scholarly journals Acanthamoeba Keratitis- Camouflage Entity in Eastern Nepal: A Case Series

2021 ◽  
Vol 4 (1) ◽  
pp. 59-63
Author(s):  
Sanjay Kumar Singh ◽  
Karthik Ambur ◽  
Prija Poudyal ◽  
Sagun Malla ◽  
Amit Rajbanshi
Keyword(s):  
Hand Movement ◽  
Case Series ◽  
Visual Outcome ◽  
Clinical Problem ◽  
Acanthamoeba Keratitis ◽  
Polymyxin B ◽  
Corneal Tissue ◽  
Neomycin Sulfate ◽  
Polymerase Chain ◽  
High Level

Acanthamoeba keratitis is a sight-threatening corneal infection and is a growing clinical problem in the world. Though Acanthamoeba keratitis is considered uncommon and rarely reported in Nepal, we encountered six cases in 2019. All patients had redness, photophobia, decreased vision, and pain with ring infiltrate. Ten percent potassium hydroxide mount revealed Acanthamoeba cyst in all cases. Non-nutrient agar overladen with Escherichia coli revealed feeding tracks and Polymerase Chain Reaction revealed T4 genotype Acanthamoeba in four cases. Amoebicidal treatment was started with chlorhexidine 0.02% eye drop half-hourly and supplementary treatment included moxifloxacin eye drop, a combination of polymyxin B sulfate, neomycin sulfate, and bacitracin eye ointment. After treatment, one patient had the best-corrected visual acuity of 6/9 while others had a visual outcome of hand movement. A high level of clinical suspicion and wet mount examination of specimen from infected corneal tissue are essential to aid in rapid diagnosis.

scholarly journals Acanthamoeba keratitis - Camouflage entity in Nepal

2020 ◽  
Author(s):  
Sanjay Kumar Singh ◽  
Karthik Ambur ◽  
Prija Poudyal ◽  
Sagun Malla ◽  
Amit Rajbanshi
Keyword(s):  
Hand Movement ◽  
Visual Outcome ◽  
Clinical Problem ◽  
Developed Countries ◽  
Acanthamoeba Keratitis ◽  
Diagnostic Techniques ◽  
Good Prognosis ◽  
Polymerase Chain ◽  
Vegetative Matter ◽  
Time Of Presentation

Abstract Background Acanthamoeba keratitis is a sight threatening corneal infection and is a growing clinical problem in developing countries as well as developed countries. Acanthamoeba keratitis is a local infection of the eye and does not produce systemic illness. Proper diagnostic techniques and appropriate medical management are necessary for good prognosis. Findings We report a series of six cases of acanthamoeba keratitis diagnosed and managed at Biratnagar Eye Hospital in the year 2019. The patients age ranges from 28-58 years, with four males and two females. The mean duration of presentation to hospital was 19 days. Four patients had trauma with vegetative matter. All patients had redness, photophobia, decreased vision, pain among which only two had pain out of proportion. One patient had visual acquity of 2/60 whereas the rest had hand movement to perception of light at time of presentation. Ring infiltrate was noted in all the cases. Five patients had ulcer in central and paracentral regions, four had ulcer larger than 6mm and three showed presence of hypopyon. KOH stained smears revealed acanthamoeba cyst in all cases while Gram stain was positive in only one case. Non-nutrient agar overladen with Escherichia coli revealed feeding tracks in four cases and polymerase chain reaction revealed T4 genotype acanthamoeba in four cases. Amoebicidal treatment was started with Chlorhexidine 0.02% eye drop half hourly. Other drugs Natamicin 5% eye drop half hourly, Fluconazole 0.3% eye drop half hourly and antibiotic Moxifloxacin 0.5% eye drop half hourly were also used simultaneously. Pain was reduced in all patients. After treatment, only one patient had BCVA of 6/9 while others had visual outcome of hand movement. Conclusions Acanthamoeba keratitis can be severe and vision-threatening. Centrally located ulcer, size of the ulcer > 6mm and visual acuity Hand Movement/Perception of light at the time of presentation were associated with poor outcome. Clinically suspected lesions associated with microbiological assessment help in early diagnosis and prompt treatment.

scholarly journals The Outcome of Vitrectomy in Acute Postoperative Endophthalmitis

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Sindy Boru Sembiring ◽  
Yulia Aziza ◽  
Gitalisa Andayani Adriono
Keyword(s):  
Visual Acuity ◽  
Clinical Diagnosis ◽  
Hand Movement ◽  
Case Series ◽  
Visual Outcome ◽  
Advanced Technology ◽  
Postoperative Endophthalmitis ◽  
Light Perception ◽  
Retrospective Case ◽  
Retrospective Case Series

Introduction: Twenty years ago, the results of Endophthalmitis Vitrectomy Study (EVS) were adapted worldwide as the standard management of endophthalmitis. The study suggested that there was no benefit of performing vitrectomy for acute postoperative endophthalmitis, unless for patients who presents with visual acuity of light perception. However, vitrectomy with advanced technology and technique has been changed rapidly in the last decades; therefore, we need to reconsider its role. We conducted a study and the purpose of our study was to describe the indications for vitrectomy and the outcomes in acute postoperative endophthalmitis at Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Methods: Our study was a descriptive-retrospective case series. We reviewed clinical and microbiological records of all patients with clinical diagnosis of acute postoperative endophthalmitis who underwent vitrectomy in Cipto Mangunkusumo Hospital between 2007 and September 2015.  Presenting visual acuity, visual outcome and complications were described. Result: Our study was a descriptive-retrospective case series. We reviewed clinical and microbiological records of all patients with clinical diagnosis of acute postoperative endophthalmitis who underwent vitrectomy in Cipto Mangunkusumo Hospital between 2007 and September 2015.  Presenting visual acuity, visual outcome and complications were described. Conclusion: An eight-year experience has taught us that vitrectomy offers better treatment outcome in the group with visual acuity of hand movement than those who only had visual acuity of light perception.

scholarly journals Lens induced glaucoma: An experience in tertiary eye care center in eastern Nepal

2017 ◽  
Vol 8 (2) ◽  
pp. 161-166 ◽  
Author(s):  
Rakshya Pant Sitoula ◽  
Indrajit Sarkar ◽  
Devdutta Nayak ◽  
Sanjay Kumar Singh
Keyword(s):  
Cataract Surgery ◽  
Care Center ◽  
Hand Movement ◽  
Case Series ◽  
Corneal Edema ◽  
Visual Outcome ◽  
Late Presentation ◽  
Delayed Presentation ◽  
Poor Visual Outcome ◽  
Prospective Case Series

Introduction: Lens Induced Glaucoma (LIG), is one of commonest cause of secondary glaucoma due to senile cataracts. The purpose of this study was to see the outcome of cataract surgery in patients with LIG. Methods: This was a prospective case series of 40 patients with LIG who presented to our hospital between April to June 2014. The purpose of this study was to look into the age and sex distribution, causes for delayed presentation, immediate post-operative visual outcome and the reasons for poor visual outcome. Result: There were 23 phacomorphic cases and 17 phacolytic glaucoma patients included in our study. The mean age at presentation was 63±10 years. Female to male ratio was 2.1:1. The majority of patients 57% presented after 2 weeks of symptoms and the reason for late presentation in more than half of the patients (52.5%) was financial constraints. At presentation, mean preoperative intra ocular pressure was 39±10 mm Hg. Following surgery, 36 of 40 eyes (90%) had an IOP less than 21 mm Hg at discharge. Visual acuity was either hand-movement or just perception of light in all eyes before surgery. At discharge, 26 of 40 operated eyes (65%) achieved 6/60 or better, 2 (5%) had less than 6/60 and 12 (30%) less than 3/60. The reasons for poor VA in these 12 patients were optic atrophy in 5 patients, uveitis in 5 patients, macular cause in one and corneal edema in one. Conclusion: Cataract surgery proves to be effective in lowering the Intraocular pressure and visual recovery in patients with lens induced glaucoma. 

scholarly journals Tectonic Graft for Persistent Leakage and Visual Outcome After Corneal Perforation Repair: A Case Series

2020 ◽  
Vol 58 (229) ◽  
Author(s):  
Rachana Rana ◽  
Leena Bajracharya ◽  
Reeta Gurung
Keyword(s):  
Road Traffic ◽  
Hand Movement ◽  
Case Series ◽  
Visual Outcome ◽  
Corneal Perforation ◽  
Tertiary Center ◽  
Visual Potential ◽  
History Of ◽  
Old Men ◽  
Corneal Laceration

Keratoplasty is a modality of treatment for large and leaking corneal perforation in a tertiary center. We report cases of 20and 30-years old men presented in an emergency with history of road traffic accident 1 and 3 days back. Best corrected visual acuity was hand movement in both injured eye. Slit lamp examination of both cases revealed full thickness corneal laceration with Siedel test positive. Both cases underwent corneal laceration repair with resuturing and corneal glue on consecutive days but couldn't seal the leaking wound. Then ultimately both were undergone for tectonic keratoplasty. The final best corrected visual activity of involved eye was 6/36 in case 1 and 6/24 in case 2. Most cases of traumatic corneal perforation undergone urgent corneal repair but sometimes very difficult to seal the wound. In such cases donor cornea tissue may have to be used to maintain integrity of globe and better visual potential.

scholarly journals Ocular and Systemic Manifestations in Paediatric Multisystem Inflammatory Syndrome Associated with COVID-19

2021 ◽  
Vol 10 (13) ◽  
pp. 2953
Author(s):  
Tzu-Chen Lo ◽  
Yu-Yen Chen
Keyword(s):  
Serum Antibody ◽  
Case Series ◽  
Pooled Analysis ◽  
Rt Pcr ◽  
Laboratory Findings ◽  
Systemic Manifestations ◽  
Polymerase Chain ◽  
Exposure History ◽  
Systemic Symptoms ◽  
Inflammatory Syndrome

This study aimed to achieve a better understanding of the epidemiological and clinical characteristics of multisystem inflammatory syndrome in children (MIS-C) following coronavirus disease 2019 (COVID-19). We searched PubMed and Embase between December 2019 and March 2021 and included only peer-reviewed clinical studies or case series. The proportions of patients who had conjunctivitis, systemic symptoms/signs (s/s), Kawasaki disease (KD), and exposure history to suspected/confirmed COVID-19 cases were obtained. Moreover, positive rates of the nasopharyngeal real-time reverse transcriptase polymerase chain reaction (RT-PCR) and serum antibody for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were recorded. Overall, 32 studies with 1458 patients were included in the pooled analysis. Around half of the patients had conjunctivitis. The five most common systemic manifestations were fever (96.4%), gastrointestinal s/s (76.7%), shock (61.5%), rash (57.1%), and neurological s/s (36.8%). Almost one-third presented complete KD and about half had exposure history to COVID-19 cases. The positivity of the serology (82.2%) was higher than that of the nasopharyngeal RT-PCR (37.0%). MIS-C associated with COVID-19 leads to several features similar to KD. Epidemiological and laboratory findings suggest that post-infective immune dysregulation may play a predominant role. Further studies are crucial to elucidate the underlying pathogenesis.

Clinical outcomes of the piggyback secondary implantation of a novel multifocal lens in the ciliary sulcus: A case series

2021 ◽  
pp. 112067212110294
Author(s):  
Gerardo Valvecchia ◽  
Guadalupe Cervantes-Coste ◽  
Oscar Asis ◽  
Federico Pereyra ◽  
Manuel Garza-León ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Case Series ◽  
Visual Outcome ◽  
Iol Implantation ◽  
Secondary Implantation ◽  
Intermediate Distance ◽  
Efficient Alternative ◽  
Monofocal Iol ◽  
Multifocal Lens ◽  
Prospective Case Series

Purpose: Evaluate the clinical outcomes of the secondary piggyback add-on IOL implantation in the ciliary sulcus for pseudophakic patients previously implanted with a monofocal IOL, who pursue a spectacle-free option after IOL surgery. Methods: A prospective case series including seven pseudophakic patients who underwent an in-the-bag monofocal IOL implantation. All eyes underwent a piggyback IOL implantation of the new sulcus designed A4 AddOn IOL in the ciliary sulcus as a secondary procedure for pseudophakic patients pursuing a spectacle-free option for near and intermediate distance after IOL surgery. Results: Seven eyes from six patients were included in this study, from which 4 (71.43%) were female, with a mean age of 58.33 ± 3.5 years (range 54–63; 95% CI 54.66, 62.01). The postoperative spherical equivalent at the 3-month visit was −0.10 m ± 0.82. Also, the UDVA was 0.11 ± 0.08 logMAR, the UIVA 0.01 ± 0.03, and the UNVA 0.01 ± 0.03 3 months after their surgical procedure. Conclusions: The A4 AddOn multifocal IOL’s secondary piggyback implant is an efficient alternative for monofocal pseudophakic patients seeking presbyopia solutions. This sulcus-designed IOL provides an optimal visual outcome for near and distance vision.

Retinotomy and retinectomy for anterior inferior proliferative vitreoretinopathy: Can visual outcome be improved?

2021 ◽  
pp. 112067212110128
Author(s):  
Mumin Hocaoglu ◽  
Murat Karacorlu ◽  
M. Giray Ersoz ◽  
Isil Sayman Muslubas ◽  
Serra Arf
Keyword(s):  
Proliferative Vitreoretinopathy ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Clinical Stage ◽  
Case Series ◽  
Visual Outcome ◽  
Attachment Rate ◽  
Good Visual Outcome ◽  
The Mean

Purpose: To describe the treatment outcomes and prognostic factors of retinotomy/retinectomy for rhegmatogenous retinal detachment (RD) complicated anterior inferior proliferative vitreoretinopathy (PVR). Methods: Retrospective, nonrandomized, single-center case series. The outcomes of 126 cases of retinotomy/retinectomy for RD complicated by advanced (Grade C) anterior inferior PVR managed consistently by one surgeon during a 15-year period were evaluated. Results: Forty-two eyes (33%) had primary RDs and 84 (67%) had recurrent RDs. The extent of retinotomy/retinectomy varied: 90° in 21 eyes (17%), >90° to <180° in 49 eyes (39%), and ⩾180° to ⩽240° in 56 eyes (44%). The retinotomy/retinectomy location was peripheral in 58 eyes (46%) and equatorial in 68 eyes (54%). The mean follow-up period was 43 ± 42 months. The silicone oil (SO) was removed from 98% of the eyes. The single-operation success rate after the primary retinectomy was 87%, and the final attachment rate was 94%. Visual acuity improved from 20/630 to 20/160 ( p < 0.001). Vision ⩾20/200 was achieved in 101 eyes (80%). Good visual outcome was correlated positively with preoperative VA ( p = 0.02), previous vitrectomy with gas tamponade ( p = 0.007), and was negatively correlated with number of previous RD operations ( p = 0.01), larger extent of RD ( p = 0.02) and more extensive retinotomy/retinectomy ( p = 0.04). Conclusions: An appropriate and timely intervention, including vitrectomy alone, inferior relaxing retinotomy/retinectomy and standard SO tamponade provide satisfactory outcomes for RDs complicated by PVR. Lesser extension of grade C PVR at baseline, such as PVR limited to one quadrant should encourage vitreoretinal specialists to consider retinotomy/retinectomy at a milder clinical stage of PVR development.

scholarly journals Repeated SARS-CoV-2 Positivity: Analysis of 123 Cases

Viruses ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 512
Author(s):  
Szilárd Váncsa ◽  
Fanni Dembrovszky ◽  
Nelli Farkas ◽  
Lajos Szakó ◽  
Brigitta Teutsch ◽  
...  
Keyword(s):  
Individual Patient Data ◽  
Case Reports ◽  
Severe Disease ◽  
Descriptive Analysis ◽  
Case Series ◽  
Disease Course ◽  
Chain Reaction ◽  
Baseline Characteristics ◽  
Polymerase Chain ◽  
Meta Analyses

Repeated positivity and reinfection with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) is a significant concern. Our study aimed to evaluate the clinical significance of repeatedly positive testing after coronavirus disease 2019 (COVID-19) recovery. We performed a systematic literature search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. With available individual patient data reporting on repeatedly SARS-CoV-2 positive (RSP) patients, case reports, and case series were included in this analysis. We performed a descriptive analysis of baseline characteristics of repeatedly positive cases. We assessed the cases according to the length of their polymerase chain reaction (PCR) negative interval between the two episodes. Risk factors for the severity of second episodes were evaluated. Overall, we included 123 patients with repeated positivity from 56 publications, with a mean repeated positivity length of 47.8 ± 29.9 days. Younger patients were predominant in the delayed (>90 days) recurrent positive group. Furthermore, comparing patients with RSP intervals of below 60 and above 60 days, we found that a more severe disease course can be expected if the repeated positivity interval is shorter. Severe and critical disease courses might predict future repeatedly positive severe and critical COVID-19 episodes. In conclusion, our results show that the second episode of SARS-CoV-2 positivity is more severe if it happens within 60 days after the first positive PCR. On the other hand, the second episode’s severity correlates with the first.

scholarly journals Molecular Confirmation of Salmonella typhimuriumin Poultry from Kathmandu Valley

2018 ◽  
Vol 4 ◽  
pp. 86-89 ◽  
Author(s):  
Sanjeev Kumar Adhikari ◽  
Arrogya Gyawali ◽  
Sajan Shrestha ◽  
Swoyam Prakash Shrestha ◽  
Meera Prajapati ◽  
...  
Keyword(s):  
Salmonella Typhimurium ◽  
Molecular Level ◽  
Kathmandu Valley ◽  
Agarose Gel ◽  
Chain Reaction ◽  
Pcr Assay ◽  
Selective Media ◽  
Poultry Products ◽  
Polymerase Chain ◽  
High Level

A prevalence study was carried to isolate Salmonella typhimurium from blood (n= 50) and gut samples (n=100) of poultry in Kathmandu valley during early 2016. Salmonella typhimurium bacteria isolated in the selective media were biochemically confirmed based on Bergey’s Manual. Two sets of oligonucleotide primers-the genus specific 16S rRNA and the organism specific invA were employed for molecular level confirmation by the Polymerase Chain Reaction (PCR) assay. The amplified fragments in 1% agarose gel observed at 406bp and 285bp, respectively confirmed the isolates to be Salmonella typhimurium. Of 150 samples tested, Salmonella typhimurium were isolated from 49 samples, among which nine were from blood (18%) and forty from the gut (40%). The present result indicated an alarmingly high level of Salmonella typhimurium, which can result inzoonotic infection in humans owing to increased contact with poultry and consumption of poultry products in the Kathmandu valley.

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