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Pathak M, Sahu V, Kumar A, Kaur K, Gurnani B. Current Concepts and Recent Updates of Optical Biometry- A Comprehensive Review. Clin Ophthalmol 2024; 18:1191-1206. [PMID: 38711575 PMCID: PMC11073143 DOI: 10.2147/opth.s464538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 04/28/2024] [Indexed: 05/08/2024] Open
Abstract
One of the most recent advancements in the field of cataract surgery is optical biometry. With the advent of optical biometry ocular measurements are now simpler, quicker, and more precise. The devices have made intraocular lens (IOL) power calculations easier in difficult situations too, such as in cases with extremes of axial lengths, silicone filled eyes, cataract surgery in post-keratoplasty eyes, post Laser-Assisted in Situ Keratomileusis (LASIK) eyes, etc. The gold standard for IOL power calculation in the present day is by the use of optical biometry devices. The anatomical measurements by these devices are highly precise and because of these measurements and the incorporation of various IOL power calculation formulas the optical biometry devices give the accurate power and the post-operative visual outcome is highly satisfactory among the patients. The growing use of these devices has made cataract the most commonly performed refractive surgical procedure nowadays. In the current scenario, optical biometry has widespread acceptance in almost all countries and has many advantages over ultrasound or immersion biometry. Cataract surgeons can obtain easy and reliable measurements from these devices. Refractive surprises have also decreased considerably with their use. This article will comprehensively review the principles of the various optical biometry devices, the parameters used in each of the devices, the advantages and disadvantages, and add more like what all this article will add.
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Affiliation(s)
- Madhumallika Pathak
- Department of Ophthalmology, Sai Baba Eye Hospital, Raipur, Chhattisgarh, 492099, India
| | - Vijaya Sahu
- Department of Ophthalmology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, 492099, India
| | - Aseem Kumar
- Department of Ophthalmology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, 492099, India
| | - Kirandeep Kaur
- Department of Pediatric Ophthalmology and Strabismus, Gomabai Netralaya and Research Centre, Neemuch, Madhya Pradesh, 458441, India
| | - Bharat Gurnani
- Department of Cataract, Cornea and Refractive Surgery, Gomabai Netralaya and Research Centre, Neemuch, Madhya Pradesh, 458441, India
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Gurnani B, Kaur K. Intricacies and solutions for interpretation of microbiologic samples of Pythium insidiosum keratitis. Indian J Ophthalmol 2024; 72:602-603. [PMID: 38546474 DOI: 10.4103/ijo.ijo_1573_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Affiliation(s)
- Bharat Gurnani
- Cataract, Cornea, External Diseases, Trauma, Ocular Surface and Refractive Services, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Janaki Kund, Chitrakoot, Madhya Pradesh, India
| | - Kirandeep Kaur
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Janaki Kund, Chitrakoot, Madhya Pradesh, India
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Gurnani B, Natarajan R, Mohan M, Kaur K. Breaking-Down Barriers: Proposal of Using Cellulose Biosynthesis Inhibitors and Cellulase Enzyme as a Novel Treatment Modality for Vision Threatening Pythium Insidiosum Keratitis. Clin Ophthalmol 2024; 18:765-776. [PMID: 38495678 PMCID: PMC10941664 DOI: 10.2147/opth.s450665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 03/05/2024] [Indexed: 03/19/2024] Open
Abstract
Pythium insidiosum, an Oomycete, causes severe keratitis that endangers vision. Its clinical, morphological, and microbiological characteristics are often indistinguishable from those of fungal keratitis, earning it the moniker "parafungus". Distinctive clinical hallmarks that set it apart from other forms of keratitis include radial keratoneuritis, tentacles, marginal infiltration, and a propensity for rapid limbal spread. The therapeutic approach to Pythium keratitis (PK) has long been a subject of debate, and topical and systemic antifungals and antibacterials have been tried with limited success. Approximately 80% of these eyes undergo therapeutic keratoplasty to salvage the eye. Hence, there is a need to innovate for alternative and better medical therapy to safeguard these eyes. The resistance of Pythium to standard antifungal treatments can be attributed to the absence of ergosterol in its cell wall. Cell walls of plants and algae have cellulose as an essential constituent. Cellulose imparts strength and structure and acts as the "skeleton" of the plant. Fungal and animal cell walls typically lack cellulose. The cellular architecture of Pythium shares a similarity with plant and algal cells through the incorporation of cellulose within its cell wall structure. Inhibitors targeting cellulose biosynthesis (CBI), such as Indaziflam, Isoxaben, and Quinoxyphen, serve as critical tools for elucidating the pathways of cellulose synthesis. Furthermore, the enzymatic action of cellulase is instrumental for the extraction of proteins and DNA. To circumvent this issue, we hypothesize that CBI's and cellulase enzymes can act on the Pythium cell wall and may effectively treat PK. The available literature supporting the hypothesis and proof of concept has also been discussed. We have also discussed these drugs' molecular mechanism of action on the Pythium cell wall. We also aim to propose how these drugs can be procured and used as a potential medical management option for this devastating entity.
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Affiliation(s)
- Bharat Gurnani
- Department of Cataract, Cornea and Refractive Surgery, ASG Eye Hospital, Jodhpur, Rajasthan, 342008, India
| | - Radhika Natarajan
- Department of Cornea and Refractive Surgery, Sankara Nethralaya Medical Research Foundation, Chennai, Tamil Nadu, 600006, India
| | - Madhuvanthi Mohan
- Department of Cornea and Refractive Surgery, Sankara Nethralaya Medical Research Foundation, Chennai, Tamil Nadu, 600006, India
| | - Kirandeep Kaur
- Department of Pediatric Ophthalmology and Strabismus, ASG Eye Hospital, Jodhpur, Rajasthan, 342008, India
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Gurnani B, Kaur K, Savla HR, Prajjwal P, Pentapati SSK, Simhachalam Kutikuppala LV. Navigating diagnostic and therapeutic challenges in ocular manifestations of Hansen's disease and trachoma: A narrative review. Indian J Ophthalmol 2024:02223307-990000000-00116. [PMID: 38454868 DOI: 10.4103/ijo.ijo_793_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 01/03/2024] [Indexed: 03/09/2024] Open
Abstract
Neglected tropical diseases (NTDs) encompass a group of approximately 20 diseases prevalent in tropical and subtropical regions, closely associated with poverty, affecting over a billion people in low-income countries. This manuscript aims to explore the ocular manifestations and burden of two significant NTDs, namely Hansen's disease and trachoma while addressing gaps in understanding and management. Hansen's disease, caused by Mycobacterium leprae, has a long history and presents with diverse neurological and ocular manifestations. Despite the availability of treatment, ocular complications persist, leading to significant visual impairment in some cases. The manuscript emphasizes the importance of early diagnosis, regular ophthalmic examinations, and follow-ups to prevent and control ocular complications, reducing the burden of visual impairment and blindness. Trachoma, caused by Chlamydia trachomatis, remains the leading infectious cause of blindness in underdeveloped and remote areas. The manuscript highlights the clinical diagnosis and implementation of the World Health Organization's (WHO's) SAFE (surgery, antibiotics, facial hygiene, and environmental sanitation) strategy to prevent transmission and associated blindness. However, challenges in health surveillance tools and underreporting of trachoma cases are addressed, emphasizing the need for improved strategies to combat the disease effectively. Through a comprehensive review of the ocular manifestations and management of Hansen's disease and trachoma, this manuscript contributes to the existing knowledge base and enhances a deeper understanding of these NTDs. Addressing gaps in understanding and management emphasizes the importance of implementing WHO's strategies and collaborative efforts to achieve the global goal of reducing the burden of NTDs and improving community health and well-being. The manuscript underscores the significance of early intervention, preventive measures, and technological advancements, providing valuable insights for policymakers, healthcare professionals, and researchers working in the field of NTDs.
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Affiliation(s)
- Bharat Gurnani
- Cataract, Cornea, Trauma, Refractive Surgery, Ocular Surface and External Diseases, ASG Eye Hospital, Jodhpur, Rajasthan, India
| | - Kirandeep Kaur
- Consultant Cataract, Pediatric Ophthalmology and Strabismus, ASG Eye Hospital, Jodhpur, Rajasthan, India
| | - Hritik R Savla
- Department of General Ophthalmology, Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India
| | - Priyadarshi Prajjwal
- Department of Medicine, Bharati Vidyapeeth University Medical College, Pune, Maharashtra, India
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Venugopal A, Gurnani B, Ravindran M, Uduman MS. Management of symblepharon with Gore-tex as a novel treatment option for ocular chemical burns. Eur J Ophthalmol 2024:11206721241238302. [PMID: 38444229 DOI: 10.1177/11206721241238302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
PURPOSE To assess the clinical outcomes of symblepharon release in patients with ocular surface chemical injury using Gore-Tex as a novel treatment option. METHODS This was a retrospective analysis of 23 eyes of 22 chemical injury patients done during a period of January 2014 to December 2021 at a tertiary eye care centre in South India. All patients underwent symblepharon lysis along with Gore-Tex application over the sclera with minimum 1 year follow up. The patients were assessed for demographic details, visual acuity, intraocular pressure, anterior and posterior segment details, photographic documentation, preoperative diagnosis, previous surgical details in recurrent cases, surgical procedures, final visual acuity, surgical outcomes, and complications. The clinical outcomes were assessed and outcomes were defined as success, partial success, or failure. RESULTS The median age was 17 years (IQR, 12-39 years). Among them 10 eyes with symblepharon had grade 3 length, 12 eyes grade 3 width and 12 eyes had grade 3 loss of palisades of Vogt. The success was achieved in 52.2% of the patients; partial success in 34.8% and 13.3% had failure. The mean duration of recurrence was 6.75 ± 3.6 months. Failure was noted in young patients with mean age 9.75years and with grade 3c symblepharon. There was no sight threatening complications noted. CONCLUSION The study showed very good results with Gore-Tex as a novel treatment option for chemical injury patient with symblepharon formation. It can be easily employed to prevent the symblepharon recurrence of various ocular surface disorders.
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Affiliation(s)
- Anitha Venugopal
- Cornea, Ocular Surface, Trauma and Refractive Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India
| | - Bharat Gurnani
- Cataract, Cornea, Refractive Surgery, Trauma, External Disease and Ocular Surface, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry, India
| | - Meenakshi Ravindran
- Paediatrics and Strabismology Department, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India
| | - Mohammed Sithiq Uduman
- Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India
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Parkash RO, Gurnani B, Kaur K, Parkash TO, Vajpayee RB. Novel trocar assisted intraocular lens and capsular bag complex fixation. Eur J Ophthalmol 2024; 34:583-588. [PMID: 37882171 DOI: 10.1177/11206721231208662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
PURPOSE To describe the innovative technique of trocar-assisted intraocular lens (IOL) and capsular bag complex fixation. METHODS In this technique, initial pupil dilatation is achieved either with intracameral adrenaline or with the help of iris hooks. Automated anterior vitrectomy is performed in cases with vitreous prolapse. A 25 G trocar cannula is placed at the limbus through a paracentesis opposite the zonular dialysis area. The cannula lumen act as a guide to pass the double-arm polypropylene suture attached to the needle. This prevents any inadvertent corneal injury and acts as a perpendicular tract to pass the needle through IOL capsular bag complex. RESULTS We performed this technique in 9 cases with an excellent outcome with a minimum of 3 months of follow-up. All patients had well-centred IOL. There was no incidence of corneal injury, Descemet membrane detachment, iris trauma, IOL tilt, decentration, dislocation, vitreous prolapse or retinal detachment. All patients achieved excellent visual acuity ranging from 6/12-6/6 postoperatively. CONCLUSION The novel trocar-assisted IOL bag complex fixation technique is very effective and allows smooth IOL fixation in technically challenging cases with IOL subluxation. The trocar acts as a guide to prevent injury to the surrounding tissue, and IOL fixation is achieved with minimal manipulations in the anterior chamber. It also prevents the need for IOL explantation in these cases.
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Affiliation(s)
| | - Bharat Gurnani
- Dr. Om Parkash Eye Institute, Amritsar, Punjab, India
- Sadguru Netra Chikitsalya, Chitrakoot, Madhya Pradesh, India
- ASG Eye Hospitals, Jodhpur, Rajasthan, India
| | - Kirandeep Kaur
- Dr. Om Parkash Eye Institute, Amritsar, Punjab, India
- Sadguru Netra Chikitsalya, Chitrakoot, Madhya Pradesh, India
- ASG Eye Hospitals, Jodhpur, Rajasthan, India
| | | | - Rasik B Vajpayee
- Vision Eye Institute, Melbourne, Australia
- Royal Victorian Eye and Ear Hospital, Melbourne, Australia
- University of Melbourne, Australia
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Gurnani B, Kaur K. Leveraging ChatGPT for ophthalmic education: A critical appraisal. Eur J Ophthalmol 2024; 34:323-327. [PMID: 37974429 DOI: 10.1177/11206721231215862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
In recent years, the advent of artificial intelligence (AI) has transformed many sectors, including medical education. This editorial critically appraises the integration of ChatGPT, a state-of-the-art AI language model, into ophthalmic education, focusing on its potential, limitations, and ethical considerations. The application of ChatGPT in teaching and training ophthalmologists presents an innovative method to offer real-time, customized learning experiences. Through a systematic analysis of both experimental and clinical data, this editorial examines how ChatGPT enhances engagement, understanding, and retention of complex ophthalmological concepts. The study also evaluates the efficacy of ChatGPT in simulating patient interactions and clinical scenarios, which can foster improved diagnostic and interpersonal skills. Despite the promising advantages, concerns regarding reliability, lack of personal touch, and potential biases in the AI-generated content are scrutinized. Ethical considerations concerning data privacy and potential misuse are also explored. The findings underline the need for carefully designed integration, continuous evaluation, and adherence to ethical guidelines to maximize benefits while mitigating risks. By shedding light on these multifaceted aspects, this paper contributes to the ongoing discourse on the incorporation of AI in medical education, offering valuable insights and guidance for educators, practitioners, and policymakers aiming to leverage modern technology for enhancing ophthalmic education.
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Affiliation(s)
- Bharat Gurnani
- Cataract, Cornea, Trauma, External Diseases, Ocular Surface and Refractive Services, ASG Eye Hospital, Jodhpur, Rajasthan, India
- Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, India
| | - Kirandeep Kaur
- Cataract, Pediatric Ophthalmology and Strabismus, ASG Eye Hospital, Jodhpur, Rajasthan, India
- Children Eye Care Centre, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, India
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Meena A, Agrawal A, Parmar G, Gurnani B. Subconjunctival dexamethasone-assisted conjunctival autograft harvesting versus normal saline during pterygium surgery - A randomized clinical trial. Indian J Ophthalmol 2024; 72:217-222. [PMID: 38099381 PMCID: PMC10941926 DOI: 10.4103/ijo.ijo_969_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 08/04/2023] [Accepted: 08/10/2023] [Indexed: 12/19/2023] Open
Abstract
PURPOSE To evaluate the effect of subconjunctival dexamethasone compared to normal saline on conjunctival autograft harvesting in patients undergoing pterygium surgery. METHODS Fifty-two eyes of 52 patients who underwent pterygium excision combined with autologous conjunctival graft (CAG) using releasable suture were included in this prospective interventional study. The patients were randomized into two groups of 26 patients each. Group A consisted of patients in whom CAG was harvested using subconjunctival 0.5 ml of 0.4% dexamethasone sodium phosphate and in group B patients, normal saline was used. The patients were assessed for postoperative pain, foreign body sensation, and watering as the subjective signs of inflammation and conjunctival inflammation and lid edema as the objective signs of inflammation at 12 and 24 h postsurgery. RESULTS The mean age of group A and B patients was 47.69 + 13.09 and 46.00 + 10.76 years, respectively. The male:female ratio was 1.6:1 in group A and 1.1:1 in group B. The mean surgical time in group A was 243.96 ± 52.13 s and in group B was 258.08 ± 43.99 s. Postoperative pain, foreign body sensation, and watering were significantly lower in group A patients than in group B patients at both 12 and 24 h postoperatively (group A: 4.65 ± 1.33, 4.88 ± 1.73, and 3.85 ± 1.43, respectively, at 12 h; 1.89 ± 1.03, 1.69 ± 1.09, and 1.69 ± 0.97, respectively, at 24 h and group B: 6.42 ± 0.95, 6.65 ± 0.98, and 6.27 ± 1.40, respectively, at 12 h; 3.27 ± 1.43, 3.12 ± 1.25, 2.58 ± 1.14, respectively, at 24 h) ( P < 0.001). Conjunctival inflammation was significantly lower in group A at 12 h ( P < 0.05) and 24 h ( P < 0.05) after surgery compared to group B. Lid edema failed to show any significant ( P = 0.17) difference with respect to severity in both the groups at 12 and 24 h ( P = 0.699). CONCLUSION Subconjunctival dexamethasone decreased patient discomfort following pterygium surgery. The dexamethasone group had reduced conjunctival inflammatory signs without any notable complications.
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Affiliation(s)
- Ashok Meena
- Department of Cornea and Refractive Services, Sadguru Netra Chikitsalya and Postgraduate Institute of Ophthalmology, Chitrakoot, Madhya Pradesh, India
| | - Ashish Agrawal
- Department of Cornea and Refractive Services, Sadguru Netra Chikitsalya and Postgraduate Institute of Ophthalmology, Chitrakoot, Madhya Pradesh, India
| | - Gautam Parmar
- Department of Cornea and Refractive Services, Sadguru Netra Chikitsalya and Postgraduate Institute of Ophthalmology, Chitrakoot, Madhya Pradesh, India
| | - Bharat Gurnani
- Department of Cornea and Refractive Services, Sadguru Netra Chikitsalya and Postgraduate Institute of Ophthalmology, Chitrakoot, Madhya Pradesh, India
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Kaur K, Srividya KS, Kabra N, Saranath R, Gurnani B, Venkatesh R. Patterns of ophthalmic emergencies presenting to a tertiary eye care hospital in India. Indian J Ophthalmol 2024; 72:296-297. [PMID: 38273691 PMCID: PMC10941940 DOI: 10.4103/ijo.ijo_1578_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Affiliation(s)
- Kirandeep Kaur
- Cataract, Pediatric Ophthalmology and Strabismus, Pondicherry, India
| | | | - Neha Kabra
- Fellow Cornea, and Refractive Services, Aravind Eye Hospital, Pondicherry, India
| | | | - Bharat Gurnani
- Cataract, Cornea, External Diseases, Trauma, Ocular Surface and Refractive Services, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
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Kaur K, Gurnani B. Manual small-incision cataract surgery - A stepping stone toward self-independent cataract surgeons. Indian J Ophthalmol 2024; 72:140. [PMID: 38131590 PMCID: PMC10841779 DOI: 10.4103/ijo.ijo_1581_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Affiliation(s)
- Kirandeep Kaur
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
| | - Bharat Gurnani
- Cornea and Refractive Services, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
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Gurnani B, Kaur K. Rare coexistence of Mittendorf dot with persistent hyaloid artery in a young Asian child. J Fr Ophtalmol 2024; 47:103933. [PMID: 37658031 DOI: 10.1016/j.jfo.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/17/2023] [Accepted: 07/28/2023] [Indexed: 09/03/2023]
Affiliation(s)
- B Gurnani
- Shri Sadguru Seva Sangh Trust, Janaki Kund, Sadguru Netra Chikitsalya Hospital, 485334 Chitrakoot, Madhya Pradesh, India.
| | - K Kaur
- Shri Sadguru Seva Sangh Trust, Janaki Kund, Sadguru Netra Chikitsalya Hospital, 485334 Chitrakoot, Madhya Pradesh, India
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Gurnani B, Kaur K, Chaudhary S, Kaur RP, Nayak S, Mishra D, Balakrishnan H, Parkash RO, Morya AK, Porwal A. Pediatric corneal transplantation: techniques, challenges, and outcomes. Ther Adv Ophthalmol 2024; 16:25158414241237906. [PMID: 38533487 PMCID: PMC10964464 DOI: 10.1177/25158414241237906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 02/13/2024] [Indexed: 03/28/2024] Open
Abstract
Pediatric corneal transplant is a highly demanding and technically challenging procedure for the cornea surgeon in today's era. These cases pose unique challenges in clinical and surgical management. The indications of pediatric corneal transplant can be therapeutic, tectonic, optical, and cosmetic. Pediatric patients undergoing corneal transplants are at a high risk of graft infection, failure, rejection, dehiscence, and amblyopia due to young age, robust immune system, increased incidence of trauma, and compliance issues. The other factors contributing to graft failure can be allograft rejection, secondary glaucoma, corneal vascularization, multiple surgeries, vitreous prolapse, and lack of treatment compliance. A successful corneal transplant in children depends on meticulous preoperative evaluation, uneventful surgery, the expertise of a corneal surgeon, and regular and timely postoperative follow-up. Therapeutic and optical penetrating keratoplasty are the most commonly performed transplants in children. However, with the advancements in surgical technique and management protocol, the current focus has shifted toward lamellar keratoplasty. Lamellar keratoplasty offers early visual recovery and potentially fewer complications. Visual rehabilitation through corneal transplant in otherwise blind eyes can be a boon for the children. Recently, keratoprostheses have been promising in children with multiple graft failures. The current review gives insights into epidemiology, etiology, indications, clinical characteristics, investigations, management options, recent advances, and the future of pediatric corneal transplants. As surgical techniques continue to grow and comprehension of pediatric corneal transplants is improving, we can safeguard these eyes with the best possible anatomical and functional outcomes.
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Affiliation(s)
| | - Kirandeep Kaur
- Cataract, Paediatric Ophthalmology and Strabismus, India
- ASG Eye Hospital, Jodhpur, Rajasthan, India
| | | | | | - Swatishree Nayak
- All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Deepak Mishra
- Regional Institute of Ophthalmology, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | | | | | - Arvind Kumar Morya
- Cataract, Glaucoma, Refractive, Squint Paediatric Ophthalmology and Medical Retina Services, Department of Ophthalmology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Amit Porwal
- Head of the Department, Glaucoma Services, Choitram Netralaya, Indore, Madhya Pradesh, India
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Gurnani B, Kaur K. Molecular and epigenetic mechanisms governing ocular surface squamous neoplasia: opportunities for diagnostics. Expert Rev Mol Diagn 2023:1-15. [PMID: 38131180 DOI: 10.1080/14737159.2023.2298681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 12/20/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION Ocular surface squamous neoplasia (OSSN) is the most common ocular malignancy; the pathophysiology is influenced by molecular, genetic, and epigenetic mechanisms. The incidence of OSSN is associated with the anatomy and physiology of the ocular surface, limbal stem cell configuration, limbal vulnerability, cancer stem cells, dysplasia, neoplasia, angiogenesis, invasion, and metastasis. The key etiological factors involved are human papillomavirus (HPV), human immunodeficiency virus (HIV), immunosuppression, p53 tumor suppressor gene, hypovitaminosis A, and failure of Deoxyribonucleic acid (DNA) repair mechanisms. AREAS COVERED This special report is a focussed attempt to understand the molecular mechanism, genetic and epigenetic mechanism, and diagnostic modalities for OSSN. EXPERT OPINION While these mechanisms contribute to genome instability, promoter-specific hypermethylation might facilitate and promote tumor formation by silencing tumor suppressor genes. OSSN understanding has improved with increased literature available on various genetic, molecular, and epigenetic mechanisms, although the exact genetic and epigenetic mechanisms still need to be elucidated. It is important to note that the molecular mechanisms of OSSN can vary among individuals, and further research is required to elucidate the underlying processes fully. Understanding these mechanisms is crucial for the development of targeted therapies and improved management of OSSN.
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Affiliation(s)
- Bharat Gurnani
- Cataract, Cornea, Refractive Services, Trauma, External Diseases, Contact Lens and Ocular Surface, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Chitrakoot, India
| | - Kirandeep Kaur
- Children Eye Care Centre, Department of Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Janaki Kund, Chitrakoot, India
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Gurnani B, Kaur K, Tandon A. Letter Regarding: Randomized Double-Masked Placebo-Controlled Trial for the Management of Pythium Keratitis: Combination of Antibiotics Versus Monotherapy. Cornea 2023; 42:e22-e23. [PMID: 37487172 DOI: 10.1097/ico.0000000000003350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Affiliation(s)
- Bharat Gurnani
- Cataract, Cornea, Refractive Services, Trauma, External Diseases, and Ocular Surface, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Janaki Kund, Chitrakoot, Madhya Pradesh, India
| | - Kirandeep Kaur
- Children Eye Care Centre, Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Janaki Kund, Chitrakoot, Madhya Pradesh, India
| | - Astha Tandon
- Cornea and Refractive Services, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Janaki Kund,, Chitrakoot, Madhya Pradesh, India
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Gurnani B, Kaur K. Re: Dot et al.: Incidence of retinal detachment, macular edema, and ocular hypertension after neodymium:yttrium-aluminum-garnet capsulotomy: a population-based nationwide study-The French YAG 2 Study (Ophthalmology. 2022;130:478-487). Ophthalmology 2023; 130:e43. [PMID: 37737811 DOI: 10.1016/j.ophtha.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/04/2023] [Accepted: 08/15/2023] [Indexed: 09/23/2023] Open
Affiliation(s)
- Bharat Gurnani
- Ocular Surface and Refractive Services, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Janaki Kund, Chitrakoot, Madhya Pradesh, India.
| | - Kirandeep Kaur
- Ocular Surface and Refractive Services, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Janaki Kund, Chitrakoot, Madhya Pradesh, India
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Maling S, Kaur K, Gurnani B. Should there be global standards in ophthalmology training? Eye (Lond) 2023; 37:3710-3711. [PMID: 37248428 PMCID: PMC10697952 DOI: 10.1038/s41433-023-02582-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/02/2023] [Accepted: 05/11/2023] [Indexed: 05/31/2023] Open
Affiliation(s)
- Sarah Maling
- Buckinghamshire Healthcare Trust, Stoke Mandeville Hospital, Aylesbury, UK.
| | - Kirandeep Kaur
- Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Janakikund, Chitrakoot, Madhya Pradesh, 485334, India
| | - Bharat Gurnani
- Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Janakikund, Chitrakoot, Madhya Pradesh, 485334, India.
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Gurnani B, Kaur K. Understanding barriers, recommended solutions, and future prospects for the diagnosis and management of Pythium insidiosum keratitis. Indian J Ophthalmol 2023; 71:3584-3586. [PMID: 37991287 PMCID: PMC10788758 DOI: 10.4103/ijo.ijo_1041_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 07/31/2023] [Accepted: 08/04/2023] [Indexed: 11/23/2023] Open
Abstract
Pythium insidiosum keratitis (PIK) is a devastating corneal infection resulting in blindness in a large number of cases. Clinically and morphologically, it closely mimics fungal keratitis, and hence is also labeled as "parafungus." Although many clinical studies have documented evidence regarding the virulence of microorganism, and anatomical and functional outcomes, it remains a clinical challenge and diagnostic dilemma for most clinicians. Till today, PIK is being diagnosed and treated with certainty at only limited centers across the globe. But the question is why this is so? Taking this as the research question, this section on current ophthalmology aims to highlight the understanding of barriers to diagnosing and treating PIK, the suggestions to improve diagnosis and treatment, and the future prospects.
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Affiliation(s)
- Bharat Gurnani
- Cataract, Cornea, Trauma, External Disease, Ocular Surface and Refractive Services, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, India
| | - Kirandeep Kaur
- Cataract, Pediatrics Ophthalmology and Strabismus Services, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, India
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Rani K, Pal A, Gurnani B, Agarwala P, Sasmal DK, Jain N. An Innate Host Defense Protein β 2-Microglobulin Keeps a Check on α-Synuclein amyloid Assembly: Implications in Parkinson's Disease. J Mol Biol 2023; 435:168285. [PMID: 37741548 DOI: 10.1016/j.jmb.2023.168285] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/14/2023] [Accepted: 09/15/2023] [Indexed: 09/25/2023]
Abstract
Amyloid formation due to protein misfolding has gained significant attention due to its association with neurodegenerative diseases. α-Synuclein (α-syn) is one such protein that undergoes a profound conformational switch to form higher order cross-β-sheet structures, resulting in amyloid formation, which is linked to the pathophysiology of Parkinson's disease (PD). The present status of research on α-syn aggregation and PD reveals that the disease progression may be linked with many other diseases, such as kidney-related disorders. Unraveling the link between PD and non-neurological diseases may help in early detection and a better understanding of PD progression. Herein, we investigated the modulation of α-syn in the presence of β2-microglobulin (β2m), a structural protein associated with dialysis-related amyloidosis. We took a multi-disciplinary approach to establish that β2m mitigates amyloid formation by α-syn. Our fluorescence, microscopy and toxicity data demonstrated that sub-stoichiometric ratio of β2m drives α-syn into off-pathway non-toxic aggregates incompetent of transforming into amyloids. Using AlphaFold2 and all-atom MD simulation, we showed that the β-strand segments (β1 and β2) of α-synuclein, which frequently engage in interactions within amyloid fibrils, interact with the last β-strand at the C-terminal of β2m. The outcome of this study will unravel the yet unknown potential linkage of PD with kidney-related disorders. Insights from the cross-talk between two amyloidogenic proteins will lead to early diagnosis and new therapeutic approaches for treating Parkinson's disease. Finally, disruption of the nucleation process of α-syn amyloids by targeting the β1-β2 region will constitute a potential therapeutic approach for inhibiting amyloid formation.
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Affiliation(s)
- Khushboo Rani
- Department of Bioscience and Bioengineering, Indian Institute of Technology Jodhpur, NH 62, Nagaur Road, Karwar 342030, Rajasthan, India. https://twitter.com/khushboo251995
| | - Arumay Pal
- School of Bioengineering, Vellore Institute of Technology, Bhopal, India. https://twitter.com/Arumay_Pal
| | - Bharat Gurnani
- Department of Bioscience and Bioengineering, Indian Institute of Technology Jodhpur, NH 62, Nagaur Road, Karwar 342030, Rajasthan, India. https://twitter.com/bgurnani05
| | - Pratibha Agarwala
- Department of Chemistry, Indian Institute of Technology Jodhpur, NH 62, Nagaur Road, Karwar 342030, Rajasthan, India
| | - Dibyendu K Sasmal
- Department of Chemistry, Indian Institute of Technology Jodhpur, NH 62, Nagaur Road, Karwar 342030, Rajasthan, India
| | - Neha Jain
- Department of Bioscience and Bioengineering, Indian Institute of Technology Jodhpur, NH 62, Nagaur Road, Karwar 342030, Rajasthan, India; Centre for Emerging Technologies for Sustainable Development (CETSD), Indian Institute of Technology Jodhpur, Nagaur Road, Karwar 342030, Rajasthan, India.
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Kaur K, Gurnani B. Targeting the blind years, not the blind eyes - Need to update current pediatric ophthalmology practices. Indian J Ophthalmol 2023; 71:3573-3574. [PMID: 37870029 PMCID: PMC10752306 DOI: 10.4103/ijo.ijo_838_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023] Open
Affiliation(s)
- Kirandeep Kaur
- Department of Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalya and Postgraduate Institute of Ophthalmology, Chitrakoot, Madhya Pradesh, India
| | - Bharat Gurnani
- Department of Cornea, External Diseases, Trauma and Refractive Services, Sadguru Netra Chikitsalya and Postgraduate Institute of Ophthalmology, Chitrakoot, Madhya Pradesh, India
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Kaur K, Muralikrishnan J, Hussaindeen JR, Deori N, Gurnani B. Impact of Covid-19 on Pediatric Ophthalmology Care: Lessons Learned. Pediatric Health Med Ther 2023; 14:309-321. [PMID: 37849985 PMCID: PMC10578174 DOI: 10.2147/phmt.s395349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/04/2023] [Indexed: 10/19/2023] Open
Abstract
The COVID-19 pandemic came with many new challenges that forced personal and professional lifestyle modifications. Medical facilities were in scarcity against this new unknown enemy and were challenged with the overloaded patient flow, scarcity of healthcare staff, and evolving treatment modalities with a better understanding of the virus each day. Ophthalmology as a "branch of medicine" suffered challenges initially because of a lack of guidelines for patient management, close working distance during routine examinations, and halt of major surgeries, including cataracts. Pediatric ophthalmology had major implications, as reduced outpatient visits would mean deeper amblyopia, and changed lifestyles, including online classes and home refinement, predisposing children to myopia, digital eye strain, and worsening of strabismus. COVID-19 also unveiled underlying accommodation and convergence anomalies that predisposed pediatric and adolescent patients to an increased prevalence of headache and acute onset esotropia. Teleophthalmology and other innovative solutions, including the use of prism glasses, safe slit-lamp shields, alternative ways of school screening with the use of photoscreeners, performing retinoscopy only when needed, and using autorefractors were among the few guidelines or modifications adopted which helped in the efficient and safe management of pediatric patients. Many pediatric ophthalmologists also suffered in terms of financial constraints due to loss of salary or even closure of private practices. School screening and retinopathy of prematurity screening suffered a great setback and costed a lot of vision years, data of which remains under-reported. Important implications and learnings from the pandemic to mitigate future similar situations include using teleophthalmology and virtual platforms for the triage of patients, managing non-emergency conditions without physical consultations, and utilizing home-based vision assessment techniques customized for different age groups. Though this pandemic had a lot of negative implications, the innovations, modifications, and other important learnings helped pediatric ophthalmologists in navigating safely.
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Affiliation(s)
- Kirandeep Kaur
- Children Eye Care Center, Department of Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, India
| | - Janani Muralikrishnan
- Department of Pediatric Ophthalmology and Strabismus, Aravind Eye Hospital, Chennai, India
| | | | - Nilutparna Deori
- Department of Pediatric Ophthalmology and Strabismus, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | - Bharat Gurnani
- Department of Cornea and Refractive Services, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, India
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Balamurugan S, Kaur K, Gurnani B, Agrawal A. Bilateral acute vision loss as the initial presentation of chronic myeloid leukemia in a young female. Indian J Cancer 2023; 60:578-582. [PMID: 38206079 DOI: 10.4103/ijc.ijc_573_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 10/16/2021] [Indexed: 01/12/2024]
Abstract
Chronic myeloid leukemia (CML) is a hematological malignancy characterized by structural/functional changes and increased neutrophils. Rarely, ophthalmic manifestations are the first clue toward underlying pathology. We report a case of a 34-year-old woman who presented with sudden-onset diminution of vision in both eyes. On examination, she was diagnosed with panuveitis in the right eye and choroiditis in the left eye. Further investigations revealed an underlying CML in the accelerated phase. The patient was managed with systemic immunomodulators along with topical and periocular steroids. Prompt diagnosis and management in collaboration with an oncologist and hematologist helped us achieve a good outcome.
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Affiliation(s)
- Sivaraman Balamurugan
- Department of Uvea Services, Aravind Eye Hospital, Thavalakuppam, Cuddalore Main Road, Pondicherry, India
| | - Kirandeep Kaur
- Department of Pediatric Ophthalmology and Strabismus, Aravind Eye Hospital, Thavalakuppam, Cuddalore Main Road, Pondicherry, India
| | - Bharat Gurnani
- Department of Cornea and Refractive Services, Aravind Eye Hospital, Thavalakuppam, Cuddalore Main Road, Pondicherry, India
| | - Anushri Agrawal
- Department of General Ophthalmology, Aravind Eye Hospital, Thavalakuppam, Cuddalore Main Road, Pondicherry, India
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Gurnani B, Kaur K. Re: Improving the patient decision making experience for cataract surgery during the COVID-19 era. Can J Ophthalmol 2023; 58:505. [PMID: 37156475 PMCID: PMC10106816 DOI: 10.1016/j.jcjo.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 04/12/2023] [Indexed: 05/10/2023]
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23
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Gurnani B, Balamurugan S, Kanakath A, Kaur K, Gupta A, Chaudhary S. First clinical case series of frosted branch angiitis: A diagnostic algorithm is suggested. Clin Case Rep 2023; 11:e7778. [PMID: 37636879 PMCID: PMC10457482 DOI: 10.1002/ccr3.7778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/02/2023] [Accepted: 06/19/2023] [Indexed: 08/29/2023] Open
Abstract
Key Clinical Message FBA is a clinical diagnosis of a diverse spectrum, which needs a high index of suspicion to identify the possible specific etiologies. The zones of retinal involvement can help in predicting the final visual outcome. The proposed diagnostic algorithm facilitates meticulous evaluation and targeted treatment to improve the final visual outcome. Abstract Frosted branch angiitis is a clinical diagnosis of a diverse spectrum, which needs a high index of suspicion to identify the possible specific etiologies. We present a series of three cases of FBA with an attempt to formulate a diagnostic algorithm and refine the definition of FBA.
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Affiliation(s)
- Bharat Gurnani
- Cataract, Cornea, External Diseases, Trauma, Ocular Surface, Uvea and Refractive Services, Sadguru Netra ChikitsalyaShri Sadguru Seva Sangh Trust, Janaki‐KundChitrakootMadhya PradeshIndia
| | - Sivaraman Balamurugan
- Cataract and Uvea ServicesAravind Eye Hospital and Post Graduate Institute of OphthalmologyPondicherryIndia
| | - Anuradha Kanakath
- Cataract and Uvea ServicesAravind Eye Hospital and Post Graduate Institute of OphthalmologyCoimbatoreTamil NaduIndia
| | - Kirandeep Kaur
- Children Eye Care Centre, Cataract, Pediatric Ophthalmology, and Strabismus Services, Sadguru Netra ChikitsalyaShri Sadguru Seva Sangh Trust, Janaki‐KundChitrakootMadhya PradeshIndia
| | - Abhay Gupta
- Cataract and Cornea ServicesShri Baba Haidakhan Charitable and Research HospitalRanikhetUttarakhandIndia
| | - Sameer Chaudhary
- Aravind Eye Hospital and Post Graduate Institute of OphthalmologyMaduraiTamil NaduIndia
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Gurnani B, Kaur K. Leap forward in clinical and photographic diagnosis of Pythium insidiosum keratitis. Indian J Ophthalmol 2023; 71:3263-3264. [PMID: 37602622 PMCID: PMC10565910 DOI: 10.4103/ijo.ijo_355_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023] Open
Affiliation(s)
- Bharat Gurnani
- Consultant Cataract, Cornea, External Diseases, Trauma, Ocular Surface and Refractive Services, Janaki-Kund, Chitrakoot, Madhya Pradesh, India
| | - Kirandeep Kaur
- Consultant Cataract, Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Janaki-Kund, Chitrakoot, Madhya Pradesh, India
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Gurnani B, Kaur K. Inflammatory cytokines in tears of patients with lacrimal duct obstruction. Indian J Med Res 2023; 158:317. [PMID: 37815066 PMCID: PMC10720965 DOI: 10.4103/ijmr.ijmr_1487_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Indexed: 10/11/2023] Open
Affiliation(s)
- Bharat Gurnani
- Om Prakash Eye Hospital, Amritsar 143 001, Punjab, India
| | - Kirandeep Kaur
- Om Prakash Eye Hospital, Amritsar 143 001, Punjab, India
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Parkash RO, Gurnani B, Kaur K, Parkash TO, Sharma T. Assessing the validity of flap motility sign in predicting the extent of anterior capsular tears in phacoemulsification. Indian J Ophthalmol 2023; 71:3095-3099. [PMID: 37530287 PMCID: PMC10538828 DOI: 10.4103/ijo.ijo_2552_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023] Open
Abstract
Capsulorhexis is an integral step of cataract surgery, and continuous curvilinear capsulorhexis is crucial during phacoemulsification to prevent intraoperative complications. However, sometimes during phacoemulsification in complicated and hard cataract cases, rhexis extension may occur, resulting in posterior capsular rent, nucleus drop, cortex drop, and aphakia. It may not always be possible to continue with phacoemulsification in all cases. In this perspective, the authors describe a novel flap motility sign (FMS) to predict the extent of anterior capsular tear during phacoemulsification. A total of 21,678 patients underwent phacoemulsification for three years, from July 2016 to June 2019. One hundred and twenty-one patients had an anterior capsular tear. There were 102 cases (84.3%) with pre-equatorial tears and 19 cases (15.70%) with postequatorial tears. All pre-equatorial flaps were everted and fluttering, and all postequatorial flaps were inverted and nonfluttering. Posterior capsule rupture (PCR) was observed in all 19 cases of postequatorial flaps (100%). No PCR was observed in patients with fluttering and everted flaps (0%). In-the-bag and scleral-fixated intraocular lens implantations succeeded in pre-equatorial and postequatorial tears, respectively. There was no case of a nucleus drop. This study validates FMS as a predictor for identifying the extent of anterior capsular tears, thereby determining the endpoint of safe phacoemulsification and the site for intraocular lens implantation. Pre-equatorial tears allow for the continuation of safe phacoemulsification and in-the-bag intraocular implantation. Postequatorial tears necessitate timely conversion to small-incision cataract surgery or extracapsular cataract extraction.
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Affiliation(s)
- Rohit Om Parkash
- Chief Medical Officer, Department of Cataract and IOL, Dr. Om Parkash Eye Institute, Amritsar, Punjab, India
| | - Bharat Gurnani
- Consultant, Department of Cornea, Refractive Services, Trauma, External Diseases, Uvea and Ocular Surface, Dr. Om Parkash Eye Institute, Amritsar, Punjab, India
| | - Kirandeep Kaur
- Consultant, Department of Pediatrics Ophthalmology and Strabismus, Dr. Om Parkash Eye Institute, Amritsar, Punjab, India
| | - Tushya Om Parkash
- Consultant Department of Cornea and Refractive Services, Dr. Om Parkash Eye Institute, Amritsar, Punjab, India
| | - Trupti Sharma
- Consultant, Department of Cornea, Squint and Pediatric Ophthalmology, Dr. Om Parkash Eye Institute, Pathankot, Punjab, India
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Gurnani B, Kaur K. Bilateral limbal stem cell deficiency with xeroderma pigmentosum in a young Asian child. Clin Case Rep 2023; 11:e7746. [PMID: 37529126 PMCID: PMC10387588 DOI: 10.1002/ccr3.7746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/11/2023] [Accepted: 07/18/2023] [Indexed: 08/03/2023] Open
Abstract
Key Clinical Message Xeroderma pigmentosum is an autosomal recessive disorder with various ocular manifestations of which bilateral limbal stem cell deficiency is a rare manifestation. Timely diagnosis and meticulous management are vital in these cases to prevent irreversible ocular sequelae. Abstract Bilateral limbal stem cell deficiency (LSCD) can be a rare manifestation in patients afflicted with xeroderma pigmentosum (XP). The authors report a rare case of a 12-year-old boy who presented with redness and defective vision and was diagnosed with bilateral LSCD and hyperpigmented lesion over the face and trunk suggestive of XP.
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Affiliation(s)
- Bharat Gurnani
- Cataract, Cornea, External Disease, Trauma, Ocular Surface and Refractive ServicesSadguru Netra Chikitsalya, Shri Sadguru Seva Sangh TrustChitrakootMadhya PradeshIndia
| | - Kirandeep Kaur
- Cataract, Paediatric Ophthalmology and Strabismus Services, Children Eye Care CentreSadguru Netra Chikitsalya, Shri Sadguru Seva Sangh TrustChitrakootMadhya PradeshIndia
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Morya AK, Ramesh PV, Kaur K, Gurnani B, Heda A, Bhatia K, Sinha A. Diabetes more than retinopathy, it’s effect on the anterior segment of eye. World J Clin Cases 2023; 11:3736-3749. [PMID: 37383113 PMCID: PMC10294174 DOI: 10.12998/wjcc.v11.i16.3736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/25/2023] [Accepted: 05/06/2023] [Indexed: 06/02/2023] Open
Abstract
Diabetes mellitus (DM) is one of the chronic metabolic noncommunicable diseases that has attained worldwide epidemics. It threatens healthy life around the globe, with mild-to-severe secondary complications and leads to significant illness including nephropathy, neuropathy, retinopathy, and macrovascular abnormalities including peripheral vasculopathy, and ischaemic heart disease. Research into diabetic retinopathy (DR), which affects one-third of persons with diabetes, has made considerable strides in recent years. In addition, it can lead to several anterior segment complications such as glaucoma, cataract, cornea, conjunctiva, lacrimal glands and other ocular surface diseases. Uncontrolled DM also caused gradual damage to corneal nerves and epithelial cells, which raises the likelihood of anterior segment diseases including corneal ulcers, dry eye disease, and chronic epithelial abnormalities. Although DR and other associated ocular complications are well-known, the complexity of its aetiology and diagnosis makes therapeutic intervention challenging. Strict glycaemic control, early detection and regular screening, and meticulous management is the key to halting the progression of the disease. In this review manuscript, we aim to provide an in-depth understanding of the broad spectrum of diabetic complications in the anterior segment of the ocular tissues and illustrate the progression of diabetes and its pathophysiology, epidemiology, and prospective therapeutic targets. This first such review article will highlight the role of diagnosing and treating patients with a plethora of anterior segment diseases associated with diabetes, which are often neglected.
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Affiliation(s)
- Arvind Kumar Morya
- Department of Ophthalmology, All India Institute of Medical Sciences, Hyderabad 508126, Telangana, India
| | - Prasanna Venkatesh Ramesh
- Glaucoma and Research, Mahathma Eye Hospital Private Limited, Tennur, Trichy 620001, Tamil Nadu, India
| | - Kirandeep Kaur
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya, Sadguru Seva Sangh Trust, Janaki-Kund, Chitrakoot 485334, Madhya Pradesh, India
| | - Bharat Gurnani
- Cornea and Refractive Services, Sadguru Netra Chikitsalaya, Sadguru Seva Sangh Trust, Janaki- Kund, Chitrakoot 485334, Madhya Pradesh, India
| | - Aarti Heda
- Department of Ophthalmology, National Institute of Ophthalmology, Pune 411000, Maharashtra, India
| | - Karan Bhatia
- Department of Ophthalmology, Manaktala Eye and Maternity Home, Meerut 250001, Uttar Pradesh, India
| | - Aprajita Sinha
- Department of Ophthalmology, Worcestershire Acute Hospital, Worcestershire 01601, United Kingdom
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Gurnani B, Kaur K, Rustagi IM. Is refractive enhancement a safer option for post laser in situ keratomileusis and small incision lenticule extraction regression - How far we have come? Indian J Ophthalmol 2023; 71:2597-2598. [PMID: 37322689 PMCID: PMC10417950 DOI: 10.4103/ijo.ijo_450_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Affiliation(s)
- Bharat Gurnani
- Cataract, Cornea, External Diseases, Trauma, Ocular Surface and Refractive Services, Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Janaki-kund, Chitrakoot, Madhya Pradesh, India
| | - Kirandeep Kaur
- Cataract Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Janaki-kund, Chitrakoot, Madhya Pradesh, India
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Kaur K, Gurnani B. Early postoperative complications of manual small-incision cataract surgery. Indian J Ophthalmol 2023; 71:2611-2612. [PMID: 37322701 PMCID: PMC10417988 DOI: 10.4103/ijo.ijo_2910_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Affiliation(s)
- Kirandeep Kaur
- Department of Pediatric Ophthalmology and Strabismus, Dr. Om Parkash Eye Institute, Mall Road, Amritsar, Punjab, India
| | - Bharat Gurnani
- Department of Cornea and Refractive Services, Dr. Om Parkash Eye Institute, Mall Road, Amritsar, Punjab, India
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Parveen S, Mishra D, Gurnani B, Kaur K, Ziada HA, Srivastav T, Bhushan P. Correlation between different retinal layers with visual acuity in diabetic retinopathy patients with clinically significant macular edema. Indian J Ophthalmol 2023; 71:2526-2530. [PMID: 37322674 PMCID: PMC10417999 DOI: 10.4103/ijo.ijo_1880_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 12/05/2022] [Accepted: 02/23/2023] [Indexed: 06/17/2023] Open
Abstract
Purpose To study the corelation between outer retinal layer thickness (ORL), outer photoreceptor segment thickness (PROS), and central macular thickness (CMT) with best-corrected visual acuity (BCVA) in patients having clinically significant macular edema (CSME) and compare these parameters with normal patients. Methods This was a prospective, nonrandomized, observational, comparative study done during the period of January to May 2019. The study included 60 eyes of 36 patients. The patient population was segregated into two Groups: Group I (30 normal eyes of 15 normal patients) and Group II (30 eyes of 21 diabetic patients) with CSME. The comparison between ORL, PROS, and CMT was made between both the groups, and the correlation between ORL thickness, PROS thickness, and CMT with BCVA in Group II was studied. Results The mean age in Group I was 52.6+10.66 years, and 53.42+8.15 years in Group II. The male/female ratio was 1.1:1 in Group I and 4:3 in Group II. The mean CMT was greater in Group II (330.13 ± 37.01) than in Group I (222.20 ± 12.30). The mean ORL thickness was greater in Group I (97.73 ± 6.92) than in Group II (80.63 ± 9.03). The PROS thickness was statistically significant in Group I (35.05 ± 3.4) than in Group II (28.57 ± 3.53). There was a strong correlation between BCVA and ORL thickness (r = -0.580, P < 0.001) and more strong correlation between BCVA and PROS thickness in Group II (r = -0.611, P < 0.000). There was a moderate correlation between BCVA and CMT (r = 0.410, P < 0.025), and all results were statistically significant. Conclusion Both ORL and PROS thickness were greater in healthy normal eyes than in eyes with CSME. BCVA was strongly correlated with PROS and ORL thickness and moderately associated with CMT.
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Affiliation(s)
- Shama Parveen
- Senior Resident, Regional Institute of Ophthalmology, Department of Ophthalmology, BHU, Varanasi, Uttar Pradesh, India
| | - Deepak Mishra
- Senior Resident, Regional Institute of Ophthalmology, Department of Ophthalmology, BHU, Varanasi, Uttar Pradesh, India
| | - Bharat Gurnani
- Cornea, Cataract and Refactive Surgery, Sadguru Netra Chikitsalya, Chitrakoot, Madhya Pradesh, India
| | - Kirandeep Kaur
- Cornea, Paediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalya, Chitrakoot, Madhya Pradesh, India
| | | | - Tanmay Srivastav
- Department of Ophthalmology, Maa Vindhyavasini Autonomous State Medical College Mirzapur, Uttar Pradesh, India
| | - Prashant Bhushan
- Senior Resident, Regional Institute of Ophthalmology, Department of Ophthalmology, BHU, Varanasi, Uttar Pradesh, India
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Gurnani B, Kaur K. Comment on: Clinical and mycological profile of fungal keratitis from North and North-East India. Indian J Ophthalmol 2023; 71:2607-2608. [PMID: 37322697 PMCID: PMC10418030 DOI: 10.4103/ijo.ijo_1655_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
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Kaur K, Gurnani B. Commentary: A novel way to assess corneal biomechanics in human eyes - The corneal stress-strain index. Indian J Ophthalmol 2023; 71:2427-2428. [PMID: 37322653 PMCID: PMC10417971 DOI: 10.4103/ijo.ijo_300_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Affiliation(s)
- Kirandeep Kaur
- Cataract Pediatric Ophthalmology and Strabismus, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, India
| | - Bharat Gurnani
- Cataract, Cornea, External Diseases, Trauma, Ocular Surface and Refractive Services, Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, India
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Gurnani B, Kaur K, Sharma T. Comment on: Comparison of axial length measurements in silicone oil-filled eyes using SS-OCT and partial coherence interferometry. J Cataract Refract Surg 2023; 49:654. [PMID: 37083138 DOI: 10.1097/j.jcrs.0000000000001202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 04/06/2023] [Indexed: 04/22/2023]
Affiliation(s)
- Bharat Gurnani
- From the Cataract, Cornea, External Diseases, Trauma, Ocular Surface, Uvea and Refractive Services, Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, India (Gurnani, Sharma); Cataract, Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, India (Kaur)
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Morya AK, Shrivastava AK, Janti SS, Tejaswini A, Gupta R, Gurnani B, Venkatesh D, Prasad R. Effect of Asanas in Yoga on Intraocular Pressure of Practicing Healthy Individuals: a Prospective Observational Study. Maedica (Bucur) 2023; 18:238-245. [PMID: 37588839 PMCID: PMC10427079 DOI: 10.26574/maedica.2023.18.2.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
Introduction: Yoga is focused attention by breath and mantra. This forms the basis for a scientific investigation of its effect on various physiological functions such as intraocular pressure (IOP). Objective: To evaluate the effect of asanas in Yoga on the IOP of practicing individuals. Methods:A prospective, observational study was performed on 107 volunteers practising the asanas such as Sun salutation exercise (Surya Namaskar), Skull shining breath (Kapalabhati Pranayama), Downward facing dog (Adho Mukha Svanasana), Standing forward bend (Uttanasana), Legs up the wall pose (Viparita Karani), Alternate breathing technique (Anulom Vilom), Deep meditation (Dhyana), Bellows breath (Bhastrika Pranayama), Yoga head stand (Shirshasana) and control of breathing exercise (Pranayama) each for five minutes/day (40-60 minutes) for at least five days in a week for 12 weeks. The IOP measurement was performed for each asana (before and after) at baseline and every four weeks. The primary outcome was the change in IOP. Statistical analyses were performed using Statistical Package for Social Sciences version 23.0. A p-value of less than 0.05 was considered statistically significant. Results:The mean age of the participants was 42.64±7 years, and the male to female ratio was 1.2:1. Skull shinning breath, Sun salutation, Downward facing dog, Standing forward bend, Legs up the wall pose, Deep meditation and alternate breathing techniques showed a significant mean reduction in IOP at baseline, followed by every four weeks, till week 12, while Yoga head stand, Bellows breath and control of breath led to a significant increase in IOP. Conclusion:Yoga head stand, Bellows breath and control of breathing technique worsen IOP transiently.
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Affiliation(s)
- Arvind Kumar Morya
- Cataract, Glaucoma, Refractive, Squint, Pediatric Ophthalmology and Medical Retina Services, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | | | - Siddharam S Janti
- All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | | | - Rajan Gupta
- Rajan Eye Heart & Laser Centre, Tohana Distt. Fatehabad, Haryana, India
| | - Bharat Gurnani
- Consultant Cataract, Cornea, External Disease, Trauma, Ocular Surface and Refractive Surgery, Dr. Om Parkash Eye Institute, Amritsar, Punjab, India
| | - Dharavath Venkatesh
- Department of Ophthalmology, All India Institute of Medical Sciences, Bibinagar, Telangana, India
| | - Rajendra Prasad
- Department of Ophthalmology, RP Eye Institute, New Delhi, India
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Bejjenki P, Gurnani B, Kaur K, Tejaswini A, Sinha A, Venkatesh D, Morya AK. Commentary: Impact of manual small-incision cataract surgery on outreach and training curriculum across the world. Indian J Ophthalmol 2023; 71:2478-2479. [PMID: 37322665 PMCID: PMC10417978 DOI: 10.4103/ijo.ijo_2230_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Affiliation(s)
- Priyanka Bejjenki
- Department of Ophthalmology, All India Institute of Medical Sciences, Bibinagar, Telangana, India
| | - Bharat Gurnani
- Consultant Cataract, Cornea, External Disease, Trauma, Ocular Surface and Refractive Surgery, Amritsar, Punjab, India
| | - Kirandeep Kaur
- Consultant Cataract, Pediatric Ophthalmology and Strabismus, Dr. Om Parkash Eye Institute, Amritsar, Punjab, India
| | - Antarvedi Tejaswini
- Department of Ophthalmology, All India Institute of Medical Sciences, Bibinagar, Telangana, India
| | - Aprajita Sinha
- Specialty Doctor in Ophthalmology, Worcestershire Acute Hospitals NHS Trust, Worcester, United Kindgom
| | - Dharavath Venkatesh
- Department of Ophthalmology, All India Institute of Medical Sciences, Bibinagar, Telangana, India
| | - Arvind K Morya
- Department of Ophthalmology, Cataract, Glaucoma, Refractive, Squint, Pediatric Ophthalmology and Medical Retina Services, All India Institute of Medical Sciences, Bibinagar, Telangana, India
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Gurnani B, Kaur K. Evolving concepts in etiopathogenesis of keratoconus: Is it quasi-inflammatory or inflammatory? Indian J Ophthalmol 2023; 71:2609-2610. [PMID: 37322699 PMCID: PMC10418007 DOI: 10.4103/ijo.ijo_783_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Affiliation(s)
- Bharat Gurnani
- Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Cuddalore Main Road, Thavalukuppam, Pondicherry, India
| | - Kirandeep Kaur
- Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Cuddalore Main Road, Thavalukuppam, Pondicherry, India
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38
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Gurnani B, Kaur K. Predicting Prognosis Based on Regional Prevalence, Ulcer Morphology and Treatment Strategy in Vision-Threatening Pythium insidiosum Keratitis. Clin Ophthalmol 2023; 17:1307-1314. [PMID: 37181081 PMCID: PMC10167989 DOI: 10.2147/opth.s412274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 04/24/2023] [Indexed: 05/16/2023] Open
Abstract
Pythium insidiosum is an oomycete belonging to the phylum Straminipila and family Pythiaceae. It causes rapidly progressive vision-threatening keratitis. Clinically, microbiologically and morphologically, it closely resembles fungal keratitis; hence it is also labelled as a "parafungus". The clinical features mimicking fungus are subepithelial and stromal infiltrate, endo-exudates, corneal melt and hypopyon. The hallmark features of Pythium are tentacular projections, reticular dot-like infiltrate, peripheral furrowing and thinning, and rapid limbal spread. Microbiological corneal smearing on KOH and Gram stain reveal septate or aseptate, obtuse to perpendicular hyphae which mimic fungal hyphae. Culture on any nutritional agar reveals cream, cottonwool-like, fluffy colonies, and diagnosis is confirmed by zoospore formation by the leaf incarnation method. Medical management with antifungals and antibacterials still presents a dilemma. Early therapeutic keratoplasty has been the proposed treatment in most cases. We hypothesize that the prognosis of Pythium keratitis is governed by regional geographical variations, ulcer size and density on presentation, and initial treatment strategy. The available literature supporting the proposed hypothesis is also discussed, along with the hallmark features of Pythium and how it masquerades as other microorganisms causing keratitis. We also aim to propose a novel diagnostic and treatment algorithm for managing this vision-threatening keratitis.
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Affiliation(s)
- Bharat Gurnani
- Department of Cornea and Refractive Surgery, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, 485334, India
| | - Kirandeep Kaur
- Department of Pediatric Ophthalmology, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, 485334, India
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Gurnani B, Kaur K, Kumar T. Commentary: Current concepts, recent updates, and future treatment options for Pythium insidiosum keratitis. Indian J Ophthalmol 2023; 71:1874-1876. [PMID: 37203047 PMCID: PMC10391502 DOI: 10.4103/ijo.ijo_80_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Affiliation(s)
- Bharat Gurnani
- Departments of Cataract, Cornea, Trauma, External Disease, Ocular Surface and Refractive Services, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Janaki Kund, Chitrakoot, Madhya Pradesh, India
| | - Kirandeep Kaur
- Department of Cataract, Pediatric Ophthalmology and Strabismus Services, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Janaki Kund, Chitrakoot, Madhya Pradesh, India
| | - Tathagata Kumar
- Department of Optometry, Dr. Om Parkash Eye, Institute, Amritsar, Punjab, India
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Saroya S, Kaur K, Saroya AS, Gurnani B, Morya AK. Commentary: Tonometry probes - Is sterilization mandatory with every reutilization? Indian J Ophthalmol 2023; 71:1937-1938. [PMID: 37203060 PMCID: PMC10391515 DOI: 10.4103/ijo.ijo_238_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Affiliation(s)
- Shaina Saroya
- Vitreoretinal Services, Dr.Aggarwal Eye Hospital, Chennai, Tamil Nadu, India
| | - Kirandeep Kaur
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
| | - Arnav S Saroya
- Cornea and Refractive Surgery, Dr.Aggarwal Eye Hospital, Chennai, Tamil Nadu, India
| | - Bharat Gurnani
- Cornea and Refractive Services, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
| | - Arvind K Morya
- Glaucoma, Refractive, Squint Paediatric Ophthalmology and Medical Retina Services, Department of Ophthalmology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
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Gurnani B, Kaur K. Commentary: Leap forward in presbyopia management - Correcting beyond spectacles. Indian J Ophthalmol 2023; 71:1843-1844. [PMID: 37203041 PMCID: PMC10391491 DOI: 10.4103/ijo.ijo_803_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Affiliation(s)
- Bharat Gurnani
- Cornea and Refractive Services, Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Janaki-Kund, Chitrakoot, Madhya Pradesh, India
| | - Kirandeep Kaur
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Janaki-Kund, Chitrakoot, Madhya Pradesh, India
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Mohanasundaram AS, Gurnani B, Kaur K, Manikkam R. Madras eye outbreak in India: Why should we foster a better understanding of acute conjunctivitis? Indian J Ophthalmol 2023; 71:2298-2299. [PMID: 37202982 PMCID: PMC10391441 DOI: 10.4103/ijo.ijo_3317_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Affiliation(s)
| | - Bharat Gurnani
- Cornea and Refractive Services, Dr. Om Parkash Eye Institute, Amritsar, Punjab, India
| | - Kirandeep Kaur
- Pediatric Ophthalmology and Strabismus, Dr. Om Parkash Eye Institute, Amritsar, Punjab, India
| | - Radhakrishnan Manikkam
- Centre for Drug Discovery and Development, Sathyabama Institute of Science and Technology, Chennai, Tamil Nadu, India
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Abstract
After the global COVID-19 pandemic, there has been an alarming concern with the monkeypox (mpox) outbreak, which has affected more than 110 countries worldwide. Monkeypox virus is a doublestranded DNA virus of the genus Orthopox of the Poxviridae family, which causes this zoonotic disease. Recently, the mpox outbreak was declared by the World Health Organization (WHO) as a public health emergency of international concern (PHEIC). Monkeypox patients can present with ophthalmic manifestation and ophthalmologists have a role to play in managing this rare entity. Apart from causing systemic involvement such as skin lesions, respiratory infection and involvement of body fluids, Monkeypox related ophthalmic disease (MPXROD) causes varied ocular manifestations such as lid and adnexal involvement, periorbital and lid lesion, periorbital rash, conjunctivitis, blepharocounctivitis and keratitis. A detailed literature review shows few reports on MPXROD infections with limited overview on management strategies. The current review article is aimed to provide the ophthalmologist with an overview of the disease with a spotlight on ophthalmic features. We briefly discuss the morphology of the MPX, various modes of transmission, an infectious pathway of the virus, and the host immune response. A brief overview of the systemic manifestations and complications has also been elucidated. We especially highlight the detailed ophthalmic manifestations of mpox, their management, and prevention of vision threatening sequelae.
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Affiliation(s)
- Bharat Gurnani
- Cornea and Refractive Services, Dr. Om Parkash Eye Institute, Mall Road, Amritsar, Punjab, India
| | - Kirandeep Kaur
- Pediatric Ophthalmology and Strabismus, Dr. Om Parkash Eye Institute, Mall Road, Amritsar, Punjab, India
| | - Sameer Chaudhary
- Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, Tamil Nadu, India
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Gurnani B, Kaur K. Empowering outreach activities and ocular screening through trained manpower. Indian J Ophthalmol 2023; 71:2311. [PMID: 37202992 PMCID: PMC10391410 DOI: 10.4103/ijo.ijo_2890_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Affiliation(s)
- Bharat Gurnani
- Cataract, Cornea, External Diseases, Trauma. Ocular Surface and Refractive Services, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Janki Kund, Chitrakoot, Madhya Pradesh, India
| | - Kirandeep Kaur
- Cataract, Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Janki Kund, Chitrakoot, Madhya Pradesh, India
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Gurnani B, Kaur K. Commentary: Evolution and practice patterns of thin flap sub-Bowman laser in situ keratomileusis in refractive surgery. Indian J Ophthalmol 2023; 71:1903-1904. [PMID: 37203053 PMCID: PMC10391396 DOI: 10.4103/ijo.ijo_278_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Affiliation(s)
- Bharat Gurnani
- Cataract, Cornea, External Diseases, Trauma, Ocular Surface and Refractive Services, Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, India
| | - Kirandeep Kaur
- Catarat Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, India
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Kaur K, Gurnani B. Comment on "Lessons Learned From School-Based Delivery of Vision Care in Baltimore, Maryland". Asia Pac J Ophthalmol (Phila) 2023; 12:339-340. [PMID: 36650097 DOI: 10.1097/apo.0000000000000528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
- Kirandeep Kaur
- Cataract, Pediatric Ophthalmology and Strabismus Services, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai, Tamil Nadu, India
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Gurnani B, Kaur K, Gurav J. Natasol as a future management option to combat fungal keratitis. Indian J Ophthalmol 2023; 71:2302-2303. [PMID: 37202986 PMCID: PMC10391390 DOI: 10.4103/ijo.ijo_190_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Affiliation(s)
- Bharat Gurnani
- Cataract, Cornea, External Diseases, Trauma, Ocular Surface and Refractive Services, Sadguru Netra Chikitsalya, ShriSadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, India
| | - Kirandeep Kaur
- Pediatric and Squint Services, Sadguru Netra Chikitsalya, ShriSadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, India
| | - Jaiprakash Gurav
- Medical Cadet, Armed Forces Medical College, Pune, Maharashtra, India
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Gurnani B, Kaur K. Tips to prevent inadvertent stromal staining and Descemet membrane detachment while performing paracentesis during cataract surgery. Indian J Ophthalmol 2023; 71:2300-2301. [PMID: 37202984 PMCID: PMC10391443 DOI: 10.4103/ijo.ijo_3310_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Affiliation(s)
- Bharat Gurnani
- Cataract, Cornea, External Diseases, Trauma, Ocular Surface and Refractive Surgery, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Janki Kund, Chitrakoot, Madhya Pradesh, India
| | - Kirandeep Kaur
- Cataract, Paediatric Ophthalmology and Squint Services, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Janki Kund, Chitrakoot, Madhya Pradesh, India
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Kaur RP, Gurnani B, Kaur K. Intricate insights into immune response in dry eye disease. Indian J Ophthalmol 2023; 71:1248-1255. [PMID: 37026255 DOI: 10.4103/ijo.ijo_481_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
Dry eye disease (DED) is a complex disorder of the ocular surface with a loss of tear film homeostasis, causing an imbalance in the tear-air interface and leading to ocular discomfort, pain, and vision issues. Immune control issues are a primary factor in dry eye disorder's origin, progression, and management. The aim of managing DED is to reduce symptoms and improve the life quality of those affected. Despite the diagnosis, up to half of the patients do not get proper care. The scarcity of successful treatments for DED is worrisome, and it is of increasing importance to comprehend the root causes and create more effective therapies to alleviate the distress of those afflicted with the disorder. Therefore, the role of the immune system in the initiation and progression of DED has become the research focus. This paper reviews the current insight into the immune response in DED, the existing treatment methods, and ongoing research to search for better treatments.
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Affiliation(s)
- Ruminder P Kaur
- Department of Emergency Medicine, Civil Hospital, Moga, Punjab, India
| | - Bharat Gurnani
- Cornea and Refractive Services, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Janaki-Kund, Chitrakoot, Madhya Pradesh, India
| | - Kirandeep Kaur
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Janaki-Kund, Chitrakoot, Madhya Pradesh, India
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Morya AK, Kaur K, Gurnani B, Janti SS, Shrivastava AK, Tejaswini A, Sinha A, Venkatesh D. A clinical trial on phakic intraocular lens for the treatment of refractive amblyopia in children and adolescents. Indian J Ophthalmol 2023; 71:804-809. [PMID: 36872683 DOI: 10.4103/ijo.ijo_2567_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023] Open
Abstract
Purpose To analyze the demographics and clinical outcomes of posterior chamber phakic intraocular (IOL) implantation for refractive amblyopia in children and adolescents. Methods A prospective interventional study was performed on children and adolescents with amblyopia at a tertiary eye care center from January 2021 to August 2022. Twenty-three eyes of 21 anisomyopic and isomyopic amblyopia patients operated for posterior chamber phakic IOL (Eyecryl phakic IOL) as a treatment for amblyopia were included in the study. Patient demographics, pre- and postoperative visual acuity, cycloplegic refraction, anterior and posterior segment examination, intraocular pressure, pachymetry, contrast sensitivity, endothelial count, and patient satisfaction scores were evaluated. Patients were followed up at day 1, 6 weeks, 3 months, and 1 year after surgery, and visual outcomes and complications were documented. Results The mean age of patients was 14.16 ± 3.49 years (range: 10-19 years). The mean intraocular lens power was - 12.20 diopter spherical (DS) in 23 eyes and - 2.25 diopter cylindrical (DC) in four patients. The mean unaided distant visual acuity (UDVA) and best-corrected visual acuity (BCVA) were 1.39 ± 0.25 and 0.40 ± 0.21 preoperatively on the log of minimum angle of resolution (logMAR) chart. Postoperatively, the visual acuity improved by 2.6 lines in 3 months period and maintained till 1 year. Postsurgery, contrast sensitivity in the amblyopic eyes significantly improved, and the average endothelial loss recorded was 5.78% at 1 year, which was statistically insignificant. Patient satisfaction score was statistically significant, with 4.736/5 recorded on the Likert scale. Conclusion Posterior chamber phakic IOL is a safe, effective, and alternative method for treating amblyopia patients who are noncompliant with glasses, contact lenses, and keratorefractive procedures.
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Affiliation(s)
- Arvind Kumar Morya
- Cataract, Glaucoma, Refractive, Squint, Pediatric Ophthalmology and Medical Retina Services, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Kirandeep Kaur
- Consultant Cataract, Pediatric Ophthalmology, and Strabismus, Satguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Janaki-kund, Chitrakoot, Madhya Pradesh, India
| | - Bharat Gurnani
- Cataract, Cornea, External Disease, Trauma, Ocular Surface and Refractive Surgery, Satguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Janaki-kund, Chitrakoot, Madhya Pradesh, India
| | - Siddharam S Janti
- Department of Ophthalmology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Ankur Kumar Shrivastava
- Department of Ophthalmology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Antarvedi Tejaswini
- Department of Ophthalmology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Aprajita Sinha
- Specialty Doctor Ophthalmology, Worcestershire Acute Hospitals NHS Trust, United Kingdom
| | - Dharavath Venkatesh
- Department of Ophthalmology, All India Institute of Medical Sciences, Bibinagar, Telangana, India
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