Intravitreal sustained-release dexamethasone implant for the treatment of persistent cystoid macular edema in ocular syphilis

With a resurgence of syphilis with human immunodeficiency virus (HIV) infection in last few years, various ocular manifestations of syphilis have been described in literature. This case report described an HIV-positive patient on anti-retroviral therapy who was diagnosed and treated for posterior uveitis secondary to ocular syphilis in the recent past presented to our clinic with cystoid macular edema (CME). CME, which did not respond to periocular corticosteroid, resolved with intravitreal sustained release dexamethasone implant. There was a recurrence CME 9 months later and repeat injection of intravitreal implant showed complete resolution. A long-term follow-up did not reveal reactivation of the infection with intravitreal corticosteroid. Intravitreal sustained release dexamethasone implant can be an effective treatment for refractory CME in patients with regressed syphilitic uveitis.

Short term outcome, complications and average direct cost in managing extremely low birth weight infants in a tertiary care centre in Sri Lanka.

Introduction: Data on cost, short term complications and outcome of Sri Lankan extremely low birth weight (ELBW) babies is largely unavailable. Objective: To determine the cost, selected short term complications (surfactant treated and untreated) and short term outcome of ELBW infants in a tertiary care unit in Sri Lanka. Design, setting and method: A descriptive longitudinal study was carried out at Castle Street Hospital for Women over a 6 month period on all ELBW infants, excluding babies who were born after less than 23 completed weeks of gestation and babies who were transferred from the unit. Results: During the study period there were 39 ELBW babies. Ranges of birth weights and maturity were from 540g to 980g (mean 853g) and from 25 weeks to 34+3days respectively. Fifty one percent were small for gestational age. Survival rate was 76.9% at discharge. Hospital stay, intensive care unit stay, duration of mechanical ventilation and supplemental oxygen were 60.6, 13, 3.5 and 9.0 days per survivor respectively. Direct cost per survivor was SLR 82,207. Incidences of complications were 19.4% intraventricular haemorrhage, 8.3% necrotising enterocolitis, 22.2% pulmonary air leak, 11.1% pulmonary haemorrhage and 2.7% patent ductus arteriosus. Average weight gain on discharge was 5.2g/kg/day. Conclusions: Overall survival rate was 77%. IVH was significantly less in surfactant treated babies.

Hypertension due to angiodysplasia.

Renovascular hypertension is non essential hypertension, wherein anatomically evident arterial occlusive disease and increased blood pressures are related as cause and effect. The hypertension is due to renal ischemia. Angiodysplasia is an uncommon angiopathy associated with heterogeneous histological changes that may affect the carotid circulation and the visceral and peripheral arteries.

Cardiology--a saga of one hundred years "but, where is the conductor?"--Braunwald, 2003.

Modern Cardiology was born with the birth of ECG invented by Einthoven in 1903. Since then a galaxy of great pioneers in succession led Cardiology through unprecedented landmark achievements to the present state which is as promising as challenging. This article reviews the journey of Cardiology as a speciality in the last one hundred years of its noteworthy life while highlighting the future directions and challenges the specialty is likely to face."

Protective effect of N-acetylcysteine against gamma ray induced damages in rats--biochemical evaluations.

The effect of N-acetylcysteine (NAC) (Ig/kg body weight in saline for 7 days) against the damages induced by gamma ray was studied. Whole body exposure of rats to gamma-rays (3.5 Gy) caused increases in lipid peroxides (P < 0.01). Reduced glutathione (GSH) (P < 0.01) and total sulphydryl groups (TSH) (P < 0.05), were found to be increased probably to counteract the damages produced by the lipid peroxides. The plasma antioxidant vitamins E, C and A were reduced. The activities of antioxidant enzymes, superoxide dismutase (SOD), catalase and glutathione peroxidase (GPx) were enhanced, which might be to eliminate the superoxide radical and H2O2 and accompanied by a fall in glutathione-s-transferase (GST) and glutathione reductase (GR) activity. The excessive production of free radicals and lipid peroxides might have caused the leakage of cytosolic enzymes such as aminotransferases (AST and ALT), lactate dehydrogenase (LDH), creatine kinase (CK) and phosphatases. Membrane damage is quite evident from histological studies undertaken in the intestinal tissue, which is susceptible to radiation damage. Intragastric pretreatment of NAC (1g/kg body weight in saline for 7 days) prevented the radiation induced damage to an appreciable extent. From the results it may be concluded that NAC is effective in protecting from the damages caused by gamma-ray radiations and its prospects as an adjuvant to radiotherapy should be considered.