Intraoperative aberrometry versus preoperative biometry for intraocular lens power selection in patients with axial hyperopia

Purpose:This study was conducted to evaluate the accuracy of intraoperative aberrometry (IA) in intraocular lens (IOL) power calculation and compare it with conventional IOL formulas.Methods:This was a prospective case series. Eyes with visually significant cataract and axial hyperopia (AL <22.0 mm) underwent IA-assisted phacoemulsification with posterior chamber IOL (Alcon AcrySof IQ). Postoperative spherical equivalent (SE) was compared with predicted SE to calculate the outcomes with different formulas (SRK/T, Hoffer Q, Haigis, Holladay 2, Barrett Universal II and Hill-RBF). Accuracy of intraoperative aberrometer was compared with other formulas in terms of mean absolute prediction error (MAE), percentage of patients within 0.5 D and 1 D of their target, and percentage of patients going into hyperopic shift.Results:Sixty-five eyes (57 patients) were included. In terms of MAE, both Hoffer Q (MAE = 0.30) and IA (MAE = 0.32) were significantly better than Haigis, SRK/T, and Barrett Universal II (P < 0.05). Outcomes within ±0.5 D of the target were maximum with Hoffer Q (80%), superior to IA (Hoffer Q > IA > Holladay 2 > Hill-RBF > Haigis > SRK/T > Barrett Universal II). Hoffer Q resulted in minimum hyperopic shift (30.76%) followed by Hill-RBF (38.46%), Holladay 2 (38.46%), Haigis (43.07%), and then IA (46.15%), SRK/T (50.76%) and Barrett Universal II (53.84%).Conclusion:IA was more effective (statistically significant) in predicting IOL power than Haigis, SRK/T, and Barrett Universal II although it was equivalent to Hoffer Q. Hoffer Q was superior to all formulas in terms of percentage of patients within 0.5 D of their target refractions and percentage of patients going into hyperopic shift.     

Mature solid teratoma of the rectum: Report of a case

A case of an unusual occurrence of mature solid teratoma of the rectum is reported with a review of the literature. A 30-year-old woman presented with bleeding per anum without any alteration in her bowel habits. Sigmoidoscopy revealed a pedunculated polypoidal mass arising from the posterior wall of the rectum. A polypectomy specimen on microscopy showed the components of all the three germ layers. This may be the largest polypoidal type of rectal teratoma reported in the English literature to date. A review of the literature indicated only 50 previously reported cases, with all except one being female. The common presentations include prolapse and bleeding per anum.     

Complex posterior urethral disruptions: management by combined abdominal transpubic perineal urethroplasty

PURPOSE: We present our short-term results of abdominal transpubic perineal urethroplasty for complex posterior urethral disruption. MATERIALS AND METHODS: From January 2000 to March 2005, 21 patients with complex posterior urethral disruption underwent abdominal transpubic perineal urethroplasty. Complex disruption was defined as stricture gap exceeding 3 cm or associated perineal fistulas, rectourethral fistulas, periurethral cavities, false passages, an open bladder neck or previous failed repair. Preoperative voiding cystourethrogram with retrograde urethrogram and cystourethroscopy were done to evaluate the stricture and bladder neck. Followup consisted of symptomatic assessment and voiding cystourethrogram. RESULTS: There were 11 adults and 10 prepubescent boys with an average age of 26 years (range 6 to 62). Mean followup +/- SD was 28 months (range 9 to 40). Mean stricture length was 5.2 +/- 1.4 cm. Of the 21 patients 12 had previously undergone failed urethroplasty. The mean period between original trauma/failed repair and definitive repair was 10.2 +/- 4.3 months. Urethroplasty was achieved through the subpubic route in 16 patients, while 5 required supracrural rerouting. In 20 of 21 patients (95%) postoperative cystourethrography showed a wide, patent anastomosis. Postoperative incontinence developed in 2 of 21 patients (9.5%). Seven of the 21 patients (33%) were impotent after the primary injury, while 3 of 14 (21.4%) had impotence postoperatively. There were no complications related to pubic resection, bowel herniation or periurethral cavity recurrence. CONCLUSIONS: Combined abdominal transpubic perineal urethroplasty is a safe procedure in children and adults. It allows wide exposure to create a tension-free urethral anastomosis without significantly affecting continence or potency. Complications of pubic resection are now rarely seen.     

Pediatric Scrub typhus in Indian Himalayas

To retrospectively confirm the suspected rickettsial disease (Scrub typhus) using a gold standard diagnostic test i.e. microimmunofluorescence in pediatric patients with acute febrile illness of unknown etiology. Two serological tests, Weil-Felix and Microimmunofluorescence were used to confirm infection. All five children had fever, vomiting and generalized lymphadenopathy, but none had eschar or rash. One was cured with doxycycline, remaining four patients treated with azithromycin and one died despite treatment. Scrub typhus is a cause of fever of unknown origin in Himalayan region of India and azithromycin is an effective alternative to doxycycline in treating this disease.     

Serodiagnostic evaluation of recombinant CdtB of <Emphasis Type="Italic">S</Emphasis>. Typhi as a potential candidate for acute typhoid

Typhoid fever caused by human restricted Salmonella typhi presents a considerable health burden on developing South-Asian nations like India. The suboptimal sensitivity and specificity associated with culture-based isolation of etiological agent and the extensively used surface antigen-based serological assays often lead to misdiagnosis and inappropriate antimicrobial treatment. The increasing reports of the emergence of resistant strains and undefined disease burden signify the critical need for an inexpensive, reliable, easy-to-use, and highly sensitive diagnostic test for typhoid fever. Utilizing S. typhi-specific and immunogenic antigens in sero-diagnostic assays could lead to precise diagnosis of acute typhoid and prompt treatment. In this study, we report cloning, expression, and purification of recombinant Cytolethal distending toxin subunit B (CdtB) of S. typhi, which is reported to be highly specific, immunogenic, and expressed only upon S. typhi infection. We further evaluated the purified recombinant CdtB for its diagnostic potential in an IgM-based indirect ELISA format using 33 human samples. Twenty-one serum samples from blood culture confirmed cases (n?=?21) of typhoid and 12 samples from healthy controls (n?=?12) were tested. The assay showed sensitivity of 100% and specificity of 83.3% respectively with positive and negative predictive values of 91.3 and 100% respectively. Efficient detection of specific IgM antibodies indicates that CdtB could be highly valuable in sero-diagnosis of acute typhoid and rapid screening of clinical samples.     

Design of an efficient,tunable and scalable freestanding flexible membrane for filter application

To address the global challenge of water pollution, membrane-based technologies are being used as a dignified separation technology. However, designing low-cost, reusable, freestanding and flexible membranes for wastewater treatment with tunable pore size, good mechanical strength, and high separation efficiency is still a major challenge. Herein, we report the development of a scalable, reusable, freestanding, flexible and functionalized multiwalled carbon nanotube (FMWCNT) membrane filter with tunable pore size for wastewater treatment, which has attractive attributes such as high separation efficiency (>99% for organic dyes and ∼80% for salts), permeance (∼225 L h⁻¹ m⁻² bar⁻¹), tensile strength (∼6 MPa), and reusability of both the membrane as well as contaminants separately. This FMWCNTs membrane filter has been developed by a simple vacuum-assisted filtration technique followed by the synthesis of MWCNTs using a cost-effective spray pyrolysis assisted chemical vapor deposition (CVD) technique and chemical functionalization. This study deals with understanding the rejection, retrieval, and reusability of both the membranes as well as waterborne contaminants separately. The developed membrane filter has potential utility in many applications such as wastewater treatment, food industry, and life sciences due to its robust mechanical and separation performance characteristics.

Severe impacts of water contamination on the environment and human health have compelled us to study and design an efficient and reusable filter with tunable pore size.     

Efficacy of modified constraint induced movement therapy in improving upper limb function in children with hemiplegic cerebral palsy: A randomized controlled trial

Purpose: The objective of this randomized single blind (outcome assessor) controlled trial was to evaluate the efficacy of 4 weeks of modified constraint induced movement therapy (mCIMT) in improving upper limb function in 3–8 years old children with hemiplegic cerebral palsy. Methods: Thirty-one children were randomly assigned to receive the mCIMT (N = 16) with conventional therapy or conventional therapy alone (N = 15). Children were evaluated three times (at enrollment, follow up at 4 weeks and 12 weeks). The primary outcome measure was difference in “change in mean total QUEST scores” at 4 weeks of intervention between the intervention and the control arm. Results: After 4 weeks of intervention, mCIMT group showed significant change in the affected upper limb in QUEST scores (10.7 ± 5.2 vs 1.4 ± 1.7, p < 0.001) and time (s) to complete nine-hole-pegboard test compared with control group [60(0–130) vs 5(−12 to 30), p < 0.001]. The improvement observed in upper limb function after 4 weeks of intervention persisted 8 weeks after discontinuation of intervention in mCIMT group. Conclusion: The modified constraint induced movement therapy appears to be effective in improving upper limb function in 3–8 years old hemiplegic cerebral palsy children.