Subtenon carboplatin in the management of intraocular retinoblastoma

Purpose: To evaluate the efficacy of adjuvant subtenon carboplatin in the management of intraocular retinoblastoma. Methods: This study was conducted as a randomized, double-masked clinical trial. A diagnosis of intraocular retinoblastoma was made based on clinical examination, ultrasonography and orbital CT-scanning. The greatest basal dimension of the tumors was estimated in disc diameter (DD) by indirect ophthalmoscopy. Tumor thickness was determined by ultrasonography. Each eye was assigned to one of 10 blocks based on tumor stage (Reese-Ellsworth classification) and randomly received systemic chemotherapy alone (control group) or systemic chemotherapy plus 20mg subtenon carboplatin (case group). Indirect laser photocoagulation or cryotherapy was performed as additional treatment. Results: The study included 35 tumors in 17 eyes of 14 patients (19 tumors in 8 eyes in the control group and 16 tumors in 9 eyes in the case group). There was 57.22 and 61.73 decrease in tumor thickness in the control and case groups, respectively. This difference was not statistically significant (P=0.12). The decrease in greatest basal tumor dimension in the control group (47.32) was not significantly different from that in the case group (38.80). One eye (12.5) in the control group and 3 eyes (33.3) in the case group were enucleated. Conclusion: Adjuvant subtenon carboplatin does not seem to increase the efficacy of systemic chemotherapy in the treatment of intraocular retinoblastoma

Association between C-reactive protein with all-cause mortality in ELSA-Brasil cohort

Background: High-sensitive C-reactive protein (hsCRP) has been proposed as a marker of incident cardiovascular disease and vascular mortality, and it may also be a marker of non-vascular mortality. However, most evidence comes from either North American or European cohorts. The present proposal aims to investigate the association of high-sensitive C-reactive protein with the risk of all-cause mortality in a multi-ethnic Brazilian population Methods: Cohort data from baseline (2008–2010) of 14 792 subjects participating in the Brazilian Longitudinal Study of Adult Health were used. HsCRP was assayed with Immunochemistry. The association of baseline covariates with all-cause mortality was calculated by Cox regression for univariate model and adjusted for different confounders after mean follow-up of 8.0 ± 1.1 years. The final model was adjusted for age, sex, self-rated race/ethnicity, schooling, health behaviours and prevalent chronic disease. Results: The risk of death increased steadily by quartiles of hsCRP from 1.45 (95% Confidence Interval: 1.05, 2.01) in Quartile 2 to 1.95 (1.42, 2.69) in Quartile 4 compared to Quartile 1. Furthermore, the persistence of a significant graded association after the exclusion of deaths in the first year of follow-up suggests that these results are unlikely to be due to reverse causality. Finally, the hazard ratios were unaffected by the exclusion of participants that had self-reported past medical history for diabetes, cancer and chronic obstructive pulmonary disease. Conclusions: Our study shows that hsCRP levels is associated with mortality in a highly admixed population, independently of a large set of lifestyle and clinical variables

Professional development and sustainable development goals

Professional development is defined as a consciously designed systematic process that helps professionals to attain, utilize, and retain knowledge, skills, and expertise. It is simply a process of obtaining skills, qualifications, and experience that help in advancement in one’s career. In the field of education, it is defined as the process of improving staff skills and competencies needed to produce outstanding performance of students. It also refers to a process of improving an organization’s staff capabilities through access to education and training opportunities for better output. Professional development can include a variety of approaches such as formal and informal education, vocational, specialized, or skill-based training, or advanced professional learning

Diagnostic techniques for inflammatory eye disease: past, present and future: a review

Investigations used to aid diagnosis and prognosticate outcomes in ocular inflammatory disorders are based on techniques that have evolved over the last two centuries have dramatically evolved with the advances in molecular biological and imaging technology. Our improved understanding of basic biological processes of infective drives of innate immunity bridging the engagement of adaptive immunity have formed techniques to tailor and develop assays, and deliver targeted treatment options. Diagnostic techniques are paramount to distinguish infective from non-infective intraocular inflammatory disease, particularly in atypical cases. The advances have enabled our ability to multiplex assay small amount of specimen quantities of intraocular samples including aqueous, vitreous or small tissue samples. Nevertheless to achieve diagnosis, techniques often require a range of assays from traditional hypersensitivity reactions and microbe specific immunoglobulin analysis to modern molecular techniques and cytokine analysis. Such approaches capitalise on the advantages of each technique, thereby improving the sensitivity and specificity of diagnoses. This review article highlights the development of laboratory diagnostic techniques for intraocular inflammatory disorders now readily available to assist in accurate identification of infective agents and appropriation of appropriate therapies as well as formulating patient stratification alongside clinical diagnoses into disease groups for clinical trials

BEHÇET’S DISEASE

Behçet’s disease (BD) which is classified among vasculitides is a systemic disease with various manifestations. Its clinical course is characterized by attacks and remissions. Till now, two nationwide surveys of BD from Iran and Japan and 4 major case series from Turkey, Korea, Morocco and England have been reported. Clinical picture of BD is dominated by mucous membrane manifestations, including oral aphthosis - seen in 96.8% of patients in Iran, 98.2% in Japan, 100% in Turkey, 97.5% in Korea, 100% in Morocco and 100% in England- and genital aphthosis which is seen less frequently- 65.3% in Iran, 73.2% in Japan, 88.2% in Turkey, 56.7% in Korea, 83.5% in Morocco and 89% in England. Skin aphthosis is not frequent but it is the most characteristic lesion of BD. Ocular manifestations include anterior uveitis, posterior uveitis and retinal vasculitis. Joint manifestations include arthralgia, monoarthritis, oligo/poly arthritis, and ankylosing spondylitis. Other manifestations include neurological, gastrointestinal and cardiopulmonary manifestations, vascular involvement, orchitis and epididymitis. Erythrocyte sedimentation rate is usually elevated. Urinary abnormalities are infrequent and transient. Positive pathergy test has been reported in 57.4% of patients in Iran, 44% in Japan, 57% in Turkey, 40% in Korea, 68% in Morocco and 32% in England. Lesions usually heal without sequela, except for lesions of eyes, brain and vascular system. The major cause of morbidity is the ocular lesion, which could lead to severe loss of vision or blindness

cas de myase ophthalmique par la larve de rhinostrus purpureus

Conjonctival Myiasis- This is an exceptionally rare disease in Iran. We found one case due to . which after removal of the larvea- cleared completely, and the eye became normal