Optical coherence tomography-angiography in diabetic retinopathy diagnosis and monitoring

Optical coherence tomography-angiography is a modern noninvasive method of 3D imaging and quantitative analysis of the retinal and choroidal microvasculature. It allows detecting manifestation and progression of diabetic retinopathy, planning treatment and evaluating its results.Optical coherence tomography angiography expands our understanding of microvascular changes in retinal vascular plexuses at different disease stages and deepens the understanding of its pathogenesis.

One year outcome and predictors of treatment outcome in central serous chorioretinopathy: Multimodal imaging based analysis

Purpose To evaluate the follow up and treatment outcome of central serous chorioretinopathy (CSCR) based on the new multimodal imaging-based classification and identify the predictors for anatomic and visual outcome. Methods Retrospective, multicentric study on 95 eyes diagnosed with CSCR and a follow up of at least 12 months were included. Eyes with macular neovascularization, atypical CSCR or any other disease were excluded. Results At the baseline, observation was advised to 70% eyes with simple CSCR whereas photodynamic therapy (PDT) was performed in 49% eyes with complex CSCR. Over the follow up, decrease in CMT was significantly higher in simple CSCR as compared to complex CSCR ( P = 0.008) and the recurrences were significantly more in eyes with lower CMT at baseline ( P = 0.0002). Median time of resolution of SRF was 3 months and 6 months in simple and complex CSCR respectively ( P = 0.09). For the 12 months follow up, the median fluid free period was greater ( P = 0.03) while number of interventions performed was lesser in eyes with simple CSCR as compared to complex CSCR ( P = 0.006). Multiple regression analysis showed baseline best corrected visual acuity (BCVA) and baseline persistent SRF to be significantly predictive of BCVA and persistent SRF at 12 months ( P < 0.0001, 0.04) respectively. Conclusions Complex CSCR more often required PDT, was associated with shorter fluid free interval and longer time for SRF resolution. Baseline BCVA and persistent SRF were predictive of final visual and anatomical outcome. The new multimodal imaging based classification is helpful in establishing objective criteria for planning treatment approaches for CSCR.

The Preferences of the Ideal Veneer Smile Design of a Saudi Sample in Riyadh

Esthetic is considered a prime concern for both the practitioners and patients in the area of dentistry. Dentists should thoroughly understand the factors like beauty, harmony, balance, and proportion as are they perceived by the societies while planning treatment. Aim: The aim of the study is to evaluate how different gender, age groups, marital status, educational level, and previous cosmetic dental experience of the Saudi dental professionals and the laypersons will influence the selection of an ideal veneer smile design with various shapes of anterior maxillary teeth to their esthetic preferences. Methods: The present survey-based study included 282 dental professionals and lay persons as the sample. The patient and the treating doctor were administered the questionnaire and were further asked to rank the images in terms of score and order of preference. They were asked to put a checkmark on the five cells visual analogue scale (VAS) next to each image to define attractiveness, considering that, on the VAS, one indicated the least attractive and 5 showed the most attractive veneer smile design. Results: Out of 282 participants 106 were male and were 176 female participants. The participant ages were between 16 and 53 years. To find the association between categorical variables, the Mann-Whitney U test was used (with statistical significance set at 0.05). When the responses were compared between the dentist and non-dentist, there was only a statistically significant difference (0.013) for picture 11 among all the 12 pictures responses. Conclusion: The Dental professionals and laypersons showed more similarities than differences when esthetic dental values were considered. Dental professionals were more critical than laypersons. Keywords: Veneer, Dentists, Smile

CRITICAL ANALYSIS OF NIDANA AND NIDANAPARIVARJANA IN HRIDROGA

Ayurveda is the oldest medical science of human civilization which helps in preventing diseases and promoting health and longevity. Cardiovascular diseases are chronic disease pathology with acute manifestation and is a major cause of death in both the elderly and middle-aged. Nidana is the foremost component of Nidana Panchaka, which not only gives knowledge about causative factors of diseases but also helps in planning treatment protocol. Cardi- ovascular disorders as per Ayurveda can be studied under the spectrum of Hridroga. Over nourishment accompa- nied with physical inactivity leading to Santarpana state is well known to cause plethora of diseases like Hridroga. Consumption of food having mutual contradictory qualities results in morbid accumulation of Kapha and Meda in Raktamarga heralding Margavarana. It is said that the best treatment is Nidanaparivarjana i.e, to abstain from the causative factors. This paper deals with all the Nidanas of Hridroga and the importance of Nidanaparivarjana in preventing them. Keywords: Hridroga, Cardiovascular diseases, Nidana, Nidanaparivarjana

Toxic adenoma: to biopsy or not to biopsy?

Toxic adenoma nodules rarely harbour cancer. Fine-needle aspiration (FNA) is often not done because of the rarity of these lesions being cancer, the difficulty in interpreting cytology in hyperthyroid patients and the rare precipitation of thyrotoxicosis. We present two young, Caucasian female patients aged 29 and 13 years who were each diagnosed with a toxic nodule categorised as benign and indeterminate respectively. They underwent hemithyroidectomy after being rendered euthyroid, however their histology unexpectedly revealed differentiated follicular cancer. Despite thyroid cancer being rare in patients with toxic adenomas, it should be considered when planning treatment, especially if there are risk factors for cancer, or suspicious features on ultrasound examination. A review of the literature shows that compared with adenomas in euthyroid patients, patients in this group are generally younger and predominately female. If an FNA is considered, it should be performed after the patient is rendered euthyroid.

Application of a Simulation System Using Augmented Reality to Practice the Skills of Minimally Invasive Spine Surgery

The developed HoloDoctor software package allows performing surgical operations in real time. It should be emphasized that the operation time on the HoloDoctor PC is reduced by 20-30% compared to traditional methods. The performance of HoloLens glasses with our program is high, while allowing the doctor to save time. The complex provides diagnostics, therapy planning, treatment adjustment as needed and minimizes the risk of medical error. HoloDoctor can be used in educational practice by integrating it into educational programs for medical specialties.

Kronik Hastalıkların Tedavi ve Bakımında Umut Terapisinin Kullanımı

In addition to the biological changes brought about by the disease, individuals with chronic disease may encounter many difficulties such as economic difficulties, deterioration in family relationships, decrease in social activities, and feeling lonely. These difficulties cause a decrease in the hope levels of individuals. With the decrease of hope of the individual, adherence to treatment and quality of life are adversely affected. Among the interventions that can be applied to strengthen hope is hope therapy based on Snyder's theory of hope. Hope therapy can be applied to many diseases from chronic diseases to mental disorders as well as to protect and improve the mental health of healthy individuals. All health professionals, who play an important role in protecting and improving the health of individuals, should consider the individual holistically while planning treatment and care. The individual's desire for life should determine the goals he wants to achieve, the motivation and sources of hope to reach his goal and should support the individual in a positive way. In this review study, it is aimed to draw attention to the use of hope therapy in increasing and developing hope in the care and treatment of individuals with chronic diseases, and to raise awareness in health professionals on this subject by giving place to the stages and application examples specified in Snyder's theory of hope.

Pulmonary Artery Intimal Sarcoma Diagnosed Preoperatively by Endovascular Biopsy and Treated via Right Pneumonectomy and Pulmonary Arterioplasty

Introduction. Intimal sarcoma is a very rare tumor arising within the intima of the pulmonary artery. Preoperative diagnosis of pulmonary artery sarcoma is difficult, and the tumor is sometimes misdiagnosed as pulmonary thromboembolism. We report a case of pulmonary artery intimal sarcoma successfully diagnosed by preoperative endovascular biopsy and treated via right pneumonectomy and pulmonary arterioplasty. Presentation of a Case. A 72-year-old woman was referred to our hospital with a low-attenuation defect in the lumen of the right main pulmonary artery by computed tomography. Pulmonary artery thromboembolism was suspected, and anticoagulation therapy was administered. However, the defect in the pulmonary artery did not improve. Endovascular catheter aspiration biopsy was performed. Histological examination revealed pulmonary artery sarcoma. The patient was treated with right pneumonectomy and arterioplasty with the use of cardiopulmonary bypass. Discussion. Preoperative biopsy by endovascular catheter is worth considering for a patient with a tumor in the pulmonary artery and can help in planning treatment strategies.

Detection of oncological diseases in patients with pelvic organ prolapse. Case report

Pelvic organ prolapse is a common benign disease among women that is characterized by an isolated or combined descent of the anterior, posterior vaginal wall, uterus, and vaginal dome after hysterectomy. Given the fact that most of the operations are performed among middle-aged and elderly patients, the probability of detecting previously undiagnosed tumor of the abdominal cavity and pelvic region increases, which may be due to the limited volume of basic preoperative diagnosis. The purpose of our report is to draw the attention of clinicians to the problem of insufficient examination of women when planning treatment of pelvic organ prolapse on the example of our experience in managing a patient with this pathology in combination with pelvic tumor.