Ipsilateral rotational autokeratoplasty: an alternative to penetrating keratoplasty in nonprogressive central corneal scars

PURPOSE

To report the outcome of ipsilateral rotational autokeratoplasty performed for nonprogressive central corneal opacities.

METHODS

Medical records of 27 patients who underwent ipsilateral rotational autokeratoplasty between June 1995 and December 1998 were retrospectively reviewed. The etiology of corneal opacity, preoperative visual acuity, and size of the trephine used was noted. Any intraoperative and early and late postoperative complications were noted in all patients. The final outcome, visual acuity, and astigmatism at final correction were analyzed.

RESULTS

The main etiology of corneal opacity was trauma (44.4%), followed by resolved keratitis (29.6%). The size of the graft ranged from 6.5 to 9 mm. Fifteen patients underwent autokeratoplasty alone; additional procedures were combined in the remaining 12. Wound leak was the most common postoperative complication, which was seen in seven patients. The mean follow-up was 12.11 months (SD = 11.95 months). Five patients (18.5%) were lost to follow-up. Of the remaining 22, 19 (86.36%) had clear grafts and 3 (13.6%) had failed grafts. The mean astigmatism at final correction was 4.25 diopters cylinder (SD = 2.72). Final visual acuity of 20/80 or better was obtained in 13 cases (59.09%).

CONCLUSIONS

Contrary to common belief, ipsilateral rotational autokeratoplasty is a safe and effective surgical procedure. It can be considered as an alternative procedure to penetrating keratoplasty in a scenario in which tissue scarcity exists, as well as in cases that have a high risk of developing immunologic allograft rejection. Further prospective studies with preoperative specular microscopy and postoperative corneal topography will provide greater insight into the usefulness of this procedure.

Amniotic membrane transplantation in the management of shield ulcers of vernal keratoconjunctivitis

PURPOSE

To report our experience with amniotic membrane transplantation in the management of severe shield ulcers.

DESIGN

Retrospective, interventional, noncomparative case series.

PARTICIPANTS

Four patients (seven eyes) with grade 2 (ulcer with opaque base) and grade 3 (plaquelike lesions) shield ulcers not responding to steroid therapy with or without surgical debridement.

INTERVENTION

Amniotic membrane transplantation with stromal side down was performed after meticulous debridement of the ulcer.

MAIN OUTCOME MEASURES

Healing of the ulcer with no epithelial defect.

RESULTS

The ulcers healed with disintegration or retraction of the membrane in all patients within 2 weeks.

CONCLUSIONS

Amniotic membrane transplantation in combination with debridement is an effective surgical modality in the management of severe shield ulcers. Further studies are warranted to confirm the efficacy of amniotic membrane transplantation in the management of shield ulcer and its correct position in the treatment algorithm.

Oxidative damage induced by the injection of HIV-1 Tat protein in the rat striatum

Oxidative stress has been hypothesized to play a role in the pathogenesis of different neurodegenerative disorders, including HIV-related dementia. Tat, a nonstructural protein of HIV, is implicated in potentiation of neuronal apoptosis by mechanisms involving the disruption of calcium homeostasis and oxidative stress. The injection of Tat caused an increase of protein carbonyl formation in the rat striatum. Increased oxidative modification of proteins occurred early after Tat injection and preceded Tat-mediated astrogliosis. Immunostaining of brain sections demonstrated that an area of prominent protein carbonyl immunoreactivity surrounded an injection site in the striatum of Tat-injected rats. Intense protein carbonyl immunoreactivity was localized in cell bodies. Our study suggests that increased protein oxidation may be an important part of the mechanism of Tat neurotoxicity.

Impression cytology-proven corneal stem cell deficiency in patients after surgeries involving the limbus

PURPOSE

To report three cases of limbal stem cell deficiency (confirmed by impression cytology) that followed multiple pterygium surgeries and therapeutic penetrating keratoplasty.

METHODS

The first case, after multiple pterygium surgeries, presented with corneal scarring and thickened epithelium with vascularization sparing the central cornea in the right eye and involving the entire cornea in the left eye. The second case presented with superficial scarring and extensive vascularization after failed therapeutic graft performed for a large perforated corneal ulcer. The third case was a clear graft performed for a progressing fungal ulcer with signs of conjunctivalization inferotemporally. Limbal stem cell deficiency was clinically suspected in all of these cases.

RESULTS

Goblet cells with mucin globules were found on the corneal surface by impression cytology in all three cases.

CONCLUSIONS

We report three cases of limbal stem cell deficiency (proven by impression cytology) that followed multiple pterygium surgeries and therapeutic penetrating keratoplasty. Surgical insult to the limbus is the predisposing factor for stem cell damage in these cases. Involvement of the limbus by infection and use of intensive medications are probable contributing factors for stem cell damage in cases of therapeutic penetrating keratoplasty.

Benzyl ester prodrug of ibuprofen: pharmacological and toxicological profile

Prodrug approach is a promising way of overcoming gastrotoxicity associated with long term oral use of NSAIDs like ibuprofen. The candidature of benzyl ester prodrug of ibuprofen was examined to assess its ability to reduce gastrotoxicity without affecting pharmacological response. It gave highly promising activity profile in established animal models like carrageenan induced rat paw oedema and acetic acid induced writhing reflex assay. The effect of physicochemical properties like aqueous solubility, octanol-water partition coefficient, hydrolysis kinetics in human plasma and simulated gastric fluid, on activity profile has been investigated.

Alkyl ester prodrugs for improved topical delivery of ibuprofen

Topical delivery of ibuprofen directly to the site of inflammation can overcome gastrointestinal side effects associated with its long term oral administration. The set of physicochemical properties necessary for optimum topical delivery of ibuprofen can be imparted by formation of its ester prodrugs. Various alkyl ester prodrugs (methyl, ethyl, n-propyl, iso-propyl, n-butyl, iso-butyl, sec-butyl, tert-buty, n-pentyl, hexyl, heptyl, octyl, lauryl, cetyl and octadecyl esters) were synthesised and studied for their physicochemical properties and activity in the carrageenan induced rat paw oedema by topical route. Favourable shift in lipophilicity and self penetration enhancing effect of prodrugs responded in improved topical activity over the parent drug ibuprofen.

Activity profile of glycolamide ester prodrugs of ibuprofen

Glycolamide esters of ibuprofen (I), namely, unsubstituted (II), N,N dimethyl (III), and N,N diethyl (IV), were synthesized and studied for different physicochemical, pharmacological, and toxicological properties. They were comparable with I in respect of anti-inflammatory and analgesic activity but did not exhibit reduction in the ulcerogenicity on oral administration. However, all three exhibited significantly better topical activity in carrageenan-induced rat paw edema assay. In the same assay, they provided significant protection against inflammation when applied at a site remote to the inflammation site.

Bilateral infectious keratitis after laser in situ keratomileusis: a case report and review of the literature

OBJECTIVE

To report a case of bilateral infectious keratitis after simultaneous bilateral laser in situ keratomileusis (LASIK) and to explore appropriate preventive, diagnostic, and therapeutic measures.

DESIGN

Interventional case report and literature review.

INTERVENTION

A 22-year-old woman had bilateral corneal infiltrates after simultaneous bilateral LASIK. The same set of instruments was used for surgery on both eyes. Corneal scrapings from the edge of the infiltrate and underneath the flap were taken for microscopic examination and inoculation on culture media. Treatment consisted of irrigation of stromal bed with amikacin sulphate (2.5%) solution along with half hourly instillation of amikacin (2.5%) and cefazolin (5%) eye drops.

MAIN OUTCOME MEASURES

Causative organism and response to medical treatment.

RESULTS

Culture revealed a significant growth of Mycobacterium chelonae from the corneal scrapings of both eyes. There was progressive thinning of corneal stroma in the right eye requiring cyanoacrylate tissue adhesive application. The left eye showed progressive worsening after initial response and required penetrating keratoplasty.

CONCLUSIONS

The risk of bilateral sight-threatening complications must be kept in mind when contemplating bilateral simultaneous LASIK. Nontuberculous mycobacteria should be considered as an etiologic agent in cases of infectious keratitis occurring after LASIK. Microbiology work-up of a specimen collected directly from the site of lesion can help in early diagnosis and institution of appropriate therapy.

Neurotoxicity of HIV-1 proteins gp120 and Tat in the rat striatum

HIV-associated dementia complex is a serious disabling disease characterized by cognitive, behavioral and motor dysfunction. Basal ganglia involvement in HIV-1 infection may be responsible for some of the psychomotor symptoms associated with HIV dementia. The objectives of the present study were to determine: (1) whether gp120 and Tat produce striatal toxicity, and (2) whether gp120 and Tat show synergistic toxicity in the striatum. In these studies, the recombinant proteins gp120, Tat, or saline (0.9%) were stereotaxically injected in the striatum of adult male rats. The striatal sections were evaluated for area of tissue loss (Cresyl-violet stained sections) and the number of GFAP immunoreactive cells 7 days after the injections. Doses of gp120 250 ng/microl or higher and Tat 5 microg/microl or higher produced a significant area of tissue loss and significantly increased the number of GFAP reactive cells. We found no toxicity in animals treated with immunoabsorbed gp120 or Tat. Combined gp120 (100 ng/microl)+Tat (1 microg/microl) injections into the rat striatum significantly increased the area of tissue loss and altered morphology and increased number of GFAP reactive cells, as compared to controls. Thus, the present results suggest the involvement of gp120 and Tat in striatal toxicity and provide a model for further studies to fully characterize their role in HIV-1 toxicity and to develop therapeutic strategies for HIV-1 associated dementia complex.

Hepatic and renal oxidative stress in acute toxicity of N-nitrosodiethylamine in rats

Nitrosoamines such as N-nitrosodiethylamine (NDEA) produce oxidative stress due to generation of reactive oxygen species and may alter antioxidant defence system in the tissues. NDEA was administered ip as a single dose to rats in LD50 or in lower amounts and the animals were sacrificed after 0-48 hr of treatment. The results showed that lipid peroxidation in liver increased, however no significant increase in kidney LPO was observed after NDEA administration. Superoxide dismutase (SOD) and glutathione reductase (GSH-R) activity increased in liver, however, catalase (CAT) activity in liver was inhibited in NDEA treated rats. Kidney showed an increase in SOD activity after an initial decrease along with increase in GSH-R activity in NDEA treated rats. However, kidney CAT activity was not significantly altered in NDEA intoxicated rats. Serum transaminases, serum alkaline phosphatase blood urea nitrogen, serum creatinine and scrum proteins were elevated in NDEA treated rats. The results indicate NDEA-induced oxidative stress and alteration in antioxidant enzymes in liver and kidney to neutralise oxidative stress.

Amniotic membrane transplantation in acute chemical and thermal injury

PURPOSE

To present a case of chemical injury and a case of thermal injury treated by amniotic membrane transplantation in acute phase.

METHODS

Case reports. An eye with sodium hydroxide injury, opaque cornea, and limbal ischemia of more than 180 degrees and an eye with hot tea injury, opaque cornea, stromal edema, and scarring were treated by amniotic membrane transplantation within the first few weeks of injury.

RESULTS

In the eye with sodium hydroxide injury, 4 months after amniotic membrane transplantation, the ocular surface is stable, superficial corneal scarring with vascularization is present, and visual acuity is 20/25. In the eye with thermal injury, 6 months after amniotic membrane transplantation, the ocular surface is stable, but there is superficial scarring and vascularization, and visual acuity is 20/20.

CONCLUSIONS

Amniotic membrane transplantation can be considered in chemical injury with severe limbal ischemia and in severe thermal injury in acute phase. Long-term studies are warranted to evaluate further the efficacy of amniotic membrane transplantation in these clinical situations.

Aspergillus flavus keratitis after laser in situ keratomileusis

PURPOSE

To report a case of fungal keratitis caused by Aspergillus flavus after laser in situ keratomileusis surgery.

METHODS

Case report. A 24-year-old woman developed pain, redness, decreased vision, and an infiltrate posterior to the corneal flap in her right eye 3 days after laser in situ keratomileusis. On referral, approximately 3 weeks after laser in situ keratomileusis, examination of the right eye revealed light perception vision, a large full-thickness corneal infiltrate, and hypopyon. Corneal scrapings were taken for direct microscopic examination and culture.

RESULTS

Corneal scraping revealed the presence of fungal filaments in smears and in culture. The fungus was identified as A. flavus. Intensive topical natamycin and systemic ketoconazole therapy was initiated. Despite intensive medical treatment, the infiltrate progressed and the patient was subjected to a therapeutic penetrating keratoplasty. There was no recurrence of infection after surgery. At last follow-up 4 months after surgery, the eye was quiet with graft edema.

CONCLUSION

Fungal keratitis is a rare complication of laser in situ keratomileusis surgery. In a case that does not respond to medical treatment, early surgical intervention must be considered.

Corneal triple procedure: indications, complications, and outcomes: a developing country scenario

PURPOSE

We report the indications, complications, and outcomes of 104 corneal triple procedures in our institute.

METHODS

Patient records of 104 consecutive cases of corneal triple procedure (penetrating keratoplasty with extracapsular cataract extraction and intraocular lens implantation) performed by experienced corneal surgeons between January 1992 and December 1997 were retrospectively reviewed. Relevant preoperative, operative, and postoperative data were collected. The outcome was assessed by the graft clarity and visual acuity at the last visit. Survival analysis of these grafts was determined by Kaplan-Meier method.

RESULTS

Of 104 patients, 70 were men and 34 were women. Mean age of these patients was 48.5+/-17.1 years (range, 1-75 years). Corneal scarring with cataract was the reason for surgery in 69 (66.4%) cases. The intraoperative complications included vitreous upthrust in seven (6.9%) cases and posterior capsular dehiscence in three (2.9%) cases. The most common early postoperative complications were increased intraocular pressure in 19 (18.3%) and increased anterior chamber reaction in 25 (24%) cases. Posterior capsular opacification was seen in 26 (25%), graft reaction in 15 (14.4%), and secondary glaucoma in 15 (14.4%) cases. These formed the important late postoperative complications. The average postoperative follow-up was 23.7+/-17.6 months (range, 1.6-79.4 months); at which time 72% of the grafts remained clear. At last follow-up, 40% of patients had a visual acuity of > or = 20/40.

CONCLUSIONS

Corneal scarring with cataract is the most common reason for triple procedure in this part of the world. This is a safe surgical procedure with good graft clarity and reasonable visual recovery.

Amniotic membrane transplantation for ocular surface reconstruction in Stevens-Johnson syndrome

PURPOSE

To evaluate amniotic membrane transplantation (AMT) for ocular surface reconstruction in Stevens-Johnson syndrome (SJS).

DESIGN

Prospective interventional case series.

PARTICIPANTS

Ten consecutive patients (10 eyes) with SJS that underwent AMT as the first step in staged ocular surface reconstruction were included.

METHODS

Amniotic membrane was processed under sterile conditions from a fresh placenta obtained from cesarean section in a seronegative pregnant woman and stored at -700 degrees C. Symblepharon release, excision of epibulbar fibrous tissue, and clearing of the fibrovascular membrane over the cornea was performed in all cases. Amniotic membrane covered the entire bulbar surface up to the fornices in five eyes; cornea and the perilimbal area in two eyes; cornea, the inferior bulbar surface, and the lower fornix in two eyes; and cornea and the superior bulbar surface in one eye. Obliterated fornices were deepened by use of fornix-formation sutures in all eyes. Symblepharon ring was placed postoperatively for 3 weeks to 2 months. Mean postoperative follow-up was 13.5 months (SD, +3.8 months; range, 9-30 months).

MAIN OUTCOME MEASURES

Restoration of adequate bulbar surface free of symblepharon and good fornix depth were the main outcome measures.

RESULTS

Complete corneal reepithelization occurred in all eyes between 1 and 6 weeks. Adequate bulbar surface and fornix depth were achieved in nine eyes, all of which were free of symblepharon at the final follow-up visit. Cicatricial entropion resolved in four of five lower eyelids and one of two upper eyelids after AMT. One patient had a central corneal melt that required or necessitated a penetrating keratoplasty.

CONCLUSIONS

AMT restores adequate bulbar surface and fornix depth and prevents recurrence of symblepharon in severe cases of SJS.

Fungal keratitis after laser in situ keratomileusis

A 22-year-old woman presented with pain, redness, watering, and decrease in vision in her left eye 15 days after laser in situ keratomileusis for myopia. Slitlamp examination showed a central full-thickness infiltrate with hyphate edges. Microscopic examination of corneal scrapings from the edge and underneath the flap showed fungal filaments, and the growth on culture media was identified as Scedosporium apiospermum.

An automated comparative analysis of 17 complete microbial genomes

MOTIVATION

As sequenced genomes become larger and sequencing becomes faster, there is a need to develop accurate automated genome comparison techniques and databases to facilitate derivation of genome functionality; identification of enzymes, putative operons and metabolic pathways; and to derive phylogenetic classification of microbes.

RESULTS

This paper extends an automated pair-wise genome comparison technique (Bansal et al., Math. Model. Sci. Comput., 9, 1-23, 1998, Bansal and Bork, in First International Workshop of Declarative Languages, Springer, pp. 275-289, 1999) used to identify orthologs and gene groups to derive orthologous genes in a group of genomes and to identify genes with conserved functionality. Seventeen microbial genomes archived at ftp://ncbi.nlm.nih.gov/genbank/genomes have been compared using the automated technique. Data related to orthologs, gene groups, gene duplication, gene fusion, orthologs with conserved functionality, and genes specifically orthologous to Escherichia coli and pathogens has been presented and analyzed.

AVAILABILITY

A prototype database is available at ftp://www.mcs.kent.edu/arvind/intellibio / orthos.html. The software is free for academic research under an academic license. The detailed database for every microbial genome in NCBI is commercially available through intellibio software and consultancy corporation (Web site: http://www.mcs.kent.edu/årvind/intellibio . html).

CONTACT

arvind@mcs.kent.edu.

[Computer analysis of regulatory signals in complete bacterial genomes. Translation initiation of ribosomal protein operons]

Signals of translation initiation of operons of Haemophilus influenzae ribosomal proteins were predicted. This process is regulated by the formation of secondary RNA structures to which one of the proteins encoded in a particular operon binds. In some cases, these structures imitate the region of protein binding to rRNA. Predictions are made by comparing with homologous operons of Escherichia coli and analogous regions of rRNA and by estimating the energy of secondary structure formation. It is shown that this regulatory mechanism occurs: in operons L11, S10, S15, spc, and alpha of H.influenzae and, probably, in operon S15 of Helicobacter pylori, Bacillus subtilis, and Mycoplasma genitalium.

Photoastigmatic refractive keratectomy for correction of astigmatism after keratoplasty

BACKGROUND

The efficacy and safety of photoastigmatic refractive keratectomy (PARK) to correct astigmatism after keratoplasty was evaluated.

METHODS

PARK was performed using the Nidek EC-5000 excimer laser in 10 eyes of 10 patients (mean age: 49.5 +/- 11.5 years) with astigmatism after keratoplasty.

RESULTS

The refractive cylinder decreased from 5.80 to 3.20 D, whereas at 6 months, topographic cylinder decreased from 7.40 to 5.90 D post-operatively. Five eyes (50%) had uncorrected visual acuity of 20/60 or better at 3 months. Stromal haze increased from 3 to 6 months postoperatively, and at 6 months, 5 eyes (50%) had a haze score of greater than or equal to 2.0.

CONCLUSION

PARK is a moderately effective method of correcting astigmatism after keratoplasty.

Diagnosing ascitic etiology on a biochemical basis

BACKGROUND/AIMS

The analysis of ascitic fluid has been complicated by several new tests. To simplify its assessment, we evaluated ascitic fluid pH with six other parameters prospectively and simultaneously in blood and ascitic fluid in sixty patients with ascites.

METHODOLOGY

Sixty patients were selected on whom abdominal paracentesis was performed in order to determine which tests were the most reliable for the etiological diagnosis of ascites. Their ascitic fluid pH, cholesterol, albumin, and total proteins were analyzed to distinguish between malignant and cirrhotic ascites. The diagnosis of cirrhosis was based on histological findings, and/or clinical, biochemical, and endoscopic/ultrasonographic findings in whom percutaneous liver biopsy was contraindicated.

RESULTS

The serum-ascites albumin gradient was higher (p<0.001) in cirrhotic as compared to tubercular, malignant or cardiac ascites. We discovered that ascitic fluid lactate dehydrogenase and cholesterol were best for diagnosing malignant ascites, ascitic fluid glucose and ascitic fluid/blood glucose ratio were perfect for diagnosing tubercular ascites, and ascitic fluid pH and lactate dehydrogenase were suitable for diagnosing spontaneous bacterial peritonitis. Correspondingly, ascitic fluid albumin, ascitic fluid/serum albumin, total proteins, and serum ascites albumin gradient were best for diagnosing sterile cirrhotic ascites.

CONCLUSIONS

Diagnostic paracentesis is a useful procedure. The practice of ordering a battery of tests on every ascitic fluid specimen should be abandoned. Rather, an algorithm approach should be adopted in which the results of initial analysis guide us to further relent tests that help in arriving at the etiology of ascites.

The epidemiology of dry eye in Melbourne, Australia

OBJECTIVE

To describe the epidemiology of dry eye in the adult population of Melbourne, Australia.

DESIGN

A cross-sectional prevalence study.

PARTICIPANTS

Participants were recruited by a household census from two of nine clusters of the Melbourne Visual Impairment Project, a population-based study of age-related eye disease in the 40 and older age group of Melbourne, Australia. Nine hundred and twenty-six (82.3% of eligible) people participated; 433 (46.8%) were male. They ranged in age from 40 to 97 years, with a mean of 59.2 years.

MAIN OUTCOME MEASURES

Self-reported symptoms of dry eye were elicited by an interviewer-administered questionnaire. Four objective assessments of dry eye were made: Schirmer's test, tear film breakup time, rose bengal staining, and fluorescein corneal staining. A standardized clinical slit-lamp examination was performed on all participants. Dry eye for the individual signs or symptoms was defined as: rose bengal > 3, Schirmers < 8, tear film breakup time < 8, > 1/3 fluorescein staining, and severe symptoms (3 on a scale of 0 to 3).

RESULTS

Dry eye was diagnosed as follows: 10.8% by rose bengal, 16.3% by Schirmer's test, 8.6% by tear film breakup time, 1.5% by fluorescein staining, 7.4% with two or more signs, and 5.5% with any severe symptom not attributed to hay fever. Women were more likely to report severe symptoms of dry eye (odds ratio [OR] = 1.85; 95% confidence limits [CL] = 1.01, 3.41). Risk factors for two or more signs of dry eye include age (OR = 1.04; 95% CL = 1.01, 1.06), and self-report of arthritis (OR = 3.27; 95% CL = 1.74, 6.17). These results were not changed after excluding the 21 people (2.27%) who wore contact lenses.

CONCLUSIONS

These are the first reported population-based data of dry eye in Australia. The prevalence of dry eye varies by sign and symptom.

Visual impairment in school children in southern India

This study was done to determine the prevalence of visual impairment due to refractive errors and ocular diseases in lower middle class school children of Hyderabad, India. A total of 4,029 children, which included 2,348 males and 1,681 females, in the age range of 3 to 18 years from 9 schools were screened with a detailed ocular examination protocol. Among 3,669 children in whom visual acuity could be recorded, on presentation 115 (3.1%) had visual acuity < 6/18 in the better eye (equivalent to visual impairment), while 41 (1.1%) had visual acuity < or = 6/60 [corrected] in the better eye (equivalent to legal blindness) out of which 18 (0.5%) had visual acuity < 6/60 in the better eye (equivalent to economic blindness). Of 115 children who presented with initial visual acuity < 6/18, vision improved to > or = 6/18 with refraction in 109 (94.8%). No child was legally or economically blind after refractive correction. Prevalence of hyperopia was 22.6%, myopia 8.6% and astigmatism 10.3%. The prevalence of myopia was significantly higher among children > or = 10 years of age (P < 0.001). The maximum, mean and median values for myopia were 10.00, 1.35 and 0.75 D in the better eye. For hyperopia these values were 8.50, 0.65 and 0.50 D. The major causes for best corrected visual acuity < 6/9 in the worse eye for 51 (1.4%) children included amblyopia in 40 (1.1%), corneal diseases in 5 (0.1%), cataract in 2 (0.05%) and others in 4 (0.1%). Out of the total, 30 (0.7%) children had strabismus. These data support the assumption that vision screening of school children in developing countries could be useful in detecting correctable causes of decreased vision, especially refractive errors, and in minimising long term permanent visual disability.

Co-occurring adenoviral keratitis and hemorrhagic cystitis. A case report

Adenoviruses are ubiquitous viruses, commonly causing ocular infections. They are also known to cause multisystem infections. External ocular infections caused by adenovirus are most often due to contaminated secretions. We report a patient in whom genitourinary symptoms developed and subsided along with ocular symptoms. Adenovirus was isolated on ocular culture. This is the first reported case of concurrent adenoviral keratitis and hemorrhagic cystitis. Eliciting a history of genitourinary and respiratory symptoms is important in patients with ocular adenoviral infections.

Incidence of diarrhoea and some related environmental and behavioural factors in Jhuggis of Delhi

A total of 6285 persons residing in 1090 households in three Jhuggi clusters of Delhi were studied for incidence of diarrhoea by 2 weeks recall method and environmental and behavioural factors affecting it. Overall incidence of Diarrhoea was 29.1 per thousand persons, and was selectively predominant among under fives (60.2 per thousand). This low incidence of diarrhoea could be attributed to safe drinking water availability and common practice of handwashing by most of the people. But unsafe storage of drinking water at household level (70.5%) and peridomestic open air defaecation by children (22.9%) are potential threat for transmission of the disease.

Cadmium-induced lipid peroxidation and the status of the antioxidant system in rat tissues

Cadmium may induce oxidative damage in different tissues by enhancing peroxidation of membrane lipids and altering the antioxidant system of the cells. The peroxidative damage to the cell membrane may cause injury to cellular components due to the interaction of metal ions with the cell organelles. The treatment with Cd (0.4 mg/kg body wt, ip) significantly increased lipid peroxidation (LPO) in heart within 3 h of the Cd injection, while the increase in kidney and liver followed 6 to 12 h after Cd intoxication. The antioxidant enzymes and other antioxidants provide protection to the cells against oxidative damage. The superoxide dismutase (SOD) activity increased in heart, kidney and liver within 24 h of Cd intoxication. The CAT activity increased significantly in heart 9 h after Cd injection; however, no significant change in CAT activity was observed in kidney and liver tissues. The GSH content and the activity of GR decreased in heart, kidney and liver 72 h after Cd administration, which has been suggested to be the cause for increased LPO in the tissues. The hexose monophosphate (HMP) shunt enzymes generate NADPH required for the activity of GR which may affect the GSH content in the tissues. The generalised decrease in glucose 6-phosphate dehydrogenase (G6PDH) and 6 phospho gluconate dehydrogenase (6PGDH) at 9 h followed by an increase in these enzymes in tissues 72 h after Cd intoxication suggest that the production of NADPH by the HMP shunt is required to reduce the oxidative damage. The results show that Cd induced LPO in the tissues and the condition was partially counteracted by the antioxidant system.

Effect of group substitution on the physicochemical properties of ibuprofen prodrugs

A series of alkyl ester prodrugs of ibuprofen was synthesized and studied for its physicochemical properties like aqueous solubility, octanol-water partition coefficient and hydrolysis kinetics in aqueous buffer and human plasma. These physicochemical parameters have a forebearing on the overall activity profile of these prodrugs. Mathematical relationships have been derived to characterize these properties.

Computer based statistical study of cartography in mortality upto age of one year

Present cartography procedures for quantitative indicators are arbitrary on choice of the number of categories in which a particular area is to be divided. The choice of initial cutoff and the choice of the width of each category is also arbitrary. To remove this arbitrariness and thus to introduce objectivity, we propose use of a statistical procedure called cluster analysis. This procedure is easy to use on a computer. We also propose using computer based maps. We use these methods on mortality indicators upto age of one year for major states of India to devise objective maps. The terminology of mortality indicators upto age of one year has been used by UNICEF document(1). The mortality indicators analysed are infant mortality rate, neonatal mortality rate, postneonatal mortality rate, perinatal mortality rate and still birth rate. Different indicators reveal different pictures. In this paper, we also propose an innovation to obtain an integrated picture by simultaneously considering all the four indicators in a multivariate setting. Such mapping could help the health managers and planners to devise more effective strategies to control child mortality.

Serum lipids & lipoprotein profiles of cigarette smokers & passive smokers

Serum lipids and lipoproteins of 50 active and passive smokers were compared with levels in 25 control subjects. Active smoking resulted in an increase in total cholesterol (Tc) and triglycerides (Tg) as compared to control group. The passive smokers also showed relatively higher levels but the effect was not significant. Active smoking raised the low density lipoprotein cholesterol (LDLc) and very low density lipoprotein cholesterol (VLDLc) levels whereas high density lipoprotein cholesterol (HDLc) content was lowered, thus resulting in decreased ratios of HDLc/Tc and HDLc/LDLc. The passive smokers also showed slightly higher levels of LDLc and VLDLc but lower levels of HDLc, and a lower HDLc/LDLc ratio. Our findings suggest that smoking alters the serum lipids and lipoproteins and these changes are related to the duration and amount of smoking.

Computer based application software for histopathological reporting system

For better follow up of patient and the immediate retrieval of records, we have developed a computer based application software for histopathological reporting system (HIPRIS). With its help, among others, we can (i) retrieve the biopsy report of a patient from the accession number of the specimen; (ii) find out the number of cases for a particular period as well as can analyse cases by any relevant referral parameter like department, specialty and disease and (iii) find out the time gap between receiving the specimen and reporting of result. Our experience suggests that this system greatly improves the efficiency of the histopathological laboratory.