Background: It has been reported that cataract surgery can compromise the function of a filtering bleb, resulting in loss of control of intraocular pressure (IOP). In a number of retrospective studies a rise of IOP after extra capsular extraction and even after phacoemulsification in filtered glaucoma eye was shown. Objective: To evaluate the effect of temporal clear corneal Phacoemulsification with Intraocular Lens implantation (IOL) on IOP control in glaucoma patients who had previous successful trabeculectomy. Methods: The clinical course of 60 patients (60 eyes) who underwent temporal clear corneal phacoemulsification after successful trabeculetomy was studied over a period of 3 years. The number of Primary Open Angle Glaucoma (POAG) and Primary Angle Closure Glaucoma (PACG) cases was equal in our study. Comparison of pre-operative and post-operative IOP, visual acuity, bleb morphology and the number of medications was made at follow up interval of 1 month, 3 months, 6 months and 12 months respectively. Results: The mean ± SD IOP before phacoemulsification was 12.2 ± 4.608 mmHg and it increased to 14.98, 14.47, 15.44 and 15.71 after 1, 3, 6 and 12 months respectively. At each interval the mean IOP was significantly higher than the pre-operative value (p = 0.000, 0.015, 0.000, 0.001 respectively) There was also an increase in the number of antiglaucoma medications used after phacoemulsification. The mean ± SD of medication before phacoemulsification was 0.57 + 0.62 and it increased to 0.65, 0.70, 0.68, 0.67 after 1, 3, 6 and 12 months respectively. But the difference was not statistically significant. Conclusion: Temporal clear corneal phacoemulsification significantly increases IOP in eyes with pre-existing functioning filtering bleb. No statistically significant difference was found between the outcomes of POAG and PACG groups. There is a statistically significant improvement in visual acuity following phacoemulsification with intraocular lens implantation.

Background: The problem of obesity is confined not only in adults but also among the children and adolescents. The most significant long term consequence of childhood obesity is its persistence into adulthood along with its attendant risks. The surveys on childhood obesity in under surveyed areas help to identify risk factors. Objectives:

1. To study the prevalence of obesity among school children of Karimnagar town.
2. To study the factors associated with obesity.

Methods: A cross sectional study was conducted in schools of Karimnagar town. A total of 892 students were randomly selected belonging to 6th to 10th standard in randomly selected schools. Data was collected in a predesigned questionnaire. The cut off points for age and gender specific BMI recommended by Agarwal et al were used. Statistical analysis: The data was analyzed using chi square test. P value of less than 0.05 was considered as significant. Results: The mean age of study subjects was 13.03+1.52 years. The overall prevalence of overweight and obesity was 11.99% and 2.69% respectively and 14.68% combined together. Out of the factors studied, children belonging to open category (caste), upper social class were found to be significantly associated with obesity (p < 0.05). Other factors were not associated with obesity. Conclusion: The overall prevalence of obesity in the present study is high it is significantly associated with caste and upper social class. There is a need to increase awareness on physical fitness, regular exercise and appropriate dietary habits among children through schools.

Background: Glaucoma is a common cause of visual impairment and blindness. The Heidelberg Retinal Tomogram (HRT) evaluates the structural details of the optic disc and has been widely investigated as a research tool in imaging of the ONH. The correlation between the perimetry and HRT data in Caucasian eyes has been reported previously. Objective: To correlate the HRT parameters and visual field indices in Indian eyes including established glaucoma and glaucoma suspect patients. Methods: Eighty-three eyes of 50 patients having primary open angle glaucoma underwent automated Humphrey perimetry (30-2) and confocal scanning laser ophthalmoscopy (HRT II). The global visual field indices and the HRT II parameters were correlated. Results: The average MD of the study group was –3.70±3.99dB (range 1.11 to –19.54). The correlations between global parameters by HRT and global visual field indices were found to be significant for rim area, rim volume, height variation contour, mean RNFL thickness and found RNFL cross sectional area. The strongest correlation was between rim area and PSD (r = 0.32, p = 0.0029). Conclusion: There was a good correlation between global visual field indices and HRT II parameters with highest correlation coefficient of 0.32. Since we had several parameters correlating well, we can say that in early glaucomatous damage HRT II is as sensitive as perimetry and HRT II could be a useful tool in evaluation and diagnosis of glaucoma.

Background: Adenosine deaminase (ADA) is a cytosolic enzyme, which participates in development and maintenance of the immune system. Diabetic patients have a higher prevalence of thyroid disorders compared to the normal population because patients with one organ-specific autoimmune disease are at risk of developing other autoimmune disorders. Methods: A total number of one hundred subjects were divided into four groups consist of group A. Type II Diabetic patients, group B. Hypothyroid patients, group C. Hyperthyroid patients and group D. Healthy controls of either sex between age group of 30-70 years. The following biochemical parameters were estimated for all the groups. Fasting plasma glucose, Serum T3, T4, TSH and Adenosine deaminase. Results: Mean serum ADA levels were raised in diabetic and hypothyroid patients when compared to that in controls and which was statistically significant (p<0.0001). Unlike hypothyroid, serum ADA levels in hyperthyroid patients were within normal limits. Conclusion: Increase in serum ADA levels in the diabetic and the hypothyroid patients when compared to controls, are suggestive of an association with a common immunological disturbance. Increase in serum TSH levels in diabetes patient increase in fasting blood sugar level in hypothyroid patients, when compared to healthy controls is suggestive of diabetic patients probably suffering from subclinical hypothyroidism and patients with hypothyroidism suffering from impaired glucose metabolism.

Background: There is growing evidence that increase in free radical production and impaired antioxidant activity is important in the pathogenesis of acute myocardial infarction(AMI).increased lipid peroxidation is thought to be a consequence of lipid peroxidation which occurs when the dynamic balance between prooxidant and antioxidant mechanism is impaired. Malondialdehyde (MDA) is one of the most frequently used indicators of lipid peroxidation. It is one of the several byproducts of lipid peroxidation processes. Objective: The objective of this study was to evaluate the role of lipid peroxidation through measuring the MDA levels in cases of AMI and also to find out the changes in the levels of MDA through the course of the disease. Methods: A total of 30 patients were eligible for the study who met the inclusion and exclusion criteria. Blood sample was collected from these patients on the day of admission (day 0), 12-30 hrs after collecting the first sample (day 1), and 35-54 hrs after collecting the second sample (day 2). The patients were followed up to their discharge. MDA levels were estimated in the plasma by thiobarbituric acid (TBA) method. Results: This study showed a statistically significant increase in the MDA levels during the course of the study. Conclusion: There is clear evidence from this study and various other studies that there is a definite increase in the lipid peroxidation products in the event of AMI. Whether These changes, primary or secondary to the event, have any bearing on the prognosis of the patient and whether MDA can be used as a prognostic marker have to be investigated further.

Background: It is clear from the population based studies that type-2 diabetes generally is associated with a 50% to 100% elevation in the plasma levels of total and VLDL triglycerides. Objective: To find the pattern of Dyslipidemia in type-2 diabetics in comparison with non diabetic individuals. Methods: A case control study was conducted. Hundred type-2 diabetes mellitus patients were taken as cases and hundred age and sex matched non diabetic individuals were taken as controls. The labeling of dyslipidemia was based on NCEP guidelines. Results: Dyslipidemia was present in 86% of diabetic patients. LDL dyslipidemia was observed in 64%, HDL dyslipidemia in 71% and hypertriglyceridemia in 47% and hypercholesterolemia in 41% of diabetic patients. The total cholesterol, triglycerides, LDL-C are significantly elevated in diabetics when compared to control (p=0.003, p<0.0001, p<0.0001) while HDL-C values are significantly lowered in diabetics when compared to Non-diabetics (p=0.007). Conclusion: The alteration of lipid metabolism of type-2 diabetics has raised a serious medical concern with respect to vascular complications like coronary artery disease, cerebro vascular diseases and the recommendation of greater routine evaluation of serum lipid profile, its treatment and good glycemic control in patients of type-2 diabetes mellitus is strongly suggested.

Background: Hypothyroidism in the young child and neonate is an urgent situation as proper development of neural tissue in early life requires adequate levels of thyroid hormones. Deficiency can cause severe irreversible mental, physical handicaps-cretinism. Therefore an early diagnosis and treatment is very essential by neonatal screening for this disorder worldwide. Objective: To study the importance of reticulocyte count and to evaluate various parameters like T3, T4 and TSH in the hypothyroid cases. Methods: 14 cases and 9 controls in the pediatrics age group and 19 cases and 6 controls in the adult age group were studied. Both cases and controls were subjected to investigations like T3, T4 and TSH, Reticulocyte count and Hemoglobin. Statistical analysis was done using mean and standard deviation. Mean difference was tested using student ‘t’ test and with and without log transformations. Results: The values of the T4 levels in the hypothyroid cases recorded was 2.53±4.4 mcg/dl which was moderately significant when compared to the controls who had values of 6.31±1.09 (p < 0.05). Similarly TSH values were also high with values of 63.61±46.53 microunits/ml which was found to be more significant than control who had low levels of 3.15±1.58 (p < 0.01). Reticulocyte counts in the pediatric cases of hypothyroidism showed low values of 0.63±0.27% which was highly significant to that of controls with values of 1.19±0.46% (p < 0.01). Conclusion: Reticulocyte count can be used as an alternate economical and accessible indicator in knowing the prognosis of hypothyroidism.

Government of India (GOI) introduced in 1975, its most ambitious and comprehensive plan to increase child survival rates among the poorest and enhance the health, nutrition and learning opportunities of preschool children and their mothers through the Integrated Child Development Services (ICDS) scheme. The ICDS scheme can have positive impact on the health status of the children. The objective of the study is to compare the morbidity pattern among children of 0-6 years in ICDS and non ICDS area. The present cross sectional study with comparison group was planned to compare the health status of 0-6 years children in ICDS and non ICDS urban slums of Nagpur city. Morbidity was assessed for recent illness in last 90 days prior to the visit. Statistical test used were Z test for difference between two proportions and Z test for difference between two means. There were total 239 and 321 morbid conditions found during study in ICDS and non ICDS areas respectively. Anemia was most frequent morbid condition in both the areas. Mean morbid condition per child in ICDS and non ICDS areas was 0.85 ± 1.01 and 1.14 ± 1.2 respectively. No morbid condition was in 132 (47.2%) children in ICDS and 110 (39.3%) children in non ICDS area. Thus we can say that the overall health status of children of ICDS area is better off (though not very good) when compared with children from non ICDS areas.