ABSTRACT
Background: Aniridia is defined as missing iris tissue which can be partial, subtotal, or total. Characteristic clinical symptoms include photophobia and decreased visual acuity due to an increased light perception. In addition to this, disturbing cosmetic problems are prevalent. Even after implantation of an intraocular lens, patients often tend to be unsatisfied. Purpose: The answer to this problem lies in the implantation of an aniridic scleral fixation of intraocular lens (SFIOL), which has a central optical axis that acts as the refractive lens and a peripheral rim of a hyperpigmented area that mimics the iris and hence reduces photophobia. The purpose of the video was to demonstrate the use of black diaphragm intraocular lens (BDIOL) implantation, its surgical steps, and its outcomes. Synopsis: We report one such case where a young patient presented with post?traumatic aniridia with subluxated total cataract and spillover vitreous hemorrhage. He was subjected to a vitrectomy, cataract removal, and placement of an aniridic SFIOL with prolene 9?0 using the four?point fixation method. This gave an extremely gratifying outcome and solved both problems, that is, vision and photophobia. Highlight: Before implantation of the SFIOL, the patients had reduced visual acuity from aphakia and intolerable glare from aniridia. In this case?based approach and with relevant example, we tried to provide a solution for tricky scenarios like co?existing traumatic cataract and traumatic aniridia. The patient showed improved visual acuity and marked glare reduction after black diaphragm SFIOL implantation.
ABSTRACT
Ayurveda and medicinal plants of folklore are the primary sources of health care in rural areas of India. Medicinal plants are the basis of Ayurveda drugs. Kothi village at an elevation of around 1,100m from the sea level is a hamlet in Kangra District of Himachal Pradesh and it has a good diversity of medicinal plants. The medicinal plants' diversity in this village is not studied to date. This cross-sectional survey study (observational study of descriptive and analytical type) was conducted to discover the diversity of medicinal plants in the Kothi village. The medicinal plant diversity at RGGPGAC&H territory was the sample chosen for this study. The total diversity of medicinal plants in the Kothi village was considered as the population of the study. Questionnaire based interviews and discussions with local villagers and sellers were used as a method for medicinal plants sample collection from the sample area. The sample medicinal plants were then verified by the faculty of PGDD at RGGPGAC&H. After verification, samples were cross-verified with authoritative publications by the government of Himachal Pradesh and India. A total of 151 different indigenous cum migrated medicinal plant diversity belonging to 69 families is found occurring in the Kothi village.
ABSTRACT
Purpose: To determine the level of awareness and knowledge about glaucoma surgery and post?surgery counseling amongst paramedical staff at a tertiary eye?care hospital. Methods: This observational cross?sectional study included a random sample of 94 hospital personnel: 37 general nurse midwives, 47 ophthalmic assistants, and 10 patient caretakers (PCTs). Participants were administered a questionnaire about glaucoma surgery and post?surgery counseling of patients. Results: The study included 41 (43.6%) females and 53 (56.4%) males. The mean age of the participants was 24.85 ± 4.54 years. All participants were aware of trabeculectomy surgery in glaucoma (100%). A total of 95.7% knew that surgery helps in controlling IOP, of whom 57 (60.6%) participants got information during their course of learning. Overall 53 (56.4%) believed that surgery is done when medication failure occurs, and 58 (61.7%) knew that surgery helps in preserving vision. A total of 63 (67.0%) participants knew to counsel patients to visit an ophthalmologist when called for and take the treatment as advised, whereas 74 (78.7%) correctly said to visit an ophthalmologist immediately if pain/diminution of vision/discharge occurs. Overall, PCTs were found to be having significantly better knowledge (P = 0.01) compared to others and they also reported ophthalmologists as the chief source of information. Conclusion: This study revealed that paramedical staff had an excellent awareness of trabeculectomy surgery. However, the knowledge and counseling parts of the questionnaire revealed less than satisfactory responses. So, there is a need to continuously educate paramedical staff members so that they can help in propagating information about the role of glaucoma surgery and the importance of proper follow?up
ABSTRACT
Sushruta Samhita is one of the foundational literature included in the Brihat traiye literatures of Ayurveda. Out of 37 different Ganas mentioned in Sutra Sthana of Sushruta Samhita, Dravya-sangrahaniya-adhyaya; Salsaradi-gana is one of them in which 23 medicinal plants have been described. Classically Salsaradi-gana is clinically indicated for Kushta (skin diseases), Prameha (diabetes mellitus), Pandu (anemia), and Kapha-medo-vishoshana (anti-hyperlipidaemic) disease. For this study, a review of the original commentary of Acharya Dalhana and Acharya haranchandra on Sushruta Samhita and the scientific research papers published on the medicinal plants listed in the Salsaradi-gana of Sushruta Samhita in indexed journals is done. Out of 23 medicinal plants mentioned 8 plants have controversial identification. The controversy in the identification of these medicinal plants is seen directly affecting the pharmacological action and clinical efficacy. Those 8 plants’ controversial identity is cleared with the establishment of a genuine plant for each of the plants through scientific and classical justification.
ABSTRACT
Background: Acne vulgaris is a common dermatological disease affecting 85% of adolescents across the globe with 40% having persistent acne well into their twenties. Acne and post-inflammatory hyperpigmentation often negatively impact self-perception, social interactions, and affect quality of life scores in adolescents. Aims and Objectives: The aim of the study was to evaluate the prescription pattern of drugs used in the treatment of acne to find out the current prescribing practices relating to comprehensive care being provided at a tertiary care hospital. Materials and Methods: This was a cross-sectional and observational study conducted after getting approval of Institutional Ethics Committee on 135 patients of either sex and age more than 12 and ?40 years diagnosed with acne. Results: Data of 135 prescriptions of acne patients were analyzed. Most patients presented with Grade 2 (n = 56; 41.5%) acne followed by Grade 3 acne (n = 40; 29.6%) patients. The average numbers of drugs per prescription was 3.87. Out of 522 drugs prescribed, 436 (83.5%) were topical and 86 (16.5%) were oral formulations. Among topical formulations, most frequently prescribed drug was tretinoin prescribed to 92 (68.1%) patients whereas, doxycycline was the most preferred oral antibiotic prescribed to 66 (48.9%) patients. Conclusion: The study revealed that drugs prescribed were found to be in accordance with the treatment guidelines proposed by Indian dermatologists and American Academy of Dermatology.
ABSTRACT
Coronavirus has left severe health impacts on the human population, globally. Still a significant number of cases are reported daily as no specific medications are available for its effective treatment. The presence of the CD147 receptor (human basigin) on the host cell facilitates the severe acute respiratory disease coronavirus 2 (SARS-CoV-2) infection. Therefore, the drugs that efficiently alter the formation of CD147 and spike protein complex could be the right drug candidate to inhibit the replication of SARS-CoV-2. Hence, an e-Pharmacophore model was developed based on the receptor-ligand cavity of CD147 protein which was further mapped against pre-existing drugs of coronavirus disease treatment. A total of seven drugs were found to be suited as pharmacophores out of 11 drugs screened which was further docked with CD147 protein using CDOCKER of Biovia discovery studio. The active site sphere of the prepared protein was 101.44, 87.84, and 97.17 along with the radius being 15.33 and the root-mean-square deviation value obtained was 0.73 Å. The protein minimization energy was calculated to be –30,328.81547 kcal/mol. The docking results showed ritonavir as the best fit as it demonstrated a higher CDOCKER energy (–57.30) with correspond to CDOCKER interaction energy (–53.38). However, authors further suggest in vitro studies to understand the potential activity of the ritonavir.
ABSTRACT
About one-fourth of the global population is either overweight or obese, both of which increase the risk of insulin resistance, cardiovascular diseases, and infections. In obesity, both immune cells and adipocytes produce an excess of pro-inflammatory cytokines that may play a significant role in disease progression. In the recent coronavirus disease 2019 (COVID-19) pandemic, important pathological characteristics such as involvement of the renin-angiotensin-aldosterone system, endothelial injury, and pro-inflammatory cytokine release have been shown to be connected with obesity and associated sequelae such as insulin resistance/type 2 diabetes and hypertension. This pathological connection may explain the severity of COVID-19 in patients with metabolic disorders. Many studies have also reported an association between type 2 diabetes and persistent viral infections. Similarly, diabetes favors the growth of various microorganisms including protozoal pathogens as well as opportunistic bacteria and fungi. Furthermore, diabetes is a risk factor for a number of prion-like diseases. There is also an interesting relationship between helminths and type 2 diabetes; helminthiasis may reduce the pro-inflammatory state, but is also associated with type 2 diabetes or even neoplastic processes. Several studies have also documented altered circulating levels of neutrophils, lymphocytes, and monocytes in obesity, which likely modifies vaccine effectiveness. Timely monitoring of inflammatory markers (e.g., C-reactive protein) and energy homeostasis markers (e.g., leptin) could be helpful in preventing many obesity-related diseases.
ABSTRACT
Introduction: cancers is associated with a favourable outcome. Stomach cancer is one of the most common cancers of gastrointestinal tract. Majority patients visit physicians in developed stages. To evaluate theObjective: reporting pattern of stomach cancer patients living in Kashmir valley in order to determine the median time of delay from the beginning of symptoms to diagnosis. Total 116 proven stomach cancer patientsMethod: were evaluated for the pattern of presentation at endoscopy laboratory of Super Speciality Hospital, Shireen Bagh Kashmir from April 2019 to September 2020. In this study, the mean age (SD) of participantsResults: was 60.22 ± (11.90) years. Majority of the participants (69.8%) were males. Cases were predominantly from the rural area (58%).Only 15.5 % of the cases were diagnosed within one month of their symptoms while as 3.4% of the cases had a total delay of more than 12 months. The study found a considerable total delay in the diagnosis of stomach cancer. The mean of the patient delay was 45.6 days. The median total delay was 20 weeks. Since stomach cancer has high mortality and morbidity rates associated, creatingConclusion: awareness among the population and training of physicians regarding timely referral of patients seems important
ABSTRACT
Background: Pharmaceutical companies use drug promotional literature (DPL) as an important mode to promote their products and it also influences the prescribing behavior of prescribers. However, information provided in promotional literature may be inadequate or misleading which may lead to irrational prescribing. The WHO has provided ethical criteria for medicinal drug promotion. Aims and Objectives: This study was undertaken with the aim to analyze the promotional drug literature for their compliance to the WHO ethical criteria for medicinal drug promotion, 1988. Materials and Methods: A cross-sectional and observational study was carried out to evaluate the extent to which promotional literature collected from private physicians meet the WHO ethical criteria for medicinal drug promotion. A total of 100 promotional literature were evaluated for their fulfillment of the WHO criteria. Results: Information regarding brand name, generic name of drugs, dosage form, therapeutic uses, and active ingredient per dosage form was present in most of the promotional drug literature in the present study. However, the information such as safety profile of drugs, precautions, warnings, and drug interactions was not mentioned in most of the DPLs. Conclusion: The majority of DPLs evaluated in this study did not comply with the WHO guidelines for medical drug promotion. As prescribing behavior of physicians is influenced by promotional literatures, regular training of health professionals and medical students regarding critical analysis of DPLs can help in ethical and rational prescribing.
ABSTRACT
Introduction: Lifestyle modification is key to management of diabetes. Behavioural change is key to adopt lifestyle modification. The current study was planned with objective to assess the impact of coun-selling on knowledge, attitude, and practices among patients with diabetes mellitus in rural and urban areas of Gujarat. Method: It was a non-randomized interventional study conducted in the state of Gujarat, India. Known cases of diabetes were enrolled for the study. Two equal size groups of study participants from urban and rural area were divided equally for intervention group (N=77; 28 urban +49 Rural) and control group (N=77; 28 urban +49 Rural). Regular counselling on role of diet in DM management, self-care, deaddiction, role of physical activity, and drug compliance was given by community physician for three months to 6 months. Pre and post intervention KAP score was collected and evaluated. Result: The knowledge, attitude and practice score were increased among counselling group in compar-ison to traditional treatment group in both urban and rural area. The score increased from 5.4 to 10.4 in knowledge; 3.07 to 5.07 in attitude and 5.07 to 8.92 in practice among urban participants. Similarly, the score increased from 4.14 to 7.16 in knowledge, 2.57 to 3.67 in attitude and 4.73 to 7.42 in practice among rural participants. Conclusion: With counselling the knowledge, practice and attitude of chronic patients are improving. The study recommended that counselling services should be available to all diabetes patients. It should be available to patients at their doorstep if possible as study depict
ABSTRACT
The biopotency and toxicity of two groups, conventional and newer insecticides [eight commercial insecticides] were determined against Bihar or Common hairy caterpillar (BHC) Spilarctia obliqua (Walker). Experiment carried out in the laboratory by exposing BHC larvae to insecticides. Biopotency was measured at different time intervals from 12-72 h after insecticidal application showed that all of the insecticides outperformed the control. At 48 h after imposing, the highest mortality percentage (100) was observed on spinetoram 11.7 SC and chlorfenapyr 10 SC, which are comparable to cyantranaliprole 10.26 OD, followed by chlorantraniliprole 18.5 SC, ?-cyhalothrin 5 EC and chlorpyriphos 20 EC, with the lowest mortality percentage observed on tolfenpyrad 15 EC (66.67 %). In chlorantraniliprole, cyantranaliprole, spinetoram, tolfenpyrad, fipronil, chlorfenapyr, ?-cyhalothrin and chlorpyriphos, respectively, the toxicity level of insecticides was calculated based on median lethal concentration (LC50) values of 0.36, 0.48, 0.52, 0.50, 0.69, 0.98, 1.43 and 3.82 ppm. The overall conclusion of this trial was that spinetoram 11.7 SC and chlorfenapyr10 SC are the best chemicals for controlling the early stages of BHC larvae. In comparison to traditional insecticides, new insecticides have the highest level of toxicity
ABSTRACT
Background: Migraine is a debilitating neurological disorder. As a leading cause of disability worldwide, it affects health-related quality of life (HRQoL). There are limited studies assessing the prescription pattern and improvement in HRQoL post-treatment. Aims and Objectives: This study aims to evaluate the drug use pattern and compare the effects of medications on HRQoL as per Migraine Disability Assessment Score (MIDAS). Materials and Methods: A prospective observational cross-sectional study was conducted on migraine patients attending neurology OPD at a tertiary care hospital. One hundred and seven patients were recruited by periodic sampling over 6 months. Prescription indicators assessed were number of antimigraine drugs per prescription, frequency of prescribed drugs, prescriptions by generic name, etc. Data were analyzed using descriptive statistics. The HRQoL was assessed after 3 months of medications by telephonic questionnaire. The change was analyzed by Wilcoxon matched pair signed-rank test. Results: Majority patients were in the third (40.2%) and fourth decade (32.7%) with a female preponderance (72.9%). Nonsteroidal anti-inflammatory drugs were commonly prescribed for aborting acute attacks with naproxen (24.1%) followed by diclofenac (2.71%). Prophylactically topiramate (27.51%), amitriptyline (18.6%), and propranolol (3.1%) were prescribed. About 36.43% of drugs were prescribed by generic names. Improvement in HRQoL was reflected by a significantly reduced MIDAS (13.95 ± 5.20 to 11.39 ± 5.07 [P < 0.05]). Conclusion: In our study, there was low generic prescribing. Naproxen was most prescribed for acute migraine and topiramate for prophylaxis. The HRQoL significantly improved after 3 months of antimigraine medications causing lesser disease burden.
ABSTRACT
Background: In the developing countries like India, infections are still very common. About 50% of the patients presenting to general practitioners had fever as the complaint pointing that infective ailments still predominate. Aims and Objectives: The use of antimicrobials is very common in practice that leads to the development of antimicrobial resistance. Materials and Methods: A total of 120 GP’s were registered for the present study. Assessment was done based on the special questionnaire prepared for assessing the knowledge, attitude, and practice (KAP) of the GP’s. Results: Data were collected from the Google Forms, which was then analyzed using Statistical software. No statistical difference between KAP of all pathies was observed. There is a statistically significant positive correlation between number of patients attended per day and antibiotics prescribed. This correlation is strong between allopathy practitioners whereas it’s moderate in homeopathy and Ayurveda practitioners. There is a statistically significant association between KAP. Conclusion: Self-medication and modification in the treatment by the patients; unnecessary and improper use by physicians and pharmacists themselves giving antimicrobials without prescription are some of the common problems in irrational use of antimicrobials. From this study, we can conclude that KAP of GP’s has an association with usage of antibiotics and thus programs for promoting and improving KAP’s can be useful in managing the irrational use of antibiotics.
ABSTRACT
Background: Compliance with treatment is the key link between treatment and outcome in medical care, non-compliance leads to failure of treatment. Noncompliance with antimicrobial agents (AMAs) is the important reason for Resistance to antimicrobials. Forgetting to take medicine is one of the important causes of non-compliance. Aim and Objectives: Hence, the present study was planned to evaluate the compliance for antimicrobial treatment in patients receiving a short course of antimicrobials, with or without reminding them to take medicine using a smartphone app. Materials and Methods: Prospective interventional study was planned in a tertiary care hospital after permission from the ethics committee. The present pilot work of the study was carried out on 30 patients receiving AMAs. Patients receiving a short course of chemotherapy were enrolled and stratified based on the frequency of administration of antimicrobials. They were then allocated alternately in control (15) and study (15) groups. After explaining the prescription to all, “Pill Reminder” app was downloaded on smartphones of participants in the study group. All were contacted to enquire about compliance at the end of the treatment period. Results: Baseline characteristics of participants in both groups were comparable. URTI, UTI Tinea cruris, Tinea capitis were the disorders for which they received AMAs. The frequency of administration was once/twice/thrice a day. Duration was 3–14 days in both groups. At the end of the study, 53.3% of patients in control group and 100% of patients in intervention group were compliant to the treatment. Conclusion: The use of the reminder app significantly improved patient’s compliance with medications. Further studies are required to validate these results.
ABSTRACT
Background: Inflammation is a protective response of the body to the harmful stimuli. Inflammation can be either acute or chronic, always associated pain, redness and loss of function. Vanilla planifolia (VP) is the aromatic plant, as per literature, it has anti-inflammatory activity, which has not been tested as per modern medicinal parameters. Non-steroidal anti-inflammatory drugs are commonly used for the treatment but have many adverse effects such as gastritis, hepatitis etc. Therefore, there is always a search for new safe drug. Aim and Objectives: The aim of the study is to evaluate the anti-inflammatory activity of VP seeds in acute and chronic animal model of inflammation. Materials and Methods: Rats weighing 150–200 g of either sex were included in the study. Acute Anti-inflammatory activity tested with carrageenan-induced paw edema and chronic with cotton pellet-induced granuloma model. Animals were divided into five groups – Gr-I Control, Gr-II Vehicle control, Gr-III Diclofenac sodium, Gr-IV (VPLD), Gr-V (VPHD). Drug treatment was given 1 h before carrageenan injection. Paw volume measured at different time interval with plethysmometer. In chronic model, drug treatment was given for 7 days after pellet implantation. On 8th day, pellets removed and dried in oven. Weight of wet and dry pellets from all the groups compared with vehicle control. Data obtained was analyzed with Graph pad prism 6. Results: Reduction in paw volume started in all drug treated groups after 1 h of treatment. Paw volume was significantly reduced (P < 0.001) in group III, IV & V in 5 h. reached to near normal. In chronic model, VPLD showed decrease in wet pellet (P < 0.01) and dry pellet weight (P < 0.05) significantly. VPHD was more effective in reducing wet pellet (P < 0.001) and dry Pellet weight (P < 0.01). Similar results were seen on the left side. Conclusion: VP seed extract showed promising anti-inflammatory effect in both models of inflammation.
ABSTRACT
Objectives: This study evaluated the perception and practices of health care providers (physicians, diabetologists, and endocrinologists) regarding the treatment of hypertension in patients with diabetes in India. Methods: Health care providers throughout India who treated patients with diabetes and hypertension were invited to participate in an online survey and periodic 21 virtual meetings. They were questioned about their perception and practices in managing these patients, and strategies to improve blood pressure (BP). Results: The online survey was completed by 2,513 health care providers, and 344 participated in virtual meetings. More than 50% reported that 31–50% of their patients with diabetes also had hypertension. Home BP monitoring was recommended by 88%, and lifestyle modifications were consistently recommended. Choice of antihypertensive treatment varied based on comorbidities, and a renin–angiotensin system blocker plus a calcium channel blocker (CCB) was the most common combination for dual antihypertensive therapy. Suggested strategies to improve BP control included patient awareness/education, lifestyle modifications, better follow-up/monitoring, and optimization of therapy. Conclusion: Indian health care providers were aware of clinical recommendations and practices regarding treatment of patients with diabetes and hypertension, and generally make clinical decisions consistent with current guidelines. Optimization of care for these patients is essential to reduce cardiovascular disease risk and improve patient outcomes.
ABSTRACT
Purpose: To determine the correlation between functional parameters and optical coherence tomography (OCT) features in patients of idiopathic intracranial hypertension (IIH). Methods: A prospective observational study in early and established cases of papilledema in IIH presenting from December 2017 to February 2019. Functional parameters (visual acuity, contrast sensitivity, mean deviation, VER, and MfERG) and structural parameters (RNFL, GCL?IPL, and optic disc height) were measured at baseline and every 6 weeks for 6 months. Results: At baseline, average RNFL had a moderate negative correlation with mean deviation (r = ?0.45; P = 0.0007) and a positive correlation with logMAR visual acuity (r = 0.18; P = 0.17). On the contrary, baseline GCL and logMAR visual acuity had a negative correlation (r = ?0.4, P = 0.02). Optic disc height (ODH) had a negative correlation with visual field mean deviation (r = ?0.046; P = 0.0005). At 6 months, ODH and GCL?IPL complex had a statistically significant correlation with functional parameters. However, RNFL values did not show any significant correlation with any of the functional parameters. Baseline GCL?IPL and optic disc height values had a moderate and significant correlation with final functional parameters. However, RNFL did not show any correlation with final functional parameters. Correlation between GCL?IPL thickness at 6 weeks and final functional parameters were stronger than that with baseline GCL values. Conclusion: In the setting of severe papilledema, RNFL can misguide the prognosis. GCL?IPL can be a valuable tool for an objective evaluation of the integrity of the optic nerve in IIH and ODH may be used as an alternative or in combination with GCL?IPL in these cases.
ABSTRACT
Background: Anemia prevalence in young children con?nues to remain over 70% in most parts of India and Asia. In developing countries like India,anemia is a significant cause of mortality and morbidity in children under 5 years of age. In public health terms, Iron deficiency anemia (IDA) is a very important causa?ve factor for childhood anemia. Materials & Methods: A prospec?ve observa?onal study was conducted on hospitalized children in ter?ary care center. All children between 1 month to 18 years of age were admi?ed in Pediatric ward were taken to the study for 1.5 years study period. Results: Total number pa?ents admi?ed in pediatric ward were 1280 out of which 812 were enrolled for the study, out of which 522 pa?ents have been studied in detail as they had iron deficiency anemia. The total prevalence in our study period is 65.64%. Our analysis showed that males outnumbered females with sex ra?o of Male: Female is1.76:1. This study shows that the children of 1 month to 5 years is 361 which are 69.1%, children of age 5-12years are 123 which is 23.6%, children of age 12-18years are 38 which is 7.3%. We observed that the most common age group involved is less than 5 years which is significant. The e?ology of the hospitaliza?on has been studied, out of which Lower respiratory infec?ons were more common. Conclusion: This study revealed that the prevalence of IDA in under 5 years is more common than in other age groups. Children with anemia and those with iron deficiency anemia were found to be more suscep?ble to lower respiratory tract infec?ons.