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Background: The present study was conducted to determine the fetomaternal outcome among Rh-negative pregnancies presenting to a secondary care hospital of North India. Methods: A prospective observational design was carried out among Rh negative mothers presenting to the Department of Obstetrics and Gynecology of Swaroop Rani Hospital, Prayagraj, from December 2021 to July 2022. On admission each mother was interviewed using a questionnaire. ABO/Rh grouping of the mothers as well as their husbands/partners were done. Rh antibody titers of the patients were done at first visit and repeated at 28 and 32 weeks respectively. The labor of each of the mothers was monitored carefully, with the mode of delivery and outcome of labor being recorded in the proforma. For the Rh typing of the neonate, cord blood was collected after delivery and sent for ABO/Rh grouping. Both the mother and the neonate were followed up till their discharge/death, and any adverse maternal or neonatal outcome in this period were noted. Results: During the study period, 46 mothers were assessed. The mean age was 23.9±1.4 years. Most of the mothers were multipara. 4.4% of them had a raised Rh antibody titer. Of the mothers, 13% delivered preterm and most required lower segment cesarean section (56.5%). 93.5% of the deliveries resulted in live births. The incidence of Rh incompatibility among the Rh-negative mothers was 83.7%. The mean birth weight was 2.8±0.4 kgs, with most of the babies being male (60.5%). The most common complications developing in the neonates was anemia (21%) and neonatal hyperbilirubinemia (9.3%). Only one (2.3%) of the neonates born to the mothers died due to post-birth complications. Conclusions: Rh incompatibility was observed to be high among the mothers assessed in the study, with 4.4% having raised anti-D titers. Anemia and neonatal hyperbilirubinemia were found to be the most common problems associated with such pregnancies.
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Introduction: Post the coronavirus disease (COVID-19 pandemic), there was a spike in demand for immunity boosters, leading to the irrational use of supplements. To assess the usage of immunity boosters among the citizens of Pune City and correlate the side effects associated with supplements. Material and Methods: A cross-sectional study was conducted from September 2020 to May 2021 in Pune. Data, such as demographic, supplement intake (allopathic, homeopathic, and ayurvedic/home remedies), duration, frequency of supplements, and side effects associated with supplements, were collected through a personal interview and e-form circulation. The correlation of the immunity boosters with the side effects was done using Karl Pearson’s Correlation test in SPSS software version 22.0. Results: Out of 1006, the ayurvedic supplements/home remedies were preferred by 906 (98%) allopathic supplements by 599 (65%) and homeopathic supplements by 256 (28%) participants. The commonly reported side effects were acidity (37%), headache (29.6%), nausea (9%), loss of appetite (8.8%), diarrhea (7%), stomach ache (6%), cough (5.6%), and constipation (4.1%). These side effects had a weak positive linear proportionality with ayurvedic supplements such as amla (r = 0.162), Giloy Vati (r = 0.139), turmeric (r = 0.108), and Kadha (r = 0.102); also, Eupatorium perfoliatum, Vitamin C, and Vitamin D showed a linear proportionality with loss of appetite (r = 0.15), headache (r = 0.12), and cough (r = 0.12), respectively. A higher incidence of side effects such as nausea (r = 0.267), diarrhea (r = 0.243), headache (r = 0.164), and acidity (r = 0.113) was observed when supplements were taken for 6 months. Conclusion: Most participants were on immunity boosters during the COVID-19 pandemic. The study concluded that using immunity boosters in excess or for more than 6 months causes side effects, the most recurrent ones being acidity, headache, nausea, and lack of appetite.
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Purpose: Barrett toric calculator (BTC) is known for its accuracy in toric IOL (tIOL) calculation over standard calculators; however, there is no study in literature to compare it with real?time intraoperative aberrometry (IA). The aim was to compare the accuracy of BTC and IA in predicting refractive outcomes in tIOL implantation. Methods: This was an institution?based prospective, observational study. Patients undergoing routine phacoemulsification with tIOL implantation were enrolled. Biometry was obtained from Lenstar?LS 900 and IOL power calculated using online BTC; however, IOL was implanted as per IA (Optiwave Refractive Analysis, ORA, Alcon) recommendation. Postoperative refractive astigmatism (RA) and spherical equivalent (SE) were recorded at one month, and respective prediction errors (PEs) were calculated using predicted refractive outcomes for both methods. The primary outcome measure was a comparison between mean PE with IA and BTC, and secondary outcome measures were uncorrected distance visual acuity (UCDVA), postoperative RA, and SE at one month. SPSS Version?21 was used; P < 0.05 considered significant. Results: Thirty eyes of 29 patients were included. Mean arithmetic and mean absolute PEs for RA were comparable between BTC (?0.70 ± 0.35D; 0.70 ± 0.34D) and IA (0.77 ± 0.32D; 0.80 ± 0.39D) (P = 0.09 and 0.09, respectively). Mean arithmetic PE for residual SE was significantly lower for BTC (?0.14 ± 0.32D) than IA (0.001 ± 0.33D) (?0.14 ± 0.32D; P = 0.002); however, there was no difference between respective mean absolute PEs (0.27 ± 0.21 D; 0.27 ± 0.18; P = 0.80). At one?month, mean UCDVA, RA, and SE were 0.09 ± 0.10D, ?0.57 ± 0.26D, and ?0.18 ± 0.27D, respectively. Conclusion: Both IA and BTC give reliable and comparable refractive results for tIOL implantation.
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Aim: To study the efficacy of uptitrating the dose of Teneligliptin from 20 to 40 mg in patients with type II diabetes mellitus. Method: A retrospective, comparative analysis was undertaken in 853 type II diabetes mellitus patients (499 males and 354 females) who had follow-up records for more than 6 months. These patients were uncontrolled after use of atleast three oral antidiabetic drugs (OADs) and Teneligliptin 20 mg was added as the fourth drug. Patients who remained uncontrolled with the addition of 20 mg of Teneligliptin at the end of 3 months and were switched to receive 40 mg of Teneligliptin daily were included in this study. Results were analyzed at 3 and 6 months to ascertain efficacy of high-dose (40 mg) Teneligliptin. All other OADs remained the same in both groups. In all patients, the fasting blood glucose, postprandial blood glucose, and hemoglobin A1c (HbA1C) were evaluated and compared. Result: A total of 853 patients whose dose of Teneligliptin was increased from 20 to 40 mg were included in the study. At the end of 3 months after using Teneligliptin 40 mg, mean reduction in HbA1C was 0.5% (p-value 0.154). Similarly, mean reduction in fasting blood sugar (FBS) and postprandial blood sugar (PPBS) was 6.5 and 3.6 mg/dL, respectively (p-value 0.234 and 0.143). At the end of 6 months after using Teneligliptin 40 mg HbA1C showed no change but mean FBS and PPBS showed a modest reduction of 14.6 and 14 mg/dL, respectively (p-value < 0.001). Conclusion: The results of our study show that there was no statistically significant improvement in glycemic parameters when dose of Teneligliptin was increased from 20 to 40 mg at 3 months. But at 6 months, the FBS and PPBS showed a modest reduction of 14.6 and 14 mg/dL, respectively (p-value < 0.001) but the HbA1C showed no change
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Purpose: To evaluate and compare the efficacy of autologous platelet?rich plasma (aPRP) eye drop and artificial tear (AT) eye drop in moderate to severe symptomatic dry eye disease (DED). Methods: This prospective interventional study included 121 eyes of 61 patients of moderate to severe DED. Patients were divided into aPRP (31 patients) and AT (30 patients) group. Ocular Surface Disease Index (OSDI) score, tear film breakup time (TBUT) (s), corneal fluorescein staining (CFS) score, and Schirmer test score (mm) of both the groups were evaluated and compared pre?treatment and post?treatment at the end of 3 months. Results: The mean age of the aPRP group and AT group was 52.8 ± 12.8 years and 55.5 ± 13.4 years, respectively. At the end of 3 months, OSDI score reduced more in the aPRP group as compared to AT group, and the mean difference (?22.7) was statistically significant (P < 0.001). There was no significant difference in post?treatment Schirmer test score between the two groups (P = 0.44). Post?treatment improvement in TBUT and CFS score in the aPRP group was significantly higher in the aPRP group as compared to that in the AT group (P < 0.05). Bruising at the site of blood withdrawal was noted in two patients in the aPRP group. Conclusion: aPRP is safe and more effective than AT in treating patients with moderate to severe symptomatic DED
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Purpose: To assess impact of tear optics on repeatability of a Scheimpflug device with a Hartmann Shack aberrometer and a ray tracing aberrometer. Methods: One hundred healthy and 100 postrefractive surgery eyes underwent dry eye evaluation including Schirmer抯 test and tear film break?up time (TBUT). They underwent optical quality analyzer (OQAS, Visio metrics S.L, Terrassa, Spain) to assess objective scatter index (OSI), three scans each on Pentacam AXL wave (OCULUS Optikgerate Gmbh, Wetzlar, Germany), iTrace (Tracey� Technologies, Texas, USA) for flat, steep keratometry, thinnest corneal thickness, root mean square higher?order aberrations (RMS HOA), RMS lower?order aberrations (LOA), spherical aberrations, RMS COMA. Repeatability of Pentacam AXL wave and iTrace in healthy and postrefractive eyes (OSI >1 vs OSI <1) was studied using within?subject standard deviation (Sw) test杛etest repeatability (TRT), coefficient of variation (COV). Results: OSI showed an inverse association with TBUT (P < 0.001). All measurements with Pentacam AXL wave with OSI < 1 had excellent repeatability, intraclass correlation coefficient (ICC) ranging from 0.88 for HOA, to 0.92 for LOA. The Sw, TRT, and COV of all aberration measurements were significantly lower (better) than those of iTrace. In eyes with OSI ?1, the repeatability with Pentacam AXL wave dropped with ICC ranging from 0.77 for HOA, to 0.84 for LOA with lower Sw, TRT, and COV of all aberration measurements as compared to iTrace. Maximum variation was seen with HOA and minimum with LOA. Conclusion: Tear optics affected repeatability of Pentacam wave and iTrace. Pentacam wave had better repeatability in eyes with a poor tear film as compared to iTrace. Thus, the tear film can impact repeatability of an instrument and it is important to assess the tear film prior to imaging patients, which can change the way we interpret and image these patients.
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Background: Post kala-azar dermal leishmaniasis (PKDL) is thought to be the reservoir of infection for visceral leishmaniasis in South Asia. The development of strategies for the diagnosis and treatment of PKDL are important for the implementation of the visceral leishmaniasis elimination program. Aims: Liposomal amphotericin B (L-AMB) has been an overwhelming success in the treatment of visceral leishmaniasis. However, the empirical three-week regimen of L-AMB proposed for PKDL was shown to be inadequate, especially in the macular variant. This study aimed to delineate response of the different variants of PKDL to L-AMB. Methods: Skin biopsies were collected from PKDL cases at disease presentation and upon completion of treatment with L-AMB. Parasite DNA was detected by Internal Transcribed Spacer-1 PCR (ITS-1 PCR) and quantified by amplification of parasite kDNA. CD68 + macrophages were estimated in tissue sections by immunohistochemistry. Results: Treatment with L-AMB decreased the parasite load by 97% in polymorphic cases but only by 45% in macular cases. The median parasite load (89965 vs 5445 parasites/μg of genomic DNA) as well as infiltration by CD68+ cells before treatment was much greater in the polymorphic cases. Limitations: Although monitoring of the parasite load for 12 months post-treatment would have been ideal, this was not possible owing to logistical issues as well as the invasive nature of biopsy collection procedure. Conclusion: A dramatic decrease in the parasite burden was noted in patients with polymorphic lesions. Although patients with macular disease also had a decrease in parasite burden, this was not as marked as in the polymorphic cases. There was also a significantly greater infiltration of CD68 + macrophages in polymorphic PKDL before therapy
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Background: SMT (sensorimotor training) is a form of exercise aiming to decrease the muscle imbalance by maximizing the sensory input coming from three sites in the body where there is a large number of propioception(the foot, sacroiliac joint ,cervical spine).The purpose of study is to check the effect of SMT on neuromuscular control, balance and reaction time using three levels i.e. stable surface , unstable surface and sand in elderly population. Method:The study was an experimental study with a sample size of 30 elderly subjects of age group 60-80 years. They had performed exercises in st three levels 1 in stable then foam then sand. They were assessed using SOT test, test for neuromuscular control and reaction time. Conclusion: The study shows that the sensorimotor training which is given in three levels i.e., in stable surface , foam and sand are effective in improving balance, increasing neuromuscular control and decreasing reaction time in elderly for decreasing risk of fall and improving quality of life in elderly.
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We propose a technique for combined femto laser?assisted cataract surgery (FLACS) and limited vitrectomy from the pars?plana site for optimization of surgical results in subluxated cataracts. FLACS creates a free?floating, customised capsulotomy, minimizes stress on compromised zonules, and prechops the nucleus, effectively reducing the ultrasonic power as well as the forces required to chop the nucleus. The area of zonular dehiscence creates a direct communication between the irrigation fluid and the anterior vitreous, leading to its hydration. Trans?limbal vitrectomy creates a continuum between the liquefied vitreous and the main wound, leading to further vitreous loss, and exaggeration of the zonular weakness, while pars?plana vitrectomy avoids this by cutting the liquefied vitreous, near its attachment, thereby preventing further hydration and causing lesser stress to the zonules. A combination of these procedures, along with a capsule support device, gives favorable surgical outcomes in moderate to severe subluxations.
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Pituitary apoplexy typically presents with acute headache, vomiting, visual disturbance, and confusion. Herein, we report a rare presentation of ischemic stroke due to pituitary apoplexy. A 16.5-year-old male presented with reduced Glasgow Coma Scale (GCS) score, slurred speech, right-sided hemiparesis, and bitemporal hemianopia. Magnetic resonance imaging of the brain showed a large hemorrhagic sellar/suprasellar mass and an area of cortical T2/FLAIR hyperintensity with corresponding diffusion restriction in the middle cerebral artery territory. Computed tomography (CT) intracranial angiogram showed luminal occlusion of the clinoid and ophthalmic segments of both internal carotid arteries (ICAs, left>right) due to mass pressure effect. Biochemical investigations confirmed hyperprolactinemia and multiple pituitary hormone deficiencies. Stress-dose hydrocortisone was commenced with cabergoline, followed by urgent endoscopic transsphenoidal debulking of the tumor (subsequent histology showing prolactinoma). Postoperative CT angiogram showed improved caliber of ICAs. Intensive neurorehabilitation was implemented and resulted in complete recovery of motor and cognitive deficits. At the last assessment (18.8 years), the patient remained on complete anterior pituitary hormone replacement without cabergoline. Pituitary apoplexy is a medical emergency requiring prompt recognition and treatment and should be suspected in patients presenting with sudden, severe headache; nausea; or visual disturbance and meningism. Ischemic stroke is a rare manifestation of pituitary apoplexy in the pediatric population.
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Objectives@#Healthcare workers (HCWs) are at a high risk of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) due to the increased likelihood of clinical exposure during patient management. The study objective was to determine the seroprevalence of antibodies to SARS-CoV-2 and its predictors among hospital employees. @*Methods@#The cross-sectional study was conducted at a teaching hospital from August 2020 to September 2020 among 1,401 employees, including 1,217 HCWs, in New Delhi, India. The serum samples were examined for immunoglobulin G (IgG) antibodies to SARS-CoV-2 using the COVID Kavach-Anti-SARS-CoV-2 IgG Antibody Detection enzyme-linked immunosorbent assay kit. Data were collected electronically using the EpiCollect mobile platform. A p<0.05 was considered to indicate statistical significance. @*Results@#A total of 169 participants (12.1%) had detectable IgG antibodies to SARS-CoV-2. The highest seropositivity rate was observed in the administrative staff (20.1%), while it was lowest among medical doctors (5.5%, p<0.001). Male sex and ever having lived in a containment zone were independently associated with past infection with SARS-CoV-2. @*Conclusion@#The seroprevalence of SARS-CoV-2 infection in health workers may be lower than in the general population in New Delhi. However, nonpharmaceutical interventions were not associated with a reduction in the risk of acquisition of SARS-CoV-2.
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Background/Aims@#Crohn’s disease (CD) and intestinal tuberculosis (ITB) remain “difficult-to-differentiate” diseases. We have previously documented peripheral blood frequency of CD4+CD25+FOXP3+ T-regulatory cells (Treg) as a biomarker to differentiate CD and ITB. We tried to validate these results in a larger cohort of CD and ITB patients. @*Methods@#Seventy treatment naïve patients of CD (n = 23) and ITB (n = 47) (diagnosed by standard criteria) were recruited prospectively from October 2016 to May 2017. Patients with history of antitubercular therapy in the past were excluded. The frequency of Treg cells in peripheral blood was determined by flow cytometry, and compared between CD and ITB patients. @*Results@#Similar to our previous study, frequency of Treg cells in peripheral blood was significantly increased in ITB as compared to CD patients (40.9 [interquartile range, 33–50] vs. 24.9 [interquartile range, 14.4–29.6], P 31.3% had a sensitivity and specificity of 83% and 82.6% respectively, to differentiate ITB from CD. Even for the indeterminate cases (n = 33), Treg cell frequency had similar diagnostic accuracy with an AUC of 0.85 (95% confidence interval, 0.68–0.95) and a cutoff of 32.37% had sensitivity and specificity of 87% and 95% respectively, to differentiate ITB from CD. @*Conclusions@#The current findings validate that the increased frequency of CD4+CD25+FOXP3+ Treg in the peripheral blood can be used as a biomarker with high diagnostic accuracy to differentiate ITB from CD.
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Objectives@#Healthcare workers (HCWs) are at a high risk of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) due to the increased likelihood of clinical exposure during patient management. The study objective was to determine the seroprevalence of antibodies to SARS-CoV-2 and its predictors among hospital employees. @*Methods@#The cross-sectional study was conducted at a teaching hospital from August 2020 to September 2020 among 1,401 employees, including 1,217 HCWs, in New Delhi, India. The serum samples were examined for immunoglobulin G (IgG) antibodies to SARS-CoV-2 using the COVID Kavach-Anti-SARS-CoV-2 IgG Antibody Detection enzyme-linked immunosorbent assay kit. Data were collected electronically using the EpiCollect mobile platform. A p<0.05 was considered to indicate statistical significance. @*Results@#A total of 169 participants (12.1%) had detectable IgG antibodies to SARS-CoV-2. The highest seropositivity rate was observed in the administrative staff (20.1%), while it was lowest among medical doctors (5.5%, p<0.001). Male sex and ever having lived in a containment zone were independently associated with past infection with SARS-CoV-2. @*Conclusion@#The seroprevalence of SARS-CoV-2 infection in health workers may be lower than in the general population in New Delhi. However, nonpharmaceutical interventions were not associated with a reduction in the risk of acquisition of SARS-CoV-2.
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Background/Aims@#Crohn’s disease (CD) and intestinal tuberculosis (ITB) remain “difficult-to-differentiate” diseases. We have previously documented peripheral blood frequency of CD4+CD25+FOXP3+ T-regulatory cells (Treg) as a biomarker to differentiate CD and ITB. We tried to validate these results in a larger cohort of CD and ITB patients. @*Methods@#Seventy treatment naïve patients of CD (n = 23) and ITB (n = 47) (diagnosed by standard criteria) were recruited prospectively from October 2016 to May 2017. Patients with history of antitubercular therapy in the past were excluded. The frequency of Treg cells in peripheral blood was determined by flow cytometry, and compared between CD and ITB patients. @*Results@#Similar to our previous study, frequency of Treg cells in peripheral blood was significantly increased in ITB as compared to CD patients (40.9 [interquartile range, 33–50] vs. 24.9 [interquartile range, 14.4–29.6], P 31.3% had a sensitivity and specificity of 83% and 82.6% respectively, to differentiate ITB from CD. Even for the indeterminate cases (n = 33), Treg cell frequency had similar diagnostic accuracy with an AUC of 0.85 (95% confidence interval, 0.68–0.95) and a cutoff of 32.37% had sensitivity and specificity of 87% and 95% respectively, to differentiate ITB from CD. @*Conclusions@#The current findings validate that the increased frequency of CD4+CD25+FOXP3+ Treg in the peripheral blood can be used as a biomarker with high diagnostic accuracy to differentiate ITB from CD.
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Musculoskeletal disorders are typically characterised by discomfort (often persistent) and restrictions in mobility, dexterity and functional ability, reducing people’s capability to work and participate in social roles with associated influences on psychological welfare, and at a wider level influence on the prosperity of communities Information technology- has played a vital role in transforming India from a slow administrative economy into a land of innovational entrepreneurs. The aim of this review is to, critically analyze the literature and report on the prevalence of work-related musculoskeletal disorders in information technology professionals. The review focused on computers users and software professionals. An extensive literature search was undertaken using google scholar and PubMed databases for last 10 years from 2011 to 2020. Further Following a thorough search of the databases, a total of 25 articles were evaluated. A number of articles reported a high prevalence of MSD, generally various studies have been done on information technology professionals and related to the work of IT professionals and studies on various risk factors also have been done in different states of India. 17 articles had selected for the study purpose in which prevalence study had selected for the review. The prevalence among the IT professionals is not uniform; however, Software engineers and computer operators appear to be more prone to neck, shoulder and back pain.
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Background: The World Health Organization (WHO) factsheet revealed that 15 million babies are born too early every year and almost 1 million children die each year due to complications of preterm birth. The objective of this study was to determine whether cervicovaginal β-hCG level can be used as predictor of preterm delivery in asymptomatic high-risk pregnant women at 24-34 weeks gestation age.Methods: This was prospective observational study. Total 134 asymptomatic pregnant women were taken for study who had at least one risk factor for preterm delivery at 24-34 weeks gestation age. Cervicovaginal secretion was collected and β-hCG level was measured by chemiluminescent immunoassay.Results: Out of 134 cases, 42.5% had preterm delivery and 57.5% had term delivery. Mean cervicovaginal β-hCG level (mIU/ml) in preterm delivery group was 39.38±19.66 and term delivery group was 21.86±11.18. Cervicovaginal β-hCG level was significantly higher in preterm group compare to term group demonstrating significant association of raised β-hCG with preterm group (p value <0.001). ROC curve analysis was done to find out best cut off value of cervicovaginal β-hCG for prediction of preterm delivery and optimal cut off value was 36.45 mIU/ml. The optimal cut off value for cervicovaginal β-hCG (36.45 mIU/ml) gave sensitivity 71.9%, specificity 81.8%, positive predictive value 74.5%, negative predictive value 79.7% and diagnostic accuracy of 77.6% for prediction of preterm delivery.Conclusions: Cervicovaginal β-hCG can be used as sensitive and specific biomarker of prediction of preterm delivery in asymptomatic high-risk women.
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Background: Cervical cancer is the fourth most common cancer in women. In India and other developing countries cervical cancer is the leading cause of morbidity and mortality. Cancer cervix continues to be most common genital carcinoma in India accounting for 80% of all female genital malignancies. Pre-invase lesions can spontaneously regress to normal or remain stable for long period or progress to a higher degree of dysplasia. Cancer of cervix is preventable if diagnosed at the pre-invasive stage with regular intervals of cytological screening by Papanicolaou (Pap) smears. The aim of the study is to analyse the pap reports in terms of normal findings, infections, premalignant lesions and invasive cancers.Methods: All women attending the outpatient department gynaecology at TMMC and RC Moradabad, Uttar Pradesh over a period of 1 year from august 2017-18 presented of obstetrics and with white discharge per vagina were screened for cervical cancer using pap smear. All the smears were reported as per the 2014 Bethesda system.Results: Out of 1392 Pap smear reports ASCUS was reported in 27 cases (2%), LSIL in 27 cases (2%), HSIL in 15 cases (1%), malignant cells in 15 cases (1%) and normal including the infection is reported in 1308 cases (94%).Conclusions: Early cervical epithelial changes can be identified by a Pap smear test, which is the primary screening test for detection of precancerous cervical intraepithelial neoplasia and the early stage of invasive cervical cancer.
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Background: Hydrocephalus is a heterogeneous disease marked by abnormal dilatation of the cerebral ventricles secondary to varying etiologies. This study was aimed to determine the incidence, risk factors, severity, and outcome of hydrocephalic fetuses presenting to a tertiary healthcare hospital located in northern India.Methods: In this prospective observational study, pregnant women visiting the obstetrics outpatient department of our hospital from 01 July 2017 to 31 June 2018 were screened for hydrocephalic fetuses via ultrasonography along with a detailed history, and a comprehensive battery of diagnostic investigations. They were followed up for a minimum period of two months after delivery/termination of pregnancy.Results: A total of 3627 pregnant women were screened, of which 10 had hydrocephalic fetuses in the observed time period. The incidence of hydrocephalus was determined to be 2.75 per 1000 live births. Low socio-economic status was identified as a major risk factor. 50% of the hydrocephalic fetuses were severely afflicted and were discontinued. The remaining 50% were successfully delivered and were managed via a ventriculo-peritoneal shunt or are under close observation in the postnatal period without any adverse outcome.Conclusions: The burden of hydrocephalus is considerably high in India, as compared to western countries. In rural settings, low socioeconomic status and lack of folic acid supplementation have a major influence in the etiopathogenesis of hydrocephalus. Management of hydrocephalus requires a multidisciplinary approach and is tailored according to the severity of the presentation. Severe cases of hydrocephalus and cases with associated anomalies have a poor prognosis.
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BACKGROUND AND PURPOSE: To adequately evaluate the extent of neurocognitive impairment in patient living with human immunodeficiency virus (PLHIV), a battery of neuropsychological tests is typically administered which are neither cost effective nor time efficient in the outpatient clinical setting. The aim of the study was to assess neurocognitive status and functional ability of people living with HIV and find a brief screening tool to identify those who would benefit from a full diagnostic evaluation.METHODS: The study enrolled 160 PLHIV (80 pre-antiretroviral therapy [ART] and 80 on ART) fulfilling the inclusion and exclusion criteria. Neurocognitive assessment and an assessment of Functional ability was done by using the Montreal Cognitive Assessment (MoCA) and Lawton and Brody Instrumental Activities of Daily Living Scale scale, respectively.RESULTS: The study population consisted of 75.6% males and 24.4% females with mean age of 44±10 years. The overall prevalence of HIV associated neurocognitive disorder (HAND) in the study subjects was 52.5%. Of these, 47.5% had asymptomatic neurocognitive impairment and 5% had minor neurocognitive disorder. In MoCA, the most frequently affected domains were Language (97.6%), visuospatial ability (92.9%) and memory (71.4%).CONCLUSIONS: The prevalence of HAND in both groups were similar suggesting that neurocognitive impairment starts early in HIV infection. Memory and Visuospatial function impairment had the most predictive potential for detecting the presence of HAND. HAND screening is recommended in all PLHIV at enrolment into care. Simple tools like MoCA can be used in busy outpatient settings by healthcare workers to screen for HAND.
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Female , Humans , Male , Activities of Daily Living , Delivery of Health Care , Hand , HIV , HIV Infections , Mass Screening , Memory , Methylenebis(chloroaniline) , Neurocognitive Disorders , Neuropsychological Tests , Outpatients , PrevalenceABSTRACT
Introduction: Indirect bonding has been in orthodonticsfor a long time. It has been recognized that accuratebracket positioning is of clinical importance for efficientapplication of biomechanics. Previosly so many methodshave been used for checking accuracy which is verytechnique sensitive, require special equipments, difficultto fabricate and cost effective. Here, to make it moresimplified, photographic method is used for accuracymeasurement. The aim of this study was to compare theaccuracy, and time consuming between direct and indirectbonding by photographic method.Material and methods: Study was performed on 5 patientswith split mouth technique in upper arch where bracketswere bonded on one quadrant of orthodontic modelsfor Indirect bonding one set as predetermined “ideal”bonding. A transfer tray was prepared using biostar sheetand glue gun, then tray is placed into patients mouth andother half quadrant was directly bonded to patients teeth.The accuracy was checked using photographic method inthree parameters Bracket height, Mesiodistal position andAngulation. Time taken for bonding direct and indirectprocedures were calculated.Results Unpaired t test was done which showed statisticalsignificant difference in bracket height and angulation andinsignificant for mesiodistal position. Proving indirectbonding is more accurate and less time consuming than thedirect bonding of braces.Conclusion: There is difference between mean bracketplacement errors for direct and indirect methods, the rangeof errors in the three directions assessed and time takenwere greater for direct than indirect bracket placement.The magnitudes of the findings are of clinically relevantand this method is clinically feasible and cost ineffective.