Clinical utility, feasibility of home tonometry using iCare HOME by glaucoma patients

Purpose: To determine agreement between diurnal variation testing (DVT) of intraocular pressure (IOP) with Goldmann applanation tonometer (GAT) and iCare HOME (IH) by an optometrist (OP) and home monitoring by participants (PT). Methods: Patients (18–80 years) with glaucoma and suspects were enrolled. IH IOP and GAT were taken by an OP at 2 h intervals from 8 AM to 4 PM on Day 1 and PT between 6 AM and 9 PM, for the next 2 days. IOP, date, and time were viewed via iCare LINK software. Results: In total, 72.9% (51/70) PT trained were able to take reliable readings. One hundred two eyes (51 patients, age 53 ± 16 yrs) were analyzed. Correlation between optometrist (OP) and participants (PT) was strong and positive {IH OP?IH PT? r = 0.90, p?0.0001;IH PT?GAT? r = 0.79, p?0.0001}. Agreement by Bland Altman plots was limited {IH OP?IH PT mean 0.1 mmHg (95% LOA ?5.3 to 5.5), IH PT?GAT 2.2 mmHg (?5.7 to 10.1)}. Intraclass correlation coefficient for IH OP?IH PT was 1.18 (95% CI 1.37?1.09). Intradevice {0.95 (95% CI 0.94?0.97)} and interrater repeatability {0.91 (0.79–0.96)} were good. 37% of eyes had a synchronous peak on GAT and IH during the day DVT. Conclusion: Home tonometry by iCare HOME is easy, feasible, but due to limited agreement cannot substitute GAT DVT.

Incidence Of Jejunogastric Intussussception Following Gastric Surgery In Our Hospital

INTRODUCTION:Jejuno gastric intussusception as a complication following gastrectomy occurs at an incidence of 0.1%. It follows several types of gastric surgeries like Billroth 2 and gastro jejunostomy. The mortality of the patient usually confirms to the 10% range but a high mortality of 50% has been reported in cases of delayed diagnosis paired with late intervention. In order to bypass the morbidity of the condition timely surgical invervention is the rule of the day. Though the history of gastric surgery may point towards the diagnosis, preoperative anticipation or the same has proven to be difficult in most of the cases AIMS AND OBJECTIVES: To study the incidence of jejunogastric intussusception following gastric surgery in KAPV medical college Tiruchirappalli during 10 years period from 2006 to 2016.The need for early intervention to prevent mortality and investigations needed to diagnose intussusception. METHODS AND MATERIALS: 50 patients who underwent gastrojejunostomy in KAPV medical college Tiruchirappalli during the period 2006 to 2016 were taken up for study. . Patient demographics, clinical presentation, diagnosis, investigations, operative notes, management and histopathology reports were reviewed and data was collected from case records from medical records department. RESULTS AND OBSERVATIONS: There were 5 cases of JGI. All were males. The mean age at presentation was 54.69 years (range 46–62). All patients presented with hematemesis or coffee ground vomiting. In addition, 3 patients had pain abdomen and 2 patients had malena. . All patients underwent surgical management. Most common type was Type II (efferent loop) seen in 3 patients. Type III (combined type) was seen in 1 patient. One patient had Type I (afferent loop). CONCLUSION: JGI is a rare complication after gastrojejunostomy. Upper gastrointestinal endoscopy is diagnostic. Ultrasound and computed tomography of abdomen can of additional help. This complication can occur years after surgery. High index of suspicion is required for diagnosis. Prompt surgical intervention, still remains the main stay of treatment.

Evaluation of microshear bond strength and nanoleakage of etch‑and‑rinse and self‑etch adhesives to dentin pretreated with silver diamine fluoride/potassium iodide: An in vitro study.

Aims: The aim of this in vitro study was to comparatively evaluate the microshear bond strength (MSBS) of etch‑and‑rinse and self‑etch (ER and SE) bonding systems to dentin pretreated with silver diamine fluoride/potassium iodide (SDF/KI) and nanoleakage at the resin‑dentin interface using transmission electron microscope (TEM). Subjects and Methods: Seventy‑two dentin slabs of 3 mm thickness were prepared from extracted human permanent third molars and divided into four groups (n = 18) based on the dentin surface treatment as follows: (1) ER adhesive bonding without dentin pretreatment; (2) SDF/KI pretreatment of dentin followed by ER adhesive bonding; (3) SE adhesive bonding without dentin pretreatment; and (4) SDF/KI pretreatment of dentin followed by SE adhesive bonding. Resin composite was built on the dentin slabs to a height of 4 mm incrementally, and dentin‑composite beams of approximately 1 mm2 cross‑sectional area were prepared. The beams were subjected to MSBS analysis, and the fractured surface was observed under scanning electron microscope to determine the mode of failure. The resin‑dentin interface was examined under TEM for evaluation of nanoleakage. Statistical Analysis Used: One‑way ANOVA followed by Tukey’s post hoc multiple comparison tests. Results: Pretreatment of dentin with SDF/KI increased the MSBS of ER and SE adhesives, though not statistically significant, except between Groups 2 and 3. In all the groups, the predominant mode of failure was adhesive followed by cohesive in resin, mixed and cohesive in dentin. TEM examination of resin‑dentin interface showed that pretreatment with 38% SDF/KI reduced nanoleakage regardless of the type of bonding system used. Conclusions: Pretreatment of dentin with SDF/KI minimized nanoleakage at the resin‑dentin interface without adversely affecting the bond strength of resin composite to dentin.

What could ‘integrative' medicine mean: Social science perspectives on contemporary Ayurveda.

The paper attempts to critically engage with the idea of integrative medicine as a marker of pharmaceuticalization of Ayurveda in the recent decades. It examines what it means to say ‘integrative’ medicine using the metaphor of language from philosophy of science. Drawing upon fieldwork with Ayurveda practitioners, the paper also discusses the ramifications of integrative medicine in the current scenario in which there is no organizational parity between Ayurveda and biomedicine. The paper calls for a focus on Ayurveda for public health rather than the global health market.

Studies on potassium chloride based –controlled release fertilizer made from sand– cement matrix coated with napthalene.

Sand matrix based KCl controlled release fertilizer is made and tested. The parameters of the study are initial fraction of KCl, fractional binder, Fractional inert, Diameter of the pellet and Particle size of the sand. The release of fertilizer from the pellet depended on the compositional parameters of the study. Based on Fick`s second law, a model was developed for the sand matrix fertilizers with napthalene coating. Simulated data from the model was agreeing well with experimental values. The developed equations are as follows: