Novel COVID-19 Pandemic Threat: Systematic Approaches To Preventing and Controlling Transmission in Eye Care System in Developing Countries

Background: 2019-novel coronavirus is a pandemic and major threat being how to avoid catching an infection. Purpose: To develop a working protocol to prevent and control community transmission of novel and life-threatening corona viral strain (COVID 19) in a tertiary eye care system of a tier-three city in developing counties such as India and underdeveloped countries. Methods: Prevention and control measures concerning staff training, working environment, staff health, patients, and outreach activities implemented and being practiced in our tertiary care ophthalmology hospital are focussed. Results: Proper and adequate training imparted by a qualified immunologist in addition to continual updates on disease out breaking news and guidelines to the employees. Ways to limit transmission within and between patients and staff are discussed in conjunction with the disinfection of equipment and high- and low-risk areas in a more frequent manner. Outreach camps are stopped in the obedience of the authorized governing bodies. Conclusion: This systemic approach developed based on our experience, and observational data will be useful in preventing transmission of this pandemic threat.

Serum Prostate-specific Antigen Following Antibiotics in Symptomatic Patients with Lower Urinary Tract Symptoms

Introduction: With the current practice of routine Serum PSA examination, there arises a diagnostic dilemma with regard totheir further evaluation and treatment.Aim: The aim is to study the incidence of cancer (CA) prostate in cases with elevated Serum PSA.Methodology: We studied 50 men aged between 50 and 80 years with elevations in Serum PSA (total PSA) after certainexclusion criteria, these cases are given a course of antibiotics for 6 weeks and repeat Serum PSA levels obtained. In thosewith persistent elevation in Serum PSA above 4 ng/ml, transrectal ultrasound-guided biopsy was done.Results: In our study population, 36.6% of cases with persistent PSA elevation were proven positive for malignancy by biopsy.Conclusion: A fall in Serum PSA following a course of antibiotic therapy does not exclude the presence of a carcinomatouselement in prostates.

Study of Normoalbuminuric Diabetic Nephropathy in Type 1 Diabetics

Introduction: Diabetic kidney disease (DKD) is one of the primary causes of end-stage renal disease. Early diagnosis is veryimportant in preventing the development of DKD. Urinary albumin excretion rate and glomerular filtration rate (GFR) are widelyaccepted as criteria for the diagnosis and clinical grading of DKD, and microalbuminuria has been recommended as the firstclinical sign of DKD.Aim: The aim of the study was to study the existence of normoalbuminuric diabetic nephropathy in type 1 diabeticsMaterials and Methods: This prospective study was conducted in type 1 diabetic by documenting low c-peptide level. Fastinglipid profile was done in these patients. Serum electrolytes such as potassium, sodium, magnesium, and uric acid were measured.The characteristic profile of patients with duration of diabetes and low GFR was analyzed with respect to the duration of diabetes,serum magnesium level, hypertension, retinopathy, and renal biopsy features.Results: In 95 patients, of 17 patients with renal biopsy-proven normoalbuminuric diabetic nephropathy, 11 patients (65%) hadserum magnesium of <2 mg/dl, and only six patients had serum magnesium of >2 mg/dl. Among the 17 patients, five patients(29%) had hypertension and eight patients (47%) had diabetic retinopathy changes.Conclusion: There exists an entity – normoalbuminuric diabetic nephropathy in type 1 diabetic patients. The incidence ofnormoalbuminuric diabetic nephropathy increases with duration of diabetes.

Comparison between Airtraq Optical Laryngoscope and Conventional Macintosh Laryngoscope for Intubation in Adult Surgical Patients: A Prospective Randomized Controlled Study

Introduction: Intubating trachea and securing the airway remain a challenge although it is a routine practice for theanesthesiologist. Failure to successfully intubate the trachea remains a leading cause of morbidity and mortality in anestheticand emergency setting.Aim: This study aims to compare the intubating conditions in adult surgical patients using Airtraq optical laryngoscope withMacintosh laryngoscope with respect to ease of intubation, the time taken for intubation, airway trauma, and hemodynamicresponse to laryngoscopy.Methods: In a single-center, prospective, randomized, parallel group, open-label, interventional study, 40 adult patients postedfor surgery under general anesthesia need of endotracheal intubation were recruited and allocated into two groups: Group A(n = 20) intubated with Airtraq laryngoscope and Group B (n = 20) intubated with conventional Macintosh laryngoscope instandard intravenous induction.Results: Mean duration of intubation with the Airtraq group was 15.93 s, whereas in the Macintosh group, it was found to be38.70 s (P < 0.0001). The increase in mean heart rate from the pre-induction to post-intubation in Airtraq group was 20.9/min,whereas in Macintosh group was 31.9/min. The increase in mean arterial pressure from pre-intubation to post-intubation inAirtraq group was 12.6 mmHg, whereas in Macintosh group was 30.3 mmHg. Three patients in the Macintosh group and twopatients in the Airtraq group experienced trauma to the airways (P = −0.958).Conclusion: A study concluded that endotracheal intubation is easier, less time is taken for intubation, less trauma, and lesshemodynamic response when using Airtraq laryngoscope than Macintosh laryngoscope.

Iron Status of Pregnant Women and Their Newborns Using a Combination of Hematologic and Biochemical Parameters for the Diagnosis of Iron Deficiency

Background: Iron deficiency anemia is the most common nutritional deficiency in the world; estimates suggest that 2 billion persons worldwide are iron deficient. Because of the increased iron requirements of pregnancy and growth, pregnant women and infants are recognized as the groups most vulnerable to iron deficiency anemia. Aim: To determine the relationship between the iron status of pregnant women and their newborns using a combination of hematologic and biochemical parameters for the diagnosis of iron deficiency.Methods: The study was conducted on 75 pregnant women either prime or second gravida delivering singleton live births at term gestation (37-41 weeks). The subjects (n=61) were divided into 4 groups: Group 1: Hemoglobin ≤ 6.9g/dl, Group 2: Hemoglobin 7-9.9g/dl, Group 3: Hemoglobin 10-10.9g/dl, Group 4: Hemoglobin ≥ 11g/dl. Results: Positive correlation exists between the maternal and the neonatal hemoglobin levels. The serum iron and serum ferritin values of the neonates correlate with the maternal hemoglobin levels and serum ferritin are very low in the neonates of the mothers with severe iron-deficiency. The lower iron and ferritin values of the neonate were not reflected by the neonatal RBC indices, hence they should not be used as a indicator for assessing the iron status. Conclusion: Iron related parameters are correlated between pregnant women and their corresponding newborns meaning that iron is transported from mother to fetus in direct proportion with the levels found in the maternal circulation

Effect of Cigarette Smoking on Fibrinogen

Background:Cigarette smoking is one of the significant health hazards, and it contributes significantly to cardiovascular morbidity and mortality. Aim: To study the levels of serum fibrinogen among the smokers and to compare the concentration of fibrinogen in smokers. Methods: 150 cases admitted detailed clinical examination and history regarding smoking, alcohol, diabetes, hypertension, coronary heart disease, renal disease, any infection, surgery, and trauma are enquired. Serum fibrinogen was measured in all these 150 patients who are included in the study and the values interpreted. Results: The mean serum fibrinogen value in non-smokers is 318 mg%. The mean serum fibrinogen value in smokers is 489 mg. The smoker who has smoked less than 10 years have serum fibrinogen levels between 450 to 475 mg%. The persons who smoked >10 years have serum fibrinogen levels between 500 to 525 mg% with a statistical significance of 0.0001. Conclusion: Smoking potentially increases with smoking cessations. Increased fibrinogen level in the smokers is dose-dependent, that is directly associated with smoking duration and frequency.