Study of tear function before and after laser-assisted in-situ keratomileusis

Purpose: This work assesses the change in tear function after LASIK surgery. Methods: This prospective, observational study was conducted in the Refractive Clinic of a tertiary care rural hospital. Tear dysfunction symptoms and the tear function tests were assessed in 269 eyes of 134 patients, OSDI score was used to document the tear dysfunction symptoms. Tear function was assessed by tear meniscus height, tear film break?up time (TBUT), Lissamine green staining, corneal fluorescein staining, Schirmer test 1 without anesthesia before and at 4–6 weeks and 10–12 weeks after LASIK surgery. Results: Preoperatively OSDI score was 8.54 ± 7.71. It increased to 15.11 ± 9.18 postoperatively at 4–6 weeks after LASIK surgery and 13 ± 9.56 at 10–12 weeks after LASIK surgery Mean TBUT preoperatively was 7.82 ± 3.57 sec which decreased to 5.34 ± 2.56 sec at 4–6 weeks and to 4.53 ± 2.63 sec at 10–12 weeks postoperatively. The number of eyes with clear secretion decreased from 40.5% preoperatively to 23.4% at 4–6 weeks and to 22.3% at 10–12 weeks postoperatively, whereas the granular and cloudy secretions increased significantly in eyes after LASIK surgery. The prevalence of eyes with Lissamine green score >3 (dry eye) increased from 17.1% preoperatively to 27.9% at 4–6 weeks and to 30.5% at 10–12 weeks. Similarly, the number of eyes showing positive fluorescein corneal staining increased from 5.6% preoperatively to 19% postoperatively at 4–6 weeks. Mean Schirmer score was 28.83 ± 6.39 mm preoperatively, 22.47 ± 5.38 mm at 4–6 weeks, and 21.27 ± 4.99 mm at 10–12 weeks after LASIK surgery. Conclusion: The prevalence of dry eye increased after LASIK as was assessed by an increase in the tear dysfunction symptoms using OSDI score and the deranged values of various tear function tests after LASIK surgery

Association of pattern reversal VEP parameters with the Meandefect of Humphrey visual field in patients of primary open Angleglaucoma.

Glaucoma is a chronic, progressive bilateral optic neuropathy which disturbs the structural or functional integrity of the optic nerve that causes characteristic atrophic changes in it, which leads to specific visual field defects over time with loss of visual function. Primary open angle glaucoma (POAG) is the most common form of glaucoma in India and is fast emerging as a major cause of bilateral blindness. This rural hospital based study was conducted to evaluate whether glaucomatous visual field defects particularly the mean defect of Humphrey visual field could be related to VEP parameters of patients having POAG. Visual field by Humphrey perimeter and simultaneous recordings of pattern reversal visual evoked potential (PRVEP) were assessed in 100 patients with POAG. There was a significant (P<0.05) negative correlation of P100 latency, N155 latency and P100 duration and a highly significant (P<0.001) positive correlation of P100 amplitude with mean deviation (index of global visual field damage, MD) of Humphrey visual field in the subjects of POAG in various age groups. N70 latency showed a non-significant positive correlation with MD. The VEP changes observed by us in POAG patients were consistent with the progressing mean defect quantitatively. Therefore, it can be concluded that the VEP parameters can be useful quantitative indices in the evaluation of glaucomatous visual function damage.

Diagnostic utility of ki67 and p53 immunostaining on solitary thyroid nodule - A cytohistological and radionuclide scintigraphic study.

Background: For management of thyroid nodules, distinction between benign and malignant tumors is essential. Present study was undertaken to differentiate between benign and malignant lesions by using Ki-67 and p53 immunostaining and radionuclide perfusion scan. Materials and Methods: Study comprised of 25 prospective and 25 retrospective cases of solitary thyroid nodules. Fine needle aspiration was done on 25 prospective cases, which was correlated with histopathological diagnosis in 24 surgically excised cases. Immunostaining for p53 and Ki-67 was put on histopathological sections of 25 retrospective and 24 prospective cases. Radionuclide perfusion scan was performed and vascularity patterns were compared with their pathological nature to differentiate between benign and malignant nodule. Results: Cytohistological correlation was present in 80% of cases. On immunostaining, significant difference in mean value of Ki67 positivity was found between benign and malignant nodules (P < 0.05). On p53 immunostaining significant difference was observed in counts of benign and malignant lesions (P = 0.037). On radionuclide perfusion scan mean of difference between maximum and minimum perfusion activity between benign and malignant nodules was found to be statistically significant (P = 0.04), however there was no correlation between perfusion patterns and antigenic characteristics. Conclusions: P53 and Ki-67 immunostaining along with radionuclide perfusion scan appears to be useful tools to differentiate between benign and malignant lesions in solitary thyroid nodule; however, more studies are needed to confirm this observation.

Primary renal fibrosarcoma: a rare case report and review of literature.

Primary renal fibrosarcoma is a rare tumor. We describe a case of primary renal fibrosarcoma in a 54-year-old male who presented with abdominal lump and intermittent hematuria.

Detection of HPV16 and 18 by in situ hybridization in precancerous and cancerous lesions of cervix.

Fifty cervical biopsies from women with preinvasive and invasive malignancies of uterine cervix and ten normal cervical biopsies were examined for the presence of human papilloma virus (HPV) 16 and 18 DNA sequences by in situ hybridization (ISH) method with biotinylated DNA probes. The overall positivity of HPV DNA was 48% (24/50). The positivity of HPV 16 DNA for low grade squamous intraepithelial lesion (LSIL), high grade squamous intraepithelial lesions (HSIL) and squamous cell carcinoma (SCC) were 33.33%, 45.45%, 42.30% respectively. The positivity for HPV 18 DNA for LSIL, HSIL and SCC were 0%, 18.18%, 30.76% respectively. Two cases of cervical adenocarcinomas showed positivity for HPV 18 DNA only.

Epithelial myoepitheial carcinoma of minor salivary gland--low grade malignant tumor presenting with nodal metastasis.

Epithelial myoepithelial carcinoma (EMC) is a rare low grade malignant salivary gland neoplasm that most commonly occurs in the parotid gland but can also arise in minor salivary glands. We report a case of primary epithelial myoepithelial carcinoma of minor salivary gland in a 25 year old women who presented with swelling left cheek of one year duration and bilateral submandibular lymphadenopathy. A mass causing erosion of mandible, thyroid cartilage and masseter muscle was identified on CT scan. This was excised and histological examination revealed a mixture of ductal structures consisting of inner dark cells and outer clear cells seen in solid sheets. Immunohistochemical analysis showed the clear cells to be weakly positive for S100 and smooth muscle actin (SMA) and ductal cells to be positive for cytokeratin (CK) and epithelial membrane antigen (EMA). The characteristic morphological and immunohistochemical features aided in the diagnosis of epithelial myoepithelial carcinoma.

Antemortem diagnosis of gastrointestinal mucormycosis in neonates: report of two cases and review of literature.

Gastrointestinal mucormycosis has been reported more frequently in adults than in children. Due to high mortality diagnosis is usually made at autopsy. Only 3 cases of neonates surviving this disease have been described. We report two cases of preterm neonates presenting clinically with symptoms of necrotizing enterocolitis (NEC), but lacking radiological characteristics of NEC where histopathology confirmed the diagnosis of gastrointestinal mucormycosis involving caecum and appendix.