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Introduction: Cancer is a disease that emerges as a result of abnormal cell proliferation and their propensity to spread from one bodily region to another. There are over a hundred different types of cancer that impact individuals all over the world. It is difficult to identify in the early stages, but there are certain warning signals that the cells will turn malignant. Quality of life (QOL) is described by the World Health Organisation as "individuals' perception of life, values, objectives, standards, and interests within the cultural framework of the social environment in which they live and in relation to their goals, expectations, standards, and concerns." QOL assessment in health system is a multidimensional construct that can be measured by evaluating objective levels of health status filtered by the subjective perceptions and expectations of the individual. Aim and Objective: To assess socio-demographic factors and quality of life among cancer patients in tertiary care hospital. Materials and Methods: A hospital-based prospective observational study was conducted at Guru Gobind Singh Medical College and Hospital Faridkot district, Punjab (India). The study was conducted for a period of six months after getting approval from Institutional Ethical Committee (IEC). Generic instrument, SF-36 was used to assess the QOL. The study was analyzed on SPSS version 26.0 software. Descriptive and analytical analysis was used to describe the results. Results: Linear regression was conducted to see the relationship of physical functioning score with age and weight of the patients. The descriptive statistics shows the mean and standard deviation of the variable. The mean of physical functioning score was found to be (M = 27.82, SD = 15.635). The physical functioning score and age, weight of the patients in linear regression shows that the age and weight explain 17.5% Conclusion: Treatment revealed that severe and moderate activities restricted nearly half of the assessed patients, with body pain interfering with employment and routine activities. According to the findings of the current study, QOL deteriorates as the disease progresses. Cancer unquestionably has a detrimental influence on patients' quality of life, which is connected to the illness process itself, the therapy administered, and the length of the disease. (AU)
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Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Qualidade de Vida , Inquéritos e Questionários , Perfil de Saúde , NeoplasiasRESUMO
Background: Ovarian cancer is a leading cause of death from gynecological cancer in the world and in India. This study aims to evaluate the efficacy and toxicity profile of oral metronomic chemotherapy (MCT) in the form of etoposide, cyclophosphamide, and tamoxifen in recurrent and metastatic ovarian cancer. Methods: This was a retrospective observational study that included those post?treatment patients who had the recurrent or metastatic disease after completion of treatment in 2018 at Regional Cancer Centre, Bikaner, Rajasthan. Forty patients who were unfit for further intensive intravenous chemotherapy were included. The oral MCT constituted etoposide, cyclophosphamide, and tamoxifen. Descriptive statistics and Kaplan?Meier analyses were performed. Progression?free survival (PFS) and overall survival (OS) were assessed. Results: Forty women with a median age of 62 (range: 35?80) years were enrolled in the study to receive oral MCT. The Eastern Cooperative Oncology Group?Performance Status (ECOG?PS) was 0�in 28 patients and 2�in 12 patients. The best clinical response rate post?oral MCT was seen in the first 4 months. Objective response was observed in 24 (60%) of patients in the form of stable disease (19, 47.5%) and partial response (5, 12.5%). Disease progression was observed in 10 (25%) of patients. The median follow?up was 6.4 months (4.5�2 months). The median estimated OS was 6.5 months. The median estimated PFS was 3.7 months. Nineteen (47.5%) patients had grade?I/II mucositis. Grade?III/IV mucositis were observed in 9 (22.5%) patients. Thirty?seven (92.5%) patients died at the end of the study at 1 year. Dose reduction was required in 15 (37.5%) patients. Conclusion: Oral MCT was found to be an effective and well?tolerated regime with good symptomatic control and low?moderate toxicity profile in patients with relapsed and metastatic ovarian cancer. However, 22% of patients showed grade?III/IV thrombocytopenia.
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Background: Tooth stains on the front teeth are a common esthetic issue caused by tooth discoloration. Good oral hygiene habits, such as brushing your teeth twice daily with fluoride toothpaste and after meals, flossing daily, and using a whitening toothpaste, can help reduce staining and prevent cavities. Material & Methods: Many in-vitro studies has conducted to develop Dente91 Anti-Stain Toothpaste that can help in resolving the issue of demineralization, hypersensitivity, microbial strains, plaque, dental caries/tooth decay, and dental stain more effectively than other marketed products. Its composition includes ingredients such as Sodium Hexametaphosphate (SHMP), Polyvinylpyrrolidone (PVP), Tetrasodium Pyrophosphate, Covarine Blue, Zinc Citrate, Potassium Citrate, and Xylitol. Results: DENTE91 Anti-Stain toothpaste has over 99.9% significant antimicrobial efficacy and effectively reduces demineralization while enhancing the remineralization process. It also provides protection against acid attacks, promotes cell proliferation in NIH/3T3 cells, and shows significant healing activity on dental cavities. Additionally, it has the ability to occlude dentine disc lesions and reduce hypersensitivity. The findings of this study suggest that the toothpaste after using it twice a day for three days removes 63.02 % stains and also shows 80.33% improvement in teeth whitening from baseline.Conclusion: These in-vitro studies of dente91 anti-stain toothpaste concluded that toothpaste helps in resolving demineralization, hypersensitivity, plaque, dental caries/tooth decay, and dental stains. It has antimicrobial activity and teeth whitening effect too
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We report two adult cases of abducens nerve palsy presenting immediately (within weeks) after they received the first dose of Covishield vaccination. Magnetic resonance imaging (MRI) of the brain obtained after the onset of diplopia demonstrated demyelinating changes. The patients had associated systemic symptoms. Post-vaccination demyelination typically known as acute disseminated encephalomyelitis (ADEM) associated with several vaccines is more common in children. Although the mechanism of the nerve palsy remains unclear, it is suspected to be related to the post-vaccine neuroinflammatory syndrome. Cranial nerve palsies and ADEM-like presentations may represent part of the neurologic spectrum following COVID-vaccination in adults, and ophthalmologists should be aware of these sequelae. Although cases of sixth nerve palsy following COVID vaccination are already reported, associated MRI changes have not been reported from India.
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Purpose: Dry eye syndrome (DES) is a global issue occurring due to tear deficiency or excessive tear evaporation. It is associated with a variety of symptoms causing ocular discomfort. The purpose of the study was to evaluate causative factors, treatment modalities, quality of life, and preservatives used in eye drops. Methods: This prospective, follow?up study was conducted in the ophthalmology outpatient department of a tertiary care teaching hospital. Patients older than 18 years of age of either sex diagnosed with DES and willing to give written informed consent were included. The patients were subjected to the Ocular surface disease index Questionnaire (OSDI Questionnaire) twice; at the time of the first visit and at 15 days follow?up. Results: A male preponderance was observed with a 1.86:1 male?to?female ratio. The mean age of the study population was 29.15 ± 10.07 years. The most common presenting complaints were symptoms related to dryness of the eyes followed by refractive error. Exposure to TV/computer screen for more than 6 hours is the most common causative factor. There was a statistically significant improvement in overall quality of life (QoL) in patients of DES on treatment. However, no significant difference was seen in the improvement of quality of life in comparison with different preservatives used in prescribed eye drops for the treatment of DES. Conclusion: DES can adversely affect the quality of life of patients. Prompt treatment of this condition can significantly improve the patient’s QoL. Physicians should be encouraged to perform quality of life evaluations for patients with DES to guide them in treatment with more individual?specific treatment options.
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Purpose: To investigate the prognostic factors for visual outcome in patients undergoing immediate pars plana vitrectomy (PPV) for posteriorly dislocated lens fragments during phacoemulsification surgery. Methods: This was a single?center, retrospective, cross?sectional study of 37 eyes of 37 patients undergoing immediate PPV for posteriorly dislocated lens fragments from 2015 to 2021. The primary outcome measure was changes in the best?corrected visual acuity (BCVA). Additionally, we analyzed the predictive factors for poor visual outcomes (BCVA <20/40) and perioperative complications. Results: The mean (±standard deviation [SD]) age of the patients was 66.57 (±10.86) years, with an almost identical gender profile (M: F = 18/19 [48.64%:51.36%]). The median (interquartile range [IQR]) log of minimum angle of resolution (logMAR) BCVA improved significantly from the baseline (1 [0.6–1.48], ~20/200) to the final visit (0.3 [0.2–0.6], ~20/40) (P < 0.0001) after a mean (±SD) follow?up of 6.35 (±6.32) months. The final BCVA was 20/40 or better in 59.5% of the eyes. Poor final BCVA (<20/40) was associated with small preoperative pupillary size (P = 0.02), presence of preoperative ocular pathology (P = 0.02) including uveitis, glaucoma, and clinically significant macular edema (CSME), intraoperative displacement of >50% of lens matter into the vitreous (P < 0.001), use of iris?claw lens (P < 0.001), and postoperative cystoid macular edema (CME; P = 0.007). The postoperative complications included CME (13.51%), retinal detachment (10.81%), chronic uveitis (8.11%), glaucoma (8.11%), iritis (2.7%), posterior chamber IOL (PCIOL) dislocation (2.7%), and vitreous hemorrhage (2.7%). Conclusion: For retained lens fragments in complicated phacoemulsification surgery, immediate PPV is a viable approach with the potential for a good visual outcome. The important predictors for poor visual outcomes include a small preoperative pupil size, preexisting ocular pathology, displacement of significant volume of lens matter (>50%), use of an iris?claw lens, and CME.
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Purpose: To determine the pattern of pediatric ocular morbidities in western India. Methods: This was a retrospective longitudinal study that included all consecutive children aged ?15 years who presented to the outpatient department of a tertiary eye center for the first time. Patient demographics, best?corrected visual acuity (BCVA), and ocular examination data were compiled. Subgroup analysis was also performed based on age group (years): ?5, 5–10, and >10–15. Results: A total of 11,126 eyes of 5563 children were included in the study. The mean age of the study population was 5.15 (±3.32) years with males (57.07%) being predominant. Approximately half of the patients (50.19%) were under the age of 5 years, followed by those aged 5–10 years (45.1%) and >10–15 years (4.71%). Among the study eyes, the BCVA was ?20/60 in 58.57%, indeterminable in 35.16%, and <20/60 in 6.71%. The commonest ocular morbidity noted was refractive error (28.97%) followed by allergic conjunctivitis (7.64%) and strabismus (4.95%) in the total study cohort and also after age stratification. Conclusion: Refractive error, allergic conjunctivitis, and strabismus are the major causes of ocular morbidity in pediatric eyes at a tertiary care center. Planning screening programs at the regional and national levels is crucial to decreasing the burden of eye disorders. These programs also need to have a suitable referral mechanism established and be smoothly connected to primary and secondary health?care centers. This will help to assure quality eye care delivery, while also reducing the strain of overworked tertiary centers.
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Purpose: The study intends to evaluate the demographic and clinical profile of pediatric patients (0–18 years) attending six vision centers (VCs) of a tertiary eye care facility in south India. Methods: This is a cross?sectional observation study conducted at six major peripheral VCs of a tertiary eye care facility in South India from June 20 to Dec 20. All children presenting at the VCs under a base hospital (BH) in Pondicherry, whose parents gave consent were included. Data were entered by the ophthalmic assistants in the VC and cross checked by the principal investigator at the BH. Results: A total of 250 pediatric patients were brought to the VCs during the study period, predominantly males (60.8%), with a mean age of 8.2 ± 4.5 years (0– 18 years). Half of them were staying within 5 km from the VCs. Most children were escorted by their parents (88%), and the expenditure of travel to the VC was affordable for most of the parents (75%). Also, 53.6% of patients were in their primary school, while schooling had not started for 28% of children. Visual acuity (VA) could be assessed only for school?going children and older children due to lack of age?matched VA assessment tools. Most children (91.3%) had uncorrected VA better than or equal to 6/18 in the better eye, and approximately 3% had VA worse than 6/60. All patients had best corrected VA of 6/6–6/18 after cycloplegic refraction. Most children reported to the VC for allergic conjunctivitis (25%), followed by refractive error (13%) and squint (10.4%). Urgent referral to the BH was made for 47 children. Conclusion: Primary eye care in pediatric population?I (PREPP?I) showed that most children can be treated at the VCs and only one?fifth of the children require active intervention at higher referral centers. Further study on satisfaction of services provided for pediatric patients in these VCs and barriers of not reporting to the BH when referred are considered for the PREPP?II study
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The implementation of digital payment mechanism has changed the basics of money payment as a medium of exchange. The revolutionary changes that happened in the Information Communication Technology (ICT) has paved the way for drastic changes in various spheres of activities such as government to citizens government to business government to government government to employee and government to foreign trade. In line with the developments that have been taking place across the world in Electronic Payment System (EPS) changes have taken place in the UAE also. The rulers of the country are keen in establishing a high-tech oriented EPS system supported by the platform of knowledge management (KM) system. The study is an effort to explore various dimensions of EPS such as security speed ease of payment convenience and control and its importance in generating various bene?ts to the stakeholders in the form of value driven bene?ts citizen driven bene?ts economic cost driven bene?ts and technology driven bene?ts. The study attempts to ?nd out the relationship between various dimensions of EPS on stakeholders bene?t in the UAE.
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Introduction: Hip fractures in the elderly have represented a major public health concern. Studies have shown that over 90% of the patients having these fractures are people of more than 50 years. These fractures have been classified according to their anatomical location into the neck of femur fracture, intertrochanteric fracture, and subtrochanteric fracture. The neck of femur fractures is associated with high mortality in the elderly compared to young adults. Surgical treatment is an established gold standard, with the option being osteosynthesis and hip replacement. Hemiarthroplasty is one of the gold-standard treatments chosen for the geriatric age group and has yielded universally acceptable results. Materials and Methods: The study evaluates the clinical, radiological, and functional outcomes of hip hemiarthroplasty in elderly with fracture neck of the femur Data of patients above 60 years who were operated on for fracture neck of the femur by bipolar hemiarthroplasty from May 2018 till December 2021were retrieved from the Medical Records Department of SCL Municipal General Hospital, affiliated to NHL Municipal medical college. The patients fitting the inclusion criteria were selected for the study. The sample size was calculated to be 43. Data were collected from the inpatient files, and then patients were asked to complete the questionnaire form during the final follow- up. All the patients were evaluated clinically and radiologically during the follow-up, and the functional outcome was assessed using the Harris Hip Score. Thirty-five patients had a domestic fall as the mode of injury. The lateral decubitus position of all patients was used during the operation that was performed using the Southern Moore approach. Forty patients received cemented femoral stems; the remaining three received press-fit ones. Results: The average age was calculated to be 71.86 years with the male-to-female ratio of 1: 1.15 with an average follow-up of 12.7 months. Eight patients had acetabular erosion at the end of 1 year. There was no femoral stem malalignment or aseptic loosening at the final follow-up. Nine patients had excellent Harris Hip scores, and five had fair scores. The remaining 29 patients had good Harris hip scores. Bipolar hemiarthroplasty has served us well in the study. Forty-one patients were able to get back to their preinjury functional level. Only one patient reported major pain in the hip at the final follow-up. In this study, there was no incidence of dislocation or revision surgeries. Conclusion: The present study modular bipolar hemiarthroplasty provides better pain relief with early mobilization and a good level of return to daily routine activities with minimal complications.
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Background@#and Purpose New studies have shown that endovascular thrombectomy (EVT) is safe and effective for acute ischemic stroke (AIS) patients with large ischemic areas. The aim of our study is to conduct a living systematic review and meta-analysis of randomized trials comparing EVT versus medical management only. @*Methods@#We searched MEDLINE, Embase, and the Cochrane Library to identify randomized controlled trials (RCTs) comparing EVT versus medical management alone in AIS patients with large ischemic regions. We conducted our meta-analysis using fixed-effect models to compare functional independence, mortality, and symptomatic intracranial hemorrhage (sICH) between EVT and standard medical management only. We assessed the risk of bias using the Cochrane risk-of-bias tool and the certainty of evidence for each outcome using the Grading of Recommendations, Assessment, Development, and Evaluations approach. @*Results@#Of 14,513 citations, we included 3 RCTs with a total of 1,010 participants. We found low-certainty evidence of possibly a large increase in the proportion of patients with functional independence (risk difference [RD] 30.3%, 95% CI 15.0% to 52.3%), low-certainty evidence of possibly a small non-significant decrease in mortality (RD -0.7%, 95% CI -3.8% to 3.5%), and low-certainty evidence of possibly a small non-significant increase in sICH (RD 3.1%, 95% CI -0.3% to 9.8%) for AIS patients with large infarcts who underwent EVT compared to medical management only. @*Conclusion@#Low-certainty evidence shows that there is possibly a large increase in functional independence, a small non-significant decrease in mortality, and a small non-significant increase in sICH amongst AIS patients with large infarcts undergoing EVT compared to medical management only.
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COVID-19 is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It commonly affects the respiratory system, producing pneumonia-like symptoms. Among extrapulmonary manifestations, involvement of the gastrointestinal tract is common with symptoms of nausea, vomiting, diarrhea, and abdominal pain. Coronavirus acts by targeting the ACE-2 receptors in the alveoli of the lungs, but because these receptors are also present in other organs, such as the pancreas, it can affect the pancreas as well, thus causing acute pancreatitis. We here discuss a case of a 72-year-old hypertensive male with COVID-19 who presented with atypical presentation of acute abdominal pain and a few episodes of vomiting. Laboratory investigations were inconclusive. Imaging findings were suggestive of small bowel obstruction and perforation; thus, an exploratory laparotomy was done in which a mesenteric growth was found, reported as acute pancreatitis on histopathology. Therefore, attention should be paid to the pancreatic involvement and atypical presentations in COVID-19 patients.
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Introduction :Birth weight is one of the most important criteria for determining neonatal and infant survival and is considered a sensitive index of the nation's health and development. The World Health Organization (WHO) defines low birth weight (LBW) as “Birth weight less than 2500 grams” regardless of gestational age, the measurement being taken preferably within the first hour of life. 1)ToObjectives : estimate the prevalence of LBW among sample population at tertiary care hospital. 2)To study the distribution of newborns, according to socio-demographic characteristics of the mother and its association with LBW. A hospital based cross-sectional study was carried out among 500 newborns betweenMethod: December 2020 and November 2021. Participants were selected by systematic random sampling technique. The data were collected from the case file and face-to-face interview. Both descriptive and inferential statistics were used in the analysis. Prevalence of low birth weight was 29.2%. Majority 271Results: (54.2%) of newborn mothers' age group was between 21 to 25 years. More than half 272 (54.4%) newborns were from mothers who studied up to primary level education and more than three forth 389 (77.8%) were from mothers who were housewives. Majority 293 (58.6%) of newborns were from the urban area, around three forth 382 (76.4%) newborns were Hindu and nearly two fifth 194 (38.8%) newborns belonged to lower middle class. Prevalence of low birth weight was significantly higher in mothers aged >35 andyears ?20 , who were illiterate, doing labour work and belonging to lower socio-economic class.years Conclusion: The prevalence of Low Birth Weight was 29.2% among sample population. Socio-demographic variables like maternal age >35 years 20 years, illiteracy, labour work and lower socio-economic class, ? had shown significant risk for delivering Low Birth Weight babies.
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Introduction: Lumbar spine pathology is major healthcare burden encountered in district and urban hospitals. Diagnostic imaging in these patients is not always indicated. Imaging is considered in those patients who show little or no improvement in their LBP after approximately six weeks of medical management with or without physical therapy, the current study was undertaken to assess the appropriateness of LBP imaging in primary care following the ACP guidelines. The inclusion criteria for the study were adult patients with persistent low back pain with orMethod: without radiculopathy post six weeks of medical management affecting their activity of daily living. And the exclusion criteria were spinal trauma , neurological impairment, bladder and bowel involvement, spinal malformations, history of malignancy presenting at the time of index visit. The study included total 115 patients. Out of 115 patients 87Result: [70%] patients showed abnormal finding on the radiographs. The most common abnormal finding was disco vertebral degeneration such as spondylosis (osteophyte formation) in 49.6%. Routine x-ray imaging in low backConclusion: pain patients is not always warranted. Moreover routine radiological imaging methods are not associated with meaningful clinical outcomes for the patients. Unnecessary imaging can lead to harmful radiation exposure of the patients and can further lead to additional medical expenditure and needless surgical intervention. Diagnostic radiological imaging should be used judicially.
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Introduction : Rashtriya Bal Swasthya Karyakram (RBSK) is a systemic approach of 4‘D’s (Defect, Diseases, Deficiency, Developmental delay) for early identification and linkage with care, support and treatment. (1) Document utilization of RBSK services within a year of referral, (2) Assess reasonsObjectives : for non-utilization of services and (3) Assess out of pocket expenditure (OOPE) among users and non-users of the program. Retrospective Cohort Study was conducted at an Urban Health Centre (UHC) takingMethod: two cohorts of children referred for 4‘D’s during April 2018-March 2020 under RBSK. A total of 102 cases were sampled. Probability Proportionate to size (PPS) method was used to ensure proportionate representation of each of 4‘D’s in the sample. Required number of participants in each category were selected randomly. Out of 102 sampled cases, 97 were covered. Utilization of services was 50.5%; majorResults: reasons for non-utilization were preference for private providers and reluctance to stay at Comprehensive Malnutrition Treatment Centre (CMTC). Mean OOPE in users was Rs. 21545, significantly less (p <.05) than Rs. 70198 in non-users. After referral by RBSK team, only half utilized the services. Among users,Conclusion: OOPE was less for total cost incurred and also for direct cost incurred like consultation charges, medicines, consumables etc. Counselling those parents whose children are detected with any of 4Ds, to visit Child Malnutrition Treatment Center (CMTC)/ District Early Intervention Center (DEIC) remains a challenge.
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Background & Objective: Umbilical cord length and number of loops around fetal neck leadsto intrapartum complication which can predict by antenatal screening.This study was carried out to find the effect of length of umbilical cord on intrapartumcomplication, mode of delivery, perinatal outcome.Methods: This is a prospective study conducted at NHL MMC from August 2020 to July 2021.Total 300 cases were taken. Antenatal ultrasound carried out to screen nucle cord and afterdelivery number of loops were noticed and APGAR score noted.Results: Out of 300 cases 5 case were <35 cm and 2 cases >102 cm ,97 cases were 66-75cm.86% had medium cord length, 8.67% had long, 5.3% short cord length. 11.5% case with longcase had IUFD. 85.7% with 3 loops delivered by cesarean section.Conclusion: Increase umbilical cord length and loop associated with complication like fetalheart rate variation, fetal asphyxia, increase cesarean rate. Intrapartum fetal monitoring avoidsperinatal morbidity and mortality.
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India's “National Policy on older persons” classifies 60 years and above as aged who will constitute 10% of the total population by 2021. It is estimated that depression affects approximately 350 million people worldwide. An increasing geriatric population is associated with rising prevalence of chronic non-communicable diseases; therefore, the magnitude of depression is also expected to grow. Keeping the above background in mind, the present study will be conducted among elderly to determine the prevalence of depression. A cross sectional study was carried among 685 elderly people selected by Cluster Sampling and contacted through house to house survey in urban, rural and tribal areas of Chhattisgarh using a pre designed structured questionnaire i.e. Geriatric depression scale. It was found that 11.8% subjects were having depression, 25.1% were suggestive of depression and 63.1% subjects were not having any depressive symptoms. It is concluded that depression is prevalent among elderly persons residing in tribal area therefore it needs to be identified at an early stage, so that proper interventions can be started at the primary care level to ensure healthy ageing.
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Purpose: This study was done to evaluate the clinical profile in pediatric patients (0–16 years) presenting with acute onset esotropia due to sixth nerve palsy and its management options in a tertiary care set up of Southern India. Methods: A total of 12 patients presenting to our OPD with acute onset esotropia due to sixth nerve palsies were included in this retrospective study. All patients were observed for 6 months and managed with prism and/or patching while waiting for spontaneous resolution and later managed surgically. Neuroimaging was done in all cases. Results: The mean deviation of esotropia at presentation was 30.17 ± 5.7 Prism Diopter (range 12–50 Prism Diopter 95% CI, SD 10.11). Mean age of the patients during presentation was 8.6 ± 2.4 years (range: 1–15 years, SD 4.27). Among the common causes of sixth nerve palsy in our study population were trauma and idiopathic intracranial hypertension followed by tumor and miscellaneous causes. Only three patients underwent surgical correction of residual deviation after a waiting period of 6 months for self?resolution. Spontaneous resolution was observed in 41.6% patients, and surgical correction (unilateral resection–recession) was done in 25% of the patients with good surgical outcome. Conclusion: At 1?year follow up, the motor outcome was satisfactory except for one patient who had diffuse pontine glioma and had worsening neurological symptoms on follow?up
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Introduction: Determination of difference between conventional and passive self?ligating brackets (SLBs) in respect of extraction space closure, patient perception and root resorption. Material and Methods: Eighty patients were divided into four groups of 20 each with age?sex?matched control using a simple randomisation technique and allocation concealment with a closed opaque envelope method. Group 1 consisted of conventional brackets with Connecticut New Archwire (CNA) wire mushroom loop, group 2 consisted of conventional brackets with TAD (AbsoAnchor, Korea) supported retraction, group 3 consisted of passive SLB with CNA archwires (Libral Traders, India) mushroom loop and group 4 consisted of passive SLB brackets with TAD (AbsoAnchor, Korea) supported retraction. The rate of retraction, root resorption and patient satisfaction were assessed. All conventional brackets (Orthox, USA) and passive SLBs (CaptainOrtho, India) had 0.018 Roth prescriptions with a slot size of 0.018 × 0.025. Results: Retraction was the fastest in group 2 with a mean of 1.266 ± 0.14 mm/4 week and a duration of 23.40 weeks. Similarly, group 4 showed the most sluggish movement with a mean of 1.182 ± 0.80 mm/4 weeks with a total duration of 25 weeks; howeverdifferencesce among groups were not statistically significant (P = 0.470). Conclusion: SLBs have advantage of better patient comfort, less pain and reduced chairside time. Though the present study found increased treatment duration with SLB along with friction mechanics, refuting the previous claims of reduced friction with SLBs, however, the difference was not statistically significant and results have to be extrapolated with caution and experience considering other advantages of SLBs.
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Purpose: To study the clinical profile and magnetic resonance imaging (MRI) features in patients of COVID?19?associated rhino?orbital?cerebral mucormycosis (CA?ROCM) with orbital involvement and perform a clinicoradiological correlation. Methods: A cross?sectional study was performed at a tertiary care center in north India from May 2021 to June 2021. Consecutive patients with clinical, nasal endoscopic, and/or microbiological evidence of CA?ROCM underwent MRI of paranasal sinuses, orbit, and brain as per the study protocol. Orbital MRI findings were studied in detail and were correlated with clinical signs. Results: Two hundred and seventy patients were studied. The mean age was 48.4 (± 16.82) years. A male predilection was noted (male:female = 1.77). Orbital involvement was seen in 146 (54%) patients on clinical evaluation and in 184 (68%) patients on MRI. Unilateral orbital involvement was more common (134; 92%). The most common presenting symptom was periorbital and/or facial pain (141; 52.2%) and the most common clinical sign was periorbital edema (116; 43%). The most common MRI finding was suggestive of orbital cellulitis (160; 59%). Orbital compartment syndrome was found in 17 (6.3%) patients. The inter?rater agreement between clinical and radiological assessments to detect the involvement of infraorbital nerve and frontal nerve was found to be 85.56%, (? 0.621) and 93.70% (? 0.776), respectively. The diagnostic accuracy, sensitivity, and specificity of MRI to detect medial orbital wall defect were found to be 87.9%, 65%, and 97%, respectively. Conclusion: Orbital imaging features of a cohort of ROCM patients have been presented with clinicoradiological correlation.