Adherence to Eye Drops Usage in Dry Eye Patients and Reasons for Non-Compliance: A Web-Based Survey

This study aimed to investigate the actual use of eye drops for dry eye disease (DED), the reasons for instillation behavior, and the relationship between instillation behavior and subjective symptoms. This web-based cross-sectional study collected data on instillation behavior, medication instruction, reasons for instillation behavior, and subjective symptoms. In total, 2645 participants were enrolled. The proportion of participants who instilled at the frequency specified in the package insert (the specified frequency) was 10.2%. The most common reason for not instilling at the prescribed frequency was as-needed instillation to alleviate subjective symptoms, and 61.3% of participants instilled when feeling symptoms. The improvement in the subjective symptoms score was significantly greater in the group that regularly instilled at the specified frequency than the other group (p = 0.0027), and patients in the other group were younger and had a higher rate of contact lens use and over-the-counter eye drops use. In conclusion, most participants did not instill the DED eye drops at the specified frequency to alleviate symptoms. In order to obtain the appropriate effect of eye drops, ophthalmologists need to impress upon patients the importance of regular instillation at the frequency specified in the package insert, while taking into account patient characteristics.

Role of homoeopathic medicine in the treatment of a case of carpal tunnel syndrome with dysthymia: A case report

This case report focuses on 50-year-old woman who was diagnosed with dysthymia and carpal tunnel syndrome (CTS). After reviewing her detailed history, she was prescribed homoeopathic medicine Natrum Carb considering the grief after death of her middle daughter, suppression of emotions since her childhood and her characteristic mental state of desiring to be alone and weeping when alone; her characteristic physical generals and dispositional qualities were also considered. After taking homoeopathic medicine, significant improvement occurred in her subjective symptoms such as paraesthesia as well as in the objective CTS-related signs such as the Tinel sign and Phalen test. Her anger, weeping spells, sleep disturbances and sadness were ameliorated as well. Homoeopathic medicine was found to be effective in relieving CTS and dysthymia in this case. Further research is needed to prove the efficacy of this treatment method in this disease.

Veränderung des NPC bei Personen mit Konvergenzinsuffizienz nach I.F.S.-Visualtraining

Purpose. The aim of this study was to evaluate the efficacy of the I.F.S. visual therapy (convergence training) developed by Bruce Evans in a randomized-controlled setting. The analysis of the changes of the near point of convergence (NPC) was the main target of the study. Material and Methods. 20 subjects (39.0 ± 15.32 years) with convergence insufficiency and an NPC > 10 cm underwent 4 weeks of visual therapy in a randomised-controlled singleblind setting. The verum group followed the I.F.S. exercises, while the control group performed a placebo therapy. Before and after the training phase, the NPC and the positive fusional vergence (PFV) were measured in all subjects and the Sheard and Mallett criteria were also assessed. The CISS questionnaire was used to record and quantify subjective symptoms. Results. The statistical analysis (α = 0.05) shows that the NPC of the verum group improved significantly compared to the control group (p = 0.0008) and within the verum group only (p = 0.0002). The positive effect of the I.F.S. exercises is confirmed by the also significant improvement of the PFV. Conclusion. The results as well as the practical experience with the exercises indicate that the I.F.S. visual therapy proves to be effective for individuals with a convergence insufficiency and an NPC > 10 cm in improving the near point of convergence. Keywords. convergence insufficiency, near point of convergence, NPC, visual therapy, convergence training, I.F.S. exercises

Mouth breathing – A predictor for patient satisfaction after nasal septoplasty?

Background: No reliable marker exists to predict septoplasty outcome. Most patients suffering from nasal airway obstruction (NAO) caused by a deviation of the nasal septum report a bothersome mouth breathing and dryness. In this study our aim was to assess, whether mouth breathing could be objectified in these patients and whether mouth breathing could predict septoplasty outcome. Methods: A monocentric, prospective case-control study of 21 patients was conducted. The proportion of mouth breathing was measured in a blinded manner. As a measurement of patient satisfaction, subjective symptoms pre- and postoperatively, were assessed by using VAS, NOSE and SNOT-20 score. In the patient group an additional acoustic rhinometry and a clinical examination of the nose were performed. Results: With a mean of 25% (SD = 20%) the proportion of mouth breathing in patients with NAO did not differ significantly from the proportion in controls without NAO, with a mean of 27% (SD = 23%). Analysis of subjective scores revealed a significant reduction of subjective symptoms after septoplasty. A higher preoperative proportion of mouth breathing correlated with more remaining postoperative NAO. Conclusions: The percentage of mouth breathing is no different in patients with symptomatic septal deviation than in control patients. Mouth breathing in patients with NAO, evaluated for septoplasty, could be a negative predictive factor for patient satisfaction after nasal septoplasty. Mouth breathing in these patients should be observed carefully because more preoperative mouth breathing should make one more hesitant to consider septoplasty.

Evaluating Post-COVID-19 Conditions

Persistent symptoms, physical signs, and abnormal test results after acute coronavirus disease 2019 (COVID-19) illness have emerged as a significant problem in the current and ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus pandemic. Finding a rational balance between compelling subjective symptoms and limited objective findings in patients with post-COVID-19 conditions is challenging. We advise caution in adopting attributions, explanations, and management strategies, and especially in conferring formal disability status, for these disorders until we understand them more completely. The prevalent uncertainties threaten both overevaluation and overtreatment, with substantial personal and societal consequences, and all stakeholders need to be both intellectually open and cautious going forward. This article highlights several concerns in evaluating and treating patients with enduring COVID-19-related illness.

A Case Report on Symptom Improvement in a Polycythemia Vera Patient Treated with Acupuncture

Objectives: This study investigated the effectiveness of acupuncture for improving polycythemia-vera-related symptoms and quality of life.Methods: A 56-year-old woman diagnosed with polycythemia vera received acupuncture treatment between February 19, 2021, and August 26, 2021. We observed the changes in subjective symptoms and conducted myeloproliferative neoplasm symptom assessment form total symptom score (MPN-SAF TSS) questionnaire.Results: After 13 acupuncture treatment sessions over six months, symptoms of polycythemia vera, such as fatigue, bone pain, itching, and headache, improved.Conclusion: This study suggests that acupuncture may be a helpful treatment strategy for polycythemia vera patients suffering from significant symptom burdens and reduced quality of life.

A Case Report on Pain Associated with a Varicocele Treated with Korean Medicine, including Dong’s Acupuncture

Objectives: This study investigated the effectiveness of Dong’s acupuncture for pain associated with a varicocele.Methods: A 23-year-old male patient visited for pain due to varicocele that occurred on March 2 and was treated with acupuncture and moxibustion three times on March 16, 17, and 19. The Numerical Rating Scale (NRS) was used to evaluate the patient’s pain.Results: After the three treatments, the NRS scores decreased, and the patient’s subjective symptoms improved. Also, the patient required no medication for a week from the date of treatment start.Conclusions: These findings demonstrate that Korean medicine may be an option for treating a painful varicocele, but further research is required for confirmation.

Atopic dermatitis in a 2-year-old child treated with individualised homoeopathic medicine: A case report

Atopic dermatitis (AD) is a chronic, relapsing pruritic skin condition which is accompanied by inflammation of the affected parts. It usually develops during early childhood and has a predilection for the skin flexures. Approximately 70% of cases start before the age of 5 years: Only 10% begin in adulthood. Asthma and allergic rhinitis are comorbid in most cases. This is a case report of a 2-year-old child who presented with reddish elevated papular eruptions on the skin with severe itching. After thorough case taking and examination, the diagnosis was AD, based on the Hanifin and Rajka criteria. The patient underwent individualised homoeopathic treatment. In subsequent follow-ups, the patient’s improvement was monitored using the PO-SCORAD scale and the subjective symptoms. Marked improvement was noted within a few months. Homoeopathic treatment is effective in these cases to yield rapid improvement without any adverse effects.

Clinical effectiveness of diquafosol ophthalmic solution 3% in Korean patients with dry eye disease: a multicenter prospective observational study

AIM: To investigate the effectiveness of diquafosol ophthalmic solution 3% administered in Korean patients with dry eye disease in real-world clinical settings. METHODS: Diquafosol was administered for 8wk to 3 patient groups who received diquafosol as add-on therapy to existing medication (Add group, n=150); received diquafosol only (Monotherapy group, n=196); or discontinued part of their existing medication in favor of diquafosol (Switch group, n=11). Tear break-up time (TBUT), cornea and conjunctival staining based on National Eye Institute/Industry scoring scheme, subjective symptoms using the Ocular Surface Disease Index (OSDI) questionnaire, and meibum quality and expressibility were evaluated at baseline, week 4, and week 8. RESULTS: The mean TBUT increased (from 3.46, 3.92, and 5.84s, respectively, to 5.15, 5.53, and 8.59s, respectively) and corneal staining score decreased (from 2.23, 2.24, and 3.09, respectively, to 0.85, 0.97, and 1.64, respectively) in a time-dependent manner from baseline to week 8 in all three groups. Conjunctival staining score, OSDI questionnaire, and meibum quality and expressibility improved over time from baseline to week 8 in the Add and Monotherapy groups, but differences were not statistically significant in the Switch group. CONCLUSION: Diquafosol improves subjective symptoms and objective signs in patients treated with existing medicines combined with diquafosol and treated solely with diquafosol. Diquafosol can be used as an effective therapeutic agent for dry eye disease or additionally applied in patients who have insufficient response to existing medicines.