Obesity in Adolescents: Prevalence and Association with Sociodemographic and Lifestyle Factors

Introduction: Overweight and obesity has become a worldwide epidemic and is a growing public health concern. The increase in prevalence and severity of obesity among children and adolescents has been attributed largely to behavioral factors such as changing eating habits and sedentary lifestyles. Objective: To determine prevalence of obesity and abdominal obesity among adolescents and its association with sociodemographic factors and lifestyle. Methods: Present cross-sectional study was conducted in the urban field practice area under the Community Medicine Department of LLRM Medical College, Meerut, among 872 adolescents. All localities in the field area were covered and house to house survey was done. Questions were asked about eating patterns, physical activity and sedentary lifestyle. Data was collected and analyzed using appropriate statistical tests. Results: The prevalence of overweight and obesity was 17.43, 6.88%, respectively. Obesity was significantly higher among females, those who indulged in unhealthy eating habits were physically inactive, watched television for a longer duration and ate junk while watching television. Conclusion: In the present study, we found that high junk food consumption and a sedentary lifestyle were found to be significantly associated with childhood overweight/obesity. As a result, timely interventions should be taken to improve awareness about healthy lifestyle behavior to prevent obesity and its complications among adolescents.

A randomized comparative study of preoperative fentanyl and dexmedetomidine nebulization on the hemodynamic response to endotracheal intubation

Background: Intense sympathetic activity is linked to laryngoscopy and endotracheal intubation, which could lead to intraoperative problems. We undertook this study to compare the effects of preoperative nebulized Fentanyl and Dexmedetomidine on hemodynamic response to laryngoscopy and endotracheal intubation, taking advantage of their high bioavailability and better absorption through nasal mucosa. Aim and Objectives: The objectives of the study were (i) to compare the effect of preoperative nebulization on the hemodynamic response to laryngoscopy and intubation; and (ii) to assess intraoperative requirement of anesthetic agents. Materials and Methods: This prospective, randomized, and comparative study was conducted among 100 American Society of Anesthesiologists (ASA) I, II patients (of either gender) undergoing elective surgeries and requiring tracheal intubation, were randomized in two groups. Group A was given Fentanyl Nebulization (2 ?g/kg in 4 ml of 0.9% saline) and Group B was given Dexmedetomidine nebulization (1 ?g/kg in 4 ml of 0.9% saline) 10 min before anesthesia induction. Hemodynamic parameters were noted before and immediately after induction, 1 min, 5 min and 10 min after intubation. The main goal was to assess how Fentanyl and dexmedetomidine nebulization affect the laryngoscopy and intubation-induced stress response. The secondary outcome was to assess the intraoperative requirement of anesthetic agents, observe adverse effects of study drug and sedation score. Results: Dexmedetomidine nebulization was found to be more effective in blunting rise in heart rate post laryngoscopy compared to Fentanyl Nebulization (P < 0.0001) as well as in MAP after 10 min of intubation (P < 0.0001). Requirement of propofol was seen to be significantly reduced in Group B compared to Group A (P < 0.05). Sedation scores were significantly higher in Group B (P < 0.05). No evidence of side effects was observed in any group. Conclusion: Nebulisation of dexmedetomidine was found to be more effective in attenuation of stress response of laryngoscopy and intubation compared to nebulisation of fentanyl, with stable intraoperative hemodynamic and no significant side effects.

Proficiency of topical platelet-rich plasma with vacuum-assisted closure over platelet-rich plasma alone in diabetic foot ulcers - A clinical prospective comparative study

Background: Type 2 Diabetes Mellitus is usually associated with peripheral neuropathy, peripheral vascular disease with consequential limb ischemia, and eventually diabetic foot ulcers (DFU). The healing process is slow due to microangiopathy and wound is easily infected with microbials leading to superficial infection, progressing to deep infection and eventually landing in amputation most of the times. Plate rich plasma (PRP) is very cost-effective, readily available blood derivative and has the capability to stimulate cell proliferation and differentiation. It improves tissue healing and regeneration and exhibits potent activities against a number of pathogens. Vacuum assisted closure (VAC), on the other hand, is a new novel way to treat DFU by having negative pressure wound healing. The present study focused on the advantage of (PRP+VAC) dressing over (topical PRP application with its peripheral injection) alone for aiding and enhancing the process of wound healing in DFU. Aims and Objectives: To appraise the advantage of (PRP+VAC) dressing over (topical PRP application with its peripheral injection) alone for aiding and enhancing the process of wound healing in DFU. Materials and Methods: This was a prospective comparative study of 100 cases to compare the outcomes of wound healing by (topical PRP application with its peripheral injection. Results: Mean time taken for appearance of granulation tissue, 100% granulation tissue, average reduction in wound surface area, showed significant (P => 0.005) differences between the (PRP+VAC) and the (topical PRP application with its peripheral injection) dressing groups. Conclusion: (PRP+VAC) dressings are more effective than conventional (topical PRP application with its peripheral injection) dressings in wound healing of DFU.

Management of recurrent rhegmatogenous retinal detachment

Rhegmatogenous retinal detachment (RRD) repair is one of the most common vitreoretinal surgeries a surgeon performs. In an ideal scenario, RRD can be repaired with a single surgical intervention; however, despite excellent skill, flawless technique, and the introduction of high-end technology, up to 10% of cases require additional interventions to ultimately repair recurrent detachments. It is thus important to study the outcomes of multiple interventions to understand whether performing repeat vitrectomy on patients with a history of failed surgeries is worthwhile. Thus, recurrent retinal detachment (re-RD) remains a significant challenge for vitreoretinal surgeons as well as the patients considering the economic and the emotional burden of undergoing multiple interventions. The advent of microincision vitrectomy system, perfluorocarbon liquids, and effective intraocular tamponades has opened new doors for managing re-RDs. In this article, we have reviewed and summarized the various causes and approaches for management for optimal anatomical and functional outcomes.

Secondary Coats' response to retinal vasculitis managed with bevacizumab

We report a case of 22-year-old young male who presented with a 3-month history of gradual and painless decrease of vision in his right eye (RE). On ophthalmological examination, best-corrected visual acuity in his RE was counting finger close to the face. Left eye ophthalmic examination was unremarkable. RE indirect ophthalmoscopy revealed multiple telangiectatic vessels, aneurysmal dilations, extensive yellow (lipid) exudation over the posterior pole along with perivascular exudation, and multiple sclerosed vessels in peripheral retina. Fluorescein angiography also revealed progressive leakage from telangiectasias, multiple aneurysmal outpouchings, extensive capillary dropouts, and vascular communicating channels in all quadrants. Spectral-domain-optical coherence tomography of macula demonstrated marked intraretinal fluid. Based on the above findings, a diagnosis of healed retinal vasculitis with Coats'-like response was made. The patient received 4-weekly two intravitreal bevacizumab injections which resulted in stabilization of the retinal findings and improvement in visual acuity.

Measles & Rubella Vaccination Campaign in India: Why, How, When and Where

Globally, in 2015, measles killed an estimated 1,34,200 children - mostly under-5 years of age and an estimated 49,200 deaths occurred due to measles in India. Most of these children were the ones who have not received two doses of measles vaccine. This is despite the fact that the Government of India is providing vaccines free of cost under the Universal Immunization Programme. Even today some of the children in the country are not protected against the deadly life-threatening diseases. Some of these children are left unvaccinated because their parents are hesitant to immunise, believes that vaccines are dangerous. (1)

Branch retinal artery occlusion post-penetrating globe injury with intraocular foreign body

Intraocular foreign body (IOFB) in cases of penetrating eye injury accounts for an important indication of vitreoretinal intervention following ocular trauma. Vascular occlusion as a complication of IOFB is rare. Here we present a case of a 34-year-old male with post-traumatic cataract and an intraocular metallic foreign body (IOFB) lodged in the superficial layers of the retina inferotemporal to the disc, causing an inferotemporal branch retinal artery occlusion. The case was managed by lensectomy with pars plana vitrectomy and IOFB removal followed by a second procedure of secondary IOL implantation. Final best-corrected visual acuity improved to 6/24. This case highlights an unusual sequelae following penetrating ocular trauma.

Maternal and Neonatal Outcome in Patients with History of Previous One Cesarean Section.

Background : Cesarean section has become the most common operation in obstetric practice. A critical evaluation of the attitude towards the liberalization of the indications for cesarean section is warranted. The present study was conducted to determine the maternal and neonatal outcome of pregnancy among women with one previous cesarean section in relation to vaginal delivery, repeat cesarean section, maternal complications and neonatal complications. Aims and Objectives : To determine the maternal and neonatal outcome of pregnancy with previous one cesarean section. To estimate the rate of repeat cesarean section and vaginal deliveries in our population. Research Question : What is the maternal and neonatal outcome in women with history of previous one cesarean section? Study Design : Prospective Study. Study Participants : All women with term pregnancy, with previous one lower segment cesarean section and single live fetus in cephalic presentation. Statistical Analysis : Simple percent and proportions, Chi Square test.

Eclampsia : before and after magnesium sulphate.

This study was done to see the incidence and impact of changes in the intervention strategy for the management of eclampsia in a maternity hospital on maternal and perinatal outcome. Analysis of case records of all eclampsia cases over two different study periods designated as study period A (April, 1994 to Oct, 1996) and study period B (April, 2000 to April, 2001) were done. Total number of eclampsia cases who received intervention over two different study period (46 in study period A and 47 in study period B) were comparable despite the difference in the duration of study period. During study period A, diazepam was used as anticonvulsant, whereas magnesium sulphate was used to control fits during study period B. Incidence of eclampsia has markedly increased in this hospital (0.12% vs 0.29%). Epidemiology and clinical profile of eclamptic patients do not show remarkable change. There was no maternal death in study period B (April, 2000 to April, 2001) whereas there was one maternal death in the study period A (April, 1994 to October, 1996). Marked improvement was noticed in terms of recurrence of fit (19.13% vs 73.91%) with change in the intervention strategy. Perinatal deaths were fewer in study period B (20% vs 33%). Overall, it seems that care of eclamptic patients and use of magnesium sulphate as anticonvulsant has resulted in positive impact on maternal outcome.

B-Lynch brace suture: an effective method of conservative surgical management for placenta increta.

Placenta accreta is defined as an abnormal adherence, either in whole or in part, of the afterbirth to the underlying uterine wall. Placenta increta occurs when the placenta invades deeply into the myometrium. Placenta increta is a life threatening condition. We report a case of placenta increta managed by unilateral uterine artery and ovarian artery ligation followed by B-Lynch Brace suturing of the uterus to control bleeding from the placental bed.

Desquamative interstitial pneumonia.

A rare case of Desquamative Interstitial pneumonia confirmed by open lung biopsy, is reported. The course was marked by development of spontaneous pneumothorax and failure to respond to steroids.