Publications by authors named "Ruchi Goel"

70 Publications

Diet, Fluid Intake, Urine Output and Urinary Sodium/Potassium Ratios in Children with Urolithiasis.

Indian Pediatr 2022 Aug 10. Epub 2022 Aug 10.

Department of Dietics, Maulana Azad Medical College and associated Lok Nayak Hospital and Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, University of Delhi, New Delhi.

We performed a cross-sectional study on 25 children (17 boys) with urolithiasis with normal glomerular functions at a tertiary care teaching hospital between March, 2018 March, 2019. Dietary assessment showed that caloric intake was below recommended dietary allowance (RDA) in 68% patients while the median protein intake was 34.3% more. The fluid intake was below the recommended standards in 56%, and 48% of the children had urine output below 1.5 mL/kg/hour. The urinary sodium was elevated in 96% of the children, urinary potassium was low in 40%, and hypercalciuria was seen in 28%. While metabolic causes predominate in childhood urolithiasis, other factors like dietary changes, liberal fluid and low sodium intake are advised for prevention of recurrences as they have a contributory role too.
View Article and Find Full Text PDF

Download full-text PDF

Source
August 2022

Thyroid-Associated Peripapillary Vascular Remodelling - A Novel Area for Research? [Letter].

Clin Ophthalmol 2022 12;16:1475-1476. Epub 2022 May 12.

Department of Ophthalmology (Guru Nanak Eye Centre), Maulana Azad Medical College, New Delhi, India.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2147/OPTH.S372789DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9113653PMC
May 2022

Outcome of transcanalicular laser dacryocystorhinostomy with endonasal augmentation in acute versus post-acute dacryocystitis.

Eye (Lond) 2022 May 19. Epub 2022 May 19.

Department of Ophthalmology, Guru Nanak Eye Centre (Associated with Maulana Azad Medical College), New Delhi, India.

Objective: To study the outcomes of transcanalicular laser dacryocystorhinostomy (TCL-DCR) with endonasal augmentation in acute versus post-acute dacryocystitis and compare it with external DCR in post-acute settings.

Methods: A prospective, randomised study was conducted in 90 adult cases of Acute dacryocystitis. All the patients were started on systemic antibiotics and a 4 mm × 4 mm osteotomy was created using TCL-DCR. The osteotomy was enlarged to 8 mm × 8 mm by endonasal augmentation at the same sitting in group 1, after 10 days in group 2 and after 10 days with external DCR in group 3. The cases were assessed for symptomatic relief and complications. Success was defined as functional and anatomical patency at 36 months.

Results: The mean age was 45.33 ± 15.06 years and the male: female ratio was 1:2. The presenting complaints were painful swelling (100%), epiphora or discharge (88.8%), fistula (33%) and fever (6%). The average number of acute episodes was 2.96. The intra-group pain reduction from day 1 to day 4, was significant in all three groups (p = 0.000). Intra-operative (p = 0.015, χ = 8.37) and post-operative complications (p = 0.002, χ = 0.002) were higher in group. Anatomical success was achieved in all the three groups, however, the functional success in Group 3, Group 2 and Group 1 was 100%, 86.7% and 66.7% respectively (p = 0.002, χ = 12.86).

Conclusions: The creation of osteotomy using TCL-DCR provides early relief in symptoms. Single-stage surgery in inflamed tissues is associated with higher complication rates. External DCR in post-acute settings gives the best outcomes with minimal complications, endoscopic augmentation requires a close follow-up.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41433-022-02104-4DOI Listing
May 2022

MR imaging spectrum in COVID associated Rhino-Orbito-Cerebral mucormycosis with special emphasis on intracranial disease and impact on patient prognosis.

Eur J Radiol 2022 Jul 6;152:110341. Epub 2022 May 6.

Department of Ophthalmology, Maulana Azad Medical College and Guru Nanak Eye Centre, New Delhi 110002, India.

In the wake of the ongoing Coronavirus Disease 2019 (COVID-19) pandemic, a new epidemic of COVID associated mucormycosis (CAM) emerged in India. Early diagnosis and prompt treatment of this deadly disease are of paramount importance in improving patient survival. MRI is the cornerstone of diagnosis of early extrasinus disease, particularly intracranial complications which have traditionally been associated with a high mortality rate. In this review, we depict the sinonasal, perisinus, orbital and intracranial involvement in CAM. Special emphasis is laid on intracranial disease which is categorized into vascular, parenchymal, meningeal, bony involvement and perineural spread. Vascular complications are the most common form of intracranial involvement. Some unusual yet interesting imaging findings such as nerve abscesses involving the optic, trigeminal and mandibular nerves and long segment vasculitis of the internal carotid artery extending till its cervical segment are also illustrated. In our experience, patient outcome in CAM (survival rate of 88.5%) was better compared to the pre-pandemic era. Presence of intracranial disease also did not affect prognosis as poorly as traditionally expected (survival rate of 82.8%). Involvement of brain parenchyma was the only subset of intracranial involvement that was associated with higher mortality (p value 0.016). The aim of this review is to familiarise the reader with the MR imaging spectrum of CAM with special focus on intracranial complications and a brief account of their impact on patient prognosis in our experience.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ejrad.2022.110341DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9074238PMC
July 2022

Ocular sequelae in severe COVID-19 recovered patients of second wave.

Indian J Ophthalmol 2022 05;70(5):1780-1786

Society for Health Education and Allied Research, New Delhi, India.

Purpose: To evaluate the retinal microvascular changes in patients, recovered from severe COVID-19 during the second wave of the pandemic in North India.

Methods: In this observational cross-sectional study, 70 eyes of 35 patients who recovered from severe COVID-19 during the second wave underwent detailed ophthalmic evaluation 4-6 weeks after discharge. Twelve controls were also enrolled, and the difference in the findings between the case and control groups on optical coherence tomography (OCTA) were studied.

Result: The ages of study participants ranged from 27 to 60 years with the male:female ratio being 1.05:1. The fundus changes suggestive of ischemia in the form of cotton wool spots and vascular tortuosity were seen in 25 eyes (35.71%). Increased venous tortuosity was the most common finding seen in 23 eyes (32.85%), of which 10 eyes (28.57%) had concurrent hypertensive retinopathy (HTR) changes. There was a significant reduction in the mean vascular density (VD) and perfusion density (PD) for both the superficial capillary plexus (SCP) and deep capillary plexus (DCP) at inner, outer ring, and whole (P < 0.05). Foveal avascular zone was significantly enlarged in both the SCP (P = 0.01) and the DCP (P = 0.03). The mean ganglion cell-inner plexiform layer (GC-IPL) was significantly reduced in comparison to controls (P < 0.001).

Conclusion: Severe COVID-19 can result in microvascular changes at the macula in the form of reduction in vascular and perfusion density, which can be evaluated using OCTA. As structural changes precede functional changes, a close watch is recommended in patients showing compromise in retinal microvasculature.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/ijo.IJO_2882_21DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9332963PMC
May 2022

Sensitivity of liquid-based cytology in the diagnosis of mucormycosis in COVID-19 treated patients.

Cytopathology 2022 Apr 18. Epub 2022 Apr 18.

Maulana Azad Medical College and Associated Hospitals, New Delhi, 110002, India.

Background: The coronavirus disease 2019 (COVID-19) infection caused by the novel severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) is associated with a wide range of disease patterns, ranging from mild to life-threatening pneumonia. COVID-19 can be associated with a suppressed immune response and/or hyperinflammatory state due to cytokine storm. Reduced immunity, combined with steroid usage to prevent cytokine storm along with various pre-existing co morbidities can prove to be a fertile ground for various secondary bacterial and fungal infection, including mucormycosis. Diagnosis of mucor is a challenging task given high negativity rate of various detection methods. While histopathology is considered the gold standard, the acquisition of necessary tissue biopsy specimens requires invasive procedures and is time consuming.

Method: In this study various methods of mucor detection, like conventional cytopathology (CCP), liquid-based cytology (LBC, BD Surepath ), potassium hydroxide mount (KOH) preparation, culture and histopathology were analysed. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for various methods.

Results: This study showed that LBC has sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 72.4%,100%,100% and 38.4% respectively.

Conclusion: This study showed that, liquid-based cytology (LBC) can be a rapid and effective alternative to histopathology in mucor diagnosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/cyt.13131DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9111708PMC
April 2022

A challenging journey of maxillofacial implants placement and rehabilitation in an irradiated exenterated socket.

J Oral Biol Craniofac Res 2022 May-Jun;12(3):319-323. Epub 2022 Apr 4.

Department of Ophthalmology, Maulana Azad Medical College, New Delhi, India.

Rehabilitation of a post-exenterated orbital defect is a necessity, to restore a patient's esthetic appearance and help overcome the associated psychosocial stigma. An implant supported prosthesis enjoys a better patient acceptance due to its superior retention and stability. This clinical report highlights the challenges faced in planning, designing and placement of maxillofacial implants in the supra-orbital rim of an exenterated socket post-radiotherapy along with the management of the unexpected complications which developed subsequently. Administration of hyperbaric oxygen therapy, fabrication of a digitally designed surgical guide to ensure predictable implant placement, selection of surface treated implants for better biomechanical anchorage, and a gentler surgical technique for recovery of irradiated hard and soft tissues were measures undertaken during the treatment phase. An effort has been made to point-out the fact that despite the various approaches adopted in an irradiated patient, success of implant placement in such a situation remains a challenge.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jobcr.2022.03.011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9011021PMC
April 2022

Outcome of COVID-19-Associated Rhino-Orbital Mucormycosis.

JAMA Ophthalmol 2022 05;140(5):548

Department of Otorhinolaryngology, Maulana Azad Medical College, New Delhi, India.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1001/jamaophthalmol.2022.0618DOI Listing
May 2022

Challenges in the Management of Upper Lid Keloid.

Case Rep Ophthalmol Med 2022 25;2022:3032246. Epub 2022 Mar 25.

Pathology, Govind Ballabh Pant Hospital, New Delhi, India.

A middle-aged lady presented with a firm, nontender mass on the left upper lid and area behind the left ear following lid reconstruction with postauricular graft for cicatricial ectropion 11 months prior. She had a similar mass on the right shin. She was diagnosed as a case of multiple keloids. Intralesional injection of triamcinolone acetonide suspension and 5-Fluorouracil (5-FU) in the upper lid keloid resulted in ulceration of its surface. Surgical excision, injection of 5-FU in the keloid bed with temporal forehead flap reconstruction, was performed. Occurrence of inadvertent postoperative wound infection with was treated with local dressing with colistimethate sodium. Adjuvant therapy with topical imiquimod cream 5% was given subsequently for 24 weeks with no recurrence of the lid keloid after 16 months. The patient was managed using a combination of conservative and surgical therapy and multidisciplinary team work and kept on a long term follow-up.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2022/3032246DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8975687PMC
March 2022

Ganglion cell layer thickness - a marker for early dysthyroid optic neuropathy.

Eye (Lond) 2022 Mar 28. Epub 2022 Mar 28.

Department of Ophthalmology (Guru Nanak Eye Centre), Maulana Azad Medical College, New Delhi, India.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41433-022-02035-0DOI Listing
March 2022

Role of ocular hypertensives on outcome of dacryocystorhinostomy.

Eye (Lond) 2022 Feb 15. Epub 2022 Feb 15.

Department of Ophthalmology (Guru Nanak Eye Centre), Maulana Azad Medical College, New Delhi, India.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41433-022-01972-0DOI Listing
February 2022

Clinico-Radiological-Pathological Correlation of Visual Loss in COVID-Associated Rhino-Orbito-Cerebral Mucormycosis.

Ophthalmic Plast Reconstr Surg 2022 May-Jun 01;38(3):242-249. Epub 2022 May 11.

Department of Radiodiagnosis, Maulana Azad Medical College, New Delhi, India.

Purpose: To correlate the clinical, radiological, and histopathological features in Covid-associated Rhino-orbito-cerebral mucormycosis cases presenting with acute visual loss.

Design: Cross-sectional study.

Methods: Covid-associated Rhino-orbito-cerebral mucormycosis cases with unilateral visual loss, planned for exenteration, underwent orbital and ophthalmological ocular examination. The available radiological sequences, doppler ultrasonography and histopathology findings were correlated with clinical manifestations.

Results: The median age was 51 years and the male: female ratio was 3:1. All except one presented with unilateral ophthalmoplegia. The ocular media were hazy in 2 eyes. In 8 eyes, retinal changes were suggestive of occlusion of CRA (6), combined occlusion of CRA and central retinal vein (1), and myopic degeneration with hypertensive retinopathy (1). The contralateral eye showed retinal ischemic changes in one patient. Radiological imaging showed orbital apex involvement in the 10 affected eyes and one contralateral eye. Ipsilateral cavernous sinus thrombosis, diffusion restriction on MRI of optic nerve, internal carotid artery narrowing/thrombosis, and cortical watershed infarcts were seen in 8, 4, 4, and 2 cases, respectively. The blood flow in CRA and ophthalmic artery was absent or reduced in all the 10 affected eyes and in 1 contralateral eye. On histopathology, orbital fat necrosis, fungal hyphae, acute inflammation, granuloma formation, ischemic thrombosis of ophthalmic artery was observed in 10 specimens. CRA was patent in 9 and thrombosed in 1 eye. Optic nerve was ischemic in 8 and viable in 2 eyes.

Conclusion: Acute visual loss in ROCM cases is associated with orbital apex involvement and thrombotic ischemia of ophthalmic artery. Cessation of flow in CRA possibly occurs secondary to ophthalmic artery thrombosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/IOP.0000000000002112DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9093237PMC
May 2022

Intraosseous solitary myofibroma of the orbit in an adolescent woman.

BMJ Case Rep 2021 Oct 7;14(10). Epub 2021 Oct 7.

Pathology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India.

A 16-year-old woman presented with a painless, progressive, hard swelling in the left inferolateral orbital wall for the past 1 year. There was no diminution of vision or limitation of ocular motility. Imaging revealed an intraosseous, well-defined, expansile, soft tissue lesion in the inferolateral wall of the left orbit. A left anterior orbitotomy with complete surgical excision was performed. Histopathological evaluation of the specimen revealed fascicular pattern of spindle cells with a rich network of slit-like, branching blood vessels. Tumour cells exhibited smooth muscle actin and vimentin positivity but were negative for CD-34 and STAT-6. In absence of any systemic manifestation, a diagnosis of intraosseous solitary orbital myofibroma was made. The case highlights the importance of integrating clinical, radiological and histopathological features in overcoming the diagnostic challenge of differentiating myofibroma from other mesenchymal neoplasms. It also brings forth the importance of complete resection and curettage to prevent recurrence.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bcr-2021-244800DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8499239PMC
October 2021

COVID associated mucormycosis: A preliminary study from a dedicated COVID Hospital in Delhi.

Am J Otolaryngol 2022 Jan-Feb;43(1):103220. Epub 2021 Sep 11.

Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India.

Background: It is an incontrovertible fact that the Rhino Orbital Cerebral Mucormycosis (ROCM) upsurge is being seen in the context of COVID-19 in India. Briefly presented is evidence that in patients with uncontrolled diabetes, a dysfunctional immune system due to SARS-COV-2 and injudicious use of corticosteroids may be largely responsible for this malady.

Objective: To find the possible impact of COVID 19 infection and various co-morbidities on occurrence of ROCM and demonstrate the outcome based on medical and surgical interventions.

Methodology: Prospective longitudinal study included patients diagnosed with acute invasive fungal rhinosinusitis after a recent COVID-19 infection. Diagnostic nasal endoscopy (DNE) was performed on each patient and swabs were taken and sent for fungal KOH staining and microscopy. Medical management included Injection Liposomal Amphotericin B, Posaconazole and Voriconazole. Surgical treatment was restricted to patients with RT PCR negative results for COVID-19. Endoscopic, open, and combined approaches were utilized to eradicate infection. Follow-up for survived patients was maintained regularly for the first postoperative month.

Results: Out of total 131 patients, 111 patients had prior history of SARS COVID 19 infection, confirmed with a positive RT-PCR report and the rest 20 patients had no such history. Steroids were received as a part of treatment in 67 patients infected with COVID 19. Among 131 patients, 124 recovered, 1 worsened and 6 died. Out of 101 known diabetics, 98 recovered and 3 had fatal outcomes. 7 patients with previous history of COVID infection did not have any evidence of Diabetes mellitus, steroid intake or any other comorbidity.

Conclusion: It can be concluded that ROCM upsurge seen in the context of COVID-19 in India was mainly seen in patients with uncontrolled diabetes, a dysfunctional immune system due to SARS-COV-2 infection and injudicious use of corticosteroids.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.amjoto.2021.103220DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8432976PMC
December 2021

Rhino-Orbito-Cerebral-Mucormycosis During the COVID-19 Second Wave in 2021 - A Preliminary Report from a Single Hospital.

Clin Ophthalmol 2021 17;15:3505-3514. Epub 2021 Aug 17.

Society for Health Education and Allied Research, New Delhi, India.

Purpose: To list the clinico-epidemiological profile and possible risk factors of COVID-19 associated rhino-orbital-cerebral mucormycosis (CA-ROCM) patients presenting to a COVID dedicated hospital during the second wave of COVID-19 in India.

Patients And Methods: A cross-sectional, single-center study was done on 60 cases of probable CA-ROCM based on clinical features and supportive diagnostic nasal endoscopic findings and/or radiologic findings. Patients with recent or active COVID-19 were included. The demographic profile, clinical features, possible risk factors and diagnostic workup (microbiological, pathological and radiological) were analysed to identify the triggering factors for CA-ROCM.

Results: The age of patients ranged from 29 to 75 years and male-female ratio was 3:1. The duration between the first positive COVID report and onset of CA-ROCM was 0 to 47 days. Forty-nine (81.66%) patients had a recent COVID infection and 11 (18.33%) had active COVID infection at presentation. Thirty-five patients (58%) had ocular/orbital involvement at presentation. In the affected eye, 10 had no perception of light and in the rest visual acuity ranged from log MAR 0 to +1.5. Ocular manifestations were ptosis (29), ophthalmoplegia (23), periocular tenderness and edema (33), proptosis (14), black discoloration of eyelids (3), facial palsy (3), endophthalmitis (4), retinal artery occlusion (8), disc edema (4) and disc pallor (5). Twenty-two (25%) patients had neither received steroids nor oxygen. Thirty patients (50%) were managed with oxygen while 38 patients (63.3%) with systemic steroids. The most common risk factor was diabetes in 59 patients. The average glycosylated hemoglobin (HbA1c) was 10.31 ± 2.59%. Systemic Amphotericin B was started in all the patients. Radical surgical debridement was performed in 12 patients and the remaining were planned.

Conclusion: SARS-CoV-2 variant with accompanying glycaemic dysregulation was found to be the triggering factor for the epidemic of CA-ROCM.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2147/OPTH.S324977DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8380130PMC
August 2021

Changes in corneal curvature and visual acuity in North Indian adults after pterygium excision with modified sutureless, glueless limbal-conjunctival autograft.

Indian J Ophthalmol 2021 Sep;69(9):2401-2405

Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.

Purpose: To identify the exact time point during after following pterygium excision with a modified technique of sutureless, glueless limbal-conjunctival autograft, when stabilization of the change in corneal curvature is achieved; correlate size of pterygium with uncorrected visual acuity and astigmatism at baseline, and assess changes in these parameters postoperatively over time.

Methods: This prospective study longitudinally assessed 30 eyes of 30 north Indian adults with primary pterygium encroaching upon ≥1 mm of the cornea pre- and postoperatively at 1 week and then monthly for 4 months, recording uncorrected (UCVA) and best-corrected logMAR visual acuity, astigmatism and keratometry. Results were analyzed using ANOVA, Mauchly's test of sphericity with Greenhouse-Geisser correction, and post-hoc test using Bonferroni correction. Pearson's correlation coefficient r > 0.5 was considered clinically significant, and P < 0.05 statistically significant.

Results: Pterygium size was well correlated with pre-operative astigmatism (r = 0.867, P < 0.001) and pre-operative UCVA (r = 0.856, P < 0.001). There was mean improvement of 0.43 logMAR units of visual acuity (P < 0.00001), a mean increase of 0.79D of keratometric value for the flatter meridian (P < 0.00001) and a mean reduction of 2.00D of astigmatism (P < 0.00001). At 2-month follow-up, the keratometric value for the flatter meridian approached the final keratometric reading at 4 months such that the difference was not significant (t = 1.185, P = 0.245). There were no significant complications or recurrence during the follow-up period.

Conclusion: Pterygium excision with modified autograft reduced corneal astigmatism and improved visual acuity comparable to classical technique. Alteration in corneal curvature stabilizes 2 months after surgery, when spectacle correction can be given to patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/ijo.IJO_2747_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8544074PMC
September 2021

Comparative evaluation of dacryocystorhinostomy with retrograde intubation and conjunctivo-dacryocystorhinostomy.

Can J Ophthalmol 2021 Aug 7. Epub 2021 Aug 7.

Department of Ophthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India.

Objective: To compare the surgical outcomes of dacryocystorhinostomy with retrograde intubation and conjunctivo-dacryocystorhinostomy for the management of proximal mid-bicanalicular lacrimal obstruction.

Design: Randomized, controlled trial.

Methods: The study was conducted in 50 eyes of 50 adult patients with bicanalicular obstruction ≤ 6 mm from the punctum. The etiology, duration of symptoms, and Munk scores were recorded. Group A underwent dacryocystorhinostomy with retrograde intubation, and in group B, conjunctivo-dacryocystorhinostomy was performed. Success was defined as anatomic patency on syringing, a negative fluorescein dye disappearance test, and a Munk score < 2 twelve months postoperatively.

Results: There were 23 males and 27 females, 18-66 years of age, with a 6-month to 20-year duration of epiphora. The etiologies were idiopathic, trauma, and allergic conjunctivitis and ocular surface inflammation. In group A, the pseudopunctum was located medial to the diagnosed level of canalicular block by 1.28 ± 0.54 mm and 1.04 ± 0.88 mm in upper and lower canaliculi, respectively. Four post-traumatic cases required intervention following closure of the pseudopunctum, all being located ≥ 7 mm from the true punctum (p = 0.001). The complication rate was higher in group B than in group A (p = 0.001). At 12 months, the success rate was 100% in group A and 88% in group B (22 of 25; p = 0.74), with reduction in Munk scores from preoperative levels in both groups (p = 0.001).

Conclusion: Dacryocystorhinostomy with retrograde intubation and conjunctivo-dacryocystorhinostomy have comparable success rates in the management of proximal mid-bicanalicular obstructions. Dacryocystorhinostomy with retrograde intubation has lower complication rates and does not require long-term maintenance of the bypass tube, unlike conjunctivo-dacryocystorhinostomy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jcjo.2021.07.002DOI Listing
August 2021

Comparison of external versus diode laser conjunctivodacryocystorhinostomy with lacrimal bypass tube placement in proximal canalicular blocks.

Oman J Ophthalmol 2021 May-Aug;14(2):100-107. Epub 2021 Jun 28.

Department of Opthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India.

Aims: Hyperlacrimation due to ocular surface or lid abnormality was ruled out and apposition of lower punctum to globe was checked.

Subjects And Methods: This was a pilot study at a tertiary eye care center where 40 patients of proximal canalicular block <8 mm on probing were divided into two equal groups. The external CDCR group underwent routine dacryocystorhinostomy with partial carunculectomy. A tract was created from canthus to nasal cavity with von Graefe knife. In the laser CDCR group, the osteotomy was created using 980 mm diode laser with a power of 8 W. Glass tubes of appropriate length were placed and fixed using 5-0 polypropylene with our "mirror tuck technique." Results were analyzed using the Chi-square test for parametric and ANOVA test for nonparametric variables using SPSS software.

Results: Success defined as patency on syringing was achieved in 18 patients in the laser group and 16 in the external CDCR group which was comparable ( > 0.05). Complications include tube extrusion, dislocation, conjunctival overgrowth, and sump syndrome.

Conclusion: Laser and external CDCRs are both effective and safe procedures for the treatment of proximal canalicular blocks with comparable success rates and complications.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/ojo.OJO_49_2020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8300289PMC
June 2021

Massive Retinal Gliosis in Microphthalmic Globe With Cyst Masquerading as a Neoplasm.

Cureus 2021 Jun 3;13(6):e15419. Epub 2021 Jun 3.

Ophthalmology, Maulana Azad Medical College, New Delhi, IND.

We report a rare case of a bilaterally blind, 33-year-old male, who presented with rapidly progressive, painless swelling in the right orbit for two months, in the absence of ocular trauma. Suspecting an intraocular neoplasm, a contrast-enhanced MRI (CE-MRI) orbit was performed, which was suggestive of a right-sided superomedial eccentric soft-tissue lesion with bilateral rudimentary globes associated with cyst, hypoplastic optic nerves, and focal areas of calcification. Diffusion-weighted MRI demonstrated diffusion restriction and yielded an indeterminate value of apparent diffusion coefficient (ADC). A right enucleation with excision of the cyst was performed. Histopathological examination confirmed the diagnosis of a right-sided massive retinal gliosis (MRG) with bilateral microphthalmia with cyst. This case demonstrates the role of a detailed histopathological analysis along with immunohistochemistry (IHC) in differentiating MRG from a neoplasm.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.15419DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8254426PMC
June 2021

Role of intrastromal vancomycin in recalcitrant corneal abscess after phacoemulsification.

BMJ Case Rep 2021 May 24;14(5). Epub 2021 May 24.

Ophthalmology, Maulana Azad Medical College, New Delhi, Delhi, India.

Side port infection and corneal abscess after cataract surgery can produce devastating outcomes. Topical antibacterial drugs are the mainstay in management of these cases. Although intrastromal antifungal agents are an established modality for fungal keratitis, such use of antibacterial agents is rarely reported due to better pharmacokinetic profile of antibacterial agents.We report a case of methicillin-resistant corneal abscess following phacoemulsification that responded to intrastromal vancomycin injection in addition to conventional therapy.This case of postphacoemulsification corneal abscess highlights the importance of postoperative hygiene practices, use of anterior segment optical coherence tomography for monitoring these patients and use of intrastromal vancomycin as an adjunct to topical and systemic therapy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bcr-2021-241709DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8149318PMC
May 2021

Steroid-induced Pseudomonas aeruginosa endophthalmitis outbreak.

J Cataract Refract Surg 2022 01;48(1):113-115

From the Department of Ophthalmology (Guru Nanak Eye Centre), Maulana Azad Medical College, New Delhi, India (Arora, Goel, Khanam); Department of Microbiology, G B Pant Hospital, New Delhi, India (Loomba).

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/j.jcrs.0000000000000673DOI Listing
January 2022

Comment on: Malignant tumors of the eyelid in India: A multicenter, multizone study on clinicopathologic features and outcomes.

Indian J Ophthalmol 2021 06;69(6):1639-1640

Department of Ophthalmology, (Guru Nanak Eye Centre) Maulana Azad Medical College, New Delhi, India.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/ijo.IJO_155_21DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8302285PMC
June 2021

Comparative Evaluation of Tears and Nasopharyngeal Swab for SARS-CoV-2 in COVID-19 Dedicated Intensive Care Unit Patients.

Ocul Immunol Inflamm 2021 May 11;29(4):690-696. Epub 2021 May 11.

Department of Anaesthesiology, Maulana Azad Medical College, New Delhi, India.

: To compare the cycle threshold (Ct) values of tears and nasopharyngeal (NP) swab in severe COVID-19 ICU patients with positive NP swabs.: A cross-sectional study for the detection of SARS-CoV-2 by real-time RT-PCR on simultaneously collected NP swabs and tears was performed. Detailed demographic profile, including comorbidities, ocular, and systemic features were analyzed.: In the 78 cases, the mean tear positivity was 26.92% (21/78), 2 tear samples being positive despite a negative NP swab. The mean Ct value of tears and NP were 28.17 ± 4.76 and 23.71 ± 6.19, respectively (= .003). None of the cases had ocular findings or relationship between tear positivity and comorbidity.: The viral load of tears is less than the NP secretions with the possibility of prolonged shedding in tears. Tears act as an additional source of contact transmission in ICU that can possibly be decreased by frequent hand hygiene by the patient.: SARS-CoV-2: Severe acute respiratory syndrome coronavirus; RT-PCR: Real-time Reverse transcriptase-polymerase chain reaction; COVID-19: Corona virus disease 2019; ICU: Intensive care unit; RdRp: RNA-dependent RNA polymerase; ORF 1b: Open reading frame 1b; AIIR: Airborne infection isolation room; HCW: Health care workers; VTM: viral transport media; NP: Nasopharyngeal swab; PPE: Personal protective equipment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/09273948.2021.1903938DOI Listing
May 2021

Utility of Antigen-Based Rapid Diagnostic Test for Detection of SARS-CoV-2 Virus in Routine Hospital Settings.

Lab Med 2021 Nov;52(6):e154-e158

Department of Ophthalmology, Guru Nanak Eye Center, New Delhi, India.

Objective: This study aims to evaluate the performance of an antigen-based rapid diagnostic test (RDT) for the detection of the SARS-CoV-2 virus.

Methods: A cross-sectional study was conducted on 677 patients. Two nasopharyngeal swabs and 1 oropharyngeal swab were collected from patients. The RDT was performed onsite by a commercially available immune-chromatographic assay on the nasopharyngeal swab. The nasopharyngeal and oropharyngeal swabs were examined for SARS-CoV-2 RNA by real-time reverse-transcription quantitative polymerase chain reaction (RT-qPCR) assay.

Results: The overall sensitivity of the SARS-CoV-2 RDT was 34.5% and the specificity was 99.8%. The positive predictive value and negative predictive value of the test were 96.6% and 91.5%, respectively. The detection rate of RDT in RT-qPCR positive results was high (45%) for cycle threshold values <25.

Conclusion: The utility of RDT is in diagnosing symptomatic patients and may not be particularly suited as a screening tool for patients with low viral load. The low sensitivity of RDT does not qualify its use as a single test in patients who test negative; RT-qPCR continues to be the gold standard test.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/labmed/lmab033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8135470PMC
November 2021

Clinical Presentation and Management Strategies in Intraorbital Foreign Bodies.

Case Rep Ophthalmol Med 2021 30;2021:6645952. Epub 2021 Mar 30.

Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India.

The authors present a retrospective, observational case study of seven patients, who presented with retained Intra-Orbital Foreign Bodies (IOrbFBs) following penetrating orbital injury at a tertiary eye hospital over a period of one year. Cases were reviewed for epidemiological features, mechanism of injury, nature of foreign body, clinical features, imaging modality, associated complications, management outcomes, and the final prognosis. The mean age of presentation was 27.43 years. Amongst the seven patients, two were children (aged <10 years). The male : female ratio was 4 : 3. Of the seven retained IOrbFBs, two were plastic, two wooden, and three metallic in nature (one gunshot injury, one ball projectile (commonly referred to as BB) injury, and one with knife). Two out of seven had no light perception at presentation. The periocular location of the foreign bodies was inferior in 4 cases and medial in 3 cases. Computed Tomography scan confirmed the diagnosis in five cases and Magnetic Resonance Imaging (MRI) was diagnostic in one. Surgical intervention was done in five cases, and two cases were managed conservatively. The authors conclude that favourable outcome can be achieved even without surgical removal in cases of inert metallic/inorganic IOrbFBs. The properties of plastic FBs can frequently render them invisible on imaging, or they may mimic chronic inflammatory conditions like tuberculosis. Long-standing wooden IOrbFBs evade identification radiologically due to prolonged hydration. The ultimate choice of intervention must be individualised, weighing the risks of retention against the risk of iatrogenic damage.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2021/6645952DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8026326PMC
March 2021

Immunoglobulin G4-related disease masquerading as metastatic malignant melanoma of the choroid.

BMJ Case Rep 2021 Apr 1;14(4). Epub 2021 Apr 1.

Pathology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bcr-2021-241605DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8021736PMC
April 2021

Rabies Antigen Detection in Postmortem Cornea.

Cornea 2021 05;40(5):e10-e11

Department of Microbiology, Maulana Azad Medical College, New Delhi, India.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/ICO.0000000000002663DOI Listing
May 2021

Redefined role of eye bank counselors during COVID-19 pandemic.

Indian J Ophthalmol 2021 Feb;69(2):452-453

Department of Medicine, Maulana Azad Medical College, New Delhi, India.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/ijo.IJO_3185_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7933882PMC
February 2021

Is it essential to perform COVID-19 testing prior to ophthalmic procedures?

Indian J Ophthalmol 2020 11;68(11):2335-2337

Department of Microbiology, Maulana Azad Medical College, New Delhi, India.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/ijo.IJO_3020_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7774133PMC
November 2020

Viral shedding in tears of COVID-19 cases presenting as conjunctivitis.

Indian J Ophthalmol 2020 Oct;68(10):2308

Department of Ophthalmology (Guru Nanak Eye Centre), Maulana Azad Medical College, New Delhi, India.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/ijo.IJO_2567_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7728002PMC
October 2020
-->