Biomedical subjects
Publications and source records attributed to H Kumar.
We are reporting a case which developed idiosyncratic anterior granulomatous uveitis following a single dose of subconjunctival 5 Fluorouracil. This has not been previously reported anywhere in the world.
Hundred patients of open angle glaucoma (OAG) who were on any one of the three drugs pilocarpine, timolol and epinephrine--for an average period of 3.3 years were chosen. Proforma regarding socio-economic status and the patients' reaction to long-term medication were recorded. Though the objective and subjective effects of long term medication were negligible the financial constraints were considerable. More than 70% patient would prefer laser's and surgery because of the cumbersome schedule and financial burden. The visit to the clinic was a time consuming process suggesting a lack of adequate glaucoma follow-up at the peripheral level. The study reflects a need for reorientation of glaucoma management.
A case is reported of a 9-year old male who presented with abnormal behaviour and progressive diminution of vision. Pupils were middilated in both eyes but the pupillary reflexes were preserved. Fundus examination revealed a bilateral optic atrophy and radiological investigations showed a bilateral occipital calcification. We hereby document a case of retrograde transsynaptic neuronal degeneration of the visual system secondary to bilateral occipital lesions. Transsynapptic neuronal degeneration of optic nerves consequent to occipital lobe lesions is a rare phenomenon. Experimentally occipital lobe ablation in non-human primates has been shown to result in optic atrophy. Herein, we document a case of retrograde transsynaptic neuronal degeneration of the visual system secondary to bilateral occipital lesions.
A case of destructive ocular myiasis resulting in complete loss of the globe in two days time is documented. To the best of our knowledge this is the first report of such a severe involvement in a healthy and non-compromised host. Mechanical removal and good local hygiene helped heal the wound. The larvae were isolated to be that of Chrysomyia bezziana (screwworm fly). This is possibly the first report of destructive ocular myiasis caused by Chrysomyia bezziana from the Indian subcontinent and the second in world literature. Infestation of human eyes with larvae of flies (myiasis) has been reported. Serious consequences of destructive myiasis are seen in emaciated and diseased patients. Only one report of total destruction of the globe by maggots of Chrysomyia bezziana exists in the literature. As in previous communications, the patient in this report had no predisposing factors both systemic and local. We here in document a case of orbital myiasis leading to rapid destruction of the globe within two days in a healthy and a non-compromised patient.
A prospective double blind study was carried out to evaluate the role of soluble antigen fluorescent antibody (SAFA) test to detect ocular Tuberculosis. The study material comprised 39 patients with suspected ocular tuberculosis suffering from interstitial keratitis, sclero keratitis, granulomatous uveitis, phlyctenular keratoconjunctivitis, Eales disease and central serous retinopathy. The cases of proven ocular tuberculosis showed up as 70 percent strong reactors and 30 percent weak reactors to SAFA while none had a negative response to SAFA. Of these cases skin hypersensitivity reaction was positive only in 40 percent of the cases. The control group revealed a strong SAFA reaction in only 4 percent of cases with a weak reaction in 44 percent of cases. It thus appears that SAFA test can provide a useful addition to the routine tests in diagnosing tuberculosis.
Filtering surgery for glaucoma usually controls the intraocular pressure adequately. However, in glaucoma patients with aphakia, neovascularisation of iris, previous failed filtering surgeries and relatively young patients, results of surgery leave much scope for improvement. Most failures of filtering surgery are related to extra-ocular factors. Histopathological studies of eyes after failed filtering operations have suggested that proliferation of fibroblasts and deposition of collagen constitute a barrier to filteration. There is also a positive correlation between success of filtering surgery and inhibition of fibroblast growth by the patients aqueous humour. Thus agents inhibiting fibroblast proliferation should play an important role in increasing the success rate of filtering surgery. 5 Fluorouracil is a pyrimidine analogue which has been utilised for over 15 years as an antimetabolite in cancer therapy. Its efficiency in inhibiting fibroblast proliferation in vitro and in rabbit eyes has been proved beyond doubt. We undertook a pilot project to estimate the efficiency of the subconjunctival 5 FU to increase the changes of success in problematic cases of glaucoma in pigmented eyes.
The microsurgical instruments should be chosen such that they are less than 10 cm long, made of titanium, dulled, have very little closing pressure and the working parts do not open more than 10mm. They should be cleaned with ultrasonic cleaners and sterilised preferably by Ethylene oxide, though Cidex and dry heat can also be used.
A case of multiple wooden foreign bodies is presented. Any case presenting with a history of injury and a discharging sinus with osteomyelitis warrants a thorough exploration of the orbit. Anterior orbitotomy was performed and 4 pieces of arhar sticks were taken out. The guidelines for the management of the wooden foreign bodies are highlighted.
A prospective study was carried out on 27 patients with optic neuritis. Besides detailed clinical examination, visual evoked responses (VER) were studied utilising the checker board pattern reversal and flash stimuli. The recording with the 30 minute check size was found to be the most consistent both for the controls and the patients. Flash evoked VER was most useful in determining the wave form in cases with severe disruption of the visual pathways. Neither the implicit time nor the amplitude of the VER could be directly correlated to the visual acuity changes or other clinical parameters. Implicit time offered a more reliable criterion for evaluation as compared to the amplitude in patients with optic neuritis. The VER recording helps in serial follow-up of a patient and can indicate previous attacks suffered by the patient.
Explore the source record for details and available documents.