North Bengal Medical College and Hospital (NBMC&H) is located in Sushrutanagar, on the outskirts of Siliguri, West Bengal, India. It is the largest and the oldest healthcare teaching institute in North Bengal region of the West Bengal, serving as a tertiary referral institute. The college has teaching programs for graduation and postgraduation. It is one of the 23 government medical colleges in West Bengal and the largest in terms of area. Patient influx is also huge .
Background: Elevated intraocular pressure (IOP) is a major risk factor for glaucoma, the second most common cause of blindness worldwide. Objective: To determine the prevalence of raised IOP in a community and study the possible associated risk factors. Materials and Methods: A community-based cross-sectional study was conducted among 280 adult participants in the Matigara block from March 2024 to June 2024. Clinical and ophthalmological examinations were performed on each participant. To measure IOP, an Applanation tonometer was used. To identify the variables associated with IOP levels >21 mm Hg, multivariable logistic regression analysis was used. Adjusted odds ratio (AOR) and 95% confidence interval (CI) were reported. Results: A total of 25.7% of the participants in this study had elevated IOP in one or both eyes. After adjusting for covariates such as age, sex, education level, occupation, and history of smoking or tobacco use, a multivariable logistic regression analysis showed a significant association between respondents with a history of ocular trauma (AOR 16.48; 95% CI 1.72–157.91), ocular surgery (AOR 10.93; 95% CI 3.79–31.50), diabetes (AOR 4.43; 95% CI 1.80–10.90), hypertension (AOR 6.74; 95% CI 2.52–18.04), and elevated IOP. Conclusion: The prevalence of raised IOP was high and possible risk factors, including diabetes, hypertension, ocular trauma, ocular surgery, and socio-demographic characteristics, such as low socioeconomic status and the use of biomass fuels found to be associated with it.
Background Shoulder pain is one of the most prevalent musculoskeletal complaints encountered in orthopaedic practice. Rotator cuff disorders represent the most common cause. High-resolution ultrasonography (HRUSG) is a readily available, cost-effective, dynamic imaging modality, while 3 Tesla (3T) MRI is widely regarded as the reference standard. This prospective study aimed to evaluate the diagnostic accuracy of HRUSG in detecting rotator cuff tendon pathologies and to correlate its findings with 3T MRI. Methods Fifty-nine patients with chronic shoulder pain (duration ≥ 6 months) and clinical suspicion of rotator cuff pathology were prospectively enrolled between March 2021 and August 2022 at a tertiary care centre in eastern India. All patients underwent HRUSG followed by 3T MRI of the affected shoulder. Findings were classified as full-thickness tear, partial-thickness tear, intrasubstance tear, tendinosis, or normal for each tendon. Diagnostic accuracy indices and kappa agreement statistics were calculated. Results The study population comprised 59 patients (mean age range 26–65 years; 56% male). The supraspinatus was the most commonly affected tendon. For full-thickness tears, HRUSG demonstrated sensitivity of 100%, specificity of 92.31%, positive predictive value (PPV) of 86.96%, negative predictive value (NPV) of 100%, and overall accuracy of 94.92%. For partial-thickness tears: sensitivity 93.55%, specificity 78.57%, PPV 82.86%, NPV 91.67%, and accuracy 86.44%. For tendinosis: sensitivity 86.36%, specificity 80.00%, PPV 92.68%, NPV 66.67%, and accuracy 84.25%. Kappa agreement was ‘almost perfect’ for full-thickness tears (k = 0.89) and tendinosis (k = 0.85), and ‘substantial’ for partial-thickness tears (k = 0.72). Conclusions HRUSG shows high sensitivity and specificity for detecting rotator cuff tears and compares favourably with 3T MRI. It can serve as a reliable first-line imaging modality for chronic shoulder pain. MRI should be reserved as a problem-solving tool, particularly for labral and capsular pathologies and pre-surgical planning.
Background: Procedural sedation of pediatric patients is necessary to minimize physical pain and psychological trauma and return the patients safely to their parents. Although ketamine and dexmedetomidine have been studied separately for minor surgical procedures, an ideal combination of doses of these two drugs through the intranasal route remains unclear. Aims and Objectives: The aim of the study was to compare the different dosage combinations of intranasal dexmedetomidine and intranasal ketamine that can be utilized for procedural sedation in pediatric patients undergoing surgeries in a day care setup to find a suitable dose combination for future use. The objectives of the study were to determine the degree of sedation at the time separation from the parents along with hemodynamic changes after drug instillation. Materials and Methods: A total of 60 pediatric patients scheduled for day care surgeries were randomized into two groups. Group DK1 received intranasal dexmedetomidine 1 mcg/kg combined with ketamine 5 mg/kg, whereas Group DK2 received intranasal dexmedetomidine 1 mcg/kg with ketamine 7 mg/kg. Sedation level and parental separation were assessed 30 min after drug administration using the parental separation anxiety scale (PSAS) and Ramsay sedation score. Results: The DK2 group had significantly better parental separation with a mean PSAS score of 1.6 compared to 2.6 in Group DK1 (P<0.001). Adequate sedation as assessed by Ramsay sedation score was achieved in 13 patients (43%) in DK1 and 22 patients (73%) in DK2. Conclusion: The study observed that dexmedetomidine with the higher dose of ketamine, in the pediatric age group, decreases the parental separation anxiety without serious clinical side effects.
Background: Fixed-dose combination (FDC) therapy of dapagliflozin and pioglitazone provides a synergistic mechanism of action, potentially improving glycemic control. This study examined the efficacy, safety, and tolerability of a FDC of pioglitazone and dapagliflozin in individuals with type 2 Diabetes mellitus (T2DM) inadequately managed with metformin. Materials and Methods: This was a phase III, prospective, randomized, open-label, multicenter clinical study. The FDC of dapagliflozin 10 mg + pioglitazone 15 mg tablets (test group) or dapagliflozin 10 mg tablets and pioglitazone 15 mg tablets (reference group) were administered separately to 184 T2DM patients for a 12-week period in a 1:1 ratio. The primary endpoint was the mean change in glycosylated hemoglobin (HbA1c) from baseline to the end of 12 weeks, in both groups. The data were analyzed by using appropriate statistical methods. Results: For the test and reference groups, there was no difference in the mean change in HbA1c values from baseline to end of the study −0.86% versus −0.81%, the mean fasting plasma glucose level −33.44 mg/dl versus −33.78 mg/dl, and in the mean postprandial blood glucose level −50.17 mg/dl versus −53.41 mg/dl, respectively. A total of 35 adverse events were reported, which were mild in severity. Conclusion: The FDC of dapagliflozin 10 mg and pioglitazone 15 mg proved to have the efficacy, safety, and tolerability comparable to concomitant separate pill administration of 10 mg dapagliflozin and 15 mg pioglitazone in T2DM patients inadequately controlled on metformin monotherapy.
