RESUMEN
Cataract is the second leading cause of preventable blindness on the globe. Several programs across the country have been running efficiently to increase the cataract surgical rates and decrease blindness due to cataract. The current COVID-19 pandemic has led to a complete halt of these programs and thus accumulating all the elective cataract procedures. At present with the better understanding of the safety precautions among the health care workers and general population the Government of India (GoI) has given clearance for functioning of eye care facilities. In order to facilitate smooth functioning of every clinic, in this paper, we prepared preferred practice pattern based on consensus discussions between leading ophthalmologists in India including representatives from major governmental and private institutions as well as the All India Ophthalmological Society leadership. These guidelines will be applicable to all practice settings including tertiary institutions, corporate and group practices and individual eye clinics. The guidelines include triage, use of personal protective equipment, precautions to be taken in the OPD and operating room as well for elective cataract screening and surgery. These guidelines have been prepared based on current situation but are expected to evolve over a period of time based on the ongoing pandemic and guidelines from GoI.
Asunto(s)
Betacoronavirus , Extracción de Catarata/normas , Consenso , Infecciones por Coronavirus/epidemiología , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Oftalmología , Pandemias , Neumonía Viral/epidemiología , COVID-19 , Infecciones por Coronavirus/transmisión , Humanos , Equipo de Protección Personal/normas , Neumonía Viral/transmisión , SARS-CoV-2RESUMEN
A case of primary chondrosarcoma of the left lung in 50 year-old man is presented. The tumor was diagnosed as primary chondrosarcoma of the lung after exclusion of any primary lesion elsewhere. Histologically, tumor consisted of predominantly chondromatous lesion. Immunohistochemistry showed that tumor cells positive for S-100 protein and vimentin, and negative for epithelial markers. On the basis of clinical, histological and immunohistochemical studies, the tumor was diagnosed as a primary chondrosarcoma of the lung.
Asunto(s)
Condrosarcoma/diagnóstico , Neoplasias Pulmonares/diagnóstico , Biomarcadores de Tumor/metabolismo , Condrosarcoma/patología , Femenino , Humanos , Inmunohistoquímica , Pulmón/patología , Neoplasias Pulmonares/patología , Masculino , Proteínas S100/metabolismo , Vimentina/metabolismoRESUMEN
BACKGROUND: In Bihar, India, where visceral leishmaniasis (VL) is hyperendemic and refractory to antimony, amphotericin B is the most effective option for the treatment of VL. Lipid formulations of amphotericin B are able to circumvent the toxic effect of conventional amphotericin B, and the total dose of these formulations can be administered over a short duration. However, cost is a major constraint in the use of lipid formulations of amphotericin B. Amphotericin B colloidal dispersion (ABCD), which is a less expensive lipid formulation, has not been tested for the treatment of VL in India. METHODS: In an open-label, randomized clinical trial, we evaluated the efficacy and safety of a 6-day course of ABCD administered to 3 different dose groups (total dose: 7.5 mg/kg [group A], 10 mg/kg [group B], and 15 mg/kg [group C]), each of which included a cohort of 135 patients. RESULTS: Although infusion-related fever and chills occurred in 56%-68% of patients in the 3 different dose groups, 401 of 405 patients completed the treatment. All 135 patients in group A completed treatment, and the final cure rate for this group was 97%. In the group that received the highest dose of ABCD (group C), severe backache, an unusual side effect, was observed in 8 patients (5.92%). Serious adverse effects led to the withdrawal of 2 patients (1.48%) each from group B and group C. CONCLUSIONS: Although the cost of ABCD is prohibitive, the high level of efficacy associated with short-term treatment with low-dose ABCD provides another alternative for the treatment of VL, especially in regions where VL is antimony refractory.
Asunto(s)
Anfotericina B/uso terapéutico , Antiprotozoarios/uso terapéutico , Leishmaniasis Visceral/tratamiento farmacológico , Adolescente , Adulto , Anfotericina B/administración & dosificación , Antiprotozoarios/administración & dosificación , Niño , Preescolar , Relación Dosis-Respuesta a Droga , Femenino , Humanos , India/epidemiología , Leishmaniasis Visceral/epidemiología , Masculino , Persona de Mediana EdadRESUMEN
Adult granulosa cell tumor (GCT) of the ovary is the most common malignancy amongst the sex cord stromal tumors. Clinical stage, age, tumor size, residual disease and several histologic factors have been reported to be of prognostic significance. There were 839 ovarian malignancies at our institute during the period from 1998 to 2002. Out of 54 granulosa cell tumors, 40 cases were evaluable which includes 37 cases of adult GCT and 3 cases of juvenile GCT. They were studied retrospectively. Majority of patients presented with abdominal symptoms and FIGO stage I. All patients were treated surgically and 62.1% of adult GCTs were given post-operative chemotherapy. Clinical stage, presence of residual disease and tumor volume were the most important prognostic factors. Age of patient, menstrual status, post-operative chemotherapy, mitosis or histological patterns were of little significance in our study.
Asunto(s)
Tumor de Células de la Granulosa/patología , Neoplasias Ováricas/patología , Adulto , Anciano , Femenino , Tumor de Células de la Granulosa/mortalidad , Tumor de Células de la Granulosa/terapia , Humanos , India/epidemiología , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias Ováricas/mortalidad , Neoplasias Ováricas/terapia , Pronóstico , Estudios Retrospectivos , Tasa de SupervivenciaRESUMEN
In Bihar, India, where visceral leishmaniasis is hyperendemic, amphotericin B deoxycholate is now first-line parenteral treatment. To test the efficacy of amphotericin B deoxycholate versus that of its lipid formulations, Indian patients were randomized to receive treatment with amphotericin B deoxycholate (1 mg/kg on alternate days for 30 days; n=51), liposomal amphotericin B (2 mg/kg per day for 5 days; n=51), or amphotericin B lipid complex (2 mg/kg per day for 5 days; n=51). Infusion-associated reactions were frequent and persistent in subjects treated with amphotericin B deoxycholate. The illness of 3 patients failed to respond to treatment, and 5 patients experienced relapse. Final cure rates were similar. Estimated total treatment costs for a 25-kg patient-417 dollars for amphotericin B deoxycholate, 872 dollars for liposomal amphotericin B, and 947 dollars for amphotericin B lipid complex-differed as a result of drug cost. Substantial reductions (approximately 60%) in the price of liposomal amphotericin B and amphotericin B lipid complex would make treatment costs comparable to that of amphotericin B deoxycholate, permitting administration of short-course regimens in India.