PURPOSE: To develop and standardize a universally acceptable new staging system for idiopathic retinal periphlebitis (Eales disease). METHODS: A new staging system was established and standardized based on standard terminology and features. Idiopathic retinal periphlebitis was classified as peripheral and central types. Peripheral disease consisted of four stages. Stage 1 is periphlebitis of small (1a) and large (1b) caliber vessels with superficial retinal hemorrhages. Stage 2a denotes capillary nonperfusion and 2b neovascularization elsewhere/of the disc. Stage 3a is classified as fibrovascular proliferation and 3b vitreous hemorrhage. Stage 4a is traction/combined rhegmatogenous retinal detachment whereas 4b is rubeosis iridis, neovascular glaucoma, complicated cataract, and optic atrophy. A total of 253 cases of idiopathic retinal periphlebitis (mean age, 24.7 +/- 4.7 years, all male) presenting at this tertiary care center were classified prospectively according to the new staging system, by two independent observers (interobserver correlation = 0.7). RESULTS: The new staging system was consistent, simple, and easy to recall. Peripheral and central types of idiopathic retinal periphlebitis were found in 94.07% and 5.93% of cases, respectively. The new staging system also defined the severity of the disease. Vitreous hemorrhage was found to be the commonest presenting feature (51.68%), whereas traction/combined rhegmatogenous detachment was found in 5.88% of cases. CONCLUSIONS: The new staging system is useful in classifying and assessing the severity of disease. Management strategy can also be defined according to the stage of the disease. It is designed to promote the use of standard assessment with applications to clinical management and research.

Adolescent↗

PubMedDate not supplied

Response time and safety profile of pulsed oral methotrexate therapy in idiopathic retinal periphlebitis.

PURPOSE: To evaluate the response time and safety profile of low-dose oral methotrexate pulsed therapy in idiopathic retinal periphlebitis (Eales' disease). METHODS: A tertiary care center-based prospective interventional study, based on visual acuity grading, was undertaken. Twenty-one consecutive patients with idiopathic retinal periphlebitis were administered 12.5 mg methotrexate as a single oral dose, once per week for 12 weeks (cumulative dose = 150 mg). Each patient was assessed for change in visual acuity grades. Time of first therapeutic response was also noted. Drug safety was monitored by laboratory tests that included twice-weekly white blood cells and differential counts, twice-weekly platelet counts, and monthly liver function tests. RESULTS: Twenty-one eyes were assessed. Mean follow-up period was 6 months. All showed improvement in visual acuity grades. An excellent visual outcome (6/6 or better) was achieved in 18 (69%) eyes. Time of first therapeutic response varied from 2 to 6 weeks with a majority of eyes (80%) showing response by 4 weeks (median = 3 weeks). All the side effects of methotrexate were mild or moderate in severity and rapidly reversible on dose reduction or discontinuation. No patient had any constitutional symptoms severe enough to necessitate cessation of therapy. CONCLUSIONS: Low dose oral methotrexate pulse therapy (at a dose of 12.5 mg/week) is clinically effective within 4 weeks, and is associated with an acceptable safety profile.

Administration, Oral↗

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Disability and burden of depressive disorders.

Explore the source record for details and available documents.

Depressive Disorder↗

PubMedDate not supplied

Issues related to disability in India: a focus group study.

BACKGROUND: Systematic research into disability has been scarce, especially from India, even though an estimated 5% of the population may have significant disability due to physical disorders. Depression as a common psychiatric disorder affects about 3%-5% of the population. Thus, the impact of disability related to physical, mental and substance use disorders is enormous and it influences resource allocation and policy planning. METHODS: The issues relating to disability were addressed through a qualitative multicentered study. Focus groups were conducted at three sites in Chennai, Bangalore and Delhi on three themes: (i) parity, stigmatization and social participation; (ii) current practices and needs; and (iii) the General Disability Model as proposed by the World Health Organization. The focus groups were homogeneous and included members from six categories of participants: individuals with physical disability, individuals with mental disability, individuals with alcohol/drug-related disability, family members of mentally disabled persons, family members of physically disabled persons and health professionals. In all, 118 groups were conducted with a mean (SD) group size of 8.6 (1.6). RESULTS: Patients with mental and alcohol/drug-related disability were more discriminated against than those with physical disability. Awareness regarding the existing laws and social programmes was uniformly poor across the three centres. Stigmatization was a major reason for under-utilization of the meagre resources available. There was poor awareness of the Disability Act, 1996. The consumers felt more comfortable with the earlier terms of 'handicap' and 'impairment'. CONCLUSIONS: The study has implications for policy planning, clinical decision-making and social behaviour. Awareness of the laws, facilities and programmes needs to be increased, especially regarding the Disability Act, 1996 among consumers as well as health professionals. More disability-friendly facilities are required.

Disability Evaluation↗

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Study of events leading cellular senescence to human mammary epithelial cancer cells in vitro.

Role of various growth regulatory factors in inducing senescence in cultured HMEC cells have been investigated in ten cases of breast cancer. The histological grade of tumour cells is found to play significant role in controlling the proliferation and phenotypic charateristics of cultured HMEC cells during primary culture and also number of subsequent passages resulting in complete cellular senescence in them. Effects of conditioned media (CM) collected from primary and senescent cultures of these HMEC cells had also been studied on proliferation of their own HMEC cells used as target cells, to evaluate the role of various autocrine growth factors produced by them. Significant increase in proliferation of target cells was noticed on their exposure to CM from senescent cultures, while cessation of their proliferation was found on their exposure to CM from senscent cultures, suggesting that HMEC cells produce growth promoting factors during primary culture and growth inhibitory factors on subsequent passages, responsible for inducing features of cellular senescence in them. The role of epidermal growth factors (EGF) and transforming growth factors (TGF) alpha and beta as autocrine factors in inducing senescence of cultured HMEC cells were also investigated. Deletion of EGF from growth media initially caused decreased proliferation to target HMEC cells, followed by improvement in their proliferation. Supplementation of growth media by TGF-alpha induced significant increase in proliferation of target cells. Addition of epidermal growth factors receptor (EGFR) antibody to cells exposed to media devoid of EGF and media supplemented with TGF-alpha showed marked suppression of proliferation of target cells. The morphologic and phenotypic characteristics of target HMEC cells exposed to TGF-alpha were also found similar to those HMEC cells grown during primary culture, suggesting autocrine production of EGF and TGF-alpha by cultured HMEC cells during primary culture. Supplementation of TGF-beta to growth media induced marked suppression of proliferation to target cells along with morphologic and phenotypic features of terminal differntiation or senescence. Exposure of senescent cells to media supplemented with EGF and TGF-alpha could not induce their proliferation. This suggest that HMEC cells on subsequent passages undergo some genetic and phenotypic alterations resulting in production of growth inhibitory factor like TGF-beta which induces cessation of their proliferation alone with features of senescence.

Breast Neoplasms↗

PubMedDate not supplied

Angiomatoid malignant fibrous histiocytoma of the eyelid.

A 20 year old female had an angiomatoid malignant fibrous histiocytoma of her left upper eyelid extending into the orbit, frontal and temporal regions. The tumor was excised and radiotherapy was given. Nine months follow-up did not reveal any recurrence.

Adult↗

PubMedDate not supplied

Lisch spots in neurofibromatosis type 1.

The eyes of 28 patients of Neurofibromatosis type 1 were examined. Lisch spots were present in all the patients above 20 years. Their clinical appearance is being presented as seen in Indian subjects.

Adolescent↗