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   2018| July-December  | Volume 5 | Issue 2  
    Online since July 12, 2020

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Role of Gambhari, Amalaki, and Haritaki Aschyotana in Shuktika with specific reference (W.S.R.) to conjunctival xerosis
Rahul, Abhinav Rathore, Rahul Nigam, Bhappil Sharma
July-December 2018, 5(2):56-60
The xerosis of the conjunctiva is a symptomatic condition in which the conjunctiva becomes dry, lusterless, and nonwettable. These patches almost always involve the interpalpebral area of the temporal quadrants and often nasal quadrants as well. Typical xerosis may be associated with conjunctival thickening, wrinkling, and pigmentation. Xerosis is correlated with Shuktika as the per Ayurvedic reference. In this disease, a small elevated blackish spot resembling shell appears in Shukla mandala. There are various noninvasive as well as safe treatment modalities mentioned in Ayurvedic classics for the treatment of Shuktika. Gambhari, Amalaki, and Haritaki Aschyotana are some of the medicines mentioned in Sushruta Samhita in the management of Shuktika. Hence, an attempt has been made in this regard to review the role of these drugs, i.e. topical instillation of Gambhari, Amalaki, and Haritaki eye drops in Shuktika. Ashchyotana is one among the seven Netra kriya kalpa. Gambhari, Amalaki, and Haritaki are found useful in treating Shuktika, i.e. conjunctival xerosis. As per Sushruta Samhita, the causative dosha in Shuktika is Pitta, and hence, the treatment involves in mitigating the Pitta dosha. It is told in Sushruta Samhita that the causative dosha should be eliminated. Gambhari, Amalaki, and Haritaki Ashchyotana have properties to eliminate Pitta dosha. The medicines mentioned in the present review are Pittahara and are considered best for the eyes. Gambhari, Amalaki, and Haritaki Ashchyotana are cost-effective, safe, and easy procedures which can be done by the patient himself/herself in their own homes.
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Intravitreal dexamethasone implant versus triamcinolone acetonide for macular edema due to central retinal vein occlusion: Quantifying efficacy and safety
Sanjay K Mishra, Abhishek Gupta, Sagarika Patyal, Santosh Kumar, K Raji, Anirudh Singh, Vijay Sharma
July-December 2018, 5(2):35-40
Background: Central Retinal vein occlusion (CRVO) is one of the commonest retinal vascular disease in Diabetics. Intravitreal corticosteroids (IVS) implants and injection are gaining popularity in managing Macular Edema (ME) of RVO. Objective: To assess Intravitreal Dexamethasone Implant versus Triamcinolone Acetonide for Macular Edema due to Central Retinal Vein Occlusion: regarding Efficacy and Safety. Materials and Methods: In a hospital-based prospective, comparative study, a single 0.7 mg IVD Ozurdex Implant compared to single injection of 1.0 mg IVTA for ME due to CRVO: regarding Efficacy and Safety. 40 patients, were involved between September 2012 and May 2014. In 5 follows-up Results; up to 24 months; were evaluated clinically and by fundus fluorescein angiography (FFA) beside optical coherence tomography (OCT) with significant cystoid ME as defined by CRVO study. Results: IVD implant and IVTA both were effective in restoring vision in patients of early CRVO, with a high proportion (40%) gaining ≥3 lines. In terms of safety, drug-induced IOP rise 35% lesser with IVD compared than IVTA. 67% requiring combination of anti-glaucoma medications up to at 6 months. Cataract progression and propensity for cataract surgery is 25% and 100% lesser with IVD implant at same period. The as was the gain in the BCVA and at the end of 6 months (P = 0.582), were similar in both groups. Central Macular Thickness (CMT) decreased significantly in both groups, from 551 ± 17.16 μm to 237 ± 20.71 μm in the IVD-group (P < 0.001) and from 547.5 ± 13.79 μm to 232.6 ± 18.54 μm in the IVTA-group (P = 0.001) at the end of 6 months; thus, at the final follow-up, CMT was similar in both groups (P = 0.4244). Conclusion: Intravitreal steroids are effective in managing ME of RVO, while the newer formulation of sustained-release dexamethasone implant is significantly safer than IVTA.
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Antibacterial monomer-containing adhesive system versus conventional one in reducing demineralization of the enamel around orthodontic brackets: A split-mouth study
Eqbal Nasser Aqeel, Marwa Sameh Shamaa, Ahmed A El-Bialy
July-December 2018, 5(2):41-46
Objective: The objective of the study was to assess the efficiency of an antibacterial monomer-containing adhesive in the reduction of white-spot lesions (WSLs) around orthodontic brackets (in vivo) in comparison to the conventional adhesive systems. Materials and Methods: This study was conducted on twenty patients, provided that they required the extraction of the maxillary first premolars as part of their orthodontic treatment plan. This involved only on the maxillary first bicuspids (n = 40) and the left maxillary first premolars represented the control side (n = 20) where the metal brackets (3M, Unitek™ Gemini) were bonded to that side using Transbond XT light cure adhesive (3M, Unitek). Meanwhile, the right side represented the experimental one (n = 20) and the brackets were bonded to them using Clearfil SE protect (Kuraray). After 3 months, both teeth were extracted and examined by both the energy-dispersive X-ray spectroscopy to assess the calcium and phosphorus atomic percentages were assessed in the area surrounding the bracket by and the scanning electron microscopy to evaluate the morphology and crystalline structure of the tooth surfaces. Results: A significant difference between the antibacterial monomer-containing adhesive and the conventional adhesive system in the prevention of the WSLs formation was evident in the study. Moreover, the difference in the enamel surface morphology was noted. Conclusions: Antibacterial monomer-containing adhesive can minimize demineralization around the metal brackets (in vivo) compared to the conventional one after a period of 3 months.
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Lateral rectus paralysis: An emerging neuro-ophthalmic manifestation in dengue fever
Prabhakar Srinivasapuram Krishnacharya, Suraj Kumar, Sarat Jakka, S Maheshwari
July-December 2018, 5(2):47-50
The purpose of presenting this case study is to find out the possible etiopathogenesis of lateral rectus (LR) palsy. A 17-year-old female patient presented with acute vomiting, diplopia, and bleeding per vagina for 3 days after 10 days of persistent fever. Restricted ocular movements in the right field of gaze suggested right LR paralysis, although diplopia charting performed by red and green glasses showed inconsistent results. Dilated fundoscopy examination revealed asymmetrical early papilledema. Reduced serum sodium levels less than 130 mEq/l with positive enzyme-linked immunosorbent assay NS1 antigen were found. Management included administration of intravenous fluids, inotropes, 20% mannitol, and 4 units of donor platelet transfusion. Symptomatic improvement with complete remission of diplopia was observed. This is the first case study that revealed the transient course of dengue-induced LR paralysis, the pathophysiology of which may possibly due to reduced serum sodium levels and/or raised intracranial pressure (ICP). The pathophysiology of raised ICP in dengue fever merits further research.
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Congenital optic disc anomalies: Diagnosis and clinical manifestations
Anushree Gupta
July-December 2018, 5(2):51-55
Congenital optic nerve head anomalies are a group of structural malformations of the optic nerve head and surrounding tissues. Visual prognosis depends on the type of anomaly present. Different systemic associations can be seen with congenital optic nerve anomalies. Newer ancillary investigations aid in diagnosis as well as detection of complications. Therefore, correct diagnosis and monitoring is important. Congenital optic nerve head anomalies are classified according to the abnormalities of optic disc size, conformation, or by the presence of abnormal tissue at the nerve head (pseudoswelling). Here, we present two cases of congenital optic disc anomalies with abnormality of conformation – optic disc pit and Morning Glory disc.
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