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With limited areas where people can work out, an increase in sedentary work with the growing popularity of desk jobs and television and video devices, inactive lifestyles are becoming more and more common around the world. The objective of the current review is to explore the role of sedentary habits in the causation of different diseases and their impact on global health standards. Consequently, the associated health problems are becoming more serious. Inactivity has a significant influence on the human body in numerous ways. It disrupts lipolysis, transporter proteins, muscle glucose, the metabolic process, and lipoprotein lipase functionality. Prolonged sedentary behavior directly impacts the gravity, body weight balance, and can lead to fluid retention, obesity, and an increase in oxidative stress. An inactive lifestyle has a range of adverse impacts on our bodies, including a surge in all-cause mortality, coronary heart disease mortality, and the probability of contracting diseases like diabetes mellitus, hypertension, and dyslipidemia, in addition to physical ailments like arthralgia and osteoporosis, mental health issues like depression, and mental retardation. Consequently, to advance public health, we need to reduce sedentary practices and increase physical activity.

In the context of medical education, empathy goes way beyond the delivery of effective patient care as it also remains one of the core competencies that medical students must cultivate during the course of their undergraduate training. The findings of different studies have reported a gradual decline in empathy among medical students during the course of their undergraduate training. A number of challenges and barriers have been identified in the development of empathy in medical education, which together can hinder the process of delivery of empathetic healthcare. In order to address these identified challenges, we will require collaborative efforts from administrators and teachers to enable the creation of a supportive environment, wherein empathy development is prioritized. In conclusion, the incorporation of empathy into medical practice has been linked with multiple benefits to patients, healthcare providers, and healthcare delivery system. However, considering the fact that a number of factors influence the development of empathy among medical students, it is the need of the hour to implement strategies to nurture empathy during medical education, which will enable the delivery of patient-centered care and the formation of strong doctor-patient relationships.

Practicing medicine is a stressful and complex process, wherein a lot is expected of the doctors and they have to be professional in their approach while discharging their duties. Acknowledging the importance of professionalism in medical practice, the practice of teaching and assessing professionalism has begun in most medical institutions. Even though a humble beginning has been made, in various settings it has been reported that medical students and/or doctors don’t behave professionally in their workplace. A wide range of challenges involving different stakeholders have been identified that play their part in hindering the medical students and practicing doctors to discharge their role as a professional. To conclude, professionalism is an important trait for all medical students to become successful in their clinical practice. However, the pathway to train medical students in professionalism is full of challenges. The need of the hour is to identify these challenges and devise solutions to overcome them to strengthen the overall process of training and assessment.

Background A medical teacher has a very complex job profile, wherein they are expected to train a cohort of newly joined medical aspirants to competent health care professionals. The current study was conducted to identify the challenges faced by the faculty members in medical teaching and to assess the perception of teachers on the role of medical education workshops in addressing these challenges. Methods It was a Mixed Methods study conducted over a period of 9 months from January to September 2021 in a tertiary teaching medical college and hospital of Chengalpet District of Tamil Nadu amongst the faculty members of the teaching medical college and hospital. In the first phase, universal sampling method was employed, wherein all faculty members were asked to fill the online semi-structured questionnaire. In the second phase, purposive sampling was employed, wherein all teachers who have a minimum teaching experience of 3 years and have attended any medical education workshop were included and interviewed using a focus group discussion guide. The quantitative date was analyzed using descriptive statistics, while the qualitative data was analyzed using manual content analysis. Results In the quantitative phase, 149 faculty members filled the online questionnaire, of which majority were females (52.3%) and were from the clinical departments (63.1%). The manual thematic content analysis of the FGD resulted in the identification of two themes (challenges and utility of workshops). The challenges theme consisted of three categories of Faculty, Students, and Administration, while Utility of workshops theme included two categories of refinement of skills, and suggestions for future Conclusion In conclusion, lack of teamwork in the department, multiple responsibilities assigned to a single person, and shortage of clinical material during COVID-19 were identified as the main challenges in teaching–learning. The medical education workshops play a significant role in improving the knowledge of various domains of teaching and assessment, introduction of innovations, and ensure better performance of the faculty members.

Introduction: Coronavirus Disease-2019 (COVID-19) infections may be associated with a wide range of opportunistic bacterial and fungal co-infections. Both Aspergillus and Candida have been reported as the main fungal pathogens for co-infection in people with COVID-19. During the COVID-19 pandemic, another threat has emerged as a challenge to India was in the form of COVID-associated mucormycosis. Aim: To study the incidence of COVID-associated rhino-orbital mucormycosis in vaccinated and unvaccinated patients. Materials and Methods: A prospective observational study was carried out at Gajra Raja Medical College and Jay Arogya Hospital, Gwalior, Madhya Pradesh, India, over a period of two months (May to June 2021). A total of 94 patients with post-COVID rhino-orbital mucormycosis were reported in the institute during the study period. Biopsy or postoperative surgical specimens were received for histopathological examination with a proper history of diabetes mellitus, steroid intake, and vaccination status. Histologically confirmed COVID-associated rhino-orbital mucormycosis cases were included in the study and its incidence was compared in vaccinated and unvaccinated patients. Results: Total 94 patients were confirmed histopathologically, with mucormycosis. It was noted that mucormycosis was more common in males as compared to females. Of the total number of cases, 71 (75.5%) cases had a history of diabetes mellitus and 73 (77.7%) had a history of steroid intake. Eighty-six (91.5%) cases were unvaccinated while only 8 (8.5%) were either completely or partially vaccinated. Incidence of mucormycosis was found to be more amongst unvaccinated patients as compared to vaccinated patients. Conclusion: Mucormycosis is one of the major post-COVID threats. Diabetes mellitus and steroid intake were found to be the main risk factors for post-COVID mucormycosis. However, it has also been noted that mucormycosis can occur without a previous history of diabetes and steroid intake. Incidence of mucormycosis was found to be higher amongst unvaccinated patients as compared to vaccinated patients. Hence, vaccination against COVID-19 is likely to be effective in the prevention of COVID-associated mucormycosis.

Context: Visual impairment is one of the major health-care problems in the world. People pursuing higher education with long hours of studies and excessive near work are more prone to develop refractive error causing visual impairment. Dental students come into this category. In this study, we are trying to evaluate the level of awareness and practices of dental undergraduates toward refractive errors. Aim: The aim of the study was to assess the level of awareness and various practices toward refractive error correction methods among dental undergraduate students of a tertiary care center in Navi Mumbai. Settings and Design: A cross-sectional study was done by recruiting dental undergraduate students as the subjects, after obtaining ethical approval from the institute and informed consent from the students. Subjects and Methods: A random sample of 198 undergraduate dental students were surveyed by a questionnaire. A similar study was conducted in the Goan population, and the questionnaire was taken from that study. Statistical Analysis: Statistical Package for the Social Sciences (SPSS v 21.0, International Business Machines (IBM)) was used for the statistical analysis. Results: Of 198, a total of 165 students, 58 males (35.15%) and 107 females (64.84%), had got their eyes examined. It was found that 135 students (68.2%) knew the difference between ophthalmologist and optometrist. Females have more usage of spectacles. The use of glasses was maximum among the students with family income >180,000/annum. Around 82 (41.4%) students using spectacles noticed that the use of glasses causes limiting effects on their activities. Hundred and four students were aware of the refractive surgeries. There was a statistically significant difference seen about the awareness between students having annual income 180,000/annum (P < 0.05), and 111 students knew about the side effects of refractive surgery. Conclusion: There is a lack of knowledge about refractive errors among dental students. It is important to create awareness among them and thereby in the society.

Coronavirus disease-2019 pandemic: Envisaging community involvement through clearing myths

A patient who is suffering from complete loss of one eye or one phthisical eye due to injury, inflammation, or tumor experiences lot of physical and psychological trauma. Ocular prostheses are used in the management of a wide variety of acquired and congenital anopthalmia. Several techniques have been used in fitting and fabricating artificial eyes. These eyes can be prefabricated or custom made, but a prosthesis that is lifelike in appearance provides a sense of psychological security to the patient, which is better achieved with custom ocular prosthesis. This article discusses series of cases made by utilizing one of the latest techniques of iris duplication (digital imaging) and also aims at enhanced awareness of the cosmetic benefits of custom designed ocular prosthesis when compared with stock eye.

Intensification of research activities in the battle against coronavirus pandemic

Aim: We aimed to detect a possible biomarker, in tear samples, for POAG. Method: It was a case–controlled prospective study conducted over a period of 2 years. Tear samples were collected from 30 glaucoma eyes to 30 control eyes tears were collected using a sterile capillary tube and then stored in the laboratory refrigerator at 0°C for measuring the Total antioxidant activity using modified nitroblue tetrazolium method. Protein estimation by modified Lowry's method for protein quantification (1951). Sodium dodecyl sulfate-polyacrylamide gel electrophoresis for protein profiling for various determination of molecular weight. Lipase estimation by Modified Winkler and Stuckmann method, 1979.Carbonic anhydrase-like enzyme activity using synthetic substrate. For Statistical analysis The data were entered in Microsoft Excel and analyzed using Stata Version 24. Results: The mean protein level in glaucoma patients in our study was 8.68 mg/ml, whereas the mean protein level in the control group was 8.34 mg/ml. There was no statistical difference in the mean protein level was between glaucoma and normal patients. Our study shows that the antioxidant activity was significantly lower in glaucoma patients, as compared to controls. The mean level of carbonic anhydrase-like enzymes in glaucoma patients' eyes was 12.90 IU/ml while the mean level for control eyes was 10.03 IU/ml. This is statistically significant. Glaucoma samples showed a mean lipase level of 0.05 IU/ml while controls showed a much higher value of 0.25 IU/ml. After matching the mean levels for age and sex, they were statistically significant. Conclusion: In our study, we found the levels of carbonic anhydrase, lipase, and antioxidants to be significantly different in glaucoma eyes. Each of these hold a promise of being useful as a predictive biomarker for POAG. Further studies need to be carried out to confirm all of the above findings and to thus find a sensitive and specific biomarker for glaucoma, which can be used as a screening tool in the near future.

AIM: The aim of this study is to evaluate the efficacy of 2% rebamipide ophthalmic solution on the tear functions and ocular surface status in patients with dry eyes. MATERIALS AND METHODS: A prospective study was carried out on forty eyes of patients having signs and symptoms of dry eye. Two percent rebamipide ophthalmic solution was applied four times a day for a period of 4 weeks. Patients were evaluated on the basis of dry eye-related symptom score, tear film break-up time (TFBUT), tear meniscus height, fluorescein ocular surface staining score (FOSS), and the Schirmer's test at the end of 2, 4, 6, and 12 weeks and their values were compared with the baseline. RESULTS: Significant improvement was noted in the mean dry eye-related symptom score, TBUT, and the FOSS values from the baseline at the end of 2, 4, 8, and 12 weeks. The values of tear meniscus height and Schirmer's test were improved at the end of 8 weeks but were not statistically significant. CONCLUSION: Nearly 2% rebamipide ophthalmic solution provided relief in the symptoms of patients having dry eyes. It also prevented further ocular surface damage and aided in stabilizing the tear film.

Developing a framework to respond to the coronavirus disease-2019 infodemic and the key considerations

Impact of COVID-19 pandemic on the attainment of universal health coverage and sustainable development goals

Cholera has been regarded as one of the major public health concerns of infectious origin in the low- and middle-income nations. It is quite encouraging to know that a decline of almost 60% was reported in the incidence of the cases in the year 2018, with a significant reduction in the number of cases in the high endemic nations. The reported decline is an outcome of the sustained commitment of policy makers, efforts of the health workers, community engagement and organization of the mass vaccination campaigns against the disease. In order to expedite the gains accomplished, the global readers have formulated a roadmap for attaining the specified target by 2030 and it lays down the plan to prevent and eventually eliminate the disease. In conclusion, despite the significant gains accomplished in the battle against the prevention and control of the disease, a lot needs to be done and this will essentially require a multisectoral and a concerted approach.

Human Immunodeficiency Virus (HIV) infection has been regarded as one of the major public health concerns affecting the general population worldwide. Even though, many people are getting appropriate treatment, many more have not been able to access the same due to not being diagnosed. In other words, diagnosis is the crucial step to ensure that all the infected people are benefited and for averting all the adverse consequences. The World Health Organization has advocated for HIV self-testing in various population groups based on the evidence that most of the high-risk population groups are more comfortable with self-testing instead of going to the health care establishments. In conclusion, it is important to acknowledge that the process to save lives from the infection actually starts with detecting the infection at the earliest. The newly proposed recommendations will be of immense utility for the policy makers to expedite their battle against the infection.

Background To provide the reliable and immediate feedback on the medical students' professionalism during the OSCE, we developed a modified Medical Students' professionalism assessment scale (MSPAS) which is relevant in the history taking and physical examination OSCE stations. Methods We developed two sets of questionnaires, Medical Students' Professionalism Assessment Scale- History taking (MSPAS-H) and Medical Students' Professionalism Assessment Scale- Physical Examination (MSPAS-PE).The Cronbach's alpha correlation coefficient was calculated to determine the internal consistency and exploratory factor analysis was carried out. Results The Content validity index was calculated by using the expert's rating on relevance and all the 12 items in the MSPAS had above 0.85 of CVI. Reverse scoring was required for item No 4 (MSPAS-H) and item No 5 (MSPAS-PE). The Cronbach's alpha was calculated for reliability and found to have 0.87 for MSPAS-H and 0.92 for MSPAS-PE. Discussion All the 6 items in the history taking and 6 items in the physical examination were loaded in each scale with the factor loading of 0.5 and above for all the items. This MSPAS is short and simple scale, it can be completed in a short time period if the simulated patients are provided the proper training on this assessment.

Aim: The aim of this study is to compare the outcome of conjunctival autograft (CAG) surgery for pterygium using autologous serum versus fibrin glue. Materials and Methods: A prospective, randomized controlled trial was carried out on 40 patients over a period of 2 years. Group I (20 eyes) underwent CAG with fibrin glue and Group II (20 eyes) underwent CAG with autologous serum. Postoperatively, the parameters noted in both the groups were the time taken for surgery in both the groups, postoperative outcomes such as redness and discomfort during blinking, outcome of the graft (graft edema, graft retraction, graft rejection, graft displacement, and graft loss), and recurrence of the pterygium. Results: In Group I (autologous serum), the mean surgical time was 34.8 min (standard deviation [SD] = 3.664912), whereas in Group II (fibrin glue), the mean surgical time was 22.95 min (SD = 3.086047). The intensity of postoperative discomfort was greater in Group I (autologous serum) than Group II (fibrin glue) on postoperative visits. However, the difference was not statistically significant. Graft rejection was observed in one patient belonging to the fibrin glue group, after 1 month postoperatively, which eventually by the end of 3 months led to graft loss. We found decreased postoperative inflammation and decreased recurrence rate at both a 3- and 6-month time period with the use of fibrin glue compared with autologous serum. Conclusion: Fibrin glue is generally considered safe; however, since it is made from human plasma, it carries the risk of transmitting infections. There was marked reduction in the operating time in fibrin glue group as compared with the autologous blood group. Cost of the surgery was more with fibrin glue. The graft edema, graft loss, graft retraction, and displacement of the graft were more with the use of fibrin glue. However, the difference was not statistically significant.

Aim The aim of the study was to compare the outcome of conjunctival autograft (CAG) surgery for pterygium using autologous serum versus fibrin glue. Materials and methods A prospective, randomized, controlled trial was carried out on 40 patients over a period of 2 years. Twenty eyes underwent CAG with fibrin glue and another 20 eyes underwent CAG with autologous serum. Postoperatively, the parameters noted in both groups were the time taken for surgery in both groups, postoperative outcome like redness and discomfort during blinking, outcome of the graft (graft edema, graft retraction, graft rejection, graft displacement, and graft loss) and pterygium recurrence. Results In the CAG group with autologous serum, the mean surgical time was 34.8 min (SD=3.66), whereas in the group of CAG with fibrin glue the mean surgical time was 22.95 min (SD=3.09), a statistically significant difference (P=0.0000). The intensity of postoperative discomfort was greater in the group with autologous serum than the group with fibrin glue; however, the difference was not statistically significant. Graft rejection was observed in one patient belonging to the fibrin glue group, after 1 month postoperatively, which eventually by the end of the third month, led to graft loss. Conclusion The operating time in the fibrin glue group was significantly less as compared with the autologous serum group. The cost of surgery was more with fibrin glue. Graft edema, graft loss, graft retraction, and displacement of the graft were more with the use of fibrin glue. However, the difference was not statistically significant.

Dengue fever is caused by a flavivirus. This infection is endemic in the tropics and warm temperate regions of the world. Ocular manifestations of dengue fever include subconjunctival, vitreous, and retinal haemorrhages; posterior uveitis; optic neuritis; and maculopathies, haemorrhage, and oedema. However anterior ischemic optic neuropathy is a rare presentation. Optic nerve ischemia most frequently occurs at the optic nerve head, where structural crowding of nerve fibers and reduction of the vascular supply may combine to impair perfusion to a critical degree and produce optic disc oedema. Here we present a case of anterior ischemic optic neurapathy associated with dengue fever.

Rehabilitation of maxillofacial defect patients is a challenging task. The most common prosthetic treatment problem with such patients is, getting adequate retention, stability, and support. In cases of large maxillofacial defect, movement of the prosthesis is inevitable. The primary objectives in rehabilitating the maxillofacial defect patients are to restore the function of mastication, deglutition, speech, and to achieve normal orofacial appearance. This clinical report describes maxillofacial prosthetic rehabilitation of large midfacial defect including orbit along with its contents, zygoma and soft tissues including half of the nose, cheeks, upper lip of left side, accompanying postsurgical microstomia and orofacial communication, which resulted from severe fungal infection mucormycosis. The defect in this case was restored with magnet retained two piece maxillofacial prosthesis having hollow acrylic resin framework and an overlying silicone facial prosthesis. The retention of prosthesis was further enhanced with the use of spectacles. This type of combination prosthesis enhanced the cosmesis and functional acceptability of prosthesis.

Fibrous dysplasia (FD) is a slow growing benign noninherited disorder in which normal bones are replaced by fibrous tissue and immature woven bones. Here we report a case of 30-year-old female who presented with unilateral proptosis and lagophthalmos without any visual loss; was diagnosed with polyostotic FD. Patient was taken up for surgery. Osseous reconturing was done by shaving of involved facial bones. Postoperatively, there was a decrease in proptosis and lagophthalmos.

Purpose: The aim of the study was to analyze the effect of cataract surgery on ocular hypertension and to evaluate if type of surgery changes the postoperative intraocular pressure (IOP) outcome. Materials and Methods: A prospective longitudinal study of sixty patients out of which forty of them underwent phacoemulsification and twenty underwent manual small incision cataract surgery over a period of 2 years from December 2014 to October 2016. Data were entered in Microsoft Excel and analyzed using Strata version 13. We calculated the means and standard deviations for the linear variables and proportions for the categorical variables. The means between two groups were compared using the unpaired t-test (for different groups). The proportions were compared using Chi-square test or Fisher's exact test (for low expected cell counts). We used Mann–Whitney test for comparing the distribution of the variables and Wilcoxon matched-pairs signed-ranks test for equality of matched pairs. Conclusion: In our study, 22.7% fall is noted by the end of 3 months. Pressure-to-depth (IOP/anterior chamber depth) ratio is a valuable prognostic indicator in ocular hypertensives as well to predict postoperative IOP outcome. The type of surgery did not effect the reduction in IOP postsurgery by the end of 3 months.

ÖZET Konjenital anomaliler yapısal veya fonksiyonel olarak tanımlanır ve doğuştan ortaya çıkan metabolik/biyokimysal bozuklukları içerir. Evrensel bir problem olan konjenital anomaliler; uzun süreli bozukluklarla ilişkili olmaları; sosyal stigma, ailelerin duygusal / fizyolojik stres yaşamaları, artan medikal maliyetlerle birlikte sosyal sağlık sistemlerine yük oluşturmaları nedeniyle önemli bir halk sorunu olarak tanımlanmaktadır. Konjenital anomalilerin ortaya çıkmasından korunmak için; toplumdaki ve hastanedeki vakaların kaydedilmesi amacıyla gözetim sistemi kurulmalı, halk sağlığı sistemi güçlendirilmeli, etyolojik faktörlerin araştırılması, teşhis ve korunma stratejilerinin geliştirilmesi için teşvik verilmeli, uluslararası işbirliği yapılmalı ve akraba evliliği/ ilerlemiş yaşlarda gebe kalma/ malformasyona sahip çocuklu ailelerin yeniden çocuk dünyaya getirmeleri konusunda uyarılarda bulunmak gerekmektedir. Sonuç; sağlık profesyonelleri ve gönüllülerin katılımıyla etkin bir gözetim sistemi tarafından desteklenen kapsamlı bir politika sistemi formüle edilmelidir

We report a case of a 6-year-old child who presented with an orbital mass, in which invasive and non-invasive radiological investigations were used for diagnosis and its subsequent management with angiographic guided intralesional sclerotherapy using 3% sodium tetradeclysulphate. Angiographic guided sclerotherapy prevents accidental injection into major vessel and its extravasation into surrounding tissue. The use of sclerosing agents in the treatment of lymhangiomas of the orbit and other parts of body is known but angiographic guided sclerotherapy in the treatment of a vascular orbital mass is still not well-known.

No Abstract.

Congenitally missing eye, often called as anopthalmia, is a rare condition. This causes disfigurement of the face, which poses psychological effect on children, making them emotionally weak and conscious which, in turn, causes anxiety, stress, and depression at an early age in life. The custom-made ocular prostheses should thus be provided as soon as possible to help children improve their social acceptance. We present a case of 9-year-old boy who reported with congenital anopthalmia of right eye, which was then restored with custom-made ocular prosthesis.

Objective: To study knowledge about reproductive health among female adolescents and to assess their treatment seeking behavior regarding reproductive health problems in an urban slum of Mumbai. Materials and methods: Cross sectional descriptive study was undertaken in an urban slum area of Mumbai for period of 3 months. All adolescent girls from 10 - 19 years of age, who had attained menarche, attending general OPD and STI clinic were included. Subjects were interviewed face to face using pretested semi-structured questionnaire after obtaining informed consent. The questionnaire contained information regarding socio demographic parameters and that related to reproductive health i.e. menstrual hygiene, knowledge and practices related to HIV / AIDS, contraception, abortion, Medical Termination of Pregnancy (MTP), etc. and their treatment seeking behavior in last 3 months for reproductive health problems. Privacy and confidentiality was strictly maintained. Analysis was done with SPSS version 17. Results: Seventy nine (32.8%) subjects had unsatisfactory menstrual hygienic practices. Two hundred twelve (88%) women were aware about availability of ANC services. Sixty six percent of women had correct knowledge of modes of transmission of HIV while only 18.7% knew about safe sexual practices. Education status and early adolescents age group (10 -14 years) was found to be significantly associated with knowledge of adolescents regarding menstruation. Conclusion:Female adolescents should be given appropriate knowledge regarding puberty and sexual health to help them confidently deal with their reproductive and sexual health issues.

Global Tuberculosis (TB) report (2013) has revealed that an estimated 8.6 million people developed TB of which, India accounts for almost 26% of the cases. These estimates clearly suggest that the country’s efforts to achieve Millennium Development Goal 6 by 2015 have not delivered the desired output. In India, the TB prevention and control activities are supervised and implemented under the Revised National TB Control Program (RNTCP), which recognizes that implementation of a good quality Directly Observed Treatment with Short course chemotherapy (DOTS) is the first priority for TB control. Directly Observed Treatment (DOT) is the key element in DOTS strategy, in which a DOT provider insures and supports the patients in consuming their drugs throughout the course of treatment. In order to meet the country’s vision to achieve universal access of TB care, the RNTCP has launched a “treatment adherence scheme” (public-private partnership scheme). Further, an evidence-based integrated strategy should be formulated for addressing the identified barriers which advocates universal administration of DOT. To conclude, DOT in RNTCP insures long-term adherence to the treatment, with right drugs in right doses, at right intervals and thus plays an indispensable role in improving the outcome indicators of the program and the quality of life in patients.