SUCCESSFUL HYSTEROSCOPY GUIDED SUCTION & EVACUATION OF PRODUCT OF CONCEPTION ALONG WITH REMOVAL OF UTERINE SEPTUM IN SAME SITTING

Objective To report a case of early pregnancy loss with septate uterus, successfully managed by hysteroscopy guided suction & evacuation of product of conception along with removal of uterine septum in same sitting. Case report. Tertiary care hospital. One woman with early pregnancy loss with septate Design Setting Patient uterus. Hysteroscopy guided suction & evacuation of product of conception along with removal of uterine septum Intervention in same sitting. Hysteroscopy guided suction & evacuation of product of conception followed by septum removal with Result hysteroscopic scissor was performed, with minimal blood loss, in same sitting. Products of conception were sent for pathologic examination. There were no intra-operative or postoperative complications. Even though the role of septum as a Conclusion contributing factor to miscarriage in not certain, early pregnancy loss may be seen in patients with septate uterus. Blind removal of POCs with dilatation & curettage, may be complicated with retained products of conception (RPOC) or intrauterine adhesion formation, which can lead to adverse fertility outcomes in the future. Also removal of septum, which may or may not be the cause, is often performed before further pregnancy. This requires another admission & exposure to anaesthesia, along with added cost. Hysteroscopy guided resection of POC with septum removal in same sitting has been associated with complete tissue removal under vision, less damage to surrounding endometrium, cost effective combination of two surgical procedures & earlier time to conception compared with 2 sitting procedure (dilation and curettage than septum removal). Thus, hysteroscopy guided suction & evacuation of POC & septum removal in same sitting can be considered as an alternative surgical technique for management of early pregnancy loss in patients diagnosed with septate uterus. This case report demonstrates the successful application of hysteroscopic procedure in a case of early pregnancy loss with septate uterus.

IDENTIFYING THE ECOTOURISM SUITABILITY SCORE FOR MARINA BEACH AND ELLIOT'S BEACH OF CHENNAI COAST, TAMIL NADU, INDIA.

At the Chennai Coast in Tamil Nadu, India, research is done. Finding out whether Marina Beach and Elliott's Beach are suitable for ecotourism is the study's main goal. For the research using the ecotourism suitability index methodology, land use, land cover, erosion, accretion, beach type, beach width, proximity to bus stop, proximity to train station, and suspended sediment load have all been taken into account. The suitability index of eco tourism is assigned into 4 (four) classes, which are: Class S1 (Highly suitable), Class S2 (Quite Suitable), Class S3 (Suitable with condition) and Class N (Not Suitable). Result of analysis indicates that coast area of Marina Beach and Elliots beach area comes in the class of Highly suitable (S1) by score total of 129 or 95.5 % and 116 or 85.9 % respectively. According to the research, Marina Beach has a sand feature as a land use land cover, 213 metres of beach width, good clarity (500 mg/L), is located 361 metres from a bus stop and 681 metres from a train station, has moderate erosion, and has not experienced any accretion. The beach type is white sand. Likewise, Elliots Beach has a sand feature as a land use land cover, with 222 metres of beach width, good clarity (600 mg/L), 642 metres from the bus stop, and 2351 metres from the railway station, which is high. There is moderate erosion and no accretion, and the sand is of the beach type, which is white. Marina beach has high tourism suitability index as compared to Elliot's beach. By considering marina beach, all the eight parameters are considered to be ne whereas Elliot's beach has far away accessibility this is the main reason for lowering the tourism suitability.

Challenges Faced in Biomedical Waste Management by Waste Handlers amidstthe COVID-19 Pandemic in a Tertiary Care Hospital: A Qualitative Study

Introduction :Coronavirus disease 2019(COVID-19) saw an overhaul in the biomedical waste management (BMWM) practices. Waste handlers were at the brunt of these changes. If the challenges pertaining to BMWM at the ground level are better understood, more effective measures to overcome them can be formulated. 1. To identify myths and concerns regarding BMWM in the context of COVID-Objectives: 19 pandemic. 2. To explore the challenges faced in BMWM amidst the COVID-19 pandemic. 3.To explore opportunities and future perspectives of BMWM. In-depth interviews were conducted among 17Method: purposively selected Class IV health care workers during August to November 2021 in a tertiary care institute in Mumbai. Data was reported using thematic analysis. Three major themes - challengesResults: and concerns faced by BMW handlers, enablers/ motivators, opportunities and future practices were generated from the transcripts. Various challenges faced by waste handlers were- difficulties in segregation and transport of BMW, exhaustion from PPE usage and fear of acquiring and spreading COVID-19 from work, stigma faced from public, and handling COVID-19 deaths. Support from family and colleagues, incentives and a positive change in public perception enabled them to work. Forming redressal committees, addressing job security concerns and timely provision of good quality equipment can improve hospital waste management measures in the future. It is of utmost importance to address challenges faced byConclusion: waste handlers in BMWM. Onus should also be on periodic training in BMWM

Access–Watch Ratio Based on Access, Watch, and Reserve Classification of Antibiotics in Public Health Facilities of Tamil Nadu

The rise in cases of antibiotic resistance can be mainly attributed to the overuse and misuse of antibiotics. To address this issue, the WHO launched Access, Watch, and Reserve (AWaRe) classification of antibiotics in 2017 as a surveillance tool. Many countries have adopted it to monitor and optimize their antibiotic usage. However, implementation of it is yet not seen at a very appreciable level. Through this survey, we tried to explore the prescribing pattern of antibiotics based on the WHO AWaRe classification in selected secondary and tertiary care health facilities of Tamil Nadu. In-patient case sheets were audited in selected departments across 18 health facilities in six districts. Proportionately higher use of the watch group of antibiotics was found in all the districts. A lower access–watch ratio suggests the need for judicious implementation of such tools to safeguard this life-saving good and ensuring its sustainability.

Global pattern and trend of cervical cancer incidence from 1993 to 2012: Joinpoint regression and age?period?cohort analysis

Background: Cervical cancer ranks fourth in global cancer incidence and mortality among women. A comparison of the global trends in cervical cancer would help us to identify high focus regions and serves an opportunity to evaluate the impact of the screening programs. Hence, the current study was done to assess the global trend in the incidence of cervical cancer from 1993 to 2012 among individuals aged between 30 and 79 years. Methods: This secondary data analysis was conducted using the World Health Organization (WHO) Cancer Incidence data of five continents plus database (America, Asia, Europe, and Oceania) on the incidence of cervical cancer. Joinpoint regression was performed to determine the average annual percent change (AAPC) in cervical cancer incidence. We performed an age-period-cohort analysis to obtain age, period, and cohort-specific deviations and rate ratio (RR). Results: Out of the four regions studied, all the regions showed a declining trend in cervical cancer incidence. The maximum decline was found in Oceania (AAPC = ?3.3%) followed by America (AAPC = ?2.0%). There was a consistent rise in cervical cancer incidence across the age groups in all the four continents with the maximum burden among the elderly. All the regions showed a steady decline in the rate of cervical cancer through the periods 1998–2002 to 2007–2012. There was also a steady decline in cervical cancer incidence across the cohorts from 1923–1927 to 1978–1982 in all the regions except America. Conclusion: To summarize, cervical cancer incidence showed a declining trend globally, with the maximum decline in the Oceania region from 1993 to 2012.

Prevalence and determinants of breast and cervical cancer screening among women aged between 30 and 49 years in India: Secondary data analysis of National Family Health Survey – 4

Background: Breast and cervical cancers are the two leading causes of cancer-related morbidity and mortality in India. Early diagnosis of these cancers through screening offers the best chance to achieve successful treatment outcomes. Hence, the current study was done to determine the prevalence and predictors of breast and cervical cancer screening among women aged 30-49 years in India. Methods: We have analyzed the most recent National Family Health Survey-4 data (NFHS-4) gathered from Demographic Health Survey program. Stratification and clustering in the sample design were accounted using svyset command. Adjusted prevalence ratio (aPR) with 95% confidence interval (CI) was reported. Results: In total, 336,777 women aged 30-49 years were included. Proportion of women aged 30-49 years with history of breast cancer examination in their lifetime was 12.9% (95% CI: 12.6-13.2%), while it was 29.8% (95% CI: 29.3-30.3%) for cervical cancer. It was found that women aged 45-49 years (aPR=1.09), married (aPR=2.18), higher educational level (aPR=1.28), richest quantile (aPR=1.96), no history of pill use (aPR=1.24), obese (aPR=1.06), and healthy dietary habits (aPR=1.47) were more likely to be screened for breast cancer. Predictors for cervical cancer screening were higher age group (aPR=1.06), married (aPR=2.94), secondary educational level (aPR=1.05), richest quantile (aPR=2.24), nonpill user (aPR=1.24), nontobacco user (aPR=1.07), and lower parity (aPR=1.09). Conclusion: A total of 1 out of 10 women in reproductive age group were screened for breast cancer while less than one in three for cervical cancer. Hence, it is important to spread awareness and increase access to screening services to achieve early diagnosis and better treatment outcomes.

Reliability in detection and differentiation between calcification and hemorrhage by 3 d GRE/ SWI technique compared to CT

This study was conducted to evaluate the sensitivity of Magnetic Resonance (MR) Susceptibility- Weighted Imaging (SWI) and also to compare the sensitivity of Magnetic Resonance (MR) susceptibility-Weighted Imaging (SWI) and Computed Tomography (CT), such that SWI can replace the use of CT as a standard protocol in the detection and differentiation between calcification and hemorrhage. A series of 70 patients included in this study with clinical suspicion or known history of intracranial hemorrhage/ calcifications for follow up, were scanned using both Philips Multiva 1.5T (MRI/SWI) and Philips Ingenuity 128 slice (CT). Results showed that SWI had 100% relative sensitivity, as it was able to detect both hemorrhage and calcifications in all the cases identified in CT. In addition, SWI detected hemorrhage in 2 additional cases that were nonspecific in CT. Furthermore, SWI detected signal from micro bleeds, which was missed on CT in three cases, and also detected calcification in two cases, which were not positively identified in CT. In conclusion, Susceptibility- Weighted Imaging (SWI) is highly sensitive for the detection and differentiation of hemorrhage and calcifications using Phase reconstructed images compared to conventional MRI methods and Computed Tomography

A Comparison Study of Four Cervical Disk Arthroplasty Devices Using Finite Element Models

Methods@#A validated C2–T1 finite element model was subjected to flexion-extension. CDAs were simulated at the C5–C6 level with the Secure-C, Mobi-C, Prestige LP, and Prodisc C prosthetic disks. We used a hybrid loading protocol to apply sagittal moments. Normalized motions at the index and adjacent levels, and intradiscal pressures and facet column loads were also obtained. @*Results@#The ranges of motion at the index level increased after CDA. The Mobi-C prosthesis demonstrated the highest amount of flexion, followed by the Secure-C, Prestige LP, and Prodisc C. The Secure-C demonstrated the highest amount of extension, followed by the Mobi-C, Prodisc C, and Prestige LP. The motion decreased at the rostral and caudal adjacent levels. Facet forces increased at the index level and decreased at the rostral and caudal adjacent levels following CDA. Intradiscal pressures decreased at the adjacent levels for the Mobi-C, Secure-C, and Prodisc C. Conversely, the use of the Prestige LP increased intradiscal pressure at both adjacent levels. @*Conclusions@#While all artificial disks were useful in restoring the index level motion, the Secure-C and Mobi-C translating abilities allowed for lower intradiscal pressures at the adjacent segments and may be the driving mechanism for minimizing adjacent segment degenerative arthritic changes. The facet joint integrity should also be considered in the clinical decision-making process for CDA selection.

A Comparison Study of Four Cervical Disk Arthroplasty Devices Using Finite Element Models

Methods@#A validated C2–T1 finite element model was subjected to flexion-extension. CDAs were simulated at the C5–C6 level with the Secure-C, Mobi-C, Prestige LP, and Prodisc C prosthetic disks. We used a hybrid loading protocol to apply sagittal moments. Normalized motions at the index and adjacent levels, and intradiscal pressures and facet column loads were also obtained. @*Results@#The ranges of motion at the index level increased after CDA. The Mobi-C prosthesis demonstrated the highest amount of flexion, followed by the Secure-C, Prestige LP, and Prodisc C. The Secure-C demonstrated the highest amount of extension, followed by the Mobi-C, Prodisc C, and Prestige LP. The motion decreased at the rostral and caudal adjacent levels. Facet forces increased at the index level and decreased at the rostral and caudal adjacent levels following CDA. Intradiscal pressures decreased at the adjacent levels for the Mobi-C, Secure-C, and Prodisc C. Conversely, the use of the Prestige LP increased intradiscal pressure at both adjacent levels. @*Conclusions@#While all artificial disks were useful in restoring the index level motion, the Secure-C and Mobi-C translating abilities allowed for lower intradiscal pressures at the adjacent segments and may be the driving mechanism for minimizing adjacent segment degenerative arthritic changes. The facet joint integrity should also be considered in the clinical decision-making process for CDA selection.

Prevalence of iodine deficiency disorders and its determinants among school children aged 6 to 12 years in rural areas of Koppal district, Karnataka

Background: Iodine deficiency disorders are recognized as major public health problem in India and the simplest, most effective and inexpensive preventive method is the consumption of Iodized salt. The objective of this study is to estimate the prevalence of goitre among children aged 6 to 12 years in rural areas of Koppal district, to determine various factors associated with goiter among children, to estimate the level of urinary iodine excretion among urine samples collected from children and to estimate the level of iodine content among salt samples collected in the study setting.Methods: A cross sectional study was conducted for a duration of 6 months from June 2018 to November 2018 in rural areas of Koppal district among 3047 school children aged 6 to 12 years selected by cluster sampling technique. Goiter was detected and graded using standard techniques and the collected salt and urine samples were sent to MRHRU, Sirwar, Raichur for analysis. Data was collected using pretested and semistructured questionnaire and was analyzed using WHO Epi info software version 3.5.4.Results: The prevalence of goitre among school children in Koppal district was 442 (14.5%) and it was found to be significantly associated with age and source of drinking water. Majority i.e., 65.96% of urine samples had iodine content less than 100 µg/l and majority i.e., 79.15% of salt samples had iodine content less than 15 PPM.Conclusions: Goiter is mild public health problem in Koppal district with majority of urine samples excreting iodine below optimum levels and majority of salt samples being inadequately iodized.

Does the morbidity management and disability prevention (MMDP) clinic serve the filarial lymphedema (FLE) patients’ preeminent expectation?

@#Advocacy and training on “Home care” for filarial lymphoedma (FLE) patients are provided through morbidity management and disability prevention (MMDP) clinic commonly known as filariasis clinic and clinical improvement is assessed by follow-up visits. While the physicians aim at reducing the recurrent ADL (coined as ADLA in 1997) episodes, the patients expect reduction in LE volume. The objective of the present study was to know whether the MMDP clinic serves the primary expectation of the FLE patients. LE patients who attended the clinic for at least four follow-up consultations and had LE volume measurements at three points of time during the one year period of observation were considered for analysis. Clinical assessment was done for LE grading and LE volume was measured by water displacement volumetry. Sixty-three patients who fulfilled the follow up criteria were included. It was observed that the median LE volume was 914ml (IQR 269 – 1935) at first visit of the observation period which reduced to 645ml (IQR 2151666) and 752ml (IQR 215 – 1720) at first and second follow-up visits respectively. Over all, in short span of one year, 21 of the 63 patients (33.3%) who visited MMDP clinic at least four times in a year were benefitted through the MMDP advocacy and the National filariasis control programme need to emphasise on the importance of follow up visits to FLE patients.

Investigation of an outbreak of suspected food poisoning in a school

Background: An outbreak investigation for food poisoning in a school of rural Maharashtra was carried out. This school had central kitchen for children staying at hostel. During monsoon season occurrence of acute gastroenteritis diseases is common and hence it important to investigate each and every suspected outbreak presenting with similar symptoms to that of acute gastroenteritis.Methods: It was a retrospective and prospective study design. All 140 children who ate food from central kitchen were interviewed and followed up. Median incubation period was obtained from the 12 children who fitted into case definition which was given by integrated diseases control program of Maharashtra. Environmental and food sampling along with laboratory investigations was done for diagnosis.Results: Total 12 children had symptoms of food poisoning. The median incubation period was around 8 hours. Gastrointestinal symptoms were the commonest reported by all the 12 children. It was found out that all the symptomatic children had eaten laddu brought from outside and stored in unhygienic conditions.Conclusions: Eating of laddu which were stored in unhygienic conditions had resulted into growth of Clostridia streptofaecalis in it causing food poisoning to children.

An evaluation of compliance with the cigarettes and other tobacco products act 2003 in Koppal district, Karnataka

Background: Tobacco is a major risk factor for a number of diseases affecting all age groups. One person dies every six seconds due to tobacco use and up to half of current users will eventually die of a tobacco-related disease. Government of India has enacted cigarette and other tobacco products act (COTPA) in the year 2003 to control tobacco use. The objective of study was to estimate the level of compliance to selected sections (4 to 9) of COTPA (cigarette and other tobacco products – prohibition of advertisement and regulation of trade and commerce, production, supply and distribution) act, 2003 in Koppal district, Karnataka.Methods: The present study was a cross sectional study conducted as an independent evaluation of COTPA act 2003 in Koppal district as per National Tobacco Control Program guidelines. Cluster sampling technique was used for sample selection and sample consisted of 158 public places, 102 educational institutional, 87 shops/ sell points and 60 tobacco products. Data entry and analysis was done using microsoft office excel 2013.Results: The prevalence of compliance to section 4, 5, 6A, 6B, 7, 8 and 9 of COTPA act 2003 in Koppal district were 80.3%, 96.5%, 98.9%, 64.8%, 53.3%, 63.3% and 50% respectively.Conclusions: Compliance level was poor especially in relation to display of health warnings on tobacco products which needs to be tackled through strict enforcement of the existing laws.

A Cadaveric Study Of Variations In The Urological System

Introduction: Knowledge of anatomical variations of the urinary system is important for urological surgeriesinvolving renal transplant and radiological interpretations. When urologists and clinicians have a soundknowledge of anatomical variations, it eases management, surgical interventions and helps to reducecomplications.Advanced imaging technology is the boon for the patients requiring minimally invasive approaches for variouskidney disorders. These approaches require precise knowledge of normal and variant anatomy of the kidneys,ureters and vascular structures at the hilum of the kidney. Therefore, the objective of this study was to furnish theclinicians with the major anatomical variations of urological system.Method: Ninety adult human cadavers were examined for number, shape and position of kidneys and the uretersover a period of 5 years. Out of these, 85 were males and 15 were female cadavers.Results: Kidneys were bilaterally present in all the cadavers. Hypoplastic kidneys were seen bilaterally in 3.3%cadavers. Out of 90 cadavers, 3 showed bilateral and 6 showed unilateral lobulated kidneys. 2 cadavers showedunilateral (1 L, 1 R) incomplete double ureter. One showed bilateral and 5 showed unilateral accessory renalartery amongst 90 cadavers. Ectopic kidney was seen in one cadaver.Conclusions: Morphological variations in the kidney are very common and are clinically important for urosurgeons

Banana peel culture as an indigenous medium for easy identification of late‑sporulation human fungal pathogens.

Aim: Fungi are increasing in incidence as human pathogens and newer and rarer species are continuously being encountered. Identifying these species from growth on regular culture media may be challenging due to the absence of typical features. An indigenous and cheap medium, similar to the natural substrate of these fungi, was standardised in our laboratory as an aid to species identification in a conventional laboratory setting. Materials and Methods: Ripe banana peel pieces, sterilised in an autoclave at 121°C temperature and 15 lbs pressure for 15 min promoted good growth of hyphae and pycnidia or acervuli in coelomycetes, flabelliform and medusoid fruiting bodies of basidiomycetes and fruit bodies such as cleistothecium in ascomycetes. The growth from the primary isolation medium was taken and inoculated onto the pieces of double‑autoclaved ripe banana peel pieces in a sterile glass Petri dish with some moisture (sprinkles of sterile distilled water). A few sterile coverslips were placed randomly inside the Petri dish for the growing fungus to stick on to it. The plates were kept at room temperature and left undisturbed for 15–20 days. At a time, one coverslip was taken out and placed on a slide with lactophenol cotton blue and focused under the microscope to look for fruit bodies. Results: Lasiodiplodia theobromae, Macrophomina phaseolina, Nigrospora sphaerica, Chaetomium murorum, Nattrassia mangiferae and Schizophyllum commune were identified by characteristic features from growth on banana peel culture. Conclusions: Banana peel culture is a cheap and effective medium resembling the natural substrate of fungi and is useful for promoting characteristic reproductive structures that aid identification.

Problem Based Learning In Anatomy – Our Experience.

Background: Presently Anatomy is taught in a traditional way through lectures, small group teaching and demonstration. All these are teacher-controlled methods for teaching as per Medical Education Technology. So it was decided to introduce a learner-controlled method for teaching of Anatomy i.e. problem-based learning (PBL) with the following. Objectives:To compare the performance of the students undergoing PBL with the performance of the students taught in a traditional way To compare the perception of the students about PBL in comparison to Traditional way Materials and methods: 32 students who volunteered for the study were divided into two groups. The first group was taught cerebellum by PBL method and the second group was taught cerebrum by PBL method. Cross over method was then applied. Thereafter a theory examination was conducted. A feedback questionnaire was given to the students after the examination. Results: The average score of the students in the PBL group was more than that of the students in the lecture group in 60% questions. The score was same in 20% questions. The score was reverse in 20% of questions. PBL was appreciated and accepted by the students. It can be introduced partly in the existing curriculum.

Uncommon Parameters for Hip bone sexing.

Background- It is very difficult to determine sex of skeleton when pieces of skeletal bones are exhumed Objectives- Thus our study aims at: 1. Finding accuracy of the previously set criteria for sexing of hip bone. 2. To find the validity of other criteria in sexing of hip bone by which sex of the skeleton can be determined from small portion of hip bone. Methods- 200 hip bones of known sex (100 male and 100 females) were studied from various medical colleges. Results and Interpretation- Unpaired 't' test was found to be highly significant when values of true pelvic height in males and females were compared. Similarly, 'p' value was found significant in comparing mid-pubic width in males and females. Mean of distance from ischial tuberosity to farthest rim of acetabulum in males was found to be more than that of the females. Very significant differences were observed in the mean of pubic length and acetabular diameter in females. The index mentioned by Maclaughline and Bruce in 1985 was calculated in males and females. The index showed a value of 100.226 in males and 126.944 in female. Conclusion- Apart from the previously mentioned criteria in hip bone sexing, the study helped to prove the importance of following criteria in hip bone sexing : 1.True pelvic height 2.Mid-pubic width 3.Distance from ischial tuberosity to farthest rim of acetabulum 4.Index mentioned by Maclaughline and Bruce 5.Distance from anterior superior iliac spine to pubic tubercle 6.Distance from anterior superior iliac to iliopubic eminence.

Isolation and characterization of 2-hydroxy-9,10-anthraquinone from Streptomyces olivochromogenes (ERINLG-261) with antimicrobial and antiproliferative properties

Abstract Currently Streptomyces is one of the most important antibiotic producing microorganisms against several diseases. In the present study Streptomyces olivochromogenes ERINLG-261 was isolated from the soil samples of the Mudumalai hills, Western Ghats, India. Morphological, physiological, biochemical and 16S rRNA studies strongly suggested that this isolate belonged to the genus Streptomyces. ERINLG-261 showed good antimicrobial activity against different bacteria and fungi in Micromonospora fermentation medium. The active ethyl acetate extract was packed in column chromatography over silica gel which led to the isolation of 2-hydroxy-9,10-anthraquinone as the active principle. The isolated compound showed good antimicrobial activity against tested bacteria and fungi in minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) studies. The compound showed moderate in vitro antiproliferative activity against A549 and COLO320 cells. The compound was subjected to molecular docking studies for the inhibition of Topoisomerase, TtgR and Beta-lactamase enzymes which are targets for antimicrobials. Docking results of the compound showed low docking energy with these enzymes indicating its usefulness as antimicrobial agent. This is the first report of antimicrobial and antiproliferative activity of 2-hydroxy-9,10-anthraquinone isolated from Streptomyces olivochromogenes along with molecular docking studies.

Oro-Cutaneous Sinus Tract: A Case Report.

Common dental causes of odontogenic sinus tracts include endodontic or periodontal infections, trauma, retained roots and residual chronic infection of the jaws. They are uncommon, and often misdiagnosed. The sinus tracts are most frequently associated with mandibular teeth, which have been documented in 80 to 87% of the reported cases. Extraoral fistulas typically present as erythematous, symmetrical, crusting, smooth and non-tender nodules with periodic drainage. Cutaneous sinus tracts of odontogenic origin represents one among the many types of sinus tracts that may form on the face and neck region. They are usually present on the chin and cheek region. The cutaneous sinus resolves rapidly if the lesion is recognized early and diagnosed properly followed by surgical excision of sinus tract, removal of offending tooth and cutaneous closure is performed.

Diabetic retinopathy and its risk factors in patients with type 2 diabetes attending rural primary healthcare facilities in Tamil Nadu.

Background. India has a high burden of diabetic retinopathy ranging from 12.2% to 20.4% among patients with type 2 diabetes mellitus (T2DM). A T2DM management programme was initiated in the public sector in Tamil Nadu. We estimated the prevalence of diabetic retinopathy and its associated risk factors. Methods. We did a cross-sectional survey among patients with T2DM attending two primary health centres for treatment and follow-up in Kancheepuram, Tamil Nadu in January– March 2013. We did a questionnaire-based survey, and measured blood pressure and biochemical parameters (serum creatinine, plasma glucose, etc.) of the patients. We examined their eyes by direct and indirect ophthalmoscopy and defined diabetic retinopathy using a modified classification by Klein et al. We calculated the proportion and 95% CI for the prevalence and adjusted odds ratio (AOR) for risk factors associated with diabetic retinopathy. Results. Among the 270 patients, the mean (SD) age was 54.5 (10) years. The median duration of T2DM was 48 months. The prevalence of diabetic retinopathy was 29.6%. Overall, 65.9% of patients had hypertension, 14.4% had nephropathy (eGFR <60 mg/dl) and 67.4% had neuropathy. Among patients with comorbid conditions, 60%, 48%, 32%, and 3% were already diagnosed to have hypertension, neuropathy, retinopathy, and nephropathy, respectively. The risk factors for diabetic retinopathy were hypertension (AOR 3.2, 95% CI 1.7–6.3), duration of T2DM >5 years (AOR 6.5, 95% CI 3.6–11.7), poor glycaemic control (AOR 2.4,