Detection of ocular hypertelorism among Indian children

Background & objectives: Ocular hypertelorism constitutes an important component of many clinical syndromes. It is typically recommended to use inter-pupillary distance (IPD) for objective evaluation of ocular hypo/hypertelorism. Barring infancy, there is a scarcity of data on this anthropometric parameter relating to the ocular apparatus. This study aims to study auxological dynamics of IPD in children of Indian origin. Methods: A total of 3622 ( 2239 males and, 1383 females) normal, healthy Indian children of North-western origin, aged one month to 14 yr comprised the sample for this study. Inner and outer-canthal distance were measured using standardized anthropometric techniques. None of the children who participated in this study had craniofacial dysmorphism or any body deformity. Mean (standard deviation SD) and percentiles were calculated for IPD in male and female subjects at different age levels. Results: IPD increased from 4.68±0.21 to 6.19±0.36 cm in males and from 4.59±0.26 to 6.08±0.25 cm in females between one month and 14 yr of age. Boys in general, possessed larger IPD than girls, however, the gender differences became significant (P?0.05) at 10, 11, 16-18 and 22-24 months, respectively, and five and 10 yr of age, respectively. Interpretation & conclusions: The results of this study suggest that the patients having IPD less than the 3rd percentile should be treated as cases of hypotelorism while, those exceeding 97th percentile as cases of hypertelorism. The use of percentile grids presented for IPD may be used to detect ocular hypotelorism and hypertelorism in male and female children to corroborate diagnosis of different syndromes

Dilemma in diagnosing ovarian ectopic pregnancy

To study different presentation of ovarian ectopic pregnancy and its management. All the 4 patients of ovarian ectopic pregnancy presented in our hospital in the month of April 2019 were analysed. We reported 4 cases with a pre-operative provisional diagnosis of ruptured ectopic pregnancy and intra-operative diagnosis of? ovarian ectopic pregnancy, however histopathological examination confirmed the diagnosis of ovarian ectopic pregnancy in only 2 of the cases while the other 2 were ruptured corpus luteal cyst. Wedge resection was performed in all 4 patients. Ovarian ectopic pregnancy is rare and can be missed radiologically and intra-operatively. Establishing early diagnosis is a challenge to the clinician, it commonly mimics tubal ectopic or ruptured corpus luteal cyst. Provisional diagnosis can be made intra-operatively when a hemorrhage mass is seen near the ovary with a normal fallopian tube but can be confirmed by histopathological examination. The chief goal of the treatment remains life-saving intervention by early diagnosis to reduce maternal mortality and morbidity.

Oral health in relation to nutritional status, age and sex among14-18 years children of Naraingarh, Haryana / Saúde Bucal em relação ao estado nutricional, idade e sexo de crianças de 14-18 anos de Naraingarh, Haryana

Objetivo: Descrever a prevalência de cárie dentária e estudar a associação entre o estado nutricional e de saúde bucal baseada em vários índices, em adolescentes de comunidades sob privilegiados. Material e Métodos: O estudo teve uma amostra transversal de 196 crianças aparentemente saudáveis (104 meninos e 92 meninas), na faixa etária de14 a 18 anos, pertencentes a comunidades menos privilegiadas. Cada indivíduo teve a altura e o peso corporal medidos para determinar o estado nutricional. Vários traços de saúde bucal como cárie dental, placa, cálculo e gengivite foram analisados clinicamente. Resultados: O índice CPOD (dentes cariados, perdidos devido à cárie e dentes obturados)foi baixo entre os adolescentes; sendo 0,48 para os meninos e 0,93 para as meninas. A prevalência de cálculo foi maior entre as meninas de todas as faixas etárias, enquanto a prevalência de placa foi maior entre os meninos. As diferenças entre os gêneros foram significantes apenas para os índices de placa e CPOD. A falta de adequação da alimentação não foi um fator determinante para a magnitude observada de depósitos, placa e índices de cálculo, com exceção para os índice de condições de saúde bucal e CPOD, nos quais foram observados maiores índices em crianças com baixo peso. Conclusão: O estado nutricional inadequado não foi um dos principais determinantes da saúde oral, indicando a consciência geral de higiene oral e sua observância como ator importante. As meninas foram mais propensas a cárie dentária do que os meninos, sendo a severidade da cárie também maior para as meninas.

determinant of oral health indicating the generalawareness of oral hygiene and its observance wasa major factor. Females were more prone to dental caries than the males and the severity was also significantly higher in the former.

Has Vector-Rodent Relationship Changed in Plague? Experiences of Plague Affected Hilly Terrains of Himachal Pradesh, India.

Background: The present study was conducted with objectives to elucidate the existence of sylvatic cycle of plague and to document the changing pattern of relationship between rodents and fleas. Methods: Collection of samples was done from 15 sites (25 locations) from plague affected areas of Shimla district of Himachal Pradesh, India during 5 visits between June 2011 to July 2012, which were thereafter entomologically investigated in a BSL-3 laboratory Results: 57 fleas (3 species) from 243 rodents (3 species) were collected in domestic (n=16), peridomestic (n=3) and wild (n=6) locations. Rattus rattus (n=197) and Nosopsyllus fascitus (n=43) was most frequently trapped rodent and flea species respectively. Rattus rattus (domestic rodent species) was also trapped from wild areas and Nosopsyllus fascitus (domestic flea species) was also isolated from Rattus norvegicus (wild rodent species). One rare rodent species Cornilurus albipes was also found. Most common rodent-flea association was Rattus norvegicus-Nosopsyllus fascitus. The recovery of rodents and flea was higher in months of June and December respectively. Conclusions: The study concluded that sylvatic cycle persisted in study area and rodent and flea mixing was widely prevalent between domestic and wild area. This demands regular and intensive surveillance in plague prone hilly areas of Himachal Pradesh.

Linking Lifestyle of Marginalized Gujjar Population in Himachal.

It was a qualitative enquiry conducted amongst Gujjar population of Shimla district, Himachal Pradesh (HP). The study was carried out to link various lifestyle factors of the Gujjar population with the 2002 outbreak of plague in HP. Focus Group discussions guide was prepared beforehand which had information about education, livelihood, dietary pattern, relationships, personal hygiene and habits and health care utilization. It was emerged out of the study that the population has poor literacy levels, poor personal hygiene, overcrowding in hutments, closely-knit social structure, lack of awareness about common diseases, and frequent visits to forests and living in caves during their visits. Further, government health care facilities are not routinely utilized by the Gujjar community. These factors might lead to increased proximity and exposure to wild rats among Gujjar population, thus increasing their susceptibility to plague. They are, therefore a potential link between any source of infection in forests and in native population of HP and other states. The government agencies should take various measures to increase health care access of such vulnerable population through outreach health care programs.

People's perception of leprosy--a study in Delhi.

Leprosy is considered to cause more social than medical problems. The present study focussed on this aspect in order to investigate the level of awareness among people--about their attitude towards the disease and the afflicted. The results are based on interviews with 104 persons in Delhi. The sample data revealed that the level of knowledge of leprosy was inadequate. The cause of the disease was known to 44.2% of those interviewed, while 31.7% were completely ignorant; 6.7% believed it to be the consequence of an individual's past misdeeds, and 1.9% believed it to have been caused by divine curse. 63.1% were aware that the disease is curable. 73.1% of the persons interviewed sympathised with leprosy-afflicted beggars. 61.5% favoured leprosy patients to stay with their families and within their communities. 67.3% felt that the cured could marry, while 25% felt that the leprosy-afflicted should stay in leprosy colonies away from the society. 54.8% were reluctant to employ the leprosy-afflicted as domestic help, and 31.7% were reluctant to establish matrimonial relationship with a family having a leprosy-afflicted person. The data call for intensification ofpublic awareness regarding the aetiology of leprosy. Positive and scientific information should be disseminated to minimize the social prejudices associated with the disease.