mostrou que existiam variações altamente significativas (P<0,01) entre os grupos de teste e controle para sementes e mudas. Ao comparar os dois repelentes, detectaram-se diferenças significativas (P<0,05) e a antraquinona apresentou maior eficácia quando comparada ao metilantranilato, mas em mudas de milho, ambos os repelentes são iguais às propriedades repelentes. As diferenças não significantes (P>0,05) foram observadas em diferentes classificações de repelentes químicos naturais para sementes de milho, enquanto as variações significativas (P<0,05) foram observadas para as mudas de milho quando fornecidas aos pardais. Por um comportamento gravado em video, os pardais apresentaram manifestações de cabeça e vibrações de penas por consumo de sementes tratadas e mudas com maiores concentrações de repelentes de aves naturais.

Potential of natural repellents methylanthranilate and anthraquinone applied on maize seeds and seedlings against house sparrow (Passer domesticus) in captivity.

Various bird pests caused severe economic losses to valuable crops and fruit orchards all over the world. Among the birds, house sparrow is also considered to cause heavy plunder, not only to seeds of crops but also seedlings especially in organic farming. In present study two bird repellents, methylanthranilate and anthraquinone tested against house sparrows on maize seeds and seedlings in aviary conditions. Trial group in aviary-I, the treated maize seeds and seedlings with different doses of both bird repellents, control group in aviary-II, untreated seeds and seedlings were provided for three hours in the early morning. In each aviary, two closed circuit cameras were also installed to monitor the behavioral responses against different concentrations of both chemical repellents. Statistical analysis showed that there existed highly significant (P<0.01) variations among the trial and control groups for seeds and seedlings. By comparing both repellents, significant (P<0.05) differences were detected and anthraquinone showed better efficacy when compared to methylanthranilate, but in maize seedlings both repellents equal repellent properties. Non-significant (P>0.05) differences were observed in different grading of both natural chemical repellents for maize seeds while significant (P<0.05) variations were noticed for maize seedlings when provided to sparrows. By videotaped behavior sparrows presented manifest head juddering and feather upsetting activities by consumption of treated seeds and seedlings with higher concentrations of both natural bird repellents.

Impact of health literacy on diabetes outcomes: a cross-sectional study from Lahore, Pakistan.

OBJECTIVES: To evaluate the functional health literacy of patients with type 2 diabetes in Lahore and its impact on glycaemic control. STUDY DESIGN: A six-month cross-sectional study. METHODS: Health literacy in 204 patients with diabetes was evaluated using a validated questionnaire (Short Test of Functional Health Literacy [s-TOFHLA]). RESULTS: The frequency distribution among various age groups (P = 0.003), education levels (P = 0.0005), socio-economic status levels (P = 0.0005) and glycated haemoglobin (HbA1C) levels (P = 0.0005) differed significantly with health literacy level. The majority of patients with diabetes (86.1%) with poor glycaemic control (HbA1C >9%) had inadequate health literacy and were more likely to have retinopathy (odds ratio = 13.1, P = 0.003). Health literacy levels were not significantly different when compared for antidiabetic therapies (P = 0.234). Significant associations were observed between predictors of glycaemic control (s-TOFHLA score [P = 0.0005], education status [P = 0.0005] and disease risks [P = 0.005]) and HbA1C, level. However, after adjusting for basic characteristics, only s-TOFHLA score had a significant association with HbA1C level (P = 0.001). CONCLUSIONS: These data suggest that inadequate health literacy is potentially associated with poor glycaemic control, and microvascular and macrovascular complications, particularly retinopathy. As such, educational and training programmes should be introduced to improve functional health literacy of patients with diabetes for better glycaemic control.

Potential of natural repellents methylanthranilate and anthraquinone applied on maize seeds and seedlings against house sparrow (Passer domesticus) in captivity

Abstract Various bird pests caused severe economic losses to valuable crops and fruit orchards all over the world. Among the birds, house sparrow is also considered to cause heavy plunder, not only to seeds of crops but also seedlings especially in organic farming. In present study two bird repellents, methylanthranilate and anthraquinone tested against house sparrows on maize seeds and seedlings in aviary conditions. Trial group in aviary-I, the treated maize seeds and seedlings with different doses of both bird repellents, control group in aviary-II, untreated seeds and seedlings were provided for three hours in the early morning. In each aviary, two closed circuit cameras were also installed to monitor the behavioral responses against different concentrations of both chemical repellents. Statistical analysis showed that there existed highly significant (P 0.01) variations among the trial and control groups for seeds and seedlings. By comparing both repellents, significant (P 0.05) differences were detected and anthraquinone showed better efficacy when compared to methylanthranilate, but in maize seedlings both repellents equal repellent properties. Non-significant (P>0.05) differences were observed in different grading of both natural chemical repellents for maize seeds while significant (P 0.05) variations were noticed for maize seedlings when provided to sparrows. By videotaped behavior sparrows presented manifest head juddering and feather upsetting activities by consumption of treated seeds and seedlings with higher concentrations of both natural bird repellents.

Resumo Várias pragas de aves causaram graves perdas econômicas para cultivos valiosos e pomares de frutas em todo o mundo. Entre os pássaros, o pardal da casa também é considerado um grande saqueo, não só para as sementes das culturas, mas também para as mudas, especialmente na agricultura orgânica. No presente estudo, dois repelentes de aves, metilantranilato e antraquinona testados contra pardais de casa em sementes de milho e mudas em condições de aviário. O grupo de ensaio em aviary-I, as sementes de milho tratadas e as mudas com diferentes doses de repelentes de aves, grupo de controle em aviary-II, sementes não tratadas e mudas foram fornecidas por três horas no início da manhã. Em cada aviário, duas câmeras de circuito fechado também foram instaladas para monitorar as respostas comportamentais contra diferentes concentrações de ambos os repelentes químicos. A análise estatística mostrou que existiam variações altamente significativas (P 0,01) entre os grupos de teste e controle para sementes e mudas. Ao comparar os dois repelentes, detectaram-se diferenças significativas (P 0,05) e a antraquinona apresentou maior eficácia quando comparada ao metilantranilato, mas em mudas de milho, ambos os repelentes são iguais às propriedades repelentes. As diferenças não significantes (P>0,05) foram observadas em diferentes classificações de repelentes químicos naturais para sementes de milho, enquanto as variações significativas (P 0,05) foram observadas para as mudas de milho quando fornecidas aos pardais. Por um comportamento gravado em video, os pardais apresentaram manifestações de cabeça e vibrações de penas por consumo de sementes tratadas e mudas com maiores concentrações de repelentes de aves naturais.

Seroprevalence of Helicobacter pylori Infection in Renal Transplant Recipient Attending Duhok Kidney Disease Center.

INTRODUCTION: Helicobacter pylori plays an important role in the development of gastritis, peptic ulcer disease, and gastric cancer in the general population. Although dyspeptic complaints are frequent in renal transplant subjects, the role of H pylori in such complaints is not clear. This study was conducted to examine the prevalence of H pylori infection in patients with renal transplant and its role in the development of upper gastrointestinal tract (GIT) symptoms. MATERIALS AND METHODS: We compared the prevalence of H pylori in 109 renal transplant subjects with the prevalence of 161 healthy volunteers using an enzyme-linked immunosorbent assay to measure anti-H pylori IgG. Then, within the transplant group, we stratified our data in accordance with different variables, including upper GIT symptoms, sex, education level, smoking, and dialysis history. RESULTS: The prevalence of H pylori in the control group was 111 of 161 (68.9%), which was significantly higher than that found in renal transplant subjects (48/109; 43.04%; P = .001). Within the transplant group, no association was found between immunoglobulin G positivity and different variables including upper GIT symptoms, sex, education level, smoking, and dialysis history. CONCLUSIONS: The prevalence of H pylori was lower in transplant subjects than that of general population. Upper GIT symptoms were equally found in both groups. Hence, the routine eradication of H pylori might not be indicated.

Determination of sodium hyaluronate in pharmaceutical formulations by HPLC-UV.

A liquid chromatography (HPLC) method with UV detection was developed for determination of sodium hyaluronate in pharmaceutical formulation. Sodium hyaluronate is a polymer of disaccharides, composed of d-glucuronic acid and d-N-acetylglucosamine, linked via alternating ß-1, 4 and ß-1, 3 glycosidic bonds. Being a polymer compound it lacks a UV absorbing chromophore. In the absence of a UV absorbing chromophore and highly polar nature of compound, the analysis becomes a major challenge. To overcome these problems a novel method for the determination of sodium hyaluronate was developed and validated based on size exclusion liquid chromatography (SEC) with UV detection. An isocratic mobile phase consisting of buffer 0.05 M potassium dihydrogen phosphate, pH adjusted to 7.0 using potassium hydroxide (10%) was used. Chromatography was carried out at 25 °C on a BioSep SEC S2000, 300 mm×7.8 mm column. The detection was carried out using variable wavelength UV-vis detector set at 205 nm. The compounds were eluted isocratically at a steady flow rate of 1.0 mL/min. Sodium hyaluronate retention time was about 4.9 min with an asymmetry factor of 1.93. A calibration curve was obtained from 1 to 38 g/mL (r>0.9998). Within-day % RSD was 1.0 and between-day % RSD was 1.10. Specificity/selectivity experiments revealed the absence of interference from excipients, recovery from spiked samples for sodium hyaluronate was 99-102. The developed method was applied to the determination of sodium hyaluronate in pharmaceutical drug substance and product.

A simple and rapid high-performance liquid chromatographic method for determining tobramycin in pharmaceutical formulations by direct UV detection.

BACKGROUND: Tobramycin, an aminoglycoside antibiotic, is a polar pharmaceutical compound which lacks a UV absorbing chromophore. Due to the absence of a UV absorbing chromophore and high polar nature of this antibiotic, the analysis of such compounds becomes a major challenge. OBJECTIVE: To overcome these problems, a novel method for the determination aminoglycoside tobramycin was developed and validated based on reversed-phase high-performance liquid chromatography (RP-HPLC) with UV detector. MATERIALS AND METHODS: An isocratic mobile phase consists of buffer 0.05 M diammonium hydrogen phosphate, pH adjusted to 10.0 using tetramethyl ammonium hydroxide. Chromatography was carried out at 25°C on a Purosphere RP-8e, 250 mm × 4.6 mm, 5mm. The detection was carried out using variable wavelength UV-Vis detector set at 210 nm. The compounds were eluted isocratically at a steady flow rate of 1.0 mL/min. RESULT AND DISCUSSION: Tobramycin retention time was about 9.0 min with an asymmetry factor of 1.4. A logarithmic calibration curve was obtained from 0.47 to 0.71 mg/mL (r > 0.9998). Within-day %RSD was 0.29 (n = 6, 0.60 mg/mL) and between-day %RSD was 0.54 Specificity/ selectivity experiments revealed the absence of interference from excipients, recovery from spiked samples was between 99.0-100.0 percent. CONCLUSIONS: A HPLC method based on UV detection has been developed and validated for determination of tobramycin from ophthalmic solution. The method is simple, rapid, specific, accurate (error 0.80%), precise (RSD <2.0%) and linear (r2=0.9998). The described method is suitable for routine analysis and quality control of ophthalmic solution containing tobramycin.

The value of transformed lymphocyte count in subclassification of non-Hodgkin's lymphoma by fine-needle aspiration.

No established criteria exist for predicting lymphoma grade or transformation in cytologic material. We counted transformed lymphocytes in fine-needle aspiration (FNA) biopsy specimens to determine whether the percentage of these cells in the smear could predict the histologic grade, the biologic behavior, or both. The percentage of transformed lymphocytes out of total lymphoid cells was determined on Papanicolaou-stained smears. Afterward, a cytodiagnosis was based on clinical information available at the time of the FNA, cytomorphologic data, and flow cytometry data. Results were correlated with results of examination of the surgical biopsy specimen, clinical behavior of the lymphoma, or both. The percentage of transformed lymphocytes was 10% or less in all low-grade or indolent lymphomas. Aspirates with transformed lymphocyte counts of 20% or greater were aggressive lymphomas. We also report our experience in the diagnosis of non-Hodgkin's lymphoma by FNA using cytomorphologic examination and immunophenotyping by flow cytometry at a cancer referral hospital. This is a preliminary study, and larger series may help establish the ranges of transformed lymphocyte counts that correlate with the lymphoma subtype.