Rheumatic heart disease was the predominant type. Patients in NYHA class I/II had a better maternal and fetal outcome than those in NYHA class III/IV. Surgical correction of the cardiac lesion prior to pregnancy was associated with better pregnancy outcome. Pregnant women with prosthetic valves tolerated pregnancy well.

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Here, we report a case of acute endothelial graft rejection following coronavirus disease 2019 (COVID-19). A 57-year-old woman who underwent therapeutic penetrating keratoplasty for a perforated infectious corneal ulcer in her right eye developed severe acute respiratory syndrome coronavirus 2 infection, which required intensive care and treatment with steroids. Acute endothelial graft rejection was seen at three weeks postoperatively and managed with high-dose corticosteroids. Despite standard therapy, secondary graft failure was observed. Immune dysregulation associated with COVID-19 may be a significant cause of acute endothelial graft rejection among keratoplasty patients with COVID-19.

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Lichen planus is an idiopathic inflammatory condition, which may involve mucosa of the oral cavity, gastrointestinal tract, larynx or the cutaneous surface either in isolation or in combinations. Mucosal lichen planus is more common than the cutaneous variant. Isolated lip involvement is very rare and should be differentiated from other similar leukoplakic lesions. We are reporting a rare case of oral lichen planus in an elderly male that was exclusively localised to the lower lip.

Our case report highlights the rare association of a unilateral congenital corneal keloid with anterior-segment mesenchymal dysgenesis and bilateral subluxated lens.

To estimate the concentration of methemoglobin (MetHb) in malaria patients and correlate with severity of malaria infection. This prospective study included 30 untreated cases of malaria confirmed by Quantitative Buffy Coat (QBC) test and 30 age sex matched non-malarial cases taken as controls. All the patients underwent thorough clinical examination and routine biochemical investigation. Methemoglobin levels were estimated by spectrophotometric (co-oxymeter) method on day 1 and day 10 of diagnosis of all study group patients and correlated with clinical profile and severity. Out of 30 malaria patients 22 were males and eight were females. The clinical presentations in complicated malaria group (n = 21) were fever 21 (100 %), anemia 17 (80.95 %), renal failure 12 (52.38 %) and coma/convulsion 5 (23.8 %). The mean age of the study group was 41.66 years. Mean MetHb in complicated malaria on day 1 was 2.55 ± 1.75 % and day 10 was 10.69 ± 8.19 % (statistically significant). The overall mortality was 13 (43.33 %) among study group while 5 (16.66 %) was found among control group. Mean MetHb who died (n = 13) on day 1 was 3.144 ± 1.829 % and (n = 8) on day 10 it was 19.982 ± 8.406 %. Increase in level of methaemoglobin is detrimental to the body and is associated with increase in mortality. Routine MetHb estimation may be used as a prognostic indicator in the management of malaria patients. It is suggested that addition of drugs which reduce MetHb may be tried along with antimalarial drugs to decrease morbidity and mortality in malaria.

No abstract