Sambuddha Ghosh

Prospective randomized comparative study of macular thickness following phacoemulsification and manual small incision cataract surgery

Purpose:  To compare macular thickness following uncomplicated phacoemulsification with foldable acrylic lens and manual small incision cataract surgery (MSICS) with non‐foldable polymethyl methacrylate (PMMA) lens implantation.

Visual impairment in urban school children of low-income families in Kolkata, India

To evaluate pattern of visual impairment in school children from low-income families in Kolkata, India, an institutional cross-sectional study was conducted among 2570 children of 10 primary schools. Ocular examination including refraction was done and pattern of visual impairment and refractive error was studied. The age range was 6-14 years. Refractive error was seen in 14.7%. Only 4 children were already wearing correction. Myopia and hypermetropia was present in 307 (11.9%) and 65 (2.5%) children, respectively. Visual acuity of less than 6/12 in better eye was present in 109 (4.2%) and 5 (0.2%) children pre- and post-correction, respectively. Eighteen children had amblyopia. Although prevalence of refractive error in this group is less compared to school children of all income categories reported from other cities of India, it is more compared to school children of all income categories from the same city. Refractive error mostly remains uncorrected in this group.

Touton like giant cell in lymph node in a case of langerhans cell histiocytosis

Aspiration cytology of lymph node of a one-year old girl suffering from acute disseminated Langerhans cell histiocytosis revealed pleomorphic histiocytes and multinucleated giant cells, including Touton like giant cells. Histology of the same lymph node showed atypical histiocytes but no giant cell. We report this case because presence of Touton like giant cells in aspiration cytology smear of lymph node is a rare finding. Journal of Cytology 2007; 24 (4) : 191-192

Correlation of C-reactive protein and body mass index with diabetic retinopathy in Indian population.

BACKGROUND Association of C-reactive protein (CRP) and body mass index (BMI) with diabetic retinopathy (DR) has conflicting reports. METHOD Sixty diabetes patients each with DR (Group A), no DR (Group B) and 60 healthy volunteers (control, group C) were studied. CRP was measured. BMI was calculated. RESULT Significant difference in CRP was observed between groups A & B (p=0.000) and A & C (p=0.007). No significant difference in BMI was observed. Central macular thickness correlated positively with CRP and negatively with BMI. CONCLUSION We observed strong association of CRP with DR and no significant relationship between DR and BMI.

A clinicopathological study of malignant melanoma with special reference to atypical presentation

Malignant melanoma is a tumor of melanocytic origin. Lymphatic and hematogenous metastases are common in this condition. Retrospective analysis was performed in 16 consecutive cases diagnosed histopathologically as malignant melanoma at the pathology department of a medial college in eastern India. 75% of the patients were male; majority of them was in their sixth decade. All (100%) the lesions were pigmented. The primary site was known in all cases, except two (12.5%). Out of the 14 cases with known primary site 11 (78.57%) were cutaneous melanomas, including one arising in labia minora, two (14.29%) were ocular and one (7.14%) was vaginal in origin. Among cutaneous melanomas, superficial spreading type was the commonest variety and mixed population of epithelioid and spindle cell was the commonest histopathological pattern. The commonest grade of invasion was grade III (Clarks). The clinical presentation of the case of vaginal melanoma and the two cases of secondary melanomas, including the one with obscure primary tumor, were bewildering and hence are discussed separately.

An observational study of the pattern of HIV infection in a specified rural area of India with special reference to migratory laborers.

Objective: Determination of the pattern of HIV/AIDS in patients attending voluntary confidential counseling and testing center (VCCTC) and prevention of parent-to-child transmission (PPTCT) center of a low-prevalence district of Eastern India. To find out high-risk group and interventional strategy for prevention. Method: Cross-sectional exploratory secondary data analysis from the VCCTC and PPTCT register. Result: Of the 1348 participants, 160 (11.86%) adults were HIV seropositive. Prevalence in males and females was 9.8% and 20.7%, respectively. Among 22 (1.63%) seropositive children, transmission was vertical in 18 (81.8%). Seventy-one (88.75%) positive adult males were migratory goldsmiths working in Mumbai and other big cities. They were clustered in a particular locality (Daspur). Conclusion: Goldsmiths migrated from Daspur to big cities are the bridge populations who are responsible for higher prevalence of HIV in their families and locality. Interventional strategies targeted at this high-risk group are suggested.

Change in tear protein profile in diabetic retinopathy with duration of diabetes.

AIMS To study change in tear protein profile with duration of diabetes and severity of diabetic retinopathy (DR) in type 2 diabetes patients. MATERIALS AND METHODS Tear protein profile was ascertained by SDS PAGE method in 30 patients with DR (group A) and 37 patients without DR (group B). RESULTS Six distinct bands of proteins were identified; these proteins are as follows: 91kDa (P1), 66kDa (P2), 60kDa (P3), 30kDa (P4), 18.4kDa (P5) and 14.4kDa (P6). Prevalence of P3 was significant (p=0.036) in group A, especially in cases with diabetes ≤8 years compared with diabetes >8 years (p=0.0107). In group B, P2 was significantly prevalent (p<0.0013) in cases with diabetes ≤8 years compared to diabetes >8 years. Considering the changes in terms of duration of diabetes in general, patients with diabetes of ≤8 years, P3 was significantly prevalent in group A compared to group B (p=0.004); and when the duration of diabetes is >8 years, P2 was found significantly more in group A compared to group B (p=0.01). No significant difference in P3 (p=0.025), P4 (p=0.2877), P5 (p=0.4801), P6 (p=0.0985) was observed in mild to moderate NPDR group compared to severe NPDR to PDR group. P1 and P2 were present only in severe NPDR and PDR. CONCLUSION Variable protein expression was observed with duration of diabetes and severity of diabetic retinopathy.

Characterization of changes in Retinal Pigment Epithelium layer in Choroidal Neovascularization through analysis of Optical Coherence Tomographs

Choroidal Neo-Vascularization (CNV) is a form of Age related Macular Degeneration (AMD) which leads to severe central vision loss. Therefore, it is needed to analyze the alterations that occur during CNV by quantification of the changing parameters. In CNV, the Retinal Pigment Epithelium (RPE) layer undergoes many changes and could be recorded by Optical Coherence Tomography (OCT). The highly reflective band, corresponding to the RPE and choriocapillaries visible in an OCT image, shows a fusiform thickening, loss of linearity, and disruption in CNV due to proliferation of new abnormal blood vessels there. This study characterizes the CNV related changes in the RPE layer. Initially by image processing, the RPE layer is segmented out and quantification of the features related to the mentioned changes is done through computing the Euler number, thickness standard deviation, mean thickness, maximum thickness and area of the RPE layer. There is a notable increase in the Euler number, thickness standard deviation, and maximum thickness during CNV.

Idiopathic Intracranial Hypertension in a Child After Hemodialysis

Idiopathic intracranial hypertension remains a disease of unknown etiology. Epidemiology, associations, features, and prognosis in children have changed over the years. The main clinical complaint of pediatric idiopathic intracranial hypertension is headache with visual disturbance. We report on a patient with childhood idiopathic intracranial hypertension, who presented without headache after hemodialysis for acute renal failure. Idiopathic intracranial hypertension without headache is believed to have a poor prognosis. However, this child demonstrated a favorable outcome with medical therapy. The child was followed with serial optical coherence tomography of retinal nerve fiber layer thickness around the optic nerve head. In the absence of a reliable procedure to evaluate the therapeutic efficacy in the follow-up of patients with idiopathic intracranial hypertension, the importance of optical coherence tomography, a noninvasive, objective, and reproducible procedure, is highlighted as a useful adjunct in the management of idiopathic intracranial hypertension.

Segmentation of retinal blood vessels through Gabor features and ANFIS classifier

We introduce a technique for extracting the vessel structure in the fundus image of a retina. Retinal vessel segmentation achieved by categorizing every pixel belonging to vessel structure or not, derived from characteristic vector consisting of the gray level values and coefficients of 2-D Gabor wavelet at various scales. Specific frequency tuning of Gabor wavelet allows vessel segmentation even in the presence of noise in the image. We use Adaptive Network Fuzzy-Inference System (ANFIS) classifier with linguistic expression modeling capability and self-learning, yielding accurate classification. The openly accessible DRIVE database is used for performance evaluation of manually labeled images. In addition, Performance evaluation carried on fundus images provided by the ophthalmologist. The results obtained are quiet promising when inspected visually in both normal as well as pathological images.