Prevalence of pseudoexfoliation in diabetic patients with senile cataract: A hospital-based study in Kashmir, India

Purpose: To study the prevalence of pseudoexfoliation syndrome (PEX) in diabetics with senile cataracts and compare it to the prevalence in nondiabetic control group. Methods: Two hundred and fifty diabetics and 250 nondiabetics (age and sex matched) were evaluated for PEX deposition. Results: Chi?squared test was employed, and a P value < 0.05 was considered significant. In the PEX group, most patients belonged to the age group of 60–70 years (55.17%). Out of 18 patients with PEX, 11 (61.1%) showed bilaterality. There was a higher frequency of raised intraocular pressure (IOP; >20 mmHg) in PEX eyes (10.3%) than in the non?PEX eyes (5.9%). The PEX group had a higher number of eyes with cup?to?disc ratio (CDR) >0.6 (11.12%) than the non?PEX group (4.32%). Nuclear cataracts were more frequent in PEX eyes than non?PEX eyes, whereas PSC and mature cataracts were more prevalent in the non?PEX group. Most eyes had PEX deposition on the anterior lens capsule and pupillary margin. Of the 500 study eyes corresponding to the diabetic group, 418 had cataracts (rest pseudophakic), of which 28 had pseudoexfoliation, accounting for 6.7% of the total. In the nondiabetic control group comprising 500 eyes, 430 had senile cataracts (rest pseudophakic), of which 105 had PEX deposition, accounting for 24.4% of the total. Conclusion: According to our findings, diabetics have a lower prevalence of PEX than nondiabetics. Few such studies have been conducted so far, and none have been conducted in the Indian population.

CAUSES OF OCCUPATIONAL STRESS AMONG JUNIOR COLLEGE LECTURERS

Occupational stress is a noticeable and widespread aspect of contemporary businesses. The right amount of stress may motivate someone and boost performance, while too much stress results in poor performance. One of the jobs with the highest stress is teaching. Psychiatric disorders can result from excessive stress. The study's goal is to identify the main factors contributing to junior college lecturers' stress. The present study involves 79 lecturers from private junior colleges (43 male and 36 female). Two sections (Part A & B) make up the questionnaire. Part-A contains demographic data on junior college lecturers, and Part-B has nine stress-related factors against which lecturers have to give ranking from most stress factor 1 to least stress factor 9. Statistical analysis employs the Garrett ranking approach. The ?ndings show that lecturers experience the highest stress from students' misbehavior, followed by work pressure and no job security.

Short Term Outcome of Extracorporeal and Intracorporeal Anastomosis in Laparoscopic Colorectal Surgeries – A Prospective Observational Study

Aim of Study:Laparoscopiccolorectal surgery has gained popularity around the Globe. Laparoscopiccolectomy significantly improves the short term and long term outcomes of patients. The bowel anastomosis after laparoscopic resection of the tumour can be done in two ways -extracorporeal anastomosis and Intracorporeal anastomosis. Our study observed and evaluated the data of the patients who underwent these two techniques.Materials and Methods:A prospective observational study was conducted in the department of General Surgery, SMHS hospital of Government Medical College, Srinagar. A total of 32 patients were studied out of which 20 patients had undergone intracorporeal anastomosis and 12 patients had undergone extracorporeal anastomosis. The aims of the study were to assess the operative time, post-operative ileus, length of hospital stay, anastomoticleak and other anastomotic complications,wound infections and extraction site hernias.Results:The patients in our study were in the range of 30-85 years with a mean age of 59.18 ± 14.92. and 59.4% of patients were males and the rest 40.6% were females, with male/female ratio of 1.46:1. There was no significant difference in mean operative time between the intracorporeal group and extracorporeal group (188±9.78 minutes’ vs.180.3±13.8 minutes). The patients in the intracorporeal group had earlier return of bowel function than extracorporeal group as reflected by earlier appreciation of flatus and tolerance to orals. This had led to the shorter hospital stay of the intracorporeal group than the extracorporeal group of patients (median of 5 days vs. 6.5 days) The wound infection rate was 6.3 percent in our study, 5.0% in the intracorporeal group and 8.3% in the extracorporeal group. Only 1 out of the total 32 patients developed mesenteric twist to the extracorporeal group (1 out of 12 patients). We observedno leak or incisional hernia in either groups.Conclusion:Intracorporeal anastomosis in laparoscopic colorectal surgeries leads to earlier return of bowel function, earlier resumption of orals and shorter hospital stay than the extracorporeal anastomosis. There does not exist a significant difference between the two modes of anastomosis in terms of anastomotic and wound related complications

Laparoscopic Fundoplication for Gastro-esophageal Reflux Disease and Hiatus Hernia: A Short Term Outcome of First 8 Cases

Background:Acute gastro-esophageal reflux disease is a common ailment in kashmiripopulation. Most of these patients are managed by gastroenterologist, physicians and surgeons in daily outpatient basis. Majority of them settle by medical management with the help of proton pump inhibiters, prokinetics and antacids., laparoscopic Nissen’s fundoplication (LNF) is currently the procedure of choice for the surgical management of GERD.Aims and Objectives:The aim of this study was to know the feasibility of laparoscopic fundoplication for hiatus hernia and acute gastro-esophagealrefluxdisease in termsof operative time, post operative pain, length of hospital stay, conversion rate and recurrence of symptoms.Materialsand Methods:The present prospective observational study was conducted in the Post-Graduate Department of General Surgery and minimal access surgery Government Medical College Srinagar from June 2013 to June 20117. The patients that were included in the studyhad symptomatic gastro-esophageal reflux(documented by endoscopy) with either persistent symptomsdespite adequate and prolonged medical treatment, CT documented hiatus hernia and patients, who wanted to avoid long-term medical treatment. The duration of reflux symptoms ranged from 9 months to 30 years (median 6 years). Patients who were excluded from the study were those unfit for anesthesia. Informedconsent was taken before surgery in the language, the patients understood.Results:This study includes 8 patients, with median age of 40 years (range 20-70 years). In the study group, 5 were males and 3 were females. The mean operative time was 90 minutes (range 60 t0 120 minutes). There were no major intra operative and postoperative complications. The postoperative pain was minimal as compared to open surgery. The median hospital stay was 3.5 days (range 3 -6 days). Two patients developed symptoms of bloating, early satiety, nausea and diarrhea. However these symptoms improved within weeks with a good response to appropriate medication. The median time until normal physical activity resumed was 2 weeks (range 3 days to 4 weeks). Median follow-up was 6 months (range1-12 months).The overall short-term results in appropriately selected patients were excellent. The recurrence of symptoms was not observed in any patient within follow up of 6 months. Conclusion:We conclude from our early series of 8 cases, that patients having long standing GERD not responding to medical management who areat a threat to develop barrettes esophagus should be given the benefit of laparoscopic fundoplication. However proper evaluation, patient selection is mandatory. The choice of fundoplication should be dictated by thesurgeon’s preference and experience. Currently, the main indication for laparoscopic fundoplication is represented by PPI-refractory GERD, provided that objective evidence of reflux as the cause of ongoing symptoms has been obtained by impedance-pH monitoring

Genetic study in congenital heart defects

Background: Congenital heart diseases (CHD) are relatively common with a prevalence ranging from 3.7 to 17.5 per 1000 live births. Little is known about genetic link with respect to congenital heart disease. Iroquoise (Irx) homeobox genes have been widely studied and their expression in both developing and adult heart. Author tried to study the role of irx4 and irx5 genes in structural congenital heart disease, keeping the focus on study reported by Cheng Z et al.Methods: Author studied reported mutation site sequences in 25 various congenital heart disease patients and control healthy relatives of patients. It is a unique study and there has not been such a study reported in literature till date. Besides comparison with healthy related controls, author took cardiac tissue biopsy in patients while doing corrective cardiac surgery. However, blood samples were taken from controls due to ease of feasibility.Results: Although, there were no sequence variations in the studied exon regions, but author got a base pair sequence change at 6 bp intron region, which is near the exon splice site in irx4 gene. Besides two ASD patient’s male children (one child each) had ASD prompting us to believe some role of sex linkage. However later needs pedigree analysis and sex chromosome studies for further analysis.Conclusions: Gene sequence in the Kashmiri population is unique. There is possibility of role of irx genes in CHD. ASD might have sex linkage in some.

A Prospective Study of Efficacy and Safety of Azithromycin and Ofloxacin in the treatment of Typhoid Fever in Children at a Tertiary Care Hospital

Introduction: Antimicrobial therapy is the mainstay for the treatment of Typhoid fever that shortens the clinical course of typhoid fever and reduces the risk of death. For decades, chloramphenicol has been highly effective against S. typhi, but multi-drug resistant (MDR) strains of S. typhi (resistant to chloramphenicol, trimethoprim sulfamethoxazole, and ampicillin) has restricted its use in typhoid fever. Objective: To compare the efficacy and safety of Azithromycin and Ofloxacin in children suffering from uncomplicated typhoid fever. Methods: Blood culture proven, uncomplicated typhoid fever patients admitted in the pediatric ward of J. N. Medical college, Aligarh were treated with ofloxacin orally (15mg/kg/24 hrs BD for 5 days) and azithromycin orally (10mg/kg/24 hrs OD on Day 1, then 5mg/kg OD for next 4 days). Patients were clinically and bacteriologically evaluated during the study period and follow-up. Results: 96.7 % cure rate was observed in azithromycin group. No relapse was recorded. Conclusion: Both Ofloxacin as well as azithromycin may be considered as an empirical therapy for  the  treatment of uncomplicated  typhoid in  children .

Clindamycin induced Cutaneous Drug Reaction – A Case Report

Adverse drug reactions (ADRs) due to antibiotics is one of the major concern. Hypersensitivity reactions with clindamycin may be immediate or delayed type, but their frequency and severity are relatively rare. We here report a case of a 32-year-old male patient with road traffic accident, who later developed osteomyelitis of occipital bone. After two weeks of therapy and debridement, the patient was on maintenance therapy receiving clindamycin 300 mg q8h, ciprofloxacin 500 mg q12 h and rifampicin 450mg fasting. After six days, he developed erythematous maculopapular rashes, initially on the trunk followed by neck and arm of both upper limbs with limitation of movement, fever, chills and night sweats. The reaction subsided after withdrawal of clindamycin and administering i.v. hydrocortisone 100mg stat followed by tablet promethazine 25mg 12hourly for 3 days. The causality assessment was done as per WHO-UMC scale and it was “probable” in this case. Although the incidence of clindamycin induced drug reaction is rare, the clinicians should be aware of such reactions before prescribing it.

Sharbat: an important dosage form of unani system of medicine

The present study was designed to discuss many important points related to Sharbat with different types of drugs [juicy fruits, dried sour fruits, dried sweet fruits, dry herbal drugs, mucilaginous drugs, drugs having volatile constituents, and so forth]. It also aimed to extensively discuss the drug and water ratio and drug and sugar ratio to prepare Sharbat, which is mentioned in different reference books of Unani system of medicine [USM]. USM includes many safe and effective single drugs as well as compound formulations of herbal, animal, and mineral origin, which are used to cure a wide range of diseases. Unani compound preparations are commonly used in four forms: solid [Hab, Qurs, Safoof, Kushta, and so forth]; semisolid [Majoon, Laooq, Marham/Zamad, and so forth]; liquid [Sharbat, Sheera, Rooh, Tila, and so forth]; and gaseous [Bakhoor, Inkabab, and so forth]. Sharbat is an important dosage form used from ancient times. It is mostly used for the respiratory, urinary, digestive, and cardiovascular systems of the body

Anterior Segment Changes Following Bee Sting to Cornea

We present a rare case or bee-sting to the cornea which leads to a variety of changes involving the anterior segment of the eye.

Comparison of Latanoprost and Dorzolamide in Patients with Open Angle Glaucoma

To compare the ocular hypotensive efficacy and side effects of either latanoprost or dorzolamide in patients with open angle glaucoma, forty-four patients with open angle glaucoma were included in a randomized, double masked study for a period of 3 months. All previous glaucoma medications were stopped and the patients were randomized to receive either latanoprost 0.005% at bed time or dorzolamide 2% three times daily. After 3 months, the mean reduction in rap was 6.8 (SD 3.1) mm Hg in the latanoprost group as compared to 4.7 (SD 2.4) mm Hg in the dorzolamide group. The difference of 2.1 nun Hg was highly significant. Both the drugs were well tolerated systemically and locally. Latanoprost was superior to dorzolamide in reducing the mean lOP and thus has the potential for becoming the first line treatment in glaucoma.