A case report of pregnant female with right eye acremonium keratitis

Study report a case of a 22-years-old female with history of vegetative trauma in right eye with 7th running months of amenorrhoea (RMOA). She came after 10 days of trauma, with chief complaint of pain, watering and diminution of vision in right eye. Her visual acuity was PLPR4 in affected eye and 6/9 in other. Central corneal ulcer with abscess and hypopyon was noted with inability to see fundal glow. To study response of fungal keratitis to voriconazole and natamycin eye drop. Corneal tissue obtained by a corneal scrape was plated on Sabouraud’s agar, KOH mount, gram and giemsa staining was performed. SDA shows a filamentous colony of fungus is grown upon aerobic incubation at 37◦C for 5-7 days. Patient was treated with combination therapy of voriconazole and natamycin eye drop. Patient responded well to combination therapy of voriconazole and natamycin eye drop. Patient developed corneal healing with little amount of fibrosis. We lost patient on follow up after that. Patient responded well to combination therapy of voriconazole and natamycin eye drop. The most common risk factors for acremonium fungal keratitis is ocular trauma, and acremonium fungal keratitis might be treated better with natamycin and voriconazole than other alternatives. our results are clinically significant and may provide some useful information on the diagnosis and management of acremonium fungal keratitis

Pseudophakic cystoid macular edema after uneventful small incision cataract surgery

Background: To study the clinical profile of patient undergone small incision cataract surgery. To measure the incidence of CME after manual SICS and phacoemulsification method of cataract extraction.Methods: It`s a hospital based prospective study carried in ophthalmology dept. patients with normal clinical profile with no history of hypertension, diabetes mellitus, or any ocular trauma or infection/inflammation are randomly selected for cataract surgery either phacoemulsification or manual SICS and were regularly followed till sixth week after cataract surgery. During follow up complete examination including visual acuity, anterior segment examination fundoscopy and FFA done.Results: Out of 115 patients, 59 were operated by phacoemulsification and 56 were operated by manual SICS. 59were operated by phaco, 9 patients lost in follow up. Out of these, 2 patients developed CME. One was operated by phaco and the other by SICS (P value = 1.000) BCVA 6/9 or more after second follow up was seen in 42.45% of phaco patients and 40.56% of SICS patients which is statistically insignificant (P value = 0.343607).Conclusions: With advent of modern cataract surgery, rapid visual rehabilitation and unaided best corrected visual acuity is achieved with negligible early and late postoperative complications and thereby cystoid macular edema

Subluxation of lens alarms to homocystinuria

Homocystinuria is a disorder of methionine metabolism. The term Homocystinuria refers as abnormally large amounts of homocystine are excreted in the urine. The condition was caused by impaired functioning of the cystionin B-synthetase (CBS) enzyme. Homocystinuria is an autosomal recessively inherited defect in the trans-sulfuration pathway (homocystinuria I) or methylation pathway (homocystinuria II and III). The most common form of homocystinuria is characterized by near sightedness, dislocation of the lens at the front of the eye, an increased risk of abnormal blood clotting, and brittle bones that are prone to fracture or other skeletal abnormalities. Some affected individuals also have developmental delay and learning problems. Homocystinuria has a current cumulative detection rate of 1 in 344,000. A high concentration of homocysteine makes fibrillin unstable. Fibrillin is responsible to form the structures which hold the lens of the eye in place. We report a case of 28 year old male with unilateral Subluxation of lens following trauma coincidentally diagnosed to have Homocystinuria and bilateral Subluxation of lens. On account of case we would like to emphasize homocystinuria should be considered as differential diagnosis in Subluxation of lens

A case report on bilateral neuromyelitis optica

Neuromyelitis optica (NMO, Devic disease) is an autoimmune inflammatory disorder of the central nervous system (CNS) in which the autoimmune system attacks myelin of the neurons located at the optic nerve and spinal cord, thus producing a simultaneously or sequential longitudinally extensive inflammation of the optic nerve (optic Neuritis) and spinal cord (myelitis). Early discrimination between NMO and multiple sclerosis is important because the two diseases have different natural histories and treatment regimens. Seropositivity for NMO-IgG and longitudinally extensive spinal cord lesions are characteristic of NMO. Despite the absence of a definitive therapeutic strategy for NMO syndrome, methylprednisolone pulse therapy is recommended in the acute phase. Treatment strategies in relapse phases are aimed at preventing relapses, and increasing evidence shows a better clinical response of immunosuppressive therapy than immuno-modulating therapy (a standard multiple sclerosis-modulating therapy). We have described a 32 years old girl who had visual loss due to acute optic neuritis before 15 days in right eye and followed by complete visual loss in left eye. NMO was diagnosed because of its characteristic longitudinal myelitis and positive NMO-IgG. After combine therapy with prednisolone and an immunosuppressant, the patient’s medical condition was stable and no relapse symptoms were observed

Clinico-epidemiological profiles of patients sustaining ocular trauma due to firecrackers during the festive season of Diwali

Background: Considerable number of cases of firecracker injuries is reported during the festive season of Diwali in India. The purpose of this study is to identify the clinico-epidemiological patterns of ocular injuries caused by firecrackers during this period.Methods: This was a prospective case series of patients attending eye OPD with ocular trauma sustained by Firecrackers during the festive season of Diwali, 2016 in a Tertiary Care Centre in Surat. Demographic data of all the patients and type of firecracker causing injury were noted. Ocular examination of all patients was performed at the time of presentation and on follow-up. Treatment received by the patients was noted.Results: Out of total 20 patients, 85% were male (17 out of 20). Mean age of the patients was 12.15 years and majority of patients (45%) were of 6 to 10 years’ age group. Most patients (85%) sustained injury by Single shot crackers like Bijili crackers and Timing bombs. The injuries reported ranged from Eyelid burns, conjunctival or corneal burns to partial thickness corneal tear and macular scar formation with interventions ranging from ocular wash with saline to repair of partial thickness corneal tear. Many of the injuries were caused because of negligence. Corneal epithelial defect was the most frequent injury (affecting 96% of the total no. of eyes affected) followed by Eyelid burns (affecting 56% of the total no. of eyes affected). Cases having visual impairment or blindness had corneal and/or retinal involvement.Conclusions: Ocular trauma resulting from firecrackers can lead to significant ocular morbidity and permanent blindness and is a preventable cause. All steps must be taken through public awareness and legislation to ensure that firecrackers are used in a safe manner during Diwali celebrations. The medical professionals should be adequately trained to give primary emergency care which has a key role in the visual outcome

Subluxation of lens alarms to homocystinuria

Homocystinuria is a disorder of methionine metabolism. The term Homocystinuria refers as abnormally large amounts of homocystine are excreted in the urine. The condition was caused by impaired functioning of the cystionin B-synthetase (CBS) enzyme. Homocystinuria is an autosomal recessively inherited defect in the trans-sulfuration pathway (homocystinuria I) or methylation pathway (homocystinuria II and III). The most common form of homocystinuria is characterized by near sightedness, dislocation of the lens at the front of the eye, an increased risk of abnormal blood clotting, and brittle bones that are prone to fracture or other skeletal abnormalities. Some affected individuals also have developmental delay and learning problems. Homocystinuria has a current cumulative detection rate of 1 in 344,000. A high concentration of homocysteine makes fibrillin unstable. Fibrillin is responsible to form the structures which hold the lens of the eye in place. We report a case of 28 year old male with unilateral Subluxation of lens following trauma coincidentally diagnosed to have Homocystinuria and bilateral Subluxation of lens. On account of case we would like to emphasize homocystinuria should be considered as differential diagnosis in Subluxation of lens

A case report on bilateral neuromyelitis optica

Neuromyelitis optica (NMO, Devic disease) is an autoimmune inflammatory disorder of the central nervous system (CNS) in which the autoimmune system attacks myelin of the neurons located at the optic nerve and spinal cord, thus producing a simultaneously or sequential longitudinally extensive inflammation of the optic nerve (optic Neuritis) and spinal cord (myelitis). Early discrimination between NMO and multiple sclerosis is important because the two diseases have different natural histories and treatment regimens. Seropositivity for NMO-IgG and longitudinally extensive spinal cord lesions are characteristic of NMO. Despite the absence of a definitive therapeutic strategy for NMO syndrome, methylprednisolone pulse therapy is recommended in the acute phase. Treatment strategies in relapse phases are aimed at preventing relapses, and increasing evidence shows a better clinical response of immunosuppressive therapy than immuno-modulating therapy (a standard multiple sclerosis-modulating therapy). We have described a 32 years old girl who had visual loss due to acute optic neuritis before 15 days in right eye and followed by complete visual loss in left eye. NMO was diagnosed because of its characteristic longitudinal myelitis and positive NMO-IgG. After combine therapy with prednisolone and an immunosuppressant, the patient’s medical condition was stable and no relapse symptoms were observed

Grain refinement of ASTM A356 aluminum alloy using sloping plate process through gravity die casting

Sloping plate flow is used for enhancement of material properties through grain refinement in gravity die casting of Aluminum alloy ASTM A356. The castings are prepared with different slope angles of an 800 mm long, naturally cooled stainless steel plate. The specimens obtained are then tested for tensile strength and elongation. Microstructure of the cast specimens is observed and conclusions drawn on the grain size and precipitate morphology as a function of angle of sloping plate. Analysis is presented for the boundary layer created while the material flows over the plate. An indication of the boundary layer thickness is determined by measuring the thickness of the residual metal layer on the plate after casting. An analytical solution of the boundary layer thickness is also presented. It is shown that the calculated boundary layer thickness and the thickness of the layer of material left in the channel after casting are in good agreement. Moreover, microstructure examination and tensile tests show that best properties are achieved with a 60° sloping plate