Impact of learning effect on reliability factors and global indices in visual field testing by standard automated perimetry in normal healthy subjects and primary open-angle glaucoma patients to obtain an accurate baseline perimetry chart

Purpose: To record and evaluate the reliability parameters (fixation loss (FL) %, false positive (FP) %) and global indices (mean sensitivity (MS), mean deviation (MD), pattern standard deviation in dB) in three visual field test sessions within two weeks to assess the learning effect in normal healthy subjects and POAG patients and comparison of learning effect gender wise and age wise in primary open?angle glaucoma (POAG) patients. Methods: This study was a prospective observational study. An oculus visual field testing was done and analyzed in 30 eyes of POAG patients and 30 eyes of normal healthy subjects in three visits. Results: There were 16 (53.3%) males and 14 (46.6%) females in the POAG group and 16 (53.33%) males and 14 (46.66%) females in the normal healthy subject group. A significant difference in data change between each visit in FL, FP, MD, MS was found though the difference was more pronounced in the second visit than in the third visit. The pattern standard deviation does not change significantly in subsequent visits in both groups. Gender wise and age wise no significant difference was found in the POAG group. Conclusion: Significant improvement in reliability parameters and global indices with each subsequent visit in both the POAG group and normal patients signifies the importance of learning effect on these parameters and the need to perform at least three tests to get the baseline perimetry chart, especially in POAG patients, while in normal subjects, second perimetric result can be accepted. It was also concluded that the learning effect is not influenced by age and gender.

Assessment of optic disk by disk damage likelihood scale staging using slit-lamp biomicroscopy and optical coherence tomography in diagnosing primary open-angle glaucoma

Purpose: The current study was aimed at assessment of optic disk by disk damage likelihood scale (DDLS) staging using slit?lamp biomicroscopy and optical coherence tomography (OCT) in diagnosing primary open?angle glaucoma (POAG) patients. Methods: This was a cross?sectional observational study of 106 POAG patients, which was conducted from April 2017 to April 2018. All patients underwent slit?lamp fundoscopy with a +78 D lens and high?definition (HD)?OCT, and the vertical cup disk ratios (VCDRs) were recorded. Disk size and neuroretinal rim assessment were done, and the disk was then staged using the recent version, which stages the optic nerve head (ONH) from 1 to 10 as read from the DDLS nomogram table. DDLS scores >5 indicate glaucomatous damage. Pearson coefficient was used to correlate the DDLS staging by slit?lamp biomicroscopy with best?corrected visual acuity (BCVA), intraocular pressure (IOP), disk size, and VCDR and VCDR, mean deviation, and DDLS staging by HD?OCT. Results: The mean age of the patients was 59.54 ± 6.61 years. The male: female ratio was 2:1. The mean IOP was 16.04 ± 1.97 mmHg, and BCVA was 0.72 ± 0.13 LogMAR units. The mean VCDR on 78 D slit?lamp biomicroscopy was 0.76 ± 0.09 (standard deviation [SD]) (range 0.1–0.77), whereas on HD?OCT, the mean VCDR was 0.81 ± 0.09 (SD) (range 0.07–0.81). The mean deviation on visual field testing in decibels was ?14.43 ± 3.31 (SD). The correlation coefficient between DDLS staging by slit?lamp biomicroscopy and DDLS staging by HD?OCT parameters was r = 0.96. Conclusion: There is a positive correlation between the DDLS system of optic disk evaluation on slit?lamp biomicroscopy and most of the HD?OCT evaluation parameters

Prevalence and Determinants of Early Childhood Caries among Children Enrolled in Anganwadi Centres in Bhilai of Central India: A Cross-Sectional Study

Introduction: Early childhood caries (ECC), which results in rapid involvement and progression of several teeth, is a growing concern in preschool children. It directly affects a child’s overall health and quality of life. Aim: To assess the prevalence and determinants of ECC among children enrolled in Anganwadi centres in Bhilai city of Chhattisgarh. Methodology: This descriptive cross?sectional study was conducted among 360 children enrolled in Anganwadi of Bhilai. An oral examination and findings were recorded in ‘dmft’ using the WHO oral health assessment form for children 2013. The mothers’ knowledge, attitude, and practice were determined by a professionally administered 10?item pre?tested short questionnaire with Cronbach’s alpha of 0.86. The data were compiled and analysed using Microsoft Excel vs. 2013 and Statistical Package of Social Science (IBM SPSS version 23; Chicago Inc., USA). Results: The prevalence of ECC was 25.83%, out of which 13.33% in boys and 12.50% in girls. Children of middle school?educated mothers have 35.48% ECC, followed by high school and primary school, that is, 24.73 and 23.66, respectively. Mothers who assisted the children in tooth brushing have less prevalence of ECC (8.15%) as compared to non?assisted (17.8%) (P = 0.044). Conclusion: Although mothers’ knowledge was appreciable regarding reasons for tooth decay, still 1/4th of the children were found to be affected by ECC. This necessitates the importance of regular/periodic screening campaigns for the children, implementing institutional preventive programmes, and referral for children to secondary/tertiary healthcare centres.

Age-related hearing loss and its association with central obesity: experience at a tertiary centre

Background: Presbycusis is a slow, progressive, age-related sensorineural hearing loss, which is insidious, slow, progressive and irreversible disease and usually affects high pitch sound. It can be associated with various factors. Obesity is such a modifiable factor and its independent role with age-related hearing loss needs to be explored.Methods: This is a prospective study carried out over a period of three years in department of otorhinolaryngology at study institute. It included 1000 cases with symmetrical sensorineural hearing loss.Results: Among obese cases, high frequency hearing loss was found in significantly large number of cases. The most common audiogram in both male and female was Abrupt high tone loss type, irrespective of presence or absence of obesity.Conclusions: Obesity is a modifiable factor which has a significant association with high frequency hearing loss among the elderly population.

Audit on results of tympanoplasty: experience at a tertiary centre

Background: Chronic otitis media can be associated with various extracranial and intracranial complications. It has led to rise in number of people living with discharging ear and reduced hearing.Methods: Authors have shared their 3 years’ experience of a single tertiary institute regarding disease burden and management and results. This is a retrospective study including 500 cases of mucosal type of chronic otitis media and underwent tympanoplasty at the study institute. Follow-up records were kept for at least 6 months.Results: Graft uptake rate after 6 months follow-up was 86.2%. Cartilage tympanoplasty was performed for revision cases and had good results. Average air-bone gap closure was 17 dB. It is a simple surgery which can be performed in day care OT without any significant intra-op or post-op complication.Conclusions: Surgical treatment is significantly useful to reduce the disease burden due to chronic otitis media.

Obstetrical outcome of pregnancy complicated with first trimester bleeding and subchorionic hematoma

Background: First trimester bleeding complicates around 20-27% of pregnancy. Objective of this study was to evaluate and compare the feto-maternal and pregnancy outcome in patients presenting with live pregnancy complicated with first trimester bleeding and subchorionic hematoma with those without subchorionic hematoma.Methods: In this prospective observational study, based on ultrasonography, live pregnancies were categorized into two groups, first group having first trimester bleeding with subchorionic hematoma and second with first trimester bleeding only without any hematoma. They were evaluated for the end outcome of pregnancy in terms of abortion and continuation. Continued pregnancies were evaluated for antenatal complications, delivery and intrapartum events along with fetal outcomes.Results: Outcome of pregnancies presenting with first trimester bleeding in terms of abortion was similar in both the groups, 22.8% and 21.5% with hematoma and without hematoma respectively. Incidence of preeclampsia was 11.4% and Fetal growth restriction was 7% in pregnancies with first trimester bleeding with hematoma and was significantly higher than those without hematoma which was 3.07% for preeclampsia and 3% for fetal growth restriction. Incidence of antepartum haemorrhage was higher in hematoma group but the result was not statistically significant. 20% pregnancies with first trimester bleeding with hematoma had preterm deliveries, while it was 7.7% in pregnancies without hematoma and the difference was statistically significant. Low birth weight had occurred in 20% of babies in first group of patients while 4.6% in second group, difference being statistically significant.Conclusions: We found that live pregnancies with first trimester bleeding and subchorionic hematoma were associated with similar risk of miscarriage and antepartum haemorrhage while increased risk of preeclampsia, fetal growth restrictions, preterm birth, non-reassuring fetal heart pattern, caesarean delivery and low birth weight baby when compared to patients with first trimester bleeding without subchorionic hematoma. There was no difference in 5 minutes Apgar score and the NICU admission in both the groups.

A systematic review of conventional and advanced approaches for the control of plant viruses

Viruses are the obligatory intracellular parasites infecting microbes, plants, animals, and humans. They aredead outside host cell but can take-over the host’s cell machinery as soon as they are into it. Several studies oninhibitor compounds have been done for animal viruses including those that are affecting humans, but thereis inadequacy in terms of research and literature for plant viruses that are responsible for losses in crop yieldand quality loss all across the globe. This could be focal point to study plant viruses, their transmission andpathogenicity, and to establish widely used, effective, and advanced approaches for their control. The purposeof this review is to discuss various approaches to control plant viruses that have been developed and applied tocombat plant viral infections. We have divided these approaches into two categories conventional (meristemtip culture, cryotherapy, thermotherapy, and chemotherapy) and advanced (nucleic acid-based approacheslike RNA Silencing, cross-protection, transgenic plants, gene pyramiding, and protein-protein interaction).Moreover, we have discussed and compared the principles, methodologies, advantages, and disadvantages ofeach technique. The approaches have been explored to promote their application in best suited way on variousplants to control viral diseases and to improve food crops quality with increase in production.

A realização do direito à saúde por meio da cobertura universal de saúde / Realizing right to health through universal health coverage

O reconhecimento do direito à saúde é um passo essencial para a promoção de avanços em termos de saúde pública e para que se alcancem elevados padrões de saúde física e mental na população.O direito à saúde na Índia é parte integrante do direito à vida, previsto no Artigo 19 da Constituição do país, mas não é reconhecido per se. A Cobertura Universal de Saúde tem como base os princípios de universalidade, equidade, empoderamento e integralidade dos cuidados em saúde. Com o objetivo de aprimorar o sistema de saúde e, assim, garantir o direito dos indianos à saúde,o Relatório sobre Cobertura Universal de Saúde na Índia faz recomendações em seis áreas: financiamento da saúde e proteção financeira; normas para os serviços de saúde; recursos humanos para a saúde; participação da comunidade e engajamento dos cidadãos; acesso a medicamentos, vacinas e tecnologia; e reforma administrativa e institucional. Este artigo tem o objetivo de delinear os caminhos pelos quais a Cobertura Universal de Saúde pode contribuir na realização do direito à saúde, e consequentemente dos direitos humanos, nos países em desenvolvimento.

Recognition of right to health is an essential step to work towards improvement of public health and to attain highest standard of physical and mental health of the people. Right tohealth in India is implicit part of right to life under Article 19 mentioned in the Constitution of India but is not recognized per se. Universal Health Coverage adopts rights based approach and principles of universality, equity, empowerment and comprehensiveness of care. The Universal Coverage Report of India makes recommendations in six identified areas to revamp the health systems in order to ensure right to health of Indians. These areas are:health financing and financial protection; health service norms; human resources for health; community participation and citizen engagement; access to medicines, vaccines and technology; management and institutional reforms. This paper attempts to determine the ways in which Universal Health Coverage can make a contribution in realizing right to health and thus human rights in developing countries.

Prevention of Hepatitis B-Knowledge and Practices Among Medical Students.

Background: Hepatitis B is the major infectious disease of mankind. It is the most common cause of chronic hepatitis, liver cirrhosis and hepato-cellular carcinoma world wide .The health professionals are at the most risk. Vaccination against Hepatitis B can prevent this deadly disease. This survey was conducted to assess the knowledge and status of Hepatitis B vaccination among the medical students of B.J. Medical College, Ahmedabad. Methods: A cross-sectional study was conducted among 150 medical students of II, III/I and III/II year .Pre-tested questionnaire were administered to 50 students of each semester. Data was analyzed using SPSS version 16.0. Results: 86.7 % of the medical students had correct knowledge about Hepatitis B virus, though only 66 % of II year students knew about the virus. Majority of the medical students had correct knowledge regarding mode of transmission however, the knowledge was found to be less among II year students. Only 20% of the II year students had the correct knowledge regarding Post Exposure Prophylaxis for hepatitis B. 29.3% of the medical students were not vaccinated for Hepatitis B. Conclusion: The present study concludes that there is a lack of awareness among the medical students entering into the profession about Hepatitis B, its route of transmission and modes of prevention .Similarly all the students were not vaccinated against Hepatitis B, which makes them vulnerable to the disease.