Biomedical subjects
H K Tiwari
Publications and source records attributed to H K Tiwari.
Photocoagulation of large iris cysts.
Large epithelial iris cysts, whose anterior walls are in contact with the corneal endothelium, are difficult to treat. Initial surgical decompression with later argon laser photocoagulation has been advocated, but the attendant complications are many. In four patients, we barraged the posterior wall of the cyst and the surrounding iris with the argon laser. The cyst was then collapsed using the argon or neodymium-yttrium aluminum garnet laser, and the anterior wall, which fell away from the cornea, was then photocoagulated. No recurrences or untoward sequelae were seen on follow-up. We recommend this noninvasive technique for all large iris cysts.
Platelet aggregation and retinal microangiopathy in diabetes and hypertension.
Platelet aggregation studies were done in 10 cases of diabetes with and without retinopathy and 7 cases of hypertensive retinopathy with adenosine diphosphate (ADP) and adrenaline (ADR). It was observed that the rate and degree of aggregation was significantly increased in the retinopathy group both with ADP and ADR. A significant alteration in the latent period was found with ADP, whereas no such change was found with ADR. It is proposed that the increased platelet reactivity in retinal microangiopathy could be due to different mechanisms. Increased sensitivity of the platelets to ADP resulting in the rapid inductive phase of aggregation together with accelerated intrinsic ADP release in diabetic retinopathy may cause hyperaggregation of platelets. Hyperaggregation in hypertensive retinopathy, however, may occur due to accelerated ADP release only. Platelet metabolism supporting the release reaction is altered in both.
Anti-insulin antibodies and retinopathy in juvenile onset type-1 diabetes.
Juvenile diabetics have severe loss of beta cell function and require replacement therapy with insulin. Insulin antigenicity can produce anti-insulin antibodies resulting in allergic reactions and insulin resistance. The role of insulin-anti-insulin antibody complexes in the development and progress of chronic diabetic complications like microangiopathy is not very clear. In the present study, there was statistically a significant trend of higher insulin antibody binding levels in IDDM patients who developed retinopathy. Though there was a trend of higher insulin antibody in IDDM patients with retinopathy, there was no association between insulin antibody and HLA antigen which some authors have reported.
Genetic marker in juvenile diabetic retinopathy.
Thirty five patients with insulin dependent diabetes mellitus (IDDM) were investigated for development of retinal microangiopathy by fluorescein angiography. HLA typing (A,B.C antigens) was done as a genetic marker. There was no statistically significant difference in the frequency of HLA antigens between patients without retinopathy (Gr.I) and with retinopathy (Gr.II) Frequency of various HLA antigens did not differ significantly in the mild and severe retinopathy groups or in comparison with controls. HLA B8 was significantly over represented in the patients of IDDM as a single group (GrI + II) when compared with controls (26% vs 8%). HLA profile was not a predictor of either the development or the severity of retinopathy in IDDM.
Risk factor profile in retinal detachment.
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