Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 184
Filtrar
1.
Indian J Ophthalmol ; 2024 Jul 11.
Artículo en Inglés | MEDLINE | ID: mdl-38990636

RESUMEN

PURPOSE: To compare the visual outcomes, postoperative complications, and graft asymmetry between precut and manually dissected donor tissues for Descemet stripping automated endothelial keratoplasty (DSAEK) and Descemet stripping endothelial keratoplasty (DSEK) procedures, respectively. METHODS: Seventy eyes of 70 patients undergoing DSEK/DSAEK at a tertiary eyecare center in eastern India were included in this prospective randomized control study. The 70 eyes were divided equally into two groups. Group A (n = 35) and Group B (n = 35) underwent DSEK and DSAEK procedures, respectively. the operating surgeons prepared the manually dissected corneal grafts using lamellar dissectors. the eye bank technicians prepared the precut corneal grafts using a microkeratome. The patients were investigated postoperatively after 1 day, 1 week, 1 month, 3 months, and 6 months. The data were compared for visual outcomes [uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), spherical and cylindrical refraction, and spherical equivalent], incidence of postoperative complications, and pachymetry. RESULTS: The mean age was 56.5 (±17.8) years, and the male-to-female ratio was 1.3:1. The most common indications were pseudophakic bullous keratopathy (45.71%, 32/70), failed graft (32.86%, 23/70), and Fuchs' endothelial corneal dystrophy (10%, 7/70). The indications for surgery (P = 0.732) and donor (P = 0.258) and host pachymetry (P = 0.986) were comparable between both groups. There was no significant difference in change of UCVA, BCVA, and postoperative refraction (mean spherical refraction, P = 0.849; mean cylindrical refraction, P = 0.516; spherical equivalent, P = 0.518) between the two groups. Postoperative complications like graft detachment (P = 0.179), graft failure (P = 0.513), graft infiltrate (P = 0.428), and endophthalmitis (P = 0.493) were higher in the DSAEK group; however, the difference between the groups was insignificant. The graft asymmetry index was higher in DSAEK than in DSEK; the difference was significant till the 1-month follow-up (P = 0.005). CONCLUSION: The outcome was similar in both groups. Therefore, manual donor dissection can be an alternative for microkeratome-assisted dissection in low-resource centers and countries to achieve good results.

3.
Ocul Surf ; 34: 22-29, 2024 Jun 08.
Artículo en Inglés | MEDLINE | ID: mdl-38857689

RESUMEN

Filamentary keratitis (FK) is a clinical sign of underlying ocular and systemic conditions. FK can cause significant irritation, tearing, and photophobia in the eye. It is a refractory debilitating condition caused by dry eye that affects the day-to-day activities of patients. The etiopathogenesis of FK is not well known; there are numerous predisposing causes. The condition starts as a sub-epithelial or Bowman's membrane dysfunction and leads to the shedding of epithelial cells that take a strand-like form and attach to the cornea. These strands are surrounded by mucin and continue to elongate to become filaments. The filament formation is further aided by the shearing action caused by eyelid movements. Several management approaches, such as addressing the underlying causes of filamentary keratitis, administering copious lubricants, topical corticosteroids, mucolytic agents, bandage contact lenses, punctal plugs, and mechanical removal of filaments are available. The prognosis is fair, and most cases resolve with occasional recurrences. Traditionally FK has been treated with lubricants, mechanical removal, and bandage contact lenses. The newer treatments are topical immunomodulators especially that treat filamentary keratitis associated with aqueous deficient dry eye. The review describes the treatment as well as pathogenesis.

4.
Free Radic Res ; : 1-18, 2024 Jun 22.
Artículo en Inglés | MEDLINE | ID: mdl-38810269

RESUMEN

(-)-Epigallocatechin-3-gallate (EGCG), a bioactive polyphenol of green tea, has chemo-preventive effects against various cancer cells. Nanoparticles (NPs) carrying different ligands are able to specifically interact with their receptors on different cancer cells that can provide effective release of cytotoxic drugs. In the present study, we have prepared EGCG entrapped NPs using PLGA (poly(d,l-lactide-co-glycolide)). Polyethylene glycol (PEG) and folic acid (FA) via double emulsion solvent evaporation (DESE) method obtained PLGA-EGCG (P-E), PLGA-PEG-EGCG (PP-E), and PLGA-PEG-FA-EGCG (PPF-E). Nanoformulations had been characterized with 1H NMR and FT-IR techniques, AFM, and DLS. PPF-E NPs showed an average size of 220 nm. Analysis of zeta potential confirmed the stability of NPs. HCT-116, HT-29, HCT-15, and HEK 293 cells were treated with both the prepared NPs and free EGCG (0-140 µM). Result showed PPF-E NPs had improved delivery, uptake and cell cytotoxicity toward human folic acid receptor-positive (FR+) colorectal cancer (CRC) cells as mainly on HCT-116 compared to HT-29, but not on the folic acid-negative cells (FR-) as HCT-15. PPF-E NPs enhanced intracellular reactive oxygen species (ROS) level in absence of N-acetyl-l-cysteine (NAC), elevated DNA fragmentation level, and increased apoptotic cell death at higher doses compared to other two NPs and free EGCG. In conclusion, PPF-E NPs exerted greater efficacy than PP-E, P-E, and free EGCG in HCT-116 cells.

5.
Eye Contact Lens ; 50(6): 265-269, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38687618

RESUMEN

PURPOSE: To examine the microbiological profile of cases of culture-positive fungal keratitis presenting to a tertiary eye care center in eastern India. METHODS: Microbiology records of all culture-positive microbial keratitis patients presenting to L V Prasad Eye Institute, Bhubaneswar, between January 2020 and December 2021, were retrospectively reviewed. Collected data included smear results of culture-positive fungal or mixed infections, the species isolated, and the time taken for organisms to grow in each media. RESULTS: Fungal keratitis formed 36% of all culture-positive microbial keratitis, whereas mixed infections (fungi and other organisms) formed 8.5%. The most common fungal species isolated was Fusarium spp. (25.8%). The most common bacteria involved in mixed infection with fungi was Staphylococcus spp. (54.8%). The positivity of potassium hydroxide+calcofluor white stain in detecting fungal filaments was 89.0% and that of Gram stain was 76.1%. Culture-positive cases of fungal keratitis showed most frequent growth on potato-dextrose agar (77.6%). A similar pattern was observed in culture-positive mixed infections (Sabouraud dextrose agar [SDA]: 84%). Most frequent growth of bacteria in mixed infections was seen in thioglycolate broth (54.7%). The shortest time to achieve significant fungal growth was observed in blood agar (BA) and chocolate agar (CA) (2.2/2.3 days, and 1.8/2 days for fungal keratitis and mixed infections, respectively). Filamentous hyaline fungi took the shortest time to achieve significant growth (2.8 days), whereas yeast forms took the longest (5 days). CONCLUSION: This study highlights the importance of combined use of both solid and liquid culture media, especially potato dextrose agar (PDA)/SDA and CA, to arrive at a definitive diagnosis of fungal keratitis and possible bacterial co-infection, which forms a significant proportion of cases with fungal keratitis. In resource-poor laboratories, two culture media, either SDA or PDA, along with BA, may be plated to detect mixed infections. Examination of stained smears of corneal samples provides an inexpensive method of rapid diagnosis of fungal keratitis when culture media is not available.


Asunto(s)
Infecciones Fúngicas del Ojo , Hongos , Queratitis , Humanos , Infecciones Fúngicas del Ojo/microbiología , Infecciones Fúngicas del Ojo/diagnóstico , Estudios Retrospectivos , Hongos/aislamiento & purificación , Queratitis/microbiología , Queratitis/diagnóstico , Masculino , Femenino , Persona de Mediana Edad , Adulto , India , Bacterias/aislamiento & purificación , Anciano
6.
Indian J Ophthalmol ; 72(Suppl 4): S542-S552, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38454864

RESUMEN

This review highlights the evolution in the scope of eye banking activities in India. The roles and responsibilities of the eye banks have expanded to match the requirements and necessities that arose because of advancements in keratoplasty techniques and the need for corneal surgeons. Adoption of different types of corneal preservation solutions and methods of donor cornea preservation was a consequence of the changing and unprecedented times. The growth of eye banking in India has been a commendable journey and has placed the country in an "almost sufficient" category in eye banking and corneal transplantation. There exists a potential to reach the status of cornea surplus country in the future. The rules and laws governing eye banking operations need dynamic amendments based on the trends in keratoplasty, surgical practice patterns, and status of self-sufficiency. Newer technological advances and quality measures must be adopted in donor cornea evaluation and tissue preparation. Research should be integrated as an important component of eye banking, especially in developing novel methods of donor preservation, and evaluating and validating the existing and changing practices of eye banking.


Asunto(s)
Trasplante de Córnea , Bancos de Ojos , Humanos , India , Donantes de Tejidos , Obtención de Tejidos y Órganos/legislación & jurisprudencia , Córnea , Preservación de Órganos/métodos
7.
Ocul Immunol Inflamm ; : 1-3, 2024 Mar 21.
Artículo en Inglés | MEDLINE | ID: mdl-38512320

RESUMEN

PURPOSE: To elucidate a distinctive clinical feature in cases of microsporidial stromal keratitis (MSK). METHOD: A retrospective observational study of cases with a histopathological and/or microbiological diagnosis of MSK on corneal biopsy or host corneal button between 2016 and 2022 was conducted. RESULTS: Eighteen cases with a confirmed histopathological and/or microbiological diagnosis of MSK were detected. Careful review of slit-lamp photographs revealed the presence of pigmented keratic precipitates (KPs) beyond the area of stromal keratitis in five out of eighteen cases (27.7%). CONCLUSION: The presence of pigmented KPs beyond the area of lesion can alert the clinician to keep microsporidia as a differential cause for stromal keratitis. Management can be tailored accordingly for a better outcome.

8.
Cornea ; 43(2): 141-145, 2024 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-37318143

RESUMEN

PURPOSE: The aim of this study was to analyze the tissue quality and outcomes of corneal transplants from donor corneal tissues harvested from drowning victims. METHODS: This retrospective study was conducted on corneal tissues harvested from drowning victims between March 2018 and September 2022. Details of the tissue quality and outcomes after keratoplasty were collected from the eye bank and outpatient records. RESULTS: Thirty-four donor corneas were collected from drowning victims during the study period. The mean age of the donors was 37.1 ± 20.3 years. The mean donor-to-preservation time was 4.9 ± 2.6 hours. The mean endothelial cell density was 3025 ± 271 cells/mm 2 . Twenty donor corneas (58.8%) were used at our institute, 2 were stored in glycerol for future use, and 12 were transported to other transplant centers. The overall utilization was 94.1% (32/34 corneas). Of the 20 corneas used at our institute, 17 were used for optical grafts and 3 for therapeutic indications. Of the 17 optical grafts, 10 were used for optical penetrating keratoplasty, 6 for endothelial keratoplasty, and 1 for anterior lamellar keratoplasty. The most common indication for keratoplasty was regrafting the previously failed grafts (25%). None of the transplanted eyes developed an infection in the immediate postoperative period. Eight eyes had clear grafts after 3 months. Of the 12 tissues transferred to other keratoplasty centers, 10 were used for optical grafts and 2 for therapeutic/tectonic grafts. CONCLUSIONS: Donor corneas retrieved from drowning victims may be considered safe for transplantation. The postoperative outcomes of the tissues obtained from these donors were satisfactory. Hence, these donor corneas can be optimally used in routine transplantation procedures.


Asunto(s)
Trasplante de Córnea , Ahogamiento , Humanos , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Estudios Retrospectivos , Córnea , Trasplante de Córnea/métodos , Donantes de Tejidos
9.
Appl Radiat Isot ; 204: 111128, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38056282

RESUMEN

Multiple patient doses of [201Tl]TlCl has been produced using electrodeposited enriched 203Tl in 30 MeV cyclotron (Cyclone-30) with 28 MeV proton energy at 50 µA beam current for 8 h. Ion Exchange Column Chromatography (IECC) and liquid-liquid extraction has been employed for semi-automated radiochemical separation and purification of produced [201Tl]TlCl. The produced [201Tl]TlCl was used in coronary artery disease (CAD) patients.


Asunto(s)
Ciclotrones , Talio , Preparaciones Farmacéuticas , Talio/análisis
10.
Indian J Ophthalmol ; 72(4): 571-577, 2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-38099368

RESUMEN

PURPOSE: Corneal biopsy helps in diagnosing deep-seated or recalcitrant lesions of microbial keratitis (MK). We aim to analyze its role in managing these challenging cases. METHODS: This is a retrospective review of 22 cases of corneal biopsy at our institute from January 2010 to December 2021. Data were retrospectively collected using the electronic medical record (EMR) system. Those cases of indolent, progressive MK or deep-seated lesions where cornea scraping was not possible were considered for corneal biopsy to establish the microbiological diagnosis. The primary aims of our study were to analyze the indications, success rates, and outcomes for biopsy patients in our series. Additional outcomes that were analyzed included the average time from presentation to biopsy, the type of causative organism isolated from the biopsy by either histopathological or microbiological method, and the frequency and outcome of surgical interventions performed. Descriptive statistics using mean (±standard deviation) and median (±range) were used to interpret the demographic data. RESULTS: Overall, 15 of 22 patients (68%) had a positive corneal biopsy after microbiological or histopathological examinations. The most identified organism was microsporidia (n = 4,30.7%), followed by mycobacteria (n = 2,15.4%), gram-negative bacilli (n = 2,15.4%), acid-fast bacilli (n = 1,7.6%), fungus (n = 2,15.4%), gram-positive cocci (n = 1,7.6%), and mixed bacterial infection (n = 1,7.6%). CONCLUSION: Corneal biopsy should be considered a diagnostic modality for patients with deep-seated or unresponsive MK. It can improve the treatment for MK, ensuring targeted therapy.


Asunto(s)
Infecciones Bacterianas del Ojo , Queratitis , Humanos , Estudios Retrospectivos , Infecciones Bacterianas del Ojo/diagnóstico , Infecciones Bacterianas del Ojo/terapia , Infecciones Bacterianas del Ojo/microbiología , Queratitis/microbiología , Córnea/patología , Biopsia/métodos
11.
Indian J Ophthalmol ; 72(1): 19-28, 2024 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-38131566

RESUMEN

Atypical mycobacteria or non-tuberculous mycobacteria (NTM) are a group of acid-fast bacteria that are pathogenic to different parts of the eye. The organisms can cause a spectrum of ocular infections including keratitis, scleritis, uveitis, endophthalmitis and orbital cellulitis. Trauma, whether surgical or nonsurgical, has the highest correlation with development of this infection. Common surgeries after which these infections have been reported include laser in situ keratomileusis (LASIK) and scleral buckle surgery. The organism is noted to form biofilms with sequestration of the microbe at different inaccessible locations leading to high virulence. Collection of infective ocular material (corneal scraping/necrotic scleral tissue/abscess material/vitreous aspirate, etc.) and laboratory identification of the organism through microbiologic testing are vital for confirming presence of the infection and initiating treatment. In cluster infections, tracing the source of infection in the hospital setting via testing of different in-house samples is equally important to prevent further occurrences. Although the incidence of these infections is low, their presence can cause prolonged disease that may often be resistant to medical therapy alone. In this review, we describe the various types of NTM-ocular infections, their clinical presentation, laboratory diagnosis, management, and outcomes.


Asunto(s)
Infecciones Bacterianas del Ojo , Infecciones del Ojo , Queratitis , Infecciones por Mycobacterium no Tuberculosas , Humanos , Micobacterias no Tuberculosas , Infecciones por Mycobacterium no Tuberculosas/terapia , Infecciones por Mycobacterium no Tuberculosas/tratamiento farmacológico , Antibacterianos/uso terapéutico , Infecciones Bacterianas del Ojo/terapia , Infecciones Bacterianas del Ojo/tratamiento farmacológico , Queratitis/diagnóstico , Córnea/microbiología
12.
Indian J Ophthalmol ; 72(1): 105-110, 2024 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-38131579

RESUMEN

PURPOSE: This paper aims to describe the clinical presentation and demographic distribution of keratoconus (KCN) in India by analyzing the electronic medical records (EMR) of patients presenting at a multitier ophthalmology hospital network. METHODS: This cross-sectional hospital-based study included the data of 2,384,523 patients presenting between January 2012 and March 2020. Data were collected from an EMR system. Patients with a clinical diagnosis of KCN in at least one eye were included in this study. Univariate analysis was performed to identify the prevalence of KCN. A multiple logistic regression analysis was performed using R software (version 3.5.1), and the odds ratios are reported. RESULTS: Data were obtained for 14,749 (0.62%) patients with 27,703 eyes diagnosed with KCN and used for the analysis. The median age of the patients was 22 (inter-quartile range (IQR): 17-27). In total, 76.64% of adults (odds ratio = 8.77; P = <0.001) were affected the most. The majority of patients were male (61.25%), and bilateral (87.83%) affliction was the most common presentation. A significant proportion of the patients were students (63.98%). Most eyes had mild or no visual impairment (<20/70; 61.42%). Corneal signs included ectasia (41.35%), Fleischer ring (44.52%), prominent corneal nerves (45.75%), corneal scarring (13.60%), Vogts striae (18.97%), and hydrops (0.71%). Only 7.85% showed an association with allergic conjunctivitis. A contact lens clinic assessment was administered to 47.87% of patients. Overall, 10.23% of the eyes affected with KCN underwent a surgical procedure. the most common surgery was collagen cross-linking (8.05%), followed by deep anterior lamellar keratoplasty (1.13%) and penetrating keratoplasty (0.88%). CONCLUSION: KCN is usually bilateral and predominantly affects males. It commonly presents in the second and third decade of life, and only a tenth of the affected eyes require surgical treatment.


Asunto(s)
Queratocono , Adulto , Humanos , Masculino , Femenino , Queratocono/diagnóstico , Queratocono/epidemiología , Queratocono/tratamiento farmacológico , Estudios Transversales , Ciencia de los Datos , Agudeza Visual , India/epidemiología , Prevalencia , Estudios Retrospectivos
13.
BMJ Case Rep ; 16(12)2023 Dec 19.
Artículo en Inglés | MEDLINE | ID: mdl-38114293

RESUMEN

A patient in his sixth decade presented to us with redness, pain and a deterioration of vision in his left eye. He had previously been diagnosed with lattice corneal dystrophy (LCD). He was diagnosed with microbial keratitis, and mixed infection was confirmed on culture (bacteria and fungus) with a protracted healing period before resolution of keratitis. He presented 2 years later with similar issues in the same eye and was noted to have a second episode of microbial keratitis, with microsporidia spores noted on gram, potassium hydroxide and calcofluor white stains. He was diagnosed with microsporidial stromal keratitis and underwent therapeutic penetrating keratoplasty. Unfortunately, he suffered a recurrence of microsporidial keratitis following surgery with eventual transplant failure. Microsporidia as an infection in LCD has, to our knowledge, not been previously reported. We aim to discuss microsporidial infection and recurrent microbial keratitis in the setting of LCD.


Asunto(s)
Neuropatías Amiloides Familiares , Distrofias Hereditarias de la Córnea , Infecciones Fúngicas del Ojo , Queratitis , Microsporidios , Humanos , Masculino , Córnea/microbiología , Infecciones Fúngicas del Ojo/microbiología , Queratitis/microbiología , Persona de Mediana Edad , Anciano
14.
Optom Vis Sci ; 100(12): 887-894, 2023 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-38019963

RESUMEN

SIGNIFICANCE: This case series is the first to illustrate mixed infection from Pythium sp. and fungal species in corneal ulcer. PURPOSE: This case series aimed to alert all toward the possibility of both Pythium sp. and fungal species infection in case of nonresponding corneal ulcer treated with either antifungals or antipythium drugs alone. Increased suspicion of mixed infection in case of nonresponding fungal/ Pythium keratitis may facilitate early and prompt management. CASE REPORTS: Six patients presented with signs of either fungal or Pythium keratitis. They underwent ophthalmological examinations, smear examinations, cultures, and polymerase chain reaction (PCR). Therapeutic penetrating keratoplasty was performed in cases where symptoms worsened after treatment with either antifungal or antipythium drugs. The half corneal button (HCB) was shared for histopathological and microbiological examinations. In the first case, smear examination from corneal scraping (CS) revealed Pythium -like filaments, which were confirmed with PCR; however, Aspergillus nidulans grew in culture. In the second case, iodine-potassium iodide (IKI) staining was positive for Pythium ; however, PCR was positive for both Pythium and fungus, which was further confirmed by DNA sequencing. In the third case, IKI staining and HCB were positive for Pythium ; however, PCR was positive for fungus, which was identified as Candida saitoana with DNA sequencing. In the fourth case, Pythium grew in the CS culture; however, Candida sp. grew in the HCB culture. In the fifth case, Cladosporium sp. grew in culture from CS; however, Pythium insidiosum grew from the anterior chamber exudate after therapeutic penetrating keratoplasty. In the sixth case, smear examination revealed septate fungal filaments, and Cladosporium sp. grew in culture; however, HCB on histopathological examination showed features of Pythium keratitis. CONCLUSIONS: In unresponsive cases of Pythium or fungal keratitis, diagnostic modalities such as IKI and PCR should be implemented as a routine practice, in addition to smears and cultures.


Asunto(s)
Coinfección , Úlcera de la Córnea , Infecciones Fúngicas del Ojo , Queratitis , Pitiosis , Pythium , Animales , Humanos , Úlcera de la Córnea/diagnóstico , Úlcera de la Córnea/tratamiento farmacológico , Pythium/genética , Coinfección/tratamiento farmacológico , Pitiosis/diagnóstico , Pitiosis/microbiología , Pitiosis/terapia , Queratitis/diagnóstico , Queratitis/microbiología , Queratoplastia Penetrante , Antifúngicos/uso terapéutico , Infecciones Fúngicas del Ojo/diagnóstico , Infecciones Fúngicas del Ojo/tratamiento farmacológico
15.
Int J Psychiatry Med ; 58(5): 493-509, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37528759

RESUMEN

OBJECTIVE: COVID-19 may lead to a range of clinical outcomes among older people with psychiatric and medical conditions. Evidence guiding management of future outbreaks among this vulnerable population in psychiatric hospital settings are sparse. In this study, we examined the correlates of poor clinical outcomes related to COVID-19 and explored the perspectives of COVID-19 survivors hospitalized in psychiatry settings. METHOD: The correlates of poor clinical outcomes related to COVID-19 were examined using a retrospective chart review of 81 older people hospitalized in psychiatry settings. Correlates of clinical outcomes related to COVID-19 were assessed by multiple logistic regression models. In addition, the perspectives of 10 COVID-19 survivors were explored by qualitative interviews. The qualitative data was subject to thematic analysis. RESULTS: Although 25.9% (n = 21) participants were asymptomatic, there was high COVID-19 related mortality (14.8%; n = 12). Vitamin-D deficiency, anticholinergic burden, and isolation policies within psychiatric wards were significantly (p < 0.05) related to COVID-19 related deaths. In qualitative interviews, participants emphasized the importance of strengthening local support networks and making vaccination centers more accessible. CONCLUSIONS: Reducing anticholinergic prescriptions and improving isolation policies may help to mitigate poor clinical outcomes. Future research investigating the impact of vitamin-D supplementation on COVID-19 related outcomes is warranted.


Asunto(s)
COVID-19 , Trastornos Mentales , Humanos , Anciano , COVID-19/epidemiología , SARS-CoV-2 , Estudios Retrospectivos , Suplementos Dietéticos , Vitamina D , Vitaminas , Antagonistas Colinérgicos
16.
Indian J Ophthalmol ; 71(9): 3166-3170, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37602603

RESUMEN

Purpose: To observe the trends of various types of keratoplasties in different etiologies over a period of 10 years (2011-2020) in a tertiary eye care center of eastern India. Methods: A retrospective review of patients undergoing keratoplasties from 2011 to 2020 was performed in a tertiary eye care hospital situated in eastern part of India. Apart from demographic data, primary indication for each surgery and type of procedure carried out was recorded. For comparison, data were divided into two time periods: Group I: Jan 2011 to Dec 2015 and Group II: Jan 2016 to Dec 2020. Results: Over a period of 10 years, a total of 2365 (Group I: 902, Group II: 1463) keratoplasties were performed. The average age of patients was 45.8 ± 19.9 and 46.9 ± 20.9 years in Group I and Group II, respectively. Among all the corneal grafts, 1747 (74%) surgeries were full-thickness. Although optical penetrating keratoplasty (OPK) was most the common indication for full-thickness keratoplasties, Descemet's stripping endothelial keratoplasty (DSEK) remained most performed lamellar keratoplasty. Keratitis, corneal scars, and bullous keratopathies remain to be most common indications in both groups. Number of lamellar keratoplasties increased significantly from Group I to Group II for corneal scars (P = 0.02), bullous keratopathies (P = 0.01), and endothelial dystrophies (P = 0.00). Conclusion: With change in time, the indication and technique of keratoplasty has witnessed a changing trend from full-thickness keratoplasty to lamellar keratoplasty. There is rise in trend of lamellar keratoplasties over the period.


Asunto(s)
Trasplante de Córnea , Queratoplastia Penetrante , Humanos , Estudios Retrospectivos , India/epidemiología , Ceguera/epidemiología , Ceguera/cirugía , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Queratoplastia Endotelial de la Lámina Limitante Posterior
17.
Indian J Ophthalmol ; 71(9): 3192-3197, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37602607

RESUMEN

Purpose: To describe the outcomes of eyes with calcium carbide (CaC2)-related thermo-chemical injury. Methods: This study included 28 eyes of 23 patients who presented with calcium carbide-related ocular burns. Only patients with more than three months of follow-up were included. Group A included 16 eyes with Dua's Grade I-III burns, while Group B included 12 eyes with Grade IV-VI burns. Electronic medical records were reviewed to provide data on the etiology of burn, presenting clinical signs and visual acuity, sequelae, and surgical interventions performed, both in the acute and chronic phases. Results: The overall mean age was 28.48 ± 11.8 years. Fifteen patients were injured while using carbide to create an explosion to scare away animals on farms. The median presenting BCVA (best-corrected visual acuity) in Group A (20/160) was significantly better than in Group B [(20/2000) (P = 0.002)]. Five eyes in Group A and one eye in Group B underwent medical management. There was no difference in the duration of follow-up for both groups (P = 0.24). The median final BCVA in Group A (20/32) was significantly better than in Group B [(20/200) (P = 0.02)]. Two eyes in Group A and nine eyes in Group B developed LSCD. Two eyes in Group B were phthisical at the last visit. Conclusion: Calcium carbide-related ocular injuries can result in significant visual morbidity in young adults. Early presentation and management may improve outcomes. Prevention of these injuries by increasing awareness and increasing advocacy efforts is necessary.


Asunto(s)
Quemaduras Químicas , Lesiones Oculares , Animales , Estudios Retrospectivos , Progresión de la Enfermedad , Ojo , Lesiones Oculares/diagnóstico , Lesiones Oculares/etiología , Quemaduras Químicas/diagnóstico , Quemaduras Químicas/etiología , Quemaduras Químicas/cirugía
18.
Indian J Ophthalmol ; 71(5): 1877-1881, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-37203048

RESUMEN

Purpose: This study aims to analyze the pattern of follow-ups and the reasons for follow-up loss in keratoplasty cases in a tertiary eye care center. Methods: This is a single-center retrospective cross-sectional study. During the study period, 165 eyes underwent corneal transplantation. The data on the demographic features of the recipients and the indications of keratoplasty, including visual acuity before and after surgery, duration of follow-up, and the condition of the graft at the last follow-up, were collected. The primary outcome was to determine the factors causing lost-to-follow-up (LTFU) among graft recipients. LTFU was defined when a patient failed to adhere to any of the following seven follow-up visits since the surgery: 4 ± 2 weeks, 3 ± 1 months, 6 ± 1 months, 12 ± 2 months, 18 ± 2 months, 24 ± 3 months, and 36 ± 6 months. The secondary outcome was to analyze the best-corrected visual acuity (BCVA) among patients available for the final follow-up. Results: The recipient follow-up rates at 6, 12, 18, 24, and 36 months were 68.5%, 57.6%, 47.9%, 42.4%, and 35.2%, respectively. Old age and distance to the center were significant factors for lost-to-follow-up. A failed graft as an indication for transplantation and those undergoing penetrating keratoplasty for optical purposes were significant factors for completing follow-up. Conclusion: The inability to follow-up after corneal transplantation is a common challenge. Elderly patients and those living in remote areas must be prioritized for follow-ups.


Asunto(s)
Enfermedades de la Córnea , Trasplante de Córnea , Humanos , Anciano , Enfermedades de la Córnea/diagnóstico , Enfermedades de la Córnea/cirugía , Estudios Retrospectivos , Estudios Transversales , Resultado del Tratamiento , Queratoplastia Penetrante , India/epidemiología , Estudios de Seguimiento , Supervivencia de Injerto
19.
PLoS One ; 18(4): e0271867, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37036838

RESUMEN

BACKGROUND: Midwifery-led care is a key factor in reducing maternal and new-born mortality globally. In Bangladesh, only a third of births are attended by professionals and almost 70% of births occur outside healthcare facilities. Midwifery is a relatively new profession in Bangladesh and a midwifery centre care model has only recently been introduced. This study aims to explore the willingness within the healthcare system to support a greater role for midwifery centres in maternity services. METHODS: Data were collected through individual semi-structured interviews with 55 midwives, midwifery educators and final year midwifery students. Two of the midwifery educators were principals of nursing institutes involved in the government's midwifery leadership and considered as experts in the midwifery care system. The data was analysed using qualitative content analysis. The transcribed interviews comprised 150 pages. The study received ethical approval from the Directorate General of Nursing and Midwifery in Bangladesh. RESULTS: One main category emerged from the study: "The foundations of a midwifery centre care model need to be strengthened for the sustainable implementation of midwifery centres in Bangladesh to continue". Five additional categories were identified: 1) The midwifery centre care model is inaccessible for communities, 2) Striving for acceptable standards of care within a midwifery centre care model is not a priority 3) Respectful, woman-centred care is weak, 4) Community engagement with the midwifery centre care model is insufficient, and 5) The midwifery centre care model is not integrated into the healthcare system. These categories were supported by the identification of 11 sub-categories. CONCLUSION: The willingness to commit to a midwifery centre care model is not yet in place in Bangladesh. Advocacy, information, and education about the benefits of normal birth assisted by professional midwives is needed at all levels of Bangladeshi society.


Asunto(s)
Bachillerato en Enfermería , Servicios de Salud Materna , Partería , Humanos , Femenino , Embarazo , Partería/educación , Bangladesh , Estudiantes , Investigación Cualitativa
20.
Appl Radiat Isot ; 195: 110744, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-36867922

RESUMEN

68Ga is produced from enriched zinc-68 target electrodeposited on copper base material which was irradiated with 15 MeV proton energy in 30 MeV cyclotron. A modified semi-automated separation and purification module was used to obtain pharmaceutical grade [68Ga]GaCl3 in 35 ± 5 min. The quality of [68Ga]GaCl3 produced was in accordance with Pharmeuropa 30.4. The [68Ga]GaCl3 was utilized for the formulation of multiple doses of [68Ga]Ga-PSMA-11 and [68Ga]Ga-DOTATATE. The quality of [68Ga]Ga-PSMA-11 and [68Ga]Ga-DOTATATE were also in accordance with Pharmacopeia.


Asunto(s)
Radioisótopos de Galio , Compuestos Organometálicos , Cloruros , Isótopos de Zinc
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...