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Biomedical subjects

L Verma

Publications and source records attributed to L Verma.

At least 37 records · Page 2Linked to original sources

Optic neuritis following albendazole therapy for orbital cysticercosis.

PURPOSE: To report the occurrence of optic neuritis following oral albendazole therapy for orbital cysticercosis. METHODS: Two patients having definitively diagnosed orbital cysticercosis at the orbital apex developed an acute visual loss 1 week after initiation of oral albendazole. Ultrasonography and magnetic resonance imaging determined that the cause was optic neuritis due to disorganization of the cyst with inflammation of the adjacent optic nerve. RESULTS: Oral corticosteroids (prednisolone 1 mg/kg per day) given for a period of 4 weeks led to resolution of the optic neuritis, with full visual recovery. CONCLUSION: Corticosteroids should be given in addition to albendazole in the treatment of orbital cysticercosis when cysts are in close proximity to the optic nerve.

Administration, Oral↗

A follow-up study on visual outcome after camp-based intracapsular cataract extraction.

The visual outcome of 164 intracapsular cataract extractions (ICCE) performed in 158 patients at an eye-camp was evaluated. 93.3% had a preoperative visual acuity of less than 3/60. On the 4th/5th post-operative day, 39.3% had a visual acuity between 6/18 and 6/36; 84.7% had vision better than 3/60. Six weeks post-operatively, 44.1% had visual acuity better than 6/18 and a total of 84.1% better than 3/60. The vision of 40.7% improved between the 4th/5th post-operative day and the follow-up visit at 6 weeks. 46.4% of patients had post-operative corrected visual acuity better than 6/18, 24.3% had vision between 6/18 and 6/36, and a total of 84.3% had vision better than 3/60. The patients' satisfaction in terms of improvement in mobility and ability to do housework at 6 weeks after the operation correlated better with the improvement in vision in terms of the number of Snellen's lines than with the actual post-operative visual acuity.

Aged↗

Major histocompatibility complex class I expression on neurons in subacute sclerosing panencephalitis and experimental subacute measles encephalitis.

Lack of major histocompatibility class I antigens on neurons has been implicated as a possible mechanism for viral persistence in the brain since these antigens are required for cytotoxic T-lymphocyte recognition of infected cells. In subacute sclerosing panencephalitis (SSPE), measles virus (MV) persists in neurons, resulting in a fatal chronic infection. MHC class I mRNA expression was examined in formalin-fixed brain tissue from 6 SSPE patients by in situ hybridization. In addition MHC class I protein expression in MV-infected neurons was examined in experimental Subacute Measles Encephalitis (SME) by double immunohistochemistry. MHC class I mRNA expression was found to be upregulated in SSPE tissues studied, and in 5 out of 6 cases the expression was definitively seen on neurons. The percentage of neurons expressing MHC class I mRNA ranged between 20 to 84% in infected areas. There was no correlation between the degree of infection and expression of MHC class I molecules on neurons. Importantly, the number of neurons co-expressing MHC class I and MV antigens was markedly low, varying between 2 to 8%. Similar results were obtained in SME where 20 to 30% of the neurons expressed MHC class I but <8% co-expressed MHC class I and MV antigens. Perivascular infiltrating cells in the infected regions in SME expressed IFNgamma immunoreactivity. The results suggest that MV may not be directly involved in the induction of MHC class I on neurons and that cytokines such as IFNgamma may play an important role. Furthermore, the paucity of neurons co-expressing MHC class I and MV antigens in SSPE and SME suggests that such cells are either rapidly cleared by cytotoxic T lymphocytes (CTL), or, alternatively, lack of co-expression of MHC class I on MV infected neurons favors MV persistence in these cells by escaping CTL recognition.

Adult↗

Plasticity in the adult human oligodendrocyte lineage.

Preoligodendrocytes have been described in cultures and tissue prints of adult human white matter (Armstrong et al., 1992). To characterize further these precursors of human oligodendrocytes, we have investigated whether they express genes playing a critical role in oligodendrocyte development. In the intact human brain, platelet-derived growth factor receptor alpha (PDGF alpha R) and myelin transcription factor 1 (MyTI) transcripts are expressed in 1-2% of cells of the oligodendrocyte lineage (OL), and clusters of such cells can be found in the periventricular region. Myelin basic protein transcripts containing exon 2 information (exon 2+ MBP), which are characteristic of the premyelinating stage, are detected in 15-20% of OL cells in vivo. When OL cells are separated from human white matter and allowed to regenerate in vitro, a much larger proportion of these cells express developmentally regulated genes, while exon 2- MBP and proteolipid protein (PLP) transcripts characteristic of mature OL cells appear transiently downregulated. Basic fibroblast growth factor (bFGF), even in the presence of PDGF, does not promote DNA synthesis in these cultured OL cells. Yet bFGF induces human oligodendrocytes to regenerate their processes rapidly in vitro and to express O4 antigens as well as exon 2+ MBP, MyTI, and PLP transcripts. While bFGF accelerates early regenerative processes, it also maintains high expression of exon 2+ MBP transcripts in OL cells for up to 2 weeks in vitro. In contrast, high levels of insulin in the absence of bFGF allow accumulation of exon 2- MBP and PLP transcripts in most OL cells at 2-3 weeks in vitro. We propose that the myelinated human brain harbors a small pool of precursors of oligodendrocytes and that growth factor-regulated phenotypic plasticity rather than mitogenic potential accounts for the regeneration of oligodendrocytes in the initial stages of demyelinating diseases such as multiple sclerosis.

Adolescent↗

Evaluation of an innovative school eye health educational mode.

An innovative mode of using school children as health educators for transmitting messages on eye health care in the school environment was evaluated. Fifty children were evaluated at baseline and immediately after the educational session. A significant change in cognitive aspects of eye care was demonstrated (p < 0.001). Knowledge on vitamin A related aspects and childhood ocular trauma improved substantially compared to all other aspects of eye care.

Child↗

Eye casualty department.

A retrospective analysis of all new patients attending our eye casualty department was carried out during the 1 year period, from January to December 1987. During this time the casualty unit saw and treated 4905 new patients. Of these 40.61% were traumatic in origin, 30.52% comprised various ocular infections and the remaining 28.87% had miscellaneous ocular problems. On average, 13 new patients and seven consultations from other departments were seen and treated daily. Apart from the management of ocular emergencies, other functions provided by our department included glaucoma screening, donor eye collection, attending to referrals from other departments and eye health education.

Emergency Service, Hospital↗

Ocular ethambutol toxicity: is it reversible?

Delayed onset ocular ethambutol toxicity is usually considered to be reversible following prompt withdrawal of the drug. However, in a series of seven consecutive patients with severe visual deficit due to ethambutol toxicity, only 42.2% (3 of the 7 patients) achieved a visual recovery of better than 20/200 after an average follow-up of 8.3 +/- 2.1 months after stoppage of the drug. On fluorescein angiography, three cases (42.2%) progressed to optic atrophy during the follow-up with permanent visual damage. There were no predisposing or risk factors to contribute toward the poor visual gain. In this background, we recommend discontinuation of ethambutol from the antituberculous regimen. As an additional sidelight, the value of visually evoked potential in the monitoring of patients on ethambutol, especially in cases with early periaxial neuritis, has been emphasised.

Adolescent↗

Peribulbar anesthesia in retinal reattachment surgery.

We prospectively evaluated the effectiveness of peribulbar anesthesia in retinal reattachment surgery. Of the 24 patients studied, 2 required retrobulbar supplementation during the latter part of the surgery. Our results show that peribulbar anesthesia can be effectively used for retinal reattachment surgery and probably should be the preferred form of local anesthesia for this surgery, since the eyes involved have a relatively high incidence of axial myopia and posterior staphyloma.

Adult↗

Echographic measurement of extraocular muscle thickness in proptosis.

Echographic extraocular muscle thickness was measured in 102 eyes of 51 patients with proptosis of varied etiology. That of vascular origin was associated with extraocular muscle enlargement in all cases. Enlargement of the medial rectus was found to be statistically significant in thyroid orbitopathy. Sixty percent of cases with nonspecific orbital inflammatory disease had enlarged extraocular muscles. We discuss the supportive role of determining echographic measurements of extraocular muscle thickness in proptosis and highlight the uniform extraocular muscle enlargement found in proptosis of vascular origin.

Adolescent↗

Peribulbar anesthesia and optic nerve conduction.

Serial recordings of distance visual acuity and visually evoked potentials (VEPs) after peribulbar anesthesia in three patients are reported. Visual acuity was not markedly affected but the latency and amplitude of VEPs were. This study concludes that optic nerve conduction is not significantly affected by peribulbar anesthesia.

Adolescent↗

Ultrasonography in optic nerve head avulsion.

The diagnosis of post traumatic optic nerve avulsion is often obscured by the presence of concomitant vitreous haemorrhage. Electrodiagnostic tests, CT scan and fluorescein angiography have not proved helpful in substantiating the diagnosis of this entity in the early stages. We herein present the echographic features in a case of post traumatic optic nerve avulsion that, to the best of our knowledge, have not been previously described. The role of ultrasonography in the diagnosis of suspected optic nerve head avulsion has been high-lighted.

Adolescent↗

Cryopexy in pars planitis.

Cryotherapy has been reported to be of benefit in pars planitis. We studied 16 eyes with classic pars planitis unresponsive to corticosteroid therapy. Eight eyes continued with systemic and periocular steroid therapy, and in the remaining eight eyes transconjunctival cryopexy of the peripheral retina and vitreous base was done as an additional procedure. At 6 months four of the eyes that received cryopexy showed an improvement in Snellen visual acuity, and in the other four the acuity was unchanged; none of the eyes showed any vitreous base neovascularization. Among the eyes that received steroid therapy only, the acuity was unchanged in five, improved in one and reduced in two.

Adolescent↗

Nyctalopia.

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Child↗