ABSTRACT
A 43-year-old male presented with left eye foveal retinits causing an acute visual loss following influenza virus type A infection (H1N1 infection or Swine flu). Considering viral (influenza) etiology, a prompt treatment with oral corticosteroids was started. But an initial poor response prompted an immediate diagnostic vitrectomy, which revealed Candida albicans. The retinitis healed with scar formation following anti-fungal therapy. This case highlights that even in the setting of an acute retinitis in an immunocompetent patient with recent history of viral systemic illness, a high index of suspicion of a fungal (rather than viral) infection should be kept in mind.
ABSTRACT
Introduction: Nasal surgeries like septoplasty, polypectomyand laryngeal surgeries for removal of vocal nodule, cysts etcare commonly performed. Changes in haemodynamics due tolaryngoscopy and endotracheal intubation are likely to persistduring these procedures. These surgeries also require bloodless field. The present study was conducted to evaluate andcompare the efficacy of oral metoprolol tartrate versus oralivabradine versus placebo in attenuation of haemodynamicresponses during laryngoscopy, tracheal intubation andthroughout nasal and laryngeal surgeries.Methods: This was a prospective, randomized, comparative,double blind study. . Patients were randomly allocated bysimple randomization into 3 groups having 30 patients in each.Neither the patient nor the investigator was aware, whichpatient is allocated into which group and were unaware of thedrug being administered as it was given to the patient by aperson not involved in the study. Data collections were carriedout by investigator in a double blind manner. All the patientswere explained about the anesthesia technique and writteninformed consent was taken. Group 1: Oral Ivabradine 5mgtablet was given orally 2 hours before induction of anaesthesia.Group 2: Oral Metoprolol tartrate 50mg tablet was given orally2 hours before induction of anaesthesia. Group 3: Oral placebowas given 2 hours before induction of anaesthesia.Results and Conclusion: We concluded that both the drugscan be used as an effective premedication, to attenuate thesympathetic response to laryngoscopy, endotrachealintubation, extubation and throughout nasal and laryngealsurgeries. However Metopolol was found to have better controlthan Ivabradine in maintaining the vitals at all points andproviding a good hypotensive effect than ivabradine.
ABSTRACT
Fungal endogenous endophthalmitis (EE) secondary to contaminated intravenous fluid infusion is frequently seen in developing countries. Molds and yeasts are commonly implicated as the causative agents. Dematiaceous fungi such as Lecythophora have been linked to exogenous endophthalmitis but have never been reported to cause EE. We report a case of Lecythophora EE that was successfully managed with pars plana vitrectomy along with intravitreal and systemic voriconazole. Endogenous endophthalmitis (EE) is a potentially devastating intraocular infection caused by intraocular spread of pathogens through blood stream. It generally accounts for 2%�% of all reported endophthalmitis cases.[1] Predisposing risk factors include diabetes mellitus, malignancies, intravenous drug use, organ abscess, immunosuppressive therapy, indwelling catheters, urinary tract infection, organ transplant, end-stage renal or liver disease, and endocarditis.[2] It may occur in patients with no overt signs of systemic infection, particularly in the setting of contaminated intravenous fluid infusion in a rural setting.[3] Among the three broad categories of pathogens responsible for EE-bacteria, yeast, and molds, cases caused by molds are most infrequent and have the worst outcomes.[4] While Candida and Aspergillus are the most common species among fungal causes of EE, Lecythophora has been rarely reported as a cause of endophthalmitis due to exogenous causes.[5],[6],[7],[8] We, herein, report a case of EE caused by Lecythophora species.
ABSTRACT
BACKGROUND: Primary gastrointestinal system malignancies constitute approximately 2% of pediatric neoplasm and of these; colorectal carcinoma is the second most common malignancy. This is one of the rarer diseases in children. AIM: We reviewed our records to study the clinical features, outcome and the follow-up of this condition with evaluation of the prognostic factors. SETTINGS AND DESIGN: Tertiary care Pediatric Surgery centre. Retrospective study. MATERIALS AND METHODS: The data of all patients with diagnosis of colorectal carcinoma from January 1986 to January 2006 were reviewed. The confirmation of the diagnosis was by biopsy from the lesion. The age, sex, family history, clinical features, response to the treatment and follow-up were studied. RESULTS: There were four male patients. All had bleeding per rectum as the presenting complaint. Three patients had advanced disease at presentation. All the patients had signet cell adenocarcinoma. The two patients expired and one was lost to follow-up. One patient is alive after one year of follow up and is receiving treatment. CONCLUSION: Colorectal cancer in children though rare can be a reality, hence any children presenting with pain in abdomen along with doubtful history of constipation and rectal bleeding should be examined carefully with special emphasis on digital rectal examination.