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Introduction: Psoriasis Vulgaris (PV) is a chronic inflammatory dermatological disorder that affects skin, nails, and joints and has various systemic associations. The current case report is the first of its type to highlight the observations on manifestations of Psoriasis Vulgaris in an adolescent girl with Naturopathic diet, treatment, and Yoga Intervention. Method: An eighteen-year-old female who was diagnosed with Psoriasis Vulgaris at 9 years of age was administered Nature cure and Yoga for 16 weeks as an individualized diet and treatment protocol in an inpatient Nature Cure and Yoga Hospital in South India. Improvement in Psoriasis Area Severity Index (PASI) score and reduction in body mass index (BMI) were observed. Conclusion: The changes observed are found to be consistent over 1 year. This case report also demonstrates the beneficial effects of Naturopathic diet, treatment, and Yoga as an effective treatment modality in the management of Psoriasis Vulgaris for both physical and psychological levels.

This study delves into the impact of downstream obstruction angles on the discharge coefficient (Cd) over ogee weirs within open channel flows, a critical factor for accurate flow rate predictions in hydraulic engineering. Employing a series of detailed laboratory experiments, the influence of various obstruction angles on Cd was scrutinized applying a suite of regression analysis to develop predictive models. The analysis was enriched by considering hydraulic parameters such as flow rate, water level, and weir geometry. Despite the established importance of Cd in hydraulic designs the nuanced effects of downstream obstructions have received limited attention, highlighting a critical research gap. The findings highlight a strong correlation between obstruction angles and Cd, with developed regression models demonstrating notable predictive strength. Remarkably the models exhibited varying levels of accuracy, with the Random Forest regressor achieving an exceptionally low root mean square error (RMSE) of 0.005, indicating superior predictive performance. Conversely, traditional models like Decision tree and XG BOOST reflected higher RMSE values of 0.60, suggesting less predictive accuracy in this context. LASSO, Bayesian Ridge, and OMP regressors stood out with an RMSE of zero, denoting perfect predictions under the study's specific conditions. HIGHLIGHTS The study employed multilinear and polynomial regression techniques to predict variations in the coefficient of discharge for an ogee weir due to downstream obstructions at different angles. This approach provides a quantifiable understanding of how such obstructions impact hydraulic efficiency.; Results highlight the significant impact of obstructions on the discharge efficiency of ogee weirs, emphasizing the need for careful consideration of potential downstream barriers in the design and management of hydraulic structures to optimize performance and reduce flood risks.; The findings offer valuable insights for engineers and practitioners in the field, suggesting that regression models can serve as effective predictive tools for estimating the discharge coefficient under various scenarios, aiding in the design and operation of more efficient hydraulic systems.;

Capsicum is generally infested with many biotic agents mainly sucking insects, among them the major is aphid (Myzus persicae). Chemical management is one of the most common strategies for their management. However, there are no recommended insecticides for insect management in polyhouse. An experiment was designed to assess the bio-potency of four popularly used insecticides (Imidacloprid-17.8SL, Acephate-75SP, Dimethoate-30EC and Buprofezin-25SC), a botanical (Neem oil 10000 ppm) and two entomopathogenic fungi (Metarhizium anisopliae 1.15%WP and Lecanicillium lecanii 1.15%WP) for two consecutive seasons. Most effective and the highest reduction of aphid population (78.14–81.92 %) were found in imidacloprid (17.8SL) treated plots. This effective molecule imidacloprid was further studied for its dissipation pattern under polyhouse and open condition and found that the imidacloprid residues in capsicum fruit dissipated below quantification limit (BQL) within 10days after final spray and the residues in the soil sampled at harvest time were found below the detection level. The half-lives of imidacloprid were 1.88 and 2.61 days under polyhouse and 1.07 and 1.52 days in open field at recommended doses (25 g a.i. ha−1) and double doses (50 g a.i. ha−1) of application respectively. The dietary exposure of imidacloprid on capsicum fruit under both conditions exposed that hazard quotient (HQ) values obtained from the different treatment doses have not exceeded the upper limit of toxicity (HQ

Soft grippers are garnering increasing attention for their adeptness in conforming to diverse objects, particularly delicate items, without warranting precise force control. This attribute proves especially beneficial in unstructured environments and dynamic tasks such as food handling. Human hands, owing to their elevated dexterity and precise motor control, exhibit the ability to delicately manipulate complex food items, such as small or fragile objects, by dynamically adjusting their grasping configurations. Furthermore, with their rich sensory receptors and hand-eye coordination that provide valuable information involving the texture and form factor, real-time adjustments to avoid damage or spill during food handling appear seamless. Despite numerous endeavors to replicate these capabilities through robotic solutions involving soft grippers, matching human performance remains a formidable engineering challenge. Robotic competitions serve as an invaluable platform for pushing the boundaries of manipulation capabilities, simultaneously offering insights into the adoption of these solutions across diverse domains, including food handling. Serving as a proxy for the future transition of robotic solutions from the laboratory to the market, these competitions simulate real-world challenges. Since 2021, our research group has actively participated in RoboSoft competitions, securing victories in the Manipulation track in 2022 and 2023. Our success was propelled by the utilization of a modified iteration of our Retractable Nails Soft Gripper (RNSG), tailored to meet the specific requirements of each task. The integration of sensors and collaborative manipulators further enhanced the gripper’s performance, facilitating the seamless execution of complex grasping tasks associated with food handling. This article encapsulates the experiential insights gained during the application of our highly versatile soft gripper in these competition environments.

Abstract Pesticides are widely used in agriculture, but their persistence in agricultural products can lead to potential health risks and environmental pollution. Traditional methods for removing pesticide residues from food products, such as washing, peeling, and salting, are often insufficient and time‐consuming. As a result, there has been a shift towards nonthermal processing techniques, such as ultraviolet (UV) disinfection. UV disinfection methods, such as low‐pressure and medium‐pressure mercury lamps, are more efficient and environmentally friendly and can effectively remove pesticide residues from food and agricultural products. Recently, the contamination of food products' surfaces with pesticides has become a significant concern in the food industry. This review paper provides an overview of the basic principles of UV light production, pesticides, and the use of UV in eliminating pesticide residues from agricultural products. The toxicity of photoproducts from pesticides that result from UV treatment is also discussed. Additionally, this paper explores how modified, and combined UV light applications can impact the dissipation of pesticides in agricultural commodities. To sum up, the use of UV light is effective for pesticide degradation but requires further research to optimize the technology and evaluate potential photoproduct toxicity. Future studies should concentrate on developing UV Vacuum technology and exploring synergistic combinations with other methods to improve pesticide reduction in agricultural commodities.

Background and Aims: Approximately 570,000 new cases are diagnosed with esophageal cancer worldwide annually and approximately 510,000 deaths from this disease per year. There are currently no effective second-line treatments for patients who progress on cisplatin and 5-fluorouracil. Esophageal squamous cell carcinomas and adenocarcinomas have proven to be inherently resistant to systemic treatments as a result of histological, molecular and etiological heterogeneity, with limited responses seen after first line therapy. Methods: We are presenting 3 case reports of 57 year old man, 53 year old man & 47 year old woman who, presented with dysphasia for solid foods, weight loss and dyspepsia since 1 month, 3 months & 1.5 months respectively. Upper gastro oesophageal endoscopy shows ulcerated friable lesion with minimal luminal compromise with biopsy showing poorly differentiated adenocarcinoma (PDAC) and PECT-CT showed FDG avid lesions in gastroesophageal junction, gastric cardia, multiple retroperitoneal lymph nodes and bilateral liver lesions. All 3 were having stage IV disease, with PDAC, squamous cell carcinoma & PDAC respectively. We have started 1st patient on DOX regimen containing Docetaxel, Oxaliplatin and Capecitabine at an interval of 2 weeks and after 4 cycles he was having stable disease in GE junction, liver and slightly increased size of retroperitoneal lymph nodes. Second & 3rd patient was put on Pclitaxel-carboplatil protocol, after 6 cycles both were having partial response & was managed with 6 cycles CAPOX as second line che otherapy. After 5th & 6th months of second line chemotherapy both patients were having progressive disease. Results: In view of radiological progression we started him on Injection, Nivolumab 240mg intravenously every 2 weekly along with low dose capecitabine 500mg twice a day. After 4 cycles of treatment his PET-CT showing complete metabolic response in GE junction, liver and retroperitoneal lesions. Now we are continuing Nivolumab and low dose capecitabine planned to complete for 2 years. Conclusion: So to conclude nivolumab along with metronomic chemotherapy with low dose capecitabine was very well tolerated and exhibited antitumor activity in extensively pretreated patient with metastatic esophageal poorly differentiated adenocarcinoma. Additional studies of Nivolumab and metronomic chemotherapy and immuno-immuno combination therapy in these diseases are ongoin.

Lagophthalmos is a condition characterized by incomplete or abnormal closure of eyelids along with the evaporation of tear film. If left untreated, it progresses to corneal ulceration, perforation, and visual loss. Conservative nonsurgical treatment includes the use of artificial tears, ointments, and therapeutic contact lenses. However, if nonsurgical approaches are not effective, surgical procedures such as tarsorrhaphy and gold/platinum implantation are used which are expensive with risks of poor cosmetic appearance. The current case was diagnosed as lagophthalmos which can be clinically correlated to Vatahata vartma described in Ayurveda. Amapachana followed by Panchakarma and Kriyakarmas along with Vata shamana chikitsa were adopted which are cost-effective, less invasive, and cosmetic friendly when compared with conventional science. This article highlights the successful reduction in core symptoms of lagophthalmos with the Ayurveda line of treatment.

We report the occurrence of unilateral central retinal vein occlusion (CRVO) in a young yoga enthusiast who presented amidst the COVID-19 pandemic. Subtle signs of uveitis when systemically investigated revealed a multitude of causes, but ocular fluid polymerase chain reaction was positive for varicella zoster virus (VZV). The prompt initiation of antivirals resulted in a good visual outcome. Our case describes the rare presentation of VZV retinal vasculitis as CRVO in a young healthy individual and highlights the importance of early antiviral therapy for favorable outcomes.

BACKGROUND: Women are known to be at high risk of human papillomavirus (HPV) infection and its associated cervical pathology. However, limited data are available on circulating genotypes, especially among human immunodeficiency virus (HIV)-negative women. Therefore, the present study was designed to gauge the prevalence of HPV genotypes in HIV-negative women. MATERIALS AND METHODS: This cross-sectional study was conducted on a total of 96 HIV-negative women in the age range of 18–45 years. Cervical samples were collected from the transformation zone of the cervix using the deoxyribonucleic acid collection device (cytobrush), which was rinsed in 20 ml of PreservCyt® vial (Hologic, Inc.). HPV genotyping was done with the linear array HPV genotyping test (Roche, Branchburg, NJ, USA) at National Aids Research Institute, Pune. RESULTS: A significant linear increasing trend in proportion of carcinogenic and noncarcinogenic genotypes over grade was observed (P = 0.039 and P = 0.0024, respectively). HPV 59 was reported to be the most common genotype followed by 16, 53, 62, and 72 but without any statistical significance. CONCLUSION: Screening strategies incorporating HPV genotyping and vaccination should be effective in preventing cervical cancer in HIV-negative women.

Background and Aim: Human papillomavirus (HPV) infection is the established cause of cervical cancer. There is sparse literature with regard to HPV infection from the southern Belagavi region of India. This study was aimed to detect the HPV genotype distribution, the associated risk factors, and relation with cervical precancerous lesions among HIV-infected women from Belagavi, India. Materials and Methods: In this prospective observational study, a total of 214 HIV-infected women aged 18–45 years were recruited. Cervical samples were subjected to the Roche Linear Array assay for HPV detection and genotyping. Cervical status was determined by composite assessment of cytology, colposcopy, and histology. Data were analyzed using Software R version 3.6.0. Results: Of the 197/214 women with the adequate cervical sample, 86 (43.6%) were HPV positive, and 111 (56.3%) were HPV negative cases. A total of 132 (69.1%) women had normal cervical status, 26 (13.6%) had CIN1 lesions, 1 (0.5%) had CIN2 lesions, and 12 (6.3%) had CIN3 lesions. Single HPV infection was detected in 47 (54.6%) women and multiple (≥2) HPV genotypes were detected in 39 (45.3%). The HPV genotypes detected in descending order of frequency were HPV 16, HPV 33, HPV 35, HPV 52, and HPV 58. Ever pregnant (parous) women were 4.47 more likely to have HPV infection. Conclusion: A high prevalence of HPV infection, with a wide diversity of HPV genotypes and a greater prevalence of HPV 16 among HIV-positive women from Belagavi, India, was observed. Parity was the independent factor associated with HPV detection.

PURPOSE: The purpose of the study was to assess the treatment protocol of topical 2.5% Povidone-Iodine (PovI) and 0.1% fluorometholone (FluM) for Adenoviral Epidemic keratoconjunctivitis (EKC) in reducing the duration and severity of the disease as compared to conventional treatment. This was a retrospective case–control study. MATERIALS AND METHODS: Cases were defined as patients with EKC receiving the treatment protocol and conjunctival swab taken for polymerase chain reaction. Controls were defined as similar patients receiving conventional treatment protocol. Forty-one cases and 35 controls were identified for analysis. Cases were treated with a protocol using 2.5% povidone-iodine eye drops and 0.1% FluM eye drops. Controls received conventional treatment until resolution of signs and symptoms. Both the groups were followed up for 1 month. Data collected were analyzed for effect of the two treatment protocols on the duration of EKC, rate of recovery, and incidence of complications. RESULTS: The treatment protocol was significantly better than conventional treatment protocol in achieving cure (P = 0.002) with large effect size. The proportion of cases achieving cure was significantly higher with treatment protocol (64% vs. 11% at 5 days, P < 0.001) by 5 days. There was a significant reduction of the subepithelial infiltrates (SEI) incidence group (10% vs. 57%, P < 0.001). There were no SEI at 1 month in the treatment group (0% vs. 31%). CONCLUSION: Treatment protocol used in our study can significantly reduce the severity and duration of EKC. It can prevent chronic keratitis in majority of cases. Since povidone-iodine is nonspecific and virucidal for adenovirus, this therapy can be used for other types of adenoviral conjunctivitis.

CONTEXT: Although relation between Lens Opacities Classification System III (LOCS III) and nuclear density is established, no data are available about nuclear size at different LOCS III grades. AIMS: The aim of this study is to evaluate the relation between LOCS III grading of nuclear opacity obtained preoperatively and the size of the nucleus obtained during cataract surgery. SETTINGS AND DESIGN: This was a prospective observational study carried out in a hospital attached to medical college. MATERIALS AND METHODS: Patients who underwent manual small-incision cataract surgery or extra-large temporal tunnel cataract extraction and gave consent were included in this study. Institutional Ethics Committee clearance was taken for the study. Preoperative LOCS III grading was obtained at slit-lamp biomicroscope. Ocular dimensions were obtained by preoperative immersion biometry. The thickness and diameter of the nucleus obtained by extraction were measured up to 10 μ accuracy. Data were analyzed for the change in nuclear thickness, nuclear diameter, age, lens thickness, and anterior chamber depth in relation to the LOCS III grade of the nucleus. STATISTICAL ANALYSIS USED: Statistical analysis used in this study was one-way ANOVA, mean, and range. RESULTS: There was a significant increase (P < 0.05) in nuclear thickness, nuclear diameter, and age with increasing LOCS III grade of the nucleus. The change in nuclear size was linear between Grades 1 and 4. The nuclear size did not increase between Grades 4 and 5. It increased steeply from Grade 5 to Grade 6.9. CONCLUSION: LOCS III grading of the nucleus can be utilized for determining the nuclear thickness and diameter preoperatively. These data can be helpful in adjusting machine parameters during phacoemulsification.

Purpose: The objective of the study is to report a rare case of severe vaso-occlusive retinopathy with bilateral simultaneous Central Retinal Artery Occlusion (CRAO) in a patient with Systemic Lupus Erythematosus (SLE). Observations: A female patient aged 22 years, presented with a sudden onset of painless diminution of vision in both eyes for three weeks. She had systemic features of SLE for six months at the time of the study. A diagnosis of bilateral CRAO was made after an examination of the fundus and by ruling out other causes of severe vaso-occlusion based on clinical and angiogram findings. Her antiphospholipid antibody (APLA) levels were normal. The visual prognosis was poor even after treatment with intravenous steroids and panretinal photocoagulation. Conclusion and importance: This case highlights the importance of bilateral CRAO as an initial presentation of severe systemic disease. This case demonstrates that despite apparent normal APLA levels, a state of hypercoagulability can exist in SLE patients. In addition, it demonstrates that severe vaso-occlusive complications such as CRAO, which results in blindness, can also develop in a patient with apparently well-controlled SLE. Therefore, it is important to take cognizance of this sight-threatening complication in SLE patients at initial presentation. A holistic approach to management, both systemic and ocular, is required to prevent sight-threatening complications from vaso-occlusion. Early and aggressive intervention can be beneficial in the prevention of severe visual loss.

Skin metastases from colorectal carcinoma are rare and signal advanced disease. Skin metastasis refers to growth of cancer cells in the skin originating from an internal cancer. In most cases, cutaneous metastasis develops after the initial diagnosis of the primary internal malignancy and late in the course of the disease. In very rare cases, skin metastasis may occur at the same time or before the primary cancer has been discovered and may be the prompt for further thorough investigation. The incidence of skin metastasis varies but is somewhere between 3-10% in patients with a primary malignant tumor. Most common ones are melanoma (45%), breast cancer (30%), nasal sinus cancers (20%), cancer of the larynx and cancer of the oral cavity (12%) cases. Here we present a case of 39-year-old man presented to us with multiple subcutaneous lesions over the chest and forehead. Fine needle aspiration cytology of skin nodules revealed metastatic adenocarcinoma features. Further imaging of the abdomen with computed tomography (CT) revealed circumferential narrowing of caecum and ascending colon. The patient was managed with palliative right hemicolectomy in view of constipation and palliative chemotherapy as systemic treatment. An extensive review of the English literature did not reveal extensive data on metastatic subcutaneous nodules leading to diagnosis of colon cancer.

Background: Hepatitis C virus (HCV) known to be associated with wide variety of liver pathology. It is less studied in India as compared to western region. Methods: Suspected patients sera screened for HCV by ELISA and confirmed with reverse transcription polymerase chain reaction (RT-PCR) along with routine investigations and liver profile. All HCV positive patients were undergone liver biopsy. Results: All 24 HCV ELISA reactive and two ELISA indeterminate sera are confirmed by RT- PCR. The liver biopsy of these patients showed normal picture (19.2%), Acute hepatitis (11.5%), Chronic hepatitis (23.7%), Cirrhosis (34.72%), Hepato-cellular carcinoma (HCC) (15.38%). ALT levels were not significant. Conclusion: All the suspected HCV cases need to be confirmed for HCV by RT-PCR.

Genetic variability studies offers basic information related to genetic properties of the population based on which breeding methods could be formulated for further improvement of the crop. The estimates of heritability, coefficients of variability and genetic advance was calculated in a multi-parent advanced generation inter-cross (MAGIC) F2 segregating populations for 10 traits including nicotine percentage, total soluble sugars and yield contributing traits during 2015 seasons at Northern Light Soils (NLS). The estimates of phenotypic coefficients of variation (PCV) were high and moderate for plant height (18.16%), number of leaves (15.96%), leaf area index (27.35%), internodal length (21.01%), stem diameter (16.73%), grade index (13.86%), nicotine percentage (19.87%), total soluble sugars (39.81%), chlorides (23.35%) and leaf yield (13.27%) in MAGIC-F2 segregating populations at NLS 2015 season. High heritability coupled with high and moderate genetic advance was observed for all the traits studied. Correlation studies revealed that total soluble sugars was positively and significantly correlated with leaf area index, stem diameter, grade index and leaf yield. However total soluble sugars was negatively correlated with nicotine as total nicotine alkaloid and with chlorides percentage. Path coefficient analysis revealed that total percentage of sugars could be improved through selection of grade index, stem diameter, leaf area index and cured leaf yield which were positively correlated with total soluble sugar percentage. The current study also revealed that the MAGIC F2 population could be used for development high sugar lines with moderate or low levels of nicotine and chlorides in tobacco.

Chloroma (granulocytic sarcoma or myeloid sarcoma) is a rare malignant extra-medullary neoplasm of myeloid precursor cells. It is usually associated with myeloproliferative disorders but very rarely may precede the onset of leukaemia. Here we are presenting a rare case of chloroma in a female patient without initial presentation of AML. 38 year old female patient, with performance score-1 had complaining of per vaginal bleeding for 1-2 days. Patient consulted gynaecologist and underwent biopsy from anterior fornix of vagina. Biopsy material was positive for LCA (leukocyte common antigen), MPO (myeloperoxidase), c-kit positive on IHC (immunohistocytochemistry) while negative for cytokeratin, synaptophysin, chromogranin, CD20 (cluster of differentiation. Whole body CT scan was non informative except mass lesion at vagina. Patient was given 3+7 induction chemotherapy which was tolerated well followed by high dose cytarabine as consolidation therapy.

Introduction: Diabetes is a chronic condition requiring lifelong management, associated with increased mortality and morbidity. It is important for diabetic patients to have knowledge regarding the disease and self-care. The objective of current study was studying correlation of patients’ knowledge regarding diabetes with their glycaemic control. Methods: It is a cross-sectional study conducted among the patients attending a diabetic clinic in a tertiary care hospital, from Sangli City (Maharashtra).The study tool was pretested and self- administered questionnaire. Analysis was done using Microsoft Excel and SPSS- 22. Results: Of the 573study participants, only 114 (19.9%) had fasting plasma glucose level ≤ 130 mg/dl. Considering the knowledge regarding diabetes; 46.4% participants had scored less than 50%, while only 12.9% participants had scored >75%. The participants with fasting plasma glucose level at ≤130 mg/dl had highest mean knowledge score. On examining with Pearson correlation; the knowledge regarding diabetes had a positive correlation with the period of diabetes morbidity and a negative correlation with fasting plasma glucose. Conclusion: The knowledge regarding diabetes was helpful in achieving better glycaemic control. Hence efforts should be made to increase the diabetes related literacy among the patients.

Background: The culture has always been the gold standard test for diagnosis of human brucellosis but the conventional Brucella diagnostic tests viz. serology and culture are often beset with poor specificity & sensitivity respectively. The culture positivity rates for Brucella vary from 92% for bone marrow to 10% for non-blood samples and also dependent on the type of sample. The primary immune-determinant for Brucella species is the cell wall surface lipopolysaccharide, which is antigenically similar to other gramnegative rods. Hence, Brucella serological tests cross react with Escherichia coli 0116 and 0157, Salmonella urbana, Yersinia enterocolitica 0:9, Vibrio cholerae, Xanthomonas maltophilia and Afipia clevellandensis infections, which are common in developing countries also having higher incidence of brucellosis. Aim: The aim of the study was evaluation of conventional serological techniques and PCR for diagnosis of human brucellosis in and around north Karnataka which is endemic for brucellosis and patients often present with elevated base line antibody titers and confounding clinical manifestations. Materials and Methods: Blood/serum samples of 400 patients suffering from acute undifferentiated fever (AUF) were subjected to culture, Brucella slide agglutination test (SAT), standard tube agglutination test (STAT coupled with 2 ME) and PCR. Results: Of the 400 AUF patients, anti-Brucella antibodies were detected by SAT and STAT in serum of 35 and 34 patients respectively. IS711 gene for Brucella was identified in 32 patients by PCR. Twenty samples yielded Brucella in culture on biphasic medium with average incubation period of 9 days. All patients having titer of ≥ 160IU / ml in STAT were found positive by PCR also. Conclusion: Brucella STAT corroborated well with PCR results in all those cases where antibodies were present at least one dilution above cut-off value of 80 IU/ml. We probably need to raise cut-off titers to ≥160 IU/ml because of endemic region. The SAT was upheld as very good quick, easy to perform and economical screening test for human brucellosis. SAT as rapid screening test and STAT as more definitive test can be very well adopted by laboratories working in resource scarce settings for diagnosis of human brucellosis in absence of PCR even for population with normally elevated antibodies levels due to residing in Brucella endemic areas.

A 38 years old female patient presented with unilateral cataract without known predisposing factors. During cataract extraction, the surgeon noticed multiple white dots scattered over inner surface of the posterior capsule. These dots were of uniform size and shape. They were distributed uniformly and involved all the areas of the posterior capsule and extended up to equator. The surgeon decided to implant IOL and tackle the opacities in a later setup. In spite of the extensive opacities, the patient's Uncorrected Corrected Visual Acuity (UCVA) at six weeks was 6/9, Best Corrected Visual Acuity(BCVA) was 6/6 and near vision with correction was N6. The other eye was normal. This case is reported for the peculiar appearance and distribution of the capsular opacities and good visual outcome in spite of this.

Introduction: Acute angle closure glaucoma is rarely seen as complication of snake bite.We report three cases of bilateral acute angle closure glaucoma with capillary leak syndrome and acute renal failure secondary to hematotoxic snake bites. We are also briefly discussing the association of capillary leak syndrome and angle closure glaucoma in hematotoxic snake bite. This is the first time an association between angle closure and capillary leak syndrome following snake bite is reported. Study type: Descriptive case series. Materials and Methods: Records of all patients admitted to ICU with snake bite were reviewed to identify cases developing acute angle closure glaucoma. These cases with acute angle closure glaucoma are analysed in detail for systemic condition. Diagnosis, management and outcome of cases are described. Results: Of the 119 snake bites admitted, 47 patients had confirmed hematotoxic snake bite. Fifteen of these patients underwent hemodialysis for acute renal failure. Seven of them were diagnosed to have capillary leak syndrome and all of them complained of decreased vision. Three of the 7 cases had acute angle closure glaucoma on the second day of bite. One of the patients expired and other two recovered fully, both of them had normal IOP and good vision at one month follow-up. Conclusion: Acute angle closure glaucoma seems to be associated with systemic capillary leak syndrome in hematotoxic snake bite. High suspicion, early recognition, timely and appropriate treatment can prevent visual loss in this rare complication.

Purpose: To determine the outcomes of extra large temporal sclero-corneal tunnel incision Cataract Surgery. Materials and Methods: This consecutive case series of eyes undergoing temporal tunnel cataract extraction with tunnel length of 8 to 10 mm was identified retrospectively. Surgical procedure details, follow up, complications, visual and astigmatic outcomes at 6wks were recorded and analysed. Results: Ninety six eyes with extra large tunnel incision were identified for analysis from a dataset of 670 manual small incision cataract surgery cases. 58% eyes had NO5 or denser cataracts. Intraoperative complications included, tunnel related problems (1 eye, 1.04%), bleeding into Anterior Chamber (10 eyes, 10.4%), Posterior Capsular Rent (2 eyes, 2.1%). Early postoperative complications included striate keratopathy (7 eyes, 7.3%). The mean Best Corrected Visual Acuity was 6/7.5 (0.1 logMAR) and 98% cases had Best Corrected Visual Acuity of 6/12 (0.3 logMAR) or better at 6wk. The aggregate Surgically Induced Astigmatism was 0.32D at 850 . Conclusion: Extra Large Tunnel of length 8 to 10 mm can be self sealing with low SIA. The complication rates and visual outcomes of ETCE are comparable to those of conventional MSICS. This method can be valuable in complicated cases and during learning period.