Indirect ophthalmoscopy should be performed at 4 weeks of post natal age in all preterm babies with birth weight < or = 1500 gm, and intensified in the presence of risk factors like oxygen administration, apnoea and septicemia.

An outbreak of nosocomial fungemia due to the unusual yeast, Pichia anomala occurred in the pediatric wards of our hospital over a period of 23 months (April 1996 to February 1998). A total of 379 neonates and children (4.2% admissions) were infected. The probable index case was admitted to the pediatric emergency ward, with subsequent transmission to the premature nursery, pediatric intensive care units, and other children wards. Carriage on the hands of health care personnel was likely to be responsible for dissemination of the fungus. The outbreak could only be controlled after a health education campaign to improve hand-washing practices was instituted and after nystatin-fluconazole prophylaxis to all premature neonates and high-risk infants was introduced. In a case-control study, we identified a lower gestational age, a very low birth weight (<1,500 g), and a longer duration of hospital stay as significant risk factors associated with P. anomala fungemia in premature neonates. We conducted a culture prevalence survey of 50 consecutive premature neonates and found that 28% were colonized with P. anomala at a skin or mucosal site on the date of delivery and that 20% of these neonates subsequently developed P. anomala fungemia. We performed multilocus enzyme electrophoresis on 40 P. anomala outbreak isolates (including patient and health care workers' hand isolates), and the results suggested that these isolates were identical. Our study highlights the importance of P. anomala as an emerging nosocomial fungal pathogen.Deep-seated fungal infections are important causes of morbidity and mortality in hospitalized patients (1, 2, 5, 13). Disseminated candidiasis is the most common nosocomial fungal infection, and Candida albicans has been reported to account for 50% to more than 70% cases of invasive candidiasis (2,5,6,8). However, recent reports have also suggested the emergence of infections caused by non-C. albicans candidas (3,14,21). In addition, less-common pathogenic yeasts (Malassezia, Trichosporon, Hansenula, and Rhodotorula spp.) have recently been reported, with increased frequency, as causes of nosocomial infections (7).Although a rare clinical isolate, the ascosporogenous yeast, Pichia anomala (formerly Hansenula anomala) has been implicated in causing fungemia in a neonatal intensive care unit (10), interstitial lung disease (19), endocarditis (12), and enteritis (9). In addition, there have been two reports of nosocomial outbreaks due to P. anomala: one in a Neonatal Intensive Care Unit in Liverpool, United Kingdom (10), and the other in an oncology hospital in Brazil (18). We describe here an outbreak of invasive P. anomala infection in the pediatric wards of our medical center that occurred during April 1996 to February 1998, with an attack rate of 4.2%. MATERIALS AND METHODSEpidemiologic investigation. The Nehru Hospital, affiliated with the Postgraduate Institute of Medical Education and Research, Chandigarh, India, is a 1,200-bed tertiary adult and pediatric referral center. The pediatric depa...

In developing countries, where manpower and other resources are limited and patient-load high, ophthalmic surgeons should choose a procedure that is simple, quick and effective. This study suggests that terminal tarsal rotation after transverse tarsotomy should be the procedure of choice in the correction of moderate or severe (without lid gap) trachomatous entropion.

The subclasses S*(ot, 3) and C*(a, 3) of T , the class of . IntroductionLet S denote the class of functions of the form equal to GO 3 + Y \ a \ z that are analytic and univalent in the unit disk \z\ < 1 .

Bacillus anthracis MoxXT is a Type II proteic Toxin-Antitoxin (TA) module wherein MoxT is a ribonuclease that cleaves RNA specifically while MoxX interacts with MoxT and inhibits its activity. Disruption of the TA interaction has been proposed as a novel antibacterial strategy. Peptides, either based on antitoxin sequence or rationally designed, have previously been reported to disrupt the MoxXT interaction but cause a decrease in MoxT ribonuclease activity. In the present study, we report the crystal structure of MoxT, and the effect of several peptides in disrupting the MoxXT interaction as well as augmentation of MoxT ribonuclease activity by binding to MoxT in vitro. Docking studies on the peptides were carried out in order to explain the observed structure activity relationships. The peptides with ribonuclease augmentation activity possess a distinct structure and are proposed to bind to a distinct site on MoxT. The docking of the active peptides with MoxT showed that they possess an aromatic group that occupies a conserved hydrophobic pocket. Additionally, the peptides inducing high ribonuclease activity were anchored by a negatively charged group near a cluster of positively charged residues present near the pocket. Our study provides a structural basis and rationale for the observed properties of the peptides and may aid the development of small molecules to disrupt the TA interaction.

Abstract. For a simple C * -algebra A and any other C * -algebra B, it is proved that every closed ideal of A ⊗ min B is a product ideal if either A is exact or B is nuclear.

This study of sixty ASA grade 1 or 2 children, aged 1 to 12 years, undergoing elective ophthalmic procedures, compared the use of the laryngeal mask airway (LMA) with that of an endotracheal tube. Changes in intraocular pressure and haemodynamic parameters, and intraoperative and postoperative complications were measured. Patients were randomly allocated into two groups of 30 patients. In group 1, the airway was secured with an LMA and in group 2 with an endotracheal tube. A standard technique of general anaesthesia incorporating positive pressure ventilation was used in both groups. The changes in intraocular pressure, heart rate (HR) and mean arterial pressure (MAP) were observed before and after insertion of the airway device, two minutes after insertion, and pre and post removal of the device. The incidence of airway complications was also noted. There was no significant change in mean intraocular pressure after insertion of the LMA, but removal caused a significant increase to 19.3± 7.6 mmHg (from a baseline of 13.9±4.3 mmHg). In the endotracheal tube group, intubation increased the mean intraocular pressure significantly to 19.9±7.3 mmHg (from a baseline of 13.1±4.0 mmHg) and extubation caused an increase to 24.6±10.4 mmHg which was clinically as well as statistically significant. The incidence of postoperative coughing was lower in the LMA group, but the incidence of vomiting higher. Two patients had displacement of the LMA during the procedure. We conclude that the use of an LMA is associated with less increase in intraocular pressure than the use of an endotracheal tube in children.

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