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Biomedical subjects

Supriyo Ghose

Publications and source records attributed to Supriyo Ghose.

18 recordsLinked to original sources

Evaluation of the stability of extemporaneously prepared ophthalmic formulation of mitomycin C.

Mitomycin C (MMC) is a cytostatic agent topically used in conjunctival neoplasms, secondary to glaucoma filtering, pterygium, and strabismus surgery to increase the success rate. The topical formulation of MMC for ocular use is always extemporaneously prepared. Our study evaluated the stability of extemporaneously prepared formulations of MMC at different concentrations (150, 300, & 600 microg/mL) kept at different temperatures (25 degrees , 4 degrees , and -70 degrees C) and at different pH range (6, 7, and 8). Aliquots from the above formulations were subjected for quantification of MMC on days 0, 7, 14, 21, and 28 using high-performance liquid chromatography. MMC stored at 25 degrees C for 6 months was also subjected to flow cytometry and compared to freshly prepared MMC. The results indicated that the degradation of MMC is very high in acidic pH at room temperature. Increasing the pH to 7 or 8 and keeping MMC at low temperatures significantly decreased the degradation of MMC. Interestingly, the flow cytometry data revealed that the 6-month-old MMC showed an antiproliferative effect compared to that of freshly prepared MMC. To conclude, the extemporaneously prepared MMC at pH between 7 and 8 and stored in the refrigerator can increase the duration of its stability. However, the antiproliferative study using flow cytometry revealed that degraded MMC retained its activity even after degradation.

Antibiotics, Antineoplastic↗

Orbital ectopic glial tissue in relation to medial rectus: a rare entity.

Heterotopic brain tissue is a rare entity and it is rarer still in the orbit. There have been very few case reports of orbital ectopic glial tissue. The case is described herein of a 3-month-old baby presenting with an orbital glial hamartoma inseparable from the medial rectus muscle. The diagnosis was based on the histopathological features and a positive GFAP stain. The features of this case and the previously reported cases are discussed.

Brain↗

Pattern of orbital exenteration in a tertiary eye care centre in India.

PURPOSE: This study aimed to determine the clinical indications for orbital exenteration, profile of these patients and clinicopathological correlations, and to compare these results with previous published data. METHODS: A retrospective analysis was conducted of exenterations performed in adults at a tertiary eye care centre in India over a period of 10 years (January 1990 to December 2000). Patient records were reviewed to obtain demographic data, presenting symptoms and their duration, laterality, and clinical and histopathological diagnosis. RESULTS: A total of 26 cases were identified. Patients ranged in age from 32 to 72 years (mean +/- SD 58.7 +/- 9.23 years). No sex predilection was observed. Classification of cases on histopathological criteria showed that exenterations were performed mostly for squamous cell carcinoma (10 cases), followed by sebaceous gland carcinoma (six cases) and basal cell carcinoma (two cases) of the eyelid. Conjunctival malignant melanoma contributed to 5 of 26 cases of exenteration. Adenoid cystic carcinoma of the lacrimal gland (one case), neurofibroma (one case) and orbital fungal infection (one case) were the other indications of exenteration. The clinicopathological correlation was 100% for squamous cell carcinoma, 100% for basal cell carcinoma, 80% for malignant melanoma and 75% for sebaceous gland carcinoma. CONCLUSION: Exenteration is mainly performed as a life-saving treatment for advanced malignant tumours with epithelial tumours being the commonest. In comparison to previous published data, the indications of surgery in India differed, as squamous cell carcinoma and sebaceous gland carcinoma were the commonest indications for exenteration.

Adult↗

Evaluation of polytetrafluoroethylene suture for frontalis suspension as compared to polybutylate-coated braided polyester.

PURPOSE: To evaluate the efficacy of polytetrafluoroethylene (Gore-Tex) suture as compared to polybutylate-coated braided polyester (Ethibond) suture as sling materials for frontalis suspension in bilateral congenital ptosis. METHODS: Frontalis sling surgery by modified Crawford's double triangle technique was performed on 30 patients (60 eyes) with bilateral ptosis. The patients were randomized into two groups depending on the type of suture material used: polytetrafluoroethylene or braided polyester. RESULTS: Polytetrafluoroethylene suture achieved a statistically significant better and more stable ptosis correction, with slightly more lagophthalmos, than braided polyester suture over a mean (+/- SD) follow-up period of 16 +/- 3.24 months. There were more postoperative complications with braided polyester suture, but the difference was not statistically significant. CONCLUSION: This is the first clinical study in which polytetrafluoroethylene in the form of suture has been studied. Polytetrafluoroethylene suture was found to be a safe and effective sling material for frontalis suspension and it can be recommended for clinical use.

Adolescent↗

Pleomorphic adenomas of the lacrimal gland: a clinicopathological analysis.

PURPOSE: To analyse retrospectively 32 cases of pleomorphic adenoma of the lacrimal gland diagnosed over a 10-year period in a tertiary referral eye centre from North India. METHODS: The clinical features of 32 cases of pleomorphic adenomas diagnosed between 1991 and 2000 were analysed and the histopathological features reviewed light microscopically. RESULTS: Among the clinical features, a marked male predominance with younger age of presentation and left-sided dominance was noted. The duration of symptoms was less than 10 months in 28% cases. Histopathologically, the features included presence of cystic degeneration (15.6%) and squamous metaplasia (18.7%). Calcification, osteoid formation and malignant transformation (3.1% each) were occasionally observed. CONCLUSIONS: Pleomorphic adenomas of the lacrimal gland may present with duration of symptoms of less than 10 months. Cystic degeneration, squamous metaplasia, calcification or ossification may be observed in lacrimal gland pleomorphic adenomas, as has been described in pleomorphic adenomas of salivary glands. However, the presence of calcification and bone erosion radiologically in a lacrimal gland tumour does not necessarily indicate malignancy.

Adenoma, Pleomorphic↗

A prospective randomized double masked controlled clinical trial to determine the efficacy of multiple drop centbucridine as an ocular surface anaesthetic.

In this study, the ocular surface anaesthetic and analgesic efficacies of 0.5% and 1% centbucridine both in saline were compared with 4% lignocaine drops in distilled water in normal healthy volunteers divided into three equal groups. In 99 healthy eyes, keeping one eye as an unanaesthetized control, one drop of any of the above three coded drugs was instilled in the contralateral eye, followed by one more drop of the same drug in the same eye after 3 minutes. The oneset of anaesthesia, achievement and duration of peak activity, total duration of action, the depth of analgesia, and period of burning sensation were all noted in this double-masked randomized controlled trial with the various drug solutions. Total peak duration of anaesthetic as well as analgesic effects in the 99 healthy normal eyes were found to be the highest with centbucridine 1%, followed by 4% lignocaine and 0.5% centbucridine respectively.

Anesthetics, Local↗

Conjunctival malignant melanoma.

A 65-year-old woman was diagnosed clinically to have a tarsal conjunctival malignant melanoma of the upper eyelid. She also had multiple, diffusely pigmented, flat conjunctival lesions. No local or distant metastasis was detected. She was treated conservatively by a combination of surgery and cryotherapy as this was her only seeing eye. Histopathology of the tumor tissue and biopsy specimens of the flat conjunctival lesions proved them to be conjunctival malignant melanoma and primary atypical melanosis with atypia, respectively. Over a follow-up of two years, no clinical recurrence of the tumor was seen. To conclude, a malignant melanoma arising from the tarsal conjunctiva is extremely rare. The goal of treatment should be eradication of the tumor as well as preservation of a functionally and cosmetically acceptable eye.

Aged↗

Phthisis bulbi with a large protruding foreign body--a rare complication of penetrating injuries.

Spontaneous extrusion of a retained intraocular foreign body is a rare occurrence. An unusual case is described in a 30-year-old male, where a foreign body remained in the eye for four years and then, as phthisis set in, the foreign body gradually extruded, causing constant irritation of the upper lid. Such a situation has not been documented before. Its management along with the histopathologic features are discussed in the light of the available literature.

Adult↗

Centbucridine, a newer topical anaesthetic compared with lignocaine: a randomized double masked single drop instillation clinical trial.

A randomized double-masked single drop instillation clinical trial was conducted on 60 healthy volunteers divided into 3 equal groups to compare the efficacies of centbucridine and lignocaine. One eye of each volunteer was instilled with a single drop of either 0.5% centbucridine hydrochloride, 1% centbucridine hydrochloride or 4% lignocaine hydrochloride, with the other eye as an unanaesthetized control-side effects, if any, were also recorded. The onset of anaesthesia assessed both objectively and subjectively, was quickest with lignocaine 4% (P < 0.001) followed by centbucridine 0.5% and 1%. However, the period of peak activity as well as the total duration of surface anaesthesia, and also the depth of analgesia, were significantly highest with 1% centbucridine, followed by 0.5% centbucridine and 4% lignocaine respectively. Minor side effects like burning sensations were longest with 1% centbucridine--no significant adverse effects, local or systemic, were observed. Prolonged surface anaesthetic and analgesic actions of centbucridine 1% may be advantages for longer duration ophthalmic microsurgeries.

Administration, Topical↗

Evaluation of amniotic membrane grafting in the reconstruction of contracted socket.

PURPOSE: To study the use of amniotic membrane for the reconstruction of mild to moderate grades of contracted socket and compare it to mucous membrane grafting. METHODS: A total of 20 patients with acquired, anophthalmic contracted socket of mild to moderate grades were studied and divided into two groups: the amniotic membrane graft (AMG) group (10 patients) and the mucous membrane graft (MMG) group (10 patients). The preoperative and postoperative measurements of forniceal depth and volume of socket were compared. After surgery, motility of the prosthesis was also compared. RESULTS: The mean preoperative depth of the lower fornix in the AMG group and the MMG group was 1.5 mm and 1.4 mm, and after surgery, at final follow-up was 5.4 mm and 5.5 mm, respectively. The preoperative mean height of the upper fornix in the AMG group and the MMG group was 10.3 mm and 10.7 mm, and after surgery, at final follow-up was 12.6 mm and 13.2 mm, respectively. The mean preoperative volume of the socket was 0.84 ml in the AMG group and 0.80 ml in the MMG group, and after surgery, at final follow-up was 1.43 ml and 1.48 ml, respectively. The various quantitative parameters including motility of the prosthesis were comparable in the two groups. CONCLUSIONS: Amniotic membrane grafting gave cosmetically and functionally acceptable results in cases of mild to moderate grades of anophthalmic socket contraction. The results were comparable to those of mucous membrane grafting.

Adolescent↗

Visual outcome in macular retinoblastoma treated with primary chemotherapy.

In this prospective clinical study, we treated 8 patients (8 eyes, 11 tumors) of macular retinoblastoma with chemotherapy alone, with the aim of avoiding visual loss because of retinal damage by radiation or adjuvant therapy and to assess their final visual outcome. The mean basal dimension of the tumor was 5.0 +/- 2.6 mm and the mean height was 2.9 +/- 1.3 mm. The fovea was involved in 4 patients (50%) and foveal detachment was present in 3 patients (37.5%). All the patients required less than 6 cycles for tumor control. Four patients (50%) obtained visual acuities ranging from 20/25 to 20/200. Two patients (25%) could gain visual acuity of 20/20. The mean follow-up of patients was 3.24 +/- 0.9 years (range 2-5). No patient developed recurrence or metastatic disease. In conclusion, recent trends for ocular salvage have favored chemoreduction followed by focal therapy for the treatment of retinoblastoma. This study supports the consideration of chemotherapy alone as the primary treatment in eyes with macular retinoblastomas, under close supervision, with satisfactory visual outcome.

Antineoplastic Agents, Alkylating↗

Atypical presentations of retinoblastoma.

PURPOSE: To study the atypical presentations of retinoblastoma in our institution. METHOD: Retrospective, clinical study. RESULTS: A total of 392 cases of retinoblastoma were reviewed; 72.2% of the patients had leukocoria, 13% had proptosis, 10% had strabismus, 1.5% were asymptomatic (detected on screening), and 3.3% had atypical presentations. Fourteen different atypical findings were observed including endophthalmitis (0.76%), secondary glaucoma (0.76%), uveitis (0.5%), corneal edema (0.5%), phthisis bulbi (0.5%), orbital cellulitis (0.5%), cataract (0.25%), pseudohypopyon (0.25%), iris nodules (0.25%), hyphema (0.25%), iris neovascularization (0.25%), microphthalmos (0.25%), exposure keratopathy (0.25%), and corneal blood staining (0.25%). All of the patients had Reese-Ellsworth grade V disease. On histopathology, invasion of neighboring structures was seen in 10 patients. All patients underwent enucleation with adjuvant radiotherapy, chemotherapy, or both. CONCLUSIONS: Retinoblastoma can mimic any orbital or ocular pathology. Atypical presentations of retinoblastomas are usually associated with advanced disease. The possibility of ocular tumor should be entertained whenever there is an unusual presentation that is unresponsive to the usual therapy. Ultrasonography and computed tomography should be performed in all such patients, especially if the posterior segment is not visible.

Adolescent↗

Atypical oculo-orbital complex choristoma in organoid nevus syndrome.

We report organoid nevus with left oculo-orbital choristoma fixing the globe in hypotropia, precanthal skin tag, and upper eyelid coloboma and right limbal dermoid. Computed tomography revealed a dilated lateral ventricle and cerebral atrophy. No neurologic deficit existed. The coloboma was repaired, choristoma debulked, and precanthal tag excised.

Calcinosis↗

Nasal endoscopy in congenital dacryocystitis.

PURPOSE: Controversy exists regarding the relationship between nasal pathology and congenital dacryocystitis. The recent advent of nasal endoscopes has greatly improved visualization of deep and hidden areas of nasal anatomy and has led to the elaboration of nasal anatomical variants and pathologies that were previously unknown. The current study aimed to evaluate for associations, if any, between anatomical abnormalities or variations in the lateral nasal wall and the presence and resolution of congenital dacryocystitis. PATIENTS AND METHODS: Phase I was a case-control study that compared the incidence of a predefined set of nasal endoscopic variations in infants with congenital dacryocystitis versus normal infants. Phase II was a cohort study that evaluated the impact of nasal endoscopic variations on the effectiveness of conservative treatment for congenital dacryocystitis. "Failure" to respond to conservative treatment measures was defined as the persistence of symptoms at the first birthday. RESULTS: Inferior turbinate hypertrophy and inferior meatal narrowing were significantly more frequent in the case group than in the control group. Conservative treatment measures resulted in 70 of 83 resolved cases on subsequent follow-up. The occurrence of inferior turbinate hypertrophy or inferior meatal narrowing at final examination was associated with non-resolution. The relative risk of non-resolution with inferior turbinate hypertrophy or inferior meatal narrowing was 7.7 (confidence interval, 2.32 to 25.72) and 12 (confidence interval, 3.7 to 39.2), respectively. CONCLUSION: Inferior turbinate hypertrophy and inferior meatal narrowing are more frequent in cases of congenital dacryocystitis. They are predictive of a poor outcome when congenital dacryocystitis is treated with conservative measures. This information should be considered when making clinical decisions for patients with congenital dacryocystitis.

Case-Control Studies↗