Anatomical outcome of laser treatment alone in aggressive retinopathy of prematurity.

PURPOSE: The purpose is to study the anatomical outcome of eyes in aggressive retinopathy of prematurity (AROP), treated with laser photocoagulation alone and to evaluate factors affecting outcomes. METHODS: Records of consecutive babies diagnosed with AROP, undergoing laser photocoagulation treatment in rural tertiary care centers from October 2016 to January 2021 were reviewed retrospectively. Anatomical outcome at 6 months follow-up was grouped as good in eyes with complete regression and poor in those who developed retinal detachment (stage IV a, IV b, and V). Both groups were compared with respect to the period of gestation, birth weight (BW), age at screening, age at treatment, zone of disease, presence of retinal fibrovascular proliferation (FVP), tunica vasculosa lentis, preretinal bleed, need for supplement laser, and associated systemic risk factors. RESULTS: Of the total of 2468 babies screened, 124 (5.02%) were diagnosed with severe retinopathy of prematurity (ROP), of which 54 (43.5%) lasered AROP babies were analyzed. Mean BW and gestation period of the AROP cohort were 1.43 kg and 31.1 weeks, respectively. Eighty-six eyes (79.6%) had good outcomes with laser photocoagulation alone. Posterior location of disease, presence of FVP, neonatal sepsis, shock, and late screening for ROP were found to be factors associated with poor outcomes. CONCLUSION: Adequate and timely treatment with laser photocoagulation in AROP can achieve good treatment outcomes in a significant proportion of babies. Although a combined approach using laser, anti-vascular endothelial growth factor and early vitrectomy is better, laser remains a viable treatment option in AROP, especially with limited resources and high risk of loss to follow-up.

Heavy metal contamination in river water, sediment, groundwater and human blood, from Kanpur, Uttar Pradesh, India.

Exponential industrialization and anthropogenic activities have resulted in water contamination by various heavy metals in Kanpur city, India. Heavy metal pollution, an issue of great concern, is not only affecting river water, but contamination of groundwater is creating health issues and worries. In the present investigation, blood samples were collected from selected volunteers, water and sediment samples from four sites of river Ganga and drinking groundwater samples from 23 locations of Kanpur city. Heavy metals analysis in river water, sediment, and human blood, was done by inductively coupled plasma optical emission spectroscopy (ICP-OES) and atomic absorption spectroscopy (AAS) was used for groundwater samples. Human blood showed a high concentration of arsenic (As) (66.6 ± 0.00 and 76.9 ± 0.01 µg L-1 in males and female subjects, respectively) and thallium (Tl) (13.4 ± 0.004 and 16.6 ± 0.005 µg L-1 in males and female subjects, respectively) with higher concentrations in females than males. Other heavy metals (Nickle, Beryllium, Cadmium, Cobalt, Chromium, Lithium, Molybdenum, Lead) were not observed in any of the tested human blood samples. However, in groundwater sampling, iron (Fe), copper (Cu), and arsenic (As) were detected, one sample had the presence of chromium (Cr), and two samples showed lead (Pb) contamination. River water [Cu (32-125 µg L-1), Cr (19-725 µg L-1), Cd (1-59 µg L-1), Pb (37-163 µg L-1), As (32-153 µg L-1), Th (26.75 µg L-1)] showed a high level of the heavy metals, as compared to reference values of BIS, CPCB (2016a), WHO, EPA and USEPA. River sediment [Cu (4168-34,470 µg Kg-1), Cr (4040-145,650 µg Kg-1), Cd (326-5340 µg Kg-1), Pb (1840-19,350 µg Kg-1), As (103-188 µg Kg-1)] also showed high concentration when compared to reference values of USEPA and PASS. River site 4, with high Cr (725 µg L-1), also showed Cr levels (19.8 µg L-1) in the groundwater samples, indicating Cr contamination in groundwater while Pb was observed at groundwater samples close to two industrial sites. Drinking water might be the primary exposure pathway for As and Tl to enter the human body. The study recommends periodic monitoring of river water, sediment, groundwater, and human blood samples for contamination of heavy metals.

Prevalence, risk factors and pattern of severe retinopathy of prematurity in eastern Madhya Pradesh.

Purpose: To describe the prevalence, characteristics including risk factors, and pattern of severe ROP from eastern Madhya Pradesh region of India. Methods: In this 5-year retrospective study, Baseline characteristics, systemic risk factors, and findings of ROP screening were noted. Factors associated with severe ROP including aggressive posterior ROP (APROP), stage IV and V ROP were analyzed. Statistical analysis was done using SPSS version 20. Results: Of 763 babies screened, 30% were diagnosed to have ROP. Prevalence of severe ROP was 14.2% (109) of which 60 (55.5%) were classic and 30 (27.7%) were APROP. Eighteen (16.6%) were diagnosed as advanced ROP (stage IV and V). Mean gestational age (GA) and birth weight (BW) for severe ROP were 31.05 weeks and 1.34 kg, respectively which were inversely associated with severe ROP. But a significant 10% of severe ROP were seen in late preterm babies, >34 weeks. Low GA and respiratory distress syndrome (RDS) were significant risk factors for APROP. Most important factor for stage IV and V ROP was late presentation for screening. Conclusion: The study found a high prevalence of severe ROP including APROP. Almost 7% severe ROP cases were outside screening guidelines of NNF. Late presentation for screening is the most important factor associated with ROP related blindness.

Virulent methicillin resistant Staphylococcus aureus (MRSA) in street vended foods.

Street foods are one of the important sources of foodborne infections and Staphylococcus aureus is an important infectious agent transmitted through various sources including street foods. The methicillin-resistant S. aureus (MRSA) are of public health significance, hence the study was taken to assess the street foods as a source of MRSA, for which 430 street vended foods of animal origin (meat, milk, eggs and their products) and associated environmental samples were processed for isolation and characterization. A total of 52 (12.1%) S. aureus were isolated and resistant was observed to oxacillin (36.5%), cefoxitin (25%) and penicillin G (82.7%) by disc diffusion test. On genotypic screening, mecA and blaZ have detected in 17.3% and 69.2% isolates, respectively. The virulence typing identified nuc, coa, clfA, spA, FnbA and enterotoxin A (sea) genes in 100%, 96.2%, 30.8%, 55.8, 50% and 7.7% isolates, respectively. Genetic diversity among the isolates was observed by enterobacterial repetitive intergenic consensus PCR with a D value of 0.77. The presence of virulent MRSA in street vended foods trigger the public health concern and emphasis to educate the consumers and street food vendors about quality and safety of such foods.

Purtscher-like retinopathy: A rare ocular finding in nephrotic syndrome.

In this report, we present a case of Purtscher-like retinopathy in a 12-year-old male child with nephrotic syndrome. He was a known case of steroid-dependent nephrotic syndrome, frequent relapser with spontaneous bacterial peritonitis, who presented with complaints of difficulty in vision in both eyes. The fundus examination showed multiple cotton-wool spots and Purtscher fleckens centered around the optic nerve head with superficial retinal hemorrhages in both eyes. Fluorescein angiography confirmed the diagnosis of Purtscher-like retinopathy.

Evaluation of immunohistochemical subtypes in diffuse large B-cell lymphoma and its impact on survival.

BACKGROUND AND AIM: Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma in Indian population. The disease could be divided into the prognostically important subtypes, germinal center B-cell (GCB)-like and activated B-cell-like, using gene expression profiling (GEP). The molecular subtype as defined by GEP could also be predicted by using immunohistochemistry (IHC) based algorithms using three biomarkers CD10, BCL-6, and multiple myeloma oncogene-1 (MUM1). It has been confirmed that patients belonging to the GCB subtype have a better outcome and survival than those belonging to the second subtype. The present study was conducted to study the prevalence of these two subgroups and their correlation with survival of the patients. MATERIALS AND METHODS: A total of 83 patients of DLBCL were included in the study. Hematoxylin- and eosin-stained sections were prepared from the paraffin-embedded tissue blocks. The staining for all the three antibodies was considered positive when more than 30% cells were stained with the respective antibody. RESULTS: The results showed that 44 patients (53%) had GCB immunophenotype and 39 patients (47%) had non-GCB phenotype. However, no statistically significant difference in overall and disease-free survival was noted between the subgroups. CONCLUSION: This study demonstrated that frequency of GCB subtype of DLBCL is significantly higher than the non-GCB subtype, and the non-GCB immunophenotype has better relapse-free survival 78% (standard error = 0.10) at the end of 3 years, while GCB has 56% (standard error = 0.23). Further studies should be performed with larger number of patients to show difference in clinical outcome between GCB and non-GCB subgroups.

Golden half ring sign for identification of pseudophacocele.

Dislocation of intraocular lens (IOL) is a serious complication of blunt ocular trauma in pseudophakic eyes. Here, a 72-year-old male patient with subconjunctival dislocation of an IOL (pseudophacocele) secondary to bull horn injury was reported. In this case report, a new sign named as "golden half ring sign" was described for easy identification and localization of subconjunctival dislocation of IOL in patient with open globe injury (surgical wound dehiscence) associated dense subconjunctival hemorrhage.

Red eye: rule out Ophthalmomyiasis too.

Ophthalmomyiasis is the infestation of human eye by the larvae of certain flies. Sheep botfly commonly manifests as Ophthalmomyiasis externa when there is conjunctival involvement or rarely as Opthalmomyiasis interna when there is larval penetration into the eyeball. It appears to be more common than what has been indicated by previously published reports. We present a report of seven cases of Ophthalmomyiasis by Oestrus ovis, from central India who presented with features of conjunctivitis varying between mild to severe. The larvae were seen in bulbar and palpebral conjunctiva and also entangled in lashes with discharge. Since the larvae are photophobic, it is prudent to look for them in the fornices and also in discharge. Prompt removal of the larvae from the conjunctiva helps in relieving the symptoms and also prevents serious complications. Taxonomic identification of the species is important to estimate the risk of globe penetration by the larvae.