Plaque brachytherapy – Radiating positivity

Background: Plaque brachytherapy is an evolving, yet effective globe and vision-sparing modality for the treatment of intraocular tumors by transscleral irradiation of the tumor base with a radioactive implant. The American Brachytherapy Society (ABS) along with the collaboration of the international multicenter Ophthalmic Oncology Task Force (OOTF) was assembled to reach a consensus regarding establishing practice guidelines and setting standards of care for intraocular tumors. The advent of plaque brachytherapy has revolutionized the outcomes of intraocular tumors, thus ensuring globe salvage, reducing morbidity and mortality, and avoiding cosmetic disfigurement. A well-planned dosimetry for plaque brachytherapy results in achieving local tumor control and excellent prognosis. Purpose: This technique provides the advantage of focal radiation, thus eliminating the damage to the adjacent structures, minimal periorbital tissue damage, absence of cosmetic disfigurement owing to lack of retarded bone growth as seen in external beam radiotherapy. Thus, it reduces the risk of metastasis, and with the recent advances, it provides a shorter duration of treatment. Synopsis: In this video, we shall display the concept of plaque brachytherapy, the various types of plaques available, different radiations sources, planning dosimetry and calculations, target disease spectrum, surgical placement, and post-radiation outcomes in terms of local tumor control and prognosis. Highlights: This video highlights the history, basic principles and techniques of plaque brachytherapy and provides an understanding of its applications in the world of ocular oncology.

Posterior segment involvement in systemic lupus erythematosus – A series from South India

Purpose: To report the spectrum of posterior segment manifestations and visual outcomes in a large series of patients with systemic lupus erythematosus (SLE). Methods: Retrospective study at a tertiary referral eye center in south India between 2016 and 2022. Results: Charts of 109 patients diagnosed to have SLE were retrieved from our medical database. Only nine cases of SLE (8.25%) had posterior segment involvement. The male: female ratio was 1:8. The mean age was 28 years. Unilaterality was the most common presentation in eight cases (88.89%). Lupus nephritis was the most common systemic presentation in five cases (55.56%). Antiphospholipid antibodies (APLA) positivity was seen in two cases (22.22%). Ocular manifestations included microangiopathy (cotton wool spots) in one case, occlusive retinal vasculitis with cotton wool spots in four cases (five eyes), optic disc edema with combined venous and arterial occlusion (one case), central retinal vein occlusion with cotton wool spots and hemorrhages (one case), macular edema (four cases), posterior scleritis with optic disc edema and exudative retinal detachment in the posterior pole (one case), and tubercular choroidal granuloma (one case). Treatment included systemic steroids, hydroxychloroquine sulfate (HCQS), and immunosuppression in all cases, blood thinners in two cases, and laser photocoagulation in four cases. HCQS?related retinal toxicity was not seen in any of the 109 cases. Ocular manifestation was the initial presentation of SLE in one case. Visual outcome was poor in three cases. Conclusion: Presence of posterior segment findings in cases with SLE may suggest a severe systemic disease. Early detection and aggressive treatment result in better visual outcomes. Ophthalmologists could play a vital role in guiding systemic therapy.

Burden of sickle cell disease in tribal students in Maa-Baadi institutions in southern Rajasthan - A pilot study

Background & objectives: Sickle cell disease (SCD), an inherited disorder of erythrocytes, is highly prevalent in the tribal population of India. The tribal population of India is approximately 100 million and it is necessary to identify the magnitude of this problem. Furthermore, the prevalence of the disease is unknown among the five million tribal people of southern provinces of Rajasthan. In this study, we intended to determine the prevalence and characteristics of sickle cell disorder among the tribal inhabitants of southern Rajasthan. Methods: This cross-sectional study was conducted among the tribal students of the Maa-Baadis and hostels situated in the five tribal sub-plan districts of Rajasthan. Maa-Baadi centres are located in every village, whereas for every four to five villages, one hostel is allocated to accommodate the tribal students. The screening for SCD was done by solubility test and electrophoresis was used for confirmation. Results: A total of 36,752 tribal students were screened from 1,006 Maa-Baadi centres and 243 hostels. The prevalence of SCD among the tribal students was 5.8 per cent. The prevalence of heterozygous and homozygous conditions was 5.61 and 0.17 per cent, respectively. Among the five sub-plan districts, the highest prevalence was observed in Sirohi district (10.5%) followed by Banswara (7.42%), Udaipur (6.53%), Pratapgarh (5.51%) and Dungarpur (1.89%). Among the four major tribes belonging to these districts, the highest prevalence was recorded in Garasia tribes (13.81%). The history of leg ulcers and the mean pulse rate were significantly high in SCD individuals. Interpretation & conclusions: SCD is a significant problem among the tribes of southern Rajasthan, with the highest prevalence among the Garasia tribe. The present study recommends that a structured screening programme targeting the entire tribal population with appropriate counselling as well as providing treatment through the existing health system is the need of the hour.

The safety profile of COVID-19 Vaccination among 1373 elderly population

Introduction: COVID-19 infection caused by the SARS COV-2 virus is one of the largest pandemics and has affected every nation worldwide. The introduction of different vaccines against COVID-19 infection has bought new hope in the fight against COVID-19, which would decrease the ongoing crisis. These vaccines were approved for emergency purposes, which had fewer clinical trials involving elderly populations. Hence, this study intends to know the safety profile of the COVID-19 vaccine in the elderly population. Methods: In a cross-sectional study, we have collected data regarding the onset of symptoms within 72hrs following first dose of COVID-19 Vaccination among elderly people through a direct interview and by phone call, using a questionnaire. Results: Among 1373 elderly, 445 (32.41%) had no symptoms, while the remaining 928 (67.54%) had developed symptoms. The commonest symptoms were fever 738 (53.75%), pain at local site 536 (39.01%), and body ache 382 (27.82%). All these symptoms were relieved by taking Paracetamol 650mg tablet provided by the vaccination center. The commonest co-morbidities observed were hypertension, diabetes, and ischemic heart disease. There was no mortality. Conclusion: So far, very few studies have been conducted on the elderly population. Our study has an advantage where it has involved a large number of elderly populations. The majority of the elderly in our study received covishield vaccine. We conclude covishield and covaxin vaccines had minor side effects which were selflimiting and can be considered safe in the elderly population despite having multiple co-morbidities. This study endorses that vaccines are safe in the elderly population irrespective of co-morbidities and increasing age.

Acid-functionalized single-walled carbon nanotubes alter epithelial tight junctions and enhance paracellular permeability

The T(EB4)Nta, T(IBj5)Nta, and T(B362i)NtA strains were constructed by introgressing the insertionaltranslocations EB4, IBj5, and B362i from Neurospora crassa into the related species N. tetrasperma. Theprogeny from crosses of T(IBj5)Nta and T(B362i)NtA with opposite mating-type derivatives of the standard N.tetrasperma strain 85 exhibited a unique and unprecedented transmission ratio distortion (TRD) that disfavoredhomokaryons produced following alternate segregation relative to those produced following adjacent-1 segregation. The TRD was not evident among the [mat A ? mat a] dikaryons produced following either segregation. Further, crosses of the T(IBj5)Nta and T(B362i)NtA strains with the Eight spore (E) mutant showed anunusual ascus phenotype called ‘max-4’. We propose that the TRD and the max-4 phenotype are manifestations of the same Bateson-Dobzhansky-Muller incompatibility (BDMI). Since the TRD selects against 2/3 ofthe homokaryotic progeny from each introgression cross, the BDMI would have enriched for the dikaryoticprogeny in the viable ascospores, and thus, paradoxically, facilitated the introgressions.

Musculoskeletal Disorders among Dentists: A Review.

Dental professionals are facing a variety of occupational hazards. Technological advancements in the field of dental equipment and materials have not fully eliminated the musculoskeletal problems of dentists. When practicing, dentists sometimes are forced to adopt unhealthy postures that depend mainly on factors related to the working conditions. These lesion starts to appear at beginning of clinical practice as a student, and it will persist as they acquire independent posture and working habits during the professional life. Th e pervasive of musculoskeletal complaints among dentists is high and well documented. Based on the relevant literature, the present manuscript discusses the musculoskeletal problems of dental professionals.

Clinical Profile of Hand, Foot, and Mouth Disease and its Associated Complications among Children in Shimoga City, Southern Karnataka: A Hospital-Based Study.

Hand, foot, and mouth disease (HFMD) is one of the important public health problems. It has become a common childhood illness in our part of the country. In most instances, this is a mild self-limiting illness. The affected children are often given outpatient care. However, over the last decade, HFMD has emerged as a growing health problem in Asian countries following frequent outbreaks of deaths associated with HFMD caused by a more virulent member of human enterovirus (HEV), namely, HEV71. A hospital-based descriptive study about the clinical presentations and complications of HFMD at the hospitals of Shimoga city between March 2013 and August 2013 is documented and presented here. HFMD was more common in the 1-3-year old age group, with aseptic meningitis being the most common complication. Surveillance of HFMD must be maintained as there is no effective chemoprophylaxis or vaccine available.

Does Co-Suffering by Ischemic Heart Disease and Tuberculosis Exist in Community Endemic for These Diseases.

Aims: Tuberculosis (TB) has been thought associated with developing atherosclerosis, a hallmark of ischemic heart disease (IHD) pathology. Animal studies and human autopsy & case studies have shown association of TB with atherosclerosis. There is paucity of data showing co-suffering by TB and IHD. The objective of the study was to explore the co-suffering by IHD and TB in community endemic for these diseases. Study Design: Retrospective secondary data analysis. Place and Duration of Study: Mahatma Gandhi Hospital, Jodhpur, Rajasthan, India between January 2011 and December 2011. Methodology: Retrospective secondary data analysis done for patients admitted with IHD at tertiary hospital in Jodhpur, Rajasthan, India; a setting endemic for TB and IHD both. Results: Study revealed 1.6% of total admitted cases of IHD were co-suffering with TB. Majority of these (68.2%) reported history of TB diagnosis and/or treatment. About one third (31.8%) cases were co-suffering with current diagnosis and/or treatment for TB. Cases co-suffering by TB & IHD were on average 7 years elder than cases of IHD. This difference in age was statistically significant (p=0.05). Conclusion: The study demonstrated that co-suffering by IHD and TB does exist in setting endemic for both these diseases. Patients older than 53 yrs (Mean age 65.63 yr - 2 SD 12.47 yr) age presenting with clinical features suggestive of IHD should be explored for the history or current status of TB. Studies on co-suffering by these are needed among patients attending peripheral health centres for validation.

Oxidant and Antioxidant Status in Parkinson’s Disease.

Parkinson’s disease (PD) is a progressive, neurological disease that mainly affects movements and occurs at older ages and is clinically characterized by resting tremor, rigidity, bradykinesia and postural imbalance. These clinical manifestations of PD are caused by a selective degeneration of dopamine-producing neurons in substantia nigra in the brain stem and the consequent dopamine shortage in the striatum. Oxidants and antioxidants related substances may contribute to the pathogenesis and the progression of Parkinson’s disease. Research can make great progress in understanding and further treating the PD. This study demonstrates significant variation of oxidants-antioxidants status in Parkinson’s disease. Oxidative stress plays a crucial role in progression of PD; however, oxidative stress is a cause or the consequence of PD is debatable. In our study we observed there is significant increase in the levels of serum Malondialdehyde (p< 0.001), Nitric oxide end products (p< 0.001), and significant decrease in the activity of Glutathione peroxidase (p< 0.001), Superoxide dismutase (p< 0.001), and Catalase (p< 0.001) in PD patients as compared with controls. Further Vitamin C (p< 0.05), Vitamin E (p< 0.05) significantly decreased, but Uric acid levels (p> 0.05) remain unchanged and this may be due to compensatory mechanism of body against oxidative stress, which not allowed much alteration in other parameter in the PD patients as compared with controls.

Evaluation of C677T polymorphism of the methylenetetra hydrofolate reductase gene and its association with levels of serum homocysteine, folate, and vitamin B12 as maternal risk factors for Down syndrome.

Aims and Objective: Evaluation of C677T polymorphisms of the methylenetetra hydrofolate reductase (MTHFR) gene and its association with level of serum homocysteine, folate, and vitamin B12 as possible maternal risk factors for Down syndrome. Design: This was a case-control study. Material and Methods : Fifty-two mothers (mean age 27.6 years) with babies having free trisomy 21 of North Indian ethnicity and 52 control nonlactating mothers (mean age 24.9 years) of same ethnicity attending services of genetic lab for bloodletting for other causes were enrolled after informed written consent. Fasting blood was collected and was used for determination of plasma homocysteine, vitamin B12, and folate (serum and RBC), and for PCR amplification of the MTHFR gene. Results: The prevalence of MTHFR C677T polymorphism in north Indian mothers of babies with trisomy 21 Down syndrome was 15.38% compared to 5.88 % in controls. The difference between two groups was not statistically significant ( P = 0.124). Low serum folate was demonstrated in 34.62% of cases vs. 11.54% in controls, which was significant ( P = 0.005). Low RBC folate was found in 30.7% of cases versus 11.53% in controls, which was not significant ( P = 0.059), when analyzed independently. But on multiple regression analysis the difference was statistically significant. Low serum vitamin B12 was found in 42.31% of cases versus 34.62% in controls, which was not significant ( P = 0.118). The mean serum homocysteine in cases was 10.35 ± 0.68 while controls were 9.02 ± 0.535. Conclusion: Serum levels of folate were low in cases. The RBC folate levels were comparable in both groups. However the combined serum folate and RBC folate were low in cases compared to control groups. Homocysteine levels in our study were higher in Down syndrome mothers compared to controls; however high-serum level of Homocysteine had no association with MTHFR polymorphism. No association of serum vitamin B12 with MTHFR polymorphism in occurrence of Down syndrome births was found. Peri- or preconceptional folate supplementation may therefore lead to a decline in DS births, if supported by larger studies.

Synthesis of New VO(II), Co(II), Ni(II) and Cu(II) Complexes with Isatin-3-Chloro-4-Floroaniline and 2-Pyridinecarboxylidene-4-Aminoantipyrine and their Antimicrobial Studies

The complexes of tailor made ligands with life essential metal ions may be an emerging area to answer the problems of multi drug resistance. The coordination complexes of VO(II), Co(II), Ni(II) and Cu(II) with the Schiff bases derived from isatin with 3-chloro-4-floroaniline and 2-pyridinecarboxaldehyde with 4-aminoantipyrine have been synthesized by conventional as well as microwave methods. These compounds have been characterized by elemental analysis, molar conductance, electronic spectra, FT-IR, FAB mass and magnetic susceptibility measurements. FAB mass data show degradation of complexes. Both the ligands behave as bidentate and tridentate coordinating through O and N donor. The complexes exhibit coordination number 4, 5 or 6. The Schiff base and metal complexes show a good activity against the bacteria; Staphylococcus aureus, Escherichia coli and Streptococcus fecalis and fungi Aspergillus niger, Trichoderma polysporum, Candida albicans and Aspergillus flavus. The antimicrobial results also indicate that the metal complexes are better antimicrobial agents as compared to the Schiff bases. The minimum inhibitory concentrations of the metal complexes were found in the range 10~40 microg/mL.

Verbal Learning & Memory Function among Children with ADHD and Emotional Disorders.

Memory function and learning process are commonly observed impaired among children with Attention Deficit Hyperactive Disorder (ADHD). However, children with Emotional Disorders (ED) too report inability to attend, register and recall the stimuli that eventually result in poor academic performance. The present study aimed to study the nature of impairment in verbal learning and memory function among children with ADHD and ED. The study further aimed to explore the effect of severity of illnesses over the degree of impairment in verbal learning and memory function in both the groups. Twenty children meeting the ICD-10 criteria for ADHD and twenty children meeting the ICD-10 criteria under F-93 for Emotional Disorders (ED) were assessed on the measure of verbal learning & memory and compared with twenty age and education matched normal control group. Children with ADHD and ED performed poorly on the measure of verbal learning and memory in comparison of normal control, but the degree of impairment was observed relatively higher among ADHD children than children with ED. However, severity of illness was not observed a contributory factor for the impairment in verbal learning and memory function in both the groups. Impairment in verbal learning and memory function is not confined only to the children with ADHD but these are now recognizable among children with Emotional Disorders too. Both the groups (Children with ADHD and ED) reflected impaired memory and learning function but in terms of degree of impairment the children with ADHD were always found standing towards higher side than children with emotional disorder.

Perceived Self Efficacy and Mental Health among Elderly.

Objectives: Perceived self-efficacy is a belief centers on appraisal vs. misappraisal of capabilities within the individual to produce designated level of performance. It mediates the relationship between functional decline, health condition and the need for formal care services. The present stduy aimed to study the impact of perceived self efficacy on mental health and to explore the predictor of mental health among elderly population. Method: The study consisted of 160 elderly respondents. Half of these were males and the other half females. They were further sub-divided into eight groups on the basis of their gender and age. Each of eight subgroups consisted of 20 respondents and assessed on the measures of Perceived Self Efficacy (PSE) and Mental Health i.e. General Health Questionnaire (GHQ). Results: The mean differences showed that the elderly males scored higher on the measure of PSE and GHQ and showed better meatal health than elderly females. Again the younger elderly groups scored higher on the measures of PSE and GHQ and reported better mental health than the elderly of advanced age groups. Conclusion: The present study revealed that the problem of elderly is emerging not only due to their increasing proportion of age but also due to their own faulty cognitions and perceptionof aging. Perceived self efficacy emerged as an imjportant predictor of mental health among elderly males and females i.e. elderly who perceive themselves self efficacious to have control over their environment reported better mental health and vice versa.

Investigation of the outbreak of typhoid in a village of Thar Desert Rajasthan, India.

Background & objectives: Outbreaks of typhoid have been reported from Maharashtra, Bangalore, West Bengal and Pondicherry in India but rarely from Rajasthan. We investigated an outbreak of typhoid in a village of Thar Desert of Rajasthan. Methods: A retrospective cohort study was carried out during May-July 2007 in Varkana village, Pali district, Rajasthan, to identify the risk factor for disease. The information on outbreak was collected and then described in time, place and person characteristics to arrive at aetiological hypotheses. Results: There were 219 cases of typhoid in village. Attack rate was 104 cases per 1000 population. Maximum attack rate of 276 cases per 1000 population was noted in persons of 10-14 yr age group. Forty three serum samples were reported positive for Widal agglutination test out of 70 tested. Drinking of water from government overhead tanks was associated with disease significantly (RR= 11.1, 95% CI= 3.7-33). Two of the three water samples from government tanks were found positive for faecal contamination. Interpretation & conclusion: The outbreak of typhoid in a village affected >200 persons of all age groups and both gender. Exposure to the drinking water from government tanks was found significantly associated with the disease. Preventive and control measures undertaken after analytical epidemiological study helped in terminating the outbreak.

Arsenic in the environment: effects on human health and possible prevention.

Arsenic is a major environmental pollutant and exposure occurs through environmental, occupational and medicinal sources. The contaminated drinking water is the main source of exposure and affected countries are India (West Bengal), Bangladesh, China, Taiwan, Thailand, Chile, Argentina and Romania. Concentrations of arsenic in affected areas are several times higher than the maximum contamination level (MCL) (10 microg/l). Arsenic exposure to human results in degenerative, inflammatory and neoplastic changes of skin, respiratory system, blood, lymphatic system, nervous system and reproductive system. There is no particular remedial action for chronic arsenic poisoning. Low socioeconomic status and malnutrition may increase the risk of chronic toxicity. Early intervention and prevention can give the relief to the affected population.

Childhood illnesses and malnutrition in under five children in drought affected desert area of western Rajasthan, India.

The study was undertaken to asses the impact of drought on childhood illnesses and nutrition in under five children of rural population using three stage sampling design. The study has been carried out in 24 villages belonging to 6 tehsils of Jodhpur district which was a drought affected desert district of Western Rajasthan in 2003. A total of 914 under five children (0-5 years) could be examined for their childhood illnesses, malnutrition, dietary intake and clinical signs of nutritional deficiency. Childhood illnesses observed at the time of drought were respiratory (7.5 %), gastroentrological (7.5%), and 5.6% fever (viral, malaria and jaundice), higher in males than females. Children suffered from recent and long term malnutrition were 39% and 26% respectively as per National Centre for Health Statistics (NCHS) standards. The extent of malnutrition was significantly higher in females than in males (p<0.01). Vitamin A & B complex deficiencies were 0.7% and 3/% respectively. The protein energy malnutrition (PEM) was observed in 44.4%. Overall mean calorie and protein intake deficit was observed to be very high (76.0 & 54.0 %). The comparison of present drought results with earlier studies in normal and drought conditions showed higher prevalence of PEM and deficiencies of calories & proteins in their diet. Respiratory, gastroentrological and fever were main childhood illnesses observed and were higher in males at the time of drought. PEM, vitamin A & B- complex deficiencies, anemia along with deficit in calories and proteins in their diet was observed higher in present study as compared to non desert areas, which may be due to the harsh environmental conditions in desert areas and paucity in the consumption of daily food intake. Due to inadequate consumption of daily food, the children were suffering from PEM resulting in several childhood illnesses. Effective measures making availability of adequate calories and proteins to all age groups especially to under five children through the ongoing nutrition programs needs to be ensured.

Acute respiratory distress syndrome due to Strongyloides stercoralis in non-Hodgkin's lymphoma.

Strongyloides stercoralis is a nematode endemic in tropical and subtropical regions. In immunocompetent subjects, pulmonary disease caused by the parasite is unremarkable but the same can be life threatening in immunocompromised subjects. Though described in literature it is rarely seen in Indian subjects. We report a patient with ARDS due to Strongyloides stercoralis complicating non-Hodgkin's lymphoma with neutropenia.

Evaluation of the mutagenic potential of chlorpyrifos (CPF) using polytene chromosomes of Anopheles mosquito.

Diverse cytogenetic tests are employed for short term screening of suspect environmental mutagens by using insects and mammals as models. In the present paper the polytene chromosomes of a mosquito Anopheles maculatus were used to evaluate the mutagenic potential of a widely used organophosphate pesticide chlorpyrifos-[o, o-diethyl-o-(3, 5, 6-trichloro-2-pyridyl) phosphothioate]. The results are based on the frequency of various structural aberrations encountered in the polytene chromosomes of the larvae treated with LC20 of chlorpyrifos (CPF). These aberrations were dominated by inversions, stickiness of the chromosomes, heterochromatinization of the bands and lack of polyteny. The frequency of various aberrations was highest in the left arm of chromosome number 2L followed by 2R, 3L, 3R, and X-chromosomes i.e. 2.10 +/- 0.44, 1.84 +/- 0.44, 1.57 +/- 0.54, 1.31 +/- 0.50, and 0.22 +/- 0.27 respectively. The susceptibility of different chromosomal arms to this pesticide was 2L > 2R > 3L > 3R > X and the regions prone to these aberrations have been marked on the polytene chromosome map of Anopheles maculatus.