Intermediate-term outcomes of the Aurolab aqueous drainage implant in neovascular glaucoma.

PURPOSE: To assess the outcomes of the non-valved Aurolab aqueous drainage implant (AADI) in neovascular glaucoma (NVG). METHODS: Data of consecutive patients with NVG who underwent AADI and had a minimum follow-up of 2 years were included. The primary outcome measure was the cumulative rate of surgical failure defined as intraocular pressure (IOP) >21 mm Hg or reduced <20% below baseline, IOP ≤5 mm Hg, reoperation for glaucoma or a complication, or loss of light perception vision. RESULTS: We included 85 eyes of 85 patients with NVG, with a mean age of 61.2±9.3 years. The most common aetiologies were proliferative diabetic retinopathy (n=43) and central retinal vein occlusion (n=24). The mean IOP decreased from 36.8±12.5 mm Hg at baseline to 15.8±7.5 mm Hg at 2-year follow-up (p<0.001) and the number of IOP-lowering medications reduced from 3.4±0.8 to 1.5±1.1 (p<0.001). The cumulative rate of failure increased from 3.1% (95% CI 1.1% to 11.8%) at 1 year to 33.8% (95% CI 20.4% to 52.5%) at 2 years. Multivariable analysis showed that eyes with open angles had a lower risk of failure (HR 0.17, 95% CI 0.10 to 1.03, p=0.09). The logarithm of minimum angle of resolution visual acuity declined from 0.98±0.7 to 1.8±1.0 at 2 years (p<0.001). CONCLUSION: Approximately one-third of NVG eyes that received the AADI failed after 2 years of follow-up similar to other series. Early AADI implantation at the open angle stage of NVG may yield better results.

Molecular epidemiology of norovirus variants detected in children under five years of age in Hyderabad, India.

PURPOSE: Noroviruses are common viral agents in acute diarrhea in all age groups worldwide. Norovirus has been classified into 10 genogroups, GI to GX with over 48 genotypes among them the GII.4 genotype has evolved over time with a clear pattern of periodic variant replacement. Immunity is strain or genotype specific with little or no protection conferred across genogroups. The present study was aimed to determine the epidemiology, prevalent genotypes of norovirus in children below five years of age in the Hyderabad region, India. METHODS: The stool samples and clinical data were collected from 458 children below 5 years of age comprising of cases with acute gastroenteritis (n â€‹= â€‹366) and a control group (n â€‹= â€‹92) admitted to the pediatric ward. All the samples were tested for Norovirus by ELISA and RT-PCR. Sequencing was done for predominant strains. RESULTS: 10.3% (n â€‹= â€‹38) of cases and 3.2% (n â€‹= â€‹3) of the control group were found to be Norovirus positive. Predominant genotypes were GII-82.5% followed by GI-12.5%. CONCLUSION: Sequencing and Phylogenetic analyses of 20 GII.4 strains was done. All of the isolates are clustered away from published the GII.4 variants thus suggesting the appearance of a new variant.

Plasmid-mediated antibiotic resistance among uropathogens in primigravid women-Hyderabad, India.

With the growing threat of antimicrobial resistance worldwide, uncovering the molecular epidemiology is critical for understanding what is driving this crisis. We aimed to evaluate the prevalence of plasmid-mediated-quinolone-resistance (PMQR) and extended-spectrum beta-lactamase- (ESBL) producing gram-negative organisms among primigravid women with bacteriuria. We collected urine specimens from primigravid women attending their first antenatal visit at Gandhi Hospital during October 1, 2015 to September 30, 2016. We determined antimicrobial susceptibility and ESBL and quinolone resistance using VITEK-2. We performed polymerase chain reaction amplification on resistant isolates for detection of ESBL-encoding genes (TEM, SHV, CTX-M) and PMQR genes (qnrA, qnrB, qnrD, qnrS, aac (6')-Ib-cr). Of 1,841 urine samples, 133 demonstrated significant bacterial growth with gram-negative bacilli accounting for 85% of isolates, including Escherichia coli (n = 79), Klebsiella pneumoniae (n = 29), Sphingomonas (n = 3), Enterobacter (n = 1), and Citrobacter (n = 1). We found 65% of E. coli isolates and 41% of K. pneumoniae isolates were ESBL positive. Of ESBL-positive isolates, the most common genes conferring resistance were TEM-1 (66.7%) followed by CTX-M-15 (33.3%). Fifty-seven percent of ESBL-positive E. coli also demonstrated resistance to quinolones with the most common PMQR genes being qnr-S (62.5%) and aac (6')-Ib-cr (37.5%). We did not find any resistance to quinolones among ESBL-positive K. pneumoniae isolates. Across different classes of antibiotics we found a strong clustering of multi-drug resistance in E. coli with over 45% of ESBL-positive isolates demonstrating resistance to at least three classes of antibiotics. This study emphasizes the high prevalence of plasmid-mediated ESBL and quinolone resistance in community-acquired urinary tract infections of primigravid women. The overall abundance of multi-drug-resistant isolates in this population is alarming and may present therapeutic challenges.

Comparison of the Anchorage Value of the First Molars Supported with Implant and First Molars Supported with Second Molar during En Masse Retraction.

AIMS AND OBJECTIVES: The aim of this study was to determine the efficacy of mini-implants as adjuncts for intraoral anchorage units for en masse retraction of maxillary anterior teeth in bimaxillary dentoalveolar protrusion cases. MATERIALS AND METHODS: The study sample consisted of 15 patients (10 females and 5 males). The samples were compared for anchorage loss with the implant-supported molar and conventional molar contralaterally in both the maxilla and mandible after six months of retraction period. The mini-implants used were 1.5 mm in diameter and 8 mm in length and were inserted in the first and third quadrant between the roots of second premolar and first molar under local anesthesia at an angle of 45°. For en masse retraction, active tiebacks with ligating (100g) were used bilaterally extending from molar hooks to J-hook on a 0.019" × 0.025" stainless steel arch wire. Lateral cephalograms were taken before and after retraction for assessing the loss of anchorage in maxillary and mandibular first molars. RESULTS: Anchorage loss of 1.46 mm in the maxilla and 1.36 mm in mandible was found with conventional molar anchorage, whereas no statistically significant anchorage loss was found in the implant-supported molar side. CONCLUSION: Implant-supported molar side showed better anchorage compared with the conventional molar side. Hence, implant-supported molar can be used as an absolute anchorage unit in the en masse retraction of anterior teeth.

A decade of research on Bluetongue virus in Andhra Pradesh, a Southern state of India.

High sheep population density, congenial climatic conditions for Culicoides propagation, and susceptible sheep breeds may be contributing to the higher incidence of Bluetongue (BT) in Southern states of India. Sheep farming in this part of the country is nomadic in nature and BT is one of the major infectious diseases inflicting huge losses. Andhra Pradesh is one of the Southern states with high sheep population in India. Although isolation studies in this region were started in 1993, concerted efforts only began in 2002. More than 50 isolates were obtained in the last decade, and 7 Bluetongue virus (BTV) serotypes (1, 2, 9, 10, 12, 16 and 21) were isolated. Among them, BTV-10, BTV-12, and BTV-21 were reported for the first time from India and the genome analysis of these viruses revealed that BTV-10 and BTV-12 have high sequence identity with the modified live virus (MLV) vaccines used in USA and South Africa, respectively. At the same time, BTV-21 has probably originated from Southeast Asia. Furthermore, some of the BTV isolated from Europe have high sequence identity with viruses isolated from Andhra Pradesh indicating common ancestry. The analysis of different isolates involved in outbreaks revealed that more than 1 BTV serotype is involved and that mixed infections with different serotypes is not uncommon. In a limited study conducted during 2005-2009, it was observed that most of the sheep seroconverted to more than 1 serotype, which further supports circulation of multiple serotypes and mixed infections in Andhra Pradesh. Based on the virus isolation data, in this study it was observed that a few serotypes dominate for 3-4 years followed by domination of others. Continuous monitoring of circulating serotypes is essential to understand the distribution and spread BTV in endemic areas and for devising suitable control measures.

Self-reported and clinically diagnosed dental needs among institutionalized adults in Vijayawada: A cross-sectional study.

BACKGROUND: Frail and functionally dependent elderly people, living in institutions, have difficulties in accessing dental care. Hence, the present study aims to determine the relationship between subjective need and the equivalent clinical findings in an attempt to understand the factors that contribute to individual's perception of the need for dental care among institutionalized adults in Vijayawada. MATERIALS AND METHODS: A cross-sectional study is conducted in all old age homes in Vijayawada. A total of 182 subjects were interviewed with a questionnaire consisting of demographic details, dental behavior (last visit, reason for the last visit), and self-rating of oral health and impact of oral problems, followed by the clinical examination for oral mucosal condition, dentition status and treatment needs, prosthetic status and treatment needs, and periodontal status by using World Health Organization proforma. RESULTS: Results showed that normative needs of subjects are significantly more than the self-perceived needs. Response of subjects regarding their present condition of mouth and teeth is 65.4% of subjects reported good and 0.5% reported poor, with respective to perceived oral symptoms 61.9% of subjects' complaints of hypersensitivity and 23.1% of subjects were having toothache and 80.5% subjects are having difficulty in eating. The overall prevalence of complete Edentulous and require complete denture was 12.1%, and 60.4% required partial denture. CONCLUSION: About half of the participants confirmed need for problem-oriented dental care. The main reason for the problems faced by the institutionalized people is due to lack of teeth which could be prevented by appropriate care.