Performance of a truncated-edged silicone foldable intraocular lens in Indian eyes

PURPOSE: To study the role of truncated-edged silicone foldable intraocular lenses (IOLs) in preventing posterior capsule opacification (PCO) in Indian eyes. SETTING: Cornea and Anterior Segment Service, L.V. Prasad Eye Institute, Hyderabad, India. METHODS: This prospective study evaluated 39 Indian patients (39 eyes) with a mean age of 55.4 years who had uneventful implantation of the CeeOn Edge 911A IOL (Pharmacia). All IOLs were placed in the bag. Except in 4 patients, the capsulorhexis margin overlapped 360 degrees on the IOL optic periphery. The mean follow-up was 10.9 months (range 6.5 to 13.0 months); 32 patients were followed for 1 year. RESULTS: Intraoperatively, posterior capsule fibrosis was noted in 7 patients. Diffuse haze was noted in the IOL optic in 1 patient. Clinically significant PCO did not occur in any case. One patient had clinically nonsignificant (grade 1) PCO at the 6- and 12-month follow-up visits. Although epithelial pearl accumulation (Soemmering's ring) was seen beyond the edge of the IOL in the 32 patients followed for 1 year, the epithelial pearls were central only in the patient with grade 1 PCO. Significant cell deposits were noted in 1 patient who had fibrinous uveitis at the 1-week postoperative visit; both resolved by 1 month. All eyes achieved a best corrected visual acuity of 20/30 or better. CONCLUSIONS: The CeeOn Edge 911A IOL was well tolerated in Indian eyes, and the posterior capsule remained clear. Larger patient groups with a longer follow-up will provide more useful information.     

Comparison of Scrub Typhus With and Without Meningitis

Objective

To compare the children admitted with scrub typhus with and without meningitis.

Methods

All children admitted with scrub typhus over a 62 mo period were reviewed. Statistical analysis was performed to compare those with and without meningitis for demographic, clinical, investigations and outcome parameters.

Results

Four hundred twenty seven children were admitted with scrub typhus and 63 (14.8%) had meningitis. The mean cerebrospinal fluid white blood cell (CSF WBC) count was 71 cells/cu.mm. with mean lymphocyte proportion of 92%. The mean CSF protein was 67 mg/dl and mean CSF glucose, 55 mg/dl. Of those who had meningitis, 24 (38.1%) had seizures, 17 (27%) had altered sensorium and 37 (58.7%) had nuchal rigidity. Finding an eschar, being male, breathing difficulty, and hepatomegaly were significantly more common in those without meningitis. Children with meningitis also had shorter duration of fever at presentation (median [IQR] 7 [3] days vs. 10 [4] days; p = 0.028). Headache and vomiting were significantly more common in those with meningitis. Hemoglobin and platelet were significantly lower in those without meningitis. Duration of hospitalization was significantly longer in those with meningitis, whereas acute respiratory distress syndrome (ARDS) was significantly more common in those without meningitis. There was no neurological deficit in both the groups. There was no mortality in the meningitis group compared to 3.6% mortality in the non-meningitis group (p = 0.213).

Conclusions

Meningitis occurs in 15% of those with scrub typhus; those with meningitis have good neurological outcome with little mortality; those without meningitis have more complications and poorer outcome.

     

Cancer patterns in eastern India: the first report of the Kolkata cancer registry

There are no population-based data available for the cancer patterns in Eastern India. This is the first report of cancer incidence in the region from the population-based cancer registry in Kolkata (Calcutta), the capital city of the state of West Bengal, India, for the period 1998-1999. The cancer registry collects data on all new cases of cancer diagnosed in the resident population of Kolkata. Since cancer is not a notifiable disease in India, registration is carried out by active data collection by the registry staff. The cancer registry staff visits 50 data sources comprising cancer hospitals, secondary and tertiary care hospitals, nursing homes, diagnostic laboratories and death registration offices; scrutinizes medical records and collects details on incident cancer cases. A customized version of CanReg-3 software was used for data entry and analysis. A total of 11,700 cases were registered during the 2-year period from 1 January 1998 to 31 December 1999. The overall age-adjusted (world population) incidence rates were 102.1 per 100,000 males and 114.6 per 100,000 females. The most frequently reported malignancies in males were lung cancer (16.3%), followed by cancers of the oral cavity (7.1%), pharynx (5.7%) and larynx (5.7%). In females, the most frequently reported malignancies were breast (22.7%) followed by uterine cervix (17.5%), gallbladder (6.4%) and ovary (5.8%). The data reported by the Kolkata cancer registry provide information on the cancer profile in Eastern India for the first time. The highest incidence rate of lung cancer in males in India is reported from Calcutta. A high risk of gallbladder cancer is observed in women. The observed cancer patterns indicate that tobacco-control measures and early detection of head and neck, breast and cervical cancers are of importance for cancer control in this population.     

Evaluation of the underlying causes of papilledema in children

ObjectiveThe purpose of this retrospective study was to identify the types and relative frequencies of intracranial disorders in pediatric patients who present with papilledema.DesignRetrospective case series.Participants and MethodsThis study was conducted in 2 pediatric ophthalmology clinics, both providing community-based care in a large inner-city urban center in the U.S. Pediatric patients aged between 0 and 16 years diagnosed with papilledema and who had an underlying etiology identified were included in the study. Patient demographic data, ophthalmologic examination findings, and diagnostic work-up results were identified from clinical records.ResultsThe mean age of 38 study patients (19 female, 19 male) was 8.6 ± 4.8 years. Of the 38 patients, 16 (42.1%) had idiopathic intracranial hypertension (IIH) as the underlying cause of the papilledema, 7 (18.4%) had a craniosynostosis disorder, 6 (15.8%) had intracranial tumours, 2 (5.3%) had primary hydrocephalus, and 1 (2.6%) patient each had transverse sinus thrombosis related to sinusitis, hypertensive crisis, subdural hematoma, intracranial abscess, Lyme disease, presumed neurosarcoidosis, and acute disseminated encephalomyelitis. Of the 6 intracranial tumours, 2 (33.3%) presented in the sellar/parasellar region, 2 (33.3%) in the posterior fossa, and 2 (33.3%) were in cortical locations.ConclusionClinicians should have a high index of suspicion for IIH and brain tumours in children presenting with papilledema. Patients with craniosynostosis should have routine eye examinations to monitor for asymptomatic papilledema. Understanding the relative incidence of etiologies for papilledema highlights the urgency of appropriate work-up and the need to consider low-frequency etiologies.     

Chaperone-mediated autophagy in aging and neurodegeneration: lessons from alpha-synuclein

Different conditions, ranging from genetic mutation to post-translational modification, result in the intracellular presence of misfolded or conformationally altered proteins. These abnormal proteins tend to organize in toxic oligomeric structures often resulting in cellular death. Alterations in the function of the surveillance systems that normally repair or remove abnormal proteins are the basis of many neurodegenerative disorders. In this review, we focus on such protein conformational disorders and on the role that altered function of intracellular proteolytic systems, in particular autophagy, plays in the evolution of these diseases. Using Parkinson disease as a main example, we recapitulate the different stages of this protein conformational disorder at the cellular level and relate them with changes in the different types of autophagy. Finally, we also comment on the effect that aggravating conditions, such as oxidative stress and aging, have on the functioning of the autophagic system and its ability to cope with altered proteins.     

Anti-bacterial activity and brine shrimp lethality bioassay of methanolic extracts of fourteen different edible vegetables from Bangladesh

Objective

To investigate the antibacterial and cytotoxic activity of fourteen different edible vegetables methanolic extract from Bangladesh.

Methods

The antibacterial activity was evaluated using disc diffusion assay method against 12 bacteria (both gram positive and gram negative). The plant extracts were also screened for cytotoxic activity using the brine shrimp lethality bioassay method and the lethal concentrations (LC₅₀) were determined at 95% confidence intervals by analyzing the data on a computer loaded with “Finney Programme”.

Results

All the vegetable extracts showed low to elevated levels of antibacterial activity against most of the tested strains (zone of inhibition=5-28 mm). The most active extract against all bacterial strains was from Xanthium indicum which showed remarkable antibacterial activity having the diameter of growth inhibition zone ranging from 12 to 28 mm followed by Alternanthera sessilis (zone of inhibition=6-21 mm). All extracts exhibited considerable general toxicity towards brine shrimps. The LC₅₀ value of the tested extracts was within the range of 8.447 to 60.323 µg/mL with respect to the positive control (vincristine sulphate) which was 0.91 µg/mL. Among all studied extracts, Xanthium indicum displayed the highest cytotoxic effect with LC₅₀ value of 8.447 µg/mL.

Conclusions

The results of the present investigation suggest that most of the studied plants are potentially good source of antibacterial and anticancer agents.     

Transient radiation myelopathy (Lhermitte's sign) in patients with Hodgkin's disease treated by mantle irradiation

Transient radiation myelopathy diagnosed by Lhermitte's sign was noted in four of 44 patients with Hodgkin's disease who were treated with 4000 rad/four wks. mantle irradiation from 1969 to 1977. Symptoms appeared four, six, six and twenty weeks after treatment and lasted for four, eight and twenty-four weeks respectively; one patient developed late minor neurological disability two years later. There was no correlation within this group of patients between incidence and time dose fractionation (TDF) or equivalent single dose (ED ret) but a dose response-incidence relationship was noted when this study was compared to others in the literature.     

Combination of photodynamic therapy with intravitreal bevacizumab for post-peribulbar anesthesia (penetrating trauma)-persistent choroidal neovascular membrane

We report a case of a choroidal neovascular membrane (CNVM) following ocular penetration during peribulbar anesthesia in a 55-year-old male patient. A combination of photodynamic therapy with intravitreal bevacizumab led to resolution of the persistent CNVM.