Sai Krishna Medical College & Hospital

Background: Pharmacological intervention is the primary treatment for glaucoma, designed to lower intraocular pressure and avert optic nerve injury. In patients with concurrent cataract, apprehensions have emerged about the long-term safety of topical anti-glaucoma medicines, including their propensity to induce ocular surface damage and affect cataract progression. Objective: To assess the risks linked to medical glaucoma treatment in patients with concurrent cataract, particularly regarding adverse drug reactions and the advancement of lens opacity. Methods: A retrospective observational study was performed on 150 individuals diagnosed with both glaucoma and cataract over the course of one year. Data pertinent to demographics, categories of anti-glaucoma drugs (betablockers, prostaglandin analogs, and carbonic anhydrase inhibitors), occurrence of adverse effects, and cataract advancement status were extracted from medical records. A chi-square test was conducted to evaluate the relationship between medication type and outcomes, with a p-value of less than 0.05 being statistically significant. Results: Adverse effects occurred in roughly 40% of individuals, predominantly manifesting as eye irritation and dryness. Despite beta-blockers and carbonic anhydrase inhibitors exhibiting a somewhat increased incidence of adverse effects, the correlation between medication type and adverse effects was not statistically significant (p = 0.56). No significant correlation was identified between the kind of anti-glaucoma medicine and cataract advancement (p = 0.75), suggesting that lens alterations were not substantially affected by medical treatment during the study period. Conclusion: Medical treatment for glaucoma seems to be comparatively safe for patients with concurrent cataract. Mild side effects are rather prevalent; however, they do not exhibit a substantial correlation with certain drug classes. No evidence was discovered indicating that these drugs hasten cataract progression. Consistent oversight and personalized therapy are crucial for good patient management.

Objectives: The present study was to evaluate the prevalence and type of refractory error in primary school aged children. Methods: A standard ophthalmic examination procedure was used for each study subject. Ophthalmic examination included assessment of visual acuity for distance with Snellen’s illiterate E chart at 6 meters in a well-illuminated room. Children detected with defective vision were referred for further examination. They were further evaluated employing subjective refraction with auto refractometer by Ophthalmologist. Prevalence of visual impairment (visual acuity less than 6/18) was calculated for uncorrected visual acuity, and best measured visual acuity. Results: A total of 222 children were enrolled. Among them, 94(42.34%) children were males and 128(57.66%) children were females. Prevalence of RE was 25.22%. Astigmatism was the commonest refractive errors in both right 27(12.16%) and left 25(19.38%) eye. While, myopia 14(10.85%) was the least frequent in both right eye 14(6.31%) and left eye 11(4.95%). All types of the refractive errors were relatively more common in females than males. It was statistically significant relation between the gender and refractive errors (p =0.008). Conclusions: Refractory error is preponderance in female children as compared to male children. RE is more common in children with age group 9-11 years. Astigmatism is the most common RE, while myopia is least frequent RE present in children.

Background: Hepatic lesions are a broad range of benign and malignant pathologies, and their correct classification is necessary when it comes to proper management of the condition in clinical practice and planning of treatment. Triphasic Computer Tomography (CT) is one of the valuable techniques since it is capable of assessing the vascularity of a lesion at various stages of enhancement. The purpose of this research was to assess the diagnostic utility of Triphasic Computed Tomography in diagnosis and differentiation of hepatic lesions. Methodology: A cross-sectional study was a retrospective study, whereby 209 patients with suspected hepatic lesions underwent triphasic CT scanning in Kulsum International Hospital and CITI Lab. The research sample consisted of patients between the ages of 23 and 80 years of any gender. The analysis of triphasic CT images included the patterns that are arterial, portal venous and delayed phase enhancement. In the diagnostic accuracy analysis, 134 patients whose final diagnoses were well documented were counted. The data were statistically analyzed using the SPSS and the diagnostic performance parameters such as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, Chi-square test and ROC curve analysis were obtained. Results: The average age of the subjects used was 56.9 ± 15.3 years with an almost equal percentage of female participants (52.6%) and male participants (47.4%). Benign lesions of the liver were predominant (70.9%) compared to malignant lesions (29.1%). Triphasic CT had a sensitivity of 64.1%, specificity of 89.5%, PPV of 71.4%, NPV of 85.9% and a total diagnostic accuracy of 82.1%. The triphasic CT enhancement patterns were found to have statistically significant correlation with final diagnosis (p < 0.001). The results of ROC analysis were good diagnostic discrimination with the area under the curve (AUC) of 0.779. Conclusion: Triphasic Computed Tomography is a non-invasive imaging modality that is reliable and has high diagnostic accuracy when it comes to characterizing hepatic lesions. Triphasic CT is useful in distinguishing between benign and malignant lesions and is effective when interpreted using structured enhancement criteria and scoring systems and is important in making clinical decisions, especially in limited resource environments.

Background: Bipolar disorder is associated with an increased risk of metabolic abnormalities, contributing to significant morbidity and premature mortality. Aim: To evaluate metabolic abnormalities and their clinical correlates in patients with bipolar disorder. Methods: This cross-sectional study included 61 drug-free patients diagnosed with bipolar disorder as per ICD10 criteria at a tertiary care center in Bihar, India. Anthropometric parameters, blood pressure, fasting blood glucose, and lipid profile were assessed. Clinical variables were evaluated using the Young Mania Rating Scale (YMRS) and Hamilton Depression Rating Scale (HAM-D). Results: Metabolic syndrome was identified in 39.3% of participants. Patients with metabolic abnormalities had significantly higher waist circumference, blood pressure, fasting blood glucose, triglyceride levels, and lowdensity lipoprotein cholesterol, along with lower high-density lipoprotein cholesterol (p < 0.05). A significant association was observed between metabolic abnormalities and the number of lifetime manic episodes. Conclusion: Metabolic abnormalities are highly prevalent in bipolar disorder and are associated with illness severity. Routine metabolic screening should be incorporated into standard psychiatric care.

Objectives: The present study was to correlate the C-Reactive Protein levels, BMI and duration of diabetes mellitus with severity of diabetic retinopathy. Methods: A complete assessment including demographic details, ocular symptoms duration of DM, treatment taken for diabetes, and other associated conditions were performed to all diabetes mellitus patients. Ophthalmic examination included visual acuity, best corrected visual acuity, slit lamp examination for anterior segment were performed. Dilated fundus examination was done with both + 90D and indirect ophthalmoscope. Fundus photos were taken using Canon CF1 Fundus Camera. Height and weight were measured to calculate the BMI. Blood was collected from the patient under aseptic conditions and CRP was assessed through laboratory analysis (Turbidometry Technique). Results: Out of total 100 patients, most of the cases 51(51%) were in age group of 46-60 years. Majorities of the cases 54% were females. Most of the cases (59%) had 6-10 years of duration of diabetes. 52% patients were without retinopathy and 48% patients were with diabetic retinopathy. NPDR was seen in (26) most of the patients. NPDR+CSME was seen in 10 patients. 6 patients had NPDR+CSME. PDR was seen in 7 patients. PDR+CSME was seen in 5 cases of diabetic retinopathy. 3 cases had duration 6-10 years of diabetic retinopathy. Majorities of cases had duration 6-10 years of DM. Diabetic retinopathy had significantly higher BMI as compared to normal diabetic patients (p=0.028). The mean CRP levels in various types of DR were 2.67 mg/L in NPDR, 2.98 mg/L in NPDR with CSME, 3.8 mg/L in PDR, and 4.0 mg/L in PDR with CSME. Significantly high values of mean CRP were observed in patients with severe forms of PDR and PDR with CSME. Conclusions: CRP level is significantly increased in diabetic retinopathy patients as compared to without diabetic retinopathy. Higher level of inflammatory activity seen in retina due to higher level of CRP in patients of diabetic retinopathy with PDR and CSME.