Outcomes of 8 × 8 mm osteotomy in powered external dacryocystorhinostomy

Purpose: To study the endoscopic ostium characteristics and outcome of 8 × 8 mm osteotomy in external dacryocystorhinostomy (DCR) using the microdrill system. Methods: This prospective interventional pilot study was performed on 40 eyes of 40 patients with primary acquired nasolacrimal duct obstruction (NLDO) from June 2021 to September 2021 in patients undergoing external DCR. An 8 × 8 mm osteotomy was performed using round, cutting burr attached to a microdrill system. Success was defined as patent ostium on lacrimal syringing (anatomical) and a Munk score <3 (functional) at 12 months. Postoperative endoscopic ostium evaluation was done using a modified DCR ostium (DOS) scoring system at 12 months. Results: The mean age of the study participants was 42.41 ± 11.77 years and the male?to?female ratio was 1:4. The mean duration of surgery was 34.15 ± 1.66 minutes and that for osteotomy creation was 2.5 ± 0.69 minutes. The mean intraoperative blood loss was 83.37 ± 11.89 ml. Anatomical and functional success rates were 95% and 85%, respectively. The mean modified DOS score was “excellent” in 34 patients (85%), “good” in 1 patient (2.5%), “fair” in 4 patients (10%), and “poor” in 1 patient (2.5%). Complications included nasal mucosal injury in 10% (4/40) of patients, complete cicatricial closure of ostium in 2.5% (1/40), incomplete cicatricial closure in 10% (4/40), nasal synechiae in 5% (2/40), and canalicular stenosis in 2.5% (1/40). Conclusion: An 8 × 8 mm–sized osteotomy created by powered drill and covered by lacrimal sac–nasal mucosal flap anastomosis in external DCR is an effective technique that has minimal complications and shorter surgical time

OBSERVATIONAL PROSPECTIVE STUDY OF DIFFERENT RECONSTRUCTIVE SURGERY IN ORAL CAVITY CARCINOMA

OBJECTIVES & AIMS:• To evaluate the outcome of different Reconstructive surgery in oral cavity carcinoma• To determine the factors which increase the complication in post op reconstructive surgery(like – diabetes, hypertension, smoking etc.)• The effect of flap transfer on complication or on post op rehabilitation of patients in oralcavity carcinoma.MATERIALS AND METHODS: This is a prospective study conducted at GCS hospital,Ahmedabad between oct. 2021 to June 2022. Sample size is 40 patients with case of oral cavitycarcinoma, out of which some cases underwent for PMMC Flap, Radial forearm free flap, ALTfree flap, fibula flap, forehead rotational flap, deltopectoral flap and local flap.CONCLUSION:Risks have not increased complications in PMMC or Free flap group in our study. Various otherstudies have similar results however a larger patient pool may be needed to assess them. ThePMMC flap is more favorable for patients with possibly lethal pre-op morbidities, when a longoperation is not advisable and a small defect is expected as compared to the longer operationduration of ALT free flap & Radial free flap.Though the flap related complications & donor site related complications are more with foreheadrotational flap as compared to PMMC. ALT & Radial forearm free flap, statistically there is nosignificant difference. Also, in the functional post-op outcomes there is minimally statisticallysignificant difference with PMMC flap, ALT free flap or Radial free flap, local flaps and otherreconstructive surgery.

PROSPECTIVE COMPARATIVE STUDY OF CONSERVATIVE VERSUS OPERATIVE MANAGEMENT AMONG PATIENT WITH CELLULITIS

INTRODUCTION: Cellulitis is a bacterial infection of the skin and subcutaneous tissuethat is more generalized than erysipelas and associated with broken skin and pre-existingulceration. Mild cases of cellulitis are generally treated with oral antibiotics, GlycerinMgSO4 dressing & affected part elevation and severe cases required admission & higherantibiotics, skin & blood culture & sensitivity & in case of systemic symptoms & abscessoperative management is required.AIMS AND OBJECTIVES:• To observe the outcome of conservative and operative patients in view ofcomorbidity and after treatment complications.• Following factors are accounting before conclusive outcome.• To understand the patients characteristics, comorbidity and mode of presentation.• To study spectrum of organism isolated from patient undergoing conservative oroperative management.• To compare treatment modality and outcome in management of cellulitis.MATERIAL & METHODS: Data consists of primary data collected by the principalinvestigator directly from the patients who were admitted from OPD in the GCS medicalcollege and hospital. It was observational study for a period of six months from April2022 to September 2022 under sample size was 50 cases.CONCLUSION: We recommended Operative management over Conservativemanagement in cellulitis because single operative incision can release toxic fluid fromaffected part and can promote faster healing and better recovery and less hospital stay.Patient has less mental trauma, less pain and more economical benefits in Operativemanagement therefore study concludes Operative management is superior Compared toConservative management. However, conservative management is preferable in earlystages of cellulitis.

Diabetes Risk Score in Indian Population: Experience from Central India

Introduction: Diabetes is a major health problem in the world causing significant morbidity and mortality. Currently, 77 million people in India and 463 million people are living with diabetes across the world, and this number is expected to rise to 101 million in India and 578 million globally by 2030. The key to reduce the morbidity and mortality is early diagnosis and management. The Madras Diabetes Research Foundation (MDRF) has developed an Indian Diabetes Risk Score (IDRS) to identify people who are at risk of developing diabetes or are undiagnosed. Thus, we conducted a study to calculate the IDRS of people from Central India and identify those who are at risk of getting diabetes. Methods: A total of 1,500 patients or attendants, aged 18 to 60 years (mean age 41.2 years), visiting the Endocrinology clinic, and not diagnosed with diabetes earlier were included in the study after taking proper consent and IDRS was calculated. Results: The male-to-female ratio was 914:586. The mean IDRS was 51.29 in our population with 35.93%, 18.2% and 45.87% of screened subjects having a score of <30, 30-60 and ?60, respectively. Conclusion: Forty-five percent people of the population was at high risk of diabetes as estimated by IDRS, which proved to be an effective and economical tool to identify persons at increased risk of diabetes and diagnose the undiagnosed cases and start early management to reduce the morbidity and mortality.

An unusual case of nasal foreign body presenting as recurrent otitis media

Otitis media (OM) is a common problem involving children. In the majority, the cause is related to dysfunction of the Eustachian tube due to bacterial or viral rhinitis and less commonly due to nasopharyngeal tumors. We present a case of recurrent OM which was evaluated and incidentally found a nasal foreign body for which the patient was asymptomatic. This nasal body was the cause of recurrent OM which is very unusual.

Role of Antihistamine in Allergic Disorders : A Review and Consensus Statements by Indian Medical Association

Background : 20-30% of the Indian population suffers from at least one allergic disease that can have an adverse impact on the quality of life of the patients. Aim : To develop expert opinion-related guidance for the diagnosis and management of allergic disorders. Methodology : An advisory board meeting (hybrid mode) was conducted with 11panel members of the Indian Medical Association (IMA). The panel members discussed issues related to the management of allergic disorders based on the Delphi method. Result : Spirometry is helpful in selected patients of allergic rhinitis where the coexistence of asthma is suspected. In patients with urticaria second-generation antihistamines are preferred for both adults and children due to their low side effects, less drug-drug interaction, anticholinergic effects, longer duration of action, and higher safety. Diagnosis of allergic contact dermatitis can be made based on occupational and exposure history. In atopic dermatitis, patient education about lifestyle changes can prevent flare-ups. In patients with asthma, patients must be educated about the use of the peak flow meter. The diagnosis of food allergy can be made by correlating the food intake timing withthe patient history and the results of allergy testing. Allergic drug reactions can be treated with oral antihistaminic drugs, emollients, and if needed topical corticosteroids. Conclusion : The diagnosis of allergic disorders requires the clinician to consider the clinical presentation, patient history, presence of triggers, and comorbid conditions. Patient education and the new generation of antihistaminic drugs can improve the quality of life of patients with allergic disorders

Screening practices for breast and cervical cancer and associated factors, among rural women in Vellore, Tamil Nadu

Background: Population-based screening coverage for breast and cervical cancer screening in the community is inadequately reported in India. This study assessed screening rates, awareness, and other factors affecting screening, among rural women aged 25� years in Vellore, Tamil Nadu. Methods: Women aged 25� years, from five randomly selected villages of a rural block were included in this cross-sectional study in Vellore, Tamil Nadu. Households were selected by systematic random sampling, followed by simple random sampling of eligible women in the house. A semi-structured questionnaire was used to assess screening practices, awareness, and other factors related to cervical and breast cancer. Results: Although 43.8% and 57.9% were aware of the availability of screening for cervical and breast cancer respectively, screening rates were only 23.4% (95% confidence interval [CI]: 18.4-28.4%) and 16.2% (95% CI: 11.9-20.5%), respectively. Adequate knowledge (score of ?50%) on breast cancer was only 5.9%, with 27.2% for cervical cancer. Only 16.6% of women had ever attended any health education program on cancer. Exposure to health education (breast screening odds ratio [OR]: 6.89, 95% CI: 3.34-14.21; cervical screening OR: 6.92, 95% CI: 3.42-14.00); and adequate knowledge (breast OR: 4.69, 95% CI: 1.55-14.22; cervix OR: 3.01, 95% CI: 1.59-5.68) were independently associated with cancer screening. Conclusion: Awareness and screening rates for breast and cervical cancer are low among rural women in Tamil Nadu, a south Indian state with comparatively good health indices, with health education being an important factor associated with screening practices.

High Fear & Stress in the Quarantine Population of COVID-19 in Southern Rajasthan : A Survey

Background : The advent of the COVID-19 pandemic has caused a significant psychological impact on the General Public, Health Care Workers, Elderly, High-risk groups, etc. Higher fear is likely among the quarantine population. Aim of this study : To evaluate the fear and stress of individuals in quarantine; to determine the possible factors that are influencing the Psychological reactions of the individuals in quarantine compared to the general population; to provide a basis for future Government policies. Methods : A semi-structured questionnaire that included a pre-tested, 7-item Fear of COVID-19 Scale (FCV-19S) was used for data collection. A total of 245 responses were received. Through random sampling, 50 participants each were chosen from the general and quarantine populations. p-value <0.05 was considered significant. Results : Individuals in quarantine had a greater fear of COVID-19 compared to the general population (p=0.0059). Symptomatic fears like clammy hands (p=0.032), sleep disturbance (p=0.00026) and heart palpitations (p=0.000034) were commoner in the quarantine population. The younger age group in the quarantine population was comparatively more affected by News and Social media (p=0.00018). Getting a negative screening test resulted in lesser fear both in the quarantine (p=0.017) and general populations (p=0.002). Conclusion : The individuals under quarantine have greater fear possibly due to stressors like transmitting the infection to family, working on the frontlines, being in high-risk groups, losing jobs, and exposure to social media. However, negative screening tests were shown to reduce the fear.

Growth and Neurodevelopmental Outcomes of Very Low Birth Weight Infants From Southern India at Corrected Age of One Year

Objective: To assess the growth and neurodevelopmental outcome of very low birth weight (VLBW) infants at corrected age of one year. Methods: This prospective cohort study enrolled VLBW infants delivered in a tertiary care hospital, and followed up till oneyear corrected age. The WHO Anthropo version 3.2.2 software was used to calculate weight for age, length for age, and head circumference z-score during follow up. Neurodevelopmental assessment was done using Developmental Assessment Scale for Indian Infants (DASII) at the age of one year. Results: The mean (SD) z-scores at one-year for weight for age, length for age and head circumference were -2.1 (1.1), -1.4 (1.03) and -2.2 (1.2), respectively. The mean (SD) DASII motor and mental scores were 90.8 (13.4) and 96.5 (13.2), respectively. Major and minor developmental abnormalities were noted in 9.4% and 18.2%, infants, respectively. Cerebral palsy was noted in 5.8% infants. Conclusion: VLBW infants showed impaired growth and significant developmental abnormalities at the corrected age of one year.

Embryonal rhabdomyosarcoma of the uterine cervix in an adult female

ABSTRACT Embryonal rhabdomyosarcoma (RMS) of the female genital tract is an uncommon malignancy, presenting mainly in the pediatric and adolescent populations, primarily affecting the first two decades of life. This malignancy presentation in adulthood is rare and is seldom seen. The incidence of this tumor affecting adult females is approximately 0.4 - 1%, with the common site being the vagina. This tumor infrequently involves the cervix. RMS has a poor survival rate and once diagnosed, it requires aggressive management by radical surgery accompanied by chemoradiation. We present a case of an anaplastic variant of embryonal RMS of the uterine cervix presenting as a cervical polyp in a 36-year-old female who complained of dyspareunia and post-coital bleeding.

Diabetes Risk Score in Indian Population: Experience from Central India

Introduction: Diabetes is a major health problem in the world causing significant morbidity and mortality. Currently, 77 million people in India and 463 million people are living with diabetes across the world, and this number is expected to rise to 101 million in India and 578 million globally by 2030. The key to reduce the morbidity and mortality is early diagnosis and management. The Madras Diabetes Research Foundation (MDRF) has developed an Indian Diabetes Risk Score (IDRS) to identify people who are at risk of developing diabetes or are undiagnosed. Thus, we conducted a study to calculate the IDRS of people from Central India and identify those who are at risk of getting diabetes. Methods: A total of 1,500 patients or attendants, aged 18 to 60 years (mean age 41.2 years), visiting the Endocrinology clinic, and not diagnosed with diabetes earlier were included in the study after taking proper consent and IDRS was calculated. Results: The male-to-female ratio was 914:586. The mean IDRS was 51.29 in our population with 35.93%, 18.2% and 45.87% of screened subjects having a score of <30, 30-60 and ?60, respectively. Conclusion: Forty-five percent people of the population was at high risk of diabetes as estimated by IDRS, which proved to be an effective and economical tool to identify persons at increased risk of diabetes and diagnose the undiagnosed cases and start early management to reduce the morbidity and mortality.

Correction of pre-existing astigmatism by on-axis incision size modulation in manual small-incision cataract surgery

Purpose: To study the effect of wound size modulation on pre?existing astigmatism by on?axis placement of incision in manual small?incision cataract surgery (MSICS). Methods: In this prospective interventional study conducted at a tertiary care centre, 40 eyes of 40 consecutive senile cataract patients with 1.00�00 D corneal astigmatism were enrolled for the study. MSICS by modified Blumenthal抯 technique was performed through 6.0, 6.5, and 7.0 mm on?axis incision in 1.0�49 D (group A), 1.50�99 D (group B), and 2.00�00 D (group C) astigmatism, respectively. Surgically induced astigmatism (SIA) was calculated by vector analysis and double angle plots (DAP) at 12 weeks postoperatively. Results: There were 22 males and 18 females with mean age of 58.12 � 1.18 years. The mean SIA at 12 weeks was 0.85 � 0.28 D in group A (17 eyes), 1.32 � 0.65 D in group B (10 eyes), and 1.91 � 0.69 D in group C (13 eyes). The overall median uncorrected visual acuity was 0.18 (IQR = 0 to 0.2). The mean astigmatism decreased from 1.95 � 0.74 D to 1.04 + 0.57 D (P = 0.00) in superior incision and from 1.70 + 0.50 D to 0.92 � 0.45 D (P = 0.00) in temporal incision group with central shift of centroid in all cases. Conclusion: The customization of on?axis external incision size can be used to manage pre?existing corneal astigmatism of less than 3.00 D using both temporal and superior incisions effectively

Geographic information system-based mapping of air pollution & emergency room visits of patients for acute respiratory symptoms in Delhi, India (March 2018-February 2019)

Background & objectives: Studies assessing the spatial and temporal association of ambient air pollution with emergency room visits of patients having acute respiratory symptoms in Delhi are lacking. Therefore, the present study explored the relationship between spatio-temporal variation of particulate matter (PM)2.5 concentrations and air quality index (AQI) with emergency room (ER) visits of patients having acute respiratory symptoms in Delhi using the geographic information system (GIS) approach. Methods: The daily number of ER visits of patients having acute respiratory symptoms (less than or equal to two weeks) was recorded from the ER of four hospitals of Delhi from March 2018 to February 2019. Daily outdoor PM2.5 concentrations and air quality index (AQI) were obtained from the Delhi Pollution Control Committee. Spatial distribution of patients with acute respiratory symptoms visiting ER, PM2.5 concentrations and AQI were mapped for three seasons of Delhi using ArcGIS software. Results: Of the 70,594 patients screened from ER, 18,063 eligible patients were enrolled in the study. Winter days had poor AQI compared to moderate and satisfactory AQI during summer and monsoon days, respectively. None of the days reported good AQI (<50). During winters, an increase in acute respiratory ER visits of patients was associated with higher PM2.5 concentrations in the highly polluted northwest region of Delhi. In contrast, a lower number of acute respiratory ER visits of patients were seen from the ‘moderately polluted’ south-west region of Delhi with relatively lower PM2.5 concentrations. Interpretation & conclusions: Acute respiratory ER visits of patients were related to regional PM2.5 concentrations and AQI that differed during the three seasons of Delhi. The present study providessupport for identifying the hotspots and implementation of focused, intensive decentralized strategies to control ambient air pollution in worst-affected areas, in addition to the general city-wise strategies.

NEUROFIBROMATOSIS ASSOCIATED DIFFUSE CYSTIC LUNG DISEASE

Neuro?bromatosis is an autosomal dominant disorder of neuroectodermal and mesenchymal origin, also known as Von Rechlinghausen disorder. It can also occur inherited or sporadically. A mutation of NF1 gene on chromosome 17q11.2 has been recognized as a disease prompter, and the spectrum of clinical phenotype is wide because of gene complexity, size and diversity of exons. In our article we are presenting a case of neuro?bromatosis associated with diffuse cystic lung disease.

Need for artificial intelligence in pharmaceutical industry and its limitations

Artificial intelligence (AI) is often being touted as the means to bring about the fourth industrial revolution and its role in almost all sectors of our society is almost certain. This brings about an urgent need for evaluating the benefits and limitations of AI and machine learning (ML) across various sectors. Pharmaceutical industry has pioneered in embracing the use of AI in all its core areas but the success as of now seems very limited. The major advantage of AI is that it reduces the time that is needed for drug development, and in turn, it reduces the costs that are associated with drug development, enhances the returns on investment, and may even cause a decrease in cost for the end user along with improved drug safety. Hence, in this article, we will review the scope and limitations of AI in the pharmaceutical industry along with the brief review of how AI/ML can impact geriatric health care.

Significance of Siddha Thirithoda Balancing Food Stuffs

The Siddha system of medicine is an ancient medical system, which provides ‘Holistic Health’. The word ‘Siddha’ originated from the word ‘Siddhi’ meaning achievement of perfection, eternal bliss and accomplishment. The Siddha system evolved based on ninety-six tools (96 Thattuvam) which include physical, physiological, psychological and intellectual aspects of every human being. Among the 96 tools, the five elements i.e. Pancha bootham namely Earth, Water, Fire, Air and Space are the fundamental units of everything in the human body and the cosmos. There are three vital life factors (Vaatham, Pittam, Kabham) responsible for good health. There is a relationship between these to maintain the body’s healthy. Any increase or decrease in humour causes diseases. Thirthoda sama porutkal (TSP) maintains these humour when we are using our regular diet. This article details the TSP to maintain the body healthy.

Human Body and its Relation with Planets Siddha Perspective

Siddha system is the foremost traditional system, which was introduced by ancient Siddhar’s. According to Siddhar’s, nature is man, man is nature. Man is said to be microcosm and universe is macrocosm. The universe is made up of five elements namely Earth, Water, Fire, Air, and Space. Our body is also made up of five elements (Panchaboothas), three vital humors known as Vatham (air, space), Pitham (fire), Kabam (Earth, water), seven physical constituents are Saram (nourishing fluid), Senneer (blood), Oonn (muscles), Kozhuppu (adipose tissue), Enbu (bone), Moolai (bone marrow), Sukkilam/Suronitham (sperm/ovum) respectively. The universe has stars and planets. Each planet has an influence that reflects in our bodies. Thoughts were controlled by cosmic force in the universe. Nine planets in the universe correlate with the organs in the body Sun-Heart, Moon-Brain, Mercury-Lungs, Jupiter-Liver, Saturn-Spleen, Mars-Gall Bladder. This article explains how the planets have a connection with our human body.

Calcifying Aponeurotic Fibroma in the left pectoral region in an adult: A Case report.

Calcified aponeurotic fibroma is a rare benign fibroblastic tumor. The lesion has property of local invasion and high recurrence. Because of this property, tumor should be accurately diagnosed pre-operatively. We report a case of 29 years old male, with a palpable painful mass on the anterior chest wall near left pectoral region, describes radiographic and MR findings. No skin defect was detected but patient feels discomfort. An excision procedure was done. The excised tissue was sent for biopsy and calcified aponeurotic fibroma was diagnosed

Correlation between D-dimer and HRCT in Covid-19

Background: To retrospectively determine the correlation between CTseverity score & D-dimer. Methodology: This is retrospective original research of 227 patients (IPD & OPD) during April 1 to May 31, 2021 for Covid-19. Patients CTseverity scores, HRCTThorax findings, D-dimer, Platelet count and Demographic variables were recorded. The correlation between CTseverity score & D-dimer were determined. Results:Between the mentioned dates, 227 patients are taken into study which includes 146 Males & 81 Females. Mean of CTseverity score was 6.7, D-dimer was 0.46mg/l. Higher CTscore is seen in males (mean -7.1) as compare to females (mean -6.12). D-dimer are seen higher in males (mean =0.52mg/l) as compare to females (median=0.37mg/l). The study of 227 patients has shown positive correlation between CTscore & D-dimer (r=0.38, p<0.05). Males showed relatively stronger positive correlation (r=0.4, p<0 .05) than females (r=0.3, p<0.05). Patients with age less than equal to 45 has shown relatively stronger positive correlation between CTscore & D-dimer (r=0.4, p<0.05) than patients with age more than 45 (r=0.35, p<0.05). Conclusion:Pulmonary lesion induced by SARS-CoV-2 infection was associated with raised inflammatory response, impairment in exchange of gases, and end organ damage. In study, we can conclude that lung lesion may exert important role in COVID-19 pathogenesis & clinical presentation

Vulnerability To Health in A Ward of Bengaluru: Insights from A Mobile-Based Survey

Context/Background: Rapid urbanization has resulted in a growing number of people living in under-served areas with inadequate and overburdened infrastructure and services, worsening of environmen-tal factors. Sustainable Development Goal 11: “sustainable cities and communities”, highlights, there is an urgent need to re-orient the community development strategies by adopting economically & techno-logically sustainable models. Aims/Objectives: An application-based household survey to assess the vulnerability and Health condi-tions among the urban poor of slums in Bengaluru. Methodology: The tool for Vulnerability Assessment by Government of India was modified to develop a user-friendly tool for Community Health Workers in an Android–based smartphone application (Namma Samudaya). Data was collected through house-to-house survey. Results: A total of 3165 households (HHs) were surveyed. Among these, 54.2% of the HHs belong to vulnerable category and 45.8% to highly vulnerable group. Conclusions: Domain-wise analysis showed, Residential -25.2% of HHs were located besides polluted water Social - “No social support” and “disability” was reported by 3% of households each; Health-Related - Catastrophic Health expenditure in the past 1 year was reported by 40.4% HHs. The baseline information of slums & their geographic mapping obtained during the survey can be used as foundation for effective planning of health care services.