Gabriella Bulloch

Childhood myopia is increasingly prevalent in routine optometric practice and is associated with a lifetime risk of ocular complications. Clinically acceptable and evidence-based strategies to slow myopia progression are therefore important for long-term eye health management across diverse populations. To assess the efficacy, feasibility and safety of repeated red-light laser (RLRL) therapy among multi-ethnic school-aged children in Australia. Randomised controlled trial. 34 multi-ethnic children aged 8-13 years with myopia were enrolled. Participants were randomly assigned to the RLRL therapy with single-vision spectacles (SVS) group or the SVS group. RLRL therapy was administered for 3 minutes, twice daily for 5 days per week, while SVS group continued routine activities. Assessments were scheduled at baseline and follow-up visits at 1, 3, 6 & 12 months, with compliance monitoring and safety assessments throughout. Axial length (AL), spherical equivalence refraction (SER) and Optical coherence tomography were conducted. A total of 34 children were randomised to 17 in the RLRL group and 17 in the SVS group. Three children in the RLRL group withdrew due to headache (n = 1) and poor compliance to treatment (n = 2). Adjusted mean changes of 12-month AL and SER were -0.03 (95% CI, -0.05 to -0.01) mm and 0.08 (95% CI, 0.04 to 0.13) D for RLRL group and 0.12 (95% CI, 0.10 to 0.14) mm and -0.20 (95% CI, -0.29 to -0.10) D for SVS group. No severe adverse events were observed during the study period. This pilot study in a non-Chinese Australian population demonstrated that RLRL therapy may be a promising alternative treatment for myopia control in multi-ethnic school-aged children, with no documented functional and structural damages. Further research with a larger cohort is warranted to confirm results and explore the long-term efficacy and safety of RLRL therapy.

Non-immune mediated anaphylaxis to Syntocinon during labour Shyam Prakaash Bhagavata Srinivasan, Ishith Seth, Gabriella Bulloch, Alexander Mills# , Nita Dhupar*Wagga Wagga Base Hospital, Murrumbidgee Local Health District, NSW 2650, Australia.# Present address: Princess Alexandra Hospital, Metro South Health, QLD 4102, Australia.* Correspondence: Dr Nita DhuparObstetrician and GynaecologistWagga Wagga Base Hospital, Murrumbidgee Local Health District,NSW 2650, AustraliaEmail: n.dhupar2016@gmail.comPhone: +61434259479Short title: Anaphylaxis to SyntocinonKeywords: Anaphylaxis; Syntocinon; Oxytocin

Pregnancy-associated breast cancer (PABC) is a rare, yet significant clinical entity which presents itself during pregnancy or within one year postpartum. This case report and literature review discusses the case of a 33-year-old G1P0 woman diagnosed with PABC at 38 weeks’ gestation with an uncomplicated pregnancy and no significant risk factors. Fine needle aspiration revealed a left-sided metaplastic grade 3 invasive ductal carcinoma with heterogeneous mesenchymal differentiation and focal ductal carcinoma in situ, and an uncomplicated nipple-sparing mastectomy was undertaken at three weeks’ post-partum. This case report emphasises the need for early diagnosis and the importance of screening for breast cancer during pregnancy, and advocates for a low threshold to screen for PABC in all pregnancies. The literature review also provides updated insights into the presentation, diagnosis, and management of PABC. We explore the diagnostic challenges associated with PABC, including physiological changes in breast tissue during pregnancy, limitations of imaging modalities, and the importance of considering PABC as a differential diagnosis.

Background: We aimed to evaluate the impacts of metabolomic body mass index (metBMI) phenotypes on the risks of cardiovascular and ocular diseases outcomes. Methods: This study included cohorts in UK and Guangzhou, China. By leveraging the serum metabolome and BMI data from UK Biobank, this study developed and validated a metBMI prediction model using a ridge regression model among 89,830 participants based on 249 metabolites. Five obesity phenotypes were obtained by metBMI and actual BMI (actBMI): normal weight (NW, metBMI of 18.5–24.9 kg/m²), overweight (OW, metBMI of 25–29.9 kg/m²), obesity (OB, metBMI ≥ 30 kg/m²), overestimated (OE, metBMI-actBMI > 5 kg/m²), and underestimated (UE, metBMI-actBMI < − 5 kg/m²). Additional participants from the Guangzhou Diabetes Eye Study (GDES) were included for validating the hypothesis. Outcomes included all-cause and cardiovascular (CVD)-cause mortality, as well as incident CVD (coronary heart disease, heart failure, myocardial infarction [MI], and stroke) and age-related eye diseases (age-related macular degeneration [AMD], cataracts, glaucoma, and diabetic retinopathy [DR]). Results: In the UKB, although OE group had lower actBMI than NW group, the OE group had a significantly higher risk of all-cause mortality than those in NW prediction group (HR, 1.68; 95% CI 1.16–2.43). Similarly, the OE group had a 1.7–3.6-fold higher risk than their NW counterparts for cardiovascular mortality, heart failure, myocardial infarction, and coronary heart disease (all P < 0.05). In addition, risk of age-related macular denegation (HR, 1.96; 95% CI 1.02–3.77) was significantly higher in OE group. In the contrast, UE and OB groups showed similar risks of mortality and of cardiovascular and age-related eye diseases (all P > 0.05), though the UE group had significantly higher actBMI than OB group. In the GDES cohort, we further confirmed the potential of metabolic BMI (metBMI) fingerprints for risk stratification of cardiovascular diseases using a different metabolomic approach. Conclusions: Gaps of metBMI and actBMI identified novel metabolic subtypes, which exhibit distinctive cardiovascular and ocular risk profiles. The groups carrying obesity-related metabolites were at higher risk of mortality and morbidity than those with normal health metabolites. Metabolomics allowed for leveraging the future of diagnosis and management of ‘healthily obese’ and ‘unhealthily lean’ individuals.