Sub-retinal abscess as presenting feature of endogenous candida endophthalmitis

Background: Sub-retinal abscess as the presenting feature in the setting of endogenous fungal endophthalmitis is extremely infrequent. Immunodeficiency states are major predisposing risk factors. To the best of our knowledge, this is the first case report of Candida sub-retinal abscess as initial presentation in an immunocompetent patient. Case Presentation: A 32-year old, generally fit and well, female presented to us with gradually deteriorating vision in her right eye. Visual acuity was counting fingers in the right eye and, 20/30 in the left eye. Right eye fundus examination showed a full thickness, yellowish-white foveal lesion, and significant vitreous haze. Left eye examination was normal. Upon direct questioning, the patient disclosed history of backstreet abortion 3 weeks prior to the onset of her ocular symptoms. She underwent vitreous tap and intravitreal antibiotics (amphotericin B, 5 μg/0.5 ml). Vitreous culture showed profuse growth of Candida albicans. Because her condition was progressively deteriorating, she underwent 25 g vitrectomy plus repeat intravitreal amphotericin B under general anaesthesia. Three weeks post-vitrectomy, vitreous inflammation resolved completely, and the sub-retinal abscess healed with a macular scar formation. Over a follow-up of 4 years, no recurrences were observed. Conclusion: Our case highlights the importance of considering Candida albicans infection in the differential diagnosis of sub-retinal abscesses. Although immunocompromised states are traditionally identified as predisposing factors for fungal infections, fungal endogenous endophthalmitis can occur in healthy individuals as well

Distal splenorenal shunt (DSRS) in children with extrahepatic portal hypertension

Portal hypertension (PH) is infrequent in children as compared to adults. Currently, repetitive endoscopic ablation of varices is standard treatment. However, endoscopic facilities are not readily available in resource-limited settings. We reviewed the indications, operative morbidity, mortality, shunt patency and re-bleeding episodes in nine patients (age range 6-16 years, M:F 6:3) who had DSRS for recurrent GI bleeding not responding to endoscopic treatment and hypersplenism. DSRS is a safe and effective treatment alternative in resource limiting setting for preventing bleeding and improving hypersplenism in children with extrahepatic portal hypertension

Comparison of choroidal thickness measurements between spectral-domain OCT and swept-source OCT in normal and diseased eyes

Purpose: Sub-foveal choroidal thickness (SFCT) is affected in many ocular diseases. The aim of this study was to compare SFCT measurements between Topcon 3D 2000 spectral-domain optical coherence tomography (SD-OCT) and Topcon swept-source OCT (SS-OCT), with different laser wavelengths, in normal and diseased populations.MATERIALS AND Methods: This was a prospective, cross-sectional, noninterventional study including 27 normal volunteers and 27 participants with retinal disease. OCT scans were performed sequentially and under standardized conditions using both SD-OCT and SS-OCT. The OCT scans were evaluated by two independent graders. Paired t-tests and intraclass correlation coefficients (ICCs) were used to assess the statistically significant difference between SFCT measurements as measured by the two devices.Results: Mean SFCT measurements for all 54 participants were 264.9±103.1 mum using SD-OCT (range: 47-470 mum) and 278.5±110.5 mum using SS-OCT (range: 56-502 mum), with an inter-device ICC of 0.850. Greater variability was noted in the diseased eyes. Inter-device ICCs were 0.870 (95% CI; 0.760-0.924) and 0.840 (95% CI; 0.654-0.930) for normal and diseased eyes, respectively. However, the difference was not statistically significant (P=0.132).CONCLUSION: Both machines reliably measure SFCT. Larger studies are needed to confirm these findings

The Effect of Market and Entrepreneurial Orientation on Firm Performance

Market orientation (MO) and Entrepreneurial orientation (EO) have gained the importance in today’s world. Now these two are considered the main sources in the increase of firm performance. A corelation analysis is performed to understand and determine whether the market orientation and entrepreneurial orientation is associated with the firm performance. The Past studies did not analyze the effect of MO and EO on the firm performance. The research design and methodology adopted is given together with the findings leading to the conclusions related to propositions concerning the variables. The data is collected from various reputed universities that are giving the business education. Entrepreneurial orientation and market orientation provides the basic knowledge about the organizational learning that enables the organization to achieve the high performance and to understand the values of customers (Liu et al, 2002). The paper draws on survey data from 100 students including male and female students. The results show that EO and MO are strongly co-related with dependent variable. However, a few recommendations and future research is also given

Three pregnancies with mechanical heart valve and no follow-up in 10 years

Anticoagulation and proper INR (International Normalized Ratio) monitoring is essential for patients having mechanical heart valves; it is vital in these patients in order to prevent lethal complications such as valve thrombosis and systemic embolism. In pregnancy, it becomes even more important as pregnancy itself is a hypercoagulable state. This report describes a female patient having undergone mitral valve replacement with a Starr Edward metallic prosthesis. She came back to the operating surgeon after 10 years of valve replacement with a history of three uneventful healthy deliveries and no follow-up and INR monitoring during this period

A Gender-based Comparison in Health Behaviors and State of Happiness among University Students

Objective: The presence of good healthy behaviors among university students is imperative for their future life. This study aimed to compare positive health behaviors and state of happiness between the two genders of Bahria University (BU), Karachi, Pakistan.Subjects and methods: This cross-sectional study was conducted at BU, Karachi, Pakistan. A total 813 students participated in this study. The healthquestionnaire, adapted from Health and Behavior Survey and the Subjective Happiness Scale, was used to assess self-reported happiness. The data were analyzed using IBM SPSS version 22.Results: Overall self-reported health behaviors were found to be more prevalent in females as compared to males, but males reported a better self-reported general health (p = 0.012). Testicular and breast self-examination was not common in both genders. Smoking was found to be more common in males (p \u3c 0.01). Males exhibited habit of regular breakfast (p = 0.013) whereas females showed a tendency to avoid food rich in cholesterol and fat (p \u3c 0.01) and the practice of consuming food rich in fiber was found to be more prevalent among females (p \u3c 0.01) and they showed urge to lose weight (p \u3c 0.01). Sleep disturbance was found in both genders, more so in females (p = 0.012). Consciousness about dental hygiene was common in females (p \u3c 0.01). As compared to the females, more males strongly believe that they are very happy in life (p \u3c 0.01), and they make the most out of everything in life (p \u3c 0.01).Conclusion: There was a diverse response to positve health behaviors and state of hapiness in both genders

Growth of Albizia lebbeck (L.) Benth. (Mimosaceae) in Polluted Soils of Landhi and Korangi Industrial Areas of Karachi, Pakistan

Growth of Albizia lebbeck was observed in the polluted soils from towel, garment, rubber and ply board factories in the vicinity of Landhi and Korangi industrial areas of Karachi. Growth of A. lebbeck was reduced in most of the industrial area soils as compared to the control soil from Karachi University campus. The rubber factory soil reduced all the growth parameters as compared to the control soil. Percentage of soil pollutants (total soluble salts and available sulfate) in all of the industrial area soils was higher than in the control area soil. Percentage of coarse sand, calcium carbonate, total soluble salts, available sulfate, and chromium was higher in soil of rubber factory then in the control area soil whereas percentage of water holding capacity, organic matter and zinc was lower in soil from rubber factory than in the control area soil. This showed that the soil of industrial areas of Landhi and Korangi particularly from rubber factory and ply board factory was contaminated by the pollutants in the area and drastically affected the plant growth. The findings of this research could be helpful in monitoring and controlling the pollutant levels in soils of the industrial areas. Such information could also be useful for landscaping and urban planning