A survey on insight of blood donors during COVID pandemic in Southern India

ABSTRACT Introduction: Knowledge, Attitude and Practices (KAP) surveys prove beneficial to the transfusion services by providing an insight into the donors and, thus, aiding in mobilizing and retaining voluntary blood donors. We aim to study the knowledge, attitude and practices of donors towards blood donation in a pandemic setting. Methods: A cross-sectional observational study to assess the knowledge, attitude and practices of blood donors was conducted between June to and October 2020. Non-parametric tests (Mann - Whitney U and Kruskal - Wallis) were performed to evaluate the relation of knowledge, attitude and practices overall scores with age group, gender and history of blood donations (first us. repeat). The Chi-Square test/Fisher's Exact test was used to evaluate the differences in the distribution of Knowledge, Attitude and Practices items within the groups. Results: A total of 403 of 2,748 individuals who came for whole blood donation participated in the study. The mean age of the study population was 31.1years (SD ± 8.4 range: 18 - 58), with 75% of the donors donating for the first time. The fear of acquiring COVID-19 infection was perceived as a major reason for the eligible population not to donate. The overall knowledge, attitude and practice score among the donors was satisfactory, being 76.14%, with a significant association with age. The overall positive attitude and practices scores of blood donors were 85.48% and 78.04%, respectively. Conclusion: The KAP scores were satisfactory among the donors. Timely communication of the precautionary measures at blood centers to contain the spread of the COVID-19 infection and effective counseling would help in motivating and retaining blood donors.

Peering into the eye: A comprehensive look at ultrasound biomicroscopy (UBM) and its diagnostic value in anterior segment disorders

Background: Ultrasound biomicroscopy (UBM) is a noninvasive imaging modality that enables in?vivo visualization of the structures of the anterior segment of the eye. Unlike routine ophthalmic diagnostic ultrasound which uses frequencies of 5–10 MHz, UBM utilizes ultrasound frequencies in the range of 50–100 MHz. The high?frequency probes in UBM allows for higher resolution and better visualization of subsurface ocular structures, even in the presence of anatomic or pathological obscuration. UBM has qualitative as well as quantitative applications in various disorders affecting the anterior segment of the eye. Despite its huge importance, many clinicians lack in knowledge about the technique and its clinical usefulness. The current educational video aims to address this gap in knowledge by highlighting the technique and various clinical indications of UBM. Purpose: The purpose of this video is to demonstrate the technique of UBM and showcase its quantitative and qualitative implications and importance through various clinical cases. Synopsis: UBM is an imaging technique that assesses the depth of tissue structures by measuring the time delay of the returning ultrasound signal. This modality is capable of measuring the size of various structures within the eye, such as the cornea, iris, ciliary body, sclera, and the depth of the anterior and posterior chamber. To perform a UBM, a transducer is inserted into a specially designed eye cup filled with distilled water, creating a water bath environment. Axial and longitudinal scans can be performed in a similar fashion as in routine diagnostic B?scan ultrasound. Quantitative indications for UBM depicted in this video include measurements of corneal thickness, depth of the anterior chamber, and the width of the angle. The video also showcases how UBM can aid in the diagnosis and management of various anterior segment disorders like angle?closure glaucoma, plateau iris configuration, secondary glaucoma, and anterior uveitis with complicated cataract. Qualitative indications for UBM highlighted in this video include its role in intermediate uveitis, ocular hypotony, ocular surface tumors, cystic lesions of iris, and identifying the location and type of intraocular foreign bodies in the anterior segment based on the type of artifact seen. Additionally, the video shows the applications of UBM in scleral and episcleral pathologies. Highlights: This video will educate clinicians about the technique of UBM and showcase a bouquet of UBM findings in various case scenarios, helping one to better understand the potential of this modality in clinical practice.

Frontal osteomyelitis post-COVID-19 associated mucormycosis

Rhino-orbito-cerebral mucormycosis (ROCM) is the most commonly noted form of mucormycosis, which is the most common secondary fungal infection following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Osteomyelitis is one of the rare sequelae of ROCM, frontal osteomyelitis being the rarest. We present four patients of coronavirus disease 2019 (COVID-19)-associated mucormycosis, who presented with frontal bone osteomyelitis after being treated for ROCM surgically and medically. This is the first case series highlighting this complication in post–COVID-19 mucormycosis patients and needs utmost attention as it can be life-threatening and can cause extreme facial disfiguration. All four patients are alive with salvage of the affected globe and vision being preserved in one patient. If identified early, disfiguration of face and intracranial extension can be avoided.

Outcomes of lensectomy with glued intraocular lens and factors associated with failure in eyes with spherophakia and glaucoma

Purpose: To evaluate the outcomes of lensectomy with a glued intraocular lens (IOL) in spherophakic eyes with secondary glaucoma and assess factors associated with failure. Methods: We prospectively evaluated outcomes of lensectomy with glued IOL in 19 eyes with spherophakia and secondary glaucoma (intraocular pressure (IOP) ?22 mm Hg and/or glaucomatous optic disc damage) between 2016 and 2018. The vision, refractive error, IOP, antiglaucoma medications (AGMs), optic disc changes, need for glaucoma surgery, and complications were assessed. Success was defined as complete when IOP was ?5 and ?21 mmHg without AGMs; qualified success as similar IOP with up to 3 AGM; the need for >3AGM/additional surgery for IOP control was considered a failure. Results: Preoperatively, the median (interquartile range: IQR) age was 18 (13.5–30) years. IOP was 16 (14–22.5) mmHg on a median of 3 (2,3) AGMs. Median postoperative follow up was 27.7 months (11.9, 39.7). Postsurgery, most patients achieved emmetropia, with significantly decreased refractive error from a median spherical equivalent of ?12.5D to + 0.5D, P < 0.0002. The complete success probability was 47% (95% confidence intervals (CIs): 29–76%) at 3 months and was 21% (8 ? 50%) at 1 year and 3 years. The qualified success probability was 93% (82–100%) at 1 year, which reduced to 79% (60–100%) in 3 years. None of the eyes had any retinal complications. The higher number of preoperative AGM was found to be a significant risk factor (p < 0.02) for the failure of complete success. Conclusion: One?third of the eyes had IOP control without the need for AGM postlensectomy with glued IOL. Surgery resulted in significant improvement in visual acuity. The higher number of preoperative AGM was associated with poor glaucoma control after glued IOL surgery

Trends of humoral immune responses to heterologous antigenic exposure due to vaccination & omicron SARS-CoV-2 infection: Implications for boosting

Background & objectives: Vaccination and natural infection can both augment the immune responses against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but how omicron infection has affected the vaccine-induced and hybrid immunity is not well studied in Indian population. The present study was aimed to assess the durability and change in responses of humoral immunity with age, prior natural infection, vaccine type and duration with a minimum gap of six months post-two doses with either ChAdOx1 nCov-19 or BBV152 prior- and post-emergence of the omicron variant. Methods: A total of 1300 participants were included in this observational study between November 2021 and May 2022. Participants had completed at least six months after vaccination (2 doses) with either ChAdOx1 nCoV-19 or an inactivated whole virus vaccine BBV152. They were grouped according to their age (? or ?60 yr) and prior exposure of SARS-CoV-2 infection. Five hundred and sixteen of these participants were followed up after emergence of the Omicron variant. The main outcome was durability and augmentation of the humoral immune response as determined by anti-receptor-binding domain (RBD) immunoglobulin G (IgG) concentrations, anti-nucleocapsid antibodies and anti-omicron RBD antibodies. Live virus neutralization assay was conducted for neutralizing antibodies against four variants – ancestral, delta and omicron and omicron sublineage BA.5. Results: Before the omicron surge, serum anti-RBD IgG antibodies were detected in 87 per cent participants after a median gap of eight months from the second vaccine dose, with a median titre of 114 [interquartile range (IQR) 32, 302] BAU/ml. The levels increased to 594 (252, 1230) BAU/ml post- omicron surge (P<0.001) with 97 per cent participants having detectable antibodies, although only 40 had symptomatic infection during the omicron surge irrespective of vaccine type and previous history of infection. Those with prior natural infection and vaccination had higher anti-RBD IgG titre at baseline, which increased further [352 (IQR 131, 869) to 816 (IQR 383, 2001) BAU/ml] (P<0.001). The antibody levels remained elevated after a mean time gap of 10 months, although there was a decline of 41 per cent. The geometric mean titre was 452.54, 172.80, 83.1 and 76.99 against the ancestral, delta, omicron and omicron BA.5 variants in the live virus neutralization assay. Interpretation & conclusions: Anti-RBD IgG antibodies were detected in 85 per cent of participants after a median gap of eight months following the second vaccine dose. Omicron infection probably resulted in a substantial proportion of asymptomatic infection in the first four months in our study population and boosted the vaccine-induced humoral immune response, which declined but still remained durable over 10 months

Laboratory detection of bacterial pathogens and clinical and laboratory response of syndromic management in patients with cervical discharge: A retrospective study

Background: Cervical discharge as part of cervicitis and pelvic inflammatory disease is a cause of significant morbidity in sexually active women worldwide. Non-gonococcal and non- chlamydial bacterial pathogens are becoming more prevalent. Aims: This study aims to determine bacterial pathogens causing cervical discharge using culture and/or polymerase chain reaction and assess the clinical and laboratory response to the conventional syndromic kit regimen established by the World Health Organisation. Methods: A retrospective review of records of women with cervical discharge over one year period. Culture and/or polymerase chain reaction results of endocervical swabs of various bacterial pathogens at baseline and after four weeks of treatment with syndromic kit regimen were recorded. Results: A total of 70 case records were reviewed for clinical details, out of which results of bacterial culture and polymerase chain reaction were available for 67 cases. Infectious aetiology was found in 30 (44.7%) patients with Ureaplasma species being the most common organism isolated on culture (18, 26.8%) and polymerase chain reaction (25, 37.3%), respectively. Polymerase chain reaction for Chlamydia trachomatis and Mycoplasma hominis was positive in ten (14.9%) and four (6%) cases, respectively. None of the patients showed positive culture for Neisseria gonorrhoeae. Coinfection was seen in eight (11.9%) patients with the majority showing Chlamydia trachomatis and Ureaplasma spp. coinfection (five patients). Forty one cases (58.5%) received tab. cefixime 400 mg and tab. azithromycin one gram stat (kit 1), while 29 cases (43.3%) received tab. cefixime 400 mg stat, tab. metronidazole 400 mg and cap. doxycycline 100 mg, both twice daily for 14 days (kit 6). Minimal to no clinical improvement with treatment was seen in 14 out of 32 cases (44%) at the end of four weeks with the conventional kit regimen. Post-treatment culture and/or polymerase chain reaction were positive in nine out of 28 cases (32.1%) with Ureaplasma spp. being the most common. Limitations: Retrospective study design, small sample size and fewer cases with follow-up data were the main limitations. Conclusion: Ureaplasma spp. was the most common infectious cause of cervical discharge in our patients. Treatment given as part of syndromic management led to a clinical and microbiological response in around half and two-third cases, respectively.

An Incidental Finding Of Button Battery In The Nose Without Any Complication- A Case Report Of A Rare Presentation

Aim And Background-A foreign body in nose presents with unilateral purulent nasal discharge, nasal obstruction and nasal bleed.We present a case in which a button battery remained uncomplicated in the nasal cavity for a year. However, if it is found, it should be removed as early as possible. A 6-year-old female child presented with aCase Description – one-year history of foul-smelling, left-sided nasal discharge. During anterior rhinoscopy, a black, rigid mass was observed. A circular foreign object was found in the floor of the left nasal cavity during a CT (computed tomography) scan of the Nose and PNS (paranasal sinuses). General anesthesia was used during the diagnostic nasal endoscopy on the child. A foreign body was visualized and removed using a curved curette. The nasal mucosa was normal on follow-up, and there was no septal perforation. A detailed history, assessment and radiological examination plays aConclusion- key role in management of foreign bodies.We report that a button battery was left in the nose for a long time without causing any problems. There were no complications from an unnoticed button battery in theClinical Significance: nose for a year. However, if it is found, it should be removed.

Visual impairment and blindness due to retinitis pigmentosa in India: 15-year follow-up of the Andhra Pradesh Eye Disease Study cohort

Purpose: To assess the incidence, visual impairment, and blindness due to retinitis pigmentosa (RP) in a rural southern Indian cohort. Methods: This is a population?based longitudinal cohort study of participants with RP from the Andhra Pradesh Eye Disease Study (APEDS) cohorts I and III, respectively. The study included participants with RP of APEDS I who were followed until APEDS III. Their demographic data along with ocular features, fundus photographs, and visual fields (Humphrey) were collected. Descriptive statistics using mean ± standard deviation with interquartile range (IQR) were calculated. The main outcome measures were RP incidence, visual impairment, and blindness as per the World Health Organization (WHO) definitions. Results: At baseline (APEDS I), 7771 participants residing in three rural areas were examined. There were nine participants with RP with a mean age at baseline of 47.33 ± 10.89 years (IQR: 39–55). There was a male preponderance (6:3), and the mean best?corrected visual acuity (BCVA) of 18 eyes from nine participants with RP was 1.2 ± 0.72 logarithm of minimum angle of resolution (logMAR; IQR: 0.7–1.6). Over a mean follow?up duration of 15 years, 5395/7771 (69.4%) were re?examined, which included seven RP participants from APEDS 1. Additionally, two new participants with RP were identified; so, the overall incidence was 370/ million in 15 years (24.7/million per year). The mean BCVA of 14 eyes of seven participants with RP who were re?examined in APEDS III was 2.17 ± 0.56 logMAR (IQR: 1.8–2.6), and five of these seven participants with RP developed incident blindness during the follow?up period. Conclusion: RP is a prevalent disease in southern India that warrants appropriate strategies to prevent this condition.

The Evolution Of Legal Framework For The Prevention And Control Of Air Pollution

The concept of air pollution is not new, it has been in prevalence since time immemorial. The problem of air pollution precedes the history of mankind. It existed even before the birth of mankind but in a negligible form. After the birth of mankind, environmental pollution started increasing. In the process of growth of the human race from a simple-minded fruit and root gatherer, the hunter and the grower of food who worshipped nature in turn to a self-centered destroyer of nature and finally to the twenty-first-century human being which has in a sense becomes synonymous with deforestation, desertification and progress with pollution. In the present paper, the author has tried to cover the major incidents of air pollution across the world. The laws enforced from time to time to tackle this problem in various countries like the United States of America, European countries and India are also covered in the present paper.

Clinical profile, demographic distribution, and outcomes of ocular siderosis: Electronic medical record–driven big data analytics from an eye care network in India

Purpose: To describe the demographics, clinical profile, and outcomes of ocular siderosis in patients presenting to a multi?tier ophthalmology hospital network in India. Methods: This cross?sectional and hospital?based study included 3,082,727 new patients who presented between August 2010 and December 2021. Patients with a clinical diagnosis of ocular siderosis in at least one eye were included. Results: Overall, 58 eyes of 57 patients (0.002%) were diagnosed with ocular siderosis. The majority were men (96.49%) and had unilateral (98.25%) affliction. The most common age group at presentation was during the third decade of life with 24 patients (42.11%). A clear history of ocular trauma was documented in 47 patients (81.03%). Major clinical signs included corneal pigment deposition in nearly half of the eyes (27/58 eyes, 46.55%), corneal scar (20/58 eyes, 34.48%), cataract (22/58 eyes, 37.93%) and retinal detachment (11/58 eyes, 18.96%). The intraocular foreign body (IOFB) was anatomically localized in a majority of the eyes (i.e., 45/58 eyes, 77.59%). The most common location of the IOFB was in the posterior segment (22/58 eyes, 37.93%). The eyes that underwent a vitreoretinal surgery with removal of IOFB had a slightly better BCVA (1.0 ± 1.01) when compared to eyes with non?removal of IOFB (1.58 ± 1.00). Conclusion: Ocular siderosis is a rare sight?threatening entity, with half of the affected eyes exhibiting severe visual impairment. Majority of the eyes in ocular siderosis will have a detectable IOFB. Surgical removal of IOFB may lead to a better visual gain when compared to non?removal.

Quality of life in patients treated for COVID-19–associated mucormycosis at a tertiary care hospital

Objectives@#Coronavirus disease 2019 (COVID-19)–associated mucormycosis (CAM) has emerged as a formidable infection in patients with COVID-19. The aggressive management ofCAM affects quality of life (QOL); thus, this study was designed to assess the QOL in patients with CAM at a tertiary healthcare institution. @*Methods@#This cross-sectional study of 57 patients with CAM was conducted over 6 monthsusing a semi-structured standard questionnaire (the abbreviated World Health Organization Quality of Life questionnaire [WHO-BREF]) and a self-rated improvement (SRI) scale ranging from 0 to 9. Cut-off values of ≤52 and < 7 were considered to indicate poor QOL and poor improvement, respectively. The correlations of QOL and SRI scores were evaluated using Spearman rho values. @*Results@#In total, 27 patients (47.4%; 95% confidence interval [CI], 34.9%–60.1%) and 26 patients (45.6%; 95% CI, 33.4%–58.4%) had poor QOL and poor SRI scores, respectively. The overall median (interquartile range) QOL score was 52 (41–63). Headache (adjusted B, −12.3), localized facial puffiness (adjusted B , −16.4), facial discoloration (adjusted B, −23.4), loosening of teeth (adjusted B, −18.7), and facial palsy (adjusted B, −38.5) wer e significantly associated with the QOL score in patients with CAM. @*Conclusion@#Approximately 1 in 2 patients with CAM had poor QOL and poor improvement.Various CAM symptoms were associated with QOL in these patients. Early recognition is the key to optimal treatment, improved outcomes, and improved QOL in patients with CAM.

Clinical presentation and treatment outcomes of an algorithmic approach to uveal effusion syndrome

Purpose: To describe the clinical features and treatment outcomes in spontaneous uveal effusion syndrome (UES). Methods: A 10?year retrospective chart review of UES patients from a tertiary eye center was carried out. Optical coherence tomography (OCT), fundus fluorescein angiography, and ultrasound biomicroscopy (UBM) scans were performed. UES was managed based on presenting best?corrected visual acuity (BCVA), symptoms, and fundus findings. Patients with secondary causes of uveal effusion were excluded. Results: Twenty?five eyes of 16 patients were included. Of the 16 patients, 14 (88%) were male and 9 (56%) had bilateral disease. Fifteen of 25 affected eyes had nanophthalmos (axial length (AL) <20.5 mm) and 6 had hyperopia with AL >20.5 mm. The presenting mean distance BCVA was 0.74 ± 0.64 logMAR (mean Snellen: 20/100). Eleven eyes had exudative retinal detachment, and 4 also had exudative choroidal detachment (CD). Choroidal thickness (CT) was increased in 11 eyes on B?scan ultrasonography, and the mean CT was 1.74 ± 0.38 mm. Sub?retinal fluid (SRF) and retinal folds were the most common OCT findings. UBM findings included shallow angles, peripheral CD, and supra?ciliary effusion. A combination of local and systemic corticosteroids was used to successfully treat 12 eyes, 6 needed surgery, and 7 were observed. Partial sclerectomy with anterior chamber maintainer?assisted SRF drainage was the favored surgery. The median period of follow?up was 6.5 months (0.1–76 months), and the mean distance BCVA at the last follow?up was 0.58 ± 0.42 logMAR (mean Snellen: 20/80). Conclusion: UES can be suitably managed both medically and surgically based on clinical presentation

A Study On Customer Satisfaction Towards E-Banking Services With Special Reference To Axis Bank In Ramanathapuram Town

In traditional banking, the products and services handed by bank branches are not acceptable to meet the customer needs and solicitation. Customers are the king in any business. Every business should know the customer perception and satisfy their requirements. Customers are precipitously more demanding with precious services customized to their exact requirements, at least bring and instantly done. It is possible by the use of Information technology in banking sector. In Moment's script E-Banking service plays a vital part in attracting new customers and retaining old customers. Without e-banking service no banks can survive in this competitive banking business. E-Banking means the provision of information about a bank and its services through a home runner on the World Wide Web (WWW). E-Banking services give customer access to accounts, the capability to transfer their plutocrat between different accounts, and making payments or applying for loans through E- Channels. Electronic Banking is else called as Internet Banking or Virtual Banking or Online Banking or Web Banking. E – Banking is the medium and rearmost delivery channel to be offered by the retail banks. It handed number of benefits to customer in term of easy to use and at least cost of deals; it may be either through internet, telephone or other electronic delivery channels. Nationalization was a structural change in the performance of marketable banks which redounded in to the emergence of public sector banks. Privatization leads to the emergence of private sector banks and globalization which eased the entry of foreign banks in India. This super study helps to know the satisfaction position of customers towards e – banking services handed by Axis Bank in Ramanathapuram Town. Then E – Banking services includes ATM service, POS using benefit card and credit services, mobile banking and EFT etc.

Weeds infesting Wheat crop in Rohtak, Haryana

Multiple field visits were performed to investigate weed flora of wheat fields in Rohtak district of Haryana, conducted during 2018 which revealed infestation of 28 weed species comprising 15 families of grasses and broadleaf weeds. The weeds were identified with the help of available literature and through comparison with the already identified weed species. Poa annua, Polypogon monspeliensis and broadleaf weeds Chenopodium album, Rumex retroflex, Coronopus didymus were the pre-dominant weeds in moist region, whereas Cynodon dactylon, Fumaria parviflora, Chenopodium album, Polypogon monspeliensis in light soil with low salinity. There was a greater variety of weeds in Bohar and Kharawar villages and the least was found in village Sheria and Garnavati from vegetative to fully grown stage. Maximum number of species were of family Poaceae and Asteraceae. This study will be helpful as an additional tool in maintaining the floristic composition of District Rohtak as well as in controlling the weed problem

A Study of Serum Ferritin Level in Patients of Dengue Fever and Its Correlation with the Severity of Dengue Fever in Tertiary Care Hospital of South Gujarat

Introduction: In more than 100 endemic countries, there are 50 to 100 million new cases reported per year, according to the WHO. The dengue pandemic has caused significant death. There is usually only supportive care offered and no effective therapy. The purpose of the study was assess any effect on the level of serum ferritin in patients of dengue. Methodology: This was an observational, Prospective study conducted at Surat Municipal Institute of Medical Education and Research General Medicine department among dengue fever cases. Result: Serum ferritin level from on admission then on day 3 and then day 5 in non-severe and severe dengue cases showed p value <0.001 which was statically significant. Conclusion: The use of a serum ferritin level alone with a cut-off value of more than 900 ng/ml is indicated.

Patient perception and satisfaction with a smartphone-based teledermatology service initiated during the COVID-19 pandemic at a tertiary care hospital in North India

Background: Telemedicine is being increasingly used to provide healthcare to patients, particularly during the COVID-19 pandemic. Aims: The study aimed to study patient perception and satisfaction with a smartphone-based hybrid teledermatology service initiated during the COVID-19 pandemic. Methods: This was a cross-sectional telephonic survey including patients ?18 years of age who had received a teledermatology consultation. After noting the demographic, clinical and teleconsultation details, patients were administered the Telemedicine Satisfaction Questionnaire and an additional 6-item questionnaire. Patients were also asked to give qualitative feedback and suggestions for improvement using a semi-structured interview guide. Results: We interviewed 201 subjects. The most common diagnoses were pemphigus (27, 13.4%), superficial fungal infections (24, 11.8%), psoriasis (22, 10.9%) and dermatitis (21, 10.4%). The overall mean Telemedicine Satisfaction Questionnaire score was 4.20± 0.71. One hundred seventy-one (85.1%) patients responded that they would use teledermatology services again, while 168 (83.6%) reported satisfaction with the quality of services. A majority of the patients were largely satisfied with the various components involved, though some concerns were raised about the care perceived as not at par with physical consultations, difficulty in procuring medicines, lack of confidence in photographic diagnoses and the lack of a personal touch. Patients with urticaria (P=0.020), those who were advised a change in treatment (P=0.029) and those with improvement in their skin disease (P=0.026) were more likely to be satisfied. Limitations: Our study was conducted during the COVID-19 pandemic when patient acceptability was likely to be higher. Only follow-up patients were included in the study. Conclusion: Patient satisfaction levels were generally high with teledermatology. Addressing lacunae that negatively impact patient perception and satisfaction will help in greater acceptance of teledermatology services.

Effectiveness and future implications of COVID-19-related risk stratification for managing retinopathy of prematurity: The Indian twin cities retinopathy of prematurity study report number 10

Purpose: To evaluate the effectiveness and future implications of COVID?related risk stratification for managing retinopathy of prematurity (ROP). Methods: A prospective study was conducted at a tertiary eye care center from the beginning of the lockdown in India from 23 March 2020 till the end of the first phase of lockdown on 29 May 2020. We evaluated 200 prematurely born infants (< 34 weeks of gestational age) using the new safety guideline protocols for low?risk babies developed in conjunction with the Indian ROP Society for care during the COVID?19 pandemic. Low risk included babies born at more than 30 weeks of gestational age, post menstrual age 34 weeks or above at presentation, more than 1000 grams of birth weight, and stable systemically with good weight gain. Results: New guidelines were implemented in 106 (53%) infants who were low risk while 94 (47%) infants with high risk were followed up as per the old guidelines. Out of the 106 infants (212 eyes) managed by the new guidelines, good outcome (group 1) was seen in 102 (96.2%) infants. Twenty?seven of the 102 infants had some form of ROP and 5 of these infants needed treatment. None of the low?risk babies with no detachment at presentation managed by new guidelines required surgery later (group 2). Two (1.9%) infants came with retinal detachment at presentation and underwent successful surgery (group 3) and two infants (1.9%) were lost to follow up. Conclusion: New risk stratification during the COVID?19 pandemic was an efficient and safe strategy in managing low?risk ROP babies.

Comparative Evaluation of Push-Out Bond Strength of AH-Plus, MTA-Fillapex and Epiphany SE Root Canal Sealers: An Ex?Vivo Study

Background: A successful root canal (RC) treatment depends upon creation of a fluid impervious seal that is commonly built by using a RC sealer along with gutta?percha. The bond strength of the RC sealer is a hallmark as it will minimize the risk of treatment failure by reducing the possibility of filling detachment from dentin. Aim: To evaluate and compare the push?out bond strength of AH?Plus and MTA?Fillapex with Gutta?Percha and Epiphany Self Etch/Resilon system using the Universal Testing Machine. Materials and Method: About 60 mandibular premolars with single canals were prepared apically with Hyflex CM files upto size #30. Out of total, 20 teeth were obturated with AH?Plus/GP (group 1), 20 with MTA?Fillapex/GP (group 2), and other 20 with Epiphany Self Etch/Resilon system (group 3). Teeth were sectioned into three slices of 2 mm each and were subjected to Universal Testing Machine. Statistical Analysis: The data obtained were tabulated and statistically evaluated using SPSS version 21.0 statistical analysis software (IBM, Chicago, Illinois, USA). Results: The mean push?out bond strength was highest for AH–Plus (14.32 MPa) followed by MTA?Fillapex (12.18 MPa) and then Epiphany SE (8.44 MPa). The results were statistically significant. Conclusion: Significantly, higher push out bond strength was displayed by AH?Plus sealer than MTA?Fillapex and least being Epiphany SE sealer. The push out bond strength was significantly highest at apical third and lowest at coronal third

Clinical evaluation of bioactive resin-modified glass ionomer and giomer in restoring primary molars A randomized, parallel-group, and split-mouth controlled clinical study

Aim: This study aims to evaluate and compare the clinical performance of two restorative materials – bioactive resin-modified glass ionomer (ACTIVA BioACTIVE restorative) and giomer hybrid composite (Beautifil Flow Plus) in restoring class I carious primary molars. Materials and Methods: The split-mouth randomized controlled study was conducted on 100 primary molars from 50 children (28 – males, 22 – females) from 50 children in age range of 5-9 years (Mean-7.29±1.34) with at least two occlusal carious lesions on either maxillary or mandibular primary molars. Each child had both the control and the experimental teeth restored with respective restorative materials, Group I (Control, n = 50) ? Giomer, Group II (Experimental, n = 50) ? Bioactive resin-modified glass ionomer. The restorations were evaluated by two independent investigators using modified United State Public Health Service criteria at immediate postoperative, 6 months, and 12 months. The Chi-square test was used for the statistical analysis after collecting the data. Results: At the 12-month follow-up, 33 children (66 teeth) reported with an attrition rate of 33%. The color match between the groups was not statistically significant at all intervals. The marginal discoloration, marginal integrity, anatomic form, and retention had no significant difference at 6 months. But at 12 months, there was a statistically significant difference between the groups with p value of 0.04,<0.001,<0.02 and <0.001 respectively. respectively. At 12 months, there was no postoperative sensitivity in both groups. Conclusion: Bioactive resin-modified glass ionomer with enhanced properties can be used as an effective restorative material, especially in children with excessive salivation.