Kilicalford2729

We experienced a case of vocal cord dysfunction (VCD) in a child to whom an adrenaline autoinjector (Epipen®) had been prescribed and frequently used following a diagnosis of exercise-induced anaphylaxis. An exercise test was performed to investigate her frequent episodes of anaphylaxis-like symptoms. A few minutes after starting the test, signs of dyspnea, such as throat tightness and stridor, appeared, although hypoxia was not present and her respiratory sounds were normal. Medications were not effective for treating her respiratory symptoms. Laryngoscopy performed at the test revealed bizarre vocal cord movement, which was diagnosed as VCD. The symptoms gradually diminished after the initiation of biofeedback therapy, including pursed lips breathing and abdominal breathing. Thereafter, she did not use an adrenaline autoinjector when symptoms appeared; instead, she would perform biofeedback therapy before using the adrenaline autoinjector. Thus, VCD should be included in the differential diagnosis of patients who show anaphylactic symptoms that are resistant to preventive therapy.We present a rare case of repetitive lung disease caused by various herbal medicines containing common ingredients. In June 201X-2, an 81-year-old man with chronic sinusitis was treated with Shini-seihai-to. One month later, the patient experienced liver dysfunction, and pulmonary opacity was observed on a chest radiograph; this condition improved following the discontinuation of Shini-seihai-to. In October 201X-2, the patient developed fever and dyspnea after treatment with Saiko-keishi-to, which was administered to treat irritable bowel syndrome, and was diagnosed with pneumonia. His condition did not improve with antimicrobial treatment but did improve with systemic corticosteroids. Following discharge from the hospital, the patient took both Shini-seihai-to and Hochu-ekki-to. He developed a fever two days later, which improved after discontinuing the medicines. The patient developed a cough after taking Sairei-to in February 201X and was subsequently admitted to our hospital with respiratory failure; pulmonary opacity was observed on a chest computed tomography scan. On the basis of clinical course, lymphocytosis in bronchoalveolar lavage fluid, and drug-induced lymphocyte stimulation tests, we diagnosed the patient with Sairei-to-induced lung disease. selleckchem The patient's condition improved after discontinuing Sairei-to. We conclude that common ingredients in different herbal medicines may cause drug-induced lung injury. Therefore, we recommend that scrupulous attention should be paid to Chinese herbal medicine use in patients with a history of lung injury induced by herbal medicines.

We reported that post-emetic serum thymus and activation-regulated chemokine (TARC) levels may be a potential biomarker to diagnose solid food protein-induced enterocolitis syndrome (FPIES). However, there are no reports on the relationship between FPIES severity and serum TARC levels.

The subjects were 13 cases of FPIES (hen's egg=10, Wheat=1, rice=1, short-neck clam=1) for a total of 22 events (7 emergency outpatient visits, 9 positive and 6 negative results of oral food challenge test). Serum TARC levels at 6 and 24 h after antigen ingestion were compared between the symptomatic and asymptomatic events and the mild-moderate and severe events. We also evaluated the correlation between vomiting duration and serum TARC levels.

The median serum TARC (pg/ml) in the asymptomatic, mild-moderate, and severe events were 546, 1093, and 3127 at 6 h after ingestion, and 910, 2053, and 6496 at 24 h after ingestion, respectively. The serum TARC level was significantly higher in the symptomatic events than the asymptomatic events, and it was significantly higher in the severe events than the mild-moderate events (p < 0.01). There was a moderate correlation between serum TARC levels and vomiting duration.

Post-emetic serum TARC correlates with the severity of FPIES. It is expected that this information will lead to an objective evaluation of the severity of FPIES.

Post-emetic serum TARC correlates with the severity of FPIES. It is expected that this information will lead to an objective evaluation of the severity of FPIES.

We studied clinical efficacy and safety after 1 year of mite sublingual immunotherapy (SLIT) for perennial allergic rhinitis in children, compared with adults.

We compared 121 children under 15 yeas old (81 male, aged 5-14 years, a median of 12 years) and 77 adults (36 male, aged 15-65 years, a median of 26 years) treated with mite SLIT tablet (10000 Japanese Allergy Unit). The clinical efficacy before and 1 year after SLIT was evaluated by assessing symptom scores by Japanese rhino-conjunctivitis quality of life questionnaire (JRQLQ No1) and visual analog scale (VAS). Combined medication was also compared. Adverse events of SLIT were checked at every visit.

All items of JRQLQ No1 scores and VAS after 1 year of mite SLIT, except eye symptoms in adults by JRQLQ No1, were significantly improved in both children and adults. Comparing children and adults, there were no differences in symptoms before and after 1 year. Combined medication score showed a similar result. Adverse events were observed in 57.9% of children and 58.4% of adults, but there were no serious adverse reactions.

There was no difference between children and adults in efficacy and safety of mite SLIT, and both group showed significant improvement of symptoms.

There was no difference between children and adults in efficacy and safety of mite SLIT, and both group showed significant improvement of symptoms.[This corrects the article DOI 10.4103/ijo.IJO_233_20].Orbital infarction syndrome is an uncommon pathology with devastating consequences. It is frequently secondary to atherothrombotic phenomena in the internal carotid artery. We report a case of a 66-year-old male with uncontrolled diabetes and use of systemic steroids for COVID-19, who presented with a sudden loss of vision in the left eye, with total ophthalmoplegia and diffuse opacification of the retina. On imaging, he was found to have features of rhino-orbital cellulitis with ischemia of the orbital tissue secondary to isolated ophthalmic artery obstruction (OAO) with a patent internal carotid artery. KOH mount of deep nasal swab was confirmatory of mucor. This is the first reported case of orbital infarction syndrome in the setting of COVID-19.A 40-year-old woman presented with headache, bilateral optic disc edema, and visual loss. She had been diagnosed with COVID-19 (coronavirus disease 2019) 15 days ago. Her cerebrospinal fluid opening pressure was 410 mmH2O, and cranial imaging was normal. She had obesity as a risk factor but had not experienced any ophthalmic complaints before. COVID-19 could be a causative or precipitating factor for intracranial hypertension especially in high-risk groups even in the late phases of the disease and has not been discussed in the literature as such. This should be studied further and kept in mind to prevent permanent loss of vision.We describe a case of 63-year-old woman, with primary open-angle glaucoma (POAG) who presented to us in the COVID era with uncontrolled intraocular pressure (IOP) on maximum medical therapy (MMT) in the right eye (OD), previously operated twice for trabeculectomy in (OD), and once in left eye (OS). A modified graft-free surgical technique of inserting the Ahmed Glaucoma valve (AGV) tube through a scleral sleeve was employed. Visual acuity and IOP remained stable during 6-month follow-up period.We describe a novel device, Jagat and Bala Intraocular lens Supporting System (JBISS), an artificial Intraocular lens (IOL) platform that facilitates IOL fixation in an aphakic patient with poor capsular support and also facilitates IOL exchange in case of myopic shift or refractive surprise. Implantation of JBISS along with IOL was carried out in four patients and results are promising without any adverse events.A 59-year-old woman who underwent uneventful laser in situ keratomileusis surgery 16 years ago presented with traumatic flap dislocation complicated by an epithelial ingrowth in the right eye. The epithelial ingrowth was managed with re-lifting the flap, mechanical debridement, soaking with 70.0% alcohol, and irrigation. The flap was repositioned and secured with a two-part glue technique. Serial anterior segment-optical coherence tomography demonstrated a well-attached flap with no gap or haze in the flap-stromal interface. Three weeks postoperatively, the patient returned to emmetropia and the uncorrected distance visual acuity improved to 20/20. Twelve months postoperatively, the patient's visual acuity remained 20/20, and there was no evidence of recurrent epithelial ingrowth.The aim of this study was to describe a novel device for improved visualization of descemet membrane (DM) during donor preparation for descemet membrane endothelial keratoplasty (DMEK). Comparative analysis was performed using this device (group 1) versus conventional technique (group 2) between an experienced and a trainee surgeon. A total of 20 eyes were analyzed in each group. Average time for DM peeling by experienced surgeon was 238.8 + 17.2 s in group 1 and 382.8 + 36.3 s in group 2 (P less then 0.0001), and for trainee surgeon it was 519 + 30.8 s and 686.8 + 31.9 s (P less then 0.0001). Retro-illumination made it easier to identify the peripheral cut edge of DM and abnormal adhesions to the underlying stroma during peeling. In group 2, DM tear occurred in 2/10 eyes with an experienced surgeon and 4/10 eyes with a trainee surgeon. Our novel device with retro-illumination allows DM peeling for donor preparation in DMEK to be performed safely with reduced risk of tissue damage.We herein describe a novel device to contain droplets and aerosols during phacoemulsification. We modified the silicon phaco test chamber into an aerosol containment chamber (ACC) by shortening the chamber and making a pear-shaped opening at one aspect of its tip. The ACC was fitted over phaco tip such that 4-5 mm of phaco tip and sleeve was exposed. When the phaco tip and irrigation port are inside the anterior chamber during phacoemulsification, the portion of the modified chamber remains around the clear corneal tunnel in an enclosing manner that contains aerosols and droplets.The procedure involved an ab-externo scleral fixation technique using a double-armed 10-0 polypropylene suture with straight needles that require no scleral flaps. The IOLs are sutured to the sclera, the free suture ends are tied to the suture loops, and they are buried together under the sclera. Forty eyes of 37 patients were included. Postoperative complications are IOL capture in five eyes (12.5%), a significant IOL tilt in one eye (2.5%), recurrent UGH (uveitis-glaucoma-hyphema) syndrome in two eyes (5%), glaucoma in three eyes (7.5%), suture exposure in two eyes (5%) and IOL drop due to haptic breakage in one eye (2.5%). The technique can be effectively used for the refixation of dislocated hydrophobic acrylic IOLs by temporary haptic externalization through a corneal incision and for the treatment of aphakia with or without penetrating keratoplasty. Surgeons should be aware of the possibility of UGH syndrome due to IOL capture, especially in young eyes.