Management of multi-surface ocular burns caused by molten iron.

Ocular thermal burns are medical emergencies that require immediate intervention before the standard management protocol, which involves obtaining a detailed history and performing an ophthalmic examination. In this case report, we report the clinical manifestations of ocular burns caused by molten iron and the steps taken for good clinical outcomes. The patient presented with an inferior epithelial defect and limbal and lower lid ischemia at four hours post-injury. Over the course of treatment, due to non-resolving epithelial defect and increased superior lid notching, amniotic membrane transplantation (AMT) and lid repair by pentagon wedge excision were performed. Following AMT, the corneal surface completely healed with residual opacity and neovascularization. Additionally, limbal ischemia was significantly reduced with the restoration of normal lid anatomy. Corneal burns initiate a cascade of inflammatory reactions disrupting the balance between pro- and anti-angiogenic factors, leading to corneal neovascularization. The eyelid damage can lead to necrosis of tissues with eschar formation and eventually quantitative tissue loss. Therefore, timely intervention is the key to the successful management of ocular burns.

Quality of life in glaucoma patients: Comparison of medical therapy, trabeculectomy, and glaucoma drainage device surgery.

Purpose: To compare the quality of life (QoL) in patients with glaucoma on medical therapy and after trabeculectomy and glaucoma drainage device (GDD) using vision, glaucoma, and surgery-specific questionnaires. Methods: This cross-sectional study enrolled 30 patients of moderate to severe glaucoma, each in medical, trabeculectomy, and GDD groups. National Eye Institute Visual Function Questionnaire 25 (NEIVFQ-25), Glaucoma Quality of Life (GQL-15), and Surgery Specific Questionnaire (SSQ) were administered, and cumulative scores were compared. Results: The mean age of the participants was 58.95 ± 13.6 years with a male preponderance (73.3%, n = 66). The mean scores (SD) in the medical, trabeculectomy, and GDD groups using NEIVFQ-25 were 68.97 (6.98), 72.83 (7.81), and 75.20 (8.77), respectively, those using GQL-15 were 20.63 (6.00), 26.23 (9.12), and 28.43 (7.74), respectively, and for the SSQ, they were 74.33 (8.75) and 72.10 (5.92) in trabeculectomy and GDD groups, respectively. NEIVFQ-25 showed a better QoL in the GDD group compared to the medical group, whereas GQL-15 showed a better QoL in the medical group and comparable QoL in trabeculectomy and GDD. Both these QoL scores correlated to the LogMAR visual acuity. SSQ scores did not show a significant difference in the QoL across both surgical groups. Conclusion: NEIVFQ-25 questionnaire scores provided a holistic measure of QoL. GQL-15 assessed the activity limitation and visual disability of the patients but did not take into account the general health and psychological factors influencing the QoL. We did not find a significant difference between trabeculectomy and GDD using the SSQ. For QoL assessment in medically or surgically treated glaucoma, vision-specific and disease-specific questionnaires should always be used in conjunction.

Eye-tunes: role of music in ophthalmology and vision sciences.

Although the healing effect of music has been recognized since time immemorial, there has been a renewed interest in its use in modern medicine. This can be attributed to the increasing focus on holistic healing and on the subjective and objective aspects of well-being. In ophthalmology, this has ranged from using music for patients undergoing diagnostic procedures and surgery, as well as for doctors and the operation theatre staff during surgical procedures. Music has proven to be a potent nonpharmacological sedative and anxiolytic, allaying both the pain and stress of surgery. This review aims to explore the available evidence about the role of music as an adjunct for diagnostic and surgical procedures in current ophthalmic practices.

Change in cardiometabolic risk factors among Asian Indian adults recruited in a mHealth-based diabetes prevention trial.

OBJECTIVE: India is experiencing an increasing prevalence of type 2 diabetes and cardiovascular diseases. Mobile health technology may be a strategy to reduce the risk of cardiometabolic disorders. This paper reports on the effect of a mobile health intervention on cardiometabolic risk factors. METHODS: The mobile health and diabetes intervention was a 12-week reality television-based mobile health program application delivered via videos, short message service and infographics through a smartphone application followed-up weekly by health coach calls. mobile health and diabetes was conducted in a randomized control trial mode randomized controlled trial methodology in three Indian cities (Chennai, Bengaluru and New Delhi) with participants recruited via community screening events. This paper looks at the pre-post changes in cardiometabolic risks among the participants and the place of demography in influencing these. RESULTS: The mobile health and diabetes intervention group experienced a small reduction in waist circumference (1.8 cm) compared to the control group (0.5 cm, p < 0.05) and a greater decrease in systolic blood pressure (2.7 mmHg) compared to the control group (p < 0.05). The improvements in cardiometabolic risk factors were more pronounced in individuals with obesity, although overall effects were very modest. CONCLUSIONS: Cardiometabolic risk factors can be reduced with a mobile health application using human coaching, especially in obese individuals, but the improvements are small. To be more effective and clinically meaningful, intensive engagement with the participants is probably required.

Engagement and Weight Loss: Results from the Mobile Health and Diabetes Trial.

Background: Prevalence of type 2 diabetes (T2D) is increasing worldwide. Identifying and targeting individuals at high risk, is essential for preventing T2D. Several studies point to mobile health initiatives delivered through personal smart devices being a promising approach to diabetes prevention, through weight loss. The aim of the mobile health and diabetes (mDiab) trial was twofold: to achieve 5% weight loss and to look at the association of weight loss with degree of engagement with the mDiab app. Methods: The mDiab randomized control trial was carried out among smartphone users who are at high risk for T2D mellitus in three cities-Chennai, Bengaluru, and New Delhi in India. The intervention was delivered through a mobile phone application along with weekly coach calls for 12 weeks. While individuals in the intervention group individuals received the app, which enabled tracking their weight, physical activity, and diet along with 12 weekly video lessons on T2D prevention and coach calls, the control group received usual care. Results: The intervention group experienced a significant 1 kg weight loss while the control group lost 0.3 kg (P < 0.05). More individuals in the intervention group (n = 139, 15%) met the 5% weight loss target than in the control group (n = 131, 9%). In the intervention group those who viewed the videos experienced greater weight loss (2.4 kg) than those who only attended coach calls (0.9 kg) (P < 0.01). Conclusions: An mHealth intervention helped to achieve moderate weight loss. Future studies should explore the sustainability of this weight loss.

Mobile Health Technology (mDiab) for the Prevention of Type 2 Diabetes: Protocol for a Randomized Controlled Trial.

BACKGROUND: The prevalence of type 2 diabetes is increasing in epidemic proportions in low- and middle-income countries. There is an urgent need for novel methods to tackle the increasing incidence of diabetes. The ubiquity of mobile phone use and access to Internet makes mobile health (mHealth) technology a viable tool to prevent and manage diabetes. OBJECTIVE: The objective of this randomized controlled trial is to implement and evaluate the feasibility, cost-effectiveness, and sustainability of a reality television-based lifestyle intervention program. This intervention program is delivered via a mobile phone app (mDiab) to approximately 1500 Android smartphone users who are adults at a high risk for type 2 diabetes from three cities in India, namely, Chennai, Bengaluru, and New Delhi. METHODS: The mDiab intervention would be delivered via a mobile phone app along with weekly coach calls for 12 weeks. Each participant will go through a maintenance phase of 6 to 8 months post intervention. Overall, there would be 3 testing time points in the study: baseline, post intervention, and the end of follow-up. The app will enable individuals to track their weight, physical activity, and diet alongside weekly video lessons on type 2 diabetes prevention. RESULTS: The study outcomes are weight loss (primary measure of effectiveness); improvement in cardiometabolic risk factors (ie, waist circumference, blood pressure, glucose, insulin, and lipids); and improvement in physical activity, quality of life, and dietary habits. Sustainability will be assessed through focus group discussions. CONCLUSIONS: If successful, mDiab can be used as a model for translational and implementation research in the use of mHealth technology for diabetes prevention and may be further expanded for the prevention of other noncommunicable diseases such as hypertension and cardiovascular diseases. TRIAL REGISTRATION: Clinical Trials Registry of India CTRI/2015/07/006011 http://ctri.nic.in/Clinicaltrials/pdf_generate.php? trialid=11841 (Archived by WebCite at http://www.webcitation.org/6urCS5kMB).

Mobile Health Technology in the Prevention and Management of Type 2 Diabetes.

Essential steps in diabetes prevention and management include translating research into the real world, improving access to health care, empowering the community, collaborative efforts involving physicians, diabetes educators, nurses, and public health scientists, and access to diabetes prevention and management efforts. Mobile phone technology has shown wide acceptance across various ages and socioeconomic groups and offers several opportunities in health care including self-management as well as prevention of Type 2 diabetes mellitus (T2DM). The future seems to lie in mobile health (mHealth) applications that can use embedded technology to showcase advanced uses of a smartphone to help with prevention and management of chronic disorders such as T2DM. This article presents a narrative review of the mHealth technologies used for the prevention and management of T2DM. Majority (48%) of the studies used short message service (SMS) technology as their intervention while some studies (29%) incorporated applications for medication reminders and insulin optimization for T2DM management. Few studies (23%) showed that, along with mHealth technology, health-care professionals' support resulted in added positive outcomes for the patients. This review highlights the fact that an mHealth intervention need not be restricted to SMS alone.