An analytical study of 50 cases on causes of amblyopia.

INTRODUCTION: It is a condition with unilateral (or) bilateral decrease of visual function caused by form vision deprivation and (or) abnormal visual interaction, that cannot be explained by a disorder of ocular media (or) visual path ways itself. In appropriate cases it is reversible by therapeutic measures. It is caused by abnormal visual experience during early childhood, the critical period of development. PREVALENCE: It affects approximately 1-4% of the general population. AIMS AND OBJECTIVES To find out the relative proportions of different types of ambloypia in a referral centre. To study the characteristics associated with different types of amblyopia in our population the extent of visual impairment produced by different types of amblyopia at presentation. METHODS AND MATERIALS Over a period of two years 2004 October to 2006 September, 1800 patients were seen in strabismus and Paediatric Ophthalmology clinic at RIOGDH, Chennai. This is a prospective study of 50 cases of amblyopia. DISCUSSION: Amblyopia is one of the most common causes of visual impairment in both children and adults. It affects 4-5% of general population and its incidence in paediatric ophthalmology and squint clinic is 30-35%. CONCLUSION The prevalence of amblyopia in our squint and neruophthalmology clinic was 30-35%. Amblyopia is a very common cause of impaired vision in child hood. The incidence of anisometropic and ametropic amblyopia is compared to be less in our population compared to western countries. 94% of the patient in our study had squint. Hypermetropia is the most common refractive error associated with the amblyopia followed by myopia and astigmatism . Esotropia is the most common form of strabismus associated with the amblyopia. 10% of patients with amblyopia had low birth weight. 12% of patients had family history of strabismus. The relative proportion of rural population compared to urban population is higher. 8% of patients with amblyopia in our study had Nystagmus. 42% of patients in our study had low vision C 6/60. Earlier diagnosis and health education and screening programmes in rural areas can reduce the prevalence of amblypias

Functional Outcome after Total Knee Replacement in South Indian Women

INTRODUCTION: Total Knee Arthroplasty has become a standard operative procedure to relieve pain and restore function in patients with disabling arthritis of the knee. It not only provides pain relief but also corrects deformity improves function and quality of life. Several studies have been conducted on the outcome of total knee replacement and the results have been very encouraging. High Tibial Osteotomy is one of the methods of treatment for Osteo Arthritis. But it is only a palliative treatment. It does not correct the Pathology in the Knee joint. Whereas total knee replacement corrects and eliminates the Pathology in the knee joint. Even though Osteo Arthritis Knee equally affects both Male and Female population, it is much more common among women. Probably household activities may be one of the important causes for this ailment. So, I have selected the topic “Functional Outcome After Total Knee Replacement” in South Indian women. Further the quality of life is quite satisfactory after total knee replacement. In this series 21 patients were treated for 22 knees (one case Bilateral). AIM AND OBJECTIVES: To assess functional outcome after total knee replacement in South Indian Women. This includes the improvement in quality of life. The Psychological uplift is also assessed. Majority of patients after Total Knee Replacement are near Normal. MATERIALS: This study was conducted at Nathan Super Speciality Hospital, Salem. Study period in the year January 2010 to December 2010. Patient Demographics from January 2010 to December 2010, a total of 21 patients who underwent total Knee Arthroplasty in 22 Knees at Nathan Hospital, Salem were included in this study. Patients with Osteo Arthritis Knee were selected. Posterior stabilized design were used. The patients included were those who had standard indications for TKA as shown in the table. No. of Patients : 21, No. of Knees : 22, Average Age : 55, Average Weight : 61 Kg, Side left : 7, Side Right : 14, Bilateral : 1. Assessment: Retrospective data collection was done through patients records which contained all the details including the pre operative assessment of the knee in K.S.K.S. score sheet. Assessment and evaluation was done using regularized custom made protocol which included the symptoms of the patients, associated medical conditions. Knee Society Knee Score, Knee Society Functional Score. WOMAC (Western Ontarid and McMaster’s Unviersity Osteo Arthritis Index) OBSERVATION AND RESULTS: Out of 21 patients who underwent T.K.R. in 22 knees (one case Bilateral) in were available for complete follow up. 1. All the patients were able to walk freely without pain. 2. 15 patients were able to climb stairs without difficulty. 3. 2 Patients were able to climb with Minor strain. 4. R.O.M. of knee 0-100 for 15 patients. 5. R.O.M. of knee 0-90 for 5 patients. 6. R.O.M. of knee 0-60 for 1 patient. DISCUSSION: TKR has been accepted line of treatment Total Knee Replacement in Chronic Osteo Arthritis is undertaken where conservative line of treatment does not give full relief to patients. Even in serve cases of Osteo Arthritis Knee, first we try conservative of treatment. In some cases patients were quite satisfactory with the outcome of treatment. Those cases were not taken for Total Knee Replacement or the Surgical Treatment is postponed for later date if necessitated. The conservative line of treatments are: 1. GAIT Training (both inside and outside parallel bars) 2. Quadriceps strengthening exercise (Static cycling). 3. Heat Treatment (Way bath). Out of 33 cases we have continued above treatment, the result was good in 12 cases. Only 21 cases we have taken for Total Knee Replacement as conservative line of treatment did not give desirable relief. COMPLICATIONS: One case developed superficial wound infections, which subsided with debridement and Antibiotics. One case developed deep vein Thrombosis 2 weeks after surgery and was treated with Warfarin for 1 week and Asymptomatic. 2 cases had knee stiffness (Flexion 45). They underwent manipulation of the knee under Anaesthesia and the knees were mobilized with CMP at subsequent follow up. They had 0-90 and 0-70 R.O.M

Wilsons disease and autoimmune liver disease overlap syndrome: a clinical study

Background: The coexistence of Wilson’s disease and autoimmune liver disease in a same patient is a rare entity. Combined treatment with steroid and D-penicillamine may be effective. Aim of the study was analyse the clinical, histological, laboratory profile for patients with chronic liver disease with aim of finding the etiology of the disease.Methods: It is an observational study. Common clinical presentations were evaluated. Laboratory investigations done include complete blood count, renal and liver function tests, prothrombin time, viral markers for hepatitis A, B, C and E, USG abdomen and pelvis, portal Doppler studies and upper GI endoscopy. Specific tests include ANA, AMA, ASMA, Anti LKM-1Ab, serum ceruloplasmin and 24hrs urinary copper were done. Liver biopsy was done in selected patients.Results: Commonest clinical presentation was abdominal distension (80%), abdominal pain (30%), pedal edema (60%), splenomegaly (40%) and upper GI bleed (40%). Laboratory investigation revealed anemia (50%), thrombocytopenia (70%), prothrombin time prolongation in (60%), normal liver function in 60%, abnormal liver function in (40%). Autoimmune markers revealed ANA strong positivity in (40%), mild positivity in (60%). AMA, ASMA, Anti-LKM-1 were negative in all cases (100%). Liver biopsy showed features of autoimmune liver disease and Periportal copper deposition in 80% of cases.Conclusions: Coexistence of Wilson’s disease and autoimmune liver disease is a rare entity and medical treatment with steroids and D-penicillamine simultaneously to be started in these patients

Electrochemical Behavior of Biomedical Titanium Alloys Coated with Diamond Carbon in Hanks’ Solution

Biomedical implants in the knee and hip are frequent failures because of corrosion and stress on the joints. To solve this important problem, metal implants can be coated with diamond carbon, and this coating plays a critical role in providing an increased resistance to implants toward corrosion. In this study, we have employed diamond carbon coating over Ti-6Al-4V and Ti-13Nb-13Zr alloys using hot filament chemical vapor deposition method which is well-established coating process that significantly improves the resistance toward corrosion, wears and hardness. The diamond carbon-coated Ti-13Nb-13Zr alloy showed an increased microhardness in the range of 850 HV. Electrochemical impedance spectroscopy and polarization studies in SBF solution (simulated body fluid solution) were carried out to understand the in vitro behavior of uncoated as well as coated titanium alloys. The experimental results showed that the corrosion resistance of Ti-13Nb-13Zr alloy is relatively higher when compared with diamond carbon-coated Ti-6Al-4V alloys due to the presence of β phase in the Ti-13Nb-13Zr alloy. Electrochemical impedance results showed that the diamond carbon-coated alloys behave as an ideal capacitor in the body fluid solution. Moreover, the stability in mechanical properties during the corrosion process was maintained for diamond carbon-coated titanium alloys

Soil organic carbon stock in natural and restored mangrove forests in Pichavaram south-east coast of India

801-808Mangrove ecosystem is one of the important coastal ecosystems providing ecological security of the coastal area and livelihood security to the coastal fishermen.  Besides it plays an important role in carbon sequestration as large amount of carbon is stored in the below ground biomass. The role of mangrove restoration in carbon stocking has not been studied comprehensively either globally or nationally. The aim of the present study is to quantify the soil organic carbon stock and carbon sequestration rate of the different age groups of restored and natural stands of Pichavaram mangroves forest. The soil organic carbon stock of the upper soil layer (0–90 cm) of six different sites from natural mangrove stands, 21years, 17 years, 16 years, 15 years and 12 years old stands were 146.1(Mg C ha-1), 99.29 (Mg C ha-1), 93.18 (Mg C ha-1), 57.41 (Mg C ha-1), 95.54 (Mg C ha-1) and 84.84 (Mg C ha-1), respectively. Carbon sequestration rate of Pichavaram mangrove forests ranged from 2.33 to 4.44 g C m-2 year-1. The result of the study reveals that soil organic carbon stock and burial rate were high in natural mangrove area than the restored areas. In this regard, restoration and rehabilitation of mangroves is required for preserving the ecologically important mangroves ecosystem to mitigate the impacts of climate change

Disruption of the autoinhibited state primes the E3 ligase parkin for activation and catalysis

The PARK2 gene is mutated in 50% of autosomal recessive juvenile parkinsonism (ARJP) cases. It encodes parkin, an E3 ubiquitin ligase of the RBR family. Parkin exists in an autoinhibited state that is activated by phosphorylation of its N‐terminal ubiquitin‐like (Ubl) domain and binding of phosphoubiquitin. We describe the 1.8 Å crystal structure of human parkin in its fully inhibited state and identify the key interfaces to maintain parkin inhibition. We identify the phosphoubiquitin‐binding interface, provide a model for the phosphoubiquitin–parkin complex and show how phosphorylation of the Ubl domain primes parkin for optimal phosphoubiquitin binding. Furthermore, we demonstrate that the addition of phosphoubiquitin leads to displacement of the Ubl domain through loss of structure, unveiling a ubiquitin‐binding site used by the E2~Ub conjugate, thus leading to active parkin. We find the role of the Ubl domain is to prevent parkin activity in the absence of the phosphorylation signals, and propose a model for parkin inhibition, optimization for phosphoubiquitin recruitment, release of inhibition by the Ubl domain and engagement with an E2~Ub conjugate. Taken together, this model provides a mechanistic framework for activating parkin

The Ndc80 complex targets Bod1 to human mitotic kinetochores

Regulation of protein phosphatase activity by endogenous protein inhibitors is an important mechanism to control protein phosphorylation in cells. We recently identified Biorientation defective 1 (Bod1) as a small protein inhibitor of protein phosphatase 2A containing the B56 regulatory subunit (PP2A-B56). This phosphatase controls the amount of phosphorylation of several kinetochore proteins and thus the establishment of load-bearing chromosome-spindle attachments in time for accurate separation of sister chromatids in mitosis. Like PP2A-B56, Bod1 directly localizes to mitotic kinetochores and is required for correct segregation of mitotic chromosomes. In this report, we have probed the spatio-temporal regulation of Bod1 during mitotic progression. Kinetochore localization of Bod1 increases from nuclear envelope breakdown until metaphase. Phosphorylation of Bod1 at threonine 95 (T95), which increases Bod1's binding to and inhibition of PP2A-B56, peaks in prometaphase when PP2A-B56 localization to kinetochores is highest. We demonstrate here that kinetochore targeting of Bod1 depends on the outer kinetochore protein Ndc80 and not PP2A-B56. Crucially, Bod1 depletion functionally affects Ndc80 phosphorylation at the N-terminal serine 55 (S55), as well as a number of other phosphorylation sites within the outer kinetochore, including Knl1 at serine 24 and 60 (S24, S60), and threonine T943 and T1155 (T943, T1155). Therefore, Ndc80 recruits a phosphatase inhibitor to kinetochores which directly feeds forward to regulate Ndc80, and Knl1 phosphorylation, including sites that mediate the attachment of microtubules to kinetochores