ABSTRACT
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.
ABSTRACT
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.
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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
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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
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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.