INHS Sanjivani is a multi-speciality hospital of the Indian Navy at Kochi, Kerala under the Southern Naval Command. It is the largest military hospital in the states of Kerala and Tamil Nadu. It is the nodal hospital for ships and other naval units at Kochi. The hospital also provides medical cover and aid to civil authorities as required, including disaster relief operations. In 2019, INHS Sanjivani was adjudged the best Naval Hospital in India.
ABSTRACT:Myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease (MOGAD) is a rare autoimmune demyelinating disorder of the central nervous system that can present with varied neurological symptoms. While commonly mistaken for multiple sclerosis or neuromyelitis optica spectrum disorders, MOGAD can also mimic cerebrovascular events, posing a diagnostic challenge. We report a case of a 30-year-old male who initially presented with acute-onset left-sided hemiplegia and right facial palsy, raising suspicion of an ischemic stroke. Despite thrombolysis, his recurrent neurological symptoms, including dysarthria and cerebellar ataxia, prompted further evaluation. Neuroimaging revealed hyperintense lesions in the right hemi-pons and bilateral middle cerebellar peduncles, raising the possibility of a demyelinating disorder. MOG-IgG seropositivity confirmed the diagnosis of MOG encephalitis. The patient responded well to pulse corticosteroid therapy, followed by maintenance immunosuppression with mycophenolate mofetil, and remained asymptomatic on follow-up. This case underscores the importance of considering autoimmune demyelinating disorders in young patients with recurrent neurological deficits and clinico-radiological dissociation. Early recognition and appropriate immunotherapy can prevent unnecessary thrombolysis and improve patient outcomes. Clinicians should maintain a high index of suspicion for MOGAD as a potential stroke mimic in atypical presentations.
Abstract Background: Adolescents constitute a major proportion of global internet users and are particularly vulnerable to cyberbullying due to extensive engagement in online platforms. Cyberbullying, differing from traditional bullying by its anonymity and reach, has significant psychological and social impacts on youth. This study aimed to determine the prevalence, correlates, and effects of cyberbullying among adolescents in Kochi, Kerala. Methodology: A cross-sectional study was conducted among 349 students aged 15–17 years from a higher secondary school in Kochi. Data were collected using a pretested semi-structured questionnaire comprising sociodemographic details, the cyberbullying victimization and offending survey, and the Strengths and Difficulties Questionnaire (SDQ). Descriptive statistics and multivariable logistic regression analyses were performed using SPSS v21. Results: The prevalence of cyberbullying victimization was 32.4%, whereas 7.2% reported perpetration of cyberbullying. About 51% had witnessed cyberbullying, and 3.4% stated that it affected their academic performance or sense of safety. Common forms included threatening messages or impersonation (18.3%), hurtful religious or ethnic remarks (6.6%), and sexually suggestive comments (1.7%). Abnormal SDQ scores indicating emotional or behavioral difficulties were present in 60% of participants. Multivariate analysis identified male gender, history of mental illness, poor childhood experiences, and abnormal SDQ scores as significant independent predictors of cyberbullying victimization. Conclusion: Cyberbullying is a prevalent and multifaceted public health issue among adolescents, closely linked to emotional distress, use of substances such as tobacco and alcohol, poor sleep, and poor childhood. Targeted interventions promoting digital literacy, emotional regulation, and awareness of cyber laws are needed. School-based initiatives integrating cyber-safety education, teacher training, peer support mechanisms, and accessible counseling can enhance the resilience and digital well-being of adolescents.
Abstract Purpose: To evaluate the correlation between preoperative myopic severity, central corneal thickness (CCT), and residual stromal bed (RSB) across wavefront-optimized (WFO) laser-assisted in situ keratomileusis (LASIK), Contoura LASIK, and StreamLight photorefractive keratectomy (PRK) and to assess their safety and refractive predictability over 6 months. Materials and Methods: This retrospective study included 84 eyes from 42 patients aged 18–35 years who underwent one of the three refractive procedures between December 2024 and June 2025 at a tertiary eye center in northern India. Data collected preoperatively and up to 6 months postoperatively included spherical equivalent (SE), CCT, and RSB. Pearson’s correlation assessed relationships among SE, CCT, and RSB. Technique-specific outcomes were evaluated for safety, efficacy, and predictability. Results: Eighty-four eyes (mean age: 26.4 ± 2.1 years; 64.3% female) were analyzed. Mean preoperative SE was −4.61 D, CCT: 529.8 μm, and RSB: 357.1 μm. Moderate myopia predominated (65.4%). WFO LASIK had the highest mean SE (−4.99 D) and RSB (364.4 μm); PRK was used in thinner corneas. SE did not correlate significantly with RSB ( r = −0.12, P = 0.27) but had a mild inverse correlation with CCT ( r = −0.27, P = 0.01). CCT showed a positive correlation with RSB ( r = 0.38, P < 0.001). All techniques demonstrated effective stromal preservation. Conclusions: Both LASIK and PRK are safe and effective for myopic correction. SE did not significantly influence RSB when individualized planning was applied. CCT remained the strongest predictor of surgical safety, supporting personalized technique selection.
Abstract Gambling Disorder (GD), currently classified as a behavioural addiction in ICD-11, is associated with impairment in reward processing and impulsivity. The role of transcranial Direct Current Stimulation (tDCS) in reducing craving and impulsive behaviours by modulating dorsolateral prefrontal cortex (DLPFC) activity has been explored. We present a case series of four male patients with Gambling Disorder who exhibited severe financial losses, socio-occupational impairment, suicidal ideation or behaviour, and persistent gambling urges despite treatment with Naltrexone and Cognitive Behavioural Therapy (CBT). All patients received adjunctive bilateral tDCS consisting of six sessions of left cathodal/right anodal stimulation over the DLPFC (2 mA for 20 minutes on alternate days for two weeks). Clinical assessment using Gambling Symptom Assessment Scale (GSAS), Barratt Impulsiveness Scale-11 (BIS-11), and Montreal Cognitive Assessment (MoCA) demonstrated reduction in gambling urges and impulsivity following intervention, with sustained improvement at one-month follow-up. No significant cognitive adverse effects were observed. Mild transient side effects included tingling sensation and headache. These findings suggest that bilateral DLPFC tDCS may serve as a safe and promising augmentation strategy for Gambling Disorder.
PURPOSE:To compare the efficacy, safety, and patient satisfaction of bepotastine besilate 1.5% versus sodium cromoglycate 4% eye drops in the management of chronic allergic conjunctivitis. METHODS:In this prospective, double-masked comparative study, 100 adult patients with chronic allergic conjunctivitis were assigned to receive either bepotastine twice daily (n = 50) or cromolyn 4 times daily (n = 50) for 6 months. The primary outcome was the change in ocular itching severity on a standardized 0-3 scale. Secondary outcomes included changes in redness, tearing, swelling, discomfort, treatment compliance, adverse events, and patient satisfaction. Assessments were conducted at baseline, 2 weeks, 6 weeks, 3 months, and 6 months. RESULTS:Both treatments significantly improved symptoms from baseline after 6 months. Bepotastine showed superior reduction in ocular itching severity (74.4% improvement) compared to cromolyn (63.8%, P < 0.01). Cromolyn was more effective in reducing conjunctival redness (70.0% vs. 59.3%). Bepotastine also showed numerical advantages in tearing, swelling, and discomfort relief. Adverse events were mild and comparable, with slightly more burning sensation reported in the cromolyn group. Compliance and patient satisfaction were higher in the bepotastine group, attributed to its convenient twice-daily dosing. CONCLUSIONS:Both bepotastine besilate and sodium cromoglycate are effective and safe for chronic allergic conjunctivitis. Bepotastine offers faster relief of itching and greater convenience, whereas cromolyn provides better control of conjunctival redness. Treatment choice should be individualized based on symptom profile and patient preferences.
