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Occurrence of postoperative cluster endophthalmitis is a nightmare for the operating surgeon, the involved hospital, and the patients. Due to its multifactorial etiology, surveillance of such an event is extremely important to identify the causative factor and to prevent recurrences in future. For surveillance, a team of ophthalmologists and microbiologists is often appointed by the local health department, and it is imperative that this team investigates thoroughly, reports appropriately safeguarding the interests of all, and also suggests remedial measures for future. Much literature is available on postoperative endophthalmitis and sterilization and disinfection protocols, but to the best of our knowledge, there is none to guide the surveillance team regarding the conduct of the entire process of investigation in the case of such unfortunate incidents. Through this article, we have made an attempt to formulate recommendations for expert teams investigating cases of postoperative cluster endophthalmitis.

Benzimidazoles are widely used and readily available ovine anthelminthics across the country. However, widespread resistance to this drug class has been documented, primarily in Haemonchus spp. The present study was conducted to determine the efficacy of closantel against benzimidazole resistant Haemonchus contortus infection in sheep. Naturally infected sheep (n=34) were divided into four groups on the basis of fecal egg counts (FEC) using modified McMaster technique with a lower detection limit of 8.3 eggs per gram of faeces (EPG) viz. Group-A (500-10000), Group- B (>10,000-20,000), Group-C (>20,000-30,000) and Group-D (>30,000). Generic differentiation of larvae was carried out by coproculture performed on pooled faeces which showed the presence of Haemonchus, Trichostrongylus, Oesophagostomum and Strongyloides larvae. To ascertain the evidence of benzimidazole resistance, Egg Hatch Assay (EHA) was performed. All animals were treated with Closantel @ 10mg\kg body weight and EPG was determined on 7th and 11th day post treatment. Animals of different groups had mean EPG range of 400 -760 at 11th day of treatment. In group A, B, C and D mean per cent efficacy of closantel was 91.24±3.49, 95.15±1.72, 97.73±0.72, 98.23±0.86 respectively. Efficacy of closantel against Haemonchus and other gastrointestinal nematodes was further confirmed by performing coproculture 11th day post treatment. Post treatment coproculture revealed presence of Trichostrongylus, Oesophagostomum and Strongyloides larvae and were devoid of Haemonchus larvae. To clear the left out infection of Trichostrongylus, Oesophagostomum and Strongyloides animals were further treated with Fenbendazole @5mg/kg body weight and EPG 14 days post treatment became zero. The results of the study suggested that closantel can be used for Targeted Selective Treatment (TST) in sheep primarily infected with Haemonchus. Since closantel is highly efficacious against Haemonchus its use as an alternative to benzimidazoles group may be helpful to decrease pasture contamination. Overall control of gastrointestinal nematodiasis may therefore be possible by use of closantel along with benzimidazoles.

Purpose: The study was conducted to evaluate occurrence of dry eye disease (DED) in type 2 diabetes mellitus (DM) and its association with diabetic retinopathy (DR) in the affected patients in western India. Methods: One hundred and five type 2 diabetic patients referred to a tertiary eye care center were consecutively selected. A detailed systemic history was evaluated. DED was assessed by Ocular Surface Disease Index questionnaire, Schirmer’s test, tear breakup time (TBUT), and fluorescein staining of cornea and conjunctiva, graded according to the National Eye Institute workshop grading. All patients underwent detailed fundus evaluation and DR, if present, was graded according to Early Treatment Diabetic Retinopathy (ETDRS) criteria. Results: Prevalence of DED in type 2 diabetics was 43.81% (92/210 eyes). The prevalence and severity of DED was found to be more in patients having higher glycosylated hemoglobin levels (P < 0.0001). Prevalence of DED was found to be high in those not taking any treatment (P < 0.0001). A statistically significant association was found between duration of DM and presence of DED (P = 0.02). Among the patients with DED, a majority had proliferative diabetic retinopathy (PDR; 57/92 eyes, 61.96%). Conclusion: The study highlights a significant correlation between DED and DM, and hence, examination for DED with fundus examination should be an integral part of the assessment of type 2 diabetics.

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Background: To study the impact of the second wave of the COVID-19 pandemic on the attitude and practice of vaccination, mental health and training of the ophthalmology residents doing COVID duties in Gujarat. Materials and methods: In this prospective study, online survey (Google Forms) was conducted during the second wave of COVID-19 pandemic from May 13 to May 17 2021 amongst the ophthalmology residents doing COVID duties in Gujarat. It was designed to understand their attitudes and practices towards COVID-19 vaccination, their mental health using the Patient Health Questionnaire (PHQ-9) and their perceived impact of the second wave of the pandemic on their ophthalmology training. Results: 148 residents responded to the survey. Mean age was 25.86 ± 1.4years and 73 (49.32%) were males. 112/148 (75.67%) had been vaccinated against COVID-19. The mean PHQ-9 score was 10.61 ± 4.5 (range of 1 to 24).130(87.83%) participants had some degree of depression. Depression was significantly more in students from government medical colleges (p=0.013). Mean duration of covid duty performed was 26.54 ± 17.63 days. 83/101 (82.18%) residents who had done COVID duties during both waves of the pandemic, found the second wave more stressful. 109/148 (73.65%) residents found COVID duties during the second wave had hampered their training in ophthalmology. Conclusion: With the constant threat of ongoing COVID-19 pandemic, an accessible psychological support system and effective e-learning process amongst the ophthalmology trainees, thereby boosting their self-confidence should be encouraged. Key words: second wave, ophthalmology residents, vaccination, mental health, training, COVID 19

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