Preferred practice patterns and review on rosacea

Rosacea is a chronic, inflammatory facial dermatosis commonly found in fair skin tone population. Recent studies have shown the increasing prevalence in the dark skin tone population as well. Ocular involvement is very common and can occur without cutaneous features. Common ocular features are chronic blepharoconjunctivitis with eyelid margin inflammation and meibomian gland dysfunction. Corneal complications include corneal vascularization, ulceration, scarring, and rarely, perforation. Diagnosis is largely based on clinical signs, although it is often delayed in the absence of cutaneous changes, particularly in children. The management ranges from local therapy to systemic treatment, depending on the severity of the disease. There is a positive association between demodicosis and rosacea; however, causality is always argued. In this review, we describe the epidemiology, clinical features, and treatment of rosacea and ocular rosacea.

EDTA contamination: a preanalytical cause for interference in iron and unsaturated iron binding capacity assay

Background: The aim of the study is focussed very keenly at performing RCA (root cause analysis) of those particular sample containing the absurd results of the Serum UIBC (Unsaturated Iron Binding Capacity), which was also tallied vigilantly side by side with Serum Iron observed at Clinical Biochemistry laboratory of The New Civil Hospital Surat, Gujarat.Methods: The Absurd value from the samples requested for Serum Iiron and Serum Serum UIBC (Unsaturated Iron Binding Capacity) from month of August 2018 till the month of August 2019 were taken in to account for analysis. RCA (root cause analysis) of absurd value for Serum Iron and Serum UIBC (Unsaturated Iron Binding Capacity) which were prepared was mainly focused on tallying with Serum Calcium and Serum Potassium result.Results: With the continious and strenous monitoring from the side of the researchers, the researchers had throughly analysed and found that in almost all of those analysed test containing absurd results of Serum Iron and Serum UIBC(Unsaturated Iron Binding Capacity) which were some way or the other, associated with absurd results of Serum Calcium along with absurd result of Serum Potassium too from the same samples.Conclusions: The Absurd results of Serum Calcium and Serum Potassium are caused mainly due to pre-analytical errors more likely due to the sample contamination with EDTA (ethylene diamine tetra acetic acid). The contaminated EDTA (ethylene diamine tetra acetic acid) sample cause interference in Serum Iron measurement by producing turbidity in sample and in Serum UIBC (Unsaturated Iron Binding Capacity) by chelating Iron.

Evaluation And Comparison Of Mandibular Asymmetry Indices In Different Classes Of Malocclusion: A Radiographic Study.

Objective: To evaluate contribution of condylar and ramal asymmetries in various classes of maloclussion with the use of Orthopantomographs by frontal aspect . Materials and Methods: Panoramic radiographs (PRs) are routinely taken radiographs for the diagnosis purpose. All radiographs were taken by experienced radiology technician on digital panoramic system. The subjects were positioned with the lips in rest position & head oriented to Frankfort horizontal plane as suggested by Azevedo et al. The sample consisted of study five groups including 150 subjects of different types of malocclusions. All the radioghraphic films were traced & measured by the same author and all the asymmetry indices were measured using formula developed by Habets et al. Results: Descriptive statistics and Comparison of Condylar Asymmetry index(CAI), Ramal Asymmetry index(RAI) and Combined Asymmetry index(CoAI) showed that there no statistical significance within RAI (0.216) and CoAI (0.116), but statistically significant values were recorded within CAI (0.0052).We have found more asymmetry in condyle than ramus. Conclusion: Generally for orthodontic treatment orthodontist see mainly skeletal malformation in sagittal plan but from our studies it can be said that it is equally important to look for skeletal asymmetry from frontal aspect, particularly in lower third of the face and condyle. If such asymmetries are diagnosed earlier then it is possible to intervene them with the help of asymmetrical myofunctional appliances. [Manjiri J NJIRM 2016; 7(5):78-81]

Can higher end tonometers be used interchangeably in routine clinical practice.

Context: Precise intraocular pressure (IOP) measurement is important in glaucoma practise. Various instruments are available today to accurately measure IOP. Thus, the question arises about which instrument to use and whether all of them can be used interchangeably. Aims: To assess the agreement between noncontact tonometer (NCT), rebound tonometer (RBT), Goldmann applanation tonometer (GAT), and dynamic contour tonometer (DCT) in measuring IOP. Subjects and Methods: 499 eyes of 250 patients were evaluated during a period of 24 months from September 2010 to August 2012 and measurement of IOP by NCT, RBT, GAT, and DCT was done in the given sequence. The agreement was assessed by use of the Bland–Altman plot keeping GAT as a gold standard technique. Results: The mean IOP value of NCT, RBT, GAT, and DCT was 15.9 ± 5.5, 15.9 ± 5.8, 15.9 ± 4.9, and 16.0 ± 4.7 mm of Hg, respectively. The limits of agreement of GAT with DCT, NCT, and RBT were found to be +5.4 to −5.2, −4.7 to +4.6, and −5.2 to +5.1 mm of Hg, respectively. Conclusions: A positive and strong correlation was found between newer tonometers and GAT, but the limit of agreement was clinically unacceptable. The use of a single tonometer should be practised at a glaucoma clinic for a patient at each follow‑up.

A case of dermatomyositis with high calcium discharge from skin nodule.

We describe a case of 46 years lady with dermatomyositis and calcinosis cutis showing extensive subcutaneous nodules with fluid discharge. The discharge fluid contained very high calcium concentration. X-ray of the subcutaneous nodules showed calcification of soft tissue. USG of spleen showed foci of vascular calcification.

Comparison of alternate glycolysis inhibitors with fluoride for preservation of blood for glucose and other common clinical chemistry examinations.

Aims: The study aims at comparing observed values of glucose and various common clinical chemistry examinations in sample containers with different glycolysis inhibitor – Glyceraldehyde. Materials And Methods: Prepare sample conainers with alternate glycolysis inhibitors.Collect blood samples in prepared sample containers (systematic sampling of 100 consenting patients admitted at various wards of New civil Hospital,Surat for each perservative).Observe values of various examinations in collected samples. Statistical Analysis Used: Perform two-sample Student's t-test on observed sets of data. Results: Average Glucose concentration in 5 mmol/L DL-Glyceraldehyde, Fluoride and Plain tube each was 118.78 mg/dl, 121.84 mg/dl and 100.24 mg/dl respectively after 8 hours. P-value for glyceraldehyde tube vs. Fluoride tube was 0.64737, P-value for glyceraldehyde tube vs. Plain tube was 0.00796 and P-value for Fluoride tube vs. Plain tube was 0.00187. P-value for Bilirubin, ALT,ALP, Amylase,Electrolytes, Triglycerides, Cholesterol, HDL Cholesterol, Urea, Uric Acid, Albumin, Total Proteins were unaffected by DL-Glyceraldehyde, while there was negative interferance with Creatinine measurement by Alkaline Picrate method. Conclusions: Use of DL-Glyceraldehyde containers for preservation of blood for Glucose measurement is as good as fluoride containers. Because Glyceraldehyde interfere with creatinine assay by Alkaline Picrate method and pottasium assay by ISE , Glyceraldehyde containers can not replace Plain tube for common routine clinical chemistry analysis.

Intraocular lens power calculation formulas in high refractive errors….what to choose and when.

Background & Objectives: Before performing the cataract surgery high level of expertise and knowledge is required to fulfil the ever increasing demands of patients. This makes a surgeon carry out detailed evaluation of a case and formulate a ‘customized IOL’. Accurate IOL power calculation is the most important part of planning a cataract surgery. Most of the formula works well with normal axial length, but with high refractive errors, there are many discrepancies for selection of IOL formula. Methods: Study included 80 high myopic eyes divided into three groups and 20 high hypermetropic eyes divided into two groups according to various A scan formulas utilised. Post-operative spherical equivalent in relation to various formulas for all groups compared. Results: Performance of all 3 formulas in high myopic group showed SRK/T formula to be most accurate with smallest Mean Absolute Error (MAE) in all axial length subcategories above 24mm, followed by Haigis, and Holladay I respectively. In high hypermetropic patients, among 2 formulas, the lowest MAE was found with Hoffer-Q (-0.03D) compared to SRK/T (-0.96D) Interpretation & Conclusion: Erroneous IOL power calculation can spoil high quality results expected by patients in terms of post-operative vision in spite of excellent surgery.

XML schema for writing ISO 15189: 2007 - Compliant SOPs for clinical laboratory examinations.

Standard Operating Procedures are generally hard copy text documents at clinical laboratories. Due to wider access to computer based technology, Standard Operating Procedures are increasingly kept in electronic form allowing easier and wider access to its users. Such electronic form of Standard Operating Procedures are generally in plain text form or some form of word-processor document. Such presentation-centric documents are difficult to append and revise and access online. Development of Standard Operating Procedures based on eXtended Markup Language(XML) can rectify these difficulties by separating data from its presentation. This study analyses requirements of IS/ISO:15189 and NABL, India for writing examination Standard Operating Procedures and develops appropriate schema for validation of Standard Operating Procedures for clinical laboratory examinations.

Antistress activity of Argyreia speciosa roots in experimental animals.

The antistress effect of a seven-day treatment (100 and 200 mg / kg, p.o.) of the hydroalcoholic extract of Argyreia speciosa root (ASE) was evaluated by using the swimming endurance test, acetic acid–induced writhing test, pentylenetetrazoleinduced convulsion test, anoxic tolerance test, cold-restraint, stress-induced gastric ulcers, aspirin-induced ulcers, and biochemical, and histopathological changes in the cold-restraint stress test. The immunomodulatory activity was also evaluated for the same doses, and treatment of ASE was done using the hemagglutination test. Both the doses of ASE showed antistress activity in all the tested models. The ASE-treated animals showed a decrease in immobility time and an increase in anoxic tolerance time in swimming endurance and the anoxic tolerance tests, respectively. The effect of glacial acetic acid and pentylenetetrazole were also reduced by decreasing the number of writhing responses and increasing the onset of convulsions, respectively. In the cold restrained stress and aspirin-induced gastric ulcer models, ASE showed a significant reduction in the ulcer index. Pretreatment with ASE significantly ameliorated the cold stress-induced variations in biochemical levels such as increased plasma cholesterol, triglyceride, glucose, total protein, and cortisol. ASE was also effective in preventing the pathological changes in the adrenal gland, due to cold restrained stress, in rats. In mice immunized with sheep red blood cells, the treatment groups subjected to restraint stress prevented the humoral immune response to the antigen. The immunostimulating activity of the ASE was indicated by an increase in the antibody titer in mice pre-immunized with sheep red blood cells and subjected to restraint stress. The findings of the present investigations indicate that the ASE has significant antistress activity, which may be due to the immunostimulating property and increased resistance, nonspecifically, against all experimental stress conditions.

Primary chondrosarcoma of lung: case report and review of literature.

A case of primary chondrosarcoma of the left lung in 50 year-old man is presented. The tumor was diagnosed as primary chondrosarcoma of the lung after exclusion of any primary lesion elsewhere. Histologically, tumor consisted of predominantly chondromatous lesion. Immunohistochemistry showed that tumor cells positive for S-100 protein and vimentin, and negative for epithelial markers. On the basis of clinical, histological and immunohistochemical studies, the tumor was diagnosed as a primary chondrosarcoma of the lung.