This is demonstration of selected ECGs for learning or for exams; guided by lessons from great teachers as Prof. Hein Wellens MD. Here we provide advanced examples with comment and analysis.

This article presents an overview of information regarding Acanthamoeba keratitis per epidemiology, host-pathogen interactions, clinical manifestations, risk factors, environmental implications, diagnosis, treatment and management as well as COVID-19 characteristics which may be taken into cognizance for suspected infected patients, researchers and ophthalmologic practitioners. Acanthamoeba spp. is pathogenetically ubiquitous in nature. Acanthamoeba keratitis is considerably an ocular-threatening and debilitating keratitis that exhibits contumacious characteristics which hinder or impede treatment or management. At inception, Acanthamoeba generally depicts atypical clinical features which are frequently misdiagnosed as other microbial keratitis. Fundamentally, it constitutes a rare corneal infection of which the aetiologic agent is the protozoon Acanthamoeba spp. in contact lens wearers, presenting features of severe ophthalmic distress, blurred vision, blepharospasm, ocular excoriation, extraneous entity sensation and photophobia culminating in aberrant visual functionality. These are perspicuously due to retarded prompt and adequate treatment and management. Personal and environmental hygiene, especially on the hands, face and ocular areas as advised for the COVID-19 protocol could prevent contamination and dissemination of Acanthamoeba keratitis infection. The differentiating relatedness of Acanthamoeba keratitis, COVID-19 ophthalmologic infections and other ocular problems may not have been clearly elucidated.

For something that’s literally as old as the universe, dark matter doesn’t get much attention outside scientific circles. Maybe that’s because, other than a short-lived SyFy series and a late-period Randy Newman album, this nebulous star stuff has had a tough time breaking the pop-culture barrier. But the truth is that today, dark matter has never mattered more. Our own Milky Way is embedded in a massive cloud of it, we’re looking for its interactions deep inside the earth, and there are whole galaxies without it. So what is dark matter, anyway? Why can’t scientists get enough of the stuff, even though they can’t actually find it? What deep, dark secrets does it hold? And could it ultimately shape the future of life as we know it?

Basic control theory equations are developed showing conventional exponential system response of refraction vs. time R (t) with a characteristic system time constant, in response to a step change of near work environmental conditions. Details from preliminary experimental design using reading glasses at the U.S. Naval Academy at Annapolis are discussed. The conclusion is that (+) add lenses, used as reading glasses during study, can prevent the development of myopia for college students in pilot training.

Among eye diseases, cataract is the most commonly encountered lens disease and the leading cause of reduced vision. Cataract caused by radiation develops due to neck & head, central nervous system tumors, eye localized tumors and total body irradiation. Today, the only treatment of cataract is surgery. Beta radiation is seen to have an important place both in the etiology and treatment of cataract. Beta-radiation creates cataract in the lens as an adverse effect. However, beta radiation implementation is used for delay or prevention of cataract in glaucoma surgery. Effects of beta-radiation on the etiology and treatment should be supported by further prospective clinical studies.

Purpose: Analyze Microincision Cataract surgery wound using Fourier-Domain optical coherence tomography. Setting: Medical School of Medicine, Catholic University of Brasilia, Brasília, Brazil. Design: Prospective comparative observational study Methods: Forty eyes were included in this prospective study divided in two groups: with contact lens (CL) and without contact lens (WCL). A line scan pattern of the corneal incisions were acquired using a Spectral domain OCT system immediately after the surgery, and at postoperative days 1, 7 and 30. Incisions were analyzed regarding length, location, angle, architecture, and anatomic imperfections. Results: All incisions were located temporal or nasal superiorly. The average wound length was 1.28 + 0.18mm and the mean incision angle was 49 + 9 degrees. The average wound length of the WCL group mean was 1.24 + 0.17 mm and the mean incision angle was 51 + 8 degrees. Comparing groups for the length and the angle, the incisions measurements were not statistically significant. Anatomic imperfections were observed at the first day postoperative in 12 eyes for CL group and in 13 eyes for the WCL group. No patient presented endophthalmitis during the follow-up. Conclusion: Epithelial imperfection was observed in two patients in the WCL group with spontaneous resolution. The CL group had the highest length and lowest angle of corneal incision. Using contact lens to prevent wound construction imperfection appears not to be a good option. Further studies using a greater number of patients with an architectural analysis of clear corneal incisions are needed to confirm these preliminary results.

Visual impairment is a global health problem. Cataract is responsible for 50% of blindness worldwide [1]. Posterior capsular opacification is the most common late complication of cataract surgery as a result of proliferation of residual lens epithelial cells overall 25% of patients undergoing extra-capsular cataract surgery develops visually significant PCO within 5 years of the operation [2]. Nd: YAG laser provides the advantage of cutting the posterior lens capsule, thereby avoiding and minimizing infection, wound leaks, and other complication of intraocular surgery. Thus Nd:YAG laser capsulotomy is noninvasive, effective and relatively safe technique [3]. However, this procedure is associated with complications such as- postoperative increased intraocular pressure (IOP), cystoid macular edema (CME), disruption of the anterior vitreous surface, uveitis, lens subluxation, increased incidence of retinal detachment and pitting of the IOL [4]. Laser shots can be applied in several patterns such as “Cruciate or Cross pattern”, “Can opener”, inverted “U-Method” and in a “Circular pattern”. Many authors promote the use of a cruciate pattern in the Centre of the visual axis, with the clinician starting off on both axes away from the Centre to avoid pitting the lens centrally [5]. This study mainly aims to analyze the effect of various forms of PCO capsulotomy openings on visual function after Nd: YAG capsulotomy.

The Nd-Yag L has been developed in Europe since the mid-1970s [10]. Today Nd-Yag LPC has become an established procedure for after cataract. Before the Nd-Yag L came into use, the capsulotomy was done by performing a small puncture with a needle knife or 27 gauge needle, either at the time of original operation or as a secondary procedure through the limbus in aphakic or through pars plana in pseudophakic. The Nd-Yag L preferred because it is non-invasive and infection cannot occur. The most important complication is a transient rise in IOP 1-3 hrs of Nd-Yag LPC [1]. Occasionally the pressure rise is high and can cause serious damage to the optic nerve, so that the IOP should be monitored and appropriate measures should be taken if necessary. Only if we can minimize its frequency or, better still, avoid it, altogether, can we accept Nd-Yag L as a safe procedure in our effort to restore vision. In otherwise normal eyes, a mild elevation of IOP is of no consequence because it usually resolves within 24 hour especially when the patient receives anti-glaucoma drugs before and after laser application. However in eyes with pre-existing glaucoma, the incidence of IOP elevation is higher and its duration is longer than in otherwise normal eyes. Some glaucomatous eyes may therefore require additional glaucoma therapy for several weeks following Nd-Yag LPC [3]. So monitoring is particularly important in the cases of glaucoma with optic nerve damage and field loss as these eyes are susceptible to small pressure rises for even a short period. A single rise to 40mmHg for a few hours can cause irreversible damage to the damaged optic nerve and lead to permanent visual loss or even blindness [1]. The purpose of this study is to evaluate the changes in IOP at 1hour,24hour and 1 week after Nd-Yag LPC.

Alzheimer’s Disease (AD) is a common dementia problem of the old population. The two main hallmarks of AD are tau protein and amyloid-beta protein. The relevant investigations on AD suggest that these proteins are also seen in the eye. There are many tests and imaging modalities are used for AD diagnosis. But these techniques are still unable to predict the disease effectively. In this regard, the lens of the eye may help in diagnosing AD. Therefore, a reliable technique for measuring the lens or retina must be selected. In this paper, we focus on the different types of retinal diseases occur in AD patients and the use of the Optical Coherence Tomography (OCT) technique is used for diagnosing AD. 

Background: Corneal abrasions are a common result of eye trauma. Corneal injuries are very common in both the adult and pediatric population and account for a significant proportion of the workload of most emergency departments. Although abrasion heals well with preservative treatment, it still causes pain and job lost. The abrasion result from the scrabble of the corneal epithelium. These injuries cause pain, tearing, lids spasm, light scare, foreign body sensation, decreased visual acuity/blurring, and a gritty feeling. The light, friction & wink was worse the condition. Most abrasion cure within 24-27 hours and seldom proceed to erosion or infection. The study aims to use bandage soft contact lens [BSCL] as a primary treatment for traumatic corneal abrasion [TCA] instead of traditionally use pressure patch [PP]. Patients and methods: The present prospective study has been conducted on 50 patients attending the out-patient department of ophthalmology in an Alyarmouk teaching hospital for six months after taking ethical permission. Before subjecting the patient to the treatment of bandage soft contact lens therapy, a detailed clinical history and thorough local examination have been done. A history indicating the occurrence of recent ocular trauma followed by severe pain, redness, lids spasm, photophobia, and tearing of the involved eye is suggestive of a corneal abrasion. Always we ask about contact lens wear as this can complicate the presence of an abrasion. To confirm the diagnosis of traumatic corneal abrasion we examine the cornea by slit-lamp under cobalt-blue filtered light after the application of tetracaine eye drops & fluorescein strips. The treatment of 50 consecutive patients presenting with traumatic corneal abrasion has been treated with anesthetic eye drop (tetracaine 0.5%) to relieve pain and lids spasm, antibiotic eye drop (ofloxacin 0.3%), therapeutic bandage soft contact lens was applied to provide pain relief and once again act as a splint to promote epithelial healing, then visual acuity was measured by Snellen chart, a cycloplegic eye drop (cyclopentolate 1%) was applied to relieve ciliary spasm & then preservative-free lubricant eye drop were applied lastly. This criterion dramatically relieves most, if not all of the pain the patient may be experiencing (which is a big plus for the patient and earns instantaneous trust), but it also allows the patient to return to work/school or any other daily activities. Patients have been evaluated after 24hours, 72hours and after 1week regarding pain, visual acuity, and complications. Though pressure patch [PP] occasionally advice in abrasion therapy, it does not assist and may prevent recovery. Employ the protective eyewear can preclude the traumatic corneal abrasion. Results: A total of 50 cases were enrolled in our study during the study period of 6 months. Out of 50 patients, there were 30males and 20 females and the male/female ratio was 3:2. The patient’s age was ranged from 5-35years. The commonest cause of injury was direct minor trauma (80% of cases), with cosmetic & optical contact lenses related problems accounting for 20% of presentations, visual acuity was documented correctly in 90% of adult and pediatric group and difficult to documented in children less than 6-year-old 10%. Traumatic corneal abrasion treated with bandage soft contact lens has an apparent advantage over the traditional pressure patch in terms of reduced pain, speedier healing, and an advantage of faster rehabilitation, facilitation epithelial healing, and proper surface hydration. Evaluation of pain revealed sufficient comfort with this regimen, allowing 45 patients (90%) to go back immediately to their occupations. Moreover, visual function is retained without any complication. Healing of the traumatic corneal abrasion occurred within 1 to 3 days in all patients, with minimal or no pain. The infection did not occur at the time of the follow up. We remove the bandage soft contact lens after 1 week to allow epithelial migration and attachment without the interference of the shearing forces of the upper lid. Conclusion: The use of bandage soft contact lens as a primary treatment for a traumatic corneal abrasion is a safe and effective method with anesthetic eye drop (tetracaine 0.5%), antibiotic eye drop (ofloxacin 0. 3%), cycloplegic eye drop (cyclopentolate 1%), preservative-free lubricant drop instead of traditionally pressure patch. Bandage soft contact lens causes dramatic improvement from pain, lid spasm, tearing & visual function is retained without any complication, and patients can immediately resume their regular activities.

Eucalyptus camaldulensis (Ec) is considered as a traditional medicinal plant with valuable therapeutic effects. Here we evaluated the antiviral activity of its ethanolic leave extract on different herpes viruses. Vero cells were infected with either of the tested viruses [herpes simplex virus -1 and 2 (HSV-1, HSV-2) and Varicella-Zoster Virus (VZV)] with or without treatment with Ec extract and viral infection development was evaluated by plaque assay. Our results showed significant antiviral activity of the examined extract against all tested viruses. The 80%-MeOH fraction of this extract offered the highest activity against these viruses with 50% inhibitory concentration (IC50) of 0.1±0.08, 0.3±0.02 and 1±0.03 μg/ml against HSV-1, HSV-2 and VZV respectively and 50% cytotoxicity (CC50) at 700 μg/ml. The highest antiviral effect of this fraction was obtained mainly when it was added during and post infection (p.i.) or when it was added only p.i. Also, this fraction significantly reduced the amount of infective endogenous viral particles in cells that were treated with the 80%-MeOH fraction only post viral entry into the host cells. A synergistic antiviral effect against all tested viruses was also observed when cells were treated with a combination of acyclovir (ACV) and 80%-MeOH fraction of Ec. Further study is required for the isolation and identification of the anti-virally active component/s of this fraction.

Standardized method of seed treatment is of prime importance in the production of groundnut. The study was to carry out control trial using bark extract (aqueous and ethanol) and oil (seed) of mahogany (Khaya senegalensis) on seven (7) isolated fungi from two groundnut varieties (peruvian and valencia). The result shows that both mahogany bark and seed extracts are capable of inhibiting mycelial growth of all the isolates. There was no significant variation between the aqueous and ethanol bark extracts in-vitro, however the in-vivo test shows a significant difference between the aqueous and the ethanol bark extract in which the ethanol extract reduced growth of the pathogens more than the aqueous. For all the pathogens except Rhizopus stolonifer there was no growth between 50% to 100% concentration of the Khaya senegalensis oil in-vitro, however in-vivo control at 50% produced scanty to moderate growth for all the pathogens except Rhizopus stolonifer on peruvian, while there was full coverage on the seeds of valencia variety with Aspergillus niger and Rhizopus stolonifer having total coverage though Pseudaiiescheria boydii and Cylindrocarpon lichenicola were effectively inhibited and showed no growth at the 50% and 100%. Further research to focus on the quantifying the chemical constituents and formulation are suggested.

Einstein’s special and general relativity revolutionized physics. The predictions of general relativity are Strong Lensing, Weak Lensing, Microlensing, Black Holes, Relativistic Jets, A Gravitational Vortex, Gravitational Waves, The Sun Delaying Radio Signals, Proof from Orbiting Earth, Expansion of the universe. The density of the universe determines the geometry and fate of the universe. According to Freedman’s equations of general relativity published in 1922 and 1924, the geometry of the universe may be closed, open and flat. It all depends upon the curvature of the universe also. Various results of Cosmic Microwave Background Radiation (CMBR), NASA’s Wilkinson Microwave Anisotropy Probe (WMAP), and ESA’s Planck spacecraft probes found that our universe is flat within a margin of 0.4% error. In this short work, by applying the laws of quadratic equations, we attempt to show that OUR UNIVERSE IS FLAT.

Commonly referred to as an ecstatic, non-inflammatory disease, Keratoconus, usually bilateral and asymmetric, is characterized by progressive steeping and thinning of the cornea. This results in irregular astigmatism which compromises vision [1,2]. Traditionally, early Keratoconus stages have been treated by prescribing a hard contact lens to obtain a regular anterior optical surface. This tendency was discontinued when contact lens intolerance in advanced stages required the use of penetrating keratoplasty (PKP) or deep anterior lamellar Keratoplasty (DALK). An alternative technique of corneal cross-linking was designed in 2003 as a treatment option for keratoconus. The cornea measured at least 400 um thickness after epithelium removal and pre-operative maximum keratometry (Kmax) measured 58D or less. As a result, no corneal transplantation was required or postponed [3].

Purpose: The purpose of the study was to evaluate which ocular parameters have an impact on visual results obtained after an extended depth of focus (EDF) wavefront-designed intraocular lens (IOL). Setting: The study was conducted in three Italian centers (private practice in Lucca and two ambulatory surgical centers in Pisa and in Rome) from 01/09/2014 to 30/09/2015.Design: The study population included 178 eyes of 91 patients who had cataract surgery and implantation of an EDF wavefront - designed IOL (Mini Well Ready - SIFI Med Tech S.r.l.).Methods: Preoperative and postoperative refractive corneal spherical aberration (SA), ocular axial length, or anterior chamber depth were measured.Results: The majority of patients were spectacle-independent for near, intermediate, and distance vision and no one reported disturbing halos or glare. No overall significant differences were observed when stratifying anterior chamber depth (ACD) and ocular axial length (AL) by uncorrected distance visual acuity (UCDVA); p = 0.465 and 1.000 respectively, corrected distance visual acuity (CDVA); p = uncorrected near visual acuity (UCNVA); p = 1.000 and 0.728 respectively; p = 1.000 under both parameters and halos; 1.000 under both parameters. Still, there was a statistically significant difference when stratifying SA with 5 mm only by UDVA (p = 0.040).Conclusion: These results are consistent with similar outcomes in the scientific literature as measured with tests of visual acuity, either with or without optical correction. We also demonstrated that these IOLs can be used in myopic and hyperopic eyes, although it may be useful to evaluate the preoperative corneal SA to achieve better results.

Indole acetic acid (AIA) is the most important plant growth hormone since it intervenes in the mechanisms of cell growth and differentiation and is produced mostly in the meristematic zones of the plant for apical dominance or root growth. AIA is also produced in root nodules and plant galls. In the latter cases, its presence is associated with endophytic bacteria. Although it is a plant growth hormone, it is also produced by bacteria such as Azospirillum brasilense and Bradyrhizobium japonicum. These species live in the soil (rhizosphere) or can colonize the roots (endophytic) of their hosts. From these bacteria, there are also isolates that are nitrogen fixers, which in addition to providing growth factors to plants, contribute by releasing nitrogenous molecules that improve plant nutrition.

Stress, pain, injuries, and errors in dental procedures are situations highly linked to dentistry derived from multiple factors making this profession a profession with high physical and mental demand to achieve quality treatment without deteriorating the health of those who perform it, in this case, the dentist, the assistant, and hygienist.The effects of wrong postures, but above all, the lack of knowledge of the proper postures, the modeling of bad habits acquired during the training stage in dental school, and the lack of work guidelines that not only take into account the dentist but also to all the work staff and the methodological organization of dental tasks can be found in the scientific literature.Magnification devices are known to improve vision, precision, and ergonomics in dentistry; advances in the area of ​​high magnification in dentistry are taking place by leaps and bounds. In recent years, a new magnification loupes design has appeared on the market, called ergonomic magnification loupes appeared that stands out from conventional Galilean and Keplerian through the lens (TTL) Flip-up loupes in terms of their postural benefits and is part of the arsenal of magnification loupes to consider in the market.The postural approach of high magnification equipment is necessary for professional practice, where the design of Ergonomic magnification loupes with consideration not only for magnification but also for the operator’s postural health which can have a significant impact on the performance and overall health of the dentist and hygienist, more if incorporated from the beginning of dental school education and training.

Background: Nursing theories are organized bodies of knowledge providing a way to define nursing as a unique discipline that is separate from other disciplines. As a profession, nursing is committed to recognizing its own unparalleled body of knowledge vital to nursing practice and science. Nursing is a science based on the theory of what nursing is, what nurses do, and why.Aim: This paper aims to elucidate the practical application of Hildegard Peplau's and Rosemarie Parse's nursing theories, individually and in synthesis, in modern nursing practice. Key points: These include a) Hildegard Peplau's Theory of Interpersonal Relations emphasizes the nurse-patient relationship, therapeutic communication, and the continuous search for improvement in patients, even those facing mental health challenges. b) Rosemarie Parse's Theory of Human Becoming underscores the uniqueness of each patient's lived experiences, the significance of "meaning" in health experiences, "rhythmicity" in patterns, and the potential for "transcendence" and growth. c) Integrating Peplau's and Parse's theories promotes holistic patient-centered care, compassionate and empathetic nursing, enhanced communication skills, patient autonomy, cultural competence, continuity of care, and a deep respect for human dignity. d) By embracing both theories, nurses can provide comprehensive, compassionate, and patient-centered care that respects each patient's individuality and capacity for growth.Conclusion: The synthesis of Hildegard Peplau's and Rosemarie Parse's nursing theories offers nurses a comprehensive framework for modern nursing practice. It guides nurses in providing high-quality, patient-centered care that preserves human dignity and recognizes the uniqueness of each patient. Drawing from multiple theoretical perspectives enhances nursing practice and ensures the well-being of patients in today's evolving healthcare landscape.

Cataracts may be described as the opacity of crystalline lenses present in the eye. The translucent crystalline lens is a part of the human eye. It possesses all the physical characteristics of a biconvex lens. The eye’s lens performs similar functions to a camera’s lens. The lens directs light rays entering the eye to the retina’s sensitive layers. Any factor that increases the absorption of scattering of light by the lens reduces its transparency. The opacity of the lens or its capsule, whether developmental or acquired, is called a cataract. Cataracts vary in degree of density and site and assume various forms. Cataract is the leading cause of reversible visual impairment and blindness globally. There are several classifications of cataracts based on morphologic and/or etiologic criteria. However, in epidemiologic studies, the simplified system of three types based on localization of lens opacities is most commonly used: Nuclear cataract is the most common type, followed by cortical cataract and posterior subcapsular cataract. This most prevalent form of acquired cataract, also known as an “age-related cataract,” affects people of both sexes equally and typically develops after age 50. More than 90% of people experience senile cataracts by age 70. Although one eye is almost always afflicted before the other, the disorder is typically bilateral. In the available literature, there is no mention of any such drug that could reverse the opacity of the lens (cataract) once it occurred and make it clear and transparent again.Only replacement of opaque lenses with artificial transparent Intraocular lens (IOL) is successful treatment of cataracts. This review focuses on senile cataracts and the best possible management of senile cataracts.