Ultrasound biomicroscopy as a tool in the evaluation and management of ocular hypotony in uveitis

Purpose:Chronic uveitis can lead to hypotony that may result in severe visual impairment. We highlight the use of ultrasound biomicroscopy (UBM) as an imaging tool to decide the modality of therapy and management of uveitic hypotony.Methods:This was a retrospective hospital-based interventional case-series study that included a total of 36 eyes of 25 patients with uveitic hypotony seen between January 1997 and January 2020.Results:Thirty-six eyes of 25 patients with uveitic ocular hypotony were included. Unilateral involvement was seen in 56%. The median age of presentation was 21 years with a median follow-up of 21.5 months. Anterior uveitis was noted in 13.88%, intermediate uveitis in 52.77%, and panuveitis in 33.33% eyes. UBM findings commonly noted were pars plana membranes, supraciliary effusion, blunted ciliary process, and ciliary body traction. Other findings included ciliochoroidal detachment and ciliary body edema. Moreover, 22.2% eyes were managed with medical therapy alone, whereas 77.8% eyes received both medical and surgical intervention based on UBM findings. Furthermore, 66.7% eyes showed improvement in intraocular pressure, 13.9% eyes maintained the same IOP, whereas 19.4% eyes had worsening of IOP at final follow-up.Conclusion:We found UBM as a useful imaging tool in evaluating and judiciously deciding the mode of management of uveitic hypotony.     

Influence of Bi2O3 on Mechanical Properties and Radiation-Shielding Performance of Lithium Zinc Bismuth Silicate Glass System Using Phys-X Software

We analyzed the mechanical properties and radiation-shielding performance of a lithium zinc bismuth silicate glass system. The composition of these glasses is 20ZnO-30Li₂O-(50-x)SiO₂-xBi₂O₃ (x varies between 10 and 40 mol%). The mechanical properties of the investigated glass system, such as Young’s modulus (E), bulk modulus (K), shear modulus (S), and longitudinal modulus (L), were determined using the Makishima–Mackenzie model. The elastic moduli gradually decreased with the addition of Bi₂O₃. E decreased from 46 to 31 GPa, K decreased from 27 to 14 GPa, S decreased from 19 to 14 GPa, and L decreased from 52 to 32 GPa as Bi₂O₃ was substituted for SiO₂. The mass attenuation coefficient (MAC) was investigated at energies between 0.284 and 1.33 MeV to understand the radiation-shielding performance of the glasses. The MAC value increased when SiO₂ was replaced by Bi₂O₃. We found that the effect of Bi₂O₃ on MAC values was noticeably stronger at energies of 0.284 and 0.347 MeV, while the effect of Bi₂O₃ on MAC values became weaker as energy increased. The linear attenuation coefficient (LAC) results demonstrated that if the samples were exposed to low-energy photons, the glass could prevent the penetration of photons, and thus, the glass samples were effective in radiation protection. The LAC values for the lowest- and highest-density samples changed from 0.998 to 1.976 cm⁻¹ (at 0.284 MeV) and from 0.286 to 0.424 cm⁻¹ (at 0.826 MeV). According to the radiation-shielding results, the thick, high-density glass sample has special and distinctive shielding properties.     

RNA viruses in community-acquired childhood pneumonia in semi-urban Nepal; a cross-sectional study

Background  

Pneumonia is among the main causes of illness and death in children <5 years of age. There is a need to better describe the epidemiology of viral community-acquired pneumonia (CAP) in developing countries.     

Alveolar soft part sarcoma of tongue base — A rare presentation of a rare tumor

Alveolar soft part sarcoma is a rare, aggressive malignancy of uncertain histologic origin and enigmatic clinical behaviour. It has a characteristic histopathological picture, with a propensity for vascular invasion and distant metastasis. We report a case of alveolar soft part sarcoma involving the tongue base in an adolescent female. She underwent laser assisted excision of the tongue base tumour followed by post-operative radiotherapy. The clinical presentation, histopathological picture, immunohistochemical & cytogenetic studies, radio-imaging, management protocols and prognosis of this tumor have been discussed.     

Analysis of prognostic factors for 5 year survival in surgically treated patients with carcinoma cervix stages IB1, IB2 and IIA

Aim: To identify pathological and clinical prognostic factors that best predict 5 year survival among patients with early stage cervical carcinoma treated with radical hysterectomy. Methods: Data from 77 patients diagnosed at Safdarjung Hospital, New Delhi, India with carcinoma cervix were taken from 1997 to 2002. Patients were followed up for 5 years. Survival probability was calculated through Kaplan–Meier method for overall survival at 5 years. Univariate and multivariate analysis with Cox's regression model was used to statistically identify the best combination of these risk factors to predict prognosis. Results: Univariate analysis revealed tumour size, lymph node involvement and parametrial spread as significant prognostic factors for survival. Multivariate analysis showed that lymph node involvement and parametrial spread remained significant prognostic factors. Overall carcinoma with tumour size of less than 4 cms had a higher chance for survival. Conclusion: The presence of lymph node involvement and parametrial spread decreased the chance of survival by two and a half and threefold, respectively. Lack of awareness about the screening, symptoms of disease and non‐availability of early diagnostic facilities such as the Pap smear at a primary health care level are areas of priority. The most pressing need is to spread awareness among sexually active women to undergo Pap tests at regular intervals.     

The association of t (13q, 14q) with Down’s syndrome and its inheritance

Cytogenetic analysis of the first child of an older couple afflicted with Down’s syndrome revealed a Robertsonian translocation between the chromosomes 13, 14 in addition to trisomy 21. His mother was found to be a carrier of this translocation with no history of abortion.     

Serum copper levels in carcinoma of ovary and cervix

The role of serum copper level (SCL) as a diagnostic and prognostic tool in genital tract malignancies was evaluated. SCL was employed as a marker for response to treatment (surgical/radiotherapy). 129 women attending gynaecology outpatient department or admitted in the gynecology ward were studied. Of these 77 patients in the disease (study) group were proven cases of genital tract malignancies and 52 served as controls. Outcome measures studied were: SCL levels estimated before initiation of any treatment i.e. surgery/radiotherapy; thereafter, at two weeks after completion of treatment. Follow up of the study subjects was done between 4-8 weeks and 8-10 weeks, when the patients were evaluated for any recurrence of disease and SCLs were also estimated. Kruskal-Wallis one-way analysis of variance determined whether values varied significantly among the different groups studied. Mean SCLs were found to be significantly elevated in cases of Ca ovary (n = 15), early CaCx (n = 14) and late CaCx (n = 48), as compared to the control group, comprising of women with no signs and symptoms of malignancy (n = 52). SCLs decreases significantly (P < 0.001) after treatment of Ca ovary and CaCx. These results indicate a possible clinical usefulness of estimating serum copper levels in women with genital tract cancer and suggest a role for SCL in the evaluation of the disease activity and as a prognostic tool in the management of genital malignancies.     

Pre-operative embolization of auricular arteriovenous fistula

Treatment of auricular arteriovenous fistula (AVF) is a challenge with surgery being the preferred option until now. We present three cases of auricular AVFs who underwent pre-operative embolization and its outcome on surgery. Three patients were diagnosed to have auricular AVF by angiography. All three patients underwent pre-operative embolization with n-butyl 2-cyanoacrylate after which they underwent surgical resection of the AVF. Pre-operative embolization resulted in significant devascularization of the AVF thus leading to near bloodless and clean surgery. Pre-operative embolization of auricular AVFs is a good treatment option, leading to significantly reduced blood loss during surgical excision.