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Purpose: Glaucoma influences vision?related quality of life (VRQoL) of an individual in various ways. There are very limited studies on the Indian population and the northern part of India. Therefore, we conducted the present study to evaluate VRQoL in glaucoma patients as well as the association between the severity of glaucoma and VRQoL. Methods: An institution?based, cross?sectional, analytical study was conducted from August 2022 to October 2022 involving 190 participants (95 glaucoma patients and 95 controls). The glaucoma quality of life?15 (GQL?15) questionnaire was explained in their vernacular language by the interviewer. The scoring was given according to the validated scoring algorithm for the questionnaire. Results: Mean GQL score in the control group was 19.66 ± 5.5 and in glaucoma cases was 32.8 ± 10.2, whereas the mean score of mild glaucoma cases was 22.3 ± 4.83, moderate glaucoma cases was 36.3 ± 4.09, and severe glaucoma cases was 47.24 ± 3.03. Therefore, as the severity of glaucoma increases, the GQL score also increases, indicating poorer quality of life. Visual field loss was strongly positively correlated (correlation coefficient = 0.759, P < 0.01) with the GQL?15 score, while a weaker positive correlation was found with best corrected visual acuity (BCVA), cup disc ratio, and duration of treatment. Conclusion: Besides controlling or reducing intraocular pressure (IOP) to the target level, the goal of glaucoma treatment should be to provide an individual with good functional vision to maintain an acceptable quality of life. It would also help in providing patients with the best possible treatment, not only in terms of good vision but also in maintaining or improving their overall quality of life.
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Abstract Objective: This meta-analysis aimed to compare the efficacy and safety of dexmedetomidine and Clonidine as an adjuvant to local anesthetics in BPBs. Methods: Two investigators independently searched databases to identify all RCTs comparing the efficacy and/or safety of dexmedetomidine and Clonidine as an adjuvant to local anesthetics in BPBs. All outcomes were pooled using the inverse variance method with a random-effect model. An I2 test was used to assess heterogeneity. The source of heterogeneity was explored through meta-regression. The quality of the evidence was assessed using the GRADE approach. Results: Out of 123 full texts assessed, 24 studies (1448 patients) were included in the analysis. As compared to Clonidine, dexmedetomidine groups showed significantly longer sensory block duration (MD = 173.31; 95% CI 138.02-208.59; I2 = 99%; GRADE approach evidence: high); motor block duration (MD = 158.35; 95% CI 131.55-185.16; I2 = 98%; GRADE approach evidence: high), duration of analgesia (MD = 203.92; 95% CI 169.25-238.58; I2 = 99%; GRADE approach evidence-high), and provided higher grade quality of block (RR = 1.97; 95% CI 1.60-2.41 ; I2 = 0%; GRADE approach evidence: moderate). The block positioning technique (regression coefficient: 51.45, p = 0.005) was observed as a significant predictor of the heterogeneity in the case of sensory block duration. No significant difference was observed for the risk of hypotension (RR = 2.59; 95% CI 0.63-10.66; I2 = %). Conclusion: Moderate to high-quality evidence suggests dexmedetomidine is a more efficacious adjuvant to local anesthetic in BPBs than Clonidine.
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Bloqueo del Plexo Braquial , Clonidina , Metaanálisis , DexmedetomidinaRESUMEN
This retrospective study was aimed to understand the clinical, laboratory, radiological parameters and the outcome of COVID-19 patients with underlying haematological disease. All patients with known haematological disease admitted with COVID-19-positive status from April to August 2020 in the COVID-19 facility of a tertiary care centre in north India, were included. Their medical records were analyzed for outcome and mortality risk factors. Fifty four patients, 37 males, were included in the study. Of these, 36 patients had haematological malignancy and 18 had benign disorder. Fever (95.5%), cough (59.2%) and dyspnoea (31.4%) were the most common symptoms. Nine patients had severe disease at diagnosis, mostly malignant disorders. Overall mortality rate was 37.0 per cent, with high mortality seen in patients with aplastic anaemia (50.0%), acute myeloid (46.7%) and lymphoblastic leukaemia (40.0%). On univariate analysis, Eastern Cooperative Oncology Group performance status >2 [odd ratio (OR) 11.6], COVID-19 severity (OR 8.2), dyspnoea (OR 5.7) and blood product transfusion (OR 6.4) were the predictors of mortality. However, the presence of moderate or severe COVID-19 (OR 16.6, confidence interval 3.8-72.8) was found significant on multivariate analysis. The results showed that patients with haematological malignancies and aplastic anaemia might be at increased risk of getting severe COVID-19 infection and mortality as compared to the general population
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Theodore maiman in 1960 invented the ruby laser, since then lasers technology has holded the attention in dental practice and has revolutionised dental treatment. Lasers have been used in initial periodontal therapy, surgery, and also in implant treatment. Lasers have various periodontal applications including calculus removal; for removal of the pocket epithelium; soft tissue excision, incision and ablation; decontamination of root and implant surfaces; biostimulation; bacteria reduction; and osseous surgery. Further research is necessary on lasers so that it can become a part of the dental procedures. This paper gives an acuity to laser in Periodontics.
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Objectives: The purpose of this study was to compare the effect of pre-etching with 37% orthophosphoric acid on the shear bond strength (SBS) of orthodontic brackets bonded using self-etching primer (SEP). Materials and Methods: Two hundred freshly extracted human premolars were divided randomly into two groups based on pre-etching with 37% orthophosphoric acid: Group 1 (control, n = 50) without pre-etching and Group 2 (experimental, n = 150) with pre-etching. Group 2 was further divided into three sub groups 2a, 2b, and 2c with 50 teeth each and was first pre-etched with 37% orthophosphoric acid for 10, 30, and 60 s, respectively. Brackets were bonded on the teeth in both the groups using SEP and light cure adhesive. The SBS were determined using universal testing machine. The comparison of SBS was done using one-way analysis of variance and Tukey's honest significant difference test. Results: The SBS of experimental Group 2 was significantly higher than the control Group 1 (p < 0.0001). Further, the SBS of Group 2a was highest, followed by Group 2b and 2c (p < 0.0001). Conclusion: It was found that pre-etching for 10 s prior to application of SEP-adhesive system increases the SBS of orthodontic brackets.
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Calcium ions play an important role in various physiological processes such as nerve impulse transmission, muscle contraction, hormone action, blood clotting. They ions act as an intracellular second messenger, relaying information within cells to regulate their activity. To understand the mechanism of hepatotoxicity of t-BHP, studies were carried out using freshly isolated rat hepatocytes. The effect of t-BHP on Ca2+ accumulation and Ca2+ uptake by rat hepatocytes was monitored using 45Ca2+. It caused decrease in 15% accumulation of 45Ca2+ in comparison to the control group. t-BHP also significantly decreased the Ca2+ ATPase activity in isolated hepatocytes. This decrease in Ca2+ATPase activity by t-BHP was reversed 40% by naturally occurring antioxidant glutathione (GSH) and 20% by the synthetic antioxidant butylated hydroxy toluene (BHT). These results indicate that the hepatotoxic action of t- BHP involves oxidative stress as evident by the protection accorded by various antioxidants employed in the study as well as impairment of intracellular calcium homeostasis which can lead to liver cell injury.