A substantial proportion of keratoconjunctivitis is not associated with a detectable adenovirus. The clinical course of those with adenovirus D keratoconjunctivitis is significantly more severe than those with non-adenovirus D species infections or adenovirus-negative keratoconjunctivitis; high viral load at presentation and non-United States origin of participants is associated with poorer clinical outcome.

Neurological manifestations are reported only occasionally in patients with thalassaemia and are given much less prominence than the complications related to anaemia and iron overload. White matter changes (WMCs) on magnetic resonance imaging (MRI) in patients with thalassaemia were first reported two decades ago but the significance of these lesions remains unclear. We studied the neurological and cognitive manifestations in 82 older patients with thalssaemia [25 Thalassaemia major (TM), 24 thalassaemia intermedia (TI) and 33 haemaglobin E b thalassaemia (EBT)] and 80 controls, and found that headaches were more common in thalassaemia patients (50/82, 61%) than in controls (18/80, 22Á5%: P < 0Á001). WMCs on MRI were found in 20/82 (24Á3%) patients and 2/29 (6Á9%) controls had (P = 0Á078). WMC were more common among those with headaches (17/50: 34%) than in those without headache (3/32; 9Á3%) (P = 0Á023). WMCs were not associated with reduction of cognition. Nevertheless, cognition was lower in the TI and EBT groups compared with those with TM (P = 0Á002). The association of headache with WMC in thalassaemia has not been reported before and warrants further study.

The distal great saphenous vein is a popular site for venous access by means of percutaneous cannulation or venous cutdown in a hemodynamically unstable patient. The aim of this study was to precisely define the surface anatomy and dimensions of the distal part of the great saphenous vein to facilitate the aforementioned procedures. Cross-sectional anatomy of the distal saphenous vein was studied in 24 cadaveric ankles sectioned at a horizontal plane across the most prominent points of the medial and lateral malleoli. The curvilinear distance from the most prominent point of the medial malleolus to the center of the saphenous vein, its widest collapsed diameter and skin depth were obtained. The great saphenous vein was located at a mean distance of 24.4 ± 7.9 mm anterior to the medial malleolus. The mean widest collapsed diameter was 3.8 ± 1.5 mm. The mean distance from the skin surface to the vein was 4.1 ± 1.2 mm. These measurements could be used to locate the saphenous vein accurately, particularly in hemodynamically unstable patients with visually indiscernible veins.

The SARS pandemic has hit the world with long-lasting consequences. The full spectrum of the disease and resulting complications are yet to be unveiled. The permanent sequelae to different organ systems, the multitude of presentations, the theories of pathogenesis, and the associations with COVID-19 infection studied and reported continuously with ever-changing evidence.COVID-19 first reported in Wuhan in China in December 2019, spread to all parts of the world to the proportion of a pandemic by March 2020. The illness can range from asymptomatic or mild flu-like symptoms to severe acute respiratory distress and death. Apart from the respiratory system, it can damage all body organs, including blood, cardiovascular, neurological, and gastrointestinal systems.An ophthalmologist was the first to report the virus in Wuhan, China, and himself contracted and succumbed to the disease while treating a patient for glaucoma. Ophthalmic manifestations vary in presentation, severity, and timing and could be the presenting feature. Ophthalmic manifestations are more common in patients with a severe systemic disease with abnormal blood and inflammatory parameters 1,2 . Exposure of unprotected eyes can lead to infection with COVID-19 virus 3 . Routes of the transmission of the virus to the eyes include direct inoculation of conjunctiva by droplets, migration of upper respiratory tract infection through the nasolacrimal duct, or lacrimal gland involvement by the hematogenous route 4 .There is no evidence of viral replication in ocular tissues 4 , 2 . But it is advisable and safer to use universal

Phacoemulsification in hyper-mature cataracts is a challenge due to high intra-lenticular pressure, resulting in the capsulorhexis extending to the periphery. A continuous curvilinear capsulorhexis (CCC) is crucial to uncomplicated, safe and successful phacoemulsification and posterior chamber intraocular lens (IOL) implantation. Achieving a CCC in eyes with white hyper-mature cataract is challenging due to high intra-lenticular pressure and risk of extension of capsulorhexis (Argentinian flag sign). Various techniques such as double capsulorhexis, phacocapsulorhexis, massaging, anterior capsular puncture with a needle or YAG laser and femtosecond laser capsulorhexis have been described to prevent this complication.