Papillomacular bundle sparing versus conventional internal limiting membrane peeling for idiopathic macular hole ?400 µm

Purpose: To compare the outcomes of papillomacular bundle (PMB) sparing internal limiting membrane (ILM) peeling (group LP) and conventional ILM peeling (group CP) for treatment of idiopathic macular hole (MH) of ?400 ?m. Methods: Fifteen eyes were included in each group. In group CP, conventional 360° peeling was done, while in group LP, ILM was spared over PMB. The changes in peripapillary retinal nerve fiber layer (pRNFL) thickness and ganglion cell?inner plexiform layer (GC?IPL) thickness were analyzed at 3 months. Results: MH was closed in all with comparable visual improvement. Postoperatively, retinal nerve fiber layer (RNFL) was significantly thinner in the temporal quadrant in group CP. GC?IPL was significantly thinner in the temporal quadrants in group LP, whereas it was comparable in group CP. Conclusion: PMB sparing ILM peeling is comparable to conventional ILM peeling in terms of closure rate and visual gain, with the advantage of less retinal damage at 3 months.

Evaluation of Revised National Tuberculosis Control Program among Ten Designated Microscopy Centers of West Tripura: A Cross-Sectional Study

Objectives?Pulmonary tuberculosis (TB) is chronic communicable bacterial disease caused by Mycobacterium tuberculosis. The objective was to assess the performance in terms of knowledge and practice of pulmonary tuberculosis (PTB) program among directly observed treatment short course (DOTS) provider, lab technician, senior treatment supervisor (STS), senior tuberculosis laboratory supervisor (STLS), factors affecting knowledge and practice of PTB program, rate of detection, cure rate and to identify the gaps and underlying contributing factors in terms of supply, manpower, and infrastructure. Materials and Methods?A cross-sectional study was conducted on knowledge and practice of PTB program among DOTS Provider, lab technician, STS, STLS in ten designated tuberculosis center of West Tripura from May 2018 to April 2019. Simple random sampling method was followed for selecting DOTS provider and sample size of 50 was taken. Results?Majority (40.0%) of patients were in the age group of 31 to 40 years and mean age of 40.98?±?10.13 years. Females and males were 68.0 and 32.0%, respectively. Among DOTS provider, 66.0% had served for more than 5 years of service and 84.0% of them had verified address before starting the treatment. Conclusion?Majority of the DOTS provider had satisfactory knowledge and practice about PTB program. Proportion of the medical officers attending DOTS training was inadequate and there were adequate number of the health care workers who had attended DOTS training. There were no gaps found in proportion of the cases receiving the supervised treatment.

Morphological Study of Accessory Foramina in Dry Mandible and Its Clinical Significance

Background: To provide anatomical information on theposition and incidence of accessory foramina in mandible asthey are important for dental surgeons and anesthetists inachieving complete nerve blocks and for avoiding injury toneurovascular structures passing through them.Objective: To study the incidence of accessory foramina in drymandible in population of Bihar & compare it with incidenceamong various races of the world.Materials & Methods: Present study is a cross sectional studywhich has been carried out on 56 dried fully ossified adulthuman mandibles, which were examined in the Department ofAnatomy and Forensic Medicine of Indira Gandhi Institute ofMedical Sciences, Patna, Bihar. The age of the bones used inthe study was not predetermined. Only fully ossified dried,macerated and thoroughly cleaned mandibles which werecomplete in all respects, in order to give the correctobservations, were included in the study while the mandibleshaving any deformity or pathology were excluded. Theaccessory foramina and their positions were observed.Results: Accessory mandibular foramina were found in 55.36%, accessory mental in 23.22 %, and retromolar in 17.85% ofthe cases. The accessory foramen observed most commonly inright side (39.28%) followed by bilateral (37.5%) then left side(19.65%).Conclusion: The anatomical variability of incidence andposition of accessory foramina should be considered as theymay be used to give additional locoregional anesthesia in caseof failed mandibular blocks. Knowledge of the commonestpositions will be beneficial for oncologists and oromaxillofacialsurgeons in planning graft implants.

IOA Index – The Predictor of Gender Dimorphism

Sex determination is utmos important for forensic experts and Anthropological studies. Aim: The aim of this study is to compare cranial morphology between male and female skull using IOA Index. Methods: A total of 100 adult dry skull (50male and 50 female) were used for study using a digital Vernier calliper. Results: The male parameters were significantly higher then female parameters with no significance difference in Right and Left side of male and female. Conclusion: The skull is most commonly site for sexual dimorphisms in human Skeleton and IOA Index can be additive value gender differentiation.

Correlation between Finger Print, and Blood Group amongst Gender- A Prospective Study

Identification or identity helps us to determine the individuality of person, living or dead. Establishing the identity is of immense importance in forensic medicine. Aim: The aim of this study was to determine the correlation between finger print, gender, and blood group. Methods: A total of 100 subjects participated in the study (M=F) in the age range of 18 to 25 years. The sample was collected by simple random sampling. The finger print was analyzed by using powerful magnifying hand lens, ink pad and white chart paper. Results: The prevalence of blood groups as observed in our study for A, B, AB and O groups were 25, 33, 39, 3 for males and 23, 35, 39, 3 for females respectively. The prevalence of thumbprint amongst the gender was highest for Loops and least for arches. Conclusion: Our study reiterates that if fingerprint patterns and blood groups are studied with a larger sample size and with a multi-centric study, it may help in prediction of blood groups based on fingerprint pattern available.

An Observation of Cooling of Dead Body for Estimation of Time Since Death in IGIMS, Patna, Bihar

Background: Cooling of body after death is also known asAlgor Mortis. Now a days recording of temperature of a deadbodies has its medico-legal importance in connection withdetermination of time since death. It is variable and dependsupon various factor including the atmospheric temperature of aparticular region.Aim & Objective: The main objective of this objective was torecord the fall of temp in dead body as supportive data fordetermination of time since death at Patna (Bihar). Materials &Methods: The present study was conducted on 140 deadbodies brought for post-mortem examination at IGIMS, Patnafrom September 2016 to March 2018 after clearance of ethicalcommittee.Results: Between 3 to 6 hours after death, temperatures wererecorded by 96.6˚F to 95.6˚F in 37.50% of cases and in28.12% cases by 95.6˚F to 94.6˚ F and in 34.37% cases by94.6˚F to 92.6˚F. In the cases examined during 24 hours to 36hours after death rectal temperatures were found to be loweredby 78.6˚F to 74.6˚F in 0.08% cases, and in 91.66% casesbodies were found to be cooled to environmental temperature.Conclusion: The most important responsibility of the doctorsperforming post mortem examination to answer this point asprecisely and accurately as possible. It is manifestly impossibleto say the exact moment of death but a near approximationmay be reached by closely recording of rectal temperatureevery half hourly for three hours

Study of Medicolegal Aspects of Unknown Cases in P.M.C.H., Patna

Introduction: When people die and their bodies are found withno identifying documentation, it is very difficult for the police toestablish their identities. These bodies are labelled as‘unknown/unidentified dead bodies’ (UIDB). The body ispreserved in the mortuary for 72 hours, from the time it isreceived in the mortuary. If no one claims the body after 72hours the police are legally authorized to dispose of the body.The aim of study is to find incidence of unnatural deaths inrelation to the age, sex, pattern of injuries and other parameterof the unknown victims and to ascertain the root cause of alltypes of deaths.Materials and Methods: This prospective study wasconducted in the Department of Forensic Medicine andToxicology, Patna Medical College, Patna, Bihar, Indiabetween August 2012 to September 2014. All the medico legalautopsies of unknown/unidentified bodies during this periodwere included in the study. Information regarding unclaimedbodies with regard to age, sex, cause of death and manner ofdeath was sourced from the autopsy reports and the inquestpapers of the investigating officers.Results: Out of total of 5103 autopsies done 401(7.85%) wereunknown/unidentified dead persons. 342 cases (85.28%) wereof male. Incidence of unknown/unidentified death was mainly inmiddle age group (30-50yrs) (42.64%). 225 (56.10%) deathswere due to accident/injury. Major cause of death due toinjuries were polytrauma. Highest cases were seen in winterseason and lowest in Autumn. 279 cases were untreated and122 hospitalized or treated cases in total unknown cases.Conclusion: Most of the literature available were on theindividual body identification or identification of victims of massdisasters. Unknown bodies comprised 7.85% of the totalautopsy load of the department. The age group 21-40 yearswas responsible for 44.85% of total cases. Accident is animportant cause of morbidity and mortality in the study area.Males are the most affected population; the common agegroup affected is 21–40 years. However, more studies arerecommended to find the actual cause of accidents andprevalence of homelessness and its health-related effects onmorbidity and mortality, which will help in providing health carefacilities to the needy.

Hazari Ragini, Kumar Aman, Maan Sushila, Kumar Arvind

Hemorrhagic septicemia (HS) is a major disease of cattle and buffaloes characterized by an acute, highly fatal septicemia with high morbidity and mortality. Sporadic cases are more difficult to diagnose clinically and hence diagnosis at an early stage is required for control of the disease. The present study was conducted to compare the temporal sensitivity of multiplex PCR and bacterial isolation to diagnose hemorrhagic septicemia due to Pasteurella multocida at an early stage i.e. before the appearance of clinical signs in mice. Multiplex-PCR (mPCR)was evaluated for simultaneous as well as temporal detection and identification of P. multocida at type level for early and accurate diagnosis of hemorrhagic septicemia (HS). Swiss albino mice were experimentally infected with 100 colony forming units (CFU) of the bacteria P. Multocida TypeB:2 Strain P52. Heart blood samples were collected, 2, 4, 8, 12 and 24 h post infection for bacterial isolation as well as detection and identification by mPCR. The P. multocida was isolated from the heart blood sample collected as early as 8 h post infection while mPCR detected the bacterial DNA as early as 4 h post infection before the appearance of clinical signs hence mPCR for P. multocida Type B:2 was found to be more sensitive than the bacterial isolation for diagnosis of HS.

A Study of the Awareness of Oral Cancer and its Associated Risk Factors Amongst O.P.D. Attendees at a Teaching Hospital of Bhubaneswar, India

Background: Oral cavity cancer is amongst the most prevalent cancers in India and incidence rates are higher in men than women. In India use of the smokeless tobacco product called gutkha /paan, is extremely popular especially in Northern part of India. Age-adjusted rates of oral cancer in India are high, which is, 20 per 100,000 population and accounts for over 30% of all cancers in the country (2) along with oral cancer there is high risk of sub-mucosal fibrosis causing sever morbidity and lifetime disability. Delayed presentation of oral cancer is mainly due to lack of awareness of the public about oral cancer and its associated risk factors. Methods: A cross section study was carried out in OPD of Medical Teaching Hospital and patients were accessed for their socio-demographic profile, awareness and knowledge about early signs of cancer. Results: Out of 450 participants 68% were male and rest females. Level of awareness about early signs of oral cancer was poor i.e. 35% whereas 49% of the studied population had one or more behavioral risk factor associated with oral cancer. Only 18% of participants who regularly take professional help for oral health. Conclusions: The awareness level is not satisfactory and presence of behavioral risk factor for oral cancer is significant among studied population. There is a need of IEC among the general population about pre-cancerous/cancerous lesions and association of smoked/smokeless tobacco or alcohol with oral cancer.

Significance of history taking before autopsy: A case study.

Many cases are being reported before the Forensic Experts, in which it becomes difficult to find out the precise cause of death. A 73 year male was brought for autopsy examination at Rajendra Institute of Medical Sciences, Ranchi, Jharkhand with suspicion of death due to brain tumor. The findings of autopsy examination was edema of brain matters and depressed area in right frontal lobe of brain with several stitches marks on right side of head. Detailed history from all the concerned persons were taken which reveals previously person was operated by neurosurgeon for space occupying lesion in cranial cavity. Histo-pathology examination of mass showed Koch’s lesion as tuberculoma en plaque a very rare presentation of tuberculosis which is very common in our country even in the era of 21st century. Case is being presented with brief discussion showing the need of early and prompt history taking including hospital records details before an autopsy examination. It may reveal important facts as well as helps the Forensic Experts to take the consideration of therapeutic artefacts during autopsy to find the exact cause of death.

Determination of time elapsed since death from the status of transparency of cornea in Ranchi in different weathers.

Determination of ‘time elapsed since death’ (TSD) is one of the important content of the post-mortem report. Although the status of transparency of cornea is variable, depending on different factors like other parameters used for the purpose of determination of time since death but it is less variable as compared to others. The study sample comprised of 238 medico-legal autopsies conducted in the department of Forensic Medicine & Toxicology, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand during June 2006 to September 2007. In majority of cases cornea remains transparent & moist in 0—06 Hrs and becomes transparent & dry in 06—12 Hrs, transparent to hazy in 12—24 Hrs, hazy to opaque in 24—36 hrs and opaque in >36 Hrs. In sequence, changes occurs more in warm & moist weather then in warm & dry weather and cold & moist weather respectively and least in cold and dry weather.