Association between helicobacter pylori and open angle glaucoma: current perspective.

Helicobacter pylori is a Gram negative, spiral-shaped, strictly micro-aerophilic and flagellate human pathogen that can inhabit many areas of stomach. H. pylori infection leads to the generation of oxygen free radicals. H. pylori infection might also aggravate the course of glaucoma by increasing the levels of nitric oxide, endothelin-1 and free radicals indirectly. This article briefly reviews the current perspectives on this issue.

Aortic wall sarcoma with tumor emboli and peripheral ischemia: case report with review of literature.

Primary malignant tumors of the aorta are rare, only a handful of isolated cases having been described in the literature. Preoperative diagnosis of these tumors is more the exception than the rule. Diagnosis of aortic tumors is difficult as they can mimic many diverse conditions including atherosclerosis. We report a patient who presented with lower extremity claudication, renal infarction, and diffuse atherosclerosis and who was found to have tumor fragments in blood clots but no evidence of a primary tumor. Immunohistochemistry narrowed the differential diagnosis to a type of sarcoma. Six months later, he developed right flank pain due to a malignant fibrous histiocytoma that involved the abdominal aorta and that had initially manifested as tumor emboli.

Stress and psychiatric disorder in the Hindu Kush: a community survey of mountain villages in Chitral, Pakistan.

BACKGROUND: It is widely believed that people in remote areas of the world suffer less emotional distress and fewer psychiatric disorders. Previous studies offer contradictory evidence. METHOD: First stage screening of two mountain villages in Chitral used the Bradford Somatic Inventory (BSI). Psychiatric interviews were conducted with stratified samples using the ICD10 Diagnostic Criteria for Research. RESULTS: The BSI was an effective screening test, with sensitivity of 80% and specificity of 77%. At a conservative estimate, 46% of women and 15% of men suffered from anxiety and depressive disorders. Literate subjects had lower levels of emotional distress than the illiterate. Higher socio-economic status was associated with less emotional distress. Members of joint and nuclear families were similar. CONCLUSIONS: The study offers no support for the belief that people who live in Chitral lead stress-free lives or have low rates of psychiatric morbidity. Women may suffer more anxiety and depressive disorders than in Western societies.

The role of 5-fluorouracil in complicated glaucomas.

The long-term efficacy of trabeculectomy in controlling intraocular pressure (IOP) has been found unsatisfactory in various complicated and refractory glaucomas. The most common cause for failure is excessive scarring at the filtering site. Several wound modulating agents which reduce scarring have been tested. In this study, 5-Fluorouracil (5-FU), a halogenated pyrimidine analogue and a potent anti-mitotic agent, was applied for seven days after trabeculectomy in eighteen complicated and unsuccessful filtering glaucomas, at a daily dosage of 5 mg in the form of 0.5 ml subconjunctival injections. The common postoperative complications encountered were corneal epithelial erosion (38%), wound leakage (16%), subconjunctival haemorrhage (32%) and hyphaema (10%), all during the first 7 to 10 days. Monitoring at regular intervals up to six months showed adequate control of IOP (less than 22mm Hg.) in 88% of the cases. Cases of aphakic glaucoma and neovascular glaucoma showed poor response. Use of 5-FU as an adjuvant to filtering surgery in various complicated glaucomas improves the long-term results.

Comparative results of limbal based versus fornix based conjunctival flaps for trabeculectomy.

Among 100 cases of primary glaucomas, 50 cases were operated for trabeculectomy by making fornix based flap and 50 cases were operated by fashioning limbal based conjunctival flap. Operative and post operative complications were studied thoroughly in the two groups. All the cases were followed up for six months to one year to assess control of intra ocular pressure, nature and functioning of filtering bleb, field changes and visual status in the two groups. It was found that the fornix based flap is much superior and carries various advantages over the limbal based flap. The operative and post operative complications are minimum in the fornix based flap as compared to the limbal based flap.

Acquired pyruvate kinase deficiency.

Pyruvate kinase (PK) is an enzyme of critical importance in the glycolytic pathway of the red cells, deficiency of which, whether congenital or acquired, results in a hemolytic anemia. Measurement of the enzyme is now rapid and simple utilizing preprepared substrate and reagents. Some caution must be taken, however, in both measurement and interpretation. Red cells must be separated from other blood cells, particularly granulocytes, since the PK of white cells is different from that of red cells and is present in much higher activity per cell. Sometimes the use of special techniques of measurement [low substrate concentration (phospho-enolpyruvate, known as PEP, 0.4 mM in place of 2 mM) or heating at 53 degrees C for 60 minutes, (to test thermostability)] are necessary to detect abnormal molecular characteristics of PK, particularly in the acquired form of deficiency. Evidence recently presented suggests that the acquired form of PK deficiency may sometimes be due to inhibitors which oxidize sulfhydril bonds in the enzyme or alter its substrate binding properties or other molecular characteristics.