Pipelle versus MVA cannula for endometrial biopsy: a comparative study

Background: Endometrial biopsy procedure is a prerequisite for evaluation of abnormal uterine bleeding, also performed to exclude the presence of endometrial carcinoma or in cases of infertility.Methods: A study was conducted at Rohilkhand Medical College and Hospital, Bareilly among 350 subjects to assess the efficacy and problems associated with endometrial biopsy technique by MVA cannula method and pipelle method of biopsy.Results: Mean age recorded was 45.14±10.11, mean parity was 3.18±1.8, mean endometrial thickness was 6.9±3.28 and mean BMI was 24.3±2.12. In our study, duration of MVA endometrial biopsy was (3.1±0.62min) and with Pipelle method was (3.01±0.77 min). Endometrial biopsy is a compulsory requirement for evaluation of endometrial causes of abnormal uterine bleeding especially malignancy, hence, it is a very frequently done procedure.Conclusions: This study concluded that manual vaccum aspiration using cannula No.4, an unconventional technique was comparable to Pipelle technique with comparable efficacy and results

Ultrasound: A Key To “Sound” Diagnosis And Healing

Since the first “hyperphonograph” was published in 1947, ultrasonography has gained immense popularity worldwide due to it being non-invasive, inexpensive, painless, portable, and ability to not cause any harmful ionizing radiation in both the patient and operator. Ultrasound is being used in the diagnosis and detection of various oral disorders (both hard and soft tissues). This review provides an overview of the most recent advances of ultrasound imaging in dentistry

Incidental retained intrauterine Lippe’s loop in 65 years old woman: a rare case report

Intrauterine contraceptive devices are a widely used method of contraception. It is cheap, easy and an effective method. The first intrauterine device was Lippe’s loop which was double S shaped trapezoid loop introduced in 1962. Nowadays, third generation intrauterine devices are used which are effective for 5 and as well as 10 years. Here we presented a rare case of first generation of intrauterine device, that was, Lippe’s loop in a 65 year old lady which was found as an incidental finding. Intrauterine device insertion without the knowledge of women can lead to the forgotten device which can adversely affect the health of women

Stem Cell Therapies in Retinal Disorders

Stem cell therapy has long been considered a promising mode of treatment for retinal conditions. While human embryonic stem cells (ESCs) have provided the precedent for regenerative medicine, the development of induced pluripotent stem cells (iPSCs) revolutionized this field. iPSCs allow for the development of many types of retinal cells, including those of the retinal pigment epithelium, photoreceptors, and ganglion cells, and can model polygenic diseases such as age-related macular degeneration. Cellular programming and reprogramming technology is especially useful in retinal diseases, as it allows for the study of living cells that have genetic variants that are specific to patients’ diseases. Since iPSCs are a self-renewing resource, scientists can experiment with an unlimited number of pluripotent cells to perfect the process of targeted differentiation, transplantation, and more, for personalized medicine. Challenges in the use of stem cells are present from the scientific, ethical, and political realms. These include transplant complications leading to anatomically incorrect placement, concern for tumorigenesis, and incomplete targeting of differentiation leading to contamination by different types of cells. Despite these limitations, human ESCs and iPSCs specific to individual patients can revolutionize the study of retinal disease and may be effective therapies for conditions currently considered incurable

Scar Formation in the Presence of Mitomycin C and the Anti-fibrotic Antibody in a Rabbit Model of Glaucoma Microsurgery: A Pilot Study

Purpose: This study aimed to evaluate the utility of a rationally engineered antibody that directly blocks collagen fibrillogenesis to reduce scar tissue formation associated with subconjunctival glaucoma surgery. Material and methods: Fourteen eyes of 7 adult rabbits underwent glaucoma filtering surgery using XEN 45 Gel Stent. The rabbits’ eyes were divided randomly into three treatment groups: (i) treated with the antibody, (ii) treated with mitomycin C, and (iii) treated with the antibody and mitomycin C. Following surgeries, the intraocular pressure and bleb appearance were evaluated in vivo. The rabbits were sacrificed 8 weeks after the surgery, and their eyes were harvested and processed for tissue analysis. Subsequently, tissue samples were analyzed microscopically for fibrotic tissue and cellular markers of inflammation. Moreover, the collagen-rich fibrotic tissue formed around the stents was analyzed using quantitative histology and infrared spectroscopy. The outcomes of this study were analyzed using the ANOVA test. Results: This study demonstrated no significant differences in intraocular pressure, bleb appearance, or presence of complications such as bleb leak among the treatment groups. In contrast, we observed significant differences among the subpopulations of collagen fibrils formed within scar neo-tissue. Based on the spectroscopic analyses, we determined that the relative content of mature collagen cross-links in the antibody-treated group was significantly reduced compared to other groups. Conclusions: Direct blocking of collagen fibrillogenesis with the anti-collagen antibody offers potentially beneficial effects that may reduce the negative impact of the subconjunctival scarring associated with glaucoma filtering surgery

Effect of Phacoemulsification on Intraocular Pressure in Eyes with Functioning Tube Shunts

Purpose: To evaluate the effect of phacoemulsification on intraocular pressure (IOP) in eyes with functioning tube shunts. Methods: This was a retrospective chart review of primary open-angle glaucoma (POAG) patients with a functioning tube who underwent phacoemulsification and had ≥24 months of follow-up. The primary end point was defined as surgical failure (IOP > 21 mmHg) at month 24, progression to no light perception (NLP) vision, glaucoma reoperation, or implant removal. Surgical failure defined as IOP >18 and >15 mmHg, changes in visual acuity (VA), IOP, and number of medications were assessed. Results: Twenty-seven eyes of 27 patients with moderate or severe POAG were included. The mean age of the patients was 64.2 ± 10.8 years. The interval between the tube shunt and phacoemulsification was 28.8 ± 25.0 months. At the end of the study, four (14.8%) eyes met the failure criteria; the average time to failure was 9.3 ± 3.8 months. The causes of failure were high IOP in two (50.0%) and glaucoma reoperation in two (50.0%) eyes; however, no eyes progressed to NLP vision. Surgical failure defined as IOP >18 and >15 mmHg showed an increasing failure rate (18.5% and 48.5%, respectively). The mean IOP and medications number remained stable at month 24 compared to baseline (P = 0.131 and P = 0.302, respectively). Initially, VA showed improvement, with the greatest improvement at 6 months (P = 0.001), but at 24 months the improvement was no longer significant (P = 0.430). Conclusion: Phacoemulsification in patients with functioning tubes did not change the mean IOP in most of the patients (86.2%); the number of medications also did not increase

Reticular Pseudodrusen in Early Age-Related Macular Degeneration Are Associated With Choroidal Thinning

PURPOSE. To compare choroidal thickness (CT) measurements in early AMD between patients with and without reticular pseudodrusen (RPD) using spectral-domain optical coherence tomography (SD-OCT). METHODS. This cross-sectional study examined 84 age-and sex-matched AMD patients (40 RPD [63 eyes], 44 non-RPD [75 eyes]). Fundus photographs and scanning laser ophthalmoscopy images were graded to identify RPD and non-RPD groups by three retinal specialists (MO, SY, SB) who were masked to corresponding SD-OCTs. CT at the fovea and 2400 to 3000 lm superior and inferior to the fovea was measured on SD-OCT by a grader (AG) and reviewed by a retinal specialist (SB). Only images with a clear posterior choroidal margin were analyzed (six eyes excluded due to poor image quality), and enhanced depth imaging SD-OCT was used when available (20 of 138 eyes). Greatest retinal thickness (RT) on horizontal foveal SD-OCT was also recorded. RESULTS. Mean CTs in the superior, foveal, and inferior macula in RPD (191.3 lm 6 57.9 SD, 176.3 lm 6 60.5 SD, 179.7 lm 6 56.24 SD) were significantly less than that of non-RPD (228.0 lm 6 66.1 SD, 216.5 lm 6 70.3 SD, 224.4 lm 6 71.9 SD; P ¼ 0.0010, P ¼ 0.0005, P ¼ 0.0001, respectively), as was greatest RT (P ¼ 0.0301). CONCLUSIONS. CT was thinner throughout the macula in the RPD group as compared with the non-RPD group. The current analysis supports an association between RPD and a thinned choroidal layer and is consistent with a choroidal etiology of RPD. CT may be integral to understanding RPD, and may be helpful in stratifying AMD progression risk. Keywords: reticular pseudodrusen, spectral-domain optical coherence tomography, choroidal layer, early age-related macular degeneration, retinal ischemia A ge-related macular degeneration is the leading cause of vision loss in developing and developed countries, 1 and accounts for more than 54% of all blindness in the United States. 2 Age-related macular degeneration is a disease characterized by extracellular material, collectively described as drusen, which accumulates under the RPE. Reticular pseudodrusen (RPD) are found in the fundus of some patients with AMD and were initially characterized as a peculiar yellow pattern occurring in the outer macula best visible under blue light in photographs of patients with AMD. 3 RPD have been associated with a higher likelihood of developing late AMD in the forms of choroidal neovascularization (CNV) 4-9 and geographic atrophy (GA). 10 However, there is no clear agreement about the prevalence of RPD, the relationship between RPD and AMD, 11 or the underlying etiology of RPD. Theories proposed for the etiology of RPD include abnormal choroidal perfusion, subretinal drusenoid deposits (SDD), or a combination of both. RPD have been associated with choroidal vascular abnormalities. A histopathologic study of one RPD eye found that there was a loss of the inner and middle layers of the choroid, subsequently leading to fibrous replacement of choroidal stroma. In normal eyes, the choroidal layer has been found to be thickest in the subfoveal region, where visual acuity and the concentration of cone photoreceptors are highest, with progressive thinning outward in both the horizontal and vertical axes

Effect of Phacoemulsification on Intraocular Pressure in Eyes With Functioning Tube Shunts

Purpose: To evaluate the effect of phacoemulsification on intraocular pressure (IOP) in eyes with functioning tube shunts. Methods: This was a retrospective chart review of primary open-angle glaucoma (POAG) patients with a functioning tube who underwent phacoemulsification and had ≥24 months of follow-up. The primary end point was defined as surgical failure (IOP \u3e 21 mmHg) at month 24, progression to no light perception (NLP) vision, glaucoma reoperation, or implant removal. Surgical failure defined as IOP \u3e18 and \u3e15 mmHg, changes in visual acuity (VA), IOP, and number of medications were assessed. Results: Twenty-seven eyes of 27 patients with moderate or severe POAG were included. The mean age of the patients was 64.2 ± 10.8 years. The interval between the tube shunt and phacoemulsification was 28.8 ± 25.0 months. At the end of the study, four (14.8%) eyes met the failure criteria; the average time to failure was 9.3 ± 3.8 months. The causes of failure were high IOP in two (50.0%) and glaucoma reoperation in two (50.0%) eyes; however, no eyes progressed to NLP vision. Surgical failure defined as IOP \u3e18 and \u3e15 mmHg showed an increasing failure rate (18.5% and 48.5%, respectively). The mean IOP and medications number remained stable at month 24 compared to baseline (P = 0.131 and P = 0.302, respectively). Initially, VA showed improvement, with the greatest improvement at 6 months (P = 0.001), but at 24 months the improvement was no longer significant (P = 0.430). Conclusion: Phacoemulsification in patients with functioning tubes did not change the mean IOP in most of the patients (86.2%); the number of medications also did not increase

Outcomes of Ahmed glaucoma valve and transscleral cyclophotocoagulation in neovascular glaucoma

Purpose: To determine the outcomes of Ahmed glaucoma valve (AGV) and transscleral diode cyclophotocoagulation (CPC) in neovascular glaucoma (NVG). Methods: This was a single-center retrospective comparative case series involving chart review of consecutive patients who underwent AGV or CPC for treatment of NVG and had ≥6 months of follow-up. Surgical failure at 6 months, defined as an IOP of \u3e21 or \u3c6 mm Hg with hypotony maculopathy after 1 month, progression to no light perception (NLP) vision, glaucoma reoperation, or removal of AGV were the main outcome measures. Results: In total, 121 eyes of 121 patients were included (70 AGV and 51 CPC). Baseline demographics, visual acuity (VA), and intraocular pressure (IOP) were comparable between groups. At 6 months, failure was significantly higher in the CPC group than in the AGV group (43.1% vs. 17.1%, P = 0.020). Both groups had similar IOP and medication number at 6 months, but VA was significantly lower in the CPC group compared to the AGV group (2.4 ± 0.8 vs. 1.9 ± 1.0, P = 0.017). More CPC eyes required reoperation for glaucoma than AGV eyes (11.8% vs. 1.4%, P = 0.041). Multivariate regression analysis identified higher preoperative IOP (P = 0.001) and CPC surgery (P = 0.004) as independent predictors of surgical failure at 6 months. Age, sex, race, NVG etiology, bilaterality of the underlying retinal pathology, perioperative retina treatment, and prior or combined vitrectomy were not significant. Conclusion: AGV and CPC had comparable IOP and medication reduction in NVG eyes at 6 months. CPC was more frequently associated with failure, reoperation for glaucoma, and worse visual outcomes. High preoperative IOP and CPC surgery independently predicted surgical failure

Post-Coronary Artery Bypass Grafting Non-Arteritic Ischemic Optic Neuropathy: Evaluation by Optical Coherence Tomography Angiography

Non-arteritic ischemic optic neuropathy (NAION) after coronary artery bypass grafting (CABG) is a rare and devastating complication typically associated with severe anemia (1). We report a case of post-CABG NAION with cotton-wool spots imaged with optical coherence tomography angiography (OCT-A)