Rhinosporidiosis, a granulomatous disease caused by Rhinosporidium seeberi, is widely prevalent in Sri Lanka and southern parts of India. Besides the eye, the lacrimal passage and nasal cavity are affected. The most common ocular involvement is a subconjunctival bleeding mass. Our case, a 9-year-old girl from a rural background with a history of pond water bathing, presented with a marginal chalazion involving the left lower lid. She had a history of chalazion involving the same site three months earlier which was managed by incision and curettage. A decision of surgical exploration was made and the evacuated mass was examined histologically showing evidence of rhinosporidiosis. This type of clinical presentation for ocular rhinosporidiosis (as recurrent chalazion) has not been reported earlier in the literature. This case emphasises that the clinicians from this part of the world must consider ocular rhinosporidiosis as differential diagnosis in cases with recurrent chalazion especially in a rural background with a habit of pond water bathing.
Aims and Objectives: The study aimed evaluation of prevalence, demographic features, clinical presentation, indication, intra-operative findings, different types of operation, and histopathological diagnosis of patients who underwent hysterectomy in our center. Materials and Methods: This retrospective study done over 3 years from May 2017 to April 2020 in Department of Obstetrics and Gynecology of Rampurhat Government Medical College, West Bengal India. Case record and data of each patient were obtained from medical record section of the hospital and analyzed after taking permission of concerned authority. Inclusion criteria: Those underwent hysterectomy for gynecological indications during our study periods. Results: During the study period, total 6014 obstetrical and gynecological surgery performed; out of them, 424 cases of hysterectomies were studied, maximum patients (64.85 %) underwent hysterectomy at the age group of 41–50 years. Menorrhagia was the most common (61.32%) presenting complains. Leiomyoma was the most common (27.12%) indication followed by abnormal uterine bleeding (22.17%) and pelvic organ prolapses (11.57%). Maximum (79.25%) with abdominal route and 20.75% cases through vaginal approach. Total abdominal hysterectomy with bilateral salpingo-ophorecctomy 270 cases (63.69%), vaginal hysterectomy with pelvic floor repair 60 (14.15%), total abdominal hysterectomy without oophorectomy 50 (11.79%), and radical hysterectomy 16(3.77%).Dominant histopathological type was leiomyoma (22.88%). Among various post-operative complications, urinary tract infection was the most common (9.19%), the most of the postoperative complication was found in abdominal hysterectomy. Conclusion: For treating pelvic pathologies such as uterine bleeding, adenomyosis, fibroid, pelvic inflammatory disease, malignant disorder, and genital prolapse hysterectomy is preferred procedure and abdominal route was most common. Complication of vaginal hysterectomy is less than abdominal approach. Vaginal approach should be preferable approach.
Aims & Objective: To compare Feto-maternal outcome in induction versus expectant management in women with singleton pregnancy without any complication with preterm prelabour rupture of membranes between 34 to 37 weeks gestation. Materials & Methods: It was a hospital based prospective clinical observational study.100 women with singleton pregnancy between 34 to 37 weeks of gestation was selected. Randomization was done 1: 1 ratio for induction or expectant management. Women with odd numbers (1,2,3 etc) was allocated for induction of labour. Labour was induced according to the local protocol within 12 hours after randomization. Women with even numbers (2,4,6 etc) were allocated for expected management and was monitored according to standard local protocol until delivery started spontaneously. Result: There was no significant difference in mean age, parity, booking status in both group but rate of caesarean section was lower in induction group (28%) than expectant group (32%), mean randomization to delivery interval was more in expectant group (42 hours) compare to induction group (20 hours). Chorioamnionitis was 10% versus 34% and statistically significant (p value 0.0251). Foetal distress seen in 22% versus 24% in induction vs expectant group. Incidence of postpartum fever was more in expectant group than induction group (32% versus 5%) and statistically significant (p value 0.0141). Better Apgar scores at 1 minute (p value 0.0141) and 5 minutes (p value 0.0007) was in induction group as compared to expectant group. Rate of neonatal intensive care unit admission in induction group (40%) was lower than expectant group (64%) and p value 0.0277. No significant difference seen in incidence of low birth weight in both groups. Rate of neonatal death was lower in induction group (2%) than expectant group (8%). Conclusion: In this study it was observed that induction of labour in case of preterm prelabour rupture of membrane between 34 to 37 weeks leads to better Feto-maternal outcomes in terms of better Apgar scores, lesser neonatal intensive care unit admission, lower randomization to delivery interval , reduced chance of developing chorioamnionitis along with decreased incidence of postpartum fever as compared to expectant management. Hence active management by induction of labour in preterm prelabour rupture of membrane is better line of management & recommended as per our study result.
BACKGROUND In diabetes mellitus microvascular damages at various end-organ frequently occurs and leads to development of diabetic nephropathy as well as diabetic retinopathy. Diabetic nephropathy ultimately causes end stage renal disease. Diabetic retinopathy even at its earlier stage is easily suspected by simple clinical examination in any ophthalmological clinic. We wanted to study the relationship between various stages of diabetic retinopathy with diabetic nephropathy. METHODS 1209 diagnosed patients of diabetic mellitus were screened for presence of diabetic retinopathy. First comprehensive ophthalmological examination including slit-lamp bimicroscopy and indirect ophthalmoscopy were done and then clinically typing of diabetic retinopathy according to ETDRS classification was done. Then all diagnosed case of diabetic retinopathy further examined for blood Glycosylated haemoglobin, blood urea and serum creatinine to detect diabetic nephropathy. RESULTS 273 patients were included in this study. Average age of patients was 64.6 years with mean duration of diabetes mellitus was 7.4 years. Patients suffering from severe NPDR and PDR had association with poor control of blood glycosylated haemoglobin. Patients with mild NPDR 31.1 %, Moderate NPDR 52.3 %, severe NPDR 67.4 % and in PDR 65.2 % patient had blood urea more than 40 mg / dl. In mild NPDR group 32.2 %, moderate NPDR 55.4 %, severe NPDR 67.4 % and in PDR group 63.9 % patients had serum creatinine more than 1.5 mg / dl. We have found statistically significant correlation between HbA1c level and severity of diabetic retinopathy. Prevalence of nephropathy increased with increments in the grade of retinopathy. CONCLUSIONS A significant number of patients with severe NPDR or PDR had increased blood urea and serum creatinine level. Clinical grading of diabetic retinopathy gives us a clue about the presence of diabetic nephropathy. As diagnosis of diabetic retinopathy is simple and straight forward clinical procedure and it can be done all ophthalmological se up, we recommend all patient with diabetic retinopathy must be screened for nephropathy. KEYWORDS Diabetic Retinopathy, Diabetic Nephropathy, Glycosylated Haemoglobin, Blood Urea, Serum Creatinine
To investigate the role of intravitreal sustained release dexamethasone implant in AIDS associated macular edema. Materials and Methods: This hospital based retrospective interventional study (nonrandomized) was conducted in Malda Medical College, West Bengal, India from September 2017 to august 2019 where 18 eyes of 18 patients with HIV were included. After proper history taking and required investigations, intravitreal sustained release dexamethasone implant was injected to each patient in respective eye under topical anaesthesia with strict aseptic measures and utmost care. Institutional clearance and written informed consent from each patient were taken before the procedure. Best corrected visual acuity (BCVA) and intraocular pressure (IOP) measurement and central macular thickness (CMT) evaluation by spectral domain optical coherence tomography (SD-OCT) were performed at baseline and after 1 month, 3 months, 6 months of injection. The data obtained then were put for paired t test using SPSS software. Results: All patients had shown improvement in terms of BCVA as well as reduction of central macular thickness (CMT). 12 patients had increased IOP at first visit for which topical anti glaucoma drugs were prescribed and on subsequent visits their IOP were under control. Conclusion: Intravitreal sustained release dexamethasone implant is a good option to tackle macular edema in HIV infected patients.
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