Prevalence of pre-perimetric primary open angle glaucoma in hypertensives of North India.

Background: Systemic hypertension is alleged to increase the risk of glaucoma. As clinically Primary Open angle Glaucoma (POAG) is diagnosed only after approximately 40% of ganglion cell loss has occurred, therefore this study was commenced with an aim to determine the prevalence of pre-perimetric glaucomatous damage and its association with systemic hypertension using optical coherence tomography (OCT). Materials and Methods: A total of 680 study participants were enrolled in this cross-sectional study. Among them 340 patients were of systemic hypertension (Group 1) and 340 patients without hypertension (Group 2). All patients underwent detailed history, ocular and systemic examination including slit lamp examination, fundus examination by +90 D lens, Humphrey field analyser for field charting and OCT for nerve fiber analysis. For glaucomatous nerve damage. Results: Group 1 and Group 2 had Male: Female ratio of 1:8 and 1:9, respectively (P = 0.809). Maximum participants 48.8% and 54.4% in Group 1 and Group 2, respectively, were in age group 50-59 years. Statistically significant difference was seen in the percentage of pre-perimetric glaucomatous patients between the two groups (P < 0.001). On OCT analysis between pre-perimetric glaucomatous eyes and healthy eyes significant difference in thickness was seen in temporal inner macula, inferior outer macula, temporal outer macula, superior outer macula and nasal outer macula. Significant difference in volume was seen for inferior temporal and nasal outer macula (P < 0.001). Conclusion: In hypertensives, glaucomatous optic nerve damage starts much earlier before the obvious clinical signs of POAG appear, as compared to normotensive individuals.

Tobacco smoking habits and nicotine dependence among the college students of University of Delhi, India.

Background: According to the report on tobacco control in India, tobacco use causes eight to nine lakh deaths annually in India. Tobacco use is on the rise among youngsters especially the college students. The Government of India has made a mandatory display of pictorial health warnings for both smoking and smokeless forms of tobacco products under the Cigarettes and Other Tobacco Product Act, 2003. The objective of the present study was to assess the prevalence of tobacco smoking and to assess nicotine dependence among the college students of the University of Delhi. Methods: A cross-sectional study was conducted among 400 college students of Delhi University from October to December 2019. A semi-structured self-administered questionnaire method was used to collect data on smoking; pictorial warnings and Fragerstrom criteria were used to assess nicotine dependence. Result: Out of the 400 study participants 92 (23%) participants were ever smokers. Among 62 current smokers, the mean age (±SD) of initiation of smoking was 17.3 years (±2.07), median (interquartile range [IQR]) number of cigarettes smoked per day was 3 (2-6), a majority (80.7%) used to smoke after 30 min of waking up in the morning, majority (59.7%) had low nicotine dependence. About half of the past smokers 47% (14 out of 30) and the current smokers 58% (36 out of 62) told that they had no effect of pictorial warning for quitting or decreasing smoking. Conclusion: The present study revealed the tobacco smoking pattern among college students of Delhi. The majority of smokers and non-smokers perceived that pictorial warning is ineffective in driving to quit smoking.

Healthy nutrition for a healthy child: A review on infant feeding in India.

Appropriate infant feeding is crucial for the improvement of child survival worldwide. This review aimed to explore the recommended practices, advantages of breastfeeding, and age-appropriate complementary feeding practices. Colostrum, which serves as the first immunization for the newborn, is largely ignored owing to the various myths surrounding it in developing countries. The World Health Organization recommends an early initiation of breastfeeding within one hour of birth and exclusive breastfeeding for 6 months to combat killer diseases such as diarrheal diseases, pneumonia, and obesity. On the other hand, complementary feeding is recommended with increase in the diversity, quantity, consistency and frequency as the child gets older along with continued breastfeeding for 12 months. Inappropriate complementary feeding is one of the major causes of malnutrition in children under the age of 5 years. Hence, appropriate guidance should be given to caregivers and health-care workers to help them promote the healthy growth of infants and young children.

Telemedicine in India: Where do we stand?

Telemedicine is considered to be the remote diagnosis and treatment of patients by means of telecommunications technology, thereby providing substantial healthcare to low income regions. Earliest published record of telemedicine is in the first half if the 20th century when ECG was transmitted over telephone lines. From then to today, telemedicine has come a long way in terms of both healthcare delivery and technology. A major role in this was played by NASA and ISRO. The setting up of the National Telemedicine Taskforce by the Health Ministry of India, in 2005, paved way for the success of various projects like the ICMR-AROGYASREE, NeHA and VRCs. Telemedicine also helps family physicians by giving them easy acess to speciality doctors and helping them in close monitoring of patients. Different types of telemedicine services like store and forward, real-time and remote or self-monitoring provides various educational, healthcare delivery and management, disease screening and disaster management services all over the globe. Even though telemedicine cannot be a solution to all the problems, it can surely help decrease the burden of the healthcare system to a large extent.

Ca-Ag coexisting nano-structured titania layer on Ti metal surface with enhanced bioactivity, antibacterial and cell compatibility.

A nano-structured titanate layer encapsulated with Ca2+ and Ag+ ions was successfully grown over commercially pure (CP) Ti metal by chemical treatment with H2O2 and subsequent treatment with Ca (NO3)2/AgNO3 solutions. Heat treatment at 600 °C, further transformed this nano-structured titanate layer into titania containing Ca2+ and Ag+ ions. Thus modified Ti metal showed significant enhancement in apatite-forming ability when soaked in simulated body fluid (SBF). Presence of Ag+ ions showed good antimicrobial activity against pathogenic Staphylococcus aureus, and, Ca2+ ions being a major component of bone mineral accelerated the apatite-forming ability over Ti metal in SBF. Further, Ca2+and Ag+ ions proportion over Ti metal surface could be optimised in order to have minimum Ag concentration that can have not only antibacterial activity and also cell compatibility against MG 63 osteoblast-like cells. Therefore, the proposed surface modification approach presented here is expected to be useful in orthopaedic implants that necessitate enhanced bioactivity, antibacterial activity and cell compatibility.

Burden of diabetes mellitus and prediabetes in tribal population of India: a systematic review.

OBJECTIVE: To estimate the burden of diabetes mellitus and pre-diabetes in tribal populations of India. METHODS: The authors reviewed studies from 2000 to 2011 that documented the prevalence of diabetes mellitus in various tribal populations of India. The search was performed using electronic and manual methods. Meta-analysis of data on point prevalence was performed. RESULTS: A total of seven studies were retrieved. The prevalence of diabetes mellitus ranged from 0.7% to 10.1%. The final estimate of diabetes prevalence obtained after pooling of data from individual studies, was 5.9% (95% CI; 3.1-9.5%). The prevalence for impaired fasting glucose (IFG) varied from 5.1% to 13.5% and impaired glucose tolerance (IGT), from 6.6% to 12.9%. CONCLUSION: Chronic disease research in tribal populations is limited. The reported prevalence of IFG/IGT was higher than the prevalence of diabetes and this observation could be suggestive of a potential increase in diabetes in the coming years. Given that lifestyle changes have occurred in the tribal populations, there is a need to synthesize evidence(s) relating to diabetes and other chronic diseases in these marginalized populations and inform policy makers.

High neonatal mortality rates in rural India: what options to explore?

The neonatal mortality rate in India is amongst the highest in the world and skewed towards rural areas. Nonavailability of trained manpower along with poor healthcare infrastructure is one of the major hurdles in ensuring quality neonatal care. We reviewed case studies and relevant literature from low and middle income countries and documented alternative strategies that have proved to be favourable in improving neonatal health. The authors reiterate the fact that recruiting and retaining trained manpower in rural areas by all means is essential to improve the quality of neonatal care services. Besides this, other strategies such as training of local rural healthcare providers and traditional midwives, promoting home-based newborn care, and creating community awareness and mobilization also hold enough potential to influence the neonatal health positively and efforts should be made to implement them on a larger scale. More research is demanded for innovations such as "m-health" and public-private partnerships as they have been shown to offer potential in terms of improving the standards of care. The above proposed strategy is likely to reduce morbidity among neonatal survivors as well.