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2021 ◽  
Vol 23 (2) ◽  
pp. 94-101
Author(s):  
Srijana Karmacharya ◽  
Pranisha Singh ◽  
Aparna Rizyal ◽  
Aditya Prasad Rijal

Amblyopia is a common cause of visual impairment in children. The aim of this study was to assess the profile of amblyopia and the outcome of occlusion therapy in amblyopic children attending the eye department of a tertiary care hospital. This was a hospital based prospective interventional study. Sixty-five eyes of 47 patients fulfilling the inclusion criteria were included in the study. Occlusion therapy was started for the diagnosed amblyopic cases after refractive adaptation of 4 weeks. The mean age of presentation was 8.8 ±3.2 years. 29(61.7%) cases had unilateral amblyopia, 18(38.3%) cases had bilateral amblyopia. Ametropic amblyopia (52.3%) was the most common type of amblyopia followed by Anisometropia (23.1%). Refractive error was the most common cause of amblyopia with compound myopic astigmatism seen among 30.8% and hypermetropia among 29.2% of patients. There was no significant association between initial visual acuity with age of presentation and types of amblyopia respectively (P=0.1, P=0.5). The final visual outcome after therapy was better among patients with Ametropic amblyopia than other types (P=0.02). There was significant association between final visual outcome with age, initial visual acuity, type and severity of amblyopia respectively (P<0.001, P<0.001, P=0.02, P=0.02). In conclusion, Ametropia was the most common type of amblyopia. The mean age of presentation was 8.8 years, which was beyond the critical period affecting the outcome of treatment. Uncorrected refractive error was the most common amblyogenic factor. Age of presentation, types and severity of amblyopia are the important contributing factors for the outcome of occlusion therapy. Therefore, early detection and management of amblyopia is important to reduce visual impairment among children.


Author(s):  
Bianca Senf ◽  
Bernd Bender ◽  
Jens Fettel

Abstract Purpose Suicidality and suicidal ideation (SI) in oncology has long been an underestimated danger. Although there are cancer-specific distress screening tools available, none of these specifically incorporates items for SI. We examined the prevalence of SI in cancer patients, investigated the relation between SI and distress, and tried to identify additional associated factors. Methods A cross-sectional study with patients treated for cancer in a primary care hospital was conducted. Psychosocial distress and SI in 226 patients was assessed. An expert rating scale (PO-Bado-SF) and a self-assessment instrument (QSC-R23) were used to measure distress. SI was assessed with item 9 of the PHQ-9. Data was descriptively analyzed, and correlations and group comparisons between clinically distressed and non-distressed patients were calculated. Results SI was reported by 15% of patients. Classified as clinically distressed were 24.8% (QSC-R23) to 36.7% (PO-Bado-SF). SI was correlated with externally (rτ = 0.19, p < 0.001) and self-rated distress (rτ = 0.31, p < 0.001). Symptoms sufficiently severe for at least a medium major depressive episode were recorded in 23.5% of patients (PHQ-9). Factors associated with SI were feeling bad about oneself, feeling down, depressed, and hopeless, deficits in activities of daily life, psycho-somatic afflictions, social restrictions, and restrictions in daily life. Being in a steady relationship seemed to have a protective effect. Conclusions SI is common in cancer patients. Distress and associated factors are increased in patients with SI. A distress screening with the ability to assess SI could be an important step in prevention, but more research is necessary.


Author(s):  
Samira Jamal ◽  
Sheikh Anwarul Karim ◽  
Sheikh Mahee Ridwan Raihan ◽  
Rajat Biswas ◽  
Mansurul Alam

Background: In this study our main goal was to evaluate the association of psoriasis as a risk predictor for the occurrence of diabetes mellitus (DM) and hypertension (HTN).Methods: This case control study was carried out in the department of dermatology and venereology, Chittagong medical college hospital (CMCH), Chittagong, Bangladesh from 15 June 2011 to 14 May 2012. Where 60 patients with psoriasis and 60 patients with skin diseases other than psoriasis were included according to availability within the study period.Results: During study, among the psoriatic patients, most of the patients with DM and HTN had body mass index (BMI) within normal limit. During analysis of different clinical findings in psoriatic patients scaling was present in all the cases followed by Auspitz sign, koebnerization, itching, scalp involvement and nail changes. Patients with psoriasis were found to have higher incidence of DM and HTN in comparison to their non-psoriatic control group. It was also observed that psoriatic patients having DM and HTN had longer duration of diseases (p<0.05).Conclusions: In conclusion, our study indicates that patients with psoriasis have an increased risk of DM and HTN, confirming the findings from previous several case control and cross sectional studies. These data illustrate the importance of considering psoriasis as a systemic disorder rather than simply a skin disease. Awareness of concurrent diseases will provide the clinician an opportunity of screening .for others systemic diseases.


Author(s):  
Kalpna Jain ◽  
Vinod Sagar ◽  
Sarita Maharia ◽  
H. S. Kumar

Background: Radiotherapy plays a critical role in the management of many patients with head-and-neck (H&N) cancer. To study the incidence of dry eye associated with radiotherapy and correlate them with dose of radiation.Methods: This Hospital based prospective study comprises of 100 patients of head and neck tumors who received radiotherapy by linear accelerator from 2015 to 2017. Ocular examination was done prior to the start of therapy, 1st follow up at 15th day of therapy, 2nd at last day of therapy (23-35 fraction), 3rd at 3 months after completion of therapy for side effects, 4th at 6 months, 5th at 12 month and 6th at 18 months after completion of therapy for assessing dry eye.Results: 59% patients developed dry eye. 44 patients received dose 45-55 Gy and out from these 13 (29.50%) patients developed dry eye, 40 patients received dose 56-65 Gy and out from these 33 (78.00%) patients developed dry eye and 16 patients received dose 66-70 Gy and out from these 13 (95.00%) patients developed dry eye.Conclusions: We concluded that the incidence of dry eye increased with increased total radiation dose. The current study suggests the importance of total dose as well as dose per fraction despite advancement of radiotherapy techniques and using protective mechanisms for eye complications developed.


Author(s):  
Jonathan M. Hyak ◽  
Mayar Al Mohajer ◽  
Daniel M. Musher ◽  
Benjamin L. Musher

Abstract Objective: To investigate the relationship between the systemic inflammatory response syndrome (SIRS), early antibiotic use, and bacteremia in solid-tumor patients. Design, setting, and participants: We conducted a retrospective observational study of adults with solid tumors admitted to a tertiary-care hospital through the emergency department over a 2-year period. Patients with neutropenic fever, organ transplant, trauma, or cardiopulmonary arrest were excluded. Methods: Rates of SIRS, bacteremia, and early antibiotics (initiation within 8 hours of presentation) were compared using the χ2 and Student t tests. Binomial regression and receiver operator curves were analyzed to assess predictors of bacteremia and early antibiotics. Results: Early antibiotics were administered in 507 (37%) of 1,344 SIRS-positive cases and 492 (22%) of 2,236 SIRS-negative cases (P < .0001). Of SIRS-positive cases, 70% had blood cultures drawn within 48 hours and 19% were positive; among SIRS negative cases, 35% had cultures and 13% were positive (19% vs 13%; P = .003). Bacteremic cases were more often SIRS positive than nonbacteremic cases (60% vs 50%; P =.003), but they received early antibiotics at similar rates (50% vs 49%, P = .72). Three SIRS components predicted early antibiotics: temperature (OR, 1.7; 95% CI, 1.31–2.29; P = .0001), tachycardia (OR, 1.4; 95% CI, 1.10–1.69; P < .0001), and white blood-cell count (OR, 1.8; 95% CI, 1.56–2.14; P < .0001). Only temperature (OR, 1.6; 95% CI, 1.09–2.41; P = .01) and tachycardia (OR, 1.5; 95% CI, 1.09–2.06; P = .01) predicted bacteremia. SIRS criteria as a composite were poorly predictive of bacteremia (AUC, 0.57). Conclusions: SIRS criteria are frequently used to determine the need for early antibiotics, but they are poor predictors of bacteremia in solid-tumor patients. More reliable models are needed to guide judicious use of antibiotics in this population.


Author(s):  
Amethyst Bamon ◽  
Rajiv Raina ◽  
Sudhir Sharma ◽  
Nidhi Chauhan

Background: Parkinson's disease (PD) is a neurodegenerative disorder, with male preponderance. It is associated with both motor and non-motor symptoms, which affect quality of life in elderly people. Due to paucity of studies on its epidemiology and prevalence, this disease needs assiduity and further exploration.Methods: A hospital based cross-sectional study was conducted in the tertiary care hospital, among 45 patients diagnosed with PD.Results: The mean age of the participants was 61.17±12.30 years, with male to female ratio was 2:1. The average age of onset of PD was 57.4±12.30 years. Tremor was the most common initial symptom (68.88%) followed by rigidity (20%) and bradykinesia. Most of the patients (86.66%) had progressive symptoms, and 69% had unilateral involvement of limbs.Conclusions: The profile of patients with PD in Himachal Pradesh is similar to that from other populations in India and other developing countries. However, the dearth of studies and data pertaining to PD, invigorate the need to explore this neurodegenerative disorder to comprehend its clinic-epidemiological profile in our state.


Author(s):  
Saleem Yousuf ◽  
Fazle E-Roub ◽  
Athiya Fahiem Khan

Background: objective of the study was to describe and compare frequency of psychiatric disorders in two groups of patients, one with psychogenic non-epileptic seizures (PNESs) and other with epilepsy.Methods: We studied 64 patients in which 32 belonged to the group with PNESs and 32 belonged to group with Epilepsy, admitted in a video-EEG unit of tertiary care hospital in Kashmir in order to confirm epileptic diagnosis. This study was conducted from March 2019 to August 2019 in neurology department and the patients underwent neurological evaluation, inter ictal EEG, MRI, neuropsychological assessment and psychiatric diagnosis codified in DSM-5.Results: Depression was found to be the most common diagnosis in the group with epilepsy-40% versus 15.75% of those with PNES, while as personality disorder (21.88%) was the common psychiatric disorder in group with PNES. Anxiety disorder was found to be the second leading psychiatric disorder and was almost common in both the groups, 13.33% in group with epilepsy and 18.75% in the group with PNES. It was also cited that Psychotic disorder (13.33%) was found only in the group with Epilepsy, while Personality disorder and PTSD was found only in the group with PNES. Bipolar disorder was more prevalent in group with epilepsy (13.33%) than in the group with PNES (3.13%). Somatic symptom disorder, dissociation and obsessive-compulsive disorder (OCD) was also found in both the groups.Conclusions: Psychiatric disorder is more common in PNES than in epilepsy.


Author(s):  
Priyal H. Tolani ◽  
Sarita K. Wadhva

Background: The emergence of tobacco related diseases is a burgeoning public health problem. Every year, more than 8 million people die from tobacco use worldwide. It is one of the major causes of death and disease in India and accounts for nearly 1.35 million deaths every year. India is also the second largest consumer and producer of tobacco. There is an urgent need to curb tobacco use and reduce the associated morbidities and mortalities. The present study was the first step in the process of generating strategies to control the use of tobacco by estimating the prevalence and pattern of tobacco use in an urban community.Methods: Study was conducted in the field practice area of an urban health training center of a tertiary care hospital. House to house survey was done. Houses were selected by systemic random sampling. All the people above 15 years of age were included in the study, with total subjects interviewed being 590.Results: 371 (62.88%) study subjects were males and 219 (37.19%) were females. The prevalence of tobacco consumption was found to be 34.06%, 28.81% used smokeless form of tobacco and 3.39% were smokers. About 1.86% consumed both forms of tobacco.Conclusions: Prevalence of tobacco consumption particularly of smokeless form was quite high. Identification of high-risk group and their pattern of tobacco consumption is crucial in developing innovative and effective strategies to curb the tobacco epidemic in India.


Author(s):  
Preeti Singh ◽  
Karanvir Attri ◽  
Deonath Mahto ◽  
Virendra Kumar ◽  
Dipti Kapoor ◽  
...  

Author(s):  
Mehwish Mooghal ◽  
Wajiha Khan ◽  
Shahid Mehmood ◽  
Lal Bux ◽  
Asrar Ahmad ◽  
...  

Introduction: The RIPASA scoring system was established specifically for Asians. Chong CF in his study consisting of 312 patients who had an emergency appendectomy concluded that optimal cut-off threshold score for negative appendectomy was 7.5. Objective: To determine the diagnostic accuracy of RIPASA scoring system in presumptive accurate diagnosis of acute appendicitis by taking histopathology as the gold standard. Materials and methods: This Cross Sectional Study was carried out at Surgery department at a tertiary care hospital, Karachi over a period of 6 months, from 15th December 2019 to 15th June 2020. A total of 141 patients of both gender of suspected cases of acute appendicitis presenting with sign and symptoms were included in the study. Patients underwent detailed history, general and physical examination and scoring of patients according to RIPASA scoring scale and then decision of appendectomy was taken on the basis of RIPASA score. Removed appendix samples were sent for histopathology. Results: Age range in this study was from 15 to 50 years with mean age of 30.191±6.09 years and mean RIPASA score was 5.375±1.77. Majority of patients were males (58.9%). RIPASA score diagnosed 28(19.9%) and histopathology diagnosed 27(19.1%) patients with acute appendicitis. RIPASA score showed sensitivity of 85.2%, specificity 95.6%, diagnostic accuracy 94%, PPV 82.1% and NPV was 96.4%. Conclusion: We conclude that RIPASA scoring system is the scoring system of choice in diagnosis of the acute appendicitis with good sensitivity albeit a hit high and specificity albeit a bit low profile.


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