Ocular decompression retinopathy after trabeculectomy with mitomycin-C for angle recession glaucoma.

A 45-year-old male presented with intractable glaucoma following 360-degree angle recession after blunt trauma. He underwent an uncomplicated trabeculectomy with mitomycin-C (MMC). Adequate precautions were taken to reduce the chances of sudden lowering of intraocular pressure (IOP). He did not have any intraoperative shallowing of the anterior chamber or postoperative hypotony, but still developed ocular decompression retinopathy. On detailed review of the previously reported cases we discovered that besides a large IOP drop after surgery, either the preoperative rise of IOP in all these cases was over a relatively short period or the course of their glaucomatous process was likely to have exposed them to intermittent spikes of high IOP. To our knowledge this factor has not been previously postulated in the pathophysiology of ocular decompression retinopathy. We illustrate this with a rare case of ocular decompression retinopathy after trabeculectomy with MMC for post-traumatic angle recession glaucoma.

A sequential study of circulating immune complexes, complement and immunoglobulins in borderline tuberculoid leprosy patients with and without reactions.

Sequential estimates of the levels of circulating immune complexes (CIC), complement catabolic fragment C3d, complement-mediated immune complex solubilization (CMS) and immunoglobulins were made in 24 newly diagnosed with borderline tuberculoid leprosy over a 20 month period after initiation of chemotherapy. Fourteen of these patients had not suffered from reversal reactions either at the time of presentation or during the follow-up. The levels of CIC were evaluated in them from the third to the eleventh month after starting chemotherapy and immunoglobulin G (IgG) levels were evaluated up to eight months. The concentrations of C3d and immunoglobulins A (IgA) and M (IgM) were normal in these patients. The other ten patients had reversal reaction at the time of diagnosis which subsided by the third month after starting treatment. They did not have reversal reactions later. The levels of CIC and IgG were elevated and those of CMS were depressed throughout the study period. Serum C3d level was initially elevated but came down to normal by the third month while IgA and IgM levels were within normal limits. The relevance of these findings to the genesis of reversal reaction is discussed in this communication.

Follow up of BL/LL patients on a slightly modified WHO regimen of multidrug therapy.

56 lepromatous leprosy patients with an initial average BI of 4.45 were administered once a month 600 mg of Rifampicin, 100 mg of Clofazimine on alternate days and 100 mg of Dapsone daily. None of these patients became smear negative in 2 years, and the same regimen was continued further. Two patients have become negative in 3 years and treatment has been stopped in them. The study indicates that highly bacilliferous LL/BL patients are likely to need 3 years or more of MDT for achieving bacterial negativity.

Dermatoglyphics in leprosy (II Metric analysis of palms).

A group of 100 leprosy patients consisting of 50 lepromatous (BL/LL) and 50 tuberculoid (BT/TT) were investigated for metric analysis of the patterns present on their palms. Hundred normal persons were also selected from the families of patients to serve as controls. BT/TT patients and controls did not show any significant difference in their palmar patterns. On the other hand, significant differences were observed in the patterns between BL/LL patients and controls.

Chemotherapeutic trials with different regimens containing rifampicin in paucibacillary type of leprosy cases--a preliminary report.

Different regimens containing Rifampicin have been tried in treating paucibacillary leprosy patients. In our study we have studied three regimens. Regimen I consists of treating patients with Rifampicin 600 mg once a month for six months combined with Dapsone 100mg daily and treatment is stopped at six months. Regimen II is same as regimen I except that instead of stopping treatment at the end of six months the treatment was continued with dapsone 100 mg daily for another six months and treatment was stopped at one year. Regimen III is the same as recommended by I.A.L. in which treatment is started with Rifampicin 600 mg daily for seven days in the first month to be followed by Rifampicin 600 mg once a month for five more months. This is combined with dapsone 100mg daily for one year. Treatment in this group is also stopped at one year. Eighty one patients in Regimen I, thirty five patients in Regimen II and sixty three patients in Regimen III completed the six month treatment. It was found that the inactivation index in all the three regimens was nearly the same.

A study of the cause of irregularity of patients attending the out patient department of Cjil, Agra.

A study of 195 patients attending the out patient department with regard to regularity is reported. 71 patients or 36.41% were found to be irregular. The causes of irregularity were found to be predominently socio-economic factors. Since irregularity may lead to emergence of drug resistance due to irregular, inadequate and interrupted drug compliance, socio-economic factor require amelioration.

Dermatoglyphics in leprosy (I. Finger patterns).

Finger dermatoglyphic patterns were studied in leprosy families selecting patients and controls from each family. A total of 100 leprosy cases (50 of TT/BT types and 50 of BL/LL types) and 100 control subjects were investigated. While a statistically significant association was noted with some finger patterns (loop ulnar, loop radial, loop twin and loop central pocket) in the lepromatous type, no such association was observed with the finger patterns in the tuberculoid type.