CLINICAL EVALUATION OF INTRAOCULAR PRESSURE MEASUREMENTS USING DIFFERENT TONOMETERS IN PATIENTS OF VARIOUS REFRACTIVE ERRORS

Background: Intraocular pressure (IOP)is an important ?rst indicator of probability and suspicion of Glaucoma. The virtual IOP status is grossly in?uenced by multiple factors including Refractive errors ,corneal biomechanics ,central corneal thickness(CCT) and Scleral rigidity. To compare relative IOP measurements and Aim: its variability in Emmetropes, myopic and hypermetropic patients using Schiotz, Goldmann Applanation(GAT)and I-Care Rebound tonometer to establish an equation between virtual and real time IOP. This observational Materials and Methods: prospective study comprised of 100 subjects above the age of 18 years inclusive37 Emmetropes , 31 Hypermetropes and remaining 32 belonged to myopia . Descriptive statistics were performed using SPSS for Windows Statistical Analysis : version 17.0 to calculate the demographic characteristics of the study cohort. The data were expressed as mean values including the standard deviation (SD) and the 95% con?dence interval (CI). Mean IOP measurements between Schiotz, I-Care and GAT were compared by One way ANOVA along with Individual pair wise comparison by applying Post Hoc Tukey Test for comparison of IOP measurements using a particular method of Tonometry in individuals of myopia, hypermetropia and emmetropia. The highest mean value of CCT 536.667 mum was in Hypermetropes whereas the lowest CCT value of Results: 507.031mum was in myopic eyes with statistically signi?cant (P<0.05). The mean value for IOP in Emmetropes was16.665 mm Hg for Schiotz , 15.027 Hg for GAT and 15.081 mm Hg for I –Care .Whereas Hypermetropes revealed mean value of 15.055 mm Hg for Schiotz , 14.323 mm Hg for GAT and 14.065 mm Hg for I –Care . The mean value for IOP in Myopic eyes was 16.875 mm Hg for Schiotz , 14.375 mm Hg for GAT and 14.688 mm Hg for I –Care . The study had revealed higher mean Conclusion : value of IOP in Myopic eyes as compare to Emetropic and Hypermetropic subjects.IOP measurements by the Schiotz tonometer were signi?cantly higher as compare to GAT and I-Care tonometer. Whereas recordings by GAT and I Care tonometers were almost in agreement .De?nitive correlation could not be established between pachymetry readings and adjusted IOP following GAT and I –Care tonometry .

Left ventricular dissecting hematoma caused by tissue stabilizer

Abstract Coronary artery bypass grafting is a commonly performed procedure for coronary revascularization. We describe the successful management of left ventricular dissecting hematoma, caused by the tissue stabilizer, while performing off-pump coronary artery bypass graft procedure.

Boswellia serrata Roxb. ex Colebr. Derived Phytochemicals against Skin Disease

Phytochemicals from Boswellia serrata Roxb. ex Colebr plant extract are traditionally used to cure skin disease. It is caused by Staphylococcus aureus. Molecular docking method applied using “Biovia Discovery Studio”. “High positive values of -CDOCKER energy and -CDOCKER interaction energy” suggested that P-cymene can effectively deactivate the shikimate dehydrogenase enzyme thereby interrupting the life cycle of the organism

Primary lumbar hernia: a rarely encountered ventral hernia

Ventral hernia is a fascial defect located on the abdominal wall. Primary ventral hernias are named as umbilical, epigastric, spigelian and lumbar hernias. A lumbar hernia is a parietal wall defect that may occur anywhere in the lumbar region between the 12th rib and the iliac crest. A 47-year-old female, came with complaints of mass in left lower abdomen since 2 months. On clinical examination a defect of 8 × 8 cm was felt in the left lumbar region with positive cough impulse. CECT abdomen and pelvis was done to confirm lumbar hernia. Patient underwent mesh repair for the same. Lumbar and flank hernias are uncommon and are a challenge to treat for any general surgeon. Surgery is considered gold standard either an open mesh repair or laparoscopically.

Primary mediastinal hydatid cyst causing diaphragmatic palsy

Abstract Hydatid cystic disease is a significant clinical problem in endemic countries. Hydatid cysts are most commonly located in the liver and lungs. Primary mediastinal hydatid cyst is a rare clinical entity. The diagnosis must be considered in a patient with a mediastinal mass, particularly in endemic regions. Mediastinal hydatid cysts causing paralysis of phrenic and recurrent laryngeal nerves have been rarely reported. We describe a rare case of primary mediastinal hydatid cyst associated with diaphragmatic palsy caused by compression of the left phrenic nerve, which was successfully treated with partial cystectomy and capitonnage with hemidiaphragmatic plication.

Effect of Dhat Syndrome on Body and Mind

Introduction: Physical and mental issues related with loss ofsemen or "dhat" results in a disorder called as Dhat syndrome.It is a culture-bound disorder portrayed by unseemly and overthe top pain of losing semen from one's body. Aim: The aimof the study was to find the socio-demographic determinantsassociated with this disorder along with finding out variousphysical complaints and co-morbid psychiatric disorders. Thestudy also focused on evaluating the quality of life of patients.Material and Methods: 100 patients were included in thisstudy with selective sampling technique. Diagnosis of Dhatsyndrome was made according to ICD-10 DCR criteria.Socio-demographic determinants, physical complaints werenoted down. HAM-A, BDI II inventory and SF36 scales wereapplied.Results: Age less than 24 years, illiteracy, marriage andpeople living in rural area were strong factors associated withDhat Syndrome. Generalized weakness and body pain weretwo complaints which were present in all the patients. Almostall the patients had moderate to severe score on HAM-A andBECK’s II inventory. SF36 PCS and MCS showed scores lessthan 11.Conclusion: Socio-demographic variables play a pivotal rolein Dhat syndrome. Physical symptoms and mental disorderwere common amongst people suffering from Dhat syndrome.The quality of life of these patients were hampered. It is aserious entity which affects the whole body and mind. It alsodisrupts the quality of life

A Study of Psychological Stress and Burden on Caregivers of Schizophrenic Patients

Introduction: Schizophrenia is a chronic severe mental illnesswhich not only affects patients but also causes significantburden and stress to the caregivers. There is definite lack ofstudies in India exploring caregiver burden and psychologicalstress. Study objective was to assess psychological stress andburden on caregivers of schizophrenic patients.Material and methods: The study sample included 52patients with a diagnosis of schizophrenia and their caregivers,randomly selected from the patients coming to the OPD of twotertiary care centres in Bareilly, as per inclusion and exclusioncriteria. Burden Assessment Schedule and General healthquestionnaire-12 were used for the study.Results: Our study also shows that 42.31% caregiversexperienced severe burden. Caregivers of patients with lowlevels of education reported greater burden. Parents andspouses reported moderately higher level of burden, butsiblings reported highest level of burden. Parents had greaterpsychological stress as compared to spouses and siblings.Caregivers with higher psychological stress found to haveheavier caregiving burden.Conclusion: Caregivers of schizophrenic patients sufferedfrom significant burden. It thus becomes important to planinterventions that would reduce their burden of care and thusimproving their psychological well-being.

Challenges of valve surgeries in post-renal transplant patients.

Renal transplantation remains a mainstay of therapy for the end‑stage renal disease. Cardiac disease has a high prevalence in this patient population. Cardiovascular disease remains the leading cause of death among kidney transplantation patients. The cardiac disease accounts for 43% of all‑cause mortality among dialysis patients and for ≈38% of all‑cause mortality after transplantation. In this article, we review the factors and outcomes associated with valve surgeries in renal transplant recipients and evaluate the strategy for open heart surgery after renal transplantation performed.

Role of transesophageal echocardiography: A rare case of acute left atrial free wall dissection.

Transesophageal echocardiography (TEE) has been used routinely in the diagnosis and follow‑up of cardiac cases. Left atrial dissection (LAd), an exceedingly rare complication of cardiac surgery, is most commonly associated with mitral valve surgery. A case of LAd is presented, and the pathology was accurately defined and immediately diagnosed using intraoperative TEE. This case highlights the importance of prompt diagnosis of LAd using intraoperative TEE, and a second cardiac surgery was avoided.

Co-existence of Carcinoma Tongue with Pulmonary Tuberculosis.

We present the case of a 45-year-old male diagnosed to have carcinoma base of tongue, whose chest radiograph showed bilateral lung infiltrates and was referred for evaluation of suspected pulmonary metastases. Diagnostic evaluation confirmed the diagnosis of smear-positive pulmonary tuberculosis.

Coexistence of carcinoma cheek with tuberculosis: a rarity.

Coexistence of tuberculosis and cheek malignancy is a rare phenomenon and it has never been reported to the best of our knowledge. Here, we present a case of carcinoma cheek with tuberculosis in a 50 year old male patient who was successfully managed by multimodality approach by combining anti-tubercular therapy with chemotherapy and radiotherapy.

Efficacy of an in-house polymerase chain reaction assay for rapid diagnosis of Mycobacterium tuberculosis in patients with tubercular lymphadenitis: Comparison with fine needle aspiration cytology and conventional techniques.

Introduction: Tubercular lymphadenitis (TB-L) is the most common manifestation of extrapulmonary tuberculosis. Excisional biopsy with histopathological examination, Ziehl-Neelsen staining (ZNS) and culture and fine needle aspiration (FNA) cytology, although useful in the diagnosis of TB-L, cannot diagnose a substantial proportion of cases. We investigated the role of an in-house polymerase chain reaction (PCR) assay targeting the IS6110 gene from the FNA material in the diagnosis of the disease. Materials and Methods: The clinical profile of 150 patients with lymphadenopathy was noted and the fine needle aspirate was collected. After cytological processing, ZNS and culture on Lowenstein-Jensen media, mycobacterial DNA was isolated from the residual aspirate material and IS6110 gene PCR was performed. Results of cytology, ZNS, culture and IS6110 gene PCR were compared. Results: There were 49 confirmed patients of TB-L based on laboratory parameters (either culture isolation of Mycobacterium tuberculosis or any two of cytology, ZNS, PCR positive) and clinical response to therapy. Sensitivity and specificity of FNA was 89.8% and 96%, of ZNS was 40.8% and 99%, of culture was 40.8% and 100% and of IS6110 gene PCR test was 100% and 92.1%. Conclusion: IS6110 PCR can be considered a valuable adjunct to cytology, ZNS and culture techniques in the diagnosis of TB-L.

Combined spinal epidural anesthesia for cesarean section in a pregnant patient with rare intracranial neoplasm

There are several reports of obstetric emergencies in pregnant patients with malignant intracranial tumors precipitated by worsening of the mother's neurological status which necessitate an early delivery of the fetus before definite therapy can be administered to the mother[1-3]. We describe a patient with a sphenoid sinus tumor who developed loss of vision due to rapid tumor progression necessitating an early delivery of her twin fetuses by cesarean section. The patient had co morbidities and requested to be awake during the surgery, she was managed using a combined spinal epidural anesthesia. The advantages of combined spinal epidural anesthesia as compared to a single shot subarachnoid block, epidural block or general anesthesia are discussed in a pregnant patient with decrease in intracranial compliance