A prospective study of 413 cases of lens-induced glaucoma in Nepal

PURPOSE: To determine the frequency and types of lens-induced glaucoma (LIG), reasons for late presentation and outcome of current management. METHODS: Prospective case series of 413 patients/eyes with LIG over a 12-month period in 1998; 311 of these patients underwent cataract surgery. Visual acuity and intraocular pressure (IOP) were pre- and postoperatively assessed. RESULTS: Four hundred and thirteen (1.5%) of 27,073 senile cataracts seen in the outpatient department of Sagarmatha Choudhary Eye Hospital, Lahan, Nepal presented with LIG. There were 298 (72%) phacomorphic cases and 115 (28%) phacolytic glaucoma. Pain for more than 10 days was reported by 293 (71%) patients. The majority, 258 (62.4%), travelled a distance of more than 100 kms to the hospital. The major reasons for late presentation were "no escort" in 143 (34.6%) and "lack of money" in 128 (31.0%) cases. At presentation the IOP was more than 30 mm Hg in 327 (79%) eyes. Following cataract surgery, 251 (80.7%) had 21 mm Hg or less at discharge. The visual acuity was hand-movement or less before surgery in all eyes; at discharge 120 of 311 operated eyes (38.6%) achieved 6/60 or better, 97 (31.2%) less than 6/60, and 94 (30.2%) less than 3/60. The main causes for poor outcome in 94 cases were optic atrophy in 32 (34%) eyes, uveitis in 25 (26.6%)eyes and corneal oedema in 24 (25.5%) eyes. CONCLUSION: The results highlight the importance of early diagnosis and treatment of visually disabling cataract. There is a need to educate both the patient and the cataract surgeon of the dangers of lens-induced glaucoma and of the poor outcome if treatment is delayed.     

Studies on the adduct heterogeneity of benzo[a]pyrene 7, 8-dihydrodiol 9,10-epoxide stereoisomers covalently bound to deoxyribooligonucleotides by induced circular dichroism and light absorption spectroscopy.

The binding conformations of single anti- and syn-BPDE-N2-dG adducts in oligonucleotides of varying base composition have been studied by induced circular dichroism (ICD) and light absorption spectroscopy. The sign of the ICD in single-stranded oligonucleotide adducts correlates with the absolute configuration of the cyclohexyl moiety of the BPDE. Adducts in oligonucleotide duplexes with UV lambdamax <350 nm exhibiting a significant duplex-induced positive ICD should have a minor groove location as the predominant conformation. Those with UV lambdamax >350 nm exhibiting either positive or negative contributions to the ICD should have intercalated binding as the predominant conformation. The magnitude of the ICD is dependent on the sequence context of the adducted strand and the particular BPDE-adduct isomer under study. In some cases, the results suggest structural heterogeneity. For instance, the (+)- and the (-)-trans-anti-BPDE-N2-dG adducts in duplexes where a dT flanks the lesion site exhibit weak positive ICD or negative ICD. These results reflect a bimodal conformational adduct distribution with contributions from both externally and internally located adducts. A key observation for the (+)-cis-syn-BPDE-N2-dG complexes in 5'-d(TGC) and 5'-d(CGC) sequence contexts is that the near-UV absorption spectra showed distinct bands corresponding to minor groove binding (lambdamax congruent with 346 nm) as well as intercalative binding (lambdamax congruent with 354 nm). Evidence for an equilibrium between the different modes of localization is provided by the results from the temperature dependence of the near-UV absorption and ICD characteristics of (+)-cis-syn-BPDE-N2-dG complexes in 5'-d(TGC) and 5'-d(CGC) sequence contexts, respectively.     

Melanotic neuroectodermal tumour of maxilla in infancy

Melanotic neruoectodermal tumour of infancy is an uncommon pigmented neural crest derivative. It is usually found affecting children aged one year or less. We present a case report of a four month old male infant with this tumour arising from the right maxilla showing extensive involovement of the surrounding bony and soft tissue structures.     

Antemortem diagnosis of Leigh’s disease: Role of magnetic resonance studies

A two-and-a-half-year-old male child presented with recurrent attacks of intractable vomiting, psychomotor retardation since 14 months of age. He had also lower cranial nerve palsy and corticospinal involvement. Magnetic resonance imaging had shown multiple well circumscribed areas of hypointusity in T, weighted image which were brightly hyperintense in heavily T₂-weighted image. The lesions were seen in basal ganglia, thalamii and brainstenvand spared mamillary bodies. Magnetic resonance spectroscopy demonstrated lactate peak in the affected areas confirming the diagnosis of Leigh’s disease. The child responded well to large dose of vitamin ‘B’, therapy.     

Analysis of phytochemical profile of Terminalia arjuna bark extract with antioxidative and antimicrobial properties

Objective

To investigate phytochemical screening, antimicrobial activity and qualitative thin layer chromatographic separation of flavonoid components, antioxidant activity and total flavonoid compound of Terminalia arjuna.

Methods

For phytochemical screening, some common and available standard tests were done. Antimicrobial bioassay was done through agar well diffusion method. Detection of antioxidant activity and flavonoid compounds were done through thin layer chromatography. Total antioxidant activity was measured by 2, 2-diphenyl-1-picrylhydrazyl (DPPH) in colorimetric method. Aluminum chloride colorimetric method was used for total flavonoid determination.

Results

Phytochemical screening showed the active compounds presence in high concentration, such as phytosterol, lactones, flavonoids, phenolic compounds and tannins and glycosides. The antimicrobial activity of extract showed that greater inhibition zone against Gram negative bacteria than Gram positive bacteria. This methanolic extract showed a promising antioxidant activity, as absorption of DPPH redicles decreased in DPPH free radical scavenging assay. Flavonoids components having antioxidant property present in the methanol extract at a level of 199.00 mg quercetin equivalent/g of dried methanol extract in colorimetric method.

Conclusions

The Terminalia arjuna bark extract revealed the presence of bio-active constituents which are known to exhibit medicinal as well as physiological activities.     

Evaluation of anti-oxidant activities and total phenolic content of Chromolaena odorata

The aim of this study was to assess the in vitro potential of chloroform extract of Chromolaena odorata leaves. The DPPH activity of the extract (0.1–5 mg/ml) was increased in a dose dependent manner, which was found in the range of 23.48–91.61% as compared to ascorbic acid (33.69–94.10%). The IC50 values of chloroform extract in DPPH radical, hydroxyl radical, nitric oxide, ABTS radical were obtained to be 0.31, 0.43, 0.28 and 1.32 mg/ml, respectively. However, the IC50 values for the standard ascorbic acid were noted to be 0.24, 0.41, 0.23 and 1 mg/ml, respectively. Measurement of total phenolic content of the chloroform extract of C. odorata was achieved using Folin–Ciocalteau reagent containing 242.2 mg/g of phenolic content, which was found significantly higher when compared to reference standard gallic acid. The results obtained in this study clearly indicate that C. odorata has a significant potential to use as a natural anti-oxidant agent.     

Accuracy of ultrasonography in the diagnosis of acute appendicitis.

Aims and Objectives: To assess the accuracy of ultrasonography in the diagnosis of acute appendicitis. Methodology: A prospective randomized study was carried in the Dept. of Radiology and Imaging, Tribhuvan University, Teaching Hospital, Maharajgunj, Kathmandu, Nepal. A total of 120 patients, who were clinically diagnosed as acute appendicitis were subjected to ultrasonography of the abdomen. A detailed ultrasonography was performed and the findings were recorded. Twenty one cases had alternate diagnosis. Ninety nine cases ultimately underwent laparotomy and the retrieved appendices were sent for histopathological examination. Intra-operative, histopathological and ultrasonographic diagnoses were then statistically analyzed. Results: Ultrasonographic, intra-operative and histopathological findings were statistically insignificant (P0.05). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy percentage of ultrasonography in the diagnosis of acute appendicitis was 85.7%, 100%, 100%, 6.7% and 85.9% respectively. Conclusion: Ultrasonography has a high degree of accuracy in the diagnosis of acute appendicitis. However, the diagnosis should be considered with the diameter of appendix over 6 mm. Therefore acute appendicitis with diameter of appendix having less than 6 mm should be evaluated with other diagnostic parameters. Key words: Acute Appendicitis, Ultrasonography.