1) Myopia is a leading cause of visual impairment worldwide and its prevalence has increased substantially in recent decades, especially among adolescents in Asia.
2) While the exact mechanisms of myopia development are not fully understood, near work is considered a major environmental risk factor.
3) Promising treatments for controlling myopia progression include muscarinic receptor antagonists like atropine and pirenzepine, as well as progressive addition lenses, though their effectiveness may depend on a patient's nearpoint phoria.
4) Other treatments such as bifocal lenses, contact lenses, and undercorrection have shown limited or inconsistent effects on slowing myopia progression. Traditional Chinese interventions still require more scientific evidence of their efficacy
Read this article by my friend and colleague, Dr. Patrick Quaid. Binocular vision (BV) dysfunction, a term generally used to describe problems with teaming and co-ordination of one’s eyes, is often a significant challenge to detect and treat in the eyecare arena. BV disorders are more frequently encountered than glaucoma, macular degeneration and diabetic retinopathy ombined. Surely a condition that occurs 8.5 – 9.7 times more ofen than all ocular disease in children aged six months to 18 years1 combined deserves greater attention.....
Diode Laser Treatment for Retinopathy of Prematurity – Our Experience in Bulg...inventionjournals
Purpose: To present early structural outcomes in patients with ROP treated with indirect diode laser photocoagulation at Pediatric Eye Unit, Eye Clinic, University Hospital "Alexandrovska", Sofia, Bulgaria for a period of five years. Patients and Methods: A 5 year retrospective study (August 2011 – December 2016) was conducted. 54 children (102 eyes) with ROP, requiring treatment were included. All children were treated with indirect diode laser photocoagulation (810 nm). Retinal status before and after treatment were documented with RetCam imaging system. Results: 54 (102 eyes) prematurely born babies are included - 33 (61.1%) boys and 21 (38.9%) girls. The mean gestational age was 26.8 weeks (± 1.93 g.w.), and the mean birth weight - 920 g (± 274.7g). Zone I ROP was observed in 9 (8.8%) eyes, and Zone II ROP - in 93 (91.2%) eyes. Favorable structural result was achieved in 89 (87.3%) eyes. In 13 (12.7%) eyes was observed unfavorable structural result, from which seven eyes were with retinal detachment. Conclusion: Widespread introduction of mandatory screening programs and conducting timely and effective treatment of ROP is a key element in reducing cases of preventable childhood blindness worldwide.
Read this article by my friend and colleague, Dr. Patrick Quaid. Binocular vision (BV) dysfunction, a term generally used to describe problems with teaming and co-ordination of one’s eyes, is often a significant challenge to detect and treat in the eyecare arena. BV disorders are more frequently encountered than glaucoma, macular degeneration and diabetic retinopathy ombined. Surely a condition that occurs 8.5 – 9.7 times more ofen than all ocular disease in children aged six months to 18 years1 combined deserves greater attention.....
Diode Laser Treatment for Retinopathy of Prematurity – Our Experience in Bulg...inventionjournals
Purpose: To present early structural outcomes in patients with ROP treated with indirect diode laser photocoagulation at Pediatric Eye Unit, Eye Clinic, University Hospital "Alexandrovska", Sofia, Bulgaria for a period of five years. Patients and Methods: A 5 year retrospective study (August 2011 – December 2016) was conducted. 54 children (102 eyes) with ROP, requiring treatment were included. All children were treated with indirect diode laser photocoagulation (810 nm). Retinal status before and after treatment were documented with RetCam imaging system. Results: 54 (102 eyes) prematurely born babies are included - 33 (61.1%) boys and 21 (38.9%) girls. The mean gestational age was 26.8 weeks (± 1.93 g.w.), and the mean birth weight - 920 g (± 274.7g). Zone I ROP was observed in 9 (8.8%) eyes, and Zone II ROP - in 93 (91.2%) eyes. Favorable structural result was achieved in 89 (87.3%) eyes. In 13 (12.7%) eyes was observed unfavorable structural result, from which seven eyes were with retinal detachment. Conclusion: Widespread introduction of mandatory screening programs and conducting timely and effective treatment of ROP is a key element in reducing cases of preventable childhood blindness worldwide.
Restoration of visual acuity with #Isotine eye drops - An Ayurvedic formulati...Mandeep Basu
Approximately 8 million to 2.3 million people worldwide have impaired vision due to uncorrected refractive error and cataract1. Hence the World Health Organization (WHO) has initiated Vision 2020 global program – “The right to sight”. The main motto of Vision 2020 is to correct refractive errors. The author after years of trial and error has formulated unique Ayurvedic eye drops “ISOTINE”. This has a very precise and balanced combination of Ayurved content that not only corrects the refractive errors but also visual acuity and subjective symptoms.
Velocardiofacial Syndrome Associated with Adolescent PsychosisCarlo Carandang
"Velocardiofacial Syndrome Associated with Adolescent Psychosis,"
Halifax, Nova Scotia, Canada; October 4, 2006
Psychiatry Clinical Case Conference at IWK Health Centre
*Learn clinical features of velocardiofacial syndrome (VCFS)
*Learn association of VCFS with psychosis and other psychiatric disorders
*Learn genetic and biochemical abnormalities leading to psychosis in VCFS
*Discuss case report of metyrosine in psychosis associated with VCFS
*Discuss case reports of VCFS in childhood-onset schizophrenia
This presentation brings together 3 currents in my approach to treating pediatric epilepsy: a recognition of the importance of epilepsy comorbidities, partnering with families in patient assessment and decision making, and creative use of informatics/EHR's to gather information about clinical aspects of epilepsy. A presentation to the Missouri Valley Child Neurology Colloquium, March 2012.
http://igolenses.co.uk
This short US paper reviews the evidence of clinical trials conducted to date where short-sighted children have undergone Overnight Vision Correction (OVC) treatment and tries to draw conclusions on the effectiveness of the treatment in slowing down or halting the further development of short-sightedness as well as in terms of the safety risks - if any - associated with OVC.
Guidelines for Effective and Appropriate Pediatric Assent and Parental Permis...jbarag
During this presentation, Angi Robinson and Elizabeth Jay reviewed the regulatory requirements for parental permission and pediatric assent; provided practical tips for compliant and age-appropriate form development including which elements to incorporate, the number of required signatures, and how to check for reading comprehension level; and offered recommendations for documentation of the consenting/assenting process.
Acute ocular chemical injury: a descriptive assessment and management review ...Riyad Banayot
Background: The purpose of the study was to assess caregivers’ compliance with the management protocol for
chemical injury at St. John Eye Hospital, Jerusalem.
Materia l and methods: Charts of all new chemical injury patients who presented to St. John Eye Hospital,
Jerusalem, between January and December 2019 were retrospectively reviewed. Data categories collected included:
Presentation, age, sex, injury, irrigation, lids, visual acuity, slit-lamp examination (SLE), management plan, and
medications given. Data were stored and analysed using Excel.
Results: Patients’ presentation date and time, sex, and age were recorded in over 90% of cases. The mechanism of
injury and type of offending chemical were recorded in 65% of cases. The irrigating solution was identified in 50%
of cases. Corrected visual acuity was recorded in both eyes in almost 50% of cases. Limbal ischemia was documented
in 45% of cases, and intraocular pressure (IOP) was recorded in 25%. The management plan and explanation of the
condition to patients were documented in less than 50% of cases. Antibiotics and steroids (drops/ointment) were
prescribed in 92.5% of cases.
Conclusi ons: The results of this study reveal that our documentation needs improvement for several parameters.
Several recommendations were formulated:
1. Emphasize to caregivers that irrigation must be done first.
2. Corrected visual acuity should be attempted for both eyes in all cases, and reasons for not recording it should be
documented.
3. It is important to document and record limbus details, iris details, and IOP in all cases.
We report a case of a 7-yeas old boy with Cornea plana who presented with heavy amblyiopia due to high refractive error. Cornea plana is a genetically determined condition that can be accompanied by a range of complications and have virtually no possible treatment. The child underwent a treatment for the amblyopia with very good results, but still presents a challenge in terms of early detection of possible glaucoma.
College of Optometrists in Vision Development Annual Meeting 2013Dominick Maino
This is the preliminary program for the 2013 COVD Annual meeting in Florida. I am a moderator/presenter for a program on 3D Vision and will be presenting a poster on the single case longitudinal study of a child (now an adult0 with traumatic brain injury. This is a great meeting. Plan on being there!
Restoration of visual acuity with #Isotine eye drops - An Ayurvedic formulati...Mandeep Basu
Approximately 8 million to 2.3 million people worldwide have impaired vision due to uncorrected refractive error and cataract1. Hence the World Health Organization (WHO) has initiated Vision 2020 global program – “The right to sight”. The main motto of Vision 2020 is to correct refractive errors. The author after years of trial and error has formulated unique Ayurvedic eye drops “ISOTINE”. This has a very precise and balanced combination of Ayurved content that not only corrects the refractive errors but also visual acuity and subjective symptoms.
Velocardiofacial Syndrome Associated with Adolescent PsychosisCarlo Carandang
"Velocardiofacial Syndrome Associated with Adolescent Psychosis,"
Halifax, Nova Scotia, Canada; October 4, 2006
Psychiatry Clinical Case Conference at IWK Health Centre
*Learn clinical features of velocardiofacial syndrome (VCFS)
*Learn association of VCFS with psychosis and other psychiatric disorders
*Learn genetic and biochemical abnormalities leading to psychosis in VCFS
*Discuss case report of metyrosine in psychosis associated with VCFS
*Discuss case reports of VCFS in childhood-onset schizophrenia
This presentation brings together 3 currents in my approach to treating pediatric epilepsy: a recognition of the importance of epilepsy comorbidities, partnering with families in patient assessment and decision making, and creative use of informatics/EHR's to gather information about clinical aspects of epilepsy. A presentation to the Missouri Valley Child Neurology Colloquium, March 2012.
http://igolenses.co.uk
This short US paper reviews the evidence of clinical trials conducted to date where short-sighted children have undergone Overnight Vision Correction (OVC) treatment and tries to draw conclusions on the effectiveness of the treatment in slowing down or halting the further development of short-sightedness as well as in terms of the safety risks - if any - associated with OVC.
Guidelines for Effective and Appropriate Pediatric Assent and Parental Permis...jbarag
During this presentation, Angi Robinson and Elizabeth Jay reviewed the regulatory requirements for parental permission and pediatric assent; provided practical tips for compliant and age-appropriate form development including which elements to incorporate, the number of required signatures, and how to check for reading comprehension level; and offered recommendations for documentation of the consenting/assenting process.
Acute ocular chemical injury: a descriptive assessment and management review ...Riyad Banayot
Background: The purpose of the study was to assess caregivers’ compliance with the management protocol for
chemical injury at St. John Eye Hospital, Jerusalem.
Materia l and methods: Charts of all new chemical injury patients who presented to St. John Eye Hospital,
Jerusalem, between January and December 2019 were retrospectively reviewed. Data categories collected included:
Presentation, age, sex, injury, irrigation, lids, visual acuity, slit-lamp examination (SLE), management plan, and
medications given. Data were stored and analysed using Excel.
Results: Patients’ presentation date and time, sex, and age were recorded in over 90% of cases. The mechanism of
injury and type of offending chemical were recorded in 65% of cases. The irrigating solution was identified in 50%
of cases. Corrected visual acuity was recorded in both eyes in almost 50% of cases. Limbal ischemia was documented
in 45% of cases, and intraocular pressure (IOP) was recorded in 25%. The management plan and explanation of the
condition to patients were documented in less than 50% of cases. Antibiotics and steroids (drops/ointment) were
prescribed in 92.5% of cases.
Conclusi ons: The results of this study reveal that our documentation needs improvement for several parameters.
Several recommendations were formulated:
1. Emphasize to caregivers that irrigation must be done first.
2. Corrected visual acuity should be attempted for both eyes in all cases, and reasons for not recording it should be
documented.
3. It is important to document and record limbus details, iris details, and IOP in all cases.
We report a case of a 7-yeas old boy with Cornea plana who presented with heavy amblyiopia due to high refractive error. Cornea plana is a genetically determined condition that can be accompanied by a range of complications and have virtually no possible treatment. The child underwent a treatment for the amblyopia with very good results, but still presents a challenge in terms of early detection of possible glaucoma.
College of Optometrists in Vision Development Annual Meeting 2013Dominick Maino
This is the preliminary program for the 2013 COVD Annual meeting in Florida. I am a moderator/presenter for a program on 3D Vision and will be presenting a poster on the single case longitudinal study of a child (now an adult0 with traumatic brain injury. This is a great meeting. Plan on being there!
3D Vision Syndrome:A Technologically Induced Visual ImpairmentDominick Maino
3D Vision Syndrome is a public health imperative that if left undiagnosed and untreated will result in millions of individuals world wide who cannot benefit or enjoy 3D content. Individuals experience many symptoms including but not limited to headaches, blurred vision, double vision, asthenopia, eyestrain, and vision induced motion sickness. This disorder can be diagnosed and then treated with glasses, prisms, and optometric vision therapy. Once treated most individuals can then enjoy and benefit from viewing 3D content.
How Primary Care ODs can Profit from Pediatric PracticeDominick Maino
I wrote "How Primary Care ODs can Profit from Pediatric Practice" some time ago....but its basic premise is still true today and you may find this useful.
Clinical study of fundal changes in high myopiaiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Interventions to Reduce Myopia Progression in Children (Journal Club) (health...Bikash Sapkota
DIRECT DOWNLOAD LINK ❤❤https://healthkura.com/reduce-myopia/❤❤
Dear viewers Check Out my other piece of works at___ https://healthkura.com
Interventions to Reduce Myopia Progression in Children (Journal Club)
Objectives:
- To discuss about the different interventions to reduce myopia progression in children
- To determine the effectiveness of different interventions to slow down the progression of myopia in children
Interventions to Reduce Myopia Progression:
Environmental Considerations
- Time Spent Outdoors
- Near-Vision Activities
Spectacles & Contact Lenses
- Gas-Permeable Contact Lens Wear
- Bifocal & Multifocal Spectacles
- Soft Bifocal Contact Lenses
- Orthokeratology
Pharmacological Therapies
- Antimuscarinic Agents: Atropine & Pirenzepine
Under Correction of Myopia
April 2019 . Cataracts secondary to intraocular diseases are complicated cata...Vinitkumar MJ
DEMOGRAPHIC PROFILES AND AETIOLOGY OF COMPLICATED CATARACTS: A HOSPITAL BASED STUDY.
Aim: To study demographic profiles and aetiology of complicated cataracts in patients presenting to the Out-Patient Department of B. P. Koirala Lions Centre for Ophthalmic Studies (BPKLCOS).
http://igolenses.co.uk
After reading the outcomes of the LORIC, CRAYON and SMART studies, two US opticians then undertook their own investigation into whether Overnight Vision Correction (OVC) can slow down or halt the further development of short-sightedness once patients are fitted with overnight ortho-k corrective contact lenses. T
My students and I wrote several translations of how to conduct an eye examination (mostly my students since my language skills are not very good!). I know there are many ways, and perhaps better ways to ask these questions, but this could be a starting point. Feel free to adapt this to your needs and to make this even better. Please share when you do.
My students and I wrote several translations of how to conduct an eye examination (mostly my students since my language skills are not very good!). I know there are many ways, and perhaps better ways to ask these questions, but this could be a starting point. Feel free to adapt this to your needs and to make this even better. Please share when you do.
Let me know what you think. (dmaino@ico.edu).
Neuroplasticity and Vision Therapy for Adults; A Case SeriesDominick Maino
This poster was presented at the American Optometric Association's Annual meeting in Boston, MA 06/2016
The bottom line:
The visual cortex has the capacity for experience dependent change (neuroplasticity) throughout life. Unfortunately, when it comes to the adult with binocular vision problems, this is not always recognized as being true even though there is strong clinical evidence to suggest a high level of adult neuroplasticity. Current research shows that adults tend to have numerous anomalies associated with the binocular vision system especially within certain populations. This case series demonstrates how those even approaching 70 years of age can benefit from optometric vision therapy.
Current Clinical Case Reorts & Research You Should Incorporate into Your Mode...Dominick Maino
Dominick Maino, OD, MEd, FAAO, FCOVD-A
Moderator
Featuring the Best of AOA's 2016 Poster Presentations
Saturday, July 2nd 8-10AM
Five of the very best, clinically relevant posters were chosen to be given during the American Optometric Association meeting in Boston in 2016. These posters were chosen by the AOA Poster Committee (Dr. Dominick M. Maino, Chair).
PDF Handout: D Maino: Visual Diagnosis and Care of the Patient with Special N...Dominick Maino
This is a copy of my handout of the lecture given in class today. (Copyright 2016). You may download and use this for any non-commercial educational purpose.
Writing the Perfect Poster Abstract in 20 Minutes or LessDominick Maino
One of the easiest ways to begin your publishing career is to present a poster during one of the many annual meetings held by professional optometry. These meetings include but are not limited to the College of Optometrists in Vision Development, American Academy of Optometry and the American Optometric Association. This presentation reviews the step by step process involved in writing an abstract that will be accepted for presentation by these and other organizations most of the time. Once the abstract is written, you are one third of the way to making a significant contribution to the optometric literature. The other two thirds include, creating the poster and writing the final paper to be submitted to an appropriate journal for publication (the last two topics will be addressed at other meetings and/or within future VDR articles). You are encouraged to bring information for a case report and/or case series that you wish to use for a poster in the future.
This course presents the latest information concerning cortical visual impairment, its etiology, diagnosis and treatment. Various topics reviewed include cortical vs cerebral visual impairment, ventral/dorsal visual streams, visual acuity, and contrast sensitivity. Also discussed are various retinoscopy techniques, overlapping functional vision disorders, and visual stimulation/therapy for these disorders.
Course Objectives
At the end of this course, the participant will:
Be able to identify cortical vs cerebral visual impairment
Be able to access various vision functions such as visual acuity, contrast sensitivity, oculomotor and accommodative disorders
Be able to treat the diagnosed vision problems with all the tools available to the optometrist (spectacles, low vision devices, vision rehabilitative techniques)
Be aware of and use outside resources to supplement and add to any therapeutic interventions recommended
AOA "There's More to 3D than Meets the Eye"Dominick Maino
The American Optometric Association did an awesome job in making a potentially hard to understand topic...easier to understand. If you have problems with viewing 3D, please review this PowerPoint presentation.
A,B,V's of School Performance: Academics, Behavior and VisionDominick Maino
This presentation is geared towards teachers and professional teaching staff, but can also be adapted for parents and others. It reviews the three O's of eye care (Optometry, Ophthalmology, Optician), the optometric examination, learning related vision problems and more.
060915 current research that you should incorporate into yourDominick Maino
Current Research that You Should Incorporate into Your Mode of Practice Now!
Dominick Maino, OD, MEd, FAAO, FCOVD‐A
Moderator
Featuring the Best of AOA's 2015 Poster Presentations
Jun‐27‐2015 8:00AM ‐ 10:00AM
Optic Nerve Head Drusen: A Myriad of Presentations
Jennifer L. Jones, Sylvia E. Sparrow, Christina Grosshans
Validation Study of New LCD‐Based Contrast Sensitivity Testing Method
Sarah Henderson, Jeung H Kim, Paul Harris
Bilateral Cystoid Macular Edema in Retinitis Pigmentosa and its Management
Lindsay T. Gibney
An ODE to Optic Disc Edema
Kelli Theisen
Is Binocular Balancing with Subjective Refraction a thing of the Past?
David Geffen
Optometry's Meeting 2015
Seattle, Washington
Maino D. Agenda Driven Research. Vis Dev Rehab 2015; 1(1):7-11.
Read the editorial.....
Conclusion
It is time for all to put aside our agendas,
our biases, our preconceived notions. It is time
to work together to determine best practices
even if it is contrary to prevailing opinion. The
world is not flat. Amblyopia can be treated at
any age. And optometric vision therapy is an
appropriate treatment modality for disorders of
he binocular vision system.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
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Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
1. Review Article
Myopia: Can Its Progression Be Controlled?
Yi Pang, PhD, OD1
Dominick M. Maino, OD, MEd, FAAO1
Guoming Zhang, MD, PhD2
Fan Lu, MD, OD3
1. Illinois College of Optometry, Chicago, IL
2. Shenzhen Eye Hospital, Guangdong, P.R. China
3. School of Optometry & Ophthalmology, Wenzhou Medical College, P.R. China
ABSTRACT Myopia is considered to be a leading cause of visual
Myopia is considered to be a leading cause of visual impairment with those having a high magnitude of
impairment. Furthermore, the prevalence of myopia in myopia being susceptible to a range of potentially serious
young adolescents has increased substantially over the ocular pathologies.1 The prevalence of myopia in young
past few decades. Although myopia was identified more adolescence has increased substantially over the past few
than two thousands years ago, a consistently effective decades affecting 25% of the adult population in the
approach to myopia control for all patients still eludes United States and 70-90% in various Asian countries.1,2
clinicians. The mechanism of development and the treatment of
Among all the treatments mentioned in this review, myopia has been a major research topic for decades.
the most promising ones are muscarinic receptor Despite the heritability of high magnitude myopia,
antagonists, including atropine and pirenzipine. Bifocal environmental factors including the level of education,
and progressive lenses can be effective in the control of urbanization, and intensity of near work play an
myopia and have greater effectiveness for subjects with important role in the development of mild and moderate
nearpoint esophoria and a high lag of accommodation. myopia. 3 There are several theories about the
The treatment outcomes of gas permeable contact lenses mechanisms of myopia development. Given the clear
have been confirmed to be effective but with association between myopia and near work, excessive
questionable overall clinical effect. Other treatments accommodation has been proposed to be the cause of
including the under correction of myopia have been myopia.4 Recent animal studies suggest myopia can be
shown to be ineffective while traditional Chinese caused by hyperopic and myopic retinal defocus,5,6 high
interventions for myopia prevention need further study lag of accommodation,7 and near-work induced transient
to access their efficacy. myopia.8,9 Chemicals such as dopamine, various growth
KEY WORDS factors, and muscarinic antagonists are proposed to be
myopia, near work, esophoria, accommodation, involved in the local retinal effects and resultant scleral
muscarinic receptor antagonists, progressive lenses growth.10-12
Although myopia was identified by Aristotle more
Correspondence regarding this article can be e-mailed to than 2300 years ago, an effective therapy for all patients
ypang@ico.edu or sent to Dr. Yi Pang, Illinois College of Optometry
3241 S. Michigan Ave., Chicago, Il. 60616. All statements are the still eludes clinicians. Several treatments towards
authors’ personal opinion and may not reflect the opinions of the slowing myopia progression have been suggested by
College of Optometrists in Vision Development, Optometry and recent animal studies. The outcomes from research with
Vision Development or any institution or organization to which they humans are not quite as straightforward because of the
may be affiliated.
difficulties associated with isolating specific
Pang Yi, Maino D, Zhang G, Lu F. Myopia: Can Its Progression Be
environmental variables. This review summarized the
Controlled? Optom Vis Dev 2006:37(2):75-79.
Volume 37/Number 2/2006 75
2. efficacy and potential adverse side effects of current found that mean three-year increases in myopia were
treatments aimed at slowing down myopia progression. -1.28 D in the PAL group and -1.48 in the SVL group,
Bifocal and progressive addition spectacle lenses which was statistically significant.18 The mean myopic
The rationale for using positive lens additions in progression in the PAL group with nearpoint esophoria
myopia control is to optimize accommodative accuracy was -1.18 D compared to -1.39 D in SVL group. Children
for near tasks and minimize the retinal blur. Despite the with nearpoint exophoria had a myopia increase of -1.43
clear effect of positive lens additions in animal studies,13 D in PAL group and -1.38 D in SVL group, which was
the results of clinical trials are inconsistent.14-18 Goss consistent with other similar studies. In summary,
examined longitudinal records from three optometry clinical trials indicate that bifocal and progressive lenses
practices, comparing 52 subjects with single vision can be effective in control of myopia and show greater
lenses (SVL) to 60 subjects with bifocal lenses.14 He effectiveness for subjects with nearpoint esophoria.
reported that esophores wearing bifocals had lower Muscarinic receptor antagonists: atropine and
progression rates than those wearing SVL (-0.32 diopters pirenzipine eye drops
(D) vs. -0.54 D), and exophores wearing bifocals had The use of muscarinic antagonists has been based on
similar progression rates as those wearing SVL (-0.45 vs. the hypothesis that excessive accommodation leads to
-0.43). No effect on myopic progression was noted in increases in myopia.24 Other mechanisms have been
other randomized clinical trials where the nearpoint reported, including retardation of axial length elongation
phoria was not taken into consideration.19,20 Another by affecting release of dopamine neurotransmitter and
study by Goss confirmed that bifocal wearers with synthesis of glycosaminoglycan in the sclera.25,26 The
nearpoint esophoria had progression rates of only -0.33 slowing of myopia progression has been observed with
D/year compared with -0.59 D/year for those of atropine instillation27-30 even in high myopes (-10 to
age-matched children who wore single vision lenses.21 -12D);31 however, some of the studies were retrospective
Fulk studied 82 myopic children with esophoria at near and/or had an insufficient sample size. Recently, Shih
and reported that myopia progression averaged -0.99 D and Lin conducted a double-masked randomized clinical
for bifocals and -1.24 D for SVL over 30 months.15 Those trial involving 227 Chinese children aged 6 to 13 years.29
studies suggest that the effectiveness of bifocals in The mean progression of myopia in the atropine with
slowing myopia progression may depend on the PAL group (-0.41 D) was significantly less than the PAL
nearpoint phoria. Bifocals seem to slow the myopia only group (-1.19 D) and SVL only group (-1.40 D) at the
progression in children with nearpoint esophoia, but not end of the 18 months follow-up period. No progression
necessarily in children with exophoria. of myopia (less than 0.25 D/year) was shown in 57.6% of
Progressive addition lenses (PAL) are often more the children receiving 0.5% atropine vs. 4.9% in SVL
cosmetically acceptable than bifocal lenses. group. The elongation of axial length was 0.22 mm in
Furthermore, children may not always use the lower atropine group and 0.59 mm in SVL group.
segment of the bifocal for reading. Thus, several clinical The side effects of atropine have been frequently
trials with PALs have been conducted. Leung and Brown reported and include: mydriasis, photophobia, blurred
examined 32 Chinese children (9 to 12 years old) with vision, and allergic dermatitis, as well as other significant
SVL and 36 children with PAL.22 They reported that the systemic effects. Thus an M1 specific muscarinic
rates of myopia progression over 2 years in PAL and SVL antagonist, pirenzepine, was tested both in the United
groups were -0.76 D and -1.23 D respectively with States and several Asian countries. The Asian
statistical significance. Another masked and randomized Pirenzepine Study with 353 myopic children aged 6 to 12
study with 254 Chinese myopic children (7 to 9 years years showed that the rate of myopia progression was
old) by Edwards and Lam noted less of a difference -0.47 D/year with pirenzepine (2% Gel twice a day) and
between PAL and SVL groups (-1.12 D vs. -1.26 D over 2 -0.84 D/year in the control group.32 The increase in axial
year) (not statistically significant).23 They found that length was 0.20 mm/year in pirenzepine vs. 0.33
PALs had a greater preventative effect on those with mm/year in control group. The United States Pirenzepine
myopia and esophoria at near (-0.89 D in PAL vs. -1.26 D Study with 174 children, aged from 8 to 12 years (mixed
in SVL) (not statistically significant). Edwards ethnicity/73% were Caucasian), found that the mean
suggested that age differences in myopic children may increase in myopia was -0.26 D/year in the pirenzepine
partially explain the different findings between the two group vs. -0.53 D/year in the control group.33 There was a
studies. The Correction of Myopia Evaluation Trial mean increase in axial length of 0.19 mm /year in the
(COMET) was a multi-center randomized clinical trial, pirenzepine group and 0.23 mm /year in the control
involving 469 ethnically diversified subjects. This study group with no statistical significance. Both studies
76 Optometry and Vision Development
3. reported that pirenzepine had innocuous side effects suggested that myopia correction by minus lenses
compared to atropine. The efficacy of pirenzepine was requires subjects to accommodate for the near demand
greater than that reported by the use of PALs,18,33 but less and leads to hyperopic retinal defocus. This would then
than the use of atropine. This may be due to the fact that stimulate the compensative ocular elongation. This
subjects in these studies were not allowed to wear theory is supported by animal studies which show that
bifocals or progressive lenses. A continuing second year the increase in axial length can be inhibited by plus
controlled evaluation of pirenzepine now being lens.40,41 In a human study, Tokoro found that the mean
conducted by the US Pirenzepine Study Group will change in myopia is significantly reduced in the under
provide further evidence of the efficacy of pirenzepine in corrected group as compared to the fully corrected
myopia prevention. group.42 However, this study did not match subjects for
Contact lenses age and had a very small sample size. Recently Chung
Soft contact lenses do not appear to affect myopia and O’Leary carried out a single masked randomized
progression compared to spectacle correction.34,35 The clinical trial with 94 myopes aged 9-14 years.43 Forty
treatment outcomes of using gas permeable (GP) contact seven myopes were under corrected by +0.75 D while 47
lens are somewhat mixed.36-38 Perrigin reported that the subjects were fully corrected. At the end of the 24 month
mean increase in myopia for 56 GP-wearing myopes period, the mean progression in the under corrected
from 8 to 13 years of age was -0.48 D as compared with group was -1.00 D versus -0.77 D in fully corrected
-1.53 D for spectacle wearers after three years of group. A greater axial length elongation was also found
follow-up.38 Although the age and initial refractive error in the under corrected group. This study indicated that
in the two groups were matched, this study had problems under correction of distance spectacles enhances rather
of high rates of loss to follow-up and was not a than prevents myopia progression. Hung and Ciuffreda
randomized design. Since myopia progression slows explained this new finding using their proposed
down as age increases, the high loss rate in young Incremental Retinal-Defocus theory.44 They stated that
children from the GP group but not the spectacle group, with myopia under correction focusing from far-to-near
may lead to the false impression that GPs significantly results in reduction of retinal image defocus, which
slow the myopic progression. A recent randomized decreases the rate of retinal neuromadulator release. This
clinical trial with 428 Chinese children by Katz and in turn decreases the rate of proteoglycan synthesis and
Chew show that there was no significant difference in adversely affects scleral structural integrity, resulting in
myopia progression between GP wearers and spectacle axial elongation.
wearers.36 The mean increase of myopia was -1.33 D and Traditional Chinese interventions
-1.28 D, and axial length increased by 0.84 and 0.79 mm China, one of several countries with high rates of
over 2 years in GP and spectacles wearers, respectively. myopia, has a myopia prevalence of 20.23% in primary
This trial however had a low retention rate (only 37.5% school, 48.18% in middle school, 71.29% in high school,
of the GP wearers and 67.8 % of the spectacle wearers and 73.01% of college students (reported by the Chinese
remained at the end of 2 year study). The latest National Teaching Institute).45 A great deal of time and
randomized study (Contact Lens and Myopia effort has been utilized to study myopic progression.
Progression Study; CLAMP) with 84.5% Causation Many traditional Chinese interventions have been tried
subjects used a better design to reduce the drawbacks of in China and other countries. These include Chinese eye
previous studies.39 The mean myopic increase was -1.56 excises, acupuncture, Qi-gong ocular exercises,
D for 59 GP wearers and -2.19 D for 57 soft contact electrophotomagnitostimulation, and eye massage.
lenses wearers after a 3 year follow-up (statistically Those interventions are based on the theory of Jing-Luo.
significant). The axial growth of the eyes was not Jing represents channels which connect the interior and
significantly different between the two groups, the exterior as well as the upper and lower parts of the
indicating that the decreased myopia progression by GPs human body. Luo represents the collaterals which
was likely due to corneal flattening instead of the slowing connect these channels and are distributed all over the
axial growth. Based on results from recent randomized body surface. Acupuncture, as well as several other
clinical trials, the effects of GPs on myopia prevention interventions, have claimed to influence circulation of
are small and may have no significant clinical blood and Qi, reduce eyestrain, and improve the neural
implications. nutrition of the eyes leading to prevention of myopia.
Undercorrection of distance spectacles Although the Chinese believe these therapies are
Myopia is proposed as an adaptive response to the effective, there has been little scientific support. 46
accommodative demand during near work. It has been
Volume 37/Number 2/2006 77
4. Chinese eye excises originally created by the that in order to slow myopic progression, clinicians
Jing-Luo school of acupuncture approximately 4000 should consider the following:
years ago are a part of the school routine and are regularly 1. Fully correct all myopia present.
performed by Chinese children 5 to 15 years of age. It is a 2. Consider using pharmacological intervention (atro-
massage and pressure exercise on selected acupuncture pine and pirenzepine) in conjunction with progres-
pressure points around the eye. A pilot study with 10 sive multifocal lenses.
subjects found that the Chinese eye excises did not have 3. Use progressive multifocal lenses for those individ-
any effect on accommodation or critical flicker fusion.47 uals with esophoria/and or a high lag of accommo-
Shih reported that Qi-Qong ocular exercise, another dation at near.
popular Chinese myopia intervention, improved It is time for optometrists to use all the resources
accommodative amplitude and accelerated the available to decrease myopic progression by using those
accommodative response;48 however, this study had only mechanisms most suitable for the individual patients we
1 7 su b j ect s. S hakola used acupunct ure a nd diagnose and treat. All too often eye and vision care
electrophotomagnitostimulation to treat 98 patients, 5 to professionals do not use these appropriate therapies
45 years, and reported a decreased myopic progression either because they choose to ignore their existence or
for 91.5% of the subjects.49 Since this was an abstract and have not kept up to date on the very latest approaches to
there was no further report, the details of the study were vision care in this area 59 We can reduce the impact
unavailable. In summary, although traditional Chinese myopia has on the child and later the adult, if we treat it
methods of intervention have been available for now.
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