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ABSTRACT Objective: Data regarding rare FPAs from India, a resource limited setting, are limited. We describe a case series of rare FPAs from a single center in western India. Materials and methods: This was a retrospective case record review of patients diagnosed between January 2010 and July 2022. The diagnosis was based on biochemical (inappropriately elevated serum FSH/LH) and pathologic (positive immunostaining for FSH/LH) features in patients with FGA, and elevated serum thyroid hormones and normal/elevated TSH in patients with TSHomas. Results: We identified 11 patients with a total of six FGAs (median age 43.5 years, five men, one FGA cosecreting TSH, median largest dimension 40 mm, range 33-60 mm) and six TSHomas (median age 34.5 years, four women, two TSHomas cosecreting GH, median largest dimension 42.5 mm, range 13-60 mm). Symptoms of sellar mass effects led to pituitary imaging in most patients with FGA. Patients with TSHomas had symptoms of excess hormone secretion (GH/TSH) or sellar mass effects. The TSHomas that cosecreted GH/FSH were larger than those secreting only TSH. Transsphenoidal resection was the most common first-line therapy but significant residual disease was frequent (3 out of 6 FGAs and 4 out of 5 TSHomas). Conclusion: This is the first and second case series of FGAs and TSHomas, respectively, from India. In this study, TSHomas presented at younger age, were larger and had low surgical cure rates.
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Purpose: To determine agreement between diurnal variation testing (DVT) of intraocular pressure (IOP) with Goldmann applanation tonometer (GAT) and iCare HOME (IH) by an optometrist (OP) and home monitoring by participants (PT). Methods: Patients (18–80 years) with glaucoma and suspects were enrolled. IH IOP and GAT were taken by an OP at 2 h intervals from 8 AM to 4 PM on Day 1 and PT between 6 AM and 9 PM, for the next 2 days. IOP, date, and time were viewed via iCare LINK software. Results: In total, 72.9% (51/70) PT trained were able to take reliable readings. One hundred two eyes (51 patients, age 53 ± 16 yrs) were analyzed. Correlation between optometrist (OP) and participants (PT) was strong and positive {IH OP?IH PT? r = 0.90, p?0.0001;IH PT?GAT? r = 0.79, p?0.0001}. Agreement by Bland Altman plots was limited {IH OP?IH PT mean 0.1 mmHg (95% LOA ?5.3 to 5.5), IH PT?GAT 2.2 mmHg (?5.7 to 10.1)}. Intraclass correlation coefficient for IH OP?IH PT was 1.18 (95% CI 1.37?1.09). Intradevice {0.95 (95% CI 0.94?0.97)} and interrater repeatability {0.91 (0.79–0.96)} were good. 37% of eyes had a synchronous peak on GAT and IH during the day DVT. Conclusion: Home tonometry by iCare HOME is easy, feasible, but due to limited agreement cannot substitute GAT DVT.
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Objective: To describe the characteristics of gonadotropin-dependent precocious puberty (GDPP) in Indian children. Methods: Clinical profiles of GDPP (n=78, 61 females) and premature thelarche (n=12) from a single center in Western India were retrospectively studied. Results: Pubertal onset was earlier in boys than girls (29 vs 75 months, respectively; P=0.008). The basal luteinizing hormone (LH) was ?0.3 mIU/mL, except 18% of GDPP girls. At 60 minutes after GnRHa-stimulation, all patients (except one girl) had LH ?5 mIU/mL. The GnRHa-stimulated LH/FSH ratio was ?0.34 at 60 minutes in girls with GDPP unlike premature thelarche. Only one girl had an allergic reaction to long-acting GnRH agonist. Among GnRH agonist-treated girls (n=24), the predicted final adult height was -1.67±1.5 SDS, whereas the attained final height was -0.25±1.48 SDS. Conclusion: We establish the safety and efficacy of long acting GnRH agonist therapy in Indian children with GDPP. The 60-minute stimulated serum LH/FSH of ?0.34 differentiated GDPP from premature thelarche.
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Purpose: Comparison of the conjunctiva related complication rates and success rates among eyes with Ahmed glaucoma valve (AGV) implantation in which eye bank derived scleral and corneal patch grafts had been used to cover the tube. Methods: Retrospective comparative study. Patients who underwent AGV implantation between January 2000 to December 2016 were included. Demographic, clinical data, intra and post operative data was obtained from electronic medical records. Conjunctiva related complications were divided into two groups: with and without implant exposure. Conjunctiva related complication rates, success rate, risk factors among eyes with corneal and scleral patch graft were compared. Results: Three hundred and twenty three eyes of 316 patients underwent AGV implantation. Scleral patch graft was used in 214 eyes of 210 patients (65.9%) and corneal patch graft was used in 109 eyes of 107 patients (34%). Median follow up was 14 months. There was no significant difference in the conjunctiva related complication rate (7.3 % in corneal patch graft versus 7.0% in scleral patch graft;p=0.5) and conjunctival dehiscence rate (3.7% versus 4.6%, P = 0.7) among the two groups. Success rate was significantly higher in the corneal patch graft group versus the scleral patch graft group (98% versus 72%; p=0.001). Eyes with corneal patch graft had a higher survival rate (P = 0.01). Conclusion: There was no significant difference in the rate of conjunctiva related complications following corneal and scleral patch grafts used to cover the AGV tube. Eyes with corneal patch graft had a higher success rate and survival rate.
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Background: In 1972, Dr Sharp and colleagues described a new connective tissue disease, characterized by overlapping features of systemic lupus erythematosus (SLE), systemic sclerosis (SSc), and polymyositis/ dermatomyositis (PM/DM) and by the presence of antibodies against the U1 small nuclear ribonucleoprotein autoantigen (U1 snRNP). This condition was termed mixed connective tissue disease (MCTD) and proposed as a distinct disease. Later, after observing the clinical evolution of MCTD patients, Sharp himself agreed that the original concept of MCTD had to be modified and that Internal organs were at risk for serious complications; patients were not always steroid responsive; prognosis was not always benign. Materials and methods: Patients in the age group of 15-50 years diagnosed to have connective tissue diseases were included. 8 patients in the age group of 15-50 admitted in Medicine department were taken and they were evaluated for the clinical profile of sharp syndrome by thorough clinical examination, routine laboratory tests and special investigations depending on the clinical profile. Results: 8 patients with connective tissue disease attending the medicine OPD were studied. Of these 8 patients were female patients. The median age of onset was 36 years, 8 patients met criteria by sharp and Alarcon-Segovia. The clinical features of patients at presentation are Raynaud抯 phenomena, Puffy fingers, esophagus dysmotility, skin rash, interstitial lung disease, arthritis, pulmonary hypertension, myositis, anemia. Conclusion: SHARP syndrome is a rare condition, as evidenced by the small series of cases reported to date. Diagnosis is based on clinical and paraclinical criteria. The evolution can be interspersed with various complications that can affect the short, medium and long-term prognosis
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Background: There is a substantial increase in the coincidence of diabetes mellitus and cardiomyopathy. The cardiomyopathy may occur in patients who have no evidence of large vessel disease or abnormalities. The early and commonest hemodynamic derangement of diabetic cardiomyopathy is left ventricular diastolic dysfunction. So, the present study was undertaken to assess the prevalence of diastolic dysfunction in patients with type 2 diabetes and to assess the correlation of diastolic dysfunction and HbA1c% levels. Materials and methods: A total of 100 diabetic patients with minimum 5 years duration of diabetes were selected from Malla Reddy Hospital, Suraram from August 2020 to June 2022. Patients with minimum history of 5 years of type 2 diabetes were scrutinized for Doppler echo cardiography and HbA1c levels. Results: Diastolic dysfunction of left ventricle was observed in 58 patients out of 100, of which 54 (93.1%) patients had HbA1c% of > 6.4. 2 (3.4%) patients belong to HbA1c% group of 5.7-6.4. and 2(3.4%) patients belong to HbA1c% of < 5. Conclusion: Our findings indicate that myocardial damage in patients with diabetes affects diastolic function before systolic function. Diabetic cardiomyopathy is characterized by an early diastolic dysfunction and a later systolic dysfunction. Impaired diastolic function was not affected by sex or type of diabetes. Even young patients with diabetics with normal systolic ventricular function have diastolic dysfunction, which serves as a marker of a diabetic cardiomyopathy. Diastolic seems not to correlate with disease duration. HbA1c% can be a very good indicator of long term prognosis. Strong corelation exists between diastolic dysfunction and HbA1c.
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Objective@#To determine the level of knowledge and factors affecting knowledge and satisfaction with diabetes care among persons with diabetes at urban health centre (UHC) and community health worker (CHW)-led outreach clinics (ORC) in South India.@*Methodology@#A cross-sectional study was carried out using a structured questionnaire. One hundred patients at the UHC and 200 patients at the ORC were included.@*Results@#Patients with DM of more than eight years, with co-morbidities and maintained on insulin had good knowledge at the UHC. At the ORC, participants who received education beyond the primary level and belonging to non - Hindu religion had higher knowledge. Patients at the ORC experienced better satisfaction in terms of waiting time for appointments, consultation, registration system and counselling. At the UHC, those who received primary education or those with lower educational attainment had better satisfaction. Overall, knowledge (p=0.03) and satisfaction (p=0.00001) of diabetes care was better at the ORC than at the UHC.@*Conclusions@#Our study found better knowledge and satisfaction with diabetes care at the ORC than at the UHC. Whether or not the difference can be attributed to CHW-based clinics in the community needs to be further elucidated.
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Community Health Workers , Primary Health Care , Knowledge , Personal SatisfactionABSTRACT
ABSTRACT BACKGROUND: Acute appendicitis is a common surgical emergency worldwide. Recent studies on hematological inflammatory markers concerning acute appendicitis have shown variable results. AIMS: The aim of this study was to evaluate pre-operative values of platelet indices such as mean platelet volume (MPV) and platelet distribution width (PDW), and red cell distribution width (RDW) in relation to the diagnosis of acute appendicitis and their efficacy as predictors of appendicular perforation. METHODS: A prospective observational study of 190 patients diagnosed with appendicitis and who underwent an appendectomy was undertaken and confirmed histopathologically. Preoperatively, blood samples of white blood cells (WBCs), platelet count, MPV, PDW, and RDW were analyzed using a Sysmex XN1000 analyzer machine. RESULTS: Of 190 patients, 169 had acute appendicitis, and 21 had perforated appendicitis. The mean age of patients was 28.04 ± 14.2 years. The male-to-female ratio was 1.5:1. The WBC (p<0.05), MPV (p<0.05), and PDW (p<0.05) were found to have higher statistically significant values in acute appendicitis and perforated appendicitis compared to the RDW (p>0.05). However, perforated appendicitis had a higher RDW value compared to acute appendicitis, which can be a predictive factor. CONCLUSIONS: The elevated value of MPV and PDW associated with leukocytosis can be used as supportive evidence for the clinical and radiological diagnosis of acute appendicitis and appendicular perforation. Thus, these values can be used as diagnostic cost-effective inflammatory biomarkers.
RESUMO RACIONAL: A apendicite aguda é uma emergência cirúrgica comum em todo o mundo. Estudos recentes sobre marcadores inflamatórios hematológicos relacionados à apendicite aguda mostraram resultados variáveis. OBJETIVOS: Avaliar valores pré-operatórios de índices plaquetários como volume médio de plaquetas (VPM) e largura de distribuição de plaquetas (PDW), largura de distribuição de hemácias (RDW) em relação ao diagnóstico de apendicite aguda e sua eficácia como preditores de apendicite perfuração. MÉTODOS: Estudo observacional prospectivo de 190 pacientes diagnosticados com apendicite e submetidos a apendicectomia confirmados histopatologicamente. Amostras de sangue pré-operatórias de glóbulos brancos (WBC), contagem de plaquetas, volume plaquetário médio (MPV), distribuição das plaquetas (PDW) e distribuição dos glóbulos vermelhos (RDW) foram analisadas usando uma máquina analisadora Sysmex XN1000. RESULTADOS: Foram incluídos 190 pacientes, sendo que 169 tiveram apendicite aguda e 21 tiveram apendicite perfurada. A média de idade dos pacientes foi de 28,04 ± 14,2. A proporção homem-mulher foi de 1,5:1. Verificou-se que WBC (p<0,05), MPV (p<0,05) e PDW (p<;0,05) têm valores estatisticamente significativos mais altos na apendicite aguda e na apendicite perfurada em comparação com o RDW (p> 0,05). No entanto, a apendicite perfurada apresentou um valor de RDW maior em comparação com a apendicite aguda, o que pode ser um fator preditivo. CONCLUSÕES: O valor elevado de MPV e PDW associado à leucocitose pode ser usado como evidência de suporte para o diagnóstico clínico e radiológico de apendicite aguda e perfuração apendicular. Assim, esses valors podem ser usado como biomarcadores inflamatórios diagnósticos de baixo custo.
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Purpose: To compare outcomes of surgical management of uveitic glaucoma (UG) and steroid?induced glaucoma (SIG) in children in terms of intraocular pressure (IOP) control, visual acuity, and associations for failure. Methods: This was a retrospective case–control study of consecutive UG (cases) and non?uveitic SIG (controls) in children <18 years of age who underwent surgery between January 2005 and December 2017. Results: Primary trabeculectomy with mitomycin C (MMC) was performed in 12 cases (mean age: 9.2 ± 4.3 years) and 40 controls (mean age: 10.4 ± 3.7 years) (P = 0.33). Primary phaco?trabeculectomy with MMC was performed in 11 cases (mean age: 11.4 ± 4.7 years) and 16 controls (mean age: 10.4 ± 3.4 years) (P = 0.57). IOP control (P = 0.26), visual acuity (P = 0.97), number of glaucoma medications (P = 0.06), and survival rates (49% cases vs. 68% controls at 5 years; P = 0.22) were similar between the two groups following trabeculectomy. Survival rates in the phaco?trabeculectomy group at 5 years were 68% cases vs. 69% controls (P = 0.71). IOP was higher (P = 0.008) and visual acuity was worse (P = 0.02) in cases at the last visit. Associations for failure (univariate analysis) were younger age (OR: 6.29, 95% CL: 1.43, 27.67; P = 0.03) and male gender (OR: 4.79, 95% CL: 1.09, 20.97; P = 0.04). On multivariate analysis, younger age (OR: 11.985, 95% CL: 1.071, 134.153; P = 0.04) remained significant. Preoperative number of uveitic attacks was protective on univariate (OR: 0.75, 95% CL: 0.48, 1.15; P = 0.1) and multivariate analyses (OR: 0.49, 95% CL: 0.24, 0.09; P = 0.04). Conclusion: Outcomes of trabeculectomy between cases and controls were similar in our series. However, phaco?trabeculectomy in pediatric uveitic eye group fared worse than eyes with SIG.
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Maternal SARS-CoV-2 infection can adversely afect the birth and neonatal outcomes. The authors prospectively enrolled 196 neonates born to 193 SARS-CoV-2–positive mothers to determine the rate of mother-to-baby transmission of SARSCoV-2 and its efect on short-term neonatal outcomes in Indian population. Nineteen babies turned out to be RT-PCR– positive for SARS-CoV-2, carrying a perinatal transmission rate of 9.8%. Rates of prematurity and low birth weight were 12.8% and 18.9% in the neonatal group, respectively. On comparing SARS-CoV-2–positive (n=19) and negative (n=177) neonatal groups, rate of prematurity, hospital admission rate, and death rate were higher in the former group. The placental positivity rate for SARS-CoV-2 was 8.1%, but no relation was found between placental and neonatal infection.
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In Purpose: The fabrication technique can influence the mechanical properties of Cobalt-Chromium (Co-Cr) dental alloys. Hence, the present study aims to determine the corrosion resistance and thermal expansion of alloys manufactured using three contemporary techniques. Material and Methods: A total of nine specimens of Co-Cr alloy were prepared according to ISO 22674 by each one of the three manufacturing processes (three in each process); conventional casting, direct metal laser sintering (DMLS) and milling (MIL). All these specimens were tested for coefficient of thermal expansion and corrosion resistance. The data was tabulated and analyzed statistically. Results: The difference in the thermal expansion of alloys fabricated using three techniques was non-significant at almost all the temperatures from 50 ºC to 950 ºC (p>0.05), except 450 ºC and 600 °C. The polarization resistance of specimens manufactured using the conventional method was more compared to DMLS and MIL at pH 5 (Conventional>MIL>DMLS) (p<0.001). Conclusion: The thermal expansion behavior of alloys manufactured using the three selected techniques were similar, whereas, at acidic pH, the corrosion resistance of conventional and MIL were better than the DMLS.
Antecedentes: La técnica de fabricación puede influir en las propiedades mecánicas de las aleaciones dentales de cobalto-cromo (Co-Cr). Por lo tanto, el presente estudio tiene como objetivo determinar la resistencia a la corrosión y la expansión térmica de aleaciones fabricadas con tres técnicas contemporáneas. Material y Métodos: Se prepararon un total de nueve probetas de aleación de Co-Cr según ISO 22674 por cada uno de los tres procesos de fabricación (tres en cada proceso); fundición convencional, sinterización directa de metal por láser (DMLS) y fresado (MIL). Todos estos especímenes fueron probados para determinar el coeficiente de expansión térmica y la resistencia a la corrosión. Los datos fueron tabulados y analizados estadísticamente. Resultados: La diferencia en la dilatación térmica de las aleaciones fabricadas con las tres técnicas no fue significativa en casi todas las temperaturas desde 50ºC hasta 950ºC (p>0,05), excepto 450ºC y 600ºC. La resistencia a la polarización de las muestras fabricadas con el método convencional fue mayor en comparación con DMLS y MIL a pH 5 (Convencional>MIL>DMLS) (p<0, 0 01). Conclusión: El comportamiento de expansión térmica de las aleaciones fabricadas con las tres técnicas seleccionadas fue similar, mientras que, a pH ácido, la resistencia a la corrosión de la convencional y la MIL fue mejor que la de la DMLS.
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Humans , Temperature , Chromium Alloys , Corrosion , Dental Alloys , Surface Properties , In Vitro Techniques , Chromium/chemistry , Cobalt/chemistry , LasersABSTRACT
Proptosis, the forward protrusion of the eyeball, is a common manifestation of a wide variety of diseases inside the orbit and its spaces. The causes of unilateral proptosis are innumerable and its evaluation requires a multidisciplinary approach. Paranasal sinus mucoceles are epithelium-lined cystic masses usually resulting from obstruction of sinus ostia. The close proximity of paranasal sinus mucoceles to the orbit and skull base predispose patients to significant morbidity. Primary ethmoid mucocele is an uncommon entity, especially in the absence of prior ear, nose and throat complaints, and therefore should remain an important differential when a patient presents with a unilateral swelling causing proptosis. Herein, we report an unusual case of a primary frontoethmoid mucocele in a 35 years old woman who presented with a painless swelling with an obvious displacement of the left eye since 1 year, associated with restriction of ocular movements, thus prompting radio imaging of orbits. The results showed a large well-defined expansile lesion suggestive of Left Eye frontoethmoidal mucocele, prompting an immediate surgical referral.
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Pituitary adenomas are rare neoplasms with a propensity for unusual presentations and an aggressive clinical course. An 8 years old female child presented to Department of Ophthalmology at SVS Medical College and Hospital Mahabubnagar with the chief complaints of mild ptosis of RE since 1month, associated with fever, headache, vomiting and diplopia since 2 days. On ocular examination, BCVA in BE - 6/9 and anterior segment examination suggested RE mild ptosis with hypotropia and adduction restriction. Fundus examination was normal. There was no palpable mass/ bruit in the orbit. MRI revealed lobulated enhancing soft tissue lesion in sella and parasellar region extending into basifrontal region causing pressure over optic chiasm, 3rd ventricle and cavernous sinuses suggestive of pituitary macroadenoma. Hormonal essays revealed elevated prolactin, beta HCG levels and abnormal thyroid profile. On the basis of clinical examination and investigations a clinical diagnosis of pituitary macroadenoma was made. Then the case was referred to department of neurosurgery where transphenoidal resection under GA was planned and after 2days of admission she had a respiratory arrest and could not be resuscitated.
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Background: Sleep is an essential component of human life because it provides for relaxation and recovery from the stresses of everyday living. Reduced sleep quantity or quality leads to sleep deprivation which may offer indirect dangers by affecting cognitive and physical performance and raising the chance of motor vehicle and occupational accidents. Insomnia chronic sleep debt snoring sleep apnea circadian rhythm disturbances (including shift work syndrome) RLS parasomnias and uncommon diseases such as narcolepsy are the most common sleep disorders found in sleep clinics according to experts. Obstructive Sleep apnea is a common disorder in which your breathing stops and starts periodically while you sleep. To determine the design and validation of an Integrated Yoga Module (IYM) for OSA patients. The ?rst phase - IYM for OSA - was created based on a survey of classic books and Materials and Procedures: recently available research studies. The designed IYM was validated by 20 subject matter (yoga) experts in the second phase. Lawshe's formula was used to calculate the content-validity ratio (CVR). Yoga practices were created for the OSA Results: Integrated Yoga Module. The ?nal Integrated Yoga Module featured yoga practises with CVR ?0.5 that were assessed by 20 yoga experts and agreed in faculty group discussion. The yoga practices were designed and validated for IYM for Conclusion: OSA. By applying Lawshe's content validity criteria 20 yoga professionals veri?ed the IYM design.
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Arsha's is one among the Astamahagada, and a commonest ano-rectal disease with a wide range of symptoms. It affects all economic groups of the population. In Ayurveda, Arsha's is a growth of Mamsa with obstructs the anal opening. Anatomically anal canal is 51/2 Angula's length. A faulty lifestyle and dietary habits along with occupational and physical stress triggers the pathology of Arsha's. Doshic involvement includes Rakta along with Mamsa dhatu at Rakthavaha Dahmanis of Guda, which forms as Mamsa Ankura. Acharya Susrutha mentioned 4 curative measures for the treatment, they are Bhesaja, Kshara karma, Agni karma, Shastra karma. Hemorrhoids are dilated rectal veins. Thrombosed piles occur where there is high venous pressure, which is associated with severe pain, which hampers their daily routine, thereby they avoid defecation which leads to hardening of stool, constipation and rectal bleeding. The treatment includes the surgical excision of the thrombosed pile mass. A case study of thrombosed pile treated with Jaloukavacharana (leech therapy) has been recorded which has reduced the mass, pain, bleeding per rectum
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Thyroid Eye Disease also known as Thyroid Associated Orbitopathy, Grave’s Disease is typically a self-limiting autoimmune process associated with dysthyroid states usually manifesting in middle age. The clinical presentation may vary from very mild disease to severe irreversible sight threatening complications. Primary risk factors for TED are environmental influences especially smoking, previous pathogen exposures, stress, previous use of radio iodine and complex genetic components. Here we report a case of 25-year-old male who presented to our OPD with complaints of swelling of eyes, photophobia, lacrimation since 3days. Bilateral mild proptosis, severe congestion and conjunctival injection with 20/20 vision in both eyes were noted on examination. Blood investigations showed Eu-clinical Thyroid state whereas MRI Brain and Orbits showed all four Recti muscle belly enlargement. This case emphasizes one of the rare presentations of TED in accordance to Age, Sex and Clinical status of the thyroid.
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Purpose: Idiopathic elevated episcleral venous pressure (IEEVP) is a rare cause of secondary glaucoma and is a diagnosis of exclusion. The aim of this study was to describe the clinical presentation and analyze the outcomes of medical and surgical management in eyes diagnosed with idiopathic elevated episcleral venous pressure. Methods: A retrospective analysis of eyes diagnosed with IEEVP over a 5?year period between April 2012 and March 2016 was performed. The demographic details, medical history, and clinical course of the cases were obtained from the medical records. Data pertaining to the severity of glaucomatous damage, response to medical management, need for surgical intervention, and their outcomes were analyzed. Results: Fifteen eyes of 13 patients were included. Thirteen eyes (86.6%) had open angle configuration. Among the 13 eyes that had glaucoma, eight eyes (61.5%) had severe glaucoma, four eyes (30.7%) had moderate glaucoma, and one eye (7.6%) had mild glaucoma. The median follow?up was 210 days. Seven of the 15 eyes (46.6%) required a glaucoma filtration procedure, and three underwent prophylactic sclerotomies. 71.4% of these eyes had complete success. One out of the seven operated eyes required choroidal drainage post?operatively. Conclusion: IEEVP is an extremely rare condition and presents with raised intra?ocular pressure and tortuous episcleral vessels. The management of IEEVP is similar to that of primary open angle glaucoma. Uveal effusion is to be anticipated, and hence, combining trabeculectomy with prophylactic sclerotomies is advisable.
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Background: Advances in oral and periodontal disease diagnostic research are moving towards methods wherein periodontal risk can be identified and quantified by objective measures such as bio?markers. Given the roles of vitamin D binding protein (DBP) in modulating the immune response and in the transport of vitamin D, it is hypothesised that quantitative changes of vitamin DBP are associated with periodontal disease. Aim: The aim of the current study is to measure DBP levels in serum and gingival crevicular fluid (GCF) of patients with generalised chronic periodontitis, in comparison to healthy controls. Materials and Methods: The present cross?sectional clinico?bio?chemical study includes 30 systemically healthy subjects with 15 periodontally healthy and 15 chronic periodontitis subjects who were recruited from the out?patient Department of Periodontics. GCF and blood samples were collected from all the patients. DBP estimation was performed in both the samples using a commercially available ELISA kit. Results: Serum and GCF DBP levels in chronic periodontitis subjects were significantly higher when compared to the periodontally healthy group. There were no significant correlations found among serum and GCF DBP levels with gender and increasing age in both the groups. An increase in disease severity measured by the increase in probing pocket depth and clinical attachment loss did not show correlation with the GCF and serum DBP levels in the chronic periodontitis group. Conclusion: Based on the findings of the present study, increased serum and GCF DBP levels in chronic periodontitis seem to be a probable marker for identifying ongoing periodontal destruction.
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Purpose: To evaluate the incidence of shallow anterior chamber in the early postoperative period following Ahmed glaucoma valve (AGV) implantation and its effect on the hypertensive phase (HP), intermediate-term intraocular pressure (IOP) control, and success rate. Methods: A retrospective analysis of 369 eyes of 360 patients who underwent AGV implantation between January 2005 and January 2020 with a minimum follow-up of 2 months was performed. Twenty-six patients developed shallow anterior chamber (AC) within 8 weeks following surgery (cases). They were compared with 39 randomly selected controls (no shallow AC post AGV). HP (IOP spike >21 mmHg), use of ocular hypotensive medications, and other associations were compared. Results: Incidence of shallow AC post AGV was 7% (95% confidence interval [CI] 4, 9). The onset of shallow AC was 3 ± 2.1 days and resolved within 6 ± 4.7 days. Hypotony (12 [47%] vs. 1 [2.5%], P 0.0001) and choroidal detachment (CD; 7 [27%] vs. 3 [8%], P 0.03) were more common in cases compared to controls. The HP occurred in 11 (43%) cases versus 13 (34%) controls (P 0.4). Cases required more ocular hypotensive medications than controls at the end of 8 weeks (1.1 ± 1 vs. 0.5 ± 0.5, P 0.01). There was no significant difference in the qualified success between the groups at 1 year. Conclusion: The development of postoperative shallow AC post AGV implantation was not detrimental to IOP control at 1 year. However, there is a need to monitor the occurrence of HP in these eyes.
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Background: A group of heterogenous entities having the common clinical feature of altered facial pigmentation have been informally called as facial melanoses. Since, the cosmetic disfigurement is easily visible, it has a lot of impact on the psychological well being of the person. To assess the patients of facial hyper Aim: pigmentary disorders for demographic , etiological and clinical profile. A prospective clinical study was conducted in a tertiary care ce Methods: nter in Ananthapuram over period of 6 months. 100 patients with facial hyper pigmentary disorders were assessed by detailed history and clinical examination. In our study, most common age group Results: which sought treatment was 30-50 years. Female were predominantly affected. five different facial melanosis were observed which included melasma, postinfiammatory hyperpigmentation, reihl's melanosis, exogenous ochronosis,topical steroid damaged face. Reihl's melanosis was the most common disorder reported by 30 patients out of 100. Limitations: Dermoscopy could not be done to resource constraint. Conclusion: Increase in awareness and concern with appearance has led to an increase in reported incidence of facial melanosis in both sexes. Prior application of over-the-counter products poses difficulty in correct evaluation and treatment. Psychological evaluation forms an integral part of the treatment of these patients.