Background:Refractive errors (RE) are the most common cause of avoidable visual impairment in children. But benefits of visual aids, which are means for correcting RE, depend on the compliance of visual aids by end users.Aim:To study the compliance of spectacle wear among rural school children in Pune district as part of the sarva siksha abhiyan (education for all scheme) after 6 - 12 months of providing free spectacles.Settings and Design:Cross-sectional follow-up study of rural secondary school children in western India.Materials and Methods:The students were examined by a team of optometrists who collected the demographic details, observed if the child was wearing the spectacles, and performed an ocular examination. The students were asked to give reasons for non-wear in a closed-ended questionnaire.Statistical Analysis:Chi-square test and multiple logistic regression used for data analysis.Results:Of the 2312 students who were dispensed spectacles in 2009, 1018 were re-examined in 2010. 523 students (51.4%) were female, the mean age was 12.1 years 300 (29.5%) were wearing their spectacles, 492 (68.5%) students claimed to have them at home while 211 (29.4%) reported not having them at all. Compliance of spectacle wear was positively associated to the magnitude of refractive error (P < 0.001), father's education (P = 0.016), female sex (P = 0.029) and negatively associated to the visual acuity of the better eye (P < 0.001) and area of residence (P < 0.0001). Of those that were examined and found to be myopic (N = 499), 220 (44%) wore their spectacles to examination. Factors associated with compliance to spectacle usage in the myopic population included increasing refractive error (P < 0.001), worsening visual acuity (P < 0.001), and higher academic performance (P < 0.001). The causes for not wearing spectacles were ‘lost spectacles’ 67(9.3%), ‘broken spectacles’ 125 (17.4%), ‘forgot spectacles at home’ 117 (16.3%), ‘uses spectacles sometimes’ 109 (15.2%), ‘teased about spectacles’ 142 (19.8%) and ‘do not like the spectacles’ 86 (12%).Conclusion:Spectacle compliance was poor amongst school children in rural Pune; many having significant vision loss as a result.

Background: Corneal blindness is one of the important causes of blindness in India that can be conventionally cured by corneal transplantation. The number of corneal transplants done is less than the actual requirement in India due to inadequate number of corneas collected. Therefore increasing awareness regarding eye donation and also willingness to pledge for the same is the today’s need. Hence current study was undertaken to assess the awareness regarding eye donation and the willingness to pledge the eye for donation amongst the shopkeepers in urban area of Pune city.Methods: Total 1014 shopkeepers above 15 years of age from field practice area of Urban Health Training Center of a private medical college, Pune were interviewed regarding awareness of eye donation and willingness to pledge eye for eye donation.Results: Out of total 1014 subjects, 752 (74.16%) were aware of eye donation amongst which males were maximum (75.13%) compared to females (24.87%). Awareness was more in the age group >40 years i.e. 47.87%. Willingness to pledge eyes for eye donation was 19.83%.Conclusions: Though the awareness regarding eye donation is high very few of them are ready to donate their eyes. Therefore more transfer of knowledge is needed to motivate people for eye donation which will be helpful in reducing the gap between the availability of corneas and actual requirement.

Background Most studies assessing drug resistant tuberculosis (DRTB) in human immunodeficiency virus (HIV) co-infected patients in India have used conventional culture- based systems to diagnose DRTB that have a longer turnaround time leading to risk of amplification of resistance to an empirical regimen. We determined the prevalence of DRTB amongst people living with HIV (PLHIV) using the line probe assay and determined risk factors associated with the presence of multi drug resistant tuberculosis (MDRTB). Methods A Cross-sectional study was undertaken at Poona Hospital and Research Center (PHRC) and the Institute of Infectious Diseases, two tertiary level private care centers in Pune, India. Consenting PLHIV with confirmed Pulmonary TB (PTB) and/or extra-pulmonary TB (EPTB) diagnosed based on detection of Mycobacterium TB by line probe assay (Geno Type MTBDRplus version 2) on clinical specimens were included. Those with documented past history of DRTB were excluded. Resistance against anti-TB drugs was determined by the same assay. The prevalence of any form of drug resistant TB (DRTB), MDRTB, Rifampicin resistant TB (RRTB) and Isoniazid (INH) mono-resistant TB were determined as the proportion of these amongst all included PLHIV-TB. A multivariate analysis was conducted to determine risk factors that were statistically associated with MDRTB, DRTB, RRTB and INH mono-resistant TB. Results Two hundred PLHIV were recruited. The prevalence (95% CI) of MDRTB, INH mono- resistance and RR resistance was 12.5% (7.9–17.1%), 9% (6.9–11.2%) and 2.5% (1.4–3.6%), respectively. The prevalence (95% CI) of MDRTB among new and relapsed patients was 8.8% (6.5–11.1%) and 23.1% (17.2–28.9%), respectively. Tuberculosis relapse was the only factor significantly associated with MDRTB, DRTB and INH mono-resistant TB. Conclusion We document a high prevalence of drug resistance to anti-TB drugs including MDRTB among PLHIV in our setting using Geno Type MTBDRplus directly on clinical specimens. This validates the WHO recommendation of performing routine rapid molecular resistance testing prior to initiating anti-TB treatment among all PLHIV with presumptive TB. Using rapid molecular testing especially Geno Type MTBDRplus (that detects resistance to INH and Rifampicin simultaneously) reduces the turn-around time helping in optimizing treatment.

The modified pectoral nerves (Pecs II) block as a method of analgesia after breast cancer surgery has proven highly efficacious. This technique blocks the pectoral nerves, long thoracic nerve, thoracic intercostal nerves from T2-T6, and thoracodorsal nerve and can be effectively used as a postoperative analgesic after breast cancer surgeries. The aim of the study is to evaluate the effectiveness of the Pecs II block given intraoperatively for pain relief in the postoperative period of patients undergoing modified radical mastectomy. The outcome after intraoperative Pecs II block administration was analyzed and compared in test (general anesthesia with endotracheal intubation with Pecs II block) and control (general anesthesia with endotracheal intubation only) groups of patients (50 each) scheduled to undergo modified radical mastectomy. In the postoperative period, the patients were evaluated using a visual analogue scale to determine pain scores at 6, 12, and 24 h, and their analgesic requirements were documented. Hundred patients (50 in each group), between the ages of 24 to 76 years (54.76 ± 10), were included in the study. There was no significant difference in ages or comorbidities for test and control groups. In the postoperative period, the test group had significantly lower median pain scores at 6 and 12 h as compared with control group. The modified pectoral nerves (Pecs II) block given intraoperatively is an effective technique for postoperative analgesia in patients undergoing modified radical mastectomy.

Purpose: To estimate the prevalence of blindness and severe visual impairment (SVI) by using a door-to-door screening and vision center (VC) examination strategy in an urban area in western Maharashtra (Pune), India and repeat the exercise after 4 years to study its impact. Methods: Four trained community health workers measured the visual acuity and performed an external ocular examination in patients’ homes. People with vision <6/18 were requested to visit the VC for a comprehensive eye examination by an optometrist. An ophthalmologist examined people whose vision did not improve to 6/12. A home examination was done for people who did not visit the VC despite two requests. The same population was examined twice in an interval of 4 years. Results: In the study, 44,535 people in 2015–16 and 98.14% (n = 43,708) of them in 2018–19 were examined. Blindness (vision < 3/60 in better eye), and moderate-to-severe visual impairment (MSVI, vision 6/18–6/60 in better eye) were 0.26% and 1.3%, respectively, in the first cohort, and 0.16% and 1.1%, respectively, in the second cohort ( P < 0.001 ). When the worse eye was considered, the prevalence of blindness reduced from 0.72% to 0.44%, SVI reduced from 0.1% to 0.07%, and MVI decreased from 1.7% to 1.49% between 2015 and 2019 ( P < 0.001). Females ( P < 0.001) and older individuals ( P < 0.001) were more likely to have blindness or SVI. In the VC, 8211 people were examined in 4 years. Conclusion: The reduction of blindness and MSVI in the urban area of Pune can be partly ascribed to the presence of a VC and attendant screening in this locality.