Renal support in acute kidney injury.

Acute kidney injury requiring renal replacement therapy (RRT) is associated with an unacceptably high mortality rate. Despite the identification of the modality, timing and intensity of dialysis, membrane biocompatibility, hollow fiber and catheter properties as potential modifying factors, there is little convincing evidence for the superiority of one over the other. However, the available data suggest that the early initiation of RRT may be beneficial. A focused review of clinical trials and meta-analysis of clinical trials of RRT is provided.

Eagle' syndrome. Anatomy of the styloid process.

The observations made on the angulations and the length of styloid processes from a hundred skulls are presented. Morphometrical data compiled is correlated to those available in literature. The dimension and angularity of the process when in extreme is known to produce symptoms classified as Eagle's syndrome. This paper discusses the probable incidence of dysphagia due to predisposition of the elongated styloid process in Indian context. Most statistics on the metrics of the process are called from radiographic studies done in western centres. Osteometry of the styloid with reference to the risk factors in causation of the syndromes probably, presented in this paper for the first time in this part of the world. It is hoped that despite the rarity of the syndrome, this brief study will spur research into the osteological basis for the peculiar clinical condition.

Multibacillary nerve histology in clinically diagnosed borderline tuberculoid leprosy patients.

The classification of leprosy into multibacillary (MB) and paucibacillary (PB) patients in almost all clinics is entirely dependent on clinical examination. In a study of 21 patients clinically classified as borderline tuberculoid (BT) and, therefore, belonging to the PB group, skin smears and skin and nerve biopsies were examined. Four patients did not have any histopathological evidence of leprosy. Skin smears showed that 1 patient was positive for acid-fast bacilli (AFB), 2 skin biopsies belonged to the borderline lepromatous (BL) category and showed AFB in their lesions, and AFB were present in 10 nerve biopsies classified as BL. It is possible that reported relapses among PB patients may be in those patients with demonstrable AFB in the lesions, including nerves. A careful follow-up study of this particular group of patients after PB multidrug therapy is suggested to resolve this question.

Correlation between the optic disc and results obtained with conventional, high-pass resolution and pattern discrimination perimetry in glaucoma.

The purpose of this study was to determine whether results obtained with two new techniques, high-pass resolution perimetry and pattern discrimination perimetry, correlated better to the appearance of the optic disc than results obtained with conventional automated perimetry in patients with open-angle glaucoma. Our sample consisted of 28 eyes of 28 patients with early glaucomatous field damage who are part of a prospective follow-up study. We used the second of two sets of baseline perimetric examinations separated by 1 week in the analysis. Neuroretinal rim area was calculated by planimetry of stereophotographs of the disc and was correlated to the visual field sensitivity measured with each of the techniques. We found a poor correlation between the disc and field measurements (correlation coefficients; -0.048 for conventional perimetry, 0.111 for high-pass resolution perimetry and -0.315 for pattern discrimination perimetry). Although the correlation appeared to be higher with the newer techniques, the differences were not statistically significant.

Comparison of reliability indices in conventional and high-pass resolution perimetry.

PURPOSE: The purpose of this study is to compare reliability indices in conventional (Humphrey) and high-pass resolution (Ring) perimetry in healthy subjects followed prospectively at 6-month intervals. METHODS: Of the 146 healthy subjects (mean age, 50.24 years; range, 30-84 years) enrolled in the study, 102 have been tested twice and 71 three times. The authors compared the reliability indices, fixation losses, false-positive rate, and false-negative rate between the two techniques, both cross-sectionally and serially. RESULTS: Fixation losses were slightly higher with high-pass resolution perimetry, whereas false-positive errors were higher with conventional perimetry. False-negative errors were uncommon with either technique. Of 319 fields, 30 (9.4%) conventional and 39 (12.2%) high-pass resolution perimetry fields were unreliable using the current suggested reliability criteria. Nearly all unreliable fields were due to high fixation errors. Using alternative criteria derived from baseline 95th percentile values, unreliable fields were attributed more equally to all three reliability parameters. In subjects tested three times, the reliability indices remained constant. CONCLUSION: The results of this study showed that healthy subjects have comparable reliability indices when tested with conventional and high-pass resolution perimetry.