BackgroundBeedi also known as poor man’s cigarette is manufactured in almost all major states of India. Beedi workers are exposed to various health risks. There is an increased risk of systemic absorption of tobacco through skin and mucous membrane. The optic nerve is susceptible to damage from several toxic substances including tobacco. This group of disorders is known as toxic optic neuropathy (TON). The association of TON with occupational exposure to unburnt tobacco in beedi rollers has not been explored.ObjectivesAmong the beedi rollers in Mangaluru and Bantwal talukas of Dakshina Kannada District, Karnataka, India: to assess the magnitude of potential TON utilizing colour vision and contrast sensitivity as screening tools and to identify the demographic, biological and occupational factors associated with potential TON.MethodsA community-based cross-sectional study was conducted from April-Sept 2016 in Mangaluru and Bantwal talukas, of Dakshina Kannada district, Karnataka. Beedi rollers from twelve villages (six from each taluka) were included. In each of the selected villages, the investigators identified beedi collection centres and all the eligible beedi rollers were included in the study till the required number of beedi rollers for that village was achieved. Participants were screened at the study site for visual acuity, colour vision and contrast sensitivity and those with abnormal colour and contrast sensitivity in the presence of good visual acuity were considered to have potential TON.ResultsA total of 377 beedi rollers were approached; of which 365 consented to take part in the study (response rate: 96.81%). Women constituted the majority of the participants (n = 338, 92.6%). Based on the screening criteria, the prevalence of potential TON was 17.5% (n = 64, 95% CI: 13.5–21.9). On multiple logistic regression analysis, duration of beedi rolling (Adj OR: 1.061; 95% CI 1.015–1.109, p = 0.009), advancing age (Adj OR: 1.096; 95% CI 1.058–1.136, p<0.001) and presence of diabetes (Adj OR: 6.315; 95% CI 1.4572–27.376, p = 0.014) were independent correlates of potential TON.ConclusionIn the present study, almost one out of six beedi rollers displayed clinical signs of potential TON. Increased duration of beedi rolling, advancing age and presence of diabetes were the independent correlates of potential TON. However, with this cross-sectional study it is not possible to conclude if these factors play a role individually or collectively or are a serendipitous association, for which large scale analytical studies are required.
Aims of the Study:To study the frequency of meibomian gland dysfunction (MGD) in patients of diabetes mellitus with dry eye.Materials and Methods:A case-control cross sectional study.Sampling:Purposive random sampling. Totally, 200 eyes of 100 patients of diabetes mellitus and an equal number of eyes of normal subjects as control, who were gender and age matched and all of whom were symptomatic for dry eye were assessed for MGD by noting the symptoms and determining the meibomian gland expression scale for volume and viscosity, and ocular surface staining with Lissamine green, and Fluorescein sodium. All the subjects were graded for the severity of MGD. The results were compared in both the groups to ascertain whether the frequency of MGD in diabetics is significantly more as compared to nondiabetics.Statistical Analysis:The data were analyzed by Chi-square test for significance. P < 0.05 was considered as statistically significant.Results:There was a significant increase in the frequency of MGD in diabetics as compared to the nondiabetics.Conclusion:Diabetes mellitus is associated with MGD.
MDA and AOPP could be considered better than IMA in the evaluation of diabetes progression, but MDA is more useful as a diagnostic indicator to detect vascular complications. HbA1c measurement is of greater value than the oxidative stress markers in the prediction of vascular complications.
Introduction: Ergonomics in ophthalmology is neither taught during professional training nor does it readily receive consideration or priority in clinical practice. Owing to a high prevalence of musculoskeletal disorders among ophthalmologists, ergonomic awareness, and practices are vital in averting this modern epidemic. Objective: To assess the ergonomic practices and prevalence of self-reported musculoskeletal disorders among ophthalmologists in India. Method: An online survey was conducted among ophthalmologists who were registered with the All India Ophthalmological Society of India using a pre-tested and validated questionnaire. Results: The prevalence of self-reported musculoskeletal disorder in the 377 participants was 75.3% (284; 95% confidence interval: 70.6–79.5). Low back pain (149, 52.9%) was the most commonly reported symptom. Musculoskeletal disorder–attributed productivity loss was reported by 58.45% (166) of the respondents. Musculoskeletal disorder was most frequently associated with less than 10 years of work experience (odds ratio: 1.2; 95% confidence interval: 1.1–1.3, p = 0.01) and lack of good clinic (odds ratio: 1.7; 95% confidence interval: 1.1–2.7, p = 0.03) and operation room ergonomic practices (odds ratio: 1.8; 95% confidence interval: 1.1–2.9, p = 0.03). Only 27.9% (105) of the respondents had accessed information related to ergonomics in ophthalmic practice. Conclusion: The self-reported musculoskeletal disorder among ophthalmologists in India is quite high and significant enough to cause some degree of productivity loss. It is thus imperative to emphasize the implementation of good ergonomic practices, especially among relatively young ophthalmologists.
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