Primary Mucosal Melanoma of Maxilla: A Case Report and Review of Literature.

Oral malignant melanomas are extremely rare lesions and occur commonly in the maxillary gingiva more frequently on the palate with fewer incidences in the mandibular gingiva. Malignant melanomas of oral cavity are extremely rare accounting for 0.2-8% of all malignant melanomas. A 51-year-old female reported a growth about left maxillary region with black pigmentation in anterior maxillary region and palatal region. Differential diagnosis of gingival hyperplasia, giant cell epulis, Kaposi’s sarcoma and malignant melanoma were kept. Histopathological sections showed sheets of pleomorphic spindle cells with intracytoplasmic Brown-black pigment, involving the lower part of the squamous epithelium. Tumor cells were positive for S-100 and a human melanoma black-45 immunostain, and a diagnosis of malignant melanoma was rendered. The patient underwent partial maxillectomy on left side and the case was categorized as Stages I level III. Complete excision with adequate negative margins is the treatment of choice. Malignant melanoma is relatively insensitive to radiation; hence, the role of radiotherapy is not well-defined. The tendency to invade and cause early hematogenous metastasis results in poor prognosis. The most common cause of treatment failure is Nodal involvement and multiple local recurrences.

The Chennai glaucoma study: Prevalence and risk factors for glaucoma in cataract operated eyes in urban Chennai.

We report the prevalence and risk factors for glaucoma among aphakes and pseudophakes in 3850 subjects who participated in a population-based study in urban south India. The subjects underwent an ophthalmic examination including applanation tonometry, gonioscopy, optic disc evaluation and frequency doubling perimetry. Glaucoma was diagnosed using the International Society of Geographical and Epidemiological Ophthalmology (ISGEO) criteria. Thirty eight, 15 aphakes and 23 pseudophakes (0.99% of 3850 subjects) of the 406 persons who had undergone cataract surgery were diagnosed with glaucoma. Aphakes/pseudophakes were at higher risk of glaucoma as compared to the phakic population (Odds Ratio: 2.71, 95% CI: 1. 94, 3.38, p=0.001). On multivariate analysis, older age and higher intra ocular pressure were risk factors for glaucoma. Blindness attributable to glaucoma was detected in 20% of aphakic and 4.3% of pseudophakic eyes. Glaucoma was a significant cause of morbidity in those who had undergone cataract surgery in this urban population.

Agreement between two Goldmann type applanation tonometers.

The aim of the study was to assess agreement between two commercially available applanation tonometers for the measurement of intraocular pressure (IOP). Forty subjects underwent IOP measurement on two accurately calibrated Goldmann type applanation tonometers (Zeiss AT 030 (GATZ) and Inami L-5110(GATI)). The order of examination was randomized and observers were masked to the IOP recorded. The mean of two consecutive readings, from a randomly selected eye for each subject, was used for analysis. Agreement was assessed using the Altman and Bland plot. The mean (SD) IOP readings on GATZ was 15.32 (+/-6.80) mm Hg and on GATI was 13.52 (+/-5.65) mm Hg (p< 0.001, 95% CI of the difference: -2.48 to -1.11). The 95% limits of agreement on the Altman and Bland plot were:-2.47 to 6.16 mm Hg). There was significant inter-instrument variability between the two accurately calibrated Goldmann type applanation tonometers studied.

A randomized, crossover, open label pilot study to evaluate the efficacy and safety of Xalatan in comparison with generic Latanoprost (Latoprost) in subjects with primary open angle glaucoma or ocular hypertension.

AIM: To compare the efficacy and tolerability of Xalatan with generic latanoprost (Latoprost) in subjects with primary open angle glaucoma (POAG) or ocular hypertension (OH). MATERIALS AND METHODS: This was a single-center, randomized, open label, crossover, two period comparative study. At the baseline visit, subjects were randomized to two groups. Group A received Xalatan for weeks 1-12 followed by Latoprost for weeks 13-24. Group B received Latoprost for weeks 1-12 followed by Xalatan for weeks 13-24. RESULTS: 30 subjects were recruited, 12 in Group A and 18 in Group B. In subjects administered Xalatan, intraocular pressure (IOP) showed a greater decrease (P < 0.001) from 23.64 +/- 3.13 mmHg at baseline to 14.29 +/- 1.61 mmHg at week 12 (fall of 9.35 +/- 3.55 mmHg, 38.66% +/- 10.29) than that seen in the Latoprost group (22.74 +/- 2.47 mmHg to 16.98 +/- 2.49 mmHg, fall of 5.76 +/- 1.41 mmHg; 25.42% +/- 5.98). In period 2 when subjects were crossed over to Xalatan from Latoprost, there was a further fall from 16.98 +/- 2.49 mmHg to 16.09 +/- 1.49 at week 24 (fall of 0.89 +/- 1.59 mmHg; 4.3% +/- 8.76). However, when subjects were crossed over to Latoprost from Xalatan, the IOP rose from 14.29 +/- 1.61 mmHg to 15.36 +/- 1.71 mmHg at week 24 (8.86% +/- 17.76). There was no significant difference in incidence of conjunctival hyperemia or any other adverse events in both the groups. CONCLUSION: The magnitude of IOP lowering in patients with POAG and OH with Xalatan and Latoprost is different. In our study, the IOP lowering with Xalatan was higher than that with Latoprost.

Efficacy and safety of latanoprost for glaucoma treatment: a three-month multicentric study in India.

PURPOSE: To evaluate the short-term efficacy and safety of 0.005% topical latanoprost in Indian eyes. DESIGN: Prospective non-randomised open-label multicentric trial. METHODS: One hundred and fifty patients with ocular hypertension (OHT), primary open-angle, pseudoexfoliation or pigmentary glaucoma were enrolled at four centers. Each center contributed at least 20 patients. Following baseline measurements, 0.005% latanoprost was applied topically once daily in the evening for three months. Patients were examined at 2, 6 and 12 weeks. The primary outcome measure was mean intraocular pressure (IOP) reduction. The mean diurnal variation of IOP (difference between highest and lowest IOP) at baseline and at 12-weeks was compared. RESULTS: One hundred and thirty of 150 enrolled patients completed the study. One randomly selected eye of each patient was included for analysis. At three months, latanoprost reduced the mean IOP from 24.9 (+/- 3.16) mmHg at baseline to 16.10 (+/- 2.7) mmHg, a reduction of 35.25%. 83% had a reduction in IOP of > 25%. The IOP reduction was maintained throughout the study period, and was not affected by gender or age of the patient. One eye did not show any response to the drug. Daytime diurnal variation of IOP was reduced from 4.5 to 2.9 mmHg. 20 patients had conjunctival hyperemia. Six patients had side effects requiring withdrawal from the study. CONCLUSIONS: In this short-term multicentric study, latanoprost effectively reduced IOP and stabilised the diurnal curve in Indian eyes. There were no clinically significant ocular or systemic adverse effects.