Epidemiology

ABSTRACTThe visual system is the portion of the central nervous system through which human organism is able to see. Eye is very sensitive organ of our system so the care is very important. The task of the visual system is a big one. This system must have an almost innumerable amount of available information and extract only the useful information. Most important special sense in human being is the vision. For normal physical, mental, psychological development and education, vision should be normal. The aim of this review is to evaluate the ocular morbidity in the population of Uttarakhand. This study is a literature review of published studies from 2013 to 2017, held in the different journal and article and websites. Refractive error was the commonest ocular morbidity followed by disorders of conjunctiva, congenital malformations of eye, disorders of eyelid, lacrimal system and orbit, injury of eye and orbit, superficial injury of eye, disorders of sclera, cornea, iris and ciliary body, disorders of choroid and retina and presence of functional implant. Most common complaint among children was watering of the eye followed by discharge from eyes, redness of eye and headache, diminished vision, itching and inability to see clearly in dim light. Prevalence of ocular morbidity was significantly associated with age. Commonest causes of injury were contact lens wear, road traffic accidents, sports playing & recreational activities and occupational. Delay in presentation was associated with complications. Stable intervention programs targeting refractive errors, allergic conjunctivitis, infections of lid and adnexa and trauma are used to decrease the burden of ocular morbidity. Keywords: Visual System, Vision, Visual pathway, Visual Defects, Epidemiology, Ocular Morbidity

ABSTRACTClostridium Difficile (CD) is the most important cause of nosocomial diarrhea in adults. Illness may range from mild watery diarrhoea to life-threatening colitis. CD has now also emerged in the community in populations previously considered low risk. Emerging risk factors and disease recurrence represent continued challenges in the management of CDI. Diagnosis is based primarily on the detection of C. difficile toxin A or toxin B. These toxins primarily disrupt the cytoskeletal structure and the tight junctions of target cells causing cell rounding and ultimately cell death. The toxins trigger a complex cascade of host cellular responses to cause diarrhoea, inflammation and tissue necrosis- the major symptoms of CDI. The factors responsible for the epidemic of some C. difficile strains are poorly understood the organism has evolved over the last 8 years to become more virulent and resistant to antimicrobials causing a more severe form of the disease that has increased mortality and healthcare costs. The guideline provides recommendations for the diagnosis and management of patients with CDI as well as for the prevention and control of outbreaks while supplementing previously published guidelines. New molecular diagnostic stool tests will likely replace current enzyme immunoassay tests. We suggest treatment of patients be stratified depending on whether they have mild-to-moderate, severe or complicated disease. This chapter highlights the current knowledge on C. difficile how to produce infection in human, transmission, guidelines, Epidemiology, risk and diagnosis. Keywords: Clostridium difficile, pathogenesis, guidelines, Epidemiology, risk factors, diagnosis.