Post-traumatic endophthalmitis in children.

PURPOSE: To study the clinico-microbiological profile and evaluate the functional and anatomical outcomes of pediatric post-traumatic endophthalmitis (PPTE). METHODS: This was a retrospective interventional case series. All medical case records of patients diagnosed with PPTE over a 5-year period from January 2011 to December2015 were reviewed. Data recorded was: age, sex, type of trauma, mode of injury, interval between trauma and presentation, treatment, follow-up duration and final functional and anatomical outcomes. RESULTS: Forty-one eyes of 41 patients diagnosed with PPTE met the inclusion criteria. There were 26 boys and 15 girls. The mean age at the time of presentation was 7.34 years (1month -16years). The median interval between trauma and presentation was 3 days (mean = 13.71 days; 1-240 days). The average follow-up period was 292.24 days (median 150 days; 30 1440 days). Injury with wooden stick (20,50%) was the most common mode of injury. Culture positivity was noted in 25(61%) cases. Staphylococcusaureus was the most common organisms identified on culture. Univariate analysis of in dependent variables was done using the Chi-square test showed patients with positive culture for gram-positive organisms had better anatomical (p=0.038) and functional outcomes (p=0.043). 35(85%) patients underwent vitrectomy along with intraocular antibiotics. Optimal anatomical and functional outcomes were noted in 23(56.1%) and12(29.3%) respectively. CONCLUSION: PPTE carries a significantly poor prognosis in terms of ocular integrity and visual function. PPTE is common in boys and often caused by vegetative matter. Staphylococcus aureus is the most common organism seen in PPTE. Early presentation following trauma and identification of gram-positive organisms have a better prognosis.

Denture hygiene habits among elderly patients wearing complete dentures.

OBJECTIVE: To determine the denture hygiene habits in complete denture patients according to their age and time of dentures. METHODS: In this study a self administered structured was developed to know the attitude of the patients regarding denture hygiene in the department of Prosthodontics. The total study sample consisted of 230 subjects including 124 (53.9%) males and 106 (46.1%) females. Data was analyzed using SPSS version 15.0 with chi-square test at p-value <0.05. RESULTS: Nearly half of the subjects clean their dentures daily once. Participants from the younger age group and who had been wearing dentures since 2 years maintain better frequency of cleaning. The majority of these subjects used water and brush for denture cleansing. After seeing the condition, half of the dentures were rated as good 50.3%, followed by fair and poor as 29.5 and 20.2% respectively. CLINICAL SIGNIFICANCE: Poor condition of complete dentures seen in the population is mainly due to irregularly cleansing habits and also less usage of cleansing solutions. Dentists should give proper instructions regarding maintenance of denture hygiene.

The business case for transforming care at the bedside among the "TCAB 10" and lessons learned.

It is believed that Transforming Care at the Bedside (TCAB) has improved nursing care and nurses' satisfaction. Yet there may also be financial benefits to TCAB. This study estimates the net benefits of implementing TCAB by using data from the original 10 TCAB hospitals. The analysis indicates that, on an average, TCAB units had fewer patient falls with harm and less RN turnover and overtime compared with other hospitals in the United States. Financial benefits calculated from these outcomes were $847 861 per unit from 2004 to 2007. Estimates of costs of TCAB averaged $222 258 per unit. The net benefit per unit was $625 603.

Immunohistochemical expression of epithelial cell markers in corneas with congenital aniridia and ocular cicatrizing pemphigoid.

PURPOSE: We investigated the immunohistochemical characteristics of corneal specimens in congenital aniridia and pemphigoid using various corneal markers to determine the status of the corneal epithelium. METHODS: Conjunctivalization was clinically suspected in all corneas. Ten aniridia and seven pemphigoid paraffin-embedded corneal specimens were stained with periodic Schiff reagent (PAS) and antibodies against CK3/12, CK12, CK19, breast cancer resistance protein 1 (BCRP) and p63. RESULTS: Aniridia: six cases contained goblet cells, four were negative. Both groups had cases with (three of six; one of four) and without CK19 positivity and cases with (two of six; three of four) and without p63 positivity. All aniridia cases except two in the goblet cell group were CK3/12- and CK12-positive and BCRP-negative. Pemphigoid: only one of the seven cases contained goblet cells. This case stained positively for CK19, 3/12, 12 and p63 and negatively for BCRP. The other six cases were positive for CK3/12, five of which were positive for CK12; only one case was CK19-positive. Three cases were p63-positive and two BCRP-positive. The CK12 staining was heterogenous in most cases and was often found in the superficial layer. CONCLUSION: Three different stages of epithelial characteristics were found in congenital aniridia and pemphigoid: (i) CK19-negative and inhomogenous CK12-positive cases indicating epithelium mainly from (partly) CK12-deficient limbal stem cells; (ii) CK19- and/or goblet cell-positive and CK12-positive cases with their epithelia originating from CK12-deficient limbal stem cells and from incursing conjunctival cells; and (iii) CK19-positive and CK12-negative cases consisting of conjunctival cells alone.