Acute oral poisoning due to pretilachlor herbicide - a rare case report from Nepal.

Introduction: Acute oral intoxication of pretilachlor, a synthetic chloroacetanilide herbicide, can present similar clinical manifestations of organophosphorus toxicity in humans. Case presentation: A 15-year-old male was admitted after suicidal ingestion of pretilachlor poison, with decreased consciousness and blood-mixed vomiting. Discussion: Pretilachlor is a colorless and odorless liquid that can cause neurotoxicity and carcinogenicity due to its prolonged exposure. The effects of acute oral exposure are mild and may differ from chronic exposure. Individuals exposed to chloroacetanilides may not show symptoms or experience vomiting and neurological issues. Clinical manifestations such as vomiting, excessive lacrimation, bowel and bladder incontinence, bradycardia, and hypotension can be observed in both organophosphate poisoning and pretilachlor poisoning, making accurate diagnosis challenging, particularly in resource-limited settings like ours. There is no specific antidote for pretilachlor poisoning. Treatment focuses on symptomatic care and monitoring the patient's hemodynamics as per standard protocol. Conclusion: This case underscores the need for prompt stabilization, vigilant monitoring, and supportive care to ensure timely recovery in pretilachlor poisoning cases despite similarities with organophosphate poisoning. It emphasizes the importance of educating and raising awareness among physicians about potential mimickers like organophosphates.

Citrobacter freundii-associated osteomyelitis and thromboembolic events following Moderna COVID-19 vaccination: a rare case report from Nepal.

Introduction: Vaccination against coronavirus disease 2019 (COVID-19) is essential for controlling the ongoing cases of this disease. Citrobacter infections of the bones and joints are extremely uncommon. Thromboembolism and deep vein thrombosis (DVT) are very rare complications. Case presentation: The authors present a rare case of osteomyelitis, septic arthritis, deep venous thrombosis, and pulmonary embolism in a 15-year-old previously healthy boy occurring shortly after receiving the second dose of the Moderna COVID-19 vaccine. He experienced pain, swelling in the right leg, shortness of breath, and fever, followed by chest pain and leg edema. Treatment included anticoagulation, ketorolac for pain management, antipyretics, and intravenous antibiotics (Tazobactam/Piperacillin, Linezolid, Clindamycin) for osteomyelitis. Discussion: The risk of COVID-19 vaccine-related thrombotic events is minimal. Thrombotic events reported among mRNA is very rare. Citrobacter freundii bone and joint infections are very rare, accounting for a small percentage of cases. Some documented cases include cefotaxime-resistant strains causing necrotizing fascitis and osteomyelitis, including postarthroplasty infections. Due to the diverse range of susceptibility patterns and the widespread occurrence of drug resistance, personalized treatment based on culture and sensitivity testing is recommended. However, in rare cases, severe complications like DVT and joint infections associated with Citrobacter infection may occur and should be reported to the vaccine adverse events reporting system. Conclusion: Administering the COVID-19 vaccine to enhance natural antibodies is crucial, despite the low risk of infection, thromboembolism, and DVT. Healthcare providers should stay vigilant about adverse effects postvaccination and promptly report those cases.

Intestinal tuberculosis can masquerade as Crohn's disease: A teachable moment.

Intestinal tuberculosis and Crohn's disease are chronic granulomatous diseases with similar clinical presentations and can mimic one another. Their treatment modalities are completely different; however, sometimes it is challenging to differentiate them. We report a case of a 51-year-old female presenting with abdominal pain and on-and-off diarrhea for 4 years with weight loss. Clinical symptoms along with multiple aphthous ulcers in the terminal ileum and negative tuberculin test favored the diagnosis of Crohn's disease. The patient did not respond to steroids. A repeat colonoscopy with acid-fast bacilli stain showed Mycobacterium tuberculosis. This case highlights that acid-fast bacilli culture and tuberculosis polymerase chain reaction to confirm or rule out the diagnosis of intestinal tuberculosis in all patients suspected of Crohn's disease.

Acute abdomen due to rupture of a hydatid cyst of the liver: a rare complication - a case report.

Hydatid cyst is a parasitic disease that is transmitted from animals to humans caused by the larval stage Echinococcus, especially Echinococcus granulosus. A complication of a hydatid cyst of the liver is its rupture, either traumatic or spontaneously. Case presentation: A 19-year-old male presented with an acute abdomen for 12 h. After clinical assessment, contrast-enhanced computed tomography showed a rupture of the anterior wall of the hepatic hydatid cyst with intra-abdominal and pelvic dissemination. Exploratory laparotomy was performed with the evacuation of the daughter cyst and peritoneal lavage. The patient recovered well and was discharged with albendazole therapy. Clinical discussion: Hydatid cyst rupture is a rare but serious complication. Computed tomography has high sensitivity in demonstrating cyst rupture. The patient underwent laparotomy, where disseminated cysts were evacuated, and the anterior wall of the cyst was deroofed, along with the removal of a ruptured laminated membrane. Emergency surgery plus albendazole therapy are recommended protocols for cases like ours. Conclusions: A patient from an endemic region with acute presentation of right upper quadrant pain can have spontaneously ruptured hydatidosis as a differential diagnosis. Intraperitoneal rupture and dissemination of hydatid cysts of the liver can be life-threatening if intervention is delayed. Immediate surgery is life-saving and prevents complications.

Mayer-Rokitansky-Kuster-Hauser Syndrome: A rare case report from Nepal.

Introduction: Mayer-Rokitansky-Kuster-Hauser Syndrome (MRKHS) is a rare congenital disorder with an incidence of 1 in 5000 females. It is characterized by uterovaginal aplasia with normal secondary sexual characteristics and genetic karyotype 46XX. The exact etiology of MRKH syndrome is not known. Case presentation: We report a case of type 2 MRKHS with agenesis of left kidney. Discussion: The diagnosis of MRKH mainly depends on imaging study. Transabdominal ultrasonography is the first line investigation but abdomino-pelvic MRI gives more precise and clear information than the prior. So, we suggested our patient to do MRI even though she had done ultrasonography earlier. The differential diagnosis includes congenital vaginal agenesis, low transverse vaginal septum, androgen insensitivity, and imperforate hymen. Conclusion: This case presents that MRKH syndrome can occur with normal endocrine function and secondary sexual characteristics. Surgical correction by creating a neovagina is a good treatment method in young females for sexual intercourse.

Introduction to the Collection: Climate Change, Insect Pests, and Beneficial Arthropods in Production Systems.

Climate change is expected to alter pressure from insect pests and the abundance and effectiveness of insect pollinators across diverse agriculture and forestry systems. In response to warming, insects are undergoing or are projected to undergo shifts in their geographic ranges, voltinism, abundance, and phenology. Drivers include direct effects on the focal insects and indirect effects mediated by their interactions with species at higher or lower trophic levels. These climate-driven effects are complex and variable, sometimes increasing pest pressure or reducing pollination and sometimes with opposite effects depending on climatic baseline conditions and the interplay of these drivers. This special collection includes several papers illustrative of these biological effects on pests and pollinators. In addition, in response to or anticipating climate change, producers are modifying production systems by introducing more or different crops into rotations or as cover crops or intercrops or changing crop varieties, with potentially substantial effects on associated insect communities, an aspect of climate change that is relatively understudied. This collection includes several papers illustrating these indirect production system-level effects. Together, biological and management-related effects on insects comprise the necessary scope for anticipating and responding to the effects of climate change on insects in agriculture and forest systems.

Do Invasive and Naturalized Aphid Pest Populations Respond Differently to Climatic and Landscape Factors?

Ongoing environmental change affects pest populations, migration, and propensity to damage crops, but the responses to climatic drivers could vary among newly invasive and already naturalized closely related species. To compare these responses of a newly invasive aphid, Metopolophium festucae cerealium (Stroyan), with its naturalized congeneric [M. dirhodum (Walker)] and confamilial [Sitobian avenae (Fab.)], we conducted annual surveys over four years across a total of 141 winter wheat fields in the inland Pacific Northwest, USA. Key climatic factors (cumulative precipitation for each calendar year to sampling date, cumulative degree days), landscape factors (proportion of wheat and landscape diversity within the sample year), and Julian day were calculated for each sampling event, and aphid abundance by species, total aphid abundance, overall species richness, diversity, and aphid community composition were assessed. Metopolophium f. cerealium, the second most abundant species, was positively associated with precipitation, suggesting a projected increase in precipitation in winter and spring in the region could favor its establishment and expansion. Although M. dirhodum and S. avenae linearly (positively) associated with temperature, M. f. cerealium did not, indicating that continued warming may be detrimental to the species. Despite the weak impacts of landscape factors, our study indicated that more wheat generally facilitates cereal aphid abundance. Metopolophium f. cerealium abundance tended to be higher in earlier (May/early June vs. late June/July) samples when wheat crop could be vulnerable to aphid feeding. This study suggests that the new presence of M. f. cerealium has important pest management implications in the region.

Simultaneous multiple laser beam intensity profile correction and its application to a vitiated bluff body combustor field.

Simultaneous high-speed stereo-particle image velocimetry, OH planar-laser-induced fluorescence (PLIF), and CH2O PLIF measurements in a vitiated bluff body combustor are considered. An ex situ, simultaneous, time-resolved laser sheet intensity profile correction procedure is introduced. This procedure is easily implemented experimentally and is capable of correcting multiple sheets at the same time. As a proof of concept, the procedure is applied to perform correction of the CH2O PLIF images in vitiated and unvitiated conditions. The challenges associated with CH2O PLIF under these combustor operating conditions are also discussed.

Genetic diversity and population structure of a global invader Mayweed chamomile (Anthemis cotula): management implications.

Mayweed chamomile (Anthemis cotula) is a globally invasive, troublesome annual weed but knowledge of its genetic diversity, population structure in invaded regions and invasion patterns remains unstudied. Therefore, germplasm from 19 A. cotula populations (sites) from three geographically distinct invaded regions: the Walla Walla Basin (located in southern Washington) and the Palouse (located in both northern Idaho and eastern Washington), Pacific Northwest, USA and Kashmir Valley, India were grown in the greenhouse for DNA extraction and sequencing. A total of 18 829 single-nucleotide polymorphisms were called and filtered for each of 89 samples. Pairwise F ST, Nei's genetic distance, heterozygosity, Wright's inbreeding coefficient (F) and self-fertilization rates were estimated for populations within and among the three regions with a total of 19 populations comprised of 89 individuals. Overall measurements of genetic variation were low but significant among regions, populations and individuals. Despite the weak genetic structure, two main genetic clusters were evident, one comprised of populations from Palouse and Kashmir Valley, the other comprised of populations from the Walla Walla Basin. Significant selfing was observed in populations from the Walla Walla Basin and Palouse but not from Kashmir Valley, indicating that Mayweed chamomile in the Pacific Northwest, USA could persist with low pollinator or pollen donor densities. Although F ST values between the regions indicate Palouse populations are more closely related to Kashmir Valley than to Walla Walla Basin populations, based on Migrate-n analysis, panmixis was the most likely model, suggesting an unrestricted gene flow among all three regions. Our study indicated that Kashmir Valley populations either originated from or shared the origin with the Palouse populations, suggesting human-mediated migration of A. cotula between regions.

Colonic Duplication Cyst in an Adult Woman: A Case Report.

Intestinal duplications are rare congenital anomaly found in pediatric age group. Although, ileum is the most common site, there are cases of colonic duplications even in the adult. We report a case of 43 years woman presented with chronic constipation, intermittent colicky abdomen pain and a cystic lump in left abdomen diagnosed as tubular duplication cyst of descending colon. Colonoscopy is a good investigation tool for diagnosis of colonic duplications; however, it may not be true in all cases. She was managed with left hemicolectomy and excision of cyst with uneventful post-operative days. This case has been reported as it is a rare condition.

Comparison of preoperative Nutritional Risk Index and Body Mass Index for predicting immediate postoperative outcomes following major gastrointestinal surgery: Cohort-study.

BACKGROUND: Malnutrition is a major risk factor for morbidity and mortality following gastrointestinal (GI) surgery. Nutritional Risk Index (NRI) and Body Mass Index (BMI) are the two well-validated tools that are readily available and do not add financial burden to the patients. The study aimed to analyze NRI and BMI as a preoperative nutritional indicator of postoperative complications following GI surgeries. METHODS: It is an observational study, where preoperative nutritional status and early postoperative complications <30 days (infectious or noninfectious) were studied. The patients admitted between July 2015 to May 2017, who underwent major GI surgeries were included in the study. The correlation between NRI and BMI of these patients were evaluated. RESULTS: The rate of wound infection was 4 (30.7%) out of 13 in severe malnutrition subgroup defined by NRI <83.5 which was found to be statistically significant (p = 0.003). However, it was not significant in a subgroup of patients with undernutrition defined by BMI <18.49%. In a subgroup analysis, abnormal NRI was found to be statistically significant (p = 0.004) in patients with malignant disease and malnutrition 64 (47.76%) out of 97 (72.3%). The mean NRI (94.49 ±â€¯9.164) better correlated with advancing age (p < 0.05) and the correlation coefficient of 0.3100 showed a significant negative correlation. With 10 fold increase in age (r2 = 0.096) the likelihood of malnutrition was 9.6% and subsequently increased postoperative complications. CONCLUSION: In cases of malignancy and advanced age, NRI is a better predictor of immediate postoperative outcome than BMI.

Quality of Life Following Surgical Treatment of Post Cholecystectomy Bile Duct Injury.

BACKGROUND: The Roux-en-Y hepaticojejunostomy surgery provides the mainstay of treatment in cases of bile duct injury following cholecystectomy.The aim of this study is to assess the quality of life in patients who underwent surgical repair of bile duct injury following cholecystectomy. METHODS: The prospective cross sectional study was conducted in Gastrointestinal Surgery Unit, Bir Hospital, National Academy of Medical Sciences. The cases of bile duct injury following cholecystectomy who underwent surgical repair from April 2013 to March 2018 were included. The data collection was done using SF-36 quality of life questionnaire tool.The study was conducted after ethical clearance from Institutional Review Board of National Academy of Medical Sciences. RESULTS: There were 26 cases of referred bile duct injury admitted in gastrointestinal surgery department from 2013 April till 2018 March out of which 19 (73%) were included in the study.More than half of the patients had limitations in carrying out vigorous activities (as running or lifting heavy objects) and 5.2% had a lot of limitations in carrying our moderate activities (as moving a table).63.1% of the patients did not have any interference with social activities with family, friends, neighbors or social groups because of their physical health or emotional problems. CONCLUSIONS: The surgical repair of bile duct injury following laparoscopic cholecystectomy has an impact on ability to perform work or daily activities as a result of physical health. However, it has little impact on patient's perception of general health and social activities.

Incidence of The Bowel, Bladder, and Sexual Dysfunction Following Surgery for Colorectal Malignancy.

BACKGROUND: Colorectal malignancy is a very common disease of the gastrointestinal tract. Surgery following neoadjuvant chemoradiotherapy has been found to improve the survival of the patients with colorectal carcinoma. Research on bowel, bladder and sexual dysfunction following colorectal surgery remains limited in Nepal. The aim of this study is to evaluate the incidence of the bowel, bladder, and sexual dysfunction after colorectal surgery. METHODS: It is a cross-sectional study carried out at National Academy of Medical Science, Bir hospital. Patients who underwent low anterior resection and abdominoperineal resection with curative intention post neoadjuvant chemoradiotherapy were included in the study. RESULTS: A total of 26 patients [20 (76.9%) males and 6 (23.1%) females] who underwent surgery for the colorectal malignant disease were included. 24 (92.30%) underwent low anterior resection and 2(7.6%) patient underwent abdominoperineal resection respectively after neoadjuvant chemo radiotherapy. 19(79.16%) of the patients developed bowel dysfunction with mean low anterior resections score of 22.88±4.394. And 5(20.83%) had normal bowel function. Bladder dysfunction was seen in 3 (11.5%) patients. And rest of the 23 (88.5%) patient had normal bladder function. In males, Sexual Dysfunction was observed in 11 (42.3%)and no sexual dysfunction was observed in 15(57.69%). While in females, 38.46% had no sexual desire and 50% had dyspareunia due to vaginal dryness. CONCLUSIONS: This study clearly demonstrated a higher incidence of bowel and sexual dysfunction compared to bladder dysfunction following low anterior resection and abdominoperineal resection for colorectal malignant diseases.

Dryland Organic Farming Partially Offsets Negative Effects of Highly Simplified Agricultural Landscapes on Forbs, Bees, and Bee-Flower Networks.

Industrialized farming practices result in simplified agricultural landscapes, reduced biodiversity, and degraded species-interaction networks. Thus far, most research assessing the combined effects of farming systems and landscape complexity on beneficial insects has been conducted in relatively diversified and mesic systems and may not represent the large-scale, monoculture-based dryland agriculture that dominates many regions worldwide. Specifically, the effects of farming systems on forbs, bees, and their interactions are poorly understood in highly simplified dryland landscapes such as those in the Northern Great Plains, United States, an area globally important for conventional and organic small grain, pulse, forage, and oilseed production. During a 3-yr (2013-2015) study, we assessed 1) the effects of dryland no-till conventional and tilled organic farming on forbs, bees, and bee-flower networks and 2) the relationship between natural habitat and bee abundance. Flower density and richness were greater in tilled organic fields than in no-till conventional fields, and forb community composition differed between farming systems. We observed high bee diversity (109 taxa) in this highly simplified landscape, and bee abundance, richness, and community composition were similar between systems. Compared with tilled organic fields, bee-flower interactions in no-till conventional fields were poorly connected, suggesting these systems maintain relatively impoverished plant-pollinator networks. Natural habitat (11% of the landscape) did not affect small-bodied bee abundance in either farming system but positively affected large-bodied bees within 2,000 m of crop-field centers. In highly simplified agricultural landscapes, dryland organic farming and no-till conventional farming together support relatively high bee diversity, presumably because dryland organic farming enhances floral resources and bee-flower networks, and no-till management in conventional farming provides undisturbed ground-nesting habitats for wild bees (Hymenoptera: Apoidea).

Farming system and wheat cultivar affect infestation of, and parasitism on, Cephus cinctus in the Northern Great Plains.

BACKGROUND: Cephus cinctus infestation causes $350 million in annual losses in the Northern Great Plains. We compared infestation and parasitism of C. cinctus in spring (including Kamut; Triticum turgidum ssp. turanicum) and winter wheat cultivars grown in organic and conventional fields in Montana, USA. In the greenhouse, we compared C. cinctus preference and survival in Kamut, Gunnison, and Reeder spring wheat cultivars. RESULTS: Stems cut by C. cinctus varied by farming system and the seasonality of the wheat crop. No stems of Kamut in organic fields were cut by C. cinctus, but 1.5% [±0.35% standard error (SE)] of stems in conventional spring wheat, 5% (±0.70% SE) of stems in organic winter wheat, and 20% (±0.93% SE) of stems in conventional winter wheat fields were cut by C. cinctus. More larvae of C. cinctus were parasitized in organic (27 ± 0.03% SE) compared with conventional (5 ± 0.01% SE) winter wheat fields. Cephus cinctus oviposition, survival, and the number of stems cut were lowest in Kamut compared with Gunnison and Reeder. CONCLUSION: Cephus cinctus infestation was more common in winter wheat than in spring wheat. Organic fields with fewer cut stems also supported more parasitoids. Kamut is a genetic resource for developing C. cinctus-resistant cultivars. © 2018 Society of Chemical Industry.

Fiber-coupled LWIR hyperspectral sensor suite for non-contact component surface temperature measurements.

We report on the development of a robust fiber-coupled long-wavelength infrared (LWIR) hyperspectral sensor suite for accurate and reliable non-contact surface temperature measurements in propulsion systems with limited optical access. We first experimentally investigate various state-of-the-art LWIR optical fibers and identify the ideal fiber for efficient coupling and transmission of LWIR signals. The effects of the fiber material, structure, bending, and thermal heating on LWIR fiber transmission are characterized. Subsequently, we discuss the development of a fiber-coupled LWIR hyperspectral sensor using a multi-mode polycrystalline fiber. The temperature measurement accuracy and precision of the sensor are determined using a well-calibrated blackbody radiation source and heated thermal barrier coating. The sensor is integrated into a homemade water-cooled probe housing and environmental protection box and subsequently used for reliable combustor liner temperature measurements in a high-pressure, liquid-fueled combustor rig with no built-in optical access. We also discuss the measurement challenges associated with flame interference and potential solutions. The LWIR sensor shows significant promise in its application to surface temperature measurements, and our findings can aid propulsion system engineers and researchers in system design and operation optimization.

Coevolutionary elaboration of pollination-related traits in an alpine ginger (Roscoea purpurea) and a tabanid fly in the Nepalese Himalayas.

Geographical variation in the interacting traits of plant-pollinator mutualism can lead to local adaptive differentiation. We tested Darwin's hypothesis of reciprocal selection as a key driving force for the evolution of floral traits of an alpine ginger (Roscoea purpurea) and proboscis length of a tabanid fly (Philoliche longirostris). We documented the pattern of trait variation in R. purpurea and P. longirostris across five populations. At each site, we quantified pollinator-mediated selection on floral display area, inflorescence height and corolla length of R. purpurea by comparing selection gradients for flowers exposed to natural pollination and to supplemental hand pollination. Reciprocal selection between plant and fly was examined at two sites via the relationship between proboscis length and nectar consumption (fly benefit) and corolla length and pollen deposition (plant benefit). Local corolla tube length was correlated with local fly proboscis length among the five sites. We found strong linear selection imposed by pollinators on corolla tube length at all sites, but there was no consistent relationship of fitness to inflorescence height or floral display area. Selection between corolla length and proboscis length was reciprocal at the two experimental sites examined. The geographical pattern of trait variation and the evidence of selection is consistent with a mosaic of local, species-specific reciprocal selection acting as the major driving force for the evolution of corolla length of R. purpurea and proboscis length of P. longirostris.

Ethnic Variation in Consumption of Traditional Tobacco Products and Lung Cancer Risk in Nepal.

Lung cancer is the leading contributor to cancer deaths in the developing world. Within countries, significant variability exists in the prevalence of lung cancer risk, yet limited information is available whether some of the observed variability is associated with differences in the consumption pattern of local tobacco products with differing potency. We recruited 606 lung cancer cases and 606 controls from the B.P. Koirala Memorial Cancer Hospital in Nepal from 2009-2012. We estimated odds ratios (ORs) and 95% confidence intervals (CI) for lung cancer risk associated with different tobacco products, using unconditional logistic regression. Unfiltered cigarettes tended to be the most frequently used products across ethnic subgroup with about 53.7% of Brahmins, 60.1% of Chettris, and 52.3% of Rai/Limbu/Magar/others. In contrast, about 39.9% of Madishe/Tharu smokers reported using bidi compared with only 27.7% who smoked unfiltered cigarettes. Among those who only smoked one type of product, choor/kankat smokers had the highest lung cancer risk (OR 10.2; 95% CI 6.2-16.6), followed by bidi smokers (OR 5.6; 95% CI 3.6-8.7), unfiltered cigarettes (OR 4.9; 95% CI 3.4-7.2), and filtered cigarettes (OR 3.4; 95% CI 2.2-5.3). A clear dose-response relationship was observed between increased frequency of smoking and lung cancer risk across all ethnic subgroups. These results highlight the important role of traditional tobacco products on lung cancer risk in the low income countries.

Effects of apical meristem mining on plant fitness, architecture, and flowering phenology in Cirsium altissimum (Asteraceae).

UNLABELLED: • PREMISE OF THE STUDY: Interactions that limit lifetime seed production have the potential to limit plant population sizes and drive adaptation through natural selection. Effects of insect herbivory to apical meristems (apical meristem mining) on lifetime seed production rarely have been quantified experimentally. We studied Cirsium altissimum (tall thistle), whose meristems are mined by Platyptilia carduidactyla (artichoke plume moth), to determine how apical damage affects plant maternal fitness and evaluate both direct and indirect mechanisms underlying these effects.• METHODS: In restored prairie, apical mining was manipulated on tall thistles by applying insecticide, water, or no spray to apical meristems. We quantified effects on lifetime seed production, plant architecture, and flowering phenology. Seed germinability and seedling mass were evaluated in a greenhouse.• KEY RESULTS: Apical meristem miners decreased lifetime seed production of C. altissimum, but not seed quality. Higher mortality rates of damaged plants contributed to reduced seed production. Apical damage reduced plant height and increased the proportion of blooming flower heads in axial positions on branches. Apical damage delayed flowering and shortened flowering duration.• CONCLUSIONS: Apical meristem mining reduced plant maternal fitness. The shift in the identity of blooming flower heads from terminal to axial positions contributed to this reduction because axial heads are less fecund. Shorter, meristem-mined plants may have been more susceptible to competition, and this susceptibility may explain their higher mortality rates. The kinds of changes in architecture and phenology that resulted from apical damage to C. altissimum have been shown to affect floral visitation in other plant species.

Vincristine-induced blindness: a case report and review of literature.

BACKGROUND: Neurotoxicity is a dose-limiting side-effect of vincristine therapy. Blindness is a rare central neurotoxicity of vincristine with few case reports. CASE REPORT: In the present article, we report a rare case of vincristine-induced blindness in a patient with diffuse large B cell lymphoma. Literature search identified eleven published cases of vincristine-induced blindness. We reviewed patient characteristics, chemotherapy used and type of blindness. CONCLUSION: Vincristine-induced blindness is rare and unpredictable. Prompt recognition and discontinuation of vincristine may lead to recovery of vision.