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The path to becoming a clinical academic researcher is arduous and convoluted, with many hurdles. A good mentor is key to growth and development, not only as one embarks on the journey, but also as a 'sounding board' throughout one's career. [ABSTRACT FROM AUTHOR]

Importance Argon laser peripheral iridoplasty (ALPI) could be effective in widening residual angle closure following laser peripheral iridotomy (LPI). Background: We investigated changes in angle parameters following ALPI and its safety profile in this study. Design Retrospective, observational case series. Participants: The records from a single centre, of 36 patients (60 eyes) who underwent ALPI, for residual angle closure following LPI, were reviewed. Methods: We analysed anterior chamber parameters in anterior segment optical coherence tomography (ASOCT) images using customized software pre‐ and post‐ALPI. Paired t‐test was used to compare changes. Main Outcome Measures: ASOCT parameters analysed included angle opening distance (AOD 500 and 750), trabecular iris surface area (TISA 500 and 750), anterior chamber width (ACW), anterior chamber volume (ACV), angle recess area (ARA), anterior chamber area (ACA), anterior chamber depth (ACD) and lens vault (LV). Results: There was a mean increase in AOD 500 (0.05 vs. 0.16 mm, P < 0.001), AOD 750 (0.15 vs. 0.27 mm, P < 0.001), TISA 500 (0.010 vs. 0.038 mm2, P < 0.001), TISA 750 (0.039 vs. 0.102 mm2, P < 0.001), ACV (89.76 vs. 102.25 mm3, P = 0.01), ARA 500 (0.015 vs. 0.033 mm2, P < 0.001) and ARA 750 (0.044 vs. 0.088 mm2, P < 0.001). There was no significant change in ACW, ACD, ACA and LV. Mean intraocular pressure (IOP) decreased post‐ALPI (17.2 vs. 15.7 mmHg, P = 0.002). The mean follow‐up duration was 2.1 years (range 0.5–5 years). Conclusions and Relevance: ALPI results in changes to the angle morphology and lowered IOP in eyes with residual angle closure. Our findings suggest a possible role for ALPI in eyes with residual angle closure following peripheral iridotomy. [ABSTRACT FROM AUTHOR]

We present 2 patients with pituitary metastases from thyroid carcinoma—the first from anaplastic thyroid carcinoma and the second from follicular thyroid carcinoma. The first patient, a 50-year-old lady, presented with 2-week history of hoarseness of voice, dysphagia, dyspnoea, and neck swelling. Imaging revealed metastatic thyroid cancer to lymph nodes and bone. Histology from surgery confirmed anaplastic thyroid cancer. She was found to have pituitary metastases postoperatively when she presented with nonvertiginous dizziness. She subsequently underwent radiotherapy and radioiodine treatment but passed away from complications. The second patient, a 65-year-old lady, presented with loss of appetite and weight with increased goitre size and dyspnoea. Surgery was performed in view of compressive symptoms and histology confirmed follicular thyroid carcinoma. Imaging revealed metastases to bone, lung, and pituitary. She also had panhypopituitarism with hyperprolactinemia and diabetes insipidus. She received radioiodine therapy but eventually passed away from complications. [ABSTRACT FROM AUTHOR]

Fish allergy is common in countries where consumption is high. Asian nations are amongst the world’s largest consumers of fish but the allergen profiles of tropical fish are unknown. This study sought to evaluate the allergenicity of four commonly consumed tropical fish, the threadfin ( Polynemus indicus), Indian anchovy ( Stolephorus indicus), pomfret ( Pampus chinensis) and tengirri ( Scomberomorus guttatus). Immunoglobulin E (IgE) cross-reactivity with parvalbumin of cod fish (Gad c 1), the major fish allergen, was also studied. Detection of tropical fish and cod specific-IgE was performed by UniCap assay, and skin prick tests were also carried out. The IgE-binding components of tropical fish were identified using IgE immunoblot techniques, and cross-reactivity with Gad c 1 was assessed by ELISA inhibition and IgE immunoblot inhibition. Clinically, nine of 10 patients studied were allergic to multiple fish. All patients exhibited detectable specific-IgE to cod fish (10 of 10 skin prick test positive, eight of 10 UniCap assay positive) despite lack of previous exposure. The major allergen of the four tropical fish was the 12-kDa parvalbumin. IgE cross-reactivity of these allergens to Gad c 1 was observed to be moderate to high in the tropical fish studied. Parvalbumins are the major allergens in commonly consumed tropical fish. They are cross-reactive with each other as well as with Gad c 1. Commercial tests for cod fish appear to be sufficient for the detection of tropical fish specific-IgE. [ABSTRACT FROM AUTHOR]

Johar A, Lim D, Mad Arif SA, Hawarden D, Du Toit G, Weinberg E, Motala C, Fieggen G, Yeang HY, Potter PC. Low prevalence of latex sensitivity in South African spina bifida children in Cape Town.Pediatr Allergy Immunol 2005.© 2005 Blackwell MunksgaardSpina bifida children have a high prevalence of latex allergy in studies reported from Europe and the USA. This study investigated the prevalence of latex allergy in a cohort of 24 spina bifida children at the Red Cross Children's Hospital from Cape Town, South Africa. The children were investigated using a detailed questionnaire, skin prick tests (ALK-Abello), ImmunoCap RASTs, Western blotting and ELISA, using the purified latex proteins Hev b1 and Hev b3 and whole latex preparation. A low overall prevalence of latex sensitization of 16.7% was found in the children. Children who were sensitive reacted to water insoluble to Hev b1 and Hev b3 proteins. The low prevalence of latex sensitization in the South African children may not be entirely explained by stringent latex avoidance. The children were from a low socioeconomic social status and‘hygiene’ and other factors should be considered. [ABSTRACT FROM AUTHOR]

Tan TN, Lim DL, Lee BW, Van Bever HP. Prevalence of allergy-related symptoms in Singaporean children in the second year of life.Pediatr Allergy Immunol 2005.© 2005 Blackwell MunksgaardThis study describes the cross-sectional prevalence of symptoms associated with eczema (chronic itchy rash), asthma (wheeze), and allergic rhinitis (rhinoconjunctivitis) in 1026 subjects between 18.5 and 23 months old (median age is 21 months) in Singapore. The first 2 yr cumulative prevalence of chronic itchy rash, wheeze, and rhinoconjunctivitis were 22.1% (n = 227), 22.9% (n = 235), and 8.4% (n = 86) respectively. In total, 42.2% (414 of 979) reported ever having any of these symptoms. Eczema, although prevalent, was diagnosed only in 34.4% (n = 78) of children with chronic itchy rash. Children with this eczematous rash were also more prone to wheeze (cOR = 2.0, 95% CI: 1.2–3.0) and rhinoconjunctivitis (cOR = 2.0, 95% CI: 1.4–2.8). Similarly, subjects who reported rhinoconjunctivitis and chronic itchy rash were 2.4 times (95% CI: 1.6–3.6) and 1.4 times (95% CI: 1.0–2.0) more at risk of wheezing respectively. Family history of allergy was a significant risk factor for chronic itchy rash (aOR = 1.8, 95% CI: 1.3–2.4) and wheeze (aOR = 1.7, 95% CI: 1.3–2.4). Thus, symptoms related to allergy were already prevalent during the second year of life. Significant proportions of these symptoms are likely to be due to true atopy as strong relationship with familial history and comorbidity with other potential allergic symptoms were observed. [ABSTRACT FROM AUTHOR]

In recent years, there has been a paradigm shift in glaucoma surgical procedures. Glaucoma drainage implant (GDI) surgeries are being performed much more commonly. Thus, it is important for surgeons to be cognisant of potential complications and their management. Exposure of a GDI is a well‐known complication, and prompt recognition and treatment are required to prevent endophthalmitis, a potentially blinding condition. In this review, we discuss the mechanisms and risk factors for GDI exposure, highlight important considerations for repair, and discuss repair techniques, with the aim of improving patient outcomes and minimising the risk of re‐exposure. [ABSTRACT FROM AUTHOR]

Corneal neovascularization (CoNV) is a sight-threatening condition affecting an estimated 1.4 million people per year, and the incidence is expected to rise. It is a complication of corneal pathological diseases such as infective keratitis, chemical burn, corneal limbal stem cell deficiency, mechanical trauma, and immunological rejection after keratoplasties. CoNV occurs due to a disequilibrium in proangiogenic and antiangiogenic mediators, involving a complex system of molecular interactions. Treatment of CoNV is challenging, and no therapy thus far has been curative. Anti-inflammatory agents such as corticosteroids are the mainstay of treatment due to their accessibility and well-studied safety profile. However, they have limited effectiveness and are unable to regress more mature neovascularization. With the advent of advanced imaging modalities and an expanding understanding of its pathogenesis, contemporary treatments targeting a wide array of molecular mechanisms and surgical options are gaining traction. This review aims to summarize evidence regarding conventional and emerging therapeutic options for CoNV. [ABSTRACT FROM AUTHOR]