Multifocal versus modified monovision corrections: A non-dispensing comparison of visual assessment in presbyopic neophytes

Purpose: To compare the visual performance of two simultaneous?vision soft multifocal contact lenses and to compare multifocal contact lens and its modified monovision counterpart in presbyopic neophytes. Methods: A double?masked, prospective, comparative study was conducted on 19 participants fitted with soft PureVision2 multifocal (PVMF) and clariti multifocal (CMF) lenses in random order. High? and low?contrast distance visual acuity, near visual acuity, stereopsis, contrast sensitivity, and glare acuity were measured. The measurements were conducted using multifocal and modified monovision design with one brand and then repeated with another brand of lens. Results: High?contrast distance visual acuity showed a significant difference between CMF (0.00 [?0.10–0.04]) and PureVision2 modified monovision (PVMMV; ?0.10 [?0.14–0.00]) correction (P = 0.003) and also between CMF and clariti modified monovision (CMMV; ?0.10 [?0.20–0.00]) correction (P = 0.002). Both modified monovision lenses outperformed CMF. The current study did not show any statistically significant difference between contact lens corrections for low?contrast visual acuity, near visual acuity, and contrast sensitivity (P > 0.01). Stereopsis at near distance was significantly lower with both modified monovision (PVMMV: 70 [50–85]; P = 0.007, CMMV: 70 [70–100]; P = 0.006) and with CMF (50 [40–70]; P = 0.005) when compared to spectacles (50 [30–70]). Glare acuity was significantly lower with multifocal (PVMF: 0.46 [0.40–0.50]; P = 0.001, CMF: 0.40 [0.40–0.46]; P = 0.007) compared with spectacles (0.40 [0.30–0.40]), but no significant difference was noted between the multifocal contact lenses (P = 0.033). Conclusion: Modified monovision provided superior high?contrast vision compared to multifocal correction. Multifocal corrections performed better for stereopsis when compared to modified monovision. In parameters like low?contrast visual acuity, near acuity, and contrast sensitivity, both the corrections performed similarly. Both multifocal designs showed comparable visual performances.

The effect of different thickness scleral lens on corneal parameters in eyes with keratoconus

Purpose: To investigate the impact of different?thickness scleral lenses (SLs) on corneal thickness, curvature, and fluid reservoir thickness in keratoconic eyes. Methods: Schiempflug imaging and AS?OCT was captured before and immediately following 6 h of SL wear. Different?thickness lenses were used while keeping the other parameters the same. The timing of the measurement for day 1 and day 2 was matched to allow for the control of the confounding influence of diurnal variation. Results: Immediately after 6 h of lens wear, no statistically significant difference (P > 0.05) was noted in corneal edema in any region and quadrants between thin? and thick?lens wearers. The calculated percentage of corneal edema was also within the range of overnight closed eye physiological swelling. Pentacam measured higher central corneal thickness compared to AS?OCT in both baselines and after 6 h of lens wear. The current investigation reported minimal but not statistically significant (P > 0.05) flattening in anterior and steepening in posterior curvature parameters in both thin and thick SLs. The mean reduction in the fluid reservoir thickness was 80.00 ± 3.99 and 79.36 ± 3.84 microns after 6 h of thin? and thick?lens wear, respectively, which was not statistically significant (P > 0.05). A statistically significant positive correlation (r = 0.67, P = 0.02) was found between lens thickness and change in anterior steep k with thick?lens wear. Conclusion: Central lens thickness of 200–400 ?m did not cause any significant change in corneal curvature and fluid reservoir thickness and did not induce clinically significant corneal edema after short?term SL wear.

Efficacy and Tolerability of Tianeptine Versus Escitalopram in Patients with Irritable Bowel Syndrome: A Hospital based, Randomized Comparative Study

Introduction: The fallopian Tube or the oviduct has beennamed after Gabrielis Fallopius, who was the first to describethe tubes very accurately. It is one of the commonest surgicalspecimens received in the histopathological laboratory. It isthe commonest cause of infertility and inflammatory diseases.Malignancy of the fallopian tube is rarely encountered. Thepresent study was undertaken with the following objectivesto evaluate the histological patterns of the fallopian tube insurgically resected specimens and to determine its relationshipwith uterine or ovarian pathology.Material and Methods:A total number of 309 specimensof Fallopian tube were obtained from the patients whounderwent pan hysterectomy with salpingectomy andsalpingo-oophorectomies in Assam Medical College andHospital during the period from October 2016 to September2018. The clinical datas along with gross and microscopicfindings were studied. Incidence and prevalence of variouslesions were calculated.Results: In our study 10cases (3%) had been marked asunremarkable. 77.4% were diagnosed as Chronic Salpingitis,8.95% as Hydrosalpinx and 2.47% as Ectopic Pregnancy. Theother cases comprised mainly of Haematosalpinx andnormalhistologyConclusion: Fallopian tubes can present with differentpathological findings. Malignancies of the Fallopian Tube areuncommon but it has to be examined properly to exclude aprecursor Tubal Pathology

An Unusual Spectrum of Upper Gastrointestinal Tract Foreign Bodies: A 4-Year Prospective Endoscopic Study

Introduction: Ingestion of a foreign body (FB) is a commonoccurrence in day to day clinical practice; however, fewstudies have been reported from Northern India. The aimof this study was to study the spectrum and managementoutcome of patients with FBs in their gastro intestinal tracts(GIT) presenting to gastroenterology unit in a tertiary carereferral hospital.Material and methods: Data were collected from allconsecutive patients with history of FB ingestion admitted toour endoscopy centre from January 2015 to December 2018.The demographic data, clinical presentations, and endoscopicmanagement was reviewed and analyzed.Results: A total of 204patients with suspectedFBingestionunderwent endoscopic management. 211 FBs were found in204 patients with suspected FB.Scarf pin was most common(57.3%) followed by knitting needle in twenty-six (12.3%)cases. Most of theFBs were located in the stomach (72.6%). Themajorityof patients (95.2%) were successfully removed withflexibleendoscopy with the addition of suitable accessorieswithout any serious procedure-related complications.Conclusion: In this part of the world the pattern and types ofUpper gastrointestinal tract foreign bodies is unique not seenelsewhere across the globe. Endoscopic management wasfound to be highly safe and efficacious.

Revamping soil quality and correlation studies for yield and yield attributes in sorghum-legumes intercropping systems / Melhoria da qualidade do solo e estudos de correlação para a produtividade e os atributos de produtividade em sistemas de plantio consorciado de sorgo e legumes

Restoration, preservation and sustainability of agricultural resources including soil demands biologically and economically viable farming practices. For boosting physico-chemical properties of soil from 2012 to 2015, three legumes including cowpea, cluster bean and soybean were intercropped with sorghum in 40-60, 75-25 and 100-100 seed blending ratios, while pure stand of sorghum was kept for comparison. Correlation studies were also conducted to determine linear or inverse relationship between physiological and agronomic attributes with green forage yield of sorghum. Results revealed that intercropping systems were not effective in significantly improving the physical properties of soil, however soybean and sorghum mixed seeded crop in 100-100 seed ratio resulted in the highest total and available nitrogen especially during last two years of the study and it was followed by mixed seeded crop of cluster bean and sorghum (100-100 seed ratio), while pure stand of sorghum appeared to be the most exhaustive farming system. Correlation analysis depicted a linear relationship between all agronomic attributes (seedling count, plant population at harvest, plant height, stem diameter, number of leaves and leaf area per plant, fresh and dry weights per plant) and physiological growth parameters (leaf area index and leaf area duration, crop growth rate and net assimilation rate) with forage yield of sorghum. Thus, legumes inclusion was found to be effective in restoring soil fertility, while long term legumes inclusion by following rotation may be suggested.

A restauração, a preservação e a sustentabilidade dos recursos agrícolas, incluindo o solo, exigem práticas agrícolas biologicamente e economicamente viáveis. Para aumentar as propriedades físico-químicas do solo de 2012 a 2015, três leguminosas, incluindo feijão-fradinho, guar e soja, foram consorciadas com sorgo nas proporções de mistura de 40-60, 75-25 e 100-100, enquanto que o sorgo puro foi mantido por comparação. Estudos de correlação também foram conduzidos para determinar a relação linear ou inversa entre atributos fisiológicos e agronômicos com a produtividade de forragem verde do sorgo. Os resultados revelaram que os sistemas consorciados não foram eficazes em afetar significativamente as propriedades físicas do solo, no entanto, soja e sorgo misturados na proporção de sementes 100-100 resultou no maior nitrogênio total e nitrogênio disponível, especialmente durante os últimos dois anos do estudo e foi seguido do plantio de sementes mistas de guar e sorgo (100-100 rácio de semente), enquanto a monocultura de sorgo parecia ser o sistema de agricultura mais exaustivo. A análise de regressão mostrou uma correlação linear entre todos os atributos agronômicos (contagem de plântulas, população de plantas na colheita, altura de planta, diâmetro de caule, número de folhas e área foliar por planta, peso fresco e seco por planta) e parâmetros de crescimento fisiológico (índice de área foliar e duração da área foliar, taxa de crescimento da cultura e taxa de assimilação líquida) com o rendimento de forragem do sorgo. Assim, a inclusão de leguminosas foi eficaz no aumento da fertilidade do solo, enquanto a inclusão de leguminosas a longo prazo por rotação de diferentes leguminosas é sugerida.

Comparison of Role of Different Doses of Rectal Paracetamol with Rectal Diclofenac as Pre-emptive Analgesics for Postoperative Pain Relief in Paediatric Surgeries.

Background: Post operative pain is a major concern in children particularly in developing countries were opioids are not freely available. Use of opioids is associated with side effects increasing patient discomfort and delaying patient discharge from hospital. We conducted a study comparing the use of different doses of rectal paracetamol with rectal diclofenac when used as pre-emptive analgesics on postoperative pain and recovery in paediatric patients considering the relative risk of diclofenac to increase bleeding in surgeries like tonsillectomy, cleft lip and cleft palate. Methods: Study groups included 20 patients in each. Group P40 receiving 40 mg/kg rectal paracetamol, Group P20 receiving 20 mg/kg rectal paracetamol, Group D receiving rectal diclofenac 1 mg/kg. Pain scoring was done by TPPPS (Toddler Pre-schooler postoperative pain scale) time to first need of analgesia and total dose of analgesia was noted. The rates of recovery were evaluated by using “Modified Steward Coma Scale”at 5 and 10 minutes after extubation. Results: Time of first demand of analgesic was delayed in Group-P40 as compared to Group-D and Group-P20 and difference was statically significant. TPPPS of the three studied groups varied significantly at different time intervals in favour of Group-P40. Total duration of analgesia in Group- P40 was (646±9.94) min Group- D (501±10.63) min and in Group-P20 (294±23.17) min Total analgesic requirement was also low in Group P40 and the difference between groups was significant. Conclusion: Pre-emptive high dose rectal paracetamol appears to be more effective than rectal diclofenac sodium suppository for postoperative analgesia in children without additional risk of bleeding in surgeries like tonsillectomy and cleft lip and cleft palate repair. Hence, high dose rectal paracetamol can be used as an alternative to diclofenac sodium due to higher risks of bleeding with diclofenac sodium in surgeries with increased risk of bleeding.

An Assessment of Fate of CHA Blocks Used in the Cystic Lesions of Bone.

Background: The calcium phosphate system and in particular hydroxyapatite (CHA), has been the subject of intensive investigation. Although coralline hydroxyapatite is not inherently as strong as trabecular bone and does not exhibit plastic properties owing to the absence of a collagen matrix, with subsequent growth of native bone, it has been shown to become stronger but less stiff than autogenous graft material. Method: Thirty six cases of cystic lesions of long bones were curretted and filled with CHA blocks with or without autogenous cancellous bone chips between 2013 to 2014 with follow up duration ranging from 12 to 24 months. Filling by CHA blocks, mixing with autogenous bone grafts was done in osteoclastoma and fibrous dysplasia cases, while only CHA block filling was done in solitary bone cyst, aneurysmal bone cyst and fibroma cases. In all the cases, the diagnosis was made on the basis of clinical, radiological and histopathological examination. Both with and without pathological fractures cystic lesions were taken. Results: In the present study, 11 cases had pathological fracture. In our series, maximum cases were of osteoclastoma. Most of the cases were associated with pathological fracture. The pathological fractures united from 20-30 weeks time, Radiologically, the density of CHA blocks increased with the lapse of time. In our series, the longest follow up period was about 24 months and the shortest was of 12 months duration. 20 patients had excellent results with full functional, anatomical restoration without any pain and radiograph shows no recurrence, with healing of pathological fracture. While 2 patients had poor results they were not able to do activities of daily living, had pain and delayed healing. Conclusion: The CHA has favourable clinical result because of less adverse effects, biocompatibility to the tissue of the body, ease of manufacture, production and shape adjustment. Therefore, it is strongly suggested as a useful bone substitute.In our limited experience with coralline hydroxyapatite bone graft substitutes, we have encountered no significant complications related to implant themselves.

Cytotherapy for Osteonecrosis of Hip.

Osteonecrosis of hip is a pathological condition that leads to collapse of the femoral head, & the need for total hip replacement (THR). Research has shown that at the cellular level there is decrease in osteoblastic activity & the local mesenchymal stem cells (MSC) population that leads to osteonecrosis of femoral head (ONFH). Cellular therapy could thus be used to improve the local cellular environment. Th is can be achieved by implanting bone marrow, containing osteogenic precursors into the necrotic lesion of the femoral head.

Pattern of Orthopaedic Injuries Among Patients Attending the Emergency Department in a Tertiary Care Hospital – An Analytical Study.

Introduction: Th is study was aimed at analyzing the pattern of Orthopaedic injuries among patients attending the Emergency department in a tertiary care hospital. Retrospective study was conducted in the Department of Orthopaedics, Teerthanker Mahaveer Medical College & Research Centre. Methods: Th e record analysis of injured patients seen at the emergency department over a 12 months period from June 2012 to may 2013 was done. Th e data was analyzed with special reference tothepattern of Orthopaedic injuries. Results: A total of 1110 records of injured patients that attended the emergency department were analyzed. Study showed that themajority of victims were in the age group of 11-44 years (n=909, 81.89 percent). 71.09 percent (n=789) were males and 28.9 percent (n=321) were females. Road traffi c accident was the most common cause of injuries being responsible for 59.72 percent, (n=663) followed by fall from height (22.5 percent, n=247). Study revealed that the most common presentation of injuries was fracture (68.64 percent, n=762) and the most common site was lower limbs in 48.16 percent cases, (n=367). Next most common site was upper limbs (28.08 percent, n=214) followed by pelvic fracture (10.01 percent, n=77), spine fractures (8.26 percent, n=63), facial fracture (2.88 percent, n=22) & Ribs fracture (2.49 percent, n=19). Th ere were 71.65 percent cases (n=546) of simple fracture and 28.34 percent cases (n=216) ofthecompound fracture. Th ere were 3.87 percent cases (n=43), of various dislocations, shoulder dislocation being the most common. Crush injury was seen in 7.5 percent cases. Most commonly associated visceral injury wasthehead injury in 17.20 percent cases (n=191). Conclusion: Fractures were the most common pattern of Orthopaedic injuries, frequently associated with head injuries. Research in to appropriate strategies for prevention of injuries, especially RTA is required in tertiary care hospitals.