Alteration in pattern reversal visual evoked potential in pediatric population with amblyopia and spherical refractive errors

Purpose: To study the effect of refractive errors on pattern visual evoked potential (VEP) recordings in the pediatric population. Methods: This cross?sectional observational study assessed 240 eyes of 120 participants attending the outpatient department of a tertiary care center in North India. Participants were between 8 and 18 years of age; 30 participants each were recruited into four groups, namely emmetropia, myopia, hypermetropia, and amblyopia. They were then subjected to pattern reversal VEP, with P?100 amplitude and latency recorded for each participant. Results: The emmetropic group in this study provided normal values of P?100 parameters, namely P?100 latency and P?100 amplitude with readings of 115.78 ± 10.19 ms and 11.11 ± 4.08 ?V, respectively. P?100 amplitude was significant compared to P?100 latency in detecting the presence or absence of a specific type of refractive error. It was found that there was a significant association between severity of myopia and P?100 latency (both unaided and aided) with P < 0.05. The severity of hypermetropia showed a significant association with P?100 amplitude (unaided) (P < 0.05). Receiver operating characteristics analysis revealed P?100 amplitude to be a good predictor of refractive error and the cut?offs were calculated. Conclusion: The P?100 parameters of the pediatric Indian population were comparatively higher than conventional values. P?100 latency seemed to better correlate with myopia, while hypermetropia correlated with P?100 amplitude. P?100 amplitude appears to be the most significant predictor of the presence of refractive error in an individual.

Pattern of liver function test variations in COVID-19 infection & its clinical significance: A study from a dedicated COVID-19 tertiary care centre from India

Background & objectives: Coronavirus disease 2019 (COVID-19) affects respiratory, gastrointestinal, cardiovascular and other systems disease. Studies describing liver involvement and liver function test (LFT) abnormalities are sparse from our population. This study was undertaken to estimate the LFT abnormalities in patients with COVID-19 in a tertiary care set up in India. Methods: In this retrospective study conducted at a tertiary care centre in Mumbai, India, all consecutive patients with proven COVID-19 by reverse transcriptase–PCR from March 23 to October 31, 2020 were enrolled. Of the 3280 case records profiled, 1474 cases were included in the study. Clinical characteristics, biochemical parameters and outcomes were recorded. Results: Overall 681 (46%) patient had deranged LFTs. Hepatocellular type of injury was most common (93%). Patients with deranged LFTs had more probability of developing severe disease (P<0.001) and mortality (P<0.001). Advanced age (P<0.001), male gender (P<0.001), diabetes mellitus (P<0.001), lower oxygen saturation levels at admission (P<0.001), higher neutrophil–lymphocyte ratio (P<0.001), history of diabetes mellitus and cirrhosiss were associated with deranged LFTs. Acute liver injury was seen in 65 (4.3%) cases on admission and 57 (3.5%) cases during hospital stay. On multivariate analysis for predicting mortality, age >60 yr serum creatinine >2 mg%, PaO2/FiO2 ratio ?200 and raised AST >50 IU/l (OR: 2.34, CI: 1.59-3.48, P<0.001) were found to be significant. Interpretation & conclusions: In COVID-19, LFT abnormalities were common, and derangement increased as severity progressed. The presence of deranged LFT worsens the clinical outcome and predicts in-hospital mortality.

Burden of ocular morbidities and color blindness among school-attending children in a foothill town of Uttarakhand State

Purpose: To estimate prevalence of common ocular morbidities including color blindness among school?attending children of an urban foothill town of Uttarakhand State in Northern India. Methods: A cross?sectional study was conducted among school?going children of age group 6–16 years of standard I– XII. Schools were selected using population proportionate to the size sampling technique. Detailed ocular examination including color vision and unaided or aided visual acuity for various ocular morbidities was done. Data was entered into MS excel with statistical analysis using SPSS version 23 with significant P value <0.05. Results: In total, 13,492 students (mean age 10.9 ± 2.7 years) with almost equal male to female ratio were screened. Overall prevalence of ocular morbidity was 23.2%, with refractive error (18.5%) on top, followed by color blindness (2.2%). The later was observed more among males (3.0%) as compared to females (1.4%) with significantly higher odds, OR = 2.3 (1.7–2.9) (P < 0.001). Conclusion: Refractive error has been the most common ocular morbidity, followed by color blindness. Earliest detection can prevent permanent disability and disappointment among youngsters when rejected from entering certain professions due to color vision defect

Study of Carotid Intima Media Thickness (CIMT) In Type 2 Diabetes Mellitus and Its Correlation with Glycaemic Control and Inflammatory Marker HsCRP

Background: Carotid Intima Media Thickness (CIMT) andCRP (C Reactive Protein) are have been used for measuringAtherosclerotic Risk in Diabetics. However there is paucity ofdata regarding their importance in Statin Naïve Diabetics.Aim: To study Correlation of CIMT with glycaemic control andhsCRP in Statin Naïve Diabetics.Materials and Methods: 80 Cases (Patient suffering from type2 Diabetes Mellitus) and 20 controls (non- diabetic healthpatients) presenting in outpatient department of a tertiaryHospital were included in this observational cross sectionalobservational study. Complete Blood Count, urine Routine andMicroscopy, urine for microalbuminuria, fasting plasma glucose(FPG), postprandial plasma glucose (PPPG), glycatedhaemoglobin (HbA1C), lipid profile, renal function test, hs-CRPand CIMT were evaluated in each individual. Independentsamples T-test was used to compare CIMT and hs-CRP bothcases and controls. Test of proportion and chi-square test wasused for association between categorical variables.Spearman’s method was used to assess correlation betweenhsCRP and CIMT.Results: 80 cases (Statin naïve and Non-smoker Diabeticpatients and 20 healthy controls were included in this study.Average CIMT in cases was significantly higher in Diabeticcases than Control (0.66 + 0.14 vs 0.56±0.05, difference= 0.10 mm, 95% C.I. (0.1 - 0.17), p < 0.0001). HsCRP wassignificantly correlated with average CIMT in Diabetic cases.(r=0.512, 95% C.I. 0.33-0.658, p<0.0001). Fasting Blood Sugarwas correlated with average CIMT in Diabetic cases. (r=0.234,95% C.I. 0.015-0.432, p=0.0366). Post Prandial Blood Sugarwas also correlated with average CIMT (r=0.300, 95% C.I.0.086-0.488, p=0.00677).Conclusion: Cardiovascular risk factors like glycaemic controland inflammatory markers like hsCRP are significantlyassociated with CIMT even in non-smoking and statin naïveDiabetics.

Development of Species-specific Polymerase Chain Reaction (PCR) Targeting on Mitochondrial D-loop for Identification of Buffalo and Goat Raw Meat

Abstract: Today's, consumers are concerned about the meat they eat and also demandaccurate labeling. Mitochondrial Analysis of DNA was the most frequently used DNA, becauseof its highly conserved sequences in various organism species. In this study, a rapid,reproducible and simple method for simultaneous identification of multiple meat species ina single step mitochondrial DNA based test has been developed based on the designing ofspecies-specific primer. Meat samples of goat and buffalo were selected to verify theapplicability of the technique. A species specific forward and reverse primer was designedwith the help of the primer3 tool for amplification of mitochondrial D-loop region. Thespecies-specific primers were verified in silico by SnapGene software. The two pairs ofprimers amplified the expected fragment of 338bp for buffalo and 450bp for goat. The changein the size of the PCR product was due to the existence of highly polymorphic regions withinthe buffalo and goat D-loop region. The tested species gives a unique band pattern for eachspecies by using successful amplification of these polymorphic regions in the D-loop region.Overall, the simplicity of amplification of mitochondrial D-loop region could make thistechnique suitable for meat authentication in routine analysis.

Use of Preoperative Inhaled Budesonide to Reduce Postoperative Sorethroat Incidence after Endotracheal Intubation

Introduction: Post-operative sore throat (POST) andhoarseness of voice are common complaints from patientsreceiving tracheal intubation. Budesonide is used to reduceall these complications and metered dose delivery of drugis considered as simple and less time consuming with highpatient acceptability. The present study was study was plannedto assess the effect of use of preoperative inhaled budesonideto reduce postoperative sorethroat incidence after endotrachealintubation.Material and methods: All the patients scheduled to undergoshort elective laproscopic surgeries, lasting <2hrs undergeneral anaesthesia with endotracheal intubation will beincluded in this study. The patients were selected randomlyinto two equal groups as follows: Group A- 20 patientsreceived 200μg budesonide inhalation suspension, using ametered dose inhaler 10 min before intubation, which wasrepeated 6hrs after extubation. Group B- 20 patients with nosuch interventions was performed before intubation or afterextubation. Post-operative sore throat was assessed at 2,6,12and 24hrs. All the results were categorized and summarized.Results: Incidence of POST was significantly higher amongsubjects of Group B in comparison to subjects of group A atdifferent time intervals.Conclusion: Administration of budesonide significantlyreduced the incidence of postoperative cough hoarseness ofvoice and POST among subjects undergoing laparoscopiccholecystectomy

Assessment of Efficacy of Nalbuphine and Dexmedetomidine versus Nalbuphine and Propofol in Middle Ear Surgeries under Monitored Anaesthesia Care: A Comparative Study

Background: For middle ear surgery, familiarity with theinterrelationships of the anatomical structures is as essential asknowledge of their individual morphology, as surgery isstrongly influenced by the close spatial relations between thedifferent components. In the present study, we assessed andcompared the efficacy of nalbuphine and dexmedetomidineversus nalbuphine and propofol in middle ear surgeries undermonitored anaesthesia care.Materials & Methods: A total of 40 patients scheduled toundergo MESs were included in the present study and werebroadly divided into two categories as follows: Group 1:Included patients who received injection dexmedetomidinealong with nalbuphine (intravenously), Group 2: Includedpatients who received injection propofol along with nalbuphine(intravenously). Visual analogue score (VAS) was used forassessing the intraoperative and postoperative pain. Recoveryto be assessed using Modified Aldrete scoring system (scoreranging from 0 to 10) in the recovery room every 5 min, tillscore of 10 was achieved. Adverse events were recorded. Bothpatient satisfaction score (PSS) and surgeon satisfaction score(SSS) were recorded on a scale on 1 to 7; with 1 indicatingextremely dissatisfied and 7 indicating extremely satisfied.Results: Significant results were obtained while comparing themean VAS, number of patients with PSS of 5 to 7 and numberof patients with SSS of 5 to 7 in between the two study groups.Non-significant results were obtained while comparing theincidence of complications between the two study groups.Conclusion: In patients undergoing middle ear surgeries,Nalbuphine/ dexmedetomidine appeared to be significantlymore effective combination in comparison to the nalbuphine/propofol combination.