ABSTRACT
Purpose: The aim of this study was to estimate the prevalence and causes of visual impairment (VI) and blindness and diabetic retinopathy (DR) in Siwan district, Bihar. Methods: A population-based cross-sectional study was done from January to March 2016 using the Rapid Assessment of Avoidable Blindness 6 (RAAB 6, incorporating DR module) methodology. All individuals aged ?50 years were examined in 57 randomly selected clusters within the district. Results: A total of 3476 individuals were enumerated and 3189 (92%) completed examination. The overall prevalence of blindness and severe VI was 2.2% (95% confidence interval (CI): 1.6–2.8) and 3.4% (95% CI: 2.6–4.3), respectively. Untreated cataract was the leading cause of blindness (73%) and severe VI (93%). The cataract surgical coverage (CSC) at <3/60 was 71.5% for eyes and 89.3% for persons in this sample and the CSC was similar between the genders. Refractive error (71%) was the primary cause of early VI. The overall prevalence of known and newly diagnosed diabetes was 6.3% (95% CI, 5.4–7.2%). Prevalence of any DR, maculopathy, and sight-threatening DR was 15, 12.4, and 6%, respectively. Conclusion: To conclude, as compared to previous reports, the prevalence of blindness and DR in Siwan district of Bihar was found to be lower and the CSC was higher. However, the problem of avoidable blindness remains a major problem in this region.
ABSTRACT
ackground: Aims: To compare the anti ischaemic efficiency of antianginal thepapy using a combination of metoprolol, Long acting nitrate (LAN) & trimetazidine/ranolazine in patients with stable effort angina with impaired LV function. Methods: The study enrolled 200 patients (male & female) aged 55-70 years with stable effort induced angina (functional class II and III angina) documented coronary artery disease. When the patients taking metoprolol 50mg twice daily& LAN 2.6 mg twice daily continued to have angina, after that 120 patients received an additional 35mg of trimetazidine twice a day or ranolazine 500 mg twice daily & 80 patients had double antianginal thepapy –methoprolol & LAN. Treadmill exercise test and transthoracic echocardiography were performed at weeks (WO, & W12). Results: After 12 weeks, treadmill exercise showed there were significantly greater improvements in the triple antianginal group (metoprolol+ LAN+ trimetazidine / ranolazine): time to I mm ST segment depression, maximum ST segment depression, mean weekly number of angina attacks, mean weekly nitrate consumption, & grade of angina pain and transthoracic echocardiogram showed improved left ventricular systolic and diastolic function. Conclusion: Triple antianginal thepapy with metoprolol+ LAN+ trimetazidine/ ranolazine combinations produced significant improvement in exercise stress test & the symptoms of angina relative to double antianginal therapy(metoprolol+ LAN) as well as improved left ventricular function.