Outcomes of 8 × 8 mm osteotomy in powered external dacryocystorhinostomy

Purpose: To study the endoscopic ostium characteristics and outcome of 8 × 8 mm osteotomy in external dacryocystorhinostomy (DCR) using the microdrill system. Methods: This prospective interventional pilot study was performed on 40 eyes of 40 patients with primary acquired nasolacrimal duct obstruction (NLDO) from June 2021 to September 2021 in patients undergoing external DCR. An 8 × 8 mm osteotomy was performed using round, cutting burr attached to a microdrill system. Success was defined as patent ostium on lacrimal syringing (anatomical) and a Munk score <3 (functional) at 12 months. Postoperative endoscopic ostium evaluation was done using a modified DCR ostium (DOS) scoring system at 12 months. Results: The mean age of the study participants was 42.41 ± 11.77 years and the male?to?female ratio was 1:4. The mean duration of surgery was 34.15 ± 1.66 minutes and that for osteotomy creation was 2.5 ± 0.69 minutes. The mean intraoperative blood loss was 83.37 ± 11.89 ml. Anatomical and functional success rates were 95% and 85%, respectively. The mean modified DOS score was “excellent” in 34 patients (85%), “good” in 1 patient (2.5%), “fair” in 4 patients (10%), and “poor” in 1 patient (2.5%). Complications included nasal mucosal injury in 10% (4/40) of patients, complete cicatricial closure of ostium in 2.5% (1/40), incomplete cicatricial closure in 10% (4/40), nasal synechiae in 5% (2/40), and canalicular stenosis in 2.5% (1/40). Conclusion: An 8 × 8 mm–sized osteotomy created by powered drill and covered by lacrimal sac–nasal mucosal flap anastomosis in external DCR is an effective technique that has minimal complications and shorter surgical time

CYTOMORPHOLOGY PATTERN ON FNAC AND AFB POSITIVITY IN CASES OF TUBERCULAR LYMPHADENITIS IN A TERTIARY CARE CENTRE OF CENTRAL INDIA

Background- One of the most typical diagnoses at OPDs in a developing nation like India is tuberculous lymphadenitis. Anti-tubercular therapy, however, cannot be started based solely on clinical suspicion. Along with culture, cytomorphology with acid fast staining is an effective tool for diagnosing these cases. The purpose of the study was to examine the usefulness, limits, and relationships between Ziehl-Neelsen staining in tuberculous lymphadenitis and various cytomorphological presentations using fine needle aspiration cytology. At a tertiary care facility, the study was Materials and Methods- carried out over the course of a year with a total of 146 cases. Patients who had lymphadenopathy that was clinically suspected were chosen. There were 36.3% cases of tuberculous Resultlymphadenitis out of which 66.04% cases were overall AFB positive. The most frequent cytological finding was epithelioid cell granulomas with lymphocytes, and cases with granulomas and necrosis had the highest levels of AFB positivity. Most patients first showed up in their third or fourth decade of life. Solitary lymphadenopathy, as opposed to matted lymph nodes as reported by others, was the most frequent presentation and the cervical area was the most frequently involved site. Fine needle as Conclusion- piration cytology is a highly sensitive method for diagnosing tuberculous lymphadenitis that is inexpensive, safe, and dependable. By adding acid fast staining and culture procedures to cytomorphology, the diagnostic index can be raised even higher. However, FNAC combined with methods like ELISA and PCR would improve the current landscape of diagnostic and therapeutic options.

ROLE OF ELECTRICALLY DRIVEN CPAP MACHINE WITH OXYGEN ENRICHMENT FOR OXYGEN CONSERVATION IN COVID ICU

INTRODUCTION: Acute respiratory distress syndrome (ARDS) is a major complication of COVID-19 that occurs in 20-41% of patients with severe disease. (7) SARS-CoV-2 patients present with a wide spectrum of clinical severity, ranging from asymptomatic to pneumonia to ARDS-like phenotypes. (8,9) During the early months of the COVID-19 pandemic unprecedented numbers of patients presented to hospitals with acute respiratory failure. With intensive care services at risk of being overwhelmed, strategies were soussght to reduce invasive mechanical ventilation (IMV). Whilst not previously a standard treatment for viral pneumonitis, early anecdotal accounts and preliminary data highlighted the use of continuous positive airway pressure (CPAP) in COVID-19. (7,10) Subsequently it gained traction as an intervention that could be delivered outside of the intensive therapy unit (ITU) and high-dependency unit (HDU) along with conservation of oxygen. Oxygen conservation posed a huge challenge in COVID ICU’s. HFNO being the major cause of oxygen consumption. Electrically driven CPAP machines • Use air to maintain Continuous positive airway pressure. • Decrease atelectasis. • Increase surface area of alveolus. • Improves V/Q matching. Thus, improving oxygenation and saving Oxygen with the use of electrically driven CPAP with oxygen supplement. CPAP has mostly been studied in relation to OSA and a lot is yet to be explored regarding its potential in COVID ICU’s. OBJECTIVES: I. To note the change in Spo2 II. To note if CPAP delivery system can reduce oxygen consumption as to HFNO III. To note if treatment is well tolerated IV. To note if use of CPAP can avoid/delay the use of HFNO/NIV METHOD: Patient’s vitals were noted before shifting to electrically driven CPAP machine and monitored throughout. Properly fitted vented Bi-pap mask was attached with the electrically driven CPAP machine and the oxygen was supplemented with the help of tubing connecting the Bi-pap mask vent to the flow-meter. The flow of oxygen was titrated according to patients requirements ranging from 8-12 liters/min.The pressure was set as per patients need and titrated as per the condition of the patient. During meal times the patients were shifted to HFNO. RESULT: Out of the total 30 patients in our study, 25 patients were successfully treated with the Electrically driven CPAP machine with O2 enrichment and did not require stepping up to further modalities of oxygen therapy. Around 1700 - 1900 L/hr of oxygen was being used by HFNO whereas only 600 - 720 L/hr of oxygen was used by use of CPAP which helped us to save about 29-80% of oxygen by the use of CPAP machine. CONCLUSION: From our limited study we can only conclude that the CPAP when used with Oxygen enrichment in COVID ICU’s can help in conservation of Oxygen by improving the respiratory mechanics of the COVID affected lung, which becomes an essential aim in a pandemic to serve maximum patients with limited resources.

Efficacy and safety analysis of intravitreal bio-similar products of bevacizumab in patients with macular edema because of retinal diseases

Purpose: The purpose of this study was to evaluate retrospectively the efficacy and safety profile of intravitreal injection of bevacizumab bio?similar product Zybev(Z) for macular edema because of retinal diseases. Methods: A retrospective analysis was conducted on patients with macular edema because of retinal diseases, who had been administered intravitreal injections of bio?similar bevacizumab at a tertiary eye care center. Changes in the retinal thickness and visual acuity were evaluated to judge the efficacy, and adverse events were noted for the safety profile over a period of 6 weeks. Results: A total of 104 patients were included in the study. The mean age of the patients was 53 ± 13.5 years. The mean pre?injection best corrected visual acuity (BCVA) was 1.32 ± 0.70 log minimum angle of resolution (logMAR) with a central subfield thickness (CST) of 429.26 ± 204.30 ?m, and the post?injection BCVA at 6 weeks was 1.13 ± 0.71 logMAR with a CST of 302.26 ± 104.50 ?m; this change was statistically significant (P < 0.05) for all groups. The mean average cube thickness (?m) decreased from 11.85 ± 1.96 pre?injection to 10.52 ± 1.75 post?injection, and the mean average cube volume (mm3) decreased from 329.30 ± 54.35 to 302.23 ± 49.56 (P < 0.05). During the follow?up period after injection, no patient had inflammation, endophthalmitis, an increase in intra?ocular pressure, or systemic side effects. Conclusion: This short?term retrospective analysis provides evidence regarding the efficacy and safety of intravitreal injection of bio?similar products of bevacizumab for the treatment of macular edema because of retinal diseases

Assessment of C Reactive Proteins Levels in Hypertensive Patients of Tertiary Care Teaching Hospital in Central India

Background: The present study was conducted for assessing C reactive proteins levels in hypertensive patients Materials & Methods: The study included 100 hypertension cases and 100 controls who met the inclusion requirements. Data were collected through interview and review of medical records. Newly diagnosed 100 treatment naive cases of Essential Hypertension attending medical OPD and admitted in medical wards was included in the study. Patients diagnosed as hypertensive by physician were enrolled in the study. For each case one control was selected. History of co - morbid illness, prolonged co - morbidity, and history of hypertension w as evaluated. All subjects had 5 mL of blood drawn into serum tubes after an overnight fast. After letting the blood clot for 15 minutes at 3000 RPM, the serum was centrifuged out. C - reactive protein levels in the blood were checked right away. CRP levels were evaluated using Immunoturbidimetry. The data was analysed by using descriptive and inferential statistics. Results: The mean CRP in Cases was more (5.38 ± 1.62) as compared to Controls (1.13 ± 0.48) found statistically significant. (By Un - paired T tes t; p>0.05). The above table shows association of type (NYHA) of hypertension and CRP among cases. The mean CRP in Stage II was more (6.13 ± 1.28) as compared to Stage I (5.19 ± 1.78) shows statistically significant. Conclusion: This study confirmed the fun ction of CRP and established its significance as a marker for early detection and prevention of myocardial infarction in hypertensive patients.

Exposure to Electromagnetic Fields from Mobile Phones and Fructose consumption Coalesce to Perturb Metabolic Regulators AMPK/SIRT1-UCP2/FOXO1 in Growing Rats / 生物医学与环境科学（英文）

OBJECTIVE@#In this study, the combined effect of two stressors, namely, electromagnetic fields (EMFs) from mobile phones and fructose consumption, on hypothalamic and hepatic master metabolic regulators of the AMPK/SIRT1-UCP2/FOXO1 pathway were elucidated to delineate the underlying molecular mechanisms of insulin resistance.@*METHODS@#Weaned Wistar rats (28 days old) were divided into 4 groups: Normal, Exposure Only (ExpO), Fructose Only (FruO), and Exposure and Fructose (EF). Each group was provided standard laboratory chow ad libitum for 8 weeks . Additionally, the control groups, namely, the Normal and FruO groups, had unrestricted access to drinking water and fructose solution (15%), respectively. Furthermore, the respective treatment groups, namely, the ExpO and EF groups, received EMF exposure (1,760 MHz, 2 h/day x 8 weeks). In early adulthood, mitochondrial function, insulin receptor signaling, and oxidative stress signals in hypothalamic and hepatic tissues were assessed using western blotting and biochemical analysis.@*RESULT@#In the hypothalamic tissue of EF, SIRT1, FOXO 1, p-PI3K, p-AKT, Complex III, UCP2, MnSOD, and catalase expressions and OXPHOS and GSH activities were significantly decreased ( P < 0.05) compared to the Normal, ExpO, and FruO groups. In hepatic tissue of EF, the p-AMPKα, SIRT1, FOXO1, IRS1, p-PI3K, Complex I, II, III, IV, V, UCP2, and MnSOD expressions and the activity of OXPHOS, SOD, catalase, and GSH were significantly reduced compared to the Normal group ( P < 0.05).@*CONCLUSION@#The findings suggest that the combination of EMF exposure and fructose consumption during childhood and adolescence in Wistar rats disrupts the closely interlinked and multi-regulated crosstalk of insulin receptor signals, mitochondrial OXPHOS, and the antioxidant defense system in the hypothalamus and liver.

Incidence of postoperative pain after using single continuous, single reciprocating, and full sequence continuous rotary file system: a prospective randomized clinical trial

Background@#Extrusion of debris is a major factor that results in postoperative pain during root canal treatment with various instruments and instrumentation techniques. Therefore, instrumentation techniques that extrude minimal debris into the periapical area while reducing pain are desirable. This study aimed to compare the incidence of postoperative pain and intake of analgesic medication (frequency and quantity) after endodontic treatment of mandibular posterior teeth using two single files and full-sequence continuous rotary systems with different kinematic motions. @*Methods@#Thirty-five of 105 patients were assigned equally to three groups according to the instrumentation system used: ProTaper Next (PN) X2, 25/06 (Dentsply, Maillefer, Ballaigues, Switzerland), One Shape (OS), #0.25/06 (Micro Mega, Besancon, France), and Wave One Gold (WG), Red - #0.25, 0.07 (Dentsply, Maillefer, Ballaigues, Switzerland). Five specialists were included in this study design; each professional prepared 21 teeth, and randomly selected 7 per instrument system. The VAS sheet ranging from 0 to 10 was used to record the initial and postoperative pains at 24, 48, and 72 h, and 7th day after single visit endodontic treatment in mandibular premolars and molars with a diagnosis of asymptomatic irreversible pulpitis with or without apical periodontitis. Postoperatively, an analgesic, ibuprofen 400 mg was administered for intolerable pain at a dose of 1 tablet for 6 h. The patients were asked over the telephone regarding postoperative pain at intervals of 24, 48, and 72 h, and 7 th day using a visual analogue scale.Result: There were no statistically significant differences among the PN, OS, and WG systems (P > 0.05) with regard to the incidence of postoperative pain at any of the four time points assessed. @*Conclusion@#The intensity of postoperative pain, frequency, and analgesic intake were similar across all three types of instrument systems; however, the reciprocating single file (WG) was associated with less postoperative pain than the full sequence continuous rotary file.

Effect of COVID-19 Lockdown on Lifestyle Habits and Self-Care Practices of Diabetic and Hypertensive Patients in Rural Shimla and Udaipur – Findings from the HealthRise India program

Background: COVID-19 pandemic has increased the risk of mortality among patients with noncommunicable diseases. Maintaining a good metabolic control, lifestyle modification along with improved self?care practices are not only associated with less severe COVID?19 infections but also with a high recovery rate. Objectives: This research article explores the changes in lifestyle habits, self-care practices, and metabolic control among patients enrolled in the HealthRise program. The study compares behavioral changes, before COVID-19 pandemic and during COVID-19 pandemic, between intervention and control arms in Shimla and Udaipur. Methods: A quasi-experimental study design was employed for program implementation in select villages of Shimla district, and Udaipur district. A total of 459 patients from Shimla and 309 patients from Udaipur with diabetes mellitus or hypertension or with both were enrolled and followed for 1 year. Results: Metabolic control in Shimla intervention arm was 2.6 times higher than in control arm (P = 0.001) before COVID?19 pandemic. During COVID?19 pandemic, Odds of metabolic control in Shimla intervention was 1.5 times higher when compared with control arm (P = 0.03). In Udaipur, metabolic control before COVID-19 pandemic was comparable between control and intervention arms. During the pandemic, metabolic control in intervention arm of Udaipur was 5 times higher when compared to the control arm ((P = 0.001). Conclusion: Participants exposed to support, appreciate, learn, and transfer-community life competence process (SALT-CLCP) intervention maintained metabolic control during the COVID-19 pandemic with improved behavioral and self-care practices. Community-based interventions such as SALT-CLCP method bring ownership and empower community in achieving the better health outcomes.

Comparison in the rise of Compassion Fatigue and Stress Levels for Male and Female COVID Caregivers

The COVID-19 pandemic has had a significant impact on everyone’s health, particularly the vulnerable populations. One such group is that of informal caregivers. The onset of the pandemic has led to many individuals assuming COVID caregiving responsibilities within their homes. They often already suffer from psychological and physical distress which has risen immensely during the pandemic. The research seeks to examine the rise in the level of Compassion Fatigue and Stress for these COVID caregivers and if their gender has had an impact on the same. In the context of this study, compassion fatigue refers to the condition of emotional and physical exhaustion experienced as a result of helping or wanting to help individuals experiencing trauma (in the case of the pandemic, people suffering from COVID-19). Constant exposure to such trauma can lead to a severely diminished ability to empathize and feel compassion. Eight COVID caregivers, including four males and four female, were interviewed and their responses have been analyzed within this paper. These caregivers are either salaried employees or self-employed professionals.

Smoking Rationalisation, Tobacco Dependence and Intention to Quit among Indian Adults and Adolescents

Introduction: Unfortunately, indicators of tobacco dependence are present even after low levels of exposure in young smokers. Early emergence of these signal risk for subsequent chronic smoking and nicotine dependence is negatively associated with cessation in young adults. One important yet understudied modifiable predictor of intention to quit among smokers is smoking rationalization. Smokers often subscribe to smoking rationalisation beliefs, also known as self?exempting beliefs, to justify or rationalize their smoking behaviors. Smoking rationalizations can predict a lack of intention to quit. Objective: To assess the correlation between smoking rationalisation, tobacco dependence and intention to quit among Indian adults and adults. Methodology: A cross?sectional pilot study was carried out among 18–60?year?old subjects. Data were collected for tobacco dependence, smoking rationalisation and intention to quit (no/yes) by structured interview. Data were analysed using IBM SPSS statistics for windows, version 16 (IBM Corp, Armork, NY.) The independent t?test and one way ANOVA and binary logistic regression were performed for inferential statistics. Results: Smokers with no intention to quit and high tobacco dependence scores had significantly higher smoking rationalisation than those to quit and low dependence scores. Logistic regression models demonstrated that all types of rationalisation beliefs were consistently inversely associated with the intention to quit and low tobacco dependence. Conclusion: Findings suggest that smoking rationalisation plays an important role in the lack of intention to quit among Indian smokers. Future interventions should tackle smoking rationalisation beliefs as a strategy to promote smoking cessation.

The Rare Imitator : Pulmonary Nocardiosis Mimics Tuberculosis Reactivation

Pulmonary Nocardiosis is a rare bacterial infection of lungs, caused by a filamentous bacterium. Immunocompromised people are known to be at danger, but there are other new emerging risk factors to consider. The presentation and clinical course in such patients differ from the previous. Here the present case is aimed to underline the presentation and diagnosis in non-risk individual.

Correction of pre-existing astigmatism by on-axis incision size modulation in manual small-incision cataract surgery

Purpose: To study the effect of wound size modulation on pre?existing astigmatism by on?axis placement of incision in manual small?incision cataract surgery (MSICS). Methods: In this prospective interventional study conducted at a tertiary care centre, 40 eyes of 40 consecutive senile cataract patients with 1.00�00 D corneal astigmatism were enrolled for the study. MSICS by modified Blumenthal抯 technique was performed through 6.0, 6.5, and 7.0 mm on?axis incision in 1.0�49 D (group A), 1.50�99 D (group B), and 2.00�00 D (group C) astigmatism, respectively. Surgically induced astigmatism (SIA) was calculated by vector analysis and double angle plots (DAP) at 12 weeks postoperatively. Results: There were 22 males and 18 females with mean age of 58.12 � 1.18 years. The mean SIA at 12 weeks was 0.85 � 0.28 D in group A (17 eyes), 1.32 � 0.65 D in group B (10 eyes), and 1.91 � 0.69 D in group C (13 eyes). The overall median uncorrected visual acuity was 0.18 (IQR = 0 to 0.2). The mean astigmatism decreased from 1.95 � 0.74 D to 1.04 + 0.57 D (P = 0.00) in superior incision and from 1.70 + 0.50 D to 0.92 � 0.45 D (P = 0.00) in temporal incision group with central shift of centroid in all cases. Conclusion: The customization of on?axis external incision size can be used to manage pre?existing corneal astigmatism of less than 3.00 D using both temporal and superior incisions effectively

Re-inventing the straight incision with a single central suture in manual small-incision cataract surgery to minimize surgically induced astigmatism

Purpose: To calculate the surgically induced astigmatism (SIA) in MSICS through a superiorly placed straight scleral incision closed with a single, central, perpendicular 10?0 polyamide suture and to document any suture?related complaints and complications. Methods: A retrospective, hospital?based study was carried out in 50 cases of uncomplicated senile cataract (>50 year) with nuclear sclerosis ? grade 4, 搘ith the rule� astigmatism who underwent MSICS through a superior, straight incision with a single, central, perpendicular 10?0 nylon suture. Patients with 揳gainst the rule� astigmatism, keratoconus, pre?existing corneal opacity, astigmatism >2D, distorted or oblique mires, and previous ocular surgeries and unwilling to participate were excluded. Results: The mean age of the patients was 64.81 + 2.824 years, with a male: female ratio of 1.38:1. The mean SIA at day 7, week 6, and 12 weeks was 0.539 + 0.118, 0.529 + 0.134, and 0.524 + 0.129, respectively. Only 6 patients (12%) complained of foreign body sensation. No patient developed any suture?related complications. Conclusion: SIA is significantly reduced in straight incision by applying a single, central, and perpendicular 10?0 polyamide suture, as compared to a straight incision without a suture.

Comparison of surgically induced astigmatism in chevron, straight, and frown incisions in manual small-incision cataract surgery

Purpose: The study was conducted to calculate and compare the surgically induced astigmatism (SIA) in chevron, frown, and straight incisions in manual small-incision cataract surgery (MSICS). Methods: A prospective, hospital-based study was conducted on 90 patients aged 50 years and above with nuclear sclerosis of grade 4 or more. Each group had 30 patients, divided into Group V (chevron incision), Group S (straight incision), and Group F (frown incision). Patients who had with-the-rule (WTR) astigmatism were operated on through a chevron or straight incision superiorly, while patients who had against-the-rule (ATR) astigmatism underwent MSICS through a temporal frown incision. The patients were followed up post-operatively on days 1, 7, 6 weeks, and 12 weeks, and at each visit, the uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and SIA were calculated and compared. Results: The mean age of all the patients was 66.22 � 8.05 years. BCVA of at least 6/18 or better at 12 weeks post?operatively was achieved in 29 patients (97%) in Group V, 28 patients (93%) in Group F, and 29 patients (97%) in Group S. The mean SIA in Group V was 0.34D � 0.22D, in Group S was 0.97D � 0.29D, and in Group F was 0.575D � 0.25D. Conclusion: SIA by chevron incision is the least followed by the frown incision and straight incision. The superiorly placed chevron incision in WTR astigmatism provided optimal results for the best UCVA and minimal SIA. The temporal frown incision in ATR astigmatism also had good results.

Dedifferentiated chordoma: A rare tumor with diagnostic challenge

Chordomas are rare locally invasive malignant bone tumors arising from remnants of embryonic notochord. Dedifferentiated chordoma (DC), a rare subtype, is characterized by the presence of a sarcomatous component in conventional chordoma (CC) which may arise de novo or as a malignant transformation of previously treated chordoma. The presence of dedifferentiation warrants a poor prognosis due to distant metastasis and recurrences. De novo DCs pose a diagnostic challenge especially in small biopsies and at metastatic sites. Here, we report the case of a 45-year-old female presenting with a long history of backache and constipation, finally diagnosed as DC. Radiological as well as histomorphological pictures of the tumor posed diagnostic challenges because they can mimic other tumors occurring in a similar location. We found this case worth reporting as de novo DC is rarely reported in the literature and it has the potential to pose diagnostic as well as therapeutic challenges.

Challenges in diagnosis and management of acquired factor V inhibitors

Inhibitors to factor V is a rare phenomenon with varied clinical presentation ranging from asymptomatic states to life-threatening bleeds. They are known to be associated with exposure to bovine thrombin, drugs, autoimmune diseases and malignancies. Establishing the diagnosis of FV inhibitors is challenging and the presence of lupus-like properties of the inhibitor can further complicate the diagnosis. Here we document an unusual case of an asymptomatic elderly female posted for pacemaker implantation and incidentally, the laboratory workup revealed a disproportionately abnormal coagulation screen. The intricacies in the diagnosis and management are discussed along with a brief review of the literature. An awareness of the diverse manifestations of this underrecognized disorder and difficulties in management is essential for medical practitioners, particularly in patients with idiopathic severe bleeding diathesis.

Hypothyroxinemia in sick term neonates and its risk factors in an extramural neonatal intensive care unit: a prospective cohort study

ABSTRACT Objective: Thyroid functions in the sick newborns may be altered in the first week of life. Transient hypothyroxinemia has been reported in these babies, which could be due to the immaturity of the hypothalamic-pituitary-thyroid axis or to acute illness. We conducted this study to estimate the incidence of hypothyroxinemia and determine its risk factors in sick term newborns. Materials and methods: We analyzed free T4 (FT4) and thyroid-stimulating hormone (TSH) levels in sick term neonates (≤7 days of life) admitted to the neonatal intensive care unit. FT4 and TSH levels were estimated in the first week of life in all the enrolled neonates (N = 98) and then repeated at 14-21 days of life in 46 babies. Risk analysis was conducted using univariate and multivariate logistic regression, and numerical data was compared using the Mann-Whitney U test and t-test. Results: Hypothyroxinemia was seen in 10 (10.2%) of the admitted term babies. Male gender, vaginal delivery, presence of hypoxic ischemic encephalopathy, and need for mechanical ventilation (>24 hours) were identified as risk factors. There was a significant negative linear correlation between FT4 level in the first week of life and duration of hospital stay. Conclusion: Hypothyroxinemia is common in sick term neonates.

A Study of Changes in Refractive Status Pre and Post Pterygium Surgery among Patients of Tertiary Care Hospital of Ahmedabad City

Background : Pterygium is a fibrovascular subconjunctival tissue also called Tenon’s Capsular growth occurring mostly in the palpebral fissure area from the nasal aspect towards the limbus over the Cornea and in this process the Corneal Pathology is changed especially the epithelium and bowman’s layer of the cornea are destroyed1. A major problem seen in most of postpterygium surgery is the complication of recurrence and it is usually seen in young patients with fleshy large pterygium1. This issue is addressed by Pterygium Surgery with either Conjunctival Autograft (CAG) or Amniotic Membrane Graft (AMG)1. Stem cells are present in limbal conjunctiva and in amniotic membrane, which provide a barrier between cornea and conjunctiva, preventing regrowth and also provide a smooth regular surface to the eyeball2. another reason and technique to prevent recurrence is by excising the pathological part of conjunctiva and resecting tenon’s capsule up to far periphery2. Aims and Objectives : The aim of the study is to investigate pre-operative and postoperative difference between the amount of astigmatism prior to the surgery and after the Pterygium Excision Surgery with either CAG or AMG. Materials and Method : A prospective cross-sectional study was undertaken of 26 cases, who underwent Pterygium Surgery under local anaesthesia with Conjunctival Autograft or Amniotic Membrane Graft for a period of one year in a Tertiary Healthcare Hospital. Pre-operative Best Corrected Visual Acuity, Anterior Segment Examination, Slit Lamp Examination, Dilated Retinoscopy and Fundus examination, Keratometry and Post mydriatic refraction was done. Then the patient underwent Pterygium Excision Surgery with Conjunctival Autograft or Amniotic Membrane Graft under local anaesthesia. All patients were re-examined 1 month after the surgery for final Refraction and Keratometry. Result : Among total of 26 patients, the comparison between pre- and postoperative values of Refraction and of Corneal Astigmatism was performed using z test. The pre-operative Mean for Astigmatism was 1.70 and SD was 0.43. The postoperative mean for Astigmatism was 0.57 and SD was 0.26. The pre-operative Keratometry mean was 2.73 and SD was 0.14. The Post operative Keratometry Mean was 1.50 and SD was 0.55. (p value, 0.0001) Conclusion: Pterygium is a lesion which also affects the ocular surface, thus leading to one of the causes for ocular surface abnormality. Pterygium surgeries results in elimination of the Pulling Factor and Corneal Curvature thus reducing or eliminating Astigmatism and thereby providing better visual restoration and cosmetic outcome

Ocular sequelae in severe COVID-19 recovered patients of second wave

Purpose: To evaluate the retinal microvascular changes in patients, recovered from severe COVID?19 during the second wave of the pandemic in North India. Methods: In this observational cross?sectional study, 70 eyes of 35 patients who recovered from severe COVID?19 during the second wave underwent detailed ophthalmic evaluation 4–6 weeks after discharge. Twelve controls were also enrolled, and the difference in the findings between the case and control groups on optical coherence tomography (OCTA) were studied. Result: The ages of study participants ranged from 27 to 60 years with the male:female ratio being 1.05:1. The fundus changes suggestive of ischemia in the form of cotton wool spots and vascular tortuosity were seen in 25 eyes (35.71%). Increased venous tortuosity was the most common finding seen in 23 eyes (32.85%), of which 10 eyes (28.57%) had concurrent hypertensive retinopathy (HTR) changes. There was a significant reduction in the mean vascular density (VD) and perfusion density (PD) for both the superficial capillary plexus (SCP) and deep capillary plexus (DCP) at inner, outer ring, and whole (P < 0.05). Foveal avascular zone was significantly enlarged in both the SCP (P = 0.01) and the DCP (P = 0.03). The mean ganglion cell?inner plexiform layer (GC?IPL) was significantly reduced in comparison to controls (P < 0.001). Conclusion: Severe COVID?19 can result in microvascular changes at the macula in the form of reduction in vascular and perfusion density, which can be evaluated using OCTA. As structural changes precede functional changes, a close watch is recommended in patients showing compromise in retinal microvasculature

Effect of waterlogging on physiological traits and yield in black gram (Vigna mungo L.) in field condition

Waterlogging is an important abiotic factor affecting crop productivity worldwide. Black gram (Vigna mungo L.) is very sensitive to waterlogged conditions. A field experiment was conducted in randomized complete block design to evaluate three black gram genotypes for waterlogging tolerance. Stress was imposed by maintaining the water level above the soil surface for 10 days after 30 days of sowing. Different physiological parameters including chlorophyll (Chl), chlorophyll fluorescence, normalized difference vegetation index (NDVI), sugars, along with the yield per plant and thousand grain weight (TW) were recorded in control and stressed plants. Results showed that NDVI, Chl, chlorophyll fluorescence, sugars, seed yield and TW reduced significantly during stress. Stress susceptibility index (SSI) for grain yield varied from 0.32 to 2.38. Linear correlation study showed that SSI was negatively correlated with NDVI (0.43),Chl (0.68) and TW (0.42) and grain yield (0.96). NDVI and sugars were correlated to TW under stress. IC530491 and IC559933 (SSI < 0.5) were waterlogging tolerant under field conditions. The study concluded that identified black gram lines may be utilized as trait donors in breeding program.