Correlates of breakthrough Omicron (B.1.1.529) infections in a prospective cohort of vaccinated patients with rheumatic diseases.

BACKGROUND: Data on the effectiveness of SARS-CoV-2 vaccines and the durability of protection against the prevalent Omicron variant are scarce, especially in patients with autoimmune rheumatic diseases (AIRDs). Hence, we prospectively studied Omicron breakthrough infections in patients with AIRDs and attempted to isolate associated risk factors. METHODS: Patients with AIRDs who had completed primary vaccination with either AZD1222 or BBV152 vaccines were included and prospectively followed up from January 2022 onwards for the development of breakthrough Omicron infections. The time interval from the last event [2nd dose of vaccination (V) or past COVID-19 infection (I) whichever was later] to Omicron infection was recorded. Patients were divided based on the events and their order of occurrence into V + V, V + I, I + V, V + I + V, and V + V + I groups. The incidence of breakthrough infections and their predictors were studied with a focus on the vaccine type and hybrid (H) immunity (vaccinated individuals with a history of COVID-19 infection). RESULTS: We included 907 patients with AIRDs (53.5 ± 11.7 years and a male-to-female ratio of 1:5.1), and the majority of patients had received AZD1222 (755, 83.2%). Breakthrough infections were observed in 158 of 907(17.4%) of which 97 (10.4%) were confirmed by RT-PCR. Breakthrough infections were significantly greater in the V versus the H group (15.7% and 3.5%, log-rank test, p = < 0.01). Among the hybrid group, the order of infection and vaccination had no bearing on the risk of breakthrough infections. On multivariate analysis, breakthrough infections were significantly lesser in the H versus the V group [HR: 0.2(0.1-0.4); p = 0.01]. CONCLUSION: The risk of breakthrough Omicron infections in fully vaccinated patients with AIRDs was 17.4% with a significantly lower risk in patients with hybrid immunity.

Efficacy and safety of curcumin in maintaining remission during disease-modifying antirheumatic drug withdrawal in rheumatoid arthritis at 52 weeks: a phase III double-blind, randomized placebo-controlled trial.

Curcumin has anti-inflammatory properties but current evidence is limited to advocate its use in rheumatoid arthritis (RA). We explored whether curcumin could maintain remission in patients with RA while tapering conventional synthetic Disease-Modifying Antirheumatic Drugs (csDMARD). In this patient-and investigator-blinded trial, adults with RA in sustained remission for more than six months were randomized to oral curcumin (1 g) with piperine (5 mg) twice daily or matching placebo. Patients who had received biological DMARDs or curcumin supplements in the last 6 months were excluded. csDMARD were tapered and stopped sequentially as per a fixed protocol. The primary outcome was flare-free survival at 52 weeks. The secondary outcomes were flare rate, correlation of serum curcuminoid levels with flares and safety. 200 patients (100 per arm) entered the trial with comparable baseline characteristics. Per protocol analysis included 92 and 93 participants in the curcumin and the placebo group, respectively. Flare-free survival at week 52 was similar between both groups (60% versus 64%; p = 0.76). The median time to flare was similar [Curcumin: 219 days (IQR: 123) versus placebo: 214 days (95.8); p = 0.067]. Cox proportionate regression modelling showed that the flare-free survival was independent of serum curcuminoid levels [adjusted HR = 0.99 (95% CI: 0.97-1.0)]. The model showed that flare-free survival was not associated with age, gender, seropositivity, or csDMARD used at baseline. No serious adverse effects were noted. Curcumin did not impact the flare-free survival in patients with RA in remission during the tapering of csDMARDs despite achieving adequate serum levels.Trial registration: CTRI/2018/04/013279.

Myopia Progression in Adults: A Retrospective Analysis.

SIGNIFICANCE: Studies on adult myopia progression are limited. This retrospective analysis of a large data set of young adult myopes characterizes myopia progression during adulthood. PURPOSE: This study aimed to determine the mean annual progression of myopia and to estimate the proportion of progressors in adult myopes. METHODS: Longitudinal, noncycloplegic subjective refraction data for young adult myopes (spherical equivalent refractive error, -0.5 D or more), age ranging from 18 to 30 years, were retrospectively analyzed. The mean annual progression, as well as the proportion of progressors (at least -0.50 D shift between visits and annualized progression of -0.25 D or more), was estimated. RESULTS: A total of 354 myopes (230 females [64.7%]), with a mean (standard deviation) age of 22.2 (3.8) years, were considered. The mean (standard deviation) annualized progression was -0.10 (0.21), -0.08 (0.2), and -0.04 (0.21) D in the 18- to 21-year, 22- to 26-year, and 27- to 30-year age groups, respectively ( P = .003). The difference between 18- to 21- and 27- to 30-year age groups was significant ( P = .05), whereas all other pairwise comparisons were not significant. The proportion (95% confidence interval) of progressors in the 18- to 21-, >21- to 26-, and >26- to 30-year age groups was 18.3% (14.9 to 21.7%), 10.9% (7.1 to 14.7%), and 8.8% (4.4 to 13.1%), respectively. The proportion of progressors working or studying in a higher learning/academic environment was 16.2% with an odds ratio (95% confidence interval) for progression of 2.07 (1.15 to 3.74) compared with those in nonacademic environments ( P = .02), with no significant effect of sex or ethnicity. CONCLUSIONS: This study is consistent with other studies on myopia in young adults, which show that myopia does not progress by substantial amounts throughout the adult years, particularly after the age of 21 years. Although future studies may be challenged by the small rates of change and the small proportion of progressors, further research is needed to understand the implications of adult myopia progression on clinical management.

Alterations in reproductive hormone levels among farm women and their children occupationally exposed to organophosphate pesticides.

Exposure to organophosphorus pesticides may lead to reproductive hormone dysfunction. Even among children of pubertal age, the exposure may disrupt growth, development, and maturation. The present study was conducted to assess the alterations in the reproductive hormone levels, among farm women (24-45 years, n = 129) and their children (9-12 years, n = 66 and 13-15 years, n = 63) and compare them with age and gender-matched control group [women (n = 134) and their children (9-12 years, n = 69 and 13-15 years, n = 65)] belonging to villages of Ranga Reddy District, Telangana, India. Blood pesticide residues and reproductive hormone (follicle-stimulating hormone-FSH, luteinizing hormone-LH, estradiol, and testosterone) levels were analyzed. The detected pesticide residues (ng/mL) were chlorpyrifos, diazinon, malathion, and monocrotophos among the farm women, while the farm children of 9-12 years age groups were detected with residues of chlorpyrifos, diazinon, malathion, monocrotophos, and phosalone. The farm children of 13-15 years age group were detected with residues of chlorpyrifos, diazinon, malathion, monocrotophos, and phosalone. However, no residues were detected among the samples of women and children of control groups. Significantly lower levels of FSH (in follicular phase) were observed among the farm women than the control group. Significant alterations in FSH and LH levels of farm women were observed with a significant correlation between the chlorpyrifos residue levels and estradiol hormone. While no such significant change in hormone levels was observed among the farm children of both age groups of both genders. Though the present study showed pesticide-induced alterations in hormone levels among the farm women, research is needed to elucidate the critical windows during which exposure may adversely affect the reproductive system in children at the pubertal stage and women at reproductive age and subsequently their progeny's health at a later stage of life.

Effect of background derivatization on the signal enhancement of pesticide residues extracted from edible oils.

The effect of background derivatization on the signal enhancement of pesticide residues extracted from edible oil samples was studied by GC with negative chemical ionization MS. The analytes were extracted by a solvent extraction process, and the extract was subjected to rapid low-temperature fat precipitation. The residual fatty acids were silylated by derivatization with N,O-bis(trimethylsilyl)trifluoroacetamide. The chromatograms obtained from the derivatized samples showed higher signal intensity and lower detection levels when compared to the direct analysis without derivatization. The sensitivity levels of the method are either better or comparable to that of previously reported methodologies. The LODs of the analyzed organochlorine, organophosphorus, and synthetic pyrethroid residues in sunflower, rice bran, and ground oil samples were in the range of 0.02­0.5 ng/g, and the LOQs were in the range of 0.1­2 ng/g. The intraday and interday accuracies were in the range of 81­116% with RSDs less than 14%. The recoveries obtained were in the range of 53­89% with the RSD values less than 13% for all the studied pesticide residues.

Molecular Characterization and Toxicity Confirmation of LukM/F'-PV Producing Staphylococcus aureus Isolated from Bovine Mastitis Samples in Mysore, India.

The widespread status of subclinical condition of bovine mastitis is often associated with the production of leukotoxin M/F'-PV producing Staphylococcus aureus. The present study aims for the profiling of such leukotoxin producers through conventional and molecular methods in parallel to their leukotoxicity. The incidence of this particular pathogen was assessed in mastitis infected Holstein-Friesian cattle, where eight isolates of staphylococci were found to be present in 20 % of collected samples. Being intermediately resistant to vancomycin, they showed characteristic double zone hemolysis on 7 % sheep blood agar and typical type II reaction for coagulase test indicating the pathogenic attributes. Further with RAPD-PCR and 16S rDNA-RFLP, epidemiological specificity and genotypic relatedness of isolates to S. aureus was confirmed. Subsequently, the presence of leukotoxin (lukM) gene in native isolates was detected by leukotoxin gene specific PCR. MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium) assay evaluated for secreted leukotoxin in cell free supernatant was estimated to be 223 toxic units which had an LD50 cytotoxic activity on bovine neutrophil. Thus, the data acquired during study can be of prime diagnostic method for timely and accurate analysis of subclinical mastitis samples which goes undetected at consumer level.

Myopia and sleep in children-a systematic review.

Worldwide, approximately one in three people are myopic or short-sighted. Myopia in children is of particular concern as younger onset age implies a higher risk of progression, and consequently greater risk of developing vision-threatening complications. The importance of sleep in children's health has long been acknowledged, but evidence for its role in childhood myopia is fairly new and mixed results were presented across studies. To facilitate better understanding of this relationship, a broad literature search, up to and including October 31, 2022, was performed using three databases (PubMed, Embase, and Scopus). Seventeen studies were included in the review, covering four main aspects of sleep, namely duration, quality, timing, and efficiency, and their associations with myopia in children. The present literature review discussed these studies, revealed potential limitations in their methodologies, and identified gaps that need to be addressed in the future. The review also acknowledges that current evidence is insufficient, and the role of sleep in childhood myopia is far from being fully understood. Future studies that primarily, objectively, and accurately assess sleep and myopia, taking other characteristics of sleep beyond duration into consideration, with a more diverse sample in terms of age, ethnicity, and cultural/environmental background, and control for confounders such as light exposure and education load are much needed. Although more research is required, myopia management should be a holistic approach and the inclusion of sleep hygiene in myopia education targeting children and parents ought to be encouraged.

Knowledge, attitude and practices related to pesticide usage among farmers: Findings from a hospital based cross-sectional study.

BACKGROUND: In India, where agriculture is the prime occupation among the rural population, farmers are extensively using pesticides in crop production without taking adequate precautions. OBJECTIVE: The current study aimed to examine pesticide usage patterns, usage of personal protective equipment (PPE), knowledge on pesticide toxicity, and attitude towards occupational safety among farmers diagnosed with leukaemia (n = 60), lymphoma (n = 33), and breast cancer (n = 30) visiting a tertiary cancer care hospital in Hyderabad, India. METHODS: Face-to-face interviews were conducted using a pre-tested questionnaire and the data collected were analysed with statistical software SPSS 23. RESULTS: The survey revealed that the participants had an average of 19.6 years of farming experience and women were predominantly involved in the mixing of pesticides and other agricultural work apart from spraying. All of them were not using any PPE and the majority of them did not have any knowledge on the route of exposure, toxicity symbols, and safe handling of pesticides. Statistical analysis showed no significant association between educational status and knowledge, attitude and practices (p > 0.05). CONCLUSION: Even though the majority of the farmers were educated, their lack of adequate knowledge on pesticides had enabled them to adopt risky behaviours in handling and storage of pesticides. There is a need for continuous training programs for farmers to promote awareness and minimize the hazards of occupational exposure.

Genetic Polymorphism in Xenobiotic Metabolising Genes and Increased Oxidative Stress among Pesticides Exposed Agricultural Workers Diagnosed with Cancers.

BACKGROUND: Oxidative stress combined with nullity of xenobiotic metabolizing GSTT1/GSTM1/CYP2E1 genes may increase the susceptibility of agricultural workers to adverse health effects including cancer. The present study was conducted to determine; the prevalence of polymorphisms in GSTM1, GSTT1 and CYP2E1 genes, serum 8-hydroxy-2'-deoxygunosine levels, and the role of these markers in risk of cancer among agricultural workers occupationally exposed to pesticides. METHODS: A total of 360 participants, of which 180 belonging to farming group diagnosed with leukemia (n=60), lymphoma (n=60) and breast cancers (n=60), 90 in non-farming group diagnosed with similar cancers and the other 90 as healthy controls with neither history of occupational exposure nor diagnosed with any type of cancers were recruited. Following the questionnaire survey, serum 8-OHdG and genetic polymorphisms in the three genes were determined using ELISA and PCR methods respectively. RESULTS: The results of the study revealed that farm workers carrying GSTT1 null genotype had increased risk for lymphoma (OR = 5.34; 95% CI = 1.80-15.82) and breast cancer (OR=4.04; 95% CI = 1.24-13.07). For farm workers carrying GSTM1 null genotype, the risk was six-fold for breast cancer (OR = 6.88; 95% CI =1.88-25.99). Further, there found a significant difference between 8-OHdG and nullity of CYP2E1 among the farm workers diagnosed with leukemia. CONCLUSION: The findings of the present study suggest that the polymorphisms in detoxifying genes among farm workers occupationally exposed to pesticides and the oxidative stress may likely be responsible for triggering the mechanism of malignancy.

The impact of the use of personal-protective-equipment on the minimization of effects of exposure to pesticides among farm-workers in India.

Introduction: Although excessive use of pesticides and unsafe agricultural practices may contribute to numerous intoxications, the role of PPE (personal-protective-equipment) in the minimization of toxicological effects due to pesticide exposure has not been addressed so far. The present study aimed to assess the impact of the use of PPE on the minimization of effects of exposure to pesticides among farm-workers. Methods: A community-based follow-up study with questionnaire-based survey and field observations was undertaken among farm-workers (n = 180) of Rangareddy district, Telangana, India. Biomarkers of exposure such as cholinesterase activity, inflammatory markers (TNF-α, IL-1ß, IL-6, cortisol, and hs-C reactive protein), nutrients (vitamins A, E), liver function (total protein and A/G ratio, AST and ALT levels) were investigated in the laboratory by following the standard protocols. Results: Farm-workers who had a mean farming exposure of 18 years of and who neither followed safe pesticide handling practices nor used PPE and also showed reluctance to obey good agricultural practices (GAPs). Inhibition of AChE (acetylcholine esterase) with increased inflammation was found among farm-workers as compared to their respective normal values when they have not used PPE. Linear regression statistical analysis revealed a profound effect on inhibition in the AChE activity and various inflammatory markers with the increase in the duration of pesticide exposure. Further, there was no effect of the duration of pesticide exposure on the levels of vitamins A, E, ALT, AST, total protein, and A/G ratio. Further, intervention studies carried out on the use of PPE provided (commercially available and cost-effective) for 90 days showed a significant reduction in the biomarker levels (p < 0.01). Conclusion: This study demonstrated the importance of the use of PPE during pesticide applications and other agricultural tasks to minimize pesticide-associated adverse health effects.

Lifestyle factors influencing the academic performance among the secondary school students in an urban area of south India.

OBJECTIVE: School children are exposed to various social, environmental, nutritional and cultural changes which will influence their lifestyle and can impose behavioral change. This study was formulated to assess the lifestyle factors influencing the academic performance among secondary school students in an urban area of south India. MATERIALS AND METHODS: A cross sectional study was conducted among secondary school students of grade 8, 9 and 10 in public and private schools of an urban area. Data was collected using a pre-designed, pretested, questionnaire. Demographic data and socio-economic status was assessed. Lifestyle assessment included the dietary habits, physical activity, tobacco and other substance use and anthropometric measurements. Academic performance was assessed by attendance, past annual examination grades. Results were expressed in percentages and analysis was done using Chi-square test and Fischer exact test. RESULTS: Study participants included were 613. Overall prevalence of tobacco use 14.0%. Skipping breakfast was associated with poor performance (p=0.002) among public school students. Private school students' academic performance was significantly associated with the BMI (p=0.03). Prevalence of underweight, overweight and obesity was 70.5, 5.0 and 5.5% respectively. Physical activity didn't show any significant influence on academic performance (p=0.69, 0.76). CONCLUSION: Academic performance of secondary school students is influenced by various factors including, regularity of attendance, socio-economic status, skipping breakfast and consumption of tobacco and other substances. Study establishes the need for proper motivation and reinforcement of safe healthy lifestyle practices to achieve complete academic excellence.

Impact of Micronutrient Supplementation on Pesticide Residual, Acetylcholinesterase Activity, and Oxidative Stress Among Farm Children Exposed to Pesticides.

The present interventional study aimed to assess the impact of micronutrient supplementation on pesticide-residues concentrations, vitamins, minerals, acetylcholinesterase activity and oxidative stress among 129 farm children (9-12 years, n = 66 and 13-15 years, n = 63) involved in farming activities in Ranga Reddy district, Telangana, India. Our data showed the presence of five organophosphorus pesticide residues (chlorpyrifos, diazinon, malathion, monocrotophos, and phosalone) among children before-supplementation (both age-groups); while post-supplementation, only two pesticide residues (chlorpyrifos and diazinon) were detected indicating improved metabolic rate. Vitamin E, copper, magnesium and zinc levels were also improved in both the age-groups and manganese levels were significantly increased only among children of 13-15 years age group. Further, post-supplementation also showed an improvement in acetylcholinesterase activity and a decrease in lipid peroxidation among both the age groups of children. However, further research for ascertaining the ameliorating effect of micronutrients in preventing adverse effects of organophosphorus pesticides must be conducted.

Organophosphate pesticide exposure among farm women and children: Status of micronutrients, acetylcholinesterase activity, and oxidative stress.

Nutritional status plays a major role in determining the possible adverse health outcomes due to pesticide toxicity. The objective of the present study was to assess the organophosphorus pesticide residue levels among farm women (FW) (24-45years) and farm children (FC) (9-12 and 13-15years) belonging to the Rangareddy district (Telangana, India) along with their micronutrient status, inhibition of acetylcholinesterase activity, and oxidative stress levels. Residues of Chlorpyrifos, Diazinon, Malathion, Monocrotophos and Phosalone were found in the serum samples of FW and FC along with significantly low levels of vitamins and minerals. Inhibition of AChE activity was observed in FW and FC and altered oxidative stress parameters among FW. Correlation studies have found significant associations between the pesticide residues, micronutrients and antioxidant enzymes. The study suggests an association between pesticide exposure coupled with micronutrient deficiency, induced AChE inhibition, and oxidative stress.

Effect of organophosphorus pesticide exposure on the immune cell phenotypes among farm women and their children.

Epidemiological studies suggest suppression of the lymphocytes function through cholinergic stimulation due to organophosphorus pesticide exposure. The study aimed to assess the alteration in the levels of immune cell phenotypes among farm women (FW) and farm children (FC) who were occupationally exposed to pesticides and age/gender-matched control subjects belonging to Rangareddy district (Telangana, India). A total of 129 FW, 129 FC and 268 age/gender-matched controls were recruited. Blood samples were collected from the selected subjects to estimate the levels of nine organophosphorus pesticide residues and CD (CD3+, CD4+, CD8+, CD16+ and CD19+) cell markers using LC-MS/MS and flow cytometry, respectively. Independent t-test analysis was conducted to compare the immune cell phenotypes between exposed and control groups. Spearman's rank correlation test was further carried out to identify any possible correlation between the pesticide residues and CD markers. The mean percentage for CD4+, CD8+ and CD16+ was found to be significantly low, while for CD19 + itwas significantly high in the FW as compared to the CW group (p < 0.01). Further, the residues of chlorpyrifos and monocrotophos among FW were found to be significantly correlating with the mean percentages of CD19+ and CD8+ markers, respectively. The cell marker subsets of CD4+ and CD8+ were significantly low in FC children 9-12 years and 13-15 years age groups, respectively (p < 0.05). Also, these levels were significantly correlating with the residues of malathion and monocrotophos. The present study could indicate an alteration in the lymphocytes' subpopulations, which may thereby infer the toxicity in the first phase assessment of immunotoxicity. Therefore, further studies may be conducted to understand the suspected pesticides' mechanism along with various other factors in causing immune suppression coupled with nutritional and other related disorders.

Assessment of dermal exposure to pesticides among farmers using dosimeter and hand washing methods.

Inappropriate use of pesticides followed by unsafe handling practices to control the insect infestation among the farming groups in developing countries has resulted in a high exposure risk. The use of personal protective equipment is also negligible among Indian farmers due to their affordability to access the same. Very little research has been conducted to establish an exposure assessment procedure through dermal penetration of pesticide residues. Therefore, to quantify the contamination of pesticide residues through dermal exposure along with detailed field observations and pesticide management practices, a field study was conducted in Rangareddy district, Telangana, Southern India, to assess the dermal exposure based on dosimeter and hand washing methods. The analytical method was modified and validated in-house for performance parameters such as limit of detection, quantification, linear range, recovery, and precision. The potential dermal exposure values ranged from 0.15 to 13.45 µg, while a reduction was found in exposure levels as actual dermal exposure values ranged from 0 to 0.629 µg. Contamination through hand washing was the major contributor to overall dermal exposure. Statistical analysis revealed a significant difference in the exposed dermal regions of the leg and torso after the use of PPE. Penetration factor for each anatomical region and risk evaluation in terms of the Margin of Safety implies unsafe handling of pesticides. The findings of the present study confirm the increased exposure to organophosphate pesticides among operators and highlight the importance of the use of protective measures, especially among those that focus on dermal exposure mitigation.

External ocular surface and lens microbiota in contact lens wearers with corneal infiltrates during extended wear of hydrogel lenses.

OBJECTIVES: To determine whether carriage of microbes on the contact lens or ocular surfaces during extended wear (EW) with soft hydroxyethyl methacrylate (HEMA)-based contact lenses predisposes the wearer to adverse events. METHODS: Participants (non-contact lens wearers) were enrolled in a clinical study involving wear of HEMA-based hydrogel lenses on a six night EW basis with weekly replacement. Type and number of bacteria colonizing the lower lid margins, upper bulbar conjunctiva, and contact lenses during EW after one night, 1 week, 1 month, and thereafter every 3 months for 3.5 years were determined. The association of bacteria with adverse responses was compared between carriers (defined as having significant microbes cultured from two or more samples with 1 year) and noncarriers, and the strength of the association was estimated using multivariate logistic regression. RESULTS: Carriers of gram-positive bacteria on lenses (particularly coagulase negative staphylococci or Corynebacterium spp.) were approximately three and eight times more likely to develop contact lens-induced peripheral ulcers (CLPUs) and asymptomatic infiltrates (AIs), respectively. Staphylococcus aureus was most frequently isolated from lenses during CLPU. Carriers of gram-negative bacteria on lenses were five times more likely to develop contact lens-induced acute red eye (CLARE). Haemophilus influenzae was isolated most frequently from lenses during CLARE and AI events. CONCLUSIONS: Bacterial carriage on contact lenses during EW predisposes the wearer to the development of corneal inflammatory events including CLARE, CLPU, and AI.

Predominant role of antioxidants in ameliorating the oxidative stress induced by pesticides.

Oxidative stress has been reported as one of the adverse effects caused due to pesticides, which is the main mechanism of the toxicity in humans and animals and is a useful parameter in monitoring studies. It involves an imbalance in the equilibrium state of ROS and antioxidant defenses leading to alterations in various antioxidant enzyme levels and lipid peroxidation. The objective of the current paper is to present a review of the potential role and protective mechanism action of the antioxidant micronutrient supplementation to ameliorate the oxidative stress induced by pesticides. Studies in animal models and human were retrieved through the relevant search of the literature and categorized. Various animal studies were categorized according to the type of supplementation. Animal studies provide evidence to conclude the potential protective role of antioxidants in ameliorating the adverse effects of pesticides. Similar studies in humans are meager suggesting for further comprehensive research.

Clinical profile and outcomes of COVID-19 positive patients -A cross sectional study.

BACKGROUND: Globally 220 countries and territories are affected and cases of COVID-19 have increased by 8% resulting in 3.6 million new cases. The most common symptoms include fever, cough, loss of taste or smell, headache and mortality rate was uncertain. The objective of this study is to know the clinical profile and outcomes of COVID-19 positive patients. METHODOLOGY: A Cross-Sectional Study was conducted for 2 months (October-December 2020) among 727 COVID 19 positive patients residing in the field practice area of 4 health centers. Details regarding medical history, exposure history, underlying co-morbidities, symptoms, signs clinical features and outcomes (i.e, cured, mortality, and length of stay) were obtained. RESULTS: The mean age of participants was 41 ± 17 years, 59.28% were males, 40.71% were females. A significant association was found between age, family history of disease, co-morbid disease, medication history, smoking habit, alcohol consumption, type of symptoms, isolation type, treatment given with outcomes (P < 0.05). Subjects with previous history of medication (HR, 2.749; 95% CI 1.0774-7.015), and those who had symptoms (HR, 3.6446; 95% CI1.0280-12.921) were associated with increased risk of death as compared to others. CONCLUSION: COVID-19 positive was found in 56% of patients, they were less severe and improved with medication and deaths were found in 3.85% of patients. Fever was noted in only 15.72% of patients, gastrointestinal symptoms in 1.22% and respiratory symptoms in 14.74% of patients. Participants with older age were significantly associated with complications and those with co-morbidities were significantly associated with death on multinominal logistic analysis.

Diabetic macular edema treatment guidelines in India: All India Ophthalmological Society Diabetic Retinopathy Task Force and Vitreoretinal Society of India consensus statement.

Diabetic macular edema (DME) is a common cause of moderate visual impairment among people with diabetes. Due to the rising number of people with diabetes in India, the absolute numbers of people with DME are significant. There are several treatment options for DME, and the choice of treatment is based on the availability of retinal specialists and infrastructure for the delivery of treatment. A major challenge is the out-of-pocket expenditure incurred by patients as most treatment options are costly. Treatment also varies based on the associated ocular and systemic conditions. The All India Ophthalmology Society (AIOS) and the Vitreo-Retinal Society of India (VRSI) have developed this consensus statement of the AIOS DR task force and VRSI on practice points of DME management in India. The objective is to describe the preferred practice patterns for the management of DME considering the different presentations of DME in different clinical scenarios.