OBJECTIVES: This study was conducted to show the intraocular pressure (IOP) distribution and the factors affecting IOP in subjects with type 2 diabetes mellitus (DM) in India. METHODS: We measured the anthropometric and biochemical parameters for confirmed type 2 DM patients. A comprehensive ocular examination was performed for 1377 subjects aged > 40 years and residing in Chennai. RESULTS: A significant difference in IOP (mean +/- standard deviation) was found between men and women (14.6+/-2.9 and 15.0+/-2.8 mmHg, p = 0.005). A significantly elevated IOP was observed among smokers, subjects with systemic hypertension and women with clinically significant macular edema (CSME). After a univariate analysis, factors associated significantly with higher IOP were elevated systolic blood pressure, elevated resting pulse rate and thicker central corneal thickness (CCT). In women, elevated glycosylated hemoglobin was associated with a higher IOP. After adjusting for all variables, the elevated resting pulse rate and CCT were found to be associated with a higher IOP. CONCLUSIONS: Systemic hypertension, smoking, pulse rate and CCT were associated with elevated intraocular pressure in type 2 DM. Women with type 2 DM, especially those with CSME, were more prone to have an elevated IOP.
Adult ; Aged ; Blood Pressure ; Cornea/physiology ; Diabetes Mellitus, Type 2/complications/*physiopathology ; Female ; Heart Rate ; Hemoglobin A, Glycosylated/metabolism ; Humans ; Hypertension/complications ; India ; Intraocular Pressure/*physiology ; Macular Edema/complications ; Male ; Middle Aged ; Risk Factors ; Smoking

INTRODUCTIONThe aim of this study was to investigate the role of ultrasound biomicroscopy (UBM) in imaging anterior segment foreign bodies and compare it with conventional B-scan ultrasound and computed tomography (CT).

MATERIALS AND METHODSThe charts of 18 eyes with anterior segment foreign bodies were reviewed. The rates of detection of foreign bodies using ultrasound, CT scan and UBM were compared.

RESULTSThe foreign body detection rates were 36.5% by ultrasound, 88.9% by CT scan, and 94.4% by UBM. The diagnosis of presence of a foreign body using UBM was made based on high reflective echoes causing shadowing or reverberations. In 7 eyes, UBM detected injury to the zonules, guiding the operative procedure. In the 8 eyes for which all tests were performed, rates of detection of foreign bodies were 25% (2/8) with ultrasound, 87.5% (7/8) with CT, and 100% (8/8) with UBM.

CONCLUSIONUBM is a valuable adjunct for the accurate localisation of small foreign bodies, including cilia. It offers a higher detection rate than that provided by ultrasound and CT scan.

Adolescent ; Adult ; Anterior Eye Segment ; ultrastructure ; Diagnostic Errors ; prevention & control ; Eye Foreign Bodies ; diagnostic imaging ; surgery ; Female ; Humans ; Male ; Microscopy, Acoustic ; Middle Aged ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome ; Ultrasonography ; methods ; Wounds, Penetrating ; complications

The purpose of this study is to describe the correlation of findings between results from spectral domain optical coherence tomography (SD-OCT) and microperimetry in a case series regarding patients with Goldmann-Favre syndrome. Goldmann-Favre syndrome is a rare autosomal recessive hereditary vitreo-retinal degeneration that impacts the functionality of vision in subjects. Three men with this condition were assessed and subjected to microperimetry and SD-OCT. Two of the men were brothers. This study finds that the retinoschisis and macular cystoid changes noted in the SD-OCT matched the scotomas revealed by the microperimetry. The findings of each of the individual cases are reported herein.
Adult ; Eye Diseases, Hereditary/*pathology ; Humans ; Macular Edema/*pathology ; Male ; Retinoschisis/*pathology ; Scotoma/pathology ; *Tomography, Optical Coherence ; *Visual Field Tests ; Young Adult

STUDY DESIGN: Retrospective study. PURPOSE: The aim of this study was to analyze various diagnostic tools, including GeneXpert, for the management of tuberculosis of the spine. OVERVIEW OF LITERATURE: Traditional diagnostic methods of microscopy, histology, and culture have low sensitivity and specificity for the management of tuberculosis of the spine. METHODS: Of the 262 treated cases of spinal tuberculosis, data on 1 year follow-up was available for 217 cases. Of these, only 145 cases with a confirmed diagnosis were selected for retrospective analysis. RESULTS: In 145 of the 217 patients (66.80%), diagnosis was confirmed on the basis of a culture. Of the 145 patients with a confirmed diagnosis, 98 (66.20%) patients were diagnosed on the basis of clinical presentation, whereas 123 (84.8%) exhibited a typical magnetic resonance imaging (MRI) picture. In 99 surgically treated patients, the diagnosis was confirmed on the basis of an intraoperative tissue biopsy. Among the 46 patients treated conservatively, 35 underwent a transpedicular biopsy, 4 patients underwent computed tomography-guided biopsy, 6 patients were diagnosed on the basis of material obtained from a cold abscess, and 1 patient underwent an open biopsy. The sensitivity of the culture for the detection of Mycobacterium tuberculosis was 66.80% (145/217) in our patients. Among the cases in which GeneXpert was used, the sensitivity for the detection of Mycobacterium tuberculosis was 93.4% (43/46). Moreover, the sensitivity of GeneXpert to detect rifampicin resistance was 100% (7/7) in our study. CONCLUSIONS: Majority of the patients with tuberculosis of the spine can be diagnosed on the basis of a typical radiological presentation via MRI. In our study, 84.8% cases exhibited typical MRI findings. For patients presenting with atypical MRI features, a rapid and accurate diagnosis is possible by combining GeneXpert with MRI. The combined use of MRI and GeneXpert is a rapid and highly sensitive tool to diagnose tuberculosis and rifampicin resistance in patients with tuberculosis of the spine. Furthermore, we achieved a 97.9% sensitivity for the detection of Mycobacterium tuberculosis and 100% sensitivity for the detection of rifampicin resistance in our study.
Abscess ; Biopsy ; Diagnosis ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Microscopy ; Mycobacterium tuberculosis ; Retrospective Studies ; Rifampin ; Sensitivity and Specificity ; Spine* ; Tuberculosis* ; Tuberculosis, Spinal

PURPOSE: To evaluate a customized, portable Farnsworth-Munsell 100 (FM 100) hue viewing booth for compliance with colour vision testing standards and to compare it with room illumination in subjects with normal colour vision (trichromats), subjects with acquired colour vision defects (secondary to diabetes mellitus), and subjects with congenital colour vision defects (dichromats). METHODS: Discrete wavelengths of the tube in the customized booth were measured using a spectrometer using the normal incident method and were compared with the spectral distribution of sunlight. Forty-eight subjects were recruited for the study and were divided into 3 groups: Group 1, Normal Trichromats (30 eyes); Group 2, Congenital Colour Vision Defects (16 eyes); and Group 3, Diabetes Mellitus (20 eyes). The FM 100 hue test performance was compared using two illumination conditions, booth illumination and room illumination. RESULTS: Total error scores of the classical method in Group 2 as mean+/-SD for room and booth illumination was 243.05+/-85.96 and 149.85+/-54.50 respectively (p=0.0001). Group 2 demonstrated lesser correlation (r=0.50, 0.55), lesser reliability (Cronbach's alpha, 0.625, 0.662) and greater variability (Bland & Altman value, 10.5) in total error scores for the classical method and the moment of inertia method between the two illumination conditions when compared to the other two groups. CONCLUSIONS: The customized booth demonstrated illumination meeting CIE standards. The total error scores were overestimated by the classical and moment of inertia methods in all groups for room illumination compared with booth illumination, however overestimation was more significant in the diabetes group.
Adolescent ; Adult ; Color Perception Tests/*instrumentation/*methods/standards ; Color Vision Defects/congenital/*diagnosis/etiology ; Diabetes Complications ; Equipment Design ; Humans ; *Lighting ; Middle Aged ; Young Adult

INTRODUCTIONThe aim of this study was to compare the occurrence of diabetic retinopathy in targeted screening diabetic patients (Group I) with newly diagnosed diabetic patients in general practice (Group II).

MATERIALS AND METHODSThis was an observational cross-sectional study. Data were obtained from 25,313 subjects who participated in the diabetic screening camps, and 128 newly diagnosed diabetes who presented to the diabetic retinopathy screening camps in general practice in rural and urban south India. The study variables were collected from all patients who underwent eye examination from the target screening detected diabetics [(n = 173) Group I] and those newly diagnosed in general practice [(n = 128) Group II]. The variations in prevalence of diabetic retinopathy and sight-threatening diabetic retinopathy in Group I and Group II and the factors affecting it were identified.

RESULTSThe occurrence of diabetic retinopathy was 6.35% (95% CI, 2.5-9.5) in Group I and 11.71% (95% CI, 5.6-16.4) in Group II. No significant difference was observed on occurrence of diabetic retinopathy, including sightthreatening retinopathy, in rural versus urban population and in Group I versus Group II. Patients diagnosed in general practice (Group II) with systolic blood pressure (BP) >140 were more likely to have retinopathy (P = 0.02).

CONCLUSIONSDiabetic retinopathy including sightthreatening complications was found at the time of diagnosis of diabetes in the targeted screening group as well as in newly diagnosed diabetics in the general practice group.

Adult ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2 ; complications ; Diabetic Retinopathy ; epidemiology ; prevention & control ; Family Practice ; Female ; Humans ; Hypertension ; complications ; India ; epidemiology ; Male ; Mass Screening ; Middle Aged ; Prevalence ; Rural Population ; Urban Population

PURPOSEThis prospective study aimed to investigate the epidemiologic parameters of supracondylar humeral fractures in children admitted to a teaching institution of a developing country primarily catering to rural population, to find any preventable cause of such injuries.

METHODSAll suspected cases of supracondylar humeral fracture reporting to emergency or outpatients department were analysed for various epidemiologic parameters including age, sex, laterality, time of presentation, associated injuries, neurovascular complications and classification over a period of four years.

RESULTSWe analysed a total of 263 patients and most of the fractures were seen in 5-8-year age group with a mean of 7.9 years. A total of 157 cases were males and non-dominant extremity was involved in 65% of fractures in our series. Fall on outstretched hand was the predominant cause of injury and fall from rooftop was the predominant mode. In all patients, 36.12% reported to our hospital 1 week after injury, 39.92% presented to hospital within 48 h after trauma and the remaining 23.95% presented 48 h to 1 week after trauma. None had a bilateral injury. Gartland type 3 fractures constituted 54.37% of patients, followed by type 1 (23.95%) and type 2 (21.67%).

CONCLUSIONAlmost one fourth of supracondylar humeral fractures in children can be prevented by installing railing of rooftops and stairs. It is necessary to educate people on hazards of treatment by traditional bonesetters. Moreover, the children with supracondylar humeral fractures should be screened for associated injuries.

In this study we examined the suitability of the-imidazo[4,5-]pyridine ring system in developing novel anticancer and anti-inflammatory agents incorporating a diaryl pharmacophore. Eight 2,3-diaryl-3-imidazo[4,5-]pyridine derivatives retrieved from our in-house database were evaluated for their cytotoxic activity against nine cancer cell lines. The results indicated that the compounds showed moderate cytotoxic activity against MCF-7, MDA-MB-468, K562 and SaOS2 cells, with K562 being the most sensitive among the four cancer cell lines. The eight 2,3-diaryl-3-imidazo[4,5-]pyridine derivatives were also evaluated for their COX-1 and COX-2 inhibitory activity. The results showed that compoundexhibited 2-fold selectivity with ICvalues of 9.2 and 21.8 µmol/L against COX-2 and COX-1, respectively. Molecular docking studies on the most active compoundrevealed a binding mode similar to that of celecoxib in the active site of the COX-2 enzyme.