Coin-shaped epithelial lesions following an acute attack of erythema multiforme minor with confocal microscopy findings.

We report an interesting ocular finding of bilateral multiple coin-shaped epithelial lesions along with the confocal microscopy findings in a patient following an acute attack of erythema multiforme (EM) minor. A 30-year-old male presented with a history of watering and irritation in both eyes of three days duration. He was diagnosed to have EM minor and was on oral acyclovir. Slit-lamp examination revealed multiple coin-shaped epithelial lesions. Confocal microscopy showed a corresponding conglomerate of hyper-reflective epithelial lesions. The corneal lesions resolved over six weeks with oral steroids and acyclovir. An immunological mechanism is suspected.

A study of the efficacy of endoscopic cyclophotocoagulation for the treatment of refractory glaucomas.

BACKGROUND: Endoscopic cyclophotocoagulation (ECP) is a relatively new method of cyclodestruction which can be used in the management of refractory glaucomas. AIM: To evaluate the safety and efficacy of ECP in the management of refractory glaucomas. SETTINGS AND DESIGN: Prospective interventional non-comparative study. MATERIALS AND METHODS: Fifty eyes of 50 patients with refractory glaucoma, whose intraocular pressures (IOP) were not under control with maximal medical therapy underwent ECP, by the anterior, or pars plana route. IOP, best corrected visual acuity (BCVA), and the number of anti-glaucoma medications, were compared postoperatively to preoperative values. Success was defined as IOP pound 22 mmhg, with or without use of medications. STATISTICAL ANALYSIS USED: Student's t test and repeated measures ANOVA were used to evaluate change in IOP and Student's t test, for comparison of BCVA. Kaplan Meier survival curve was plotted. Wilcoxon signed rank test was used to evaluate reduction in medications. RESULTS: Patients were followed for an average of 12.27 months (3-21months). IOP decreased significantly from 32.58 +/- 9.16 mmHg to 13.96 +/- 7.71 mmHg at last follow-up ( P < 0.001, student's t test). BCVA was significantly improved in the postoperative period ( P < 0.001, student's t test). The average number of antiglaucoma medications decreased from 2.51 +/- 0.97 to 1.09 +/- 1.16 ( P < 0.001, Wilcoxon signed rank test). ECP had a success rate of 82.2%. CONCLUSION: Endoscopic cyclophotocoagulation is an effective procedure in this subset of refractory glaucomas.

In vivo confocal microscopy in different types of posterior polymorphous dystrophy.

Posterior polymorphous dystrophy is a rare corneal dystrophy, usually detected by chance. This case series describes the morphologic features in the three different types of posterior polymorphous dystrophy using confocal microscopy.

NK/T-cell lymphoma in AIDS.

A 42-year-old man diagnosed to be HIV positive and on highly active antiretroviral treatment (HAART), presented with double vision and gradual drooping of the left eyelid. He had left 3rd cranial nerve palsy and partial right lower-motor-neuron facial palsy. CT of the PNS revealed soft tissue filling the right maxillary sinus antruin. Further workup showed the mass to be an NK/T cell lymphoma.

Effect of Indian red scorpion (Mesobuthus tamulus concanesis, Pocock) venom on thyroxine and triiodothyronine in experimental acute myocarditis and its reversal by species specific antivenom.

Acute myocarditis was induced in dogs and rabbits by injection of scorpion (M. tamulus concanesis, earlier called Buthus tamulus) venom by s.c., i.m. or i.v. routes. A decrease in thyroxine (T4) levels was observed following i.v. injection of venom in dogs. In rabbits the venom (i.m.) did not elicit any change in T4 levels. Envenomation (s.c.) resulted in a reduction in triiodothyronine (T3) levels in dogs. Venom injection (s.c.) along with i.v. administration of the species specific antivenom (AScVS) did not cause any change in T3 and T4 levels in general. However an increase in T3 levels following AScVS was observed in envenomated dogs. The results suggest that scorpion envenomation caused an autonomic storm releasing massive amounts of catecholamines, angiotensin II, suppressed insulin secretion and reduced circulating T4 and T3 levels. Decrease in thyroid hormones results in fall in body temperature. Changes in the body temperature may increase the sensitivity of the scorpion venom and influence the course of toxicity.

Colour of the nucleus as a marker of nuclear hardness, diameter and central thickness.

Hundred and thirty patients, aged above 40 years, with senile cataract were examined. Age and colour were selected as the probable preoperative indicators of nuclear hardness. The lens material collected after manual extracapsular extraction was washed and the nucleus isolated. The diameter and central thickness of the nucleus were measured; the mean diameter and mean central thickness were 7.13 mm +/- 0.76 and 3.05 mm +/- 0.48, respectively. The hardness of the nucleus was measured with a lens guillotine designed by us. Regression analysis was applied to the parameters measured and these were compared with the colour and age. The parameters measured had the following relationship: Colour vs hardness (r value = 0.7569) (p < 0.001) Colour vs diameter (r value = 0.3962) (p < 0.001) Colour vs central thickness (r value = 0.4785) (p < 0.001) Age vs hardness (r value = -0.0499) (p > 0.05) Age vs diameter (r value = 0.0987) (p > 0.05) Age vs central thickness (r value = 0.1700) (p > 0.05) The values showed that colour had a statistically significant relationship with all the 3 parameters (p < 0.001), while age had no significant relationship with the same parameters. The results indicated that colour can be used more reliably to predict physical characteristics of the cataractous lens nucleus, the preoperative knowledge of which would help the surgeon in planning small-incision surgery including phacoemulsification.

Immunotherapy in allergic conjunctivitis.

Eighty patients with allergic conjunctivitis were treated with immunotherapy employing specific allergens. Sixty-two percent of these showed beneficial response. In cases of vernal conjunctivitis needing topical steroid preparations frequently for control of symptoms, immunotherapy is worth attempting to cause remission of symptoms.

Acute pancreatitis and reduction of H+ ion concentration in gastric secretions in experimental acute myocarditis produced by Indian red scorpion, Buthus tamulus, venom.

Crude venom (4 mg/kg) of scorpion (B. tamulus) was given in saline to anaesthetized dogs and rabbits. It produced a reduction in gastric H+ ion concentration in dogs with acute myocarditis. Simultaneously an increase in circulating amylase and lipase level was also observed. However 60% venom poisoned rabbits showed an elevated lipase level without a parallel increase in amylase. It is suggested that the venom acts directly on exocrine pancreas to cause acute pancreatitis.