Effect of dacryocystorhinostomy on systemic adverse effects of topical timolol maleate.

Purpose: To evaluate whether transformation of the naso-lacrimal passage as happens after dacryocystorhinostomy (DCR) operation has any effect on the systemic adverse effects of topically administered timolol maleate. Materials and Methods: Fifty otherwise healthy adult patients without any prior history of cardiac or pulmonary problems scheduled for elective DCR surgery received a drop of timolol maleate 0.5% on the healthy eye. This eye served as a control. Six weeks after successful DCR surgery, the operated eye received the same medication. Parameters compared included intraocular pressure (IOP), pulse rate, blood pressure and forced expiratory volume in the first second (FEV1) findings. Observations: Post DCR patients showed an increased incidence of reduced pulse rate and FEV1. Conclusion: Timolol maleate ophthalmic preparation should be used with caution in post-DCR patients.

Original research paper a study of rational use of drugs among the ophthalmic-in-patients of a government teaching hospital in view of forensic pharmacology.

Inappropriate, irrational and cost-ineffective practices of pharmaceuticals are worldwide phenomena. A retrospective study was conducted among the Ophthalmic-in-patients to investigate the nature of utilization of drugs in respect of rationality correlating the clinical and forensic pharmacology. Prescriptions in the Bed Head Tickets were the study samples which were analyzed according to the WHO/INRUD Indicators. Incurred cost per day per prescription was calculated. Commonly prescribed drugs were also studied. Result revealed that proportion of drugs from Essential Medicines List (EML) was 51.62%, while 54.05% was prescribed by generic names. Most commonly prescribed drugs were antibiotics (100%), analgesic-anti-inflammatory agents (100%) and mydriatic-cycloplegic agents (91.98%). Average number of drugs per prescription was 4.03±1.5 and average cost per day per prescription was 99.22 INR (Indian Rupees). Injectables were prescribed in 97.36% cases, and 10.81% of total drugs (37) prescribed. Prescribing practices were not always in accordance with the WHO criteria for rational use of drugs. It is suggested that there is a felt need to provide more inputs to the Ophthalmologists to promote rational use of drugs.

Animal study of silicosis in respect of morbidity and mortality.

Silica activates release of biochemical substances in lungs. To evaluate duration dependent toxic effects of silica by biochemical changes in Broncho Alveolar Lavage Fluid (BALF) and by post-mortem findings we developed a series of rat silicosis. Based on duration of exposures, single intratracheal injection of quartz dust in saline to acute models (n=3) and inhalation of quartz dust with air to chronic models (n=3) were administered. Control rats received vehicle only. Group wise BALF was collected on completion of exposure periods. Post-mortem examination was performed. Protein, hydroxyproline, elastase and Elastase Inhibitory Capacity (EIC) in BALF were measured. Post-mortem examination revealed progressive fibro-nodular changes in lungs. Biochemical parameters excepting EIC in both models showed significant (p< 0.001) gradual rise. Duration dependent biochemical changes in BALF due to silica were found responsible for progressive morbidity and may be considered as early markers for diagnosis, thereby, preventing increasing morbidity and death.

A case of unusual presentation of Takayasu's arteritis.

Takayasu's arteritis is a chronic inflammatory disease of the large and medium-sized arteries. It commonly involves the aorta with its branches and the pulmonary arteries. The retinal hemodynamics suggest that the carotid artery involvement causes diminished retinal blood flow. This is the pathogenetic mechanism of Takayasu's retinopathy with characteristic features of microaneurysms, arterio-venous anastomosis and non-perfused retinal areas. Our case presented as branch retinal artery occlusion with collaterals and iris neovascularization. The branch retinal artery, a small retinal artery occlusion in our case is an unusual presenting feature of Takayasu's aorto-arteritis.

Conjunctival intra-epithelial neoplasia in a young Indian male with human immunodeficiency virus (HIV) infection.

Conjunctival intra-epithelial neoplasia is a disease of the elderly but recently this ocular surface tumour has been observed in younger age group specially who are serologically human immunodeficiency virus (HIV)-positive. Here a case of conjunctival intra-epithelial neoplasia of a 38-year-old male who was HIV-positive from Kolkata is reported. The patient presented with a growth at limbus in his left eye. Excision of the mass under local anaesthesia was done. Biopsy report confirmed conjunctival intra-epithelial neoplasia. The serological tests for HIV were found positive.

Review of ocular leprosy.

Leprosy, a chronic infectious disease caused by Mycobacterium leprae, affects peripheral nerves and skin. Eye is also frequently affected, partial or total loss of vision is especially tragic in leprosy. But ocular leprosy is still neglected by the leprosy workers due to lack of knowledge, and is also often overlooked even by the ophthalmologists. Here, an update review of ocular leprosy has been attempted regarding its epidemiology, clinical features, pathology, management and prevention under one umbrella.