Efficiency of fenofibrate in facilitating the reduction of central macular thickness in diabetic macular edema

Purpose: The purpose of this study is to study the benefit of addition of oral fenofibrate to the current regimen of diabetic macular edema (DME) management and quantify its effect on macular thickness and visual function in DME. Methods: Fifty-three eyes of 50 patients were randomized into treatment (Group A) (oral fenofibrate 160 mg/day) and control groups (Group B). Both groups underwent treatment of DME as per the standard treatment protocol of our hospital including intravitreal injections (anti-vascular endothelial growth factor/steroid) and grid laser. Patients were followed up every 2 months to note the visual acuity and central macular thickness (CMT) for 6 months. Results: Our groups were matched with respect to age (P = 0.802), mean diabetic age (P = 0.878), serum HbA1C levels (P = 0.523), and serum triglyceride levels (P = 0.793). The mean reduction in CMT was 136 ? in Group A and 83 ? in Group B at the end of 6 months. This difference was statistically significant (P = 0.031). Visual acuity improvement was 0.15 in Group A and 0.11 in Group B at the end of 6 months (P = 0.186). On subgroup analysis in Group A, we found that there was no difference in reduction of CMT between hypertensives and normotensives (P = 0.916), in patients with normal triglyceride levels and increased triglyceride levels (P = 0.975). Conclusion: Addition of fenofibrate to the standard protocol of DME management seems to facilitate reduction of CMT and probably have an added benefit on the visual functions.

Sublingual misoprostol: A better choice for cervical priming before manual vacuum aspiration.

Background: Misoprostol is effective for cervical priming before manual vacuum aspiration (MVA). Aim of study was to determine whether sublingual misoprostol with a shorter interval of 2 hours before MVA would be as effective as its standard vaginal administration. Study Design: This randomized control trial included 82 women randomly assigned to receive 400 mcg of misoprostol, either sublingually or vaginally. MVA was performed 2 hours and 3 hours after in sublingual and vaginal group, respectively. Results: Cervical dilatation of 8 mm was achieved within 2 hours in sublingual group. Mean time taken for procedure (14.4 ± 5.3: sublingual group and 16.2 ± 5.7: vaginal group), and blood loss was comparable (12.2 ± 9.7 ml in sublingual group and 13.7 ± 8.5 ml in vaginal group). Conclusion: 2 hour of cervical priming with 400 mcg of sublingual misoprostol before MVA was as good as 3 hours with vaginal administration of the same dose.

Frontal convexity primary lymphoma masquerading meningioma: a case report and review of literature.

Primary non-Hodgkin's lymphoma of the skull with extra- and intracranial extension without systemic or skeletal manifestation in a nonimmunocompromised patient is extremely rare. These lesions often cause difficulty in diagnosis because they mimic other conditions. We report a case of primary lymphoma involving scalp, skull vault, meninges and invading the brain parenchyma and masquerading clinically and radiologically as a meningioma.

Connective tissue naevus.

A case of non hereditary connective tissue naevus without any association with systemic complaints, in a 20-year old male is reported.

A clinical study of vitiligo.

A clinical study of one hundred patients having vitiligo revealed the incidence among new patients to be 1.84%. The male/female ratio was 1:1.22. Family history of vitiligo was available in 8% of our patients. The different morphological pattern consisted of vitiligo vulgaris (39 cases), focal vitiligo (27 cases), acrofacial vitiligo (18 cases), lip-tip vitiligo (7 cases), lip vitiligo (5 cases), segmental vitiligo (3 cases) and universal vitiligo (1 case). Associated diseases include atopic dermatitis (2 cases), Hansen's disease (2 cases), alopecia areata (1 case), halo naevus (1 case), chronic urticaria (1 case), lichen planus (1 case), diabetes mellitus (9 cases), hypertension (4 cases), hypothyroidism (2 cases), epilepsy (1 case) and IHD (1 case).

Pigmented xerodermoid.

An 18-year-old female who presented with features suggestive of pigmented xerodermoid is reported.

Lipoprotein lipase deficiency.

A rare case of a 3 month old child with lipoprotein lipase deficiency who presented with bronchopneumonia is reported. After noticing lipaemic serum and lipaemia retinalis, a diagnosis of hyperlipoproteinaemia was considered. Lipoprotein lipase deficiency was confirmed with post heparin lipoprotein lipase enzyme activity estimation.

Bacterial clearance with WHO--recommended multidrug regimen for multibacillary leprosy.

Sixty multibacillary leprosy patients with an average initial bacteriological index (BI) of 2.5 were followed up after they had completed the WHO--recommended multidrug therapy regularly till attaining bacteriological negativity. The minimum duration of treatment was two years as stipulated by WHO and the maximum duration for reaching negativity was seven years (mean 4.25 years). The minimum time for the attainment of bacteriological negativity was one year and the maximum was 6.75 years (mean 3.75 years). The higher the initial BI the longer was the time taken for the attainment of bacteriological negativity. The average fall of BI per year was 0.67. Dapsone monotherapy received before the commencement of MDT, prednisolone received during therapy and the type of leprosy did not have any effect on the time taken for bacteriological clearance. There was no relapse during the period of observation (mean 2.83 years). The site to attain negativity last was the ear lobe, in 95% of the cases.

Knowledge, attitude and practices of the community and patients regarding leprosy in Mangalore--a study.

To get acquainted with the knowledge, attitude and practices of the community and the patients towards leprosy so as to evolve a suitable health education programme, a study was conducted in Mangalore as per the schedule prepared for the purpose. The information so collected has been summarised below. Very few people among the community know that leprosy is caused by a germ (8%). Knowledge regarding this was slightly better (22%) among patients. Only 15% of the community members and 42% of the patients were aware of the early signs of the disease. 54% of the community members and 41% of the patients felt that leprosy is contagious. 60% of the community and 86% of the patients were of the opinion that leprosy is curable. Many believe that leprosy is associated with deformities and disabilities (community 64%, patients 76%). Most of the community members (79%) and patients (88%) said it is necessary to attend a hospital for treatment when leprosy is suspected. 60% of the community members and 56% of the patients felt that it is necessary to segregate leprosy patients. The findings are highlighted and discussed in the article.