Confocal Scan Features of Keratic Precipitates in Granulomatous versus Nongranulomatous Uveitis

Purpose: To compare the morphologic features of keratic precipitates (KPs) by confocal microscopy in granulomatous versus nongranulomatous noninfectious uveitis. Methods: KP morphology was determined by confocal scan in patients with noninfectious granulomatous and noninfectious nongranulomatous uveitic cases. Results: One hundred and twenty-seven eyes of 90 subjects with noninfectious uveitis were studied. Thirty-nine eyes had granulomatous and 88 had nongranulomatous uveitis. Smooth-rounded KPs were significantly more common in the granulomatous subgroup (P<0.001) while cruciform and dendritiform KPs were more frequent in nongranulomatous uveitis (P<0.001 and P<0.005 respectively). Conclusion: Confocal scan may be used as an adjunctive tool for differentiating granulomatous from nongranulomatous uveitis. Smooth-rounded KPs are strongly suggestive of granulomatous inflammation

Bilateral Primary Intraocular Lymphoma

Purpose: To report a case of bilateral primary intraocular lymphoma. Case report: A 33-year-old man presented with bilateral blurred vision since two years ago. Examination revealed large keratic precipitates, anterior chamber reaction, posterior subcapsular cataracts, and vitreous infiltration. After a short trial of topical and periocular steroids, diagnostic 25-gauge pars plana vitrectomy was performed and cytologic evaluation of the aspirate confirmed a diagnosis of intraocular lymphoma. The patient was subsequently managed with intravitreal methotrexate in both eyes and responded favorably. Central nervous system workup for lymphoma was negative. Conclusion: Primary intraocular lymphoma should be considered in young adults suffering from chronic recalcitrant panuveitis

Critical study of Mamsadhara Kala

Every concept of Ayurveda has its own importance. There are many concepts mentioned in the classics are scientific and worth understanding in modern words. Among these concepts Acharya Sushruta mentioned Sapta Kalas in the body. While considering upon the Ashaya they had also thought of the linings making internal walls of the Ashaya, designating them as Kala. They presented it in a very silent way. Among the Sapta Kala, Mamsadhara Kala is one described by Sushruta and other Acharyas. There are 3 layers of connective tissue which extended from the deep fascia and protects and give strength to the skeletal muscle. They are epimysium, perimysium and endomysium, they may extend beyond the muscle fiber to form tendons. So by this we can understand the Mamsadhara Kala in gross anatomy, i.e. fascia or deep fascia and in the histological level it can be taken as Endomysium. So the collection and comprehensive review of information regarding Mamsadhara Kala becomes significant. Hence to unravel and accumulate the hidden scientific information about Mamsadhara Kala, in different resources and its structure and function on common parlon, presents intended research work has been undertaken and planned to carry out

A 27-Year Report from the Central Eye Bank of Iran: A complete translation from Farsi

This article is based on a study first reported in Farsi in the Bina Journal of Ophthalmology, titled گزارش عملکرد سه دهه اي بانک چشم جمهوري اسلامي ايران, Volume 24, Issue 2 (Winter 2019) 2019/05/28. Original URL: https://www.sid.ir/fa/journal/ViewPaper.aspx?ID=487896 Purpose: To report the 27-year statistical data from the Central Eye Bank of Iran (CEBI) and its activity. Methods: All CEBI records regarding procured eyes, tissue utilizations, corneal transplants per capita, and indications for keratoplasty from 1991 to 2017 were analyzed. Results: In total, 115,743 whole eyes were donated during the 27-year period. Out of the 114,169 eyes donated between 1994 and 2017, 95,314 eyes were distributed for transplantation, and 95,057 corneas were actually transplanted. The mean annual rate of corneal transplants per capita was 55.10−6 ± 27.10−6. Although penetrating keratoplasty (PKP, 70%) was the most common technique of corneal transplantation during the study period, it exhibited a decreasing trend between 2006 and 2017 (P = 0.048). It was in contrast to Descemet stripping automated endothelial keratoplasty (DSAEK) that demonstrated an increasing trend during the same period (P &lt; 0.001). Keratoconus (KCN, 39.70%) was the most leading indication for keratoplasty over the last three decades followed by bullous keratopathy (BK, 18.5%), corneal scar and opacities (15.7%), and graft failure (GF, 7.5%), with an increasing trend for BK, GF, and KCN. A majority of scleral tissues (83.7%) were utilized for orbital implant protection. Conclusion: An increasing trend in the number of procured eyes was observed over the past 27 years in Iran. The most leading indications for corneal transplantation were KCN and BK. While PKP was the most common keratoplasty technique, DSAEK showed an increasing trend over the last 12 years

Congenital cystic adenomatoid malformation (CCAM): antenatal and postnatal management

Background: Congenital cystic adenomatoid malformation (CCAM) is a rare abnormality of lung development. The estimated incidence ranges from 1: 10,000 to 1.35,000 live births. It is diagnosed by prenatal screening at 18-20 weeks of gestation. Surgical excision of symptomatic lesions is relatively straight forward, but management of asymptomatic lesions is controversial.Methods: Among women who delivered at St. Johns medical college and hospital, Bangalore between Jan 2011 to Dec 2016, those with the diagnosis of CCAM during anomaly scan were included in the study. Antenatal and Post-natal period and their outcomes were evaluated. Follow up was extend up to the childhood in the affected foetus.Results: There were 5 cases of CCAM in 13057 deliveries during 5-year study. Incidence was 1:2611. Mean gestational age at diagnosis was 21.6±2.5weeks. All foetus had CVR (CCAM volume) ratio more than 1.6 and there was no compromise on lung volume. Mean lung volume was 62.8±8.6 cc. and mean Apgar score at 1minute was 6.8±2.7 and at 5 minutes was 8.0±2.2. Among 5 foetuses, 2 foetuses had regression of cyst by birth and 3 underwent surgery for resection after birth.Conclusions: CCAM remains a challenge for obstetricians, neonatologists and paediatric surgeons. The combination of prenatal MRI and serial ultrasound studies optimize foetal surveillance and postnatal care. In asymptomatic CCAM, babies should be followed up to adolescence and adulthood, as they can manifest with malignant changes

A case study on Dusta Vrana (Non Healing Varicose Ulcer)

Any kind of destruction / break / rupture / discontinuity of body tissue/part of the body is called Vrana. Vrana which doesn’t heal in its natural course of healing time is said to be Dusta Vrana along with other pathological manifestations further. Acharya Susruta explains, when a person&nbsp; does not have control over his indriya’s and&nbsp; follows Apathyaja ahaar ,vihar with untimely treated wound&nbsp; leads to severe vitiation of Doshas forming Dushta Vrana. In classics it’s been widely explained about the chikitsa of&nbsp;&nbsp; Vrana. Considering clinical features of dusta vrana and cause here the correlated with Non healing varicose ulcer. The Chronic non healing ulcer are the ulcers that have failed to progress through a time. Sequence of repair, or one that proceeds through the wound healing process without restoring anatomic and functional results

Anatomical Interpretation of Kakshadhara Marma and its Clinical Importance

The term Marma indicates the sense of vital parts of the human body. and injury to these spots leads to the death and death like miseries. The Knowledge regarding location and sites of the Marma in the body have great importance in Traumatology. Marmas are grouped separately on the basis of the structural classification, based on the injury consequence, based on the Pramana &amp; based on the location in the body. Marma Viddha Lakshanas are explained in detail by the Acharya Sushruta. Kakshadhara Marma is Vaikalyakara Marma in the Urdhwa Shakha it is Snayu Marma according to the Sushruta which causes Vaikalyata once injured. The main of the study is to explore the structures present in the Kakshadhara Marma and to study its clinical importance

Specular Microscopic Features of Corneal Endothelial Vacuolation

Purpose: To introduce a specular microscopic reference image for endothelial vacuolation in donated corneas. Methods: Two corneas from a donor with diffuse, round to oval dark areas at the endothelial level on slit lamp biomicroscopy and one normal-appearing donor cornea underwent specular microscopy, histopathologic evaluation and transmission electron microscopy. Results: Specular microscopy of the two corneas with abnormal-looking endothelium revealed large numbers of dark, round to oval structures within the endothelium in favor of endothelial vacuolation. Light microscopy disclosed variable sized cyst-like structures within the cytoplasm. Transmission electron microscopy showed electronlucent and relatively large-sized intracytoplasmic vacuoles. These features were not observed in the endothelium of the normal cornea. Conclusion: The specular microscopic features of endothelial vacuolation in donated corneas were confirmed by light microscopy and transmission electron microscopy, therefore the specular image may be proposed as a reference to eye banks

Review of maternal mortality in a tertiary care urban teaching hospital: 10 year retrospective study

Background: The objectives of this study were to calculate the maternal mortality ratio, causes for maternal death in our institution and the duration of hospital admission to death interval.Methods: The study included collecting and analyzing the details of maternal death in women who were admitted to St. Johns Medical College Hospital, Bengaluru, from January 2007 to December 2016. Results: Total maternal deaths were 61 and live births were 26,001 during the study period. The maternal mortality ratio (MMR) was 234.6 per 100,000 live births. Majority of maternal deaths occurred in women aged 18 - 35 years 56 (91.80%) women, primipara 45 (73.77%) and referred cases to our institution from other hospitals 52 (85.24%).                      Most of the women died in the postnatal period 54 (88.52%). Direct obstetric causes accounted for 44 (72.13%) maternal deaths and indirect causes 17 (27.86%) deaths. Preeclampsia and eclampsia were the leading causes for death 13 (21.31%) followed by acute fatty liver of pregnancy 12 (19.67%), hemorrhage 7 (13.11%) and sepsis 6 (9.83%). Anemia was present in 77.04% of women at the time of admission to our hospital. Thirty six (59.01%) women died within a week of admission to the hospital, in which 13 (21.31%) women died in less than 24hours of admission. Twenty five (40.98%) women died after a week of admission to hospital.Conclusions: Apart from the triad of preeclampsia, obstetric haemorrhage and sepsis, acute fatty liver of pregnancy has emerged as an important cause of maternal death. Most of the maternal deaths are preventable. Early detection of complications and timely referral to tertiary care hospital in St. Johns Medical College Hospital, Bengaluru, Karnataka, India decreases maternal morbidity and mortality

Pathogenic Tau Protein Species: Promising Therapeutic Targets for Ocular Neurodegenerative Diseases

Tau is a microtubule-associated protein, which is highly expressed in the central nervous system as well as ocular neurons and stabilizes microtubule structure. It is a phospho-protein being moderately phosphorylated under physiological conditions but its abnormal hyperphosphorylation or some post-phosphorylation modifications would result in a pathogenic condition, microtubule dissociation, and aggregation. The aggregates can induce neuroinflammation and trigger some pathogenic cascades, leading to neurodegeneration. Taking these together, targeting pathogenic tau employing tau immunotherapy may be a promising therapeutic strategy in fighting with cerebral and ocular neurodegenerative disorders