RESUMO
Background: Use of spectacles is common for people having vision problems. Unifocal and bifocal are usually the commonly used lenses for vision correction. The aim of the present study was to compare the effect of type of lenses in eyeglasses on the neck muscles endurance and neck posture.Methods: A sample of 132 subjects were recruited and divided in three groups according to use of unifocal, bifocal or no glasses. Normal healthy subjects using eyeglasses for a minimum of 2 years and as per selection criteria were assessed for their deep neck flexor endurance (DNF) and craniovertebral angle (CVA).Results: Females had less DNF endurance than males in all groups. DNF endurance was also least reported in subjects using bifocal lenses followed by unifocal and no glasses. These results were similar for both males and females. Bifocal group also had least CVA amongst both sexes.Conclusions: Use of bifocal lenses reduces the DNF endurance and leads to forward head posture over time. These two factors are commonly associated with development of neck pain and disability. Assessment for the type of lens in eyeglasses should be added in diagnosing musculoskeletal problems in neck. Appropriate neck exercises, corrective postures and advise for correct eyeglasses at an early stage could maintain DNF endurance and therefore, prevent faulty neck postures and associated pain. This small check could be a big step towards reducing the financial and psychological burden on the patient and an affordable and less invasive public health solution to neck related problems.
RESUMO
Background: Congenital malaria is defined as malarial parasites demonstrated in the peripheral blood smear of the newborn from twenty four hours to seven days of life. Malaria is endemic in India, neonatal disease is considered rare. Routine screening for malaria is essential for all neonates with fever in endemic areas. Early diagnosis and treatment of malaria could effectively prevent infant mortality. The aim of the present observational prospective study is to describe the occurrence and clinical spectrum of congenital vivax malaria in admitted neonates in Bikaner, India (low endemic region). Congenital malaria has been predominantly reported for P. falciparum from different parts of the world but the reports with P. vivax are very scanty. Methods: This prospective study was conducted on admitted neonate from January 2011 to December 2012. The species diagnosis was done by peripheral blood smear examination and rapid diagnostic test. The possibilities of other disease/infections causing similar illness were investigated thoroughly and stringently. A structured questionnaire was used to collect clinical data on newborn and maternal health during pregnancy. Results: A total of 1168 new born admitted in first week of life were screened. Out of them 23 (1.97%) had evidence of parasitaemia (P. vivax 17 and P. falciparum 6). The criteria for admission in these 17 neonates with congenital vivax malaria were LBW and prematurity (41.18%), septicemia (35.29%), perinatal asphyxia (17.65%), jaundice (17.65%) and seizures (5.88%). Conclusions: This study emphasizes the occurrence of P. vivax congenital malaria even in neonates in low transmission area and without typical manifestations. The emphasis is also on the relevance even in very low transmission areas of not only maintaining, but even increasing clinical and epidemiological awareness of this preventable and treatable disease in pregnancy and in the neonate.
RESUMO
Laparoscopic cholecystectomy is the treatment of choice for uncomplicated gallstone disease. Laparoscopic cholecystectomy may result in lost (spilled) gallstones. Such stones may precipitate various infective intra-abdominal complications. An unusual case of spilled gallstones eroding the diaphragm and eventually being expectorated out 12 months after laparoscopic cholecystectomy is reported.