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Background: Diabetes, hypertension, obesity, and dyslipidemia, all are the risk factors of metabolic syndrome (MS). Various studies have shown that each risk factor is associated with increased inflammation. hsCRP is a non-specific, sensitive inflammatory marker that is raised in various inflammatory conditions. Similarly, glutathione is an antioxidant which binds with ROS produced during inflammation and reduces damage caused by ROS. Aims and Objectives: This study has been planned to find the correlation between oxidative stress and metabolic risk factors in apparently healthy adults. Materials and Methods: We recruited apparently healthy adults (n = 120) and measured waist circumference, blood pressure, lipid profile, Fasting blood sugar, serum GSH, and hsCRP in all the subjects. Seventy-seven subjects were found to have at least one or more metabolic risk factors (Group A) according to NCEP ATP III criteria with waist circumference >90 cm for male and >80 cm for female and 43 were without any metabolic risk factors (Group B). Thereafter, we compared the serum levels of hsCRP and serum GSH with persons having one or more risk factors for MS. Results: In this study, we observed that subjects with metabolic risk factors were having more oxidative stress indicated by increased hsCRP (4783.1 ± 2060.21) and low serum GSH (3.17 ± 0.81) in comparison to controls (1640.5 ± 547.47 and 4.79 ± 0.77, respectively). This increase in hsCRP and decrease in GSH in case group was statistically significant. We also found the higher basal hsCRP levels in control group as per AHA/CDC study. Conclusion: We observed in this study that Indians without any risk factors for MS have relatively higher CRP levels and are at intermediate risk for cardiovascular disease. It was also observed that as the number of metabolic risk factors increases, the levels of hsCRP increases, and serum GSH decreases. This indicates that more risk factors are associated with higher oxidative stress.
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Aim: The study aimed to investigate the prevalence of undernutrition in terms of low birth weight, stunting, wasting, and underweight among children up to 3 years of age. Materials and Methods: We recruited 150 children of the Bhoksa Tribe aged between 2 to 36 months. Information related to nutritional indicators (length-for-age, weight-for-age, and weight-for-length) of the child and socio-demographic variables of the household were collected. Results: The prevalence of undernutrition in terms of low birth weight, stunting, wasting, and underweight was 15.4%, 32%, 29.98%, and 36.66%, respectively. The prevalence percentage of undernutrition was high among girls but the difference based on sex was not significant. A significant difference in mean birth weight was observed between low and high SES (2.45 kg v/s 2.93 kg). Conclusion: High prevalence of undernutrition concerning birth weight among the children of the Bhoksa Tribe was observed which may be due to socioeconomic inequality in the population.
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Leech invasion into a bodily cavity or orifice is known as hirudiniasis. This article’s objective is to explain an uncommon cause of epistaxis brought on by a leech infestation in the nasal cavity, nasopharynx, or oropharynx in the hilly Rajouri district of Jammu and Kashmir, as well as how to manage it. This retrospective case series consisted of seven cases. All the cases present with unilateral epistaxis. Anterior rhinoscopy with or without endoscope reveal smooth, grayish-black mobile leech inside nasal cavity, nasopharynx, or oropharynx which was removed by suction or forcep.
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This study aimed to explore ethical dilemmas and challenges faced by young mental healthcare researchers and professionals working with survivors of suicide (hereinafter suicide survivors). Two focus group discussions (FGDs) Researcher FGD (with those engaged in suicide research) and Clinician FGD (with those providing treatment to suicide survivors) – consisting of open-ended questions and lasting for 70-90 minutes were conducted and analysed using Thematic Analysis. Five themes were identified: i) struggling with the incongruity of harm within benefit, ii) difficulty in delineating boundaries, iii) self-doubt in one’s professional competence, iv) nature of suicide straining the limits of confidentiality, and v) working with structural limitations. The study helps to understand the obstacles and dilemmas encountered in adhering to ethical principles while working with vulnerable individuals.
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Background: Needle stick injuries (NSIs) are serious occupational health problem related to accidental exposure of health care workers (HCWs) while involved in patient care services. The percutaneous exposure to potentially contaminated blood and body fluids with blood borne pathogens are responsible for significant prevalence of Hepatitis B, C & HIV infections amongst HCWs. Methods: This is a descriptive cross sectional study conducted in hospital settings over a period of one year. 178 HCWs were selected for study using systematic random sampling after proportional allocation for each professional category in the hospital. Collected data was processed on SPSS ver 24. The association between needle stick and associated factors were measured using the odds ratio at a 95% confidence interval. The statistical significance was made at a p-value of less than 0.05. Results Total of 62 incidences of sustaining a needle stick injury in a year was recorded amongst 178 HCWs. In this study, statistically significant results with p value less than 0.05 was obtained with association with variables like gender [AOR=1.36 (0.64 - 2.68)], experience in years as HCWs [AOR=1.23 (0.32 - 2.12)], profession [AOR=0.063 (0.001- 0.43)], observance of universal precautions as wearing gloves [AOR=0.33 (0.169 – 0.631)] or any training on PEP or universal precautions [AOR=2.29 (1.320 - 4.696)]. Conclusion: NSIs have the potential to affect the health system both directly and indirectly. To lessen the dangers and impacts of NSIs stringent training should coordinate the endeavors toward preparing of health care workers, utilization of wellbeing designed gadgets, and diminishing patient burden per health care workers.
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Objectives: Orexins are hypothalamic neuropeptides, which are involved in feeding behaviour, sleep-wakefulness, and neuroendocrine homeostasis in the body. The study was conducted with the aim to estimate the serum orexin levels in reproductive age group (RAG) women and to determine the association of serum orexin levels with body mass index (BMI) in females of RAG. Materials and Methods: One hundred and forty apparently healthy women of RAG (20–40 years) were randomly selected. Fasting serum orexin levels were measured using ELISA and BMI was calculated in women based on their height and weight. Results: Serum orexin levels were significantly higher in women with BMI ? 25 kg/m2 (P = 0.035) as compared to women with BMI < 25 kg/m2 . Conclusion: In the present study, BMI correlated significantly with mean serum orexin levels. However, serum orexin levels did not correlate with the age of women.
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Introduction Undernutrition puts children at greater risk of dying from common infections, increases the frequency and severity of such infections, and delays recovery. The percentage of undernutrition, stunting and wasting in children under 5 years of the age in India are 35.7, 38.4 and 21.0 respectively. The etiology of malnutrition is complex and multi-factorial usually a consequence of inadequate dietary intake and various diseases. Methodology: A community based case-control study was conducted among children aged 6 to 59 months, registered at the Anganwadi centers in an urban locality of Surat city, Gujrat. Study population was divided into cases and controls using WHO classification based on anthropometric measurements. Result: The prevalence of undernutrition and severe acute malnutrition among the under-five children were 26.2 and 8.7% respectively. Significant association was found between nutritional status of the children and type of the family( OR 3.84, 95% CI =1.87-7.86, p = 0.000), low birth weight (OR 4.85, 95% CI =2.29 � 10.26, p = 0.000), poor appetite (OR = 2.89, 95% CI = 1.38-6.01, p = 0.004), bottle feeding (OR = 5.41, 95% CI = 1.91-15.29, p= 0.001) and children with habits of eating wafers/candies (OR = 21.99, 95% CI = 9.02-53.60, p = 0.000). Conclusion: Severe acute malnutrition continues to be an important health concern among under five children in the urban area and is affected by many risk factors which can be mitigated through structured and timely interventions using IEC materials.
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Background: Vitiligo places a significant psycho-social burden on caregivers and family members. Aims: The aim of the study was to develop and preliminarily validate a scale to measure the psychosocial impact of vitiligo on adult family members. Methods: Themes that emerged from qualitative interviews and a focus group discussion with family members were used to generate items for a preliminary scale, followed by pre-testing and scale development. The new scale was then tested with two comparator scales and a global question. Results: A preliminary scale with 32 items was pilot tested on 30 participants. Following this, the scale was condensed to 16 items in 12 domains that were administered to 159 participants. Scale scores ranged from 0 to 48 with a mean of 19.75 ± 12.41. The scale had excellent internal consistency with Cronbach’s alpha coefficient of 0.92 (0.70–0.95) and also showed good test-retest reliability at two weeks (r = 0.946). The scale showed criterion, convergent and known group validity. Limitations: It was conducted in a large teaching hospital which may have resulted in selection of patients with persistent or progressive disease and more worried family members. Vitiligo is highly stigmatized in our country and the performance of the scale may need to be evaluated in other communities and cultures as well where stigma is less oppressive. Conclusion: Family Vitiligo Impact Scale appears to be an easy-to-complete, reliable and valid instrument to measure the psychosocial impact of vitiligo in family members of patients. It may be useful as an outcome measure in both clinical and research settin
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Background:Brahmi has been used by Ayurvedic medical practitioners in India for almost 3000 years. The earliest chronicled mention is in the Ayurvedic treatise, the Charaka Samhita (100 A.D.), in which Brahmi is recommended in formulations for the management of a range of mental conditions including anxiety, poor cognition and lack of concentration. According to the Charaka, Brahmi acts as an effective braintonic that boostsone's capabilities to think and reason. The Sushruta Samhita 6 (200 A.D.) attributes the plant with efficacy in maintaining acuity of intellect and memory. The Bhavprakasha Nighantu, commonly known as the Indian Materia Medica (1500 A.D.),cites the plant as a brain tonic that is effective in maintaining vigor and intellect. Material And Methods:Method for the study has been selected as placebo controlled “Double Blind Method”.Result:In drug proving out of seventeen provers sixteen manifested the symptoms consequent upon the administration of drug. There is a drop of one prover due to death of near one on the 5thday of phase-I. One prover got the typhoid fever so he was continued on abstinence of medicine because of the symptoms persisted till the completion of phase-II.Conclusion:This drug is initially use d clinically in mother tincture form and not proved completely on the principles laid down in Organon of medicine. I have taken this drug to prove it in 30c & 200c potency. For the study placebo control “Double blind method” is been selected.
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Now a day with modern civilized life a report suggests that women are probably dying because incidence is increasing due to change of life style. Women’s health is compromised at practically in every step.The statement has been amplified to include the ability to lead a ‘socially and economically productive life’. Among the people the health of women requires high attention. There are several medical disorders from which women suffer, from puberty to till after menopause like leucorrhoea, painful menses, menstrual irregularities; dysfunction uterine bleeding, cancer of genital organ, cervical and endometrial polyposis etc are chief problems. Many of victims suffer from among all this, but leucorrhoea is universal problem of all women. Material & Methods:Type of study: Comparative study& Prospective study.Type of sampling: random sampling Conclusion:These prove when homoeopathic medicine selected on bases of Totality of symptoms, causation, constitutionally and on bases of individualization, it gives permanent improvement without recurrences.
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Background: Sclerotherapy is the treatment of choice for first and second grade haemorrhoidal disease. The aim of this study is to assess the efficacy and safety of polidocanol foam for haemorrhoidal disease.Methods: A total of 50 patients were treated with foam sclerotherapy (polidocanol 3%). Patients who presented with complain of bleeding per anum and diagnosed with first and second grade hemorrhoidal disease were included. Patients without bleeding per anum were not included. The primary objective was the stopping of perianal bleeding after one sclerotherapy session. Sclerotherapy was repeated at 2-week intervals until patients were free of bleeding. The final follow-up was 12 weeks after the last sclerotherapy session.Results: After one foam sclerotherapy session, 82% of patients (41 out of 50) were treated successfully. After second sclerotherapy, 98% of the patients (46 out of 50) were treated successfully. 2% of the patients received third sclerotherapy.Conclusions: In the treatment of first and second grade haemorrhoidal disease, polidocanol 3% foam is very effective and safe. The results of this study show that foam sclerotherapy is a new, innovative, effective and safe non-surgical treatment option for haemorrhoidal disease.
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Aim: To explore bacterial diversity associated to polyketide synthase (PKS) genes in the TsoKar brackish metagenome.Methodology: The metagenomic DNA of TsoKar water and sediment samples were isolated and amplified using pks specific degenerate primers. PCR amplified products were analysed using Ion Torrent PGM platform and revealed a total of 2,11,030 reads with 534 contigs and 55% of G+C content. The results of BLASTx was further analyzed for species diversity using MEGAN5 software. Results: Halomonas was found to be the dominant phyla followed by Cyanobium, Acinetobacter and Burkholderia, respectively, along with majority of uncultured microorganisms present in TsoKar metagenome. Since TsoKar is a brackish water lake, and brackish aquatic ecosystems are a major hub of diverse microbes was also revealed in this study. TsoKar metagenomic sequence with accession number SRR8381943 was deposited in SRA database. Interpretation: TsoKar Lake is considered as one of the most important biosphere reserves. The results of this study confirm that this unique niche harbors good bacterial diversity associated with polyketide synthase genes, which justifies the idea of bioprospecting such niches for the discovery of novel metabolites like antimicrobial compounds using next-generation sequencing approach
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Purpose: An Accredited Social Health Activist (ASHA) available in community could be a potential primary eye care (PEC) worker. Training programme for ASHAs on PEC was undertaken & evaluated in a district of a capital city. Methods: ASHAs selected randomly from a district were imparted one day training on PEC & expected to refer patients to nearby Vision Centres (VC). Their knowledge was assessed before & after training and re-evaluated 1 year later. ASHAs were asked to conduct vision screening of 40+ population in their areas and ASHA referrals were noted by Optometrist in VC. Focus Group Discussions (FGD) of ASHAs were held to find barriers & facilitating factors in engaging ASHAs in PEC. Training was evaluated using Kirkpatrick's evaluation model for measuring reactions, learning, behaviour and results. Results: Mean knowledge score increased from 14.96 (±4.34) pre-training to 25.38 (±3.48) post- training and sustained at 21.75 (±4.16) at 1year. Monthly average OPD of vision centres increased by 23.6% after ASHA training. FGDs revealed that ASHAs were willing to work in eye care for awareness generation and patient facilitation but were hesitant in conducting vision screening. Conclusion: ASHAs can be trained as PEC workers provided they have adequate support.
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Childhood blindness is one of the priority targets of Vision 2020—Right To Sight due to its impact on the psychological and social growth of the child. An extensive search was performed to locate research papers on childhood blindness prevalence and its causes in the community based and blind schools, respectively, conducted from 1990 onward up to the present. Cross references were also manually searched along with expert consultation to enlarge the reference data. A total of five community-based studies on the prevalence including two refractive error studies conducted all over India in children less than 16 years were found. The causes of childhood blindness from the available blind school studies revealed that causes of childhood blindness have mainly shifted from corneal causes to whole globe abnormalities. This article highlights that though with the availability of proper healthcare facilities, the trend is changing for the causes but still a lot of effort in the form of timely neonatal eye care facilities, pediatric surgical services and proper refraction strategies is required.
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The study describes the technique of combining microscope-integrated optical coherence tomography (mi-OCT) and proportional reflux hydrodissection (PRH) during pars plana vitrectomy (PPV) in eyes with complex proliferative diabetic retinopathy (PDR) including tractional retinal detachment (TRD), combined retinal detachment (CRD), and taut posterior hyaloid membrane (TPHM). In this technique, PRH is used to create tissue planes between fibrovascular adhesions in areas identified using mi-OCT for insinuating the vitrector, enabling tissue dissection and release of traction. About 46 patients were operated using this technique. 34 eyes had TRD, 9 eyes had CRD, and 3 eyes were diagnosed with TPHM. A second instrument was used only in nine eyes. None of the eyes required use of intraocular scissors. Iatrogenic breaks occurred in six eyes. All patients had successful reattachment at 3-month follow-up. Thus, combination of mi-OCT and PRH is useful incomplete fibrovascular tissue dissection during PPV for complex PDR cases.
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A 48-year-old female presented with complaints of recent onset diminution of vision of the left eye (OS) for the past 2 months. She was highly myopic and was using glasses for the past 30 years. Ocular examination revealed presence of a myopic fundus with high axial lengths in both the eyes. Fundus examination of the OS revealed a myopic tessellated fundus with prominent choroidal vessels and a blunted foveal reflex. There was a small pale whitish lesion just superior to the foveal center. Optical coherence tomography (OCT) scans (both horizontal and vertical) confirmed presence of dome-shaped maculopathy. There was subretinal fluid in the OS. A vertical OCT scan also revealed a subretinal hyperreflective material, which was confirmed to be due to a small mixed type 1 and type 2 choroidal neovascularization (CNV) on swept-source (SS) OCT angiography in the OS. The patient was given intravitreal injection of ranibizumab (0.5 mg/0.05 mL) in the OS. At 1-month follow-up, the subretinal fluid completely resolved. The CNV lesion regressed significantly on SS-OCT angiography. The best-corrected visual acuity improved from 20/80 to 20/20 in the OS, which was maintained at 3 months of follow-up.
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A 11-year-old boy presented with complaints of blurred vision and on evaluation was found to have X-linked retinoschisis (XLRS) with angle-closure glaucoma. Clinical and genetic evaluation of first-degree family members was done. His brother had a milder form of XLRS with shallow anterior chamber. Topical dorzolamide 2% and timolol 0.5% were used to control intraocular pressure. Genetic analysis revealed a novel three base pair deleterious mutation (c. 375_377 del AGA) in exon-5 of the RS1 gene in three members of the family.
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Purpose: Diagnosis of choroidal neovascular membrane (CNVM) is difficult in chronic central serous chorioretinopathy (CCSC) due to overlapping features of both on conventional dye angiography. Optical coherence tomography angiography (OCTA) allows a quick and noninvasive detection of CNVM in these eyes. We compared the fluorescein angiography (FA) features of CNVM with those of OCTA to assess the role of FA in detecting CNVM in CCSC eyes. Methods: Patients with CCSC undergoing FA, spectral domain (SD)-OCT, and OCTA were identified (March 2015–June 2015). Four retina specialists individually reviewed FA images (without OCTA and SD-OCT) to determine whether CNVM was present. In parallel, two other retina specialists reviewed all images (FA/SD-OCT/OCTA) for CCSC features and confirmed whether CNVM was present using OCTA as the gold standard. The inter- and intraobserver variability was measured by Kappa (k) coefficient. The FA features of CNVM were compared and correlated with those on OCTA. Results: Of 43 eyes (26 patients, mean age 45.6 ± 8.5 years, all males), a definite CNVM (detected by OCTA) was present in nine (20.9%) eyes. FA alone detected CNVM in 13 (30.2%) eyes [sensitivity 44.4% (95% confidence interval (CI): 11.9–76.9), specificity 73.5% (95% CI: 58.7–88.3), positive and negative predictive values 30.8% and 83.3%, respectively, and accuracy 67.44% (95% CI: 53.4–81.4)]. Conclusion: When compared with OCTA, the FA was unable to characterize CNVM in CCSC (with a very low sensitivity and moderate specificity) as none of the specific dye leakage patterns on FA correlated with CNVM seen on OCTA, limiting its usefulness and accuracy in detecting CNVM in these eyes.