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Purpose: Allergic conjunctivitis (AC) is commonly associated with dry eye. This study was conducted to assess the prevalence of dry eye in different subsets of AC patients. Methods: This observational, cross?sectional study, conducted in the Department of Ophthalmology of a tertiary center in north India, included 132 patients of AC. The diagnosis of dry eye disease (DED) was made on the basis of Ocular Surface Disease Index (OSDI), Schirmer’s test, and tear film break?up time (TFBUT). Results: The prevalence of dry eye in AC patients was found to range between 31% and 36%. On OSDI scoring, 20.45% of patients had mild, 18.18% moderate, and 31.81% had a severe grade of DED, respectively. The mean OSDI score was noted to be significantly higher in patients with perennial allergic conjunctivitis (PAC) (29.82 ± 12.41), followed by seasonal allergic conjunctivitis (SAC) (25.35 ± 12.88), and least in the patients of vernal keratoconjunctivitis (VKC) (13.60 ± 8.63) (p < 0.0001), respectively. The TFBUT was found to be less than 10 s in 45.45% of PAC, 30.43% of SAC, and 20% of VKC patients, respectively. The difference between the mean TFBUT among the three groups was statistically insignificant (p = 0.683). Schirmer’s test value of <10 mm was observed in 45.45% of PAC, 43.47% of SAC, and 10% of VKC patients, respectively. Conclusion: This study revealed a high prevalence of DED in patients with AC. Among the different types of AC patients, PAC had the highest percentage of DED followed by SAC and least in VKC, respectively.
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In both biomedical research and medical academia, research publications serve a critical role. There are a huge number of research publications published all around the world. However, only a small percentage of them are good and have any research or academic worth. So, properly evaluating published publica-tions has become vital in this circumstance. This article is intended with medical graduates and post-graduates in mind, in order to clarify them how to critically evaluate research publications. It may also be used to write published research articles in an indirect way. A collection of questions is supplied to cover all aspects of a published research paper. To assess the quality of an article, a score system based on the following questions can be established.
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Background and objectives: Non-communicable diseases (NCDs) are highly prevalent in the tribal populations; however, there are limited data regarding health system preparedness to tackle NCDs among these populations. We estimated the availability of human resources, equipment, drugs, services and knowledge of doctors for NCD management in the selected tribal districts in India. Methods: A cross-sectional survey was conducted in 12 districts (one from each State) with at least 50 per cent tribal population in Andaman and Nicobar Islands, Himachal Pradesh, Madhya Pradesh, Odisha and eight northeastern States. Primary health centres (PHCs), community health centres (CHCs) and district/sub-district hospitals (DHs) were surveyed and data on screening and treatment services, human resources, equipment, drugs and information systems indicators were collected and analysed. The data were presented as proportions.Results: In the present study 177 facilities were surveyed, including 156 PHCs/CHCs and 21 DHs. DHs and the majority (82-96%) of the PHCs/CHCs provided outpatient treatment for diabetes and hypertension. Overall, 97 per cent of PHCs/CHCs had doctors, and 78 per cent had staff nurses. The availability of digital blood pressure monitors ranged from 35 to 43 per cent, and drugs were either not available or inadequate. Among 213 doctors, three-fourths knew the correct criteria for hypertension diagnosis, and a few correctly reported diabetes diagnosis criteria. Interpretation & conclusions: The results of this study suggest that the health system of the studied tribal districts was not adequately prepared to manage NCDs. The key challenges included inadequately trained workforce and a lack of equipment and drugs. It is suggested that capacity building and, procurement and distribution of equipment, drugs and information systems to track NCD patients should be the key focus areas of national programmes
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Background & objectives: Non-communicable diseases (NCDs) are the leading cause of death in India. Although studies have reported a high prevalence of NCD in tribal populations, there are limited data pertaining mortality due to NCDs. Therefore, in this study we estimated the proportion of deaths due to NCDs among 15 yr and older age group in tribal districts in India. Methods: We conducted a community-based survey in 12 districts (one per State) with more than 50 per cent tribal population. Data were collected using a verbal autopsy tool from the family member of the deceased. The estimated sample size was 452 deaths per district. We obtained the list of deaths for the reference period of one year and updated it during the survey. The cause of death was assigned using the International Classification of Diseases-10 classification and analyzed the proportions of causes of death. The age-standardized death rate (ASRD) was also estimated. Results: We surveyed 5292 deaths among those above 15 years of age. Overall, NCDs accounted for 66 per cent of the deaths, followed by infectious diseases (15%) and injuries (11%). Cardiovascular diseases were the leading cause of death in 10 of the 12 sites. In East Garo Hills (18%) and Lunglei (26%), neoplasms were the leading cause of death. ASRD due to NCD ranged from 426 in Kinnaur to 756 per 100,000 in East Garo Hills. Interpretation & conclusions: The findings of this community-based survey suggested that NCDs were the leading cause of death among the tribal populations in India. It is hence suggested that control of NCDs should be one of the public health priorities for tribal districts in India.
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Purpose: An unprecedented surge has been noted in rhino?orbital?Cerebral mucormycosis (ROCM) in times of current COVID?19 pandemic. The present prospective study aims to evaluate clinico?epidemiological profile, risk factors, management, and outcome of the cases of ROCM that presented to our tertiary care center during the study period from April to June 2021. Methods: All patients were subjected to complete history taking, ophthalmological examination, and imaging studies. The patients were staged and were treated with intravenous liposomal amphotericin B (AMB) and sino?nasal debridement of local necrotic tissue. Transcutaneous retrobulbar AMB (TRAMB), orbital decompression, and exenteration were instituted as indicated. All patients were followed up for a minimum of 6 months before arriving at the final outcome. Statistical analysis was performed. Results: A total of 49 patients presented during the study period, with a mean age of 42.2 years. The major risk factors included uncontrolled diabetes (89.8%), COVID?19 positivity (51.02%), and concurrent steroid use (38.77%). The most common presenting symptom was facial pain/swelling (43.65%), while the most common presenting sign was deterioration in vision (75.51%). Intravenous liposomal AMB was given to all patients along with sino?nasal debridement (85.71%), TRAMB (57.14%), orbital decompression (14.28%), and exenteration (12.24%). Overall, mortality at 6 months was 22.45% (11 patients). Age more than 60 years, intracranial extension, and HbA1c of more than 8.0% were observed to be statistically significant indicators of mortality. Conclusion: Early suspicion and timely diagnosis of mucormycosis at rhino?orbital stage is warranted in order to salvage life as well as visual function. TRAMB may prove as potentially favorable treatment modality in cases with limited orbital involvement.
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Background: The problem of increased ARI morbidity and mortality has arisen as a result of modernization, industry, and urbanization. There is a deficiency of epidemiological studies on risk factors and treatment. There is a significant vacuum in our understanding of these issues, which must be filled by methodical research. The purpose of this study is to evaluate the risk factors developing pneumonia in our area.Material & Methods:This was a prospective clinical study of pneumonia conducted on 90 children who were admitted to Paediatric ward in Abdul MalekUkil Medical College, Noakhali, Bangladesh in study duration. Epidemiological factors affecting the same were studied and bronchoscopy was done whenever it was needed. A detailed history of the relevant symptoms, such as fever, cough, rapid breathing, refusal of feeds, noisy breathing, bluish discolouration etc., was collected.Results:The most affected children belonged to the age group of 1 year to 3 years (64.9%). Bronchopneumonia (86.2%) was the most common clinical diagnosis made at admission. According to WHO ARI control programme, 28.7% had pneumonia, 54.3% had severe pneumonia and 17% very severe pneumonia. It was found that younger age group, malnutrition, kutcha house, crowding, poor sanitation facilities, cooking with fuel other than LPG (indoor pollution) and low socio economic status and high respiratory rate were significant risk factors for pneumonia in children.Conclusions:One of the leading causes of mortality and death in children is particularly pneumonia. In newborns and preschool children, bronchopneumonia is the most common symptom.
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The MMR vaccine as we know is a vital vaccine to protect against three disease-causing microbes- measles, mumps, and rubella. To commemorate 75 years of Indian independence, the present study delves into the achievement of Indian research and lists out articles retrieved from the Web of Science Core Collection database on the domain of MMR vaccine research. The data has been restricted to the publication from India, thereby, has throwing some understanding into the MRR vaccine research in India over the last 28 years- 1994 to 2021. The data have been compared based on scientometric analysis. Qualitative and quantitative analysis have also been taken into account in order to give a comparative insight into the research. The comparison was done based on citation data, usage count data, year of publication, journals, publication media, domains focussed on the papers, and type of document. Astonishingly, in 2021, the most number of papers were published, most of them have related MMR vaccine as a potential immunity developer against COVID-19 infection. A total of 43 articles were retrieved from the search, the numbers are quite big, and the highest citation among them being 99 which was published in 2014, which is quite impressive for such a short duration of time. The comparative study suggests a positive growth of MMR vaccine research in India.
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We describe a modified technique of intraoperative optical coherence tomography (iOCT)?guided removal of post?laser?assisted in situ keratomileusis (LASIK) epithelial ingrowth with interface ethyl alcohol and mitomycin C application to prevent a recurrence. Epithelial ingrowth was visualized as hyperreflective deposits in the interface on iOCT, and the location and extent were noted at the beginning of the procedure. A simple dimple?down maneuver was performed to help identify the circumference of the LASIK flap. iOCT helped to delineate the flap edge and ensure dissection in the correct plane with complete removal of epithelial cell nests. Real?time visualization of the interface helped in on?table decision making regarding the extent of lifting the flap to encompass the entire region of hyperreflective epithelial ingrowth, as well as the need for additional interventions to ensure complete flap apposition at the end of surgery. All patients gained an uncorrected visual acuity of 20/20–20/25 with no recurrence
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Lymphangioma circumscriptum (LC) is a form of lymphatic hamartoma, which mainly involves the skin and subcutaneous tissues. The mucosa of the mouth, tongue, groin, trunk, and axilla are the most common locations of LC, and the scrotum is a rare site of occurrence. Here we report a case of LC of scrotum occurring in a 58-year-old man without any history of surgery and radiation. The man was presented with multiple small vesicles containing clear fluid in the scrotum and subsequent histopathology confirmed the diagnosis. We are presenting this case for its rare presentation.
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The beneficial or deleterious effects of nanomedicines emerge from their complex interactions with intracellular pathways and their subcellular fate. Moreover, the dynamic nature of plasma membrane accounts for the movement of these nanocarriers within the cell towards different organelles thereby not only influencing their pharmacokinetic and pharmacodynamic properties but also bioavailability, therapeutic efficacy and toxicity. Therefore, an in-depth understanding of underlying parameters controlling nanocarrier endocytosis and intracellular fate is essential. In order to direct nanoparticles towards specific sub-cellular organelles the physicochemical attributes of nanocarriers can be manipulated. These include particle size, shape and surface charge/chemistry. Restricting the particle size of nanocarriers below 200 nm contributes to internalization
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Background: A prospective clinical trial to evaluate the prevalence of thyroid disorder among pregnant women and obstetrical and fetal outcome was done in a tertiary health centre (RKDF Medical College and Research Centre, Bhopal) located in central India.Methods: This prospective study was carried out in antenatal women in their first trimester attending antenatal OPD in RKDF Medical College and Research Centre, Bhopal, Madhya Pradesh to know the prevalence of thyroid disorder and its association with pregnancy outcome.Results: In this study prevalence of thyroid disorder was 12.4%, subclinical hypothyroidism 7.2%, overt hypothyroidism 3.4%, subclinical hyperthyroidism 1.4%, overt hyperthyroidism 0.4%. Thyroid disorder is responsible for several obstetrical and fetal complication like pre-eclampsia, preterm delivery, abortion, IUGR and low birth weight.Conclusions: Thyroid disorder associated with poor obstetrical outcome and fetal complication. so timely diagnosis and treatment is required. Universal screening should be preferred over high-risk screening because of high prevalence of the disease in India.
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Background: A study to compare the efficacy, acceptability and side effect of combined contraceptive vaginal ring with the combined oral contraceptive pills in a tertiary health centre (RKDF Medical College and Research Centre, Bhopal) located in central India.Methods: This prospective randomized comparative trial enrolled hundred women aged between 20 to 40 years seeking for contraception with no contraindication to hormonal contraception. After proper counseling and informed consent, women divided into two groups, study group (50) includes women using contraceptive vaginal ring and control group (50) include women using combined oral contraceptives. The contraceptive efficacy, acceptability, tolerability and adverse events were recorded at each follow-up visit at RKDF Medical College and Research Centre, Bhopal.Results: Vaginal ring and combined oral contraceptives were found to have comparable contraceptive efficacy. In study group no pregnancy reported during study period while one pregnancy reported in control group, which was statistically insignificant. Satisfaction, continuation and recommendation to others were more with vaginal ring which were not significant statistically. Cycle control is superior with vaginal ring. Incidence of adverse effects was same in both groups.Conclusions: Combined contraceptive vaginal ring is an effective and reliable contraception with excellent cycle control, well-tolerated and highly acceptable to most women.
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Neurofibromatosis type 1 (NF1), also known as von Recklinghausen's disease, is a type of genodermatoses having an autosomal dominant inheritance pattern and is recently considered as a RASopathy. Such patients are very much prone to develop mesenchymal tumors. However, carcinomas are quite rare in NF1 patients. This case study is the first case of oral squamous cell carcinoma (SCC) in tongue of an NF1 patient. A 35-year-old male reported to the Department of Oral Pathology in a tertiary care center with a chief complain of a painful ulcer on tongue for last 1 month. For confirmation of diagnosis of NF1, the “Diagnostic Criteria for Neurofibromatosis Type 1” was followed. Biopsied specimen of the tongue lesion was examined under microscope and histopathological features were suggestive of infiltrating SCC. Immunohistochemistry with Pan CK and beta-catenin was positive. RASopathy, WNT–beta-catenin pathway alteration, heat shock factor 1 production, and miRNA activity are investigated to explain the pathogenesis of malignancies in NF1 patients. In this first case of tongue SCC, we have found out the altered WNT–beta-catenin pathway.
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A 47-year-old lady (index case) with diabetes and deafness showed multiple oval circumferential areas of perifoveal atrophy in both eyes. Autofluorescence revealed areas of hypoautofluorescence. Optical coherence tomography (OCT) showed depression of inner retinal surface, inner retinal hyporeflective spaces (pseudocysts), disorganization/thinning of outer retina, outer retinal tubulation, loss of external limiting membrane, ellipsoid and interdigitation zone, and thinning of the retinal pigment epithelium and choriocapillaris. The patient was evaluated using OCT angiogram. Retinal lesions of her mother (68-year-old) were very obvious on autofluorescence imaging. The result of A3243G mutation in MTTL1 gene was positive in the index case confirming the diagnosis of maternally inherited diabetes and deafness (MIDD).
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Aim: To develop economically viable integrated fertilizer prescription equation for recommendation of fertilizers in potato on alluvial soils of Eastern India.Methodology: Soil test crop response (STCR) experiments on potato were conducted in alluvial soils of Eastern India during 2016-17 to assess the relationship between yield and availability of plant nutrients for developing fertilizer prescriptions of desired yield targets. The decision on optimum fertilizer doses for varying yield targets were made on the basis of crop nutrient requirement per quintal of potato production, soil efficiency, fertilizer efficiency, and FYM efficiency computed from field experimental data. The optimum fertilizer doses for different yield targets were validated in farmers’ field for economic and environmental benefits as compared to general recommended doses of fertilizers and farmers’ practice. Results: Targeted yield equation for potato for alluvial soil of Eastern India was developed based on soil test values, nutrient requirement and contribution of NPK from soil and fertilizer sources as well as FYM. The prescription based fertilizer application along with FYM increased tuber yield of potato in farmers’ field. Validity of the yield target for 22 and 24 t ha-1 was tested in farmer’s fields and variation in potato yield obtained from targeted yield was 7.6% to 9.8%. Interpretation: Fertilizer prescription equations and ready reckoner developed for potato will be useful in alluvial soils of Eastern India for large scale recommendations and in regions with similar soil and agro-climatic conditions. By following ready reckoner, a farmer can save 61 kg N, 55 kg P2O5 and 44 kg K2O ha-1 over general recommended dose, approximately equal to Rs. 4800/- per hectare.
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Background: HIV/ AIDS is one of the major global health issue, resulting an epidemic. Understanding the socio-demographic profile with magnitude of risky behavior might include positive messages in the routine HIV/AIDS care and treatment. Objective of this study was to find out the socio-demographic, behavioural characteristics among patients receiving second line ART (Anti-Retroviral therapy) in a tertiary centre of North-East India.Methods: A cross sectional study was carried out among 90 PLWHA patients receiving second line ART in Regional Institute of Medical Sciences (RIMS), Imphal from March 2016 to August 2017. A predesigned and pretested schedule was used as study tool to collect required information.Results: Majority participants (43.3%) belonged to 30-40 years age group, mean age 39.96±8.021 years; 51.1% were female. Majority (58.9%) got infected with HIV through heterosexual route followed by IV drug use (31.1%). Nearly half (51.1%) were diagnosed with HIV for 11-15 years duration and majority (61.1%) were under 2nd line ART for 6-10 years duration. Here, 3.3% subjects had Hepatitis B and 7.8% were infected with hepatitis C.Conclusions: Young population were most affected group and heterosexual route being the commonest mode of transmission. Combination of socio-demographic, behavioural risk factor and unawareness are responsible for rapid spread of HIV/AIDS. So, people need to be educated for primary and secondary prevention.
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Background: Medications are an important part of the treatment of patients by clinicians in addition to other measures to be followed by the patients during the entire period of treatment. Objective: To assess patients’ understanding about the use of medications after medicines are dispensed to them by a pharmacist at a tertiary care hospital of Vadodara district in Gujarat. Materials and Methods: It was a descriptive cross-sectional study conducted between the time periods of January 2015 and August 2015. A total of 464 patients were interviewed after they had received medications from the pharmacy window. Descriptive statistics were used for summarizing data. Results: Majority of the interviewed subjects belonged to 25–44 years age group with almost equal representation from both gender and new as well as follow-up visit patients. The patients were prescribed on average of 4.14 medicines (standard deviation 2.10). Only 62 participants (13.4%) had a correct understanding about the use of medication in terms of purpose (20.9%), quantity (86.4%), and frequency in a day (73.1%), and relation of its consumption with food (37.2%). The majority (71.2%) took only one attempt by the investigator for a complete understanding of drug dosages after explanation. Conclusion: The understanding of patients about dispensed medications was low, the lowest being the purpose of medication.
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Objective: In this study our main goal is to evaluate thedemographic profile and operative findings after conventionalsurgery in rectal cancer patients.Method: This quasi experimental study was carried out at Thedepartment of General Surgery and Colorectal unit ofBangabandhu Sheikh Mujib Medical University (BSMMU),Dhaka and Somorita Hospital, Dhaka from July 2005 to June2007 where patients who having carcinoma involving themiddle and lower third of the rectum were evaluated. Duringthe study patients were divided into two groups: Group A:Patients undergone total mesorectal excision (TME) and GroupB: Patients undergone conventional operative method. Allpatients were operated under general anesthesia, placed inLloyd- Davies position.Result: In the study, most of the patients belong to 21 - 30years age group and 46.7% patients of Group-A and 56.6% ofGroup-B were males. The rest 52.8% of Group-A and 43.4% ofGroup-B were females. Sexual function preoperatively wellmaintained in 50 (94.3%) patients of group A and 51 (96.2%)patients of group B. Also, local recurrence rate in Group A ratewas 5.7% and in group B was 20.8%.Conclusion: We can conclude that, for management of rectalcancer conventional surgery has some limitation which canaffect the patient’s recovery and health condition. Further studyis needed for better outcome.
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Background: This have a look at evaluated the position oflaparoscopic surgical procedure is the early control of acutegallbladder disease among a hundred and twenty patients inShaheed Suhrawardy Medical College Hospital and PrivateClinics of Dhaka City.Methods: Information of all emergency admissions for acutegallbladder diseases from March 2014 to June 2016 wasidentified and additional data from the hospital facts becomereviewed retrospectively.Results: Hundred and twenty students are gallbladder disease(87 patients presented with acute biliary pain and 33 patientspresented with acute cholecystitis). The conversion rate turnedinto better throughout early laparoscopic surgical treatment foracute calculous cholecystitis than in operations for acute biliarycolic. In sufferers with acute calculous cholecystitis theconversion charge turned into extensively lower in operationswithin 48 hour of admission than when surgical procedurebecome not on time past 48 h or ultimately carried outelectively.Conclusion: Laparoscopic cholecystectomy for acutegallbladder diseases should be performed well and givepositive feedback after the surgery.
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Background: Men having sex with men (MSM) are at higher risk of getting STIs, including HIV. Their role as bridge population is also very important in the spread of HIV. This study was done with the objective to study the demographic and behavioural factors of MSM and to measure the prevalence of STI among MSM using laboratory facilities of regional RTI/STI centre.Methods: This was a cross sectional study conducted at a targeted intervention (TI) site of Vadodara city. Sixty-eight MSM were enrolled, counselled regarding HIV and other STI testing followed by an interview using a pretested semi-structured study instrument for the information regarding socio-demographic status, sexual behaviour, present and past history of STI and health seeking behaviour. Following that, clinical examination for presence of any signs of STI and sample collection [oro-pharyngeal, urethral and anorectal swab] was done in an examination room and blood samples were collected. The samples were tested for various STIs at Regional RTI/STI centre.Results: Thirty-seven percent of MSM were bisexual. 37% MSM were not using condom consistently with ‘unavailability at all the time’ being the main reason. Six out of 68 MSM found positive of STI. Prevalence was maximum for Chlamydia infection followed by HSV2, HBsAg.Conclusions: Prevalence of STI was 8.82% among MSM of Vadodara city