ABSTRACT
A well-centered, adequately sized continuous curvilinear capsulorhexis (CCC) is a prerequisite for successful cataract surgery. A perfect capsulorhexis ensures safe and effective performance of various steps of surgery as well as a correctly positioned intraocular lens (IOL) with optimal rotational stability. Ganesh and Grewal (GG) cystitome maker is a step toward standardizing the creation of a cystitome to reduce variations and complications associated with the crucial step of CCC in cataract surgery. We conducted a study to measure the repeatability and precision of cystitomes made by the GG cystitome maker versus those made manually with a needle holder. The results showed that the cystitomes made with GG cystitome maker had a lesser degree of variation. This indicates a more repeatable cystitome, which will inadvertently help in reducing the error caused by the instrument in making a good CCC during cataract surgery.
ABSTRACT
Purpose: To study and compare the demographic and clinical profile of acute ocular burns (AOB) in children and adults. Methods: This retrospective case series included 271 children (338 eyes) and 1300 adults (1809 eyes) who presented to two tertiary eye care centers within one month of sustaining AOB. Data regarding demographics, causative agents, severity of injury, visual acuity (VA), and treatment were collected and analyzed. Results: Males were more commonly affected particularly among adults (81% versus 64%, P < 0.00001). Among children, 79% sustained domestic injuries, whereas 59% of adults had work?place injuries (P < 0.0001). Most cases were due to alkali (38%) and acids (22%). Edible lime (chuna, 32%), superglue (14%), and firecrackers (12%) in children, and chuna (7%), insecticides, lye, superglue (6% each), toilet cleaner (4%) and battery acid (3%) in adults, were the main causative agents. The percentage of cases with Dua grade IV?VI was greater in children (16% versus 9%; P = 0.0001). Amniotic membrane grafting and/or tarsorrhaphy were needed in 36% and 14% of affected eyes in children and adults, respectively (P < 0.00001). The median presenting VA was logMAR 0.5 in children and logMAR 0.3 in adults (P = 0.0001), which improved significantly with treatment in both groups (P < 0.0001), but the final VA in eyes with Dua grade IV?VI burns was poorer in children (logMAR 1.3 versus logMAR 0.8, P = 0.04). Conclusion: The findings clearly delineate the at?risk groups, causative agents, clinical severity, and treatment outcomes of AOB. Increased awareness and data?driven targeted preventive strategies are needed to reduce the avoidable ocular morbidity in AOB
ABSTRACT
Purpose: To assess the need for spectacles and low?vision aids (LVA) in students attending schools for the blind and study their compliance with use. Methods: Comprehensive ocular evaluation was performed using a hand?held slit lamp and ophthalmoscope. Vision acuity was measured using a logarithm of the minimum angle of resolution (logMAR) chart for distance, as well as for near. Spectacles and LVAs were dispensed after refraction and LVA trial. Follow?up was performed to assess the vision using the LV Prasad Functional Vision Questionnaire (LVP?FVQ) along with compliance with use after 6 months. Results: Of the 456 students examined from six schools, 188 (41.2%) were female; 147 (32.2%) were <10 years of age. In all, 362 (79.4%) were blind since birth. The students dispensed only LVAs were 25 (5.5%), only spectacles were 55 (12.1%), and both spectacle and LVAs were 10 (2.2%). The vision improved using LVAs in 26 (5.7%) and using spectacles in 64 (9.6%). There was a significant improvement in LVP?FVQ scores (P < 0.001). Also, 68/90 students were available for follow?up, of whom 43 (63.2%) were compliant to use. Causes of not wearing spectacles or LVA in 25 were left somewhere or lost 13 (52%), broken 3 (12%), uncomfortable to use 6 (24%), not interested to use 2 (8%), and got operated 1 (4%). Conclusion: Although the dispensing of LVA and spectacles improved the visual acuity and vision function of 90/456 (19.7%) students, nearly a third were not using them after 6 months. Efforts need to be taken to improve the compliance of use
ABSTRACT
Aims: Dermatophytoses are commonest type of fungal infections seen in human beings, invading keratinised tissue skin, hair and nails by keratinophilic fungi. Dermatophytoses can be treated effectively by antifungals. Retrospective study A total of 200 patients which were Settings and Design: Methods and Material: referred from the department of dermatology to the department of microbiology were collected from July 2020 to June 2021. After cleaning with povidone iodine and 70% alcohol, the skin was scrapped, hair was plucked and nails were clipped. Skin, Hair and Nail were treated with 10%, 20% and 40% KOH respectively to identify septate hyphae and arthrospores. The specimen was cultured on Sabouraud's dextrose agar (SDA) with and without cycloheximide. Microscopic description of the growth was done by Lactophenol cotton blue (LPCB) staining. Antifungal susceptibility testing was done by E strip method using Rosewell Park memorial institute (RPMI) media for Ketoconazole, Itraconazole, Fluconazole, Voriconazole, Posaconazole, Griseofulvin and Terbina?ne. Out of 200 samples, the commonest age group affected was between (21-30 yrs) 39.5%. Female to Results: male ratio was 2.5:1.6. Tinea corporis was 63% and tinea cruris 27%. The commonest species isolated was Trichophyton rubrum 47.5%. Antifungal susceptibility test – Most susceptible to Itraconazole 81.4% and resistant to Griseofulvin 67.9%. Conclusions: Dermatophytosis is prevalent in high temperature zones. Most common isolates were T. rubrum and Trichophyton mentagrophytes in tinea cruris and tinea corporis respectively, they were most susceptible to Itraconazole and resistant to Griseofulvin. Resistance pattern of antifungal drugs helps in deciding empirical therapy for patient's better outcome.
ABSTRACT
Introduction: The aim of this study was to compare the fracture resistance of simulated immature teeth using four different apical plug materials, i.e. Pro? Root MTA, Neo? MTA Plus, Biodentine, and Bioactive Glass. Materials and Methods: 80 extracted human maxillary anterior teeth were divided into 4 groups for this study. They were prepared using Peeso reamers to simulate immature teeth and to mimic Cvek’s stage 3 of root development. A 5 mm apical barrier was placed using different materials. The remaining canal was obturated using gutta?percha and AH plus sealer. The final samples were stored at 37°C and 100% humidity for 4 weeks. Fracture resistance of the teeth was measured in Newtons using a universal testing machine. The comparison of fracture resistance between the four groups was done using Kruskal Walis ANOVA followed by post hoc Mann Whitney U test for pairwise comparison. Results: Biodentine group showed the highest fracture resistance as compared to the other three groups and the difference was highly significant (P < 0.001). Conclusions: Biodentine can be advocated over MTA as an effective material for the management of teeth with wide open apex. Bioactive glass also has shown promising results in increasing the fracture resistance of simulated immature teeth.
ABSTRACT
Purpose: The aim of this study is to determine if in vitro fertilization (IVF) is associated with an increase in the incidence of retinopathy of prematurity (ROP) among preterm infants. Methods: This retrospective, comparative study included all the preterm babies who were screened under an urban multicentric outreach project between April 2019 and August 2022. Infant details including gender, birth weight, mode of conception, single or multiple gestation, gestational age and post?menstrual age in weeks, age at presentation, and any presence of risk factors were recorded and analyzed. Results: Among 444 preterm babies included in the study, 373 (84%) were conceived normally and 71 (16%) were conceived by IVF. ROP was found in 99 (22.29%) babies in total. There was no significant difference in the incidence of any stage of ROP between the two groups; however, higher stages of ROP were found to be relatively more frequent in the spontaneous conception group in our study. We also found a statistically significant difference in the presence of ROP among singletons, twins, and triplets. Conclusion: IVF was found not to independently increase the risk of ROP in preterm infants. More prospective studies and randomized controlled trials are needed to establish the relationship between the mode of conception and development of severe ROP in preterm infants
ABSTRACT
Cleidocranial Dysplasia (CCD) is a rare autosomal dominant condition which is mainly characterised by skeletal abnormalties like hypoplastic or aplastic clavicles, increase in transverse diameter of the cranium, delayed closure of fontanelles with presence of open sutures and skeletal changes in maxilla and mandible. 2,4 These patients usually presents with delayed exfoliation of deciduous teeth, delayed or failed eruption of the permanent dentition with multiple supernumerary teeth, protruding mandible and mid- face retrusion.2 We present a case report of a 16 year old girl undergoing multiple surgical exposure of impacted permanent teeth under conscious sedation so as to move them in normal occlusion with orthodontic traction.
ABSTRACT
Background & objectives: India targets malaria elimination by 2030 in a phased manner, so malaria’s assured diagnosis is crucial. Introduction of rapid diagnostic kits in India in 2010 has revolutionized malaria surveillance. The storage temperature of rapid diagnostic tests (RDTs), kit components and handling in transportations impact the results of RDTs. Therefore, quality assurance (QA) is required before it reaches end-users. The Indian Council of Medical Research-National Institute of Malaria Research (ICMR-NIMR) has a World Health Organization (WHO) recognized lot-testing laboratory facility to assure the quality of RDTs. Methods: The ICMR-NIMR receives RDTs from different manufacturing companies as well as various agencies such as National and State Programmes and Central Medical Services Society. The WHO standard protocol is followed to conduct all the tests, including long-term and post-dispatch testing. Results: A total of 323 lots tested during January 2014-March 2021 were received from different agencies. Amongst them, 299 lots passed the quality of test and 24 failed. In long-term testing, 179 lots were tested and only nine failed. A total of 7741 RDTs were received from end-users for post-dispatch testing of which 7540 qualified the QA test with a score of 97.4 per cent. Interpretation & conclusions: RDTs received for quality testing showed compliance with QA evaluation of malaria RDTs based on the protocol recommended by the WHO. However, continuous monitoring of the quality of RDTs is required under QA programme. Quality-assured RDTs have a major role, especially in areas where low parasitaemia of parasites persists.
ABSTRACT
Oroxylum indicum (L.) Kurz, commonly called as Broken bones tree or Indian trumpet flower, belonging to Fam. Bignoniaceae, is traditionally used as a contraceptive by ethnic people of Tripura, North-East India. Here, we investigated the scientific basis for use of O. indicum as male antifertility agent by folklore healers. In vitro spermicidal activity of aqueous (AEOI) and methanolic (MEOI) extracts of O. indicum stem bark were studied on human sperm. The in vivo activity was experimented on male albino rats. The treated animals were allowed to mate and the pups delivered by female rat partners were counted. Phytochemical estimation of test samples was done using HPLC. The AEOI and MEOI treatments significantly decreased human sperm motility and viability. Test extracts have increased the hypo-osmotic swelling of sperm. Both the extracts were significantly declined the weight of reproductive organ. The MEOI treated rats have shown significant decrease in sperm motility and sperm counts. AEOI and MEOI treatment significantly reduced level of testosterone, but sharply raised dihydrotestosterone and prostaglandin in rats. Results testified the traditional claim for use of O. indicum as a male contraceptive agent, where MEOI have shown reversible action on male reproductive system leading to contraception without harming the libido.
ABSTRACT
Background@#Intraoral local anesthesia is essential for delivering dental care; however, injection of this local anesthetic is perceived as the most painful and distressing agent for children, parents, and healthcare providers.Reducing pain as much as possible is essential to ensure smooth subsequent treatment procedures, especially in pediatric dentistry. In clinical practice, oral sucrose administration has been reported to decrease the pain during heel lance and cold pressor tests in neonates and children. This study aimed to determine whether the prior administration of a 30% sucrose solution reduced the pain related to inferior alveolar nerve block in children. @*Methods@#A total of 42 healthy children aged 7–10 years requiring dental treatment of mandibular molars involving inferior alveolar nerve block were recruited. The participants’ demographic details were recorded, height and weight were measured, and the anesthetic injection was delivered after receiving the respective intraoral sucrose solution and distilled water by the intervention (group 1) and control (group 2) group participants for 2 min.The subjective pain perceived during injection was measured using an animated emoji scale. The pain scores between the groups were compared using the Mann–Whitney U test. @*Results@#The median pain score and range for the intervention and control groups were 4 (2 – 6) and 6 (4 – 8), respectively, and statistically significant differences (P < 0.001) were observed in the intervention group.Age, sex, height, and weight did not influence the analgesic effect of the sucrose solution. @*Conclusion@#Oral administration of sucrose may relieve pain associated with inferior alveolar nerve block in children.
ABSTRACT
Appendicitis has always been considered a clinical diagnosis wherein the surgeon’s clinical acumen and laboratory investigations take priority over the radiological imaging. However, an atypical presentation of appendicitis can occur due to the varying location of the appendix which may result in delayed diagnosis and complications. In such cases radiological imaging such as contrast enhanced computerized tomography helps in the diagnosis. We report two cases of subhepatic appendicitis with different clinical findings.
ABSTRACT
Background: Polycythaemia is defined as an increase in the hemoglobin above normal. This increase may be real or only apparent because of a decrease in plasma volume (spurious or relative polycythaemia) and the real polycythaemia can be because of primary due to genetic mutations or secondary due to increased erythropoietin production. The dominant symptoms from an increased red cell mass are related to hyper viscosity and thrombosis (both venous and arterial), because the blood viscosity increases logarithmically at hematocrits >55%. The present study aimed to characterize the different clinical presentations and to find out the complications associated with polycythaemia. Aim and objectives: To identify different clinical presentations of polycythaemia and to evaluate various etiologies of polycythaemia. Materials and methods: Patients with polycythaemia presented to OPD or in patient in the Department of General Medicine in Malllareddy Institute of Medical Sciences, Suraram from June 2020 to January 2022 were included. This was a descriptive observational study in which total of 24 patients were analyzed. Patients with polycythaemia (male Hb >16.5g/dl and females Hb>16.0g/dl) were included. Patients admitted with acute dehydration, sepsis and shock and other conditions leading to spurious polycythaemia and patient on diuretics were excluded. All the patients includedwho were found to have increased RBC mass not including patients from exclusion criteria. A detailed clinical history and physical examination was performed to identify clinical patterns of presentation and look for any complications, and necessary lab investigations were sent accordingly, to evaluate for the cause of polycythaemia. Results: A total of 24 patients were included in the study out of which 16 were males .and 8 were females. Polycythaemia Vera was found in 33% while secondary causes were seen in 67%, patients with polycythaemia vera were found to have more thrombotic complications and the mean age of presentation was in between 30- 40 years. Amongst the secondary causes COPD was the most common cause and smoking was the most common risk factor. Conclusion: Polycythaemia presents wide and varied clinical manifestations. polycythaemia rubra vera is a not an uncommon finding in patients presenting with symptoms of arterial or venous thrombosis, polycythaemia rubra vera is more commonly associated with thrombotic tendencies when compared to secondary causes of polycythaemia, when evaluating a case of polycythaemia it is necessary to look for signs and symptoms of secondary causes, to especially look for erythropoietin secreting tumors an high index clinical suspicion is required in such cases.
ABSTRACT
An 80-year-old systemically stable female presented with sudden blurring of vision post the first dose of Covishield™, a non-replicating viral vector vaccine. On examination, she was found to have bilateral serous choroidal effusions. A thorough systemic and ocular workup was performed to rule out other causes of choroidal effusion. The effusions resolved with tapering doses of oral and systemic steroids. To the best of our knowledge, at the time of submission, this is the first case of choroidal effusion being reported after the coronavirus disease 2019 (COVID-19) vaccine.
ABSTRACT
Introduction: Forensic odontology involves the collection, management, interpretation, evaluation, and presentation of dental evidence for criminal or civil legal proceedings, a combination of various aspects of the dental, scientific and legal professions. Bite mark analysis is an essential aspect of it that can significantly impact the courtroom or when considering the care of children and women deemed at risk. Materials and Methods: Data were obtained and analyzed from previously published literature and electronic database searches of relevant published literature from PubMed and Google Scholar. Forensic odontologists examine, interpret, analyze, and prepare reports on bruises or marks thought to be caused by teeth and, on occasion, are cross-examined in a court of law. Hence, they are considered essential in forensic dentistry in solving crimes to find either suspects or even victims in self-inflicted injuries as they are caused either by humans or animals that reveal biting edges, spacing, restorations, missing teeth, broken teeth, or supernumerary teeth unique to that individual. The main reasons for causation are sexual crimes, homicides, child abuse, and violent fights. There are many methods to analyze, that are classified into manual, semi-automatic, and automatic methods. Objectives: This review highlights the bite marks in detail about their characteristics, methods of collection and different methods of analysis and its applications in forensic odontology. Conclusion: This review shows different methods of analyzing bitemarks and explains the advantages, disadvantages, and limitations, and identifies which method is better advisable and adaptableforanalysis.
ABSTRACT
Introduction: Forensic odontology is an important and evolving branch. It has been established for critical issues like medi- colegal cases and identification of a dead person. Radiographic assisted documentation will provide objective information including the precise recording of the uniqueness of every individual where it has been used extensively in dental identification based on anatomy and by comparing maxillofacial skeletal landmarks in antemortem and post mortem records. Main body: Human Identification is mainly based on a dead body decomposition state. More likely of missing persons and the identification of individuals in conditions like criminal investigations and mass disasters. Odontological method for human identification is used commonly as it is simple by comparing with other methods, but complex in execution and requires skills and expertise. There are so many radiological techniques for forensic purposes like Computer tomography, cone-beam com- puter tomography, Orthopantomogram, 3D facial reconstruction, Radiovisiography, and Virtopsy. Objectives: This review highlights the different radiographic techniques and procedures and its application in forensic odon- tology. Source search criteria: Data were obtained and analyzed from previously published literature and electronic database search- es of relevant published literature from PubMed and Google Scholarfrom the 2001 to 2021 year. Conclusion: Imaging technologies and radiographs have become a vital component of modern medical practice and foren- sic odontology. The application of any of the mentioned techniques depends on the availability of previous images, data, or skeletal findings for Identification. So forensic radiology has a potential for crime-solving and is useful in conventional dental identification based on anatomy and by comparing maxillofacial skeletal landmarks in antemortem and post-mortem records, as they have become a crucial part of dental practice as well as in forensic odontology for diagnosis of disease, treatment plan- ning, identification of tooth structures, and age estimation.
ABSTRACT
In the present era of modernization and fast life, everybody is over busy and living a very stressful life. Faulty dietetic habits and sedentary life style is responsible for early degenerative changes in bodily tissue. As per Ayurveda, Greevastambha has been described under Vataj Nanatmaja Vikaras. Few Lakshanas of Kupitoanilah such as Pani-Prishta-Shirograha, Gatrasuptata, Greevaya-Hundanama, Bhedastoda-arti are the well-known features of Greevastambha. Greevastambha can be correlated with Cervical Spondylosis of modern medical sciences. Cervical Spondylosis is a degenerative condition of cervical spine that affects the vertebral bodies and intervertebral disc of the neck as well as contents of the spinal canal. It leads to pain and stiffness in neck, radiating pain into arm, headache, vertigo, dizziness, paraesthesia, numbness etc. Material and Methods- Patients fulfilling the diagnostic and inclusion criteria were selected for the present study from the OPD/IPD of our institute. The present study was carried out in a single group of 10 patients. In the present study, Snehana Nasya along with Greevabasti with Karpasasthyadi Taila was taken to evaluate the combined effect in the management of Greevastambha w.s.r. to Cervical Spondylosis. Result- Statistically significant results were observed in the present study.
ABSTRACT
India’s target of malaria elimination by 2030 may not be achieved solely by detecting Plasmodium falciparum and P. vivax, the two common Plasmodium species causing infections in humans. Sporadic reports have been documented on other Plasmodium species in the country, associated mostly with travel history. A febrile patient of Indian origin (Non-resident Indian (NRI)) was diagnosed with an infection of Plasmodium ovale curtisi malaria on his arrival from Sudan. A case report from Kerala was published in December 2020 and this is second report. Due to the inaccessibility of molecular techniques for routine diagnosis, this neglected non-falciparum malaria goes undetected. For an accurate diagnosis, suspected malaria cases should be tested using PCR and other advanced methods.
ABSTRACT
Background: The present study evaluated the correlation of hepatobiliary toxicity and radiation dose received in patients undergoing neoadjuvant chemoradiotherapy (NACRT) for locally advanced unresectable gall bladder cancers (LAGBC). Methods: Twenty-six patients with LAGBC, treated with NACRT (55–57 Gy/25 fractions/5 weeks and weekly gemcitabine 300 mg/m2) within a phase II study, were included. Whenever feasible, surgery was performed after NACRT. Acute and late hepatobiliary toxicity was recorded. Treatment scans were retrieved to delineate central porto-hepatobiliary system (CPHBS), resected liver surface, segment IV B and V, and duodenum. The doses received by these structures were recorded and correlated with toxicity. Results: Of 26 patients, 20 (77%) had partial or complete response and 12 (46%) had R0 resection. At the median follow-up of 38 months, overall survival was 38%. Eight (30%) patients had post-treatment toxicity, of which most common was biliary toxicity (30%). A correlation was observed between the biliary leak and V45Gy CPHBS >50 cm3 (P = 0.070). Higher toxicity was observed in those with metallic stents (P = 0.072). Conclusion: The incidence of the biliary leak was 46%. CPHBS dose was found to correlate with biliary leaks. Restricting V45Gy CPHBS <50 cm3 and using plastic stent may facilitate a reduction in hepatobiliary toxicity in patients undergoing NACRT and surgery.
ABSTRACT
Increased level of Fibrinogen is supposed to be a risk factor for Macrovascular disease. Insulin acutely increases Fibrinogen production in an individual with Type 2 Diabetes. There is a correlation between fibrinogen level and duration of Diabetes. Aim : To evaluate the levels of Plasma Fibrinogen and its association with Microalbuminuria and glycemic control in patients of Type 2 Diabetes Mellitus (T2DM). Materials and Methods : A hospital-based Cross-Sectional Study was conducted at the Department of Medicine, Bharati Hospital and Research Centre. The study aimed to evaluate the levels of plasma fibrinogen and its association with microalbuminuria and glycemic control in patients with T2DM. A total of 100 subjects (males and females) presenting with Diabetes Mellitus to our hospital were included in the study after informed consent. A detailed clinical history and relevant laboratory investigations were done. Statistical Analysis : The quantitative data was represented as their Mean盨D. Categorical and nominal data were expressed in percentage. The t-test was used for analysing quantitative data, or else non-parametric data were analysed by Mann Whitney test. All analysis was carried out by using SPSS software version 21. Results : Mean Fibrinogen level in study cases was 507.8 mg/dl with 26% had Fibrinogen levels of more than 500 mg/dl. Micro and Macro-albuminuria were seen in 25% and 9% cases. Mean Fibrinogen level was significantly more in cases with a duration of Diabetes 5 years, poor glycemic control and Microalbuminuria. Conclusion : Microalbuminuric Diabetic patients and poor Glycemic control patients showed higher fibrinogen levels. It can be concluded that Hyperfibrinogenaemia may precede the onset of Clinical Vascular Complications
ABSTRACT
Background:During hemodialysis there is decrease in both systolic blood pressure (SBP) and diastolic blood pressure (DBP) and hence Mean Arterial Pressure (MAP) due to decrease in body fluid volume. Due to reduc?on in MAP there is decrease in Mean Ocular Perfusion Pressure (MOPP) and also there is increase in IOP during dialysis. Objec?ve:To study changes in MOPP and IOP among pa?ents undergoing hemodialysis Methods:An observa?onal study was carried out among 100 pa?ents undergoing hemodialysis Under asep?c condi?on, Proparacaine eye drops were ins?lled in both eyes, IOP was measured by Schiotz Indenta?on Tonometer 30 min before, during hemodialysis and 30 min a?er hemodialysis in supine posi?on. Tonometer was sterilized by Isopropyl alcohol and was washed with normal saline before using on next pa?ent. Systolic and diastolic blood pressure were measured by using sphygmomanometer 30 min before, during and 30 min a?er hemodialysis. Results:The varia?ons in the SBP, DBP and MAP before, during and a?er hemodialysis were not sta?s?cally significant (p>0.05). There was significant differences for IOP between before, during and a?er hemodialysis and same for MOPP except before and 30 min a?er hemodialysis (p < 0.0001). Conclusion:Significant fluctua?ons were seen from the present study in the intra-ocular pressure and mean ocular perfusion pressure during, before and a?er hemodialysis.