Corneal neurotization in the management of neurotrophic keratopathy: A review of the literature.

Neurotrophic keratopathy (NK) is a rare degenerative disease in which damage to the corneal nerves leads to corneal hypoesthesia or anesthesia. Neurotrophic corneal ulcers are notoriously difficult to treat and can lead to blindness. Corneal neurotization (CN) is a recent surgical technique aimed at restoring corneal sensation and may offer a definitive treatment in the wake of NK. Herein, we review the surgical techniques utilized in direct and indirect CN. Technical considerations, outcomes, current limitations and future perspectives are also discussed. This article highlights the key points of this promising procedure and biological aspects that will help provide the best treatment options for patients with severe NK.

Human papillomavirus viral load on careHPV testing of self-collected vaginal samples vs. clinician-collected cervical samples.

OBJECTIVE: To compare viral load on careHPV DNA testing in self-collected vaginal (VHPC) and clinician-collected cervical (CHPC) samples for the detection of high-grade cervical intra-epithelial neoplasia (CIN). STUDY DESIGN: Cross-sectional study. Ever-married women aged 30-59 years were targeted for cervical screening. On attendance for screening, vaginal self-sampling was performed by the woman, and an auxiliary nurse midwife subsequently performed a per-speculum examination, collected a CHPV sample and a Pap smear, and made a visual inspection of the cervix with acetic acid. The ratio of viral load expressed in relative light units to positive controls set at a cut-off of 1pg/ml was used for careHPV quantitative assessment. The median viral load was compared using non-parametric tests. Receiver operating characteristic (ROC) curves were constructed for the detection of CINII+ and CINIII+ in CHPV and VHPV samples. RESULTS: Overall, the median viral load in the 4658 women screened was higher in CHPV samples compared with VHPV samples (9.8-fold higher in cases of high-grade CIN). The median viral load was significantly higher among Pap-positive women compared with Pap-negative women in both CHPV and VHPV samples (p<0.01). Assessment by ROC analysis for the detection of high-grade CIN did not differ significantly between CHPV and VHPV samples. CONCLUSION: Viral load on careHPV testing was comparable between self- and clinician-collected samples for the detection of high-grade CIN. The self-sampling approach may be an option for screening in low-resource countries.

CareHPV cervical cancer screening demonstration in a rural population of north India.

OBJECTIVE: To compare cervical careHPV screening in a rural community setting with other methods of cervical screening for the detection of high-grade cervical intra-epithelial neoplasia (CIN). STUDY DESIGN: Cross-sectional study. All ever-married women aged 30-59 years surveyed in an administrative area of Uttar Pradesh, India were targeted for screening by careHPV (cervical and vaginal samples), Pap test and visual inspection of the cervix following application of acetic acid (VIA). Women who screened positive were referred for colposcopy and the results were confirmed histologically. Sensitivity, specificity and predictive values for the detection of histological CINII+ and CINIII+ were assessed for each screening test. RESULTS: Sixty-five percent (5032/7704) of the women invited for cervical screening agreed to participate in the study. Screen-positive rates for cervical careHPV, vaginal careHPV, Pap test and VIA were 3%, 2%, 3% and 6%, respectively. Data for women who did not complete all screening modes, women lost to follow-up and women with missing histological results were excluded before data analysis, resulting in a final sample size of 4658. Cervical careHPV had high sensitivity (85%) for the detection of CINIII+ lesions and moderate sensitivity (53%) for the detection of CINII+ lesions. Sensitivities for the detection of CINIII+ and CINII+ were 54% and 41% for vaginal careHPV, 62% and 44% for Pap test, and 8% and 22% for VIA, respectively. CONCLUSION: Cervical careHPV testing is superior to VIA and Pap test for the detection of high-grade CIN in a rural community setting.

Childhood cancer incidence in India: a review of population-based cancer registries.

OBJECTIVES: To summarize and provide an overview of the childhood cancer incidence reported in 25 population-based cancer registries of India. METHODS: Secondary data on age-adjusted rates of cancer incidence for children (0-14 years) were collected from the report of the National Cancer Registry Programme in the year 2013. range of age-adjusted-rates per million children were tabulated for six regions of the country. RESULTS: Age-adjusted cancer incidence rates ranged from 18.6 per million to 159.6 per million for boys and 11.3 to 112.4 for girls. The highest incidence was observed for males (159.6) in Southern region of the country and the lowest in North-east in both boys (18.6) and girls (11.3). Leukemia and lymphoma were the commonest malignancies in boys whereas leukemia and brain tumors were commonest in girls. CONCLUSION: Childhood cancer incidence appears to be increasing in India.

Neonatal brucellosis.

Three Arab children with neonatal brucellosis are described. The first presented with late neonatal hyperbilirubinaemia, the second with a septicoemia-like picture and the third was born prematurely and presented with respiratory distress. The diagnosis of brucellosis was based on a positive blood culture and on a high or rising titre of antibodies to the Brucella organism. All the three neonates responded well to antibiotic therapy as monitored by a Brucella titre of less than 1:40 and a negative blood culture 10 weeks after the onset of therapy. The three mothers had Brucella infections during pregnancy and the Brucella agglutination titre of the breast milk was high. No Brucella microorganism was isolated from the breast milk. The mode of transmission of brucellosis in neonates is discussed.