Retinal abnormalities in children suffering from low hemoglobin levels

Background: Anemia is a major public health problem with total prevalence of 30%. It is one of the hematological disorders which can induce retinal changes that are due to retinal hypoxia that leads to nerve fiber layer infarction. Other change includes increased vascular permeability, venous stasis, angiospasm and increased blood viscosity.Methods:  This is the cross-sectional study that includes 230 children with age group of 1 to15 years having hemoglobin levels less than 10 gm/dl referred to eye OPD. Ocular examination was done which included-visual acuity, anterior segment, dilated fundus examination.Results: Retinopathy was observed in 95% children of severe anemia and 84% children of moderate anemia. Common findings observed vascular changes, dot blot hemorrhages, flame shaped hemorrhages, sub hyaloids hemorrhages, disc pallor and macular edema.Conclusions: Retinopathy is a frequent finding seen in moderate to severe anemic patients, as the retinal changes were found significantly in maximum patients, it is recommended that all anemic patients particular Hb less than 10 g/dl must undergo routine fundus examinations.

Correlative study of diabetic retinopathy in type 2 diabetes mellitus with haemoglobin A1c, duration of diabetes and modifiable risk factors: smoking, alcohol and BMI in adult population attending a tertiary care hospital

Background: Diabetes is a disease, which if not controlled, affects every cell of the body from head to toe. No wonder it is often referred to as the “SILENT KILLER”. So through our study, we aim to study the correlation between (haemoglobin A1c) HbA1c levels, duration of diabetes and modifiable risk factors with diabetic retinopathy (DR) in patients of type 2 diabetes mellitus.Methods: This study was conducted in 100 patients (200 eyes) who were diagnosed cases of type 2 diabetes mellitus. A detailed history of the duration of diabetes, alcohol intake and smoking and HbA1c levels was taken. Complete ocular examination was done. BMI was also calculated.Results: 2/3rd of the eyes with grade 3 DR were of>10 years duration while 2/3rd of the eyes with grade 2 DR were of 5-10 years duration. Of the eyes with grade 3 DR, all the patients had HbA1c of more than 8. Significant p value shows strong correlation between DR and obesity. No significant correlation of DR was found with alcohol and smoking.Conclusions: The findings in our study endorse the view that duration and HbA1c are important risk factors for occurrence and severity of DR and therefore a regular follow up and good glycemic control is highly essential for the prevention of occurrence and progression of DR. Strong correlation between BMI and DR suggest that lifestyle changes play a pivotal role

A 3D Automated Classification Scheme for the TAUVEX data pipeline

In order to develop a pipeline for automated classification of stars to be observed by the TAUVEX ultraviolet space Telescope, we employ an artificial neural network (ANN) technique for classifying stars by using synthetic spectra in the UV region from 1250\AA to 3220\AA as the training set and International Ultraviolet Explorer (IUE) low resolution spectra as the test set. Both the data sets have been pre-processed to mimic the observations of the TAUVEX ultraviolet imager. We have successfully classified 229 stars from the IUE low resolution catalog to within 3-4 spectral sub-class using two different simulated training spectra, the TAUVEX spectra of 286 spectral types and UVBLUE spectra of 277 spectral types. Further, we have also been able to obtain the colour excess (i.e. E(B-V) in magnitude units) or the interstellar reddening for those IUE spectra which have known reddening to an accuracy of better than 0.1 magnitudes. It has been shown that even with the limitation of data from just photometric bands, ANNs have not only classified the stars, but also provided satisfactory estimates for interstellar extinction. The ANN based classification scheme has been successfully tested on the simulated TAUVEX data pipeline. It is expected that the same technique can be employed for data validation in the ultraviolet from the virtual observatories. Finally, the interstellar extinction estimated by applying the ANNs on the TAUVEX data base would provide an extensive extinction map for our galaxy and which could in turn be modeled for the dust distribution in the galaxy.Comment: 8 pages, 12 figures, Accepted for publication in MNRAS; High resolution figures available from the authors on reques

Acute myocardial infarction in labor: a rare case report

Myocardial infarction (MI) presenting first time in labor is rare with incidence of 3 case per 1,00,000 and its management during labor is rarely seen in literature. In this case, a 29-year-old gravida 2 para 1 with previous caesarean section 1 year back with history of postpartum eclampsia presented with acute breathlessness and lower abdominal pain. She was diagnosed with acute MI. Patient had emergency caesarean section due to scar tenderness. Post operatively patient was managed in ICU with multi-disciplinary team of critical care, cardiologist and obstetrician.

It is Time for Zero Tolerance for Sexual Harassment in Academic Medicine

While there are more women in leadership positions in academic medicine now than ever before in our history, evidence from recent surveys of women and from graduating medical students demonstrates that sexual harassment continues in our institutions. Our ability to change the culture is hampered by fear of reporting episodes of harassment, which is largely due to fear of retaliation. We describe some efforts in scientific societies that are addressing this and working to establish safe environments at national meetings. We must also work at the level of each institution to make it safe for individuals to come forward, to provide training for victims and for bystanders, and to abolish locker room talk that is demeaning to women

Fc-Optimized Anti-CD25 Depletes Tumor-Infiltrating Regulatory T Cells and Synergizes with PD-1 Blockade to Eradicate Established Tumors

CD25 is expressed at high levels on regulatory T (Treg) cells and was initially proposed as a target for cancer immunotherapy. However, anti-CD25 antibodies have displayed limited activity against established tumors. We demonstrated that CD25 expression is largely restricted to tumor-infiltrating Treg cells in mice and humans. While existing anti-CD25 antibodies were observed to deplete Treg cells in the periphery, upregulation of the inhibitory Fc gamma receptor (FcγR) IIb at the tumor site prevented intra-tumoral Treg cell depletion, which may underlie the lack of anti-tumor activity previously observed in pre-clinical models. Use of an anti-CD25 antibody with enhanced binding to activating FcγRs led to effective depletion of tumor-infiltrating Treg cells, increased effector to Treg cell ratios, and improved control of established tumors. Combination with anti-programmed cell death protein-1 antibodies promoted complete tumor rejection, demonstrating the relevance of CD25 as a therapeutic target and promising substrate for future combination approaches in immune-oncology

Health, education, and social care provision after diagnosis of childhood visual disability

Aim: To investigate the health, education, and social care provision for children newly diagnosed with visual disability.Method: This was a national prospective study, the British Childhood Visual Impairment and Blindness Study 2 (BCVIS2), ascertaining new diagnoses of visual impairment or severe visual impairment and blindness (SVIBL), or equivalent vi-sion. Data collection was performed by managing clinicians up to 1-year follow-up, and included health and developmental needs, and health, education, and social care provision.Results: BCVIS2 identified 784 children newly diagnosed with visual impairment/SVIBL (313 with visual impairment, 471 with SVIBL). Most children had associated systemic disorders (559 [71%], 167 [54%] with visual impairment, and 392 [84%] with SVIBL). Care from multidisciplinary teams was provided for 549 children (70%). Two-thirds (515) had not received an Education, Health, and Care Plan (EHCP). Fewer children with visual impairment had seen a specialist teacher (SVIBL 35%, visual impairment 28%, χ2p < 0.001), or had an EHCP (11% vs 7%, χ2p < 0 . 01).Interpretation: Families need additional support from managing clinicians to access recommended complex interventions such as the use of multidisciplinary teams and educational support. This need is pressing, as the population of children with visual impairment/SVIBL is expected to grow in size and complexity.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited

Fc Effector Function Contributes to the Activity of Human Anti-CTLA-4 Antibodies.

With the use of a mouse model expressing human Fc-gamma receptors (FcγRs), we demonstrated that antibodies with isotypes equivalent to ipilimumab and tremelimumab mediate intra-tumoral regulatory T (Treg) cell depletion in vivo, increasing the CD8+ to Treg cell ratio and promoting tumor rejection. Antibodies with improved FcγR binding profiles drove superior anti-tumor responses and survival. In patients with advanced melanoma, response to ipilimumab was associated with the CD16a-V158F high affinity polymorphism. Such activity only appeared relevant in the context of inflamed tumors, explaining the modest response rates observed in the clinical setting. Our data suggest that the activity of anti-CTLA-4 in inflamed tumors may be improved through enhancement of FcγR binding, whereas poorly infiltrated tumors will likely require combination approaches