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Tic is rapid recurrent non-rhythmic motor movement or vocalization; movement of limbs or other body parts is known as motor tic and involuntary repetitive sound like grunting sniffing throat clearing is known as a vocal tic. Tic is a neurodevelopmental disorder and has its onset in the developmental period. According to diagnostic and statistical manual of mental illnesses (DSM) 5, tic should have its onset before 18 years of age and can resolve with proper treatment. In this case, a 23-year-old female presented with recurrent abnormal throat clearing and excessive loud sounds which started for the last 1 year. Initially, she was diagnosed with psychogenic hiccup in another department and was treated with Baclofen 30 mg for 1 month but as no improvement was observed later she was referred to psychiatry outpatient department (OPD) for further treatment where she was diagnosed with adult onset vocal tic with a premonitory urge for tics scale (PUTS) score of 27 on admission and she was treated with tablet Risperidone 2 mg and after 4 weeks of treatment all symptoms subside and PUTS score came to be 6 at the time of discharge.
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Background: Obstructive sleep apnoea syndrome (OSAS) is a common sleep-related breathing disorder of multi-risk factorial pathogenesis and is characterized by recurrent, partial or complete upper airway obstruction resulting in intermittent hypoxia during sleep. It has been implicated in both cardiovascular and cerebrovascular diseases. Objective of the study was to determine the association of Plasma Fibrinogen levels with the severity of OSA patients in a tertiary care hospital. Methods: This cross-sectional observational study with group comparison was conducted among all the patients attending in the Department of Respiratory Medicine, BSMMU with suspicion of OSA within one year after the clearance of institutional review board (IRB) using STOP-BANG questionnaire and Epworth sleepiness scale (ESS) and confirmed by polysomnography. Plasma fibrinogen was measured in all OSA and non-OSA patients. Data were analyzed with the help of statistical package for the social sciences (SPSS) version 26. Results: Sociodemographic analysis found no significant differences in age, gender, area, occupation, or smoking between OSA and non-OSA groups (p>0.05). However, witnessed apnoea (p=0.002), breathlessness (p=0.005), higher ESS (p<0.001), and STOP-Bang scores (p<0.001) were associated with OSA. Plasma fibrinogen levels were significantly higher in OSA (319.2±63.7 mg/dl versus 242.5±20.33 mg/dl, p<0.001), positively correlating with AHI (r=+0.876, p=0.001). Positive correlations were also found between fibrinogen levels and daytime sleepiness (r= +0.393, p=0.002), waist circumference (r =+0.346, p=0.007), and BMI (r =+0.297, p=0.021) in OSA patients. Conclusions: In conclusion, this study establishes a notable connection between plasma fibrinogen levels and the severity of OSA. Elevated fibrinogen levels correlate with increased OSA severity, indicating a link between OSA, inflammation and coagulation.
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Background: Alpha-1 antitrypsin deficiency (AATD) is a hereditary disorder linked to early onset COPD, notably the emphysema variety, but often goes undetected. Low serum AAT levels may impact lung function and correlate with COPD severity. The aim of the study was to detect possible associations of serum AAT level with the severity of COPD patients on the basis of post bronchodilator FEV1 in Bangabandhu Sheikh Mujib Medical University (BSMMU). Methods: A cross-sectional study was conducted at the Department of Respiratory Medicine, BSMMU, Dhaka, from October 2022 to September 2023. Adult patients (?18 years) of both genders diagnosed with COPD based on spirometry were included. COPD was defined per GOLD guidelines, with a post-bronchodilator FEV1/FVC ratio <70%. Severity was categorized based on post-bronchodilator FEV1% predicted. Association between serum AAT level and COPD severity was analyzed using SPSS version 26, with significance set at p <0.05. Results: The study involved 80 COPD patients, with 1.25% showing low serum AAT levels and 98.75% normal. No significant differences in age, sex, or smoking status were observed among severity groups. Mean serum AAT levels varied across severity groups but were not statistically significant (p=0.377). Smoking was prevalent (66.3%), with common comorbidities like hypertension (26.3%), IHD (16.3%), and diabetes mellitus (15.0%). Shortness of breath (95.0%) and cough (92.5%) were common symptoms, with most patients having moderate disease severity (42.5%). Conclusions: The study indicates a weak association between serum AAT levels and COPD severity, with only 1.25% of 80 patients exhibiting low AAT levels.
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The inferior alveolar nerve block is a Mandibular nerve block given to anesthetize the mandibular teeth. Due to its proximity to other nerves and muscles and salivary glands it has many complications if the technique in which it is given is wrong. IANB usually presents with mild or minimal complications following it’s administration. The complications that arise are usually reversible when the action of the local anaesthetic wears off. These complications are usually associated with improper technique and anatomical variations, which can be rectified there itself with slight modifications. This is a very rare complication which has been reported where the patient has experienced numbness of the auricle on the side of inferior alveolar injection which lasted for an hour. This is seen due to the accidental anesthetic injection to the auriculotemporal nerve resulting in numbness. To perform successful inferior alveolar nerve blocks it is mandatory to be familiar with anatomical landmarks. Proper technique can reduce the complications.
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A field experiment was conducted at the Instructional-cum-Research (ICR) Farm, Assam Agricultural University, Jorhat during the summer season of the year 2020 to evaluate the effects of integrated weed and nutrient management on weed growth, yield attributes and yield of summer maize. The experiment was laid out in factorial randomized block design and replicated thrice. The treatment consisted of three nutrient management practice viz., 100% RDF (N1); N1+ 25 kg ZnSO4/ha (N2) and 75 % RDN and 100 % P2O5 and K2O through chemical fertilizer (CF) + 25 % N through vermicompost + 25 kg ZnSO4/ha (N3) and four weed management practices viz., weedy check (WM1), live mulching with cowpea (WM2), WM2 + hand weeding at 25 and 45 DAS (WM3) and Atrazine 500g+Pendimethalin 500g/ha followed by hand weeding at 45 DAS (WM4). Experimental findings revealed that the different INM practices significantly affected the growth parameters, yield and yield attributes of summer maize. The maximum values of growth parameters were recorded in the treatment involving application of 75 % RDN and 100 % P2O5 and K2O through chemical fertilizer + 25 % N through vermicompost + 25 kg ZnSO4/ha (N3). Similarly, yield and yield attributing characters viz., weight of cob with and without husk, length of cob without husk, number of rows per cobs, grain per row, grain per cob, 1000 grain weight, shelling percentage, grain (23.76 q/ha) and stover (74.55 q/ha) yield. The growth, yield and yield attributing parameters of maize were significantly affected by the different weed management practices. Pre emergence application of Atrazine 500g+Pendimethalin 500g/ha followed by hand weeding at 45 DAS (WM4) resulted the highest value of yield. The highest grain (21.77 q/ha) and stover (71.12 q/ha) yield were recorded in the treatment WM4.The interaction effects of different nutrient and weed management practices were found not significant. The economic study revealed that the highest gross return (?.1, 03816.00/ha), net return (?.67, 956.00) and B: C (1.90) were recorded from the treatment combination N3WM4.
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Background: The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is increasingly drawing worldwide attention. Among multiple risk factors, obesity is one of the factors that can influence the disease severity. This study aimed to explore the impact of obesity on the severity of COVID-19 infection. Methods: This cross-sectional study was conducted in the Department of Respiratory Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka from September 2020 to February 2021. The Adult (Aged ?18 years) patients of both genders, who were COVID-19 positive, were included in this study. Ninety-one COVID-19 patients with BMI?25 kg/m2 were set as case and another ninety-one patients with BMI<25 kg/m2 were selected as control. The patient's BMI and waist circumference (WC) were recorded. Disease severity was evaluated by the management of COVID-19 disease guidelines by the World Health Organization (WHO) 2020. Results: The maximum patients were male (65.38%), in the sixth and seventh decades. The proportion of severe illness was higher in the obese group 69.2% compared to the non-obese 47.3%. Patients with obesity require more ICU support (15.4% versus 5.5%) and invasive mechanical ventilation (9.9% versus 2.2%) compared to non-obese patients. In multivariate logistic regression analysis, after adjusting age, diabetes mellitus, and hypertension, obesity (BMI>25 kg/m2) was an independent risk factor for severe illness. Conclusions: Obese patients are associated with severe COVID-19 pneumonia. As BMI increases, disease severity increases, needs more ICU support, and needs more invasive mechanical ventilation.
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Background: Coronary artery disease is a type of heart disease where the arteries of the heart cannot deliver enough oxygen-rich blood to the heart. This study aimed to evaluate the association between neutrophil to lymphocyte ratio (NLR) with the severity of coronary artery diseases. Methods: This cross-sectional study was conducted in the Department of Cardiology, Chittagong Medical College Hospital, Chattogram, Bangladesh during the period from 1 July 2020 to 31 June 2021. 160 patients undergoing elective coronary angiography with the symptoms of coronary artery disease were enrolled in this study. A purposive sampling technic was used. The association between NLR and Gensini score was assessed using Pearson’s or Spearman’s correlation analysis as appropriate. All data were processed, analyzed and disseminated by using MS Excel and SPSS version 23.0 program as per necessity. Results: The mean (±SD) Gensini score of our participants was 42.75 (±29.50) and the mean (±SD) NLR (Neutrophil-lymphocyte ratio) was 2.38 (±1.11). In this study, the AUROC for NLR was found as 0.851 with a P-value of <0.001, indicating a statistically significant association of NLR with the severity of CAD. The scatter dot diagram showed the correlation between NLR and Gensini score. Both the variables were positively correlated and the degree of correlation was found statistically significant (r=0.44; p<0.001) by Pearson’s correlation test. The multivariate logistic regression analysis showed that a high level of NLR had an independent association with severe CAD (with OR being 3.308) along with dyslipidemia. Conclusion: High blood NLR is associated with the severity of CAD and it may be useful for predicting angiographically severe disease.
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Background: Tuberculous pleural effusion (TPE) is the most common etiology of exudative pleural effusion in high tuberculosis burden countries like Bangladesh. The usefulness of pleural fluid cholesterol for the diagnosis of TPE is not evaluated yet. This study aimed to assess the usefulness of pleural fluid cholesterol for the diagnosis of TPE. Methods: This cross-sectional study was conducted at the department of respiratory medicine at Bangabandhu Sheikh Mujib medical university. A total of thirty-five TPE was included in this study. Pleural fluid aspiration followed by cytological (total count, differential count), and biochemical (protein, glucose, lactate dehydrogenase, adenosine deaminase, and cholesterol) investigations were done. At the same time, blood was sent for biochemical (protein, glucose, and lactate dehydrogenase) investigation. Pleural biopsy followed by a histopathological examination was done to confirm TPE. Ethical clearance was obtained from the institutional review board (IRB) prior to starting this study. Results: In our study, the mean age of the participants was 35.54±14.13 years, and male predominant (74.3%). The mean pleural fluid cholesterol was 99.87±23.82 mg/dl. With a cut of value 69.85, the sensitivity, specificity, and accuracy were 97.14%, 57.14%, and 77.14% respectively. Conclusions: Pleural fluid cholesterol has significant diagnostic usefulness for the diagnosis of tuberculous pleural effusion.
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The primary report of intussusception was made in 1674 by Barbette of Amsterdam. It increases the patient's risk of intestinal obstruction, parietal ischemia, perforation, and peritonitis. Small intestinal submucosal lipomas are an uncommon kind of gastrointestinal tumour. It is a silent disease that occasionally causes gastrointestinal haemorrhage, intussusception, and bowel obstruction. Surgery is frequently required to confirm the diagnosis and rule out an underlying malignancy. We present a case of submucosal lipoma causing enteric obstruction in a young female.
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Introduction: In squamous cell carcinoma, cells invade the stroma in the form of islands, strands or sheets, which are surrounded by an extracellular matrix, thus producing reactive changes in the stroma. These reactive changes in the stroma may alter the biological behavior of oral cancer which convey some diagnostic and prognostic significance. Objective: This study was to compare staining intensity of various components of connective tissue such as collagen, elastin and glycoprotein among three histological grades of oral squamous cell carcinoma and normal oral mucosa. Materials and Methods: A total sample of 48 in which 36 cases of histologically diagnosed oral squamous cell carcinoma, 12 each of well, moderate and poorly differentiated squamous cell carcinomas and 12 sections of normal mucosa as the control group were selected for the present study. The sections of tissue blocks were stained with connective tissue specific stains such as Verhoeff’s -VanGieson stain and PAS for collagen, elastin and glycoprotein respectively. Results: Staining intensity of collagen, elastin and glycoprotein around tumor island among different grades of OSCC and normal mucosa revealed statistically significant changes (P value <0.001). Collagen and glycoprotein degradation and elastosis are more prominent in poorly differentiated squamous cell carcinomas. Conclusion: Observable changes were seen in the stroma, in all the three grades of OSCC’s compared to normal mucosa. There was an increased stromal response in poorly differentiated carcinomas, when compared to the other grades. Role of the stroma is like a double-edged sword, at times helping in tumor invasion and otherwise warding off the tumor cells.
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Background: The pattern of bacterial infection in acute exacerbation of bronchiectasis is varied with geographical area and lobar distribution of bronchiectasis. The exact pattern of bacterial infection in acute exacerbation of bronchiectasis according to lobar distribution is not known in our country. This study aimed to investigate the pattern of bacterial infection in acute exacerbation of bronchiectasis according to lobar distribution. Methods: A total of eighty-four patients diagnosed with acute exacerbation of bronchiectasis were included in this cross-sectional study in the department of respiratory medicine, Bangabandhu Sheikh Mujib Medical University. Sputum culture and real-time polymerase chain reaction were used to characterize the bacterial profile and high-resolution computed tomography scans for the location of the bronchiectasis. Before enrolment, informed written consent was obtained from the participants. Results: The mean (SD) age of this study population was 47.89 (±14.95) years, 29.8% were female and 60.7% were a non-smoker. Bronchiectasis was more common in the right middle lobe (63.1%), followed by the right lower lobe (44%), and the left lower lobe (42%). Bacteria were isolated in 66% of patients and Gram-negative bacteria were predominant (78.6%). Pseudomonas aeruginosa (25%) and Klebsiella pneumoniae (17.9%) were the most common bacteria. Conclusions: Pseudomonas aeruginosa was identified predominantly in the right upper lobe, right middle lobe, left upper lobe, and bilateral upper lobe and Klebsiella pneumoniae was in the right lower lobe, left lower lobe, and bilateral lower lobe.
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Background: The pattern of bacterial infection in acute exacerbation of bronchiectasis is varied with geographical area and lobar distribution of bronchiectasis. The exact pattern of bacterial infection in acute exacerbation of bronchiectasis according to lobar distribution is not known in our country. This study aimed to investigate the pattern of bacterial infection in acute exacerbation of bronchiectasis according to lobar distribution. Methods: A total of eighty-four patients diagnosed with acute exacerbation of bronchiectasis were included in this cross-sectional study in the department of respiratory medicine, Bangabandhu Sheikh Mujib Medical University. Sputum culture and real-time polymerase chain reaction were used to characterize the bacterial profile and high-resolution computed tomography scans for the location of the bronchiectasis. Before enrolment, informed written consent was obtained from the participants. Results: The mean (SD) age of this study population was 47.89 (±14.95) years, 29.8% were female and 60.7% were a non-smoker. Bronchiectasis was more common in the right middle lobe (63.1%), followed by the right lower lobe (44%), and the left lower lobe (42%). Bacteria were isolated in 66% of patients and Gram-negative bacteria were predominant (78.6%). Pseudomonas aeruginosa (25%) and Klebsiella pneumoniae (17.9%) were the most common bacteria. Conclusions: Pseudomonas aeruginosa was identified predominantly in the right upper lobe, right middle lobe, left upper lobe, and bilateral upper lobe and Klebsiella pneumoniae was in the right lower lobe, left lower lobe, and bilateral lower lobe.
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Background: Bronchial carcinoma has different demographical, clinico-radiological, and histopathological profiles depending on the environment, gender, and racial group. The purpose of this study was to explore the sociodemographical, clinical, radiological, and histopathological patterns of bronchial carcinoma in Bangladesh. Methods: This cross-sectional descriptive study was conducted at the respiratory medicine department of Bangabandhu Sheikh Mujib Medical University (BSMMU). The study period was one year from January 2021 to December 2021. Our study documented socio-demographic patterns, smoking habits, history of COPD, clinical features, radiological findings, histopathological patterns of the tumor, and participants' performance status. Results: One hundred histopathologically confirmed patients with bronchial carcinoma were included in this study. The mean age of the participants was 59.57±10.41 years. The majority of the participants were in the 5th and 6th decade, 35% and 34% respectively. Smokers were 80% in our study. The presenting complaints were cough (87%), shortness of breath (61%), and chest pain (58%). Mass lesions (83%) followed by collapse (8%) were the most common imaging findings. Adenocarcinoma (48%) and squamous cell carcinoma (35%) were the predominant histological types. Conclusions: The histopathological profiles of bronchial carcinoma are changing and adenocarcinoma is becoming the predominant type in Bangladesh.
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Background: Stroke is defined as an abrupt onset of a neurologic deficit lasting for more than 24 hours that is attributable to a focal vascular cause. Hyperglycemia and dyslipidemia are often documented in stroke patients. Elevated CRP level is independently associated with the excessive risk of ischemic stroke. Aim and Objectives were to evaluate the glycemic status, lipid profile and c-reactive protein level in stroke patients admitted in a teaching institute of north-east India. Methods: A cross-sectional hospital-based study conducted in the department of medicine, Agartala Government Medical College and GBP hospital, within a period of January 2020 to June 2021. Data were analyzed by SPSS software version 15 using appropriate statistical tests. Results: Among 200 patients of stroke, 50% was found to be pre-diabetic, 40% known diabetic and 10% newly diagnosed diabetic. 60% were hypertensives. Among them, 80% had ischaemic stroke and 20% hemorrhagic stroke. 70% of the patients had hypercholesterolemia, 60% had hypertriglyceridemia. 80% had raised serum LDL and 57% decreased serum HDL. Out of 200 patients, 60% was found to have raised serum CRP level. 55% of ischaemic stroke patients and 5% of hemorrhagic stroke patients had raised CRP level. Conclusions: Prediabetes and newly diagnosed diabetes are highly prevalent in patients with stroke or TIA. As the prevalence of prediabetes is growing rapidly, prediabetes might become one of the most important modifiable therapeutic targets in both primary and secondary prevention. Early detection of dyslipidemia and treatment with drugs along with dietary modifications and lifestyle changes can reduce the risk of stroke. Since, it was a cross-sectional study, these results need to be validated by further long-term prospective studies.
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Methods@#Radiograms of 1,496 patients (555 males and 941 females) from the first to 9th decade were examined for this study. Sagittal and coronal alignment, disc space narrowing, spur formation including diffuse idiopathic spinal hyperostosis (DISH), spondylolisthesis, and ballooned discs associated with biconcave bodies due to osteoporosis were among the parameters of lumbar spine morphologies examined on high-quality radiographs by both human observers and computers. @*Results@#The alignment of the lumbar spine altered after birth and set at growth maturity, and then the curve was maintained till the end of the 5th decade afterward and the curve gradually hypolordotic. There were three types of coronal alignment abnormalities can be seen: idiopathic, osteopathic, and discogenic (degenerative lumbar scoliosis [DLS]). DLS developed after 6th decade. There was no scoliosis associated with spondylolysis or the post-laminofacetectomy period. Disc space narrowing and corporal spur formation were not seen till the end of 3rd decade comparatively speaking, the corporal spurs generated in the non-scoliotic spine were smaller than those in the scoliotic spine. DISH began to appear in the 5th-decade patients and its incidences increased gradually afterward. Porosis-related vertebral body collapse started to happen after 6th decade. There are three different types of spondylolisthesis: anterior, posterior, and lateral. The lateral slip occurred only in the scoliotic spine. All types were related to degenerative discs. @*Conclusions@#It has been shown that the morphology of the lumbar spine changes throughout time.
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Background: We sought to describe global patterns in achievement of risk factor control for primary prevention in patients with T2D and explore the association of country's GNI/capita with risk factor control. Methods: The DISCOVER study is a prospective, observational study of patients with T2D from 38 countries enrolled at initiation of second-line glucose-lowering therapy. We examined achievement of risk factor control (glycosylated hemoglobin <7%, blood pressure <140/90 mmHg, prescription of a statin) at 3 years among those without optimal control at baseline. Countries were stratified by gross national income (GNI)/capita, from 2017). We examined the impact of country GNI/capita with achievement of risk factor control. Findings: Our cohort included 9613 patients with T2D and without baseline cardiovascular disease (mean age 57.2 ± 8.7 years, 47.9% women). At baseline, 6354/7646 patients (83.1%) had suboptimal glucose control, 3449/9200 patients (37.5%) had suboptimal BP control, and 2800/4221 patients (66.7%) were not on an appropriate statin (sample sizes differed due to missing covariate data). Optimal control at 3 years of follow-up was achieved in 41% (glucose), 56% (blood pressure), and 29% (statins) of patients. There was significant variability in achievement of risk factor control across countries but no association between country GNI/capita with achievement of risk factor control (p > 0.08 for all). Interpretation: In a global, prospective study of patients with T2D, we found that cardiovascular risk factor control achievement was suboptimal despite 3 years of follow-up in specialized health care systems. Neither country-level nor patient-level socioeconomic factors fully explained this finding.
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Background: Stressful life events may lead to insomnia, a very common sleep disorder. Aim and Objectives: The aim of the study was to study the correlation of perceived stress levels and sleep quality among physicians during the coronavirus disease-19 Pandemic. Materials and Methods: Physicians working in Burdwan Medical College were selected as a study group and age, sex-matched controls were selected from other non-medical workers. This online survey was conducted using Google Forms. The form was shared with participants using emails and WhatsApp. In the first section of the form the importance of the study was explained and informed consent was taken from the participants. In the second part of the form, subjects were asked to fill up demographic details and relevant history; in the third part, participants were asked to fill up two scales: Perceived Stress Scale (PSS) and Pittsburgh Sleep Quality Index (PSQI). Results: 128 doctors and 114 other staff participated in the present study. Doctors had significantly higher PSS and PSQI levels as compared to the other group. Doctors’ PSQI: Mean ± SD = 7.59 ± 4.37 and other staff PSQI: Mean ± SD = 5.77 ± 2.75; P: 0.00013**. Doctors’ PSS: 18.43 ± 4.04 and other staff PSS: 15.14 ± 1.7; P < 0.0001**. PSS and PSQI levels were positively correlated in both groups with r values of 0.975 for Doctors and 0.544 for other staff, respectively. Conclusions: Doctors were found to have higher PSS and PSQI levels as compared to the control group. PSS levels were found to be positively correlated with PSQI levels and more so among doctors.
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Background@#Health information systems (HIS) such as Electronic Medical Record (EMR) systems are essential in the integration of fragmented local health systems. Investing in HIS is crosscutting; it can address multiple interrelated health system gaps. However, public health authorities, especially those in resource-constrained communities, are often faced with the dual challenge of upgrading and digitalizing local HIS and addressing other more apparent health system gaps. @*Objectives@#The study aimed to identify and document strategies that not only motivate policy change towards adoption of electronic HIS but also address other health system gaps. @*Methodology@#The author, in his capacity as a local health official in a resource-constrained community, developed, implemented, and documented a social marketing strategy wherein community stakeholders were influenced to invest in an electronic medical record (EMR) system because it was shown to also have the capacity to address other priority health system gaps identified. @*Results@#The strategy, based on situational, stakeholder, and risk analyses, prompted local governance to first invest in improving the delivery of services accredited by the national health insurance program (PhilHealth), for which reimbursements would require electronically submitted claim forms. Community stakeholders then supported the proposal to invest in an EMR system because they were persuaded that it can facilitate increased financing from PhilHealth claims reimbursements, which could be used to enable not only improvement in existing health services but to also initiate other health programs.@*Conclusion@#Social marketing using the perspective of health as an investment influenced stakeholders to invest in an EMR system.
الموضوعات
Public Health , Health Information Systems , Health Communication , Social Marketingالملخص
Objective@#To present a case of neovascular glaucoma secondary to ocular ischemic syndrome following an uncomplicated phacoemulsification@*Methods@#This is a case description of a 74-year-old male who developed blurred vision and increased intraocular pressure (IOP) two months after an uncomplicated phacoemulsification cataract surgery with posterior chamber lens implantation of the left eye. There was iris neovascularization with absence of retinal dot/blot hemorrhages or neovascularization. The fluorescein angiogram (FA) showed delayed choroidal fluorescence and arteriovenous time. IOP-lowering medications and intravitreal injection of aflibercept were given. Carotid doppler test showed 70% stenosis of the ipsilateral artery but a subsequent magnetic resonance angiography (MRA) did not show evidence of significant stenosis. @*Results@#At his last consultation, visual acuity improved to counting fingers. IOP was maintained at 12 mmHg with one anti-glaucoma medication.@*Conclusion@#Ocular ischemia can confound the outcome of an uncomplicated cataract surgery. Doppler scans are usually chosen as the first-line exam for those suspected of carotid stenosis but, at times, may have contradictory results with MRA.
الموضوعات
Glaucoma, Neovascular , Phacoemulsificationالملخص
This investigation presents the food and feeding activity of and endangered riverine catfish Rita rita, during February 2017-January 2018. A total of 225 fish individuals was analyzed for stomach contents by characterizing the dominant food items and morphometric features. The results divulged ten major food items consumed, preferably fish scales and eggs, teleost fishes, copepods, cladocerans, rotifers, and mollusks. Total length and body weight of fish varied between 9-34 cm (20.53 ± 6.90 cm) and 10-400 g (9125.94 ± 102.07 g), respectively. The index of relative importance (IRI%) showed the importance of rotifers over the other food items. Morisita's index of diet overlap indicated seasonal variations in catfish diets with summer and monsoon displaying the least overlap, while maximum overlap during monsoon and winter seasons. The non-metric multidimensional scaling (nMDS) indicated the close association between the food items available during summer and winter seasons with a significant difference among the seasons (ANOSIM, R = 0.638, P = 0.013). Levins niche breadth index arranged in the order of 0.88>0.81>0.78>0.63>0.43 for the size classes of V, IV, III, II and I, respectively. The PCA explained 95.39% of the total variance among the food items and fish size groups. Small-sized fish individuals displayed a greater correlation with food items suitable for their mouth size. In conclusion, the variety and frequency of food items recorded indicated considerable feeding plasticity and opportunistic feeding behavior with a shift from carnivorous to omnivorous feeding nature. This study could render useful information on the food and feeding habits of R. rita and provide background for preparing its diet for future aquaculture practices.
Esta investigação apresenta a alimentação e a atividade alimentar de bagres ribeirinhos Rita rita ameaçados de extinção, no período de fevereiro de 2017 a janeiro de 2018. Um total de 225 peixes foi analisado quanto ao conteúdo do estômago, caracterizando os itens alimentares dominantes e as características morfométricas. Os resultados apresentaram dez principais itens alimentares consumidos, preferencialmente escamas e ovos de peixes, teleósteos, copépodes, cladóceros, rotíferos e moluscos. O comprimento total e o peso corporal dos peixes variaram entre 9-34 cm (20,53 ± 6,90 cm) e 10-400 g (9125,94 ± 102,07 g), respectivamente. O índice de importância relativa (IRI%) mostrou a importância dos rotíferos sobre os demais itens alimentares. O índice de sobreposição de dieta de Morisita indicou variações sazonais nas dietas de bagres no verão e nas monções, exibindo a menor sobreposição, enquanto a sobreposição máxima ocorreu durante as estações das monções e do inverno. A escala multidimensional não métrica (nMDS) indicou a estreita associação entre os itens alimentares disponíveis durante o verão e o inverno, com uma diferença significativa entre as estações (ANOSIM, R = 0,638, P = 0,013). O índice de amplitude de nicho de Levin foi organizado na ordem de 0,88 > 0,81 > 0,78 > 0,63 > 0,43 para as classes de tamanho de V, IV, III, II e I, respectivamente. O PCA explicou 95,39% da variação total entre os itens alimentares e os grupos de tamanho de peixes. Peixes de pequeno porte apresentaram maior correlação com itens alimentares adequados ao tamanho da boca. Em conclusão, a variedade e a frequência dos itens alimentares registrados indicaram plasticidade alimentar considerável e comportamento alimentar oportunista, com uma mudança da natureza carnívora para onívora. Este estudo pode fornecer informações úteis sobre os hábitos alimentares e de alimentação de R. rita e apresentar subsídios para a preparação de sua dieta em futuras práticas de aquicultura.