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Our study compares the sensitivity, specificity and cost of visual acuity screening as performed by all class teachers (ACTs), selected teachers (STs) and vision technicians (VTs) in north Indian schools. Prospective cluster randomized control studies are conducted in schools in a rural block and an urban-slum of north India. Consenting schools, with a minimum of 800 students aged 6 to 17 years, within a defined study region in both locations, were randomised into three arms: ACTs, STs or VTs. Teachers were trained to test visual acuity. Reduced vision was defined as unable to read equivalent of 20/30. Optometrists, who were masked to results of initial screening, examined all children. Costs were measured for all three arms. The number of students screened were 3410 in 9 ACT schools, 2999 in 9 ST schools and 3071 in 11 VT schools. Vision deficit was found in 214 (6.3%), 349 (11.6%) and 207 (6.7%), (p <.001) children in the ACT, ST and VT arms, respectively. The positive predictive value of VT screening for vision deficit (81.2%) was significantly higher than that of ACTs (42.5%) and STs (30.1%), (p <.001). VTs had significantly higher sensitivity of 93.3% and specificity of 98.7%, compared to ACTs (36.0% and 96.1%) and STs (44.3% and 91.2%). The cost of screening children with actual visual deficit by ACTs, STs and VTs, was found to be $9.35, $5.79 and $2.82 per child, respectively. Greater accuracy and lower cost favours school visual acuity screening by visual technicians in this setting, when they are available. [ABSTRACT FROM AUTHOR]

Byline: Ishan. Kumar, Zeeshan. Siddiqui, Ashish. Verma, Aarushi. Chokhani, Govind. Srivastava, Ram. Shukla BACKGROUND: Accurate staging of disease severity and its serial monitoring thus is central to the effective management [...]

Explore door-to-door eye screening in India as a model to reach school age children in need of eye care, especially during school closures due to the Covid-19 pandemic. Children between 5 and 18 years were screened in an urban-slum of Delhi from September 2020 to March 2021. Screening included capturing ocular complaints, visual acuity and conducting a torchlight examination. Children with any eye-related complaints, gross abnormality or a LogMAR acuity of more than 0.2 in either eye were referred to the nearby vision centre. Data were disaggregated by gender and age group. Reporting after referral and proportion of true positives referrals were used to assess the model. 32,857 children were screened. 55% were boys. Only 917 children (2.8%) had previous eye examinations. 1814 (5.5%) children were referred. Overall compliance rate amongst those referred was 59% (1070 of 1814) and compliance was significantly higher (72%) amongst those referred with poor vision as compared to those with only ocular morbidities (38%). Overall compliance was significantly higher amongst older age group (64% vs 50%) and amongst girls than boys (61% vs 56%). 3.9% children were detected with refractive error (RE) and 2.5% with uncorrected RE which was significantly higher in girls and in older age group. Of 1070 children reporting after referral, 85% had confirmed diagnosis for RE or other ocular pathology. Door-to-door screening had good referral compliance and positive predictive value. We recommend this model as a supplement to school screening especially in regions with low enrolment and high absenteeism in schools. [ABSTRACT FROM AUTHOR]

BACKGROUND: Detection of breast cancer in its earliest possible stage is ultimate goal in breast imaging & role of radiologist is therefore vital. OBJECTIVE: The aim of USG as a diagnostic tool for breast diseases is to study the mode of presentation, nature of the lesion, USG features, and their correlation with clinical sign and symptoms, and cytological study. MATERIAL & METHODS: Study Design: Prospective study. Study Period: September 2014 to August 2015(1 year). Work Place: Department of Radiodiagnosis G.R. Medical College & Jayarogya Hospital, Gwalior. Using USG machine Aloka prosound alpha-6 (Aloka triviton pvt ltd Tokyo, Japan.) Linear 6-12 MHz probes will be used for real time B-scan. Study Group: 106 patients with complaints of breast pain, local breast tenderness, breast lump, discharge or skin changes. (irrespective of age/marital status/ breastfeeding). Correlation of USG findings along with cytological findings. RESULT: The Sensitivity, Specificity, Positive predictive value, Negative predictive value of Ultrasonography in diagnosing carcinoma breast are 55.55%,97.72%, 83.33% and 91.48% respectively. The Chi square test of USG correlation with FNAC was performed which was found to be statistically significant. CONCLUSION: USG is an individually effective diagnostic modality for detection of breast lesions. Thus sonography plays an important role in management of breast lesions. Sonography is highly sensitive and specific in diagnosing breast mass, breast abscess, differentiating b/w solid and cystic lesions, characterization of the lesions. [ABSTRACT FROM AUTHOR]

Background: Transthoracic ultrasonography (TUS) is suggested as a noninvasive, radiation-free method for the assessment of interstitial lung disease (ILD). This study was designed to study TUS features of ILD. Furthermore, possible correlations of these features with parameters of spirometry, arterial blood gas (ABG) analysis and 6-min walk test (6MWT) were assessed. Materials and Methods: Fifty patients with ILD were diagnosed based on history, examination, chest X-ray/high-resolution computed tomography, and spirometry. Each patient underwent 6MWT, ABG analysis, and TUS. TUS was also performed on 20 healthy volunteering controls. Results: The TUS features among patients were B pattern in 40 patients (80.0%, P < 0.001), decreased lung sliding in 22 patients (44.0%, P < 0.001), pleural line thickening in 28 patients (56.0%, P < 0.001), pleural line irregularity in 39 patients (78.0%, P < 0.001) and subpleural changes in 22 patients (44.0%, P < 0.01). Increasing pleural line thickness was inversely correlated with forced vital capacity (FVC) percent predicted (r = -0.345, P < 0.05), pO2 (r = -0.335, P < 0.01), SpO2 at rest (r = -0.444, P < 0.01), 6-min walk distance (6MWD) (r = -0.554, P < 0.001) and distance-saturation product (DSP) (r = -0.572, P < 0.001). Increasing distance between B lines also correlated inversely with FVC percent predicted (r = -0.278), pO2 (r = -0.207), SpO2 at rest (r = -0.170), 6MWD (r = -0.209), and DSP (r = -0.214); however these correlations were not statistically significant (P > 0.05). Conclusion: TUS seems to be a useful imaging method for the diagnosis of ILD. It can be used to estimate the severity of ILD. It is simple, bedside, cost-effective, and radiation-free. It may be especially useful in the follow up of patients in low resource settings, pregnant females, and bed-ridden or unstable patients who cannot be shifted to radiology suite. [ABSTRACT FROM AUTHOR]