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1.
Article | IMSEAR | ID: sea-240395

ABSTRACT

Background: Community-acquired pneumonia (CAP) remains one of the leading causes of mortality and morbidity in children under 5 years of age. Early diagnosis and effective management remain the cornerstone to reduce complications and fatalities associated with CAP. Lately, C-reactive protein (CRP) and procalcitonin (PCT) have gained much attention as useful biomarkers in CAP. Recent data suggest that a very low PCT value has a high negative predictive value while identifying a population of children at low risk of typical bacterial infections. Hence, we propose to take up this study to assess the clinical utility of PCT in pediatric CAP. Aims and Objectives: The aim of this study was to study serum PCT level in children with the clinical diagnosis of CAP admitted at R.G Kar Medical College and Hospital, Kolkata, and its role in severity identification and contribution in the treatment of CAP. Materials and Methods: This cross-sectional hospital-based observational study was performed from January 2020 to June 2021 in the R.G Kar Medical College and Hospital, Kolkata, West Bengal, India. A total of 50 children were included within the age group of 2 months–5 years with CAP admitted in the Children’s ward and intensive care unit at our hospital. Clinical characteristics such as age, sex, symptoms such as history of fever, difficulty feeding or drinking, convulsion, lethargy, cyanosis, chest in-drawing, respiratory rates, auscultatory findings such as air entry of bilateral lungs, added sounds like-(inspiratory crept, bronchial breathing), and oxygen saturation were studied. Routine investigations such as complete blood count, serum CRP, blood culture, and chest radiograph sent along with serum PCT. Results: Out of 50 children diagnosed with CAP, 30 (60%) fell within the age range of 2–5 months of age. Among the study population, 70% of children displayed weakly positive and 20% strongly positive serum PCT values. A strong correlation (P < 0.001) was revealed between the severity of pneumonia and PCT, and also a positive correlation (P < 0.001) between clinical outcome and PCT. However, the role in contribution in early diagnosis could not be concluded. Conclusion: This study concluded that serum PCT may be used as a valuable indicator for assessing the severity and prognosis of CAP. All children with elevated PCT who were prescribed antibiotics did not experience further complications of CAP.

2.
Article | IMSEAR | ID: sea-240308

ABSTRACT

Background: A healthy mental adjustment to life is associated with a higher life expectancy than emotional disorders and stress. Age-related depression and dementia are major global public health issues that contribute to significant morbidity and disability among the elderly. Aims and Objectives: The aim of this study was to estimate the prevalence of depression and dementia among the elderly population residing in the rural field practice area of Medical College, Kolkata. Materials and Methods: This cross-sectional study was conducted among 110 elderly populations obtained through multistage random sampling, in the villages under ROHANDA health and wellness center using pre-tested, validated questionnaires called the short version of Geriatric depression scale -15, and Ascertain Dementia 8 to screen and estimate the prevalence of depression and dementia among the elderly. Results: The prevalence of depression and dementia among the elderly (mean age ± SD = 62.5 ± 6.69 years) was 18.2% and 17.3%, respectively. Increasing age, low socioeconomic status, low education, and nucleation of families were found to have significance in developing both dementia and depressive symptoms among the elderly. Binary logistic regression analysis was performed with the risk factors that found to be significantly associated with the development of depression and dementia. For depression type of family (adjusted odds ratio [AOR] 0.11; 95% confidence interval [CI] [0.013–0.983]), body mass index (AOR 7.07; 95% CI [2.104–23.755]) were found to be independent risk factors and for dementia age (AOR 13.60; 95% CI [3.168–58.375]), socioeconomic status (AOR 0.063; 95% CI [0.007–0.563]), marital status (AOR 7.83; 95% CI [1.767–34.696]) were found to be significant after controlling other relevant factors. Conclusion: As aging-related changes take place, depression and cognitive impairment in the elderly go undiagnosed. Therefore, early screening in primary care can aid in early diagnosis and the implementation of suitable interventions to lessen the severity and burden of the condition and enhance the quality of life.

3.
Article | IMSEAR | ID: sea-240078

ABSTRACT

Background: Medical students need to develop self-directed learning skills in early medical schools and it is important to develop critical thinking and creative skills among young learners. Aims and Objectives: The aim of the study to determine the effects of training first-phase MBBS students in workshop mode for learning ethical principles, leadership skills, and stress management. Materials and Methods: This study was conducted on 145 first MBBS students after taking institutional ethical clearance and informed consent. Three workshops were organized by the department of physiology and the medical education unit to implement the module. A workshop was conducted to sensitize faculty members. Written feedback was taken from students and assessments were done using pre-validated questionnaires. Results: The students were able to solve problems in groups which increased their problem-solving and critical-thinking skills. The mean ± standard deviation of the class of performance following the workshops - leadership skills: 70.25 ± 6.45; ethics: 85.24 ± 3.68; and stress management: 84.86 ± 4.5. In the workshop on stress management, it was observed that females had higher anxiety scores as compared to male counterparts. Conclusions: Engaging students to learn leadership skills, ethical principles, and stress management techniques in workshops motivated the young learners and made the teaching–learning experience for the learners as well as faculty members enjoyable. The use of technological assistance decreased the number of faculty members needed to conduct workshops and the whole batch of students could be controlled effectively.

4.
Article | IMSEAR | ID: sea-227731

ABSTRACT

Background: Majority of the medical and surgical emergency procedures being dependent on Blood and blood components, it has played a vital role in patient management. This enlightens the importance and need of proper utilization of blood and its components by ensuring minimal wastage. Aim was to determine the percentage of blood and blood component wastage in a blood bank of a tertiary care hospital. Methods: A retrospective study of donors from January 2015 to December 2020 was done in a blood bank of a tertiary care hospital located in western Maharashtra. Results: Out of the total blood bags collected, 411 (2.8%) blood bag units were discarded due to seropositivity, 373 whole blood bags and 2588 platelet bags had to be discarded. The most common reason for discard of platelet bags were due to expiry; 1789 FFP (fresh frozen plasma) bags, 131 bags of PRBC (packed red blood cells), 85 bags of plasma and 235 cryoprecipitate bags were discarded due to various reasons. Conclusions: Blood being an irreplaceable and important resource, needs to be properly utilized and ideally zero percent wastage should be encouraged. Training programmes for doctors on usage of blood / blood components is highly recommended.

5.
Article | IMSEAR | ID: sea-237563

ABSTRACT

The gingival biotype is critical for implant health and esthetic, masticatory, and hygienic peri-implant soft tissue thickness (STT) results. However, there is no unanimity of data on the effect of gingival biotypes on dental implant survival. Therefore, the current research was aimed at evaluating the outcome of flapped and flapless (FL) surgical interventions on gingival biotypes. The split-mouth study placed forty dental implants in twenty patients (n = 20) in the mandible’s first molar area using flapped and FL implant surgical procedures. Clinical measurements of STT and buccolingual width (BLW) were done at baseline, 3 months, 6 months, and 1 year. Appropriate statistical tests were conducted for intragroup and intergroup comparisons for all the groups with 95% confidence intervals. A p-value less than 0.05 was considered significant. The results revealed a time-dependent increase in the STT in both groups. A significant increase was observed in STT in the flapped group compared to the FL group for 6 months (p = 0.026) and 1 year (p < 0.001). Furthermore, both flapped, and FL groups observed a time-dependent decrease (p < 0.050) in BLW. A significant reduction was observed between the two groups at 6 months (p = 0.040) and 1 year (p = 0.050). The study concluded that between the two groups, the flapped procedure led to a significant increase in STT and a decrease in the BLW of bone. Therefore the FL procedure needs a decrease in the BLW of bone.

6.
Article | IMSEAR | ID: sea-236707

ABSTRACT

Out of diseases affecting kidney functions in humans, immunoglobulin A (IgA) nephropathy is the most common. Available treatments are mainly targeted to reduce proteinuria and creatinine levels and corticosteroids are the mainstay therapy to delay the end-stage renal disease (ESRD). However, corticosteroids are associated with dire adverse effects in 55% of the patients receiving the treatment consisting of metabolic disorders, osteoporosis, and others which drive the idea for the search for anti-inflammatory drugs which alleviate inflammation and fibrosis in the kidneys of the patients resulting in either cure or at least delay the ESRD. Phytomolecules have long been associated with the effective treatment of various disorders since ages. This study focuses on identifying the immunomodulatory pure molecules isolated from plants which can be studied for their effect in alleviating IgA nephropathy. All the phytomolecules mentioned in this study have inflammation-reducing properties as is evident from many studies mentioned here and IgA nephropathy, being an autoimmune disease, can be a good target of these phytomolecules. Various pathological pathways of IgA nephropathy can be targeted with these phytomolecules and this study is an effort to find out the rationale behind the choice of the molecules based on their ability to target the effector molecules of those pathological pathways.

7.
Article | IMSEAR | ID: sea-239251

ABSTRACT

Background and Aims: Nasogastric tube (NGT) insertion can be challenging in an anaesthetised patient, with the conventional method bearing a failure rate of about 50%; hence, several different techniques including a novel digital assistance technique has been tried over years. Objectives: To compare the success rates, procedure time and incidence of adverse events for NGT insertion, among the conventional and digital assistance technique in anaesthetised, intubated adult patients. Materials and methods: 80 patients, aged 18 years and above, of either sex, posted for elective surgeries, requiring nasogastric tube intraoperatively, were randomly, divided into two equal groups. After doing endotracheal intubation, NGT were inserted in patients of Group A by conventional method, and that of Group B by digital assistance technique. The procedure time was calculated from insertion of the tip of the NGT into nostril till the confirmation of its position. Number of attempts and total procedure time were recorded upto 5 times, in both the groups. Results: In the first attempt, successful NGT placement and procedure times in Group A was in 19 patients (47.5%) and 68 ± 16.4 seconds respectively while that in Group B was in 32 patients (80%) and 69 ± 13.7 seconds respectively (p value 0.026). Adverse events occurred in 35% in Group A and 15% in Group B (p value 0.069). Conclusion: The digital assistance technique appears to be a better alternative to the conventional blind technique in adult patients with better success rate, less procedure time and lesser adverse events.

8.
Article | IMSEAR | ID: sea-230856

ABSTRACT

A heightened emphasis on augmenting millet production and accentuating their nutritional benefits is pivotal in mitigating reliance on conventional crops, fostering dietary diversity, and enhancing food security, particularly in times of natural calamities when food scarcity is prevalent. The United Nations General Assembly has designated the year 2023 as the International Year of Millet. Millets hailed as 'superfoods,' boast high levels of protein, fibre, vitamins, and minerals. India stands as a major contributor, producing 80% of Asia's millets and 20% globally, as reported by the Ministry of Agriculture and Farmers Welfare. Statistics reveal that over 90 million individuals in Africa and Asia incorporate millets into their diets, with Africa accounting for more than 55% of global production, followed by Asia at nearly 40%, while Europe constitutes approximately three per cent of the worldwide market. Specifically in India, West Bengal adheres to a predominantly monocultural cropping system, predominantly focused on rice. Monoculture systems are highly susceptible to blights and pests due to their lack of diversity, leading to reduced soil fertility and compromised soil structure. Cultivating millets not only offers a viable solution by diminishing reliance on synthetic fertilizers and pesticides but also facilitates a transition towards sustainable agriculture. This involves diversifying crop rotations and steering clear of the pitfalls associated with mono-cropping systems. Introducing various millet types into cropping systems can significantly enhance food security. Each millet variant possesses unique qualities that enable them to withstand extreme climatic conditions, making them particularly relevant as adaptive measures in the current context of global warming and climate change issues.

9.
Article | IMSEAR | ID: sea-233541

ABSTRACT

Background: Every pregnant woman faces the risk of sudden, unpredictable complications that could end in death or injury to herself or to her infant. Birth preparedness and complication readiness is a strategy that encourages pregnant women, their families, and communities to effectively plan for births and deal with emergencies, if they occur. Objectives were to study the Knowledge of Birth Preparedness & Complication Readiness among the study subjects in the field practice area of RHTC of a tertiary care establishment in Central India. Methods: This cross-sectional study was carried out from January 2016 to June 2017 in the field practice area of RHTC of a tertiary care establishment in Central India. In the study d 420 women were included as per criteria. Data was recorded in the predesigned and pre tested proforma and were analysed by using SPSS V.20 software. Results: Out of the total 420 mothers, 75% belonged to the age group 20-25 years. Maximum study subjects (33.1%) belonged to General Category while 23.1% of mothers were Schedule Caste. Maximum mothers (70%) were homemakers, the rest were occupied in various capacities. The BPCR index overall was 49.86, with 85% institutional deliveries; ANC visits initiation at 68%. General awareness shows certain gaps which needs attention of health care workers. Conclusions: Lack of awareness about possible complications during the time of pregnancy, that of time of delivery or post-natal period was observed while interviewing the mothers.

10.
Article | IMSEAR | ID: sea-216386

ABSTRACT

Background: Coronavirus disease 2019 (COVID-19) is majorly known to cause mild to moderate disease, but a small fraction of patients may develop respiratory failure due to diffuse lung injury, requiring management in the intensive care unit (ICU). This study attempts to identify factors that can predict unfavorable outcomes in moderate to severe COVID-19 patients. Methods: Hospital records of 120 COVID-19 patients admitted to the ICU were retrospectively analyzed and data pertaining to demographic, clinical, and laboratory parameters were obtained. These data were then compared with outcome parameters like survival, duration of hospital stay, and various adverse events. Results: Out of 120 patients, 70% were male, with a mean age of 54.44 years [standard deviation (SD) ± 14.24 years]. Presenting symptoms included breathlessness (100%), cough (94.17%), fever (82.5%), and sore throat (10.83%). Diabetes, hypertension, and chronic obstructive pulmonary disease (COPD) were the common comorbidities associated. Increased serum D-dimer, ferritin, interleukin-6 (IL-6) levels, and unvaccinated status were associated with higher mortality. Overall, 25.83% of patients survived, 24.41% of patients developed septic shock, and 10.6% of patients were discharged on oxygen. World Health Organization (WHO) clinical progression scale score ? 6 had 57 and 82% sensitivity and 83 and 77% specificity on days 7 and 14 after admission, respectively, for predicting mortality. A baseline National Early Warning Score 2 (NEWS 2) ? 9 had 48% sensitivity and 88% specificity for predicting mortality. Conclusion: Advanced age and associated comorbidities are linked to adverse outcomes in moderate to severe COVID-19. Persistently high D-dimer levels, despite standard treatment, may also contribute to increased mortality. WHO clinical progression scale and NEWS 2 have high specificity for predicting mortality.

11.
Indian J Ophthalmol ; 2020 Feb; 68(2): 371-374
Article | IMSEAR | ID: sea-197805

ABSTRACT

Purpose: Glaucoma is the leading cause of irreversible blindness in the world. The current study aims to estimate prevalence, features, and associations of open angle glaucoma (OAG) in a rural and urban East Indian population. Methods: This is a population based cross sectional study with two arms, rural (28 contiguous villages from 13 Gram Panchayats in Balagarh Police Station, Hooghly district) and urban (Kolkata). Individuals residing in the study area aged 40 years and above were included using multistage random cluster sampling. All subjects underwent a detailed ophthalmic examination at our base hospitals including applanation tonometry, ultrasound pachymetry, gonioscopy, and frequency doubling technology perimetry. The primary outcome was the prevalence of POAG (95% CI). Age and gender specific prevalence estimates were calculated. Multiple logistic regressions were used to analyze the risk factors. Results: Data from 7128 and 6964 subjects aged 40 years or older from Kolkata city and Hooghly district, respectively were analyzed. In the urban population, 2.10% (95% CI: 1.99–2.21%) had POAG and 0.15% (95% CI: 0.13–0.17%) had secondary OAG. In the rural population, 1.45% (95% CI: 0.59–2.31%) had POAG and 0.10 ± 0.03% (95% CI: 0.07–0.13%) had secondary OAG. Conclusion: The study concludes that higher age, higher vertical cup disc ratio (VCDR), and lower central corneal thickness (CCT) are important independent predictors of OAG and emphasizes that increased intraocular pressure (IOP) is not POAG. Gonioscopy, disc evaluation, and screening perimetry need to be incorporated in the detection protocol for glaucoma if we intend to lighten the burden of blindness due to glaucoma.

12.
Article | IMSEAR | ID: sea-205584

ABSTRACT

Background: This study aims to report on our institutional experience of palliative radiotherapy (RT) in the locally advanced head and neck by cyclical hypofractionated RT (Quad Shot) which is a short-course palliative regimen with good patient compliance, low rates of acute toxicity, and good response rates. Objectives: The objectives of the study were to review the use of the Quad Shot technique at our institution to quantify the palliative response in locally advanced head-and-neck cancer. Materials and Methods: Between April 2017 and July 2019, 45 patients with biopsy-proven squamous cell carcinoma of the head-and-neck region at the Department of Radiotherapy, Nil Ratan Sircar Medical College, Kolkata, which were deemed to be fit for palliative RT by departmental tumor board were given cyclical hypofractionated palliative RT as 14 Gy in four fractions over 2 days, twice daily, repeated every 4 weeks for a maximum of 3 cycles. Retrospective assessment was done for improvement in pain and dysphagia and also response to treatment. Results: Pain response occurred in 66.7% of the patients. The mean pain scores decreased significantly from pre- to post-treatment, 47.4 to 21.5 (P < 0.0001). The mean initial dysphagia score improved from 21.9 to 38.2 (P = 0.0002). About 60% of patients developed mucositis (≤ Grade 2), while no Grade 3 mucositis was reported. A total of 30 patients had partial response (66.67%) and 6 patients had stable disease. However, a total of nine patients had progressive disease which included those patients that were given fewer courses of Quad Shot. Conclusion: In locally advanced head-and-neck cancer patients particularly with poor performance status or elderly patients who are in dire need of some form of local therapy for symptom control and palliation, the hypofractionated palliative RT regimen (Quad Shot) offers an effective and quick treatment option which is beneficial both clinically and in logistics issue.

13.
Indian J Lepr ; 2019 Sep; 91(3): 207-215
Article | IMSEAR | ID: sea-195051

ABSTRACT

Leprosy is an infectious disease, which may lead to disability before, during or after treatment. Leprosy is associated with social stigma and discrimination because of disability and disfigurement and recognized as a disease of major public health significance. As factors associated with occurrence and management of disabilities may vary from area to area, it is important to generate this information in affected populations. This study has been carried out to determine the extent and pattern of disabilities among newly diagnosed leprosy cases, factors associated with disability, provision and utilization of disability preventive services. This cross-sectional study was conducted in Siliguri subdivision of Darjeeling district, West Bengal. All newly diagnosed and registered leprosy cases in a reference year (April 2013 - March 2014) were included. Detailed medical examination and interviews was carried out to assess the disability and to study the relevant aspects. The entire collected data was analysed using SPSS software and chi-square, binary logistic regression were applied to test association between disability and other epidemiological correlates. It was observed that all the disabilities were in multibacillary (MB) cases only. Child leprosy rates of 5.5% appears to be promising statistics. Among 110 new leprosy cases studied, overall proportion of disability was 15.5%; grade 1 and grade 2 disabilities were 9.1% and 6.4% respectively. Hand was the commonest site of involvement, whereas grade 2 disability was highest in feet (2.7%). Disability status was found to be significantly associated with number of nerve involvement and history of treatment interruption. Utilization of disability preventive services was found very poor. Significantly the proportion of disability was highest among leprosy cases aged 60 years or more (37.5%). As no disability was noted in patients below 15 years, march towards achieving one of the targets of Global Leprosy Strategy 2016-20 appears to be closing to goal. Though the situation may be better comparably to some other parts of country, yet the overall proportion of disabilities as well as grade 1 and grade 2 disabilities among newly diagnosed leprosy cases is unacceptably high in the studied area. Community based studies and appropriate interventions can help in achieving the targets pertaining to leprosy situation in general and access to quality services in particular

14.
Article | IMSEAR | ID: sea-205528

ABSTRACT

Background: Hypertension (HTN) is one of the most common diagnoses in a primary health care setting and it is one of the important and preventable contributors to disease and death. HTN is considered as an additional risk factor in anesthesia and HTN is of special importance to the anesthetist for various reasons. Tracheal intubation, surgical incision, recovery from anesthesia, and post-operative pain can increase blood pressure (BP). Objectives: This study aims to find out the burden of pre-operative HTN and its risk factors among patients who were admitted for surgical procedures at a tertiary health care facility of Durgapur, West Bengal, India. Materials and Methods: After obtaining permission from the Institutional Ethics Committee, an institution based, observational, and cross-sectional study was conducted from January 2019 to February 2019. A pre-tested, semi-structured schedule was used to collect Clinic Social data. Anthropometric measurements and BP were taken as per the world health organization STEP-wise approach to surveillance guidelines. BP was classified as per “The eighth joint national committee (JNC-8) guidelines. Results: Data were collected from 150 study subjects and were analyzed using SPSS, version 20.0 for windows. The frequency of pre-operative HTN and pre-HTN was found to be 38.0% and 32.0% respectively. As per JNC-8, 34.7% had Stage-1 HTN followed by 32.0% and 3.3% who had pre-HTN and Stage-2 HTN, respectively. Increasing age, male gender, smoking, increasing body mass index, dyslipidemia, and Type 2 diabetes mellitus (T2DM) were significantly associated with a higher frequency of HTN. Conclusion: There is a very high prevalence of pre-operative HTN and pre-HTN. Increasing age, male gender, smoking, overweight, obesity, dyslipidemia, and T2DM were significant risk factors for HTN. Routine screening of HTN should be done in surgical ward to see if there are cases of “white coat” HTN.

15.
Article | IMSEAR | ID: sea-196330

ABSTRACT

Post chemotherapy Wilms Tumour (PCWT) is a diagnostic conundrum both for the clinician and the pathologist, in view of its morphological similarity with ectopic immature renal tissue (EIRT). However, due to their varying prognoses and different lines of management, it is important to distinguish between the two. Here, we discuss clinical presentation and pathology of a case of PCWT, arising in a horse shoe deformity of the kidney in a 5 year old girl. The discussion focuses on the pathogenesis of Extra Renal Wilms Tumour (ERWT) as well as its distinguishing morphological features and chemotherapy induced changes in Wilms tumour.

16.
Article | IMSEAR | ID: sea-196329

ABSTRACT

Focal nodular hyperplasia (FNH) is a benign non-neoplastic lesion of the liver usually found in adults. It is uncommon in children, comprising 2-10% of all pediatric liver tumours. In children, it can occur at all ages, with increased frequency between 6-10 years. We present two cases of FNH in childhood- the first being that of a 5-month-old infant, and the second in a 6-year-old boy. The possibility of congenital FNH had been excluded in the first case. The second case posed diagnostic difficulty initially and was wrongly treated for hepatoblastoma by neoadjuvant chemotherapy, but later correctly diagnosed to be FNH. Both the children are doing well on follow-up. Paediatric FNH though rare, should be kept in mind while dealing with a hepatic mass. Radiological features can be variable and needle sampling may not be sufficient to reach to a diagnosis. Histological examination with glutamine synthetase immunostaining should be performed in doubtful cases to differentiate FNH from other paediatric liver masses, as management differs.

17.
Article | IMSEAR | ID: sea-196243

ABSTRACT

Aim: Microsatellite instability (MSI) pathway is known to be implicated in carcinogenesis of 15% colorectal carcinomas (CRC), including 2%–3% of cases of Lynch syndrome, as per western literature. MSI status has important prognostic and therapeutic implications. The prevalence of MSI in Indian CRC patients is unknown. We aimed to determine the prevalence by studying 231 consecutive unselected cases of CRC. Methods: Tissue microarrays using duplicate cores per case for 141 cases, and whole tissue sections for 90 cases, were used. Immunohistochemistry with four mismatch repair (MMR) markers – MLH1, MSH2, MSH6, and PMS2 was performed. Molecular analysis for MSI status was performed in 18 randomly selected cases. Correlation with various clinical and histopathological features was done using univariate and multivariate analysis. Results: Loss of MMR immunohistochemical (IHC) was seen in 53/231 cases, i.e. 22.94% (95% confidence interval 17.52%–28.36%). MLH1-PMS2 dual loss comprised 13.9%, MSH2-MSH6 7.4%, and isolated PMS2 loss in 1.73% of cases. Univariate analysis showed significant association with age (<60 years), right-sided tumor location, histologic type, high grade, the presence of severe intratumoral lymphocytic (ITL) and peri-tumoral lymphocytic response, and N0 nodal stage. On multivariate analysis, independent variables were age < 60 years, right-sided location, and severe ITL. Molecular testing for MSI corroborated with the IHC results. Conclusion: The study results show a slightly higher prevalence of MSI-H phenotype, compared to Western literature, stressing the need for more widespread testing for better clinical management and identification of possible hereditary colon cancer syndrome.

18.
Indian J Ophthalmol ; 2018 Sep; 66(9): 1285-1290
Article | IMSEAR | ID: sea-196864

ABSTRACT

Purpose: To estimate the prevalence, features, and associations of primary angle closure disease (PACD) in rural and urban populations from West Bengal in eastern India. Methods: This was a population-based cross-sectional study with two arms, rural and urban. The rural study area consisted of 28 contiguous villages from 13 gram panchayats in Balagarh Police Station, with rural base hospital at Dhobapara, Balagarh Police Station, in the village Kuliapara of Hooghly district. A tertiary eye hospital in central Kolkata was the urban study center. Individuals residing in the study area aged 40 years and above were included in this study using multistage random cluster sampling. All subjects underwent a detailed ophthalmic examination at our base hospitals including applanation tonometry, ultrasound pachymetry, gonioscopy, and frequency doubling technology perimetry. Data collected were analyzed using SPSS 13. Multiple logistic regressions were used to analyze risk factors for PACD. Results: A total of 7,408 and 7,248 subjects aged 40 years or older were enumerated from Hooghly district and Kolkata city, respectively. PACD was detected in 1.9% subjects in rural arm and 1.54% subjects in the urban arm (P < 0.001). In rural arm, 0.3% had PACS, 0.56% had PAC, and 1.03% had PACG. In urban arm, 0.22% had PACS, 0.35% had PAC, and 0.97% had PACG. Conclusion: The study concludes that higher age, higher CCT, and shorter axial length/presence of hyperopia are important independent predictors of ACD. ACD is more common in eastern India than previous estimates.

19.
Indian J Cancer ; 2015 Oct-Dec; 52(4): 563-567
Article in English | IMSEAR | ID: sea-176282

ABSTRACT

BACKGROUND: Plasmablastic lymphoma (PBL), a rare non‑Hodgkin’s lymphoma (NHL) variant specifically associated with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), expresses well‑differentiated plasma cell markers like CD138, bright CD38, and MUM1; but not conventional B‑cell markers. It occurs at unusual sites like oral cavity and orbit, and has poor survival rates. AIMS: This study serves as a review of a clinical experience with six HIV patients with PBL and observes the spectrum of clinical presentations, histopathologies, and 1‑year outcomes in PBL patients. MATERIALS AND METHODS: This review of six PBL patients was conducted at a tertiary care hospital in eastern India using relevant radiological, histopathogical, and immunohistological studies. RESULTS: Incidence of PBL among HIV patients was 0.58% (6/1,028). Mean CD4 count at presentation was 125.5 ± 71.1 cells/μL. Sites of involvement included pleura, lung parenchyma, suprarenal gland, pelvic cavity, and retroorbital space (one each). Immunohistopathology of biopsied sample in each patient revealed PBL (positive plasma cell markers MUM‑1/ IRF4, CD38, and CD138/syndecan; and negative of B‑cell markers CD3, CD20, and CD30). Three (60%) were positive for Epstein Barr virus (EBV) immunoglobulin G (IgG). Five surviving patients received CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) regimen and attained partial remission (PR) after six cycles. Subsequently, three patients were started on EPOCH (etoposide, cyclophosphamide, doxorubicin, vincristine, prednisone) therapy; two attained near total regression after 6 months (four cycles). Overall, four patients remained alive with good quality of life at the end of 1 year of follow‑up. CONCLUSION: PBL in HIV occurs at unusual sites with varying aggressivity. This study is too small to comment on the long‑term outcomes of PBL in HIV; however, coadministration of antiretroviral therapy (ART) with standard chemotherapy may improve survival.

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