Aims To estimate the incidence of acuteonset presumed infectious endophthalmitis (PIE) following cataract surgery in the UK and provide epidemiological data on the presentation, management, microbiology, and outcome of cases of endophthalmitis. Methods Cases were identified prospectively by active surveillance through the British Ophthalmological Surveillance Unit reporting card system, for the 12-month period October 1999 to September 2000 inclusive. Questionnaire data were obtained from ophthalmologists throughout the UK at baseline and 6 months after diagnosis. Under-reporting was estimated by independently contacting units with infection databases. Results Data were available on 213 patients at baseline and 201 patients at follow-up. The minimum estimated incidence of PIE was 0.086 per 100 cataract extractions and the corrected incidence was 0.14 per 100 cataract extractions. For the management of PIE, 96% of patients received intravitreal, 30% subconjunctival, 65% oral, and 17% intravenous antibiotics. In all, 17% of patients received intravitreal steroid. From the intraocular samples taken for microbiological analysis, 56% were culture positive. At followup, 48% of patients achieved visual acuity of 6/ 12 or better and 66% achieved better than 6/60. 13% of patients were unable to perceive light or had evisceration of the globe. Conclusions The incidence of PIE after cataract surgery in the UK is comparable to that of other studies. Approximately 50% of patients achieved a visual acuity close to the driving standard.

This study suggests that MMC is more effective than 5-FU for needle revision of failed trabeculectomy blebs.

Candida endophthalmitis is associated with a high rate of visual loss, particularly in patients with poor presenting visual acuity or centrally located lesions. Early vitrectomy reduces the risk of retinal detachment.

-Metastatic or endogenous endophthalmitis (EE) is a serious consequence of systemic sepsis. It is defined as intraocular infection resulting from haematogenous spread of organisms in which the initial focus of infection is at a site distal to the eye. A red/sore eye in a patient with a known septic focus needs urgent attention as EE can be a major cause of visual loss. Early diagnosis and treatment are associated with better visual outcome. This article focuses on the two main causes of EE, namely bacterial and fungal infections, and also briefly mentions dissemination of cytomegalovirus to the eye in immunocompromised patients. Although conscious patients may notice an ocular problem, unconscious or very sick patients may not; vigilance by medical staff in looking for early signs of this is extremely important.KEY WORDS: candida, ciprofloxacin, cytomegalovirus (CMV), endophthalmitis, floaters, hypopyon, red eye, retinal infiltrates, retinitis, septicaemia Endogenous fungal endophthalmitisFungal sepsis is identified most frequently in hospitalised patients who are seriously ill. Endogenous fungal endophthalmitis (EFE) occurs in 28-45% of patients with candidaemia 1,2,3 and is the most common form of endogenous endophthalmitis (EE) 4 . Patients usually present with floaters and decreased vision, unilateral or bilateral. Onset is often insidious; in its early stages EFE can be asymptomatic 2 , but if left untreated can have devastating consequences for visual function. Therefore, regular screening of high risk cases is undertaken in many centres 5,6 . High risk characteristics include those listed in Table 1. CandidiasisCandida albicans is the most common pathogen causing EFE and in some series is the causative agent in 85-99% of all cases 6,9 . Non-albicans candida spp are important as aetiological agents 10 because fungaemia with these species is associated with a higher incidence of endophthalmitis than with C. albicans 11 . Other causes of EFE in descending order of importance are Aspergillus fumigatus, cocciodioides, cryptococcus, fusarium, histoplasmosis and paecilomyces 4 .Diagnosis of ocular candidiasis. The clinical diagnosis of ocular candidiasis is largely made on the ocular appearance 8 . The organism typically causes inflammation in the choroid and retina, with subsequent spread into the vitreous cavity 8 . The ophthalmoscopic appearance is of one or more creamy-white, usually round and sometimes elevated retinal lesions, often sited in the posterior pole of the eye (Fig 1). They may vary in size from small pinpoint lesions to two-disc diameter in width 8 . If the vitreous is involved, multiple clumps may form ('puff balls') (Fig 2). Thread-like strands may connect these, producing a so-called 'string of pearls' appearance. Ocular lesions can indicate otherwise occult deep tissue fungal infection and are useful indicators of systemic candidiasis 12,13 . Although autopsy studies have demonstrated a high incidence (78%) of ocular involvement in patients with candidaemia 12 , the eye can be the ...

establishing the efficacy and safety of using injectable, shape-memory alloy clips to fixate scleral buckling hardware. The technique is technically simpler and faster than tying conventional suture, and the clips are several times stronger than conventional suture. Further testing is underway to determine the stability, biocompatibility and surgical utility of these injectable shape-memory clips.

Objectives This study aimed to evaluate the prevalence and severity of temporomandibular joint (TMJ) disorders among undergraduate students. In addition, the severity of TMD was examined in terms of its relationship with gender, age and field of study. Methods A total of 439 undergraduate students of both genders (age range: 20–27 years) who were studying at various colleges at Taibah University were invited to participate in this study. Each student was provided with a questionnaire, and the significance and purpose of the study were explained. The data were collected using Fonseca's questionnaire, an instrument that assessed the demographic characteristics of the students and included ten key questions. The severity of TMD was categorized as no, mild, moderate or severe. The data were analysed using SPSS Version 22 (IBM, Illinois, USA). The chi-square test was used to compare the data from different groups and to determine whether the differences were statistically significant. Results Of those who were invited, 78 students did not return the questionnaires, whereas another 11 were excluded due to their submitting an incomplete questionnaire. A majority of the students reported no TMD (46.7%) or mild TMD (42.7%). A moderate level of TMD was reported by 8.8% of students. Only 1.7% of students reported severe TMD. No significant differences were observed in the severity of TMD in terms of student age or field of study. Conclusion TMD is more prevalent among female students than male students. However, its occurrence is not affected by the age and field of study of the student.

We present a case of a 15-year-old girl with a pulsatile, rapidly enlarging mass at the root of the nose suspected to be malignant. Excisional biopsy showed worrisome histological features; however, a final diagnosis of cellular schwannoma was reached excluding the possibility of malignant peripheral nerve sheath tumour by histological and immunohistochemical attributes. Cellular schwannoma, a pseudosarcomatous entity, is a rare benign neoplasm that may cause bone erosion and may be mistaken for a malignancy, clinically and histologically. Diagnosis of cellular schwannoma is essential to prevent mismanagement as it never metastasises and responds to local excision as opposed to aggressive treatment required by a malignant neoplasm.

Background: Foreign body aspiration commonly occurs in young children and is associated with high degree of mortality and morbidity. The objectives of this study were to determine epidemiologic, clinical and endoscopic perspectives of foreign body aspiration in children of District D.I.Khan, Pakistan. Materials & Methods: This descriptive study was conducted in Department of ENT, Gomal Medical College/ DHQ Teaching Hospital, D.I.Khan, Pakistan from November 2017-April 2019. 105 children with suspected foreign body (FB) aspiration were included. All patients underwent rigid bronchoscopy under GA. After check X-ray and one day observation, they were discharged. Variables were sex, age in years and age groups, successful removal, mortality, history of FB aspiration, cough, wheezing, choking, stridor, reduced air entry and location of FB. Age in years was numeric, age groups ordinal and all other variables were on nominal scale. Age in years was described by mean & SD and others by count and percentage. Results: The sample with suspected foreign body aspiration (n=105) included 61 (58.1%) boys and 44 (41.9%) girls, with 20 (19.05%) in age group 0-2.0 years, 58 (55.24%) 2.0-5.0 years and 27 (25.71%) 5.0-14 years. Chest X-Ray was done in 98/105 (93.33%) cases. Frequency of successful FB removal by rigid bronchoscopy was 86/105 (81.90%). Mortality was none. Out of 86 confirmed cases, 51 (59.30%) were boys and 35 (40.70%) girls, with 19 (22.10%) in age group 0-2.0 years, 55 (63.95%) 2.0-5.0 years and 12 (13.95%) 5.0-14 years. Mean age was 3.57±1.78. History of FB aspiration was in 75/86 (87.21%), cough 65 (75.58%), stridor 14 (16.28%), wheezing 54 (62.79%) and choking 28 (32.56%) cases. Reduced air entry was 44 (51.16%) on right side, 17 (19.77%) on left side and 25 (29.05%) bilateral. Location of FB was larynx 6 (9.98%), trachea 20 (23.26%), right bronchus 44 (51.16%) and left bronchus 16 (18.60%). Conclusions: Foreign body aspiration in children in not an uncommon event. The parents should try to prevent such event, and if there, should present the child to emergency department of a hospital. ENT surgeons are supposed to evaluate and plan an earlier intervention as rigid bronchoscopy for these children.