Effect of atropine 0.01% on progression of myopia

Purpose: Myopia is the most common type of refractive error and the leading cause of functional visual loss. Increased risk of myopic maculopathy, retinal detachment, glaucoma and cataract has been seen with a myopia of as low as ?1D. This study was done to determine the effect of atropine 0.01% eye drops on the progression of myopia in children >5 years. Methods: This was a single?blind, prospective, randomized case–control study which included children of 5–15 years with myopia of >2D and were divided into treatment group (group 1) and placebo group (group 2). Children under treatment group were treated with application of 0.01% atropine at night. Children with history of any ocular surgery, chronic ophthalmic illness, squint and amblyopia were excluded from the study. The follow?up for myopia progression was done for two years. Results: This study showed a significant difference in increase of spherical equivalent and axial length among treatment and placebo groups after a duration of two years. Total duration of follow up was twenty?four months. Mean increase in axial length of group 1 and 2 was 0.115 mm and 0.32 mm, respectively. Mean increase in refraction of groups 1 and 2 was ?0.30 D and ?0.88 D, respectively, showing significant change in axial length and refraction (P < 0.0001). Conclusion: This study supports the use of atropine 0.01% eye drops in reducing the progression of myopia.

Analysis of COVID-19-associated rhino-orbital-cerebral mucormycosis patients in a tertiary care center in Northern India

Purpose: An unprecedented surge has been noted in rhino?orbital?Cerebral mucormycosis (ROCM) in times of current COVID?19 pandemic. The present prospective study aims to evaluate clinico?epidemiological profile, risk factors, management, and outcome of the cases of ROCM that presented to our tertiary care center during the study period from April to June 2021. Methods: All patients were subjected to complete history taking, ophthalmological examination, and imaging studies. The patients were staged and were treated with intravenous liposomal amphotericin B (AMB) and sino?nasal debridement of local necrotic tissue. Transcutaneous retrobulbar AMB (TRAMB), orbital decompression, and exenteration were instituted as indicated. All patients were followed up for a minimum of 6 months before arriving at the final outcome. Statistical analysis was performed. Results: A total of 49 patients presented during the study period, with a mean age of 42.2 years. The major risk factors included uncontrolled diabetes (89.8%), COVID?19 positivity (51.02%), and concurrent steroid use (38.77%). The most common presenting symptom was facial pain/swelling (43.65%), while the most common presenting sign was deterioration in vision (75.51%). Intravenous liposomal AMB was given to all patients along with sino?nasal debridement (85.71%), TRAMB (57.14%), orbital decompression (14.28%), and exenteration (12.24%). Overall, mortality at 6 months was 22.45% (11 patients). Age more than 60 years, intracranial extension, and HbA1c of more than 8.0% were observed to be statistically significant indicators of mortality. Conclusion: Early suspicion and timely diagnosis of mucormycosis at rhino?orbital stage is warranted in order to salvage life as well as visual function. TRAMB may prove as potentially favorable treatment modality in cases with limited orbital involvement.

Assessment of Refractive Status of 5-15 Years Old Children Attending Government Schools of Rural Agra

Introduction: In children uncorrected refractive errors have a profound effect on educational and psychosocial development hence it is necessary to estimate the prevalence both at the community and at the school level to aid planning and implementation of refractive error services in children. Objective: To determine the refractive status of 5 to 15 years old children attending government schools of rural areas of district Agra, Uttar Pradesh (UP), India. Method: Study conducted on 902 students of age group 5-15 years of randomly selected government schools of Bichpuri Block of district Agra. Children underwent visual acuity assessment and torch light examination, height and weight measurement. Children with VA ?6/9 were further examined and cycloplegic retinoscopy, fundus examination, slit lamp examination and post mydriatic refraction was done. On the basis of values of cycloplegic refraction and post mydriatic refraction, refractive error was classified as myopia, hypermetropia and astigmatism. Statistical Analysis was done by applying Chi square test. Results : Out of 902 children, 125 children (13.86 %) were having refractive error of which 76 were myopic (8.43%), 39 were astigmatic (4.32%) and 10 were hypermetropic (1.11%). There was an increase in the overall prevalence of refractive error with advancing age. There was no significant association of refractive error with gender and nutritional status. Conclusion: Vision screening of school children is very useful for early detection and correction of refractive errors. Screening of the refractive errors in school should be carried out periodically and regularly

Flubendiamide: Entry of a new insecticide into the field of clinical toxicology.

Flubendiamide is a new lepidopteron insecticide developed for the use against pests of a wide array of annual and perennial crops. It is the first commercial representative of a new chemical class, the phthalic acid diamides. Flubendiamide is said to have a low order of acute toxicity in humans via the oral, dermal and inhalation routes. There are hardly any reports of poisoning due to flubendiamide in humans. In this paper, a case of attempted suicide by consumption of flubendiamide-containing insecticide by a farmer is being reported.

Antioxidants and lipid peroxidation in gestational diabetes--a preliminary study.

Increased free radical activity in gestational diabetes (GDM) can lead to a host of damaging and degenerative maternal and fetal complications. Hence antioxidant levels in blood of GDM mothers and cord blood were estimated. Erythrocyte glutathione (GSH), superoxide dismutase (SOD) and thiobarbituric acid reactive substances (TBARS), plasma vitamins C and E and serum total glutathione-S-transferase (GST), protein thiols and ceruloplasmin (Cp) were estimated spectrophotometrically in maternal blood of age matched controls and mothers with GDM and also in cord blood samples of the above. There was a significant increase in the erythrocytic GSH, serum total GST and protein thiols in GDM maternal blood when compared to controls whereas erythrocytic SOD exhibited a marked decrease in GDM cases. The changes in plasma vitamins C and E, Cp and erythrocytic TBARS in GDM were not significantly different from controls. Cord blood levels of protein thiols were also significantly increased in GDM. No significant changes were observed in the serum Cp and GST levels of the same. Hence, elevated glucose levels can induce oxidative stress in GDM mothers.