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Objective:To provide the regional pediatric cancer (age-group 0-14 years) burden and pattern in India utilizing published data of population-based cancer registries established under the National Cancer Registry Programme and Tata Memorial Centre, Mumbai. Methods:Based on the geographic locations, the population-based cancer registries were categorized into six regions. The age-specific incidence rate was calculated using the number of pediatric cancer cases and population in the respective age-group. Age-standardized incidence rate per million and 95% CI were calculated.Results: In India, 2% of all cases were pediatric cancer. The agestandardized incidence rate (95% CI) for boys and girls is 95.1 (94.3-95.9) and 65.5 (64.8-66.2) per million population, respectively. Registries from northern India reported the highest rate; while the lowest rate was in northeastern India. Conclusion:There is a need to establish pediatric cancer registries in different regions of India to know the accurate pediatric cancer burden.
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Purpose: To report on the microbiological profile and antibiotic sensitivity patterns of infectious keratitis at a tertiary center in central India. Methods: The suspected case of severe keratitis underwent microbiological culture and identification using the VITEK 2 technique. Antibiotic susceptibility for different sensitivity and resistance patterns was analyzed. Demographics, clinical profile, and socioeconomic history was also documented. Results: Culture was positive in 233/455 (51.2%) patients. Pure bacterial growth was present in 83 (35.62%) patients and pure fungus was present in 146 (62.66%) patients. The most common bacterial cause of infectious keratitis was Pseudomonas followed by Staphylococcus and Bacillus. Pseudomonas showed 65%–75% resistance against levofloxacin, ceftazidime, imipenem, gentamycin, ciprofloxacin, and amikacin. Staphylococcus showed 65%–70% resistance against levofloxacin, erythromycin, and ciprofloxacin, with Streptococcus being 100% resistant to erythromycin. Conclusion: This study highlights the current trend of microbiological profiles of infectious keratitis and their antibiotic susceptibility at a rural setup in central India. Fungal predominance and increased resistance against the commonly used antibiotics were noted.
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Dengue fever is an arboviral infection, which is highly prevalent in tropical and subtropical climates. It is frequently associated with neurological complications but its association with ischemic stroke is ill defined. We present a case of an apparently healthy young male admitted with dengue fever complicated by ischemic infarct in corpus callosum. Our patient was managed conservatively, improved clinically and discharged in satisfactory condition.
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Migraine increased the risk of Bell palsy in the total population. Among migraine patients, between ?30 and <60 years old are at an increased risk of Bell palsy. A migraine is a primary headache characterized by recurrent headache attacks triggered by various factors. As much as 10% of the global population is thought to experience migraine headaches. It was earlier considered that migraine headaches were triggered by the dilation of cerebral vessels, and the recent evidence supports that migraine attacks can also occur in the absence of vasodilation. According to the researchers, the direct neural effects from the trigeminal nerve to the facial nerve could contribute to the risk of facial palsy among patients with migraine. An alteration of the trigeminovascular function has been suggested to trigger migraines. The neurogenic inflammation of the facial nerve trunk caused by its proximity to the dilated posterior auricular/ stylomastoid/ occipital and superficial temporal arteries during a migraine attack leads to a temporary lower motor neuron type of paresis of the muscles supplied by the facial nerve. We herewith report a rare case of migrainous left Bell抯 palsy after migrainous right external ophthalmoplegia, treated with Sumatriptan.
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Purpose: Emergency delirium (ED), a common postoperative neurologic complication, causes behavioral disturbances leading to self?traumas and also has long?term adverse effects in children. Our aim was to investigate the efficacy of a single?bolus dose of dexmedetomidine in reducing the incidence of ED. Additionally, pain relief, number of patients who needed rescue analgesia, hemodynamic parameters, and adverse events were assessed. Methods: One hundred and one patients were randomly allocated into two groups: 50 patients received 15 mL of dexmedetomidine 0.4 ?g/kg (group D) and 51 patients received volume?matched normal saline (group C). Hemodynamic parameters such as heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were monitored regularly throughout the procedure. ED was assessed with Pediatric Anesthesia Emergence Delirium Scale (PAEDS), and pain was measured using the modified Objective Pain Score (MOPS). Results: The incidences of ED and pain were higher in group C than group D (P < 0.0001 and P < 0.0001, respectively). Group D showed significant decrease in MOPS and PAEDS values at 5, 10, 15, and 20 min (P < 0.05), HR at 5 min (P < 0.0243), and SBP at 15 min (P < 0.0127). There was no significant difference in DBP between the two groups at any time point. The mean blood pressure (MBP) at 10 min was significantly less in group D than group C (P < 0.001). Conclusion: Dexmedetomidine 0.4 ?g/kg as a single bolus over 10 min immediately after intubation is effective for the prevention of ED and significantly reduces the need of rescue analgesia without compromising the hemodynamic parameters in children undergoing ophthalmic surgery.
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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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Atraumatic Non-aneurysmal sulcal subarachnoid hemorrhage is very rare. Sulcal subarachnoid hemorrhage (sSAH) is characterized by isolated bleeding in one or a few adjacent sulci. Central sulcus hemorrhage is a rare imaging finding. There are many causes for sSAH. In older patients, sSAH is due to Cerebral Amyloid Angiopathy (CAA), while in younger patients, reversible cerebral vasoconstriction syndrome (RCVS) is the most frequent etiology. Imaging studies help in the evaluation of sSAH. We report a rare case of an isolated central sulcus hemorrhage on computed tomography. sSAH usually occur on the side with acute ischemic stroke, and it is unusual for sSAH to occur on the opposite side of the infarct territory, but in our case sSAH occurred on opposite side, but after a gap of 3 years.
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Purpose: This study was performed to determine the demographic profile and clinical characteristics in patients with Fuchs’ endothelial corneal dystrophy (FECD) reporting to a tertiary eye care center in India. It is a retrospective, single?center, observational study. Methods: The study included 280 patients (559 eyes) diagnosed with FECD presenting between January 2013 and December 2020. The data was collected from the electronic medical record system of the institute. Patient data included demographic features, clinical characteristics, investigations, and surgical interventions. Results: The mean age of the patients was 62 years. Late?onset FECD (95.7%) was more common than early?onset FECD (4.3%). Male: female ratio for late?onset FECD and early?onset FECD was 1:1.65 and 3:1, respectively. More than one?third of the patients had associated systemic history. Preexisting ocular diseases were seen in 5.9% of eyes. Blurring of vision was seen in 383 eyes (68.5%), 13 eyes (2.1%) had glare, and 163 eyes (29.2%) were asymptomatic. A total of 113 surgical interventions were done in 108 eyes (including repeat transplants). Only cataract surgery was done in 40 (7.2%) eyes, whereas penetrating keratoplasty, Descemet stripping endothelial keratoplasty, and Descemet membrane endothelial keratoplasty without or with cataract surgery (sequential or triple procedure) were done in 12 (2.1%), 47 (8.4%), and 14 (2.5%) eyes, respectively. Conclusion: Patients with FECD present mostly during the sixth decade. Posterior lamellar keratoplasty is the most common transplant procedure being performed on FECD patients
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Purpose: To evaluate the efficacy of a biosimilar ranibizumab (Razumab) on outcomes of retinopathy of prematurity (ROP) for the first time. Methods: This retrospective study included infants presenting with stage 3+ ROP either in zone 1 or zone 2 posterior or aggressive posterior ROP (APROP). All eligible infants received intravitreal razumab (0.25 mg/0.025 ml) monotherapy. Follow?up was continued monthly till complete retinal vascularization was achieved while retreatment with razumab was given when recurrent neovascularization was noted. In case of no recurrence but incomplete vascularization, laser photocoagulation was done to the residual avascular retina. Results: We included 118 eyes of 59 infants with a median gestational age of 30 weeks and median birth weight of 1250 grams. At presentation, APROP was found in 28 eyes (24%) of 14 babies while stage 3 disease was seen in zone 1 in another 28 eyes (24%) and the remaining 62 eyes (52%) had stage 3 ROP in zone 2 posterior region. Complete resolution of ROP along with complete vascularization was seen in 22 eyes (19%) at a median of 55 days (IQR = 31–56 days) and 42 eyes (35%) showed a recurrent neovascularization at a median of 51 days post razumab (IQR = 42– 55 days). The cumulative incidence of recurrence of neovascularization (21%, 95% CI = 14%–29%) peaked at seven weeks and was significantly higher in eyes with APROP (43%, 95% CI = 27%–63%) compared to eyes without APROP (13.4%, 95%CI, 8%?22%) (P < 0.001). Conclusion: Razumab appears to be safe and effective in treating ROP, with about a third requiring reinjection at seven weeks after the first dose.
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AIM: To study the patient characteristics and keratorefractive surgery(KRS)practice in central India.METHOD: The retrospective study was conducted on 410 patients who underwent KRS from June 2017 to April 2022 at a tertiary eye care center in central India. Demographic data of the patients presenting for the spectacle free vision like age, sex, residence in the form of urban or rural area, refractive error, cause for spectacle-free vision, best-corrected visual acuity, types of procedure, postoperative follow-up and complications were recorded.RESULTS: Among the 410 patients who presented for spectacle-free vision, 324 patients were considered for KRS(79.0%), and 200 patients(61.7%)underwent the laser-assisted in situ keratomileusis(LASIK)procedure, whereas 124 patients(38.3%)underwent the photorefractive keratectomy(PRK)procedure. The final study group comprised 179 female and 145 male. The mean age of the patients was(25±3.5)years. A majority of patients were from urban areas(n=250, 77.2%). The mean preoperative manifest refraction in the right and left eyes was -4.5±2.1 and -4.9±2.0, respectively. The mean surgical time in the LASIK patient was(15±2)min and(17±3)min for both eyes in PRK. None of the patients exhibited epithelial ingrowth, flap healing complications, or infection, and none of them required enhancement. Suboptimal corneal thickness(n=28, 32.6%)was the most common reason for rejection. At the end of the 1-year follow up, 3 patients who underwent the LASIK procedure exhibited regression(-0.5 D±1 D), with a refractive error correction of -6.75 D, -8.5 D, and -7.0 D, respectively.CONCLUSION: LASIK is the predominant procedure for the correction of refractive error in the central Indian population. Although the number of PRK procedures was small, both LASIK and PRK exhibited excellent visual outcome. Myopic regression should be considered when choosing LASIK for high myopia.
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Nanotechnology exploits the exclusive characteristics of nanoparticles with size ranging from 1 to 1000 nanometers (nm). Various nanoparticles have presented magnificent potential for the fabrication of new drug carriers and vaccines. For designing vaccine significant attempts are done to engineer novel vaccines and to increase the efficiency of current vaccines for particular diseases. So far, few vaccines are engineered from killed pathogens or protein sub-units, while various vaccines are founded on live-inactivated pathogens that holds the danger of retrieval of their pathogenicity under some immune-compromised circumstances. To circumvent this designing of risk-free effectual vaccines in combination with satisfactory carrier systems are reflected as a vital requirement to attain preferred humoral and cellular immunity for various diseases. In the past years, utilization of vaccines based on nanoparticle has gained a pronounced responsiveness to increase aimed delivery, immunization approaches and vaccine effectiveness to attain preferred immune retorts at the cell level. To increase vaccine efficiency these nanoparticles mustguard the antigens from early proteolytic disintegration, controlled release, enable antigen internalization and management by antigen presenting cells for harmless human usage. Nanoparticles comprised of polymers, lipids, metals and proteins have previously been exploited to achievefew of these characteristics. In this context, various physicochemical characteristics of nanoparticles have a crucial part in the establishment of vaccine efficiency. This review emphases on the usage of nanoparticles centred vaccine and the importance of characteristics of nanoparticles to achieve effective vaccines delivery in order to prompt preferred host immunity against various diseases.
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Background: Avulsion is one of the most serious dental injuries due to its implications for tooth loss and sequelae following treatment. Most dental accidents in children occur at home, followed by the school therefore, first aid provided by school professionals and other school staff must be appropriate for the management of traumatic dental injury as it plays a major role in improving the prognosis. The study aims to assess the gain in knowledge of school profes Aim: sionals before and after the conduction of an awareness program regarding the emergency management of dental avulsion in Lucknow District. A cross-sectional, Materials and methods: questionnaire-based observational study was conducted in various schools in Lucknow. The questionnaire collected information on school professionals' education level, demographic characteristics, first-aid training, and attitudes towards emergency management of dental avulsion before and after the conduction of an awareness program. 200 school professionals completed Results: the questionnaire and knowledge about tooth avulsion was inadequate, and first aid training was not associated with correct responses to the management of avulsed teeth. A significantly higher percentage of school professionals expressed the need for future education in dental trauma avulsion management. However, after the conduction of an awareness program comparatively higher percentage of school professionals reported having gained knowledge regarding the emergency management of dental avulsion. Considering that there is a lack of knowl Conclusion: edge among school professionals regarding emergency management of dental avulsion, educational programs can prove to improve knowledge and awareness among school professionals.
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Objectives?The idiopathic group is a significant cause of chronic kidney disease (CKD) in developing countries. Literature available on ocular surface changes has predominantly been reported in patients undergoing hemodialysis. Little is known about the changes in patients undergoing peritoneal dialysis. The present study aimed to identify ocular surface changes in an idiopathic group of CKD undergoing dialysis. Aim?To compare tear film disorders and the severity of ocular surface changes (goblet cell density, squamous metaplasia, and corneoconjunctival calcification) in patients of idiopathic etiology with CKD undergoing hemodialysis and peritoneal dialysis. This is an analytical study. Materials and Methods?Asymptomatic adult patients of idiopathic CKD, on treatment with dialysis underwent comprehensive ophthalmic examination, including best-corrected visual acuity, slit-lamp examination, and a dilated fundus examination. Dry eye assessment was done by ocular surface staining score, Schirmer test, and tear breakup time (TBUT). Conjunctival impression cytology was studied to assess changes on ocular surface. Chest X-rays for aortic calcification were reviewed and data analyzed. Results?Both eyes of 76 patients of hemodialysis and 32 patients of peritoneal dialysis were studied. Ocular surface staining (OSS) scores were low. Impression cytology showed a drop in goblet cell density, presence of squamous metaplasia, and conjunctival keratinization significantly more in the hemodialysis group. No correlation was seen between the presence of conjunctival calcification and aortic calcification. Conclusion?The hemodialysis group had mild subclinical dry eye but keratinization of conjunctiva was seen. Similarly, advanced squamous metaplasia was seen in the peritoneal dialysis group. These changes were positively correlated to decrease in goblet cell density.
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Nata & Kushta medicinal plants are easily available in Indian diaspora and both are widely used in many Agada as Vishaghna dravya mentioned in classical texts. Both have reported acetylcholinesterase and Phospholipase A2 enzyme inhibiting property in many Research studies. The quality of Nata, Kustha & Nata Kustha Yoga was evaluated based on organoleptic, physico-chemical, and microbial quality parameters. Loss on drying at 105°C, Total ash, Acid Insoluble ash, Alcohol-soluble extractive, Water-Soluble extractive, HPTLC and pH value parameters were evaluated as per WHO guidelines, Ayurvedic pharmacopoeia and Indian pharmacopoeia. Analytic analysis of Nata, Kustha & Nata Kusthadi Yoga in this study found to be under standard limit. Standardization test done on Natakusthadi Yoga helped in authenticating the preparation and in ensuring quality of the same. The Natakusthadi Yoga prepared by following standard operative procedures should have Loss on drying at 105°C, Total ash, Acid Insoluble ash, Alcohol-soluble extractive, Water-Soluble extractive and pH value is 2.1%, 4.8%, 0.32%, 42.9%, 37.8% & 5.5 respectively
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Dengue fever is an arboviral infection, which is highly prevalent in tropical and subtropical climates. It is frequently associated with neurological complications but its association with ischemic stroke is ill defined. We present a case of an apparently healthy young male admitted with dengue fever complicated by ischemic infarct in corpus callosum. Our patient was managed conservatively, improved clinically and discharged in satisfactory condition.
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Purpose: Pregnancy?induced hypertension is a multisystem disorder that occurs after 20 weeks of pregnancy usually in primigravidas and is characterised by proteinuria, pedal edema, hypertension, and abnormal liver and kidney function tests. Since there exists a close relationship between retinal, cerebral, and renal vessels, fundoscopy gives the opportunity of observing the changes in the vascular tree. Methods: We conducted a study on 203 pregnant females over a period of 1.5 years in the rural population of North India. We recorded the baseline data from the patient files, including the biochemical investigations, and conducted a fundoscopic examination of all patients included in the study, and correlation of various variables was established. Results: Out of 203 patients (403 eyes), 60% were primigravidas of mean age 25.71 ± 4.46 years with the mean duration of pregnancy being 36 weeks. The mean systolic and diastolic blood pressure were160 and 101 mmHg, respectively. There was no significant correlation was seen of proteinuria with eclampsia and the fundus findings. But there was a significant correlation between proteinuria and pedal edema and between the fundus findings and deranged LFT and KFT values. Relationship between the variables was calculated by using Chi?square and Fisher’s exact test. A P value < 0.05 was taken as significant. Conclusion: Hypertension in pregnancy is the major concern of public health issue worldwide. With proper understanding of the correlating factors such as fundus changes which are directly correlated with whole bo dy vascular changes, which might affect the fetal growth, we can easily predict the outcome and can take appropriate actions as early as possible
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Background: Cleft lip and palate patients undergo many primary reconstructive surgical procedures which could lead to various changes in the facial morphology with growth. The most common diagnosis is unilateral cleft lip and palate (UCLP) and such patients are more prone to dental caries. Aims: This study aimed to evaluate and compare the lateral cephalometric landmarks, dental caries status, and salivary properties of surgically repaired UCLP children aged 6–15 years with lateral cephalometric landmarks, dental caries status, and salivary properties of noncleft children of the same age group. Materials and Methods: Twelve noncleft patients and 12 surgically repaired UCLP patients were chosen, and cephalometric analysis, salivary analysis, and dental caries status were recorded for both the groups. The data were then compared for both the groups. Statistical Analysis: It was analyzed using the Statistical Package for the Social Sciences (SPSS) version 21. The level of statistical significance was set at 0.05. Results: In surgical repair ULCP children, their was increased prevalance of dental caries along with decrease level of salivary calcium, Phosphorus, flow rate. Also, their was increased level of alkaline phosphatase, total protein level with acidic pH alongwith retruded maxillary complex with Class III malocclusion. Conclusion: Various primary reconstructive surgeries in UCLP children lead to maxillary retrusion with an increased prevalence of dental caries in these patients due to the maintenance of poor oral hygiene
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Aim: To study the efficacy of uptitrating the dose of Teneligliptin from 20 to 40 mg in patients with type II diabetes mellitus. Method: A retrospective, comparative analysis was undertaken in 853 type II diabetes mellitus patients (499 males and 354 females) who had follow-up records for more than 6 months. These patients were uncontrolled after use of atleast three oral antidiabetic drugs (OADs) and Teneligliptin 20 mg was added as the fourth drug. Patients who remained uncontrolled with the addition of 20 mg of Teneligliptin at the end of 3 months and were switched to receive 40 mg of Teneligliptin daily were included in this study. Results were analyzed at 3 and 6 months to ascertain efficacy of high-dose (40 mg) Teneligliptin. All other OADs remained the same in both groups. In all patients, the fasting blood glucose, postprandial blood glucose, and hemoglobin A1c (HbA1C) were evaluated and compared. Result: A total of 853 patients whose dose of Teneligliptin was increased from 20 to 40 mg were included in the study. At the end of 3 months after using Teneligliptin 40 mg, mean reduction in HbA1C was 0.5% (p-value 0.154). Similarly, mean reduction in fasting blood sugar (FBS) and postprandial blood sugar (PPBS) was 6.5 and 3.6 mg/dL, respectively (p-value 0.234 and 0.143). At the end of 6 months after using Teneligliptin 40 mg HbA1C showed no change but mean FBS and PPBS showed a modest reduction of 14.6 and 14 mg/dL, respectively (p-value < 0.001). Conclusion: The results of our study show that there was no statistically significant improvement in glycemic parameters when dose of Teneligliptin was increased from 20 to 40 mg at 3 months. But at 6 months, the FBS and PPBS showed a modest reduction of 14.6 and 14 mg/dL, respectively (p-value < 0.001) but the HbA1C showed no change
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This article first deal with the current scenario of the wind energy in India. Wind energy is available at no cost and it does not emit no greenhouse gases. Harnessing the energy of wind to obtain some useful work like pumping water, sailing boats and grinding grains has been therefore a very long time. In modern time wind energy is used to generate electricity. Wind energy is a clean sources of energy and India has a huge potential for wind energy (302 GW in the country at 100 m height and 695.50 GW at 120 m above the ground level). This vast potential has remained unexplored which can be achieved through well framed policies initiated by government of India. Wind power has emerged as a biggest source of Renewable energy in the world