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Background: Increasing awareness to lifestyle disease has led to more participation of people in taking up various forms of exercise to avail more health benefits. The ability to perform physical exercise is related to cardiovascular systems capacity to supply oxygen to muscles and pulmonary systems ability to clear carbon di oxide from blood via lungs. Spirometry is a physiological test that measures the volume and flow of air that can be inhaled and exhaled. Aim and Objectives: The purpose of this study is not only to assess the beneficial effects of pranayama and aerobic exercises but to compare the improvements in the lung functions among these two modalities of exercises. Materials and Methods: It is a non-randomized cross-sectional comparative study. Total 150 participants of both sexes aged 30–50 years were selected and divided equally into three groups: Pranayama group, aerobic exercise group, and control group who were doing pranayama and aerobic exercise and no exercise respectively from the past 3 months were included in the study. The participants were assessed by their anthropometric parameters, pulse rate, respiratory rate, blood pressure, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC, and peak expiratory flow rate (PEFR). Results: Among Pranayama groups, there was significantly higher level of FVC, FEV1, FEV1/FVC ratio, and PEFR as compared to aerobic exercise group and control group. Conclusion: Both pranayama and aerobic exercise play an important role in improving the pulmonary functions but effects were more pronounced with pranayama.
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Background: Myopia is a common condition affecting a significant proportion of the pediatric population in Asian countries. Aim and Objectives: This study was undertaken to investigate the associations of optical coherence tomography measurements of macular volume and macular thickness with refractive error and axial length in Indian children. Materials and Methods: The prospective observational study was carried out at MRA Medical College, Ambedkar Nagar, Uttar Pradesh. We enrolled 300 consecutive cases (190 cases and 110 controls) of pediatric age group (6–18 years) between January 2015 and December 2018. Pearson’s correlation was performed with refractive errors, axial length, macular thickness, and volume. Results: Children with myopia (SE ?0.5–?4.57 D) tended to have smaller total macular volume and thinner macular thickness as, compared to control. The correlation of macular thickness and macular volume was analyzed with spherical equivalent (SE) and axial length. Macular thickness had negative correlation with SE and positive with axial length, correlation coefficients being observed as (r = ?0.886 and 0.880, P ? 0.001). Total macular volume correlated negatively with SE, (r= ?0.771, P ?0.001) and positively with axial length (r = 0.764, P ?0.001). Conclusion: Increasing axial myopia was associated with increased macular volume and thickness. It establishes the importance of the fact that refractive error should be considered in the interpretation of macular thickness.
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Objectives: This study aims to assess the magnitude of anxiety, stress, and depression among private practitioners during the COVID pandemic 2020. Materials and Methods: A descriptive, observational and cross-sectional study was done using a semi-structured questionnaire through electronic media in the form of Google Forms. Patient health questionnaire 4 (PHQ4) and Perceived Stress Scale-10 were incorporated into the questionnaire to assess the psychological status in November 2020. Results: A total of 157 private practitioners participated in the study. Males constituted 60%. Participants have mean age (SD) of 44.2 (6.9) years with work experience and a mean (SD) of 16.3 (6.78) years. The anxiety and depression subscales of the PHQ-4 scale showed that 54.7% of the private practitioners have anxiety subscale ?3 and 28% have depression subscale >3 needing further psychiatric evaluation. Significant predictors of anxiety and depression were female gender, younger and less experienced, and those providing inpatient services in COVID care isolation facilities. Conclusion: There is a high prevalence of anxiety, stress, and depression among private practitioners comparable with other countries.
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Background: Higher taxes are the single most effective way to encourage tobacco users to quit tobacco use and prevent youth from initiation. Objectives: The present study aims to estimate the effect of raising the tax on smoked tobacco products on its consumption and smoking‑attributable deaths in India. Materials and Methods: A mathematical model was developed which used the projected population of India, taxation rates on smoked tobacco products, smoking prevalence, and price elasticity of demand of cigarette and bidi from 2017 to 2025. Four scenarios of tax increment (0%, 25%, 50%, and 100%) on smoked tobacco products were created which were modeled to calculate smoking prevalence and smoking‑attributable deaths due to respiratory diseases, heart diseases, stroke tuberculosis, and cancer in country till 2025. Results: A relative decrease of 6.2% in the prevalence of smoking was observed between the existing tax rates and its increment to 100% over the last increment of 6%. Similarly, smoking‑attributable deaths (SAD) decreased by 6.04% on increasing the tax rates to 100% of the existing taxation rates. There has been a steady increase in SAD in scenario 1 which decreases effectively in scenario 4, which in turn leads to the saving of around 33,000 lives due to tobacco‑related diseases by 2025. Conclusion: The consumption of cigarettes and bidis can be reduced by raising the price of these products. The model will help policymakers in deciding to fix the tax and ultimately the price of cigarettes and bidi to reduce its consumption and smoking‑attributable mortality.
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Background: Men in the 25–54 year age group form the major workforce in developing countries like India. The rising trend of hypertension in this age group is a growing matter of concern. Objectives: This study analyzed secondary data analysis from the National Family Health Survey‑4. Methods: Men in the 25–54 age group (n = 76,410) from 640 districts of the country were included in the study. State and district‑wise trends in hypertension in men along with selected individual lifestyle characteristics were displayed using a geographic information system. Results: The prevalence of hypertension among men in the age group of 25–54 was found to be 35.6% for the entire country. In urban India, the prevalence of hypertension was 38.4% (uncorrected ‑ 40.2%) compared with 33.8% (uncorrected ‑ 34.9%) in rural India. Among the 27,973 hypertensives, 6984 (25%) were the known hypertensives prior to the survey. Out of these only 2403 (34.4%) were taking medicines. The prevalence of tobacco use in any form among the men in this age group was 45.7% (uncorrected ‑ 49%). Conclusion: In conclusion, the study highlights the burden of hypertension in men in the prime age group along with the alarming burden of tobacco consumption and recommends public health and policy interventions targeting both hypertension and tobacco control. It requires urgent attention and specialized strategies in tiding over this epidemic brewing in the workforce of the country
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Background: Tobacco is one of the major behavioral risk factors for noncommunicable diseases in India. Tobacco control depends on public awareness regarding prevalent antitobacco measures. Objectives: The present study documents the understanding of young adults(<25 years) regarding the antitobacco laws and their perception regarding interventions for effective tobacco control. Methods: A cross‑sectional study was conducted in two districts of Haryana. A semistructured questionnaire was used to assess tobacco use, participants’ awareness of sections 4, 5, 6 (a), and 8 of the Cigarette and Other Tobacco Products Act (COTPA, 2003), sources of information about antitobacco laws, and their implementation. The perception of participants about the effectiveness of laws and provisions was assessed using a three‑point Likert scale. Results: Of the 1470 participants, 517 (35.2%) smoked or used smokeless products. They reported the media (84.6%) to be the most critical source of information about antitobacco laws, followed by the health department (57.6%) and family/peer group (44.9%). Most participants were aware of the prohibition of smoking in offices or banks, educational institutions, hospitals, and other public places. Both tobacco users and nonusers perceived health education programs to be an effective intervention to reduce tobacco use (P < 0.01). Conclusion: The awareness regarding COTPA has increased among the general population. The media could be a powerful tool to counteract the pro‑tobacco cues in society. The need of the hour is to focus on improving compliance with antitobacco laws at the population level to achieve a tobacco‑free India.
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Purpose: To describe the outcome of microscope integrated optical coherence tomography (MiOCT) guided removal of lenticulo-corneal adhesion and intralenticular lens aspiration (ILLA) in cases with anterior dislocation of the crystalline lens and corneal edema. Methods: MiOCT-guided ILLA was performed in three eyes of two cases of homocystinuria with spontaneous anterior dislocation of lens and corneal edema. Lenticulo-corneal adhesion was noted intraoperatively, which was not apparent pre-operatively. The lenticulo-corneal adhesion could be successfully peeled using intravitreal forceps and viscodissection with visco-dispersive viscoelastic under the guidance of MiOCT. Results: In all cases, the lenticulo-corneal adhesion could be successfully removed without any complication such as Descemet tear or worsening in corneal edema. Improvement in visual acuity was noted in all cases with resolution in corneal edema by 1 week. Conclusion: MiOCT-guided ILLA can be extremely useful in cases of lenticulo-corneal adhesion especially in cases with corneal edema.
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We report a rare case of Pseudomonas stutzeri endophthalmitis in an immunocompetent individual along with the review of the literature. A 39-year-old healthy lady presented with sudden painful loss of vision in her right eye. She was diagnosed with postcataract surgery acute endophthalmitis and underwent vitrectomy, intraocular lens explantation and intravitreal antibiotics. P. stutzeri was isolated from vitreous. Though the infection was controlled, the anatomy of the eye could not be salvaged and the right eye became phthisical. P. stutzeri is a rare cause of endophthalmitis with usually poor outcomes.
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Purpose: The aim of this study is to assess the ability of multicolour imaging (MCI) to detect foveal cysts in diabetic macular edema (DME) and compare it with conventional color fundus photography (CFP) and foveal autofluorescence (FAF) pattern. Methods: It was a retrospective review of 112 eyes of 84 DME patients with central foveal thickness ?250 ? who underwent MCI, CFP and shortwave autofluorescence imaging. MCI was performed with Sepctralis spectral domain optical coherence tomography (SDOCT) (Heidelberg Engineering, Germany). Results: 97 (86.6%) eyes had cystoid increased autofluorescence (cystoid iFAF), 9 (8%) had spot iFAF and 6 (5.35%) had irregular decreased FAF (dFAF). Among eyes with cystoid iFAF, OCT detected DME cysts in 93 (95.6%) eyes, MCI in 75 (77.3%) and CFP in 5 (5.15%) eyes. In all these eyes, the location of cysts on OCT and MCI corresponded with the location of cystoid iFAF, whereas none of the eyes with cyst seen on CFP correlated with the location of cystoid iFAF. Conclusion: MCI was superior to CFP in detecting DME cysts at fovea. It also correlated with hyperautofluorescence pattern in these eyes. MCI may have a potential role in diabetic retinopathy screening by segregating eyes with DME which would require treatment. Our findings need to be further validated in a larger and prospective study design.
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Purpose: To describe treatment outcomes of eyes with pachychoroid neovasculopathy (PNV) with PDT and anti-(vascular endothelial growth factor) VEGF therapy. Methods: Retrospective interventional case series. Records of six consecutive cases of PNV were reviewed. Four cases were treated with PDT+ inj ranibizumab. Two cases underwent only PDT. Final visual outcomes and functional outcome including macular status and choroidal thickness were assessed. Results: We analysed six eyes of six patients with PNV. There were four males and two females. Mean age of the patients was 56.5 years. Mean duration of follow up was 8.2 months. All patients received reduced fluence PDT. Four patients received ranibizumab along with PDT; mean BCVA at presentation was 0.41 log MAR units and mean BCVA at final follow up was 0.44 log MAR units. There was significant improvement at final follow up (P = 0.03). Mean subfoveal choroidal thickness (SFCT) at presentation was 445 microns and mean SFCT at final follow up was 293 microns. There was a significant reduction at final follow up (P = 0.02). Conclusion: PDT with or without ranibizumab appears to be an effective treatment modality for PNV.
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Purpose: To determine the effect of ultra-widefield fluorescein angiography (UWFFA)-guided targeted retinal photocoagulation (TRP) in branch retinal vein occlusion (BRVO) with macular edema after intravitreal Ranibizumab (RBZ). Methods: 33 eyes of 32 treatment naïve patients diagnosed as BRVO with macular edema were prospectively randomized to 0.5 mg Ranibizumab only (RBZ group) (n = 17) or Ranibizumab with UWFFA-guided laser (RBZ + TRP group) (n = 16). Both groups received three injections at monthly intervals and PRN henceforth. RBZ + TRP group additionally underwent UWFFA-guided TRP of peripheral capillary nonperfusion areas 1 week post injection. Outcome measures included improvement in visual acuity, central subfoveal thickness (CST), and the number of injections required with a minimum follow-up of 9 months. Results: Both groups showed significant improvement in mean BCVA (25.7 ± 8.19 letters, P < 0.001 vs. 23.38 ± 7.56 letters, P < 0.001; in RBZ and RBZ + TRP group, respectively) and reduction in mean central subfoveal thickness (379.12 ± 242.7 ?m, P < 0.001 vs. 253.75 ± 137.9 ?m, P < 0.001 in RBZ and RBZ + TRP group, respectively) at 9 months. The number of injections in the RBZ group (5.76 ± 1.3) was significantly greater than RBZ + TRP (4.06 ± 0.99) (P < 0.001). Both groups had significant improvement in contrast sensitivity and mean deviation on visual fields; however, the difference between the groups was not significant (P = 0.62 and P = 0.79, respectively). Conclusion: UWFFA-guided TRP reduced the number of injections of Ranibizumab in patients having BRVO with macular edema, while maintaining similar benefits in the improvement of BCVA, central subfoveal thickness without deleterious effect on the visual field, and contrast sensitivity.
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Introduction: World Health Organization in 2015 had adopted “End TB Strategy” aimed at ending the global TB epidemic by 2035. Tobacco smoking has been reported to be associated with many aspects of TB disease, including increased vulnerability to being infected, recurrence with TB and related mortality. Aims & Objectives: To determine effect of smoking on treatment outcomes of tuberculosis patients at the end of six months of standardized tuberculosis treatment. Material & Methods: A prospective cohort study was carried out among newly diagnosed tuberculosis patients of Shimla city of India. Data related to smoking status was collected using the standard questionnaire which was used for collection of data regarding tobacco use in Global Adult Tobacco Survey (GATS). Details of the participant’s final treatment outcomes after end of standardized treatment of 6 months was collected from the treatment records of the patients available in the office of district TB center. Results: 72 TB patients were included as study subjects. The prevalence of smoking came out to be 37.5% (95% CI: 26.4-49.7). In our analyses, the risk of unfavorable treatment outcomes was higher among smokers (p value 0.049), Smokeless tobacco users (p value 0.031) and those with history of harmful alcohol use (p value 0.002). Conclusions: Smoking and smokeless tobacco cessation programs need to be targeted at Tuberculosis patients.
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Acute macular neuroretinopathy (AMN) is a deep retinal ischemic manifestation. It has been reported after the use of sympathomimetics, childbirth, bee sting, oral contraceptives, flu-like illness, intravenous contrast agents and bodily trauma not directly involving the eyes. We report a case of AMN following blunt ocular trauma. An 18-year-old male presented with an acute history of blurring of vision following blunt trauma to the right eye. Spectral domain optical coherence tomography (SD-OCT) showed hyperreflectivity of the outer nuclear layer with ellipsoid layer disruption. This report highlights AMN as a manifestation of blunt trauma, presence of which may be an indicator of poor visual prognosis.
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Interpretation of optic disc cupping and neuroretinal rim is challenging in myopic eyes because of large, shallow, and tilted disc, myopic crescent, and macular degeneration. Color and red-free optic disc photographs do not reveal the cup/disc ratio often in myopic eyes. We report characteristics of multicolor optic disc photography in three myopic eyes. All eyes underwent multicolor imaging Spectralis SDOCT system (Heidelberg Engineering, Germany). Owing to use of three laser lights in a confocal design, multicolor optic disc photography was able to delineate the neuroretinal rim and optic cup more clearly than color and red-free optic disc photographs.