Spectrum of ocular malignant tumors in a tertiary care teaching hospital

Introductions: The pattern of ocular malignant tumors in institutes of Eastern Nepal was analyzed by a retrospective study. Ocular malignant tumors are relatively rare compared to other eye lesions, and require immediate diagnosis and management. Ignorance or unawareness can result into debility, loss of vision, and death. This study provides spectrum of ocular malignant tumor correlating its pathological and clinical findings. Methods: This cross sectional study includes ninety-six cases of ocular malignant tumors diagnosed in the Department of Pathology from January 2005 to December 2009. Relevant history, clinical findings and light microscopic findings were reviewed. Descriptive analysis was done. Results: A total of 96 patient’s records were studied. Age ranged between 1-90 years. Male to female ratio was 1.4:1. Retinoblastoma was found in 34.5%, basal cell carcinoma (18%), squamous cell carcinoma in 14.5% and malignant melanoma in 10.5%. Conclusions: Early diagnosis and management help to reduce debility and loss of vision of the patients as well as help ophthalmologist in shaping the strategy for diagnosis and management of malignant neoplasm. This help in decrease morbidity and mortality of the patient. Keywords: malignant melanoma, ocular malignant tumor, retinoblastoma, squamous cell carcinoma Â

Herpes zoster ophthalmicus presenting as orbital abscess along with superior orbital fissure syndrome: A case report

Orbital abscess and superior orbital fissure syndrome (SOFS) are rare manifestations of herpes zoster ophthalmicus. Herein, we report a case of orbital abscess along with SOFS in a 2.5-year-old-male child secondary to herpes zoster infection. He presented with a 5-day history of proptosis and ptosis of the right eye that had been preceded by vesicular eruptions on the right forehead and scalp. Computed tomography scan of the head and orbit showed orbital abscess and right cavernous sinus thrombosis. A diagnosis of orbital abscess with SOFS secondary to herpes infection was made. The condition subsequently improved following antiviral therapy, intravenous vancomycin and amikacin, and oral corticosteroids

Orbital cellulitis in a neonate of the tooth bud origin : A case report

Orbital cellulitis is a serious, yet uncommon infection in neonates. It can result in significant sight and life threatening complications. Most commonly, it occurs secondarily as the result of a spread of infection from the sinuses. Orbital cellulitis, secondary to dental infection is rare. We hereby report a case of orbital cellulitis secondary to dental infection in a 15-day-old neonate without any systemic features

Efficacy of topical carboxymethyl cellulose 0.5% and cyclosporine A 0.05% in dry eye syndrome

Context: Dry eyes has been associated with inflammation and apoptosis of the ocular surface which is responsible for conjunctival goblet cell loss in long term. Aim: To study the efficacy of carboxymethylcellulose and topical cyclosporine A 0.05% in the treatment of dry eyes and their effect on the density of conjunctival goblet cells (GCD). Settings and design: Hospital based, Randomized clinical trial. Methods and material: A total of 90 patients of dry eyes were enrolled and were randomly divided into two groups of 45 each. Group A was treated with topical cyclosporine A 0.05% twice daily and group B with preservative free carboxymethyl cellulose 0.5% (CMC) four times daily for 6 weeks. Different parameters like dry eye symptoms through visual analogue score (VAS), tear break up time (TBUT), Schirmer’s tests (SCH), fluorescein stain (FLU) and goblet cell density (GCD) were obtained prior to treatment and compared with the results after 6 weeks of treatment. Statistical analysis used: SPSS software, version 12.0. Results: After 6 weeks of treatment both the groups showed significant improvement from baseline values of all the parameters (p < 0.001). Comparison between these two groups after treatment showed that all the parameters except FLU score (p < 0.001) were statistically not significant. Conclusions: Both the topical CMC 0.5% and cyclosporine A 0.05% showed improvement of ocular surface at 6 weeks interval. However, there was no significant difference between the outcome of two groups

Efficacy of topical carboxymethyl cellulose 0.5% and cyclosporine A 0.05% in dry eye syndrome ABOUT THE AUTHOR

Abstract: Context: Dry eyes has been associated with inflammation and apoptosis of the ocular surface which is responsible for conjunctival goblet cell loss in long term. Aim: To study the efficacy of carboxymethylcellulose and topical cyclosporine A 0.05% in the treatment of dry eyes and their effect on the density of conjunctival goblet cells (GCD). Settings and design: Hospital based, Randomized clinical trial. Methods and material: A total of 90 patients of dry eyes were enrolled and were randomly divided into two groups of 45 each. Group A was treated with topical cyclosporine A 0.05% twice daily and group B with preservative free carboxymethyl cellulose 0.5% (CMC) four times daily for 6 weeks. Different parameters like dry eye symptoms through visual analogue score (VAS), tear break up time (TBUT), Schirmer&apos;s tests (SCH), fluorescein stain (FLU) and goblet cell density (GCD) were obtained prior to treatment and compared with the results after 6 weeks of treatment. Statistical analysis used: SPSS software, version 12.0. Results: After 6 weeks of treatment both the groups showed significant improvement from baseline values of all the parameters (p &lt; 0.001). Comparison between these two groups after treatment showed that all the parameters except FLU score (p &lt; 0.001) were statistically not significant. Conclusions: Both the topical CMC 0.5% and cyclosporine A 0.05% showed improvement of ocular surface at 6 weeks interval. However, there was no significant difference between the outcome of two groups

Hypothyroidism in diabetes mellitus patients in Eastern Nepal

Context: The coexistence of diabetes mellitus (DM) with hypothyroidism is a known clinical observation. Aims: To estimate prevalence and co-relate that of hypothyroidism in patients with DM in relation to the age and sex, the lipid profile, body mass index visiting diabetes clinic and inpatients in B. P. Koirala Institute of Health Sciences. Settings and Design: The hospital-based descriptive study. Materials and Methods: Two hundred and seventy-one known or newly detected cases of DM aged more than 15 years were selected randomly from September 2012 to September 2013 and subjected to evaluation for thyroid function - clinically and biochemically and other relevant investigations were done. Statistical Analysis Used: For descriptive statistics mean, standard deviation, percentage, proportion were calculated. For inferential statistics following test were carried out at the level of significant 0.05 where confidence interval is 95%. The statistical operations were done through Statistical Package for the Social Sciences version 10. Results: Of 271 subjects, the prevalence of hypothyroidism (clinical and subclinical) in diabetics was, 4.05% (11/271) with females preponderance, of which 7 (30.4%) were clinically hypothyroid and 4 (17.4%) were subclinical hypothyroid. One (4.3%) patient had subclinical hyperthyroidism. The mean age at diagnosis of type 2 DM was 51-60 years. 8.69% of diabetics with primary hypothyroids were having morbid obesity. High-density lipoprotein among different thyroid status were statistically significant (P = 0.042). Conclusions: Hypothyroidism is not uncommon in diabetes, and we found body mass index, mean triglyceride and cholesterol levels were more in those diabetic patients having coexisting hypothyroidism

Comparison of complications in diabetic outpatients with or without mental illness

Diabetes Mellitus (DM) and psychiatric illness are related in many ways by prevalence, burden, course, and outcome. Co-morbid mental illness may play a role in determining the complication in diabetic patients. This study was conducted in 2010 among consecutive diabetic out-patients diagnosed as per American Diabetes Association (ADA) guidelines 2009, of age above 14 years, to compare the complications in diabetic patients with or without mental illness. Diabetic neuropathies, cardiovascular complications, and morbid obesity were among the complications significantly more among diabetic patients with mental illness (GHQ-12 ≥ 2) than without mental illness (GHQ-12 ≤ 2)

Clinical profile of diabetic ketoacidosis in tertiary care hospital of Eastern Nepal

Introduction: Diabetes ketoacidoisis (DKA) is characterized by hyperketonaemia, metabolic acidosis, and hyperglycemia. Aims: The aim of this study was to describe the demographic profile, clinical characterstics of patients admitted with diabetic ketoacidosis in BPKIHS, medical ward. Settings and Design: The hospital based descriptive study. Materials and Methods: We took all the patients admitted with a diagnosis of diabetic ketoacidosis (DKA) as defined ADA 2006 consensus statement in medical ward from January 2010 to December 2010. The statistical operations was done through Manufactured by IBM Corp. Results: Only sixteen patients (7 type 1 and 9 type 2DM) were with DKA. When compared to the 16 subjects with type 1 DM ,the type 2 were older (56.8 s 25.7 years) and had a significantly higher PH levels (7.11 s 7.28 P = 0.04). The mean body mass index was 20.5±2.44 in both Type 1 and type 2 DM. Four were on diet control and Insulin respectively. Five were on oral hypoglycemic agents (OHA) and three on both (insulin and OHA). Infection was most common precipitating factor (56.25%) followed by poor drug compliance (37.5%) and first presentation (6.25%). Conclusions: We found majority of patients were type 2 DM. Metabolic acidosis has significant association in both type of diabetic. We found infection was the most common precipitating factor for DKA