Study to assess sub-foveal choroidal thickness in patients of preeclampsia through spectral domain optical coherence tomography

Background: Aim of the study was to assess sub-foveal choroidal thickness (SFCT) in preeclamptic patients by SD ocular coherence tomography (SD-OCT) and correlate its changes with severity of preeclampsia.Method: This case control, observational study, conducted in department of ophthalmology in association with department of obstetrics and gynaecology. The subjects were split into two groups: study and control. Study group was further divided in to 2 groups i.e., group A (Patients with preeclampsia) and group B (Pregnant females without preeclampsia). Control group (Group C) of non-pregnant females of similar age group. Total 100 patients were taken in each group. Subjects from both study and control groups were subjected to SD-OCT and mean choroidal thickness of both eyes was noted. Data was noted and comparison of 3 groups was done.Results: Baseline characters viz, age, period of gestation, and parity was comparable among all the groups as p>0.05. Mean arterial pressure (MAP) was 102.72±9.81 and 84.56±7.83 in group A and B respectively with statistically significant difference as p<0.01. Following a post hoc analysis, it was discovered that the SFCT of the healthy pregnancy group did not differ substantially from that of the control group, however the SFCT of the pre-eclampsia group was significantly higher than that of the control and healthy pregnancy groups.Conclusions: Pre-eclampsia causes a greater increase in sub-foveal choroidal thickness than normal pregnancy or non-pregnant women. It has the potential to be used as a predictor or marker of pre-eclampsia severity

Cross-Sectional Study to Find Out the Prevalence of Cardiovascular Diseases Through Detection of ECG Abnormalities in Undiagnosed Population Using a Handheld ECG Device, SanketLife Pro Plus

: In India, cardiovascular diseases (CVDs) are now the main cause of sudden death. Statistics on prevalence or nationally representative surveillance statistics, however, are lacking. Aim: The objective of this cross-sectional study was to assess the ECG findings in general OPD patients not yet diagnosed with any CVD using SanketLife Pro Plus handheld ECG device. Materials and methods: The study data was extracted from a free ECG test camp, which was organized in the common OPD waiting area at Indraprastha Apollo Hospitals in New Delhi. Of the 100 persons screened, 78% had sinus rhythm and 13% had tachycardia. Apart from these, no other major findings were detected in the study population. One percent ST depression and 4% T-wave inversions were the significant findings of concern, suggestive of myocardial ischemia or infarction, especially in the undiagnosed population. Conclusion: Considering the sample size, even at a 1% incidence of major ECG abnormalities, the outcome is indicative of a possible underlying danger, which is avoidable with early detection and thorough awareness. A mass ECG screening along with collection of relevant data and appropriate research design may help to identify the population at risk. Besides the ECG screening, a stroke risk assessment should be done and prophylaxis must be given to the individuals who have been diagnosed with CVDs

A Pan-India, Knowledge, Attitudes and Practices (KAP) Study of Healthcare Practitioners in India Regarding Immunomodulatory Role of Vitamin D Supplementation in COVID-19

Introduction: Vitamin D has immunomodulatory effects and vitamin D deficiency has been associated with autoimmune responses and increased risk of infections. Vitamin D-mediated antimicrobial and anti-inflammatory responses play an effective role in the prevention of various respiratory tract infections including coronavirus disease 2019 (COVID-19). Aims and objective: To evaluate the therapeutic role of vitamin D via immunomodulation in COVID-19 through a Knowledge, Attitudes and Practices (KAP) study of pan India healthcare practitioners (HCPs) to arrive at a common consensus statement regarding dosage and duration of vitamin D for immune-modulatory function. Methods: A pan-India, online, questionnaire-based, KAP survey was conducted on vitamin D and its role in immunomodulation in COVID-19 from April 2021 to January 2022 followed by polling obtained from 2,338 HCPs through round table meetings (RTMs). Results: Approximately 64% of HCPs considered the use of vitamin D in COVID-19 patients for various reasons including prevention of illness, reduced ICU stay, reduction in morbidity and mortality along with decrease in the levels of inflammatory markers in COVID-19 patients. For the dosage regime, 47% of HCPs preferred vitamin D 60,000 IUweekly while 45% of HCPs preferred both 60,000 IU weekly and 2,000 IU daily dose for boosting immune system in their patients. Conclusion: The panel agreed that vitamin D levels of 40 ng/mL and above appear to confer better immune-protective response to several infections including COVID-19

Estimating global injuries morbidity and mortality : methods and data used in the Global Burden of Disease 2017 study

Background While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria. Methods In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced. Results GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes. Conclusions GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future.Peer reviewe

Mapping development and health effects of cooking with solid fuels in low-income and middle-income countries, 2000-18 : a geospatial modelling study

Background More than 3 billion people do not have access to clean energy and primarily use solid fuels to cook. Use of solid fuels generates household air pollution, which was associated with more than 2 million deaths in 2019. Although local patterns in cooking vary systematically, subnational trends in use of solid fuels have yet to be comprehensively analysed. We estimated the prevalence of solid-fuel use with high spatial resolution to explore subnational inequalities, assess local progress, and assess the effects on health in low-income and middle-income countries (LMICs) without universal access to clean fuels.Methods We did a geospatial modelling study to map the prevalence of solid-fuel use for cooking at a 5 km x 5 km resolution in 98 LMICs based on 2.1 million household observations of the primary cooking fuel used from 663 population-based household surveys over the years 2000 to 2018. We use observed temporal patterns to forecast household air pollution in 2030 and to assess the probability of attaining the Sustainable Development Goal (SDG) target indicator for clean cooking. We aligned our estimates of household air pollution to geospatial estimates of ambient air pollution to establish the risk transition occurring in LMICs. Finally, we quantified the effect of residual primary solid-fuel use for cooking on child health by doing a counterfactual risk assessment to estimate the proportion of deaths from lower respiratory tract infections in children younger than 5 years that could be associated with household air pollution.Findings Although primary reliance on solid-fuel use for cooking has declined globally, it remains widespread. 593 million people live in districts where the prevalence of solid-fuel use for cooking exceeds 95%. 66% of people in LMICs live in districts that are not on track to meet the SDG target for universal access to clean energy by 2030. Household air pollution continues to be a major contributor to particulate exposure in LMICs, and rising ambient air pollution is undermining potential gains from reductions in the prevalence of solid-fuel use for cooking in many countries. We estimated that, in 2018, 205000 (95% uncertainty interval 147000-257000) children younger than 5 years died from lower respiratory tract infections that could be attributed to household air pollution.Interpretation Efforts to accelerate the adoption of clean cooking fuels need to be substantially increased and recalibrated to account for subnational inequalities, because there are substantial opportunities to improve air quality and avert child mortality associated with household air pollution. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd.Peer reviewe

Global injury morbidity and mortality from 1990 to 2017 : results from the Global Burden of Disease Study 2017

Correction:Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Interpretation Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.Peer reviewe