An innovative and simple method, clinically comparable to high-definition optical coherence tomography in quantifying posterior segment lesions in the retina.

Purpose: To introduce a simple and inexpensive method using a fundus contact lens and a reticle, to measure retinal lesions comparing it with values obtained with high-definition optical coherence tomography (HD-OCT). This study considers optic disc as the object for comparison. Methods: : Patients underwent routine ophthalmologic examination and their horizontal optic disc diameter was measured, both with the reticle and OCT. For measurement with reticle a simple equation was deduced, x = 0.7y, where x corresponds to the actual image size and y to the reticle scale reading in millimeters. Results: : An aggregate of 127 eyes of 75 patients were dilated and examined. The calculated mean diameter according to OCT was 1.639 mm (standard deviation = 0.179) and that assenting to reticle was 1.713 mm (standard deviation = 0.175), with a difference in mean being 0.089 mm. Conclusion: Values obtained by this new method was found to be comparable with the OCT values for retinal measurements, useful for ophthalmologists who cannot afford expensive and sophisticated machines.

Effectiveness of Minimally Invasive Hybrid Surgery for Ileal Interposition (MIHSII) for the Resolution of Type 2 Diabetes.

AIM: To evaluate the effectiveness of minimally invasive hybrid surgery for ileal interposition (MIHSII), a novel procedure for type 2 diabetes (T2DM) in patients with a body mass index (BMI) <30 kg/m(2). MATERIALS AND METHODS: MIHSII is an innovative technique in which sleeve gastrectomy is performed laparoscopically, followed by extracorporeal ileal interposition performed through a 5-cm midline incision. The procedure was performed on 31 T2DM patients, 17 males and 14 females. Their BMI values ranged from 21.8 kg/m(2) to 29.8 kg/m(2), with a mean BMI of 26.61 ± 2.61 kg/m(2). The average duration of diabetes 8.14 ± 4.89 (range = 1-20) years. Most of the patients exhibited poorly controlled diabetes despite the use of oral hypoglycemic agents (OHAs) and/or insulin. RESULTS: The mean preoperative glycosylated hemoglobin (HbA1c) for the population was 8.86%. The mean HbA1c 1 year after surgery was 6.80%. The difference between the mean preoperative and 1-year postoperative HbA1c values was significant, at P < .05 (group 1: BMI = 18.5-24.99 kg/m(2), t = 2.83, and P = .022; group 2: BMI = 25-29.99 kg/m(2), t = 4.23, and P = .001). The resolution rate of diabetes was 80.48%; 48.57% experienced complete resolution, and 31.91% experienced partial resolution. The remaining 19.52% of patients exhibited a significant reduction in HbA1c, although the HbA1c levels did not fall below 6.5%, even with medications. CONCLUSION: MIHSII is an innovative technique of metabolic surgery and is a cost-effective and minimal procedure for the resolution of T2DM in patients with BMI <30 kg/m(2).

Periorbital dirofilariasis-clinical and imaging findings: live worm on ultrasound.

Ocular dirofilariasis is a zoonotic filariasis caused by nematode worm,Dirofilaria. We present a case of dirofilariasis affecting the upper eyelid in a 2-year-old child presenting as an acutely inflammed cyst, from southern Indian state of Kerala. Live adult worm was surgically removed and confirmed to be Dirofilaria repens. Live worm showing continuous movement was seen on the pre-operative high-resolution ultrasound. Ultrasound can be helpful in pre-operative identification of live worm.Imaging findings reported in literature are very few. We describe the clinical, ultrasound, and magnetic resonance imaging (MRI) findings.

Rupture of plantaris muscle - a mimic: MRI findings.

Calf muscle trauma commonly involves the gastrocnemius and soleus muscles. Plantaris muscle is a vestigial muscle coursing through the calf. Similar clinical features may be seen with injury to the plantaris muscle. It can also mimic other conditions like deep vein thrombosis, rupture of Baker's cyst, and tumors. MRI is helpful in identifying and characterizing it. We report two cases of ruptured plantaris muscle seen on MRI.

Shorter break-in period is a viable option with tighter PD catheter securing during the insertion.

BACKGROUND: Recent single-arm studies reported good catheter outcome despite shorter break-in periods after peritoneal dialysis (PD) catheter insertions. These results were attributed to tight catheter securing during the insertions. OBJECTIVE: To compare catheter-related outcomes after different break-in periods in the tightly secured PD catheters. PATIENTS AND METHODS: The study cohort comprised 48 patients, who underwent catheter insertions with the modified insertion technique. Based on the duration of break-in period, the patients were grouped into a shorter break-in period arm, with break-in period of 7 days or less and a standard break-in period arm, with break-in period of about 2 weeks. Mean patient follow up was 9.68 +/- 4.35 months, with a similar follow-up duration between the two break-in period arms (P = 0.94). RESULTS: In the study cohort, the incidence of pericatheter leaks, pericatheter haemorrhage, catheter malfunction and peritonitis was 2/48 (4%), 1/48 (2%), 1/48 (2%) and 3/48 (6%), respectively. There was no other-site leak, bowel perforation, hernia formation or wound dehiscence. Of these complications, two pericatheter leaks, one catheter malfunction and three peritonitis episodes followed standard break-in periods, whereas, one pericatheter haemorrhage occurred in the shorter break-in period arm. CONCLUSION: After a tight catheter securing during the insertions, overall pericatheter leak incidence remained low in the whole study cohort, and it did not worsen despite a shorter break-in period. Future studies with larger patient numbers are needed to validate the role of shorter break-in period in PD practice.