Extended focal length intraocular lens implantation in posttraumatic posterior capsular rupture

We present a case of posterior capsular defect with traumatic cataract after blunt trauma in which an extended focal length intraocular lens (IOL) was implanted in the bag after conventional phacoemulsification and anterior vitrectomy. Anterior segment optical coherence tomography performed preoperatively aided in the confirmation and documentation of the capsular integrity. Intraoperative trocar anterior chamber (AC) maintainer allowed AC maintenance without further complications. IOL was well centered postoperatively at 6 months, and the unaided visual acuity was 20/20 for distance and N8 for near. The report showed that an extended depth of focus IOL can be placed in eyes with ruptured posterior capsule for good visual outcome in posttraumatic young eyes and it may not be considered as a relative contraindication for it.

Ameliorative potential of gallic acid on the activation of ROS and down-regulation of antioxidant enzymes in cardiac tissue of rats infused with advanced glycation end products.

Advanced glycation end-products (AGEs) are implicated in the pathogenesis of diabetic complications including cardiac dysfunction and heart failure. We aimed to investigate the effects of circulatory AGEs on the oxidative stress parameters in the rat hearts, and also to examine the protective role of gallic acid (GA) in attenuating the AGEs-induced oxidative stress. The experimental Wistar rats were infused with in vitro synthesized rat serum albuminderived AGEs intravenously at a dose of 50mg/kg/day, for 30 days with or without GA. The control animals received equal amount of unmodified rat serum albumin (RSA) intravenously for 30 days. The rats treated with AGEs alone exhibited increased plasma levels of creatine kinase (CK) (p<0.01), and lactate dehydrogenese (LDH) (p<0.001), when compared with controls. In parallel, a significant increase in the levels of the oxidative stress makers lipid peroxides (LPO) (p<0.001), and protein carbonyls (PCO) (p<0.01) were found in AGEs-RSA infused rat hearts compared with control rat hearts. The antioxidant enzymes analysis revealed a significant decrease (p<0.01, respectively) in the activities of superoxide dismutase (SOD) and catalase (CAT) in AGEs-RSA infused rat hearts compared with control rat hearts. Gallic acid co-treatments (administered oral gavage daily at a dose of 25 mg/kg) normalized the decreased levels of antioxidant enzymes in the cardiac tissue on AGEs infusion. The results of the present study provide in vivo evidence that the circulating AGEs induce oxidative stress in the heart, and GA attenuates AGEs-mediated cardiotoxicity.

Evidence-based National Vaccine Policy.

India has over a century old tradition of development and production of vaccines. The Government rightly adopted self-sufficiency in vaccine production and self-reliance in vaccine technology as its policy objectives in 1986. However, in the absence of a full-fledged vaccine policy, there have been concerns related to demand and supply, manufacture vs. import, role of public and private sectors, choice of vaccines, new and combination vaccines, universal vs. selective vaccination, routine immunization vs. special drives, cost-benefit aspects, regulatory issues, logistics etc. The need for a comprehensive and evidence based vaccine policy that enables informed decisions on all these aspects from the public health point of view brought together doctors, scientists, policy analysts, lawyers and civil society representatives to formulate this policy paper for the consideration of the Government. This paper evolved out of the first ever ICMR-NISTADS national brainstorming workshop on vaccine policy held during 4-5 June, 2009 in New Delhi, and subsequent discussions over email for several weeks, before being adopted unanimously in the present form.

Controversies in BCG immunization.

Despite controversies BCG vaccination has stood the test of time. World Health Organization continues to recommend its use in infant immunization programme in countries with heavy endemicity and where threatening HIV epidemic in an emerging problem > 85% efficacy have been established in recent years against hematogenous spread of the disease and > or = 50% efficacy even against pulmonary tuberculosis. Host related factors, agent related factors, vaccine related factors and inadequacy of evaluation tests determine the BCG vaccine efficacy. Identification of complete BCG genome in 1998 has opened new vistas in newer BCG vaccine development. Adoption of a '5C' concept viz. Case detection, Chemotherapy short course, Contact elimination, Chemoprophylaxis and lastly control in BCG vaccine will be a desirable national approach in combating adult and childhood TB.