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Author

Sen, Alok, Mehta, Sonali, Sule, Ashita, More, Amruta, Shetty, Sachin, Singh, Jayanti, Tripathi, Shubhi, Agrawal, Rupesh, and Talwar, Dinesh

Published
2024
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Author

Sen, Alok, Mehta, Sonali, Sule, Ashita, More, Amruta, Shetty, Sachin, Singh, Jayanti, Tripathi, Shubhi, Agrawal, Rupesh, and Talwar, Dinesh

Published
2024
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4. A practical model for effective eye care delivery in Southeast Asian rural communities: A proposal built based on experts' recommendations

Author

Liu, Renee, Sule, Ashita A, Shannon, Choo Sheriel, Ravilla, Thulasiraj, Taylor, Hugh, Rojas-Carabali, William, Khanna, Rohit C, Mishra, Chitaranjan, Sen, Alok, Khatri, Anadi, Tan, Anna C S, Sobrin, Lucia, and Agrawal, Rupesh

Subjects
Patients -- Care and treatment, Sparsely populated areas -- Evaluation, Ophthalmology -- Evaluation
Abstract

Purpose: To evaluate rural community-based eye care models from the perspective of community ophthalmology experts and suggest sustainable technological solutions for enhancing rural eye care delivery. Methods: A semi-structured descriptive survey, using close-ended and open-ended questions, was administered to the experts in community ophthalmology sourced through purposive sampling. The survey was self-administered and was facilitated through online platforms or in-person meetings. Uniform questions were presented to all participants, irrespective of their roles. Results: Surveyed participants (n = 22 with 15 from India and 7 from Nepal) in high-volume tertiary eye hospitals faced challenges with resources and rural outreach. Participants had mixed satisfaction with pre-operative screening and theatre resources. Delayed presentations and inexperienced surgeons contributed to the surgery complications. Barriers to rural eye care included resource scarcity, funding disparities, and limited infrastructure. In rural/peri-urban areas 87% of participants agreed with providing primary eye care services, with more than 60% of the experts not in agreement with the makeshift center model of eye care delivery. Key components for an effective eye care model are sustainability, accessibility, affordability, and quality. These can be bolstered through a healthcare management platform and a human-chain supply distribution system. Conclusion: Tailored interventions are crucial for rural eye care, emphasizing the need for stronger human resources, optimized funding, and community awareness. Addressing challenges pertinent to delayed presentation and surgical training is vital to minimizing complications, especially with advanced cataracts. Enhancements in rural eye care demand a comprehensive approach prioritizing accessibility, affordability, and consistent quality. Keywords: Community ophthalmology, eye care, eye care barrier, perspectives, primary eye care, Author(s): Renee Liu [1]; Ashita A Sule [2]; Choo Sheriel Shannon [3]; Thulasiraj Ravilla [4]; Hugh Taylor [5]; William Rojas-Carabali [3,13]; Rohit C Khanna [6]; Chitaranjan Mishra [7]; Alok Sen [...]

Published
2024
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6. Improving Access to Eye Care in Rural Communities: PocDoc's Web-Based Visual Acuity Screening Tool.

Author

Sah, Shreya, Liu, Renee, Lai, HaoXing, Agrawal, Mahek, Jain, Priyanka, Agashe, Prathamesh, Gupta, Akshita, Madhan, Pranay, Chauhan, Ritika, Chourasiya, Kalpana, Bansod, Samiksha, Suman, Singh, Gaganpreet, Sule, Ashita, Singh, Jayanti, Puah, Marilyn, Boon, Joewee, Rojas-Carabali, William, Sen, Pradnya, and Lee, Bernett

Subjects
EYE care, VISUAL acuity, RURAL health services, MEDICAL needs assessment, RURAL population, VISION testing
Abstract

Objective:Visual acuity (VA) testing is crucial for early intervention in cases of visual impairment, especially in rural health care. This study aimed to determine the potential of a web-based VA test (PocDoc) in addressing the unique health care needs of rural areas through the comparison in its effectiveness against the conventional VA test in identifying visual impairment among an Indian rural population. Methods:Prospective comparative study conducted in December 2022 at a tertiary referral eye care center in central India. We evaluated all patients with the PocDoc VA tests using three device types, and the conventional VA test. Bland–Altman plot (BAP) compared PocDoc and conventional VA tests. Fisher's exact tests evaluated associations between categorical parameters. Kruskal–Wallis tests followed by post hoc Dunn's tests identified association between categorical parameters and numerical parameters. Results:We evaluated 428 patients (792 measurements of VA) with mean age 36.7 (±23.3) years. PocDoc resulted in slightly worse VA scores (mean logMAR: 0.345) than conventional (mean logMAR: 0.315). Correlation coefficient between the conventional and PocDoc logMAR VA values was rho = 0.845 and rho2 = 0.7133 (p = 6.617 × 10–215; adjusted p = 2.205 × 10–214). Most data points fell within the interchangeable range of ±0.32 on BAP. Difference between the two methods increased with higher logMAR values, indicating poorer agreement for worse VA scores. Conclusions:Identifying and addressing the unique health care needs of rural populations is critical, including access to appropriate and effective VA testing methods. Validating and improving VA testing methods can ensure early intervention and improve the quality of life for individuals with visual impairment. [ABSTRACT FROM AUTHOR]

Published
2024
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7. Improving Access to Eye Care in Rural Communities: PocDoc's Web-Based Visual Acuity Screening Tool

Author

Sah, Shreya, primary, Liu, Renee, additional, Lai, HaoXing, additional, Agrawal, Mahek, additional, Jain, Priyanka, additional, Agashe, Prathamesh, additional, Gupta, Akshita, additional, Madhan, Pranay, additional, Chauhan, Ritika, additional, Chourasiya, Kalpana, additional, Bansod, Samiksha, additional, Suman,  , additional, Singh, Gaganpreet, additional, Sule, Ashita, additional, Singh, Jayanti, additional, Puah, Marilyn, additional, Boon, Joewee, additional, Rojas-Carabali, William, additional, Sen, Pradnya, additional, Lee, Bernett, additional, Sobrin, Lucia, additional, Sen, Alok, additional, and Agrawal, Rupesh, additional

Published
2023
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8. Diagnosis and biomarkers for ocular tuberculosis:From the present into the future

Author

Ludi, Zhang, Sule, Ashita Ashish, Samy, Ramar Perumal, Putera, Ikhwanuliman, Schrijver, Benjamin, Hutchinson, Paul Edward, Gunaratne, Jayantha, Verma, Indu, Singhal, Amit, La DIstia Nora, Rina, Van Hagen, P. Martin, Dik, Willem A., Gupta, Vishali, Agrawal, Rupesh, Ludi, Zhang, Sule, Ashita Ashish, Samy, Ramar Perumal, Putera, Ikhwanuliman, Schrijver, Benjamin, Hutchinson, Paul Edward, Gunaratne, Jayantha, Verma, Indu, Singhal, Amit, La DIstia Nora, Rina, Van Hagen, P. Martin, Dik, Willem A., Gupta, Vishali, and Agrawal, Rupesh

Abstract

Tuberculosis is an airborne disease caused by Mycobacterium tuberculosis (Mtb) and can manifest both pulmonary and extrapulmonary disease, including ocular tuberculosis (OTB). Accurate diagnosis and swift optimal treatment initiation for OTB is faced by many challenges combined with the lack of standardized treatment regimens this results in uncertain OTB outcomes. The purpose of this study is to summarize existing diagnostic approaches and recently discovered biomarkers that may contribute to establishing OTB diagnosis, choice of anti-tubercular therapy (ATT) regimen, and treatment monitoring. The keywords ocular tuberculosis, tuberculosis, Mycobacterium, biomarkers, molecular diagnosis, multi-omics, proteomics, genomics, transcriptomics, metabolomics, T-lymphocytes profiling were searched on PubMed and MEDLINE databases. Articles and books published with at least one of the keywords were included and screened for relevance. There was no time limit for study inclusion. More emphasis was placed on recent publications that contributed new information about the pathogenesis, diagnosis, or treatment of OTB. We excluded abstracts and articles that were not written in the English language. References cited within the identified articles were used to further supplement the search. We found 10 studies evaluating the sensitivity and specificity of interferon-gamma release assay (IGRA), and 6 studies evaluating that of tuberculin skin test (TST) in OTB patients. IGRA (Sp = 71-100%, Se = 36-100%) achieves overall better sensitivity and specificity than TST (Sp = 51.1-85.7%; Se = 70.9-98.5%). For nuclear acid amplification tests (NAAT), we found 7 studies on uniplex polymerase chain reaction (PCR) with different Mtb targets, 7 studies on DNA-based multiplex PCR, 1 study on mRNA-based multiplex PCR, 4 studies on loop-mediated isothermal amplification (LAMP) assay with different Mtb targets, 3 studies on GeneXpert assay, 1 study on GeneXpert Ultra assay and 1 study for MTBDRp

Published
2023

10. Diagnosis and biomarkers for ocular tuberculosis: From the present into the future

Author

Ludi, Zhang, primary, Sule, Ashita Ashish, additional, Samy, Ramar Perumal, additional, Putera, Ikhwanuliman, additional, Schrijver, Benjamin, additional, Hutchinson, Paul Edward, additional, Gunaratne, Jayantha, additional, Verma, Indu, additional, Singhal, Amit, additional, Nora, Rina La Distia, additional, van Hagen, P. Martin, additional, Dik, Willem A, additional, Gupta, Vishali, additional, and Agrawal, Rupesh, additional

Published
2023
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14. Improving Access to Eye Care in Rural Communities: PocDoc's Web-Based Visual Acuity Screening Tool.

Author

Sah S, Liu R, Lai H, Agrawal M, Jain P, Agashe P, Gupta A, Madhan P, Chauhan R, Chourasiya K, Bansod S, Suman, Singh G, Sule A, Singh J, Puah M, Boon J, Rojas-Carabali W, Sen P, Lee B, Sobrin L, Sen A, and Agrawal R

Subjects
Humans, Adult, Prospective Studies, Visual Acuity, Vision Tests methods, Vision Disorders diagnosis, Internet, Rural Population, Quality of Life
Abstract

Objective: Visual acuity (VA) testing is crucial for early intervention in cases of visual impairment, especially in rural health care. This study aimed to determine the potential of a web-based VA test (PocDoc) in addressing the unique health care needs of rural areas through the comparison in its effectiveness against the conventional VA test in identifying visual impairment among an Indian rural population. Methods: Prospective comparative study conducted in December 2022 at a tertiary referral eye care center in central India. We evaluated all patients with the PocDoc VA tests using three device types, and the conventional VA test. Bland-Altman plot (BAP) compared PocDoc and conventional VA tests. Fisher's exact tests evaluated associations between categorical parameters. Kruskal-Wallis tests followed by post hoc Dunn's tests identified association between categorical parameters and numerical parameters. Results: We evaluated 428 patients (792 measurements of VA) with mean age 36.7 (±23.3) years. PocDoc resulted in slightly worse VA scores (mean logMAR: 0.345) than conventional (mean logMAR: 0.315). Correlation coefficient between the conventional and PocDoc logMAR VA values was rho = 0.845 and rho2 = 0.7133 ( p  = 6.617 × 10 -215 ; adjusted p  = 2.205 × 10 -214 ). Most data points fell within the interchangeable range of ±0.32 on BAP. Difference between the two methods increased with higher logMAR values, indicating poorer agreement for worse VA scores. Conclusions: Identifying and addressing the unique health care needs of rural populations is critical, including access to appropriate and effective VA testing methods. Validating and improving VA testing methods can ensure early intervention and improve the quality of life for individuals with visual impairment.

Published
2024
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15. Successful Treatment of Recurrent Thrombosis Associated with Malignancy with Apixaban and Follow-up for 1 Year.

Author

Boey T, Sule AA, and Sule AA

Abstract

This case report aims to highlight a successful example of using novel oral anticoagulants (NOACs), such as apixaban, to prevent recurrent venous thromboembolism (VTE) in patients with solid-organ malignancy, as an alternative to low-molecular weight heparin (LMWH). Discussed is the case of a 67-year-old woman diagnosed with recurrent thrombosis in the upper-right limb and malignancy of right breast with metastasis to the axillary lymph nodes. Over a follow-up period of more than 1 year, there was no recurrence of VTE and D-dimer decreased, illuminating the possibility of apixaban as an alternative form of treatment for recurrent VTE in patients with malignancy. This appears to be one of the first case reports in Singapore., Competing Interests: Conflict of Interest None., (International College of Angiology. This article is published by Thieme.)

Published
2020
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