INTRODUCTION Rabies, an invariably fatal viral disease, is transmitted to humans through animal bites, most commonly dogs. Dog bites are the primary source of human infection in all rabies endemic countries and account for 96 % of rabies cases in South East Asia region. According to WHO, Each year, 23 000-25 000 people die in the SEA Region due to rabies. These accounts for approximately 45% human deaths due to rabies worldwide. 1 Of the estimated 25,000 deaths due to rabies in SEAR, a majority are in India (around 19,000) and Bangladesh (2000). More than 2.5 million people undergo post-exposure prophylaxis after being bitten by rabid or suspected rabid animals causing considerable morbidity and economic loss. 2 In spite of economic loss and sufferings, there is little information about the incidence of animal bites and rabies because of a lack of systematic reporting In India. As rabies is not a notifiable disease in India it is widely believed that this figure may be an underestimate. 3 Sporadic studies have been conducted indifferent parts of India but profile of bites not only varies from country to country but region to ABSTRACT Background: Rabies, an invariably fatal viral disease, is transmitted to humans through animal bites, mostly dogs. Of the estimated 25,000 deaths due to rabies in SEAR, a majority are in India and Bangladesh. Objective of the study was to study the epidemiological trend of animal bite by in central India. Methods: A cross sectional institutional study was conducted in 406 animal bite victims presenting to the tertiary care hospital and district hospital Rewa, Madhya Pradesh, India. Information collected with the pre tested structured questionnaire after obtaining informed verbal consent. Data pertaining to the socio demographic profile of victim, category of bite, provoked/ unprovoked time and place of bite, characteristic of animal was collected. Data was analysed using graph pad software. Results: Among 406 victims 76.3% were males, 56.7% belongs to 15-45 yrs, 61.6% were living in urban area, 31.3% and 21.7% of the victims were agriculture worker and laborers respectively. 95.8% victims bitten by dog of them 89% were stray, 89.4% had Category III bite, lower extremity was affected in 60.8%, 75.9% bites were unprovoked, fate of the animal was not known in 78.6% and 46% of the victims were affected during evening hours. Conclusions: Animal bites, especially dog bites still poses public health problem. Majority of the bites are attributed to stray dogs, unprovoked and category III bites. This indicates need of large amount of antirabies serum or HRIG thereby increasing the cost of management of animal bite cases. There is a need to control stray dog population and immunize pet dogs.
Corneal problems cause a significant proportion of blindness in India. Once corneal opacity is established, restoration of their vision is possible only through transplantation of cornea from donated eyes. Eye donations are dependent on people willing to pledge their eyes. PURPOSE: To determine "awareness of eye donation" and knowledge regarding eye donation and factors affecting in an adult population of northern India. METHODS: 550 Subjects who accompanied patients attending four ophthalmic clinics were interviewed using structured questionnaire. The information was collected about socio demographic profile, awareness of eye donation, knowledge about its various aspects and pledge to donate eye, reasons for donating or not donating eyes and sources of information. Data analyzed using SPSS software, Chi square test was used to test significance across category and p value <0.05 was considered statistically significant. RESULTS: Out 550 subjects 44.2% were in 18-35 years and 55.8 % were >35 yrs old. Majority was Hindu (76.73%) and males (71.64%). 78% subjects were aware of eye donation. The major source of awareness was AV aids (89%). Awareness was found to be high as age and education increases, in males, and in urban population. Significant difference (p<.05) was found between awareness and various variables except religion. 27% knew that relative can make pledge, only cornea is transplanted is known to 25.2%, 44.7% were aware about ideal time of eye removal and only 12 (2.8%) had pledged their eyes. 250(58.3%) subjects were aware but not willing to pledge their eyes or relatives eyes. Need more information to decide (79.2%), perceived objection by family members (52%) and religious reason (38.8%) were cited as major factors for not willing to pledge eyes. Nobility (76%) and pleasure (17.9%) was the main motivational force stated for willingness to donate eyes. CONCLUSION: There is good level of awareness in urban population still very less subjects is willing to pledge eyes major factor being insufficient knowledge. Targeting on aspects in which knowledge was found to be low might help to increase eye donation.
mately 6.8 million people have been estimated to have vision less than 6/60 in at least one eye due to corneal diseases; of these, about a million have bilateral involvement. [3,4] The burden of corneal disease in our country is reflected by the fact that 90% global cases of ocular trauma and corneal ulceration leading to corneal blindness occur in developing countries. [5] The prevalence of corneal blindness varies from country to country and even from one population to another. Its epidemiology is complicated and encompasses a wide variety of infectious and inflammatory eye diseases. As trachoma and vitamin A deficiency become less common, suppurative keratitis is becoming the major cause of corneal blindness in the developing world. [6] Whereas contact lens use is a major risk factor for corneal ulceration in the developed world, a high prevalence of fungal infections, agriculture-related trauma, and use of traditional eye medicines (TEMs) is unique to the developing world. [7,8] Background: Instillation of traditional eye medicines (TEMs) into the eye is one of the causes associated with poor visual outcome and corneal blindness. Objective: To determine the use of TEM and factors for its use in patients with corneal ulcer. Materials and Methods: This prospective study was conducted on 189 new patients with corneal ulcer attending cornea clinic of Gandhi Memorial Hospital, Rewa, Madhya Pradesh (India). After complete eye examination, information was collected for use of TEM, sociodemographic profile, symptoms necessitating its use, and complication. Necessary treatment was given and final visual outcome was noted. Lab investigations were performed to identify organism. Result: TEM was used by 38% subjects, especially females and subjects residing in rural areas were found to be significantly associated with its use. Majority of TEM users were farmers (51.4%). The most common symptom was poor vision (66.7%) for use of TEM. Breast milk (40%) and plant products (29%) were most commonly applied TEMs. Central and entire corneal involvement was found to be significantly high among TEM users. Scarring and perforation occurred in 70.8% and 31.9% TEM users, respectively. No significant difference was found between organism identified and the use of TEM. Visual acuity up to 6/18 was found to be higher among non-TEM users (23.9%) as compared to TEM users (9.7%). At presentation, 38.9% TEM users had already lost their vision. Significant difference was found between presenting visual acuity and final visual acuity achieved in both groups. Conclusion: Intensive health education is needed for encouraging the uptake of eye care services, particularly in rural areas.
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