Role of intrastromal vancomycin in recalcitrant corneal abscess after phacoemulsification

2021 ◽  
Vol 14 (5) ◽  
pp. e241709
Author(s):  
Mohit Chhabra ◽  
Ruchi Goel ◽  
Samreen Khanam ◽  
Sonam Singh

Side port infection and corneal abscess after cataract surgery can produce devastating outcomes. Topical antibacterial drugs are the mainstay in management of these cases. Although intrastromal antifungal agents are an established modality for fungal keratitis, such use of antibacterial agents is rarely reported due to better pharmacokinetic profile of antibacterial agents.We report a case of methicillin-resistant Staphylococcus aureus corneal abscess following phacoemulsification that responded to intrastromal vancomycin injection in addition to conventional therapy.This case of postphacoemulsification corneal abscess highlights the importance of postoperative hygiene practices, use of anterior segment optical coherence tomography for monitoring these patients and use of intrastromal vancomycin as an adjunct to topical and systemic therapy.

2006 ◽  
Vol 50 (8) ◽  
pp. 2797-2805 ◽  
Author(s):  
Jingsong Zhu ◽  
Paul W. Luther ◽  
Qixin Leng ◽  
A. James Mixson

ABSTRACT A family of histidine-rich peptides, histatins, is secreted by the parotid gland in mammals and exhibits marked inhibitory activity against a number of Candida species. We were particularly interested in the mechanism by which histidine-rich peptides inhibit fungal growth, because our laboratory has synthesized a variety of such peptides for drug and nucleic acid delivery. In contrast to naturally occurring peptides that are linear, peptides made on synthesizers can be varied with respect to their degrees of branching. Using this technology, we explored whether histidine-lysine (HK) polymers of different complexities and degrees of branching affect the growth of several species of Candida. Polymers with higher degrees of branching were progressively more effective against Candida albicans, with the four-branched polymer, H2K4b, most effective. Furthermore, H2K4b accumulated efficiently in C. albicans, which may indicate its ability to transport other antifungal agents intracellularly. Although H2K4b had greater antifungal activity than histatin 5, their mechanisms were similar. Toxicity in C. albicans induced by histatin 5 or branched HK peptides was markedly reduced by 4,4′-diisothiocyanato-stilbene-2,2′-disulfonate, an inhibitor of anion channels. We also determined that bafilomycin A1, an inhibitor of endosomal acidification, significantly decreased the antifungal activity of H2K4b. This suggests that the pH-buffering and subsequent endosomal-disrupting properties of histidine-rich peptides have a role in their antifungal activity. Moreover, the ability of the histidine component of these peptides to disrupt endosomes, which allows their escape from the lysosomal pathway, may explain why these peptides are both effective antifungal agents and nucleic acid delivery carriers.


2006 ◽  
Vol 54 (4) ◽  
pp. 583-587 ◽  
Author(s):  
Poongavanam Vasanthanathan ◽  
Manickavasagam Lakshmi ◽  
Marianesan Arockia Babu ◽  
Arun Kumar Gupta ◽  
Sathish Gopalrao Kaskhedikar

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Georgia Siasou ◽  
Gerasimos Siasos ◽  
Marilita M Moschos ◽  
Nikolaos Gouliopoulos ◽  
Evangelos Oikonomou ◽  
...  

Introduction: Primary open-angle glaucoma (POAG) is one of the most prevalent causes of irreversible blindness and is associated with endothelial dysfunction and arterial stiffness. Pseudoexfoliative glaucoma (PEG) is another type of glaucoma observed in pseudoexfoliation syndrome. It is characterized by the deposition of pseudoexfoliative material not only to the anterior segment of the eye, but also to the vessels, heart and other organs. Hypothesis: Endothelial function and arterial stiffness are impaired in patients with POAG and PEG supporting the significant role of vascular function impairment in the progression of the disease. Methods: Forty four POAG patients, 22 PEG and 38 healthy subjects (Cl) were included in this study. All subjects were free of cardiovascular or inflammatory diseases. Endothelial function was evaluated by flow-mediated dilatation (FMD). Carotid-femoral pulse wave velocity (PWV) was measured as an index of aortic stiffness and augmentation index (AIx) as a measure of arterial wave reflections Results: Between the three study groups CL, POAG, PEG there was no difference in age (67±10years vs. 70±9years vs. 66±12yeras, p=0.12) or prevalence of male sex (70% vs. 57% vs. 50%, p=0.21). Importantly, there was a linear impairment of FMD (7.35±2.77% vs. 6.58±3.18% vs. 4.88±3.29%, p=0.006), PWV (7.98±1.56m/sec vs. 9.20±1.84m/sec vs. 9.22±2.16m/sec, p=0.004) and AIx (21.29±8.77% vs. 25.14±5.71% vs. 28.20±8.75%, p=0.002) from CL to POAG and PEG. Interestingly post hoc test after Scheffe correction revealed also that PEG subjects had not only significantly impaired FMD, compared to control subjects, but also compared to POAG subjects (4.88±3.29% vs. 6.58±3.18%, p=0.02). Conclusions: Endothelial function and arterial stiffness are significantly impaired in patients with pseudoexfoliative glaucoma. These findings shed some light in the pathophysiology of pseudoexfoliative glaucoma and support the theory that pseudoexfoliative fibrils may also accumulate and damage the arterial wall.


Author(s):  
Sanjay Changole ◽  
Smita Dhane ◽  
Nilesh Agrawal

Background: Circumcision has been the traditional treatment for phimosis, but with some controversies due to complications. The current study was undertaken to evaluate the effectiveness of topical steroid therapy as primary treatment for childhood phimosis.Methods: A prospective observational study was conducted and a total of 100 patients (age- 3 to 12 years) of phimosis were enrolled. The management consisted of topical application of 0.05% betamethasone Ointment for 4 weeks. Those with partial response were advised additional 2 weeks of therapy. Failure to treatment cases were subsequently subjected to circumcision.Results: Total 100 patients were enrolled in the study. Out of 100 patients, 9 were excluded because of non-compliance and remaining 91 patients were studied and followed up. 85 cases out of 91 (93.4%) were declared a ‘success’; while remaining 6 (6.6%) were declared ‘failure’ and were subjected to circumcision. Of the 85 successfully treated; majority (70, 82.3%) responded within 4 weeks of treatment and 15 (17.6%) responded in 6 weeks. The highest number of patients who responded to treatment within 4 weeks were < 5 years of age (54, 93.1%) (p<0.05).Conclusions: Topical steroid (0.05% betamethasone ointment) is an effective, safe, conservative and non-surgical method of primary treatment of childhood Phimosis, especially when combined with good hygiene practices of foreskin with daily retraction and cleansing.


Mäetagused ◽  
2021 ◽  
Vol 79 ◽  
pp. 35-54
Author(s):  
Tatsiana Valodzina ◽  
◽  
Tatsiana Marmysh ◽  

The article gives an overview of the folk culture mechanisms that helped to cope with the pandemic situation in Belorussia during the first wave of COVID-19 (until midsummer 2020). The article is based on the qualitative analysis of interview texts related to the pandemic as well as the content of internet users’ visual reactions (memes, poems, proverbs). In folk culture the mechanisms helping to overcome the crisis situation often have a ritual-magical nature. When describing the influence of the pandemic on some practices, the authors conclude that their performing in the crisis situation was especially important for the community. One of the ancient rituals activated for preventing the epidemic was the creation of a magic circle around the village by conducting a procession around the village with a ritual towel (‘rushnik-abydzionnik’), which had to be made within one day. On March 28, this one-day-ritual was performed in Minsk with the greatest possible adherence to tradition. The initiators and participants of the practice were mainly representatives of the Students Ethnographic Society. Not all women present knew how to spin or weave, but some of the simplest operations were mastered. The towel was carried around Minsk and brought to a stone on the site of a pagan temple in the centre of Minsk at the sunset. The towel was tied around the stone, and the latter was also covered with threads spun on the same day. The ritual relieved the tension of the participants and fostered awareness of their solidarity, strengthening collective networks, and the feeling of empathy and unity. COVID-19 also affected the living traditions in Belarus. Some traditional practices were cancelled or postponed. The spread of the pandemic created a negative backdrop for living traditions. However, a number of rites and ceremonies were carried out despite the pandemic in accordance with their spatial and temporal reference. Due to the difficult epidemiological situation, the usual order of ceremonies was changed – their duration was reduced without changing the traditional rite structure. Only local residents participated in the rituals; although, formerly, many journalists and tourists had come to the villages from different parts of the country on the days of the ceremonies. For tradition bearers, such practices during a pandemic are a way to relieve stress and to share problems with people with similar interests. Traditions are one of the constants of their life; maintaining them in times of crises stabilizes the community. The coronavirus pandemic has caused a powerful explosion of folk art. The texts of various genres, both oral and written (graphic), are rapidly spreading on the Internet. A large number of them are based on the traditional worldview of Belarusians and are expressed in traditional forms (alterations, ditties, anecdotes, anti-sayings, paroemias, etc.). The role of humour has grown tremendously. Jokes and laughter in the face of an external threat are a compensatory mechanism that helps to overcome fear and uncertainty, and common laughter unites and helps to learn new rules of behaviour. Humour is not concerned with the threat of getting ill, but rather individual hygiene practices, the situation of quarantine, and circumstances of the new reality. Thus, humorous folklore becomes a way to adapt to new norms and to overcome fear and instability.


2021 ◽  
pp. 89-93
Author(s):  
A.E. Babushkin ◽  

Inflammatory eye diseases are one of the most important problems of ophthalmology. They can be caused by various pathogens of the infection, which is still more often bacterial. Therapy of bacterial inflammatory diseases of the eye involves the use of antibacterial drugs (sulfonamides, antiseptics, nitrofurans, etc.), among which antibiotics are of primary importance. Of this group of drugs, in this review article, special attention is paid to quinolones, mainly synthetic fluoroquinolones, which are distinguished by a wide range of bactericidal action, fairly high efficiency, low level of resistance of microorganisms to it and the frequency of side effects, as well as good tolerability by patients, i.e. they best meet the requirements for modern topical antimicrobial agents. In certain clinical situations and indications, it is advisable to use ophthalmic antiseptics and combined preparations containing several antibiotics of different effects at once, or an antibiotic and a corticosteroid. Key words: infectious and inflammatory eye diseases, antibacterial agents, antibiotics, combined preparations, antiseptics.


PEDIATRICS ◽  
1987 ◽  
Vol 80 (1) ◽  
pp. 107-110 ◽  
Author(s):  
Henry J. Herrmann ◽  
Michael W. Roberts

The pediatrician can assist the dental profession in preventing dental disease and maintaining the oral health of children. Pediatricians are urged to counsel parents in dietary and oral hygiene practices that will prevent dental caries and to refer patients for professional dental care when appropriate. Systemic fluoride supplements should be prescribed when needed but only after a careful review of requirements and daily consumption.


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