The spectrum of Vogt-Koyanagi-Harada disease in South India

Purpose To report the clinical spectrum of Vogt-Koyanagi-Harada (VKH) disease in a tertiary care center in South India. Methods Medical records of patients diagnosed with VKH disease who presented between January 1995 and December 2003, with a minimum follow-up of one year were reviewed. Results Of the 45 patients, 38 (84.44%) were female. The median age was 37 years (SD ± 14.23) and median duration of symptoms was 30 days (range 1 day to 1 year). 75.5% (34/45) presented with bilateral anterior uveitis. Posterior segment presentation included disc edema (31/45), bilateral serous retinal detachments (26/45), vitritis (17/45) and sunset glow (8/45). Extra ocular manifestations were seen in only 4/45 (tinnitus: 2, meningismus: 1, poliosis: 1). 97.7% (44/45) received oral Prednisolone (1 mg/kg body weight) for a median duration of 14 months. 69% (31/45) received additional three pulses of intravenous methylprednisolone and 22% (10/45) received a single infusion of intravenous Cyclophosphamide. One patient received intravitreal triamcinolone injection 53.33% (24/45) were treated with additional immunosupressants. At the first visit, best corrected visual acuity (BCVA) was ≥20/40 in 23 eyes (25.55%) and ≤20/400 in 37 eyes (41.11%). At one year, 61 eyes (67.77%) achieved BCVA of ≥20/40 while 12 eyes (13.33%) had BCVA ≤20/400. Complicated cataract, glaucoma and macular scar were the major complications encountered. Conclusions Majority of patients with ocular VKH presented with anterior uveitis and serous retinal detachments and disc edema. Extra-ocular signs are rare in our patients. Visual prognosis is good with treatment with adequate long-term corticosteroids and immunosuppressive agents.     

Fungal keratitis following amniotic membrane transplantation

Purpose To report a case of fungal keratitis following amniotic membrane (AM) transplantation for pseudophakic bullous keratopathy. Method A 55-year-old female underwent amniotic membrane transplantation (AMT) with epithelial debridement and anterior stromal puncture in the left eye for symptomatic bullous keratopathy. She developed fungal keratitis after 4 weeks. Result Aspergillus sp. was isolated from the corneal scraping. The patient was treated with systemic and topical antifungal medication. Conclusion Although AMT is safe, there is a risk of microbial infection after the procedure especially in poor ocular surfaces.     

Isthmic uterine fibroids: the dynamics of growth

The isthmus of uterus is different from the rest of uterus and cervix in anatomic as well as functional aspects. The tumors arising from it may be subjected to a different set of forces which may predispose to growth in a tangential or horizontal direction. A young woman who underwent myomectomy for a large isthmic myoma is presented and the growth dynamics are discussed.     

Processes of High-Yield Isolation and Flash Chromatographic Purification of Azadiradione from Neem Fruits

Proceedings of the National Academy of Sciences, India Section B: Biological Sciences - Neem (Azadirachta indica) is a well-known medicinal tree uniquely producing more than 300 diversified...     

Variations in the Leaf Alkaloid Content of Androgenic Diploid Plants of Datura innoxia

Anther culture of DATURA INNOXIA Mill, has permitted the obtention of spontaneous diploid androgenic plants which produced the tropane alkaloids. The source plants (zygotic diploid) showed no significant variations in the leaf alkaloid content. On the contrary, androgenic diploid plants obtained after the first cycle of androgenesis showed important quantitative and qualitative variations in the leaf alkaloid content. Thus, androgenesis was found to induce a large variation in the accumulation of these secondary metabolites in the leaves. It has also permitted the obtention of tropane alkaloid-overproductive plants, particularly rich in scopolamine. The analyses of zygotic plants obtained from seed germination of the first cycle androgenic plants have shown that this variability is transmissible by simple cross-pollination. The analyses of androgenic diploid plants obtained after the second cycle of androgenesis also showed variations in the leaf alkaloid content. IN VITRO androgenesis, therefore, clearly induced variability in the leaf alkaloid content of the androgenic plants. The role of IN VITRO androgenesis in inducing variability has been discussed.