Prevalence and causes of visual impairment among adults aged 15–49 years in a rural area of north India - A population-based study

Purpose: Very few studies have been conducted in India and other parts of the world on visual impairment among individuals aged 15–49 years. This study was conducted to determine the prevalence, causes, and associated factors of visual impairment among adults aged 15–49 years in a rural population of Jhajjar district, Haryana, north India. Methods: A population-based cross-sectional study was conducted in two blocks of Jhajjar district. A total of 34 villages were selected using probability proportionate to size sampling method. Adults aged 15–49 years were selected using compact segment cluster sampling approach. As part of the house-to-house survey, presenting visual acuity using screening chart corresponding to five “E” 6/12 optotypes was measured along with collection of other demographic details. The optometrists performed detailed eye assessment including repeat measurement of visual acuity using retro-illuminated conventional logMAR tumbling “E” charts, torch light examination, and non-cycloplegic refraction at a clinic site within the village to ascertain visual impairment and its cause. Results: Of 5,470 enumerated adults, 5,117 (94%) completed all study procedures. The age- and sex-adjusted prevalence of visual impairment was found to be 1.85% [95% confidence interval (CI): 1.48, 2.23] and blindness was 0.09% (95% CI: 0.01, 0.18). The age- and sex-adjusted prevalence of unilateral visual impairment was 1.11% (95% CI: 0.81, 1.41). Uncorrected refractive errors (84%) contributed maximum to visual impairment in this age group. The visual impairment in study participants was found to be associated with age and educational status. Conclusion: At the community level, uncorrected refractive errors contribute largely to visual impairment in the age group of 15–49 years.

Assessment of implementation status of Cigarettes and Other Tobacco Products Act (COTPA) and its awareness among residents in a block of Haryana

Background: Legislative route is one of the known method to control behaviour of population. Cigarette and Other Tobacco Products Act is one of the laws enacted to control the use of tobacco in India lunched in the year 2003. Objective: The objective of this study was to find compliance of COTPA among tobacco stores and to find the knowledge of people regarding COTPA. Methods: All selected communities were studied by community audit. All stores selling tobacco products were assessed for its compliance to COTPA. Thirty participants from selected communities with in the age range of 18- 65 years were selected and interviewed for knowledge regarding COTPA. Results: A total of 218 stores were found to be selling tobacco. None of the stores were fully compliant to all COTPA clauses. Stores in rural areas were found to be more non-complaint than urban areas. 41% of stores were selling tobacco to minors, 10% were within 100 yards of schools.8% of schools have tobacco advertisement on fa鏰de and 24% displayed tobacco products openly. Around half of the participants (n-552) had heard about COTPA whereas only 4% were aware of all 4 provisions of COTPA. Conclusion: Although more than a decade passed since the law was enacted poor compliance and knowledge was found among participants.

Infection in haematological malignancies.

Fifty-six febrile episodes in 30 haematological malignancy cases were evaluated. Of these episodes 60.7% were in leukaemia cases. Clinical evaluation and investigation suggested infection in 42 episodes (75%) of fever and in rest 14 (25%) no identifiable cause could be found. Bacterial infection predominated with an incidence of 80.9% followed by fungal infection in 11.9% and parasitic infection in 7.1% of the febrile episodes. Gram-negative bacteria were more frequently isolated (22/34) than Gram-positive bacteria (12/34). Staph aureus was the commonest Gram-positive organism. Kl pneumoniae and Esch coli were the common Gram-negative pathogens. The commonest organisms were sensitive to cephalosporin and gentamicin. Incidence of fever due to infection was significantly higher (p < 0.001) in patients with absolute neutropenia, in whom the mortality rate was significantly higher (p < 0.001).

Male gonadal function in Hodgkin's disease before and after treatment.

Twenty eight histologically confirmed cases of Hodgkin's disease were evaluates with regard to libido, sperm count, FSH, LH and urinary ketosteroid levels, before and during different stages of chemotherapy along with testicular biopsy on 16 cases. Decrease in libido during therapy improved following treatment, 50% cases who were oligospermic before treatment became azospermic, Serum FSH levels increased significantly (p 0.001) during the course of treatment. There was no significant change in LH and urinary ketosteroid levels (p 0.05). Testicular biopsy, normal initially, showed germ cell aplasia and absence of spermatogenesis after therapy. Drug induced testicular change leads to sterility.

An epidemic of encephalitis in Haryana: serological evidence of Japanese encephalitis in a few patients.

An epidemic of encephalitis occurred in the eastern, paddy growing districts of Haryana state between July and November 1990. One hundred and eighty-two patients with encephalitis were admitted to different hospitals in Haryana and 118 of them expired (mortality rate 64.8%); 88% of the patients were children. The male to female ratio was 2. 3. 1. IgM class of antibodies to Japanese Encephalitis (JE) Virus could be demonstrated in the CSF and/or sera of 3 surviving and 2 fatal patients of the 19 patients studied. This is the first detailed report on an epidemic of encephalitis in North-Western part of India. Serologically proven cases of JE are being reported, for the first time, from this region.

Coagulation disorder following viper bite in Orissa.

Forty-three cases of viper bite were studied for coagulation disorder of which 34 (79.1%) cases had bleeding manifestations from one or more sites, haematuria being the commonest (46.5%). Disseminated intravascular coagulation was the predominant coagulation abnormality. Administration of snake venom antiserum resulted in prompt recovery from coagulation disorder. However, natural recovery from coagulation abnormality did occur though took longer time.

Lipid peroxidation in acute falciparum malaria.

Lipid peroxidation was assessed by measuring malondialdehyde (MDA) in 30 patients with falciparum malaria and 20 controls (10 healthy adults and 10 patients of vivax malaria). Mean serum MDA was 0.96 +/- 0.38 nmol/ml, 1.1 +/- 0.17 nmol/ml and 2.9 +/- 1.1 nmol/ml in healthy controls, disease controls and falciparum malaria patients, respectively. Levels were significantly high (P less than 0.001) in patients with falciparum malaria. Higher values were associated with more number of complications and deaths.

Double blind clinical trial on centperazine & DEC in bancroftian filariasis.

Centperazine, an analogue of DEC, was subjected to a double blind controlled trial, to evaluate its efficacy as a newer antifilarial agent. Centperazine (300 mg/day) along with equivalent quantities of DEC and placebo were administered to different types of filariasis patients. DEC was found to be significantly effective in reducing peripheral microfilaraemia, in different weeks and months of follow-up, except at the end of 6th month, as compared to Centperazine. There was no significant difference between the placebo and Centperazine treated patients, in this respect, revealing that the drugs had no efficacy in eliminating peripheral microfilaraemia. Recurrence of acute attack within 6 months was nearly equal with both Centperazine and DEC, being 28.2 and 24 per cent respectively, whereas in the placebo group the recurrence rate was 48.9 per cent. Centperazine treated patients showed significantly less side effects (8.9%), as compared to DEC treated patients (34%). Giddiness, nausea and vomiting were the common adverse effects observed.

Immunopathological changes in kidney in Plasmodium falciparum malaria.

Fifteen (34.8%) of 43 patients of falciparum malaria screened for urinary abnormalities showed significant proteinuria (greater than 150 mg/24 h), haematuria (greater than 1/HPF) and casts, with or without azotaemia. Light microscopic examination of renal biopsy tissue from 12 patients revealed mesangial and endothelial proliferative change in 8, and acute tubular necrosis in one patient. Immunofluorescence showed IgM alone, or IgG and IgM along with C3, in 7 patients within the mesangium or along the capillary walls. Repeat kidney biopsy after 6 wk in 5 patients revealed no residual pathology indicating the reversible nature of the lesions.

Detection of a new focus of Brugia malayi infection in Orissa.

526 people were surveyed in a village called Chudamani, in Balasore district of Orissa, for detection of asymptomatic microfilaria (mf) carriers. Of these 36 (6.8 per cent) were cases found to harbour mf; 19 cases had Brugia malayi, 4 Wuchereria bancrofti and 5 cases had mixed infection. In 8 cases, species could not be ascertained. For the first time after 1955, a focus of B. malayi has been detected in Orissa.