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Purpose: The aim of this study was to present the signs, symptoms, management, and outcome of a series of cases of cluster endophthalmitis caused by a multi-drug resistant fungus, Trichosporon. Methods: This was a retrospective, non-randomized, consecutive interventional case series. Ten cases of postoperative endophthalmitis operated by a surgeon on three consecutive operation theater (OT) days presented 3�months after their surgery. All cases were microbiologically confirmed. The pathogen was found to be resistant to most antifungals, including amphotericin B. The cases had a latent period of around 45 days. Management of endophthalmitis included intravitreal injections, anterior chamber (AC) lavage, Pars Plana vitrectomy (PPV), posterior capsulotomy, IOL, and capsular bag removal. Multiple intravitreal injections were required due to recurrence of infections after initial improvement with voriconazole injections. Results: Structural integrity was maintained and infection-free status was achieved in all the eyes. The presenting vision ranged from 6/60 to PL (perception of light). Seven out of 10 had improvement in their final vision over the presenting vision. Final outcome of four patients had vision of 6/24 or better, 4 patients had vision in the range of 2/60 to 6/36 and 2 patients had PL. Conclusion: Trichosporon can cause devasting infections even in the immunocompetent, especially in association with implants and catheters. Triazoles form the mainstay of treatment of Trichosporon infection due to the high susceptibility of the organism in vitro. A regimen including voriconazole and amphotericin B may prove to be the most effective. This is the first report of an outbreak of cluster endophthalmitis caused by Trichosporon
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Background:The objective of this study was to evaluate biochemical markers as predictors of dengue severity clinical outcome, bleeding severity, capillary leakage, supportive therapy requirement and duration of hospital stay.Methods:In this observational study Patients from age more than 15 years with history of acute febrile illness Total 263 confirmed cases (based on the WHO criteria) of DF were included in this study, who have been admitted in our hospital. We measured levels of CK, LDH, AST and ALT with modified liquid-UV tests; semi-quantitative levels of CRP with a colorimetric rapid test; levels of albumin with colorimetric tests; and lipid profiles [cholesterol, triglycerides, Low-density lipoprotein (LDL) and High-density lipo-protein (HDL)] with a liquid-color test. Positive control human samples were included in all tests.Results:We found that TG and LDL-C levels were significantly lower in dengue-positive patients compared to dengue-negative patients, and that LDL-C levels showed greater decreases and thus appeared to drive the reduction in total cholesterol. LDH, CPK, AST and ALT were significantly raised in DSS in compared to DF and other febrile illness. We found that lower total serum cholesterol and LDL-C levels at presentation were associated with subsequent development of DHF/DSS.Conclusions:Assessment of lymphocyte, platelet counts, levels of LDL, TG, CPK, LDH, levels of AST and ALT are very significant and easily available and low-cost biochemical markers for prediction of dengue infection severity.
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Background: Diabetes mellitus (DM) refers to a group of common metabolic disorders that associated with abnormalities in carbohydrate, fat, and protein metabolism which results in chronic complications. Attainment of optimal blood sugar level is generally based on appropriate usage and proper adherence to prescribed medications. The study was, therefore, aimed to assess adherence to oral antidiabetic drugs among diabetic patients attending outpatient clinic of L. L. R. Hospital, G.S.V.M. Medical College, Kanpur, U.P.Methods: Hospital based cross-sectional study design was conducted from April 2017 to June 2018. The data was collected by interviewing T2DM patients receiving antidiabetic medications using Morisky’s four item adherence assessment questionnaire. The collected data was processed and analyzed with SPSS version 20.Results: From the 126 patients of diabetes, when asked about adherence to their medications as per the Morisky's four item method, 114 (90.47%) of them did not forget to take the drugs, 108 (85.71%) of patients reported that they had been being careful in taking their medications, 90 (71.42%) patients did not stop medications when they felt better and the other 108 (85.71%) patients reported that they did not stop medications when they felt worse while taking medications. This study shows that 54 (42.86%) respondents were adherent to their medications.Conclusions: This study revealed a moderate level of adherence among the participants and statistically significantly depended upon their socioeconomic status. Efforts are needed to increase the medication adherence of these patients’, so they can realize the full advantage of prescribed therapies.
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Background: Diabetes mellitus has emerged as a major public health problem in our country, and our country has a distinction of having the largest number of diabetics in the world. Only a few epidemiologic studies have been done on the prevalence of skin disorders in patients with diabetes mellitus. Present study was conducted to study of cutaneous manifestations associated with diabetes mellitus at a tertiary care teaching hospital. Methods: 200 patients with Diabetes Mellitus, visiting the Department of Medicine and Department of Dermatology (outpatient and inpatient) of Uttar Pradesh University of Medical Sciences, Saifai, Etawah, UP (India) during the period of 1 yr. from April 2015 to March 2016 were included in the study. Detailed history was taken as per proforma and patient investigated. Results: Maximum incidence was seen between 41-70 yrs. of age and in middle class. Infections and infestations were the commonest associations detected in 49.5% of cases out of which fungal infections were observed in majority of the cases (24.5%) followed by bacterial infection (15.5%) and viral infections (7.0%). Psoriasis and xerosis were detected in 6.0 % of cases each. Skin disease strongly associated with diabetes mellitus like vitiligo were observed in 3.5 % of cases. Conclusion: Skin lesions in Diabetes mellitus are sometimes mirror to an underlying disease process and they may be the first expression of the disease. Most of the diabetic patients who developed cutaneous manifestations were in the 41-70 year age group, and infections were the single largest type of involvement seen. Cutaneous lesions can serve as cutaneous markers for DM. These can be detected by a simple cutaneous examination. The commonly seen nonspecific skin manifestations can also be used as skin markers for DM. This can be especially useful in the rural areas where advanced facilities are often unavailable.
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Aims: To evaluate a new approach for recanalization (RC) of nasolacrimal duct obstruction in the treatment of the symptomatic nasolacrimal duct obstruction (NLDO). Materials and Methods: A prospective, interventional, comparative study in 302 eyes of 209 patients of symptomatic nontraumatic NLDO. Eyes with previous failed surgery were excluded. One hundred and fifty‑one eyes underwent RC with 20 G endodiathermy bipolar probe connected to a 7 W diathermy followed by bicanalicular intubation under direct visualization. One hundred and fifty‑one eyes underwent standard external dacryocystorhinostomy (DCR). Follow‑up was for 24 months and evaluation was done on basis of change in symptoms and lacrimal syringing. Data was analyzed by Chi‑square test and unpaired t‑test. P value < 0.05 was considered statistically significant. Results: Success defined as an asymptomatic patient or freely patent syringing was 92.7% (140 eyes) in RC group and 83.44% (126 eyes) in DCR group. Success was significantly more (P ≤ 0.01) in RC than DCR group. Surgical time was significantly less in RC than DCR (P ≤ 0.001). In RC group, RC could not be performed in three eyes and had to be later taken up for DCR. Intubation after RC was not achieved in four eyes; however these eyes had a patent pathway till 24 months. Twenty‑two eyes had a premature extrusion of the tube; but the success rate in these (20 eyes) was comparable to the others within the group (P > 0.05). Two eyes in RC and one in DCR group had complications. Conclusions: RC with 20 G endodiathermy bipolar probe is a quick, simple, and effective alternative to standard external DCR.
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A 16-year-old girl had decrease in vision following dapsone overdose. This case demonstrated optical coherence tomography (OCT) evaluation of macular infarction following dapsone poisoning. OCT showed characteristic serial changes as Stage 1: Cystic macular edema, Stage 2: Resolving cystic change and Stage 3: Foveal atrophy. Hence, OCT could show the progression of foveal atrophy from cystic macular edema following dapsone poisoning.
Subject(s)
Adolescent , Dapsone/poisoning , Female , Follow-Up Studies , Humans , Infarction/chemically induced , Leprostatic Agents/poisoning , Macula Lutea/blood supply , Drug Overdose , Severity of Illness Index , Suicide, Attempted , Tomography, Optical Coherence/methods , Visual AcuityABSTRACT
A plastic foreign body penetrating the anterior base of skull through the orbit in a 10-year-old male child is reported.