A Review of Central Serous Chorioretinopathy: Clinical Presentation and Management.

Central serous chorioretinopathy (CSC) may be understood as a disease of the chorioretina with the serous detachment of the neurosensory retina, which is secondary to single or multiple localized defects in retinal pigment epithelium (RPE). CSC is one of the common forms of loss of vision, usually seen in people who do belong to the working-age group. The most common symptoms are blurring of vision, usually unilateral and which is perceived as a scotoma in the center of the field of vision with associated metamorphopsia and micropsia. The risk factor associated with CSC is psychosocial stress, type A personality, pregnancy, and hypercortisolism. Normal vision is often restored within a span of a few months. After around three months, if the resolution of acute CSC did not change or, let us say, in the case of CSC that is chronic, one should consider treatment. In acute CSC, to resolve symptoms, especially in individuals who work in a field where eyesight is of utmost importance, for example, pilots, focal photocoagulation of leaking RPE lesions can be performed. CSC is a prototype cause of serous neuroretinal detachment, which involves the fovea. CSC symptoms reflect the separation between the RPE and the photoreceptors and the bullous distension of the foveal retina. The effect of therapy as such on the long-term outcome of vision visual is not sufficiently documented. The management would largely be dependent on the appropriate diagnosis made based on clinical presentations, and thus it becomes very much necessary to have knowledge about the same and counsel the patient regarding the association between stress and disease pathology. In acute CSC, retinal photocoagulation is successful to a good extent in eliminating or reducing the leakage of RPE and hence it induces resolution of the serous detachment. This review article is made to make sure the reader is updated about the various clinical and management aspects of CSC by providing a comprehensive idea that is obtained from various well-acknowledged databases across the globe on CSC.

Trends in Acute Myocarditis Related Pediatric Hospitalizations in the United States, 2007-2016.

There has been little exploration of acute myocarditis trends in children despite notable advancements in care over the past decade. We explored trends in pediatric hospitalizations for acute myocarditis from 2007 to 2016 in the United States (US). This was a retrospective, serial cross-sectional study of the National Inpatient Sample database from 2007 to 2016, identifying patients ≤18 years hospitalized with acute myocarditis. Patient demographics and incidence trends were examined. Other relevant clinical and resource utilization outcomes were also explored. Out of 60,390,000 weighted pediatric hospitalizations, 6371 were related to myocarditis. The incidence of myocarditis increased from 0.7 to 0.9 per 100,000 children (p <0.0001) over the study period. The mortality decreased from 7.5% to 6.1% (p = 0.02). A significant inflation-adjusted increase by $4,574 in the median hospitalization cost was noted (p = 0.02) while length of stay remained stable (median 6.1 days). Tachyarrhythmias were identified as the most common type of associated arrhythmia. The occurrence of congestive heart failure remained steady at 27%. In conclusion, in-hospital mortality associated with pediatric acute myocarditis has decreased in the United States over years 2007 to 2016 with a concurrent rise in incidence. Despite steady length of stay, hospitalization costs have increased. Future studies investigating long-term outcomes relating to acute myocarditis are warranted.

Evaluation of Correlation between Salivary Calcium, Alkaline Phosphatase and Osteoporosis- A Prospective, Comparative and Observational Study.

INTRODUCTION: Fixed and/or removable prosthodontics caters to the restorative needs of the largest count of geriatric patients whose rehabilitative procedures depend on the quality and quantity of available bone. The common diagnostic parameters for quantifying bone may involve an invasive blood examination, an expensive bone densitometry procedure or a urine analysis. Sialometry involving the basic biochemistry of saliva analysis may be proposed as an alternative to the conventional investigative protocol and its usefulness may be attributed owing to its non invasive and simpler procedure. AIM: The aim of this study was to compare the salivary calcium and alkaline phosphatase among osteoporotic, osteopenic and normal edentulous subjects. MATERIALS AND METHODS: A prospective, comparative and observational study was carried out on 80 selected edentulous subjects (40 males and 40 females) aged 55-75 years (30 osteoporotic, 30 osteopenic and 20 control). A sample of saliva was taken for the study. Salivary calcium was measured by Arsenazo reaction; and alkaline phosphatase by the International Federation of Clinical Chemistry (IFCC) method. Statistical analysis was done by unpaired t-test. A comparison was made in the levels of salivary calcium and alkaline phosphatase with that of osteoporosis and osteopenia. RESULTS: The mean salivary calcium and alkaline phosphatase levels were found to be significantly higher in the osteoporotic and osteopenic edentulous subjects as compared to the control group. CONCLUSION: Salivary calcium and alkaline phosphatase are increased significantly in case of osteoporosis and osteopenia. Hence, screening of salivary samples of patients may be an effective indicator for the detection of underlying disorders of bone metabolism.