Comparative study of retinal nerve fibre layer thickness in normal and glaucomatous human eyes as measured by optical coherence tomography

Background: Glaucoma is a disease primarily associated with damage to the Retinal Ganglion Cell (RGC) bodies and axons, which causes characteristic patterns of Visual Field (VF) and changes in the appearance of the Optic Nerve Head (ONH). This Study Compares Nerve Fibre layer thickness in normal and Glaucomatous Human Eye.Methods: It is a case control observational study carried out in 100 patients in a tertiary eye care hospital in the department of ophthalmology in the period from 1st January 2019 to 30th June 2019.Results: The diagnostic ability for distinguishing between normal and glaucoma patients were same when authors consider average RNFL thickness and average GCC thickness. Diagnostic accuracy increases when authors consider both RNFL and GCC thickness. There was a significant difference in both RNFL and GCC thickness between normal and glaucoma patient (p<0.001). The mean deviation shows a significant correlation with all the parameters in eyes with glaucoma (<0.001).Conclusions: RNFL thickness as measured by OCT showed statistically significant correlation with glaucoma. RNFL seems to have higher sensitivity and specificity for the detection of early glaucoma. Diagnostic accuracy increases when we include other parameters like RNFL and visual fields

A Case of “Pill-takers”: Understanding Perceptions and Stigmas surrounding Medication Usage

BACKGROUND: Over half of all Americans take prescription medications regularly, and commentators have noted that modern society has become overly reliant on “pill-taking.” OBJECTIVES: The primary objective of this study was to better understand how healthy individuals’ perceive the identity of a “pill-taker,” using Phase I trial participants as a proxy for healthy individuals.METHODS: This was a mixed methods study that utilized qualitative and quantitative analysis. The data source was semi-structured interview transcripts and demographic data (n = 131) from the HealthyVOICES project, a 5-year study in the UNC Department of Social Medicine and Center for Bioethics. Two sets of interviews were investigated for each participant (n = 261), and participants were evaluated as “pill-takers,” “not-pill-takers,” or “ambivalent” based on their responses to questions about medications. Secondary coding was conducted on interview transcripts to reveal broader themes. Chi-square analyses were conducted to test the relationships between sociodemographic factors (age, race, socioeconomic status, and gender) and “pill-taking” status. RESULTS: Chi-square analysis revealed no statistically significant relationship between sociodemographic factors and “pill-taking” status. Qualitative analysis revealed four broad themes, particularly for not pill-takers and those who were ambivalent: (1) natural/herbal remedies are preferable alternatives to pill-taking; (2) pills are dangerous chemicals and harmful to the body; (3) healthy individuals can be ambivalent about medications; and (4) pill-taking is related to the flawed medication culture in the U.S. CONCLUSION: It is possible that pill-taking culture affects demographic groups equally, and that there are no significant relationships between sociodemographic characteristics and pill-taking status. The qualitative findings indicate that there are strong negative views of pill-taking among some healthy volunteers, which could have important implications for adherence to medication regimens. When studying healthy individuals in the future, it will be important to consider that these individuals may not have fully formed opinions on medications because they have infrequent need to take them. Further research should be done in order to assess the relationship between pill-taking status and sociodemographic variables. Additionally, a more randomized sample of general Americans should be studied to further understand healthy individuals’ perceptions of medications.Bachelor of Science in Public Healt

Prevalence of various dermatoses in pregnancy at a tertiary care centre in Moradabad, Uttar Pradesh, India: an observational study

Background: This was a prospective study which was done to observe various skin lesions in pregnancy and to determine the most likely causes and their incidence in antenatal patients, it was noticed that many women in our institute were having pregnancy related cutaneous complaints thus this observational study was carried out so that better preventive measures and treatment options could be provided to these patients.Methods: Study was conducted in out-patient department of Obstetrics and Gynaecology, TMU, Moradabad. All ANC cases between October 2017 to September 2018 having any type of dermatoses were included in the study irrespective of gestational age. 6348 patients appeared in OPD in the given time period out of which 1256 were included. In case of pruritus, liver function tests were done with USG whole abdomen and patients were reviewed by physician if required. Screening with VDRL, HCV, HbSAg and ELISA for HIV was done in all. Results were tabulated and analyzed.Results: 50.8% primi gravidas ,49.2% multi gravidas. age range 18-38 years. 29.3% presented in third trimester ,25.6% presented in second trimester. Physiological changes seen in all cases, 8.68% specific dermatoses of pregnancy. 40.4 % no complaints, 5.65% melasma, 90.8% hyperpigmentation, 94.6% linea nigra. Secondary areola 89.3%,striae 80.3% out of which 38.9%- primi gravidas and 41.40% -multi gravidas. 92.9% no change in hair density. Montgomery’s tubercles 30-50% of cases. spiders nevi 67%. No cases of palmar erythema. Pruritus gravidarum 38.53%. PUPPP 28.4%. Pemphigoid Gestationis 9.17%. Prurigo of pregnancy 18.34%. Pruritic folliculitis 1.8%. Eczema in pregnancy : pre-existing in 3.7% , out of which exacerbation 1, 3 unaffected. 3 chicken pox.1 filariasis.24 herpetic lesions (herpes simplex).1 scleroderma.17.27% pre-existing taenia infection . Scabies 20.46%.11 0.87% dual infection (scabies-taenia).Conclusions: This study highlights high prevalence of community acquired infections in our region like taenia, scabies giving rise to skin lesions in Antenatal women. Moreover, it highlights a probable association between the prevalence of skin lesions with factors like poor personal hygiene, overcrowding, low socioeconomic status, anaemia and poor nutritional status

Audible Charging Sounds to Indicate Device Battery Level

Users of battery-powered electronic devices rely on visual battery level indicators to discern the charge status of the battery and correspondingly, available device usable time before the device needs to be plugged in. However, users with vision impairments or those not looking at the device screen may not be able to distinguish the battery level from displayed indicators. Such users may plug in the charging cable more often than necessary, out of precaution. This disclosure describes the use of a variety of audible sounds when a device is attached to a charging cable that is plugged into a power source to indicate that the device is being charged and also to indicate the current amount of charge remaining on the battery. The device operating system or other software can detect the plugged-in state as well as the battery level and play the corresponding sounds at appropriate times

A UNIQUE CASE OF BILATERAL VOCAL FOLD PARALYSIS FOLLOWING SPINAL ANAESTHESIA

Cranial nerve palsies are potential but rare complications of spinal anaesthesia. Most of the literatures support upper cranial nerve palsies like VI, IV and III cranial nerve palsies. Intrathecal hypotension resulting in tractional injury of the cranial nerves is the likely mechanism of injury. As on date, some cases of unilateral vocal fold paralysis and very little bilateral vocal fold paralysis have been described in case reports. We have described a patient who developed hoarseness and dysphagia 7 days after receiving spinal anaesthesia for fixation of inter-trochanteric fracture femur. The patient was diagnosed with bilateral vocal fold paralysis. He was managed conservatively and exhibited complete spontaneous recovery as has been described in the previously reported cases. Any patient presenting with idiopathic vocal fold paralysis should be enquired about the history of spinal or epidural anaesthesia. If the history is affirmative, then it points towards transient intrathecal hypotension as a potential etiology of the cranial nerve palsy

Smart-Phone Based Magnetic Levitation for Measuring Densities

Magnetic levitation, which uses a magnetic field to suspend objects in a fluid, is a powerful and versatile technology. We develop a compact magnetic levitation platform compatible with a smart-phone to separate micro-objects and estimate the density of the sample based on its levitation height. A 3D printed attachment is mechanically installed over the existing camera unit of a smart-phone. Micro-objects, which may be either spherical or irregular in shape, are suspended in a paramagnetic medium and loaded in a microcapillary tube which is then inserted between two permanent magnets. The micro-objects are levitated and confined in the microcapillary at an equilibrium height dependent on their volumetric mass densities (causing a buoyancy force toward the edge of the microcapillary) and magnetic susceptibilities (causing a magnetic force toward the center of the microcapillary) relative to the suspending medium. The smart-phone camera captures magnified images of the levitating micro-objects through an additional lens positioned between the sample and the camera lens cover. A custom-developed Android application then analyzes these images to determine the levitation height and estimate the density. Using this platform, we were able to separate microspheres with varying densities and calibrate their levitation heights to known densities to develop a technique for precise and accurate density estimation. We have also characterized the magnetic field, the optical imaging capabilities, and the thermal state over time of this platform

Evaluating diaphragmatic dysfunction and predicting non-invasive ventilation failure in acute exacerbation of chronic obstructive pulmonary disease in India

Background Baseline diaphragmatic dysfunction (DD) at the initiation of non-invasive ventilation (NIV) correlates positively with subsequent intubation. We investigated the utility of DD detected 2 hours after NIV initiation in estimating NIV failure in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients. Methods In a prospective-cohort design, we enrolled 60 consecutive patients with AECOPD initiated on NIV at intensive care unit admission, and NIV failure events were noted. The DD was assessed at baseline (T1 timepoint) and 2 hours after initiating NIV (T2 timepoint). We defined DD as ultrasound-assessed change in diaphragmatic thickness (ΔTDI) <20% (predefined criteria [PC]) or its cut-off that predicts NIV failure (calculated criteria [CC]) at both timepoints. A predictive-regression analysis was reported. Results In total, 32 patients developed NIV failure, nine within 2 hours of NIV and remaining in the next 6 days. The ∆TDI cut-off that predicted NIV failure (DD-CC) at T1 was ≤19.04% (area under the curve [AUC], 0.73; sensitivity, 50%; specificity, 85.71%; accuracy; 66.67%), while that at T2 was ≤35.3% (AUC, 0.75; sensitivity, 95.65%; specificity, 57.14%; accuracy, 74.51%, hazard ratio, 19.55). The NIV failure rate was 35.1% in those with normal diaphragmatic function by PC (T2) versus 5.9% by CC (T2). The odds ratio for NIV failure with DD criteria ≤35.3 and <20 at T2 was 29.33 and 4.61, while that for ≤19.04 and <20 at T1 was 6, respectively. Conclusions The DD criterion of ≤35.3 (T2) had a better diagnostic profile compared to baseline and PC in prediction of NIV failure

Comparative Study Of Analgesia Of Ketorolac, Tramadol, And Flupirtine In The Treatment Of Third Molar Surgery

Background: Third molar surgery is a common dental procedure often associated with significant postoperative pain. This study aimed to compare the efficacy of three commonly used analgesic agents, ketorolac, tramadol, and flupirtine, in managing postoperative pain following third molar surgery. Materials and Methods: A randomized controlled trial was conducted with 150 patients who underwent third molar extraction. The patients were divided into three groups, with 50 patients in each group. Group A received ketorolac 10 mg orally every 6 hours, Group B received tramadol 50 mg orally every 6 hours, and Group C received flupirtine 100 mg orally every 8 hours for 72 hours post-surgery. Pain intensity was assessed using a visual analog scale (VAS), and the total analgesic consumption was recorded. Adverse effects were monitored throughout the study period. Results: The mean pain scores at different time intervals (0-24 hours, 24-48 hours, and 48-72 hours) were significantly lower in the ketorolac group compared to the tramadol and flupirtine groups (p &lt; 0.05). The total analgesic consumption in the ketorolac group was significantly lower (p &lt; 0.05) than in the tramadol and flupirtine groups. Adverse effects were mild and comparable among the three groups. Conclusion: Ketorolac demonstrated superior analgesic efficacy in the management of postoperative pain following third molar surgery when compared to tramadol and flupirtine. It also resulted in reduced analgesic consumption and had a similar safety profile. Therefore, ketorolac may be considered the preferred analgesic agent for patients undergoing third molar surgery

Unraveling Prostaglandin and NLRP3 Inflammasomemediated Pathways of Primary Dysmenorrhea and the Role of Mefenamic Acid and Its Combinations

Painful menstrual cramps during or around the time of the monthly cycle are known as dysmenorrhea. The estimated global prevalence in women of reproductive age ranges from 45% to 95%. It has a significant negative impact on regular activities and productivity at work. However, despite the severe consequences on quality of life, primary dysmenorrhea&nbsp;(PD) is underdiagnosed. Dysmenorrhea has complex pathogenesis. It involves the release of prostaglandins and activation of the nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome and also includes the involvement of other mediators such as bradykinin, histamine and acetylcholine. Even though nonsteroidal anti-inflammatory drugs (NSAIDs) remain the most common type of pain medication, the question of which one should be the most preferred is still open to debate. The current review examines the existing evidence for the pathogenesis of PD and makes evidence based and clinical experience based recommendations for the use of mefenamic acid and its combination in the treatment of dysmenorrhea. Mefenamic acid alleviates PD by inhibiting endometrial prostaglandin formation, restoring normal uterine activity, and reducing the inflammatory response by inhibiting the NLRP3 inflammasome and reducing the release of cytokines such as interleukin (IL)-1β. It is also known to have bradykinin antagonist activity. Dicyclomine has a dual action of blocking the muscarinic action of acetylcholine in postganglionic parasympathetic effect or regions and acting directly on uterine smooth muscle by blocking bradykinin and histamine receptors to relieve spasms. According to the experts, mefenamic acid and dicyclomine act synergistically by acting on the different pathways of dysmenorrhea by blocking multifactorial agents attributed to the cause of dysmenorrhea. Hence, the combination of mefenamic acid and dicyclomine should be the preferred treatment option for dysmenorrhea

Scalable noninvasive amplicon-based precision sequencing (SNAPseq) for genetic diagnosis and screening of β-thalassemia and sickle cell disease using a next-generation sequencing platform

β-hemoglobinopathies such as β-thalassemia (BT) and Sickle cell disease (SCD) are inherited monogenic blood disorders with significant global burden. Hence, early and affordable diagnosis can alleviate morbidity and reduce mortality given the lack of effective cure. Currently, Sanger sequencing is considered to be the gold standard genetic test for BT and SCD, but it has a very low throughput requiring multiple amplicons and more sequencing reactions to cover the entire HBB gene. To address this, we have demonstrated an extraction-free single amplicon-based approach for screening the entire β-globin gene with clinical samples using Scalable noninvasive amplicon-based precision sequencing (SNAPseq) assay catalyzing with next-generation sequencing (NGS). We optimized the assay using noninvasive buccal swab samples and simple finger prick blood for direct amplification with crude lysates. SNAPseq demonstrates high sensitivity and specificity, having a 100% agreement with Sanger sequencing. Furthermore, to facilitate seamless reporting, we have created a much simpler automated pipeline with comprehensive resources for pathogenic mutations in BT and SCD through data integration after systematic classification of variants according to ACMG and AMP guidelines. To the best of our knowledge, this is the first report of the NGS-based high throughput SNAPseq approach for the detection of both BT and SCD in a single assay with high sensitivity in an automated pipeline