Study-of-phacoemulsification-vs-phacotrabeculectomy-in-management-of-primary-angle-closure-glaucoma

Introduction: The study was conducted to evaluate IOP management by surgical modalities such as combined trabeculectomy and phacoemulsification and phacoemulsification surgery alone. Vision impairment is a major public health problem and the burden is increasing with increase in aged population. This study wasAims And Objectives: undertaken for study the IOP management by surgical modalities such as combined trabeculectomy and phacoemulsification and phacoemulsification surgery alone. A pre-designed prospective study was conducted at the OPD of upgraded Department of Ophthalmology at LLRM Medical College, Meerut. A total of 60 patients were divided in to two equal groups randomly and studied. Majority of the patients in both the groups wereObservation And Result: aged between 61 – 70 years. Females outnumbered males in this study which was statistically significant between the two groups. The mean pre- operative intra ocular pressure was 23.3 mm Hg in combined surgery group and 23.9 mm Hg in cataract surgery alone group. Mean Intra ocular pressure decreased regularly in each follow up more in combined group than the cataract surgery alone group. The mean intra ocular pressure after 1 years follow up in combined surgery group was 10.8 mm Hg and 13.4 mm Hg in the cataract surgery alone groups which was statistically significant. Mean BCVA before the operation was 3.2 in combined surgery group and 3.8 in cataract surgery before surgery. Mean BCVA declined after 1 year of follow up in combined surgery group was 1.9 and 2.7 in cataract surgery alone group which was statistically significant. The surgery success was complete in 80.0% of the combined surgery group and 60% of the cataract alone group. Criteria For Failure Of Surgeries Ÿ The IOP >23 MMHG at the end of 1 year or Ÿ The IOP not reduced by 20 % from base line at the end of 1 year Conclusion: This study was mainly undertaken to study the efficacy of combined trabeculectomy with cataract extraction and cataract only on primary angle closure glaucoma. This study had found that, the reduction of intra ocular pressure in both the groups but more prominent in combined surgery group than cataract alone surgery group.

Intraoperative Floppy Iris Syndrome in patients on alpha 1 blocker tamsulosin: incidence and predictability

Background: Intraoperative Floppy Iris Syndrome (IFIS) was first described by Chang and Campbell in year 2005 in male patients undergoing phacoemulsification surgery who were on Tamsulosin, an alpha 1 blocker drug for their urinary symptoms for enlarged prostate. This condition was characterized by excessive floppiness of iris, prolapse of iris tissue through phaco and sideport incisions and progressive intraoperative miosis, resulting in increased surgical time and various major surgical complications compromising visual outcome.Methods: This study of 78 patients was undertaken to know the incidence and severity of IFIS as well as to predict its occurrence by observing maximum pupil dilation achieved preoperatively.Results: It was observed that majority of patients on tamsulosin dilated poorly and severe IFIS occurred in those with pupil dilation of 5 mm or less after putting mydriatic eye drops preoperatively.Conclusions: It was concluded that if IFIS was predicted and necessary precautions taken, postoperative complications can be reduced significantly with improved visual outcome.

Comparison of obstetric outcomes with use of two different standard doses of oxytocin for induction of labor

Background: The interventions used in a suspected abnormal labor include amniotomy (artificial rupture of membranes), oxytocin infusion, forceps application and caesarean section. No study is available for individualised treatment with oxytocin. Considering the literature review, many unanswered questions remain regarding the use of oxytocin and definite improvements are possible. All this led us to choose this as the topic for study.Methods: This study was conducted over a duration of 18 months (January 2017 to June 2018) where ninety (90) laboring patients admitted in a tertiary care hospital were included. They were categorized into two groups, one group (30 patients) received the low dose and the other group (60 patients) received high dose oxytocin infusions. The labor outcomes including the maternal and fetal outcomes were observed.Results: The average age in the study population was 26 years and the average gestation was 38 weeks. The overall rate of cesarean section in this study was 16.67% (23.33% in the low dose group and 13.33% in the high dose group). Gravidity and parity have an association with the vaginal delivery.Conclusions: It is safe to use oxytocin infusion either in the low dose or the high dose for induction of labor as both the regimens are equally effective and comparable in terms of outcomes. The low dose oxytocin regimen can be safely recommended in a patient requiring oxytocin infusion for induction of labor and the treating doctor should consider starting with low dose oxytocin.

Translin: A multifunctional protein involved in nucleic acid metabolism

Translin, a highly conserved, DNA/RNA binding protein, is abundantly expressed in brain, testis and in certain malignancies. It was discovered initially in the quest to find proteins that bind to alternating polypurines-polypyrimidines repeats.It has been implicated to have a role in RNA metabolism (tRNA processing, RNAi, RNA transport, etc.), transcription,DNA damage response, etc. Studies from human, mice, drosophila and yeast have revealed that it forms an octameric ring,which is important for its function. Translin is a cytoplasmic protein, but under genotoxic stress, it migrates into thenucleus, binds to the break point hot spots and therefore, thought to be involved in chromosomal translocation events aswell as DNA damage related response. Its structure is known and DNA binding regions, GTP binding region and regionsresponsible for homotypic and heterotypic interaction are known. It forms a ball like structure with open central channel foraccommodating the substrate nucleic acids. Besides this, translin protein binds to 30 and 50 UTR of certain mRNAs andprobably regulates their availability for translation. It is also involved in mRNA transport and cell cycle progression. Itforms a heteromeric complex with translin associated factor-X (TRAX) to form C3PO complex which is involved in RNAsilencing process. Recently, it has been shown that translin is upregulated under starvation conditions in Drosophila and isinvolved in the integration of sleep and metabolic rate of the flies. Earlier studies classified translin as a DNA repair protein;however subsequent studies showed that it is a multifunctional protein. With this background, in this review we havesummarized the translin biochemical activities, cellular function as well as structural properties of this important protein.

Effect of duration of pre-operative admission on surgical site infection in major abdominal surgeries: an observational study

Background: Surgical site infection (SSI) are second most common cause of mortality in surgical patient, situation has been further complicated by emergence of drug resistant strains. The importance of preventing surgical site infections is well recognized since they lead to increased morbidity, prolonged hospital stays, need for readmission, high end antibiotic treatment and re-surgery. The study was done to see if   incidence of SSI is decreased with decreased pre-operative admission time. Others factors associated with SSI were analysed including the microbiological spectrum.Methods: The study was an analytical, observational, case control study. Sixty (60) cases each of gynaecology and obstetrical post-operative patients who developed SSI within 30 days were taken as cases and who did not develop SSI were taken as controls and preoperative admission time was analysed in both cases and controls to observe if risk of surgical site infections decreases due to decreased exposure to nosocomial pathogens when the pre-operative admission time was less than 48 hours.Results: Author found that there was statistically significant difference in the time between surgery and admission in the gynaecological surgeries with p value 0.023, as compared to the obstetrics surgeries where there was no statistically significant difference. Common organism isolated was E. coli sensitive to gentamicin.Conclusions: From this study, it seems to be a good policy to evaluate the patient on OPD basis and admit them about 24 to 48 hours prior to the surgery rather them keeping them admitted for prolonged duration in wards for diagnostic evaluation. This prevents nosocomial contamination in the patient’s skin flora thereby preventing SSI. This practice not only conserves the hospital resources but also makes the patient turn over faster. Further this might in the long run reduce the antibiotic resistant hospital flora.

Cornu Cutaneum on the Penis-A Case Report.

A 60-years-old male presented with a cornu cutaneum (cutaneous horn) on the penis. Histopathology showed a well differentiated squamous cell carcinoma. Majority of the lesions at the base of the keratin mound are benign. The incidence of malignancy increases in cornu cutaneum of the penis with squamous cell carcinoma being the most common type.

Prophylactic efficacy of combination of DRDE-07 and its analogues with amifostine against sulphur mustard induced systemic toxicity.

Sulphur mustard, [bis (2-chloroethyl)] sulphide (SM), is a bifunctional alkylating agent. SM forms sulphonium ion in the body which alkylates DNA and several other macromolecules, and induces oxidative stress. Although several antidotes have been screened for the treatment of systemic toxicity of SM in experimental animals none of them are recommended so far. In the search for more effective and less toxic antidotes, various combinations were tried against SM induced toxicity and skin lesions. SM exposed through percutaneous route was used to evaluate the prophylactic efficacy of various combinations. Low dose of DRDE-07 (S-2(2-aminoethylamino) ethyl phenyl sulphide), DRDE-30 [S-2(2-aminoethyl amino) ethyl propyl sulphide], DRDE-35 [S-2(2-aminoethyl amino) ethyl butyl sulphide] with amifostine combinations, were given orally 30 min prior to SM exposure. Significant depletion was observed in body weight, organ body weight index and hepatic GSH and GSSG content in mice after SM exposure. Pretreatment with low dose of different combinations of DRDE-07, DRDE-30 and DRDE-35 with amifostine could recover biochemical alterations and histopathological changes caused by SM exposures.

Infrared spectroscopic analysis of tumor pathology.

Infrared spectra of normal and malignant breast tissues were measured in the 600 cm(-1) to 4000 cm(-1) region. The measured spectroscopic features which are the spectroscopic fingerprints of the tissues contain the vital information about the malignant and normal tissues. Fourier Transform Infrared (FTIR) data on 25 cases of infiterating ductal carcinoma of breast with different grades of malignancy from patients of different age groups were analyzed. The samples were taken from the tumor sections of the tissue removed during surgery. Infrared spectra demonstrate significant spectral differences between the normal and the cancerous breast tissues. In particular changes in frequency and intensity in the spectra of protein, nucleic acid and glycogen vibrational modes as well as the band intensity ratios for lipid/proteins, protein/nucleic acids, protein/glycogen were observed. This allows to make a qualitative and semi quantitative evaluation of the changes in proliferation activity from normal to diseased tissue. It was evident that the sample to sample or patient to patient variations were small and the spectral differences between normal and diseased tissues were reproducible. The findings establish a framework for additional studies, which may enable us to establish a relation of the diseased state with its infrared spectra.