The decision-to-delivery interval in emergency Caesarean sections and its correlation with perinatal outcome: evidence from 204 deliveries in a developing country

The international standard decision-to-delivery interval (DDI) for emergency Caesarean sections (CSs) is ≤ 30 minutes but there is little evidence to support this recommendation. The aim of this study was to evaluate DDI for emergency CS and its relationship to perinatal outcome. We undertook a prospective observational study of consecutive cases of emergency CS. Perinatal outcomes were recorded as: Apgar score; neonates requiring admission; and perinatal deaths. The relation between DDI and perinatal outcome was analysed using chi-square and one way analysis of variance (ANOVA). Of 204 pregnancies observed, 19% of deliveries were achieved in ≤ 30 minutes. The mean DDI was 42.5 ± 19.4 minutes. There was no difference between the perinatal outcome for babies with DDI of ≤ 30 versus 31-60 minutes. There was a significantly higher risk of poor perinatal outcome for babies with DDI > 60 minutes. The perinatal outcome between DDI of ≤ 30 and 31-60 minutes was statistically not different. However, the ≤ 30 minutes DDI should remain the gold standard.     

Primary tuberculosis: an unusual finding in the oral cavity

The unusual involvement of the oral cavity in tuberculosis and the non-specific nature of its presentations mean that diagnosis of tuberculosis is often delayed and is an unexpected finding. The aim of this paper is to present a case of primary tuberculosis and discuss the implications of the manifestations and diagnosis of oral tuberculosis. This paper presents an unusual case of a painless, papillary, erythematous lesion in the anterior region of a maxillary edentulous ridge. When the patient concerned was first seen by the author, the lesion had been present for six months. There was cervical lymphadenopathy and it was diagnosed initially as a malignant lesion. Eventually, after biopsy and ultrasound examination, the diagnosis of primary oral tuberculosis was reached. The patient was managed solely by anti-tubercular drug therapy.     

Ten-year trends in the incidence,clinical profile and outcomes of acute-onset endophthalmitis following combined pars plana vitrectomy and sutureless,glueless and flapless scleral fixation of intraocular lenses

International Ophthalmology - To evaluate the frequency and outcomes of acute-onset endophthalmitis following combined pars plana vitrectomy and scleral fixation of intraocular lens. We evaluated...     

Disseminated acanthamoeba infection in a renal transplant recipient: a case report

Acanthamoeba species are free-living amoebae that are the causative agents of chronic granulomatous meningoencephalitis, amoebic keratitis, pulmonary lesions, cutaneous lesions and sinusitis. Immunocompromised individuals are particularly susceptible to infections with Acanthamoeba, which can be disseminated at times. We herewith report the autopsy findings of disseminated Acanthamoeba infection in a 36-year-old female, a renal transplant recipient on immunosupressants for last four years. Central nervous system showed Acanthamoeba associated chronic granulomatous meningoencephalitis, with predominant perivascular infiltrate of amoebic cysts, trophozoites and inflammatory cells. Both lungs and pancreas also showed infiltration with Acanthamoeba.     

Therapeutic targets for altering mitochondrial dysfunction associated with diabetic retinopathy

Introduction: Retinopathy remains as one of the most feared blinding complications of diabetes, and with the prevalence of this life-long disease escalating at an alarming rate, the incidence of retinopathy is also climbing. Although the cutting edge research has identified many molecular mechanisms associated with its development, the exact mechanism how diabetes damages the retina remains obscure, limiting therapeutic options for this devastating disease.

Areas covered: This review focuses on the central role of mitochondrial dysfunction/damage in the pathogenesis of diabetic retinopathy, and how damaged mitochondria initiates a self-perpetuating vicious cycles of free radicals. We have also reviewed how mitochondria could serve as a therapeutic target, and the challenges associated with the complex double mitochondrial membranes and a well-defined blood-retinal barrier for optimal pharmacologic/molecular approach to improve mitochondrial function.

Expert opinion: Mitochondrial dysfunction provides many therapeutic targets for ameliorating the development of diabetic retinopathy including their biogenesis, DNA damage and epigenetic modifications. New technology to enhance pharmaceuticals uptake inside the mitochondria, nanotechnology to deliver drugs to the retina, and maintenance of mitochondrial homeostasis via lifestyle changes and novel therapeutics to prevent epigenetic modifications, could serve as some of the welcoming avenues for a diabetic patient to target this sight-threatening disease.