Microbiological assay of ampicillin in serum and aqueous humor of patients given ampicillin-sulbactam injection

The aim of this study was to determine the bacterial growth inhibitory activities of ampicillin in aqueous humor and serum of patients administered ampicillin-sulbactam combination intramuscularly prior to cataract surgery. 43 patients received a combination of both antibiotics intramuscularly at varying periods (60-140 minutes) prior to surgery. Aqueous humor and venous blood were collected at the beginning of the surgery. For microbiological assay, spores of Bacillus subtilis were incorporated in the agar. The test sample and the standard solutions (calibrators) of ampicillin and ampicillin-sulbactam combination were placed in 3 mm wells in the agar. The diameter zones of growth inhibitory activities of ampicillin of the calibrators and the test samples measured in mm were extrapolated to the standard curve and were recorded as ampicillin activity in (μg/ml. The results of the assay were placed in 5 groups according to the time intervals between injection and collection of serum and aqueous humor (≤70, 75, 80, 90, >90 minutes). Ampicillin activities in sera and aqueous humor of group 5 (>90 minutes) were significantly higher than the others (p<0.001). The ratio of ampicillin activities of sera and aqueous humor in group 5 patients was significantly lower indicating higher concentration of ampicillin activity in aqueous humor during this period. Bacterial growth inhibitory activities of ampicillin-sulbactam combination were adequate in aqueous humor of all patients with highest activity being 90 minutes after intramuscular administration indicating the potential usefulness of this antibiotic combination as chemoprophylaxis prior to cataract surgery

Fellow eye treatment in excimer photo refractive keratectomy

Purpose: To describe symmetry of response in fellow eyes of patients undergoing photorefractive keratectomy (PRK) for myopia, analyse the risk factors leading to asymmetry in response and to determine if delayed treatment of the second eye increases safety and predictability of PRK. Methods: Retrospective review of case records of 133 patients who underwent bilateral myopic PRK and had a minimum follow up of 6 months in both eyes. Results: Postoperative uncorrected visual acuity, spherical equivalent (SE) refraction within ±1D of emmetropia, best-corrected visual acuity (BCVA) and corneal haze were not significantly different in fellow eyes of patients undergoing PRK for myopia. Of 87 eyes in group 1 (myopia <6D), 96.6% had uncorrected visual acuity ≥6/ 12, 89.7% were within ±1D of emmetropia, none lost ≥1 line BCVA, and none had haze ≥grade 3. Similar results for 98 eyes in group II (myopia 6 to 9.9D) were 75.6%, 55.1%, 2.0% and 2.0% respectively. For 81 eyes in group III (myopia ≥ 10D) the results were 42.7%, 33.3%, 8.6%, and 4.9% respectively. Among 84 patients with similar preoperative myopia in both eyes, 54 (64.3%) patients had a postoperative SE difference ≤ ID in fellow eyes. Risk factors for asymmetric response among fellow eyes included increasing preoperative myopia (p<0.001) and dissimilar treatment technique in the two eyes (p=0.03). Corneal haze did not increase significantly after the third postoperative month. Conclusion: This study demonstrates that considerable symmetry of response exists in fellow eyes of patients undergoing myopic PRK. Early PRK in the fellow eye of patients with < 6 D myopia is safe and allows quick visual rehabilitation of the patient. In patients with myopia ≥6D, a 3-month interval before treating the second eye may improve the safety of the procedure

Conjunctival-Limbal autografts for primary and recurrent Pterygia: Technique and results

Our technique of pterygium excision with conjunctival-limbal autografting is described and the safety and efficacy of the procedure in India is analysed. Case records of 51 consecutive patients (53 eyes) who underwent surgery at our institute between November 1992 and September 1994 were retrospectively analysed. Recurrence was defined as fibrovascular tissue crossing the corneoscleral limbus onto clear cornea in the area of previous pterygium excision. 2 (3.8%) of the 53 pterygia (primary 36; recurrent 17) recurred, after a mean follow up of 18.9±12.1 months (range: 1.5-43 months). Both recurrences occurred within a year of follow up, in patients who were ≤40 years of age. No major operative or postoperative complications were encountered. The inclusion of limbal tissue in conjunctival autografts following pterygium excision appears to be essential to ensure low recurrence rates. The technique is safe, simple and inexpensive and is recommended for the management of both primary and recurrent pterygia in Indian eyes

Five-year incidence of open-angle glaucoma: the Visual Impairment Project

Publisher version is restricted access in accordance with the publisher's policy. The original publication is available at http://www.ncbi.nlm.nih.gov/pubmed/12045042Purpose: To determine the incidence of open-angle glaucoma (OAG) in Melbourne, Victoria, Australia.Design: Population-based cohort study.Participants: Total of 3271 participants aged 40 years and older from Melbourne, Victoria, Australia.Main Outcome Measures: Five-year incidence of OAG. Methods: Particpants were recruited through a cluster random sampling from nine urban clusters. Baseline examination was conducted from 1992 through 1994, and the follow-up data were collected from 1997 through 1999. Each participant both at baseline and follow-up underwent a standardized ophthalmic examination including intraocular pressure measurement, visual field assessment, cup-to-disc ratio measurement, and paired stereo photographs of the optic disc. Glaucoma was assessed by a consensus group of six ophthalmologists that included two glaucoma specialists. Glaucoma was diagnosed as possible, probable, or definite. Results: The overall incidence of definite OAG was 0.5% (95% confidence limits [CL], 0.3, 0.7); probable and definite incidence of OAG was 1.1% (95%CL, 0.8, 1.4); and possible, probable, and definite OAG incidence was 2.7% (95% CL, 1.8, 3.7). The incidence of possible, probable, and definite OAG increases significantly as age increases (P<0.001). The incidence of definite OAG increases from 0% of participants aged 40 to 49 years to 4.1% of participants aged 80 years and older. The incidence of probable and definite OAG increases from 0.2% of participants 40 to 49 years to 5.4% o participants aged 80 years and older. The incidence of possible, probable, and definiete OAG increases from 0.5% of participants aged 40 to 49 years to 11% of participants aged 80 years and older. A nonsignificant but higher incidence of definite OAG among men was observed in this study when compared with women (odds ratio 2.2%; 95% CL, 0.9, 5.0). Fifty percent of the definite OAG participants were undiagnosed. Conclusion: The incidence of OAG increases significantly with age. The undiagnosed cases suggest the need to develop novel community screening strategies for glaucoma

Association of demographic, familial, medical, and ocular factors with intraocular pressure

Publisher’s permission requested and denied.Objective: To describe the distribution and associations of demographic, familial, medical, and ocular factors with intraocular pressure (lOP).Methods: A cluster stratified random sample of urban and rural residents of Victoria, Australia, aged 40 years and older. Participants completed an interview and underwent a standardized dilated ophthalmic examination including measurement of IOP with an electronic applanation tonometer (Tono-Pen). Glaucoma status (possible, probable, definite) was determined by a consensus panel. The main outcome measure was IOP.Results: The mean age of the 4576 participants was 59 years, 53% were women, 32% were born overseas, and 132 had open-angle glaucoma. Geometric mean (SD) IOP was 14.3 (± 1.5) mm Hg. The relationship between IOP and nuclear sclerosis, iris color, and family history of glaucoma depended on glaucoma status. In those with glaucoma, family history of glaucoma and country of birth were significantly associated with IOP in multivariate models (model: r²=0.08, P=0.01). In the group without glaucoma, place of residence, use of alcohol, iris color , vitamin E intake, and spherical equivalent were associated with IOP (model: r²=0.01, P=.006).Conclusion: In participants with glaucoma, genetic factors seem to be stronger predictors of IOP, whereas in those without glaucoma, lifestyle and physiological factors seem to play a greater role

Results of treatment intensification for progressive locoregional disease in head-and-neck cancer patients undergoing postoperative radiotherapy

Purpose: Patients who develop progressive locoregional disease during radical surgery and postoperative radiotherapy for squamous cell carcinoma of the head and neck represent a management dilemma. We present our experience using treatment intensification for such patients

Prognostic Significance of (18) F-Fluorodeoxyglucose – Positron Emission Tomography After Treatment in Patients With Limited Stage Small Cell Lung Cancer

Objective: Small cell lung cancer (SCLC) represents 15% to 25% of lung cancers. Despite favorable initial treatment response rates, recurrence is likely and long-term prognosis dismal. Accurate measurement of therapy response is critical to determine which patients might be spared additional treatment, and potential side effects. 18F-fluorodeoxyglucose positron emission tomography (PET) may help distinguish necrotic or fibrous tissue from residual cancer, thus informing further treatment and prognosis

Cholesterol-lowering medications reduce the risk of age-related maculopathy progression

"McCarty CA et al. Cholesterol-lowering medications reduce the risk of age-related maculopathy progression. MJA 2001; 175: 340-. ©Copyright 2001. The Medical Journal of Australia - reproduced with permission".Re-edited by BF 22/03/2010Age-related macular degeneration (AMD) is the leading cause of blindness in elderly Australians. Currently, there are limited treatment options, and current research efforts are focused on determining the risk factors for AMD and developing effective treatment strategies. Some risk factors for cardiovascular disease have been shown to be associated with AMD, and one study has suggested that Alzheimer's disease is associated with age-related maculopathy. It has also been suggested that alleles of the apolipoprotein E (ApoE) gene may be associated with AMD, cardiovascular disease and Alzheimer's disease. Given this, it is interesting that statins - cholesterol-lowering medications - have been shown to decrease the risk of dementia and diabetes mellitus

pH-adjusted periocular anaesthesia for primary vitreoretinal surgery

<b>Purpose:</b> To evaluate the efficacy of pH-adjusted bupivacaine in conjunction with medial orbital periconal block (periocular anaesthesia). <b>Methods:</b> Sixty consecutive patients undergoing primary vitreoretinal surgery were enrolled prospectively. <b>Results:</b> Adequate anaesthesia and akinesia with no intraoperative supplementation was achieved in 53 eyes (88.3&#x0025;). Factors influencing intraoperative supplementation were combined vitrectomy with scleral buckling (p=0.005) and duration of surgery of more than 2 hours (p=0.001). No ocular or systemic complication resulted. <b>Conclusion:</b> pH-adjusted periocular anaesthesia is safe and effective in patients undergoing primary vitreoretinal surgery