Visual Outcomes in Acute Methyl Alcohol poisoning and its Biochemical Predictors: A Hospital-Based Study in Eastern India

Acute methyl alcohol toxicity can lead to severe ocular morbidity. In the present study, we aimed to observe the ocular outcomes in acute methyl alcohol poisoning and determine the biochemical predictors of the final visual outcome. This was a hospital- based descriptive study conducted on 19 consecutive patients of acute methanol poisoning presenting to the Ophthalmology department of a tertiary care multispecialty hospital in Eastern India. Thorough clinical history was obtained in each case.  A comprehensive ocular examination was done. Details of systemic treatment provided were obtained in all cases. Nineteen patients were included in the study. All patients were males. The average age of patients was 35.84 ± 9.25 years. All patients complained of bilateral blurring of vision. One patient had severe vision loss with visual acuity of hand movements in both eyes. . Colour vision was absent in 7 eyes (18.41%), and impaired in 5 eyes (13.15%). Disc edema was seen in 5 eyes (13.15%). High anion gap metabolic acidosis was seen in 13 (78.9%) cases. Serum bicarbonate level was < 22 mmol L-1 in 13 (68.42%) patients. Eleven (57.89%) patients underwent hemodialysis. The presence of metabolic acidosis, high anion gap, and high base deficit were associated with poor visual acuity and defective color vision both at the initial presentation and final follow-up. Metabolic acidosis, high anion gap, and base deficit at the time of presentation are associated with defective color vision, abnormal pupillary reaction, and poor vision both during initial and final visits. Prompt management of these metabolic abnormalities can decrease ocular morbidity and improve the final visual outcomes

A STUDY TO ASSESS THE CLINICAL AND BIOCHEMICAL PROFILE OF PATIENTS DIAGNOSED WITH HEPATITIS E IN A LARGE TEACHING HOSPITAL OF SOUTHERN INDIA

ABSTRACTObjective: Hepatitis E has been identified as a major health problem in developing countries and recently developed countries. To study the profile ofpatients diagnosed with hepatitis E infection in a tertiary care hospital in south India.Methods: A cross-sectional record-based study with the records of patients diagnosed with hepatitis E infection over a 40-month period from ateaching hospital in southern India and fulfilling the following criteria was performed.Results: The cases were predominant in the age group of 21-30 years with relative sparing of children. No seasonal variation in the occurrence orsecondary cases was observed. Temporary derangement of liver function tests was recorded in all cases. The study showed a male preponderance. Asdocumented in previous studies, the disease proved fatal in a primigravida who developed fulminant hepatic failure. Another interesting feature wasthe presence of leptospirosis, scrub typhus, and hepatitis A as co-infection with hepatitis E.Conclusion: In India, the awareness of the disease is also low, therefore, the diagnosis is usually not made in the majority of cases. Hence, theavailability of data regarding the clinical pattern of presentation and biochemical profile is restricted. However, there are some questions stillunanswered like the preference of the virus to infect individuals in the age group of 20-40 years, sparing of children, and increased rate of infectionamong the males. The cause of the increased morbidity and mortality of this virus in pregnant women is still not known. A larger sample size and thedata on the seroprevalence of this disease in the population under study are necessary for a meaningful interpretation of its epidemiological pattern.Keywords: Alanine transaminase, Alkaline phosphatase, Aspartate aminotransferase, Bilirubin, Liver

"The fruits of independence": Satyajit Ray, Indian nationhood and the spectre of empire

Challenging the longstanding consensus that Satyajit Ray's work is largely free of ideological concerns and notable only for its humanistic richness, this article shows with reference to representations of British colonialism and Indian nationhood that Ray's films and stories are marked deeply and consistently by a distinctively Bengali variety of liberalism. Drawn from an ongoing biographical project, it commences with an overview of the nationalist milieu in which Ray grew up and emphasizes the preoccupation with colonialism and nationalism that marked his earliest unfilmed scripts. It then shows with case studies of Kanchanjangha (1962), Charulata (1964), First Class Kamra (First-Class Compartment, 1981), Pratidwandi (The Adversary, 1970), Shatranj ke Khilari (The Chess Players, 1977), Agantuk (The Stranger, 1991) and Robertsoner Ruby (Robertson's Ruby, 1992) how Ray's mature work continued to combine a strongly anti-colonial viewpoint with a shifting perspective on Indian nationhood and an unequivocal commitment to cultural cosmopolitanism. Analysing how Ray articulated his ideological positions through the quintessentially liberal device of complexly staged debates that were apparently free, but in fact closed by the scenarist/director on ideologically specific notes, this article concludes that Ray's reputation as an all-forgiving, ‘everybody-has-his-reasons’ humanist is based on simplistic or even tendentious readings of his work

Ascorbate induced cross-linking of oxyhemoglobin subunits

280-282Ascorbic acid during oxidation in vitro can generate H2O2 which induces non-disulphide covalent cross-linking of coincubated oxyhemoglobin. The cross-linking phenomenon mediated by H2O2 takes place possibly without the involvement, of hydroxyl radicals as evident from the failure of radical scavengers like mannitol and dimethyl sulphoxide as well as metal-chelator, to inhibit the process. This pro-oxidant effect of ascorbic acid may have physiological significance in red blood cells in vivo.</i

Clinical manifestations and management of ocular mucormycosis during COVID-19 pandemic in Eastern India: A retrospective analysis

Purpose: To report the clinical presentation, risk factors and treatment outcomes of ocular mucormycosis during COVID-19 pandemic in Eastern India. Method: Eleven cases of biopsy-proven rhino-orbital mucormycosis with a history of concurrent or past COVID-19 presenting to the ophthalmology department of two tertiary referral centres in Eastern India from April to June 2021 were studied. Complete ophthalmological, otolaryngeal workup and imaging studies, staging was done and treatment was planned in a multidisciplinary approach. Empirical systemic amphotericin B was started. All cases underwent radical sinus surgery with orbital wall decompression, sinus and orbital irrigation with amphotericin B, followed by regular nasal debridement and serial ophthalmic examinations. Cases were followed up for a period of three months. Results: The mean age was 46.5 ± 10.7 years with male preponderance (90.9%). 90.90% of patients had elevated blood sugar levels at presentation. The common ocular presentations were conjunctival congestion (90.90%), periorbital oedema (72.72%), ophthalmoplegia (72.72%), diminution of vision (63.63%), ptosis (54.54%) and proptosis (45.45%). After treatment, regular follow-up showed clinical improvement in vision (80%), chronic ophthalmoplegia (83.3%) and complete improvement in proptosis, ptosis and periorbital oedema. COVID infection, old age, hyperglycemia, unvaccinated status and cerebral involvement were associated with increased mortality. The survival rate at three months follow-up was 81.8% and these patients were on antifungal therapy. Conclusion: A high index of suspicion and early detection as well as prompt medical and surgical treatment increases the chances of survival. Orbital wall decompression, sinus and orbital irrigation with amphotericin B are helpful in salvaging the eye and vision in most cases

Association of Cholera Toxin with Vibrio Cholerae outer Membrane Vesicles which are Internalized by Human Intestinal Epithelial Cells

Cholera toxin (CT) is the major virulence factor of pathogenic Vibrio cholerae. The present study demonstrates that a fraction of CT is associated with the outer membrane vesicles (OMVs) released by V. cholerae. Atomic force microscopy (AFM) and also transmission electron microscopy (TEM) of purified OMVs from toxigenic V. cholerae O395 revealed spherical shaped vesicles of size range 20– 200 nm. Immunoblotting of purified OMVs with polyclonal anti-CT antibody and GM1-ganglioside dependent ELISA suggest that CT is associated with OMVs. CHO cell assay indicated that OMV associated CT is physiologically active. OMVs labeled with fluorescent dye interacted with intestinal epithelial cells via the CT-receptor and were internalized increasing the cAMP level. Thus OMVs may represent an important vehicle in delivering CT to epithelial cells