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Purpose: To identify the facial anthropometric parameters that predict the difficulty during femtosecond (FS) laser. Methods: This was a single?center observational study was conducted on participants between the ages 18 and 30 years who were planned for FS?LASIK (femtosecond laser?assisted laser in situ keratomileusis) or SMILE (small incision lenticule extraction) at Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India. The front and side?facing images of the participants were analyzed using Image J software to measure different anthropometric parameters. The nasal bridge index, facial convexity, and other parameters were measured. The difficulty faced by the surgeon during docking was recorded for each subject. The data were analyzed on Stata 14. Results: A total of 97 subjects were included. The mean age was 24 (±7) years. Twenty?three (23.71%) subjects were females while the rest were males. Difficulty in docking was seen in 1 (4.34%) female and 14 (19%) males. The mean nasal bridge index was 92.58 (±4.01) in subjects with deep?set eyes and 89.72 (±4.30) in normal subjects. The mean total facial convexity was 129.28 (±4.24) in deep?set eyes, and 140.23 (±4.74) in normal subjects. Conclusion: Total facial convexity appeared as the most important feature, with the value being less than 133° in most subjects with unfavorable facial anthropometry
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Purpose: The research activity in pediatric glaucoma (PG) was qualitatively and quantitatively evaluated using a scientometric approach. Methods: The “Web of Science” database was accessed for primary bibliometric data regarding PG using search terms “pediatric glaucoma,” “paediatric glaucoma,” “congenital glaucoma,” and “childhood glaucoma.” The data was analyzed for total research productivity, citations, and scientific output in terms of journals, countries, institutions, and authors. The results were further characterized for coauthorship links and visualized by VOS viewer software. Also, the top 25 cited articles were reviewed with the above bibliometric characteristics. Results: One thousand two hundred and sixty?nine items were obtained from our search query from 1955 to 2022; these received 15,485 citations, originated from 78 countries. The top?3 contributing countries were the United States of America (n = 369), India (n = 134), and China (n = 127). LV Prasad Eye Institute (n = 58), Duke University (n = 44), and King Khalid Eye Specialist Hospital (n = 42) were the top?3 productive institutes. The top?3 prolific authors were Mandal AK (n = 53), Freedman, SF (n = 36), and Sarfarazi, M (n = 33). Journal wise, “Investigative Ophthalmology” (n = 187), “Journal of Glaucoma” (n = 92), and “Journal of AAPOS” (n = 68) were the journals in which the most articles were published. The top?25 cited documents received 3564 citations and were published between 1977 and 2016. The key areas of interest were basic sciences (genetics of childhood glaucoma) and surgical management. Conclusion: United States of America, LVPEI, Mandal AK, and “Investigative Ophthalmology” were the top rankers as far as the productivity and publications related to PG are concerned. Articles on molecular genetics in PG have received interest among the ophthalmology community.
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Purpose: To assess the need for spectacles and low?vision aids (LVA) in students attending schools for the blind and study their compliance with use. Methods: Comprehensive ocular evaluation was performed using a hand?held slit lamp and ophthalmoscope. Vision acuity was measured using a logarithm of the minimum angle of resolution (logMAR) chart for distance, as well as for near. Spectacles and LVAs were dispensed after refraction and LVA trial. Follow?up was performed to assess the vision using the LV Prasad Functional Vision Questionnaire (LVP?FVQ) along with compliance with use after 6 months. Results: Of the 456 students examined from six schools, 188 (41.2%) were female; 147 (32.2%) were <10 years of age. In all, 362 (79.4%) were blind since birth. The students dispensed only LVAs were 25 (5.5%), only spectacles were 55 (12.1%), and both spectacle and LVAs were 10 (2.2%). The vision improved using LVAs in 26 (5.7%) and using spectacles in 64 (9.6%). There was a significant improvement in LVP?FVQ scores (P < 0.001). Also, 68/90 students were available for follow?up, of whom 43 (63.2%) were compliant to use. Causes of not wearing spectacles or LVA in 25 were left somewhere or lost 13 (52%), broken 3 (12%), uncomfortable to use 6 (24%), not interested to use 2 (8%), and got operated 1 (4%). Conclusion: Although the dispensing of LVA and spectacles improved the visual acuity and vision function of 90/456 (19.7%) students, nearly a third were not using them after 6 months. Efforts need to be taken to improve the compliance of use
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Background: Medical students are reported to have high levels of mental distress that includes problems such as anxiety, depression, and stress due to the highly competitive curriculum. In the post-pandemic era with a renewed perspective toward health system and popularization of online classes, current batch of students are exposed to diverse sources of mental distress. Aims and Objectives: Objectives of this study were to find out the socio-demographic and behavioral characteristics, family background and academic profile of the study participants, and to estimate the proportion of different varieties of mental distress among them, and to examine relationship of mental distress with sociodemographic, behavioral and academic profile. Materials and Methods: A cross-sectional observational study was performed on 649 undergraduate students by census method using depression anxiety stress scale-21 items. Results: The study participants are predominantly Hindu, urban, unmarried, hostelites, males from nuclear families and belonging to upper socioeconomic class according to Modified B.G Prasad Socioeconomic Status Scale (January 2022). The proportion of depression, anxiety, and stress among study participants was found to be 49.61%, 58.86%, and 33.13%, respectively. Proportion of mental distress was significantly higher in the age group of 21–24 years. Those who preferred to study more at night were more anxious and stressed. Stress was higher in students with addiction to gadgets too. Participants hailing from rural areas, hostelites, and paying guests were relatively more depressed. Conclusion: There is urgent need for emotional support and provision of personalized counseling for the MBBS students as unchecked mental distress can turn into severe psychological morbidity.
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Background: Care giving of children with leukemia involves considerable stress and anxiety on the part of family caregivers. Although caregivers’ burden is a crucial predictor of the health of both the child and the caregiver, it is often overlooked. Aim and Objectives: The present study aimed to assess the burden faced by caregivers of pediatric leukemia patients attending a tertiary care hospital in West Bengal, to elicit their sociodemographic characteristics and patients’ profile, and to find out relationship among these, if any. Materials and Methods: The study was descriptive observational type with cross-sectional design. It was conducted among caregivers of pediatric leukemia patients. Data were collected from 38 caregivers using predesigned, pretested, semi-structured schedule, and patients’ records. Burden was measured using Zarit Burden Interview, which is a 22 item 5-point Likert scale. Data were compiled and analyzed in Microsoft Excel and Statistical Software for the Social Sciences 20.0 for statistical analysis. Sociodemographic and clinical variables were expressed as number, percentages, mean, and standard deviations. To find out the association between different factors and caregiver burden, a logistic regression model was used. P < 0.05 was considered as statistically significant. Results: Majority of the caregivers were the mothers of the patients (68.42%), and most of the families of caregivers belonged to lower middle class according to modified BG Prasad Scale. Half of the caregivers (50%) experienced moderate–to-severe burden according to Zarit Burden Interview. Association was found between burden experienced and duration of disease and treatment. However, socioeconomic status was found to be the most significant determinant of burden as per multiple logistic regression by ENTER method. Conclusions: Majority of the caregivers were having moderate to severe and severe burden, which was significantly more among people coming from lower socioeconomic status. Prolonged disease duration and treatment were also found to be associated with increased burden of the caregivers.
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Acute respiratory tract infections (ARIs) are a major cause of morbidity and mortality in under?five children worldwide. Assam has around 2500 river islands (locally called Chars/Chaporis) in the Brahmaputra River with socioeconomically deprived inhabitants lacking access to basic health?care facilities. A community?based cross?sectional study was carried out among 380 under?five children living in the Char areas of Tinsukia District to estimate the prevalence of ARI and determine the associated risk factors. The prevalence of ARI among under?five children was found to be 56.32%. Prevalence was significantly higher among children living in Dibru?Saikhowa island, with families having >2 children, belonging to socioeconomic class 5 (modified BG Prasad scale), having a positive history of smoking or ARI in family members, having homes with attached kitchens or using wood for cooking, inadequate ventilation or overcrowding and residences of katcha ghars.
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Background : Substance abuse is an important health hazard and also a major preventable cause of morbidity and mortality. This habit not only affects health, education and occupational career, but also incurs huge financial and social burden to the society specially when the doctors are involved in it. Aims and objectives : To estimate the prevalence of substance abuse, its pattern and causes among the MBBS students of West Bengal. Methods : A questionnaire based cross-sectional retrospective study was designed to collect data from the Medical Officers of the State to record their experience of substance abuse during their MBBS course. Results : The prevalence of substance abuse was 22% among the study participants. Smoking Tobacco was most common (16.67%). 76% of the subjects with substance abuse spend Rs1000 or less per month. The prevalence was 25% in upper class and 22.22% among those who belonged to lower class of socio-economic status as per BG Prasad Classification. Curiosity was the reason as per 34.5% of the subjects followed by depression (23.25%), peer pressure (13%) study pressure by 15%; media influence by 11%; to cope with home problems by 10.75% and parental influence by 2.25% of the study subjects. Conclusion : The institution should keep a Psychological Counselor who can guide the students who suffer from problems related to Depression, Peer pressure, Study pressure that may lead to substance abuse. Allotting, hobbies, sports and recreation would help in keeping away from substance abuse
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Purpose: To describe the demographics and epidemiology of uveitis presenting to a multi?tier ophthalmology hospital network in Southern India. Methods: Cross?sectional hospital?based study of 19,352 patients with uveitis presenting between March 2012 and August 2018. Results: In total, 1,734,272 new patients were seen across the secondary and tertiary centers of our multi?tier ophthalmology hospital network during the study period. Among them, 25,353 eyes of 19,352 patients were diagnosed with uveitis and were included in the study. Uveitis constituted 1.11% of all cases. The majority of patients were male (60.33%) and had unilateral (68.09%) affliction. The most common age group was 21� years with 12,204 (63.06%) patients. The most common type of uveitis was anterior uveitis, which was seen in 7380 (38.14%) patients, followed by posterior uveitis in 5397 (23.89%) patients. Among the infectious causes, tuberculosis was the most common etiology (2551 patients, 13%) followed by toxoplasmosis (1147 patients, 6%). Conclusion: Uveitis constituted 1.11% of all cases presenting to our clinics. It was more common in the age group of 21� and was predominantly unilateral. Anterior uveitis was the most common subtype seen in 38%.
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Purpose: To develop a new age?appropriate visual function questionnaire for visually impaired children. Methods: The study was conducted in north India in 20,955 (97.3%) children ?15 years who underwent visual acuity examination. Of these 20,955 children, a total of 722 children were referred with unaided visual acuity less than 6/12 in any eye. Among these referred children, parents in the age group of 5–9 years and children between 10 and 15 years underwent interviews using LV Prasad Functional Visual Questionnaire?20 (LVP FVQ 20) and Indian Visual Functioning Questionnaire?33 (IND VFQ?33). Following this, multiple steps were undertaken that involved expert opinion for the removal of items on basis of zero variance and factor analysis along with calculation of Cronbach’s alpha. Results: A Cronbach’ alpha of 0.834 was calculated for the younger age group and 0.931 for the higher age group of children. Conclusion: A new robust age?appropriate questionnaire was developed and it was observed that there was a significant change in median score (that was derived for various domains after calculating the median for the items in various domains asked pre? and post?intervention in the form of glasses or surgery) for quality of visual function in the visually impaired children. A significant change in functional vision of visually impaired children (P < 0.005) was observed in both age groups
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Background: In developing and resource-limited countries alternative screening methods like VIA, VILI, and Pap smear are used in detection of premalignant and malignant lesions of cervix. The aim of our study was to compare the efficacies of VIA, VILI, and Pap smear in detection of premalignant and malignant lesions of cervix.Methods: The study was conducted for a period of one year in the department of obstetrics and gynaecology, Dr. Rajendra Prasad Government Medical College, Kangra at Tanda, Himachal Pradesh. Women who attended the outdoor patient department of obstetrics and gynecology were subjected to collection of Pap Smear, VIA followed by VILI and a thorough pelvic examination.Results: Among the 350 women studied, 59 women (16.9%) had abnormal VIA, 64 women (18.2%) had abnormal VILI. On pap smear, 10 women were reported as ASCUS, 11 as L-SIL and 1 as H-SIL. Cervical biopsy was done in 98 women, out of which 70 had one or more abnormality on VIA, VILI, or Pap, and 28 women who had normal results. Sixteen women (16.3%) reported as CIN-1 and 2 women (2.07%) as CIN-3. VIA and VILI had a higher sensitivity as compared to pap. However, pap was more specific. The PPV of pap was also much higher as compared to VIA and VILI, whereas there was no difference in NPV of the three.Conclusions: Authors observed that VIA presented the best sensitivity (88.8%), followed by VILI (83.3%), and Pap (72.2%). Pap smear had the highest specificity of 97.2%. The positive predictive value of Pap was higher as compared to VIA and VILI, whereas there was no difference in NPV of the three. VIA and VILI have good sensitivity, with reasonable specificity and because of their cost effectiveness and ease of availability, these can be an alternative screening modality for cervical cancer screening.
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Introduction: The minimally invasive approach has become the method of choice for treating most benign abdominal diseases that require surgery. However, it is obvious that laparoscopic procedures are not risk free. The aim of this study was to evaluate the prevalence of intra abdominal adhesions underneath umbilical scar following laparoscopic sterilization, in patients who are undergoing abdominal surgeries. Materials and Methods:The present study was a hospital based prospective observational study conducted in the Department of Surgery, Dr Rajendra Prasad Government Medical College (Dr. RPGMC), Kangra at Tanda (HP). The study group consisted of patients admitted to department of surgery during a period of one year and who fulfilled inclusion criteria. During intraoperative period, they were examined for presence or absence of adhesions at the site of previous laparoscopic sterilization scar at Periumblical area.Results:Total of 60 patients were taken in this study. Two out of 60 (3.3%) patients had adhesions underneath previous Laparoscopic Sterilization scar around umbilicus and adhesive structure was omentum in both cases.Conclusion:Adhesion formation is expected in any abdominal surgery whether open orlaparoscopic surgery. In our study only 3.3% of patients had adhesions underneath previous laparoscopic sterilization scar in periumblical region. Therefore umbilical port can be considered for re-entry of index port in next laparoscopic surgery, in patients with history of laparoscopic surgery through umbilical region.
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Background: The internet is a source of valuable medical information. However, when it is employed as a diagnostic procedure, it has the potential to increase health anxiety among individuals who have no medical knowledge. This is a concerning subject as a large number of people search for health information online. Objectives: The objectives of the study were (i) to estimate the prevalence of cyberchondria among undergraduate medical students. (ii) To assess the factors influencing cyberchondria among undergraduate medical students. Materials and Methods: A cross-sectional study was conducted among undergraduate medical students of Shivamogga Institute of Medical Sciences, during June 2018–August 2018. One hundred and thirty-six undergraduate medical students were selected and data were collected using a semi-structured questionnaire. A database was created in MS Excel and analysis was done using SPSS software v.20. Descriptive statistics such as frequency and percentage were calculated and Chi-square test was used. Results: The prevalence of cyberchondria was found to be 37.5%. Cyberchondria was found to be more among males, study participants belonging to Class I according to the modified B G Prasad classification, those having 24*7 access to internet, those using internet for more than 1 h during the night, and those who were using internet for ≤5 years and for ≤6 h/day. Cyberchondria was significantly associated with the use of internet during the night. Conclusion: Excessive searching for health information online has the potential to spread threat among the people and it may lead to an increase in health anxiety. We can overcome this problem by creating awareness among the general public regarding proper usage of web search engines.
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Background: Adolescents constitute over 21.4% of the population in India and adolescent girls constitute about 10 percent of the Indian population. This age group needs special attention because of the turmoil of adolescence which they face due to the different stages of development that they undergo, different circumstances that they come across, their different needs and diverse problems. The objectives of the study were to determine the prevalence of anaemia in the study population and to assess the socio-demographic risk factors associated with the anaemia.Methods: Community based cross sectional study conducted in adolescent girls aged 10 to 19 years, permanently residing in the rural field practice area of Department of Community Medicine, Kamineni Institute of Medical Sciences, Narketpally during September 2010 to September 2012.Results: Majority of families belong to upper lower socio-economic status (57.7%) according to BG Prasad’s classification. Age-wise prevalence of anaemia shows that prevalence of anaemia was highest (69%) in 18 to 19 years age group and least (37.5%) in the age group of 16 to 17 years. Majority of subjects with anaemia were having mild anaemia (80.2%) followed by moderate anaemia (19.2%) and severe anaemia (0.6%) respectively. Highest prevalence (68.1%) was found in joint or extended and least prevalence (56.1%) was found in nuclear families. Highest prevalence (75.0%) in subjects belonging to large family and least (54.5%) with small family.Conclusions: Prevalence of anaemia was 59% with majority of study subjects having mild to moderate anaemia. Prevalence of anaemia in these girls had a significant association with socioeconomic status of the family.
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Purpose: To assess the demographic details and distribution of ocular disorders in patients presenting to a three-tier eye care network in India using electronic medical record (EMR) systems across an 8-year period using big data analytics. Methods: An 8-year retrospective review of all the patients who presented across the three-tier eye care network of L.V. Prasad Eye Institute was performed from August 2010 to August 2018. Data were retrieved using an in-house eyeSmart EMR system. The demographic details and clinical presentation and ocular disease profile of all the patients were analyzed in detail. Results: In an 8-year period, a total of 2,270,584 patients were captured on the EMR system with 4,730,221 consultations. More than half of the patients presented at tertiary centers (n = 1,174,643, 51.73%), a quarter at the secondary centers (n = 564,251, 24.85%) followed by the vision centers (n = 531,690, 23.42%). The ratio of males and females was 1.18:1. Most common states of presentation were Andhra Pradesh (n = 1,103,733, 48.61%) and Telangana (n = 661,969, 29.15%). In total, 3,721,051 ocular diagnosis instances were documented in the patients. Most common ocular disorders were related to cornea and anterior segment (n = 1,347,754, 36.22%) followed by refractive error (n = 1,133,078, 30.45%). Conclusion: This study depicts the demographic details and distribution of various ocular disorders in a very large cohort of patients. There is a need to adopt digitization in geographies that cater to large populations to enable insightful research. The implementation of EMR systems enables structured data for research purposes and the development of real-time analytics for the same.
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Background: One of the diseases assuming fast importance is non-alcoholic fatty liver disease (NAFLD) which is a clinical syndrome characterized by predominant macrovesicular steatosis of the liver which is an umbrella term for a range of liver conditions affecting people who drink little or no alcohol. Only mild to moderate elevation of serum transaminases which could be only laboratory abnormality found in NAFLD. So with this background, the study was started with the objectives of assessing the perceptions of general population regarding NAFLD and factors influencing perceptions of general population regarding NAFLD.Methods: It was a community based cross sectional study carried out for a period of 12 months from January 2018 to December 2018 among in Nanded, Maharashtra. Around 422 households were involved after simple random sampling. To assess perceptions a pretested semi-structured questionnaire was used which had 27 questions. All data collected was entered in Microsoft excel and analysed using SPSS v22.Results: Out of 422 participants, 147 (34.8%) were in the age group of 31-40 years, 333 (78.9%) were male participants, 179 (42.5%) were graduates, 284 (67.3%) belonged to joint family, 140 (33.2%) belonged to Modified BG Prasad classification 2018. 181 (42.9%) had satisfactory perception regarding NAFLD. Females, participants aged more than 40 years, nuclear family participants had better scores.Conclusions: The present study showed majority of the participants had little awareness of NAFLD regardless of their age, gender, or educational status. Awareness of NAFLD must be promoted for prevention, early detection, and treatment especially counseling by primary care physicians preponderant influence in preventive strategy for NAFLD breaking the chain of disease progression.
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Background: In a developing country like India, with limited resources health needs of individuals and community are enormously increasing. Health related problems may be addressed amicably by community diagnosis. Assessment and prioritization of health issues followed by formulation of action plans with strategies and their implementation can be effectively achieved, by using family health surveys.Methods: Using family health survey 500 families, constituting 2640 individuals were studied. Their health status and socio-demographic details were taken. Households and families were selected randomly. Data entry and analysis was done by appropriate use of statistical tools.Results: Study showed 52.27% males and 47.73% females. Majority (51.5%) belonged to 16-45 years followed by 6-15 years of age (25%). Among 9.09% of the under-five, fully immunized were 90.4% and partially immunized were 9.6%. 6.06% were above 60 years. Nuclear families were 68%. Majority (36%) of the families belonged to socio-economic class II (modified B.G. Prasad classification). 10.6% were illiterate and 11.3% were below seven years of age. Overcrowding was present in 24% of the families. Common morbidities were hypertension (32.2%), diabetes (26.9%), respiratory diseases (19.2%) eye problems (6.2%) and skin diseases (3.8%). Geriatric problems were present in one out of four individuals.Conclusions: Family health survey can be used as an educational tool for undergraduate medical students to understand common morbidities and determinants of diseases in the community. Family health surveys are important for a community as necessary intervention can be done for illnesses and health-related problems.
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Introduction: Anemia is a most common public healthproblem affecting around 1.9 billion population of the world.It is a severe public health problem in India. Medical studentsare vulnerable to develop anemia due to irregular eatinghabits due to hectic study schedule. Anemia among this agegroup has significant health consequences resulting in poorcognition, decreased attention span and memory affectingthe performance, depressed immunity, repeated infections,increased fatigue, and shortness of breath, dizziness, blurredvision, low endurance and irregular menstruation.Material and Methods: This study is conducted among 100students of both gender taking admission in MBBS first yearat MAMC, Agroha. Hemoglobin values and other relevantdetails of the students were taken from academic sectionsubmitted at time of admission. World Health Organizationcriteria were taken to determine the severity of anemia.Modified B.G. Prasad scale was used to assess the socioeconomic status of the family. Data was first entered into MSexcel sheet and then was exported to SPSS version 20.0 forappropriate analysis.Results: Prevalence of anemia came out to be 54% amongstudy subjects. Difference between the mean levels ofhemoglobin across the genders came out be statisticallysignificant (P=<0.001).Conclusion: Prevalence of anemia is high among the studysubjects with more prevalence among females study subjects.There is a need to accelerate efforts for achieving control ofanemia by strengthening multi-sectoral partnership involvinggovernment departments, academic institutions, bilateralagencies and food industry.
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Background: The use of mobile phones especially smart phones have become an integral part of everyone’s life leading to addiction. Most of the studies conducted earlier were focused on youngsters. Hence this study was conducted to find out the prevalence of smart phone addiction in the study area.Methods: Community based cross sectional study carried out in Anakaputhur, Tamil Nadu from November 2018 to January 2019. Sample size of 400 was calculated using the formula 4PQ/L2. The respondents were selected by systematic random sampling. Subjects 18 years and above who are using mobile phones were included in the study. Data was analyzed using SPSS 16 version and presented using descriptive and analytical statistics.Results: Out of 405 participants 191 participants were non smart phone users and 214 were smart phone users. Overall prevalence of smart phone addiction was 27.6%. Male respondents were more addicted than the female (OR-1.94, 95%CI: 1.12-3.77, p=0.01). There was a statistically significant association between subjects <45 years of age and smart phone addiction (OR-2.33, 95% CI: 1.31-4.13, p=0.003) compared to older age group. Likewise respondents who were class III (modified BG Prasad Scale) and above were more addicted compared to subjects below class III (OR-2.29, 95% CI: 1.32-3.98, p=0.002).Conclusions: The prevalence of smart phone addiction is high that has to be addressed seriously. This can be tackled by better life style modification, awareness creation and attitudinal changes
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Objective: Ethambutol (EMB) is known to cause ocular toxicity on prolonged use. The present studyevaluated the effect of NMDA and AMPA/Kainate receptor antagonists(memantine & trimetazidine) againstethambutol induced ocular toxicity using Optomotor response (OMR) in goldfish.Materials and Methods: Either sex of goldfishes randomized into three groups (n=8 each group) and wereexposed to daily dose of ethambutol (1 mg/ml for one hour) for 26 days. Group 1 fishes received anintravitreal injection of 1 μl of normal saline. Group 2 and 3 fishes were given intravitreal injections of 20 μgmemantine (MEM) and 10 μg trimetazidine (TMZ) respectively at 10, 15, 20th and 25th day following anesthesia.After drug exposure, fishes OMR was evaluated, and pattern velocity was recorded (on 11, 16, 21st and 26thday) at 5 rpm in different light condition (blue, green and red).Results: Upon chronic exposure (1 hr in bathing solution / day) of ethambutol, at the dose of 1 mg/ml fishesshowed statistically significant decrease in percentage relative frequency (PRF) at 7th dayupon comparison to their baseline values on day 0. Significant decrease in PRF was observed in the greencolor (550 nm, p=0.002) and red color (605 nm, p=0.001) and this effect persisted up to 21st day. BothIndian J Physiol Pharmacol 2019; 63(4) : 294–302*Corresponding author :Dr. T. Velpandian, Professor & O/I, Ocular Pharmacology and Pharmacy Division, Dr. Rajendra Prasad Centre for OphthalmicSciences, All India Institute of Medical Sciences (AIIMS), New Delhi – 110029 (India); +91-11-26593162, +91-11-26588919;E-mail: tvelpandian@hotmail.com(Received on Aug. 10, 2019) Indian J Physiol Pharmacol 2019; 63(4)NMDA Receptor and Ethambutol Induced Ocular Toxicity 295memantine and trimetazidine showed varying degrees of protection on 16th days against EMB induced oculartoxicity.Conclusion: Intravitreal administration of trimetazidine and memantine provide significant protection in thePRF-OMR, indicating the possibility of their use as a therapeutic intervention in the patients developingocular toxicity during antitubercular therapy (ATT).
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Purpose: To study the outcomes of therapeutic penetrating keratoplasty in fungal keratitis. Methods: This retrospective, observational, interventional case series involved an audit of 198 consecutive eyes that underwent therapeutic penetrating keratoplasty (ThPK) for fungal keratitis at L V Prasad Eye Institute between January 2008 and December 2010 was performed. The data on demographics, clinical characteristics, intraoperative, and late postoperative complications were noted. The primary outcome measure was eradication of infection and postoperative anatomical success. Secondary outcome measures were graft survival, risk factors, clinical features, and management of recurrent fungal keratitis post ThPK. Results: Mean follow-up after ThPK was 24 ± 17 months. A total of 178 (89.9%) eyes had complete eradication of fungal infection, whereas 20 (10.1%) eyes developed recurrence. Anatomical restoration was achieved in majority of cases (192 eyes; 97%). Larger infiltrate size was associated with a higher risk of recurrence of infection. The median graft survival rate was 5.9 months. The graft survival was better for grafts <8 mm versus those with >8 mm (P = 0.026) and not found significantly related to the species of fungus. Twenty-seven eyes underwent re-grafting: penetrating keratoplasty in 14 eyes, and Descemet's stripping endothelial keratoplasty in 13 eyes. Conclusion: As larger infiltrate prior to therapeutic keratoplasty had much higher risk of recurrences; timely surgical intervention should be considered in cases not responding to medical therapy. Alternative strategies of management of postoperative inflammation need to be considered to prevent graft failures.