An uncommon case of noninvasive ocular surface squamous neoplasia involving the entire cornea

Ocular surface squamous neoplasia (OSSN) is relatively rare with an incidence of 0.13–1.9/100,000 population. OSSN includes dysplastic lesions involving the squamous epithelium of the conjunctiva or cornea. Epibulbar squamous cell carcinoma and epithelioma have been noted commonly, but cases in which the tumor is primary on the cornea are sufficiently rare to warrant reporting in each instance. We describe a rare case of noninvasive OSSN involving the entire cornea in a human immunodeficiency virus‑negative patient. The patient was successfully treated with no recurrence, after intact surgical removal, mitomycin C treatment, and cryotherapy.Keywords: Noninvasive ocular surface squamous neoplasia, ocular surface squamous neoplasia involving entire cornea, squamous cell carcinoma corne

Political role of the Congress of South African Trade Unions (COSATU) in South Africa and what it means for black workers

Thesis (Ph. D.)--Massachusetts Institute of Technology, Dept. of Urban Studies and Planning, 2008.Includes bibliographical references (v. 2, leaves 293-303).This dissertation looks at the political role of trade unions in developing countries. Trade unions and particularly their engagement in political unionism have been absent from the development literature in recent decades. However, recently there has been a renewed interest in the role of trade unions and particularly in their political role as trade union movements in Argentina, Venezuela and Brazil have effectuated regime change by assisting labour based political parties to rise to power. I contribute to this trend by studying the role of the Congress of South African Trade unions (COSATU) and their role in shaping South Africa's transition to democracy. I use the story of COSATU to build on a theory of political unionism that is encompasses the various economic, social and political roles of trade unions and their strategic capability in capturing gains for workers.I examine COSATUs political role by creating five analytical categories to study the federations' experience; a historical review of the Black trade union movement that led to the creation of COSATU, forming alliances with political parties and civil society, building institutions for tripartism and consultation with business and government, mass mobilisation and membership and finally, shaping economic policy. I find that most of COSATUs achievements resulted from the federation's ability to engage in and find the right balance between economic and political unionism and to engage in strategic unionism in either sphere. The federation's unique participatory and democratic shop steward system also facilitated worker militancy and cohesiveness.(cont.) The federation's unique participatory and democratic shop steward system also facilitated worker militancy and cohesiveness. The federation has failed and faces challenges to both membership and organisation because it has inadequately confronted the material conditions of capitalism which have resulted in structural issues such as the informalisation and casualisation of the work force. Political engagement has had costs for COSATU, the most significant of which have been the class mobility of unionists into government and the opportunism that comes with the possibility for class mobility. The union is also drawn into the internal politics of the ANC government and likewise has seen its own internal leadership battles affected by this relationship. The federation has also failed in being adequately strategic and independent in its relationship with the ANC and risks getting consumed and distracted from its strategic and tactical goals through cooptation by the ANC.by Neeta Misra.Ph.D

Angiolymphoid Hyperplasia with Eosinophilia of Orbit in Young Male

Angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon benign clinical entity characterized by the presence of a variable number of papules, plaques or nodules of the dermis and subcutaneous tissues. ALHE shows a predilection for the head and neck area. Orbital involvement is unusual. A 20‑year‑old male presented with a 4‑month history of swelling of the upper lid of right eye. Magnetic resonance imaging orbit revealed altered signal density seen in supero‑medial aspect of right eyeball with adjacent inflammatory changes. The patient underwent anterior orbitotomy and excision biopsy of the mass under general anesthesia. Histopathology of the mass showed vascular proliferation and chronic inflammation accompanied by infiltration of eosinophils, which confirmed the diagnosis of ALHE. The patient recovered both functionally and cosmetically and had no signs of recurrence after 6 months. Angiolymphoid hyperplasia with eosinophilia with orbital involvement in males is a rare clinical entity, and further work is required to accurately describe its incidence, etiology and presentation. ALHE can be diagnosed and differentiated from Kimura’s disease (KD) on histopathological grounds. The presence of vascular hyperplasia with plump of endothelial cells protruding into the lumen is the most important discriminator in establishing the diagnosis of ALHE. Such distinction is crucial for the patient because ALHE is not associated with any of the systemic manifestations present in KD.Keywords: Angiolymphoid hyperplasia, eosinophilia, orbi

Bishop score and transvaginal ultrasound for preinduction cervical assessment: a randomized clinical trial

Background: The objective was to compare transvaginal ultrasound with the Bishop score for preinduction cervical assessment and for choice of induction agent. Methods: 150 women were randomized to have preinduction cervical assessment for choice of induction agent based on either Bishop score or transvaginal ultrasound. The primary outcome measure was the percentage of women who were administered prostaglandin as a preinduction agent. The criteria for considering the cervix as unripe and thus for using prostaglandin were either a Bishop score <6 or cervical wedging of <30% of the total cervical length. Secondary outcome measures included interval to active phase, interval to delivery and rate of Caesarean section and fetal outcome. Results: While 85% of women received prostaglandin in the Bishop score group, only 53% of them did in the transvaginal ultrasound group (p =0.001). The interval to active phase, interval to delivery, rate of Caesarean section for failed induction and fetal outcomes were similar in both groups.Conclusions: With the suggested cut-off values of a Bishop score <6 and wedging <30%, the use of transvaginal ultrasound instead of Bishop score for preinduction cervical assessment to choose induction agent significantly reduces the need for intracervical prostaglandin treatment without adversely affecting the success of induction

Clinical profile and visual outcome of ocular injuries in a rural area of western India

BackgroundOcular trauma is a major cause of visual impairment and morbidity worldwide.AimsTo identify the various type of ocular injury in a rural area, determine the presence of any associated visual damage and assess the final visual outcome after treatment.MethodHospital-based, prospective study conducted over a period of two years. A total of 60 patients of ocular trauma were included.ResultsOcular injuries were more commonly seen in adult (55 per cent) patients who were associated with agricultural work (43.33 per cent). They were more common in male patients (71.67 per cent). Closed globe injury (68.33 per cent) was more common than open globe injury (31.67 per cent). Both in open and closed globe injuries, the commonest object causing injury was a wooden stick. Just 26.7 per cent of the patients had a visual acuity better than 6/60 at presentation; while after completed treatment at two months follow-up, 68.3 per cent had best corrected visual acuity better than 6/60.ConclusionAgricultural trauma is an important cause of monocular blindness in rural India. The visual outcome depends upon the site and size of the injury and the extent of the ocular damage

Recurrent Neurofibroma of the Orbit

A 55-year-old male patient presented with gradual progressive outward and downward deviation of right eye since last two years, with history of a similar complaint 10 years ago when he was diagnosed as having neurofibroma of the orbit. Computed Tomography imaging revealed a large, multilobulated, heterogeneous, soft tissue density mass lesion in the retro bulbar region on the medial side of right orbit suggestive of a neurofibroma. Excision and histopathology confirmed it to be a recurrence of neurofibroma of the orbit

A case of conjunctival malignant melanoma with local recurrence

Malignant melanoma of the conjunctiva is a rare tumour of middle and old age. It is seen predominantly in whites, and is rare in those of pigmented ethnicity. Its clinical presentation varies, and making a clinical diagnosis may be difficult. The tumour is potentially fatal and displays a high rate of recurrence, which can be attributed to delay in diagnosis, as well as inadequate surgical approach. The literature on this melanoma is scanty, even in the West, particularly regarding the precise surgical technique. We report a case of malignant melanoma of the conjunctiva which showed a local recurrence one year after the primary surgery. However, there was no evidence of distant metastasis on either occasion. This case highlights the need for care in making a diagnosis, meticulous attention to the surgical technique, and careful follow-up to detect further disease activity

Orbital Myiasis by Green bottle fly

An 80-year-old farmer, presented with large, maggot infested ulceration involving the medial part of the right upper lid. The left eye was phthisical. There was history of untreated traumatic laceration of the right upper lid. Mechanical removal of maggots was done under turpentine coverage with regular antibiotic dressing. Microbiological examination of maggots revealed the larvae to be of Lucilia sericata (green bottle fly). The ulceration completely healed in two weeks following manual removal of maggots and regular dressing. Orbital myiasis is an uncommon clinical condition, with isolated case reports in the literature

A Comparative Rugoscopic Study of the Dentate and Edentulous Individuals in the South Indian Population

This study analyzes the rugae pattern in dentulous and edentulous patients and also evaluates the association of rugae pattern between males and females. Aims and Objectives. This study aims to investigate rugae patterns in dentulous and edentulous patients of both sexes in South Indian population and to find whether palatoscopy is a useful tool in human identification. Materials and Methods. Four hundred outpatients from Sree Balaji Dental College and Hospital, Chennai, were included in the study. The study group was equally divided between the sexes, which was further categorized into 100 dentulous and edentulous patients, respectively. Results. The edentulous male showed the highest mean of wavy pattern and total absence of circular pattern while the edentulous female group showed the highest mean of curved pattern and total absence of nonspecific pattern, while dentate population showed similar value as that of the overall population such as straight, wavy, and curved patterns. Conclusion. The present study concludes that there is similar rugae pattern of distribution between male and female dentate population while there is varied pattern between the sexes of edentulous population. However, the most predominant patterns were straight, wavy, and circular patterns

Basic science232. Certolizumab pegol prevents pro-inflammatory alterations in endothelial cell function

Background: Cardiovascular disease is a major comorbidity of rheumatoid arthritis (RA) and a leading cause of death. Chronic systemic inflammation involving tumour necrosis factor alpha (TNF) could contribute to endothelial activation and atherogenesis. A number of anti-TNF therapies are in current use for the treatment of RA, including certolizumab pegol (CZP), (Cimzia ®; UCB, Belgium). Anti-TNF therapy has been associated with reduced clinical cardiovascular disease risk and ameliorated vascular function in RA patients. However, the specific effects of TNF inhibitors on endothelial cell function are largely unknown. Our aim was to investigate the mechanisms underpinning CZP effects on TNF-activated human endothelial cells. Methods: Human aortic endothelial cells (HAoECs) were cultured in vitro and exposed to a) TNF alone, b) TNF plus CZP, or c) neither agent. Microarray analysis was used to examine the transcriptional profile of cells treated for 6 hrs and quantitative polymerase chain reaction (qPCR) analysed gene expression at 1, 3, 6 and 24 hrs. NF-κB localization and IκB degradation were investigated using immunocytochemistry, high content analysis and western blotting. Flow cytometry was conducted to detect microparticle release from HAoECs. Results: Transcriptional profiling revealed that while TNF alone had strong effects on endothelial gene expression, TNF and CZP in combination produced a global gene expression pattern similar to untreated control. The two most highly up-regulated genes in response to TNF treatment were adhesion molecules E-selectin and VCAM-1 (q 0.2 compared to control; p > 0.05 compared to TNF alone). The NF-κB pathway was confirmed as a downstream target of TNF-induced HAoEC activation, via nuclear translocation of NF-κB and degradation of IκB, effects which were abolished by treatment with CZP. In addition, flow cytometry detected an increased production of endothelial microparticles in TNF-activated HAoECs, which was prevented by treatment with CZP. Conclusions: We have found at a cellular level that a clinically available TNF inhibitor, CZP reduces the expression of adhesion molecule expression, and prevents TNF-induced activation of the NF-κB pathway. Furthermore, CZP prevents the production of microparticles by activated endothelial cells. This could be central to the prevention of inflammatory environments underlying these conditions and measurement of microparticles has potential as a novel prognostic marker for future cardiovascular events in this patient group. Disclosure statement: Y.A. received a research grant from UCB. I.B. received a research grant from UCB. S.H. received a research grant from UCB. All other authors have declared no conflicts of interes