Progressive external ophthalmoplegia with hereditary sensory neuropathy: a rare association.
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Biomedical subjects
Publications and source records attributed to V A Rao.
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PURPOSE: To study the clinical presentation and treatment outcome of patients with ocular cysticercosis in southern India. METHODS: This study included 10 patients who were diagnosed to have ocular or adnexal cysticercosis over a period of one year in Pondicherry, India. The clinical presentation, results of investigation and treatment outcome of the cases were analysed retrospectively. RESULTS: Age of these patients ranged from 12 to 55 years. Four presented with loss of vision, two with a swelling in the eyelid, one with proptosis, one with diplopia and two with conjunctival involvement. ELISA for cysticercus antibodies in serum was positive in all cases. Albendazole and prednisolone were given for the treatment of these cases. Two patients responded well to treatment and were completely cured of the disease. There was partial improvement in 6 cases. Surgery in the form of excision was performed in two cases following a course of medical therapy. There was no significant change in visual acuity in eyes with intraocular cysticercosis following treatment. CONCLUSION: Ultrasonography B scan and ELISA for anticysticercal antibodies help to establish the diagnosis of ocular cysticercosis. A combination of oral albendazole and corticosteroids is found to be effective in confirmed cases. Intraocular cysticercosis is associated with a poor prognosis for vision.
Acanthamoeba keratitis is a potentially devastating infection of the cornea caused by the free-living amoebae, Acanthamoeba species. During the period from 1997 to 2000, a total of 136 corneal scrapings from clinically suspected cases were screened and examined for the presence of the Acanthamoeba. On examination of the direct smear by microscopy, 11 out of 136 cases were positive for Acanthamoeba. Eight patients were males and 3 were females. The age of these patients ranged from 15 to 57 years. All of these cases were agricultural workers who did not use contact lens. Four cases gave a history of injury to the eye and 1 patient gave a history of applying cow dung on the eye after the injury. Rest of the patients did not give any history of trauma or wearing contact lenses. The patients were treated with topical application of neosporin ointment. Many of our cases had complications such as poor vision (all 11 cases had 6/60 or less), scar formation (3 cases), opacity (5 cases) and corneal perforation (2 cases). This report documents for the first time the cases of Acanthamoeba keratitis in Pondicherry.
Acinetobacter spp. is emerging as a common cause of nosocomial infections. Community acquired ocular infections due to Acinetobacter are rare. Only one case of perforation of cornea has been reported previously, where old nomenclature was used to describe the causal agent. We report a case of corneal perforation due to Acinetobacter junii for which a therapeutic penetrating keratoplasty was conducted and the patient eventually recovered.
In this communication, a first case of intracameral gnathostomiasis in a 34 years old woman in Pondicherry and its successful surgical removal is reported. The clinical presentation and epidemiology of the disease are discussed.
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Preseptal cellulitis has a typically benign course when treated with antibiotics, the clinical course depending on age of the patient, aetiology and the causative organism. In this study, 14 cases of preseptal cellulitis are documented with the age ranging from 2 to 55 years. The organisms isolated were Staphylococcus aureus (7 cases), Streptococcus pyogenes (2 cases) and Pseudomonas aeruginosa (1 case). In the remaining four patients no organism could be identified. All except four patients were cured within 6 weeks. Complications seen included lagophthalmos, lid abscess, cicatricial ectropion and lid necrosis in one patient each. The prognosis for preseptal cellulitis is good with appropriate antibiotics and surgical therapy.
OBJECTIVE: To determine if those who produce methane (i.e., have presence of methane in breath) have higher serum cholesterol than those who do not produce methane in subjects with impaired glucose tolerance (IGT). RESEARCH DESIGN AND METHODS: We measured breath gases and fasting serum total and high-density lipoprotein (HDL) cholesterol and triglyceride (TG) levels in 21 subjects with IGT. RESULTS: The 11 methane-producers were well matched to the 10 non-methane-producers for age, sex, and body mass index. Methane-producers had higher fasting serum total (6.5 +/- 0.3 vs. 5.5 +/- 0.2 mmol/l; P < 0.02) and low-density lipoprotein (4.3 +/- 0.3 vs. 3.4 +/- 0.2 mmol/l; P < 0.05) cholesterol concentrations with no difference in TG or HDL levels. CONCLUSIONS: The results suggest that in subjects with IGT, positive methane-producing status may be associated with increased serum cholesterol levels.
Xeroderma pigmentosum (XP) is a rare genetic disease characterised by defective DNA repair leading to clinical and cellular hypersensitivity to ultraviolet radiation. The oculocutaneous features of 10 patients with XP were studied retrospectively. General features included parental consanguinity (40%), familiarity (60%), onset of symptoms in first 2 years (50%), malignant skin neoplasms (60%), and carcinoma of the tongue (20%). Among the ocular features, 50% of patients presented with photophobia. Lid freckles or atrophic skin lesions were seen in all patients. Lower lid tumours were seen in 30%, chronic conjunctival congestion in 40%, corneal opacification in 40%, squamous cell carcinoma of limbus in 20%, bilateral pterygium in 40%, and visual impairment in 50%. The clinical features (ocular and cutaneous) of the cases are discussed.
One hundred and thirty-nine cases of rhinosporidiosis diagnosed histopathologically over a period of 4 years were analysed. Nasal rhinosporidiosis is common among males who bathe in stagnant ponds while ocular rhinosporidiosis is common among urban females. There is a seasonal variation in the incidence of nasal and ocular rhinosporidiosis.
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The effects of the glycemic index (GI) of carbohydrate eaten the previous night on the glycemic response to a standard test meal eaten subsequently in the morning (breakfast) was studied. On separate evenings normal subjects ate low- or high-GI test meals of the same nutrient composition. The dinners consisted of single foods in two experiments and mixed meals containing several foods in the third. The differences between the observed glycemic responses to low- and high-GI dinners were predicted by their GIs. The glycemic responses to breakfast were significantly lower on mornings after low-GI dinners than after high-GI dinners. Eating, at dinner, foods with different fiber contents but the same GI had no effect on postbreakfast glycemia. We conclude that the GI predicts the difference between glycemic responses of mixed dinner meals; breakfast carbohydrate tolerance is improved when low-GI foods are eaten the previous evening.
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Of 650 patients who underwent various surgical procedures on the anterior segment in which 2% lidocaine hydrochloride plus 1:100,000 epinephrine was used as a local anesthetic, 5 experienced postoperative complications attributed to the anesthetic: ptosis (in 2 cases), horizontal rectus muscle palsy (in 2) and lagophthalmos (in 1). The cause of the complications may have been inadvertent direct infiltration of the anesthetic into the levator palpebrae superioris, the horizontal rectus muscles and the orbicularis oculi respectively. All the patients recovered spontaneously in 8 to 12 weeks. The clinical course was compatible with myotoxic effects of local anesthetics.
A rare case of malignant fibrous histiocytoma involving the whole eye is reported in an Oriental 60-year-old man. Six months' follow-up after exenteration did not show any evidence of local recurrence or distant metastases.
A 24-year-old East Indian woman presented with an inflammatory swelling in the supranasal quadrant of the left orbit and vertical diplopia. The motility disorder was of typical acquired Brown's syndrome. Histopathological examination of the lesion revealed Cysticercus cellulosae, a parasitic cyst known to produce a severe inflammatory reaction. To our knowledge this is the first report of acquired inflammatory Brown's syndrome caused by cysticercosis.
A rare case of diverticulum of the lacrimal sac associated with rhinosporidiosis is reported. The clinical presentation and possible pathogenesis are discussed.
Intravenous glucose tolerance tests were performed in undernourished and well-nourished normal pregnant women and for toxemic women near term. Both blood glucose and free fatty acid levels were analyzed, till 90 min after glucose load. The results suggested that glucose response to intravenous load was poor both in normal undernourished and toxemic women as compared to well-nourished women. However, the free fatty acid pattern was abnormal only in toxemic women in that the levels free fatty acid levels were analyzed, till 90 min after glucose load. The results suggested that glucose response to intravenous load was poor both in normal undernourished and toxemic women as compared to well-nourished women. However, the free fatty acid pattern was abnormal only in toxemic women in that the levels free fatty acid levels were analyzed, till 90 min after glucose load. The results suggested that glucose response to intravenous load was poor both in normal undernourished and toxemic women as compared to well-nourished women. However, the free fatty acid pattern was abnormal only in toxemic women in that the levels did not return to basal value even after 90 min of glucose load. Since human placental lactogen in pregnancy is known to regulate free fatty acid release for energy utilization, its deficiency in toxemia (commonly known to occur) could be implicated in the abnormal free fatty acid response seen in this investigation.