European Journal of Cardiovascular Medicine

Background: Bipolar disorder is the sixth leading cause of disability worldwide, affects about 60 million people worldwide3 and has a lifetime prevalence of about 1-3% in the general population worldwide. Objective: To assess the level of perceived Stigma, Self-esteem and Quality of Life in euthymic patients of Bipolar Affective Disorder. Methods: This cross-sectional study was conducted among all euthymic patients of Bipolar Affective Disorder, attending Psychiatry services in the Department of Psychiatry, Tertiary care center of a General Hospital. Results: Bipolar Affective Disorder patients have significantly higher stigma associated with illness even when they are euthymic. Their self-esteem is significantly lower even when they are not symptomatic and it is significantly associated with number of relapses. Their quality of life is also significantly lower than healthy population across all domains specially social relation and psychological heath domain. High level of Stigma and lower Self-esteem significantly affect the Quality of Life in patients of Bipolar Affective Disorder and can predict change in it, though stigma and self-esteem show significant association but they do not seem to be predictive of each other’s severity. Conclusions: This study is a small step in demonstrating that Bipolar Disorder patients, even when they are in a euthymic period, experience lower Quality of Life, have lower Self-esteem and experience higher internalized Stigma associated with illness.

Background: Vitiligo is an acquired disorder of the melanocytes characterized by depigmented macules and patches. The chronic, unpredictable course of the disease and the visible cosmetic disfigurement leading to social discrimination lead to a decline in the quality of life (QoL) of patients suffering from Vitiligo. Aims and objectives: This study aims to assess the impact of Vitiligo on the quality of life of patients using two questionnaires – Dermatological Life Quality Index (DLQI) and Vitiligo Quality of Life (VitiQoL). Materials and methods: All patients above the age of fifteen years presenting with Vitiligo were included in the study after taking written informed consent. Patients with any other co-existing debilitating disease or disability, psychiatric problems, systemic or personal conditions which might have an impact on the Quality of life (QoL) as well as pregnant and lactating women were excluded from the study. Socio-demographic data and detailed history regarding the symptoms, duration of disease, and treatment history was recorded. A thorough general physical, systemic, and cutaneous examination was done. Patients were requested to answer the questions of the DLQI questionnaire and VitiQoL questionnaire after clearly explaining the meaning of the questions to them in their preferred language. The answers were noted by the same dermatologist in every case. The DLQI and VitiQoL score was then calculated. The scores were evaluated and compared at the end of the study. Results: A total of 78 patients were included in the study in the age group of 15-78 years and the mean age was 34.6 ± 4.4 years. There were 46 males and 32 females included in the study and the male-female ratio was 1.4:1. According to the DLQI scores, a moderate effect was seen in 27(34.6%) patients, followed by a very small effect in 24(30.7%) patients, very large effect in 18(23%) patients, no effect in 6(7.6%) patients and extremely large effect in 3(3.8%) patients. The mean DLQI score was 7.8 ± 5. There were 19(24.3%) new patients, and 59(75.6%) patients already under treatment for vitiligo. The commonest type was non-segmental (generalized vitiligo) seen in 38(48.7%) patients followed by acro-facial in 14(17.9%) patients. Segmental vitiligo was present in 8(10.2%). The duration of symptoms was greater than one year in 44(58.9%) patients and the mean duration was 1.8 years. Around 21(26.9%) patients had patches of overexposed parts of the body and a family history of vitiligo in first–degree relatives was positive in 3.8% of patients. The VitiQoL score in our study had a mean value of 37.8 with a standard deviation of 4.2. Higher mean values were seen in questions pertaining to frustration regarding the disease (3.8± 2.4), fear of progression (3.3±1.9), and worrying about what other people might think of them (3.1±2.7). Conclusion: Vitiligo is a disease that is still significantly associated with tremendous social stigma which greatly impacts the personal, professional, and social aspects of the patient’s life. Understanding the degree of impairment that Vitiligo can have on the quality of life (QoL) of patients will help us understand the magnitude of the problem and thereby take adequate steps like treatment with psychological support as well as counseling, along with community awareness programs to improve the QoL of patients.

Menstrual hygiene is a topic that has long been shrouded in silence and stigma, but in India, it has emerged as an urgent public health concern that demands our immediate attention. The lack of access to proper menstrual hygiene management not only affects the well-being of millions of Indian women and girls but also has far-reaching consequences for their health, education, and overall quality of life.¹Menstruation is a naturally unfolding biological process that takes place in adolescent girls and women of reproductive age.²

In a country as diverse as India, where cultural norms, traditions, and socioeconomic disparities vary widely,³ addressing menstrual hygiene requires a multifaceted, integrated approach. Here, we shed light on the critical aspects of this issue and the imperative need for a unified strategy to combat the menstrual hygiene crisis in India.

Background/Objectives: The knowledge, attitudes, and practices (KAP) of parents and caregivers play a pivotal role in managing and adhering to treatment for childhood epilepsy. However, there is a paucity of research on these factors in developing countries, including India. This cross-sectional observational study aims to address this research gap by assessing the KAP of parents and caregivers regarding childhood epilepsy in northern India. Materials and Methods: The study will be conducted in the Department of Anesthesia at a tertiary care hospital in Karnataka. The study sample will include all doctors from the Department of Anesthesia who have given their consent to participate, encompassing all postgraduate residents. Results & Discussion: The findings revealed significant misconceptions and knowledge gaps. Notably, 73.5% incorrectly believed epilepsy is a mental illness, 39% attributed it to supernatural causes, and 21.5% thought it was contagious. These misconceptions could contribute to stigma and social isolation. The study also highlighted the perceived social and educational impacts, with 85% believing epilepsy hinders family life and 71.5% thinking it affects school performance. Conclusion: This study reveals significant misconceptions and knowledge gaps among parents and caregivers regarding childhood epilepsy in North and South India. Key findings include incorrect beliefs about epilepsy's nature, causes, and management, as well as reports of social stigma and financial burden. These results highlight the urgent need for targeted educational interventions to improve epilepsy awareness, reduce stigma, and enhance treatment adherence

Background: Refractive error is a global health concern affecting a huge number of people and is associated with various ocular morbidities, overall prevalence of refractive errors was found to be 29%. A refractive error study in children (RESC) in India showed, hyperopia present in 7.7% of children &myopia in 7.4%. Correction of significant refractive errors in childhood helps in preventing amblyopia & strabismus. All the patients who attended the ophthalmic OPD at tertiary health care centre with visual defects were included in the study. The study is proposed to be conducted from November 2018 to May 2019. There was no significant shift in number of patients pre and post dilation in both eyes of patients of myopic astigmatism, with (p-value = 0.6478) and (p-value = 0.3862) for right and left eyes respectively, which are not significant. Materials and methods: Patients between 5 and 25 years with a visual acuity better than +0.3 logmar unit were included in this study. Noncycloplegic AR, cycloplegic AR and cycloplegic refraction were done for each patient. These results were compared. Result: In our study included 48.9% of males and 51.1% female patients, with maximum patients 30 (33.3%) in age group of 16-20years. Comparison of pre & post cycloplegic values of Auto-refractometer values in 23 & 24 right and left eyes of hypermetropia patients respectively, there was a significant increase in number of patient from dioptric range (+0.25 to +1.25) to (+2.75 to +3.75), which was 12 to 28 and 20 to 31 right and left eyes respectively, with (p- value= 0.0001) in right eye and (p-value = <0.001) in left eyes, which is significant. There was no significant shift in number of patients pre and post dilation in both eyes of patients of myopic astigmatism, with (p-value = 0.6484) and (p-value = 0.3868) for right and left eyes respectively, which are not significant. Conclusion: Retinoscopy is a reliable starting point for refraction; however, autorefraction values are important in order to accurately prescribe cylindrical correction

Background: To compare SMILE (Small Incision Lenticule Extraction) and FS-LASİK (Femtosecond Laser In Situ Keratomileusis) procedures in terms of dry eye disease. SMILE is a less invasive and flapless method, in this technique, an instrastromal lenticule is extracted through a small incision, anterior cornea is left intact thus corneal biomechanical stability is protected and nerve fibers are preserved, that causes reduction in dry eye. Materials and methods:  This is a prospective study was conducted in the Department of Ophthalmology, Mamata Academy of Medical Sciences. Before the surgery, patients read and signed an informed written consent. Forty-seven patients with myopia and/or myopic astigmatism who had undergone SMILE procedure. Forty-three patients with myopia and/or myopic astigmatism who had undergone FSLASIK procedure. Result: Post hoc tests showed that, at 1 and 3 months after operation, there was a statistically significant decrease in TBUT from preoperative values in the SMILE group (8.32 ± 1.39, 𝑝 < 0.001, and 10.25 ± 0.99, 𝑝 < 0.001, resp.), before returning to preoperative values by 6 and 12 months (11.62 ± 0.99, 𝑝 = 0.740, and 11.88 ± 0.98, 𝑝 = 1.00, resp.). In the FS-LASIK group, TBUT was statistically significantly reduced from preoperative values at 1 month, 3 months, and 6 months postoperatively (8.58 ± 1.28 𝑝 < 0.001, 9.48 ± 0.99, 𝑝< 0.001, and 10.24 ± 1.49, 𝑝 < 0.001, resp.), before returning to preoperative values at 12 months (11.35 ± 0.94, 𝑝 = 0.826) Conclusion: The results in both procedures are matching and comparable but a further contralateral eye studies is needed to have a homogenous preoperative matching and avoid bias

Introduction: Leprosy or Hansen disease is a slowly progressive infection caused by Mycobacterium leprae that mainly involves skin, peripheral nervous system, upper respiratory tract, eyes and testes. Leprosy is one of the oldest debilitating diseases, still there are no tools to diagnose subclinical infections and to culture the bacteria. Analysis of epidemiological data, clinical features and histopathological features and their interpretation plays a very crucial role in early diagnosis, treatment, disability prevention and most importantly elimination of social stigma in society pertaining to disease. Adequate clinical information combined with histopathology and bacteriological index help in diagnosis and classification of different types of leprosy there by in management of cases. Objectives: 1. To study the age and sex distribution among cases with Hansen’s disease.  2. To study the Spectrum of Clinical and Demographic features of Histopathologically proven Hansen’s disease cases and classify according to Ridley-Jopling classification. Methods: In the present study, the skin biopsies of cases clinically diagnosed or suspected of Hansen’s disease submitted to the Department of Pathology, Karnataka Institute of Medical sciences, Hubballi, over a period of 3 years (1 year retrospective and 2years prospective study) between July 2019 to June 2022, were studied. Paraffin blocks are prepared followed by staining the 5-micron thickness sections with haematoxylin and eosin with standard techniques as observed in Department of Pathology, KIMS, Hubballi. Various clinical and histopathological spectrum of skin lesions in Hansen’s disease were studied and classified according to Ridley-Jopling classification. Results: Majority of the patients, that is 72 (25.4%) cases were in age interval of 31-40 years. Least incidence of leprosy cases was observed in the age group of 71- 80 years accounting to 5 (1.8%) cases. Male to female ratio of 1.9:1. Borderline Tuberculoid Leprosy (BT) was the most common type of leprosy, accounting to 130 (45.7%) cases which was followed by Indeterminate Leprosy (IL) in 42 (14.8%) cases. Conclusions: This study concludes that correlation of clinical features, histopathological findings and bacterial index is very essential for arriving at diagnosis and proper typing of leprosy, which in turn prevents disability and drug resistance.

Cataract is the leading cause of curable blindness worldwide. Surgical extraction of cataract with concurrent posterior chamber intra ocular lens implantation most often results in complete and immediate post operative visual rehabilitation.  Objectives: In this study an attempt was made to categorize the post operative visual outcome. Analyze the causes for subnormal vision in patients undergoing manual small incision cataract surgery with posterior chamber intraocular lens implantation. Material and Methods: The present study conducted in the Department of Ophthalmology, AJ Institute of Medical Sciences and Research Centre, Mangalore. Ninety one patients were included in this prospective study from November 2023 to October 2024. Best corrected visual acuity and complications were noted at one day, one and six weeks post operatively and tabulated. Postoperative best corrected visual acuity was categorized into mild, moderate and severe vision loss based on the World Health Organization criteria for visual outcome in cataract surgery. Results: At the end of six weeks eighty patients (87.91%) had only mild vision loss while seven patients (7.69%) had moderate vision loss and four patients (4.40%) had severe vision loss. The cause of subnormal vision was found to be post operative astigmatism in eighty six patients (94.51%), followed by residual lens matter in visual axis in four (4.40%), cystoid macular oedema in three (3.30%), pigments on the intraocular lens in two (2.20%), pigments on the endothelium in two (2.20%), decentration of the intraocular lens in two (2.20%) and vitreous in the anterior chamber in one (1.10%). Conclusion: At six weeks post operative period, subnormal vision in majority of patients could be categorized as only a mild vision loss and the most common cause was post operative astigmatism in these patients

Background: Tuberculosis (TB) remains a major public-health threat in rural India, where poverty, distance and stigma undermine therapy. This study assessed treatment compliance and outcomes among drug-sensitive TB patients in rural Jalaun District, Uttar Pradesh. Methods: A descriptive cross-sectional survey in Jalaun Block enrolled all NI-KSHAY-notified, drug-sensitive patients (n = 134) starting treatment between 1 January and 30 June 2023. Participants were interviewed within four weeks using a validated questionnaire covering socio-demographics, perceived stigma and pill-taking over 30 days. Participants were predominantly male (55 %) with a mean age of 34.7 years. Most belonged to lower socio-economic classes III and IV. Compliance—defined as ingesting ≥ 90 % of prescribed doses—was analysed alongside treatment outcomes; associations used χ², Fisher’s exact or t-tests at p < 0.05. Results: Compliance reached 92.5 % (124/134). Cure or treatment completion occurred in 86.6 %, while failure, death and default were 4.4 %, 5.2 % and 3.8 %, respectively. Non-compliance (7.5 %) was tied to being unmarried (70 % vs 24.2 %), illiterate (50 % vs 37.1 %), stigmatised (80 % vs 28.3 %), experiencing side-effects (80 % vs 44.4 %), living farther from the facility (11.1 km vs 4.1 km) and longer waiting time (17.2 vs 11.6 min) (all p < 0.05). Age, weight and BMI showed no significant difference. Conclusion: Rural Jalaun’s Tuberculosis Unit achieved adherence and cure rates exceeding national targets, yet a vulnerable subgroup bore disproportionate mortality and default. Targeted stigma-reduction counselling, travel support and proactive side-effect management could close this gap and accelerate End-TB progress in similar settings.

Background: To evaluate the reliability of non-contact tonometry (NCT) compared to Goldmann applanation tonometry (GAT) for measuring intraocular pressure (IOP) in patients with myopic astigmatism and healthy controls, and to assess correlations between IOP, central corneal thickness (CCT), and keratometry values. Methods: A prospective comparative study was conducted at Vydehi Institute of Medical Sciences, involving 50 patients with myopic astigmatism (-0.25D to -3.50D) and 50 healthy controls (200 eyes total). IOP was measured using NCT (Reichert 7 Auto Tonometer) and GAT (Appasamy AATM-5001) between 9 and 11 am. CCT was measured using a Konan Specular Microscope, and keratometry values were obtained with a Unicos URK-800F. Statistical analysis was performed using IBM SPSS version 25, with Pearson’s correlation and unpaired t-tests (p ≤ 0.05). Results: Mean IOP in the myopic astigmatism group was 15.26 mmHg (right eye, RE) and 14.91 mmHg (left eye, LE) with NCT, and 14.58 mmHg (RE) and 14.62 mmHg (LE) with GAT. In controls, mean IOP was 14.49 mmHg (RE) and 14.49 mmHg (LE) with NCT, and 14.52 mmHg (RE) and 14.56 mmHg (LE) with GAT. NCT and GAT measurements were significantly correlated (p < 0.001) in both groups. No significant correlations were found between IOP and CCT or keratometry values. Conclusion: NCT is a reliable alternative to GAT for IOP measurement in myopic astigmatism (≤3.0D), facilitating glaucoma screening.

Background: Pruritus represents a distressing but often neglected comorbidity of type 2 diabetes mellitus (DM2) with possible impacts on quality of life (QoL), glycemic management, and psychological status. However, there is a dearth of Indian clinical data on this entity. The present study was designed to find out the prevalence, severity and clinical as well as psychological correlates of pruritus among adult DM2 patients in a tertiary care hospital in India. Methodology: This is a cross-sectional study that was performed from February 2023-22 at the College of Medicine, a tertiary care hospital, in which 354 adult DM2 patients were thpatient: 1). Itch was evaluated according to the Numerical Rating Scale (NRS) and Four-Item Itch Questionnaire (4IIQ). Diabetic neuropathy was evaluated by Katzenwadel scale. ItchyQoL, Hospital Anxiety and Depression Scale (HADS). Metabolic indicators including HbA1c and FPG were compared among patients with and without pruritus. Results: One hundred and thirty-nine (39.3%) of the patients reported pruritus. Mild, moderate and severe itch accounted for 27.3%, 48.2%, and 24.5% of them, respectively. Patients with pruritus had higher HbA1c levels (8.6 ± 1.2 vs. 7.9 ± 1.0; p = 0.003) and FPG (165.2 ± 28.6 vs. 151.8 ± 25.9 mg/dL; p = 0.012). Psychologic assessment demonstrated higher levels of anxiety (9.3 ± 2.1), depression (8.1 ± 1.9), and stigmatization scores (5.4 ± 1.6) in pruritic patients. Conclusion: Pruritus is a prevalent and burdensome symptom in Indian patients with DM2, significantly associated with poor glycemic control, and diabetic neuropathy. It also imposes substantial psychosocial stress, highlighting the need for integrated dermatologic and psychological evaluation in routine diabetes management.