To study the correlation of mean macular thickness using optical coherence tomography with distant and near visual acuity in patients of diabetic maculopathy

Background: to study the correlation of mean macular thickness using optical coherence tomography with distant and near visual acuity in patients of diabetic maculopathy.Methods: A prospective, single centre study was conducted on 50 eyes of diabetic patients, with Diabetic Retinopathy with CSME in which patients macular thickness was measured on Ocular Coherence Tomography using fast macular thickness scan. The unaided and best corrected visual acuity was measured in all patients using Snellens distant vision and Jaggers near vision charts.Results: A linear correlation between the OCT measured macular thickness and both the distance visual acuity and the near visual acuity. That means that for a given level of macular thickness, we can predict visual acuity for it. In our series correlation coefficient was 0.921 for distance visual acuity and 0.899 for near visual acuity. Although the correlation value is high in our study, we did find a range of visual acuities for a given range of macular thickness. For every 100 micron change in mean macular thickness, best corrected visual acuity (BCVA) changed 0.3 LogMAR units, for distance as well as for near.Conclusions: Macular thickness and visual acuities (distance as well as near) are strongly correlated but there can be variations. And a wide range of visual acuities is possible for a given degree of macular edema. Macular thickness though a strong predictor of visual acuity; other factors might also play a role in determining visual acuity for a particular patient

EFFICACY OF SUBOCCIPITAL AND STERNOCLEIDOMASTOID RELEASE TECHNIQUE IN FORWARD HEAD POSTURE PATIENTS WITH NECK PAIN: A RANDOMIZED CONTROL TRIAL

Background: Neck pain in forward head posture has a high prevalence. Suboccipital and SCM release technique has been reported effective in releasing shortened muscles, but no evidence is reported of its effectiveness in neck pain patients with or without forward head posture (FHP). This study is undertaken to find out if suboccipital and SCM myofascial release (MFR) have any effect in neck pain and FHP. Methods: Study design, A Randomized control trial 60 subjects between age 20-30 having FHP and neck pain were randomly divided into 2 groups Experimental group (n=30), control group (n=30), number of male patients (n=10) and female (n= 43), Intervention given for experimental group was MFR for suboccipital and SCM muscle and control received resisted chin tucks, Neck isometrics, Scapular sets, Hot packs, ergonomic advice (2 weeks/ 3 sessions). Outcome measures were the Craniovertebral angle (CVA), shoulder angle, NPRS, NDI, Cervical ROM assessed at baseline, post-treatment, 3rd and 4th week follow up. Results: The repeated measures ANOVA revealed a significant group by time interaction for changes in CVA angle (p 0.005), NPRS(p<0.01), NDI(p<0.01), Cervical ROM (p<0.01), in both the experimental and control group. Conclusion: This study concludes that Myofascial release for suboccipitals and Sternocleidomastoid is more effective than conventional therapy in improving Forward head posture and reducing neck pain

Correlation of Self-Reported and Performance-Based Measures In Patients With Non-Traumatic Stiff Shoulder Pathologies: An Observational Study

Background: Self-reported measures represent patients' perspectives toward their disease, but their performance levels may vary. Performance-based measures mimic the patient's functional activity movement, which helps evaluate specific task components, including how the therapist approached the task. Both measures report the patient's functional level from the patient's or therapist's perspective. The study was done to determine the correlation between self-reported and performance-based measures outcomes in non-traumatic stiff shoulder pathologies. Method: Self-reported outcome measure scores were recorded using the Shoulder Pain And Disability Index (SPADI), Disabilities of Arm, Shoulder, and Hand (DASH), and Patient Specific Functional Scale (PSFS). Performance-based measures scores of the shoulder were given using function-related tests of the shoulder: 1) Hand to the neck, 2) Hand to scapula 3) Hand to the opposite scapula. Result: Inferential statistics were done using the Pearson correlation test, and the significance level was set at p<0.05. Pearson correlation test showed: 1) Weak statistically significant correlation between SPADI versus function-related test 1(r= 0.32), DASH versus Function-related test 1(r= 0.31), and function-related test 2(r= 0.31) and PSFS versus function-related test 1(r= 0.36). 2) Other correlations were Very Weak and non-significant. Conclusion: As the correlation between all three self-reported measures and each of the three function-related tests has become weak, there is a need to include both self-reported and performance-based measures in assessing patients with non-traumatic stiff shoulder pathologies

Global Retinoblastoma Presentation and Analysis by National Income Level.

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe

Basel III & European banking

Basel III was a direct response to the Economic Crisis of 2008. There were far-reaching effects to the global economy even though banks were in compliance with Basel II. The new regulations aspire to improve the quality and depth of capital, shift the focus on liquidity and risk management, and make financial institutions more immune to adverse shocks. The main purpose of this paper is to seek to examine Basel III in Europe’s context. This has been done by throwing light on the details of the Basel III accord and how it is different from Basel II. To understand the requirements in Europe’s context, we try to inspect the major differences between Basel III and Europe’s Capital Requirements Directives – IV (CRD-IV), which is the European Union’s effort to implement Basel III, and assess the readiness of three major European Banks- UBS, Deutsche Bank and Credit Suisse in their implementation of Basel III capital and liquidity requirements. The paper then presents an analysis of the possible flaws of Basel III, and tries to identify which are the areas which Basel III is still lacking in. The new recommendations are a step in the right direction, but it may take much more to achieve the desired goal of a stable and safe financial system.BUSINES

Modal and Static Analysis of Vortex Bladeless Wind Turbines with Different Geometries

The renewable energy industry has undergone remarkable growth in recent times, with wind energy assuming a preeminent role as a source of clean energy. Five distinctive geometries were analyzed, including a traditional circular form, a decagonal form, and three sinusoidal forms to evaluate the modal and structural characteristics of vortex bladeless wind turbines. The ANSYS software was employed to carry out both the modal and structural analysis. The vortex bladeless rod was firmly fixed and the mast was exposed to a wind pressure of 15 Pa during modal analysis. The structural analysis was executed to compute the deflection of the vortex bladeless wind turbine under the same wind pressure. The results demonstrated that the sinusoidal forms exhibited the greatest deflection at a wind speed of 5m/s. These findings possess the potential to optimize and augment the design of vortex bladeless wind turbines, provide guidance for future design decisions, and boost the efficiency and dependability of these wind turbines. It is therefore posited that the consideration of diverse geometries in the design of vortex bladeless wind turbines is of paramount importance, and the findings of this study are expected to be of great use to engineers and designers in the wind energy field, thereby catalyzing the progression of this thriving renewable energy source

KNOWLEDGE, AWARENESS, PRACTICE AMONG ADOLESCENTS REGARDING SEXUALLY TRANSMITTED DISEASES IN URBAN SLUMS

Background: Sexually transmitted diseases are very important health challenges for adolescents. Many national and international governmental and nongovernmental health agencies are running programmes to reduce the incidence of these diseases. We can provide an insight to the reproductive and sexual health needs of adolescents by assessing their knowledge, attitude and practice about these diseases. Research Question: What is the level of knowledge awareness and practice among adolescents regarding sexually transmitted diseases?  Objectives: To assess the knowledge awareness and practice among adolescents regarding sexually transmitted diseases in an urban slum in Dehradun. Study Design: Cross-Sectional Settings and Participants: Adolescents belonging to registered families of Chandreshwar Nagar urban slum under the field practice area of Urban Health Training Centre (UHTC) of department of Community Medicine, Himalayan Institute of Medical Sciences. Sample Size: 166 Adolescents i.e. Males-88 and Females-78. Study Period: May 2009 to October 2009 Study Variable: A predesigned, pretested, self-administered questionnaire was used for collecting information on Age, Sex, Knowledge and awareness regarding STDs, etc. Statistical Analysis: Standard statistical package i.e. SPSS, Microsoft Excel.  Results: 51.2% of the adolescents were having knowledge about STD’s. Majority of (91.4%) the adolescents knew about AIDS as a type of STD. Their attitude cum practice towards prevention of STD was found to be 72.9% by use of condoms. Conclusions: Appropriate health care seeking behaviour and Information Education and Communication (IEC) activities should be promoted