Efficacy of deep learning-based artificial intelligence models in screening and referring patients with diabetic retinopathy and glaucoma

Purpose: To analyze the efficacy of a deep learning (DL)?based artificial intelligence (AI)?based algorithm in detecting the presence of diabetic retinopathy (DR) and glaucoma suspect as compared to the diagnosis by specialists secondarily to explore whether the use of this algorithm can reduce the cross?referral in three clinical settings: a diabetologist clinic, retina clinic, and glaucoma clinic. Methods: This is a prospective observational study. Patients between 35 and 65 years of age were recruited from glaucoma and retina clinics at a tertiary eye care hospital and a physician’s clinic. Non?mydriatic fundus photography was performed according to the disease?specific protocols. These images were graded by the AI system and specialist graders and comparatively analyzed. Results: Out of 1085 patients, 362 were seen at glaucoma clinics, 341 were seen at retina clinics, and 382 were seen at physician clinics. The kappa agreement between AI and the glaucoma grader was 85% [95% confidence interval (CI): 77.55–92.45%], and retina grading had 91.90% (95% CI: 87.78–96.02%). The retina grader from the glaucoma clinic had 85% agreement, and the glaucoma grader from the retina clinic had 73% agreement. The sensitivity and specificity of AI glaucoma grading were 79.37% (95% CI: 67.30–88.53%) and 99.45 (95% CI: 98.03–99.93), respectively; DR grading had 83.33% (95 CI: 51.59–97.91) and 98.86 (95% CI: 97.35–99.63). The cross?referral accuracy of DR and glaucoma was 89.57% and 95.43%, respectively. Conclusion: DL?based AI systems showed high sensitivity and specificity in both patients with DR and glaucoma; also, there was a good agreement between the specialist graders and the AI system

Venous malformation of the conjunctiva and orbit

A 28-year-old male presented with a large conjunctival lobulated, nonpulsatile, red vascular lesion involving a large part of the temporal quadrant of the left globe. There was no proptosis or globe displacement, but the left eye abduction was limited. T2-weighted magnetic resonance imaging scan of the brain and orbit revealed an extensive contrast-enhancing lobulated lesion in the left half of the face involving the upper lip, cheek, oral cavity, extraconal space of left orbit, and nasal cavity. He underwent surgical excision of the conjunctival lesion with amniotic membrane reconstruction.

Dry eye among medical students before and during COVID-19

Purpose: Dry eye is a multifactorial disease of the ocular surface. It showed an increased incidence during the pandemic situation, which may be due to long hours of exposure to electronic gadgets. We aimed to find the prevalence of dry eye disease among medical students during the coronavirus disease 2019 (COVID?19) pandemic and pre?pandemic periods. Methods: This was a cross?sectional study conducted in a tertiary care teaching institute. This was an institution?based, cross?sectional study conducted among medical students. A modified Ocular Surface Disease Index (OSDI) questionnaire was used to find the severity and prevalence of dry eye disease. Considering 95% confidence interval (CI) and prevalence as 50%, the calculated sample size was 271. Online responses were collected and entered in an Excel sheet. The Chi?square test, univariate and multivariate logistic regression were used for statistical analysis. Results: Data were collected from 271 medical students; the prevalence of dry eye disease was 41.5 and 55.19 during the pre?pandemic and pandemic periods, respectively. There was a significant rise in dry eye disease cases during the pandemic when compared to pre?pandemic period (P < 0.05). The odds of getting dry eye disease were 1.7 times more during the pandemic than pre?pandemic. Conclusion: The lockdown situation during the pandemic forced people to use electronic gadgets for work, recreation, and academics. Prolonged screen time predisposes to the development of dry eye disease

Guided Endodontic Surgery ? Case Series

This case report describes three cases in which periapical surgeries were carried out using a new surgical endodontic technique by using a three?dimensional (3D) printed template for guided osteotomy and root resection. In Case 1, the data obtained from preoperative CT scan and cast scan were transferred to a surgical planning software. The surgical template was printed using a 3D printer. Using the template, osteotomy and root?end resection were precisely carried out. In Case 2, after CBCT imaging, data were transferred to stereolithography and a 3D model was fabricated. With the help of the 3D model, a template was fabricated using tray material. This guided surgical template minimized the extent of osteotomy and enabled precise targeting of the apex. In Case 3, a preoperative CT scan aided in the fabrication of a surgical 3D template. The template assisted in the precise removal of the overlying cortical bone.

Artificial intelligence and machine learning in ocular oncology: Retinoblastoma

Purpose: This study was done to explore the utility of artificial intelligence (AI) and machine learning in the diagnosis and grouping of intraocular retinoblastoma (iRB). Methods: It was a retrospective observational study using AI and Machine learning, Computer Vision (OpenCV). Results: Of 771 fundus images of 109 eyes, 181 images had no tumor and 590 images displayed iRB based on review by two independent ocular oncologists (with an interobserver variability of <1%). The sensitivity, specificity, positive predictive value, and negative predictive value of the trained AI model were 85%, 99%, 99.6%, and 67%, respectively. Of 109 eyes, the sensitivity, specificity, positive predictive value, and negative predictive value for detection of RB by AI model were 96%, 94%, 97%, and 91%, respectively. Of these, the eyes were normal (n = 31) or belonged to groupA (n=1), B (n=22), C (n=8), D (n=23),and E (n=24) RB based on review by two independent ocular oncologists (with an interobserver variability of 0%). The sensitivity, specificity, positive predictive value, and negative predictive value of the trained AI model were 100%, 100%, 100%, and 100% for group A; 82%, 20 21 98%, 90%, and 96% for group B; 63%, 99%, 83%, and 97% for group C; 78%, 98%, 90%, and 94% for group D, and 92%, 91%, 73%, and 98% for group E, respectively. Conclusion: Based on our study, we conclude that the AI model for iRB is highly sensitive in the detection of RB with high specificity for the classification of iRB

Clinical Spectrum of Mercury Poisoning in India: Case-series from a Poison Control Center

Background: Mercury is a naturally occurring heavy metal that finds wide application in industrial and household settings. It exists in three chemical forms which include elemental (Hg0 ), inorganic mercurous (Hg+) or mercuric (Hg++) salts, and organic compounds. All forms are highly toxic, particularly to the nervous, gastrointestinal, and renal systems. Common circumstances of exposure include recreational substance use, suicide or homicide attempts, occupational hazards, traditional medicines, and endemic food ingestions as witnessed in the public health disasters in Minamata Bay, Japan and in Iraq. Poisoning can result in death or long-term disabilities. Clinical manifestations vary with chemical form, dose, rate, and route of exposure. Aims and objectives: To summarize the incidence of mercury poisoning encountered at an Indian Poison Center and use three cases to highlight the marked variations observed in clinical manifestations and long-term outcomes among poisoned patients based on differences in chemical forms and routes of exposure to mercury. Materials and methods: A structured retrospective review of the enquiry-database of the Poison Information Center and medical records of patients admitted between August 2019 and August 2021 in a tertiary care referral center was performed. All patients with reported exposure to mercury were identified. We analyzed clinical data and laboratory investigations which included heavy metal (arsenic, mercury, and lead) estimation in whole blood and urine samples. Additionally, selected patients were screened for serum voltage-gated potassium ion channels (VGKC)— contactin-associated protein-like 2 (CASPR2) antibodies. Three cases with a classical presentation were selected for detailed case description. Results: Twenty-two cases were identified between August 2019 and August 2021. Twenty (91%) were acute exposures while two (9%) were chronic. Of these, three representative cases have been discussed in detail. Case 1 is a 3.5-year-old girl who was brought to the emergency department with suspected elemental-mercury ingestion after biting a thermometer. Clinical examination was unremarkable. Chest and abdominal radiography revealed radiodense material in the stomach. Subsequent serial radiographs documented distal intestinal transit of the radiodense material. The child remained asymptomatic. This case exemplifies the largely nontoxic nature of elemental mercury ingestion as it is usually not absorbed from the gastrointestinal tract. Case 2 is a 27-year-old lady who presented with multiple linear nodules over both upper limbs after receiving a red intravenous injection for anemia. Imaging revealed metallic-density deposits in viscera and bones. Nodular biopsy was suggestive of mercury granulomas. A 24-hour urine mercury levels were elevated. She was advised chelation therapy with oral dimercaptosuccinic acid (DMSA). Case 3 is a 22-year-old lady who presented with acrodynia, neuromyotonia, tremulousness, postural giddiness, tachycardia, and hypertension for 2 months, associated with intractable, diffuse burning pain over the buttocks and both lower limbs, 1 month after completing a 3-week course of traditional medications for polycystic ovarian syndrome. A 24-hour urine normetanephrine levels and mercury levels were markedly elevated. Serum anti-VGKC antibodies were present. She was treated with glucocorticoids and oral DMSA with a favorable clinical response. Conclusions: The clinical manifestations of mercury toxicity are highly variable depending on the source, form, and route of mercury exposure and are related to its toxicokinetics.

STUDY ON THE EFFECT OF BLOOD PRESSURE IN GESTATIONAL DIABETES MELLITUS WOMEN AND ITS ADVERSE MATERNAL OUTCOME IN GWALIOR DISTRICT MADHYA PRADESH

Gestational diabetes mellitus (GDM) and preeclampsia (PE) are most common pregnancy complications with similar risk factors and path physiological changes. When a pregnant woman has high blood pressure, protein in her urine, and often swelling in fingers and toes that doesn't go away, she might have preeclampsia .it is a serious problem that needs to be watched closely and managed by her doctor .high blood pressure can cause harm to both the woman and her unborn baby.it might lead to the baby being born early and also could cause seizures or a stroke in the women with diabetes have high blood pressure more often than women without diabetes From previous studies suggests that the incidence of PE commonly increased in women with GDM. and GDM complicated by PE further increases the adverse effect on maternal and new born babies health. This study provides the prevalence of PE in GDM and its adverse maternal outcomes

Preclinical evaluation of Hibiscus cannabinus Linn. in the treatment of urolithiasis and cholelithiasis / 数字中医药（英文）

@#【Objective】  To investigate the therapeutic effect of Hibiscus cannabinus Linn. (H. cannabinus) leaves on cholelithiasis and urolithiasis. 【Methods】  The study evaluated the effect of aqueous leaf extract of H. cannabinus on thiouracil and cholesterol cholic acid diet induced cholelithiasis in BALB/c mice and ethylene glycol induced urolithiasis in Wistar rats. Three doses of aqueous extract (40, 80, and 160 mg/kg) were selected to evaluate the effectiveness in cholelithiasis in mice; another three doses of aqueous extract (400, 800, and 1 600 mg/kg) were administered for evaluating the effect on urolithiasis in rats. Biochemical parameters such as biliary cholesterol, biliary phospholipid, and bile acid were determined in cholelithiasis model. Similarly, 24-hour urine output, urinary parameters such as creatinine, uric acid, protein, urea, presence of calcium oxalate crystals, red blood cells (RBCs), and pyuria were determined in urolithiasis model. 【Results】  Statistically significant differences were noted in the biliary and urinary parameters after administrating three test doses of H. cannabinus aqueous extract (P < 0.05). 【Conclusion】 H. cannabinus was found to be effective against high fat lithogenic diet urolithiasis and cholelithiasis.

Posterior superior alveolar nerve block alone in the extraction of upper third molars: a prospective clinical study

Background@#Third molar extraction is the most commonly performed minor oral surgical procedure in outpatient settings and requires regional anesthesia for pain control. Extraction of the maxillary molars commonly requires both posterior superior alveolar nerve block (PSANB) and greater palatine nerve block (GPNB), depending on the nerve innervations of the subject teeth. We aimed to study the effectiveness of PSANB alone in maxillary third molar (MTM) extraction. @*Methods@#A sample size comprising 100 erupted and semi-erupted MTM was selected and subjected to study for extraction. Under strict aseptic conditions, the patients were subjected to the classical local anesthesia technique of PSANB alone with 2% lignocaine hydrochloride and adrenaline 1:80,000. After a latency period of 10 min, objective assessment of the buccal and palatal mucosa was performed. A numerical rating scale and visual analog scale were used. @*Results@#In the post-latency period of 10 min, the depth of anesthesia obtained in our sample on the buccal side extended from the maxillary tuberosity posteriorly to the mesial of the first premolar (15%), second premolar (41%), and first molar (44%). This inferred that anesthesia was effectively high until the first molars and was less effective further anteriorly due to nerve innervation. The depth of anesthesia on the palatal aspect was up to the first molar (33%), second molar (67%), and lateromedially; 6% of the patients received anesthesia only to the alveolar region, whereas 66% received up to 1.5 cm to the mid-palatal raphe. In 5% of the cases, regional anesthesia was re-administered. An additional 1.8 ml PSANB was required in four patients, and another patient was administered a GPNB in addition to the PSANB during the time of extraction and elevation. @*Conclusion@#The results of our study emphasize that PSANB alone is sufficient for the extraction of MTM in most cases, thereby obviating the need for poorly tolerated palatal injections.

Evaluation of Dental Interns' Perception and Self-Confidence Levels Regarding Endodontic Treatment"- A Questionnaire Study

ABSTRACT Objective: To evaluate the perception and self-confidence of Dental interns regarding endodontic treatment performed on patients. Material and Methods: A total of 111 dental interns from 5 different educational institutes of a state in South India participated in a questionnaire-based survey. The questionnaire consisted of 12 questions related to root canal procedures performed on patients. Analysis was done using SPSS version 17.0. Results: Sixty-five interns (59%) performed less than 10 root canal treatments on patients during the course of the internship. Twenty-eight interns (25% of the intern population) took up more than 10 root canal treatment cases, whereas only 18 interns (16%) did not perform the treatment on patients and answered the questionnaire based on their experience with extracted teeth model work. Only five interns out of 111 were 'Very confident' and 22 were 'Confident' in performing the root canal treatment. Conclusion: The present study indicates that the self-perceived confidence level among dental interns can affect their clinical performance. It also recommends additional hands-on workshops, problem-based learning and clinical guidance for the dental interns to become more confident with the root canal procedure.

Successful use of rivaroxaban achieving therapeutic anti-factor xa levels in a morbidly obese patient with acute intermediate-high risk pulmonary embolism / Uso bem-sucedido de rivaroxabana com níveis terapêuticos de antifator xa em paciente com obesidade mórbida e embolia pulmonar aguda de risco intermediário-alto

Abstract Direct oral anticoagulants (DOACs) have become the standard of care for acute and long-term therapy for venous thromboembolism (VTE) due to their efficacy and safety profiles. The 2021 International Society on Thrombosis and Haemostasis guidelines recommend using standard DOAC dosages in patients with BMI >40 kg/m2 or weight >120 kg. Use of DOACs remains uncertain in morbidly obese patients with VTE, including acute PE. A morbidly obese woman in her 30s who presented with acute worsening of dyspnea was diagnosed with acute intermediate-high risk acute pulmonary embolism and concomitant proximal deep vein thrombosis, constituting a clinically challenging scenario for treating her with rivaroxaban. Standard doses of rivaroxaban for acute and extended phase treatment of venous thromboembolism in individuals with morbid obesity at BMI>70 kg/m2 may be effective, and safe.

Resumo Devido à sua eficácia e aos seus perfis de segurança, os anticoagulantes orais diretos (DOACs) tornaram-se o padrão de cuidado para a terapia aguda e de longo prazo de tromboembolismo venoso (TEV). As diretrizes da Sociedade Internacional de Trombose e Hemostasia de 2021 recomendam o uso de dosagens padrão de DOACs em pacientes com índice de massa corporal (IMC) > 40 kg/m2 ou peso > 120 kg. O uso de DOACs em pacientes com obesidade mórbida e TEV, incluindo embolia pulmonar aguda, ainda não foi esclarecido. Uma mulher com obesidade mórbida na faixa dos 30 anos que apresentou piora aguda da dispneia foi diagnosticada com embolia pulmonar aguda de risco intermediário-alto e trombose venosa profunda proximal concomitante, com o cenário clínico desafiador de tratá-la com rivaroxabana. Doses padrão de rivaroxabana para tratamento e recorrência de tromboembolismo venoso em indivíduos com obesidade mórbida e IMC > 70 kg/m2 podem ser eficazes e seguras.

To Compare the effect of Chloroprocaine and Chloroprocaine with Fentanyl for Spinal Anaesthesia: A Prospective Randomised Double Blind Study.

Background: Usually for lower abdomen and lower limb short surgical procedures, spinal anaesthesia is a reliable and safe anaesthesia technique.2-chloroprocaine (2-CP) is an amino-ester local anaesthetic with a very short half-life. Adjuvants are required with short acting local anaesthetic for spinal anaesthesia to prolong analgesia. Aims and Objectives: The present study was conducted to analyse the effect of 2-CP alone and with fentanyl combination in spinal anaesthesia for short surgical procedures in terms of onset of block, adequacy of anaesthesia, analgesia and recovery. Materials and Methods: The study was conducted in our hospital in 60 patients undergoing lower abdomen and lower limb short surgical procedures under spinal anaesthesia with either 2-CP or 2-CP and fentanyl (group I or group II) after randomisation into two groups. Spinal anaesthesia characteristics of sensory and motor block, duration of analgesia were noted and appropriate statistical analysis was performed. Results: The onset of sensory and motor block was faster in group II[5.00 ± 3.19 vs 7.156 ± 3.38 min. (p= 0.0138) and 8.03 ± 5.65 vs 11.03 ± 3.97 min. (p= 0.021)] than in group I, and duration of effective analgesia was prolonged in group II (147.63 ± 40.71 vs 130.40 ± 50.85 min with p value of 0.0002)as compared to group I. Eleven patients in group I required analgesic supplementation in the intraoperative period. Conclusion: The patients undergoing short surgical procedures of lower abdomen and lower limb under spinal anaesthesia with short acting local anaesthetic 2-CP with fentanyl as an additive provides rapid onset of sensory and motor block and prolonged duration of analgesia.

Preterm General Movements in Prediction of Neurodevelopmental Disability and Cerebral Palsy at Two Years: A Prospective Cohort Study

Background: A neurological assessment before discharge from the NICU would enable early targeted intervention to mitigate the risk and severity of cerebral palsy (CP) and neurodevelopmental disability. Objective: To assess the accuracy of general movements (GM) in the preterm and fidgety movement periods in predicting neurodevelopmental disability and cerebral palsy in very preterm infants (?32 weeks gestational age) at 18-24 months corrected gestational age. Study design: Prospective cohort study Participants: One hundred and seventy very preterm infants, mean (SD) gestation 29.8 (1.32) weeks, and birthweight 1215 (226) g. Outcomes: Infants underwent GM assessments in the preterm period (31-36 weeks post-conception age) and fidgety movement period (8-18 weeks post term age). Neurodevelopmental outcomes were assessed in 127 children using the Griffiths Mental Developmental Scales-2. Results: Nine children had neurodevelopmental disability (two infants with cerebral palsy and seven with global developmental delay. The relative risk (95% CI) for neurodevelopmental disability was 1.46 (0.31-6.89) with preterm movements and 6.07 (0.97 – 38.05) with fidgety movements. Sensitivity and specificity values for the prediction of neurodevelopmental disability were 33% and 64% in the preterm period and 25% and 92% in the fidgety movement period, respectively. The sensitivity and specificity values for prediction of CP were 50% and 63% in the preterm period and 100% and 93% in the fidgety movement period, respectively. Conclusion: Preterm movements showed lower sensitivity and specificity than fidgety movements in predicting later CP and neurodevelopmental disability in preterm infants.

Comparing retinal sensitivities on blue-on-yellow and green-on-yellow perimetry in glaucoma suspects

Purpose: To compare the retinal sensitivities between the blue?on?yellow perimetry (BYP)/short?wavelength automated perimetry (SWAP) and green?on?yellow perimetry (GYP) among patients with and without nuclear sclerosis among glaucoma suspects. Methods: After ophthalmic examination, patients were subjected to two perimetric tests: BYP and GYP. The visual field (VF) parameters were compared between the two perimeters (p < 0.05 was considered significant). Results: Fifty?five eyes of 39 patients with a mean age of 60.53 ± 9.70 years were included in the study. Twenty?one eyes had clear lens or pseudophakia. Twenty?six eyes had lower grades of nuclear sclerosis (NO2NC2, NO3NC3) and eight eyes had higher grades of cataract (NO4NC4, NO5NC5). The mean retinal sensitivity (RS) in BYP was 22.08 ± 5.02 (dB) and in GYP was 23.84 ± 5.50 (dB) (p = 0.08). The mean defect in BYP was ?2.56 ± 4.40 (dB) and in GYP was ?3.24 ± 5.05 (dB), pattern standard deviation (PSD) in BYP was 3.65 ± 1.91 (dB) and in GYP was 3.83 ± 1.99 (dB), and foveal threshold (FT) was 24.20 ± 4.32 (dB) in BYP and 28.10 ± 4.50 (dB) in GYP. The two perimeters showed good agreement by the Bland–Altman plot for all parameters. Fourteen eyes showed perimetric changes suggestive of glaucoma by BYP. In these, GYP had a sensitivity of 92.86% (95% CI of 66.13% to 99.82%) and specificity of 95.12% (95% CI of 83.47% to 99.40%). Conclusion: BYP and GYP show good agreement. They are comparable in clear media as well as in different grades of nuclear sclerosis. GYP showed good sensitivity and specificity compared to BYP.

A Prospective and Retrospective Study of Bone Marrow in Patients with Pancytopenia– A Study of 150 Cases

BACKGROUND : The bone marrow is widely distributed organ and is the principle site for blood cells forma?on. The broad spectrum of disorders affects the marrow primarily or secondarily with presenta?on of peripheral pancytopenia. Hence, bone marrow examina?on is extremely helpful in evalua?on of pancytopenia. This study emphasizes the different causes of pancytopenia and bone marrow morphology in cases of pancytopenia. MATERIALS & METHODS: The present study is a retrospec?ve and prospec?ve study done in the department of Pathology, for a period of two years. All the relevant history, clinical details, radiological details, and biochemistry parameters were considered. RESULTS: Out of 150 cases,96 were males and 54 were females. Majority of the pa?ents were in the age group of 41-60 years (54%) amongst whom Megaloblas?c anaemia was the most important cause of pancytopenia. CONCLUSION: Bone marrow aspira?on is rela?vely a very safe invasive procedure and primarily permits cytological assessment since the underlying pathology determines the management and prognosis of the pa?ents.

A short-term chick embryo in vivo xenograft model to study retinoblastoma cancer stem cells

Purpose: Cancer stem cells (CSCs) reported in various tumors play a crucial role in tumorigenesis and metastasis of retinoblastoma (Rb). Following the efforts to reduce, replace, and refine the use of mammalian models, we aimed to establish a short?term xenograft for Rb to evaluate the CSC properties of CD133? Rb Y79 cells, using the well?established chick embryo chorioallantoic membrane (CE?CAM) assay. Methods: Y79 cells were cultured, labeled with two different dyes (CM?Dil Y79 and enhanced green fluorescent protein (eGFP)) and sorted for CD133? and CD133 + subsets. Two million cells from each of the labeled groups were transplanted onto the abraded CAM on embryonic day 7 (E7). On E14, the tumor nodule formation on CAM and spontaneous metastasis to the embryos were evaluated by confocal microscopy, in vivo imaging, and histology. Results: Y79 cells formed pink–white raised perivascular nodules with feeder vessels on the CAM with both the types of labeled CD133? cells. CD133? cells, when compared to CD133 + cells, demonstrated significantly larger tumor volume (40.45 ± 7.744 mm3 vs 3.478 ± 0.69 mm3, P = 0.0014) and higher fluorescence intensity (CM?Dil: AUF = 6.37 × 107 ± 7.7 × 106 vs 1.08 × 107 ± 1.6 × 106; P < 0.0001; eGFP: AUF = 13.94 × 104 ± 2.54 × 104 vs AUF = 1.39 × 104 ± 0.4 × 104; P = 0.0003). The metastatic potential of CD133? cells was also observed to be higher as noted by in vivo imaging and histopathology. Conclusion: This study highlights that CE?CAM is a feasible alternative nonmammalian model for evaluating tumorigenicity and metastatic potential of Y79 CSCs. Increased tumorigenicity and metastatic potential of CD133? subset of tumor cells substantiate their CSC properties

Pars plana Aurolab aqueous drainage implantation for refractory glaucoma: Outcome of a new modified technique

Purpose: To report the outcomes of pars plana insertion of Aurolab aqueous drainage implant (AADI) in adults with refractory glaucoma by the novel technique of making scleral tunnel instead of patch graft to cover the tube to prevent its migration. Methods: A retrospective study was done between April 2016 and April 2018 on patients with ?12 months of follow?up. The main outcome measure was a surgical failure at 12 months. The failure was defined as intraocular pressure (IOP) >18 mmHg or IOP ?5 mmHg on two consecutive follow?up visits after 3 months, reoperation for glaucoma, loss of light perception vision, or implant explantation. Alternate definitions of failure including IOP >21 and IOP >15 mmHg were also considered. Results: The study included 32 eyes of 32 patients. The mean age was 46.2 ± 17.5 years. The most common etiology is traumatic glaucoma (12 eyes, 37.5%). The mean preoperative IOP and anti?glaucoma medications were 43.3 ± 10.3 and 3.4 ± 0.5 mmHg, respectively; both the parameters at the final follow?up were reduced to 15.2 ± 8.1 and 1.6 ± 0.5 mmHg. The Kaplan–Meier survival estimates demonstrated that the cumulative probability of failure was 15.6% (95% CI; 6.8–33.5%) at 3 months, 18.7% (95% CI; 8.9–37.0%) at 6 months, and 25.0% (95% CI; 13.4–43.8%) at 12 months. Conclusion: Pars plana AADI implantation with a newer modification technique is a useful procedure in reducing IOP and the number of anti?glaucoma medications in the eyes with refractory glaucoma. The visual acuity may be stabilized with the concurrent treatment of posterior segment pathology

Effectiveness of Multimodal Ayurvedic Treatment in Vataja Pandu w.s.r Nutritional Deficiency Anemia - A Case Report

Panduroga is a condition where in Pitta Pradhana Tridoshas affect the Dhathus causing deterioration of Varna and Bala, leading to Twak Vaivarnyatha or Pandutha. In present day medical science, symptoms of Pandu are alike to that of anaemia. Anemia is a condition presenting with a depletion of hemoglobin concentration below normal values, or Hematocrit or Red blood cells in the blood. On an average, about 30% or nearly one third of world’s population is claimed to be affected by anemia because of numerous causes. In India prevalence is extremely high compared to world prevalence, close to 51%. Nutritional macrocytic anemia (NMA) in prevailing population and in pregnancy, commonly seen in India, most likely represents combined deficiency of iron, folic acid and vitamin B12. A 45 years old female presented with complaints of Panduta (Pallor of skin), Daurbalya (weakness), Aruchi (loss of appetite), Padashopha (pedal oedema), Pindikodweshtana (leg cramps), Shrama Shwasa (exertional dyspnoea) and Hriddrava (palpitation) with haemoglobin concentration 3.7gm% visited OPD of SJIIM, GAMC, Bengaluru. Initially she was started with oral medications followed by admission to in-patient ward on the succeeding visit. The present case study is intended to understand the accuracy of multimodal Ayurvedic approach consisting of oral medications and Matra Basti with Dadimadya Ghrita, in the management of Panduroga and is found to be effective in overcoming Vataja Pandu

EFFECT OF PNF STRETCHING VERSUS SELF STRAP STRETCHING ON ANKLE DORSIFLEXION RANGE OF MOTION AMONG COLLEGIATE ATHLETES WITH CALF MUSCLE TIGHTNESS.

BACKGROUND: Calf muscle tightness is a very common occurring condition in athlete. Stretching is form of physical exercise in which a specific muscle or tendon (muscle group) is deliberately flexed or stretched in order to improve the muscle's elasticity and achieve comfortable muscle tone. Flexibility helps with injury prevention, reduction of soreness following a workout, and a general sense of well-being. There are different stretching technique and protocol for improvement in calf extensibility and flexibility. The purpose of this study was to investigate the effectiveness of two techniques PNF and SELF STRAP STRETCHING for improving calf flexibility among collegiate athletes. MATERIALS AND METHOD: The selected 30 college athletes were randomly allocated to 2 groups equally. Group1 (n= 15) were given PNF and Group2 (n=15) were given self-strap stretching technique. Calf flexibility for each group was measured using goniometer and knee to wall test.Treatment was given for four days a week for 4 weeks. RESULT: The collected values were analyzed using paired 't' test and independent 't' test. The result showed an increase in the values of goniometric measurement and knee to wall test of the PNF technique (group A) compared to baseline value of self-strap stretching (group B) 16.4 and 10.88 at the end of 4 weeks. CONCLUSION: This study concluded that PNF technique is found to bemore effective in improving the calf muscle among collegiate athletes.

A systematic review of preclinical animal studies on fenofibrate's potential role in type 1 diabetic micro-vascular complications

Abstract Fenofibrate is a peroxisome-proliferator-activator α agonist and it is a widely used drug for hyperlipidemia since its approval in 2004. So, in this review we are focusing on the effect of fenofibric acid's mechanism to alleviate type 1 diabetic micro vascular complications like diabetic retinopathy, diabetic cardiomyopathy in animal models, since the drug is safe, efficacious and more economical when compared with the currently available treatment strategies for juvenile diabetic complications and also a profound observation is needed due to the rarity of research in these therapeutic areas. Important preclinical animal studies published from January 2001 to June 2020 were recognised from databases like PubMed and Cochrane central register of controlled trials. Reviewers screened the articles based on the selection criteria and risk of bias was determined using Systematic Review Centre for Laboratory animal Experimentation risk of bias tool for animal studies. Our literature search yielded a total of 5 studies and after pooling up the data from the 5 preclinical studies, we found that Fenofibrate have the efficacy to prevent type 1 diabetic complications, chiefly diabetic retinopathy and those mechanisms are dependent on peroxisome-proliferator-activator and fibroblast growth factor-21 pathways. Fenofibrate is a well safe and moreover, cost effective medication in preventing type 1 diabetic micro vascular complications especially diabetic retinopathy and also in maintaining the glucose homeostasis in apart from its anti-dyslipidemic effect.