Star CanVac-continuous curvilinear capsulorhexis - A novel, safe rhexis technique in intumescent total cataracts

Achieving a complete uniform capsulorhexis in an intumescent cataract is perhaps the most crucial and challenging step for surgeons. Star CanVac CCC is a new manual technique for creating a continuous curvilinear capsulorhexis (CCC) in intumescent total cataracts. Small centripetal tears in the shape of a star are created in the center of the anterior lens capsule by using a 26?G cystotome. This allows equal distribution of forces secondary to increased intralenticular pressure, thereby avoiding unidirectional or bidirectional tear extension. Subsequently, a 25?G flat?tipped fine cannula connected to a syringe is used to hold the free capsular flap. The piston of the syringe is withdrawn to create a stable suction pressure, and the rhexis is completed without withdrawing the instrument from the anterior chamber. Our technique is safe, affordable, and an alternative method to routine CCC or expensive techniques such as Femto or Zepto capsulotomy for white intumescent cataracts.

Thyroid disorders in patients with abnormal uterine bleeding in tertiary care hospital in Chengalpattu district

Background: A relationship between the thyroid gland and the gonads is suggested by far more frequent occurrence of thyroid disorders in women than in men by clinical appearance of goiter during pregnancy, puberty, and menopause. Aim of this study was to determine the association between menstrual irregularities and thyroid dysfunction. To analyse the pattern of menstrual dysfunction among women with a thyroid disorder.Methods: This cross-sectional study was done in Karpaga Vinayaga Institute of Medical Sciences and Research Center - obstetrics and gynecology OPD. Over 6 months in the year 2019. 100 women who presented with abnormal uterine bleeding with the below exclusion criteria. Detailed history taking with an emphasis on age, parity, infertility, and menstrual disorders. Evaluation by pelvic examination along with the general physical examination of those with menstrual complaints. Routine investigations like Hb, BT, CT, TLC, DLC, platelet count, and ABO-Rh in all. Then all patients were subjected to estimation of serum T3, T4, TSH with early morning samples.Results: Menorrhagia presents in 39.4% of patients in the normal cohort and 63.6% in the thyroid dysfunction cohort. Hypomenorrhea presents in 4% normal cohort and 9.1% thyroid dysfunction cohort. Hypothyroidism presents in 7.27%, subclinical hypothyroidism in 1.81%, and hyperthyroidism in 0.92% of patients. Amenorrhoea presents in 16.2% of patients of the normal cohort and 9.1% of patients of thyroid dysfunction cohort. No statistical significance between amenorrhoea and thyroid dysfunction.32.3% in the normal cohort and 36.4% in thyroid dysfunction cohort had a bulky uterus. No statistical association exists between thyroid dysfunction and uterine size. In a histopathological examination of the endometrium, 49.5% in the normal cohort and 54.5% thyroid dysfunction cohort reported as proliferative endometrium. Amenorrhoea; the significant association between abnormal uterine bleeding and thyroid disorder (10%).Conclusions: The significant association between abnormal uterine bleeding and thyroid disorder (10%). It brings into focus the increased incidence of hypothyroidism among women with menorrhagia.

Histopathological Study of Skin Adnexal Tumors – A Ten Years Study

Background: Adnexal tumors of skin are uncommon in routine practice and may cause diagnostic problems clinically. Presence of Multiple tumors can be considered as marker for visceral malignancy e.g. multiple trichilemmoma-breast malignancy. Adenexal tumors of the skin are classified into four groups. Aim: To correlate skin adenexal tumors with age, sex and location and incidence in the Department of Pathology, Gandhi Hospital, Hyderabad. Materials and methods: Total number of cases was 136, during study period from April 2007 to March 2017 (ten years) in present study. All slides stained with routine Hematoxylin and Eosin and special stains accordingly. Results: Total number of Adenexal tumors were 136; benign tumors were 134 (98.4%), malignant tumors were 02 (1.6%), Largest group was sweat gland tumors (42.1%) e.g. chondroid syringoma, eccrine poroma, syringo cystadenoma papilleferum, hair follicle tumors (35.4%) e.g. trichoepithelioma, pilomatricoma and sebaceous adenoma and sebaceous carcinoma. Undifferentiated and others (21%) e.g. benign trichogenic tumors were also noted. Conclusion: The incidence of benign skin adenexal tumors was more as compared with the malignant tumors. Malignant tumors were seen predominantly in elderly

Clinical, Cytological and Histopathological Correlation of Oral Mucosal Changes in Gutka Chewers – A Prospective Study

Background: Gutka chewing is the most and popular form of smokeless tobacco use in India. Epidemiological studies showed a strong association between smokeless tobacco use and oral precancerous lesions, carcinoma and other oral mucosal lesions. Aim and objectives: To know the patterns of clinical and pathological manifestations of oral mucosal lesions in Gutka chewers (patients) attending out-patient department of oral Medicine and Radiology at Govt. Dental college/ Hospital, Hyderabad, To assess the efficacy of the oral brush cytology in the detection of precancer and cancerous conditions of the buccal mucosa. Materials and methods: Oral mucosal lesions diagnosed in patients of both sexes with Gutka chewing habit were taken at Dept. of Oral Medicine and Radiology, Govt. Dental College, Hyderabad. Total 800 cases were studied from 2006 to 2017 (10 years study), Oral Brush cytology Procedure with papanicolaou staining procedure was used. Brush cytology results were divided into 3 groups: Negative brush cytology (normal or inflammatory smear), Positive brush cytology (Dysplasia positive smear), Atypical brush biopsy (Suspicious smear). Results: Out of 800 patients, males (80%) outnumbered females. Total no of controls 2246 with 51% were males. 75% were below 30 years of age. Higher percentage of cases (60%) belonged to the P. Ram Mohan, Lakshmi Narayana, G. Sai Sowmya, Tamilarasi. Clinical, Cytological and Histopathological Correlation of Oral Mucosal Changes in Gutka Chewers - A Prospective Study. IAIM, 2018; 5(11): 70-76. Page 71 lower socio economic groups. Clinical diagnosis of sub mucosal fibrosis and carcinoma corresponding to histopathological confirmation is almost 100%. Conclusion: Oral brush cytology is useful in early detection of precancerous and cancerous conditions of the oral cavity lesions in Gutka chewers

Diversity of root associated microorganisms of selected medicinal plants and influence of rhizomicroorganisms on the antimicrobial property of Coriandrum sativum.

The total heterotrophic bacteria, actinomycetes and fungus were enumerated from the rhizosphere and non-rhizosphere soil of 50 selected locally available medicinal plants in and around Bharathiar University. In all the plants, population of microorganism were higher in the rhizosphere soil than in the non rhizosphere soil. Among the microorganisms, bacterial population was higher in number followed by fungus and actinomycetes. Of the medicinal plants, the maximum rhizosphere effect was observed in Annona squamosa and the minimum effect was seen in Eclipta alba and Cassia auriculata. Among the bacteria the dominant species was Bacillus followed by Pseudomonas, Enterobacter, Corynebacterium, Micrococcus and Serratia. The Streptomyces species was found to be dominant followed by Deuteromycetes and Frankia among the actinomycetes. Among the fungal isolates Rhizopus was found to be higher in number followed by Aspergillus, Penicillium, Mucor and Fusarium. About 70.96% of the bacterial isolates were found to be nitrate reducers and 90.60% of the bacteria solubilised phosphate. The rhizosphere bacterial isolates were also capable of hydrolyzing starch, cellulose, casein, urea and gelatin. The isolates of bacteria, actinomycetes and fungus were also able to produce phytohormone Indole-3-acetic acid (IAA). The maximum IAA production was recorded by Fusarium sp (5.8 mg/l). The rhizosphere bacterial isolates showed resistance to 14 commercially used antibiotics. In an attempt to check the influence of these plant growth promoting microorganisms on the antimicrobial property of Coriandrum sativum against Escherichia coli MTCC-443 and Aeromonas hydrophila MTCC-646, the results observed was not encouraging since the inoculants did not influence the antibacterial property. However extensive and in depth study is required to find out the influence of rhizomicroorganisms on the antibacterial property of medicinal plants. The other results clearly indicated that the rhizosphere microorganisms could be exploited for its innumerable properties and active metabolites.

Pre-tertiary hospital care of patients with chronic kidney disease in India.

BACKGROUND & OBJECTIVES: There is paucity of data available on how chronic kidney disease (CKD) is treated before referral to a tertiary hospital. This study was conducted to assess pre-tertiary hospital care of patients with CKD 5 at their presentation to nephrology services at a tertiary care hospital. METHODS: Over a period of 8 months, consecutive patients with CKD 5 presenting at the Nephrology services at Christian Medical College, Vellore, Tamil Nadu, and their relatives were interviewed to assess the pre-tertiary hospital care and knowledge about CKD 5 and its treatment. RESULTS: A total of 561 patients with CKD 5 were enrolled. The mean duration (months) of known CKD was 12.4 +/- 23.1 and known CKD 5 was 3.2 +/- 3.5. Of these, 369 patients (65.8%) had been under the care of a nephrologist; 305 patients had CKD 5 as the initial presentation of renal illness. Vaccination against hepatitis B had been initiated in only 133 patients (23.7%). Only 172 patients(38%) had an adequately controlled blood pressure. Care under a nephrologist was more likely to result in appropriate investigation, treatment and patient education though blood pressure control did not differ. INTERPRETATION & CONCLUSION: Paucity of symptoms in the initial stages of certain forms of CKD probably led to 50 per cent of patients presenting with CKD 5 as the initial presentation of renal disease. Inadequate vaccination against hepatitis B infection highlights the need for appropriate vaccination. Prevention of CKD and its progression are important targets which requires physician awareness at all levels. Early referral to a nephrologist's care is more likely to result in appropriate investigations and treatment.