Three unusual cases of parasites in eye

A 17-year-old male patient presented with cellulitis and mass in the eye noticed approximately 3 months back. The mass was about 1 cm in size and situated at the limbus. All preoperative routine investigations were normal. Surgical exploration revealed a sub-conjunctival cystic mass near the lateral rectus muscle about 1 cm in diameter; the mass was excised. Gross pathological examination revealed a thin-walled cystic mass. There was a hard nodule in the center. Microscopy revealed a wall of cysticercosis. Scolex was also seen. Surrounding tissue revealed sparse acute and chronic inflammatory cells. The case was confirmed by CDC, Atlanta, and was also included in their departmental presentation as an interesting case. A 60-year-old lady presented with complaints of itching over the forehead and right eye for 5 days. She was prescribed steroid eyedrops and antihistaminics. The itching aggravated with eyedrops along with watering and foreign body sensation. On revisit, the ophthalmologist noticed a worm in the right upper subconjunctival space. The worm was carefully removed in toto and sent to the laboratory for identification. The worm was thin, cylindrical, 8–10 cm long and white in color. After microscopic and gross examination of the worm, it was identified as Dirofilaria spp. CDC (Atlanta) confirmed the diagnosis of Dirofilaria. The patient was treated with antihistaminics and was relieved of symptoms without recurrence. A 45-year-old male patient had a painless mass in the eye for the last 3 months. He had no systemic illness. He gave a history of swimming pool use during that time. The mass was excised and submitted for histopathology. Numerous globular cysts representing thick-walled sporangia containing numerous spores diagnostic of Rhinosporidiosis were seen.

MRI imaging of ulnar leprosy abscess.

Leprosy is a chronic granulomatous infection, caused by mycobacterium leprae, primarily affecting the peripheral nerve trunks and cutaneous nerves. It classically presents with neural or dermal signs and symptoms. The indolent course of leprosy may manifest as erythema nodosum (appearance of tender inflamed subcutaneous nodule) and reversal reaction (inflammation in the previous skin lesion, appearance of new skin lesions, neuritis and abscess). Ulnar nerve is most commonly involved. This report illustrates the MR imaging appearance of ulnar nerve abscess. ©

Burden of morbidities and the unmet need for health care in rural neonates--a prospective observational study in Gadchiroli, India.

BACKGROUND: Majority of the neonates in developing countries are born and cared for in rural homes but the available information is mostly hospital based. OBJECTIVES: To estimate: (i) the incidence of various neonatal morbidities and associated case fatality in home-cared rural neonates, (ii) proportion of neonates with indications for health care, and (iii) the proportion who actually receive it. DESIGN: Prospective observational study. SETTING: Rural homes. METHODS: Neonates in 39 study villages in the Gadchiroli district (Maharashtra, India) were observed during one year (1995-96) by 39 trained female village health workers at birth and during neonatal period (0-28 days) by making eight home visits. A physician checked the data and the morbidities were diagnosed by a computer program. Vital statistics in these villages was independently collected. RESULTS: Out of 1016 live births, 95% occurred at home and 763 (75&%) neonates were observed. The agreement between observations by health workers and physician was 92%. Total 48.2& neonates suffered high risk morbidities (associated case fatality >10%), 72.2% suffered low risk morbidities, and 17.9% gained inadequate weight (less than 300 g). Seventeen percent neonates developed clinical picture suggestive of sepsis. Though 54.4% neonates had indications for health care and 38 out of total 40 neonatal deaths occurred in these, only 2.6% received medical attention. The neonatal mortality rate was 52.4/1000 live births. CONCLUSION: Nearly half of the neonates in rural homes developed high risk morbidities ten times the neonatal morbidity rate and needed health care but practically none received it. The magnitude of care gap suggests an urgent need for developing home-based neonatal care to reduce neonatal morbidities and mortality

Significance of HBV DNA by PCR over serological markers of HBV in acute and chronic patients.

A study was undertaken to determine Hepatitis B virus DNA (HBV DNA) by PCR in acute and chronic hepatitis B infection and to correlate it with serological markers. Three hundred and forty-five serum samples of patients from all over India were categorized into different groups according to their serological profile. HBV DNA was detected upon amplification in 166/263 patients in group A, 3/14 patients in group B, and 2/32 patients in group C, and was not detected in groups D and E. The presence of HBV DNA in 49 patients with non-replicative HBV disease, as defined by the absence of HBeAg, suggests low levels of viremia which is also supported by the abnormal liver function tests (LFTs) in these patients. In addition, HBV DNA was detected in small proportion of individuals with past HBV infection. This data suggests that, detection of HBV DNA by amplification technique serves as an important supplementary tool besides serology in a number of clinical settings, especially in determining low levels of viremia in patients with non-replicative HBV disease and chronic hepatitis, and also in a few patients with past HBV infection and who could be asymptomatic carriers of HBV infection.