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Introduction: Myopia is a major health issue in our society. There is a large number of proportion remain undiagnosed. High myopia can be associated with multiple consequences as myopic retinopathy, myopic macular degeneration, retinal detachment and amblyopia. The aim of our study to focus on magnitude of childhood myopia, increase awareness for myopia in our society so that we can reduce vision threatening sequelae in children. Methods: Study was conducted in ophthalmology department and ENT department government medical college Saharanpur, medicine department Uttar Pradesh medical sciences, Saifai and pediatric department GTB medical college New Delhi. Children between 7 to 16 years with ametropia included in the study to find out magnitude of myopia among them. Result: A total of 1460 children between the age of 7-16 years with complains of eyeache, headache, heaviness of head diminution of vision, and with other asthenopic symptoms included in the study. Among these 320 children were myopic. It shows high magnitude of myopia in children. Out of these myopic children mild grade myopic children were in high proportion (35.9%). Conclusion: The study showed the pattern of myopia in children in Indian population. Screening in schools and early diagnosis of refractive error affect the learning and performances of children. In our study we showed the pattern of severity of myopia in children. Study also showed the effect of digital screen time of children with myopia.
ABSTRACT
The coronavirus pandemic is a global health crisis of recent times and the biggest threat we have faced after the Second World War. This viral infection (COVID-19) is not the only cause of deaths in this pandemic. A usual complication of viral infections is a secondary superimposed bacterial infection or a superinfection. Based on limited published data, the relatively high incidence of severe infection and mortality in COVID-19 patients is attributed to these infections. It is reasonable to anticipate that nearly half of the patients who have died from COVID-19 had superinfection. Patients who have severe form of the disease and those requiring prolonged stay in intensive care units (ICUs) are more prone to developing super added infection by nosocomial pathogens. The most common type of infection observed among COVID-19 patients is ventilator-associated pneumonia (VAP), followed by bacteremia with sepsis and urinary tract infections (UTIs). Antibiotics are commonly prescribed to keep these infections at bay which is promoting antimicrobial resistance (AMR). In developing countries like India, where there is well-established high burden of multidrug-resistant organisms in hospital settings, superinfections in COVID-19 patients can pose a biggest challenge in the treatment leading to increase mortality. There is a need of prospective studies, which should include clinical, microbiological, and epidemiological data on superinfections that can be used in forming effective antimicrobial stewardship strategies;which can have a crucial role in optimal antimicrobial prescribing.
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Aims & Objectives: The 2019 novel coronavirus (2019-nCoV) or the severe acute respiratory syndrome corona virus 2 (SARS-CoV- 2), originated in Wuhan City of Hubei Province of China. In India, first confirmed case of coronavirus disease (COVID-19) was reported on January 30, 2020 and since then the virus has spread across the country. More than 7.9 million cases of COVID-19 and more than 1.19 lakh deaths have been reported in India. The pathobiology of the disease is poorly known, and significant efforts have been made to understand the disease process worldwide. Clinical autopsies are known to have a vital role in developing an understanding of the disease process. The aim of the present study was to evaluate bone marrow findings of COVID-19 by minimally invasive autopsies. Patients/Materials & Methods: This prospective study was conducted at All India Institute of Medical Sciences, Jodhpur. After obtaining approval from Institute's ethics committee and consent from next of kins, minimally invasive autopsies were conducted within an hour after the death. Procedures were done with all biosafety measures. The tissue specimens were kept in neutral buffered formalin for 48 h and then processed with standard biosafety measures. Electronic medical records were reviewed retrospectively and patients' clinical details and results of laboratory investigations were noted. Results: In this prospective study, bone marrow biopsy procedures were done in 37 COVID-19 minimally invasive autopsies. Mean age of these cases was 61.8 years (Range, 28-85 years) and male: female ratio was 2.36. Comorbidities were observed in 25(67.5%) of all cases. Histopathological analysis revealed hypercellular, normocellular and hypocellular marrow in 5, 25 and 5 cases respectively (two biopsies were inadequate). There was marked interstitial prominence of histiocytes in 24(68.5%) cases. Out of these, evidence of haemophagocytosis (Figure 1) was observed in 14(40%) cases, marked increase of haemosiderin laden macrophages in 20(57.1%) cases. There was prominence of plasma cells in 28 (80%) cases. Discussion & Conclusion: Incorporation of minimally invasive autopsies provides an effective method to study the pathological findings in COVID-19 deaths in resource constrained settings. Histopathological findings in bone marrow suggest indirect insult to bone marrow, presumably related to circulatory and/or hyperinflammatory response to viral infections.
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Aims & Objectives: To study coagulation parameters and its effect on outcome in patients with COVID-19. Patients/Materials & Methods: : It was an observational crosssectional study conducted in single tertiary hospital. The study was conducted on samples from 230 patients. All the patients were positive for SARS-CoV-2 by RT-PCR. Patients were categorized as asymptomatic, mild, moderate, or severe according to the guidelines published by the Ministry of Health and Family Welfare (MoHFW), Government of India and World Health Organisation. Following parameters were analysed for these patients- Prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer, fibrinogen, factor-VIII, protein-C (PC), protein-S (PS) and antithrombin. Results: Our study conducted on 230 adults showed that there is increase in coagulation abnormalities with increase in severity of COVID-19. There is increase in pro-coagulant and anticoagulant activity with increase in severity of disease. 230 patients included 132 (57.4%) males and had mean age 51.82 ± 16.6 years. In this cohort, 61.3% of patients were either asymptomatic (34.3%) or had mild disease (27%), whereas 20% and 18.7% patients had moderate or severe disease, respectively. 12 (5.2%) and 26 (11.3%) patients had prolongation of PT and APTT, respectively. D-dimer levels increased with increasing disease severity and were significantly higher in nonsurvivors when compared to survivors (6.32 ± 7.62 vs 1.69 ± 3.8 lg/mL;p<0.0001). Mean levels of fibrinogen, PC, PS and antithrombin levels though remained in normal range but increased from asymptomatic to moderate disease. However, factor VIII showed significant increase in all stages. Discussion & Conclusion: Number of patients with abnormal procoagulant and anticoagulant parameters increased with increasing severity but didn't differ among survivor and non-survivors except PS. This study reveals age, D-dimer, APTT, fibrinogen and Factor VIII levels were significantly higher in patients with moderate and severe disease as compared to asymptomatic and mild disease.
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BACKGROUND: Duration of persistence of SARS-CoV-2 in the upper respiratory tract of infected individuals has important clinical and epidemiological implications. AIM: We aimed to establish the duration and risk factors for persistence of SARS-CoV-2 in the upper respiratory tract of asymptomatic infected individuals. METHODS: Data of repeat rRT-PCR (real-time reverse transcription-polymerase chain reaction) test done for SARS-CoV-2 infected individuals at our institute at Jodhpur, India were analysed from 19 March to 21 May 2020. Duration of virus persistence was estimated with parametric regression models based on weibull, log-normal, log-logistic, gamma and generalized gamma distributions. Factors associated with prolonged viral persistence were analysed with the best-fitting model. RESULTS: Fifty-one SARS-CoV-2 infected individuals with repeat rRT-PCR test were identified with 44 asymptomatics. The asymptomatic individuals had median virus persistence duration of 8.87 days (95% CI: 7.65-10.27) and 95 percentile duration of 20.70 days (95% CI: 16.08-28.20). The overall median virus persistence including both symptomatic and asymptomatic individuals was found to be 9.18 days (95% CI: 8.04-10.48). Around one-fourth asymptomatics (10/44) demonstrated SARS-CoV-2 persistence beyond 2 weeks. Age <60 years and local transmission were found to be significantly associated with longer virus persistence among asymptomatic individuals on univariate regression but not in multivariate analysis. CONCLUSION: Recommended home isolation duration for SARS-CoV-2 infected individuals in India should be extended from 17 days to at least 3 weeks. Prolonged persistence of SARS-CoV-2 in a considerable proportion of asymptomatic individuals merits attention with regard to ensuring universal infection prevention precautions irrespective of symptomatic status.