Little Flower Hospital

Aim Much existing data on childhood refractive error prevalence in India were gathered in local studies, many now dated. The aim of this study was to estimate the prevalence, severity and determinants of refractive errors among school-going children participating in a multistate vision screening programme across India. Methods In this cross-sectional study, vision screening was conducted in children aged 5–18 years at schools in five states using a pocket vision screener. Refractive error was measured using retinoscopy, and subjective refraction and was defined both by spherical equivalent (SE) and spherical ametropia, as myopia ≤−0.5 diopters (D), hyperopia ≥+1.0 D and/or astigmatism as >0.5 D. Data from the eye with less refractive error were used to determine prevalence. Results Among 2 240 804 children (50.9% boys, mean age 11.5 years, SD ±3.3), the prevalence of SE myopia was 1.57% (95% CI 1.54% to 1.60%) at 5–9 years, 3.13% (95% CI 3.09% to 3.16%) at 10–14 years and 4.8% (95% CI 4.73% to 4.86%) at 15–18 years. Hyperopia prevalence was 0.59% (95% CI 0.57% to 0.61%), 0.54% (95% CI 0.53% to 0.56%) and 0.39% (95% CI 0.37% to 0.41%), respectively. When defined by spherical ametropia, these values for myopia were 0.84%, 2.50% and 4.24%, and those for hyperopia were 2.11%, 2.41% and 2.07%, respectively. Myopia was associated with older age, female gender, private school attendance, urban location and state. The latter appeared to be driven by higher literacy rates. Conclusions Refractive error, especially myopia, is common in India. Differences in prevalence between states appear to be driven by literacy rates, suggesting that the burden of myopia may rise as literacy increases.

Introduction: Chronic Kidney Disease (CKD) is a progressive condition that impacts the quality of life (QOL) of individuals worldwide. However, the role of self-management and social support among CKD patients on their QOL remains understudied in India. Therefore, this study aims to find the correlation of self-management and social support on the QOL of CKD patients undergoing hemodialysis. Methods: This hospital-based cross-sectional study involved 110 adult CKD patients (mean (SD) age of 56 (±13.9) years, 73 % men) undergoing hemodialysis in two tertiary care hospitals in Ernakulam district. Face-to-face interviews with questionnaires, including World Health Organisation Quality of Life- Brief Version (WHOQOL-BREF), Medical Outcome Survey – Social Support Survey (MOS-SSS), and Hemodialysis Self-Management Instrument-18 (HDSMI-18) were used. Pearson correlation and simple linear regression analysis were done to find the correlation between self-management and social support with QOL. Findings: The mean (SD) QOL score was 56.27 (11.62), with the environment domain rating highest [62.47 (14.02)] and social relations lowest [52.12 (18.52)]. Mean (SD) self-management score was 41.12 (5.66) and mean (SD) social support score was 65.28 (18.21). Self-management (r = 0.382, p = 0.001) and social support (r = 0.309, p = 0.001) showed a moderate positive correlation with QOL. Discussion: Self-management and social support were moderately correlated with QOL. Strengthening self-management programs and social support networks are likely to improve the QOL of CKD patients undergoing hemodialysis.

Chlamydia-related bacteria of the Chlamydiales order have recently been described as emerging pathogens that cause pneumonia and abortion in animals and humans. We investigated the presence of Chlamydiales using real-time polymerase chain reaction (PCR) by targeting the 16S rRNA gene of a broad range of Chlamydiales in 827 fecal samples from pet birds kept in individual homes in Japan. Of the 827 samples, 493 (59.6%) tested positive for the Chlamydiales 16S rRNA gene in the real-time PCR assay. We determined the nucleic acid sequences of PCR products from 17 Chlamydiales strains. A homology search and phylogenetic analysis using these sequences confirmed that the detected Chlamydiales included C. pecorum and a broad range of Chlamydia-related bacteria. To the best of our knowledge, this is the first study to detect a wide range of Chlamydia-related bacteria in birds.

Background: Short term outcomes of patients with pulmonary hypertension are not available from low and middle-income countries including India. Methods: We conducted a prospective study of 2003 patients with pulmonary hypertension, from 50 centres (PROKERALA) in Kerala, who were followed up for one year. Pulmonary hypertension (PH) was mainly diagnosed on the basis of Doppler echocardiography. The primary outcome was a composite endpoint of all-cause death and hospital admission for heart failure. All cause hospitalisation events constituted the secondary outcome. Results: Mean age of study population was 56 +/- 16 years. Group 1 and Group 2 PH categories constituted 21.2% and 59% of the study population, respectively. Nearly two-thirds (65%) of the study participants had functional class II symptoms. 31% of Group 1 PH patients were on specific vasodilator drugs.In total, 83 patients (4.1%) died during the one-year follow-up period. Further, 1235 re-hospitalisation events (61.7%) were reported. In the multivariate model, baseline NYHA class III/IV (OR 1.87, 95% C.I. 1.35-2.56), use of calcium channel blockers (OR 0.18, 95% C.I. 0.04-0.77), vasodilator therapy (OR 0.5, 95% C.I. 0.28-0.87) and antiplatelet agents (OR 1.80, 95% C.I. 1.29-2.51) were associated with primary composite outcome at one-year (p < 0.05). Conclusion: In the PROKERALA registry, annual mortality rate was 4%. More than half of the patients reported re-hospitalisation events on follow up. Uptake of guideline directed therapies were suboptimal in the study population. Quality improvement programmes to improve guideline directed therapy may improve clinical outcomes of PH patients in India. (C) 2021 Cardiological Society of India. Published by Elsevier B.V.

Diabetic retinopathy is an irreversible eye disease that is a prominent cause of blindness globally. For proper diagnosis and vision protection, it is essential to detect DR early and accurately. In the current scenario it is challenging to detect DR in an automated manner using fundus images. This work investigates the performance of deep learning based CNN models in an effective DR classification. We explore three popular models (Xception, InceptionV3, ResNet50) for the automated categorization of this retinal disease. A comparative study of three pre-trained models are analysed for multi-class DR grading. The simulation results show that the Xception model performs well with 89.8 % classification accuracy. To assess the efficacy of the suggested method, the accuracy, mis-classification rate, quality index, F-score, sensitivity, and specificity of each model are compared.