BACKGROUND: Although cataract accounts for half the blindness in the world, the resources available are not sufficient to meet the existing need for operations. The most effective low cost cataract surgery is probably performed in community camps. METHODS: We estimated the costs incurred in performing cataract operations in makeshift comprehensive eye care camps. Both the capital and recurrent inputs were costed at current market rates. RESULTS: Rupees 1,508,600 (US$ 47,100) was spent on conducting 17 camps during April 1992 to March 1993. Recurrent inputs were responsible for 83% of the total costs. Sixty per cent of the recurrent inputs were borne by non-governmental organizations. The total capital expenditure was borne by the mobile ophthalmic units. Food and drugs for patients (40%), and staff salaries and allowances (35%) were the major recurrent expenditure, while 60% of the capital expenditure was accounted for by vehicles. The unit cost of cataract surgery was Rs 772 (US$ 23). CONCLUSIONS: We suggest that comprehensive eye camps are cost-effective.

Cataract Extraction↗

PubMedDate not supplied

Disabilities in multibacillary leprosy patients: before, during and after multidrug therapy.

One hundred fifty-one patients (125 males and 26 females) of multibacillary leprosy (LL 88, BL 40, BB 23), registered during 1986-1992 for multidrug therapy (MDT), were analysed with reference to their disabilities before, during and after MDT. At induction 48 (31.7%) had no disability (Gr 0), 59 (39.0%) had only peripheral anaesthesia (Gr 1) and 44 (29.1%) had Gr 2 and 3 deformities with or without anaesthesia. The parallel analysis of the three groups, with nearly equal duration of symptoms, revealed that new deformities developed in only a few cases during and after MDT, least in the Gr 0 group. The crude fresh deformity incidence was 59.2 per 1,000 person years of observation. The rate of recovery from anaesthesia was higher (64%) in Gr 1 group than that (44%) in group with Gr 2, 3 deformities. No significant difference was observed between the incidence of Gr 2 deformities developed before, during and after MDT (incidence of claw-hands 9.2% before and 7.9% during and after MDT, trophic ulcers 13.9% before and 17.8% during and after MDT). Out of 19 cases which developed motor weakness during MDT and follow-up, 10 (52.6%) were instances of quite nerve paralysis. Occupational factors influenced the development of deformities but not the sex and bacterial load. Generally, the lower the Grade of disability at induction of patient for MDT, the lower the chances of new disability development and higher the chances of recovery from sensory impairments.

Colony Count, Microbial↗

PubMedDate not supplied

Increasing toxoplasma seropositivity in women with bad obstetric history and in newborns.

BACKGROUND: Most infants with congenital Toxoplasma gondii infection have no symptoms at birth but few may develop retinal diseases or neurological abnormalities later in life. The presence of significant titres of antitoxoplasma antibodies in women in the reproductive age group indirectly indicates that Toxoplasma gondii is the cause of such congenital abnormalities and also sporadic abortions in some women. METHODS: We did a retrospective analysis of antitoxoplasma antibodies detected by indirect haemagglutination assay, in women with bad obstetrical history and in newborns clinically suspected of congenital toxoplasmosis during 1981-91. RESULTS: A significant increase in seropositivity in women and newborns was seen during 1989-91 as compared to 1981-88. More seropositive patients were recorded between April-June and October-December. However, no significant correlation could be observed between rising incidence of seropositivity and the seasonal distribution or age of women. CONCLUSION: Epidemiological studies are required to ascertain the reason for the increasing trend of toxoplasma seropositivity and to suggest appropriate control strategies as it is possible to prevent congenital infection.

Adolescent↗

PubMedDate not supplied

Molecular medicine: from laboratory to clinical practice.

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Animals↗

PubMedDate not supplied

Obstetric and gynecologic implication of brucellosis in Kuwait.

OBJECTIVE: To study the possible correlation between maternal Brucella infection and reproductive failure as expressed by abortion, intrauterine fetal death, and preterm delivery. STUDY DESIGN: Maternal enzyme-linked immunosorbent assay serologic and microagglutination testing and conception product culture for Brucella were done in 227 women with preterm delivery, 51 with intrauterine fetal death, 29 with spontaneous abortion, and 39 with term delivery of a normal baby. RESULTS: Ingestion of raw milk was positive in 18% of the control cases, 28% of preterm delivery cases, 30% of intrauterine fetal death cases, and 21% of spontaneous abortion cases. Acute or chronic Brucella infection was found in 8% of preterm, 10% of intrauterine fetal death, and 7% of abortion cases. None of the control cases had evidence of Brucella infection. None of the four groups showed positive culture of the placenta for Brucella. The titres of Brucella-specific immunoglobulin G and M were significantly higher in the preterm, abortion, and intrauterine fetal death groups than in the control group. CONCLUSION: A possible correlation may exist between Brucella infection and preterm and intrauterine fetal death, which does not seem to be related to transplacental infection but possibly may relate to the acute illness.

Abortion, Spontaneous↗

PubMedDate not supplied

Serum tocopherols and lipids in patients with coronary artery disease.

Serum tocopherols and lipids levels in 40 coronary artery disease patients were statistically analysed in relation to those of the normal controls and an attempt was made to define the correlation between tocopherols and various lipids. Serum tocopherols levels were found to be significantly low in coronary artery disease patients as compared to those of the controls implicating an inverse relationship between coronary artery disease and serum level of tocopherols. Coronary artery disease population did not register any significant change in various blood lipids, except triglyceride fraction, as compared to that of the normal population. Serum tocopherols and lipids were also analysed in relation to age and sex. The preliminary data suggest that coronary artery disease patients have sub-optimal tocopherols level (0.58 +/- 0.26 mg/dl) as compared to that of the normal controls (0.81 +/- 0.34 mg/dl; p < 0.001), which may be an important risk and/or contributing factor for atherogenesis and coronary artery disease

Adult↗

PubMedDate not supplied

Imaging in primary pulmonary hypertension.

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Adolescent↗