20†Simultaneous development of acute acquired concomitant esotropia in two siblings during the COVID-19 pandemic: a case report.

A 5-year-old boy (sibling one) and his 11-year-old sister (sibling two) were presented to the hospital eye service in early 2021, having both developed acute-onset large angle esotropia within three months of each other. Neither had any significant past medical, ophthalmic, or family history. The siblings lived in the same household, and both experienced lifestyle changes as a result of the UK lockdown in response to COVID-19.Sibling one had a moderate right esotropia, initially maintained straight by corneal light reflex. He measured 45/50 prism dioptres (Δ) base out at near and 45Δ base out at distance. Sibling two had esophoria which broke down into a right esotropia immediately on dissociation. The esotropia measured 30Δ base out at near and 20Δ base out at distance. At four month follow up, both siblings demonstrated a constant large angle esotropia (sibling one: 54Δ base out at near and 45Δ base out at distance, sibling two: 45Δ base out at near and 40/45Δ base out at distance).Each sibling was treated with right medial rectus recession (5.5 mm) and right lateral rectus resection (7 mm), and at a three-month follow-up, both were minimally esophoric with restored binocularity.The unusual and abrupt changes in lifestyle imposed by the COVID-19 pandemic highlight the likelihood of an environmental aetiology for some forms of esotropia and raise the possibility that extended screen time may be a contributory factor.

Role of health education in school-children with particular reference to malaria.

Knowledge and effect of health education in schoolchildren of primary, secondary and higher secondary classes were evaluated. In schoolchildren exposed to different health education activities such as live demonstrations, slide shows and when both events were grouped together a high average of correct score (47.88%) in comparison to that of control group (26.56%) was noticed. Exposed population could answer most of the questions correctly and supported the role of community participation with the help from Government Departments to control malaria. Involvement and role of schoolchildren in disease vector control programme is discussed in this paper.

Biology of malaria vectors in central Gujarat.

Biology of malaria vectors were studied in Kheda district of central Gujarat in order to understand the vector behaviour in the wake of ecological changes. Anopheles culicifacies and An. stephensi were mainly endophilic whereas An. fluviatilis exhibited marked exophily. All the three vectors were predominantly zoophilic. Peak biting activity period of An. culicifacies varied with season though biting continued in varying magnitudes throughout the night. An. stephensi and An. fluviatilis were arhythmic in their biting activity. Survival of all the three vectors was maximum during cold season owing to longer gonotrophic cycle which also yielded higher estimates for expected infective life. Instability of malaria in this area was probably due to low estimates of expected infective life for the three vectors. A wide range of breeding habitat preferences by An. culicifacies was observed whereas An. fluviatilis and An. stephensi showed restricted distribution.

Dengue in Gujarat state, India during 1988 & 1989.

Following the reports of epidemics of febrile illness from several rural and urban areas of Gujarat state (India) in 1988, epidemiological investigations were carried out and dengue (DEN) virus activity was demonstrated in large cities such as Surat and Rajkot as well as several villages in Sabarkantha district. Two strains of dengue type-2 each were isolated from human sera from Surat city and a village in Sabarkantha district. Six strains of dengue virus were isolated from Aedes aegypti mosquitoes collected at Chotasan village, two of which were confirmed as DEN type-2. Of the 560 patients' sera tested from different areas (including villages and townships), 122 showed evidence of dengue infection and another 236 showed a broader reaction with flaviviruses. Entomological investigations showed a widespread distribution of Ae. aegypti both in urban and rural areas. In the household conditions this mosquito was found to breed predominantly in containers with non-potable water. Amongst these, cement containers manufactured in towns and distributed to the villages seem to play an important role in the spread of this species. In non-residential areas prolific breeding of Ae. aegypti was observed in automobile tyre dumps, and varied types of scrap, in towns and villages. Distribution and relative prevalence of the species were studied in 46 towns and villages, covering the spectrum of rural-urban-continuum. These studies provide an indication regarding the mechanism of the spread of DEN virus through peoples' movement, transport, the process of urbanisation etc.