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Purpose: To assess the accuracy of e?Paarvai, an artificial intelligence?based smartphone application (app) that detects and grades cataracts using images taken with a smartphone by comparing with slit lamp?based diagnoses by trained ophthalmologists. Methods: In this prospective diagnostic study conducted between January and April 2022 at a large tertiary?care eye hospital in South India, two screeners were trained to use the app. Patients aged >40 years and with a best?corrected visual acuity <20/40 were recruited for the study. The app is intended to determine whether the eye has immature cataract, mature cataract, posterior chamber intra?ocular lens, or no cataract. The diagnosis of the app was compared with that of trained ophthalmologists based on slit?lamp examinations, the gold standard, and a receiver operating characteristic (ROC) curve was estimated. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were computed. Results: The two screeners used the app to screen 2,619 eyes of 1,407 patients. In detecting cataracts, the app showed high sensitivity (96%) but low specificity (25%), an overall accuracy of 88%, a PPV of 92.3%, and an NPV of 57.8%. In terms of cataract grading, the accuracy of the app was high in detecting immature cataracts (1,875 eyes, 94.2%), but its accuracy was poor in detecting mature cataracts (73 eyes, 22%), posterior chamber intra?ocular lenses (55 eyes, 29.3%), and clear lenses (2 eyes, 2%). We found that the area under the curve in predicting ophthalmologists’ cataract diagnosis could potentially be improved beyond the app’s diagnosis based on using images only by incorporating information about patient sex and age (P < 0.0001) and best?corrected visual acuity (P < 0.0001). Conclusions: Although there is room for improvement, e?Paarvai app is a promising approach for diagnosing cataracts in difficult?to?reach populations. Integrating this with existing outreach programs can enhance the case detection rate.
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Background & objectives: Serology testing is essential for immunological surveillance in the population. This serosurvey was conducted to ascertain the cumulative population immunity against SARS-CoV-2 among adults in Jammu district and to understand the association of seropositivity with sociodemographic and clinical correlates. Methods: On September 30 and October 1, 2020, a household survey was done in 20 villages/wards chosen from 10 health blocks in district Jammu, India. Demographic, clinical and exposure information was collected from 2000 adults. Serum samples were screened for IgG antibodies using COVID Kavach MERILISA kit. Tests of association were used to identify risk factors associated with IgG positivity. Crude odds ratio with 95 per cent confidence intervals (CIs) was calculated during univariate analysis followed by logistic regression. Results: Overall adjusted seroprevalence for SARS-CoV-2 was 8.8 per cent (95% CI: 8.78-8.82); it varied from 4.1 per cent in Chauki choura to 16.7 per cent Pallanwalla across 10 blocks in the district. Seropositivity was observed to be comparatively higher in 41-50 and 61-70 yr age groups, among males and in rural areas. Fever, sore throat, cough, dyspnoea, myalgias, anosmia, ageusia, fatigue, seizures, history of exposure, medical consultation, hospitalization and missing work showed significant association with seropositivity on univariate analysis. On logistic regression, only sore throat, myalgia and missing work showed significant adjusted odds of IgG positivity. Extrapolation to adult population suggested that exposure to SARS-CoV-2 was 14.4 times higher than reported cases, translating into Infection fatality rate of 0.08 per cent. Interpretation & conclusions: Since a major part of population was immunologically naive, all efforts to contain COVID-19 need to be vigorously followed while these baseline results provide an important yardstick to monitor the trends of COVID-19 and guide locally appropriate control strategies in the region
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Since the inception of implant dentistry, implant-supported metal-acrylic resin hybrid prostheses are the major prostheticdevices given to restore physiological and esthetic functions of oral tissues of edentulous or partially edentulous patients. Theclinical performance of the most commonly used acrylic resin in the fabrication of dentures, namely, polymethyl methacrylate(PMMA) resin determines its long-term deformation and wear resistance. However, its poor mechanical resistance to wearand tear poses a major setback. An attempt to incorporate graphene derivative with PMMA resin in prosthesis fabrication hasdemonstrated significant improvement in the mechanical strength as per literature. This case report presents rehabilitation ofedentulous mandibular jaw and also briefly states the properties of graphene and the polymerization process of the resin withthe graphene derivative.
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Background: Worldwide, Chronic obstructive pulmonary disease (COPD) is the one of the leading cause of chronic morbidity and mortality. COPD is one of the diseases in which smoking is the common and important risk factor when it is associated with Metabolic syndrome (MetS). The individual components of MetS, i.e., obesity, dyslipidemia, fasting hyperglycaemia, and hypertension were independently associated with impairment of lung function too. The objective of this study is to find out the prevalence of metabolic syndrome among COPD patients.Methods: This was a cross-sectional study conducted in department of Respiratory Diseases and a total of 70 COPD patients were included in the study, which were enrolled for treatment from July 2016 to July 2017. The severity level in patients with COPD were determined according to GOLD (Global Initiative for Chronic Obstructive Lung Disease), 2015 guideline. International Diabetes Federation (IDF) guideline; (2005) was used in diagnosis of metabolic syndrome.Results: Seventy patients with COPD were enrolled during the study period. There were 45 males (64.2%) and 25(35.7%) females. Mean age of male patients was 58.67±9.87 years, while mean age of female patients was 57.23±10.4 years (35-87 years). Mean BMI of male was 24.33±6.64 kg/m2, while in case of female it was 30.07±6.95 kg/m2 and overall mean BMI of study population was 26.22±7.22 kg/m2. The mean waist circumference of male was 86.91±13.31 cm while in female it was 87.18±14.51 cm. The Overall prevalence of metabolic syndrome was 31.34% and most common in GOLD stage-3 (47.06%), followed by stage-2 (40%), followed by stage-4 (25.71%) and 7.4 % in GOLD stage -1.Conclusions: The presence of metabolic syndrome is common in patients with COPD and, all COPD patients should be considered for screening for it.
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Spinal anaesthesia related hypotension and bradycardia is not rare. One of the causes for post spinal hypotension is thought to be bezold-jarisch reflex (BJR) which is mediated by serotonergic 5-HT3 receptors. Ondansetron, one of the reliable drugs for nausea and vomiting, is 5-HT3 antagonist. Effect of ondansetron to attenuate hypotension has been studied in caesarean section but there is paucity of literature for general population. Aim and Objectives: In this study we aimed at evaluating the efficacy of ondansetron on haemodynamics of patients undergoing spinal anaesthesia. Methods: This prospective study enrolled 200 ASA I and II patients assigned into 2 groups: Group O (Ondansetron group, n=100) received injection ondansetron 0.1mg/kg intravenous, diluting the drug to make volume 10 ml 5 minutes prior to spinal anaesthesia(SA). Group P (Placebo group, n=100) received injection normal saline 10 ml intravenous 5 minutes prior to spinal anaesthesia. Results: Demographic data were comparable in both the groups. There was no significant difference in MAP (mean arterial pressure), HR(heart rate) & SpO2 (oxygen saturation) values in group O whereas in group P statistically significant variations in MAP, HR & SpO2 values were observed. Fewer interventions using intravenous atropine & ephedrine were required in group O as compared to group P. Conclusion: In conclusion, intravenous administration of ondansetron 5 minutes before spinal anaesthesia attenuates the decrease in mean arterial pressure.
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Spinal Anaesthesia is widely practiced anaesthetic technique for sub - umbilical surgical procedures. However the technique is not without complications and Post Dural Puncture Headache (PDPH) remains important amongst such complications. Aims and Objectives: The present study was prospective , was conducted to study the overall incidence of PDPH using 26 G Quincke type spinal needle and to establish its relations( if any) with the age of patient, type of surgery and time to ambulate following the surgery. Methods: A total of 500 patients of ASA I and II were studied. These patients underwent various orthopaedic, general surgical, obstetrical/ gynaecological surgical procedures under Spinal Anaesthesia using 26 G Quincke type spinal needle. All the patients were followed upto 72 hours post operatively for evaluation of PDPH. Results: The incidence of PDPH in the present study was 1.6%. The incidence was higher in female patients (75%). Among the female patients, 50% of patients were those who underwent Caesarean Section. Conclusion: The present study concludes free and widespread use of 26 G Quincke type needle in all patients who require Spinal Anaesthesia irrespective of type of surgery
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Background: To combat the reproductive and child health (RCH) problems, National Rural Health Mission (NRHM) had launched Janani Suraksha Yojana (JSY) in April 2005 in all states and union territories to promote institutional deliveries among the poor population through provision of antenatal, intra-natal and post-natal care services for women to have healthy outcomes of pregnancy and child birth. Hence this study has been undertaken on one of the important aspect of services that is antenatal care services with the objective to assess the utilization of antenatal care services among JSY beneficiaries in rural area.Methods: Cross sectional observational study done in the area under rural health training centre of a private medical college of Pune district. 1st October 2014 to 30th September 2015. Study sample: All JSY beneficiaries who delivered during study period (1st October 2014 to 30th September 2015). One to one interview with the all 155 beneficiaries was conducted using the pretested, questionnaire. The interview was timed at minimum 6 week interval after the delivery. Data analysis was done by using SPSS 20.0 statistical software.Results: Majority 78 (50.3%) of beneficiaries out of 155 got registered themselves within 12 weeks of pregnancy. Antenatal coverage was quite good. Coverage of injection tetanus toxoid was 100% and all essential investigation have been carried out. Association between literacy level (up to higher secondary level) of beneficiaries and number of ANC visits was found statistically significant (p<0.001).Conclusions: In present study utilization of ANC services was found to be good.
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Background: India with 1.35 billion people is the second most populated country in the world next to China. Total fertility rate of India is 2.2 and the current total fertility rate of Jammu and Kashmir is 1.7 which is still lagging behind various states. This study was conducted to investigate the knowledge, attitude and practices of contraception in women of reproductive age in this set up.Methods: The present cross-sectional study was carried out in patients attending OPD (outpatient department) of Obstetrics and Gynecology at ASCOMS, Jammu, Jammu and Kashmir, India from 1st September 2017 to 31st August 2018. 200 married women aged between 18-49 years were included in this study. Socio-demographic characteristics of the women, their knowledge, attitude and practices on contraception were evaluated with the help of predesigned questionnaire.Results: Out of 200 women, maximum respondents belong to age group of 21-25 years (75.6%). Most of the contraceptive non-users belongs to age below 20 years (62.5%). Majority of respondents were Hindu (70.37%), maximum studied up to secondary level education (84.61%), 70.30% were housewives and 56.58% belongs to middle class. In 45% of respondents, media was the main source of information. Preferred spacing method was condom in 85% of cases. 68% women had knowledge of female sterilization. According to most women, family planning methods are meant for limitations of birth (43%) and 36% meant for spacing of birth. 80% women had positive attitude towards contraceptive usage. 50% experienced side effects with the use of contraceptives. The most common side effect was menstrual irregularities in 25% of cases. Most common reason for not using contraceptive methods among non-respondents were lack of knowledge in 50% of cases.Conclusions: The study showed that inspite of having good knowledge, utilization of contraceptives were less because of large family norm, religious myth, cultural and political barriers. Ignorance regarding use and side effects of various contraceptive methods is another reason for inadequate practice of family planning methods.
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Background: The objective of this study is to determine the trends of patients presenting in Obstetrics and Gynecology emergency department and to identify possible solutions.Methods: This retrospective hospital record-based study was conducted at Government Medical College Jammu, Jammu and Kashmir, India from the department of Gynecology and Obstetrics and comprised data of all patients presenting to the emergency department between 1st January 2018 to 31st December 2018. Patients were assessed in terms of demographic features, presenting complaints, admission types (urgent, non-urgent), referral from other hospitals or coming from home. The total number of patients admitted and the number of patients sent home was also recorded.Results: A total of 1,46,366 patients were analyzed retrospectively. Out of which 63,004 (43.05%) were send home from the OPD while 83,362 (56.95%) presented to the emergency department. Of them, 49,383 (59.24%) were discharged straight away from the ED after emergency treatment and care while 339,79 (40.76%) were admitted. Out of 339,79 patients, 24,932 (73.37%) stayed in the emergency whereas 9047 (26.63%) admitted into different wards for elective procedures. Majority of the patients 26,098 (89.92%) came from home and 2927 patients (10.08%) were referred from other hospitals. Labour pains 7833 (31.42%) was the most common presentation. Trauma was the reason for admission in 112 (0.45%) patients out of 29025. 971 (3.89%) patients presented with gynecological problems. 4093 (14.10%) patients presented with non-urgent indications. Rest of all patients presented with indications which were categorized as urgent and were admitted. All data was analysed using SPSS version 20.Conclusions: To reduce the overcrowding in the emergency department and improve quality of obstetrics and gynecological services, Inpatients and Outpatient departments at primary and secondary care levels need to be strengthened. Patients with non-urgent problems should be provided adequate care at primary and secondary health care centers.
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Background: Teaching methods used for lectures are mostly teacher-centered a nd not learner-centered. The meth-od used for lectures is mainly determined by the teacher as per his/her convenience. The students are never asked about the lecture method which helps them in better learning. This can lead to poor understanding by students which in turn may hamper the learning process. Objectives: To find out the perspectives of students & teachers about the use of different lecture methods. Methodology:Views & opinions of 488 medical students & 47 medical teachers of a medical college about different types of teaching methods namely Traditional (chalk and board), over head projector and power point presentation were collected in an observational study with the help of separate questionnaires. Results:Most of the students (51.6%) prefer traditional method for the lectures, 54.9% have better understanding with traditional method (p<0.05), 61.5% students feel that they can concentrate more with traditional method (p<0.05) while 58% students feel that it is easy to note down important points with the help of Power point presentation (p<0.05). Large proportion of teachers (78.7%) prefer Power point presentation for classroom teaching, 76.6% teachers are willing to change to other method of classroom teaching if required, 80.5% teachers would like to have their performance monitored for self evaluation & self improvement. Overhead projector is neither preferred by students nor teacher as a teaching tool. Conclusion: A combination of traditional and power point presentation is preferred by the students for a better teaching-learning process.
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Introduction: Treatment of patients with chronic hepatitis C (CHC) is difficult in the setting of end stage renal disease (ESRD). The present study aimed to analyze the treatment outcome in patients with CHC and ESRD, being evaluated for kidney transplantation. Methods: Data of 65 patients of ESRD with CHC (males: 53, mean age: 39.2±14.4 years) was analysed retrospectively. Patients were treated with either pegylated or conventional interferon (IFN) without ribavirin. Treatment response was assessed for rapid virological response (RVR), early virological response (EVR), end of treatment response (ETR) and sustained virological response (SVR). Results: All patients were receiving hemodialysis (duration 1-60 months). Sixteen patients (25%) (genotype 1: 11, genotype 3: 4, genotype 2: 1) agreed for treatment (13 pegylated IFN and 3 conventional IFN). RVR was achieved in 7 patients (44%) and out of 11 patients (69%) who achieved EVR, ETR was achieved in 7 (44%) patients. Seven patients (44%) dropped out during treatment (2 because of side effects). SVR could be demonstrated in one of 7 patients who achieved ETR (6 patients were lost to follow up after ETR). Conclusions: In our experience, dropouts before, during and after treatment are a major problem in patients with CHC and ESRD. Of those who complete treatment, around half of them are able to achieve the end of treatment response.
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Background: Child Turcotte Pugh (CTP) score and Model for End Stage Liver Disease (MELD) are used commonly to assess the prognosis of liver disease but the disadvantage of these static tests is their inability to identify the functional reserve of the liver. Among all quantitative liver function tests indocyanine green (ICG) clearance test is most widely used and has been used to determine operative risk before hepatectomy and to assess prognosis of patients with cirrhosis. Aim: To correlate indocyanine green (ICG) clearance test with MELD score in patients with cirrhosis of liver. Methods: Forty patients with cirrhosis of liver were included and divided into two groups according to their CTP scores. Group A had 20 patients with CTP class A and group B had 20 patients with CTP class B. After ICG injection, ICG retention at 15 minutes (ICGR15) and ICG clearance rate were calculated. Results: In group A, the mean ICGR15 was 32.86% + 6.4% while in group B it was 51.08% + 12.8% (p <0.001). ICG clearance rates were 4.3% + 2.8% and 3.5% + 3.8% per minute in group A and B respectively. MELD score had a strong positive correlation with ICGR15 but a negative correlation with ICG clearance rate. On ROC curve analysis, AUC for MELD was 0.805 vs. 0.88 for ICGR15 in assessing prognosis of patients with cirrhosis. The sensitivity and specificity of MELD score was 60% and 80% respectively while that of ICGR15 was 85% and 90% respectively. Conclusion: ICGR15 has a higher sensitivity and specificity than MELD score in assessing the prognosis of patients with cirrhosis of liver.
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The aim of the present work was to develop simple, shorter and effective HPLC method with UV detection (285nm) and subsequent validation for the content uniformity determination of Rabeprazole Sodium in marketed tablet samples. The method uses isocratic mobile phase of 0.1M sodium phosphate buffer (pH adjusted to 6.5 with sodium hydroxide solution) and acetonitrile 65:35 compositions on reverse phase Lichrosphere RP-100 C8 column. The RSD was observed to 0.21 percentage and linearity range of (LOQ) 0.025 – 150 percentage of label claim established with 0.9999 correlation, 8 different brands marketed samples were successfully analysed for content uniformity and compared the results with the USP and other guidelines for acceptance criteria. The developed method was found precise, linear, rugged and robust for validated parameters. The method can be used for assay and the content uniformity determination of Rabeprazole Sodium in its tablet dosage form.
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BACKGROUND: Low-risk human papillomavirus (HPV) infections are related to the genesis of various benign lesions. In an isolated report available, HPVs have been implicated in the causation of skin tags too. AIMS: The present study was designed to detect the existence of low-risk HPV types 6 and 11 in cutaneous soft fibromas (skin tag) in north Indians. METHODS: A total of 37 cases of skin tags from various sites were analyzed. Highly sensitive and comprehensive polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) assays were done for the detection of low-risk HPV types 6 and 11. RESULTS: The results revealed the presence of HPV DNA 6/11 in 48.6% of the skin tags examined by PCR-RFLP. CONCLUSION: This result corroborates the hypothesis that HPV plays a part in the etiology of benign lesions like cutaneous soft fibromas. The identification of HPV 6/11 in these lesions, which are benign proliferations of the skin, further expands the spectrum of HPV-linked lesions.
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Adolescente , Adulto , Anciano , ADN Viral/análisis , Electroforesis en Gel de Agar , Femenino , Papillomavirus Humano 11/genética , Papillomavirus Humano 6/genética , Humanos , India , Masculino , Reacción en Cadena de la Polimerasa , Polimorfismo de Longitud del Fragmento de Restricción , Proteínas Virales/genéticaRESUMEN
Primary testicular non-Hodgkin's lymphoma was first described as a clinical entity in 1866. It is a rare disease and accounts for 1 percent of all non-Hodgkin's lymphoma, 2 percent of all extranodal lymphomas and 5 percent of all testicular neoplasms. It is the most common testicular tumor in males between sixty and eighty years of age. Testicular non-Hodgkin's lymphoma is unique in its high incidence of bilateral involvement (8-38 percent), and it is also the most common bilateral testicular tumor. Testicular non-Hodgkin's lymphoma has a predilection for spreading to non-contiguous extranodal sites, especially the central nervous system. Advanced-stage disease is usually managed with doxorubicin-based chemotherapy. For early-stage disease, opinion is divided regarding systemic chemotherapy following orchidectomy. The high incidence of spreading, especially to the central nervous system, leads to advocacy of the use of central nervous system prophylaxis with intrathecal chemotherapy. Prospective multicenter trials incorporating a large number of patients may lead to better guidelines for optimal management of this subtype of non-Hodgkin's lymphoma.
O linfoma primário do testículo (LPT) foi descrito como uma entidade clínica pela primeira vez em 1866. É uma doença rara e corresponde a 1 por cento de todos os linfomas não-Hodgkin, 2 por cento de todos os linfomas extranodais e 5 por cento de todos as neoplasias testiculares. É o tumor testicular mais comum em homens entre 60 e 80 anos de idade. LPT é único em sua elevada incidência de envolvimento bilateral (8-38 por cento), sendo o tumor testicular bilateral mais comum. Tem uma predileção por disseminação para regiões extranodais não-contíguas, especialmente para o sistema nervoso central (SNC). Estágios avançados da doença são usualmente tratados com quimioterapia à base de doxorubicina. Para os estágios mais precoces, as opiniões são divergentes quanto à quimioterapia associada à orquiectomia. A alta prevalência de disseminação, especialmente para o SNC, sugere o uso de quimioterapia intratecal como profilaxia. Estudos prospectivos multicêntricos incluindo um grande número de pacientes poderiam resolver a questão com relação ao manejo deste subtipo de linfoma não-Hodgkin.