For centuries arsenic has played an important role in science, technology, and medicine. Arsenic for its environmental pervasiveness has gained unexpected entrance to the human body through food, water and air, thereby posing a great threat to public health due to its toxic effect and carcinogenicity. Thus, in modern scenario arsenic is synonymous with “toxic” and is documented as a paradoxical human carcinogen, although its mechanism of induction of neoplasia remains elusive. To assess the risk from environmental and occupational exposure of arsenic, in vivo cytogenetic assays have been conducted in arseniasis-endemic areas of the world using chromosomal aberrations (CA) and sister chromatid exchanges (SCE) as biomarkers in peripheral blood lymphocytes. The primary aim of this report is to critically review and update the existing in vivo cytogenetic studies performed on arsenic-exposed populations around the world and compare the results on CA and SCE from our own study, conducted in arsenic-endemic villages of North 24 Parganas (district) of West Bengal, India from 1999 to 2003. Based on a structured questionnaire, 165 symptomatic (having arsenic induced skin lesions) subjects were selected as the exposed cases consuming water having a mean arsenic content of 214.96 µg/l. For comparison 155 age-sex matched control subjects from an unaffected district (Midnapur) of West Bengal were recruited. Similar to other arsenic exposed populations our population also showed a significant difference (P < 0.01) in the frequencies of CA and SCE between the cases and control group. Presence of substantial chromosome damage in lymphocytes in the exposed population predicts an increased future carcinogenic risk by this metalloid.
This is a rare association and, to the best of our knowledge, the first report of successful treatment with dimercarpol. The source of arsenic was contaminated underground drinking water (from a deep tube-well). The pathophysiology is thought to be the result of an inflammatory response caused by accumulated arsenic in local tissues. Papillary conjunctivitis and dermatological changes can be successfully managed with dimercaprol and multivitamins. Further studies are required to find out the possible link between the papillary response of conjunctiva and arsenic accumulation within the body.
A 43-year-old man developed central serous choroidoretinopathy in his left eye following dacryocystorhinostomy operation on the same side. He was using xylometazoline nasal drops in his left nostril. Action of xylometazoline or the stress related to the operation or the effect of both factors played the role in the causation of this ocular condition. Omission of nasal drops or relief from stress resulted in full recovery of vision and complete resolution of symptoms within one month.
BACKGROUND Central serous chorioretinopathy (CSCR) is the fourth most common retinopathy after age-related macular degeneration, diabetic retinopathy and branch retinal vein occlusion. Chronic Central Serous Chorioretinopathy is defined as persistence of sub-retinal fluid on Ocular Coherence Tomography beyond 3 months of onset of the disease. In the current study, we evaluated the efficacy of eplerenone in patients of chronic serous chorioretinopathy (CSCR). METHODS It is a randomized double blind study of sixty-eight eyes of sixty patients who were randomized into two groups. Thirty-five eyes of thirty patients in the treatment group (Group A), received 50 mg eplerenone daily for 3 months and thirty-three eyes of thirty patients in the control group (Group B) received one capsule of placebo drug (glucose powder) each day for the same duration. Visual acuity (VA), maximum height of sub-retinal fluid (SRF) and contrast sensitivity (CS) were studied at baseline and monthly thereafter for 6 months after initiation of therapy. RESULTS Better improvement of VA, reduction of SRF and improvement of CS were observed in the treatment group as compared to placebo. t-Test showed that there was significant difference in mean CS of the two groups at 6 months (p= 0.0459) and it also showed that there was significant difference in mean SRF of the two groups at the end of 6 months (p= 0.0491). CONCLUSIONS Eplerenone could be beneficial as an alternate mode of therapy in the treatment of chronic CSCR.
BACKGROUND The purpose of this study is to assess efficacy of laser photocoagulation monotherapy, intravitreal Bevacizumab monotherapy and combined therapy (laser photocoagulation and intravitreal Bevacizumab) on the basis of mean average change in BCVA and changes in macular thickness over 6 months in DME ≥ 350 µm. This is to identify the best treatment option in Non-Proliferative Diabetic Retinopathy (NPDR) with macular thickness ≥ 350 µm in type 2 diabetic retinopathy patients. Design-An open label, randomised, parallel group, comparative trial. MATERIALS AND METHODS In this study, Best Corrected Visual Acuity (BCVA) and macular thickness (CFT) was compared before and after modified macular grid laser monotherapy, intravitreal Bevacizumab injection monotherapy and combined therapy in patients with macular oedema with thickness ≥ 350 µm measured with spectral domain OCT. One hundred and twenty (120) newly diagnosed eyes of NPDR with macular oedema (40 patients in each group, age and sex matched) attending retina clinic of Regional Institute of Ophthalmology, Kolkata, over a period of one year (01/09/2013 to 31/08/2014) were included in this study. Patients having bilateral macular oedema were treated with one group of therapy in one eye and another group of therapy in other eye. We have considered newly diagnosed non-ischaemic non-proliferative diabetic retinopathy eyes with macular oedema of ≥ 350 µm. RESULTS Mean CFT at the start of the treatment, i.e. the baseline was statistically insignificant in between and within the three groups, but it became significant at 1 month (p = 0.0001), at 3 months (p = 0.0001) and at 6 months (p = 0.0001) using One-Way ANOVA. Therefore, there is significant difference in the improvement achieved at 1 month, 3 months and 6 months in CMT within the three groups and also between the three groups. Mean BCVA at the start of the treatment, i.e. the baseline was statistically insignificant in between and within the three groups, but it became significant at 1 month (p = 0.001), at 3 months (p = 0.0001) and at 6 months (p = 0.0001) using One-Way ANOVA. Therefore, there is significant difference in the improvement achieved at 1 month, 3 months and 6 months in BCVA. CONCLUSION This parallel group comparative trial has shown that Intravitreal Bevacizumab is most effective in reducing the central macular thickness followed by combined treatment and then modified grid laser treatment. This study has also shown that Intravitreal Bevacizumab is most effective in improving the best corrected visual acuity.
BACKGROUND To compare corneal endothelial cell count (ECC) after one-step surgery: combined phacoemulsification-IOL and pars planavitrectomy (PPV) with that after two-step surgery-PPV followed by phacoemulsification-IOL after at least 2 months of the first procedure. Purpose-After reviewing the available literature, we did not find studies on the above stated topic. This study may prove helpful to the surgeon in considering one-step combined phacoemulsification-IOL and pars planavitrectomy for the patient. MATERIALS AND METHODS 62 patients (65 eyes) who underwent one-step phacovitrectomy (33 eyes of 32 patients; group 1) and two-step surgery-PPV followed by phacoemulsification-IOL (32 eyes of 30 patients; group 2) were enrolled in this study. The Corneal endothelial cell count of both the groups were compared with the baseline values of the respective groups at the end of 3months and 6 months after surgery and cell count of both the groups were compared. RESULTS The mean endothelial cell loss in group 2 (22.67%±19.49% and 23.82%±18.96% at 3 and 6 months respectively) was significantly higher than that in group 1 (16.1%±9.62% and 15.08%±11.24% at 3 and 6 months respectively) [p=0.0024 and p=0.0022 at 3 months and 6 months respectively]. CONCLUSION Corneal endothelial cell loss was found more in Group-2 patients; may be due to complications following first surgery and due to more tissue handling.
Purpose. Retinal nerve fibre layer (RNFL) is a sensitive structure, which is affected by anaemia due to hypoxia. A timely detection of RNFL thinning may aid preventing devastating complications. Optical coherence tomography (OCT) measures RNFL thinning with accuracy and helps in detecting thinning of the retinal layer in anaemic patients. This study was destined to evaluate thinning of RNFL in anaemic patients and their correlation with the haemoglobin level. Methods. It was a prospective comparative study. Total of 151 patients were included in this study. Patients with retinal diseases were excluded from this study. After initial evaluation, haematological and ophthalmological parameters were measured. RNFL was measured with OCT and corroborated with the Hb level and analysed accordingly. EPI and SPSS softwares were used for detail analysis and the correlation between RNFL thinning and the Hb level. Initially, each eye was separately assigned a value (0, 1, and 2) (normal, borderline, and abnormal, respectively) as per the severity of thinning, and then, the sum of the scores of both eyes were considered as a separate variable, and a multiple linear regression analysis was performed with the independent variables. Results. RNFL thinning was found to be significant in each group of patients. There was a strong correlation of RNFL thinning with degree of anaemia. Conclusions. Thalassaemia, iron deficiency anaemia, and anaemia of chronic diseases are associated with the significant damage to RNFL. Degree of anaemia is the most important parameter for such thinning of the RNFL layer.
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