PURPOSE: To establish the strength of the association between routine tear function tests and conjunctival impression cytology (CIC) and to determine whether they simulate the morphological and cytological changes that occur on the ocular surface in dry eye. What are the sensitivity, specificity and positive predictive values of these tests when CIC is considered the gold standard? METHODS: The tear film profile included tear film break up time (TBUT), Schirmer's-1, Rose Bengal scores (RBS), and impression cytology. CIC samples were obtained from the inferior bulbar conjunctiva and stained with periodic acid-Schiff and counter stained with hematoxylin and eosin. RESULTS: The mean Schirmer's value was 11.66 +/- 5.90 in patients and 17.17 +/- 2.97 in controls (p < 0.001). The mean TBUT in participants was 8.88 +/- 3.54 and 13.53 +/- 2.12 in controls (p < 0.001). Patients had a mean goblet cell density (GCD) of 490 +/- 213, while the value for controls was 1,462 +/- 661 (p < 0.001). Abnormal CIC was observed in 46.7% cases of dry eye and in 32.8% of controls. The correlation coefficient (L) for Schirmer's was 0.2 and 0.24 for participants and controls, respectively, while TBUT values were 0.26 and 0.38, RBS were 0.5 and 0.5, and GCD was 0.8 and 0.6 in cases and controls, respectively. CONCLUSIONS: GCD, RBS, and TBUT were better predictors of morphological and cytological changes in the conjunctiva than Schirmer's in dry eye syndrome. The sensitivity of tear function tests in diagnosing dry eye was TBUT > Schirmer's > RBS, and the specificity was Schirmer's > TBUT > RBS in decreasing order when CIC was considered the gold standard.
Adolescent ; Adult ; Case-Control Studies ; Child ; Conjunctiva/pathology ; Diagnostic Techniques, Ophthalmological/*standards ; Dry Eye Syndromes/*diagnosis/*pathology ; Eosine Yellowish-(YS)/diagnostic use ; Female ; Goblet Cells/pathology ; Hematoxylin/diagnostic use ; Humans ; Male ; Middle Aged ; Ophthalmology/*standards ; Periodic Acid-Schiff Reaction/standards ; Predictive Value of Tests ; Rose Bengal/diagnostic use ; Sensitivity and Specificity ; *Tears ; Young Adult

Subacute posttraumatic ascending myelopathy is a rare disorder, unrelated to syrinx formation or mechanical instability, which may gradually emerge within the first 1-2 weeks after a spinal cord injury and may lead to diagnostic and prognostic dilemmas. We present a case of 24-year-old female with unstable wedge compression fracture of L1 vertebrae with signal changes in the upper lumbar cord causing complete paraplegia below D9 with bladder and bowel involvement. In the subsequent week, she developed a delayed progressively increasing neurological deficit with cord signal abnormality on MRI extending cephalad from the injury site to the upper dorsal cord. The patient had no initial clinical improvement initially but showed a delayed recovery over months.
Adult ; Female ; Humans ; Spinal Cord Diseases ; etiology ; therapy ; Spinal Cord Injuries ; complications ; Spinal Fractures ; complications

Purpose::Dental and orofacial trauma among the adult population constitutes a major public health problem. The impact is not just physical but also psychological. To analyse the impacts of dental and orofacial trauma on oral health-related quality of life (OHRQoL) in adults and determine whether the 2 variables are closely interlinked.Methods::This is a systematic review. The terms "dental trauma", "orofacial trauma", "oral health", "oral health related impact life", "OHRQoL", "positive and negative affect scale", "quality of life", "facial injuries", "adults", and "young adults" were researched in the databases of PubMed, ScienceDirect, Scopus and Google Scholar for associated studies up to December 30, 2022. A comprehensive search was designed and the articles were independently screened for eligibility by 2 reviewers. The included studies’ author, year of publication, the country where the study was conducted, population demographics (number and age), an instrument used for assessing OHRQoL and the relevant result were recorded and compared. The quality of the evidence was assessed using Joanna Briggs Institute checklist for observational studies.Results::Out of 482 unique records, 3 articles were included for data extraction. Observational studies were included. Two studies did not mention confounding factors. Different scales were used for dental and orofacial trauma and OHRQoL. OHRQoL has a directly proportional relationship with orofacial trauma. Adolescents with orofacial trauma have a significant impact on this value with a prevalence of 88.4%.Conclusion::The highest impact on OHRQoL was seen immediately after the diagnosis of an orofacial trauma. The impact increases with the severity of the trauma. Therefore, to promote overall dental and general health, health education initiatives should include information on the causes, prevention, and requirement for prompt responses by the populace in seeking dental intervention.