Natl Med J India
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Numerous studies have investigated the causes of falls in the elderly. However, there is little information about metabolic syndrome (MS) as a risk factor for falls in older adults. No evaluations have given a qualitative overview of studies examining the relationship between MS and falls in the elderly. ⋯ These included 2774 people with an average age of 72 years. Even after controlling for other risk factors, two studies found that MS was significantly associated with an older adult's 1.3-2.5-fold increased risk of falling. We found that MS and its independent components were strongly linked with falls among the elderly, even after correcting for numerous variables.
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Anterior ischaemic optic neuropathies (AIONs) are a common cause of permanent visual loss in the elderly population. The non-arteritic subtype has been intensively studied. While systemic associations such as hypertension and diabetes mellitus are commonly recognized and treated, others such as obstructive sleep apnoea (OSA) are largely overlooked in daily practice. ⋯ OSA is a definitive risk factor for the development of NAION, though it remains underdiagnosed and untreated. Cataract surgery has been shown to worsen underlying NAION. Systemic stabilization averts potentially blinding sequel in the unaffected eye of these patients.
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Enterobacter is a Gram-negative anaerobic bacillus. Enterobacter-associated endophthalmitis is rare. We report Enterobacter cloacae-associated traumatic endophthalmitis following a water gun injury with no visible external entry wound. ⋯ Final visual acuity was 20/200. Traumatic endophthalmitis is usually preceded by a penetrating ocular injury in the form of a corneal, limbal or scleral tear with or without choroidal tissue prolapse and vitreous prolapse. A high index of suspicion is, therefore, needed for the diagnosis of endophthalmitis in the absence of corneal injury following water jet trauma to the eye.
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Background Advanced diagnostics are not easily accessible in austere topographical locations. We documented retinal changes in patients with acute mountain sickness (AMS+) and compared these with asymptomatic individuals (AMS-) with recent induction into high altitude using direct ophthalmoscopy as a screening tool. Methods We evaluated 97 individuals (43 AMS- and 54 AMS+) who were inducted to an altitude 3800 m above sea level by direct ophthalmoscopy after pupillary dilatation, on day 2 of arrival. ⋯ Conclusion Acute hypobaric hypoxia causes retinal venous dilatation, tortuosity and hyperaemia of the optic disc in those with AMS and correlates directly with SpO2 levels. The incidence of retinal vein dilatation increases with frequent re-entry into high altitude and more severe symptoms of AMS. Hence, all those being inducted to high altitude should be screened for retinal vascular changes.
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With the decline in HIV mortality, a concomitant increase in morbidity and death not directly related to HIV has been witnessed. Consequently, many countries especially low- and middle-income countries (LMICs) are now facing the dual burden of HIV and non-communicable diseases (NCDs). 2.3 million people living with HIV in India are at a higher risk of developing NCDs due to ageing, which can be attributed to the additional impact of long-standing HIV infection and the side-effects of antiretroviral therapy. ⋯ The health and wellness centres (HWCs) envisioned to provide an expanded range of preventive and curative services including that for chronic conditions may act as a window of opportunity for providing egalitarian and accessible primary care services to these individuals. The reasons for integrating HIV and NCD care are epidemiological overlap between these conditions and the similar strategies required for provision of healthcare services.