ABSTRACT
Introduction: Leptospirosis may have multi-organ involvement in its severe form with potentially life-threatening consequences. However, acute fulminant hepatic failure is very uncommonly reported. A case study is presented here with fulminant hepatic failure and a diagnostic dilemma for etiology. Case history: A 40-year-old man with no significant medical history presented with fever, muscle pain, weakness, and pain in the upper abdomen. On clinical work, he has developed multi-organ hepatic, respiratory, and renal failure. A timely workup was done, but due to the rapid progression of the disease, the patient succumbed to the disease in the intensive care unit by the time his report for positive leptospirosis test arrived. Conclusion: Leptospirosis must be considered as an important differential diagnosis of acute liver failure patients. An early suspicion for leptospirosis in patients with fulminant hepatic failure and multi-organ failure in India particularly in the rainy season is warranted owing to its high mortality rate.
ABSTRACT
Purpose: To compare clinical outcomes following implantation of two types of posterior chamber phakic intraocular lenses: Visian™ Implantable Collamer Lens with Centraflow (ICL, V4C Staar Surgical, Nidau, Switzerland) and Implantable Phakic Contact Lens (IPCL, V1, Caregroup Sight Solution, India) for the correction of myopia and myopic astigmatism. Methods: This retrospective case series included eyes which underwent phakic intraocular lens implantation with a minimum follow-up period of 1 year. Visual outcomes including safety, efficacy, refractive predictability, and stability were compared at 1 week and at 1, 6, and 12 months' postoperative visit. Complications and adverse events were analyzed. Results: The study included 119 and 203 eyes in the IPCL and ICL groups, respectively. At 1-year postoperative visit, median corrected distance visual acuity was 0.10 (interquartile range [IQR] 0,0.10) and 0 (IQR 0,0) in the IPCL and ICL cohorts, respectively (P = 0.066). An uncorrected visual acuity of 20/32 or better was achieved in 86.5% and 88.67% of the eyes, respectively (P = 0.574). Ninety and 94% of the eyes achieved a postoperative manifest spherical equivalent within ± 0.5D (P = 0.169, ?2 test). Three eyes (2.52%) in the IPCL group versus one eye (0.49%) in the ICL group developed visually significant cataract requiring surgical intervention (P = 0.113). No vision-threatening complications were noted in either cohort. The mean follow-up period was 94.69 ± 32.45 and 102.67 ± 61.82 weeks, respectively. Conclusion: Both groups demonstrated similar efficacy and safety profile. The IPCL is an effective and economically viable option for the correction of myopia.