Comparative study between conventional and 4 mm manual small-incision cataract surgery

Purpose: Comparative study of intraoperative and postoperative complications, visual outcomes, and cost?effectiveness between conventional and 4?mm manual small?incision cataract surgery with MVR blade. Methods: In total, 600 patients having nuclear sclerosis grade I朓V were operated under peribulbar anesthesia and were divided into two groups of 300 each. In group A (300), conventional small?incision cataract surgery was done, whereas in group B (300), 4?mm manual small?incision cataract surgery was performed through a 4?mm sclerocorneal tunnel. A wire vectis was passed through the 4?mm incision below the nucleus to stabilize it, and a 20?G MVR blade was introduced from 11o抍lock limbus and nucleus was bisected into two halves, which were removed through main incision. Cortical wash was given, and foldable IOL was implanted. Intraoperative and postoperative complications between the two groups were compared. Postoperative visual outcome and surgically induced astigmatism between the two groups was studied. Results: The most common intraoperative complication was hyphema (11.33%) and irido?dialysis (8.00%), whereas postoperatively, striate keratopathy (36.33%) and hyphema (19.33%) were common. Short?term complications such as striate keratopathy, hyphema, and irido?dialysis were significantly more in group B, and long?term results in terms of visual outcome and surgically induced astigmatism were significantly less in group B. Conclusion: Although intraoperative and short?term postoperative complications were observed more in 4?mm manual small?incision cataract surgery, it was found to be more effective in terms of surgically induced astigmatism and final visual outcome. In addition, it is cost?effective as compared to phacoemulsification.

Sleep Quality among Healthcare Professionals in a Tertiary Care Hospital

Introduction: A person spends one third life in sleep, so the quality and quantity of sleep is of utmost importance. Health Care Professionals (HCPs) are more prone to inconsistency in sleep both in quality and quantity, which leads to deflection from health and well-being of themselves and care of others. This study aims to assess the various factors influencing sleep quality and daytime sleepiness among medical and nursing healthcare professionals. Methodology: A cross sectional study was conducted using a structured questionnaire to collect socio-demographic and work-related information, co-morbidity and quality of Sleep using ESS (Epworth Sleepiness Scale) and PSQI (Pittsburgh Sleep Quality Index) scale. Results: Among the 150 HCPs, 64.7% were medical and 35.3% were nursing professionals. 53.6% of medical and 66% of nursing professionals reported poor sleep quality. Increased coffee consumption influences sleep quality and it was found to be statistically significant. Nursing professionals had more excessive daytime sleepiness (58.5%) with significant p-value (p=0.01). Conclusion: According to our study results, sleep quality was poor among nursing professionals which highlights the need for measures to improve their quality of sleep.

Perspectives on the clinical development of immunotherapy in prostate cancer / 亚洲男科学杂志(英文版)

Despite impressive survival benefits with immunotherapy in patients with various solid tumors, the full potential of these agents in prostate cancer has yet to be realized. Sipuleucel-T demonstrated a survival benefit in this population, indicating that prostate cancer is an immunoresponsive disease; however, these results have not been matched by other agents. A large trial with ipilimumab in prostate cancer failed to meet its primary objective, and small trials with PD-1/PD-L1 inhibitors did not yield a significant improvement in overall response. However, several late-stage clinical trials are underway with other vaccines in prostate cancer. Reports of clinical benefit with immunotherapies, particularly when used in combination or a select population, have provided the framework to develop sound clinical trials. Understanding immunogenic modulation, antigen spread, biomarkers, and DNA-repair defects will also help mold future strategies. Through rational patient selection and evidence-based combination approaches, patients with prostate cancer may soon derive durable survival benefits with immunotherapies.

The path forward in prostate cancer therapeutics / 亚洲男科学杂志(英文版)

The last decade has seen remarkable advances in the treatment of prostate cancer. Until 2010, only docetaxel had demonstrated the ability to improve the survival in metastatic castration-resistant prostate cancer (mCRPC). While effective, many men were reluctant to get treatment with docetaxel because of the perceived toxicity, thereby further limiting the benefit of the one available and effective therapy. Remarkably, within the last 8 years, the field has seen a multitude of therapies that demonstrate an ability to extend survival for men with prostate cancer. Abiraterone and enzalutamide demonstrated the importance of the androgen axis in propelling prostate cancer growth. Sipuleucel-T was immunotherapy's entry into the evolving prostate cancer armamentarium, as the therapeutic cancer vaccine established an ability to extend survival despite an apparent lack of short-term effect on progression-free survival and prostate-specific antigen (PSA). Radium-223 built on the palliative success of previous radiopharmaceuticals, but this alpha-emitting agent importantly had limited hematologic-related toxicity and was associated with a survival advantage, unlike its in-class predecessors. Cabazitaxel also emerged as a second-line chemotherapy option in patients who had already progressed on docetaxel.

Prevalence of deep vein thrombosis in acute stroke in Government Dharmapuri Medical College Hospital

Introduction: Venous thrombo embolism (VTE) is a frequent cause of preventable illness and death in hospitalized patients. 25% of all cases of venous thrombo embolism are associated with hospitalization and 50 to 75% of cases of VTE in hospitalized patients occur on those in medical wards. Aim of the Study: Prevalence of Deep vein thrombosis in patients admitted with acute stroke. The need for routine anticoagulation for prophylaxis against DVT in acute stroke patients. Materials and methods: Out of 145 patients enrolled for the study after applying the exclusion criteria 50 patients were selected for duplex ultrasonography of lower limb venous system. Results: In our study the prevalence of DVT in acute stroke was analyzed by ultrasound venous Doppler of lower limbs. The analysis of co morbid conditions like diabetes, systemic hypertension, ischemic heart disease, smoking and alcoholism were analyzed to find out if there was any association between their presence and occurrence of DVT. In all these parameters compared within the group of DVT positive patients the p value was more than 0.05 which is statistically insignificant. Conclusion: The prevalence of DVT in acute stroke patients in our hospital group was 6% which is significantly less than that observed in western population. Duplex USG is a useful tool which can be used as a screening tool for early diagnosis of DVT. DVT occurs more commonly in paralyzed limb than non paralyzed limb.

Understanding the processus vaginalis: the abdomino scrotal hydrocoele / Entendiendo el proceso vaginal: el hidrocele abdomino-escrotal

A knowledge of the embryology and descent of the testes is essential for all clinicians. Congenital hydrocoele, though an embryologic anomaly can present in adulthood. A abdomino scrotal hydrocole must be considered when a mass in the lower abdomen co exists with a scrotal hydrocoele.

El conocimiento de la embriología y el descenso de los testículos es esencial para todos los clínicos. El hidrocele congénito, aunque es una anomalía embriológica se puede presentar en la edad adulta. Un hidrocele abdomino-escrotal debe ser considerado cuando una masa en la parte inferior del abdomen co existe con un hidrocele testicular.

Antipathogenic potential of marine Bacillus sp. SS4 on N-acyl-homoserine-lactone-mediated virulence factors production in Pseudomonas aeruginosa (PAO1).

Antipathogenic therapy is an outcome of the quorum-sensing inhibition (QSI) mechanism, which targets autoinducerdependent virulent gene expression in bacterial pathogens. N-acyl homoserine lactone (AHL) acts as a key regulator in the production of virulence factors and biofilm formation in Pseudomonas aeruginosa PAO1 and violacein pigment production in Chromobacterium violaceum. In the present study, the marine bacterial strain SS4 showed potential QSI activity in a concentration-dependent manner (0.5–2 mg/ml) against the AHL-mediated violacein production in C. violaceum (33–86%) and biofilm formation (33–88%), total protease (20–65%), LasA protease (59– 68%), LasB elastase (36–68%), pyocyanin (17–86%) and pyoverdin productions in PAO1. The light and confocal laser scanning microscopic analyses confirmed the reduction of the biofilm-forming ability of PAO1 when treated with SS4 extract. Furthermore, the antibiofilm potential was confirmed through static biofilm ring assay, in which ethyl acetate extract of SS4 showed concentration-dependent reduction in the biofilm-forming ability of PAO1. Thus, the result of this study clearly reveals the antipathogenic and antibiofilm properties of the bacterial isolate SS4. Through 16S rDNA analysis, the strain SS4 was identified as Bacillus sp. (GenBank Accession Number: GU471751).

Comparative evaluation of possible ocular photochemical toxicity of fluoroquinolones meant for ocular use in experimental models.

Fluoroquinolones (FQs) are extensively used in bacterial keratitis and other intraocular infections. Since eye is constantly exposed to light, incidence of ocular phototoxicity due to commonly used FQs is of great interest for their safe use. Phototoxicity of commonly used FQs (ciprofloxacin, lomefloxacin, pefloxacin, ofloxacin, sparfloxacin and gatifloxacin), has been evaluated by using HET-CAM-UV model (Photo Hen Egg Test-C Chorioallantoic Membrane model). This study was further extended by adding lomefloxacin dissolved in bovine vitreous (0.5 ml) on the chorioallantoic membrane (CAM). Using a standard scale, the phototoxic damage was assessed at different time intervals. Respective controls were kept in dark to distinguish the toxicity of the drugs per se. The results showed that the phototoxicity induced by lomefloxacin was very high followed by gatifloxacin and sparfloxacin and least for other drugs studied. Interestingly, lomefloxacin along with vitreous showed significantly low phototoxicity. This could be due to the antioxidant property of ascorbic acid present in the vitreous.

Protection from ultraviolet radiation by spectacle lenses available in India: a comparative study.

BACKGROUND: Exposure to ultraviolet radiation (UVR) can result in several ocular ailments. We studied the UV absorption (UV-A and -B bands) in 20 lenses (11 hard resin and 9 glass) commonly available in India as uncut lenses for the purpose of prescription as well as non-prescription wear. METHODS: Using a UV-visible spectrophotometer (Thermo-Spectronic, UV-1 model, Thermo Electron Corporation, USA), the percentage transmittance was scanned between 190 and 400 nm, from which the results at 280, 320, 340, 360, 380 and 400 nm were analysed. RESULTS: At 360 nm (UV-A), 75% of the lenses studied failed to offer 95% protection as recommended by the United States Food and Drug Administration (US FDA). At 280 nm (UV-B), 35% of the lenses failed to offer 99% protection against UV-B. Hard resin lenses showed a higher degree of variation in protection from UV-A. CONCLUSONS: Most of the lenses studied failed to meet the US FDA recommendations in terms of protection from UV-A. Glass lenses afforded better protection up to 320 nm compared with hard resin lenses. As the claims of lens manufacturers regarding UVR protection fall short of international standards, certification of UVR protection for different lenses should be introduced in India.

Comparative randomised controlled clinical trial of a herbal eye drop with artificial tear and placebo in computer vision syndrome.

A comparative randomised double masked multicentric clinical trial has been conducted to find out the efficacy and safety of a herbal eye drop preparation, itone eye drops with artificial tear and placebo in 120 patients with computer vision syndrome. Patients using computer for at least 2 hours continuosly per day having symptoms of irritation, foreign body sensation, watering, redness, headache, eyeache and signs of conjunctival congestion, mucous/debris, corneal filaments, corneal staining or lacrimal lake were included in this study. Every patient was instructed to put two drops of either herbal drugs or placebo or artificial tear in the eyes regularly four times for 6 weeks. Objective and subjective findings were recorded at bi-weekly intervals up to six weeks. Side-effects, if any, were also noted. In computer vision syndrome the herbal eye drop preparation was found significantly better than artificial tear (p < 0.01). No side-effects were noted by any of the drugs. Both subjective and objective improvements were observed in itone treated cases. So, itone can be considered as a useful drug in computer vision syndrome.

Rare co-existence of Salmonella typhi and mycobacteria tuberculosis in a psoas abscess--a case report.

We report a rare case of dual infection in a psoas abscess. Pus from the abscess grew Salmonella typhi and the abscess wall showed epitheloid granulomas giant cells, which we confirmed as tuberculosis by PCR. Such dual infection cases may be missed unless looked for since both these infections are common in our country.