ABSTRACT
Purpose: To evaluate the retinal microvascular changes in patients, recovered from severe COVID?19 during the second wave of the pandemic in North India. Methods: In this observational cross?sectional study, 70 eyes of 35 patients who recovered from severe COVID?19 during the second wave underwent detailed ophthalmic evaluation 4–6 weeks after discharge. Twelve controls were also enrolled, and the difference in the findings between the case and control groups on optical coherence tomography (OCTA) were studied. Result: The ages of study participants ranged from 27 to 60 years with the male:female ratio being 1.05:1. The fundus changes suggestive of ischemia in the form of cotton wool spots and vascular tortuosity were seen in 25 eyes (35.71%). Increased venous tortuosity was the most common finding seen in 23 eyes (32.85%), of which 10 eyes (28.57%) had concurrent hypertensive retinopathy (HTR) changes. There was a significant reduction in the mean vascular density (VD) and perfusion density (PD) for both the superficial capillary plexus (SCP) and deep capillary plexus (DCP) at inner, outer ring, and whole (P < 0.05). Foveal avascular zone was significantly enlarged in both the SCP (P = 0.01) and the DCP (P = 0.03). The mean ganglion cell?inner plexiform layer (GC?IPL) was significantly reduced in comparison to controls (P < 0.001). Conclusion: Severe COVID?19 can result in microvascular changes at the macula in the form of reduction in vascular and perfusion density, which can be evaluated using OCTA. As structural changes precede functional changes, a close watch is recommended in patients showing compromise in retinal microvasculature
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Background. Diabetes-related health education promotes patient efficacy for diabetes self-management. However, sub-optimal knowledge of diabetes in people with diabetes is recognized as a challenge in overcrowded public health facilities in India. We aimed to determine the effect of health education through mobile phone text messages (short messaging service [SMS]) on diabetes-related knowledge of patients with diabetes. Methods. From February 2016 to February 2017, we recruited adult patients with diabetes for this quasi-experimental study done in the outpatient setting of a major tertiary care government hospital in Delhi, India. Participants in the intervention group received a text message on diabetes self-care practices every alternate day for 90 days. We evaluated the patients’ knowledge of diabetes using the Spoken Knowledge in Low Literacy in Diabetes (SKILL-D) questionnaire and a self-designed diabetes knowledge questionnaire. Results. We enrolled 190 men and 160 women, of whom 52 (13.7%) were lost to follow-up. At baseline, mean diabetes knowledge scores were higher in the intervention group compared to the control group. After the intervention period of 3 months, the diabetes knowledge scores for SKILL-D and the patient diabetes knowledge questionnaire showed a statistically significant increase in the intervention group (mean difference 0.7 and 0.5, respectively; p<0.001, but there was no increase in the control group). Conclusion. The use of mobile phone technology for diabetes-related health education through mobile text-message (SMS) technology is an effective method for health promotion.
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There are many causes of recurrent meningitis of which anatomical defects such as cephalocele are common. We report a case of a 45 year-old woman who presented with recurrent meningitis and was found to have an underlying naso-ethmoid encephalocele .
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Aim of the study was evaluation of symptoms and signs in patients with eosinophilia, to try to find its etiology and to study the natural course of eosinophilia during the period of study. Fifty patients with absolute eosinophil count (AEC) more than 350/mm3 or differential count more than 3% irrespective of their age, sex and medical condition were included. The patients were divided into mild (AEC-350 to 1500), moderate (1500 to 5000) and severe (>5000/mm3 of blood) eosinophilia. They underwent a series of routine and special hematological and biochemical investigations including bone marrow aspiration, serum IgE estimation, and pulmonary function tests. The patients were studied for a period of 3 months. Most of the patients (52%) fell in the category of mild eosinophilia. Minimum AEC at the entry of patients into the study was 600 and maximum was 22500. Commonest presenting symptoms were anorexia (40%), pain abdomen (38%), fever (32%), and breathlessness (30%). Etiology of eosinophilia was undiagnosed in 70% of the patients. Parasitism was more common than allergic rhinitis and bronchial asthma. On follow up investigations, eosinophilia resolved on its own even without specific antieosinophilic treatment. Extensive work up of patients was not associated with significant change in the management of any patients with eosinophilia. The etiology of eosinophilia remains unrevealed in majority of the patients. Extensive work up of patients with eosinophilia is not recommended.
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This study was conducted to determine the prevalence of risk factors for coronary artery disease (CAD) in apparently healthy middle aged and elderly population and to find the different between urban and rural group.Atotal of 160 individuals (80 urban and 80 rural) were included in the study. All the subjects underwent detailed history and physical examination with special emphasis on cardiovascular system. The biochemical investigations were done in all the subjects which included blood sugar, serum LDL and serum triglyceride levels. The prevalence of 2 or more than 2 risk factors were observed in 95% subjects. The prevalence of smoking was 63%, which was more prevalent in the rural population. The sedentary lifestyle was seen in 80% subjects more in females and urban group. The prevalence of asymptomatic hypertensives and isolated systolic hypertension were seen in 34% and 10% individuals respectively. Other risk factors were-diabetes mellitus (4%), Increase LDL (38%), hypertriglyceridemia (23%) and central obesity (27.50%). The two most common risk factors for CADwere sedentary lifestyle and smoking. These risk factors are modifiable and their reduction during adulthood can lead to marked reduction in the burden of CAD in middle aged and elderly Indian population.
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The present study was conducted to find out a correlation between protein to creatinine (PC) ratio in random sample and 24 hr. urinary protein (UP) in patients with proteinuria with normal renal functions (serum cretinine<1.5 mg %) -group-I, with impaired renal functions, mild to moderate (s.cretinine 1.5-4.0mg%) group-II and advance renal failure (s.cretinine >4.0mg%) -group-III. 24 hr. and a random urine sample was taken for each patient and was tested for protein and creatinine. PC ratio was found in each random sample. The mean 24 hr.UP (g/24 hr.) estimated by 24 hr. urine collection was 1.15± 0.97, 3.26 ±1.34 and 7.39±2.19 in group I, II and III respectively. However, the mean UP estimated by random sample was 1.35±1.09, 3.94±1.93 and 10.38±3.70 in group-1, group-II and group-III respectively. P value was statistically insignificant in group 1 & II. However, there was significant difference in values in group-III (P=0.012). Coefficient of correlation on univariate analysis was r=0.889 in group-I, 0.788 in group-II and 0.375 in group-III indicating a significant correlation in results in groupI and II and not in group-III. The results in the study have shown that single voided urine method of estimating quantitative proteinuria holds its value in patients with normal, as well as in mild to moderately impaired renal functions. However, this method does not hold good for patients with severely impaired renal functions.