Population-based assessment of barriers for uptake of eye care services among elderly people: Findings from rapid assessment of visual impairment studies from Telangana, India

Purpose: To report the barriers for seeking eye care among the elderly population aged ?60 years with avoidable vision impairment (VI) in the South Indian state of Telangana. Methods: A total of 3640 participants aged ?60 years were recruited using cluster?random sampling. Demographic information, including presenting visual acuity, was measured using the standard Rapid Assessment of Visual Impairment (RAVI) protocol. “Avoidable VI” was considered if the VI was due to cataract or uncorrected refractive error (URE). A detailed interview was conducted using a validated questionnaire to report the barriers for not seeking eye care. Data were analyzed using the Stata statistical software version 14. Results: Prevalence of avoidable VI was 30.2% (95% CI: 28.02–31.06; n = 1102). Among those who noticed decreased vision (n = 1074), only 392 participants (36.4%) reported that they felt the need for seeking eye care. The major barriers for not seeking eye care were: cannot afford the consultation fee and services (42.0%) and no escort (25.7%). Overall, the personal barriers (57.9%) were the major reason for not seeking care, followed by economic barriers (42.0%). No significant difference was reported in barriers between the participants with unilateral and bilateral VI (>0.05). Conclusion: Overall, among the elderly people, personal and economic barriers were the major reason for not seeking eye care. Health care providers and policymakers should focus on newer models of eye care delivery to ensure better accessibility and uptake of care by the elderly people

Initial investigations and clinical outcome in COVID-19 patients

Background: Coronavirus disease 2019 (COVID-19)has significant impact on the health infrastructure all over the world including India. We wanted to see whether the routine initial investigations done in COVID19 patients reflect the prognosis and outcome of the patient.Methods: It is a retrospective study involving the confirmed covid 19 patients admitted between April 2021 to May2021. The initial investigations done at the time of admission were studied in relation to outcome of the patient in the form of survival or death of the patient.Results: A total of 364 patients were studied. 295(81.05%) patients survived and 69(18.96%) patients died. Highest mortality was observed in 60% of patients with hemoglobinbelow 7.0mg/dl, 40.00% of patients with platelet count below 50000/cml, 28.80% with neutrophil lymphocyte ratio more than 5.5, 32.81% with CRP more than 100mg/L, 100% with D dimer more than 5000ng/ml, 33.33% with Ferritin more than 1500ng/ml, 29.54% with IL-6 more than 100pg/ml, 23.14% with Random blood sugar more than 200mg/dl, 37.50% with creatinine more than 2.0mg/dl, 75% with Bilirubin more than 2.0mg/dl, 42.85% with SGOT more than 201mg/dl, 22.22% with SGPT more than 201mg/dl, 38.46% with serum Procalcitonin more than 2.0mg/dl. CT Chest severity score of 21 to 30 and31 to 40 lead to mortality of 19.51% and 40.00% respectively. Conclusions: The physician who is taking care of COVID-19patients must get extra cautious regarding prognosis if he gets above initial parameters deranged in isolation or combination.

Bridging Thrombolysis versus Direct Mechanical Thrombectomy in Stroke Due to Basilar Artery Occlusion / 대한뇌졸중학회지

Background@#and Purpose Mechanical thrombectomy (MT) is an effective treatment for patients with basilar artery occlusion (BAO) acute ischemic stroke. It remains unclear whether bridging intravenous thrombolysis (IVT) prior to MT confers any benefit. This study compared the outcomes of acute BAO patients who were treated with direct MT versus combined IVT plus MT. @*Methods@#This multicenter retrospective cohort study included patients who were treated for acute BAO from eight comprehensive stroke centers between January 2015 and December 2019. Patients received direct MT or combined bridging IVT plus MT. Primary outcome was favorable functional outcome defined as modified Rankin Scale 0–3 measured at 90 days. Secondary outcome measures included mortality and symptomatic intracranial hemorrhage (sICH). @*Results@#Among 322 patients, 127 (39.4%) patients underwent bridging IVT followed by MT and 195 (60.6%) underwent direct MT. The mean±standard deviation age was 67.5±14.1 years, 64.0% were male and median National Institutes of Health Stroke Scale was 16 (interquartile range, 8 to 25). At 90-day, the rate of favorable functional outcome was similar between the bridging IVT and direct MT groups (39.4% vs. 34.4%, P=0.361). On multivariable analyses, bridging IVT was not asComorbidisociated with favorable functional outcome, mortality or sICH. In subgroup analyses, patients with underlying atherosclerosis treated with bridging IVT compared to direct MT had a higher rate of favorable functional outcome at 90 days (37.2% vs. 15.5%, P=0.013). @*Conclusions@#Functional outcomes were similar in BAO patients treated with bridging IVT versus direct MT. In the subgroup of patients with underlying large-artery atherosclerosis stroke mechanism, bridging IVT may potentially confer benefit and this warrants further investigation.

Non-alcoholic fatty liver disease increases risk of carotid atherosclerosis and ischemic stroke: An updated meta-analysis with 135,602 individuals

Background/Aims@#Non-alcoholic fatty liver disease (NAFLD) is associated with the development of cardiovascular disease. While existing studies have examined cardiac remodeling in NAFLD, there has been less emphasis on the development of carotid atherosclerosis and stroke. We sought to conduct a meta-analysis to quantify the prevalence, risk factors, and degree of risk increment of carotid atherosclerosis and stroke in NAFLD. @*Methods@#Embase and Medline were searched for articles relating to NAFLD, carotid atherosclerosis, and stroke. Proportional data was analysed using a generalized linear mixed model. Pairwise meta-analysis was conducted to obtain odds ratio or weighted mean difference for comparison between patients with and without NAFLD. @*Results@#From pooled analysis of 30 studies involving 7,951 patients with NAFLD, 35.02% (95% confidence interval [CI], 27.36–43.53%) had carotid atherosclerosis with an odds ratio of 3.20 (95% CI, 2.37–4.32; P<0.0001). Pooled analysis of 25,839 patients with NAFLD found the prevalence of stroke to be 5.04% (95% CI, 2.74–9.09%) with an odds ratio of 1.88 (95% CI, 1.23–2.88; P=0.02) compared to non-NAFLD. The degree of steatosis assessed by ultrasonography in NAFLD was closely associated with risk of carotid atherosclerosis and stroke. Older age significantly increased the risk of developing carotid atherosclerosis, but not stroke in NAFLD. @*Conclusions@#This meta-analysis shows that a stepwise increment of steatosis of NAFLD can significantly increase the risk of carotid atherosclerosis and stroke development in NAFLD. Patients more than a third sufferred from carotid atherosclerosis and routine assessment of carotid atherosclerosis is quintessential in NAFLD.

Clinical profile and outcome of Pelviureteric junction obstruction (PUJO) in children less than 12 years.

Background: Pelvi-ureteric junction obstruction (PUJO) is defined as anatomical or functional obstruction to the flow of urine from the pelvis to the upper ureter. This may be unilateral or bilateral. Most of the hydronephrosis cases are due to Pyelo-ureteral junction obstruction (PUJO) which can be diagnosed antenatally. The treatment protocol for antenatal diagnosed PUJO is standardized. Few children present later in life. Present study was done to evaluate clinical profile and outcome of infants and children (<12years) presenting with PUJO. Methods: A retrospective observational study conducted by the department of Paediatric Surgery, SDM hospital Dharwad. All children with age less than 12 years with PUJO from March 2017 to March 2020 were included in the study (n=51). Initial evaluation was done with Ultrasound KUB (Kidney, Ureter, Bladder). A diuretic renogram/ EC (Ethylene cysteine) was done to confirm the diagnosis. The children were managed both conservatively and surgically (Pyeloplasty), depending on the presentation. The children were followed up post-surgery. Results: Fifty one patients were included in the study. Mean age of presentation was 31±30 months. Most common presentation was pain abdomen which was seen in 9 patients (17.6%). 6 patients (11.7%) presented with Lump and 2(4%) presented with fever. Left kidney was commonly involved (66%). Males predominate (80%). The mean antero-posterior pelvic dimension (APPD) of involved kidney was 30mm with range from 12.5mm to 68mm. 4 (7.8%) children presented with poorly functioning kidney with split renal function less than 10%. PUJO was associated with Pelvic calculi, VUR, Horseshoe kidney, Mal-rotated kidney. Out of the 51 patients, 9 (17.6%) were kept in conservative management 42 (82.3%) underwent Pyeloplasty. Among 42, 1 underwent redopyeloplasty and 1 underwent nephrectomy. In rest of the operated patients (Post-pyeloplasty) diuretic renogram showed improved drainage with improved function. Conclusions: PUJO is common cause of urinary obstruction in children. Earlier the diagnosis, better the outcome. Delay in diagnosis or presentation leads to increased chances of renal damage and loss. Hence it is important to diagnose PUJ obstruction at the earliest and receive prompt treatment.

Long-term outcomes of ischaemic stroke patients with diabetes in a multi-ethnic cohort in Singapore

INTRODUCTION@#Diabetes increases the risk of ischaemic stroke especially among Asians. This study aims to investigate contemporaneous long-term cardiovascular outcomes of ischaemic stroke patients with diabetes in a multi-ethnic Asian cohort.@*METHODS@#Consecutive patients with ischaemic stroke were recruited from the National University Hospital, Singapore. Data on age, gender, ethnicity, risk factors (including diabetes status and body mass index [BMI]), stroke severity and mechanisms were collected. These patients were followed up until the day of the first cardiovascular event or July 2016, whichever was earlier. The primary endpoint was the time from enrolment to the first occurrence of a composite of cerebrovascular and coronary artery events.@*RESULTS@#Between July 2011 and December 2013, 720 patients (mean age 60.6 years, 71% men, 43% with diabetes, median National Institute Health Stroke Severity scale 2) were enrolled and followed up. A total of 175 cardiovascular events occurred during a median follow-up of 3.25 years (6.90 events per 1,000 person-month), comprising 133 cerebrovascular and 42 coronary artery events. The adjusted hazard ratio of diabetes was 1.50 (95% CI 1.08-2.10). In a multivariable Cox proportional hazards model, Malay and Indian ethnicities, BMI <23kg/m2 and a prior diagnosis of diabetes were identified as independent predictors of recurrent cardiovascular events.@*CONCLUSION@#Our study provides quantitative data on the event rates of ischaemic stroke patients with diabetes. These findings provide insights on stroke predictors in a multi-ethnic Asian population, which may have implications in the design of future interventional studies.

Retracted: Management and overview of postoperative chylothorax after congenital cardiothoracic surgery

The article " Management and overview of postoperative chylothorax after congenital cardiothoracic surgery " is retracted by the Editor-in-Chief, on the request of corresponding author and co-authors who informed errors in data collection after departmental review and post hoc analysis. The article is retracted because the results may be affected due to the errors.

Timing of Recanalization and Functional Recovery in Acute Ischemic Stroke / 대한뇌졸중학회지

Background@#and Purpose Although onset-to-treatment time is associated with early clinical recovery in acute ischemic stroke (AIS) patients treated with intravenous tissue plasminogen activator (tPA), the effect of the timing of tPA-induced recanalization on functional outcomes remains debatable. @*Methods@#We conducted a multicenter, prospective observational cohort study to determine whether early (within 1-hour from tPA-bolus) complete or partial recanalization assessed during 2-hour real-time transcranial Doppler monitoring is associated with improved outcomes in patients with proximal occlusions. Outcome events included dramatic clinical recovery (DCR) within 2 and 24-hours from tPA-bolus, 3-month mortality, favorable functional outcome (FFO) and functional independence (FI) defined as modified Rankin Scale (mRS) scores of 0–1 and 0–2 respectively. @*Results@#We enrolled 480 AIS patients (mean age 66±15 years, 60% men, baseline National Institutes of Health Stroke Scale score 15). Patients with early recanalization (53%) had significantly (P<0.001) higher rates of DCR at 2-hour (54% vs. 10%) and 24-hour (63% vs. 22%), 3-month FFO (67% vs. 28%) and FI (81% vs. 39%). Three-month mortality rates (6% vs. 17%) and distribution of 3-month mRS scores were significantly lower in the early recanalization group. After adjusting for potential confounders, early recanalization was independently associated with higher odds of 3-month FFO (odds ratio [OR], 6.19; 95% confidence interval [CI], 3.88 to 9.88) and lower likelihood of 3-month mortality (OR, 0.34; 95% CI, 0.17 to 0.67). Onset to treatment time correlated to the elapsed time between tPA-bolus and recanalization (unstandardized linear regression coefficient, 0.13; 95% CI, 0.06 to 0.19). @*Conclusions@#Earlier tPA treatment after stroke onset is associated with faster tPA-induced recanalization. Earlier onset-to-recanalization time results in improved functional recovery and survival in AIS patients with proximal intracranial occlusions.

A comparative study on safety and efficacy of tolperisone with etodolac and thiocolchicoside with etodolac in patients of acute low back pain with musculoskeletal spasm

Background: Low back pain is one of the most common health problems in society which leads to considerable disability, loss of work days, and puts a huge burden on socioeconomic and healthcare system. It is often associated with musculoskeletal spasm. The aim of the study was to compare the efficacy and safety of tolperisone and thiocolchicoside in combination with etodolac in patients of acute low back pain associated with musculoskeletal spasm.Methods: it was a prospective, randomized, open label study which included patients of either sex between age 18-50 years of acute low back pain with musculoskeletal spasm. Patients were allocated in two groups. Patients in 慓roup A� were given tolperisone 150 mg + etodolac 400 mg twice a day and patients in 慓roup B� were given thiocolchicoside 4 mg + etodolac 400 mg twice a day. Efficacy of two drugs was assessed by decrease in finger to floor distance (FFD), decrease in pain as per visual analog scale (VAS) and global assessment of efficacy of treatment by physician. Follow-up of the patients was done on day 3 and 7 of treatment. Various side effects reported by patients in both the groups were also recorded and compared.Results: Both tolperisone and thiocolchicoside caused significant decrease in FFD, reduced pain score thus indicating decrease in pain and spasm. Side effects reported in both groups were mild and did not result in discontinuation of therapy.Conclusions: Tolperisone was found to have efficacy similar to that of thiocolchicoside though number of side effects reported was more with tolperisone.

Concurrent chemoradiotherapy for head and neck cancers in older patients: Outcomes and their determinants

INTRODUCTION: Meta-analyses have shown concurrent chemoradiotherapy (CCRT) provides no survival benefit over radiotherapy in patients of head and neck squamous cell carcinoma (HNSCC) aged over 70 years. This study was performed to determine the adverse-effect profile, compliance, functional and oncological outcomes in patients of HNSCC over 70 years of age treated with CCRT. MATERIALS AND Methods: Retrospective analysis of stage III/IV HNSCC in patients above 70 years of age who received CCRT at our institution (n = 57). Cox-proportional hazards regression model was used for statistical analysis. RESULTS: There were 57 patients of stage III/IV HNSCC who underwent curative CCRT. 61% completed chemotherapy with no deaths and acceptable toxicity. The predictors of recurrence were poorer performance status (P = 0.031) and treatment breaks (P = 0.04). Tube dependence was associated with 2.7 times higher risk of mortality (P = 0.005). CONCLUSION: CCRT should be considered standard of care in those over seventy with good performance status. Patients with tube dependence have a higher risk of persistent disease or treatment related mortality.

Clinical and biochemical profile of patients hospitalized with jaundice: Experience from a teaching hospital in north India

Background: Jaundice is a common problem in both medical and surgical practice. For best line of management, it is very essential to differentiate all types of jaundice. The cause can often be correctly anticipated clinically but usually biochemical and radiological imaging investigations are required for confirmation. Here we present a study on clinical and biochemical profile of jaundice patients admitted in a tertiary care hospital.Methods: It was an observational study and all patients admitted with jaundice in the department of medicine meeting inclusion/exclusion criteria were enrolled. Data was collected on a self-designed, pretested and structured format.Results: Out of 100 patients, 77 were males, and median age of 47.5 years. Apart from jaundice, anorexia was the most common presenting complaint (90%), while ascites was the most common finding. Cirrhosis (60%) was the most common cause of jaundice. The mean total bilirubin was 7.9 mg%. Mean Hemoglobin in patients with cirrhosis was 9.7gm/dL. 78% patients of cirrhosis revealed esophageal varices. Majority (80%) showed hypoproteinemia. PT was prolonged >3sec in 87% of cases. On USG shrunken liver was noted in all patients with cirrhosis, enlarged liver was found in two patients of liver abscess while altered echotexture was seen in 66% cases. 90 patients improved, 9 died and only one was referred.Conclusions: Alcoholic liver disease was the leading cause of cirrhosis (92%). Jaundice in general and alcoholic cirrhosis in particular affects mostly the productive age group of the male population and has a high economic burden on our society.

Clinical profile and one-year survival of patients with heart failure with reduced ejection fraction: The largest report from India

Background India has one of the largest population of heart failure (HF) patients in the world; yet only limited information is available about HF in India. Methods This observational study was performed at Medanta- The Medicity, a large, tertiary-care institute in the National Capital Region of India. Records of HF patients with reduced left ventricular ejection fraction (LVEF) registered at Medanta HF clinic during the period early 2014 to mid-2017 were reviewed. Disease characteristics and one-year mortality details were collected. Results Mean age of the subjects (n = 5590) was 59.1 ± 11.8 years with 83.0% males. Mean LVEF was 30.0 ± 6.6%. Coronary artery disease (CAD) was the dominant cause of HF, accounting for 77.8% of the total population. Most patients received guideline-directed medical therapy with a beta blocker being prescribed to 81.8% subjects. The one-year all-cause mortality was 17.6%. On multivariate analysis, age, usage of loop diuretics and ivabradine, and serum creatinine were independently associated with one-year mortality, whereas rheumatic etiology had an inverse association. Conclusions This represents the largest single-center data of HF patients reported so far and the largest study describing clinical outcomes from HF patients in India. Our patients were younger, had high proportion of CAD, and there was higher usage of beta-blockers. Despite this, the one-year mortality was substantial. Given the enormous magnitude of HF burden in India and the paucity of information on this subject, these findings should be of help in identifying key problem areas and potential solutions for management of HF in India.

Carcinogenic herbs: a review

Herbal toxicity is a field that has rapidly grown over the last few years along with increased use of herbal products worldwide. People prefer using herbal medicines rather than allopathic because herbals are considered safe. Use of herbal medicines from ancient times does not ensure their complete safety. With the growing awareness regarding pharmacovigilance worldwide, there has been an increase in the number of reported adverse events occurring with the use of herbal products. The objective of the study is to aware the researchers about most commonly used Indian medicinal herbs inducing carcinogenicity like Aloe vera, Ginkgo biloba, Kava kava, etc.

HPV infection: in need of timely intervention

Persistent infection with human papilloma virus (HPV) has been proved beyond doubt to be associated with the development of cervical cancer. One woman dies of cervical cancer every 8 minutes in India. As per estimations for the year 2018, about 96922 new cervical cancer cases are diagnosed annually in India and it ranks as the second most common female cancer in all age groups. But being an infectious cause it is possible to contain its development and transmission. Coupled with this, we have a potent vaccine to fight this infection. A well documented account of positive impact of HPV vaccination has been published in numerous studies around the globe. By 2013, its vaccination had been introduced in about fifty countries around the globe. In India also, recently, two HPV vaccination projects for operational feasibility were launched in Andhra Pradesh and Gujarat. In November 2016, Punjab becamethe first state in the country to include the vaccine in its universal immunization program. This era belongs to women empowerment and we cannot deny them the opportunity of good health. Hence it’s high time India introduces an effective HPV vaccination program.

Evaluation of antihypertensive efficacy of Losartan + Hydrochlorthiazide versus Telmisartan + Hydrochlorthiazide in patients with stage 1 or stage 2 hypertension: a randomized controlled trial

Background: Cardiovascular disease (CVD) is the most common contributor of morbidity and mortality in underdeveloped and developing countries including the South Asian countries (including India and Pakistan). Amongst the cluster group of CVDs, Hypertension (HTN) represents the most common cardiovascular risk factor. The aim of this trial was to evaluate of antihypertensive efficacy and effect on biochemical parameters of Losartan + Hydrochlorthiazide versus Telmisartan + Hydrochlorthiazide in patients with stage 1 or stage 2 hypertension with a randomized controlled trial.Methods: This was a prospective, randomized controlled trial of Losartan + Hydrochlorthiazide versus Telmisartan + Hydrochlorthiazide in patients with stage 1 or stage 2 hypertension. The primary endpoint on treatment was analysis of antihypertensive efficacy of these drug combinations. The variables were compared at different time points- baseline, 3 and 6 months.Results: In the present study, 76 patients were enrolled with 38 patients each allocated to each treatment groups. The effect of Losartan 50mg + Hydrochlorthiazide 12.5mg OD was found to be significant on SBP and DBP in both supine as well as sitting position than Telmisartan 80mg + Hydrochlorthiazide 12.5mg OD group at 3 and 6 months.Conclusions: The results on anti- hypertensive efficacy was far better in Losartan 50mg + Hydrochlorthiazide 12.5mg OD group than Telmisartan 80mg + Hydrochlorthiazide 12.5mg OD group.

A study to evaluate compliance in patients of diabetes mellitus in a North-Indian tertiary care hospital

Background: The objective of the study was to determine level of adherence and recognize various causative factors which can affect the compliance in the diabetic patients.Methods: This was an observational study. The study was conducted by enrolling patients of the outpatient department of Medicine of Rajindra Hospital, Government Medical College, Patiala, Punjab. To assess adherence, a questionnaire was administered to the patients - Morisky Medication Adherence Scale (MMAS) -8 item questionnaire. The various factors affecting compliance was determined by a researcher made questionnaire.Results: Out of a total of 100 subjects, age range extended from 18 years to 80 years. The mean age was 57.52±12.33years. 51% of patients were females and 49% was males. Analysis of MMAS- 8 item scores of patients showed that 52% of patients had low adherence, 29% had medium while 19% had high adherence to the treatment. Only 30% patients were compliant i.e. with HbA1C value of 7 or less while 70% patients were non-compliant i.e. with HbA1C value of more than 7.Conclusions: Compliance to medical treatment is influenced by a myriad of factors. In order to promote compliance, it is necessary to increase awareness about the disease, possible complications and treatment guidelines among patients as well as their family members.

Periodontal Microsurgery – A Review

Over the past decade, the field of periodontics has seen increasing surgical refinement of many procedures. Consistent successful periodontal treatment procedures demand clinical expertise that challenges the technical skills of periodontists to the limit of and beyond the range of visual acuity. Periodontal microsurgery is the refinement of basic surgical techniques made possible by the improved visual acuity gained with the use of surgical microscope. The effect of periodontal microsurgery may include more predictable therapeutic results, less invasive procedure with reduced patient discomfort, more rapid healing, improved cosmetic results and greater patient acceptance. The present paper insights into the history , magnification systems, and its indications in periodontal surgery and future perspectives.

Polymorphism of glutathione S-transferase M1 and T1 genes and susceptibility to psoriasis disease: A study from North India

Background: Increased oxidative stress and resulting inflammation has been emphasized as a factor in the pathogenesis of many diseases including psoriasis. Glutathione S-transferases (GSTs) protect against oxidative stress, inflammation, and genotoxicity. Polymorphisms in the GST genes may lead to an imbalance in pro- and antioxidant systems resulting in the increased production of reactive oxygen species that could influence the pathogenesis of psoriasis. Aim: The aim of this study was to investigate the association between GSTs (GSTM1 and GSTT1) gene polymorphism in patients with chronic plaque psoriasis as a factor in the susceptibility and development of psoriasis. Materials and Methods: We assessed 128 patients with psoriasis and 250 age- and sex-matched healthy controls. Genomic DNA was extracted from peripheral blood by the phenol chloroform method. The null GSTT1 and GSTM1 genotypes were identified by multiplex polymerase chain reaction (PCR) method. Results: The null genotype of GSTM1 and GSTT1 was seen in 45.3% and 40.6% in psoriasis patients whereas in the controls it was 34.4% and 20.0%, respectively. A significant association was seen between the null alleles of the GSTT1 (OR = 2.74) and GSTM1 (OR = 1.58) alone or in combination with tobacco use (P < 0.001) and psoriasis risk. The presence of both null genotypes of GSTM1 and GSTT1 further increased the risk of psoriasis (OR = 3.52) when compared with the positive genotypes of GSTM1 and GSTT1. Limitations: A major limitation of this study was the small sample size. A large epidemiological study is necessary to confirm these findings. Conclusions: The null genotype of GSTT1 is a strong predisposing factor for psoriasis in North India.

Dental Awareness Among Medical Professionals In Bengaluru:A Questionnaire Survey

Aim :To assess the awareness of oral hygiene, periodontal diseases and availability of treatment techniques among medical professionals. Materials and method: One hundred medical professionals were interviewed through a questionnaire . This was a KAP ( knowledge, attitude, practice ) study which included questions based on knowledge, attitude and practice towards periodontal awareness among medical professionals . Results and Conclusion : Apositive attitude towards dental and periodontal check and the treatment needs was observed among those questioned. However, inputs from this survey can be used to organize periodontal health programs and for planning of joint ventures.

Sexually transmitted infections and HIV in self reporting men who have sex with men: a two-year study from India

Homosexuality is not legally and socially accepted in India. Thus, this area of research has largely been ignored by Indian authors, resulting in dearth of knowledge, particularly with respect to sexually transmitted infections [STIs] in this high-risk group. Over a period of two years [2013-2014], 738 males sought care at skin and venereal diseases clinics, 52 [7.05%, 95% CI = 5.4-9.14%] of who identified themselves as MSM and were enrolled in the study. Diagnosis was made on the basis of clinical presentation and laboratory testing, wherever indicated. Thirty six percent of MSM had only homosexual preferences, while 64% were bisexual. The most common sexually transmitted infection was genital warts [23.08%, 95% CI = 13.58-36.28%]. Fourteen patients [26.92%, 95% CI = 16.67-40.35%] were VDRL and TPHA positive [two, five and four with primary syphilis, secondary syphilis and latent syphilis, respectively]. These were followed by genital herpes [11.54%, 95% CI = 5.03-23.34%], genital molluscum contagiosum [9.62% 95% CI = 3.75-21.04%], and gonorrhea [5.77%, 95% CI = 1.38-16.25%]. Of those tested, 23.08% [95% CI = 13.58-36.28%] of patients were reactive for HIV serology. Thus, MSM is a high-risk group with high prevalence of HIV and other STIs in this group, mandating greater focus, education and counseling