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Purpose: The aim of this study was to determine prevalence, symptoms frequency and associated risk factors of digital eye strain (DES) among children attending online classes during COVID-19 pandemic. Methods: The online electronic survey form was prepared on the Google app. Children/parents were asked to indicate the total duration of digital device use before and during COVID era. The symptoms of DES, its severity and frequency were recorded & measured with the Computer Vision Syndrome Questionnaire. Results: Two hundred and sixty one parents responded to the questionnaire, of these 217 were complete. Mean age of children was 13 ± 2.45 years. Mean duration of digital device used during COVID era was 3.9 ± 1.9 h which is more than pre COVID era (1.9 ± 1.1 h, P = 5 h in COVID era as compared to 1.8% (n = 4) before COVID era. The most common digital device used were smartphones (n = 134, 61.7%). One hundred and eight children (49.8%) were attending online classes for >2 h per day. Prevalence of DES in our cohort is 50.23% (109/217). Of these 26.3% were mild, 12.9% moderate and 11.1% of severe grade. Most common symptoms were itching and headache (n = 117, 53.9%). Multivariate analysis revealed age >14 years (P = 0.04), male gender (P = 0.0004), smartphone use (P = 0.003), use of device >5 h (P = 0.0007) and mobile games >1 h/day (P = 0.0001) as independent risk factors for DES in children. Conclusion: There is an increased prevalence of DES among children in COVID era. Parents should be considerate about duration, type and distance of digital device use to avoid DES symptoms in children.

Background: It is well known fact that tobacco kills up to half of its users. 8 million people are killed by the use of tobacco annually. Direct tobacco consumption is responsible for approx seven millions of these deaths and approx 1.2 million deaths due to tobacco use are due to the exposure of non smokers to second hand smoke. The present study was undertaken to study the prevalence of use of tobacco products among rural male students and their knowledge about its injurious effects. Aims and objectives:This study was undertaken to determine the prevalence of tobacco use among students residing in rural background and to assess their knowledge about injurious effects of tobacco products in any form. Material and Methods:The study was undertaken by using a detailed, predesigned questionnaire on the use of tobacco. Results: The prevalence of tobacco smoking was found to be 21% and smokeless tobacco as 37% on regular basis. Conclusion: Present study clearly demonstrates the common practice of tobacco consumption among students living in rural background and it is of deep concern. Knowledge about harmful effects of tobacco use certainly have role in restraining the tobacco habit among students.

Introduction: Among general people anti-thyroid antibodies and thyroid profile (TSH, T4, and T3) relation is not established. In several years presence of Anti-TPO antibodies may lead to progress of clinical thyroid disease. Therefore, to rule out underlying autoimmune method screening for Anti-TPO antibodies is required. Aim of the present study was to find an association of Anti-TPO antibodies in clinical and subclinical hypothyroidism. Materials and Methods: A cross sectional study was conducted in department of medicine and biochemistry involving 74 cases and 74 controls during the period of December 2017 to December 2018. Patien ts history, clinical examination and various investigations including FT3, FT4, TSH, Anti-TPO, FBG and lipid profile were done. Results: Out of 74 cases 30 cases had clinical hypothyroidism and 44 cases have subclinical hypothyroidism. 63.5% cases of hypothyroidism were Anti-TPO positive. 70.3% cases of Clinical hypothyroidism were Anti -TPO positive and subclinical hypothyroidism had 51.5% Anti-TPO positive. TSH had a significant positive correlation with Anti-TPO antibodies. Keywords: AntiTPO, Clinical hypothyroidism, Subclinical hypothyroidism, TSH, AntiTPO, Clinical hypothyroidism, Subclinical hypothyroidism, TSH.

Purpose: To know the pattern of presentations and management outcome of steroid induced glaucoma in vernal keratoconjunctivitis (VKC). Methods: Children of VKC using steroid with two of the following criteria were enrolled: Intraocular pressure (IOP) >21 mm Hg, glaucomatous optic disc and visual field defects. Misused topical steroids were classified in 4 groups; A- Highly potent drugs (dexamethasone, betamethasone), B- Moderate (prednisolone), C- Weak (loteprednol, fluorometholone), D- Unknown drugs. Active/conservative interventions were done to control IOP. Corrected distance visual acuity (CDVA), IOP, anterior segment and fundus examinations were noted. One-way ANOVA test and post hoc Tukey HSD test were used to compare the groups. Results: Out of 1423 VKC patients, 240 were using topical steroid without prescriptions. 92 eyes of 47 patients had steroid induced glaucoma. Hence prevalence of this complication was 3.30% in this study population. Mean age was 14.1 ± 3.8 years. Mean IOP was 38 ± 12 mm of Hg and mean vertical cup disc ratio was 0.67 ± 0.25. IOP was controlled by withdrawal of steroids (9 eyes), with antiglaucoma medications (27), trabeculectomy (57) and glaucoma drainage device (1). Mean CDVA at presentation was better in group C (0.23 log MAR). Mean IOP was highest in group A (43.1 mm Hg) followed by group D (40.5 mm Hg). At presentation 17 were blind (CDVA

Introduction. To confirm the efficacy and safety of substituting teneligliptin with hydroxychloroquine in inadequately control type 2 diabetes patients (T2DM) despite treatment with teneligliptin, metformin and glimepiride with or without other antidiabetic therapy. Material and methods. This is a multicentre observational, retrospective, 24 week clinical study performed in type 2 diabetes patients with HbA1c in the range of 7.5% to 9.5%. This patients were on teneligliptin 20 mg in addition of metformin and glimepiride with or without other antidiabetic therapy. Teneligliptin 20 mg treatment was replaced by hydroxychloroquine 400 mg. The primary endpoint was change in fasting blood glucose (FBG), postprandial blood glucose (PPBG) and HbA1c from baseline to week 24. The secondary outcome of the study was the proportion of patients who achieved good glycaemic control (HbA1c Results. Total of 500 patients’ data was analysed and after 24 week of follow up these patients presented with significant decrease in HbA1c (–1.1 ± 0.17%; p = 0.000); FBG (–29.87 ± 8.9 mg/dl), PPBG (–56.89 ± 9.2 mg/dl) with 52% of patients had achieved HbA1c levels Conclusions. In T2DM patients inadequately controlled on teneligliptin 20 mg along with combination of metformin and glimepiride with or without other antidiabetic therapy, substitute with hydroxychloroquine 400 mg may be a simple yet effective therapeutic option with clinical benefit beyond strict glycemic control without compromising patient’s safety.

Coronaviruses including the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are known to affect primarily the respiratory system with additional manifestations on the enteric, hepatic, and cardiac systems as well. Neurological manifestations are increasingly being reported from all over the world though only as case reports and short case series. Neurological manifestations are not uncommon and may be seen in up to a third of patients with COVID-19 infection and may range from minor symptoms of headache, dizziness, anosmia, and ageusia to severe neurological illnesses including encephalitis, acute necrotizing hemorrhagic encephalitis, stroke, myelitis, and Guillain–Barre syndrome. Neurological symptoms may occasionally be the presenting or sole manifestation of COVID-19 infection, and a high index of suspicion is required while dealing with such cases during the COVID-19 pandemic. A Medline search was made till June 20, 2020 using the keywords SARS-CoV-2, COVID-19, and Neurological Manifestations for the review.

Group A Rotavirus remains the leading cause of gastroenteritis in children and accounts for 0.2 million fatalities each year; out of which, approximately 47,100 deaths occur in India. In adults also, rotavirus is reported to be responsible for diarrhea severe enough to require hospitalizations. India has recently introduced rotavirus vaccine in the Universal Immunization Programme and Himachal Pradesh became the first Indian state to implement this project. This study is an attempt to provide the pre-vaccination data on rotavirus gastroenteritis burden and circulating genotypes in Himachal Pradesh, India. A total of 607 faecal specimens (247 children ≤5years, 50 older children and 310 adults) from hospitalized diarrheal patients from Himachal Pradesh, India were screened for rotavirus using ELISA and RT-PCR. The positive samples were further G/P genotyped using semi-nested PCR. Rotavirus was detected in 25.2% and 28.3% of samples with ELISA and RT-PCR, respectively. In children, rotavirus frequency was significantly high with positivity in 49.0% cases whereas 14.0% adult samples have rotavirus in them. Genotyping of the positive samples revealed predominance of G1 (66.0%) and P[6] (66.7%) genotypes. The most common G and P combination was G1P[6] (62.8%) followed by G1P[8] (16.5%), G9P[6] (7.4%) and G12P[6] (5.0%). Molecular analysis reveals the belonging of P[6] strains in Lineage 1a. This pre-vaccination data on rotavirus prevalence and diversity would be helpful for assessing the affect of vaccination on the disease burden and its comparison with post-vaccination data of circulating genotypes would help in studying the effect on diversity of rotavirus strains possibly due to vaccine selection pressure.

Diarrheal diseases are responsible for a significant proportion of mortality and morbidity all around the globe. The contribution of viruses to gastroenteritis incidences in humans is well established. In the present study, we have studied the prevalence of rotavirus, norovirus and enterovirus in Himachal Pradesh, a north Indian state. A total of 287 (111 children and 176 adults) stool samples of gastroenteritis patients were screened for the viruses using RT-PCR method. 34.5 % samples were positive for the viral pathogens of gastroenteritis. Rotavirus was the predominant virus detected in the study with 49.5 and 14.8 % positivity in children and adults, respectively. Enterovirus was present in 5.6 % cases whereas norovirus had least prevalence (1.4 %). Co infection (rotavirus and enterovirus) was witnessed at the prevalence rate of 0.6 %. Among different age groups, the prevalence of studied viruses was highest in the children belonging to the age groups of

Background: Diastolic dysfunction in patients suffering from diabetes mellitus represents an earlier stage in the natural history of cardiomyopathy. This study was done to assess the left ventricular diastolic dysfunction in recently diagnosed (

BACKGROUND: Diarrheagenic Escherichia coli (DEC) signifies as an important etiological agent of moderate‐to‐severe diarrhea. This study was primarily focused on molecular identification of DEC pathotypes; their association with serogroups and estimates of resistance profiles against different antibiotics regime. METHODS: Five hundred seventy‐two stool specimens from diarrhea patients were investigated for DEC pathotypes. Molecular pathotypes were identified by amplification of virulence genes associated with distinct pathotypes followed by sequencing. Diarrhea is a self‐limiting disease, however, severity and persistence of infection suggest antibiotic use. Therefore, AST and MIC were determined against common antibiotic regimen. Correlations between molecular pathotypes and serogroups were analyzed by somatic “O” antigen serotyping. RESULTS: The present findings reveal incidence of DEC as an etiological agent up to a level of 21% among all diarrheal age groups. DEC infection rate was higher in children. Enteropathogenic E. coli EPEC, a molecular pathotype of DEC, was found as a predominant pathotype with highest frequency of 13.7%. Two other molecular pathotypes enterotoxigenic E. coli (ETEC) and enteroaggregative E. coli (EAEC) accounted for 5.7% and 1.3%, respectively for all diarrhea incidences. Serological analysis deciphered somatic antigens O26, O2, and O3 as major serogroups identified among EPEC, ETEC, and EAEC pathotypes, respectively. All DEC pathotypes exhibited high levels of antibiotic resistance except for cotrimoxazole and norfloxacin. CONCLUSION: Comprehensive molecular characterization of DEC pathotypes, their incidence estimates, and antibiogram patterns will help in ascertaining better diagnostic and therapeutic measures in management of diarrheal diseases.