Sutureless and glue-free limbal-conjunctival autograft in primary and recurrent pterygium: A pilot study

Purpose: To evaluate and analyze the outcomes of sutureless and glue?free limbal?conjunctival autografting in cases of primary as well as recurrent pterygium. Methods: This prospective interventional study was carried out between February 2019 and February 2020 at a tertiary care hospital in North India. A total of 70 patients with pterygium underwent sutureless and glue?free limbal?conjunctival autograft. The patients were divided into two groups: group 1 patients with primary pterygium (n = 45), group 2 patients with recurrent pterygium (n = 25). The patients were followed up till 12 months postoperatively. Results: The mean age of the patients in group 1 and group 2 was 37.04 ± 8.69 years and 32.52 ± 6.49 years, respectively (P = 0.04). Postoperatively, no recurrence was recorded in group 1. Recurrence was noticed in two patients (8%) of group 2. The BCVA changed from 78.73 ± 9.86 letters to 80.15 ± 7.29 letters (P = 0.45) and from 79.6 ± 6.44 letters to 79.8 ± 5.86 letters (P = 0.45) in group 1 and group 2, respectively. Graft edema was found in seven (15.55%) cases of group 1 and four (16%) cases of group 2. Graft retraction was found in two (4.44%) cases of group 1 and three (12%) cases of group 2. Conclusion: Sutureless and a glue?free limbal?conjunctival autograft is a safe and effective treatment option for primary as well as recurrent pterygium.

Assessment of risk conferred by coding and regulatory variations of TMPRSS2 and CD26 in susceptibility to SARS-CoV-2 infection in human

At present, more than 200 countries and territories are directly affected by the coronavirus disease-19 (COVID-19) pandemic. Incidence and case fatality rate are significantly higher among elderly individuals (age [60 years), type 2 diabetes and hypertension patients. Cellular receptor ACE2, serine protease TMPRSS2 and exopeptidase CD26 (also known as DPP4) are the three membrane bound proteins potentially implicated in SARS-CoV-2 infection. We hypothesised that common variants from TMPRSS2 and CD26 may play critical role in infection susceptibility of predisposed population or group of individuals. Coding (missense) and regulatory variants from TMPRSS2 and CD26 were studied across 26 global populations. Two missense and five regulatory SNPs were identified to have differential allelic frequency. Significant linkage disequilibrium (LD) signature was observed in different populations. Modelled protein–protein interaction (PPI) predicted strong molecular interaction between these two receptors and SARS-CoV-2 spike protein (S1 domain). However, two missense SNPs, rs12329760 (TMPRSS2) and rs1129599 (CD26), were not found to be involved physically in the said interaction. Four regulatory variants (rs112657409, rs11910678, rs77675406 and rs713400) from TMPRSS2 were found to influence the expression of TMPRSS2 and pathologically relevant MX1. rs13015258 a 50 UTR variant from CD26 have significant role in regulation of expression of key regulatory genes that could be involved in SARS-CoV-2 internalization. Overexpression of CD26 through epigenetic modification at rs13015258-C allele was found critical and could explain the higher SARS-CoV-2 infected fatality rate among type 2 diabetes.

A Clinical Study on Post-operative Outcome in Perforation Peritonitis Patients with Reference to the History of Nonsteroidal Anti-inflammatory Drugs Use

Background: Perforation peritonitis is a commonly encountered surgical emergency and it is defined as inflammation of the serosal membrane that lines the abdominal cavity and the visceral organs. The objective of this study is to predict a correlation between post-operative outcomes in perforation peritonitis patients with reference to the history of nonsteroidal anti-inflammatory drugs (NSAIDs) use. Materials and Methods: A total of 209 cases were studied with hollow viscous perforation peritonitis admitted in the surgical wards in Sanjay Gandhi Memorial Hospital associated with S. S. Medical College, Rewa (M.P.), India, in the period from June 1, 2018, to May 31, 2019. All necessary investigations were carried out. X-ray, ultrasonography abdomen, and blood investigations were done. Patient underwent emergency exploratory laparotomy and a careful record of pre-operative and post-operative findings was made and was carefully filled in the pro forma. All the patients were advised to attend surgical OPD for follow-up. Results: Most of the patients (73.2%) of perforation peritonitis had a history of NSAID intake, out of which 81.6% recovered from the disease while mortality rate in perforation peritonitis associated with NSAID use was found to be 18.4%. Those patients with no history of NSAID use (26.8%) had a mortality rate of 9% while 91% of patients of perforation peritonitis were recovered from the disease. Conclusion: In this study, it is concluded that the outcome of the patients of the perforation peritonitis is not dependent on the history of NSAIDs use, but NSAIDs abuse is one of the etiological factors in the pathogenesis of the perforation peritonitis

A Comparative Study of Chest X-ray and Chest High-resolution Computed Tomography in Blunt Trauma Chest Patients

Introduction: Computed tomography (CT) scan is an accurate tool for the detection of injuries in a trauma setting and is able to find the injuries that were occult in chest X-ray (CXR). In past years, the utility of CT scan was limited to severe trauma injuries but now is used in less severely injured trauma patients. The study aimed to compare the efficacy of CXR and chest CT scans in patients with chest trauma. Materials and Methods: The present study was conducted in the Department of Surgery of Medical Institute. For the study, we prospectively view the previous medical records of the patients who were admitted in our surgical ward for blunt chest trauma and received both CXR and high resolution CT chest scans. A total of 95 patients were included in the study. Data regarding the study were collected. Results: Out of 95 patients, 79 were males and 16 females. The mean age of the patients was 32.42 years ranging from 2 to 90 years. The most common cause for blunt trauma to the chest according to our results was a road traffic accident. We observed that CT scan is more accurate as compared to CXR in the detection of certain cases such as sternum fracture, rib fracture, scapula fracture, lung contusion, hemothorax, and pneumothorax. Conclusion: Chest CT scan is highly sensitive in the detection of thoracic injuries following blunt chest trauma. In day-to-day practice, CT scan is better in visualizing as sternum fracture, rib fracture, scapula fracture, lung contusion, hemothorax, and pneumothorax

A study of waist circumference and waist-hip ratio as markers of type 2 diabetes mellitus in an urban population of district Bareilly

Background: Type 2 diabetes mellitus belongs to a group of diseases labelled as lifestyle diseases and is on the rise in Asians especially Indians. Hence finding bio-markers is important to warn people and create awareness. Aim of the present study is to estimate waist-hip ratio, waist circumference in type 2 diabetic patients with respect to gender. Methods: A cross-sectional, community based study was conducted from February 2014 to February 2015 among adults in the age group of 30 year and above residing in area covered under UHTC of Bareilly City. A simple random sampling technique was adopted to achieve the desired sample size. 640 is the sample size came out to be by applying 3.8 4𝑃𝑄/d2 formula. Subject’s waist circumference, waist-hip ratio was measured in study samples. House to house survey was done for collecting data. Data tabulated and subjected to statistical analysis. Results: Prevalence of DM and IFG was more in those who were having high waist circumference and the association was also found to be statistically significant. The association was also found statistically significant between male high waist hip ratio and Diabetes Mellitus but no association was seen between female’s high waist-hip ratio and Diabetes Mellitus.Conclusions: High waist circumference can be a screening procedure for DM individuals in both sexes, but the same scenario we haven’t seen in high waist hip ratio among females and prevalence of DM. Appropriate waist circumference and waist-to-hip ratio values are complex because they are likely influenced by gender and other factors.

A Comparison of Audio and Audio-Visual Distraction Techniques in Managing Dental Anxiety in Pediatric Patients: A Clinical Study

Background: Pain and fear of pain makes dental treatmentvery difficult for clinician as well as patients. Minimizing fearand anxiety can help to treat patients more comfortably.Various techniques like audio distraction, audio visualdistraction are used to minimize anxiety.Aim: To compare audio and audio-visual distractiontechniques in managing dental anxiety.Methods: 100 children visiting the Department of Dentistry,UPUMS, Saifai for routine dental care were examined. Theselected 100 children were randomly allocated to 2 groups.Group 1: audio distraction and Group 2: audiovisual group.Results: Venham’s anxiety scale was found to be lower inaudiovisual distraction group, although the difference was notfound to be statistically significant during all the visits.Relatively less increase in pulp rate was also observed in audiovisual distraction group in current study.Conclusion: Audiovisual distraction technique can bepreferred over audio distraction in paediatric patients

Impact of socio-demographic variables and morbid conditions on general health component of perceived health using SF-36 form

Background: Perceived health (PH) is a subjective assessment of the health and it is a strong, independent and reliable predictor of morbidity, mortality. It includes so many aspects that are difficult to capture clinically such as incipient disease, physiological, psychological reserves. We assessed the impact of diabetes mellitus (DM), hypertension (HTN), co-morbidity and other associated factors on the general health (GH) dimension of the PH of the patients attending the outpatient department (OPD), Inpatient department (IPD), rural health training centre (RHTC) and urban health training centre (UHTC) of Shri Ram Murti Smarak Institute of Medical Sciences (SRMS, IMS), Bareilly.Methods: PH status of the patients was assessed by the GH dimension of the physical component summary of PH using the 36-Items short form health survey (SF-36).Results: The impact of morbidity deteriorate the GH score but hypertensive patients scored poor results as compared to those with DM and comorbid patients (p>0.05). Age was inversely related with GH scores but male gender, higher education (p<0.05) and good occupation were all associated with higher GH score. There was not much influence of geographical area on the GH scores but urban score slightly better and the association was insignificant (p>0.05).Conclusions: Male young patients from urban area, educated and good job performed better score for GH and association was significant for education and occupation. The presence of morbidity and co-morbid condition deteriorate the GH of the patients. The impact of various socio-demographic factors on the PH status was also evident in the study.

Comparative Study of Levobupivacaine with Butorphanol and Ropivacaine with Butorphanol in Supraclavicular Brachial Plexus Block

Ropivacaine and levobupivacaine are less cardiovascular and central nervous system toxic, being an alternative to bupivacaine. Butorphanol, an opioid significantly prolongs the duration of the local anaesthetics. Methods: A comparative, Prospective, Randomized, Clinical study was conducted in 60 patients of either sex of ASA I,II ,with age group 18-60 years undergoing upper limb orthopaedic surgeries under USG guided Supraclavicular Brachial Plexus block. Patients were randomly allocated to Group L: 30ml 0.5% Levobupivacaine+600 mcg Butorphanol. Group R: 30ml 0.5% Ropivacaine with 600mcg Butorphanol. Block characteristics were compared as a primary outcome. The data were analyzed with Student-t test. Results: Heart rate, Mean BP, Onset and duration of sensory and motor blockade, Post-op VAS score(every 1 hour for 16hours) were compared intraoperative as well as in the postoperative period. Demographic and hemodynamic data were comparable. All hemodynamic parameters compared were insignificant (P>0.5%).The onset of sensory and motor was significantly earlier in GROUP L (P =0.0048, P=0.002) compared to GROUP R. The duration of sensory and motor block was significantly higher in GROUP L (P=0.00073, P=0.00021). Group R required rescue analgesic earlier than Group L. Conclusion: Though both are long acting and safer than bupivacaine, Levobupivacaine is better than ropivacaine in terms of early onset of sensory-motor blockade and prolonged duration of sensory-motor blockade. Butorphanol augments the efficacy of local anesthetics without any untoward side effects.

Awareness and acceptance of contraceptives among the mothers of infants attending an immunization session at a field practices area of a tertiary care hospital

Background: India was the first country in the world to have launched a National Programme for Family Planning.Methods: A cross-sectional descriptive study was carried out in the in Vaccination unit of rural field practice area of Shri Ram Murti Smarak institute of Medical Sciences (SRMSIMS) Bareilly (U.P). Objective of the study was to assess knowledge and practice of postpartum contraception and factors affecting the usage of contraceptives in Rural area. All females who delivered within last one year were included in the study. A pre-structured questionnaire was used. A total of 98 females were included. The appropriate statistical analysis was done to present the results.Results: 28.57% females had adopted one or the other postpartum contraceptive measure. Condom was the most common method used. Usage of postpartum contraception was significantly associated with women’s and husband’s education, type of delivery and availing of antenatal and postnatal visits.Conclusions: Overall usage of postpartum contraception was low there is need to focus at every step to contact of these women with health facility or health workers

A study on health profile of manjha makers in district Bareilly

Background: Bareilly is famous for its manjha all over the world. More than 20,000 workers are engaged in the making the Manjha in Bareilly which is an important unorganized sector in western Uttar Pradesh. Objective was to study health profile of manjha makers in district Bareilly.Methods: The workers engaged in making manjha were randomly approached in the selected areas and interviewed using a semi open ended questionnaire. Responses were marked based on duration and severity of symptoms.Results: The mean age of study participants was 31±9.9 years. The mean age of starting manjha making was 15.3±6.7 years. 51 (47.2%) study participants were having wounds and cuts in hands and fingers.Conclusions: Manjha makers are in direct contact with inhalable glass dust (silica dust) and chemical colors which can reach the circulation through cuts and wounds. The higher prevalence of musculoskeletal and respiratory symptoms as well as other symptoms like cut wounds in hands and possible absorption of dyes through cuts underlines the need of a larger study to know the factors causing these symptoms and ways to prevent the suffering of manjha makers.

Study of Incidence of Helicobacter pylori Infection in Patients of Peptic Ulcer Perforation

Background: Peptic ulcer disease (PUD) is a common disorder that affects millions of individuals each year. PUD has a major impact on our health-care system by accounting for roughly 10% of medical costs for gastrointestinal diseases. Helicobacter pylori infection and the use of nonsteroidal anti-inflammatory drugs are the predominant causes of PUD overall, PU mortality and hospitalization rates have declined for the past two decades, but complications such as PU perforation and bleeding remain a substantial health-care problem. Materials and Methods: A prospective 1-year study conducted in 116 cases of peptic perforation admitted in surgical wards of Sanjay Gandhi Memorial Hospital, Rewa, M.P., during the study period June 2016–May 2017. All patients suspected of peptic perforation were admitted to surgery ward and underwent emergency exploratory laparotomy. Post-operatively, H. pylori serological test to detect IgG antibody was done with patients’ blood serum. Their findings were recorded in a pro forma and master chart. The information obtained was tabulated and analyzed. Results: The incidence of H. pylori infection in our study was found to be 31.03%, i.e., 36 cases of 116 cases. Conclusion: Tobacco chewing, smoking, alcohol, inadvertent use of analgesics, and H. pylori infection are the most common predisposing factors for PUD, and patients’ inability to get proper and complete treatment is responsible for peptic perforation. Early hospitalization and urgent surgical intervention can significantly reduce the post operative morbidity and mortality in peptic ulcer perforation patients. Post-operative H. pylori eradication therapy and follow-up endoscopic facilities in patients found positive for H. pylori can reduce recurrence rates and subsequently the burden of this disease

Assessment of Sugarcane Germplasm ( Saccharum spp. complex) Against Red Rot Pathogen Colletotrichum Falcatum

ABSTRACT Red rot, caused by Colletotrichum falcatum Went is the most important disease of sugarcane in India inflicting substantial loss to both cane industry and cane growers. To keep in view the importance of red rot disease of sugarcane, 117 accession of sugarcane germplasm including different Saccharum species and Indian and foreign commercial hybrids were tested against red rot with Cf 07, Cf 08 & Cf 09 (national pathotypes) by plug method of inoculation. Out of 117, 6 were found resistant and 12 were moderately resistant against red rot and rest were moderately susceptible/susceptible/highly susceptible. Theses resistance and moderately resistant accession can be further utilize to produce resistance varieties against the most devastating pathogen of sugarcane.

Truview PCDTM Video Laryngoscope versus McCOY Laryngoscope for Tracheal Intubation: A Comparative Study.

Background: McCoy laryngoscope and video laryngoscopes are being increasingly used and have a definitive advantage over conventional laryngoscopes in management of potentially difficult airways. The aim of our study was to compare relative effectiveness of McCoy laryngoscope and True view PCDTM video laryngoscope in patients undergoing oral tracheal intubation. Methods: Fifty patients of American Society of Anaesthesiologists (ASA) grade I and II, aged 20 – 50 years, posted for elective surgery under general anaesthesia were randomly allocated into Group T (Truview group, n=25) and Group M (McCoy group, n=25). The two groups were compared for demographic data, intubation difficulty score (IDS), Cormack-Lehane (CL) grade, POGO score, time to intubation, number of intubation attempts and haemodynamic parameters. Results: The demographic data and ASA status was comparable in both the groups. Group T had a significantly less IDS score as compared to Group M (p < 0.001). Seventeen patients in Group T and 8 patients in Group M had IDS = 0. The CL grade and POGO scores were better in Group T than in Group M. Intubation was successful in the first attempt in 94% patients in Group T and 88% patients in Group M. There was a transient increase in HR and NIBP after intubation in both the groups which returned back to the baseline within 5 minutes. No incidence of hypoxia and airway trauma was noted in the two groups.Conclusion: Truview PCDTM video laryngoscope resulted in better glottic visualization with lower IDS than McCoy laryngoscope in patients undergoing oral tracheal intubation.

Assessment of nutritional status among adolescents: a hospital based cross sectional study.

Background: Adolescence, a period of transition between childhood and adulthood, occupies a crucial position in the life of human beings. The primary causes of under nutrition in India are its large population, socio-economic differences and inadequate access to health facilities. Nutritional assessments among adolescents are important as they are the future parents and constitute a potentially susceptible group. Studies on the assessment of nutritional status of adolescents are less in number and a National database has not yet been developed. Methods: The present hospital based cross sectional study was conducted in year 2013 among 344 rural adolescents of 10-19 years age (166 boys and 178 girls) attending the outpatient department at rural health training centre (RHTC) Dhaura Tanda, district Bareilly, Uttar Pradesh, belonging to the Muslim and Hindu caste communities. The nutritional status was assessed in terms of under nutrition (weight-for-age below 3rd percentile), stunting (Height-for-age below 3rd percentile) and thinness (BMI-for-age below 5th percentile). Diseases were accepted as such as diagnosed by pediatrician, skin specialist and medical officer. Results: The prevalence of underweight, stunting and thinness were found to be 32.8%, 19.5% and 26.7% respectively. The maximum prevalence of malnutrition was observed among early adolescents (28%-47%) and the most common morbidities were URTI (38.6%), diarrhea (16.8%), carbuncle / furuncle (16%) and scabies (9.30%). Conclusion: The study concluded that the most common morbidities among adolescents were related to nutrition and personal hygiene. Regular health programmes should focus to educate and promote health among adolescent.