111 results on '"Parul Chawla Gupta"'
Search Results
2. Gomez-López-Hernandez syndrome: the triad of cerebello-trigemino-dermal dysplasia
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Anuj Prabhakar, Neha Choudhary, Vikas Bhatia, and Parul Chawla Gupta
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genetic structures ,business.industry ,Neurocutaneous Syndromes ,Alopecia ,General Medicine ,Anatomy ,medicine.disease ,Magnetic Resonance Imaging ,eye diseases ,Craniofacial Abnormalities ,Rhombencephalon ,Triad (sociology) ,Gomez Lopez Hernandez syndrome ,Dysplasia ,Cerebellum ,medicine ,Humans ,Abnormalities, Multiple ,business ,Growth Disorders - Abstract
A 14-year-old female presented with progressive diminution of vision in the right eye. She had left-sided loss of vision since 1 year of age. The patient had aggressive behaviour with irrelevant talking. She was intellectually disabled and had a history of delayed motor and language milestones. On
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- 2023
3. Tissue Adhesives for the Management of Corneal Perforations and Challenging Corneal Conditions
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Ashok Sharma, Namrata Sharma, Sayan Basu, Rajan Sharma, Shruti Aggarwal, Parul Chawla Gupta, Jagat Ram, and Verinder S Nirankari
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Ophthalmology - Published
- 2023
4. Childhood Cataract: A Clinico-Social Profile
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Deepak Jugran, Surbhi Khurana, Parul Chawla Gupta, and Jagat Ram
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- 2023
5. Programmed death-ligand 1 expression and tumor-infiltrating lymphocytes in non-small cell lung cancer: association with clinicopathologic parameters
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Valliappan Muthu, Kuruswamy Thurai Prasad, Gaurav Garg, Ashim Das, Amanjit Bal, Parul Chawla Gupta, and Navneet Singh
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Oncology ,PD-L1 ,medicine.medical_specialty ,Histology ,H&E stain ,chemical and pharmacologic phenomena ,Tumor-infiltrating lymphocytes ,Pathology and Forensic Medicine ,Metastasis ,Non-small cell lung carcinoma ,Lung neoplasms ,Internal medicine ,medicine ,Pathology ,RB1-214 ,Lung cancer ,biology ,business.industry ,medicine.disease ,biology.protein ,Immunohistochemistry ,Adenocarcinoma ,Original Article ,Immunotherapy ,business - Abstract
Background: Data on the prevalence of programmed death-ligand 1 (PD-L1) expression and tumor-infiltrating lymphocytes (TILs) in non–small cell lung cancer (NSCLC) and their clinical significance in Indian patients are limited. Methods: Newly diagnosed NSCLC cases (adenocarcinoma or squamous cell carcinoma [SqCC] histology) were included in the present study. The TILs were evaluated based on morphology on hematoxylin and eosin–stained slides. PD-L1 expression in tumors was assessed using immunohistochemistry with rabbit monoclonal antibody (SP263) on the Ventana automated immunostainer. Tumors with PD-L1 expression > 50% on tumor cells were considered PD-L1–positive. Tumors in which TILs occupy > 25% of stroma were considered to have high TILs. The association of PD-L1 expression and TILs with various clinical parameters including overall survival (OS) was investigated. Results: The present study included 128 cases of NSCLC (67 adenocarcinoma, 61 SqCC). PD-L1 positivity was observed in 17.2% of the patients with NSCLC. Baseline characteristics of PD-L1–positive subjects were similar to PD-L1–negative subjects except for a higher prevalence of liver metastasis (18.2% vs. 2.8%; p = .018) and a higher probability of diagnosis from extrapulmonary biopsies. High TILs were observed in 26.6% of the subjects. However, PD-L1 expression and high TIL did not affect OS. Conclusions: PD-L1 positivity and high TILs were observed in 20% and 25% of the patients with NSCLC, respectively, however, neither were predictors of survival in SqCC.
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- 2021
6. MicroRNA analysis of the lens capsule in pseudoexfoliation glaucoma and pseudoexfoliation cataract in the Indian population
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Alka Khera, Jagat Ram, Madhu Khullar, Faisal Thattaruthody, Parul Chawla Gupta, Gaurav Kumar, Nirbhai Singh, and Surinder Singh Pandav
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Pseudoexfoliation syndrome (XFS) effects the intraocular pressure (IOP) and vision of eye by causing pseudoexfoliation glaucoma (XFG). miRNAs have previously been linked to the aetiology of XFS and XFG. Present study focuses on the differential expression pattern of microRNAs (miRNAs) in anterior lens capsule (ALC) of XFS and XFG. For this, RNA from ALC of XFS, XFG and control patients was subjected to miRNA array followed by validation of clinically important significantly expressed miRNAs and their targets by real-time PCR. Out of 44 differentially expressed miRNAs, miR-638 showed significant increase in expression in XFG samples as compared to XFS and control (p
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- 2022
7. Clinical Outcomes of Corneal Neurotization Using Sural Nerve Graft in Neurotrophic Keratopathy
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Manu Saini, Aman Kalia, Arun Jain, Sunil Gaba, Chintan Malhotra, Amit Gupta, Tanvi Soni, Parul Chawla Gupta, and Manpreet Singh
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Objective To evaluate the efficacy of corneal neurotization using sural nerve graft coaptation to the contralateral supratrochlear nerve in unilateral neurotrophic keratopathy and corneal anaesthesia Methods A Prospective interventional study involving unilateral neurotrophic keratopathy, not responding to the medical measures was conducted. A few variations in corneal neurotization were attempted to expedient the surgical procedure. The study parameters evaluated were best corrected visual acuity improvement, ocular surface evaluation parameters [Tear break-up time (TBUT), Schirmer’s 1, and ocular surface staining scores (corneal and conjunctival staining)], central corneal sensation (Cochet Bonnet aesthesiometer), sub-basal nerve fibre length (SBNFL) and sub-basal nerve fibre density (SBNFD) determined by central confocal microscopy at recruitment and during follow-up at 1-month, 3-month, 6-month, 9-month and 12-month respectively following corneal neurotization procedure. Results Eleven eyes of 11 patients with unilateral neurotrophic keratopathy (NK) who underwent corneal neurotization were studied. Mean follow-up was 10.09 ± 2.31months (range, 6–12). Mean best corrected visual acuity at baseline, 1.35 ± 0.52 improved significantly to 1.06 ± 0.76 (P = 0.012) at 3 months and continued to 0.55 ± 0.60 (P = 0.027) at 12 months. There was a significant reduction in NK grade severity and improvement in ocular surface, as early as 1 month, and central corneal sensations (P = 0.024) as soon as 3 months. Mean corneal SBNF improved from 3.12 ± 1.84mm/mm2 to 4.49 ± 1.88 at 1-month (P = 0.008), 13.31 ± 3.61mm/mm2 (P = 0.028) at 12 months. Mean central corneal SBNFD evident at 6-months 1.83 ± 2.54no/mm2 (P = 0.018) and 4.90 ± 3.12no/mm2 (P = 0.028) at 12-month. Conclusion The study substantiates the routine practice of corneal neurotization, by simplifying the intricacies observed during the procedure.
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- 2022
8. Congenital rubella syndrome surveillance in India, 2016–21: Analysis of five years surveillance data
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Devika Shanmugasundaram, Sanjay Verma, Kuldeep Singh, Bhagirathi Dwibedi, Shally Awasthi, S. Mahantesh, Himabindu Singh, Sridhar Santhanam, Nivedita Mondal, Geetha S, Priya Sreenivasan, Shikha Malik, Manish Jain, Rajlakshmi Viswanathan, Shalini Tripathi, Bhupeshwari Patel, Gajanan Sapkal, R. Sabarinathan, Mini P. Singh, R.K. Ratho, Vijaylakshmi Nag, Ravishekhar Gadepalli, Tapas Kumar Som, Baijayantimala Mishra, Amita Jain, M. Ashok, Devara Sudha Madhuri, V Sudha Rani, Asha Mary Abraham, Deepa John, Rahul Dhodapkar, A. Syed Ali, Debasis Biswas, Deepashri Pratyeke, Ashish Bavdekar, Jayant Prakash, Varsha Singh, Nidhi Prasad, Jaydeb Ray, Agniva Majumdar, Shanta Dutta, Nivedita Gupta, Manoj Murhekar, Akhil Sharma, Aniruddha Ghosh, Arun Alexander, Arun Baranwal, Avinash Anantharaj, Adhisivam Bethou, Dolat S. Shekhawat, G. Kiruthika, Jagat Ram, Madhu Gupta, Mamatha Gowda, Manoj K Rohit, Nabaneeta Dash, Naveen Sankhyan, Nidhi Kaushal, Niranjan Hunasanahalli Shivanna, Nirupama Kasturi, P. Prem Kumar, Parul Chawla Gupta, Pradeep Kumar Gunasekaran, Pratibha Singh, Praveen Kumar, Sanjay Kumar Munjal, Siddharth Agarwal, Suhani Manasa, Suruchi Shukla, Urvashi Nehra, Valsan P Verghese, Varuna Vyas, and Vikas Gupta
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Multidisciplinary - Published
- 2023
9. Axial myopia, a protective factor for diabetic retinopathy-role of vascular endothelial growth factor
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Parul Chawla Gupta, Jagat Ram, Ashish Kulshrestha, Ramandeep Singh, Nirbhai Singh, and Bruttendu Moharana
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Vascular Endothelial Growth Factor A ,medicine.medical_specialty ,Diabetic Retinopathy ,Multidisciplinary ,business.industry ,Vascular Endothelial Growth Factors ,Protective factor ,Diabetic retinopathy ,Protective Factors ,medicine.disease ,Vascular endothelial growth factor ,Aqueous Humor ,chemistry.chemical_compound ,chemistry ,Ophthalmology ,medicine ,Diabetes Mellitus ,Myopia ,Humans ,business ,Axial myopia - Abstract
PURPOSE Long axial length is one of the ocular protective factors in development of diabetic retinopathy (DR). In this study we examined the effect of axial length (AL) on aqueous humor vascular endothelial growth factor (VEGF) levels in patients with diabetes mellitus with or without DR. METHODS Forty-eight eyes of 48 participants were divided into three groups of 16 each. Group A consisted of non-diabetic patients, Group B had diabetic patients without DR, and Group C had diabetic patients with treatment-naive non-proliferative DR (NPDR). The groups were further subdivided based on axial lengths i.e., AL ≤ 23.30 mm (A1, B1, C1) and AL > 23.30 mm (A2, B2, C2). Undiluted aqueous humor was obtained during cataract surgery to measure the VEGF levels. RESULTS We observed significant decrease in VEGF concentration in patients with AL ≥ 23.30 mm as compared with AL ≤ 23.30 mm in non-diabetic as well as diabetic patients. As the eye elongates, there is less secretion of VEGF in non-diabetics as well in diabetics with or without DR. CONCLUSION Our findings strengthened the concept that an increase in AL leads to less VEGF in diabetic eyes, thus leading to less severe DR changes.
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- 2022
10. System for administering and monitoring hydroxychloroquine prophylaxis for COVID-19 in accordance with a national advisory: preliminary experience of a tertiary care institute in India
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Ankur Gupta, Ashish Bhalla, Samir Malhotra, Deepa Kumari, Avaneesh Kumar Pandey, Amol N Patil, Praveen Kumar-M, Parul Chawla Gupta, Ritin Mohindra, Vikas Suri, Ashish Kumar Kakkar, and Nusrat Shafiq
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0301 basic medicine ,Male ,COVID-19 prophylaxis ,Tertiary care ,law.invention ,Tertiary Care Centers ,Electrocardiography ,0302 clinical medicine ,Informed consent ,law ,Health care ,Medicine ,030212 general & internal medicine ,Young adult ,Original Research ,Clinical pharmacology ,Informed Consent ,HCQ ,Long QT Syndrome ,Infectious Diseases ,HCW ,national advisory ,Mass Drug Administration ,Female ,medicine.drug ,Research Article ,Preliminary Data ,Microbiology (medical) ,Adult ,medicine.medical_specialty ,hydroxychloroquine ,Coronavirus disease 2019 (COVID-19) ,030106 microbiology ,education ,India ,Microbiology ,03 medical and health sciences ,Antimalarials ,Young Adult ,healthcare worker ,Virology ,Humans ,Adverse effect ,business.industry ,SARS-CoV-2 ,Contraindications, Drug ,COVID-19 ,Hydroxychloroquine ,Personnel, Hospital ,Emergency medicine ,business - Abstract
Background Hydroxychloroquine (HCQ) was one of the earliest drugs to be recommended for tackling the COVID-19 threat leading to its widespread usage. We provide preliminary findings of the system, established in a tertiary care academic center for the administration of HCQ prophylaxis to healthcare workers (HCW) based on Indian Council of Medical Research (ICMR) advisory. Methods A dedicated clinical pharmacology and internal medicine team screened for contraindications, administered informed consent, maintained compliance and monitored for adverse events. Results Among the 194 HCWs screened for ruling out contraindications for prophylaxis, 9 were excluded and 185 were initiated on HCQ. A total of 55 adverse events were seen in 38 (20.5%) HCWs out of which 70.9%, 29.1% were mild and moderate & none were severe. Before the completion of therapy, a total of 23 participants discontinued. Change in QTc interval on day 2 was 5 (IQR: −3.75, 11) ms and the end of week 1 was 15 ms (IQR: 2, 18). Out of the 5 HCW who turned positive for COVID-19, 2 were on HCQ. Conclusion HCQ prophylaxis was found to be safe and well tolerated in HCW when administered after appropriate screening and with monitoring for adverse events.
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- 2021
11. Ophthalmic Manifestations of the Monkeypox Virus: A Systematic Review and Meta-Analysis
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Aravind P. Gandhi, Parul Chawla Gupta, Bijaya K. Padhi, Mokanpally Sandeep, Tarun Kumar Suvvari, Muhammad Aaqib Shamim, Prakasini Satapathy, Ranjit Sah, Darwin A. León-Figueroa, Alfonso J. Rodriguez-Morales, Joshuan J. Barboza, and Arkadiusz Dziedzic
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Microbiology (medical) ,Infectious Diseases ,General Immunology and Microbiology ,Immunology and Allergy ,Molecular Biology - Abstract
Background: The accurate estimation of the prevalence of mpox-induced ophthalmic lesions will enable health departments to allocate resources more effectively during the ongoing mpox pandemic. The aim of this meta-analysis was to estimate the global prevalence of ophthalmic manifestations in mpox patients. Methods: A systematic search was carried out in seven databases—Pub Med, Scopus, Web of Science, EMBASE, ProQuest, EBSCOHost, and Cochrane—for studies published on or before 12 December 2022. The pooled prevalence of ophthalmic manifestations was estimated by the random effects model. Risk of bias assessment of the studies and sub-group analysis to explain heterogeneity were undertaken. Results: Overall, 12 studies were included, with 3239 confirmed mpox cases, among which 755 patients reported ophthalmic manifestations. The pooled prevalence of ophthalmic manifestations was 9% (95% confidence interval (CI), 3–24). Studies from Europe reported a very low prevalence of ocular manifestations of 0.98% (95% CI 0.14–2.31), compared to studies from Africa with a substantially higher prevalence of 27.22% (95% CI 13.69–43.26). Conclusions: A wide variation in the prevalence of ocular manifestations among mpox patients was observed globally. Healthcare workers involved in mpox-endemic African countries should be aware of ocular manifestations for early detection and management.
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- 2023
12. Pediatric cataract surgery practices in the COVID-19 era: Perspectives of a tertiary care institute in Northern India
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Jaspreet Sukhija, Surbhi Khurana, Savleen Kaur, Shagun Korla, Parul Chawla Gupta, Abinaya Valliappan, and Jagat Ram
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medicine.medical_specialty ,Telemedicine ,Coronavirus disease 2019 (COVID-19) ,genetic structures ,Expedited Publication, Current Ophthalmology ,media_common.quotation_subject ,challenges in pediatric cataract ,India ,Tertiary care ,Cataract ,Hygiene ,Pandemic ,Health care ,medicine ,Humans ,Child ,media_common ,business.industry ,SARS-CoV-2 ,Tertiary Healthcare ,pediatric cataract in covid-19 ,COVID-19 ,RE1-994 ,Triage ,covid-19 protocol for pediatric cataract ,eye diseases ,Surgery ,Ophthalmology ,Pediatric ophthalmology ,business - Abstract
Purpose To discuss the impact of COVID-19 pandemic on the pediatric cataract surgery services in a tertiary care institute in India, as well as the protocol followed for these surgeries. Methods COVID-19 has hampered outpatient and elective services and surgeries throughout the world. During the national lockdown imposed in March in India, outpatient services were suspended in our institute, leading to a tremendous backlog of pediatric patients with cataract. Since the delay in surgery in pediatric cataract can cause amblyopia, our institute had resumed pediatric cataract surgeries in June 2020 at the time of Unlock-1 in the country. Results We have discussed the percentage of reduction in pediatric cataract surgeries in 2020 during the Unlock 1, 2, 3, and 4, as compared to the number of surgeries done by the pediatric ophthalmology unit in the same months last year. We had introduced triage and telemedicine in our department. We have discussed the preoperative, intraoperative, and postoperative protocol followed in our institute for children with pediatric cataract, and also the measures which can be taken for the safety of patients and staff. Conclusion It is essential to ensure COVID-19 protocol, i.e., wearing a mask, social distancing, and frequent hand hygiene, among the patients and health care personnel. Redesigning pediatric cataract surgery practices is essential to ensure the safety of the health care workers and the patients.
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- 2021
13. Reworking protocols of ophthalmic resident surgical training in the COVID-19 era – Experiences of a tertiary care institute in northern India
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Ranjan Kumar Behera, Surbhi Khurana, Parul Chawla Gupta, Faisal Thattaruthody, Surinder Singh Pandav, Ramandeep Singh, and Jagat Ram
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simulator ,Coronavirus disease 2019 (COVID-19) ,medicine.medical_treatment ,education ,India ,wet lab ,Tertiary care ,medicine ,Surgical skills ,Humans ,Letters to the Editor ,Fine motor ,goat eyes ,SARS-CoV-2 ,Tertiary Healthcare ,business.industry ,COVID-19 ,Internship and Residency ,Phacoemulsification ,RE1-994 ,medicine.disease ,Surgical training ,Schedule (workplace) ,Ophthalmology ,Education, Medical, Graduate ,Clinical Competence ,Medical emergency ,business ,Residency training - Abstract
Purpose Coronavirus Disease 2019 (COVID-19) pandemic has negatively impacted medical professionals in all fields of medicine and surgery in their academic, clinical and surgical training. The impact of surgical training has been described as 'severe' by most ophthalmology residents worldwide due to their duties in COVID-19 wards, disruption of outpatient and camp services. Methods Ophthalmic surgery demands utmost accuracy and meticulousness. Fine motor proficiencies, stereoscopic skills and hand-eye coordination required can only be achieved by practice. So, a multileveled structured wet-lab teaching schedule was prepared for the residents and implemented to bridge this gap between theory and practice at our tertiary care institute. A semester-wise training schedule was made with the proper distribution of wet-lab and simulator training. Surgeries like phacoemulsification, scleral buckling, pars plana lensectomy and vitrectomy, trabeculectomy and intravitreal injections were practised by the residents on the goat eyes. Simulator training was provided for phacoemulsification and vitrectomy to increase the hand-eye coordination of the residents. Results Residents noticed improvement in their surgical skills and ambidexterity post wet-lab and simulator training . It also increased their confidence and provided essential surgical skills required to be used in the operation theater later. Conclusion It is imperative that wet-lab training be included in the residency training programme in this COVID-19 era.
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- 2021
14. A Fluid-filled Pocket of Descemet Membrane Detachment
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Surbhi Khurana, Parul Chawla Gupta, and Jagat Ram
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Ophthalmology ,Humans ,Descemet Membrane ,Corneal Diseases - Published
- 2022
15. Prediction of probability of rubella based on eye outcomes (PORBEO Nomogram)—a cross-sectional sentinel surveillance of 1134 infants
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Ravinder Kaur Sachdeva, Devika Shanmugasundaram, Ashish Bavdekar, Sanjay Verma, Mahantesh Sangappa, Parul Chawla Gupta, Jagat Ram, R Sabrinathan, Kuldeep Singh, Sanjay Shah, Deepa John, Sridhar Santhanam, Manoj V Murhekar, Praveen Kumar-M, and Krishna R Murthy
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Pediatrics ,medicine.medical_specialty ,Antibodies, Viral ,Logistic regression ,Rubella ,Odds ,Congenital Rubella ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,medicine ,Humans ,030212 general & internal medicine ,Child ,Probability ,Congenital rubella syndrome ,Univariate analysis ,business.industry ,Infant ,Nomogram ,medicine.disease ,Sensory Systems ,Nomograms ,Ophthalmology ,Cross-Sectional Studies ,030221 ophthalmology & optometry ,Etiology ,business ,Sentinel Surveillance - Abstract
Rubella is an important infectious, vaccine-preventable etiology of congenital defects. The aim of the study was to develop a prediction nomogram to assess the probability of an infant being at risk for congenital rubella based on demographics and ophthalmological findings. This was a cross-sectional sentinel surveillance study conducted at 5 centers spanning pan-India and involved 1134 infants. The diagnosis of rubella was made using standard guidelines. For the construction of the prediction model, laboratory-confirmed cases were grouped as “at-risk” (AR) infants and the discarded cases into “not at risk” (NAR) infants. Univariate analysis (p value cut-off < 0.05) followed by multivariate binary logistic regression model development was performed. The average (median) age of the suspected CRS infants was 3 (IQR 1–6) months, and the average (mean) age of their mothers was 25.8 ± 4.1 years. Out of the total infants, 81 (7.3%) died, 975 (88%) were alive, and 55 (5.0%) were lost to follow-up. The final model showed that the odds of cataract, retinopathy, glaucoma, microcornea, and age of the infant at presentation were 3.1 (2.2–4.3), 4.9(2.3–10.4), 2.7(1.1–5.9), 2.3(1.1–4.7), and 1.1 (1–1.1), respectively, for the AR infant as compared to NAR infant. AUC of final model was 0.68 (95% CI Delong, 0.64–0.72). Bootstrapping for calibration of the model showed satisfactory results. Nomogram, along with a web version, was developed. The developed nomogram would have a wide community-based utilization and will help in prioritizing attention to high-risk children, thereby avoiding loss to follow-up.
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- 2020
16. Reworking Protocols in the Ophthalmology Department during the COVID-19 Crisis
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Jagat Ram, Praveen Kumar-M, and Parul Chawla Gupta
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Chemosis ,Coronavirus disease 2019 (COVID-19) ,Immunology ,Ophthalmology department ,Eye care ,filtering face piece ,03 medical and health sciences ,0302 clinical medicine ,Health care ,conjunctivitis ,medicine ,030212 general & internal medicine ,lcsh:Science ,lcsh:General works ,lcsh:R5-130.5 ,business.industry ,Staff management ,medicine.disease ,ocular manifestations ,Triage ,eye diseases ,Ophthalmology clinic ,030221 ophthalmology & optometry ,lcsh:Q ,Medical emergency ,medicine.symptom ,triage ,business ,aarogya setu app - Abstract
Eye care professionals are susceptible to contract COVID-19 infection due to the presence of the virus in tears and conjunctival secretions and, also, partly due to the proximity required during ophthalmic examination. Although infrequent, ocular features include conjunctivitis (predominant), chemosis, follicles, itching, dry eye, and tearing. In this article, we have outlined salient safety recommendations at outpatient, inpatient and operation theater level for both patients as well as health care workers. Some of them being, creation of special triage areas at ophthalmology clinic for the screening of patients, things to be avoided at each level, procedures to manage appointments, examination room modifications, operation theater protocols, a suggestion for prioritizing cases, and finally airflow and hospital staff management. These suggestions, along with local hospital-specific modifications, will help us to go a long way in the battle against COVID-19.
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- 2020
17. COVID-19 pandemic from an ophthalmology point of view
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Jagat Ram, M Praveen Kumar, and Parul Chawla Gupta
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0301 basic medicine ,Pediatrics ,medicine.medical_specialty ,hydroxychloroquine ,Referral ,genetic structures ,contact lens ,medicine.medical_treatment ,chloroquine - contact lens - coronavirus - eye donation - eye shields - hydroxychloroquine - ophthalmologist ,030106 microbiology ,coronavirus ,Anosmia ,lcsh:Medicine ,Review Article ,medicine.disease_cause ,General Biochemistry, Genetics and Molecular Biology ,03 medical and health sciences ,0302 clinical medicine ,Pharmacotherapy ,Pandemic ,Medicine ,030212 general & internal medicine ,Corneal transplantation ,Coronavirus ,business.industry ,lcsh:R ,Chloroquine ,Hydroxychloroquine ,General Medicine ,eye diseases ,Contact lens ,ophthalmologist ,eye shields ,medicine.symptom ,business ,eye donation ,medicine.drug - Abstract
Coronavirus disease 2019 (COVID-19) is caused by a highly contagious RNA virus termed as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Ophthalmologists are at high-risk due to their proximity and short working distance at the time of slit-lamp examination. Eye care professionals can be caught unaware because conjunctivitis may be one of the first signs of COVID-19 at presentation, even precluding the emergence of additional symptoms such as dry cough and anosmia. Breath and eye shields as well as N95 masks, should be worn while examining patients with fever, breathlessness, or any history of international travel or travel from any hotspot besides maintaining hand hygiene. All elective surgeries need to be deferred. Adults or children with sudden-onset painful or painless visual loss, or sudden-onset squint, or sudden-onset floaters or severe lid oedema need a referral for urgent care. Patients should be told to discontinue contact lens wear if they have any symptoms of COVID-19. Cornea retrieval should be avoided in confirmed cases and suspects, and long-term preservation medium for storage of corneas should be encouraged. Retinal screening is unnecessary for coronavirus patients taking chloroquine or hydroxychloroquine as the probability of toxic damage to the retina is less due to short-duration of drug therapy. Tele-ophthalmology and artificial intelligence should be preferred for increasing doctor-patient interaction.
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- 2020
18. Corneal Cloudiness: A Presenting Feature of Mucopolysaccharidosis Type I
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Surbhi, Khurana, Parul Chawla, Gupta, Ranjan Kumar, Behera, Himanshi, Singh, and Jagat, Ram
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Cornea ,Mucopolysaccharidosis I ,Humans - Published
- 2021
19. Quantification of Inflammation Following Nd:YAG Laser Capsulotomy and Assessing the Anti-inflammatory Effects of Nepafenac 0.1% and Betamethasone 0.1%
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Gaurav Gupta, Rohit Gupta, Jagat Ram, Sabin Sahu, Surbhi Khurana, Jitender Jinagal, and Parul Chawla Gupta
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,genetic structures ,medicine.drug_class ,Administration, Topical ,medicine.medical_treatment ,Benzeneacetamides ,Visual Acuity ,Inflammation ,Lasers, Solid-State ,Betamethasone ,Nepafenac ,Anti-inflammatory ,Young Adult ,Postoperative Complications ,Ophthalmology ,medicine ,Humans ,Immunology and Allergy ,Prospective Studies ,Glucocorticoids ,Aged ,Phenylacetates ,Aged, 80 and over ,Phacoemulsification ,Dose-Response Relationship, Drug ,business.industry ,Anti-Inflammatory Agents, Non-Steroidal ,Capsule Opacification ,Middle Aged ,Cataract surgery ,eye diseases ,Treatment Outcome ,Nd:YAG laser ,Capsulotomy ,Female ,Laser Therapy ,sense organs ,medicine.symptom ,Laser flare photometry ,business ,Tomography, Optical Coherence ,Follow-Up Studies ,medicine.drug - Abstract
Purpose: To quantify the intraocular inflammation, measured using laser flare photometry (LFP), after Nd:YAG capsulotomy and compare the effects of different topical anti-inflammatory regimes.Metho...
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- 2019
20. Intracameral anesthetic mydriatic (ICAM) assisted pediatric cataract surgery
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Jaspreet Sukhija, Savleen Kaur, Shagun Korla, Parul Chawla Gupta, and Jagat Ram
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medicine.medical_specialty ,business.industry ,General Medicine ,03 medical and health sciences ,Ophthalmology ,0302 clinical medicine ,Anesthetic ,030221 ophthalmology & optometry ,medicine ,Pupillary response ,Pediatric cataract ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Purpose: To assess the efficacy and safety of intracameral mydriatic and anesthetic combination for pupillary dilation in pediatric cataract surgery Methods: This prospective series included children Results: We recruited 13 patients (16 eyes) with a mean age of 4.1 ± 3.9 years. The mean pupillary diameter changed increased from 1.92 to 5.68 mm after injection of one unit (0.025 ml) of drug ( p 6 mm and surgery could be completed successfully in all cases without additional mydriatics. In all cases, pupil dilated as the surgery progressed. No adverse event to the drug was noted. Conclusions: Intracameral mydriatic-anesthetic combination is an effective and safe way to obtain stable mydriasis in pediatric cataract surgery.
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- 2021
21. Psychological Impact among COVID-19 Positive Patients in a Tertiary Care Hospital: A Cross-sectional Study
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M. Singla, Poonam Bharti, Anshu Mittal, A. Bharti, Parul Chawla Gupta, L. N. Garg, and B. K. Aggarwal
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medicine.medical_specialty ,education.field_of_study ,Hamilton Anxiety Rating Scale ,Cross-sectional study ,business.industry ,Clinical Biochemistry ,Population ,General Medicine ,anxiety ,lockdown ,coronavirus disease ,Rating scale ,Pandemic ,depression ,medicine ,Marital status ,Anxiety ,Medicine ,medicine.symptom ,Psychiatry ,education ,business ,Depression (differential diagnoses) - Abstract
Introduction: Corona Virus Disease (COVID-19) outbreak is one of the biggest medical challenges to humankind in recent times, started from China in December 2019, and had spread to almost all the countries of the world The social, psychological and economic fissures exposed by the pandemic resulted in mass disruption in human behaviour population This is pushing them towards more stress Aim: To analyse the anxiety and depressive symptoms in COVID-19 positive patients Materials and Methods: A cross-sectional study was conducted on 325 COVID positive patients who were admitted in isolation ward in tertiary care centre and were enrolled in this study, out of which 18 refused to give the consent and 5 were already taking psychiatric medications and were excluded Telephonic contact was not established with rest of the 5 patients After ethical clearance, the anxiety and depressive symptoms were assessed by using Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D), respectively by using paired t-test Results: Maximum patients belonged to age group of 21-40 years (54 9%) Maximum patients were males (70%) Almost 3/4th of the population (64%) had depressive symptoms of different severity and 61% had anxiety symptoms Significant association of anxiety symptoms was seen with gender (p=0 001) and marital status (p=0 002) No association with depressive symptoms was seen with gender (p=0 087) and marital status (p=0 399) Conclusion: COVID-19 had significant impact on the patients More than half of the population had showed the psychological issues in the form of anxiety and depression Males and married patients were affected more with both anxiety and depressive symptoms [ABSTRACT FROM AUTHOR] Copyright of Journal of Clinical & Diagnostic Research is the property of JCDR Research & Publications Private Limited and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )
- Published
- 2021
22. Authors' response
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Parul Chawla Gupta, Praveen Kumar M, and Jagat Ram
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Medicine ,General Medicine ,General Biochemistry, Genetics and Molecular Biology - Published
- 2021
23. Alternate iris bypass technique of iridodialysis repair
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Jagat Ram, R Balamurugan, Surbhi Khurana, Parul Chawla Gupta, and Vijay Kumar Sharma
- Subjects
Novel technique ,medicine.medical_specialty ,genetic structures ,iridodialysis repair ,medicine.medical_treatment ,Iris ,Intraocular lens ,Cataract Extraction ,urologic and male genital diseases ,Traumatic iridodialysis ,Pupil ,Cataract ,lcsh:Ophthalmology ,iris repair ,Ophthalmology ,medicine ,Humans ,Iris (anatomy) ,Phacoemulsification ,Iridodialysis ,urogenital system ,Corectopia ,business.industry ,fungi ,medicine.disease ,eye diseases ,medicine.anatomical_structure ,Iris Diseases ,lcsh:RE1-994 ,medicine.symptom ,business ,traumatic iridodialysis - Abstract
We describe a novel technique “alternate iris bypass technique” of iridodialysis repair in four patients experiencing traumatic iridodialysis along with cataract. In these cases, we have combined iridodialysis repair with phacoemulsification and intraocular lens implantation. The main advantage of this technique is that edges of the iridodialysis can be visible till the end of the repair by bypassing the iris tissue in alternate bites which helps in minimizing the corectopia of the pupil and localized iris clumping.
- Published
- 2020
24. Compliance to spectacle use in children with refractive errors- a systematic review and meta-analysis
- Author
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Parul Chawla Gupta, Meenu Singh, Mona Duggal, Sankalp Dudeja, Nonita Dhirar, Jagat Ram, and Nishant Jaiswal
- Subjects
medicine.medical_specialty ,Adolescent ,Databases, Factual ,Visual Acuity ,CINAHL ,Compliance (psychology) ,03 medical and health sciences ,0302 clinical medicine ,Vision Screening ,lcsh:Ophthalmology ,medicine ,Humans ,030212 general & internal medicine ,Child ,Children ,Health Education ,business.industry ,Spectacle ,Refractive error ,General Medicine ,Refractive Errors ,Ophthalmology ,Study heterogeneity ,Systematic review ,Eyeglasses ,lcsh:RE1-994 ,Family medicine ,Meta-analysis ,030221 ophthalmology & optometry ,Patient Compliance ,Observational study ,Health education ,Spectacles ,business ,Research Article ,Compliance - Abstract
Background Primary objective of this review was to measure compliance with spectacle use in children with refractive errors. Secondary objective was to understand the reasons for non-compliance. Methods The databases searched were Ovid, EMBASE, CINAHL and Pubmed. All studies up to March, 2018 were included. The search terms were- ((((((Compliance [Title/Abstract]) OR Adherence [Title/Abstract]) OR Compliant [Title/Abstract]) OR Adherent [Title/Abstract])) AND (((Spectacle [Title/Abstract]) OR Spectacles [Title/Abstract]) OR Eye Glasses [Title/Abstract])) AND ((((Child [Title/Abstract]) OR Children [Title/Abstract]) OR Adolescent [Title/Abstract]) OR Adolescents [Title/Abstract]). Two researchers independently searched the databases and initial screening obtained 33 articles. The PRISMA guidelines were followed for conducting and writing the systematic review. Two reviewers assessed data quality independently using the Quality Assessment tool for systematic reviews of observational studies (QATSO). Poor quality studies were those, which had a score of less than 33% on the QATSO tool. Sensitivity analysis was done to determine if poor quality studies effected compliance. Galbraith plot was used to investigate statistical heterogeneity amongst studies. A random effects model was used to pool compliance. Results Twenty-three studies were included in the review, of which 20 were included in the quantitative analysis. All the studies were cross sectional. The overall compliance with spectacle use was 40.14% (95% CI- 32.78-47.50). The compliance varied from 9.84% (95% CI = 2.36–17.31) to 78.57% (95% CI = 68.96–88.18). The compliance derived in sensitivity analysis was 40.09%. Reasons for non-compliance were broken/lost spectacles, forgetfulness, and parental disapproval. Conclusion Appropriate remedial measures such as health education and strengthening vision care services will be required to address poor compliance with spectacle use among children.
- Published
- 2020
25. Epidemiology of Congenital Rubella Syndrome (CRS) in India, 2016-18, based on data from sentinel surveillance
- Author
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Mini P Singh, Suji George, Kuldeep Singh, Jagat Ram, Jyoti Kolekar, Daisy Khera, Munivenkatappa Ashok, R. Sabarinathan, Asha Mary Abraham, Nidhi Kaushal, Radha K. Ratho, Valsan Philip Verghese, Devika Shanmugasundaram, Ashish Bavdekar, Sridhar Santhanam, Manoj V Murhekar, Madhu Gupta, Neelam Vaid, S. S. Naik, Pradeep Haldar, Ravisekhar Gadepalli, Naveen Benakappa, Sandeep Kadam, Manoj Kumar Rohit, Mallika Aggarwal, Urvashi Nehra, S Mahantesh, Vijaya Lakshmi Nag, Sanjay Verma, Praveen Kumar, Rajlakshmi Viswanathan, Gajanan N. Sapkal, Sanjay Shah, Vykuntaraju K Gowda, Parul Chawla Gupta, Pratibha Singh, S. Manasa, Sanjay Munjal, Nivedita Gupta, Ravinder Kaur Sachdeva, and Neeraj Gupta
- Subjects
0301 basic medicine ,Male ,Pediatrics ,Viral Diseases ,Epidemiology ,RC955-962 ,Otology ,Deafness ,Antibodies, Viral ,Serology ,Geographical Locations ,Families ,0302 clinical medicine ,Arctic medicine. Tropical medicine ,Medicine and Health Sciences ,Hearing Disorders ,Children ,medicine.diagnostic_test ,Heart ,Clinical Laboratory Sciences ,Clinical Laboratories ,Infectious Diseases ,Female ,Sample collection ,Anatomy ,Public aspects of medicine ,RA1-1270 ,Infants ,Research Article ,Adult ,medicine.medical_specialty ,Asia ,Adolescent ,Infectious Disease Control ,030231 tropical medicine ,Rubella Syndrome, Congenital ,India ,Physical examination ,Disease Surveillance ,Rubella ,Measles ,03 medical and health sciences ,Young Adult ,Diagnostic Medicine ,Ocular System ,medicine ,otorhinolaryngologic diseases ,Humans ,Congenital rubella syndrome ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,Infant, Newborn ,Infant ,Biology and Life Sciences ,medicine.disease ,030104 developmental biology ,Immunoglobulin M ,Otorhinolaryngology ,Age Groups ,Infectious Disease Surveillance ,People and Places ,Cardiovascular Anatomy ,Eyes ,Population Groupings ,business ,Sentinel Surveillance ,Head - Abstract
Background Government of India is committed to eliminate measles and control rubella/congenital rubella syndrome (CRS) by 2020. In 2016, CRS surveillance was established in five sentinel sites. We analyzed surveillance data to describe the epidemiology of CRS in India. Methodology/Principal findings We used case definitions adapted from the WHO-recommended standards for CRS surveillance. Suspected patients underwent complete clinical examination including cardiovascular system, ophthalmic examination and assessment for hearing impairment. Sera were tested for presence of IgM and IgG antibodies against rubella. Of the 645 suspected CRS patients enrolled during two years, 137 (21.2%) were classified as laboratory confirmed CRS and 8 (1.2%) as congenital rubella infection. The median age of laboratory confirmed CRS infants was 3 months. Common clinical features among laboratory confirmed CRS patients included structural heart defects in 108 (78.8%), one or more eye signs (cataract, glaucoma, pigmentary retinopathy) in 82 (59.9%) and hearing impairment in 51. (38.6%) Thirty-three (24.1%) laboratory confirmed CRS patients died over a period of 2 years. Surveillance met the quality indicators in terms of adequacy of investigation, adequacy of sample collection for serological diagnosis as well as virological confirmation. Conclusions/Significance About one fifth suspected CRS patients were laboratory confirmed, indicating significance of rubella as a persistent public health problem in India. Continued surveillance will generate data to monitor the progress made by the rubella control program in the country., Author summary Rubella infection during the first trimester of pregnancy can affect the fetus, resulting in spontaneous abortion, stillbirth or an infant born with a combination of birth defects known as congenital rubella syndrome (CRS). Government of India is committed to eliminate measles and control rubella/CRS and has completed nationwide immunization campaigns using measles-rubella vaccine targeting children aged 9 months to 14 years. A case-based surveillance for CRS is one of the strategies for achieving elimination. The Indian Council of Medical Research and the Ministry of Health and Family Welfare initiated surveillance for CRS in five sentinel sites to estimate the disease burden. During 2016–18, the surveillance sites enrolled 645 suspected CRS patients, 137 (21.2%) were classified as laboratory confirmed CRS and 8 (1.2%) as congenital rubella infection. Common clinical features among laboratory confirmed CRS patients included structural heart defects (78.8%), one or more eye signs (cataract, glaucoma, pigmentary retinopathy (59.9%)) and hearing impairment (38.6%). Thirty-three (24.1%) laboratory confirmed CRS patients died over a period of 2 years. The surveillance data indicated significance of rubella as persistent public health problem in India.
- Published
- 2020
26. Association of screen time, quality of sleep and dry eye in college-going women of Northern India
- Author
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Parul Chawla Gupta, Minakshi Rana, Mamta Ratti, Mona Duggal, Aniruddha Agarwal, Surbhi Khurana, Deepak Jugran, Nisha Bhargava, and Jagat Ram
- Subjects
Adult ,Adolescent ,SARS-CoV-2 ,mini sleep questionnaire ,COVID-19 ,India ,Bayes Theorem ,RE1-994 ,Screen Time ,digital eye strain ,Young Adult ,Ophthalmology ,Cross-Sectional Studies ,Sleep Quality ,Surveys and Questionnaires ,latent class analysis ,Quality of Life ,Humans ,computer vision syndrome ,Dry Eye Syndromes ,Female ,speed questionnaire ,Sleep - Abstract
Purpose: To evaluate the association of daily screen time and quality of sleep with the prevalence of dry eye among college-going women. Methods: This study was a cross-sectional, comparative questionnaire-based study of 547 college-going women in northern India. A 10-item Mini Sleep Questionnaire was used to check the quality of sleep, and the Standard Patient Evaluation of Eye Dryness (SPEED) scale was used to examine the prevalence of dry eye among college-going women. Results: Multinomial logistic regression showed a significant association between dry eye with daily screen time spent (P < 0.05) and the quality of sleep (P < 0.05) among college-going girls. Using Latent Class Analysis, two latent classes were selected based on the Bayesian Information Criteria. It was found that the majority population falls in class two and was having Severe Sleep-Wake difficulty. It was seen that the participants in class two belonged to the age bracket of 18–21 years, were from stream Humanities, education of father and mother equal to graduation, father working only, belonging to the nuclear family, having one sibling, hailing from the urban locality, spending more than 6 h daily on-screen, a majority of them using mobile phones, not using eye lubricants, and reported an increase in screen time during COVID-19. Conclusion: Dry eye and sleep quality are essential global health issues, and coupled with increased screen time, may pose a challenge in the present era. Preventive strategies need to be incorporated in school and college curriculums to promote physical, social, and psychological well-being and quality of life.
- Published
- 2022
27. Lack of association between lysyl oxidase-like 1 polymorphism in pseudoexfoliation syndrome and pseudoexfoliation glaucoma in North Indian population
- Author
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Jagat Ram, Alka Khera, Sushmita Kaushik, Partha Chakma, Natasha Gautam Seth, Faisal Thattaruthody, Parul Chawla Gupta, Srishti Raj, Madhu Khullar, Surinder Singh Pandav, and Neera Chugh
- Subjects
Male ,medicine.medical_specialty ,Pseudoexfoliation syndrome ,India ,Glaucoma ,Single-nucleotide polymorphism ,Exfoliation Syndrome ,Polymerase Chain Reaction ,Polymorphism, Single Nucleotide ,03 medical and health sciences ,0302 clinical medicine ,Pseudoexfoliation glaucoma ,Asian People ,Gene Frequency ,Ophthalmology ,Lysyl oxidase like 1 ,Humans ,Medicine ,Genetic Association Studies ,Aged ,Genetic association ,Aged, 80 and over ,North indian population ,business.industry ,Pseudoexfoliation ,Exons ,General Medicine ,Middle Aged ,medicine.disease ,eye diseases ,Case-Control Studies ,030221 ophthalmology & optometry ,Female ,Amino Acid Oxidoreductases ,business ,Glaucoma, Open-Angle ,030217 neurology & neurosurgery - Abstract
Introduction:Pseudoexfoliation syndrome is commonly associated with pseudoexfoliation glaucoma. The two nonsynonymous single-nucleotide polymorphisms rs1048661 (R141L) and rs3825942 (G153D) within exon 1 of LOXL1 gene have been found to confer risk of pseudoexfoliation syndrome and pseudoexfoliation glaucoma in different geographical populations. This study aims to find association between two nonsynonymous single-nucleotide polymorphisms with pseudoexfoliation syndrome and pseudoexfoliation glaucoma in North Indian population.Methods:North Indian subjects clinically diagnosed with pseudoexfoliation syndrome/pseudoexfoliation glaucoma and normal age-matched control were enrolled in the study. Genomic DNA was extracted and the two single-nucleotide polymorphisms of LOXL1 gene were genotyped by polymerase chain reaction and sequencing. The association between single-nucleotide polymorphisms with pseudoexfoliation syndrome/pseudoexfoliation glaucoma was evaluated by chi-square test.Results:A total of 30 pseudoexfoliation glaucoma, 27 pseudoexfoliation syndrome and 61 control subjects were enrolled in the study. Patients with pseudoexfoliation syndrome and pseudoexfoliation glaucoma did not show any genetic association with either single-nucleotide polymorphism rs1048661 or rs3825942.Conclusion:The study shows lack of association between LOXL1 single-nucleotide polymorphisms and pseudoexfoliation in North Indian population.
- Published
- 2018
28. Visual outcomes of pediatric traumatic cataracts
- Author
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Sonam Yangzes, Rohit Gupta, Jagat Ram, Jitender Jinagal, Gaurav Gupta, Rishiraj Singh, and Parul Chawla Gupta
- Subjects
Male ,medicine.medical_specialty ,Visual acuity ,Adolescent ,genetic structures ,medicine.medical_treatment ,Visual Acuity ,Vitrectomy ,Tertiary care ,Cataract ,03 medical and health sciences ,0302 clinical medicine ,Lens Implantation, Intraocular ,Cataracts ,Ophthalmology ,Lens, Crystalline ,Humans ,Medicine ,Child ,Lens crystalline ,Phacoemulsification ,business.industry ,Medical record ,Infant ,General Medicine ,medicine.disease ,Eye Injuries, Penetrating ,eye diseases ,Child, Preschool ,030221 ophthalmology & optometry ,Referral center ,Female ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Introduction:To report visual outcomes and risk factors of pediatric traumatic cataracts in a tertiary care referral center in northern India.Methods:We analyzed medical records of traumatic cataracts in the pediatric age group (1–15 years) operated for cataract surgery with or without posterior chamber intraocular lens implantation with or without primary posterior capsulotomy with anterior vitrectomy between 2004 and 2012. Causative agents, types of trauma, demographic factors, surgical interventions, complications, and visual acuity were recorded and compared among different groups.Results:A total of 147 children were documented to have undergone cataract surgery for traumatic cataract in the study period, male-to-female ratio being approximately 5:1. Mean age was 7.67 ± 3.30 years (range, 1–15 years). Type of primary insult was penetrating injury in 100 (68%) patients and blunt trauma in 47 (32%) patients. Mean interval between injury and cataract surgery in penetrating injury cases was 3.84 ± 7.05 months and in the blunt injury cases was 6.28 ± 11.13 months. Preoperatively, only 110 patients were cooperative for visual acuity. Out of them, none had vision better than 6/18 and only 21 patients (19.9%) had vision of ≥6/60. Visual acuity of 6/18 or better (was considered good visual outcome) was achieved by 87.9%, 97.3%, and 97.9% at 1, 6, and 36 months, postoperatively. Eyes which underwent primary posterior capsulotomy and anterior vitrectomy during cataract surgery showed statistically better visual outcome than those without it.Conclusion:Phacoaspiration with posterior chamber intraocular lens implantation along with primary posterior capsulotomy and anterior vitrectomy and timely introduction of amblyopia therapy helped in gaining good visual outcome in pediatric traumatic cataract patients irrespective of the age of presentation and the type of injury.
- Published
- 2018
29. Conjunctival melanoma in a child: A clinicopathological report
- Author
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Vijay Kumar Sharma, Kim Vaiphei, Jagat Ram, Sonam Yangzes, and Parul Chawla Gupta
- Subjects
medicine.medical_specialty ,Conjunctiva ,medicine.medical_treatment ,Cryotherapy ,Case Report ,Lesion ,03 medical and health sciences ,0302 clinical medicine ,lcsh:Ophthalmology ,Cornea ,Biopsy ,Medicine ,030223 otorhinolaryngology ,medicine.diagnostic_test ,business.industry ,Mitomycin C ,eye diseases ,Surgery ,Ophthalmology ,medicine.anatomical_structure ,lcsh:RE1-994 ,030221 ophthalmology & optometry ,Histopathology ,sense organs ,medicine.symptom ,business ,Conjunctival Melanoma - Abstract
We report a case of a 16 years old Asian Indian boy who presented with a large brownish lesion measuring 20 × 12 mm on the temporal conjunctive in his right eye. Anterior segment optical coherence topography revealed cystic spaces without scleral involvement. The patient underwent conjunctival excisional biopsy using “no touch” technique with double freeze-thaw cryotherapy to underside of the adjacent conjunctival margins. Excision involved 4 mm of the surrounding apparently normal conjunctiva. Absolute alcohol epitheliectomy was done at the limbus and surrounding 2 mm of cornea to devitalize residual atypical melanocytes if any. Histopathology confirmed diagnosis of conjunctival melanoma. We started the patient on topical mitomycin C 0.04% with one weekly on and off cycles postoperatively. No recurrence was noted after nine months follow up. Keywords: Conjunctival melanoma, Asian child, Anterior segment optical coherence topography, Melanoma histopathology
- Published
- 2018
30. Pigmented Corneal Ulcer
- Author
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Sonam Yangzes, Jagat Ram, Parul Chawla Gupta, and Vivek Jha
- Subjects
Voriconazole ,Keratitis ,medicine.medical_specialty ,Slit lamp ,Itraconazole ,business.industry ,Case Report ,medicine.disease ,corneal ulcer ,Dermatology ,Ophthalmology ,Phaeohyphomycosis ,Natamycin ,lcsh:Ophthalmology ,Pigmented ,lcsh:RE1-994 ,Amphotericin B ,medicine ,sense organs ,business ,Corneal Ulcer ,medicine.drug - Abstract
Purpose: To report the clinical characteristics, laboratory findings, and treatment of a rare case of keratitis caused by pigmented fungi Bipolaris hawaiiensis. Case Report: A 55-year-old man presented with a history of trauma with vegetative matter in his left eye. Slit lamp biomicroscopic examination revealed the presence of a brownish-black pigmented plaque with surrounding infiltrates. Corneal scrapings revealed multiple septate hyphae. Culture revealed growth of the Bipolaris species. The patient was treated with topical natamycin 5%, topical voriconazole 1%, and oral itraconazole followed by intracameral amphotericin B (5 μg/mL). The patient responded well to the treatment. Conclusion: Brown pigmented infiltrates are an important clinical feature of dematiaceous fungi. B. hawaiiensis is a rare cause of corneal phaeohyphomycosis. Our patient responded well to intracameral amphotericin B, which obviated the need for penetrating keratoplasty.
- Published
- 2019
31. Systemic toxicity of topical corticosteroids
- Author
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Jagat Ram, Parul Chawla Gupta, Rakesh Kumar Pilania, and Jitender Jinagal
- Subjects
Intraocular pressure ,medicine.drug_class ,medicine.medical_treatment ,Intraocular lens ,Case Reports ,Cushingoid habitus ,03 medical and health sciences ,0302 clinical medicine ,Therapeutic index ,lcsh:Ophthalmology ,medicine ,Tobramycin ,Posterior Capsulotomy ,business.industry ,topical corticosteroids ,Ophthalmology ,lcsh:RE1-994 ,Anesthesia ,030221 ophthalmology & optometry ,Corticosteroid ,Homatropine ,business ,030217 neurology & neurosurgery ,side effects of corticosteroids ,Topical steroid ,medicine.drug - Abstract
Corticosteroids are known to cause many ocular and systemic side effects when administered by oral or parenteral routes. Corticosteroid induced systemic toxicity secondary to topical steroid eye drops is rare. A 6-week-old, male infant was brought to our tertiary eye care center with bilateral congenital cataracts. The child underwent phacoaspiration with primary posterior capsulotomy without intraocular lens implantation in both eyes at an interval of 6 weeks. Child was initiated on topical betamethsone 0.1% eight times a day, tobramycin 0.3% six times a day, homatropine 2% twice a day, and carboxymethylcellulose 0.5% four times a day. Two and four weeks later he underwent surgical membranectomy in the right and left eye respectively followed by frequent use of topical steroids, initially given 1 hourly and then tapered weekly in the follow-up period. The patient showed increase in intraocular pressure and gain in body weight along with development of cushingoid habitus nearly 6 to 8 weeks after starting topical steroids. These side effects started weaning off following the reduction in dose of topical steroids, suggesting the role of the corticosteroid-related systemic side effects. This case highlights the serious systemic side effects secondary to increased frequency and duration of topical corticosteroid use in infancy. Hence, dosage of topical steroids should be adjusted in its therapeutic range to prevent their ocular and systemic side effects. Therefore, close monitoring is advocated for children using topical corticosteroids to prevent serious ocular and systemic side effects.
- Published
- 2019
32. A clinicopathological study of persistent fetal vasculature
- Author
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Parul Chawla Gupta, Kim Vaiphei, Surbhi Khurana, Jagat Ram, and Ramandeep Singh
- Subjects
Male ,medicine.medical_specialty ,genetic structures ,medicine.medical_treatment ,Microscopy, Acoustic ,Glaucoma ,Intraocular lens ,Vitrectomy ,Cataract ,03 medical and health sciences ,0302 clinical medicine ,lcsh:Ophthalmology ,Ophthalmology ,medicine ,Humans ,Prospective Studies ,Posterior Capsulotomy ,Persistent fetal vasculature ,Hyphema ,Congenital cataract ,persistent fetal vasculature ,Lenses, Intraocular ,Phacoemulsification ,business.industry ,histopathology of persistent fetal vasculature ,persistent hyperplastic primary vitreous ,Infant, Newborn ,Infant ,Retinal detachment ,Prognosis ,medicine.disease ,eye diseases ,Vitreous Body ,Persistent hyperplastic primary vitreous ,lcsh:RE1-994 ,030221 ophthalmology & optometry ,Original Article ,sense organs ,business ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
Purpose: To study the clinicopathological findings of Persistent Fetal Vasculature (PFV) in patients with congenital cataract and PFV. Methods: Six eyes with anterior or combined PFV with cataract underwent phacoaspiration with primary posterior capsulotomy with anterior vitrectomy with intraocular lens implantation followed by histopathological evaluation of the PFV stalk and membrane. Results: Four and two patients had combined and anterior PFV respectively. There was no postoperative hyphema, vitreous haemorrhage, glaucoma or retinal detachment in six months. Haematoxylin and eosin staining showed inflammatory cells predominantly with extramedullary hematopoeisis and vascularisation. Conclusion: We recommend IOL implantation in PFV, with early and aggressive amblyopia therapy.
- Published
- 2019
33. Corneal Cloudiness: A Presenting Feature of Mucopolysaccharidosis Type I
- Author
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Jagat Ram, Ranjan Kumar Behera, H. P. Singh, Parul Chawla Gupta, and Surbhi Khurana
- Subjects
Mucopolysaccharidosis type I ,medicine.medical_specialty ,business.industry ,Feature (computer vision) ,Pediatrics, Perinatology and Child Health ,Medicine ,business ,Dermatology - Published
- 2021
34. Outcomes of cataract surgery in children with persistent hyperplastic primary vitreous
- Author
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Parul Chawla Gupta, Simar Rajan Singh, Manu Sharma, Jagat Ram, Sonam Yangzes, Jaspreet Sukhija, Ramandeep Singh, and Jitender Jinagal
- Subjects
Male ,medicine.medical_specialty ,Visual acuity ,genetic structures ,medicine.medical_treatment ,Treatment outcome ,Lens Capsule, Crystalline ,Visual Acuity ,Persistent Hyperplastic Primary Vitreous ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Lens Implantation, Intraocular ,Ophthalmology ,Primary vitreous ,Humans ,Medicine ,Posterior Capsulotomy ,Child ,Lenses, Intraocular ,Phacoemulsification ,business.industry ,Infant ,Unilateral cataract ,General Medicine ,Cataract surgery ,medicine.disease ,eye diseases ,Treatment Outcome ,Persistent hyperplastic primary vitreous ,Child, Preschool ,030221 ophthalmology & optometry ,Female ,sense organs ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
Purpose: To evaluate postoperative outcomes of cataract surgery in children with persistent hyperplastic primary vitreous (PHPV) and factors affecting outcomes. Methods: We analyzed 29 eyes of 28 children with PHPV presenting at a tertiary care center in northern India. All eyes underwent phacoaspiration followed by primary posterior capsulotomy with or without cauterization of persistent fetal vasculature under general anesthesia. Hydrophobic intraocular lens was implanted in selective cases. Postoperative outcomes such as clarity of visual axis, need for secondary surgical procedures, and complications were noted. Results: Out of a total of 28 children (16 male and 12 female), 27 were unilateral while 1 patient had bilateral involvement. Mean age at surgery was 25.14 months, ranging from 2 months to 144 months. Mean axial length of the globe at surgery was 19.66 ± 2.28 mm. Cataract surgery with intraocular lens implantation was done in 22 eyes whereas 7 were left aphakic. The most common intraoperative complication noted was intraoperative bleed in 11 eyes (37.9%) resulting in postoperative hyphema in 9 eyes (31%) and vitreous hemorrhage in 8 eyes (27.5%). Visual axis opacification was seen in 12 eyes and all required membranectomy. Three eyes developed glaucoma while retinal detachment was noted in 2 eyes and 1 of them became phthisical. Conclusions: Favorable outcome was more often achieved in anterior PHPV. Surgical outcomes in eyes with PHPV undergoing cataract surgery are limited by intraoperative and postoperative complications such as hyphema, vitreous hemorrhage, recurrent visual axis opacification, glaucoma, and retinal detachment.
- Published
- 2017
35. Knowledge and Attitude Toward Corneal Donation Among High School Children in Northern India
- Author
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Shreyaswi Sathyanath, Parul Chawla Gupta, Limalemla Jamir, Jagat Ram, Ankita Kankaria, Drishti Sharma, Mona Duggal, Rupinder Kaur, and Kirtan Rana
- Subjects
Male ,Health Knowledge, Attitudes, Practice ,medicine.medical_specialty ,Tissue and Organ Procurement ,Future studies ,Adolescent ,Cross-sectional study ,Private school ,education ,India ,Pledge ,Cornea ,Corneal Transplantation ,03 medical and health sciences ,0302 clinical medicine ,Field practice ,medicine ,Humans ,030212 general & internal medicine ,Child ,Hindi ,Government ,business.industry ,language.human_language ,Ophthalmology ,Cross-Sectional Studies ,Family medicine ,Donation ,030221 ophthalmology & optometry ,language ,Optometry ,Female ,business - Abstract
Purpose To assess the knowledge and attitude of school-going adolescents regarding corneal donation in government and private schools in an urban area of Northern India. Methods A school-based cross-sectional study was conducted in an urban field practice area of Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India. A total of 365 participants of the seventh to 10th grade were enrolled from a government school and a private school. A pretested, semistructured, self-administered, bilingual (English and Hindi) questionnaire was used to assess the sociodemographic profile and knowledge and attitude related to corneal donation. Results Most (87%) (confidence interval, 83.1%-90.0%) participants had heard about corneal donation. Only 2% of students answered all the knowledge-related questions correctly. None knew about the national toll-free number for corneal donation. Three-fourth (72%) supported the idea of corneal donation. Of them, only 44% (confidence interval, 41.0-47.1) were willing to pledge to donate their own eyes. Fears and myths were the persistent barriers. The government and private schools differed in both knowledge and attitude, with the latter performing better. Conclusions Knowledge among the selected high school children was poor. Although many supported the idea, only a few were willing to donate. We suggest that program components be evaluated from time to time. Future studies should explore the role of strengthening Information Education and Communication (IEC) activities among high school students for motivating community members to pledge to donate for corneal donation.
- Published
- 2017
36. Herpes zoster ophthalmicus with ocular involvement in overtreated hyperthyroidism
- Author
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Parul Chawla Gupta, Surbhi Khurana, Jagat Ram, and Ashok Kumar Singh
- Subjects
medicine.medical_specialty ,endocrine system ,endocrine system diseases ,reactivation of herpes zoster ,medicine.medical_treatment ,viruses ,Case Reports ,herpes zoster ophthalmicus ,Virus ,herpes zoster in thyroid disease ,lcsh:Ophthalmology ,Immunity ,medicine ,Lateral tarsorrhaphy ,integumentary system ,business.industry ,Thyroid disease ,virus diseases ,Immunosuppression ,medicine.disease ,Dermatology ,Conservative treatment ,Ophthalmology ,Herpes Zoster Ophthalmicus ,lcsh:RE1-994 ,Thyroid hormones ,business - Abstract
A 25-year-old man, with a history of hyperthyroidism presented with herpes zoster ophthalmicus (HZO) with neurotrophic ulcer and superadded infection 4 weeks after a sudden decrease in his thyroid hormones, caused by overtreatment of hyperthyroidism and radioactive iodine therapy. He underwent lateral tarsorrhaphy and was started on conservative treatment for the ulcer. The ulcer had resolved after 2 months. HZO is caused by reactivation of varicella-zoster virus by a decline in cell-mediated immunity. The decrease in thyroid hormones can also reactivate varicella-zoster by immunosuppression. This case highlights the importance of stability in thyroid hormones in a patient with thyroid disease and history of varicella.
- Published
- 2020
37. Compliance with spectacle use in children with refractive errors- a systematic review and meta-analysis
- Author
-
Nonita Dhirar, Sankalp Dudeja, Mona Duggal, Parul Chawla Gupta, Nishant Jaiswal, Meenu Singh, and Jagat Ram
- Abstract
Background Primary objective of this review was to measure compliance with spectacle use in children with refractive errors. Secondary objective was to understand the reasons for non-compliance.Methods The databases searched were Ovid, EMBASE, CINAHL and Pubmed. All studies up to March, 2018 were included. The search terms were- ((((((Compliance [Title/Abstract]) OR Adherence[Title/Abstract]) OR Compliant[Title/Abstract]) OR Adherent[Title/Abstract])) AND (((Spectacle[Title/Abstract]) OR Spectacles[Title/Abstract]) OR Eye Glasses[Title/Abstract])) AND ((((Child[Title/Abstract]) OR Children[Title/Abstract]) OR Adolescent[Title/Abstract]) OR Adolescents[Title/Abstract]). Two researchers independently searched the databases and initial screening obtained 33 articles. The PRISMA guidelines were followed for conducting and writing the systematic review. Two reviewers assessed data quality independently using the Quality Assessment tool for systematic reviews of observational studies (QATSO). Poor quality studies were those, which had a score of less than 33% on the QATSO tool. Sensitivity analysis was done to determine if poor quality studies effected compliance. Galbraith plot was used to investigate statistical heterogeneity amongst studies. A random effects model was used to pool compliance.Results Twenty-three studies were included in the review, of which 20 were included in the quantitative analysis. All the studies were cross sectional. The overall compliance with spectacle use was 40.14% (95% CI- 32.78-47.50). The compliance varied from 9.84% (95% CI=2.36-17.31) to 78.57% (95% CI=68.96-88.18). The compliance derived in sensitivity analysis was 40.09%. Reasons for non-compliance were broken/lost spectacles, forgetfulness, and parental disapproval.Conclusion Appropriate remedial measures such as health education and strengthening vision care services will be required to address poor compliance with spectacle use among children.
- Published
- 2019
38. Epithelial Ingrowth Post Phacoemulsification in a Case of Recurrent Pterygium
- Author
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R Balamurugan, Jagat Ram, Vivek Sharma, Parul Chawla Gupta, and Surbhi Khurana
- Subjects
medicine.medical_specialty ,Visual acuity ,Confocal ,Pterygium surgery ,medicine.medical_treatment ,Visual Acuity ,Epithelial ingrowth ,Pterygium ,Slit Lamp Microscopy ,Cataract ,Corneal Diseases ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,Ophthalmology ,medicine ,Recurrent pterygium ,Humans ,Aged ,Lenses, Intraocular ,Microscopy, Confocal ,Phacoemulsification ,business.industry ,Epithelium, Corneal ,medicine.disease ,eye diseases ,Left eye ,030221 ophthalmology & optometry ,Female ,sense organs ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Tomography, Optical Coherence - Abstract
Purpose To report an unusual case of epithelial ingrowth after phacoemulsification with posterior chamber intraocular lens implantation in a patient with recurrent pterygium, along with confocal microscopy findings of epithelial ingrowth. Methods This is a case report and review of the literature. Results A healthy 68-year-old woman presented with epithelial ingrowth with a best-corrected visual acuity of 6/60 in the left eye (-4.0 × 85 DC). She underwent pterygium surgery a decade ago, followed by recurrence 7 years later and an uneventful phacoemulsification surgery with posterior chamber intraocular lens implantation in the previous year. Confocal microscopy showed vacuolated cells in the area of epithelial ingrowth, which were similar to conjunctival cells of the pterygium. The postoperative period after cataract surgery was uneventful. Conclusions This is the first case report to document epithelial ingrowth after phacoemulsification in a patient with recurrent pterygium and that demonstrates confocal microscopy findings showing conjunctival cells of pterygium as the origin of epithelial ingrowth. We recommend making clear corneal side-port incisions during phacoemulsification away from the site of pterygium in such cases and to check for postoperative wound leaks and tissue incarceration.
- Published
- 2019
39. Microsporidial Keratoconjunctivitis
- Author
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R Balamurugan, Parul Chawla Gupta, Surya Prakash Sharma, Neeti Rana, and Jagat Ram
- Subjects
Ophthalmology ,lcsh:Ophthalmology ,lcsh:RE1-994 ,Photo Essay - Abstract
This is a Photo Essay and does not have an abstract.
- Published
- 2019
40. Nutritional Status and Micro Nutrient Deficiencies Among adolescents: A Pilot Study from Northern India (P18-101-19)
- Author
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Jagat Ram, Pragati Saxena, Mona Duggal, Limalemla Jamir, Ankita Kankaria, Akash Kumar, Reena Das, Deepy Zohmangaihi, Neha Singh, Parul Chawla Gupta, and Sandeep Grover
- Subjects
Nutrition and Dietetics ,Medicine (miscellaneous) ,Nutritional status ,Micronutrient ,medicine.disease ,Obesity ,Malnutrition ,MICROBIOLOGY PROCEDURES ,Geography ,Folic acid ,Environmental health ,medicine ,Nutritional Epidemiology ,Underweight ,medicine.symptom ,Food Science ,Sleep duration - Abstract
OBJECTIVES: To study the nutritional status and prevalence of RBC folate, Serum folate and vitamin D deficiency among adolescents. METHODS: A cross sectional pilot study was carried out among 96 adolescents visiting outpatient department for refraction at tertiary care hospital in North India. Anthropometric data was obtained for height in centimetres and weight in kilograms. A pretested questionnaire was used to capture quantitative data. Venous blood samples were collected where red blood cell (RBC), serum folate and serum Vitamin D concentrations were measured. Anaemia was defined as normal, mild, moderate and severe as Hb > 12gm/dl, 11–11.9 gm/dl, 8–10.9 gm/dl and
- Published
- 2019
41. Long-term outcomes of cataract surgery in children with uveitis
- Author
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Vishali Gupta, Jagat Ram, Parul Chawla Gupta, Sonam Yangzes, Natasha Gautam Seth, Ramandeep Singh, Surinder Singh Pandav, Jitender Jinagal, and Amod Gupta
- Subjects
Male ,medicine.medical_specialty ,Visual acuity ,Time Factors ,posterior chamber intraocular lens ,genetic structures ,Adolescent ,medicine.medical_treatment ,Visual Acuity ,Glaucoma ,India ,Vitrectomy ,Intraocular lens ,Cataract Extraction ,Aphakia ,Cataract ,Uveitis ,Postoperative Complications ,lcsh:Ophthalmology ,Ophthalmology ,medicine ,Prevalence ,Humans ,Child ,Retrospective Studies ,business.industry ,pediatric uveitis ,Phacoemulsification ,Cataract surgery ,medicine.disease ,eye diseases ,lcsh:RE1-994 ,Child, Preschool ,juvenile idiopathic arthritis ,Female ,Original Article ,sense organs ,uveitic cataract ,medicine.symptom ,business ,Follow-Up Studies - Abstract
Purpose: To evaluate the long-term outcomes of cataract surgery in children with uveitis. Methods: Retrospective, noncomparative review of medical records of children (≤16 years) with uveitic cataract who had undergone cataract surgery between January 2001 and December 2014 at a tertiary care center was done. The main outcome measures were visual acuity and postoperative complications. Results: We recruited 37 children (58 eyes) who were diagnosed with uveitic cataract and underwent cataract surgery. The etiology of uveitis included juvenile idiopathic arthritis (n = 19), presumed intraocular tuberculosis (n = 8), idiopathic (n = 4), Behçet's disease (n = 2), Vogt–Koyanagi–Harada syndrome (n = 2), human leukocyte antigen B-27 associated uveitis (n = 1), and toxocariasis (n = 1). Phacoemulsification with intraocular lens (IOL) implantation was performed in 17 patients (27 eyes; 46.55%), while 20 patients (31 eyes; 53.44%) were left aphakic after pars plan lensectomy and vitrectomy. At an average follow-up of 3.69 ± 7.2 (SD) years, all cases had significant improvement in corrected distance visual acuity post cataract extraction; visual acuity of 20/40 or more was achieved in 32 eyes (55.17%). The most common complication was capsular opacification (37.93%). Incidence of secondary procedures as well as glaucoma was not statistically different in patients undergoing IOL implantation from those who were aphakic. Conclusion: Even though number of secondary procedures was more in pseudophakic group, meticulous choice of surgical technique and adequate immunosuppression lead to a modest gain of visual acuity in children undergoing IOL implantation in uveitis. However, scrupulous case selection and aggressive control of pre- and postoperative intraocular inflammation are the key factors in the postoperative success of these patients.
- Published
- 2019
42. Premenstrual Syndrome and Associated Factors among Health Care Professionals: A Cross-sectional Study
- Author
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Anshu Mittal, Neha Jain, Parul Chawla Gupta, Anshu Gupta, and Poonam Bharti
- Subjects
premenstrual symptoms scale ,medicine.medical_specialty ,business.industry ,Cross-sectional study ,education ,lcsh:R ,Clinical Biochemistry ,lcsh:Medicine ,General Medicine ,menstrual cycle ,quality of life ,ovulation ,Family medicine ,Health care ,Medicine ,business - Abstract
Introduction: Premenstrual Syndrome (PMS) is the combination of physical, emotional, physiological and psychological symptoms felt by females after ovulation of each menstrual cycle which may affect the quality of life of the professionals. Aim: To assess the quality of life among Health Care Professionals (HCP) during PMS. Materials and Methods: This was a cross sectional descriptive study conducted at MMIMSR, Mullana to assess the quality of life among HCPs during premenstrual period. Total 493 subjects were enrolled out of 520 after excluding those who didn’t participate in the study. Subjects were assessed on three scalesSocio demographic Performa, Premenstrual Symptoms Scale (PMSS), Quality of Life (QoL-10). The results were computed with descriptive statistical methods (frequency tables, ANOVA) using SPSS 20 version (IBM Inc Chicago) software. Results: Out of 493 subjects 253 had PMS. The parameters which showed significant association with QoL were age (
- Published
- 2019
43. Impact of COVID-19 pandemic on cataract surgical volume: A North Indian experience
- Author
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Jagat Ram, Meenakshi Sharma, Punya Jain, Shruti Aggarwal, Deepak Jugran, Parul Chawla Gupta, and Surinder Singh Pandav
- Subjects
Government ,surgery backlog ,Coronavirus disease 2019 (COVID-19) ,SARS-CoV-2 ,business.industry ,india ,Volume (computing) ,COVID-19 ,monte carlo simulation ,RE1-994 ,Burnout ,North india ,time-series forecasting ,Tertiary care ,Ophthalmology ,Elective Surgical Procedures ,cataract ,Pandemic ,Humans ,Medicine ,business ,Pandemics ,Demography - Abstract
Purpose To analyze the impact of the pandemic on trends in cataract surgical volume in 2020 in a high-volume tertiary care academic center in North India. Methods The monthly cataract surgical volume for a large, high-volume, tertiary care academic center in North India was obtained from January 2018 through December 2020. Based on historical trends, we used time-series forecasting, probability sensitivity analysis, and linear regression models to estimate what the expected monthly cataract volume should have been from March 2020 onward. Results In 2020, we expected to perform 7500 cases (assuming historical trends) but performed only 2500 cases (33% of the expected volume). The remaining 5000 cases (67% cases) constituted the "fixed" backlog. Assuming the ramp-up in cataract surgical volume starts in January 2021, results of the Monte Carlo simulation revealed that for our system, it would take on average 5 months (May 2021) under the optimistic scenario and 10 months (October 2021) under the ambivalent scenario to reach pre-pandemic expected surgical volume. There would be a collective backlog of 5500 cases under the optimistic scenario (8.8 months' worth of cases) and a collective backlog of 6900 cases under the ambivalent scenario (11 months' worth of cases). Conclusion An intuitive approach and out-of-the-box solutions are required by the government and private institutes' collaborative efforts to help mitigate the disruptions caused by the pandemic and lessen the backlog without causing provider burnout.
- Published
- 2021
44. Toric intraocular lens implantation in children with developmental cataract and preexisting corneal astigmatism
- Author
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Parul Chawla Gupta, Jaspreet Sukhija, Jagat Ram, Garvit Bhutani, Rohit Gupta, and Rishiraj Singh
- Subjects
Male ,Cylindrical power ,medicine.medical_specialty ,Distance visual acuity ,Spherical power ,Visual acuity ,Adolescent ,genetic structures ,medicine.medical_treatment ,Visual Acuity ,Intraocular lens ,Astigmatism ,Prosthesis Design ,Refraction, Ocular ,Cataract ,03 medical and health sciences ,0302 clinical medicine ,Ophthalmology ,medicine ,Humans ,Prospective Studies ,Child ,Lenses, Intraocular ,business.industry ,General Medicine ,Cataract surgery ,medicine.disease ,Treatment Outcome ,030221 ophthalmology & optometry ,Female ,medicine.symptom ,business ,Corneal astigmatism ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
Purpose To evaluate the effect of toric intraocular lens (IOL) implantation on the refractive outcomes in children with cataract and preexisting corneal astigmatism. Methods We included children between the age group of 8–14 years who were randomized into group I (toric) and group II (non-toric), in which toric and spherical IOLs were implanted, respectively, after phacoaspiration. Primary outcome measure was comparison of preoperative keratometric and postoperative refractive cylinder. Secondary outcome measure was comparison of pre- and postoperative visual outcome. Results This study included 21 eyes of 17 children with developmental cataract. The mean spherical power of the toric IOLs implanted in the group I was 22.42 ± 4.84 D (range 12.50–29.00 D) and the mean cylindrical power of toric IOL was 3.37 ± 1.43 D (range 1.50–6.00D). The mean spherical power implanted in non-toric (group II) was 20.70 ± 7.09 D (range 10–31D). Mean preoperative keratometric cylinder in group I was 2.99 ± 0.96 D (range 1.85–5.12 D) and in group II it was 3.35 ± 0.63 D (range 2.03D–4.33 D) (p = 0.31) while the mean refractive cylinder at one year postoperatively in group I was 0.50 ± 0.39 D (range 0.00–1.00 D) and in group II it was 2.05 ± 0.39 D (range 1.25D–2.50 D; p = 0.006). Twelve months postoperatively, group I had a mean spherical equivalent (SE) 0.41 ± 0.26 D (range 0.00–0.88 D) and group II had 1.8 ± 1.03 D (range 0.63–4.00 D) (p = 0.002). Uncorrected distance visual acuity (UDVA) improved from 0.94 log MAR ± 0.51 (range 0.60–2.00) to 0.43 log MAR ± 0.33 (range 0.00–1.00) in the group I at the end of 1 year and in group II, it improved from 1.52 log MAR ± 1.12 to 0.75 log MAR ± 0.70 (range 0.00–2.00) at the end of 1 year. Corrected distant visual acuity (CDVA) improved in group I from 0.72 log MAR ± 0.17 (range 0.48–1.00) to 0.19 log MAR ± 0.26 (range 0.00- 0.78) at the end of one year while in group II, it improved from 1.33 ± 1.08 (range 0.18–3.00) to 0.49 log MAR ± 0.80 (range 0.00–2.00) at the end of 1 year. Conclusions Toric IOL implantation in children significantly reduces postoperative astigmatism and thereby improves visual outcome.
- Published
- 2016
45. Multiple-Scales Method and Numerical Simulation of Singularly Perturbed Boundary Layer Problems
- Author
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Parul Chawla Gupta and Manoj Kumar
- Subjects
0209 industrial biotechnology ,Numerical Analysis ,Computer simulation ,Applied Mathematics ,Mathematical analysis ,02 engineering and technology ,Singular boundary method ,01 natural sciences ,Computer Science Applications ,010101 applied mathematics ,Boundary layer ,020901 industrial engineering & automation ,Computational Theory and Mathematics ,0101 mathematics ,Analysis ,Mathematics - Published
- 2016
46. Phacoaspiration with a Cionni ring versus pars plana lensectomy, vitrectomy and sutureless transscleral IOL fixation in pediatric patients with a subluxated lens
- Author
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Jagat Ram, Parul Chawla Gupta, Aniruddha Agarwal, Bikram Bahadur Thapa, and Ramandeep Singh
- Subjects
medicine.medical_specialty ,Adolescent ,genetic structures ,medicine.medical_treatment ,Visual Acuity ,Vitrectomy ,Intraocular lens ,Fibrin Tissue Adhesive ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,Fixation (surgical) ,Postoperative Complications ,0302 clinical medicine ,Lens Implantation, Intraocular ,Ophthalmology ,Lens, Crystalline ,medicine ,Humans ,Glued IOL ,Prospective Studies ,Child ,Intraoperative Complications ,Ectopia lentis ,Fibrin glue ,Lenses, Intraocular ,Phacoemulsification ,Cionni ring ,business.industry ,Suture Techniques ,Lens Subluxation ,medicine.disease ,eye diseases ,Sensory Systems ,Surgery ,Child, Preschool ,Pars plana lensectomy ,030221 ophthalmology & optometry ,Tissue Adhesives ,sense organs ,business ,030217 neurology & neurosurgery - Abstract
To compare outcomes of phacoaspiration (PA) with Cionni ring-assisted posterior-chamber intraocular lens implantation (PCIOL) versus pars plana lensectomy (PPL) with anterior vitrectomy (AV) and sutureless transscleral fixation of the IOL (TSFIOL) assisted with fibrin glue in the management of a subluxated lens.In this prospective and comparative interventional study, one eye of children with a bilateral subluxated lens was randomized to undergo PA with PCIOL using a Cionni ring (group A: n = 14 eyes), and the other eye underwent PPL + AV with glue-assisted TSFIOL (group B: n = 14 eyes). The outcome measures included best-corrected visual acuity (BCVA) in logMAR units and rates of complications at 12-month follow-up visits.28 eyes of 14 children (age: 8.06 ± 4.49 years) were included in the study. BCVA improved from preoperative value of 1.21 to 0.4 (p = 0.001) in group A and from 1.53 to 0.31 (p = 0.001) in group B at month 12. There was no significant difference in the BCVA on comparing the two groups at month 12 (p 0.411). Postoperative complications in group A included corneal edema (two eyes), Cionni hook capture (one eye), elevated IOP (one eye), and posterior capsular opacification (five eyes). In group B, corneal edema was seen in two eyes, hypotony in one eye, vitreous hemorrhage in one eye and pupillary optic capture in four eyes.Head-to-head comparison of the two techniques demonstrates no significant difference in the rates of complications at month 12. The decision to choose either technique may be based on the operating surgeon's skill, experience and preference.
- Published
- 2016
47. Epidermal growth factor receptor mutation status in pulmonary adenocarcinoma: Multi-institutional data discussion at national conference of 'Lung Cancer Management in Indian context'
- Author
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Amanjit Bal, Deepak Mishra, Tripti Nakra, Divya Midha, Pragya Gupta, Nalini Gupta, Neeraj Arora, Deepali Jain, Aruna Nambirajan, Anurag Mehta, Varsha Singh, and Parul Chawla Gupta
- Subjects
Male ,0301 basic medicine ,Oncology ,Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,India ,Adenocarcinoma of Lung ,Context (language use) ,medicine.disease_cause ,03 medical and health sciences ,Exon ,T790M ,0302 clinical medicine ,Carcinoma, Non-Small-Cell Lung ,Internal medicine ,Biomarkers, Tumor ,medicine ,Humans ,Multicenter Studies as Topic ,Epidermal growth factor receptor ,Lung cancer ,Retrospective Studies ,Mutation ,biology ,business.industry ,Point mutation ,High-Throughput Nucleotide Sequencing ,Exons ,Middle Aged ,Prognosis ,medicine.disease ,ErbB Receptors ,030104 developmental biology ,030220 oncology & carcinogenesis ,biology.protein ,Adenocarcinoma ,Female ,business ,Follow-Up Studies - Abstract
The presence of activating mutations in the tyrosine kinase domain of the epidermal growth factor receptor (EGFR) gene in adenocarcinomas of lung confers sensitivity to tyrosine kinase inhibitor therapy. The prevalence of EGFR mutations varies among different ethnicities and demographic profile. This multi-institutional data was compiled to determine the EGFR mutation status in Indians patients with lung adenocarcinoma. Cohorts represented by 4 tertiary care hospitals participated in data discussion at a national conference entitled as 'Lung Cancer Management in Indian Context'. The clinicopathologic data and EGFR mutation rate in the patients of lung adenocarcinoma screened in these cohorts were collected and analyzed. The sample types included both surgical and cytological specimens. A variety of methods were used including immunohistochemistry, polymerase chain reaction, Sanger sequencing and next generation sequencing. A total of 3436 cases of treatment naïve lung adenocarcinoma were tested for EGFR mutations. The overall frequency of EGFR mutations observed was 30.03%. The most common baseline mutation detected was exon 19 deletion followed by L858R point mutation in exon 21. Dual mutations were observed in 6.5% of cases and were predominantly combinations of exon 19 deletion and T790M point mutation in exon 20. Incidence of EGFR mutations was higher among females and non-smokers diagnosed with lung adenocarcinomas. The most common histology in EGFR mutant cases was acinar predominant adenocarcinomas. With nearly one-third of Indian patients with lung adenocarcinoma harboring EGFR mutations, routine testing for these mutations is important to get the benefit of targeted therapy.
- Published
- 2020
48. Spoons in the eye
- Author
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Parul Chawla Gupta, Jagat Ram, and Surbhi Khurana
- Subjects
World Wide Web ,Ophthalmology ,business.industry ,Medicine ,Ophthalmic Images ,business - Published
- 2020
49. Globe rupture following eye rubbing in a case of Terrien's marginal degeneration in a young male
- Author
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Aman Kumar, Parul Chawla Gupta, Surbhi Khurana, and Jagat Ram
- Subjects
Corneal Dystrophies, Hereditary ,Male ,Globe rupture ,medicine.medical_specialty ,Eye rubbing ,business.industry ,Terrien's marginal degeneration ,Anterior segment OCT of Terrien's marginal degeneration ,medicine.disease ,Photo Essay ,Corneal Diseases ,Ophthalmology ,Eye Injuries ,lcsh:Ophthalmology ,lcsh:RE1-994 ,medicine ,Humans ,open globe injury in Terrien's marginal degeneration ,business ,Young male - Published
- 2020
50. Bilateral conjunctival suffusion: An ocular manifestation of leptospirosis
- Author
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Surbhi Khurana, Jagat Ram, and Parul Chawla Gupta
- Subjects
medicine.medical_specialty ,business.industry ,Conjunctival suffusion ,Ophthalmic Images ,medicine.disease ,Leptospirosis ,Dermatology ,Ophthalmology ,lcsh:Ophthalmology ,lcsh:RE1-994 ,Humans ,Medicine ,medicine.symptom ,business ,Conjunctiva - Published
- 2020
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