Browsing by Author "Prashant Bhushan"

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An overview of human health risk from opium alkaloids and related pharmaceutical products pollution in aquatic ecosystems
(Elsevier, 2022) Sonam; Markandeya; Y. Shiv Shankar; Prashant Bhushan; Deepak Gautam; Pankaj Kumar; S.P. Shukla; Devendra Mohan
Fresh water is a valuable resource, but the increase in pollution of aquatic ecosystem is a matter of concern. Industries are rapidly budding in India, which discharge their effluents into the water bodies either directly or after treating partially. Pharmaceutical compounds are very important, but at the same time, release toxic contaminants in the environment. Pharmaceutical products impose huge effects on aquatic environment, resulting in acute and chronic damages, reproductive damage, behavioral changes, and inhibition of cell proliferation. The effluents produced from alkaloid processing industries is highly polluted having low pH, high COD, BOD5, sulfate, and TKN values, and a characteristic dark brown color. A number of physical as well as biological processes occurring in aquatic ecological unit may cause reduction of trace concentrations of pharmaceutical compounds. Treatment of wastewater generated from alkaloid processing is a challenging task because of the complex mixture of contaminants. Several methods for the treatment of these wastes, such as anaerobic and aerobic biological treatment, anaerobic treatment with membrane treatment, and aerobic treatment with catalytic wet air oxidation have been reported. Studies have also been conducted on physicochemical treatment in combination with activated sludge process. Membrane processes and Fenton oxidation have also been investigated as a post-treatment method. Membrane technologies are desirable for industrial wastewater treatment as no external addition of chemicals is required. © 2022 Elsevier Inc. All rights reserved.
Assessment of optic disk by disk damage likelihood scale staging using slit-lamp biomicroscopy and optical coherence tomography in diagnosing primary open-angle glaucoma
(Wolters Kluwer Medknow Publications, 2022) Kanchan Singh; Prashant Bhushan; Deepak Mishra; Kirandeep Kaur; Bharat Gurnani; Anjali Singh; Swasti Pandey
Purpose: The current study was aimed at assessment of optic disk by disk damage likelihood scale (DDLS) staging using slit-lamp biomicroscopy and optical coherence tomography (OCT) in diagnosing primary open-angle glaucoma (POAG) patients. Methods: This was a cross-sectional observational study of 106 POAG patients, which was conducted from April 2017 to April 2018. All patients underwent slit-lamp fundoscopy with a +78 D lens and high-definition (HD)-OCT, and the vertical cup disk ratios (VCDRs) were recorded. Disk size and neuroretinal rim assessment were done, and the disk was then staged using the recent version, which stages the optic nerve head (ONH) from 1 to 10 as read from the DDLS nomogram table. DDLS scores >5 indicate glaucomatous damage. Pearson coefficient was used to correlate the DDLS staging by slit-lamp biomicroscopy with best-corrected visual acuity (BCVA), intraocular pressure (IOP), disk size, and VCDR and VCDR, mean deviation, and DDLS staging by HD-OCT. Results: The mean age of the patients was 59.54 ± 6.61 years. The male: female ratio was 2:1. The mean IOP was 16.04 ± 1.97 mmHg, and BCVA was 0.72 ± 0.13 LogMAR units. The mean VCDR on 78 D slit-lamp biomicroscopy was 0.76 ± 0.09 (standard deviation [SD]) (range 0.1-0.77), whereas on HD-OCT, the mean VCDR was 0.81 ± 0.09 (SD) (range 0.07-0.81). The mean deviation on visual field testing in decibels was -14.43 ± 3.31 (SD). The correlation coefficient between DDLS staging by slit-lamp biomicroscopy and DDLS staging by HD-OCT parameters was r = 0.96. Conclusion: There is a positive correlation between the DDLS system of optic disk evaluation on slit-lamp biomicroscopy and most of the HD-OCT evaluation parameters. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
Correlation between different retinal layers with visual acuity in diabetic retinopathy patients with clinically significant macular edema
(Wolters Kluwer Medknow Publications, 2023) Shama Parveen; Deepak Mishra; Bharat Gurnani; Kirandeep Kaur; Hossameldin A. Ziada; Tanmay Srivastav; Prashant Bhushan
Purpose: To study the corelation between outer retinal layer thickness (ORL), outer photoreceptor segment thickness (PROS), and central macular thickness (CMT) with best‑corrected visual acuity (BCVA) in patients having clinically significant macular edema (CSME) and compare these parameters with normal patients. Methods: This was a prospective, nonrandomized, observational, comparative study done during the period of January to May 2019. The study included 60 eyes of 36 patients. The patient population was segregated into two Groups: Group Ι (30 normal eyes of 15 normal patients) and Group ΙΙ (30 eyes of 21 diabetic patients) with CSME. The comparison between ORL, PROS, and CMT was made between both the groups, and the correlation between ORL thickness, PROS thickness, and CMT with BCVA in Group ΙΙ was studied. Results: The mean age in Group I was 52.6+10.66 years, and 53.42+8.15 years in Group II. The male/ female ratio was 1.1:1 in Group I and 4:3 in Group II. The mean CMT was greater in Group ΙΙ (330.13 ± 37.01) than in Group Ι (222.20 ± 12.30). The mean ORL thickness was greater in Group Ι (97.73 ± 6.92) than in Group ΙΙ (80.63 ± 9.03). The PROS thickness was statistically significant in Group Ι (35.05 ± 3.4) than in Group ΙΙ (28.57 ± 3.53). There was a strong correlation between BCVA and ORL thickness (r = −0.580, P < 0.001) and more strong correlation between BCVA and PROS thickness in Group ΙΙ (r = −0.611, P < 0.000). There was a moderate correlation between BCVA and CMT (r = 0.410, P < 0.025), and all results were statistically significant. Conclusion: Both ORL and PROS thickness were greater in healthy normal eyes than in eyes with CSME. BCVA was strongly correlated with PROS and ORL thickness and moderately associated with CMT. © 2023 Indian Journal of Ophthalmology.
Disseminated cysticercosis with a right common femoral vein thrombosis
(2013) Utpal Kant Singh; Rajniti Prasad; Prashant Bhushan; Om P Mishra
Disseminated cysticercosis is an uncommon presentation of cysticercosis. Less than 10 cases of disseminated cysticercosis have been reported worldwide in children. We report the case of an 8-year-old boy with disseminated cysticercosis, who had presented with a swelling of the body for 1 month and proptosis of the eyeballs for 14 days. On examination, he had bilateral proptosis, subcutaneous nodules and hypertrophy of muscles of the limbs, neck and face. The CT cranium was normal, but the orbit showed bilateral bulky extraocular muscles heterogeneous in their whole length. The MRI cranium and whole body showed multiple nonenhancing vesicular cysts involving the brain, extraocular muscle, heart, trunk and muscles of the extremities and subcutaneous tissues. A Doppler study of the femoral vein showed thrombosis of the right common femoral vein. He was managed with corticosteroid, albendazole, phenytoin sodium, low-molecular-weight heparin followed by warfarin for 6 months and recovered completely. Copyright 2013 BMJ Publishing Group. All rights reserved.
External dacryocystorhinostomy conventional surgery versus Pawar implant: A comparative study
(Wolters Kluwer Medknow Publications, 2019) Deepak Mishra; Prashant Bhushan; Bibhuti Sinha; Gyan Bhaskar; Raksha Rao
Purpose: External dacryocystorhinostomy (DCR) surgeries are cost-effective with excellent success rates. The present study was designed to compare the safety and efficacy of conventional external DCR versus external DCR using Pawar silicone implant in chronic dacryocystitis. Methods: This is a prospective, comparative, interventional case series over a period of 18 months with patients managed by external DCR surgery with and without Pawar implant. Institutional review board approval was obtained before the study. The success of the surgery was objectively measured by sac patency on syringing at the last follow up. Results: A total of 65 patients with chronic dacryocystitis were included in the study. The mean age of patients in the series was 41.43 years (median, 41 years; range, 12 years-60 years). All patients presented with epiphora (100%) and underwent external DCR and were chosen for conventional surgery (n = 33, 51%, group 1) or Pawar silicone implant surgery (n = 32, 49%, group 2) on a random basis. The mean duration of the surgery from the time of skin incision to skin closure for group 1 was 27.7 minutes (median, 26 minutes; range, 21-30 minutes) while in group 2, it was 75.5 minutes (median, 75 minutes; range, 60-88 minutes), which was statistically significant (P < 0.01). The success rate of the procedure done in group 1 was 90% which increased to 97% after the management of failed cases as compared to the success rate in group 2 of 91% and 94%, before and after the management of failed cases, respectively. Conclusion: External DCR using Pawar implant is a safe surgery which is faster than conventional external DCR with almost equal success rates between both the procedures. © 2019 Indian Journal of Ophthalmology Published by Wolters Kluwer - Medknow.
Immunoglobulin Concentration in Tears of Contact Lens Wearers
(Wolters Kluwer Medknow Publications, 2014) Rajendra P. Maurya; Prashant Bhushan; Virendra P. Singh; Mahendra K. Singh; Prakash Kumar; Ravindra P. S. Bhatia; Usha Singh
Purpose: To evaluate changes in the concentration of tear immunoglobulins in contact lens wearers. Methods: A total of 45 cases including 23 contact lens wearers (43 eyes) and 22 age and sex matched healthy controls having no ocular pathology were studied for immunoglobulins (IgA, IgG, IgM) in their tears by single radial immunodiffusion method. Results: Most of the cases used soft (56.6%) and semi-soft gas permeable (30.4%) contact lenses. Tear IgM was detected in only 17.4% and tear IgG in 43.6% of contact lens wearers, while in controls IgG was detected in 9.1% but none of the controls had IgM. There was a significant rise in total tear IgA (13.17 ± 4.44 mg/dl) in contact lens wearer as compared to controls (8.93 ± 3.79 mg/dl). Rise of tear IgA was more in symptomatic patients (15.38 ± 5.28 mg/dl) and in those wearing hard (19.73 ± 5.43 mg/dl) and semi-soft contact lenses (13.31 ± 5.43 mg/dl). A significant increase in tear IgA was noticed in subjects wearing lenses for >3 years (15.69 ± 5.39 mg/dl). About 43.4% of lens wearers were symptomatic and 80% of their lenses showed deposits and/or haziness. All cases with IgM in tear were symptomatic. Conclusion: The relation of immunoglobulin concentration with increasing duration of wear and material of contact lens shows that tear immunoglobulin rise accrues due to mechanical stimulation, hence contact lenses should not be used for a long period and lenses of hard nature should be discouraged. The maintenance, cleaning and deproteinization of the lenses are of high importance to avoid immunostimulation.
Prevalence of incidental and total human immunodeficiency virus, hepatitis B and hepatitis C seropositivity among patients posted for cataract surgery at a tertiary care center in India
(Wolters Kluwer Medknow Publications, 2022) Deepak Mishra; Hemendra Singh; Parkshit Gogate; Prashant Bhushan; M.K. Singh; Tanmay Srivastav; Bageshri Gogate; Smriti Gaur
Purpose: To study the prevalence of human immunodeficiency virus (HIV), hepatitis B (HBV), and hepatitis C (HCV) viral seropositive among the patients posted for cataract surgery at a tertiary care center in north India. Methods: It was a cross-sectional study done for 30 months duration. All the patients posted for cataract surgery underwent comprehensive ophthalmic evaluation followed by routine hematological workup, including viral markers for HIV, Hepatitis B surface antigen (HBsAg), and anti-HCV. Data were analyzed by the Statistical Package for Social Science (SPSS Version 20). Results: A total of 7,316 individuals underwent cataract surgery from Jan 2016 to August 2018, 4,073/7,316 (55.7%) were males. The prevalence for HIV was 58/7,316 (0.8%), HBsAg was 151/7,316 (2.1%), and HCV was 11/7,316 (0.1%); 28/58 (48.3%) HIV positives were unaware of their seropositivity till testing, as were 37/151 (24.5%) of HBsAg positives, and 4/11 (36.4%) HCV positives. There was a significant relationship between the mean age in the patients with HIV (P = 0.002) and anti-HCV (P = 0.045). A majority of the seropositive patients were found to be illiterate (45.6%), followed by educated up to high school level (29.1%), and graduate (25.0%). Conclusion: Viral seropositivity was significant among the patients posted for cataract surgery. The eye care providers could refer these patients for counseling and further management for the patient's and their caretaker's benefit. © 2022 Indian Journal of Ophthalmology.
Sturge-Weber syndrome with involvement of chest dermatomes and unilateral buphthalmos: A rare association
(2013) Deepak Mishra; Prashant Bhushan; Mahendra K. Singh; Om P. Mishra
Sturge-Weber syndrome is a rare neuro-cutaneous disease presenting as port- wine stain over distribution of trigeminal nerve. There is a wide variability in manifestations of the disease. Associated malformations in the form of buphthalmos is a rare occurrence with this disorder. We report a 2 months old infant who had bilateral port- wine stain over face and extending over the upper part of chest. There were no seizures and developmental milestones were normal. The patient had associated buphthalmos in the right eye. The intraocular pressure in the right eye was raised while it was normal in left eye. Cranial CT scan did not reveal any calcifications. In conclusion, Sturge- Weber syndrome may not present clinically in its typical form. The presence of buphthalmos is to be looked especially when there is extensive bilateral port-wine stains.
The impact of COVID-19 related lockdown on ophthalmology training programs in India - Outcomes of a survey
(Wolters Kluwer Medknow Publications, 2020) Deepak Mishra; Akshay Nair; Rashmin Anilkumar Gandhi; Parikshit J. Gogate; Satanshu Mathur; Prashant Bhushan; Tanmay Srivastav; Hemendra Singh; Bibhuti P. Sinha; Mahendra Kumar Singh
Purpose: In 2020, in response to the emergence and global spread of the disease COVID-19, caused by a new variant of coronavirus 2019-nCoV, the government of India ordered a nationwide lockdown for 21 days, which was then extended to a total of over 50 days. The aim of this study is to assess the effect of the lockdown on ophthalmic training programs across India. Methods: An online survey was sent across to trainee ophthalmologists across India through various social media platforms. Results: In all, 716 trainees responded; the average age was 29.1 years. Results showed that majority of the respondents were enrolled in residency programs (95.6%; 685/716) and the others were in fellowship programs. About 24.6% (176/716) of the trainees had been deployed on 'COVID-19 screening' duties. Nearly 80.7% (578/716) of the trainees felt that the COVID-19 lockdown had negatively impacted their surgical training. Furthermore, 54.8% (392/716) of the trainees perceived an increase in stress levels during the COVID-19 lockdown and 77.4% (554/716) reported that their family members had expressed an increased concern for their safety and wellbeing since the lockdown began. In all, 75.7% (542/716) of the respondents felt that online classes and webinars were useful during the lockdown period. Conclusion: Our survey showed that majority ophthalmology trainees across the country felt that the COVID-19 lockdown adversely affected their learning, especially surgical training. While most found online classes and webinars useful, the trainees' perceived stress levels were higher than normal during the lockdown. Training hospitals should take cognizance of this and reassure trainees; formulate guidelines to augment training to compensate for the lost time as well as mitigate the stress levels upon resumption of regular hospital services and training. Going ahead, permanent changes such as virtual classrooms and simulation-based training should be considered. © 2020 Indian Journal of Ophthalmology | Published by Wolters Kluwer - Medknow.
Variations in the central corneal thickness during the menstrual cycle in Indian women
(Wolters Kluwer Medknow Publications, 2020) Deepak Mishra; Prashant Bhushan; Shikha Sachan; M.K. Singh; Chaitra Jayadev; Pallak Kusumgar
Purpose: To determine the changes in central corneal thickness (CCT) during the menstrual cycle in Indian women. Methods: A prospective observational clinical study at a tertiary care center between December 2015 and December 2018. One hundred and twenty sixty women between 18 and 45 years were included. The CCT was measured using an ultrasound pachymeter at three specific timelines of the menstrual cycle: at the beginning (1st to 3rd day), during ovulation time (14th to 16th day), and at the end of the cycle (28th to 33rd day). Phases of the cycle were confirmed by the urine luteinizing hormone level. Results: The mean CCT of both eyes was 541.76 ± 4.21 μm, 559.21 ± 4.50 μm, and 544.52 ± 8.06 μm at the beginning, mid, and end of cycle, respectively. The mean CCT of the right eye was 541.68 ± 4.15 μm, 559.08 ± 4.50 μm, and 544.44 ± 8.06 μm and of the left eye was 541.84 ± 4.27 μm, 559.35 ± 4.50 μm, and 544.61 ± 8.06 μm at the beginning, mid, and end of cycle, respectively. Conclusion: The CCT value was significantly (P < 0.001) higher during ovulation compared to the beginning and end of the menstrual cycle. Our study recommends adding menstrual history in the workup of women undergoing refractive surgery as physiological variations in the CCT may result in unexpected surgical outcomes. © 2020 Indian Journal of Ophthalmology.