Effect of repeated epilation for minor trachomatous trichiasis on lash burden, phenotype and surgical management willingness: A cohort study

Background WHO endorsed the use of epilation as an alternative treatment to surgery for the management of both minor unoperated TT (UTT) and postoperative TT (PTT). However, some trachoma control programmes hesitated to implement epilation citing concerns that it would hamper TT surgical acceptance and result in larger numbers of and stiffer trichiatic eyelashes than the original TT lashes. We investigated the burden and phenotypes of post-epilation trichiatic eyelashes, and willingness to accept surgical management separately in unoperated and postoperative TT cases. Methodology/Principal findings We recruited cases with minor (≤5 eyelashes from the upper eyelid touching the eye or evidence of epilation in <1/3rd of the upper eyelid) UTT (170) and PTT (169) from community-based screenings in Amhara Region, Ethiopia. Participants eyes were examined and data on present and future willingness to accept surgical management collected at baseline and every month for 6-months. Eyelashes touching the eye were counted and their phenotypes documented. Participants were trained on how to epilate. Epilation was done by the participants at home and by the examiner during follow-ups when requested by the participant. Follow-up rates were ≥97%. There was evidence of a significant reduction in the burden of trichiatic eyelashes in unoperated (mean difference = -0.90 [-1.11– -0.69]; RR = 0.50 [95% CI, 0.40–0.62]; p<0.0001), and postoperative (mean difference = -1.16 [-1.36– -0.95]; RR = 0.38 [95% CI, 0.31–0.48]; p<0.0001) cases 6-month after frequent epilation. Post-epilation trichiatic eyelashes at 6-months had higher odds of being thin (40.2% vs 55.8%, OR = 1.88 [95% CI, 1.21–2.93]; p = 0.0048), weak (39.8% vs 70.8%, OR = 3.68 [95%CI,2.30–5.88]; p<0.0001), and half-length (30.9% vs 43.3%, OR = 1.71 [1.09–2.68]; p = 0.020) than the pre-epilation trichiatic eyelashes in unoperated cases. There was a significant increase in the proportion of weak trichiatic eyelashes (OR = 1.99 [95% CI, 1.03–3.83; p = 0.039) in postoperative cases. In all 6 follow-up time points, 120/164 (73.2%) of unoperated and 134/163 (82.2%) of postoperative cases indicated that they would accept surgery if their trichiasis progressed. Conclusions/Significance In this study setting, frequent epilation neither hampers surgical acceptance nor results in more damaging trichiatic eyelashes than the pre-epilation lashes; and can be used as an alternative to the programmatic management of minor unoperated and postoperative TT cases.

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Adenocarcinoma of Meibomian glands in Male- A rare case report

Community Based Medical Journal ◽

10.3329/cbmj.v2i1.14189 ◽

2013 ◽

Vol 2 (1) ◽

pp. 69-72

Author(s):

Mahmudul Hasan Siddiqi ◽

Mirza Hamidul Huq ◽

Ambia Begum ◽

MS Fazilatunnesa

Keyword(s):

Rare Case ◽

Excisional Biopsy ◽

Meibomian Gland ◽

Community Based ◽

Upper Eyelid ◽

Rare Case Report ◽

Upper Lid ◽

Lid Reconstruction ◽

The Right

A 50 years old male presented with recurrent multinodular growth on the right upper eyelid mimicking multiple chalazion for the last two years. He was treated as chalazion two times but recurred. A full thickness wide excisional biopsy of the lesion along with normal lid tissue done. Histopathological report was Adenocarcinoma of the meibomian gland of the right upper lid. Lid reconstruction done by lid sharing procedure. Result of the treatment was excellent after follow up period of six months with good lid function and no significant complication. DOI: http://dx.doi.org/10.3329/cbmj.v2i1.14189 Community Based Medical Journal Vol.2(1) 2013 69-72

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Patient perceived barriers to surgical follow-up: Study of 6-month post-operative trichiasis surgery follow-up in Tanzania

PLoS ONE ◽

10.1371/journal.pone.0247994 ◽

2021 ◽

Vol 16 (3) ◽

pp. e0247994

Author(s):

Michael Saheb Kashaf ◽

Meraf A. Wolle ◽

Beatriz E. Muñoz ◽

Harran Mkocha ◽

Nicodemus Funga ◽

...

Keyword(s):

Surgical Care ◽

Perceived Barriers ◽

Study Patient ◽

Community Based ◽

Enabling Factors ◽

Middle Income ◽

Middle Income Countries ◽

Outcome Of Surgery ◽

Trachomatous Trichiasis

Background Post-surgical follow-up is a challenge in low- and middle-income countries. Understanding barriers to trachomatous trichiasis (TT) surgical follow-up can inform program improvements. In this study, patient perceived barriers and enabling factors to follow-up after TT surgery are identified. Methods A longitudinal study was carried out in a community-based cohort of persons who received TT surgery in Bahi district, Tanzania. Questionnaires were administered before TT surgery and again after the scheduled 6-month follow-up. Those who did not return were examined at their homes. Results At baseline, 852 participants were enrolled. Of these, 633 (74%) returned at 6 months and 128 (15%) did not and were interviewed at home. Prior to surgery, attenders were more likely to report familiarity with a community health worker (CHW) (22% vs. 14%; p = 0.01) and less likely to state that time constraints are a potential reason for failure to follow-up (66% vs. 74%; p = .04). At follow-up, non-attenders were more likely to endorse barriers pertaining to knowledge about the need for follow-up, lack of transportation, and satisfaction with surgery. There was no difference in post-operative TT between attenders and non-attenders (23% vs. 18% respectively; p = 0.25). Conclusions The outcome of surgery was not a barrier to follow-up. However, better integration of CHWs into their communities and work at coordinating post-surgical care may improve follow-up rates. Moreover, provision of transportation and implementation of effective reminder systems may address patient-perceived barriers to improve follow-up.

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SURGICAL MANAGEMENT OF INTRACRANIAL MENINGIOMAS

The Professional Medical Journal ◽

10.29309/tpmj/2007.14.01.3644 ◽

2007 ◽

Vol 14 (01) ◽

pp. 170-176

Author(s):

TARIQ AHNIAD ◽

INAMULLAH ASGHAR ◽

AKMAL HUSSAIN ◽

Sibef Hasan ◽

Habib Sultan

Keyword(s):

Surgical Management ◽

Total Removal ◽

Medical College ◽

Simpson Grade ◽

Intracranial Meningiomas ◽

Grade Ii ◽

One Year ◽

Study Setting ◽

Neurovascular Structures

Objective: To study the surgical management and outcome of patients having intracranial meningiomas. Design: A retrospective study. Setting: The Department of Neurosurgery Punjab Medical College & Allied Hospital, Faisalabad. Duration From April 2004 to October 2005. Materials & Methods:Thirty patients suffering from intracranial meningiomas diagnosed on CT-scan and managed surgically were included in this study. Simpson grade I removal was possible in 21 patients. Grade II removal was done in Three patients while grade 111 removal was possible in four patients, grade IV removal was done in one patient and grade V in one patient. Post operative XRT was given in cases having grades II, 111, IV and V removal. Follow up was done at six monthly intervals. Outcome was assessed as Good .Fair, and poor depending upon clinical and radiological examinations. RESULTS: Out of 30 patients only one had recurrence after one year of follow up which was removed surgically and postoperative XRT was given.Twenty four patients had good outcome while 5 patients had fair outcome and one had poor outcome. CONCLUSION. Study showed that Simpson grade 1 removal of tumor is still effective treatment in the management of meningiomas. Postoperative XRT is used in Simpson grade 2, 3, 4 and 5 in which gross total removal is not possible due to involvement of neurovascular structures.

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RESULTS OF INTRALESIONAL TRIAMCINOLONE ACETONIDE FOR CHALAZION TREATMENT

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2011.5.13 ◽

2011 ◽

pp. 100-104

Author(s):

Thi Thu Nguyen ◽

Viet Hien Vo ◽

Thi Em Do

Keyword(s):

Success Rate ◽

Key Words ◽

Triamcinolone Acetonide ◽

Lower Eyelid ◽

Upper Eyelid ◽

Interventional Trial ◽

The Mean ◽

First Time

The study use intralesional triamcinolone acetonide injection proceduce for chalazion treatment.1. Objectives: To evaluate results of intralesional triamcinolone acetonide injection for chalazion treatment. 2. Method: This noncomparative prospective interventional trial included 72 chalazions of 61 patients. 3. Results: 61 patients (72 chalazions) with 19 males (31.1%) và 42 females (68.9%), the mean age was 24 ± 9,78 years. 31.1% patients was the first time chalazion and 68.9% patients was more than one times chalazion including 78.6% patients was recurrent at the first position and 21.4% patients occur at new position. 72 chalazions with 16 (22.2%) chalazions was treated before and 56 (77.8%) chalazions wasn’t done that. 72 chalazions with 49 chalazions (68.1%) are local in upper eyelid and 23 chalazions (31.9%) are local in lower eyelid. The mean of chalazion diameter is 6.99 ± 3.03mm. Intralesional triamcinolone acetonide is injected to treat 72 chalazions with 16 (22.2%) chalazions are injected through the route of skin and 56 (77.8%) chalazions are injected through the route of conjunctiva. After 2 weeks follow-up, the success rate was 93.1% and 6.9% failed. 4. Conclusion: intralesional triamcinolone acetonide injection for chalazion treatment is really effective. Key words: chalazion, intralesional triamcinolone acetonide.

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The Effect of Javanese Language Videos with a Community Based Interactive Approach Method as an Educational Instrument for Knowledge, Perception, and Adherence amongst Tuberculosis Patients

Pharmacy ◽

10.3390/pharmacy9020086 ◽

2021 ◽

Vol 9 (2) ◽

pp. 86

Author(s):

Fauna Herawati ◽

Yuni Megawati ◽

Aslichah ◽

Retnosari Andrajati ◽

Rika Yulia

Keyword(s):

Intervention Group ◽

Personal Control ◽

Control Group ◽

P Value ◽

Interactive Approach ◽

Community Based ◽

Tuberculosis Patients ◽

Level Of Knowledge ◽

The Impact

The long period of tuberculosis treatment causes patients to have a high risk of forgetting or stopping the medication altogether, which increases the risk of oral anti-tuberculosis drug resistance. The patient’s knowledge and perception of the disease affect the patient’s adherence to treatment. This research objective was to determine the impact of educational videos in the local language on the level of knowledge, perception, and adherence of tuberculosis patients in the Regional General Hospital (RSUD) Bangil. This quasi-experimental study design with a one-month follow-up allocated 62 respondents in the intervention group and 60 in the control group. The pre- and post-experiment levels of knowledge and perception were measured with a validated set of questions. Adherence was measured by pill counts. The results showed that the intervention increases the level of knowledge of the intervention group higher than that of the control group (p-value < 0.05) and remained high after one month of follow-up. The perceptions domains that changed after education using Javanese (Ngoko) language videos with the Community Based Interactive Approach (CBIA) method were the timeline, personal control, illness coherence, and emotional representations (p-value < 0.05). More than 95% of respondents in the intervention group take 95% of their pill compared to 58% of respondents in the control group (p-value < 0.05). Utilization of the local languages for design a community-based interactive approach to educate and communicate is important and effective.

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Are voters too afraid to tackle corruption? Survey and experimental evidence from Mexico

Political Science Research and Methods ◽

10.1017/psrm.2020.49 ◽

2021 ◽

pp. 1-19

Author(s):

Omar García-Ponce ◽

Thomas Zeitzoff ◽

Leonard Wantchekon

Keyword(s):

Political Behavior ◽

Causal Effects ◽

Willingness To Accept ◽

Survey Experiment ◽

Drug War ◽

Mexican Drug War ◽

The Face ◽

Victims Of Crime ◽

Nationally Representative

Abstract Are individuals in violent contexts reluctant to tackle corruption for fear of future violence? Or does violence mobilize them to fight corruption? We investigate these questions looking at the effects of fear and violence stemming from the Mexican Drug War on attitudes toward corruption. We conducted two surveys before the 2012 Mexican presidential election. First, as part of a nationally representative survey, we find a positive correlation between fear of violence and willingness to accept corruption in exchange for lower levels of violence. To disentangle causal effects, we conducted a follow-up survey experiment in Greater Mexico City where we manipulated fear over the Drug War. We find that individuals within this context are not easily scared. Those who received a common fear-inducing manipulation do not report higher levels of fear and are less willing to tolerate corruption. Conversely, we find strong evidence that individuals who have been victims of crime are more likely to report both higher levels of fear and willingness to accept corruption if it lowers violence. Our findings suggest that voters are more strategic and resilient in the face of violence than many extant theories of political behavior suggest.

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Client satisfaction with existing postnatal care and associated factors: A study among mothers in Awi Zone, Amhara region, Ethiopia

Women s Health ◽

10.1177/1745506520976017 ◽

2020 ◽

Vol 16 ◽

pp. 174550652097601

Author(s):

Daniel Adane ◽

Biresaw Wassihun

Keyword(s):

Antenatal Care ◽

Health Care Providers ◽

Postnatal Care ◽

Associated Factors ◽

Client Satisfaction ◽

Post Partum ◽

Care Providers ◽

Amhara Region ◽

Awi Zone

Background: The majority of maternal and neonatal adverse events take place during the postnatal period. However, it is the most neglected period for the provision of quality care. Objective: The aim of this study among mothers in the Awi Zone, Amhara region, Ethiopia, was to assess client satisfaction with existing postnatal care and associated factors. Methods: An institution-based cross-sectional study was conducted in Awi Zone hospitals from 1 to 30 April 2018. A total of 422 post-partum mothers were selected by systematic sampling. The data were collected using a pre-tested structured questionnaire via a face-to-face interview. Data entry and analysis were completed using EpiData version 3.1 and SPSS version 22, respectively. The data were summarized with frequency and cross-tabulation. Both binary and multiple logistic regressions were used to identify predictor variables using odds ratios and 95% confidence intervals. Result: The prevalence of postnatal care satisfaction was 63%. Being from urban area (AOR = 2.1, 95% CI = (1.11–3.99)), having a history of antenatal care follow up (AOR = 1.62, 95% CI = (1.23–1.64)), spontaneous vaginal birth (AOR = 3.14, 95% CI = (1.77–3.28)), and those who did not face any complications during birth (AOR = 2.90, 95% CI = (1.47–1.69)) were some of the factors associated with client satisfaction. Conclusion: According to the results of this study, the majority of mothers were satisfied with post-partum care services. The study findings indicate that maternal satisfaction on post-partum care is mainly affected by residency, antenatal care follow up, mode of delivery, and complications during birth. Therefore, health care providers and other concerned bodies should give special attention to those mothers who are from rural areas, who face complications during birth or who have instrumental-assisted or cesarean section birth. Also, every pregnant mother should be supported to have at least four regular antenatal care visits.

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Coronary artery aneurysms: outcomes following medical, percutaneous interventional and surgical management

Open Heart ◽

10.1136/openhrt-2020-001440 ◽

2021 ◽

Vol 8 (1) ◽

pp. e001440

Author(s):

Shameer Khubber ◽

Rajdeep Chana ◽

Chandramohan Meenakshisundaram ◽

Kamal Dhaliwal ◽

Mohomed Gad ◽

...

Keyword(s):

Coronary Artery ◽

Surgical Management ◽

Medical Management ◽

Cox Regression ◽

Artery Bypass ◽

Management Strategies ◽

Coronary Artery Aneurysms ◽

Kaplan Meier

BackgroundCoronary artery aneurysms (CAAs) are increasingly diagnosed on coronary angiography; however, controversies persist regarding their optimal management. In the present study, we analysed the long-term outcomes of patients with CAAs following three different management strategies.MethodsWe performed a retrospective review of patient records with documented CAA diagnosis between 2000 and 2005. Patients were divided into three groups: medical management versus percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG). We analysed the rate of major cardiovascular and cerebrovascular events (MACCEs) over a period of 10 years.ResultsWe identified 458 patients with CAAs (mean age 78±10.5 years, 74.5% men) who received medical therapy (N=230) or underwent PCI (N=52) or CABG (N=176). The incidence of CAAs was 0.7% of the total catheterisation reports. The left anterior descending was the most common coronary artery involved (38%). The median follow-up time was 62 months. The total number of MACCE during follow-up was 155 (33.8%); 91 (39.6%) in the medical management group vs 46 (26.1%) in the CABG group vs 18 (34.6%) in the PCI group (p=0.02). Kaplan-Meier survival analysis showed that CABG was associated with better MACCE-free survival (p log-rank=0.03) than medical management. These results were confirmed on univariate Cox regression, but not multivariate regression (OR 0.773 (0.526 to 1.136); p=0.19). Both Kaplan-Meier survival and regression analyses showed that dual antiplatelet therapy (DAPT) and anticoagulation were not associated with significant improvement in MACCE rates.ConclusionOur analysis showed similar long-term MACCE risks in patients with CAA undergoing medical, percutaneous and surgical management. Further, DAPT and anticoagulation were not associated with significant benefits in terms of MACCE rates. These results should be interpreted with caution considering the small size and potential for selection bias and should be confirmed in large, randomised trials.

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Failed Surgery for Patellar Tendinopathy in Athletes: Midterm Results of Further Surgical Management

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967121994550 ◽

2021 ◽

Vol 9 (3) ◽

pp. 232596712199455

Author(s):

Nicola Maffulli ◽

Francesco Oliva ◽

Gayle D. Maffulli ◽

Filippo Migliorini

Keyword(s):

Surgical Management ◽

Revision Surgery ◽

Case Series ◽

Sports Participation ◽

Patellar Tendinopathy ◽

Symptom Duration ◽

Level Of Evidence ◽

Training Time ◽

The Mean

Background: Tendon injuries are commonly seen in sports medicine practice. Many elite players involved in high-impact activities develop patellar tendinopathy (PT) symptoms. Of them, a small percentage will develop refractory PT and need to undergo surgery. In some of these patients, surgery does not resolve these symptoms. Purpose: To report the clinical results in a cohort of athletes who underwent further surgery after failure of primary surgery for PT. Study Design: Case series; Level of evidence, 4. Methods: A total of 22 athletes who had undergone revision surgery for failed surgical management of PT were enrolled in the present study. Symptom severity was assessed through the Victorian Institute of Sport Assessment Scale for Patellar Tendinopathy (VISA-P) upon admission and at the final follow-up. Time to return to training, time to return to competition, and complications were also recorded. Results: The mean age of the athletes was 25.4 years, and the mean symptom duration from the index intervention was 15.3 months. At a mean follow-up of 30.0 ± 4.9 months, the VISA-P score improved 27.8 points ( P < .0001). The patients returned to training within a mean of 9.2 months. Fifteen patients (68.2%) returned to competition within a mean of 11.6 months. Of these 15 patients, a further 2 had decreased their performance, and 2 more had abandoned sports participation by the final follow-up. The overall rate of complications was 18.2%. One patient (4.5%) had a further revision procedure. Conclusion: Revision surgery was feasible and effective in patients in whom PT symptoms persisted after previous surgery for PT, achieving a statistically significant and clinically relevant improvement of the VISA-P score as well as an acceptable rate of return to sport at a follow-up of 30 months.

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A rare triad of morning glory disc anomaly, moyamoya vasculopathy, and transsphenoidal cephalocele: pathophysiological considerations and surgical management

Neurological Sciences ◽

10.1007/s10072-021-05221-2 ◽

2021 ◽

Author(s):

Marco Pavanello ◽

Pietro Fiaschi ◽

Andrea Accogli ◽

Mariasavina Severino ◽

Domenico Tortora ◽

...

Keyword(s):

Surgical Management ◽

Missense Variant ◽

Morning Glory ◽

Morning Glory Disc Anomaly ◽

Long Term Follow Up ◽

Indirect Revascularization ◽

Peripapillary Retina

AbstractMorning glory disc anomaly is a congenital abnormality of the optic disc and peripapillary retina reported as an isolated condition or associated with various anomalies, including basal encephaloceles and moyamoya vasculopathy. However, the co-occurrence of these three entities is extremely rare and the pathogenesis is still poorly understood. Moreover, data on the surgical management and long-term follow-up of the intracranial anomalies are scarce. Here, we describe the case of a 11-year-old boy with morning glory disc anomaly, transsphenoidal cephalocele, and moyamoya vasculopathy, who underwent bilateral indirect revascularization with encephalo-duro-myo-arterio-pericranio-synangiosis at the age of 2 years, and endoscopic repair of the transsphenoidal cephalocele at the age of 6 years. A rare missense variant (c.1081T>C,p.Tyr361His) was found in OFD1, a gene responsible for a X-linked ciliopathy, the oral-facial-digital syndrome type 1 (OFD1; OMIM 311200). This case expands the complex phenotype of OFD1 syndrome and suggests a possible involvement of OFD1 gene and Shh pathway in the pathogenesis of these anomalies.

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