Indian Journal of Clinical and Experimental Ophthalmology最新文献

Clinical profile and management of vernal keratoconjunctivitis in a tertiary health care center, North Karnataka 北卡纳塔克邦一家三级医疗保健中心的春季角结膜炎临床概况和治疗方法

Indian Journal of Clinical and Experimental Ophthalmology Pub Date : 2024-07-15 DOI: 10.18231/j.ijceo.2024.062

Sheryl D Almeida, Arathi Choudhary, Chaitra Pujar, S. K. Nyamagoudar

{"title":"Clinical profile and management of vernal keratoconjunctivitis in a tertiary health care center, North Karnataka","authors":"Sheryl D Almeida, Arathi Choudhary, Chaitra Pujar, S. K. Nyamagoudar","doi":"10.18231/j.ijceo.2024.062","DOIUrl":"https://doi.org/10.18231/j.ijceo.2024.062","url":null,"abstract":":To evaluate the demography, clinical features, complications and management of patients with Vernal keratoconjunctivitis.A retrospective analysis of 80 patients who consulted in the Ophthalmology OPD of a tertiary care hospital in North Karnataka who were diagnosed with Vernal keratoconjunctivitis was done. This study was done from March 2020 to February 2021. Detailed ophthalmologic evaluation was done after taking a thorough history regarding symptoms, predisposing factors and family history. Patients were diagnosed based on their symptoms like redness, itching, watering, foreign body sensation etc and signs like papillae, limbal thickening etc into mild, moderate and severe. Detailed treatment history was also noted. Patients were also examined for any complications associated with VKC and also with the treatment. Mean age at presentation was 14.11 years ± 2.23 years. The male (M) to female (F) ratio was 1.29:1.Most of the patients had mixed pattern (71.25%) of disease. Personal or family history of allergy was noted in 5% of population. 10% of the population had moderate to severe vision loss. 30% of the patients had complications due to VKC. : Our study shows that vernal keratoconjunctivitis has early age of onset with higher male preponderance with frequent presentation during spring and summer season and less association with family history of allergy. VKC being a chronic disease need for long term follow up has to be advised and switching over to drugs like cyclosporine instead of steroids showed to be effective with minimal side effects.","PeriodicalId":13485,"journal":{"name":"Indian Journal of Clinical and Experimental Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141644693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Epiretinal membrane associated with combined hamartoma of retina pigment epithelium: Surgical outcome and histopathological features 视网膜色素上皮合并火腿肠瘤伴发的视网膜外膜：手术效果和组织病理学特征

Indian Journal of Clinical and Experimental Ophthalmology Pub Date : 2024-07-15 DOI: 10.18231/j.ijceo.2024.069

Othman Jarallah Al Jarallah

{"title":"Epiretinal membrane associated with combined hamartoma of retina pigment epithelium: Surgical outcome and histopathological features","authors":"Othman Jarallah Al Jarallah","doi":"10.18231/j.ijceo.2024.069","DOIUrl":"https://doi.org/10.18231/j.ijceo.2024.069","url":null,"abstract":"Combined hamartoma of the retina and retinal pigment epithelium (CHR-RPE) represents a rare, benign congenital anomaly typically presenting as slightly elevated, variably pigmented lesions. This report details the surgical outcome and histopathological features of an epiretinal membrane associated with CHR-RPE. A 29-year-old woman with a three-year history of gradual visual decline in her right eye underwent a comprehensive ophthalmologic examination, including spectral domain optical coherence tomography (SD-OCT), which revealed characteristic features of CHR-RPE and an overlying epiretinal membrane. She subsequently elected to undergo pars plana vitrectomy with membrane peeling. Intraoperative findings confirmed the presence of histological elements consistent with the internal limiting membrane, fibrillar collagen, vitreous, and cells positive for glial fibrillary acidic protein (GFAP), indicative of glial cells. Postoperatively, there was a noticeable improvement in the retinal architecture; however, visual acuity improvement was minimal. Histopathological analysis of the excised membrane provided insight into the lesion’s cellular composition. This case underscores the complex nature of CHR-RPE associated with epiretinal membranes and the challenges in achieving significant visual acuity improvement despite successful surgical intervention. It highlights the importance of early detection and a personalized approach to management. Future research should focus on optimizing treatment strategies and improving understanding of the prognosis for similar cases.","PeriodicalId":13485,"journal":{"name":"Indian Journal of Clinical and Experimental Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141644810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prevalence of ocular manifestations in HIV patients 艾滋病患者眼部表现的普遍性

Indian Journal of Clinical and Experimental Ophthalmology Pub Date : 2024-07-15 DOI: 10.18231/j.ijceo.2024.051

Ajay Venkat Ananthan, Meena Devi Kalyana Kumar, Vinnarasi Rayar, Sudan Marudhachalam

{"title":"Prevalence of ocular manifestations in HIV patients","authors":"Ajay Venkat Ananthan, Meena Devi Kalyana Kumar, Vinnarasi Rayar, Sudan Marudhachalam","doi":"10.18231/j.ijceo.2024.051","DOIUrl":"https://doi.org/10.18231/j.ijceo.2024.051","url":null,"abstract":": To study the prevalence of ocular manifestations in the HIV-positive individuals and find out the different types of ocular manifestations in HIV patients based on their CD4 count levels. This is a cross-sectional observational study with a sample size of 70 which will be conducted in department of Ophthalmology at Trichy SRM Medical College Hospital & Research Centre. This study includes all HIV positive patients irrespective of their age group, gender. A total of 70 cases were included in this study. HIV induced ocular manifestations were present in 33 out of 70 patients which has accounted for 47% in our study. Most of the patients with HIV were in the age group ranging between 20 years to 70 years. Most commonly seen ocular manifestations were anterior segment manifestations accounting for 33.33% and then adnexal manifestations (27%), posterior segment manifestations (24%) and the neuro-ophthalmic manifestations (15.15%). Ocular manifestations with highest prevalence were seen to be present in population with CD4 ranging between 250-300 cells/mm. Of these anterior segment manifestations were common.: In our study, anterior segment manifestations were more commonly seen than posterior segment manifestations. Dry Eye disorder and HIV Retinopathy are the most commonly seen manifestations. Early screening of HIV positive individual should be done for the ocular manifestations at time of diagnosis.","PeriodicalId":13485,"journal":{"name":"Indian Journal of Clinical and Experimental Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141645694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association between ocular pseudoexfoliation and cardiovascular disease status: An analysis in a multi-speciality Hospital 眼部假性角膜剥脱与心血管疾病状况之间的关系：对一家多专科医院的分析

Indian Journal of Clinical and Experimental Ophthalmology Pub Date : 2024-07-15 DOI: 10.18231/j.ijceo.2024.059

Radha Annamalai, Uma Ramalingam, Jai Mercy James

{"title":"Association between ocular pseudoexfoliation and cardiovascular disease status: An analysis in a multi-speciality Hospital","authors":"Radha Annamalai, Uma Ramalingam, Jai Mercy James","doi":"10.18231/j.ijceo.2024.059","DOIUrl":"https://doi.org/10.18231/j.ijceo.2024.059","url":null,"abstract":"Pseudoexfoliation syndrome (PEX) is the most common cause of secondary open angle glaucoma. It is a systemic disorder characterized by extracellular deposition of distinctive grey-white fibrillary amyloid like material. The material is found in the anterior segment of the eye, where it can be easily identified on ocular (slit- lamp) examination by ophthalmologists. This study was carried out to determine if an association does exist between ocular pseudoexfoliation and cardiovascular disease. This was a cross-sectional case-control study carried out from March 2023 to June 2023 at a tertiary hospital. A total of 46 cases (patients with ocular pseudoexfoliation) and 46 controls (patients without ocular pseudoexfoliation) were randomly selected from Ophthalmology Outpatient Department. Ophthalmological examination was done which included visual acuity testing using standard Snellen’s Chart, anterior segment assessment by slit lamp examination, Goldmann Applanation Tonometry to check intraocular pressure (IOP) and dilated fundus examination by direct/indirect ophthalmoscopy. Blood pressure (BP) was assessed and Electrocardiogram (ECG) was performed for all the patients undergoing the study. 2D Echocardiogram (ECHO) was done if ECG was abnormal. Analysis of the study results showed a positive association between ocular pseudoexfoliation and hypertension (HTN) and abnormal ECG. Also, the condition appeared to be more prevalent among the males. Since there is a positive association between pseudoexfoliation and cardiovascular diseases (CVD), ophthalmologists need to proactively investigate patients with PEX for cardiovascular abnormalities in form of HTN and abnormal ECG and refer them to physicians for appropriate management, if necessary.","PeriodicalId":13485,"journal":{"name":"Indian Journal of Clinical and Experimental Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141646275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

To study the optic nerve characteristics in patients with optic neuritis 研究视神经炎患者的视神经特征

Indian Journal of Clinical and Experimental Ophthalmology Pub Date : 2024-07-15 DOI: 10.18231/j.ijceo.2024.053

Supriya B N, Divya Prasad, Srinivas Phani Nakkella

{"title":"To study the optic nerve characteristics in patients with optic neuritis","authors":"Supriya B N, Divya Prasad, Srinivas Phani Nakkella","doi":"10.18231/j.ijceo.2024.053","DOIUrl":"https://doi.org/10.18231/j.ijceo.2024.053","url":null,"abstract":"Optic neuritis is defined as an autoimmune demyelinating disorder of the optic nerve. It can be idiopathic/post infectious/component of multiple sclerosis. It is not associated with other systemic diseases so commonly. It causes inflammation, which affects the myelin lining of the optic erve. Aim of this study was to identify study the optic nerve characteristics in patients with optic neuritis in a tertiary care center. A descriptive study was done on 30patients with optic neuritis, by considering specific components that determine the optic nerve function. Components of optic nerve studied includes, visual acuity, color vision, contrast ensitivity, visual fields, visual evoked otential and magnetic resonance imaging (MRI). Optic neuritis is more common in females than males (66.6%). Most common age group is 26-35years (36.6%). Relative afferent pupillary defect (RAPD) seen in 50% of patients (15pts). Visual acuity loss majority in between hand movements–counting fingers close to face (40%). Color vision defects were present in all the patients, Red-Green color defect was more common. Visual fields showed severely depressed fields in 30% patients. MRI was normal in 83% patients. Optic neuritis usually affects young adults. Proper diagnosis of the disease, correct treatment at right time is necessary. Combined approach for treatment with neurologist is required to make them aware of disease process, treatment & to prevent recurrences.","PeriodicalId":13485,"journal":{"name":"Indian Journal of Clinical and Experimental Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141644971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A study on central corneal thickness in diabetics and non – diabetics 关于糖尿病患者和非糖尿病患者中央角膜厚度的研究

Indian Journal of Clinical and Experimental Ophthalmology Pub Date : 2024-07-15 DOI: 10.18231/j.ijceo.2024.064

Sumalath Sai Keerthi Mathukumalli, Bharath Tumma, N. Mukkamala

{"title":"A study on central corneal thickness in diabetics and non – diabetics","authors":"Sumalath Sai Keerthi Mathukumalli, Bharath Tumma, N. Mukkamala","doi":"10.18231/j.ijceo.2024.064","DOIUrl":"https://doi.org/10.18231/j.ijceo.2024.064","url":null,"abstract":"Diabetes is one of the most leading causes of blindness with complications related to diabetic keratopathy (DK). This chronic metabolic stress makes changes in the endothelial cells of the cornea by loss in pleomorphism, corneal autofluorescence, degeneration of the cells due to stress leads to over hydration of the stroma leads to change in corneal thickness. The central corneal thickness is a sensitive indicator of corneal health and serves as an index for corneal hydration and metabolism. Accurate CCT measurement has diagnostic and therapeutic implications.Cross-sectional comparative study was done with 260 patients divided into two groups. Group 1 included patients with diabetes and group II patients without diabetes (Control group) of age group between 45 to 80 years who are attending Ophthalmology OPD in a time period of 2 months. Thorough history of patients was taken and underwent visual acuity testing, BCVA, IOP, fundus examination, HbA1c and CCT measurement using Optical Coherence Tomography (OCT).Mean CCT in diabetic population was 560.38±44.51 µm, while in control group was 500.32±39.63 µm with statistically significant p value of <0.001. Correlation analysis shows duration of diabetes and HbA1c shows significant relation and age doesn’t show any correlation with CCT.Our study demonstrates that individuals with diabetes mellitus or increased levels of HbA1c had higher CCT, regardless of age or gender. This signifies that CCT was influenced by prolonged increased levels of blood glucose.","PeriodicalId":13485,"journal":{"name":"Indian Journal of Clinical and Experimental Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141648226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Retinal changes in anemia - A comparative cross sectional study using SD-OCT 贫血症的视网膜变化--利用 SD-OCT 进行的横断面比较研究

Indian Journal of Clinical and Experimental Ophthalmology Pub Date : 2024-07-15 DOI: 10.18231/j.ijceo.2024.067

A. R. Rajan, Sreelakshmi Arun, C. V. A. (. Kakkanatt, A. Rafi, Brinda Soman

{"title":"Retinal changes in anemia - A comparative cross sectional study using SD-OCT","authors":"A. R. Rajan, Sreelakshmi Arun, C. V. A. (. Kakkanatt, A. Rafi, Brinda Soman","doi":"10.18231/j.ijceo.2024.067","DOIUrl":"https://doi.org/10.18231/j.ijceo.2024.067","url":null,"abstract":"To study the retinal changes in various grades of anemia and compare them with controls by analysing the peripapillary RNFL (retinal nerve fibre layer) thickness and CDR (cup-disc ratio) in OCT.Anemia is a common health problem, iron deficiency (IDA) being the most common type. It has deleterious visual effects through enhancement of ischemic effects.Changes in RNFL and CDR are seen in many ischemic retinal diseases.Optical coherence tomography (OCT) is a non invasive imaging modality that gives a cross-sectional topographic imaging of retina.Our study aims at analysing RNFL thickness and CDR by OCT in our subjects.Our study was conducted including 44 each of anemic and non anemic people, after classifying the anemic group further based on WHO criteria. After detailed clinical examination, OCT was done and peri-papillary RNFL in 4 quadrants and vertical CDR were assessed and compared.Peripapillary RNFL thickness in anemia group was significantly thinner than controls, the change more pronounced in severe anemia than other groups. CDR was significantly high in severe anemia than others.Retinal changes in anemia has a correlation with the severity of anemia. RNFL and CDR changes can predispose to serious visual defects in future. Hence, anemia screening and correction along with frequent clinical and OCT evaluation in such patients can be useful in early detection and prevention of anemic retinopathy.","PeriodicalId":13485,"journal":{"name":"Indian Journal of Clinical and Experimental Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141648064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Study on status of binocular vision in different occupations 关于不同职业中双眼视力状况的研究

Indian Journal of Clinical and Experimental Ophthalmology Pub Date : 2024-07-15 DOI: 10.18231/j.ijceo.2024.056

Miru Khanal, Triptesh Raj Pandey, S. K. Sah, Shrban Sah

{"title":"Study on status of binocular vision in different occupations","authors":"Miru Khanal, Triptesh Raj Pandey, S. K. Sah, Shrban Sah","doi":"10.18231/j.ijceo.2024.056","DOIUrl":"https://doi.org/10.18231/j.ijceo.2024.056","url":null,"abstract":"The study was to identify the various binocular vision dysfunctions in different occupations requiring near work. It affects their near work as well as their performance. The cross-sectional study was conducted among 105 participants. Eye examination included visual acuity assessment, objective and subjective refraction, and details of orthoptic evaluation were done. Data was taken in an Excel sheet and analysis was made using the statistical software IBM SPSS Statistics 22.: Of the total (105) participants, 20-20% were equally drawn from each occupation. the mean value of the positive fusional vergence: recovery (near) was noticed low 7.2±3.5 among the teachers compared to 8.5±4.0 among the tailors, 9.4±3.9 among the bankers and higher 11.7±5.4 among the health workers (F = 3.38, p <0.05). The mean of the accommodative facility left eye was high 4.9±2.5 among the health workers compared to 3.6±1.8 among the teachers, 2.7±1.3 among the tailors, and 2.6±1.2 among the bankers (F = 5.11, p < 0.01). Near work for 8 hrs can lead to binocular abnormalities’ despite of occupation. The majority of the groups were affected by accommodative insufficiency and convergence insufficiency. They need to be provided with therapy according to their condition for better symptom relief.","PeriodicalId":13485,"journal":{"name":"Indian Journal of Clinical and Experimental Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141648877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Can retinal nerve fiber layer thickness be an indicator of amblyopia – Opening new horizons 视网膜神经纤维层厚度能否作为弱视的指标 - 开拓新视野

Indian Journal of Clinical and Experimental Ophthalmology Pub Date : 2024-07-15 DOI: 10.18231/j.ijceo.2024.061

Naheed Akhtar, Rumana Aafreen, Abdul Waris

{"title":"Can retinal nerve fiber layer thickness be an indicator of amblyopia – Opening new horizons","authors":"Naheed Akhtar, Rumana Aafreen, Abdul Waris","doi":"10.18231/j.ijceo.2024.061","DOIUrl":"https://doi.org/10.18231/j.ijceo.2024.061","url":null,"abstract":"To study the RNFL thickness in amblyopia at Institute of Ophthalmology, JNMCH, AMU, Aligarh.Prospective cross-sectional study.This study was conducted on 30 amblyopic children of age ranging between 6-16 years at Institute of Ophthalmology, Jawaharlal Nehru Medical College and Hospital, AMU, Aligarh after taking institutional ethical clearance and informed consent from parents of the patients. A brief clinical history was taken and detailed eye examination was done for visual acuity. Evaluation and quantification of strabismus was done. SD- OCT was performed after dilatation of pupil with 1% cyclomid eye drop on all enrolled children for evaluation of RNFL thickness and GCC thickness. RNFL thickness and GCC thickness of amblyopic eyes were compared with the fellow eyes. Data entry and analysis was done using paired t-test and p- values <0.05 was considered statistically significant. JASP application version 0.16.4.0 was used for statistical analysis of data and results.Out of 30 children23 were anisometropic amblyopic and 7 were mixed amblyopic. Average RNFL thickness was more in amblyopic eye as compared to fellow eye. This difference in RNFL thickness between the eyes remained statistically significant in an anisometropic amblyopic eyes (p<0.001) but not in mixed amblyopic eyes (p=0.50). No significant difference was found on comparing GCC thickness between the eyes in both the groups (anisometropic amblyopic and mixed amblyopic) (p=0.88,0.30). Amblyopic eyes have more RNFL thickness than fellow eyes. Therefore, we conclude that amblyopia may involve retinal structure, also exploding the old age myth that only cortical changes are responsible.","PeriodicalId":13485,"journal":{"name":"Indian Journal of Clinical and Experimental Ophthalmology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141645254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Role of targeted therapy in ophthalmic tumors 靶向疗法在眼科肿瘤中的作用

Indian Journal of Clinical and Experimental Ophthalmology Pub Date : 2024-07-15 DOI: 10.18231/j.ijceo.2024.037

R. P. Maurya, Kokil Tiwari

引用次数: 0