Stereoscopic evoked responses to crossed and uncrossed disparity accompanying simulated refractive error.

Evoked potentials were recorded to the occurrence of a disparate stimulus in dynamic random dot stereograms. Seven adult males, all of whom had vision which was normal or corrected to normal, participated in the experiment. Subjects viewed 100 ms duration stimuli which embodied 30 arc min of either crossed or uncrossed disparity under four conditions of spherical overcorrection: -0.25, +1.0, +2.0, +3.0 dioptres. The first condition, essentially normal refraction, yielded reliable behavioural reports of the stimulus and clear evoked potentials to both crossed and uncrossed disparity. With increasing overcorrection the behavioural reports became less reliable, and the evoked potentials were degraded for both conditions of disparity. The responses to the crossed disparity condition, however, showed significantly less degradation in both behavioural and electrophysiological measures. The implications of this finding may be that there are separate cortical subsystems for the processing of crossed and uncrossed disparity and that the former is more robust under non-ideal viewing conditions.     

Suppurative corneal ulceration in Bangladesh

Suppurative keratitis is an important preventable cause of blindness, particularly in the developing world. This study analyses 142 cases of suppurative keratitis referred to Chittagong Eye Infirmary, Bangladesh. Some 53.5% of cases were bacterial and 35.9% were fungal. The five most common pathogens were: Pseudomonas sp. 24%, Streptococcus pneumoniae 17%, Aspergillus sp. 13%, Fusarium sp. 7% and Curvularia sp. 6%. Gram stain and culture results were consistent in 62.6% of cases. Previous antibiotic treatment was a significant factor for failure of culture isolation and less so for Gram stain failure. On Gram stain, 55.9% of pseudomonal cases were missed, but only 2% of fungal cases were missed. Over all, Gram stain had a sensitivity of 62% and positive predictive value of 84% for bacterial cases, and 98% and 94% for fungal cases, respectively. Fungal ulcers were typically filamentous, but an antecedent history of trauma was not common. The most frequent injury was due to rice grains, but the inoculum appeared to be introduced during eye washing with contaminated water. Pseudomonal ulcers occurred most frequently in the monsoon season, and Fusarium cases were seen only in the hot, dry season.     

Cremation of body parts and fetuses.

Crematoria are occasionally asked to cremate non-viable fetuses. Many doctors, especially those associated with crematoria, believe that there will be no cremated residue. However, if the cremation technique is modified, cremated remains are produced. These remains can form a focal point for the parent's grief. Crematoria are urged to ensure their technique yields a residue.     

Calciphylaxis – a topical overview

'Calciphylaxis', a calcification syndrome associated with ischaemic cutaneous necrosis, is acquired naturally in humans in disease states. It is a life and limb-threatening complication, usually observed in patients with renal disease and secondary hyperparathyroidism, but known to occur in the absence of renal or parathyroid disease. The reported mortality rate, which ranges from 60-80%, relates to wound infection, sepsis and organ failure. It is a small-vessel vasculopathy, which is estimated to occur in about 4% of haemodialysis patients. Clinically, violaceous, reticulate areas of cutaneous necrosis and eschar may be evident, particularly in the extremities. In addition to the clinical picture, a raised calcium phosphorous product, an elevated parathyroid hormone level, radiographic evidence of vessel and soft-tissue calcification and the finding of mural calcification affecting small arteries and arterioles on histopathology help to confirm the diagnosis of this entity which generally has a poor prognosis. A high index of suspicion and an active multidisciplinary management approach, with rigorous attention to wound care and prevention of sepsis, are vital in the management of these patients. In this overview, we discuss the pathophysiology, clinical features and associations, risk factors, diagnosis and management issues relating to calciphylaxis.