· AIM: To evaluate the optic disc parameters in the three main ethnic groups of Malaysia (Malay, Chinese and Indian). Possible relationships between optic disc parameters and gender, intraocular pressure and axial length of eye were also studied. · METHODS: The study included 244 eyes of 122 subjects (61 cases with open angle glaucoma and 61 non- glaucomatous individuals) with clear ocular media. Magnification corrected measurements of optic disc diameters and area were done using Zeiss FF450 Plus fundus camera. Differences between the three ethnic groups were tested by using ANOVA. The association between factors such as gender, intraocular pressure and axial length of the eye, and the optic disc size was tested through Pearson's bivariate correlation analysis. · RESULTS: The overall mean vertical optic disc diameter as (1.96 ± 0.20) mm, horizontal optic disc diameter was (1.84±0.20)mm and optic disc area was (2.84±0.56)mm2. Indians had larger optic disc area compared to Malay and Chinese. However, the difference was not statistically significant. · CONCLUSION: Optic disc size is larger in Malaysian population than Caucasians, Among the three ethnic groups, Indians have the largest optic disc size without any statistical difference.

AIM: To report the usefulness of a new parameter (maximum cross sectional area) in the measurements of B-scan ultrasonography to evaluate the progress of choroidal metastatic tumour size during the follow-up of patient.METHODS: Case report-the B-scan ultrasonographic measurements of height, base and maximum cross sectional area during the follow-up of the patient are presented.RESULTS: A 62-year-old Chinese lady, known case of non-small cell lung carcinoma, presented with painless blurring of vision in the right eye. She was diagnosed to have bilateral choroidal metastasis (advanced in the right eye and early in the left eye) with good vision in both eyes. The tumour size in the right eye reduced significantly after the first chemotherapy; but increased again 6 weeks after the end of last cycle of chemotherapy. She was given radiotherapy and another course of chemotherapy. The tumour size in the right eye did not respond much later on. However, the tumour size in the left eye was static through out the follow up period of 2years. The patient maintained best corrected visual acuity in both eyes (6/9 in right eye and 6/6 in left eye). The progress of tumour size in right eye was evaluated with serial B-scan ultrasonographic measurements.CONCLUSION: The ultrasonographic measurements were reproducible all through the follow up period and coincided well with clinical appearance of the tumour in right eye. We suggest the use of B-scan ultrasonography in the follow up of patients with elevated choroidal masses for quantitative assessment of progression/regression in their size during the treatment period.

No abstract available.
Adenosine Triphosphate/pharmacology ; Anions/metabolism ; Bicarbonates/metabolism* ; Chlorides/metabolism* ; Cyclic AMP/pharmacology ; Cystic Fibrosis Transmembrane Conductance Regulator/physiology* ; Electric Conductivity ; Electrophysiology ; Gluconates/pharmacology ; Human ; Membrane Potentials/physiology ; Membrane Potentials/drug effects ; Potassium/pharmacology ; Sweat Glands/metabolism*

Cervical ectopic thymus (CET), a common embryological anomaly detected incidentally at autopsy, is rarely described in clinical patients. Furthermore, aberrant cervical thymic tissue is an infrequently reported cause of paediatric neck masses.We report a 12-year-old female presenting with multinodular thyroid swelling since seven years of age. FNAC revealed adenomatous goitre with suspicious cystic papillary neoplastic foci, for which she underwent total thyroidectomy along with excision of a nodular swelling near the lower pole of the right thyroid lobe which was per-operatively suspected to be a lymph node. Histopathological examination revealed a follicular variant papillary carcinoma of the thyroid with background thyroiditis, and a nodule of ectopic thymic tissue. Though the presence of CET is rare, one should be aware of this entity, especially in children because it may be confused with lymph node metastasis which may lead to morbid radical neck dissection.

·AIM: To report a rare case of antiphospholipid syndrome presenting as papilledema and sixth nerve palsy in right eye due to superior sagittal sinus thrombosis, and regression of papilledema following anticoagulation and acetazolamide therapy.·METHODS: A 44-year-old Chinese gentleman presented with headache, diplopia and mild blurring of vision. Clinical examination revealed the presence of sixth nerve palsy in right eye and papilledema. There was enlargement of blind spot in the visual fields and red green deficiency in both eyes.Computed tomography and magnetic resonance imaging showed superior sagittal sinus thrombosis. Hematological investigation confirmed the presence of antiphospholipid syndrome as the underlying cause.·RESULTS: The condition was treated successfully in three months with the adjunctive use of anticoagulation and acetazolamide. Reversal of papilledema changes in the optic disc to normal indicates the anatomical recovery, while reduction of enlargement of blind spot to normal size,recovery of red green deficieny to normal colour vision in both eyes and visual improvement after regression of papilledema in right eye indicate functional recovery in this patient.·CONCLUSION: Antiphospholipid syndrome should be considered in the differential diagnosis of papilledema, and oral acetazolamide is an important adjunct therapy to anticoagulation in cases of refractory papilledema to protect the optic nerve from potential damage which results in blindness.

Elastography is an ultrasound-based newer imaging technique that is currently being used for the evaluation of breast lesions and hepatic pathology. It is also being evaluated for characterizing lesions of the prostate, thyroid, cervix and lymph nodes. We have applied real-time sonoelastography to a variety of musculoskeletal pathologies and here we report the findings of elastography for the evaluation of various musculoskeletal pathologies. Elastography of musculoskeletal lesions is not yet being routinely used in clinical practice, but it is being extensively researched.
Elasticity Imaging Techniques/*methods ; Humans ; Musculoskeletal Diseases/*ultrasonography

Summary Trichorrhexis nodosa (TN) is a hair shaft disorder characterized by fragile hair with nodes on the hair shaft. Here we report a case of aquired localised trichorrhexis nodosa and describe the importance of noninvasive tools like trichoscopy and light microscopy in the diagnosis of an isolated TN.
Hair Diseases--diagnosis

AIMTo estimate the frequency of microdeletions in the long arm of Y-chromosome of 20 infertile males from South India.

METHODSPolymerase chain reaction (PCR) amplification using Y-specific STS of azoospermia factor (AZF) regions i.e., SY 84 for AZFa, SY 127 for AZFb and SY 254 for AZFc.

RESULTSOf the 20 infertile subjects 3 (15 %), one azoospermic and two oligozoospermic, showed microdeletions in the AZF region of Y-chromosome.

CONCLUSIONThe frequency of deletions involving AZF region of the Y-chromosome is 15 % in azoospermic and severely oligozoospermic infertile men. PCR amplification of AZF locus is useful for the diagnosis of microdeletions in the Y-chromosome.

Base Sequence ; Chromosome Deletion ; Chromosome Mapping ; Chromosomes, Human, Y ; DNA Primers ; Female ; Gene Frequency ; Genetic Loci ; Humans ; India ; Infertility, Male ; genetics ; Male ; Oligospermia ; genetics ; Polymerase Chain Reaction ; methods ; Reference Values ; Seminal Plasma Proteins ; genetics

This study described the clinical and paraclinical features of south Indian patients with longitudinally extensive transverse myelitis (LETM) and contrasted the findings betweenaquaporin-4 positive versus negative patients. The subjects were recruited between2010 and 2013.The distinctive features among71 LETM patients were compared and it was observed that 56% of the total subjects were found to be AQP4-Ab positive. The ratio of female tomale was found to be higher in the AQP4-Ab positive group. Magnetic resonance imaging showed holocord involvement more commonly in AQP4-Abnegative than positive group. The presence of hypointense lesions did not correlate with severity. The main distinctive features between AQP4-Abpositive and negative cases include older onset age, higher proportion of female, low frequency of conus involvement and higher prevalence of coexisting autoimmune disorders in AQP4-Ab positive cases. Therewas no difference in attack severity, onset of optic neuritis, and spasms between the two groups. Our results suggest that the clinical and spinal cord neuro-imaging information can aid in distinguishing between the positive and negative group of patients with LETM. The early detection of AQP4-Ab positive status predicts the recurrence of LETM or occurrence of optic neuritis duringthe study period.

Ischemic priapism is a urological emergency that has been associated with long-standing and irreversible adverse effects on erectile function. Studies have demonstrated a linear relationship between the duration of critically ischemic episodes and the subsequent development of corporal fibrosis and irreversible erectile function loss. Placement of a penile prosthesis is a well-established therapeutic option for the management of erectile dysfunction secondary to ischemic priapism, and will be the focus of this review. Review of the current literature demonstrates a growing utilization of penile prostheses in the treatment of erectile dysfunction secondary to ischemic priapism. Unfortunately, there is a paucity of randomized-controlled trials describing the use of prosthesis in ischemic priapism. As a result, there is a lack of consensus regarding the type of prosthesis (malleable vs. inflatable), timing of surgery (acute vs. delayed), and anticipated complications for each approach. Both types of prostheses yielded comparable complication rates, but the inflatable penile prosthesis have higher satisfaction rates. Acute treatment of priapism was associated with increased risk of prosthetic infection, and could potentially cause psychological trauma, whereas delayed implantation was associated with greater corporal fibrosis, loss of penile length, and increased technical difficulty of implantation. The paucity of high-level evidence fuels the ongoing discussion of optimal use and timing of penile prosthesis implantation. Current guidance is based on consensus expert opinion derived from small, retrospective studies. Until more robust data is available, a patient-centered approach and joint decision-making between the patient and his urologist is recommended.
Consensus ; Emergencies ; Erectile Dysfunction ; Expert Testimony ; Fibrosis ; Humans ; Joints ; Male ; Penile Implantation ; Penile Prosthesis ; Priapism ; Prostheses and Implants ; Psychological Trauma ; Retrospective Studies