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Purpose: To profile vitreoretinal (VR) fellows?in?training from India exposed to the Eyesi surgical simulator, to identify potential barriers to voluntary use, and enumerate the most preferred tools and tasks before incorporating them into a formal skill?transfer curriculum. Methods: A questionnaire consisting of 22 questions was designed and circulated through an online portal (surveymonkey.com) to four different institutes of India having a VR surgical fellowship program and using a functional Eyesi (Haag–Streit) simulator. All fellows and trainees who were exposed to the simulator were eligible to participate, irrespective of time spent on the simulator and exposure to training steps on real patients. The responses collected were private and anonymous. Results: Of the 37 respondents, most (n = 25, 68%) considered surgical simulators to be the best training tool before operating on the human eye. A majority (n = 35, 94.5%) of participants spent <3 h per week on the simulator, which, most (n = 30, 81%) felt was not enough time. The main reasons for this underutilization were work?hour limitations (54.8%), lack of a structured training program (19.3%), or a dedicated supervisor (16.1%). Again, the majority (n = 33, 89%) of participants responded that VR surgical skills acquired during simulator training were transferrable to the operating room, which was reflected by their response (n = 31, 83.7%) that simulator?based training should be made mandatory before operating room exposure. Conclusion: This study gives an insight into the overall practice patterns and preferences in simulation training of surgical VR fellows?in?training across India. It indicates that the simulator is extremely helpful to fellows and if adopted, VR surgical simulators with organized, directed, and supervised sessions will considerably improve the surgical training experience.
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Purpose: To compare glaucomatous from non?glaucomatous optic atrophy using optical coherence tomography (OCT) based on the measurement values of Bruch’s membrane opening minimum rim width (BMO?MRW), which is a difficult task otherwise due to their varied course of disease progression, treatment protocols, and systemic association to visual impairment. Methods: This study was conducted in 40 eyes, comprising 20 eyes with non?glaucomatous optic neuropathy (NGON) and 20 eyes with glaucomatous optic neuropathy (GON). All patients underwent a complete ophthalmic examination followed by an OCT optic disc scan to calculate the measurement of BMO?MRW. Results: The 5?fold cross?validated area under the curve for GON versus NGON from logistic regression models was 0.95 (95% confidence interval [CI]: 0.86–1.00) using BMO?MRW values from all sectors. The results revealed that the measurements were significantly lesser in GON than in NGON patients. Conclusion: Hence, OCT?based BMO?MRW values could be used as an additional test to compare glaucomatous with non?glaucomatous optic neuropathy patients, especially in cases of high clinical suspicion.
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Background : Postoperative Urinary Retention (POUR) is common after regional anaesthesia with a reported incidence between 5% and 70%. POUR can lead to significant morbidity with additional surprise and mental trauma to the patient when unwarned. This study aimed to assess the occurrence of POUR in male patients undergoing Surgery under Spinal Anaesthesia and to study the risk factors related to it. Methods : 692 male patients were analysed prospectively for the need for catheterisation which was defined as 搕he inability to void in the immediate Postoperative period with accompanying discomfort and a palpable Bladder.� All such patients were catheterised as an emergency. A record was made about the mean age, surgical condition, comorbidities, duration of Surgery, use of intra-operative sedatives, intra-operative fluid infused and International Prostate System Score (IPSS). Results : The overall mean age of patients with POUR was 46 years. The incidence of POUR was highest among Perianal Surgeries ie, 52/70 (13%) followed by Hernia Surgeries, 18/70 (6.3%). An appreciable reduction was observed in urinary retention after administration of intra-operative sedatives (p=0.022) and lower IPSS (p=0.001). Factors such as age, intra-operative fluid administration, duration of Surgery and previous history of Diabetes did not reach statistical significance as being predictive of urinary retention. Conclusion : An IPSS greater than 7 increases the risk of Postoperative Urinary Retention while the use of intraoperative Sedative in combination with Spinal Anaesthesia decreases the risk. In high-risk patients undergoing perianal procedures, pre-operative patient counselling about the possibility of Postprocedure retention is recommended.
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Background: Prolonged use of N95 masks by healthcare workers might affect physical health due to mask-related hypoxia in addition to the psychological effects of N95 masks. We tried to explore the association of N95 mask-related hypoxia and headache with stress, quality of sleep, and anxiety in the current study. Materials and methods: The sample (N = 78) consisted of 41 doctors and 37 nurses involved in COVID-19 patient care and using N95 masks with or without PPE for at least 4 hours. Perceived stress scale (PSS), Coronavirus anxiety scale (CAS), and Pittsburgh sleep quality index (PSQI) were administered, and physical parameters like heart rate and oxygen saturation (SpO2) were measured. Results: Around 42% of the study participants experienced headaches after wearing an N95 mask and had a higher increase in heart rate (mean percent:10.5% vs 6.3%) and decline in SpO2 (mean percent: 2.6% vs 1.5%) compared to those who didn’t develop a headache after N95 mask use. Independent samples t-test showed a mean difference for PSS and CAS between those who experienced headaches and those who didn’t. The mean PSQI scores among the study participants were 8.91 ± 5.78; the score among those participants with and without headache was 10.57 ± 3.11 and 7.68 ± 2.53, respectively. Conclusion: Perceived corona anxiety, poor sleep quality, and corona anxiety are associated with N95-related headaches and SpO2 drop among health professionals who wear N95 masks for at least 4 hours.
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Analysis of the VP1 gene sequence of the foot and mouth disease virus (FMDV) is critical to understanding viral evolution and disease epidemiology. A standard set of primers have been used for the detection and sequence analysis of the VP1 gene of FMDV directly from suspected clinical samples with limited success. The study validated VP1-specific degenerate primer-based reverse transcription polymerase chain reaction (RT-PCR) for the qualitative detection and sequencing of serotype O FMDV lineages circulating in India. The novel degenerate primer-based RT-PCR amplifying the VP1 gene can circumvent the genetic heterogeneity observed in viruses after cell culture adaptation and facilitate precise viral gene sequence analysis from clinical samples.
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Abstract Introduction Measurement of the electrically-evoked stapedial reflex threshold (ESRT) is an objective tool used to set the comfort levels in pediatric cochlear implant (PCI) users. The levels of ESRT have a strong correlation with comfort levels. However, the clinical utility of ESRT is limited because the ESRT response is not observed in all cochlear implant users. Objective To assess the effects of probe-tone frequency on ESRT and its relationship with the behavioral comfort levels in PCI users. Methods A total of 14 PCI users aged between 5 and 8 years participated in the study. The ESRT levels were measured using high-frequency probe tones (678 Hz and 1,000 Hz), and the default 226 Hz probe tone. The ESRT was measured with single-electrode stimulation across the three electrode locations (basal [E01]; middle [E11]; and apical [E22]). The ESRT levels measured with different probe tone frequencies were compared with the behavioral comfort levels. Results The mean ESRT levels using 1,000Hz and 678 Hz were lower than those measured using 226 Hz, but there was no main effect of probe-tone frequency (p > 0.05). A significantly high incidence of successful ESRT measurements occurred with higher-frequency probe tone (p < 0.039). Additionally, ESRT using higher probe tones significantly correlated with comfort levels. Conclusion The ESRT with higher probe tones was correlated with behavioral comfort levels and increased the success rate of the measurements. Higher-frequency probe tones may be useful whenever ESRT with 226 Hz is not measurable.
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Vishatinduka Tailam is mentioned in context of Vataroga nidhanalakshana chikitshaadhyana of Basavarajiyam text for the treatment of Sarvangasandhiasthigatavata, Amlavata, Sula, Anulomanavayu, Sthambha, Dhanurvata, Kaphajavikaras, severe painful condition of the body, etc., It is prepared with ingredients like Vishatinduka, Jambira, Aranala, Tilataila and Erandataila. It is an attempt made to validate the pharmaceutical and analytical parameters of Vishatinduka taila. Three batches of Vishatindukataila were prepared. Pharmaceutical study of batches and its standardization was done. It took five days for preparation of each batch due to presence of Aranala. Intermittent cooling was done. At the end of Taila preparation, mustard brown coloured oil was obtained and strong odour present. All Sneha siddhi lakhanas were observed and the loss was approximately 10% in all the three batches of Taila. To establish standards of Vishatinduka Taila, physicochemical and chromatographical methods were performed. The results found are acid value 12.344mg/KOH/g, peroxide value 5Meq/kg, Density 0.932g/cm3, Specific gravity 0.932, pH 4.5+/_0.3, Loss on drying 0%, Refractive index 73.5+/_0.2% brix, saponification value 112.22mg KOH/1g and Total fatty matter 95.4%. Physicochemical test was done in first and second month also results obtained. In HPTLC evaluation variable number of spots are visualized. It showed the presence of four phytoconstituents.
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BACKGROUND Hyperglycaemia and hypoglycaemia in hospitalized patients are associated with poor clinical outcomes. We assessed whether administration of an online educational course for medicine residents improves the glycaemic management of hospitalized patients with diabetes. METHODS We conducted this quasi-experimental, pre-post study from January 2019 to April 2019. The contents of the course were in compliance with the American Diabetes Association Guidelines 2018. After participating in the online course, the change in the knowledge of residents was assessed by pre- and post-test questionnaire and changes in the inpatient diabetes care were assessed by case record review of the hospitalized patients with diabetes managed by them before and after the participation in the course. RESULTS Fifty-six residents participated and completed the online course. Their average post-test scores increased by 11.6%. One hundred and eighteen patients managed by the residents in the same wards before and after the participation in the course were studied. After attending the course, glycaemic targets were predetermined in 75.4% of patients compared to 32.2% before and adequacy of glucose monitoring improved. The total hypoglycaemic event rate reduced significantly by 45.8% and this was accompanied by a trend towards improved glycaemic control. At the time of discharge, the patient awareness on insulin injection technique, hypoglycaemic symptoms and its home remedies were significantly increased. CONCLUSION The administration of an online course increases the knowledge level of residents, improves patient safety and may improve glycaemic control in hospitalized patients with diabetes.
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Purpose: Novel coronavirus has brought huge changes in lifestyle, especially among children. Reports indicate that the prevalence of refractive errors among children has increased due to home confinement. Hence, this study was done to understand the current status of refractive errors among children from public schools in southern India. Methods: This cross-sectional study was conducted as part of school eye screening conducted between September and October 2021. Children between 14 and 17 years of age from public schools underwent a three-phased comprehensive eye examination. Children identified with refractive errors and an equal proportion of children without any refractive errors underwent a survey on outdoor activities. Prevalence estimates and 95% confidence interval were calculated. Chi-square tests and regression analysis were used to understand the association between refractive error and other variables. Results: From the data of 3,850 (90.69%) children, the prevalence of vision impairment, refractive errors, and myopia in at least one eye was found to be 12.83% (n = 494), 21.51% (n = 828), and 19.53% (n = 752), respectively. The average myopic spherical equivalent error was found to be -2.17 ± 1.11D (range:-0.50 D to -14.00 D). Almost 96.82% of girls had less than 3 h of outdoor activities. Refractive errors were 7.42 and 2.77 times more (95% CI: 3.51-15.70), P < 0.001) among children who had outdoor activities less than 3 h per day and sleep less than 7 h per day. Conclusion: Comparing to previous studies from North Indian and South Indian public schools, this study reports a three- to six-fold rise in myopia post-home confinement among public school children from India.
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Yellow mosaic virus (YMV) disease is known to cause severe damage in green gram in terms of yield loss. As the resistance is often governed by recessive genes, introgression of such resistance faces some difficulty. DNA molecular markers are reported to be effective in this process. However, validation of such markers is important. Here, we have made an attempt to validate DNA markers associated with YMV disease resistance gene from a diverse group of 26 green gram genotypes. A total of 19 molecular markers were used to assess the susceptibility or resistance against YMV disease. Results show that among the amplified 31 alleles, 21 were polymorphic, with a mean of 1.1.0 per locus. The polymorphism information content (PIC) values ranged from 0.32 to 0.80. Only five markers exhibited higher PIC value (>6.0) and were revealed to be polymorphic, suggesting its utility in marker assisted selection for breeding YMV resistant genotypes in greengram. Dice dissimilarity coefficient among the genotypes exhibited a range of 0.07 to 1.0 which show a wide genetic variation among the genotypes for YMV tolerance. Neighbor-joining cluster analysis has grouped 26 green gram genotypes into 4 main clusters which revealed the existence of genetic dissimilarities among the genotypes. The genotypes AUGG 6, VBN (Gg) 2 and CO (Gg) 8 carried the positive alleles for YMV disease resistance and the allele for susceptibility were found in the genotypes AUGG 12, AUGG 15, AUGG 17 and AUGG 19. Single marker analysis indicated that there was correlation between the markers and the disease reaction in the field with exceptions. The findings revealed that the SSR markers CEDG180 and YR4 could be used to screen germplasm in order to discriminate the YMV resistant genotypes from the susceptible genotypes in marker assisted selection.
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Soil salinity is one of the major abiotic stresses which affect crop productivity including rice, Oryza sativa L. Developing salt tolerant varieties gained considerable attention accordingly. Here, we studied salinity tolerance in rice crop. We screened ten rice genotypes for saline tolerance at different concentrations of 0 dSm-1, 2 dSm-1, 4 dSm-1, 6 dSm-1, 8 dSm-1,10 dSm-1, 12 dSm-1 and 14 dSm-1, respectively. Among the ten genotypes studied, CARIDhan-7 tolerated salt stress up to 6dSm-1 of irrigated water. Comparative transcriptome analysis was done with the genotypes by treating with saline water at 0dSm-1 and 6 dSm-1. A total of 1013 genes were differentially expressed under simulated stress conditions. Out of which, 551 genes were upregulated and 462 genes were downregulated. Based on the metabolic pathway analysis, the MAPK signaling pathway, along with the other 9 pathways were found to be enriched in the stressed sample. Nine ion transporter genes, 1potassium channel, 1 protein phosphatase gene, IAA homologs OsIAA9, two ROS scavenging-related genes, and 4 stress regulated genes identified were found to be significantly up-regulated along with some functional proteins previously reported under salt stress. An AP2-like ethylene-responsive transcription factor PLETHORA 2 was found to be downregulated. The results suggested that the CARIDhan-7 genotype undergoes various saline tolerant mechanisms and pathways in response to the stress imposed when compared to non-stressed seedlings.
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Hemoglobinopathies are haematalogical disorders that afflict millions of individuals worldwide. HbE is a hemoglobinvariation caused by a mutation in the ? globin gene that results in the substitution of glutamic acid for lysine at position 26 of the ? globin gene. Hemoglobin (Hb) synthesis abnormalities are among the most prevalent inherited disorders. They can be quantitative (thalassemia syndrome) or qualitative (variant HbS). Hemoglobin E (HbE) is the second most common hemoglobin variation after hemoglobin S (HbS).
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Purpose: To assess the level of knowledge, attitude, and clinical practice of glaucoma among optometry students and optometry practitioners with different years of clinical experience and academic background. Methods: A survey with 20 questions on knowledge, attitude, and practice (KAP) of glaucoma was prepared and self?administered to optometry students and optometry practitioners practicing in an eye hospital/clinic/optical with varied years of clinical experience and education qualification. Results: Among the 558 participants, 57% were optometry practitioners and 43% were students. The knowledge scores among optometry practitioners increased significantly with an increase in the years of clinical experience (P < 0.001). Participants with master’s degrees scored higher than participants with bachelor’s degrees (P = 0.12). There was no statistically significant difference in knowledge scores based on the type of clinical practice ? hospital, private practice, or optical (P = 0.39). Practicing optometrists who performed slit?lamp examination, gonioscopy, IOP measurements, and disc evaluation for the detection of glaucoma had significantly higher knowledge scores than those who did not perform these tests in their practice (P < 0.05). A positive attitude toward glaucoma learning through workshops and hands?on training was reported by optometrists and students. Conclusion: Knowledge about glaucoma was good among optometrists and optometry students and was better among those who handled the diagnostics. All the optometrists had a positive attitude toward enhancing their practice through proper training
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Diabetes mellitus with poor glycemic control is often associated with dental caries. We aim to assess the relationship between dental caries and HbA1c levels among adults with type 2 diabetes (T2D) in Chennai. A cutoff of HbA1c ?7.0 to 7.9% (53–63 mmol/mol) was used to define Group 1 (n = 113) as moderately controlled and HbA1c ?8.0% (64 mmol/mol) to define Group 2 (n = 228) as poorly controlled T2D. The absolute numbers of decayed, missing, and filled teeth were examined to calculate the decayed, missing and filled teeth index. Group 2 had a significantly higher percentage (48.2%) of decayed teeth when compared to Group 1 (28.3%). Group 2 had a 2.65 times higher risk of decayed teeth when adjusted for mean carbohydrate consumption, sweets consumption, oral hygiene, and brushing habit. T2D with higher HbA1c levels is associated with an increased number of decayed teeth. Hence, there is a need for monitoring dental status in T2D as earlier treatment may prevent or delay decay teeth.
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Introduction: Stroke is a leading cause of disability worldwide. Cognitive functions and, in particular, executive function is commonly affected after stroke, leading to impairment in daily activities. Previous studies have shown confiicting evidence regarding the incidence of executive dysfunction in patients with right or left hemispheric strokes. Few studies have shown that executive dysfunction is more prevalent in right hemispheric strokes. Aims and Objectives: 1. To study the executive dysfunction in patients with Right Hemispheric strokes. 2. To compare the impairment of executive functions with the Vascular territory involved Methods: This was a prospective observational study which included 100 patients admitted to a tertiary care center from January 2021 to August 2021. After Institutional EC clearance, patients with Right-Hemispheric ischemic stroke on neuro-imaging (CT or MRI) were included in the study. Demographic data, clinical history, neurological examination and etiological workup like echocardigraphy, carotid and vertebral artery doppler, CT/MR angiography were performed. Executive function was tested clinically using go-no-go test, digit-span test, trail making test, N-back test, Rey-osterreith complex ?gure test and clock drawing test. Data was entered to a pre-formatted data sheet and analysed. Results: The mean age of the included patients was 58.76years, 54 patients were male, Sixty-nine patients had anterior circulation stroke, 31 had posterior circulation stroke. Forty three patients had executive dysfunction as evidenced by abnormal go-no-go test (n=22), digit-span test(n=35), trail making test(n=10), N-back test(n=23), Rey-osterreith complex figure test(n=38) and clock drawing test(n=29). Executive dysfunction was more prevalent in anterior circulation strokes (n=37) as compared to posterior circulation strokes (n=6) (p=0.001) Executive dysfunction Conclusion: was a common finding in patients with right hemispheric stroke and was significantly higher in patients with anterior circulation strokes
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Neuron Speci?c Enolase (NSE) is a glycolytic enzyme. It is exclusively present in neurons and neuroendocrine cells. It is an important marker to assess functional damage to neurons. Studies have shown that NSE is more than 90% sensitive to decide the severity of stroke. This study was conducted to compare the Serum levels of NSE and radiological imaging in assessing the severity of stroke. A hospital based descriptive study was conducted on 60 stroke patients (<72hrs from onset) and 60 controls. Glasgow Coma Scale (GCS) was assessed, and serum NSE was measured. Non contrast CT brain was taken. mRS scale was assessed after 30 days of onset of stroke. ROC curve analysis was done which showed a Sensitivity of 82.5% and Speci?city of 82.5% for serum levels of NSE at a cut off value 12ng/mL. NSE showed a positive correlation with mRS; negative correlation with GCS. Hence it is advisable to measure serum NSE levels at the existing health care facilities, where CT brain is not available.
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Introduction: The surge of Covid -19 pandemic and the earlier depletion of resources have led to the need of allocation of patients based on levels of risk. The COVID 19 related mortality has been on increase in people with old age, male gender, infiammatory markers elevation and in people with history of co morbidities. With this background, thus study aimed to observe association between CRP, D-Dimer, Serum Ferritin, The Initial CT Chest Severity Score and the outcome of Covid 19 in patients with Type 2 Diabetes mellitus. A hospital based retrospective study was done among COVID 19 patie Materials and methods: nts from the period of September to December 2020. Patients with Type 2 diabetes mellitus admitted with RT-PCR positive (or) CT Thorax – CORADS 4 and above with age more than 18 years and having CRP, D-Dimer, Serum Ferritin results within 24 hours after admission were included in the study. The data was collected using a semi structured questionnaire. A total of 531 individuals were participa Results: ted in the study. The mean respiratory rate and oxygen saturation between the survived and deceased groups was statistically significant (p value 0.024 and 0.044 respectively). All the patients had normal blood urea and serum creatinine values. The mean CORADS score of the participants is 4.78 ± 0.60. There is statistically Conclusion: significant difference in the mean respiratory rate and mean SPO2 between deceased and recovered patients. With advancements in medical sciences, it may not be a rigid process to predict severity with laboratory investigations
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Purpose: To assess the retinal manifestations of Parkinson’s disease using optical coherence tomography. Methods: A prospective case?control study comparing 30 eyes from 15 patients with Parkinson’s disease and 22 eyes from 11 healthy age?matched controls. Total macular subfield thickness and the thickness of the ganglion cell layer, nerve fiber layer, and peripapillary retinal nerve fiber layer were measured with spectral?domain optical coherence tomography (SD?OCT). Results: The mean age of PD patients was 68.4 years ± 10.64 (range: 46–82) and in the control group was 66.36 ± 5.22 (range: 64–68). The average disease duration in patients with PD was 6.7 ± 2.8 years (range: 2–10 years). The mean best?corrected visual acuity in PD was 20/26 and 20/20 in controls, with P = 0.0059, which was significant. Significant difference was also found in the contrast sensitivity between both groups. Structural differences in the central macular thickness (P = 0.0001), subfield thicknesses in the superior (P = 0.003), inferior (P = 0.001), nasal (P = 0.004), and temporal subfields (P = 0.017) was seen. Severe thinning of the ganglion cell layer was seen in PD patients (P = 0.000) as well as of the nerve fiber layer (P = 0.004). Peripapillary retinal nerve fiber thickness measured showed significant thinning in superotemporal (P = 0.000), superonasal (P = 0.04), inferonasal (P = 0.000), inferotemporal (P = 0.000), nasal (P = 0.000), and temporal quadrants (P = 0.000). Conclusion: Visual dysfunction was observed in patients with PD along with structural alterations on OCT, which included macular volumes, ganglion cell layer, and peripapillary retinal nerve fiber layer.
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Background & objectives: The delay in communicating the results to tuberculosis (TB) patients leads to increased rates of initial loss to follow up of treatment. The gap in communication among healthcare providers requires application of new tools that will address the challenges. Mobile phone technologies could be a useful tool in this context for the delivery of information. The objective was thus to evaluate communication by mobile applications such as the WhatsApp Messenger to decrease initial loss to follow up after initial treatment for TB. Methods: Indian Council of Medical Research-National Institute for Research in Tuberculosis, Chennai, India undertook a community prevalence survey to find the burden of TB. During this survey, mobile phone-based technology (WhatsApp messenger) was employed as an intervention among the healthcare providers and researchers involved for communicating. This was further evaluated for its usefulness by examining the initial loss to follow up and patients initiated on treatment. Results: The study covered four blocks of Thiruvallur district of Tamil Nadu, South India, namely Kadambathur, Poondi, Thiruvalangadu and Periyapalayam. The survey population was around 20,000 from each block, and the average patients diagnosed by community TB prevalence survey were 30 patients from each block. Among the patients diagnosed through this survey, in the first block, only 55 per cent were initiated on treatment; subsequently, with the intervention, the initial loss to follow up was significantly reduced from 45 to zero per cent. Interpretation & conclusions: After integrating of WhatsApp messenger application for communication among healthcare providers and research