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Background and Objective: Most Fathers-to-be within Indian setting find it difficult to cooperate with their spouse抯 labour and encounter a great deal of stress during the journey of Childbirth. The study objective is to assess the impact of Childbirth preparation sessions (CPS) in a private maternity centre at Chennai towards shaping the willingness and attitudes of fathers-to be regarding their willingness and ability to accompany their wives during childbirth in the delivery room and to compare the attitudes with those fathers who did not attend the Childbirth preparation sessions. Materials and methods: A pilot study was conducted between October 2022 to January 2023 at a tertiary maternity hospital in a metropolitan city (Chennai) with a convenient sample of fathers-to-be who attended (Group 1, n=30) CPS and those who did not attend (Group 2, n =30). A questionnaire was given to fathers who had less than 2 year old child to analyze the difference in willingness and ability to go to the labour room among those who attended child birth preparation sessions and those who did not. Results: All men were well educated Indians and the mean age of men who attended childbirth preparation sessions were 33 years and most of them were fathers-to-be for the first time. The results showed that fathers-to-be who attended the childbirth preparation sessions were more likely to express willingness to attend labour room. Though majority of men (51 men out of 60) were willing to go to the labour room, only 47 men were able to go to the labour room out of which 28 had attended the CPS. There was a high significance in their ability to go to the labour room among those who attended the CPS (P-value - 0.010). Conclusions: The preliminary results of this pilot study indicated that a well-structured and delivered CPS could not only enhance the shared role of fathers-to-be in the critical childbirth journey but also provide them with adequate psychosocial support.
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Introduction: Diseases result from abnormal divergence of the normal structural and functional well-being of an organism. It can be brought about by physical, biological, chemical, genetic, or autoimmune causes. Autoimmune diseases occur when the body’s defence system targets its own healthy cells and tissues. The clinical signs and symptoms vary depending on the target tissues. Oral lesions such as ulcers, blisters, mucositis, and gingivitis are seen in many autoimmune diseases and may be an early sign, first recognized by the dental surgeon. Objective: To review the various autoimmune diseases affecting the orofacial region and update the clinicians about their oral manifestations. Materials and Methods: Case reports, review articles and original research papers published in various electronic databases like PubMed, Cross reference, Google scholar, and data collected from books are compiled in this review article. Result and Conclusion: This review gives an overview of some of the common autoimmune diseases affecting the head and neck region, their pathogenesis, clinical features, histopathological features and laboratory findings.
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Purpose: The aim of the study was to understand the clinical profile and anatomical and visual outcome in Tractional/Combined (Tractional + Rhegmatogenous) Retinal Detachment due to vasculitis after surgical intervention. Methods: It was an interventional retrospective study of all cases who underwent surgery for RD with vasculitis at a single tertiary eye care center for over a period of 6 years. Patients with retinal detachment due to vasculitis were included in the study. All patients underwent the following surgical procedures: 240 belt buckle with three?port pars plana vitrectomy with membrane dissection and peeling with fluid gas exchange/with endolaser with silicon oil/C3 F8 gas injection. Results: In our study, 83.33% had preoperative vision of less than 6/60, whereas postoperatively 66.66% had vision of less than 6/60. Postoperatively 33.33% patients had vision better than 6/36. Of the six eyes operated for vasculitis with RD, retina was attached in five eyes following surgery. One patient had recurrent retinal detachment due to extensive proliferative vitreoretinopathy changes, and he was advised re?procedure but was lost for follow?up. The anatomical success was 83.33% on the first surgery. Conclusion: The overall anatomic success rate of retina reattachment surgery in vasculitis patient was good, and the visual outcome following the surgery can improve in majority of the cases. Hence, timely intervention is advocated.
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Varmam- a discrete medical science and a great contribution of Siddhars to Tamil Nadu. It encompases Varma martial arts, Varma therapy, internal and external medicines. Varma therapy and medicines effectively treat neuro musculoskeletal conditions which is admirable. Shoulder pain is most common orthopaedic condition. It is the third common cause of musculoskeletal consultations in primary care. Approximately 1% of adult develops new shoulder pain annually. Common pathological conditions of shoulder like rotator cuff disorders and adhesive capsulitis etc exhibits similar clinical features like pain and stiffness of shoulder joint and restricted movements. Varma therapy rearranges and regulates the “Vaasi” and consequently helps to maintain the equilibrium of trihumours (Vatham, Pitham, Kapham). This review article explicates the Varma points for the treatment of shoulder pathological conditions, the exact anatomical location of Varma points and the appropriate method of its manipulation, certainly a key to further research articles.
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Purpose: To assess the differences in the pattern of presentation of glaucoma emergency conditions during the various phases of pandemic?related travel restrictions: first wave?related lockdown, unlock period, and the second wave?related lockdown. Methods: The number of new emergency glaucoma conditions, the various diagnoses, and the total number of all new glaucoma patients presenting to the glaucoma services at five tertiary eye care centers in south India from 24th March 2020 to 30th June 2021 were collected from the electronic medical records and were analyzed. The data were compared with the corresponding time period in the year 2019. Results: In total, 620 patients presented with an emergency glaucoma diagnosis during the first wave?related lockdown as against 1337 during the same period in 2019 (P < 0.0001). During the unlock period, 2659 such patients visited the hospital compared with 2122 in 2019 (P = 0.0145). During the second wave?related lockdown, there were 351 emergency patients compared with 526 patients in 2019 (P < 0.0001). Lens?induced glaucomas (50.4%) and neovascular glaucoma (20.6%) were the most common diagnoses during the first wave?related lockdown. During the unlock period, there was a greater proportion of neovascular glaucoma (P = 0.0123). The second wave?related lockdown had a greater proportion of phacolytic glaucomas (P = 0.005) and acute primary angle closure (P = 0.0397) patients. Conclusion: The study demonstrates that emergency glaucoma care was grossly underutilized by the people during the lockdowns. Trivial conditions like cataracts or retinal vascular diseases if not treated appropriately may progress to become emergencies in the future.
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This case report describes three cases in which periapical surgeries were carried out using a new surgical endodontic technique by using a three?dimensional (3D) printed template for guided osteotomy and root resection. In Case 1, the data obtained from preoperative CT scan and cast scan were transferred to a surgical planning software. The surgical template was printed using a 3D printer. Using the template, osteotomy and root?end resection were precisely carried out. In Case 2, after CBCT imaging, data were transferred to stereolithography and a 3D model was fabricated. With the help of the 3D model, a template was fabricated using tray material. This guided surgical template minimized the extent of osteotomy and enabled precise targeting of the apex. In Case 3, a preoperative CT scan aided in the fabrication of a surgical 3D template. The template assisted in the precise removal of the overlying cortical bone.
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Every woman who became pregnant has to undergo the process of delivery. In normal process of delivery the baby is delivered per vagina, an episiotomy is performed by health care provider or midwife. Episiotomy is a surgically planned incision on the perineum and the posterior vaginal wall during the second stage of labour to enlarge the vaginal introits so as to facilitate easy and safe delivery of the fetus. Episiotomy may be advice in the situations such as inelastic perineum, fetal distress, and complicated birth, prolonged second stage of labor, instrumental vaginal delivery and previous perineal surgeries .There are four types of episiotomy: midline, mediolateral, lateral and J shaped. Care of episiotomy involves perineal care, sitz bath, infrared heat, perineal exercises, antiseptic ointments, cold and hot packs The REEDA scale is used for assessing the perineal healing. Complications of episiotomy include perineal discomfort, perineal pain, difficulty with breast feeding and walking, perineal bleeding, infection, wound dehiscence and dyspareunia
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@#Introduction: Though there are abundant studies on entrepreneurial intention among students pursuing higher education, there is a lacuna in understanding the entrepreneurial intention of medical students. In the present scenario of increasing unemployment among young medical graduates, this quantitative study was conducted with an aim to examine the level of entrepreneurial intention among medical students and the socio-demographic factors influencing it. Methods: The participants were 318 medical students of a private university in Malaysia. A cross-sectional study design with a validated adapted questionnaire was used to collect data. The data was analysed using descriptive and inferential statistics. Results: A moderately high level of entrepreneurial intention was found among the study population. Regression analysis revealed a statistically significant impact of gender and marital status on their entrepreneurial intention while ethnicity, year of study, household income or educational loan did not have a significant influence. Conclusion: Medical students in Malaysia showed a moderately high inclination towards an entrepreneurial career. Non-economic factors like gender and marital status proved to be stronger influencers of entrepreneurial intention than economic factors. This may help policy makers plan strategies to sustain their entrepreneurial intentions and facilitate for more entrepreneurial activities among young doctors in the futu
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@#Introduction: In medical education one of the main goal is to facilitate the development of professional identity of medical students. It is influenced by sociocultural factors whose influence has been examined by the empirical scholarship on professional identity research in a robust way. The current research studied the influence of gender, ethnicity and year of study on the professional identity of medical students using a validated instrument. Methods: The quantitative research approach using the cross sectional survey design is adopted in the present study. The instrument for the measurement of professional identity was developed using the items adapted from previous research. Stratified random sampling was used to collect the data from 318 participants. The reliability and construct validity of the instrument was evaluated using Smart PLS 3. Data was analysed, for descriptive and inferential statistics using SPSS version 26. Result: Ethnicity, gender and year of study had an impact on the professional identity of medical students. Indian ethnicity had significantly higher positive influence. The female students had higher professional identity than male medical students. As the students’ progressed to higher level of their training their professional identity progressively decreased. Conclusion: The medical students trained with similar curricular activities and the learning experiences develop different levels of professional identity. The level of professional identity developed by the medical students in deferent gender, ethnicity, and year of study differes. The sociocultural factors need to be considered when designing activities aimed at development of medical students’ professional identity.
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@#Introduction: People of different cultures perceive health and disease differently. A culturally competent healthcare team is needed to provide quality healthcare. In Asian medical schools, less emphasis is laid on cultural competency training. In this context, the study aims to assess the cultural competency of medical students in Malaysia and to fathom the demographic factors influencing it. Methods: A cross sectional survey was conducted on students from all five years of a Malaysian medical school using an adapted version of Clinical Cultural Competency Questionnaire (CCCQ) to tap the self-perceived knowledge, skills, comfort level in cross-cultural encounters and attitude towards cultural competency. Descriptive and inferential statistics was used to analyse the data. Results: Among the 291 respondents, the cultural competency was found to be significantly different among medical students of different year of study, age, and ethnicity. However, with regards to gender, country of birth or the number of languages spoken, the difference was insignificant. The clinical year students had significantly higher scores on the knowledge, skills, comfort level and attitude domains of cultural competency when compared to the preclinical students. Chinese students’ perception on cultural competence was significantly distinct from Indian and Malay students. Conclusion: Exposure to cross cultural encounters in clinical settings and personal experiences seem to influence cultural competency of the medical students. It provides valuable data to plan for interventions, training and self-development strategies aimed at providing culturally attuned patient centred care.
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Siddha system granting preventive, curative and rejuvenating healthcare. According to Siddha system three humours- Vatham, Pitham and Kapham- mediate the body’s physiological function. Derangements of trihumour lead to diseases. Vatha diseases are the most common diseases presenting in Siddha hospitals nowadays. In Siddha system the primary goal of the treatment is to restore the balance of trihumours. The first and foremost treatment for Vatha disease is Bhedhi (purgation). The quote ‘BhedhiyaalVathamthaalum’ indicates purgation therapy will reduce Vatham. For this study the purgative drug Agasthiyarkuzhambu is used. Aim and Objective: To make a validation of purgation therapy to alleviate Vathaim balance. To describe purgation therapy in alleviate Vathaim balance by giving Agasthiyarkuzhambu to outpatient and inpatient Department, Govt. Siddha Medical College, Palayamkottai. To observe the increased Vatha symptoms and Neikuri changes before and after treatment. Materials and methods: ANon randomized clinical trial was done with 40 patients, data were collected by interviewing with structured questionnaire about increased Vatha symptoms and samples of urine were collected to the analysis. The data will be analysed using SPSS. Results: Out of 40 patients, based on relief of Vatha symptoms 45% of cases reported good relief and 13% of cases reported better relief from their symptoms. In Neikuri before treatment 40% of cases had typical Vathaneikuri (fast, irregular, Aravu pol) and after treatment the Neikuri pattern changed to Pithavatham, Pitham and Kapham and only 10% of cases had Vathaneikuri. Neikuri and Vatha symptoms are better parameter for assessing alleviated Vatha imbalance in this study.
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Purpose: To compare the impact of Sibling Motivational Card (SMC) and oral counseling in screening siblings of primary open?angle glaucoma (POAG) probands. Methods: Two hundred and thirty-four newly diagnosed POAG probands were randomized to receive either oral counseling or SMC to motivate their siblings for a glaucoma screening at a tertiary eye care hospital in South India from July 2015 and June 2017. A total of 116 probands were orally counseled with a standard template of dialogs about the importance of family screening to motivate their siblings for a screening. One hundred and eighteen probands were randomized to receive SMC, bearing the details of the proband, sibling, and a message stressing the importance of family screening, in addition to oral counseling. We assessed the response rate in each group. Additionally, we evaluated the prevalence of POAG in the siblings. Results: A total of 95 siblings of 234 POAG probands were screened. The mean age distribution was 53.33 ± 10.9 years (range 28–79 years). The male to female ratio was 3:4. The percentage of siblings screened was more in the oral counseling group (63.2%) than in the SMC group (36.8). About 43 (45%) siblings had some form of glaucoma, and 13.6% had POAG. An additional 22.1% were disk suspects, and 5.2% had ocular hypertension. Conclusion: SMC did not have an additional benefit over the standard oral counseling in promoting sibling screening. Our study stresses the importance of sibling screening in POAG probands. Targeting siblings of POAG probands with oral counseling may offer a relatively inexpensive way of detecting glaucoma
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Purpose: To study the clinical and demographic profile of patients less than 40 years of age presenting to glaucoma services including the reasons for referral. Methods: Patients in the age group of 5 to 39 years, visiting the glaucoma clinic, who were either suspected to have glaucoma or who had been newly/previously diagnosed with glaucoma were included in the study. After informed written consent, basic demographic details of the participants including age, gender, education, socioeconomic status, and family history were obtained. A comprehensive ophthalmological evaluation was performed by glaucoma specialists. Results: The proportion of glaucoma in the study population (n = 384) was found to be 31.25%, and the incidence of glaucoma among new patients was found to be 11.9%. Among all glaucomas (n = 120), 44.2% of patients had secondary glaucomas, 27.5% had primary glaucomas, and 28.3% had congenital glaucomas. Also, 67.3% of all glaucoma patients were males. Newly diagnosed glaucoma patients presented with a mean intraocular pressure (IOP) of 32.9 mmHg and mild–moderate disc damage with a mean cup?disc ratio of 0.65. Nearly one?third of them had a presenting visual acuity worse than 5/60. The most common reason for referral was raised IOP. Univariate and multivariate analysis revealed that the odds of developing glaucoma were less in females (P = 0.04) and in patients with a higher standard of living index (P < 0.001). Conclusion: One?third of the patients had glaucoma and another one?third were suspects. Secondary glaucomas are more common than primary/congenital glaucomas. A comprehensive eye evaluation is a must, especially in those with predisposing factors.
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Public distribution system has been an important welfare programme of government aimed to ensure food security in India ever since independence. PDS had been striving hard to provide subsidized essential commodities to the poor and needy of the country. Tamil Nadu has been implementing universal public distribution system to ensure food security for all its citizens. This paper tries to analyze the present status of Public Distribution System in Tamil Nadu. PDS had been under the wrath for many decades for the level of corruption, bogus purchases and leakage the system has. Reformation of the system was the need of the time. This paper also tries to evaluate the recent reforms introduced by the government of Tamil Nadu to make the functioning of PDS efficient.
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Risk perceptions are crucial in understanding people's thoughts about stroke risk and their preventive health behaviours. Management of risk factors plays a vital role in preventing stroke. This study aimed to identify the perceived and actual risk factors in patients with acute stroke. It was a cross-sectional descriptive study conducted in Sri Ramachandra University Hospital, India. A total of 210 in-patients of a stroke unit were included. Patients’ data were obtained by interviewing the patient and /or accompanying family member and by reviewing their medical records using a standard questionnaire. Data were analysed using descriptive and inferential statistics. The median self-perceived risk factor was three. The most commonly perceived risk factor was hypertension (53.8%), followed by stress, diabetes, hyperlipidaemia, alcohol intake, smoking and family history. The perception of risk was low when compared to actual risk (p < 0.016). The patients with coronary heart disease, family history of stroke and congestive heart failure have higher risk of having ischaemic stroke. There was a positive correlation between the actual risk and perceived risk.
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Background: Iron deficiency anemia is the commonest type of nutritional anemia seen during pregnancy. Despite implementing oral iron prophylaxis in pregnancy,IDA in pregnant women constitute a major health problem. The present study aims to look at the prevalence of IDA in a pregnant population in Seremban, Malaysia and their response to treatment. Methods: This is a retrospective study looking into the prevalence of iron deficiency anaemia among pregnant women who delivered between October 2019 to March 2020 in a state hospital in Seremban, Malaysia and their response to treatment. Main outcome measures were the prevalence of iron deficiency anaemia, associated demographic and clinical factors and response to iron therapy. Results: About 920 patients� records were included for analysis. The prevalence of anaemia in this cohort was 42.8% (N=394). The prevalence of iron deficiency anemia (IDA) was 31.5% (N=124) among the anemic patients or 13.5% of the studied population. The mean hemoglobin level for this group was 10.0�74 g/dl (6.8-10.9 g/dl) and majority had mild anemia (91.9%, N=114). 68.5% IDA patients were successfully treated by 36 weeks pregnancy. Of the remaining 39 patients who were still anemic, 37 (94.9%) had mild anemia with mean hemoglobin level of 10.3g/dl (SD 0.48, range 9.0-10.9 g/dl). Conclusion: Current treatment strategy is inadequate to achieve the set national target. There is a role foran early recourse to parenteral iron therapy to improve treatment outcome.
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Manual small-incision cataract surgery is one of the most common surgical procedures in ophthalmology. Most cataract surgeries are performed under local anaesthesia. Peribulbar or retrobulbar anaesthesia is commonly used to achieve analgesia and akinesia during surgery but it has various complications. Our aim was to study patient comfort and surgeon抯 perspective in terms of patient cooperation in MSICS under topical anaesthesia using only proparacaine 0.5% eye drops without any periocular block or intracameral drug. Also to popularise Topical MSICS similar to Topical Phacoemulsification. A prospective analytical study of 33 patients who underwent MSICS surgery from March 2022 to June 2022 using Topical proparacaine eye drops 0.5% was done and patient抯 comfort and surgeon抯 perspective in terms of patient cooperation was studied on a scale of 1-5. Out of 33 patients who underwent surgery, the average comfort score based on patient feedback was 3.45� 0.96 and average patient cooperation score based on surgeon assessment was 3.42 � 1.07 on a scale of 1-5. We concluded that MSICS using only topical proparacaine 0.5% eye drops, can provide sufficient patient comfort and can avoid complications related to peribulbar anaesthesia. Hence it can be used in large scale cataract surgeries and also provides economical utilisation of resources, lesser complications and early post operative recovery without compromising surgical outcome.
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Purpose: To analyze intraoperative difficulties and visual and surgical outcomes following pediatric cataract surgery. Methods: This five?year retrospective study (2014�19) included 138 eyes (85 children) with cataract aged between 12 months and 18 years (either sex). All children had undergone best?corrected visual acuity (BCVA), anterior and posterior segment evaluation, intraocular lens (IOL) power calculation, superior manual?small?incision cataract surgery (MSICS) with or without posterior capsulotomy/anterior vitrectomy and IOL implantation under general or local anesthesia, visual rehabilitation, and had been followed up for a minimum period of 12 months. Results: The mean age was 111.27 � 4.84 months. Preoperative BCVA distance: 113 (81.88%)eyes had BCVA < 6/60; near BCVA: 114 (82.6%) eyes had ?N36. At last postoperative follow?up (mean: 20.98 � 13.08 months): distant BCVA? ?6/60 had been recorded in 120 (86.96%) eyes; near BCVA? >N36 in 123 (89.13%) eyes. Improvement in BCVA was statistically significant. Intraoperative scleral tunnel difficulties were seen in three eyes (thin flap in two, and buttonhole in one eye); in the majority of the eyes 113 (81.88%), IOL was placed in the bag. Twenty eyes had early postoperative inflammation. At last follow?up: posterior capsular opacity was recorded in six eyes, IOL decenteration in two eyes, secondary glaucoma in six eyes, and severe amblyopia in 36 (26.09%) eyes. The mean myopic shift was ? 1.11 � 0.89 D and was statistically significant. Conclusion: Superior MSICS as a treatment for pediatric cataract has minimal intraoperative complications and satisfactory visual and surgical outcomes.
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Purpose: To study the presence and development of strabismus in children with telecanthus, epicanthus, and hypertelorism. Methods: This is a prospective, longitudinal, and observational study. Sixty children aged between 6 months and 18 years with telecanthus, epicanthus, and hypertelorism in isolation or in combination were recruited. A detailed analysis of the history, determination of best corrected visual acuity, complete evaluation of strabismus, and ocular examination were carried out. The presence of telecanthus, epicanthus, and hypertelorism and associated strabismus, if any, was noted. All children were followed up for a minimum and maximum period of 12 and 18 months, respectively, to analyze the strabismus (previously present) and for detection of strabismus in those who did not have. The data were analyzed descriptively with mean and standard deviation. Chi square test and Fishers exact test were used to analyze the data between the groups. A P value less than 0.05 was considered to be statistically significant. Results: Telecanthus was the most common lid feature (55%). At baseline, ten (16.66%) children had strabismus (six: esotropia; four: exotropia). Two (3.33%) children underwent surgery. One child developed exotropia at the third follow?up (18 months). At the end of the study, 11 (18.33%) children had strabismus. No significant association was seen between lid characteristics and the type of strabismus. Conclusion: Children with telecanthus, epicanthus, and hypertelorism in isolation or in combination may or may not have associated strabismus. These features can pose difficulty in strabismus diagnosis, which mandates a careful examination, especially in younger age groups and small?angle strabismus. On the other hand, children without strabismus need longer follow?up to detect the development of strabismus and to initiate further management at the earliest.
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Dental caries is a global oral health problem caused due to localized demineralization of the enamel. Chemical plaque control is used as an adjuvant to mechanical plaque control in removing biofilm, thereby preventing dental caries. In recent times, there has been a renewed interest in nature?based products. This systematic review aimed to analyse the existing literature to compare the effectiveness of herbal and conventional dentifrices on prevention of dental caries. A search was done in the databases of PubMed and Google Scholar in July 2020 for the related topic. A hand search was done from the references of primary studies and other clinical trial registry sites. Randomized control trials, comparative clinical trials, and in vitro studies in which the effectiveness of herbal and conventional dentifrices on prevention of dental caries were included after review by the reviewers. The systematic search revealed a total of thirty?two publications from which ten publications were included. Five studies were clinical studies and five were in vitro studies. All the studies used microbiological analysis for the determination of cariogenic microorganisms in plaque and saliva, whereas one study used pH of plaque and saliva. Among the included studies, all studies had a high risk of bias with level 2 evidence. With the evidence available, it can be concluded that herbal dentifrices and fluoride dentifrices have similar antimicrobial activity against cariogenic microorganisms.