Spectrum of ocular firework injuries in children: A 5‑year retrospective study during a festive season in Southern India.

Purpose: Ocular trauma is a major cause of acquired monocular blindness in children. Firework injuries account for 20% of ocular trauma. The purpose of our study was to document the profile of ocular firework injuries in children during the festive season of Diwali and to determine the prevalence of unilateral blindness in them. Materials and Methods: A retrospective chart analysis of ocular firework injury in children during the festival of Diwali from 2009 to 2013, conducted in a tertiary care eye center in Tamil Nadu, Southern India. Children below 18 years of age with ocular firework injuries who presented to the emergency department for 3 consecutive days ‑ the day of Diwali, 1 day before, and 1 day after Diwali ‑ were included in this study. Results: Eighty‑four children presented with firework‑related ocular injuries during the study period. Male to female ratio was 4:1 with mean age 9.48 ± 4 years. Forty‑four percentage required hospitalization. The prevalence of unilateral blindness in children due to fireworks was found to be 8% (95% confidence interval ‑ 2–13%). Conclusion: Vision 2020 gives high priority to avoidable blindness, especially in children. In our study, for every 12 children who presented with firecracker injury, one resulted in unilateral blindness. This is an avoidable cause of blindness. Awareness needs to be created, and changes in policy regarding sales and handling of firecrackers including mandatory use of protective eyewear should be considered.

Disseminated Tuberculosis with involvement of prostate - A case report.

We present a 55-year-old male who presented with painful non-healing ulcers on the lower lip and scrotum associated with productive cough, fever, anorexia and dysuria. Erythrocyte sedimentation rate was raised, sputum was positive for acid fast bacilli. Chest X-ray was suggestive of pulmonary tuberculosis. A prostate biopsy was also suggestive of tuberculosis. A diagnosis of disseminated tuberculosis was made and the patient showed a good response in two weeks.

What is the appropriate duration of a therapeutic trial in cutaneous tuberculosis? Further observations.

BACKGROUND: Laboratory tests for the diagnosis of cutaneous tuberculosis lack adequate sensitivity and specificity and a trial of therapy is often used as a diagnostic test in difficult cases. However, the duration for which the trial should be undertaken is not clearly defined. Our previous study indicated that one month of therapy was adequate to detect a clinical response to treatment. However, about half the patients first reported after one month of treatment, some much later. METHOD: We therefore analysed the treatment records of 107 patients who received four-drug, short course, antitubercular therapy for a diagnosis of cutaneous tuberculosis in our hospital and who were asked to return for follow-up at biweekly intervals in the first month of treatment. RESULT: Twenty-one patients did not return for any follow-up visit, nine patients did not respond to treatment and treatment was stopped in one patient. Of the remaining 76 patients, 72 patients were recorded to have distinct clinical improvement within five weeks of starting treatment while only four patients showed improvement after 60-123 (8-17 weeks) days of therapy. CONCLUSION: These findings indicate that five weeks appears to be an adequate duration of a therapeutic trial in patients suspected to have cutaneous tuberculosis, with the exception of tuberculids and patients showing minimal clinical activity before treatment. Patients who have not responded by this time are unlikely to do so with further treatment and should have their diagnosis reviewed.

Extensive alopecia areata treated with betamethasone oral mini-pulse therapy: an open uncontrolled study.

BACKGROUND: Extensive alopecia areata is known to respond to daily oral corticosteroids. To minimize the side effects of daily corticosteroids, oral mini-pulse therapy with betamethasone has been used in vitiligo and other dermatoses. There are a few studies in alopecia areata also. AIM: To evaluate the efficacy of oral mini-pulse therapy in extensive alopecia areata. METHODS: It is an open study on sixteen adolescents and adults with alopecia areata/ totalis/universalis treated with oral mini-pulse therapy for a minimum period of six months. The patients were evaluated clinically and with serial photographs for response and periodical investigations were undertaken to look for the side effects. All the patients were followed up for 5-8 months to look for any relapse. RESULTS: Seven (43.7%) patients showed an excellent response and five (31.2%) patients had good response. Two patients (12.5%) had unsatisfactory response and another two (12.5%) were non-responders. There were insignificant/minimal side effects. CONCLUSION: Oral mini-pulse therapy with betamethasone is a safe and effective therapeutic modality for extensive alopecia areata.