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Purpose: To evaluate the effectiveness of amblyopia treatment through a smartphone?based anaglyph system by virtual reality (VR) in adult patients. Methods: A total of 10 subjects diagnosed with anisometropic amblyopia were enrolled during the study period. Best Corrected Visual Acuity (BCVA), stereoacuity, and contrast acuity were evaluated during three visits (at presentation, 3 months and 6 months) of smartphone?based anaglyph video run in the VR mode. All the amblyogenic factors including stereopsis, color vision, and contrast acuity were compared using Friedman two?way analysis of variance. Statistical significance was considered if P < 0.05. Results: Mean BCVA in amblyopic eye improved significantly from a logMAR value of 0.73 ± 0.64 before Virtual reality vision therapy (VRVT) to a post?training VRVT value of 0.48 ± 0.44 (P < 0.01). Mean stereoacuity changed from a value of 560.00 ± 301.58 before VRVT to a value of 263.00 ± 143.58 seconds of arc after training (VRVT) (P < 0.01). Mean accommodation changes from a value of 15.00 ± 7.40 before training or VRVT to value of 12.60 ± 6.10 cm after training (P < 0.01). Mean contrast acuity changes from a value of 1.21 ± 0.72 at presentation to a value of 1.52 ± 0.49 log unit after VRVT. Conclusion: A smartphone?based anaglyph system using VR vision therapy appears to be an effective treatment option for amblyopia in adults.
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Objectives To study the course of West syndrome (WS) and coronavirus disease-19 (COVID-19) in children with WS who contracted SARS-CoV-2 infection. Methods This ambispective study was conducted at a tertiary-care center in North India between December 2020 and August 2021 after approval from the Institute Ethics Committee. Five children with WS, positive for COVID-19 based on RT-PCR, fulflled the inclusion criteria. Results One child with COVID-19 during the frst wave was retrospectively included while four children (of the 70 children screened) were prospectively enrolled. The median age at onset of epileptic spasms was 7 mo (2 boys), and that at presentation with COVID-19 was 18.5 mo. Three had underlying acquired structural etiology. Three were in remission following standard therapy, while two had ongoing spasms at the time of COVID-19 illness. During the illness, two of those in remission continued to be in remission while one child had a relapse. The children with ongoing epileptic spasms had variable course [one had persistent spasms and other had transient cessation lasting 3 wk from day 2 of COVID-19 illness, but electroencephalography (on day 8 of COVID-19 illness) continued to show hypsarrhythmia]. Fever was the most typical symptom (and sometimes the only symptom) of COVID-19, with a duration ranging from 1–8 d. Two children had moderate COVID-19 illness requiring hospitalization, while the rest had a mild illness. All the afected children had complete recovery from COVID-19. Conclusion The severity of COVID-19 illness in children with WS is often mild, while the subsequent course of WS is variable.
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The current study focuses on the relationship between workplace ostracism, psychological capital and work engagement among private sector employees in Mumbai. The data was collected from a total of 180 private sector employees (i.e., 90 males, 90 females). The tools been administered are The Workplace Ostracism Scale by Ferris et al. (2008), Psychological Capital Questionnaire- PsyCap-12 by Luthans et al. (2007), and The Utretch Work Engagement Scale- UWES-9S by Schaufeli et al. (2002). Correlational research design using quantitative approach was used. The findings of the study indicate significant relationships between the variables, with perceived workplace ostracism accounting for a significant variational impact on psychological capital and work engagement.Years of work experience also show to have a significant difference on the perception of workplace ostracism. Surprisingly, no significant gender difference was observed.
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Background: Coronavirus disease 2019 (COVID-19) is majorly known to cause mild to moderate disease, but a small fraction of patients may develop respiratory failure due to diffuse lung injury, requiring management in the intensive care unit (ICU). This study attempts to identify factors that can predict unfavorable outcomes in moderate to severe COVID-19 patients. Methods: Hospital records of 120 COVID-19 patients admitted to the ICU were retrospectively analyzed and data pertaining to demographic, clinical, and laboratory parameters were obtained. These data were then compared with outcome parameters like survival, duration of hospital stay, and various adverse events. Results: Out of 120 patients, 70% were male, with a mean age of 54.44 years [standard deviation (SD) ± 14.24 years]. Presenting symptoms included breathlessness (100%), cough (94.17%), fever (82.5%), and sore throat (10.83%). Diabetes, hypertension, and chronic obstructive pulmonary disease (COPD) were the common comorbidities associated. Increased serum D-dimer, ferritin, interleukin-6 (IL-6) levels, and unvaccinated status were associated with higher mortality. Overall, 25.83% of patients survived, 24.41% of patients developed septic shock, and 10.6% of patients were discharged on oxygen. World Health Organization (WHO) clinical progression scale score ? 6 had 57 and 82% sensitivity and 83 and 77% specificity on days 7 and 14 after admission, respectively, for predicting mortality. A baseline National Early Warning Score 2 (NEWS 2) ? 9 had 48% sensitivity and 88% specificity for predicting mortality. Conclusion: Advanced age and associated comorbidities are linked to adverse outcomes in moderate to severe COVID-19. Persistently high D-dimer levels, despite standard treatment, may also contribute to increased mortality. WHO clinical progression scale and NEWS 2 have high specificity for predicting mortality.
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Background: Carcinoma cervix contributes to a major proportion of cancer treatment in tertiary oncology centers. The outcomes are dependent on multiple factors. We conducted an audit to establish the pattern of treatment practiced for carcinoma cervix at the institute and suggest changes thereof to improve the quality of care. Methodology: A retrospective observational study of 306 diagnosed cases of carcinoma cervix was carried out for the year 2010. Data was collected with regards to diagnosis, treatment, and follow-up. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 20. Results: Out of 306 cases, 102 (33.33%) patients received only radiation therapy and 204 (66.66%) patients received concurrent chemotherapy. The most common chemotherapy used was weekly cisplatin 99 (48.52%), followed by weekly carboplatin 60 (29.41%) and three weekly cisplatin 45 (22.05%). Disease-free survival (DFS) at 5 years was 36.6% with patients of overall treatment time (OTT) of <8 weeks and >8 weeks showing DFS of 41.8% and 34% (P = 0.149), respectively. Overall survival (OS) was 34%. Concurrent chemoradiation improved overall survival by a median of 8 months (P = 0.035). There was a trend towards improved survival with three weekly cisplatin regimen, however, insignificant. Stage correlated with improved overall survival significantly with stage I and II showing 40% and stage III and IV showing 32% (P < 0.05) OS. Acute toxicity (grade I-III) was higher in the concurrent chemoradiation group (P < 0.05). Conclusion: This audit was a first of its kind in the institute and threw light on the treatment and survival trends. It also revealed the number of patients lost to follow-up and prompted us to review the reasons for it. It has laid the foundation for future audits and recognized the importance of electronic medical records in the maintenance of data
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Introduction: The study was conducted to evaluate IOP management by surgical modalities such as combined trabeculectomy and phacoemulsification and phacoemulsification surgery alone. Vision impairment is a major public health problem and the burden is increasing with increase in aged population. This study wasAims And Objectives: undertaken for study the IOP management by surgical modalities such as combined trabeculectomy and phacoemulsification and phacoemulsification surgery alone. A pre-designed prospective study was conducted at the OPD of upgraded Department of Ophthalmology at LLRM Medical College, Meerut. A total of 60 patients were divided in to two equal groups randomly and studied. Majority of the patients in both the groups wereObservation And Result: aged between 61 – 70 years. Females outnumbered males in this study which was statistically significant between the two groups. The mean pre- operative intra ocular pressure was 23.3 mm Hg in combined surgery group and 23.9 mm Hg in cataract surgery alone group. Mean Intra ocular pressure decreased regularly in each follow up more in combined group than the cataract surgery alone group. The mean intra ocular pressure after 1 years follow up in combined surgery group was 10.8 mm Hg and 13.4 mm Hg in the cataract surgery alone groups which was statistically significant. Mean BCVA before the operation was 3.2 in combined surgery group and 3.8 in cataract surgery before surgery. Mean BCVA declined after 1 year of follow up in combined surgery group was 1.9 and 2.7 in cataract surgery alone group which was statistically significant. The surgery success was complete in 80.0% of the combined surgery group and 60% of the cataract alone group. Criteria For Failure Of Surgeries Ÿ The IOP >23 MMHG at the end of 1 year or Ÿ The IOP not reduced by 20 % from base line at the end of 1 year Conclusion: This study was mainly undertaken to study the efficacy of combined trabeculectomy with cataract extraction and cataract only on primary angle closure glaucoma. This study had found that, the reduction of intra ocular pressure in both the groups but more prominent in combined surgery group than cataract alone surgery group.
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Oroxylum indicum (L.) Kurz, commonly called as Broken bones tree or Indian trumpet flower, belonging to Fam. Bignoniaceae, is traditionally used as a contraceptive by ethnic people of Tripura, North-East India. Here, we investigated the scientific basis for use of O. indicum as male antifertility agent by folklore healers. In vitro spermicidal activity of aqueous (AEOI) and methanolic (MEOI) extracts of O. indicum stem bark were studied on human sperm. The in vivo activity was experimented on male albino rats. The treated animals were allowed to mate and the pups delivered by female rat partners were counted. Phytochemical estimation of test samples was done using HPLC. The AEOI and MEOI treatments significantly decreased human sperm motility and viability. Test extracts have increased the hypo-osmotic swelling of sperm. Both the extracts were significantly declined the weight of reproductive organ. The MEOI treated rats have shown significant decrease in sperm motility and sperm counts. AEOI and MEOI treatment significantly reduced level of testosterone, but sharply raised dihydrotestosterone and prostaglandin in rats. Results testified the traditional claim for use of O. indicum as a male contraceptive agent, where MEOI have shown reversible action on male reproductive system leading to contraception without harming the libido.
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The current study focuses on the relationship between emotion regulation, perceived interpersonal support, and academic anxiety among high school students in Kerala. The data was collected from 300 high schools students from three schools in Pathanamthitta District. The tools been administered are Difficulties in Emotion Regulation Scale-DERS- SF-18 by Victor & Klonsky (2016), The Multi-dimensional Scale for Perceived Social Support by Zimet and Farley (1988), and Academic Anxiety Scale for children (AASC) by Dr. A K Singh and Dr. A Sen Gupta (2018). Correlational research design using quantitative approach has been used. The findings of the study revealed that there is a significant relationship between emotion regulation, perceived interpersonal support and academic anxiety. There is a significant difference in academic anxiety based on age, gender, birth order and family type.
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Hepaticojejunostomy is currently the best treatment for post-cholecystectomy biliary strictures. Laparoscopic repair has not gained popularity due to difficult reconstruction. We present case of 43-year-old-female with Bismuth type 2 stricture following laparoscopic converted open cholecystectomy with bile duct injury done elsewhere. Position was modified Llyod-Davis position and four 8-mm robotic ports (including camera) and 12-mm assistant port were placed. The procedure included noticeable steps such as adhesiolysis, identification of gallbladder fossa, identification of common hepatic duct, lowering of hilar plate etc. Operating and console time were 420 and 350 minutes and blood loss was 100 mL. Patient was discharged on postoperative day 4. Robotic repair (hepaticojejunostomy) of biliary tract stricture after cholecystectomy is safe and feasible with good outcomes.
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Fusobacterium nucleatum is a gram-negative bacteria associated with diverse infections like appendicitis and colorectal cancer. It mainly attacks the epithelial cells in the oral cavity and throat of the infected individual. It has a single circular genome of 2.7 Mb. Many proteins in F. nucleatum genome are listed as “Uncharacterized.” Annotation of these proteins is crucial for obtaining new facts about the pathogen and deciphering the gene regulation, functions, and pathways along with discovery of novel target proteins. In the light of new genomic information, an armoury of bioinformatic tools were used for predicting the physicochemical parameters, domain and motif search, pattern search, and localization of the uncharacterized proteins. The programs such as receiver operating characteristics determine the efficacy of the databases that have been employed for prediction of different parameters at 83.6%. Functions were successfully assigned to 46 uncharacterized proteins which included enzymes, transporter proteins, membrane proteins, binding proteins, etc. Apart from the function prediction, the proteins were also subjected to string analysis to reveal the interacting partners. The annotated proteins were also put through homology-based structure prediction and modeling using Swiss PDB and Phyre2 servers. Two probable virulent factors were also identified which could be investigated further for potential drug-related studies. The assigning of functions to uncharacterized proteins has shown that some of these proteins are important for cell survival inside the host and can act as effective drug targets.
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Purpose@#Feeding jejunostomy (FJ) is a critical procedure to establish a source of enteral nutrition for upper gastrointestinal disorders. Minimally invasive surgery has the inherent benefit of better patient outcomes, less postoperative pain, and early discharge. This study aims to describe our total laparoscopic technique of Witzel FJ and to compare its outcome with its open counterpart. @*Methods@#A retrospective database analysis was performed in patients who underwent laparoscopic (n = 20) and open (n = 21) FJ as a stand-alone procedure from July 2018 to July 2022. A readily available nasogastric tube (Ryles tube) and routine laparoscopic instruments were used to perform laparoscopic FJ. Perioperative data and postoperative outcomes were analyzed. @*Results@#Baseline preoperative variables were comparable in both groups. The median operative duration in the laparoscopic FJ group was 180 minutes vs. 60 minutes in the open FJ group (p = 0.01). Postoperative length of hospital stay was 3 days vs. 4 days in the laparoscopic and open FJ groups, respectively (p = 0.08). Four patients in the open FJ group suffered from an immediate postoperative complication (none in the laparoscopic FJ group). After a median follow-up of 10 months, fewer patients in the laparoscopic FJ group had complications such as tube clogging, tube dislodgement, surgical-site infection, and small bowel obstruction. @*Conclusion@#Laparoscopic FJ with the Witzel technique is a safe and feasible procedure with a comparable outcome to the open technique. Patient selection is vital to overcome the initial learning curve.
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Valsalva sinus aneurysm (SVAs) and double-chambered right ventricle (DCRV)is an uncommon congenitalheart defect and are usually associated with ventricular septal defect (VSD) in 50% to 60% of patient抯 population. The current case report had documented a 59 years old hypertensive asymptomatic male with a known case of SVAs presented to our hospital following device closure for 6 months. On examination, the patient was diagnosed to have DCRV induced by SVAs prior to the closure along with other factors. However, to the best of our knowledge, this is the first case report on DCRV induced by SVAs in synergy with other associated multifactors and without VSD among the Indian population.
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Purpose: Low?concentration atropine is an emerging therapy for myopia progression, but its efficacy remains uncertain among high myopic children. This study aimed to evaluate the efficacy and safety of low?concentration atropine eye drop (0.01%) in high myopic children. Methods: A non?randomized, parallel?group, longitudinal interventional cohort study. Myopic children were divided into two groups: (1) the intervention arm of children who received one drop of topical 0.01% atropine once a day at bedtime and (2) the control arm, in which enrolled children who were on observation only. Repeated measurements of spherical equivalent refractive errors (SERs) were performed at baseline and 1 and 2 years after treatment. Results: A total of 37 eyes were enrolled in the intervention arm (allocated to 0.01% atropine at year 1 follow?up) and 23 eyes in the control arm. After 1 year of 0.01% atropine therapy, the myopia progression was 0.15 ± 0.9 D in the intervention group versus 1.1 ± 1 D in the control group (P = 0.001). Similarly, after 2 years of treatment, the myopia progression was 0.3 ± 1.1 D in the intervention group versus 1.4 ± 1.1 D in the control group (P ? 0.001). Conclusion: Compared to no treatment, 0.01% atropine treatment had shown better effect on myopia progression in high myopic children
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Mucormycosisis the third most common invasive fungal infection with a high mortality rate seen in immunocompromised patients. It is an increasingly well-reported invasive fungal infection that affects recipients of solid-organ transplant. The incidence of mucormycosis in patients with heart transplants ranges from 0 to 0.6%. We reporteda case of mucormycosis in a young heart transplant male recipient.
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Hypertriglyceridemia induced pancreatitis is the third most common cause of acute pancreatitis after gall stones and alcohol. Most of the patients with Hypertriglyceridemia (HTG) has primary or genetic defect in lipoprotein metabolism. Groove pancreatitis is a rare form of Pancreatitis with most patients being male and history of alcohol consumption. Here we report a case of 33 year old female who is a known diabetic, presented with diabetic ketoacidosis. Her serum lipase was 3133 U/l (<40U/l). Here we report a case of familial dyslipidemia with severe hypertriglyceridemia causing pancreatitis involving the Groove presenting with Diabetic Ketoacidosis.
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Ayurveda is eternal and continuous flow of ancient medicine, Now a day, Pratishyaya (Allergic rhinitis) is one of the most prevalent and common ailments. It is an atopic disease. Atopic is defined as familial tendency to sensitization to environment allergens (pollen, dust etc). It is a benign but chronic disease of upper airways and over all prevalence in round about 18% in general population. In Ayurveda, concept of allergy is scientifically explained under the Asatmayaj Vyadhi while its effects are explained in hereditary, Virudhahara, Dushivish and Ritusandhi. It is recurrent frequently and attending Jeerna avastha, Nasya is the line of treatment. In present time medical fraternity is attracted towards Nasya. It is a part of Panchakarma and is believed to be all round. The Present study tested efficacy of Pathaadi taila Nasya in the management of Pratishyaya w.s.r allergic rhinitis. The study was conducted on 15 patients, duration of 60 days. Total four sitting of Nasya Karma had done after having 7 days interval. After 14 days follow up the effect of Pathaadi tail Nasya assessed statistically based on the assessment criteria. It was observed that 14 days of Nasya karma decrease Pratishyaya, In this study we found that Pathaadi taila Nasya was effective in Pratishyaya.
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Introduction: The female gender is a risk factor for idiopathic pulmonary arterial hypertension. However, it is unknown whether females with rheumatic mitral valve disease are more predisposed to develop pulmonary hypertension compared to males. Aim: We aimed to investigate whether there was a difference in genotypic distribution of endothelin-1 (ET-1) and endothelin receptor A (ETA) genes between female and male patients of pulmonary hypertension associated with rheumatic mitral valve disease (PH-MVD). Methods: We compared prevalence of ET-1 gene (Lys198Asn) and ETA gene (His323His) polymorphisms according to gender in 123 PH-MVD subjects and 123 healthy controls. Results: The presence of mutant Asn/Asn and either mutant Asn/Asn or heterozygous Lys/Asn genotypes of Lys198Asn polymorphism when compared to Lys/Lys in females showed significant association with higher risk (odds ratio [OR] 4.5; p ¼0.007 and OR 2.39; p ¼0.02, respectively). The presence of heterozygous C/T and either mutant T/T or heterozygous C/T genotypes of His323His polymorphism when compared to wild C/C genotype in females showed a significant association with higher risk (OR 1.96; p ¼0.047 and OR 2.26; p ¼0.01, respectively). No significant difference was seen in genotypic frequencies in males between PH-MVD subjects and controls. Logistic regression analysis showed that mutant genotype Asn/Asn (p ¼0.007) and heterozygous genotype Lys/Asn of Lys198Asn polymorphism (p ¼0.018) were independent predictors of development of PH in females.
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Background & Aims: The coronavirus pandemic has caused a rapid surge in patients requiring intensive care unit (ICU) admission. The mainstay of treatment is supplemental oxygen therapy by an oxygen mask, nonrebreathing mask, high flow nasal oxygen therapy (HFNOT), non-invasive and invasive mechanical ventilation. HFNOT is a relatively newer, easy-to-use technique with better patient compliance. This study aimed to assess the outcome of HFNOT in Corona Virus disease (COVID) patients in ICU. Methods: This record based; retrospective study included 43 reverse transcriptase polymerase chain reaction (RTPCR) confirmed COVID patients whose respiratory support was initiated on HFNOT as per the inclusion criteria. The primary outcome of this study was to assess the number of patients requiring mechanical ventilation (HFNOT failure). The secondary outcome was to assess the association of HFNOT failure with age, co-morbidity index, and severity of illness. Results: Out of forty-three patients, twenty-five patients (58%) required conversion to mechanical ventilation. Eighteen patients (42%) were managed with HFNOT alone. HFNOT failure was more with increasing age and higher comorbidity score (p value<0.05). Conclusion: We concluded that HFNOT can be successfully used in COVID patients in ICU without the need for mechanical ventilation. However, it should be used cautiously in patients with higher 4C mortality scores.
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Purpose: The purpose of this study was to assess the performance of the tertiary centers (TCS) and vision centers (VCs) of the four organizations participating in this research, once the lockdown was lifted, and to compare it with the performance during the same period of the previous year. Methods: This was a cross?sectional study assessing eyecare utilization in the first 2 months after resumption of services post the lockdown in 2020 and comparing that across the same time period in 2019. Anonymized data containing basic demographic details, proportions of patient visits and their reasons, as well as referral information was collected. The drop percentage method was used, and P values were calculated using paired t?tests. Results: Four TCs and 60 VCs were included. Overall, outpatient attendance dipped 51.2% at TCs and 27.5% at VCs, across the 2 years. At both levels of care delivery, the percentage drop in females was more than that in males; however, the overall drop at VCs was less than that at TCs, for both sexes. Eyecare utilization in pediatric populations dropped significantly more than in adult populations, across the overall sample. There was no significant change in referrals for refractive error as a proportion of total outpatients, although there was a significant decline in the same for cataract and specialty treatment. Conclusion: VCs are valuable and successful model for eyecare delivery especially in the continued aftermath of the COVID?19 pandemic
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Purpose: To determine the pattern of refractive error among commercial drivers in north India. Methods: Descriptive study with convenient sampling conducted among commercial drivers of north India. Results: A total of 213 (75.8%) heavy?vehicle and 68 (24.2%) light?vehicle drivers were screened for eye diseases. Refractive error for distance was reported in 44 (15.7%; 95% CI: 11.6–20.4) drivers. Hyperopia was reported in 23 (8.2%; 95% CI: 5.2–12) drivers, followed by myopia in 15 (5.3%; 95% CI: 3–8.6) drivers and astigmatism in six (2.1%; 95% CI: 0.7–4.5) drivers. Presbyopia was reported in 157 (55.8%) drivers. Dry eye was reported in 70 (24.9%), stereo deficiency in 77 (27.4%), and color vision deficiency in 11 (3.9%) drivers. Three drivers were diagnosed with cataract, and two were referred for retina evaluation. Conclusion: Hyperopia in both eyes was the most common refractive error. Dry eye disease and color vision deficiency were also reported. Most of the drivers were not using spectacles for refractive error correction. Due to their mobile nature, drivers with cataract and retina diseases did not turn up for follow?up.