Traumatic Optic Neuropathy: Analysis of Demographic and Clinical Parameters Over Three Years in a Tertiary Care Hospital in India.

Background Treatment options for traumatic optic neuropathy (TON) are limited and the role of steroids in the treatment of TON is still controversial. Hence this study was planned to highlight the role of steroids in the treatment of TON. Purpose The study aims to highlight the epidemiological and clinical characteristics, as well as the role of steroids, in TON cases seen during a three-year period at a tertiary care center in India. Methods This was a retrospective study that reviewed records of all cases of TON between January 2018 to January 2020. Results Twenty-three cases of TON were seen representing 1.26% cases of head injuries. The median age was 18 years. One patient (4.34%) had bilateral TON and 18 patients (78.26%) were referred from accident and trauma care. None of the patients presented directly to an ophthalmologist. The most common cause of injury was automobile accident (69.56%). Visual acuity at presentation was 20/80-20/100 in six (26.08%) cases. Fifteen (65.4%) patients had associated closed globe injury. Seven (30.43%) patients had ocular adnexal involvement and 10 (43.47%) patients had orbital fractures. Seventeen (73.91%) received steroid treatment and six of these patients showed visual improvement. Conclusions The study showed that there was no significant association between presenting visual acuity and treatment. The presence of significant ocular injury and orbital injury increased the likelihood of treatment. There was no difference between the treated and untreated groups with respect to final visual acuity.

Adsorption characteristics of magnetic nanoparticles coated mixed fungal biomass for toxic Cr(VI) ions in aquatic environment.

In this research, the adsorptive removal of Cr(VI) ions from the aquatic environment have been studied using newly synthesized magnetic nanoparticles coated mixed fungal biomass (MNP-FB). Two fungal biomass such as Aspergillus fumigatus and Aspergillus niger were isolated, screened, and utilized as a precursor for making an adsorbent. Molecular characterization of isolated fungal species was recognized using 18S rRNA sequencing. The characterization studies of the MNP-FB were evaluated using Fourier Transform Infrared Spectrophotometer (FTIR) and Scanning Electron Microscopy (SEM) and Energy Dispersive X-ray (EDX) analyses. Optimization studies were studied to check the effect of different operating variables such as pH (2.0-9.0), equilibrium time (10-90 min), MNP-FB dosage (0.1-1.0 g/L), temperature (30-60 °C) and concentration of Cr(VI) ions (50-500 mg/L). Additionally, Freundlich isotherm model fits well for the adsorption of Cr(VI) ion using MNP-FB. The adsorption kinetics was interpreted well by Pseudo-first order model. The thermodynamic study concluded that Cr(VI) ions removal by MNP-FB was exothermic and appreciative at low temperatures. The monolayer adsorption efficiency of MNP-FB for Cr(VI) ions was measured as 249.9 mg/g. The current results reveal that MNP-FB has considered being a proficient and economically suitable material for the Cr(VI) ions removal from the water environment.

COVID-19-related strokes are associated with increased mortality and morbidity: A multicenter comparative study from Bengaluru, South India.

BACKGROUND: COVID-19-related strokes are increasingly being diagnosed across the world. Knowledge about the clinical profile, imaging findings, and outcomes is still evolving. Here we describe the characteristics of a cohort of 62 COVID-19-related stroke patients from 13 hospitals, from Bangalore city, south India. OBJECTIVE: To describe the clinical profile, neuroimaging findings, interventions, and outcomes in COVID-19-related stroke patients. METHODS: This is a multicenter retrospective study of all COVID-19-related stroke patients from 13 hospitals from south India; 1st June 2020-31st August 2020. The demographic, clinical, laboratory, and neuroimaging data were collected along with treatment administered and outcomes. SARS-CoV-2 infection was confirmed in all cases by RT-PCR testing. The data obtained from the case records were entered in SPSS 25 for statistical analysis. RESULTS: During the three-month period, we had 62 COVID-19-related stroke patients, across 13 centers; 60 (97%) had ischemic strokes, while 2 (3%) had hemorrhagic strokes. The mean age of patients was 55.66 ± 13.20 years, with 34 (77.4%) males. Twenty-six percent (16/62) of patients did not have any conventional risk factors for stroke. Diabetes mellitus was seen in 54.8%, hypertension was present in 61.3%, coronary artery disease in 8%, and atrial fibrillation in 4.8%. Baseline National Institutes of Health Stroke Scale score was 12.7 ± 6.44. Stroke severity was moderate (National Institutes of Health Stroke Scale 5-15) in 27 (61.3%) patients, moderate to severe (National Institutes of Health Stroke Scale 16-20) in 13 (20.9%) patients and severe (National Institutes of Health Stroke Scale 21-42) in 11 (17.7%) patients. According to TOAST classification, 48.3% was stroke of undetermined etiology, 36.6% had large artery atherosclerosis, 10% had small vessel occlusion, and 5% had cardioembolic strokes. Three (5%) received intravenous thrombolysis with tenecteplase 0.2 mg/kg and 3 (5%) underwent mechanical thrombectomy, two endovascular and one surgical. Duration of hospital stay was 16.16 ± 6.39 days; 21% (13/62) died in hospital, while 37 (59.7%) had a modified Rankin score of 3-5 at discharge. Hypertension, atrial fibrillation, and higher baseline National Institutes of Health Stroke Scale scores were associated with increased mortality. A comparison to 111 historical controls during the non-COVID period showed a higher proportion of strokes of undetermined etiology, higher mortality, and higher morbidity in COVID-19-related stroke patients. CONCLUSION: COVID-19-related strokes are increasingly being recognized in developing countries, like India. Stroke of undetermined etiology appears to be the most common TOAST subtype of COVID-19-related strokes. COVID-19-related strokes were more severe in nature and resulted in higher mortality and morbidity. Hypertension, atrial fibrillation, and higher baseline National Institutes of Health Stroke Scale scores were associated with increased mortality.

Bilateral acute angle closure glaucoma following a snake bite: Are we missing it?

INTRODUCTION: We report a case series of acute angle closure following snake bite, their clinical features, treatment, and the outcomes. MATERIALS AND METHODS: Ocular examination was done in all the snake bite victims admitted over 1-year period. The systemic status, presenting intraocular pressure (IOP), treatment instituted, and outcomes were recorded for all cases of acute angle closure. RESULTS: Six patients developed angle closure following snake bite. Average IOP was in the range of 32-56 mmHg. Treatment was initiated as for cases of acute angle closure. Two patients succumbed and the other four recovered, had normal IOP at follow-up. CONCLUSION: Acute angle closure glaucoma is a rare complication of snake bite. Timely detection and management will result in good visual prognosis. Treating physicians should be aware of this rare sight-threatening complication so that a preliminary ophthalmic examination can be sought and the visual morbidity be prevented.

Nonpseudomonal ecthyma gangrenosum of the upper lid treated with lid reconstruction.

Ecthyma gangrenosum (EG) is a cutaneous infection which usually occurs in immunocompromised patients. We report a case of EG of the eyelid treated with escharotomy and skin grafting, highlighting the importance of surgical management. A 2-year-old Asian Indian female presented to us with right upper lid edema with a large necrotic area. The child received intravenous cefotaxime for a week and the necrotic area turned to a well-defined eschar. Escharotomy with wound debridement and skin grafting was done. The present case highlights the importance of surgical intervention to prevent the sequelae of scarring of upper lid.

Patterns of maxillofacial fractures in goa.

BACKGROUND: The maxillofacial skeleton is commonly fractured due to its prominent position. The pattern of maxillofacial fractures varies from one country to another. The aim of this retrospective study was to analyze the patterns of maxillofacial injuries in the state of Goa and compare the results with similar studies in India and rest of the world. PATIENTS AND METHODS: The data were collected from the records of the patients who reported to the Department of Oral and Maxillofacial Surgery, Goa Dental College and Hospital between 2005 and 2010. The site of fracture, age of patient, etiology of trauma, daily and monthly variation of the fractures was analysed. RESULTS: Records of 2,731 patients sustaining maxillofacial injury were examined. The most commonly fractured facial bone was the mandible followed by zygomaticomaxillary complex. Most fractures occurred in the third and fourth decade of life with male and female ratio of 6:1. Main etiology was road traffic accidents. CONCLUSION: Despite strict traffic legislation, road traffic accidents are the main cause of maxillofacial injuries.

Synthesis and characterization of chromium(III) Schiff base complexes: antimicrobial activity and its electrocatalytic sensing ability of catechol.

A series of acyclic Schiff base chromium(III) complexes were synthesized with the aid of microwave irradiation method. The complexes were characterized on the basis of elemental analysis, spectral analysis such as UV-Visible, Fourier transform infrared (FT-IR), nuclear magnetic resonance (NMR), electron paramagnetic resonance (EPR) spectroscopies and electrospray ionization (ESI) mass spectrometry. Electrochemical analysis of the complexes indicates the presence of chromium ion in +3 oxidation state. Cr (III) ion is stabilized by the tetradentate Schiff base ligand through its nitrogen and phenolic oxygen. From the spectral studies it is understood that the synthesized chromium(III) complexes exhibits octahedral geometry. Antimicrobial activity of chromium complexes was investigated towards the Gram positive and Gram negative bacteria. In the present work, an attempt was made to fabricate a new kind of modified electrode based on chromium Schiff base complexes for the detection of catechol at nanomolar level.

Neurorickettsioses: a rare presentation with stroke in a young adult.

Acute stroke-like presentations due to rickettsial infections have been sparsely reported in literature. We report a young patient who presented with high grade fever and acute encephalopathy with right hemiplegia. CT head showed left cerebral, bilateral thalamic and midbrain infarcts. The stroke in young work-up for conventional and non-conventional risk factors including few infections known to cause cerebral vasculitis was negative. He did not respond to empirical antimalarials and antibiotics. With a high index of suspicion of his 'febrile cerebrovasculitis' like presentation, serological test for rickettsia was done and found to be positive. He responded to doxycycline. This case expands the spectrum of presentation of neurorickettsioses and highlights the importance of considering rickettsial vasculitis as one of the potentially treatable causes of infections causing stroke.

Acute-Onset of Multiple Painful Nodules over Forearms and Back.

Angiolipomas are benign encapsulated, well circumscribed tumours, which show excessive degree of vascular proliferation. Clinically, lesions present as sudden onset of multiple painful nodules. Pain usually does not respond to analgesics. We herein, report a case of a young male, presenting with multiple painful nodules over the forearm and back, which on histopathological examination revealed, encapsulated benign tumour, comprising of proliferated small-caliber vascular channels with microthrombi and variable amounts of mature adipose tissue. Pain subsided on treatment with intralesional steroids and the nodules were excised through a narrow-hole extrusion technique.

Squaric acid/4-aminoquinoline conjugates: novel potent antiplasmodial agents.

We report the synthesis and structure-activity relationship (SAR) analysis of a series of hybrid compounds containing a squaric moiety conjugated with heterocyclic moieties from well-known antimalarials. This novel series of compounds presents improved antiplasmodial activity compared with the squaric derivatives described in our previous work. Three compounds, 8b (IC50 = 99 nM), 8c (IC50 = 95 nM), and 8d (IC50 = 105 nM) had greater in vitro potency than chloroquine 1 (IC50 = 140 nM) against chloroquine resistant Plasmodium falciparum. In addition, they were noncytotoxic against NIH 3T3 and Hek 293T cells.

Efficacy of buprenorphine added 2 % lignocaine 1:80000 in postoperative analgesia after minor oral surgery.

PURPOSE: Recent studies have demonstrated that opioid analgesia cannot be exclusively attributed to effects within central nervous system. Peripheral opioid receptors exist that can be activated by locally applied opioid agonists which mediate analgesic effects that are particularly prominent in painful inflammatory conditions. Patients who present themselves with conditions requiring minor surgery in the maxillo-facial region usually have associated ongoing inflammatory process. The aim of our study was to apply the concept of peripheral opioid analgesia in minor oral surgery and evaluate its effectiveness in managing postoperative pain. The present study was designed to evaluate the efficacy of buprenorphine added lignocaine 2 % in providing postoperative analgesia after minor oral surgery. MATERIALS AND METHODS: Hundred consenting adult patients who were scheduled to undergo various minor oral surgeries were enrolled in this double blinded study. Patients were randomly assigned into one of the two groups based on whether they received buprenorphine added 2 % lignocaine 1:80000 (Group I) or (Group II) lignocaine 2 % with adrenaline 1:80000 alone. Visual analog scale method was used for evaluation of the postoperative analgesia. RESULTS: The duration of analgesia in Group I was found to be 36 ± 1.5 h and the average consumption of NSAIDs was found to be 1.86 as compared to Group II mean value of 4.4 (P < 0.0001). CONCLUSION: Addition of small amounts of buprenorphine to 30 ml lignocaine with adrenaline 1:80000 for minor oral surgery results in significant improvement in postoperative analgesia up to 36 h and markedly reduces the need for excessive analgesic intake. Thus reducing the adverse effects associated with excessive use of NSAIDs.

Lower levels of cerebrospinal fluid amyloid beta (Abeta) in non-demented Indian controls.

Prevalence of Alzheimer's disease in Indian population is lower than in developed countries. To determine whether limitation of amyloid beta (Abeta) concentration may be responsible for lower rate of incidence, we measured the levels of Abeta in cerebrospinal fluid (CSF) collected from 72 non-demented individuals ranging in the age from 20 years to 65 years. These samples were segregated into three groups ranging from 20-35 years, 36-50 years and 51-65 years of age. Levels of Abeta could be detected in all the age groups and they were much lower than the values reported in literature from the developed countries. No significant difference in the average level of Ass was observed with increase in age.