Comparison between ocular biometry parameters in patients with unilateral congenital glaucoma

Purpose: To compare the axial length (AL) and corneal diameter between glaucomatous eye (GE) and fellow normal eye (NE) in patients with unilateral congenital glaucoma and to obtain a normative database for ocular growth among Indian children below 3 years of age. Methods: Retrospective longitudinal study. Patients who had a follow?up of 3 years from diagnosis with ocular biometry parameters being recorded at least thrice (once a year) and fellow eye being normal were included. Data collected were age, gender, intraocular pressure (IOP), AL, corneal diameter, optic disc findings, diagnosis, and surgery details. Results: Eleven patients were analyzed. All GE underwent combined trabeculotomy with trabeculectomy. Mean (SD) baseline IOP, AL, and corneal diameter were 17.1 (6.7) mmHg, 18.9 (1.1) mm and 12 (0.91) mm in GE, and 11.1 (3.8) mmHg, 17.8 (0.44) mm, and 10.5 (0.58) mm in NE, respectively. Increase in AL was 3.1 mm in the first year followed by 0.6 mm in second year and 0.4 mm in third year in GE compared to 2.6, 0.6, and 0.5 mm in NE, respectively. Corneal diameter increased by 1.1 mm in GE in the first year and remained stable thereafter compared to 0.7 mm in first year followed by 0.3 mm in second year and stable thereafter in NE. The percentage of success was 73% at 3 years. Conclusion: Axial length and corneal diameter were higher in GE than NE at all?time points. With prompt intervention, the growth curve of the GE was made parallel to that of NE.

Knowledge, attitude, and practices among clinically exposed medical students and interns towards COVID-19 vaccine in a tertiary care hospital, Kanyakumari district: a cross-sectional survey

Background: Several COVID-19 vaccines have been approved against coronavirus disease and its distribution to, different countries. The study is mainly done to determine the knowledge, attitude, and practice among clinically, exposed medical students and interns toward COVID-19 vaccine., Methods: A cross-sectional study was conducted from June 2022 to August 2022 in a tertiary care hospital. Using, questionnaires, the knowledge, attitude, and practice among medical students and interns were assessed, and they were, then analysed and categorised accordingly. Then the students were given awareness regarding COVID-19 vaccine., Results: The questionnaires were distributed among students and interns, and responses were collected. A total number, of participants (n=300), out of which the majority of responders were second-year students 89 (29.6%). Overall, 39.75%, had high-grade knowledge, 43.5% had a positive attitude and 37.5% had good practice regarding the COVID-19, vaccine. The results show that 81.2% of interns had high-grade knowledge, 76.6% possess a positive attitude and 71.9%, of good practice and preventive measures towards COVID-19 vaccine., Conclusions: Our study concludes that there were certain gaps in knowledge, attitude, and practice among second and, third-year medical students when compared with final-year medical students and interns.

Clinical Profile of Community Acquired Pneumonia (CAP) in Patients with Type 2 Diabetes Mellitus - A Hospital Based Study

It is well known fact that diabetics are prone to develop infections and have increased mortality and morbidity than non-diabetics. However, the effect of diabetes mellitus on the risk of pneumonia remains uncertain. We wanted to study the aetiology, clinical features, and the outcome of pneumonia in diabetic patients. METHODSA comparative observational study was conducted in a tertiary care hospital, southern India which included 50 diabetic patients with pneumonia and 50 non-diabetic patients with pneumonia. Clinical characteristics, x-ray findings, aetiological agents, and outcome of diabetic patients were analysed and compared with data from the control group. RESULTSDiabetic patients with pneumonia were more unwell at the time of admission in the form of high PSI (Pneumonia Severity Index) score (p = 0.004**), intensive care admissions and prolonged hospital stay (p = < 0.001**). Diabetic patients were significantly associated with multilobar involvement (p = 0.045*). There was no significant difference in age, gender, coexisting underlying disease and complications. In patients with diabetes mellitus, mortality was associated with multilobar infiltrate, increased PSI score (p = 0.078*) at admission. CONCLUSIONSThese is a significant difference between pneumonia in diabetics compared with non-diabetics. Diabetic patients had presented with higher PSI score, required more ICU admissions and had prolonged hospitalization. Diabetes is also associated with bad prognosis and high mortality.

An unusual presentation of Pseudomonas aeruginosa blebitis following combined surgery.

We report a case of blebitis that occurred 3 years later following a combined glaucoma and cataract surgery. It was an atypical presentation, as patient had no classical fiery looking signs of blebitis despite the isolated organism being Pseudomonas aeruginosa. Improvized surgical techniques like use of Mitomycin C, releasable flap sutures though considered as part of the recommended procedure for better surgical outcomes, their role as potential risk factors for visually blinding complications like endophthalmitis are often overlooked. This case report throws light on such risk factors for bleb associated infections and recommends removal or trimming of all releasable sutures and the need for a regular postoperative follow‑up.

Effect of suicide gene therapy in combination with immunotherapy on antitumour immune response & tumour regression in a xenograft mouse model for head & neck squamous cell carcinoma.

Background & objectives: Prodrug activation strategy as well as immunotherapy have been widely used for cancer gene therapy. In the present study, using a head and neck squamous cell carcinoma (HNSCC) xenograft nude mouse model, we have investigated whether the two therapies in combination could improve tumour cell kill. We also investigated induction of immune effector cells viz., NK (DX5+) and DC (CD11c+) in vivo, post-combination gene therapy. Methods: A retroviral vector producing cell line (PLTK47.1 VPC) carrying Herpes simplex virus thymidine kinase gene (HSVtk) was used for intratumoural injection into NT8e xenograft tumours followed by the prodrug ganciclovir (GCV). IL-2 plasmid DNA was injected intramuscularly. Immune cells were analyzed by flow-cytometry. Non parametric ANOVA was performed with Kruskal Wallis test. Results: IL-2 could induce proliferation of both NK cells (DX5+) and dendritic cells (CD11c+) in vivo. Apoptosis was higher in combination therapy group as compared to HSVtk/GCV alone or IL-2 alone and was mediated through caspase-3 dependent pathway. Significant reduction in tumour volume was seen in all 3 treatment arms as compared to controls. Interpretation & conclusions: Combination of suicide gene therapy and immunotherapy leads to successful tumour regression in a HNSCC xenograft mouse model. Immunotherapy could help in a systemic long lived anti-tumour immune response which would prove powerful for the treatment of metastatic cancers, and also for minimal residual disease. The results of this study may form the basis for Phase 1 clinical trials.

Mefenamic acid-induced bilateral transient myopia, secondary angle closure glaucoma and choroidal detachment.

Drug-induced secondary angle closure is quite common and in the majority of cases simply stopping the medication leads to rapid reversal of the condition and resolution of glaucoma. We describe here a patient who presented with secondary angle closure glaucoma and myopia following mefenamic acid ingestion which was managed successfully by stopping the medication, symptomatic treatment and reassurance.