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Ghāziābād, India

Bhargava R.,Laser Eye Clinic | Kumar P.,Santosh Medical College

Purpose: The aim of this study was to evaluate the effect of dietary omega-3 fatty acid (O3FA) supplementation on dry eye symptoms, tear film tests, and conjunctival impression cytology in patients with contact lens wear-associated dry eye. Methods: In this randomized, double-blind, multicentric trial, contact lens wearers (n = 496) were randomized to receive either O3FAs or placebo capsules (corn oil) twice daily for 6 months. Subjects underwent examinations at baseline, 3 months, and 6 months. At each visit, a questionnaire of dry eye symptoms and lens wear comfort was administered. Subjects further underwent measurement of tear film break-up time (TBUT) and a Schirmer test. Conjunctival impression cytology was performed by the transfer method. Improvement in symptoms and lens wear comfort were primary outcome measures. Changes from baseline in TBUT, Schirmer, and Nelson grade at 6 months were secondary outcome measures. Results: The mean improvement in symptom score in the O3FA group was 4.7 6 2 (2.0) as compared with 0.5 6 2 (0.9) in the placebo group (P , 0.0001). Lens wear comfort levels improved significantly (P , 0.0001) from baseline. There was a significant increase in TBUT [3.3 6 2 (1.5)] and Nelson grade [0.7 6 2 (0.6)] in the O3FA group (P , 0.0001) as compared with 0.3 6 2 (0.6) and 0.1 6 2 (0.4) in the placebo group (P = 0.164 and 0.094, respectively). However, the magnitude of increase in Schirmer score [2.0 6 2 (1.5)] was relatively small (P = 0.08). Conclusions: The results of this study point toward benefits of orally administered O3FAs in alleviating dry eye symptoms, improving lens wear comfort, and cytological changes in contact lens wearers. Source

Chachra V.,Santosh Medical College | Arora V.K.,University of Delhi | Arora V.K.,NCR
Indian Journal of Tuberculosis

Background: Tuberculosis is five to six times more common among diabetics than among non-diabetics and causes greater morbidity, according to reports. The effective control of each affects the control of the other. Diabetes increases the risk of developing tuberculosis, especially in developing countries with a high incidence of tuberculosis. DOTS strategy has been an effective tool on a mass basis. However, patients under DOTS are not screened for diabetes before the therapy. Aims & Objectives: To study the prevalence of diabetes mellitus in patients with tuberculosis under DOTS strategy. Material & Methods: A cross-sectional study was conducted in Santosh Medical College & Hospital, Ghaziabad, with the patients taken from different DOTS centres of NCR-Delhi, India. The present study was undertaken to evaluate the presence of undiagnosed diabetes under DOTS strategy. Fasting capillary blood glucose levels of patients diagnosed with tuberculosis were analyzed and were managed as per DOTS guidelines at multiple centres in the northwest region of India. Results: We studied 700 patients. The prevalence of diabetes was 12.6% (n=88), which is quite high. When category-wise analysis of diabetic subjects was done, it was found that patients under Category-I were 11.7% (n=47), patients under Cat- II were 15.5% (n=39) and those under Cat-III were 3.9% (n=2). The higher percentage of patients in Cat-II indicates the poor outcome of Cat-I patients, probably due to diabetes as a co-morbid disease. Conclusion: The higher prevalence of diabetes mellitus in DOTS patients raises immediate concerns in preventing the morbidity due to both the diseases. Therefore, it is recommended that some strategy on the lines of HIV disease should be formed under DOTS for the concomitant treatment of TB and diabetes for better outcome and care. Source

Singh V.,Santosh Medical College
Journal of the Anatomical Society of India

Anatomy teaching in terms of content and methodology has undergone major changes in the recent times due to time constraints, scarcity of cadavers, rapid advances in information technology, and changes in the demands of the medical profession. Moreover, there has been a major paradigm shift in medical education from passive, didactic, and teacher-centered approach to active, clinical-based, and student-centered approach. The debate on how to teach anatomy in the most effective way continues, and there is not yet a workable solution to integrate the two lines of thought (teacher-centered/student-centered) that can resolve the dispute between the two approaches. The present article therefore meta-analyses the role and effectiveness of various instructional modalities in teaching and learning anatomy in the context of the shifting paradigm from teaching to learning. The available literature on the use of various instructional strategies employed for teaching-learning anatomy suggests that the challenge should not be to determine superiority of one methodology over another but to capitalize on the learning benefits offered by the different methods. Learners should be provided opportunity to use multiple resources, thus favoring flexibility in the acquisition of knowledge. Proper amalgamation of traditional teaching methodologies such as lectures and dissection and the newer instructional methods, namely problem-based learning and computer-aided learning, would help to catalyze the shift from pedagogy to andragogy, where educators no longer serve chiefly as the dispensers of the subject content, but act as facilitators of learning and evaluators of competency. The net result should be to produce lifelong learners committed to continuous improvement of skills and knowledge. © 2013, The Anatomical Society of India. All rights reserved. Source

Narayan C.L.,Deepayan | Shikha D.,Santosh Medical College
Indian Journal of Psychiatry

Although there was a rich tradition of legal system in Ancient India, the present judicial system of the country derives largely from the British system and is based on English Common Law, a system of law based on recorded judicial precedents. Earlier legislations in respect of mental health were primarily concerned with custodial aspects of persons with mental illness and protection of the society. Indian laws are also concerned with determination of competency, diminished responsibility and/or welfare of the society. United Nations Convention for Rights of Persons with Disabilities (UNCRPD) was adopted in 2006, which marks a paradigm shift in respect of disabilities (including disability due to mental illness) from a social welfare concern to a human right issue. The new paradigm is based on presumption of legal capacity, equality and dignity. Following ratification of the convention by India in 2008, it became obligatory to revise all the disability laws to bring them in harmony with the UNCRPD. Therefore, the Mental Health Act - 1987 and Persons with Disability Act - 1995 are under process of revision and draft bills have been prepared. Human right activists groups are pressing for provisions for legal capacity for persons with mental illness in absolute terms, whereas the psychiatrists are in favor of retaining provisions for involuntary hospitalization in special circumstances. Source

Shilpasree A.S.,Santosh Medical College | Sahukar S.,JJM Medical College | Murthy J.,JJM Medical College | Kumar K.,ITS CDSR Muradnagar
Journal of Clinical and Diagnostic Research

Background: Role of Serum Lipids, Lipoproteins and Lipoprotein related variables in the prediction of Stroke is less clear. Abnormalities in plasma Lipoproteins are the most firmly established and best understood risk factors for Atherosclerosis and they are probable risk factors for Ischaemic stroke, largely by their link to Atherosclerosis. Apo B reflects the concentration of potentially atherogenic particles (LDL), and Apo A1 reflects the corresponding concentration of anti-atherogenic particles (HDL), represent additional lipoprotein related variables that may indicate the vascular risk. Aim: To study serum concentration of Apolipoprotein A1, Apolipoprotein B, Apo B/Apo A1 ratio and Lipid profile in Stroke Cases and to compare with healthy controls. Design:. A total number of 100 subjects within 30 - 70 years were considered for the study. 50 subjects with Stroke (both clinically as well as Computed tomographically proven cases) and 50 age and sex matched healthy individuals were taken for the study Materials and Methods: Total cholesterol, HDL cholesterol and Triglycerides are estimated by Enzymatic method using Semiautoanalyser. LDL cholesterol is estimated by Friedewald formula. Apo B and Apo A1 are estimated by Immunoturbidimetric method using Semiautoanalyser. Statistical Analysis: Student 't' test was used to compare the data between cases and controls. Diagnostic validity tests were conducted to assess the Diagnostic efficiency of Apo A1, Apo B and Apo B/Apo A1 ratio. Results: Total cholesterol, LDL cholesterol and Triglycerides are significantly increased in Cases compared to Controls. HDL - cholesterol is significantly decreased in Cases compared to Controls. Apo B and Apo B/Apo A1 ratio are significantly increased and Apo A1 is significantly decreased in Cases compared to Controls. Diagnostic validity tests showed that, Apo B, Apo A1 and Apo B /Apo A1 ratio have highest Sensitivity, Specificity and Diagnostic efficiency. Conclusion: Apo B, Apo A1 and Apo B/Apo A1 ratio can be used as predictors of stroke along with traditional lipid profile components. Source

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