Results of fusional vergence therapy in managing consecutive esotropia: A case series

Purpose: To analyze the efficacy of fusional vergence therapy (FVT) in management of consecutive esotropia with diplopia after intermittent exotropia (IXT) surgery. The current study is carried on how FVT affects the duration of treatment, sensory fusion, and exotropic drift. Methods: This was a retrospective study for the medical record of 11 patients with consecutive esotropia after IXT surgery of 543 patients over the period of 5 year, with mean surgery age of 9.5 (range: 4–33 y). FVT was planned after minimum 6 weeks of surgery and was considered for maximum 24 weeks. Patients underwent a combination of office-based and home-based FVT. Successful outcome of therapy was considered where diplopia resolves in free space and achieves sensory fusion, stereopsis with no manifest deviation. Results: Record of 543 patients who had horizontal muscle surgery for IXT were identified and reviewed. Records of 11 patients who showed consecutive esotropia of 10 prism diopter (PD) or more with normal retinal correspondence, with or without diplopia complaint, after 6 week of surgery and had undergone vision therapy management were reviewed. A successful outcome of binocular single vision with good sensory and motor fusion with no manifest deviation or prism requirement was achieved with in the mean duration of 4.8 month of therapy. With a mean duration of 4 weeks of therapy, the mean angle of deviation reduced by 53% for distance (17 PD to 8 PD) and 27% for near (11 PD to 8 PD) and mean stereopsis improvement by 80% with 94% patients demonstrating sensory fusion on Bagolini test and 94% of patients having no symptoms of diplopia or squint. Conclusion: With nonsurgical management involving refractive error correction, FVT, and prism, consecutive esotropia was resolved in 74% cases. Management of consecutive esotropia with FVT can result in satisfactory sensory fusion and successful motor alignment.

Allium Cepa Root Chromosomal Aberration Assay: A Review.

Higher plants, an important material for genetic tests to monitor various pollutant present in the environment. Among the plant species, Alium cepa has been used to evaluate chromosome aberrations and disturbances in the mitotic cycle. Now days, it has been used to assess a great number of genotoxic/antigenotoxic agents, which contributes to its increasing application in environmental monitoring. The A. cepa is commonly used as a test organism because it is cheap, easily available and handled and has advantages over other short-term tests. Among the endpoints of A. cepa root chromosomal aberrations, detection of chromosomal aberration have been the most used one to detect genotoxicity/ antigenotoxicity along the years. The mitotic index and chromosomal abnormalities are used to evaluate genotoxicity and micronucleus analysis used to verify mutagenicity of different chemicals. The Allium cepa root chromosomal aberration assay is widely used to determine genotoxic and antigenotoxic effects of different plant extracts.

Comparative study of histopathological Marsh grading with clinical and serological parameters in celiac iceberg of north India.

Background: Celiac disease is an autoimmune disorder caused by the ingestion of wheat gluten and related proteins in genetically susceptible individuals. It is characterized by anti-tissue transglutaminase (anti-tTG) antibodies. Duodenal biopsy is the gold standard for diagnosis. Correlation of clinical, serologic, and histological features is essential for a definitive diagnosis. The ratio of diagnosed versus undiagnosed cases is quite high. Aims: This study aimed to correlate the degree of mucosal damage with anti-tTG levels, mean baseline hemoglobin and endoscopic findings. Setting and Design: Two hundred twenty six adults suspected to have celiac disease were studied. Marsh grades were compared with anti-tTG levels, hemoglobin, endoscopy, and clinical presentations. Materials and Methods: Esophagogastroduodenoscopy, serum levels of anti-tTG, complete hematologic work-up, and duodenal biopsy were performed in all 226 cases (including three siblings of confirmed patients) with well-defined symptom groups. Histopathological grading was done as per modified Marsh system. Correlation of all the parameters was performed with Marsh grades. Statistical Analysis : Performed on SPSS version 15.0. Tests applied include one way ANOVA, Chi-square test, repeated measure analysis, and Bonferroni's method for comparison. Results were considered significant when P<0.05. Results and Conclusions: Anti-tTG levels, mean baseline hemoglobin, and endoscopic findings were found to correlate with increasing severity of mucosal damage with P<0.001 for all. Anti-tTG levels of grades 1+2 and those of grade 3a were significantly different from levels of grades 3b and 3c+4 with P<0.001 for each. Varied clinical presentations of celiac disease were seen in the adult wheat eaters of North India.

Inhibition of cutaneous oxidative stress and two-stage skin carcinogenesis by Hemidesmus indicus (L.) in Swiss albino mice.

Chemopreventive potential of H. indicus on 7,12-dimethyl-benz[a]anthracene (DMBA)-initiated and 12-O-tetradecanoyl 13-phorbol acetate (TPA) promoted murine skin carcinogenesis has been assessed. Topical application of H. indicus resulted in significant protection against cutaneous tumorigenesis. Topical application of plant extract prior to that of TPA resulted in significant inhibition against TPA-caused induction of epidermal ornithine decarboxylase (ODC) activity and DNA synthesis. Application of H. indicus at a dose level of 1.5 and 3.0 mg/kg body weight in acetone prior to that of TPA treatment resulted in significant inhibition of oxidative stress. The level of lipid peroxidation was significantly reduced. In addition, depleted levels of glutathione and reduced activities of antioxidant enzymes were restored respectively). The results indicate that H. indicus is a potent chemopreventive agent in skin carcinogenesis.

Lupeol, a triterpene, prevents free radical mediated macromolecular damage and alleviates benzoyl peroxide induced biochemical alterations in murine skin.

In our earlier communication we have shown that Lupeol inhibits early responses of tumour induction in murine skin. The free radical mediated damage to the cellular macromolecules such as DNA, proteins, lipids and alteration in the activities of quinone reductase and xanthine oxidase are important biochemical parameters of tumor development. The suppression of free radical mediated damage to cellular macromolecules and induction of quinone reductase along with depletion of xanthine oxidase are prominent characteristics of chemopreventive agents. In the present investigation, we have elucidated the mechanism of action of lupeol (Lup-20 (29)-en-3beta-ol), a triterpene found in moderate amount in many vegetables, fruits and anti-tumor herbs. In the present investigation, lupeol significantly reduced the free radical mediated DNA-sugar damage and microsomal lipid peroxidation in an iron/ascorbate free radical generating system in vitro. Benzoyl peroxide, a known free radical generating tumor promoter mediated oxidation of proteins and modulation in the activities of quinone reductase as well as xanthine oxidase was significantly prevented by lupeol when tested on murine skin in vivo. It was concluded from this study that lupeol acts as an effective chemopreventive agent against cutaneous toxicity.