Role of anterior retinal cryoablation in the management of neovascular glaucoma

In a prospective study, the effect of anterior retinal cryoablation (ARC) in the management of neovascular glaucoma (NVG) was evaluated over two years, in 72 patients (74 eyes). The outcome of trabeculectomy/seton surgery preceded by 360° ARC was also analysed in 12 eyes of 12 patients (6 eyes in each group). Following ARC, pain relief with dramatic regression of anterior chamber inflammatory reaction was observed in 95% of the patients (59 eyes). At the end of the follow up, as confirmed by iris fluorescein angiography, regression of neovascularization of the iris was documented in 93.5% (58 eyes) of the cases. Intraocular pressure control (22 mm Hg) was achieved in 82.3% (51 eyes) cases. IOP control of 22 mm Hg was achieved in all the 6 eyes with the seton surgery following ARC. Similarly, control of IOP was successfully achieved in all the 6 eyes of patients with NVG with trabeculectomy with post operative course of 5-fluorouracil following ARC. ARC is strongly recommended in NVG, especially in eyes with media opacities and as a preliminary procedure for filtering surgery or drainage implant surgery.Abbreviations ARC Anterior retinal cryoablation - NVG Neovascular glaucoma - NVI Neovascularization of the iris     

Postdatism -- a perinatal problem?

It has been traditionally accepted that maternal and fetal complications are at their lowest levels 37-42 weeks into gestation. 20% of pregnancies completed after 42 weeks gestation are thought to be affected by the postmaturity syndrome of uteroplacental insufficiency resulting in oligohydramnios, meconium passage, loss of fetal subcutaneous tissue, fetal asphyxia, and fetal death. Some workers, however, have also found that pregnancies completed between 40 and 42 weeks carry significant risk. The authors explored this question in a case-control study of 464 women seen at the Mahatma Gandhi Institute of Medical Sciences in Maharashtra, India. The cases of postdatism occurred in the absence of any other medical or obstetric problem. The operative delivery rate increased significantly among these patients compared to deliveries between 39 and 40 weeks. There was neither significant asphyxia nor perinatal loss in term completed normal patients. Asphyxia and perinatal mortality did, however, occur with postdatism. The authors note the likely role of oligohydramnios combined with placental dysfunction.     

Visual evoked responses in megaloblastic anemia

Pattern shift visual evoked responses (PSVER) were studied in thirty patients suffering from severe megaloblastic anemia (mean Hb level was 4.25 +/- 1.22 g/dL) of nutritional origin. All patients lacked clinical stigmata of visual and neurologic impairment. Mean P100 latency in thirty age and sex matched controls was 96.35 +/- 6.75 ms (range 86-108 ms) and mean amplitude was 10.37 +/- 3.88 microV (range 4.8-20.8 microV). Mean P100 latency in megaloblastic anemia was 114.77 +/- 11.68 (range 91-142) ms, P < 001 vs. control) and mean amplitude was 8.85 +/- 2.8 microV (range 5.1-16.2 microV). Seventy percent cases had prolonged latency of P 100. After correction of anemia with therapeutic doses of vitamin B12 and folic acid in three months (mean Hb level was 12.08 +/- 1.86 g/dL), the mean P100 latency was 105.13 +/- 9.30 ms (range 92-121 ms P < 0.001 vs. controls) and mean amplitude was 10.72 +/- 4.13 microV (range 5.1-21.4 microV). There was significant improvement in P100 latency after correction of anemia (P < 0.01). There was a negative correlation between P100 latency and hemoglobin levels, though it was statistically not significant.     

Anhidrotic ectodermal dysplasia presenting as nasal myiasis

An interesting case of anhidrotic Ectoderml Dysplasia (A.E.D.) which came with epistaxix, headache and maggots in nose is presented. Histopathology of forearm shin, scalp and Exercise test helped to confirm the diagnosis, AED is an X-linked recessive condition and has no cure but symptomatic treatment along with heat protection and protection of eyes especially in summer season has a role to play in the management of these cases.     

Effect of adeno-tonsilectomy on hearing threshold and middle ear pressure

Out of 50 children (100 ears) undergoing adeno-tonsillectomy, 34 ears had hearing threshold 20–50 dB (20dB is normal) and 32 ears showed negative middle ear pressure of 100 to 400 mmH₂O (100 mmH₂O is normal). Post-operatively only 7 ears had hearing threshold of 20–30 dB and negative middle ear pressure of 100 to 200 mmH₂O. Thus adenoidectomy improves eustachian tube functions.     

Splenic abscess following blunt abdominal trauma

A rare case of splenic abscess occurring after blunt abdominal trauma in a previously healthy boy is reported. The diagnosis was made by ultrasonography. The patient recovered after splenectomy and drainage of subphrenic and intraperitoneal pus.     

Vitamin A status of socio-economically backward children

A comprehensive survey was carried out to asses the Vitamin A status of pre-school (0–6 yrs.) and school age (6–12 yrs.) children of socio-economically backward families from slums of Bombay and its suburbs. The Vitamin A, protein, calories and iron from the rice and dal based diet was found to be below recommended dietary allowances (RDA). Among the 1956 children surveyed 20% of the children showed low (<20 μg/dl) serum vitamin A levels. 4.8% of the children were suffering from one or the other signs of Vitamin A deficiency. Rose Bengal stain test (RBST) and conjuctival impression cytology (CIC) indicted the signs of mild conjuctival xerosis and of early epithelial changes which were correlated with serum vitamin A levels. Serum iron, PCV, Hb and RBC levels were below normal. The anthropometric measurements of these children were below 50th percentile of Indian Council of Medical Research (ICMR) standards. Due to lack of proper nutrition, the overall growth of children is either retarded or not upto the standard levels as was noted in majority of the children.     

Evaluation of H2 receptor antagonists in chronic idiopathic urticaria

H1-antagonist (hydroxyzine hydrochloride) in dosage of 10 mg-25 mg thrice a day failed to elicit satisfactory response in 60 out of 170 patients of chronic idiopathic urticaria. Additional administration of H2-antagonist (cimetidine) in dosage of 200 mg four times a day, in patients not responding earlier to H1-antagonist alones exhibited moderate to good improvement of various parameters of urticaria in approximately 85% patients.     

Sperm Quality Improvement in Cryopreserved Human Semen

Purpose

We determined if separation of spermatozoa (washed) on a discontinuous colloidal suspension of silica (Percoll^†) density gradient before cryopreservation improves post-thaw motility compared to an unprocessed (raw) cryopreserved sample.

Materials and Methods

Ten normal healthy volunteers recruited into the andrology laboratory donor program were studied. Raw and washed cryopreserved spermatozoa were compared for loss of motility with time, motion characteristics, viability and membrane integrity after incubation for 1, 6 and 24 hours. Within group comparisons were made to baseline measurements (0 hours before incubation).

Results

Raw and washed cryopreserved spermatozoa showed statistically significant decreases in motility and other motion characteristics after thawing. There were significant decreases in motility and other motion characteristics after incubation periods of 1, 6 and 24 hours, and significant decreases in viability and membrane integrity at 6 and 24 hours in the unprocessed spermatozoa. Although, motility and motion characteristics of washed samples decreased significantly with longer incubation periods, loss of motility with time (longevity) was greater in raw samples. Washed samples retained greater sperm motility for up to 24 hours (p less than 0.03).

Conclusions

Specimens prepared by Percoll separation techniques before freezing offer the possibility of selecting spermatozoa that retain motility for up to 24 hours. This finding can be of benefit for couples undergoing intrauterine insemination to achieve pregnancy.