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A case of stage 4B retinopathy of prematurity (ROP) after successful retinal reattachment surgery with maintained vision presented with hazy cornea with spontaneous Descemet's membrane detachment (DMD) 15 years after the surgery, requiring Descemet Stripping Endothelial Keratoplasty (DSEK) to restore vision. There are reports of late spontaneous DMD after phacoemulsification or previous corneal surgeries. This report is unique as there is no published literature of spontaneous DMD after limbal surgery for ROP when searched in PubMed. The immature Descemet's membrane (DM), surgical intervention and changes in immature DM with age would have contributed to spontaneous DMD and warrant a long-term follow-up of premature kids.
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Purpose: The aim of the study was to report the occurrence of contamination/replacement of ophthalmic eye drops with liquids of acidic nature in patients treated for nonresponding scleritis. Methods: This was a retrospective interventional case series study. Results: Of the three patients (4 eyes) referred as necrotizing scleritis, two were found to have acid as the content in the bottle/s being used as eye drops, confirmed using biochemical tests. All four eyes had tarsal ischemia and tarsal conjunctival defect in addition to severe scleral ischemia involving the inferior bulbar area. All four eyes required tenonplasty with amniotic membrane transplant more than once for the ocular surface to heal. Two of the three patients were on systemic immunosuppressives including pulse cyclophosphamide for refractory necrotizing scleritis. Sulfuric and hydrochloric acid was isolated from the bottles of 2nd and 3rd patient using confirmatory biochemical tests. Conclusion: It is important to be aware of the possibility of contaminating or replacing contents of eye drops with harmful agents of acidic nature and should be considered in situations that resemble the clinical picture described herein.
ABSTRACT
Human immunodeficiency virus infection (HIV) is associated with a reduced T-helper (Th) 1 response, and vernal keratoconjunctivitis (VKC) occurs secondary to a heightened Th2 response. VKC has been reported to occur in patients with HIV. In all probability, a Th1–Th2 shift occurs in the immune response in progressive HIV patients with a decreasing CD4 count. This shift could be the probable cause for the initiation and gradual worsening of the VKC in our patient that corresponded to the dropping CD4 counts. VKC resolved only after a change in antiretroviral therapy for HIV that caused a demonstrable increase in the CD4 counts possibly by reversing the shift.
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Keratoprosthesis (Kpro) forms the last resort for bilateral end-stage corneal blindness. The Boston Type 1 and 2 Kpros, the modified osteo-odonto Kpro and the osteo-Kpro are the more frequently and commonly performed Kpros, and this review attempts to compile the current data available on these Kpros worldwide from large single-center studies and compare the indications and outcomes with Kpros in the Indian scenario. Although the indications have significantly expanded over the years and the complications have reduced with modifications in design and postoperative regimen, these are procedures that require an exclusive setup, and a commitment toward long-term follow-up and post-Kpro care. The last decade has seen a surge in the number of Kpro procedures performed worldwide as well as in India. There is a growing need in our country among ophthalmologists to be aware of the indications for Kpro to facilitate appropriate referral as well as of the procedure to enable basic evaluation during follow-ups in case the need arises, and among corneal specialists interested to pursue the field of Kpros in understanding the nuances of these surgeries and to make a judicious decision regarding patient and Kpro selection and more importantly deferral.
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Background: Depression is one of the commonest neuropsychiatric disorders in patients with diabetes mellitus (DM). Diabetes with depression is associated with a low quality of life (QoL). Complications in DM and depression still remain poorly identified and inadequately treated. But treatment of depression among DM patients is almost totally ignored and the QoL is poor. Materials and methods: A prospective observational study was conducted on 100 type 2 Diabetes mellitus patients diagnosed with clinical depression (ICD-10) at a tertiary care hospital. They were treated for depression along with DM medications and followed up till 6 months was assessed by WHO Quality Of Life (WHOQOL) – BREF scales. Results: There was a statistically significant improvement in overall WHO QOL scale from 5.96±1.23 at baseline to 6.71±1.15 at 6 months (P value < 0.001). Among various domain, the mean Physical health domain was 17.72±2.281 at baseline, which has improved to 25.56±3.367 at 6 months follow up and the mean Psychological domain score was 16.32±2.174 at baseline and has improved to 22.64±2.343 at 6 months follow up. Conclusion: QoL is a domain of major importance and it affected in patients with DM and depression. Treatment of depression in DM patients is almost ignored. In the current study, treating Sivabackiya C, Srinivasan B, Maignana Kumar, Sabari Sridhar OT, Kailash S, Shabeeba Kailash, Gopalakrishnan. Impact of treatment of depression on quality of life among diabetic patients with depression. IAIM, 2018; 5(11): 63-69. Page 64 depression in DM patients enhanced the quality of life (P value < 0.001). Hence diagnosis and treatment of depression in these patients is particularly important in order to reduce complications and improve quality of life
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Background: Alcohol use Disorders (AUDs) are related to high rates of morbidity and mortality due to associated severe and chronic medical problems such as liver disease, cardiovascular disease, endocrine diseases, obesity, diabetes, osteoporosis, and cancers. Aim and objectives: To assess the quality of life among the people with alcohol dependence, who are abstinent using WHOQOL-BREF questionnaire, to assess the correlation between age and different aspects of quality of life among study population. Materials and methods: The study was a cross-sectional study conducted in the Department of Psychiatry, Chettinad Hospital and Research Institute. The study population included all male patients treated for current alcohol dependence syndrome, who were treated and were abstinent from alcohol intake for at least 1 month. The data collection for the study was conducted for a period of 6 months from May 2016 – October 2016. Results: Among the study population, amount of alcohol consumption was 3 units per day in 1 (2.04%) subject. Nineteen (38.78%) were consuming 6 units per day, 16 (32.65%) were consuming 9 units per day, 11 (22.45%) were consuming 12 units per day, and 2 (4.08%) were consuming 24 units per day. The mean overall score was 6.96 ± 0.96 in the study population. Minimum level was 5 and maximum level was 8 in the study population (95% CI 6.68 to 7.23). There was a weak positive correlation between age of onset of dependence and WHOQOL-BREF physical health (R Value: 0.258, P value: 0.074). Maria Annita Tellcott Solomon, Sabari Sridhar O.T., B. Srinivasan. Correlation between age of alcohol dependence and quality of life - A hospital based cross sectional study. IAIM, 2018; 5(3): 88-96. Page 89 Conclusion: To conclude the findings of the study suggest poor quality of life in alcohol-dependent subjects with weak positive correlation between age of onset of the habit and physical, psychological and environmental domains of the subjects.
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Background: Duration of the untreated psychosis has been predicted to be one of a factor which affects the outcome of disease and leading to poor prognosis in the patients. Previous studies had predicted that the longer the duration of psychosis the poor the outcome of the treatment. Aim: To assess the factors affecting the Duration of untreated psychosis among patients with first episode psychosis in General hospital setup. Materials and methods: Retrospective study was done on patients who got admitted for the duration of 6 months (1st June 2014 to 31st November 2014). Patients who were diagnosed to have first episode psychosis according to ICD-10 were taken up for the study. Duration of untreated psychosis and the socio demographic details were noted. Results: The duration of untreated psychosis was seen more in male (58%), 45% in age group of 20- 29, 54% were married, 71% in lower middle economic status, 75% of people were from semi urban background and 41% of patients had duration of untreated psychosis for duration of 2-5 weeks. Mean average age is 30.75 and duration of untreated psychosis is 40 days. Conclusion: Mean average age is 30.75 and duration of untreated psychosis is 40 days. Age, gender, marital status, socio-economic status and residence (Environment) acting as a predictor for the long DUP is consistent with previous studies but significant findings couldn’t be found, when two groups Ananthi B, Sabari Sridhar O.T., Kailash S, Shajahan M Ismail, Srinivasan B. Factors affecting duration of untreated psychosis - A retrospective study done in general hospital setting. IAIM, 2017; 4(3): 10-14. Page 11 were compared thus giving the conclusion that Sociodemographic factors alone doesn’t influence on DUP
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Background: The National Institute of Health asthma guidelines recommend assessing PEF during hospitalization including improvement to a PEF of >70% of the predicted value before discharge. The Global Initiative for asthma recommends monitoring of PEF in hospitalized patients. Current guidelines for correct PEF maneuver include standing, but it has been observed that many respiratory therapists and patients use supine position. Aim: To determine which one of the 3 different positions i.e. standing, lying back at 450 angle on pillows and sitting up slumped forward 100 with legs extended generates higher peak expiratory pressure and can be used as optimal position for generating peak expiratory flow in asthmatics. Materials and methods: A cross sectional study was performed in 20 asthmatic subjects aged 18-50 years in whom correct instructions for PEF technique were given according to guidelines of National Institute of Health. The steps were repeated 3 times in each position and the best of 3 attempts in each of the 3 positions were used for analysis. Level of significance kept at 5%. Results: Mean and SD of lying back at 450 was 254.5±29.28, sitting up with slumped forward 100 was 281±28.26 and that of standing was 302.5±27.88. Statistically significant result was found using nonparametric test i.e. Friedman test where χ2 =40 and p=0.0001. Conclusion: There is significant difference between PEFR values in standing, sitting with slump forward 100 and lying back 450 position. Standing position is the best option for adult asthmatics to measure their PEF values as it generated maximum PEF.
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In view of multi-dimensional activity of plant drugs beneficial to complex disorders like diabetes, the present study has been undertaken to evaluate the effect of aqueous extract of C. peltata roots on serum glucose, lipid profile, insulin, inflammatory marker namely tumour necrosis factor (TNF)-α and muscle glycogen in type 2 diabetic rats. Aqueous extract of C. peltata at 40 and 60 mg/kg dose significantly decreased both the fasting and postprandial blood glucose of type 2 diabetic rats; 60 mg/kg dose having more pronounced effect on hyperglycemia. An enhanced insulin levels by the aqueous extract is primary for its glucose and lipid lowering activity. The extract significantly decreased the elevated TNF-α in type 2 diabetic rats. The extract at 40 and 60 mg/kg dose increased the glycogen levels in skeletal muscle by 58 and 60% respectively. Improved glycogen in peripheral tissue such as skeletal muscle indicates the ability of plant drug to combat insulin resistance of type 2 diabetes.