How to prevent endophthalmitis in cataract surgeries?

Postoperative endophthalmitis is a very devastating complication and every step should be taken to reduce its occurrence. Unattended air conditioning filter systems are often the culprits and regular maintenance of the filters is of paramount importance. Shedders of pathogenic organisms amongst the theater personnel should be identified by regular screening and should be promptly treated. In addition to the use of Povidone iodine 5% solution in the conjunctival sac few minutes prior to surgery, proper construction of wound, injectable intraocular lenses, use of prophylactic intracameral antibiotics or prophylactic subconjunctival antibiotic injection at the conclusion of cataract surgery, placing a patch after the surgery for at least 4 h and initiating topical antibiotics from the same day of surgery helps to lower the frequency of postoperative endophthalmitis. Intraoperative posterior capsule rupture and anterior vitrectomy are risk factors for acute endophthalmitis, and utmost care to prevent posterior capsular rent should be taken while performing cataract surgery. Also, in case of such complication, these patients should be closely monitored for early signs of endophthalmitis in the postoperative period. In the unfortunate event of endophthalmitis the diagnosis should be prompt and treatment must be initiated as early as possible.

Photodynamic therapy with verteporfin in Belgian patients with subfoveal choroidal neovascularization secondary to age-related macular degeneration

This is a retrospective, uncontrolled study of 55 patients (61 eyes) treated between January 2002 and January 2004 with Photodynamic Therapy with Verteporfin for subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration. The eyes were divided into three groups: predominantly classic CNV (21 eyes), minimally classic CNV (7) and occult with no classic CNV (4 eyes). For 31 patients (32 eyes) the follow-up period was at least one year. The following parameters were studied: visual acuity, progression of the CNV, and activity of the CNV expressed as leakage on fluorescein angiography and edema on OCT. In the group of predominantly classic CNV at 12 month the treatment resulted in an inactive lesion in 43% of the eyes, however in 48% the visual acuity had decreased. For the group of minimally classic CNV, regression of activity was noted in 71% but vision further decreased in 57%. In the group of occult with no classic CNV one eye developed classic CNV, whereas the lesion regressed on 3 eyes. Two of the 4 eyes lost vision. These results suggest that although PDT is capable of stabilizing the lesion, further visual loss is to be expected in a large number of patients.

An observational study to detect leptospirosis in Mumbai, India, 2000

BACKGROUND

Leptospirosis is relatively uncommon in children. Following torrential rains and flooding an outbreak of leptospirosis was suspected in Mumbai.

AIMS

To investigate the possibility of an outbreak of leptospirosis and describe the clinical illness.

METHODS

From 24 July to 14 September 2000, children with a history of abrupt onset of high fever (>39 degrees C), who presented to our hospital, were admitted and tested serologically for anti-Leptospira antibodies by a quantitative enzyme linked immunosorbent assay (ELISA) test. An IgM titre of more than 20U/ml confirmed the diagnosis of leptospirosis. Clinical features in the confirmed leptospirosis and leptospirosis negative groups were analysed.

RESULTS

Of 53 children screened, 18 (34%) had leptospirosis. In all 18, the disease was anicteric and responded well to intravenous penicillin. Four clinical features present at the time of admission were significantly associated with leptospirosis: a history of contact with flood water (18/18 v 16/35), conjunctival suffusion (5/18 v 1/35), abdominal pain (9/18 v 5/35), and skin rash (5/18 v 1/35). As the number of these four features concomitantly present increased, the chances of the child having leptospirosis also increased significantly. A history of contact with flood water had a sensitivity of 100%, and the presence of conjunctival suffusion, abdominal pain, and skin rash had a specificity of 97%, 86%, and 97%, respectively, for identifying children with leptospirosis.

CONCLUSION

Leptospirosis should be suspected in febrile children with contact with flood water.

Isolation and molecular characterization of the COP1 gene homolog from rice, Oryza sativa L. subsp. Indica var. Pusa Basmati 1

The COP1 (CONSTITUTIVE PHOTOMORPHOGENIC 1) gene has been identified earlier from dicot species namely Arabidopsis, tomato and pea. The protein encoded by this gene acts as a molecular switch that negatively regulates the transition from the skotomorphogenic to the photomorphogenic mode of plant development. We have isolated and characterized the COP1 homolog from a monocot species, i.e. rice (var. Pusa Basmati 1). All the functional domains (Zn-binding RING finger motif, coiled-coil region, WD-40 repeats, cytoplasmic/nuclear localization sequences and protein-protein interaction domains) that are known in the COP1 proteins from dicots are conserved in COP1 from rice as well. The transcript levels of COP1 vary in various tissues of the rice plant. These variations were found to be development-dependent and do not solely depend on the light conditions.

Effect of topical glyceryl trinitrate on anodermal blood flow in patients with chronic anal fissures

INTRODUCTION

Recent studies have highlighted the role of increased internal anal sphincter pressure and decreased anodermal blood flow in the pathogenesis of chronic anal fissures. The duration of the effect of topical 0.2% glyceryl trinitrate (GTN) ointment on anodermal blood flow in fissure and normal areas was investigated in patients with chronic anal fissures.

METHODS

Six patients with chronic anal fissures in the posterior midline participated in the study. Blood flow measurements were performed on the anoderm using laser Doppler flowmetry before and immediately after the topical application of 0.2% GTN ointment and subsequent readings were taken at 5, 15, 30, 45 and 60 min in all four quadrants.

RESULTS

The mean anodermal blood flow in the fissure region is significantly lower than the mean blood flow of the rest of the anoderm before 0.2% GTN ointment is applied (228.7 +/- 61.8 flux units vs 439.3 +/- 25.5 flux units, respectively; P < 0.05). Immediately after the application of local 0.2% GTN ointment there is a significant increase in anodermal blood flow over the anal fissure region (457.8 +/- 56.5 flux units; P < 0.05) compared to the rest of the anoderm (457.4 +/- 30.8 flux units). This increase is most marked at 5 min post-GTN ointment application in the fissure area (474.6 +/- 41.1 flux units) and the blood flow in the fissure region is consistently above the rest of the anoderm for most of the 60 min.

CONCLUSION

There is clearly reduced blood flow to the chronic anal fissure region compared to the rest of the anoderm. Topical application of glyceryl trinitrate ointment seems to significantly improve the blood flow to the fissured area in the first hour. This may therefore help in the healing of chronic anal fissures.

DNA-replication/DNA-damage-dependent centrosome inactivation in Drosophila embryos

During early embryogenesis of Drosophila melanogaster, mutations in the DNA-replication checkpoint lead to chromosome-segregation failures. Here we show that these segregation failures are associated with the assembly of an anastral microtubule spindle, a mitosis-specific loss of centrosome function, and dissociation of several components of the gamma-tubulin ring complex from a core centrosomal structure. The DNA-replication inhibitor aphidicolin and DNA-damaging agents trigger identical mitotic defects in wild-type embryos, indicating that centrosome inactivation is a checkpoint-independent and mitosis-specific response to damaged or incompletely replicated DNA. We propose that centrosome inactivation is part of a damage-control system that blocks chromosome segregation when replication/damage checkpoint control fails.

Evaluation of Acacia nilotica (L.) del. and Casuarina equisetifolia forst. for tolerance and growth on microbially treated dyestuff wastewater

Two tree species, Acacia nilotica (L.) Del. and Casuarina equisetifolia Forst., were tested for their tolerance and growth on dyestuff wastewater containing phenol, aniline, and methyl violet. The wastewater was treated microbially by using a culture of Pseudomonas alcaligenes in a fixed-film bioreactor. The plants were watered with untreated and treated wastewater and tap water (control) at the rate of 2 litre per plant per week. A. nilotica exhibited 100% survival with both untreated and treated wastewater, and growth (increase in height) was comparable to that of control plants. However, growth of C. equisetifolia was adversely affected. It exhibited 100% survival with treated wastewater but only 87% survival with untreated waste-water and the percentage increase in height was less with both treated and untreated wastewater. There was no effect on soil except for an increase in chloride content.