Loop myopexy with true muscle transplantation for very large angle heavy eye syndrome patient

A 42-year-old man presenting with complaints of squint for last 20 years. His visual acuity was 20/400 in right eye (RE) and 20/30 in left eye (LE) with glasses. His refraction was RE -16.75/-2.5 D cycl 180 and LE was -14.5/-1.5 D cycl 180. His axial length was 31.23 mm In RE and 29.72 mm in LE. On examination we found he had RE large esotropia with hypotropia measuring 130 pd base out and 40 pd base up in RE. A computerized tomography scan revealed that the superior rectus (SR) was shifted nasally, and lateral rectus (LR) was shifted inferiorly. A RE medial rectus (MR) recession and LR resection with muscle transplantation on the MR was done. A loop myopexy was done to correct the path of the LR and SR. The patient had only 18 pd eso and 20 pd hypo on follow-up after 3 months. Loop myopexy in conjunction with muscle transplantation is a safe and effective procedure for large angle esotropia associated with heavy eye syndrome.     

RSSDI Clinical Practice Recommendations for Management of Type 2 Diabetes Mellitus, 2015

International Journal of Diabetes in Developing Countries -     

Ototoxic manifestations of thiacetazone

317 cases of pulmonary tuberculosis were put on the following different reqimens of anti-tuberculous drugs.     

Formation of O6-ethylthioethylguanine in DNA by reaction with the sulfur mustard, chloroethyl sulfide, and its apparent lack of repair by O6-alkylguanine-DNA alkyltransferase

The reactions of the monofunctional sulfur mustard, chloro-ethylethyl sulfide, with calf thymus DNA have been studied in vitro.In addition to extensive alkylation of the 7 position of guanineand the 3 position of adenine, - 0.1% of the total alkylationis on the O⁶ position of guanine. Since chloroethyl ethyl sulfideis a model for S-adenosylmethionine and for the reactive intermediatesgenerated from ghitathione by certain environmental agents,this result establishes a route by which these compounds couldbe mutagenic. A DNA substrate modified for repair studies hasbeen produced by incubating calf thymus DNA with [¹⁴C]chloroethyl-labelledchloroethyl ethyl sulfide. This DNA contains 6 nmol/mg of alkylatedproducts including 6 pmol/mg O⁶-ethylthioethylguanine. Incubationof this substrate with up to a 20-fold excess of mammalian (O⁶-alkylguanine-DNAalkyltransferase has indicated that O⁶-ethylthioethylguanineis either not a substrate or a poor one for this DNA repairsystem.     

P-wave morphology in focal atrial tachycardia: development of an algorithm to predict the anatomic site of origin.

OBJECTIVES: The purpose of this study was to perform a detailed analysis of the P-wave morphology (PWM) in focal atrial tachycardia (AT) and construct and prospectively evaluate an algorithm for identification of the anatomic site of origin. BACKGROUND: Although smaller studies have described the PWM from particular anatomic locations, a detailed algorithm characterizing the likely location of a tachycardia associated with a P-wave of unknown origin has been lacking. METHODS: The PWMs for 126 consecutive patients undergoing successful radiofrequency ablation of 130 ATs are reported. P waves were included only when the onset was preceded by a discernible isoelectric segment. P waves were classified as positive (+), negative (-), isoelectric, or biphasic. Sensitivity, specificity, and predictive values were calculated. On the basis of these results, an algorithm was constructed and prospectively evaluated in 30 new consecutive ATs. RESULTS: The distribution of ATs was right atrial (RA) in 82 of 130 (63%) and left atrial (LA) in 48 of 130 (37%). Right atrial sites included crista (n = 28), tricuspid annulus (n = 29), coronary sinus (CS) ostium (n = 14), perinodal (n = 7), right septum (n = 1), and RA appendage (n= 3). Left atrial sites included pulmonary veins (n = 32), mitral annulus (n = 8), CS body (n= 3), left septum (n = 3), and LA appendage (n = 2). In electrocardiographic lead V1, a negative or +/- P-wave demonstrated a specificity of 100% for a RA focus, and a + or -/+ P-wave demonstrated a sensitivity of 100% for a LA focus. A characteristic PWM was associated with high sensitivity and specificity at common atrial sites for tachycardia foci. A P-wave algorithm correctly identified the focus in 93%. CONCLUSIONS: Characteristic PWMs corresponding to known anatomic sites for focal AT are associated with high specificity and sensitivity. A P-wave algorithm correctly identified the site of tachycardia origin in 93%.     

印度南古吉拉特邦血库的献血员反应性结果的通知和咨询:更好地预防具反应性结果献血员再次献血的进展

正除了献血前进行输血性感染(transfusiontransmitted infections, TTIs)筛选检测等措施外,另一个重要的预防TTI的工具是告知具反应性结果的献血员,并提供咨询,以避免他们日后再次献血。由印度南古吉拉特邦一所公立三级护理医院的血液免疫学和输血科实施的这项观察性研究,为时3年,涉及25020例献血员(其中 9 9%为无偿志愿献血),发现353例献血员输血性传染指标结果具反应性(1.41%),其中23例(6.51%)为