Subconjunctival Dirofilariasis presenting as orbital cellulitis

Background: Dirofilariasis is an emerging zoonosis in India. Most of the cases from India have been reported from the states of Kerala, coastal Karnataka and Maharashtra, and a few from the North India, Orissa and Assam. Dogs, cats, foxes and other wild animals are definitive hosts for dirofilaria. Human ocular parasitosis is prevalent in geographical areas where environmental factors and poor sanitary conditions favor parasitism between humans and animals. However, in recent years, migrating population have facilitated the spread of certain parasitic diseases from endemic to non-endemic areas. We report a case of subconjunctival dirofilariasis in a 91-year-old man, who presented with features of orbital cellulitis. An intact live worm, measuring 13.5 cm, was extracted from the subconjunctival space, following which there was prompt resolution of symptoms. Purpose: Given the increase in the frequency of dirofilariasis in humans in recent years, medical practitioners should bear in mind the possibility of ocular dirofilariasis when a patient presents with an ocular or orbital inflammatory lesion. Synopsis: This video illustrates various presentations of ocular dirofilaria and surgical extraction of a live worm from the subconjunctival space. Highlights: Lifecycle and human ocular manifestations of dirofilaria ared elucidated. Rare presentation of subconjunctival dirofilariasis as orbital cellulitis and its resolution following removal of the live worm has been demonstrated.

Assessment Of 10-Year Risk Of Developing A Major Cardiovascular Event In Patients Attending A Hospital For The Treatment Of Other Disorders

Objective: To assess the individual’s predicted risk of developing a CVD event in 10 y using risk scores among persons with other disorders/diseases. Methods: This is a cross-sectional observational study conducted for a period of 6 mo among 283 subjects. Total risk was estimated individually by using Framingham Risk Scoring Algorithm and ASCVD risk estimator. Results: According to Framingham Risk score the prevalence of low risk (<10%) identified as 67.84% (192), followed by intermediate risk (10%-19%), 19.08% (54), and high risk (≥20%) 13.07% (37). By using ASCVD Risk estimator, risk has reported in our study population was low risk (<5%) is 48.76% (138), borderline risk (5-7.4%) is 13.07% (37), intermediate risk (7.5-19.9%) is about 25.09% (71), high risk (>20%) is about 13.07% (37). Conclusion: In this study burden of CVD risk was relatively low, which was estimated by both the Framingham scale and ASCVD Risk estimator. Risk scoring of individuals helps us to identify the patients at high risk of CV diseases and also helps in providing management strategies.

Septate uterus with double cervix and longitudinal vaginal septum – A report of two cases of rare uterine anomaly

Background: Embryological maldevelopment of the Mullerian or paramesonephric duct results in congenital uterine anomalies. A rare developmental anomaly is a septate uterus with cervical duplication and a longitudinal vaginal septum. This anomaly cannot be explained by the classical unidirectional Mullerian developmental theory and does not fit into American Society for Reproductive Medicine (ASRM) classification of uterine anomalies. The bidirectional Mullerian developmental theory holds good for this type of anomalies and the new ESHRE/ESGE classification for female urogenital tract anomaly (CONUTA) is more suitable for effective categorization, diagnosis, and treatment.Case Report: Two cases of the complete uterine septum with double cervix and longitudinal vaginal septum who presented with dysmenorrhea, dyspareunia, and infertility were diagnosed and managed by hysteroscopy and laparoscopy. The vaginal and the uterine septum were resected. Both the patients had an uneventful post-operative recovery period and were followed up for a period of 1 year. The symptoms such as dysmenorrhea and dyspareunia improved significantly without any effect on the fertility outcome.Conclusion:Very few of such cases are reported in the literature. This rare anomaly is explained by the bidirectional Mullerian developmental theory and the application of the new ESHRE/ESGE classification of the urogenital tract (CONUTA) is more suitable for such anomalies for effective categorization, diagnosis, and treatment.

The Study of Prevalence of Bronchial Asthma among School Going Children in South India.

Background: Bronchial asthma (asthma) is the chronic illness in the childhood resulting in morbidity as it is not correctly diagnosed and treated properly. It is basically an allergic disorder; certain respiratory infection and air pollution also contributes to its etiology. Methods: This study focusses on prevalence of asthma among school going children and also record the demographic profile. This study also highlights to spread the awareness and policy decision making in the diagnosis and treatment of asthma in children. Results: The prevalence of asthma among school children in the current study was found to be 4.5%. Maximum numbers of positive cases were found at the age of 15 years, 10 (5.37 %) cases. In the current study the prevalence of asthma was found to be 4.24% in the 12-13 years age group and prevalence was found to be 4.73% in the 14-15 years age group. The prevalence of asthma was found to be higher among boys (5.14%) than of girls (3.77%). Conclusion: This study could identify an array of risk factors possibly involved in the prevalence of asthma in this region. Recognition of the risk factors will help parents, medical personnel and health planner’s device preventive and early intervention programs to reduce the burden of asthma in the community.

Study of variation in atypical foramina of dry human skull.

Foramina or openings in the skull are very important as they allow passage of important structures likes nerves and blood vessels through them. Various people have studied variations in foramina as these variants have been found to be related to many disease states, which can be either acquired or inherited. Out of various skull foramina, we studied three atypical foramina named lacrimal, emissary sphenoidal & parietal in 103 dried human skulls. We looked for their presence unilaterally/bilaterally, their numbers, dimension and comparison bilaterally. Lacrimal foramen was absent bilaterally in 41% of the skulls while present unilaterally in 29% with an average size of 0.86 mm. Emissary sphenoidal foramen was absent bilaterally in 49%of the skulls, present unilaterally in 20% with an average size of 0.87 mm. When compared bilaterally 11% of the skulls showed difference of more than 0.5mm in emissary sphenoidal foramen while it was multiple in 2% of the skulls studied. Parietal foramen was absent bilaterally in 20% of the skulls while it was present unilaterally in 29% with an average size of 0.91 mm. When compared bilaterally 15% of the skulls had difference of more than 0.5mm.The foramen studied showed variation in different parameters observed which might be due to genetic, nutritional, environmental differences or some disease conditions. Knowledge of presence and variation in its anatomical parameter can be crucial for surgeons and anesthetists.

A study of the efficacy of endoscopic cyclophotocoagulation for the treatment of refractory glaucomas.

BACKGROUND: Endoscopic cyclophotocoagulation (ECP) is a relatively new method of cyclodestruction which can be used in the management of refractory glaucomas. AIM: To evaluate the safety and efficacy of ECP in the management of refractory glaucomas. SETTINGS AND DESIGN: Prospective interventional non-comparative study. MATERIALS AND METHODS: Fifty eyes of 50 patients with refractory glaucoma, whose intraocular pressures (IOP) were not under control with maximal medical therapy underwent ECP, by the anterior, or pars plana route. IOP, best corrected visual acuity (BCVA), and the number of anti-glaucoma medications, were compared postoperatively to preoperative values. Success was defined as IOP pound 22 mmhg, with or without use of medications. STATISTICAL ANALYSIS USED: Student's t test and repeated measures ANOVA were used to evaluate change in IOP and Student's t test, for comparison of BCVA. Kaplan Meier survival curve was plotted. Wilcoxon signed rank test was used to evaluate reduction in medications. RESULTS: Patients were followed for an average of 12.27 months (3-21months). IOP decreased significantly from 32.58 +/- 9.16 mmHg to 13.96 +/- 7.71 mmHg at last follow-up ( P < 0.001, student's t test). BCVA was significantly improved in the postoperative period ( P < 0.001, student's t test). The average number of antiglaucoma medications decreased from 2.51 +/- 0.97 to 1.09 +/- 1.16 ( P < 0.001, Wilcoxon signed rank test). ECP had a success rate of 82.2%. CONCLUSION: Endoscopic cyclophotocoagulation is an effective procedure in this subset of refractory glaucomas.

Effect of "HAART" on CD4+ T lymphocyte counts in HIV seropositive south-Indian individuals--a follow up study.

Because of the drastic cut down in the prices of antiretroviral drugs, the antiretroviral therapy has become more affordable in India. 16 HIV-1 infected individuals who were on HAART were followed up for 12 months. The CD4 + T Cell count estimation was done at mean intervals of 6 months and 12 months. Antiretroviral therapy showed good response in 14(87.5%) and deterioration in 2 (12.5%) cases.