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Purpose: To evaluate the effectiveness of amblyopia treatment through a smartphone?based anaglyph system by virtual reality (VR) in adult patients. Methods: A total of 10 subjects diagnosed with anisometropic amblyopia were enrolled during the study period. Best Corrected Visual Acuity (BCVA), stereoacuity, and contrast acuity were evaluated during three visits (at presentation, 3 months and 6 months) of smartphone?based anaglyph video run in the VR mode. All the amblyogenic factors including stereopsis, color vision, and contrast acuity were compared using Friedman two?way analysis of variance. Statistical significance was considered if P < 0.05. Results: Mean BCVA in amblyopic eye improved significantly from a logMAR value of 0.73 ± 0.64 before Virtual reality vision therapy (VRVT) to a post?training VRVT value of 0.48 ± 0.44 (P < 0.01). Mean stereoacuity changed from a value of 560.00 ± 301.58 before VRVT to a value of 263.00 ± 143.58 seconds of arc after training (VRVT) (P < 0.01). Mean accommodation changes from a value of 15.00 ± 7.40 before training or VRVT to value of 12.60 ± 6.10 cm after training (P < 0.01). Mean contrast acuity changes from a value of 1.21 ± 0.72 at presentation to a value of 1.52 ± 0.49 log unit after VRVT. Conclusion: A smartphone?based anaglyph system using VR vision therapy appears to be an effective treatment option for amblyopia in adults.
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Purpose: To study the epidemiological pattern, prevalence, types, and correlates of age?related cataracts in a tertiary care center in central India. Methods: This hospital?based single?center cross?sectional study was conducted on 2,621 patients diagnosed with cataracts for 3 years. Data pertaining to demography, socio?economic profile, cataract grading, cataract types, and associated risk factors were evaluated. Statistical analysis using unadjusted odds ratio (OR) and multivariate logistic regression was performed, with P-value <0.05 considered significant with the power of the study being 95%. Results: The commonest age group affected was 60–79 years, closely followed by the 40–59 years age group. The prevalence of nuclear sclerosis (NS), cortical (CC), and posterior subcapsular cataract (PSC) was found to be 65.2% (3,418), 24.6% (1,289), and 43.4% (2,276), respectively. Among mixed cataracts, (NS + PSC) had the highest prevalence of 39.8%. Smokers were found to have 1.17 times higher odds of developing NS than non?smokers. Diabetics had 1.12 times higher odds of developing NS cataracts and 1.04 times higher odds of developing CC. Patients with hypertension showed 1.27 times higher odds of developing NS and 1.32 times higher odds of developing CC. Conclusion: The prevalence of cataracts in the pre?senile age group (<60 years) was found to have increased significantly (35.7%). A higher prevalence of PSC (43.4%) was found in studied subjects, as compared to the data of previous studies. Smoking, diabetes, and hypertension were found to have a positive association with a higher prevalence of cataracts.
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Background: Diabetes Mellitus refers to a group of common metabolic disorders that share the phenotype of Hyperglycemia. It is the leading cause of morbidity and mortality throughout the world with an estimated worldwide prevalence of 439 million by 2030 and 19% of world抯 DM patients are Indians. Magnesium is an important co-factor for various enzymes involved in Insulin secretion and is involved in sodium-potassium ATPase pump. 25%-38% of Type 2 DM patients had Hypomagnesemia, which has also contributed in developing microvascular complications such as Diabetic Retinopathy (DR) and Diabetic Nephropathy (DN). Various studies have suggested that Magnesium supplementation in Type 2 DM patients with Hypomagnesemia have shown beneficial effects on insulin sensitivity and glucose metabolism. Aim and objectives: To study the prevalence of Hypomagnesemia in Type 2 DM patients and to study the association of Hypomagnesemia with microvascular complications such as DR and DN. Materials and methods: It is a hospital based Observational study carried out in 2022 for a period of 1 year including 60 patients fulfilling the ADA criteria for diagnosing T2DM and patients with Diabetic Retinopathy and Diabetic Nephropathy, and excluding patients with Malabsorption, Chronic diarrhoea, Renal Failure on diuretic therapy, Sepsis, Pancreatitis. Serum Magnesium levels of 1.6 mg/dl � 2.6 mg/dl is considered as normal range. Serum Magnesium were measured using Xylidyl blue colorimetric method. Results: The Mean age of the patients in our study was 55.89 years. Among 60 patients diagnosed with Diabetes Mellitus, 42 patients had Hypomagnesemia, 18 patients had Normomagnesemia (p- value: <0.0001). Patients with an HbA1c levels > 7% had Hypomagnesemia when to compared to patients with HbA1c <7% with a significant p value of 0.009. Hypomagnesemia was also associated with Diabetic Retinopathy and Diabetic Nephropathy with a significant p-value of 0.013 and 0.009 respectively. Conclusion: In our study, it has shown that patients with uncontrolled T2DM had Hypomagnesemia, which is also associated with micro-vascular complications of T2DM such as DR and DN.
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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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Purpose: The primary objective of the study was to assess the macular retinal vessel density, subfoveal choroidal thickness, and retinal layer metrics by optical coherence tomography angiography (OCTA), enhanced?depth imaging optical coherence tomography (EDI?OCT), and spectral domain optical coherence tomography (SD?OCT), respectively, in recovered COVID?19 patients and its comparison with the same in control subjects. The secondary objective was to evaluate differences in OCTA parameters in relation with the severity of COVID?19 disease and administration of corticosteroids. Methods: A case–control study was performed that included patients who had recovered from COVID?19 and age?matched healthy controls. Complete ocular examination including OCTA, SD?OCT, and EDI?OCT were performed three months following the diagnosis. Results: Three hundred sixty eyes of 180 subjects were enrolled between the two groups. A decreased mean foveal avascular zone area in both superficial capillary plexuses (P = 0.03) and deep capillary plexuses (P < 0.01), reduced average ganglion cell layer?inner plexiform layer thickness (P = 0.04), and increased subfoveal choroidal thickness (P < 0.001) were observed among cases in comparison to the control group. A significant correlation was found between sectoral macular vessel density in relation to disease severity and a decrease in vessel density with greater severity of the disease. Conclusion: OCTA detected retinal microvascular alterations following SARS?CoV?2 infection in subjects with the absence of any clinical ocular manifestation or systemic thrombotic events. These parameters could be used to help identify patients with a higher incidence of systemic thromboembolism on longer follow?ups and identify the impact of corticosteroids on retinal architecture.
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Purpose@#There has been limited work assessing the use of re-irradiation (re-RT) for local failure following stereotactic spinal radiosurgery (SSRS). We reviewed our institutional experience of conventionally-fractionated external beam radiation (cEBRT) for salvage therapy following SSRS local failure. @*Materials and Methods@#We performed a retrospective review of 54 patients that underwent salvage conventional re-RT at previously SSRS-treated sites. Local control following re-RT was defined as the absence of progression at the treated site as determined by magnetic resonance imaging. @*Results@#Competing risk analysis for local failure was performed using a Fine-Gray model. The median follow-up time was 25 months and median overall survival (OS) was 16 months (95% confidence interval [CI], 10.8–24.9 months) following cEBRT re-RT. Multivariable Cox proportional-hazards analysis revealed Karnofsky performance score prior to re-RT (hazard ratio [HR] = 0.95; 95% CI, 0.93–0.98; p = 0.003) and time to local failure (HR = 0.97; 95% CI, 0.94–1.00; p = 0.04) were associated with longer OS, while male sex (HR = 3.92; 95% CI, 1.64–9.33; p = 0.002) was associated with shorter OS. Local control at 12 months was 81% (95% CI, 69.3–94.0). Competing risk multivariable regression revealed radioresistant tumors (subhazard ratio [subHR] = 0.36; 95% CI, 0.15–0.90; p = 0.028) and epidural disease (subHR = 0.31; 95% CI, 0.12–0.78; p =0.013) were associated with increased risk of local failure. At 12 months, 91% of patients maintained ambulatory function. @*Conclusion@#Our data suggest that cEBRT following SSRS local failure can be used safely and effectively. Further investigation is needed into optimal patient selection for cEBRT in the retreatment setting.
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Objectives@#Coronavirus disease 2019 (COVID-19)–associated mucormycosis (CAM) has emerged as a formidable infection in patients with COVID-19. The aggressive management ofCAM affects quality of life (QOL); thus, this study was designed to assess the QOL in patients with CAM at a tertiary healthcare institution. @*Methods@#This cross-sectional study of 57 patients with CAM was conducted over 6 monthsusing a semi-structured standard questionnaire (the abbreviated World Health Organization Quality of Life questionnaire [WHO-BREF]) and a self-rated improvement (SRI) scale ranging from 0 to 9. Cut-off values of ≤52 and < 7 were considered to indicate poor QOL and poor improvement, respectively. The correlations of QOL and SRI scores were evaluated using Spearman rho values. @*Results@#In total, 27 patients (47.4%; 95% confidence interval [CI], 34.9%–60.1%) and 26 patients (45.6%; 95% CI, 33.4%–58.4%) had poor QOL and poor SRI scores, respectively. The overall median (interquartile range) QOL score was 52 (41–63). Headache (adjusted B, −12.3), localized facial puffiness (adjusted B , −16.4), facial discoloration (adjusted B, −23.4), loosening of teeth (adjusted B, −18.7), and facial palsy (adjusted B, −38.5) wer e significantly associated with the QOL score in patients with CAM. @*Conclusion@#Approximately 1 in 2 patients with CAM had poor QOL and poor improvement.Various CAM symptoms were associated with QOL in these patients. Early recognition is the key to optimal treatment, improved outcomes, and improved QOL in patients with CAM.
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The concept of "One Health" recognizes the intrinsic relationship among health of human, animal and environment as a whole. All facets of One Health are undermined by the irrational use of antimicrobials and AMR cannot be effectively contained without coordinated actions of all key stakeholders including community participation.
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Plant mediated green synthesis of silver nanoparticles (AgNPs) holds promising applications in the field of Biomedicine, Food packaging and Wound healing. In the present investigation, biofabrication of AgNPs was performed using the aqueous extracts of Campsis sp. (Family Bignoniaceae) leaves and flowers growing in the premises of Kirori Mal College, University of Delhi, Delhi. Optimization of AgNPs was performed to analyse the varying effect of pH (6.0, 8.0, 10.0) and silver salt concentration (2mM, 4Mm and 6Mm) in controlling the shape and size of AgNPs which in turn governs their further applications. Interestingly, change in colour of the reaction mixture from pale yellow to reddish brown indicated the formation of AgNPs. These AgNPs were further characterized by UV-Visible spectroscopy and showed peak in the range of 400-450 nm which confirmed the synthesis of silver nanoparticles. Dynamic light scattering and zeta potential analysis (DLS-Zeta) confirmed the size of AgNPs around 200-300 nm. A significant zone of inhibition was observed for both Staphylococcus aureus (gram-positive) and Escherichia coli (gram-negative) bacterial strains which revealed the antimicrobial potential of Campsis sp. AgNPs. Therefore, Campsis AgNPs may provide a green, eco-sustainable alternate method for sustainable production of nanomaterials for biomedical applications. These AgNPs may also show tremendous applications in food packaging, wound healing and biomedical fields.
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Superior Vena Cava Syndrome is the clinical manifestation of the Superior Vena Cava obstruction, with severe reduction in venous return from the head, neck and upper extremities. More than 80% cases of SVCS is nearly attributable to advanced malignancy, most commonly lung cancer. SVC syndrome is characterized by congestion and swelling of the face and upper thorax, with distended superficial chest veins. The most severe complications of SVC syndrome include Glottic edema and venous thrombosis in the central nervous system. We represent a case SVC syndrome due to Small Cell Cancer of the lung.
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Agriculture and society are intertwined. Agriculture is necessary for human survival and social sustainability in India. Eco-friendly agriculture practices nurture ecosystems to solve current societal issues. Indian ecosystems are marred by pollution, imbalance, climate changes, food crisis, various diseases, and mal-nourishment continue as a major concern. The traditional environmental remedial strategies appear relatively ineffective in the ever expanding use of pollutants that pervade the water, air and soil environment. Nanotechnology provides an efficient, environmentally friendly and cost-effective solutions to the global sustainability challenges that society is facing. Nanotechnology utilizes nanomaterials that have remarkable physical and chemical features to make smart functional materials for developing sustainable technologies. Nanotechnology seems to be very promising in sustainable environment development, sustainable agriculture, renewable and economically energy alternative through use of nanomaterials for detection, prevention, and removing pollutants. The development of nanotechnology in India has huge potential to address the challenges like providing drinking water, healthcare, nano-based industry and sustainable agriculture. This review highlights the recent nanotechnology applications to meet the global challenges in providing clean energy technology, water purification, and greenhouse gases management. In addition, effort has been made to analyse the opportunities and limitations in engineered nanomaterials safety, solid waste management, reducing pollution of air water and soil.
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Mucormycosis has emerged as an important fungal infection with high associated mortality rates. Mucormycosis causes devastating angio-invasive fungal infections, primarily in patients with underlying risk factors. The prevalence of mortality associated with invasive Mucormycosis is high (>30-50%), with 90% mortality contributed by disseminated disease. Sudden rise in Mucormycosis cases during the COVID-19 pandemic came as a surprise to all. Lowered immunity due to COVID and associated conditions like diabetes, made the population susceptible to this dreaded disease. This disease led to both increase in morbidity and mortality among the general population. Aim of the Study : To interpret in detail the causes of mortality of patients presenting with COVID Associated Mucormycosis (CAM-19) at AIIMS Patna between May-November, 2021. Materials and Methods : An observational study of all patients who were treated for mucormycosis during the period of May 2021-Nov 2021 in ENT Department, AIIMS, Patna. During the period of study, 219 patients of RhinoOrbital-Cerebral Mucormycosis (ROCM) were admitted for treatment. Five patients had gone on Leave Against Medical Advice (LAMA). So, 214 patients were included in the study. Results : Among the 214 patients, 165 patients were treated surgically through both endoscopic and open approaches along with antifungal therapy management. 41 patients died during the hospital course of the treatment. The mortality rate of ROCM stood at 19.15% in our series. Pulmonary Mucormycosis had high mortality (100%). Diabetes is the most common risk factor. Multiple co-morbidities and extensive intracranial involvement had a strong association with mortality. Conclusion : The advanced stage of ROCM was associated with more deaths. Our series mortality rate of 19.15% is lower than most of the other documented mortality rates. Our results support that early aggressive surgical approach, antifungal therapy and multidisciplinary approach has reduced the mortality
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Abstract Introduction: More than 50% of pregnant women experience dizziness frequently in the first two gestational trimesters. During pregnancy, the changes in the metabolism of hormones are responsible for the ovarian cycle resulting in either peripheral or central vestibular alterations. The need for the study is to focus on the effect of changes during pregnancy on the vestibular evoked myogenic potential, an electrophysiological measure that investigates functions of the otolith structures. Objectives: The aim is to investigate the vestibular evoked myogenic potential responses during the first trimester of pregnancy. Methods: A total of 17 pregnant women and 17 non-pregnant women with age matched took part in this study. The cervical vestibular evoked myogenic potential were recorded from the ipsilateral sternocleridomastoid muscle and the ocular vestibular evoked myogenic potential were recorded from contralateral extraocular muscle in both groups. Results: Peak to peak amplitude of cervical vestibular evoked myogenic potential and ocular vestibular evoked myogenic potential was found to be significantly reduced in the responses obtained from first-trimester pregnant women when compared to that of non-pregnant women. Conclusions: Vestibular evoked myogenic potential tests exhibits a clinically significant reduced peak to peak amplitude in the first trimester of pregnancy, which indicates dysfunction in the otolith reflex pathway.
Resumo Introdução: Mais de 50% das mulheres grávidas apresentam tonturas frequentes nos primeiros dois trimestres da gravidez. Durante a gestação, as mudanças no metabolismo dos hormônios são responsáveis pelo ciclo ovariano, resultam em alterações vestibulares periféricas ou centrais. A necessidade do estudo é enfocar o efeito das mudanças durante a gravidez sobre o potencial evocado miogênico vestibular, uma medida eletrofisiológica que investiga as funções das estruturas otolíticas. Objetivo: Investigar as respostas do potencial evocado miogênico vestibular no primeiro trimestre da gravidez. Método: Participaram deste estudo 17 mulheres grávidas e 17 não grávidas com idades pareadas. O potencial evocado miogênico vestibular cervical foi registrado a partir do músculo esternocleidomastóideo ipsilateral e o potencial evocado miogênico vestibular ocular foi registrado a partir do músculo extraocular contralateral em ambos os grupos. Resultados: A amplitude pico a pico do potencial evocado miogênico vestibular cervical e do potencial evocado miogênico vestibular ocular estava significativamente reduzida nas respostas obtidas de mulheres grávidas no primeiro trimestre de gestação quando comparadas a de mulheres não grávidas. Conclusão: Os testes de potencial evocado miogênico vestibular mostram uma redução clinicamente significativa na amplitude pico a pico no primeiro trimestre da gravidez, o que indica disfunção na via otolítica reflexa.
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Cancer is one of the leading causes of premature death and disability worldwide. With the progress of the health-care system, the cost of cancer treatment is also rising. Poor households suffer disproportionately from the financial burden of cancer treatment, which has pushed many households into poverty. Thus, cancer poses an economic burden for individuals, families, societies, and governments because of the prolonged medical costs, out-of-pocket expenditures, loss of productivity, and premature deaths. Moreover, the psychological breakdown phenomenon and social implications of cancer play a vital role in dealing with cancer patients. The psychological effect of battling with cancer falls not only on the patient but also on the caregivers and family members. With these backgrounds, an attempt is made in this review paper to highlight the implications of cancer on financial and psychological aspects.
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The primary reason for an endodontic treatment failure is the persistence or regrowth of different species of bacteria within the root canal system. The root development and closure of its apex in a permanent tooth occurs till 3 years after the eruption. Treatment of traumatic injury of teeth during the development period of root resulting in open apex poses an endodontic challenge. Various materials are used for induction of apical closure to produce favourable conditions and to confine the root canal filling within the canal space. This paper describes clinical case of retreatment on premolar with improperly treated root canal with open apex. Multiple visit endodontic retreatment of premolar was performed. Disinfection was performed using Intracanal diode laser irrigation activation followed by placing triple antibiotic paste (TAP) as intra-canal dressing. In the second appointment apical plug of Biodentine against a platelet-rich fibrin (matrix) was condensed. The present case showed successful periapical healing and resolution of symptoms with the use of calcium silicate based cement with platelet-rich fibrin as an apical barrier matrix. Procedure is followed carefully using recommended protocols
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Research in the field of nanotechnology has witnessed rapid increase in the synthesis of Engineered nanoparticles (ENPs). This has even led to development of new discipline of Nanotoxicology. Advances in the field of Nanotoxicology further led to development of new domain-nanoinformatics. This new domain of nanoinformatics provides a computational perspective to biology and nanotechnology addressing multi level integration. Nanoinformatics not only helps in predicting nanoparticle structure, composition and behaviour but also covers raw data management, analysis of data derived from biomedical applications and simulation of nanoparticle interactions with biological systems. In addition, it accelerates nano-related research and applications into clinical practice. There are various computational models developed to study the key steps in nano-medicine like drug encapsulation and release, nanoparticle targeting, delivery and uptake and nanoparticle effects on cells and tissues. These prospects have opened up a large domain enabling possibilities of nanomedicine and frontiers for clinical practice and biomedical research in a cost-effective manner along with various applications including studies in clinical trials, toxicity assays, drug delivery systems. This review highlights new approaches for Engineered nanoparticles (ENP) risk assessment and regulation.
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We report a case of Idiopathic non-lupus full-house nephropathy (NLFHN) in a 39-year-old male who had a full-house pattern of immunofluorescence study without overt systemic lupus erythematosus after a follow-up of more than 2 years. The incidence of detection of cases of NLFHN is increasing in native kidney biopsy and is critical to report as they have poor clinical outcomes. To the best of our knowledge, it is the first case of post-transplant renal biopsy and needs to be reported to plan the treatment protocol for such transplant patients.
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Hydatid disease is caused by the adult and the larval stage of tapeworms belonging to the Echinococcus species. The major sites of its infection are the liver and lungs. Rarely, it affects the pelvic region including the ovary, accounting for 0.2–2.25%. The primary ovarian site is a rare finding. We report here a case series of two cases with hydatid cysts as the left ovarian and tubo-ovarian masses. In case 1, a 30-year-old woman complained about lower abdominal pain with swelling and had a 7-month-old child and amenorrhea. Ultrasonographic report exhibited multiple cysts in the ovary. In case 2, a 23-year-old female was having primary left ovarian mass and clinically reported an ovarian dermoid tumor after ultrasound scan and had abdominal lump with pain. Her vital indices were normal. The biopsy was sent for further investigation.
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Inherited epidermolysis bullosa (EB) is a family of diseases with blistering of skin and mucous membrane even with mild trauma. It has different subtypes based on the affected protein. Epidermolysis bullosa dystrophica (EBD) is associated with mutations in the COL7A1 gene encoding type VII collagen leading to the fragility of skin and mucosal membranes. EBD may be dominant or recessive. They should be distinguished because increased prevalence of SCC is associated with the recessive form. Here we are reporting a case at our hospital presented with various clinical features, history, clinical spectrum, renal biopsy and gene analysis giving appropriate diagnosis for the disorder. Treatment remains challenge. A multidisciplinary approach is needed for the effective management of EBD.
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This study was conducted to assess the efficacy of subcutaneous granulocyte colony-stimulating factor (G-CSF) for treating thin endometrium. Methods: Data from 88 infertile women with thin endometrium (<7 mm) aged 23 to 40 years were evaluated retrospectively over a period of 1 year. In group 1, subcutaneous infusion of G-CSF (300 μg/mL) was administered to 44 women along with other supplemental treatments. If the lining did not exceed 7 mm within 72 hours, a second infusion was administered. In group 2, which also had 44 women, only estradiol valerate and sildenafil were administered, while subcutaneous G-CSF infusion was not. Embryo transfers were performed once the lining exceeded 7.5 mm. The efficacy of G-CSF was evaluated by assessing the thickness of the endometrium before embryo transfer, pregnancy rates, and clinical pregnancy rates. Results: There were no differences between the groups regarding demographic variables, egg reserves, sperm parameters, the number of embryos transferred, and embryo quality. The pregnancy rate was significantly higher in group 1 (60%, 24 of 40 cases) than in group 2 (31%, 9 of 29 cases) (p<0.001). The clinical pregnancy rate was also significantly higher in group 1 (55%) than in group 2 (24%) (p<0.001). Conclusion: Subcutaneous G-CSF infusion improved the thickness of the endometrium when it was thin. To the best of our knowledge, this is the first documented study to clearly demonstrate the benefits of subcutaneous G-CSF infusion for treating thin endometrium.