Study 3: Anterior segment optical coherence tomography-guided surgical approach in slipped medial rectus muscle

Purpose: To discuss the novel swept?source anterior segment optical coherence tomography (SS?ASOCT)?guided surgical approach in slipped medial rectus muscles. Methods: Prospectively (between February 2020 and July 2022), six patients with a clinical suspicion of slipped medial rectus muscle were recruited. After complete ophthalmic and orthoptic evaluation, the missing medial rectus muscle is screened using Anterior Segment Optical Coherence Tomography (ASOCT). In presence of a traceable muscle, its morphology, depth, and distance from a fixed anatomical landmarks were noted; in its absence, the status of other recti was noted. Intraoperatively, the features were confirmed and the intended intervention was performed. Results: The mean age of six patients was 25.66 ± 9.72 years, two with surgical trauma and four with penetrating trauma (66.66%). In five patients, the ASOCT traced the slipped medial rectus muscle successfully (83.33%); intraoperatively, the same was confirmed (within 1–2 millimeters) with favorable outcomes. ASOCT made a significant contribution in all subjects by reducing the number of interventions and muscle surgeries. Conclusions: In eyes with slipped medial rectus muscle, especially those which are within a finite distance from the angle can be traced using ASOCT. This approach impacts the outcomes in many ways

Impact of learning effect on reliability factors and global indices in visual field testing by standard automated perimetry in normal healthy subjects and primary open-angle glaucoma patients to obtain an accurate baseline perimetry chart

Purpose: To record and evaluate the reliability parameters (fixation loss (FL) %, false positive (FP) %) and global indices (mean sensitivity (MS), mean deviation (MD), pattern standard deviation in dB) in three visual field test sessions within two weeks to assess the learning effect in normal healthy subjects and POAG patients and comparison of learning effect gender wise and age wise in primary open?angle glaucoma (POAG) patients. Methods: This study was a prospective observational study. An oculus visual field testing was done and analyzed in 30 eyes of POAG patients and 30 eyes of normal healthy subjects in three visits. Results: There were 16 (53.3%) males and 14 (46.6%) females in the POAG group and 16 (53.33%) males and 14 (46.66%) females in the normal healthy subject group. A significant difference in data change between each visit in FL, FP, MD, MS was found though the difference was more pronounced in the second visit than in the third visit. The pattern standard deviation does not change significantly in subsequent visits in both groups. Gender wise and age wise no significant difference was found in the POAG group. Conclusion: Significant improvement in reliability parameters and global indices with each subsequent visit in both the POAG group and normal patients signifies the importance of learning effect on these parameters and the need to perform at least three tests to get the baseline perimetry chart, especially in POAG patients, while in normal subjects, second perimetric result can be accepted. It was also concluded that the learning effect is not influenced by age and gender.

Essential Service Products as Channels for COVID-19 Awareness and Behavior Change: A Narrative Review

Coronavirus disease 2019 (COVID-19) is here to stay. Nonpharmacological interventions such as hand hygiene, social distancing, and respiratory hygiene have remained the mainstay to curb the spread of the virus, and these are sustainable. To understand the information, education, and communication (IEC) efforts undertaken during previous pandemics and successful behavior change strategies that may be applicable to ongoing COVID-19 pandemic, we conducted a narrative review of articles using PubMed search on September 11, 2022. The results highlighted that reinforced IEC is the need of the hour in efforts against COVID-19 pandemic. The communication strategy during a pandemic should be of three stages aligned to the objectives of building a basic understanding and knowledge in the target population: building an awareness of the threat; personal actions to minimize the impact; and reinforcing the need for appropriate actions to minimize disease transmission, in that order. An innovative strategy of displaying IEC on the daily essential products can result in a sustainable solution that might result in a “felt need” in the community to follow COVID-19 appropriate behavior. A broad base of stakeholders' engagement with civil bodies, nongovernmental organizations, private sectors with well-defined responsibilities and accountability would offer an enabling environment for these efforts in ultimately curbing the COVID-19 pandemic.

Non-alcoholic Fatty Liver Disease (NAFLD) in India : Challenges and the Ways Forward

Non-alcoholic Fatty Liver Disease (NAFLD) is a distinct hepatic condition and one of the most common causes of Chronic Liver Disease globally. In February, 2021, the Government of India had launched and integrated interventions to prevent and control NAFLD in the ongoing National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS). This review was conducted to identify challenges and proposes solutions for effective program implementation. The authors identified that since NPCDCS has been implemented as District-based program and NAFLD being new component, the lack of familiarity of various sub-group of staff could be a major challenge in roll-out. The sensitization of Health Workers, Medical Officer in Primary Healthcare System, the specialist doctors at all levels of care as well as private practitioners, on various aspects of NAFLD (including epidemiology, clinical features, treatment approach and other aspects) should be conducted. The Information Education Communication (IEC) material should be developed and campaigns for awareness generation amongst general public in prevention and management of the disease should be conducted.Ongoing activities to set up Health and Wellness Centres under Ayushman Bharat Program, is a good opportunity to integrate of NAFLD in primary care level. This will help India to accelerate progress towards Universal Health Coverage

Understanding the metrics used to assess the quality of journals

Various databases offer access to thousands of academic journals. A miscellaneous picture with respect to quality, scientific influence and prestige is presented by umpteen numbers of journals present. Authors wishing to publish their research aim to publish in journals with the highest ratings and are ultimately in no man’s land.

Dual partial arc volumetric-modulated arc therapy: The game changer for accelerated hypofractionated whole-breast radiotherapy with simultaneous integrated tumor cavity boost in early breast cancer - A comparative dosimetric study with single partial arc volumetric-modulated arc therapy

Introduction: In a previous study, we demonstrated clinical and dosimetric feasibility of single partial arc volumetric modulated arc therapy (VMAT) for accelerated hypofractionated whole breast radiotherapy with simultaneous integrated boost (SIB) to lumpectomy cavity for early breast cancer. In this dosimetric study, we compared dual partial arcs versus single arc. Patients and Methods: Fifteen consecutive patients for treatment with hypofractionated accelerated radiotherapy with SIB using VMAT were planned with single partial arc in an earlier study, initial result of which is published elsewhere. The comparative dosimetric plan was created using two partial arcs. Skewness and kurtosis test, Paired Student's t-test, and Wilcoxon signed-rank test were applied for statistical analysis. P < 0.05 was considered statistically significant. Results: Most planning targets are better achieved with dual arc technique. Coverage of planning target volume (PTV) whole breast (PTVWB) and PTV lumpectomy cavity (PTVBOOST) was significantly improved with dual partial arc without significant difference in conformity index and homogeneity index. Dual arc improved dosimetric parameter significantly. Mean dose (Dmean) and maximum dose (Dmax) of whole breast PTV as well as Dmax of PTVBOOST; ipsilateral and contralateral lung Dmean, Dmax, 5 Gy volume (V5); contralateral lung Dmean, Dmax, V5; Heart V25 and V18; Dmean of 5 mm thickness skin; Dmean and Dmax of ribs; and Dmean and Dmax of contralateral breast were improved with dual arc. Conclusion: This is first of its kind study establishing the advantage of dual partial arcs in the current context. Dual partial arcs improved dosimetry over single partial arc. Significant dose reduction can be achieved for multiple crucial organs at risk

A 10 Year Study Of Dissociative Stupor And Possession In Psychiatry Opd

The aim of the present study is to identify the incidence of Dissociative Stupor and Possessions in psychiatry OPD population. 8.92% of patients in last 10 years were in the screening group. There were 10.03% of the subjects in 2007 sliding through to 7.76% in 2016, a visible decline. Males are affected earlier (mean age 18.59 years) than females (mean age 23.4 years). The study also proved that females far outnumber males in this category of illness but in the ages between 6 to 12 years, this relationship is reversed.

Decoding mystery disease “litchi as idiopathic triggering cause of hypoglycemia-induced (LITCHI) encephalitic syndrome” – Are the evidence of association adequate?

There has been an increase in reports of outbreak of encephalopathy in children presenting with a syndrome of sudden onset of high fever and altered sensorium in and around the peak of Indian summer months in geographical regions that flourish in Litchi plantation. In the light of the increased mortality and morbidity due to the mystery disease and the speculations surrounding litchi consumptions, a study was conducted in the litchi production hub of Muzaffarpur district Bihar in India by the NCDC in technical collaboration with US CDC. The variables that were significantly associated were litchi consumption (OR: 9.6 [3.8-24.1]), visiting a fruit orchard (OR: 6 [2.7-13.4]), and absence of an evening meal (OR: 2.2 [1.2-4.3]) in the 24-h preceding illness onset. The recommendations that have been advocated are to avoid eating unripe litchi or its seed and always preferring fresh and ripe ones, children should not to go to sleep without a proper dinner meal during the litchi season and cases of altered sensorium should be always be checked for blood glucose levels and prompt correction should be done if levels suggest hypoglycemia in hospitals.

How far we are from achieving universal health coverage? A situational analysis and way forward for India

Universal Health coverage (UHC) is required for fulfilment of Health for All. Currently World Health Organization has proposed indicators for tracing coverage of UHC. This study aimed to find the current status of the UHC in India and Indian States. Material and Methods: Data were collected from the national data portals, national surveys and annual reports of ministry. In case of non-availability, numerator and denominator were used from different sources. Data were entered in to Microsoft excel and analysed using Stata-12. Results: Coverage indicators for Non Communicable diseases and cataract surgery were not available in any national survey or national report of ministry. Coverage of none of the health system indicators were found to be 100%. Few indicators like Skilled attendance at birth, TB cure rate, Preventive chemotherapy against filariasis, access to improved water source had a coverage of 80%. Across the states and union territories the coverage was variable but no significant difference was observed between the EAG and Non EAG states. Very few states have achieved the minimum coverage of 80% in various coverage indicators. Conclusion: There is non-availability of some data and some data were collected in duplication. Because of the lack of data, it is not yet possible to compare the UHC service coverage index across key dimensions of inequality. Until these data gaps are overcome, inequalities in service coverage cannot be assessed.

Pattern and distribution of shock index and age shock index score among trauma patients in towards improved trauma care outcomes [TITCO] dataset

Objective: To compare the shock index [SI . which is the ratio of heart rate to systolic blood pressure] and Age SI [Age in years multiplied by SI] with survival outcome of the patients across multicenter trauma registry in India

Methods: Study is based on Towards Improved Trauma Care Outcomes [TITCO] project. Records with valid details of age, heart rate, systolic blood pressure, Injury Severity Scale [ISS] and Glasgow Coma Scale [GCS] score was considered. SI was categorized into four groups; Group I [SI<0.6] as no shock, group II [SI>/=0.6 to <1.0] as mild shock, group III [SI >/=1.0 to <1.4] as moderate shock and group IV [SI>/=1.4] as severe shock. Age SI was categorized decade wise into six groups. Mortality was dependent variable. GCS and ISS were considered as secondary variables

Results: 10843 participants from TITCO registry satisfying inclusion-exclusion criteria were considered for study. Mean SI score in group I to IV was increasing with 0.53 to 1.72 respectively. Age SI was seen to be increasing across its six groups. Gender wise no difference was found among SI group. For severe ISS and critical ISS, mortality in SI group IV was 50% and 56 % respectively. Mortality was increasing across mild to severe GCS among all SI groups

Conclusion: The categorized SI and Age SI had shown increase in death percentages from mild to severe severity of injuries. Similar to GCS and ISS, SI and Age SI should also be calculated and categorized in all health care and further plan for management aspects

Attitude among dental practioners towards use of rotary instruments and hand instruments for root canal treatment: a comparative study

Aim: The purpose of present study is to assess the attitude of general dental practioners towards use rotary instruments and hand instruments for root canal treatment. Material and Methods: It was a cross-sectional questionnaire study conducted in the private clinics in Lucknow city, Uttar Pradesh. A total of 400 clinics were visited and face to face interview schedule was conducted. Questionnaire consists of demographic details of dental professionals. Information regarding the years of experience, OPD details and number of root canal treatment done per week by dental professionals was obtained. Use of rotary and hand instruments by dental professionals was inquired. Years of experience with Rotary instruments, procedural problems with rotary instruments faced by dental professionals and reasons for not using the rotary instruments if any was also recorded. Results: 102 (33%) of the total study samples were using rotary instruments for root canal treatment and 100 (32%) using both rotary and hand instruments for root canal treatment. Dentists who are using rotary instruments are facing the procedural problem of file breakage {70 (36%)}. And those dental professionals using hand instruments are facing the problem of ledge formation {82(40%)}. Conclusions: The main procedural failure of the rotary instruments in root canal treatment, faced by dental professionals was file breakage and with hand instrument is ledge formation. Lack of expertise is the main reason which restricts dental professionals from using rotary instruments.

Pulmonary embolism in young natives of high altitude

Thrombotic events are relatively common in high altitude areas and known to occur in young soldiers working at high altitude without usual risk factors associated with thrombosis at sea-level. However, till now, cases with thrombotic events were reported only in lowlanders staying at high altitude. These two cases of pulmonary embolism demonstrate that thrombotic events can occur in highlanders after a prolonged stay at the extreme altitude

Study of root canal morphology of mandibular premolars in an indian population

AIM: The purpose of this study was to describe the external and internal anatomy of the mandibular premolars. MATERIAL AND METHODS: 100 extracted human permanent mandibular first and second premolars teeth were collected. The length of the tooth from the cusp tip to root apex was measured with the help of Vernier calliper. In case of curved roots, ligature wire was adapted to the root and then straightened and measured. Each tooth was examined for the number of roots, curvature of root, presence of root canal invagination. India ink was injected into the pulp chamber through the access opening with a no.27 gauge needle mounted on a disposable syringe. The ink was then drawn through the root canal system by applying negative pressure to the apical end of tooth with the use of central suction system. RESULTS: The average (mean) length of mandibular first premolar was 22.25 mm. Average (mean) length of mandibular second premolar was 21.90 mm. Mandibular first premolar had a ribbon shaped root canal orifice in 35% of teeth. Mandibular second premolar had a ribbon shaped of root canal orifice in 44% teeth. Mesial invagination of the root was found in 18% of first and 8% second mandibular premolar teeth. 78% had a Type I canal pattern with Type II, Type IV, Type V, Type VI and Type VII canals being identified in 1%, 2%, 13%, 2% and 1% of the teeth respectively. CONCLUSIONS: Complex root canal anatomy frequently found with mandibular premolars among which more common with mandibular first premolars in Indian population.

Comparative study of cranial capacity of the non-tribal with Korku Tribal population of Madhya Pradesh, India / Estudio comparativo de la capacidad craneal de población no-tribal con la Tribal Korku de Madhya Pradesh, India

Knowledge of cranial capacity is useful in differentiation of racial and sexual differences, which indirectly reflects the brain volume in different populations. Most of these studies have been done on the dry skulls using linear dimensions. Only few studies have been done on living subjects. The aim of this study was to compare cranial capacity of particular age group of Korku tribe & Non-tribal population of Madhya Pradesh a state of India. This study was carried on 800 healthy volunteer of 20 - 25 year-old age group (in which each 400 males and females) in Korku tribe and Non-tribal population of Madhya Pradesh state of India, by using linear dimensions of head (Lee Pearson's formula). The mean cranial capacity and SD in Non-tribal males and Non-tribal females were 1380.5 +/- 94.6 cc and 1188.7 +/- 91.1 cc, respectively. The mean cranial capacity and SD in Korku males and Korku females were 1212.2 +/- 62.0 cc and 1047.4 +/- 72.4, cc respectively. This study has shown a significant (p<0.05) difference between the same gender populations of Korku tribe and Non-tribal population, with the absolute values being higher in Non-tribal group than in Korku tribe group.

Conocer la capacidad craneal es útil para discriminar diferencias raciales y sexuales, la cual indirectamente refleja el volumen del cerebro en diferentes poblaciones. La mayoría de estos estudios se han realizado en cráneos secos con dimensiones lineales pero escasas investigaciones se han realizado en sujetos vivos. El objetivo de este trabajo fue comparar la capacidad craneal de un grupo etáreo de la tribu Korku y población no tribal de Madhya Pradesh, un estado de la India. Este estudio fue realizado en 800 voluntarios sanos, entre 20 - 25 años de edad (400 hombres y 400 mujeres) de la tribu Korku y población no tribal de Madhya Pradesh de la India, mediante el uso de las dimensiones lineales de la cabeza (fórmula de Lee Pearson ). La capacidad craneal media y DE en la población no tribal para hombres y mujeres fueron 1380,5 +/- 94,6 cc y 1188,7 +/- 91,1 cc, respectivamente. La capacidad craneal media y DE en los hobres y mujeres Korku fueron 1212,2 +/- 62,0 cc y 1047,4 +/- 72,4 cc, respectivamente. Este estudio ha mostrado una diferencia significativa (p <0,05) entre las poblaciones no tribal y la tribu Korku del mismo sexo, con los valores absolutos mayores en el grupo no tribal en comparación con el grupo de la tribu Korku.

Agrobacterium mediated biotransformation.

Twenty-five years ago, the concept of using Agrobacterium tumefaciens (soil gm-ve bacterium) as a vector to create transgenic plants (natural transformation) was viewed as a prospect and a “wish.” Transgenic plants generated by direct DNA transfer methods (e.g., polyethylene glycol or liposome-mediated transformation, electroporation, or particle bombardment) often integrate a large number of copies of the transgene in tandem or inverted repeat arrays, in either multiple or single loci. Genetically engineered corn, cotton and other crop plants have been produced whose genome contains a delta-endotoxin-coding region regulated by sequences. Hence the engineered plants produce the delta-endotoxin protein in their tissues, making them lethal when ingested by insects such as the europian corn borer, (that currently causes crop losses of field corn, popcorn, seedcorn and sweetcorn). From this some people feared that windborne pollen could dust many other plants and potentially harm beneficial insects such as butterflies and bees. Agrobacterium mediated transformed plants have economical and medicinal valuable products.

Estimation of cranial capacity in 20-­25 year old population of Madhya Pradesh, a State of India / Estimación de la capacidad craneana en la población de 20 a 25 años de edad de Madhya Pradesh, un Estado de la India

It is known that there exists close relationship between cranial capacity and size of the brain. Several studies have estimated the cranial capacity, which indirectly reflects the brain volume in different populations. The aim of this study was to estimate cranial capacity of a particular age group of population of Madhya Pradesh. This study was carried out on 400 healthy 20-25 year old (200 male and 200 female) individuals of Madhya Pradesh state of India, by using linear dimensions of head (Lee Pearson's formula). The mean cranial capacity and SD in males & females were 1380.52+/-94.63 cc and 1188.75+/-91.16 cc respectively. This study has shown a significant (p<0.05) difference between male and female population, being higher in males than in females.

Se sabe que existe relación entre la capacidad craneana y el tamaño del cerebro. Varios estudios han estimado la capacidad craneana, la que indirectamente refleja el volumen del cerebro en diferentes poblaciones. El objetivo de este estudio fue estimar la capacidad craneana en un grupo de edad específica de la población de Madhya Pradesh. Este estudio fue realizado en 400 sujetos sanos de 20 a 25 años de edad (200 hombres y 200 mujeres) del estado de Madhya Pradesh, India, mediante el uso de las dimensiones lineales de la cabeza (fórmula Lee Pearson). La capacidad craneana media y DS en los hombres y mujeres fue 1380,52+/-94,63 cc y 1188,75+/-91,16 cc respectivamente. Este estudio demostró una disminución significativa (p <0,05) entre la población masculina y femenina, siendo mayor en hombres que en mujeres.