A cross-sectional study of anemia among urban and rural adolescent girls in district Ambala, Haryana

Background: Anemia is a continuously rising threat to not only present but also future generations as well and Indians are under high risk, especially adolescent girls. The anemic adolescent girls grow into adult women with compromised growth, both physical and mental. These women have low pre-pregnancy weight and are more likely to die during childbirth and deliver low birth weight babies. Objectives: The objectives of this study were to find the prevalence of anemia in urban and rural adolescent school-going girls 10–16 years of age, among adolescent girls of district Ambala, Haryana. Materials and Methods: A community-based cross-sectional study was conducted in government and private schools of district Ambala. This study was conducted among 300 adolescent girls, 10–16 years of age studying in government and private schools of Ambala. The blood samples were taken from the students and hemoglobin was measured. Data were collected by interviewing the study subjects using a self-designed, pre-tested semi-structured questionnaire. Results: Overall prevalence of anemia was found to be 69.7%. Conclusion: The prevalence of anemia was very high among adolescent girls. This indicates a need to educate them about anemia and its risk factors. Regular screening of school students to rule out anemia is the need of the hour.

Effects of ozone therapy on facial nerve regeneration / Efeitos da terapia com ozônio na regeneração do nervo facial

Abstract Introduction: Ozone may promote moderate oxidative stress, which increases antioxidant endogenous systems. There are a number of antioxidants that have been investigated therapeutically for improving peripheral nerve regeneration. However, no previous studies have reported the effect of ozone therapy on facial nerve regeneration. Objective: We aimed to evaluate the effect of ozone therapy on facial nerve regeneration. Methods: Fourteen Wistar albino rats were randomly divided into two groups with experimental nerve crush injuries: a control group, which received saline treatment post-crush, and an experimental group, which received ozone treatment. All animals underwent surgery in which the left facial nerve was exposed and crushed. Treatment with saline or ozone began on the day of the nerve crush. Left facial nerve stimulation thresholds were measured before crush, immediately after crush, and after 30 days. After measuring nerve stimulation thresholds at 30 days post-injury, the crushed facial nerve was excised. All specimens were studied using light and electron microscopy. Results: Post-crushing, the ozone-treated group had lower stimulation thresholds than the saline group. Although this did not achieve statistical significance, it is indicative of greater functional improvement in the ozone group. Significant differences were found in vascular congestion, macrovacuolization, and myelin thickness between the ozone and control groups. Significant differences were also found in axonal degeneration and myelin ultrastructure between the two groups. Conclusion: We found that ozone therapy exerted beneficial effect on the regeneration of crushed facial nerves in rats.

Resumo Introdução: O ozônio pode promover estresse oxidativo moderado, o que aumenta sistemas endógenos antioxidantes. Há determinado número de antioxidantes sendo investigados terapeuticamente para melhorar a regeneração do nervo periférico. No entanto, nenhum estudo anterior relatou o efeito da terapia com ozônio na regeneração do nervo facial. Objetivo: Nosso objetivo foi avaliar o efeito da terapia com ozônio na regeneração do nervo facial. Método: Ao todo, 14 ratos albinos Wistar foram divididos aleatoriamente em dois grupos com lesões experimentais por esmagamento do nervo: um grupo controle, que recebeu tratamento com solução salina pós-esmagamento; e um grupo experimental, que recebeu tratamento com ozônio. Todos os animais foram submetidos a cirurgia na qual o nervo facial esquerdo foi exposto e esmagado. O tratamento com solução salina ou ozônio se iniciou no dia do esmagamento do nervo. Os limiares de estimulação do nervo facial esquerdo foram medidos antes do esmagamento, imediatamente após o esmagamento e após 30 dias. Depois de medir limiares de estimulação do nervo aos 30 dias pós-lesão, o nervo facial esmagado foi excisado. Todas as amostras foram estudadas por meio de microscopia óptica e eletrônica. Resultados: Após o esmagamento, o grupo tratado com ozônio apresentou menores limiares de estimulação do que o grupo da solução salina. Embora isso não tenha significância estatística, é indicativo de maior melhoria funcional no grupo do ozônio. Foram encontradas diferenças significativas na congestão vascular, macrovacuolização e espessura da mielina entre os grupos do ozônio e controle. Diferenças significativas também foram encontradas na degeneração axonal e ultraestrutura de mielina entre os dois grupos. Conclusão: Verificou-se que a terapia com ozônio teve efeito benéfico sobre a regeneração dos nervos faciais esmagados em ratos.

Bilateral isolated lens coloboma associated with bicuspid aortic valve / Coloboma de cristalino bilateral isolado associado à valva aórtica bicúspide

ABSTRACT A 27-year-old woman presented with a history of long-standing poor vision in both eyes. Ophthalmologic examination after pupillary dilatation revealed bilateral lens coloboma situated in the inferotemporal quadrant. No associated ocular abnormalities were seen, except amblyopia. A bicuspid aortic valve was observed during echocardiography during systemic evaluation. Lens coloboma usually occurs unilaterally; however, bilateral lens coloboma which is isolated or associated with other ocular malformations is also encountered. This is the first description of bilateral isolated lenticular coloboma associated with bicuspid aortic valve. Although the association between bicuspid aortic valve and lens coloboma may be an incidental finding, they may be components of an unknown syndrome.

RESUMO Uma mulher de 27 anos apresentou-se com uma história de longa data de deficiência visual em ambos os olhos. O exame oftalmológico após dilatação pupilar revelou coloboma de cristalino bilateral localizado no quadrante temporal inferior. Nenhuma outra alteração ocular associadas foi observada, exceto ambliopia. A valva aórtica bicúspide foi diagnosticada no exame de ecocardiograma durante a avaliação sistêmica. Coloboma cristaliniano ocorre geralmente de forma unilateral, no entanto já foi descrito bilateralmente, associado a outras malformações oculares ou isolado. Esta é a primeira descrição de coloboma cristaliniano isolado bilateral associado à valva aórtica bicúspide. Embora a associação de valva aórtica bicúspide e coloboma cristaliniano no nosso caso pode ter sido um achado incidental, eles podem ser componentes de uma síndrome desconhecida.

Hipertensão pseudo-resistente causada por baixa adesão terapêutica / Medication adherence in patients with pseudoresistant hypertension

Este estudo teve como objetivo identificar pacientes com hipertensão arterial pseudo-resistente causada pela não- adesão terapêutica. Foi realizado um estudo transversal com pacientes com hipertensão atendidos pela Estratégia de Saúde da Família. As entrevistas e medidas da pressão arterial ocorreram nas residências dos pacientes cadastrados em uma unidade de saúde da família, em Maceió, entre abril de 2011 e fevereiro de 2012. Os pacientes com pressão arterial não-controlada foram classificados como pacientes com hipertensão arterial resistente (HAR) ou com hipertensão pseudo-resistente, definida como a observação de falha no controle da PA causada por farmacoterapia anti-hipertensiva inapropriada, não adesão aos anti-hipertensivos, medida inadequada da PA ou efeito do jaleco branco. A adesão terapêutica foi determinada por meio da Escala de Adesão Terapêutica de oito itens de Morisky (MMAS-8). Foram investigados 173 pacientes, com idade média de 55 anos (DP 11,08) e predominância do sexo feminino (71,0%). Observou-se que 63,0% dos pacientes apresentaram PA não-controlada, dentre estes, 87,2% não eram aderentes à farmacoterapia anti-hipertensiva. Apenas 4 (2,3%) pacientes foram identificados com HAR. No total, 95 pacientes não- aderentes (54,9%) poderiam ser diagnosticados erroneamente como portadores de HAR, caracterizando a hipertensão pseudo-resistente causada por não-adesão. Observou-se que a não-adesão à farmacoterapia anti- hipertensiva parece ser uma relevante ? e potencialmente a principal ? causa da hipertensão pseudo-resistente. A identificação e remoção de tal causa podem contribuir significativamente para o diagnóstico da hipertensão resistente, evitando superexposição a medicamentos desnecessários e terapias adicionais excessivas.(AU)

This study aimed to identify patients with pseudoresistant hypertension caused by poor medication adherence. We conducted a cross-sectional study with hypertensive outpatients in Maceió, Brazil, between April 2011 and January 2012. Patients with uncontrolled blood pressure were classified as patients with resistant or pseudoresistant, hypertension, which is the appearance of a lack of BP control caused by inaccurate measurement of BP, inappropriate drug choices/doses, non-adherence to prescribed therapy or white-coat effect. Adherence was assessed using a validated version in Portuguese of the 8-item Morisky Medication Adherence Scale (MMAS- 8). 173 patients participated in the study; mean age was 55 years (SD 11.08), 71.0% were female, 63.0% did not achieved BP control, of which 87.2% were non adherers. 4 (2.3%) met criteria for RH and 95 non-adherent patients (54,9%) could be diagnosed as resistant hypertensive patients. Nonadherence to prescribed antihypertensive seems to be a relevant cause of pseudoresistant hypertension. Once pseudoresistance should be identified in patients with uncontrolled BP in order to avoid overtreatment and excessive and expensive evaluation, medication adherence should be therefore routinely investigated in hypertensive patients.(AU)

Level of Recall between Verbal and Written Information about Orthodontic Treatment

A cross-sectional study was undertaken to compare patients’ level of recall on verbal and written information about orthodontic treatment. Participants were the patients and par-ents attending the orthodontic screening clinic, Universiti Kebangsaan Malaysia (UKM). Participation was voluntary. Participants were placed into two groups. One group was given only written information in the form of an information leaflet, while another group was given only verbal information. The information content comprising of 13 items was based on the Patient Information Leaflet published by the British Orthodontic Society. Both groups received similar content of information in their preferred languages. Self administered close-ended questionnaire forms were given to the subjects after 15 mi-nutes to assess the level of recall. The answers from both groups were compared. Data collected was analyzed using SPSS version 15.0. Chi-square test (p=0.05) was con-ducted to determine the effect of the method of information on the percentage of recall. A total of 79 subjects volunteered to participate in the study. There were more females than males. The majority were found to have achieved secondary level formal education. Comparison of each question item showed no significant difference between those who were provided with verbal or written information. Both groups showed a high proportion of correct responses. In conclusion, there was no difference in the patients’ level of recall whether the orthodontic patient was given verbal or written information.