University of Medical Technology Mandalay

Diabetic patients undergoing phacoemulsification for cataracts face an elevated risk of intraoperative and postoperative complications due to systemic and ocular pathophysiological changes. This narrative review aims to systematically compare visual outcomes and complication profiles between diabetic and non-diabetic individuals following phacoemulsification, while identifying current best practices and future research directions. With rising global diabetes prevalence, cataract surgery in diabetic patients is increasingly common. Understanding the interaction between diabetes-related ocular changes and phacoemulsification outcomes is vital for improving surgical planning, reducing complications, and enhancing patient satisfaction. A comprehensive literature search was conducted across PubMed, Scopus, and Web of Science using Medical Subject Headings (MeSH) and free-text terms. Eligible studies from 2020 to 2025 were selected based on predefined criteria. Data were narratively synthesized across themes, including intraoperative challenges, visual acuity outcomes, macular health, adjunctive therapies, and long-term prognosis. Diabetic patients exhibit higher risks of poor pupil dilation, capsular fragility, macular edema, and slower visual recovery. However, with good glycemic control, preoperative retinal evaluation, and adjunctive therapies, outcomes can closely approximate those of non-diabetics. Tailored perioperative management and interdisciplinary care models are critical for optimizing outcomes in diabetic cataract surgery. Future studies should focus on stratified risk assessment and long-term visual prognosis.

Objectives: The purpose of the current study is to diagnose bowel obstruction through multidetector computed tomography with emphasis on its prevalence and associated risk factors, which will enhance early detection and guide clinical decision-making.Methods: The present cross-sectional study was conducted from September 2024 to December 2024 through a non-probability convenience sampling technique. Data was collected from 157 patients, who met inclusion criteria and were referred to radiology departments of Hayatabad Medical Complex and Khyber Teaching Hospital, Peshawar. Patients with a stoma bag, pregnant women, and those with congenital anomalies were excluded from the study. A semi-structured questionnaire comprising demographics, medical history, and multidetector computed tomography (MDCT) findings was used for data collection. The data were analyzed using SPSS software version 22. Chi-square tests were applied to determine correlations, and descriptive statistics, including mean and frequency, were calculated.Results: Among the 157 patients, the majority were male with 102 males and 55 females. For marital status male ratio dominated the female (1.8:1). Looking for the residence, 30.6% resided in cities and 69.4% in rural regions. Among them, 52.2% presented with small bowel obstruction, 36.6% presented with large bowel obstruction, while 11.5% of patients showed closed-loop obstruction. Clinical history showed 58.5% adhesion, 41.4% surgeries, and 13.4% carcinoma in the small bowel, while in the large bowel obstruction, the clinical history showed 43.8% carcinoma, 40.3% surgeries, and 26.3% adhesion. There was a significant statistical association between the history of adhesion and carcinoma with the type of obstruction.Conclusion: This study found that SBO was the most prevalent, followed by LBO and closed-loop obstruction. Adhesion, carcinoma and history of surgeries were the risk factors for obstruction

<p dir="ltr">The ability of the brain to rewire itself is central to its functioning. This plasticity must be tightly regulated to ensure the stability of memories and maintain normal levels of signalling. This thesis investigates two different systems contributing to the regulation of structural plasticity.</p><p dir="ltr">Nogo receptor 1 (NgR1) is a potent negative regulator of plasticity. First characterised in the setting of central nervous system injury, it is emerging as an important regulator of memory formation as well. Understanding how this system functions and is regulated could offer novel avenues for treatment of common and severe brain diseases.</p><p dir="ltr">In paper I we investigated how Nogo receptor 1 levels influence memory function and structural plasticity. Using transgenic mice, we found that constitutive overexpression of NgR1 impaired performance in the Morris water maze, while constitutive lack of NgR1 impaired novel object recognition. Further, overexpression of NgR1 limited the formation of dendritic spines. This paper adds to the growing evidence for a role for NgR1 in regulating memory formation and structural plasticity.</p><p dir="ltr">Given that NgR1 is strongly expressed in highly plastic brain regions, we hypothesised that there must be ways to bypass the growth inhibition of NgR1 to allow for lasting memory formation. In paper IV we find that a chemical LTP protocol induces rapid downregulation of dendritic NgR1 protein. Conversely, a chemical LTD protocol rapidly upregulates dendritic NgR1 protein. These findings suggest novel ways in which NgR1 levels are dynamically regulated to permit or inhibit memory formation.</p><p dir="ltr">Sleep is a well-conserved and costly behaviour, yet its function remains poorly understood. The synaptic homeostasis hypothesis is an influential theory that proposes that sleep serves to downscale synaptic weights, and several lines of evidence point to plastic changes in dendritic structure occurring during sleep. However, the evidence is conflicted regarding whether sleep results in a net growth or shrinkage of the dendritic tree. This is an important question to elucidate if we are to develop effective treatments for the ill effects of sleep loss.</p><p dir="ltr">In paper II we investigated how CA1 dendritic structure is affected by sleep deprivation. We measured dendritic length and dendritic spine density after 5 h sleep deprivation by gentle handling, and did not find any significant effects. In paper III we looked at the same issue but through a systematic review and meta- analysis. We included 30 studies in the meta-analysis, which were individually small and with high variability We found that current evidence does not indicate an effect on CA1 dendritic structure after 24 h or less of sleep deprivation. Chronic sleep deprivation of 72 h or longer does reduce CA1 spine density and dendritic length, but it remains unclear if this is solely due to sleep loss or to stress associated with the method of sleep deprivation.</p><p dir="ltr">Together, these studies advance our understanding of how structural plasticity is regulated.</p><h3>List of scientific papers</h3><p dir="ltr">I. Tobias E Karlsson, Gabriella Smedfors, <b>Alvin TS Brodin</b>, Elin Åberg, Anna Mattsson, Isabelle Högbeck, Katrin Wellfelt, Anna Josephson, Stefan Brené, Lars Olson. NgR1: A Tunable Sensor Regulating Memory Formation, Synaptic, and Dendritic Plasticity. Cereb Cortex. 2016 Apr;26(4):1804-17. <a href="https://doi.org/10.1093/cercor/bhw007" rel="noreferrer" target="_blank">https://doi.org/10.1093/cercor/bhw007</a></p><p dir="ltr">II. <b>Alvin TS Brodin</b>, Sarolta Gabulya, Katrin Wellfelt, Tobias E Karlsson. Five Hours Total Sleep Deprivation Does Not Affect CA1 Dendritic Length or Spine Density. Front Synaptic Neurosci. 2022 Mar 14;14:854160. <a href="https://doi.org/10.3389/fnsyn.2022.854160" rel="noreferrer" target="_blank">https://doi.org/10.3389/fnsyn.2022.854160</a></p><p dir="ltr">III. <b>Alvin TS Brodin</b>, Franziska Liesecke, Julia Spielbauer, Tobias E Karlsson. Effects of sleep deprivation on dendritic architecture: A systematic review and meta-analysis of rodent studies. [Manuscript]</p><p dir="ltr">IV. <b>Alvin TS Brodin</b>, Julia Spielbauer, Katrin Wellfelt, Lars Olson, Tobias E Karlsson. Localisation and regulation of Nogo-66 receptor 1 during chemical long term potentiation and depression. [Manuscript]</p>

Performance which can affect public services and the achievement of organizational goals. This research was built with the aim of testing and analyzing the influence of education, discipline, work experience and work environment on the performance of employees of the Bondowoso Regency Community and Village Empowerment Service. This research is included in confirmatory research with a sample size of 52 respondents, saturated sampling technique was used due to the limited number of employees. The data analysis technique used is Multiple Linear Regression processed with SPSS 25.0. Based on the results of data analysis, it shows that both partially and simultaneously the variables of education, discipline, work experience and work environment have a significant effect on the performance of employees of the Bondowoso Regency Community and Village Empowerment Service. The results of the coefficient of determination show that education, work discipline, work experience and work environment have a contribution of 84.0% to the performance variable. Keywords : education, discipline, experience, work environment and performance

    The institution is part of an interactive system that is represented in the environment surrounding change in all fields, which is often unexpected, so it takes place in a crucible that brings together its human, technical and environmental components. The research is to find the relationship between the research variables (organizational structure, technology, human resources, organizational development) and the job performance as well as understanding change and managing it in order to enhance the ability of the organization to achieve outstanding performance Hence the problem of our research lies in preparing for and managing change and showing the effect of its reflection on the performance of employees in institutions and the ability of the institution to overcome all obstacles and difficulties that adopt resistance to change. The research was applied in the Ministry of Labor and Social Affairs to a community of (100) employees with a simple random sample of (75) employee using the analytical method, and the data collection tool (questionnaire) and analyzed according to the outputs of the statistical programs (STATA13) and (AMOS,24), and the most important conclusions reached by the research: One of the most important conclusions reached by the research is that change in institutions is not a random phenomenon, but rather an organized and planned process implemented according to a plan and methodology. There is a significant influence relationship between change management and its four dimensions (organizational structure, technology, human resources, organizational development) in the responding variable, the job performance of employees. The ability of management to face challenges, keep pace with developments in its internal and external transactions, and change the behaviors of its employees to face the process of change. The most important thing recommended by the research is that change requires the necessity of adapting, adapting, and planning by management, as successful change is the transition to the new situation and pushing the institution to excellence. Leadership is that the change should be purposeful and realistic, affecting its impact on their level of performance, how to preserve the rights and advantages acquired for them in the work environment, and be compatible with the organization’s goals. Resisting change is by overcoming and reducing the intensity of resistance through education, education, continuous persuasion, and pushing working individuals to participate in planning and preparation. To change

Multi-stage tuberculosis (TB) vaccines composed of active- and dormancy-associated antigens are promising to trigger the immune protection against all TB stages. However, scientists are still in quest of the suitable vaccine candidates. In this study, we identified the potential targets for this vaccine in a high TB burden country, Thailand. Peptide microarray was applied to gauge IgA and IgG antibodies specific to 16,730 linear epitopes of 52 dormancy-associated Mycobacterium tuberculosis (M. tb) proteins in three study groups: active tuberculosis (ATB), latent tuberculosis infection (LTBI) and endemic healthy control (EHC). Preferential IgA recognition against epitopes of dormancy-associated proteins was identified in LTBI group. Validation of these findings revealed that LTBI subjects exhibited the greater levels of Rv2659c- and Rv1738-specific IgA than those of household contacts, but less than did ATB subjects. Frequencies of IFNγ-producing CD4+ and CD8+ T cells induced by proteins Rv2659c and Rv1738 were higher in LTBI than ATB individuals. The results indicated that LTBI group in a high TB burden country demonstrated cell-mediated immune response to proteins Rv2659c and Rv1738 stronger than those of ATB. These immune responses likely contribute to natural protection against dormant M. tb and might be potential targets for a multi-stage TB vaccine.

This work demonstrates the ability of the Ion-Sensitive Field-Effect Transistor (ISFET)-based immunosensor to detect antibodies against the human leukocyte antigen (HLA) and the major histocompatibility complex class-I-related chain A (MICA). The sensing membrane of the ISFET devices was modified and functionalized using an APTES-GA strategy. Surface properties, including wettability, surface thickness, and surface topology, were assessed in each module of the modification process. The optimal concentrations of HLA and MICA proteins for the immobilization were 10 and 50 μg/mL. The dose-response curve showed a detection range of 1.98–40 µg/mL for anti-HLA and 5.17–40 µg/mL for anti-MICA. The analytical precision (%CV) was found to be 10.69% and 8.92% for anti-HLA and -MICA, respectively. Moreover, the electrical signal obtained from the irrelevant antibody was considerably different from that of the specific antibodies, indicating the specific binding of the relevant antibodies without noise interference. The sensitivity and specificity in the experimental setting were established for both antibodies (anti-HLA: sensitivity = 80.00%, specificity = 86.36%; anti-MICA: sensitivity = 86.67%, specificity = 88.89%). Our data reveal the potential of applying the ISFET-based immunosensor to the detection of relevant anti-HLA and -MICA antibodies, especially in the field of kidney transplantation.

Tuberculosis (TB) caused by Mycobacterium tuberculosis (Mtb) poses a major threat to the global public health. Importantly, latent tuberculosis infection (LTBI) still impedes the elimination of TB incidence since it has a substantial risk to develop active disease. A multi-stage subunit vaccine comprising active and latency antigens of Mtb has been raised as the promising vaccine to trigger immune protection against all stages of TB. Therefore, the discovery of new antigens that could trigger broad immune response is essential. While current development of TB vaccine mainly focuses on protective immunity mediated by adaptive immune response, the knowledge on triggering the innate immune response by antigens is still limited. We showed that recombinant dormancy-associated Mtb proteins Rv2659c and Rv1738 were recognized by human innate immune recognition molecules, Toll-like receptors (TLRs) 2 and 4 by using HEK-Blue™ hTLR2/hTLR4 systems. We further demonstrated that these two proteins activated phosphorylated NF-κB p65 (Ser536) in the human CD14+ blood cells. We also investigated that these two proteins significantly induced level of pro- and anti-inflammatory cytokines (IL-1β, IL-6, IL-8, IL-10 and TNF-α) which were mediated through TLR2 and TLR4 pathways in human peripheral blood mononuclear cells (hPBMCs). These findings suggest that proteins Rv2659c and Rv1738 stimulated innate immune response targeting TLR2 and TLR4 to produce inflammatory cytokines, and their benefits would be valuable for the development of an effective prophylactic tuberculosis vaccine.

Objective: Neck pain is a common cause of disability and costly problem, especially in the working population. However, there is a paucity of studies examining the efficacy of pressure-biofeedback guided craniocervical flexion exercise (CCFE) in neck pain. Therefore, this study aims to find out the efficacy of Pressure-Biofeedback guided CCFE on the treatment of neck pain. Methods: This randomized controlled trial included 60 participants with neck pain who were randomly assigned to the experimental group ([Formula: see text]) and control group ([Formula: see text]). The experimental group received pressure-biofeedback guided CCFE for four times per week for four weeks, whereas the control group received physical therapy agents (PTA) (radiant heat and transcutaneous electrical nerve stimulation). Outcome measures included the Visual Analogue Scale (VAS) and Neck Disability Index (NDI). Results: The baseline demographics and outcome measurements were not significantly different between the two groups. More significant reduction in VAS of the experimental group was found in comparison with control group at week 2 and week 4, respectively ([Formula: see text]). Regarding the NDI, there was a more significant reduction in the experimental group than the control group at week 4 ([Formula: see text]). Conclusion: Pressure-biofeedback guided CCFE was useful for improving pain and functional disability of neck for the management of neck pain.

To assess the level of knowledge regarding common worm infestation among school children by pretest. 2. To develop and administer self-instructional module on common worm infestations. 3. To determine the effectiveness of self-instructional module on knowledge regarding common worm infestation among school children by posttest. 4. To find out the association between level of knowledge regarding common worm infestation with selected demographic variables. The research approach adopted for the study was a pre-experimental approach. The population for present study consists of school children who can read and understand the Telugu and English. The size of the sample was 60. The sample was selected through non-probability purposive sampling technique. The Standard tool method was used to collect the required data from school children. The reliability of the questionnaire was assessed by split half method. Correlation Co-efficient was calculated by using Karl Pearson Formula and a value of r=0.9469 was obtained. The investigator conducted study at rural school, Rangareddy Dist.