Introduction: Psoriasis is known to be proliferative, relapsing inflammatory disorder affecting mainly skin and other parts of body. There are several co-morbidities associated with psoriasis, of which ocular findings go unnoticed. Aim: To study the spectrum of ocular manifestations in psoriasis patients in Srikakulam, north coastal region of Andhra Pradesh, India and also to identify relationship between frequency of ocular involvement in psoriasis patients with age, gender, type and severity of psoriasis. Materials and Methods: The present cross-sectional study was conducted from March 2019 to March 2021 at Great Eastern Medical School and Hospital, Ragolu, Srikakulam, Andhra Pradesh, India. The study included 80 psoriasis patients attending dermatology Outpatient Department (OPD) to know various ophthalmological manifestations. Detailed dermatological examination was done followed by ophthalmological examination. Clinical types of psoriasis, site of involvement, and the severity of the disease using Psoriasis Area and Severity Index (PASI) were noted. Statistical analysis was done using Z-test, Pearson’s correlation coefficient and linear regression coefficient. Results: Out of 80 patients with psoriasis, 51 (63.75%) were males and 29 (36.25%) were females. Out of total 80 patients, 56 (70%) patients had ophthalmic manifestations. The mean age of presentation was noted to be 49.22±8.53 years with range from 18-76 years. Most of the patients i.e. 30 (54%) had bilateral manifestations in both the eyes. Nearly 10 (18%) of psoriasis patients had multiple ocular manifestations. The p-value was calculated based on PASI score and with ocular manifestations which was found to be 0.0485 and was statistically significant. Cconclusions: Regular screening of psoriasis patients is useful in identification of ocular problems which may not be noticed by the patients until symptomatic.
BACKGROUND Retinopathy of prematurity (ROP) is a vasculopathy affecting the premature retina. In India ROP is increasing due to the increased premature deliveries, well improved neonatal care and better neonatal survival rate. ROP screening by an experienced ophthalmologist plays an important role in screening, identifying and management of at-risk premature infants. Nowadays, the gold standard treatment is laser photocoagulation of avascular retina and anti-vascular endothelial growth factor (VEGF) depending on the severity of disease. METHODS This observational study included 152 babies who were referred to the Department of Ophthalmology at Great Eastern Medical School (GEMS), Srikakulam for ROP screening. The screening of eyes was done with a binocular indirect ophthalmoscope with 20 D lens. Eyes were examined by application of topical anaesthetic drops after applying topical tropicamide drops till full dilatation was noted. ROP was staged and treatment was given accordingly. RESULTS Totally 152 infants were screened for ROP in the Department of Ophthalmology. Babies with gestational age between 26 weeks and 36 weeks were included in the present study. Babies with birth weight between 900 gm and 2000 gm were also included in the study. Of the 152 babies which were included in the study, 54 babies presented with different stages of ROP. The incidence of ROP in the present study was found out to be 35.5 %. When incidence of ROP was noted with respect to birthweight, in extremely low birth weight (ELBW) babies, incidence was found out to be 71.4 %; in very low birth weight (VLBW) babies incidence rate was found to be 48.4 %. When incidence of ROP was noted with respect to gestational age ROP incidence was found to be 65.2 % in babies with gestational age of < 32 weeks. There was no association with gender in the incidence of ROP. When ROP incidence was noted in babies who received O2 therapy 59.2 % babies who received O2 therapy developed ROP. CONCLUSIONS In our study, at our institute the incidence of ROP was 35.5 %. With appropriate screening for the babies at risk we can prevent the development of ROP and further complications. According to study results our recommendations are that initial screening should to be done as early as 4 weeks of postnatal age or 34 - 35 weeks post conceptional age and to be followed till term gestation. In the present study we found that usage of anti VEGF came out with promising outcome results. The procedure of anti VEGF was relatively safe and easy with a smaller number of complications when compared to laser photocoagulation. KEYWORDS Retinopathy of Prematurity, Laser Photocoagulation, Indirect Ophthalmoscope, Tropicamide, Anti VEGF
Introduction: Pharmacovigilance plays an important role in the healthcare sector, in terms of health and economic burden. Studies on interns are limited and it is an aspect that requires further study. Aim: To evaluate the knowledge, attitude and perception of MBBS interns at a teaching hospital in southern India. Also to study the reasons for under-reporting of Adverse Drug Reactions (ADR). Materials and Methods: This questionnaire-based, crosssectional study was conducted among the 112 MBBS interns at Konaseema Institute of Medical sciences and Research Foundation, Amalapuram, Andhra Pradesh, India, in December 2013. The interns were asked to complete 25 predesigned questionnaire based on the Knowledge, Attitude and Perception (KAP). The answered questionnaires were statistically analysed by using Microsoft Excel worksheet. Results: Out of total 112 MBBS interns, only 94 completed the questionnaire within the stipulated time. There were 41 males and 53 females, with a mean age of 25±2 years. The response rate was 83.9%. A 48 (51.1%) interns had come across Adverse Drug Reactions (ADR) cases during their practice, however, among them only 24 (50%) reported them. Difficulty to identify the causative drug was the major cause for under-reporting as per 23 (24.4%) interns. Majority (60.6%) were of the opinion that pharmacovigilance only covers drug-related side-effects, not other types of side-effects. Conclusion: Interns are the upcoming doctors, hence increased attention must be paid to their lack of pharmacovigilance knowledge in order to improve the clinical management and rational use of drugs.
BACKGROUND Lens induced glaucomas are common in India. There were different types of lens induced glaucomas based on clinical features and morphological features. This study was undertaken to evaluate the various characteristics and presentations of glaucomas, to define the risk factors and to evaluate as to how they influence the post-operative visual acuity, intra ocular pressure, inflammation and optic disc changes. METHODS This longitudinal study included 90 cases of lens induced glaucoma admitted in the ophthalmic wards of the Great Eastern Medical School and Hospital, Srikakulam, during the period March 2018 to March 2020. All consecutive patients diagnosed as lens induced glaucoma on the basis of clinical symptoms and signs were included. At presentation, visual acuity, IOP, inflammation including corneal changes were recorded, which were repeated after institution of medical line of treatment and postoperatively patients were followed up regularly at 2, 4 and 6 weeks intervals and the same parameters were evaluated including optic disc changes. RESULTS Occurrence of lens induced glaucoma in the hospital during the study period was 1.72 %. The mean age of presentation of various types of glaucomas was 60.57 years and the female to male ratio was 2:1. The most frequent type of lens induced glaucoma was phacomorphic glaucoma (70 %). In 34.4 % patients best corrected visual acuity was found to be better than 6 / 18. In 14.4 % of cases, visual acuity was found be worse than 6 / 60. In patients who presented with symptoms of less than two weeks duration, better visual acuity of 6 / 12 or more was noted (76.2 %, P < 0.01). In 60 % patients who presented with IOP levels of less than 35 mmHg, better visual acuity of 6 / 12 or more was noted in 76.2 %. The mean IOP noted in patients with symptoms of 2 to 4 weeks duration was found to be 40.33 ± 9.36 mmHg. Inflammation was more severe in patients who were symptomatic for more than 2 weeks (37.50 %, P < 0.05) and also in cases with IOP more than 35 mmHg (40 %). Optic disc of the presented eye was found to be damaged in 35.5 % of cases and in patients presenting with symptoms of more than 2 weeks’ duration it was 62.5 % (P < 0.01). CONCLUSIONS Presentation with intraocular pressure value greater than 35 mm of Hg and with symptoms of more than two weeks would result in severe inflammation further affecting the cornea and causing optic nerve damage which would ultimately jeopardize vision. This can be prevented by early presentation and regular screening of people above 60 years of age. KEYWORDS Lens-Induced, Glaucoma, Cataract
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