Primary Sjogren′s Syndrome presenting with Interstitial lung disease and Myositis

Sjogren′s syndrome (SS) is an autoimmune disease, is the most common autoimmune disease following rheumatoid arthritis but remains undiagnosed in more than half. The hallmark histopathological features of SS are periepithelial lymphocytic infiltration of the affected organs. Antibodies to SSA (Ro) and SSB (La) are characteristically associated with SS. The reported frequency of pulmonary involvement in primary SS varies widely, ranging from 9% to 75% and consists of various forms of small airway diseases and interstitial lung diseases (ILD). We are reporting a case of primary SS presenting with ILD and myositis

Angle Closure Scoring System (ACSS)-A Scoring System for Stratification of Angle Closure Disease - Fig 3

<p>Comparison of 4 quadrant (from above to below superior, nasal, temporal and inferior in that order) gonioscopic features of eyes with primary angle closure glaucoma requiring 0 medicines (group 1-a,d, g and i) with that requiring 1 medicines (group 2-b, e, h and k) or >2 medicines (group 3-c, f, i, l)showing definite differences in gonioscopic features among eyes with different number of medicines, especially group 1 and group 3.</p

Comparing ganglion cell-inner plexiform layer thickness with focal and global responses on multifocal electroretinogram in glaucoma

BACKGROUND: The aim of this study was to evaluate responses on multifocal electroretinogram (mfERG) with ganglion cell-inner plexiform layer (GCIPL) thickness on cirrus spectral-domain optical coherence tomography (SD-OCT) in glaucoma. METHODS: All diagnosed glaucoma patients attending glaucoma services at our institute from November 2012 to April 2013 were screened for this observational hospital-based study. Controls included patients attending our outpatient services for general eye checkup. Structural parameters on SD-OCT including GCIPL and retinal nerve fiber layer (RNFL) thickness were compared with functional parameters on mfERG in early (mean deviation −6 dB), moderate (−6 to − 12 dB), and controls. RESULTS: A total of 54 cases and 33 controls fulfilling inclusion criteria were recruited for the study. The average and minimum GCIPL thickness did not vary significantly between early and control eyes while moderate glaucoma eyes had marginally lower GCIPL thickness than early glaucoma eyes. The GCIPL minimum thickness on univariate regression was found to be influenced by N2 amplitudes (β = −0.5, P = 0.012) and global N2P1amplitudes (β =0.6, P = 0.01) in moderate glaucoma. In early glaucoma, these were influenced only by RNFL parameters with no association with functional mfERG responses. Multivariate logistic regression identified global N2P1 amplitude to be significantly influencing GCIPL average and minimum thickness (P = 0.01 and 0.02, R2 = 47.8% and 52.3%, respectively) in moderate glaucoma. Maximum area under the curve was found for GCIPL minimum (95% confidence interval [CI] 0.53–0.81) and N2P1 amplitude (95% CI 0.55–0.80). CONCLUSIONS: The second order responses N2P1 and N2 amplitude on mfERG predict function that correlated with structural GCIPL thickness in moderate glaucoma. Early glaucoma may be best predicted by RNFL thickness rather than on mfERG responses

Stratification of eyes with primary angle closure based on <25^th (strata 1), 25-75^th (Strata 2) and >75^th (Strata 3) percentile of sum scores of gonioscopic parameters (ACSSg).

<p>Stratification of eyes with primary angle closure based on <25^th (strata 1), 25-75^th (Strata 2) and >75^th (Strata 3) percentile of sum scores of gonioscopic parameters (ACSSg).</p

Differences in sum scores of gonioscopic parameters (ACSSg) eyes with primary angle closure (PAC) and primary angle closure glaucoma (PACG) eyes requiring medications after laser iridotomy.

<p>Differences in sum scores of gonioscopic parameters (ACSSg) eyes with primary angle closure (PAC) and primary angle closure glaucoma (PACG) eyes requiring medications after laser iridotomy.</p

Baseline characteristics of patients with primary angle closure, primary angle closure glaucoma and controls included in the study.

<p>Baseline characteristics of patients with primary angle closure, primary angle closure glaucoma and controls included in the study.</p

Comparison of sum of gonioscopic scores (ACSSg) with number of baseline medicines required in eyes with primary angle closure (PAC) and primary angle closure glaucoma (PACG)-circles represent outliers.

<p>Comparison of sum of gonioscopic scores (ACSSg) with number of baseline medicines required in eyes with primary angle closure (PAC) and primary angle closure glaucoma (PACG)-circles represent outliers.</p

Electrocardiogram pattern of some exotic breeds of trained dogs: A variation study

Aim: The present study has been conducted to evaluate the variation in electrocardiogram (ECG) parameters among different trained breeds of dogs (viz. Labrador, German Shepherd, and Golden Retriever) used for security reasons. Materials and Methods: The ECG was recorded by single channel ECG at a paper speed of 25 mm/s and calibration of 10 mm=1 mV. The recordings were taken from all the standard bipolar limb leads (Lead-I, II, and III) and unipolar augmented limb leads (Lead-aVR, aVL, and aVF). Results: Heart rate was found to be highest in Labrador and lowest in German Shepherd. P-wave duration was maximum in Golden Retriever breed and lowest in Labrador. Maximum amplitude of P-wave was found in Labrador followed by German Shepherd and Golden Retriever. There was significantly (p<0.05) higher values of PR interval in German Shepherd compared to other breeds. The variation in QRS duration, ST segment duration, T-wave duration, and T-wave amplitude was found to be non-significant among breeds. Inverted T-waves were most common in Golden Retriever and German Shepherd, whereas positive T-waves were found in Labrador. There was significant (p<0.05) variation in mean electrical axis of QRS complex among different breeds and it ranges from +60° to +80°. Conclusion: The present study provides the reference values for different ECG parameters to monitor the cardiac health status among Labrador, German Shepherd, and Golden Retriever breeds

Impact of Different Visual Field Instruction Strategies on Reliability Indices

<p>Purpose: To investigate and compare the visual field performance following three different types of visual field instruction strategies.</p> <p>Method: Ninety consecutive visual field-naïve glaucoma patients who can perform the test and understand instructions were imparted three forms of instructions prior to the visual field test. Patients with visual acuity <20/200, central corneal opacities, or anterior segment pathology and patients unable to understand general instructions/uncooperative were excluded. All forms of instructions were given by a trained optometrist in the patients’ own language as an instruction leaflet read out in 5 min for a verbal group (group1) and by a 5 min video created in house (group 2). Group 3 patients were shown the video first, followed by verbal instructions. We evaluated the reliability parameters in each group after visual field testing by an independent optometrist blinded to the form of instruction given.</p> <p>Results: Among the three groups, group 3 patients had the least number of repeat tests. Eyes with MD<–12Db had better reliability than that of the other groups. Mixed-model linear regression analysis shows that the duration of the test was significantly influenced by the severity of glaucoma in group 1, which is further predisposed by false negatives (FN; β = 0.06, <i>p</i> < 0.0001, R² 61.7%).</p> <p>Conclusion: The video with verbal instruction can minimize the number of repeated tests compared with only verbal or only video instruction medium. The video as well as the combined video/verbal instructions have a practical influence of obtaining more reliable fields compared with only verbal instruction.</p