Netarsudil monotherapy as the initial treatment for open-angle glaucoma and ocular hypertension in Indian patients: A real-world evaluation of efficacy and safety

Purpose: Glaucoma is the second leading cause of blindness worldwide, affecting more than 64 million people aged 40–80. The best way to manage primary open?angle glaucoma (POAG) is by lowering the intraocular pressure (IOP). Netarsudil is a Rho kinase inhibitor, the only class of antiglaucoma medications that reorganizes the extracellular matrix to improve the aqueous outflow through the trabecular pathway. Methods: An open?label, real?world, multicentric, observation?based 3?month study was performed for assessing the safety and ocular hypotensive efficacy of netarsudil ophthalmic solution (0.02% w/v) in patients with elevated IOP. Patients were given netarsudil ophthalmic solution (0.02% w/v) as a first?line therapy. Diurnal IOP measurements, best?corrected visual acuity, and adverse event assessments were recorded at each of the five visits (Day?1: screening day and first dosing day; subsequent observations were taken at 2 weeks, 4 weeks, 6 weeks, and 3 months). Results: Four hundred and sixty?nine patients from 39 centers throughout India completed the study. The mean IOP at baseline of the affected eyes was 24.84 ± 6.39 mmHg (mean ± standard deviation). After the first dose, the IOP was measured after 2, 4, and 6 weeks, with the final measurement taken at 3 months. The percentage reduction in IOP in glaucoma patients after 3 months of once?daily netarsudil 0.02% w/v solution use was 33.34%. The adverse effects experienced by patients were not severe in the majority of cases. Some adverse effects observed were redness, irritation, itching, and others, but only a small number of patients experienced severe reactions, as reported in a decreasing order: redness > irritation > watering > itching > stinging > blurring. Conclusion: We found that netarsudil 0.02% w/v solution monotherapy when used as the first?line treatment in primary open?angle glaucoma and ocular hypertension was both safe and effective.

Study of prevalence and types of anemia in primary hypothyroidism

Background: Hypothyroidism is common disease with varying frequency between countries. Anemia in hypothyroidism can be normocytic normochromic, microcytic hypochromic and macrocytic hypochromic. Anemia severity is associated with hypothyroidism degree. Objective of this study to study the association between anemia and hypothyroidism and prevalence and types of anemia in primary hypothyroidism (subclinical and overt both).Methods: This cross sectional study was carried out at tertiary care hospital in North India. Newly diagnosed 100 primary hypothyroid patients and 100 controls with age and sex matched evaluated for anemia. Prevalence and types of anemia were studied and severity of anemia was correlated with that of hypothyroidism.Results: Anemia was observed in 90 patients with hypothyroidism. Symptoms due to anemia were higher in cases than in controls. RBCs morphology showed normocytic normochromic in 59, microcytic hypochromic in 26 and macrocytic hypochromic in 15 cases. Serum anti-TPO positivity was present in 71.1% in cases as compared to 33.33% in controls. Anemia was severe in cases with high TSH.Conclusions: Anemia was more prevalent in cases of hypothyroidism than in euthyroid controls. Normocytic normochromic type of anemia was most common type in this study. Serum anti-TPO positivity was 71.1% in cases. There was statistically significant negative correlation between TSH and haemoglobin. Symptoms of anemia were more in hypothyroid patients than in euthyroid anemic patients.

Combined Diagnostic Approach in Breast Cancer

Breast cancer is the most common cancer in females in the world. Breast aspiration cytology, histopathology and radiology have become important diagnostic tools in diagnosis of breast cancers. Objectives: Our aim was to conduct a combined diagnostic approach comprising of clinical examination, mammography, fine needle aspiration cytology and histopathology study in breast cancers correlate with individual diagnostic modality. Methods: A prospective study was done on 100 patients suspected of breast cancer. Various investigations including radiological investigations, FNAC, biopsy of the lesion was done. Clinical diagnosis, radiological, cytological and histopathology results were combined and compared with individual diagnostic modality. Results: Most common presenting symptom was breast lump seen in 95 cases. Out of 100 cases 47% were diagnosed malignant on radiology, 71% were malignant on Fine Needle Aspiration Cytology and 85% were diagnosed malignant on biopsy. On comparing all the three diagnostic procedures (radiology, FNAC and biopsy), the correlation came out to be highly significant. Conclusion: Though histopathological examination remains the gold standard for the diagnosis of these lesions, but an accurate clinical, radiological and cytological combined approach along with the histopathological examination aids in improving the diagnostic accuracy and reduce morbidity and mortality.

Clinico-Pathological Correlation of Tubo-Ovarian Lesions

Background: The tubo-ovarian lesions manifest a wide spectrum of clinical, morphological, and histological features. Aims and objectives- To classify the lesions of tubes and ovaries and to correlate the various clinical and histopathological findings with age, chief complaints, and microscopic appearances of lesions. To correlate them radiologically and histopathologically. Methods: The present prospective study was based on the clinico-pathological correlation of various tubo-ovarian lesions in 75 cases over a period of 2 years. The histopathological reports were used to classify the tubo-ovarian lesions and correlate /substantiate the clinical and radiological findings. Results: Out of 75 cases, 51 (68%) ovarian, 18 (24%) tubal, and 6 (8%) cases showed simultaneous involvement of both tube and ovary. Amongst 18 tubal lesions,16 were of ectopic gestation (6 were ruptured) and the rest 2 of salpingitis. Amongst the ovarian lesions,41 cases were of ovarian neoplasms which were categorized as benign and malignant. Serous cystadenoma was the most common benign tumor and serous cystadenocarcinoma was the most malignant tumor. Conclusion: Clinical, radiological and histopathological diagnosis were compared and analysed statistically and the correlation was highly significant. An accurate clinical and radiological examination along with the histopathological examination aids in improving the diagnostic accuracy.