Contact lens fitting in keratoconus – a prospective study on visual and functional outcomes

Background: Contact lenses continue to play an important role in the effective management of keratoconus. To report visual and functional outcomes of various types of contact lenses in keratoconus patients at a tertiary referral centre.Methods: Study design: Prospective Cohort Study. 100 eyes of 51 patients with keratoconus were fitted with contact lenses with follow up at one and six months and evaluated. Statistical analysis: Paired t test, Chi Square test.Results: Best contact lens corrected visual acuity was better than best spectacle corrected visual acuity (p= 0.000).78 % patients were fitted with RGP, 12% with Rose K, 6 % Soft, 2% Piggy Back and 2% with Kerasoft IC lenses. Soft lens were preferred in mild keratoconus, RGP for moderate and Rose K, Piggy Back and Kerasoft IC lenses for severe keratoconus. The mean daily wear among the lenses was 7.59 hours per day with Rose K lenses having maximum wearing time of 8.33 hours. Comfort and tolerance level was maximum in Rose K, Piggy Back, Kerasoft IC and RGP lens users whereas it was less in the soft lens group. No significant complications were noted with contact lens use.Conclusion: Contact lenses continue to play an important role in the effective management of keratoconus. With the advent of newer designs of contact lenses for keratoconus it is possible to customize the lenses to optimize patient’s requirement visually and functionally.

Outdoor resting preference of Culex tritaeniorhynchus, the vector of Japanese encephalitis in Warangal and Karim Nagar districts, Andhra Pradesh

Background & objectives : Entomological investigations were carried out in Warangal and KarimNagar districts of Andhra Pradesh during viral encephalitis outbreak in July 2003.Methods : Adult mosquito collections in outdoor were done using sweep cage method and in indoorwith the help of aspirator tube and flash light. Larval collections were done by dipping method. JEvirus positivity was tested by IgM capture ELISA test.Results : Outdoor collections revealed presence of Culex tritaeniorhynchus, Cx. bitaeniorhynchusand Cx. gelidus and in indoor collections —Cx. quinquefasciatus, Cx. tritaeniorhynchus, An. vagusand An. subpictus. In the outdoor collections Cx. tritaeniorhynchus was predominant (96.3% of totalcollection). Three samples out of 55 serum samples from human cases and five from contacts showedthe presence of antibodies against JE virus.Interpretation & conclusion : Cx. tritaeniorhynchus, a known vector of JE is predominant in outdoorsand playing a main role in JE transmission in this area. Vector control aimed at the outdoor restingpopulation might limit virus circulation in the mosquito vertebrate host cycle and prevent humaninfection

Role of vitamin D3 supplementation in allergic rhinitis: an outpatient department based prospective analytical observational study

Background: Allergic rhinitis is a common disorder characterized by sneezing, rhinorrhoea, nasal congestion, itching and lacrimation which adversely affect quality of life to a substantial degree. Evidence suggests that low serum vitamin D3 has correlation with severity of allergic rhinitis. The objective of the study was to evaluate whether vitamin D3 supplementation has any role to reduce the severity of disease spectrum among allergic rhinitis patients.Methods: This prospective analytical observational study was carried out in 6 months in ENT OPD of Midnapore medical college and Hospital. Only the persistent moderate to severe allergic rhinitis patients as per ARIA-WHO guideline, aged >12 years were included in this study. 64 subjects were randomised into two groups. The test group received oral vitamin D (60000 IU/week for 2 months) along with levocetirizine, fluticasone spray and montelukast while the control group received three drug therapies without vitamin D3. Allergy symptom score (ASS) was assessed at the start and end of the study period.Results: The study population (n=64) was predominantly female (37) and had a mean age of 39.79 years. The ASS score was 14.06±1.01 in Test group and 13.93±1.01 in Control group and the Post treatment ASS score was 2.65±1.12 and 6.06±0.87 respectively. This difference between groups was significant (p<0.001).Conclusions: There was significant reduction in the Allergy symptom score after vitamin D3 supplementation which alters the course of disease towards clinical improvement

Synchronous dual malignancy: a rare case report of carcinoma breast with carcinoma gall bladder

Incidence of multiple primary cancers is reported to be between 0.18% to 17.2% in various studies. Occurrence of breast and gall bladder malignancy as synchronous malignancy is very rare. We are reporting one of such rare case. Our patient, a 64 years old lady had a unique presentation. She underwent laparoscopic cholecystectomy for a clinical diagnosis of cholelithiasis. Histopathology turned out to be adenocarcinoma of the gall bladder (Stage II A). A clinical examination done at the time of presentation to our institute revealed suspicious thickening of the skin of the left breast and a subsequent tru-cut biopsy revealed infiltrating ductal carcinoma. Hormone receptor immunohistochemistry revealed oestrogen receptor (ER) negative progesterone receptor (PR) negative and Her2neu negative tumour. Further evaluation revealed a widespread metastatic disease. She was treated with palliative radiotherapy, chemotherapy and zolendronate. She had an aggressive clinical course and succumbed to her illness within four months after diagnosis of dual malignancy. There is a high incidence of gall bladder carcinoma along the Gangetic belt of Northern India. Presence of dual malignancy with gall bladder carcinoma as one primary in these geographic location needs to be further explored for sporadic environmental factors or other genetic alterations as possible causative factors

An Outcome Analysis of Endoscopic Sinus Surgery in Chronic Sinusitis with Chronic Rhinitis Non-responsive to Medical Therapy

Introduction   Chronic sinusitis with chronic rhinitis affect the patients’ quality of life significantly. Aim of this study is to assess the outcome of Endoscopic Sinus Surgery (ESS) in terms of Quality of Life (QoL) in patient with Chronic Sinusitis with Chronic Rhinitis (CSCR), non-responsive to medical therapy.     Materials and Methods Prospective study was conducted among 75 patients of CSCR non responsive to medical therapy in the age group of 15 to 80 years over a period of 18 months (January 2018 to June 2019). The subjects were randomly grouped into two, namely Group 1- CSCR with Polyp and Group 2- CSCR without Polyp. Subjects were asked to complete SNOT-22 score and Visual analogue scale (VAS) and conventional medical treatment was given for 2 weeks. Those failed to respond as per EPOS guideline were subjected to ESS and followed up at 6 weeks and 12 weeks, re-assessed by SNOT-22 questionnaire and VAS. Data was analyzed by using Paired t- test.   Results Statistically significant (p-value <0.05) improvement in symptom score assessing QoL after Endoscopic sinus surgery.   Conclusion Patients with CRS non- responsive to medical treatment, the decision for surgery should be guided by their pre-operative QoL impairment, as measured by SNOT-22 and VAS

Quantum Black Hole and the Modified Uncertainty Principle

Recently Ali et al. (2009) proposed a Generalized Uncertainty Principle (or GUP) with a linear term in momentum (accompanied by Plank length). Inspired by this idea we examine the Wheeler-DeWitt equation for a Schwarzschild black hole with a modified Heisenberg algebra which has a linear term in momentum. We found that the leading contribution to mass comes from the square root of the quantum number 'n' which coincides with Bekenstein's proposal. We also found that the mass of the black hole is directly proportional to the quantum number 'n' when quantum gravity effects are taken into consideration via the modified uncertainty relation but it reduces the value of mass for a particular value of the quantum number.Comment: 7 pages, comments / criticisms / suggestions welcome. Accepted for publication in Physics Letters

Identification and Characterization of Inhibitors of Human Apurinic/apyrimidinic Endonuclease APE1

APE1 is the major nuclease for excising abasic (AP) sites and particular 3′-obstructive termini from DNA, and is an integral participant in the base excision repair (BER) pathway. BER capacity plays a prominent role in dictating responsiveness to agents that generate oxidative or alkylation DNA damage, as well as certain chain-terminating nucleoside analogs and 5-fluorouracil. We describe within the development of a robust, 1536-well automated screening assay that employs a deoxyoligonucleotide substrate operating in the red-shifted fluorescence spectral region to identify APE1 endonuclease inhibitors. This AP site incision assay was used in a titration-based high-throughput screen of the Library of Pharmacologically Active Compounds (LOPAC1280), a collection of well-characterized, drug-like molecules representing all major target classes. Prioritized hits were authenticated and characterized via two high-throughput screening assays – a Thiazole Orange fluorophore-DNA displacement test and an E. coli endonuclease IV counterscreen – and a conventional, gel-based radiotracer incision assay. The top, validated compounds, i.e. 6-hydroxy-DL-DOPA, Reactive Blue 2 and myricetin, were shown to inhibit AP site cleavage activity of whole cell protein extracts from HEK 293T and HeLa cell lines, and to enhance the cytotoxic and genotoxic potency of the alkylating agent methylmethane sulfonate. The studies herein report on the identification of novel, small molecule APE1-targeted bioactive inhibitor probes, which represent initial chemotypes towards the development of potential pharmaceuticals

Minimal Length Scale Scenarios for Quantum Gravity

We review the question of whether the fundamental laws of nature limit our ability to probe arbitrarily short distances. First, we examine what insights can be gained from thought experiments for probes of shortest distances, and summarize what can be learned from different approaches to a theory of quantum gravity. Then we discuss some models that have been developed to implement a minimal length scale in quantum mechanics and quantum field theory. These models have entered the literature as the generalized uncertainty principle or the modified dispersion relation, and have allowed the study of the effects of a minimal length scale in quantum mechanics, quantum electrodynamics, thermodynamics, black-hole physics and cosmology. Finally, we touch upon the question of ways to circumvent the manifestation of a minimal length scale in short-distance physics.Comment: Published version available at http://www.livingreviews.org/lrr-2013-

Incidence and Risk Factors of Pre-Eclampsia in the Paropakar Maternity and Women's Hospital, Nepal: A Retrospective Study

This study aims to determine the incidence of pre-eclampsia and distribution of risk factors of pre-eclampsia at Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal. A retrospective study included 4820 pregnant women from 17 September to 18 December 2017. Data were obtained from the medical records of the hospital’s Statistics Department. Associations between the risk factors and pre-eclampsia were determined using logistic regression analysis and expressed as odds ratios. The incidence rate of pre-eclampsia in the study population was 1.8%. Higher incidence of pre-eclampsia was observed for women older than 35 years (Adjusted Odds Ratio, AOR)= 3.27; (Confidence Interval, CI 1.42–7.52) in comparison to mothers aged 20–24 years, primiparous women (AOR = 2.12; CI 1.25–3.60), women with gestational age less than 37 weeks (AOR = 3.68; CI 2.23–6.09), twins pregnancy (AOR = 8.49; CI 2.92–24.72), chronic hypertension (AOR = 13.64; CI 4.45–41.81), urinary tract infection (AOR = 6.89; CI 1.28–36.95) and gestational diabetes (AOR = 11.79; CI 3.20–43.41). Iron and calcium supplementation appear to be protective. Age of the mothers, primiparity, early gestational age, twin pregnancy, chronic hypertension, urinary tract infection and gestational diabetes were the significant risk factors for pre-eclampsia. Iron and calcium supplementation and young aged women were somewhat protective