Rajpal

All India Institute of Medical Sciences, New Delhi, NCT, India

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Publications (7)12.74 Total impact

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    ABSTRACT: This study aimed to evaluate the human vitreous penetration of gatifloxacin in inflamed and non-inflamed eyes after oral administration. Vitreous penetration of single-dose (400 mg) oral gatifloxacin was evaluated in patients (n = 33) undergoing vitreous tap during the standard procedure for intravitreal antibiotic injection for acute postoperative endophthalmitis at various time-points. Vitreous penetration of 400 mg oral gatifloxacin was evaluated in the non-inflamed eyes of patients (n = 33) undergoing pars plana vitrectomy at similar time-points. The study was extended to evaluate the vitreous penetration of single-dose oral (800 mg) gatifloxacin at a single time-point in inflamed (n = 10) and non-inflamed (n = 11) eyes. After 400 mg oral gatifloxacin, inflamed eyes showed mean vitreous concentrations of 0.58+/-0.19 microg/ml, 1.33+/-0.33 microg/ml and 1.30 +/- 0.23 microg/ml at 2, 4 and 6 hours, respectively. The levels reached at 2 and 4 hours were found to be significantly increased compared with those in non-inflamed eyes. At the 800-mg dose, 4-hour vitreous levels in inflamed and non-inflamed eyes were 1.57 +/- 0.3 microg/ml and 1.42 +/- 0.24 microg/ml, respectively. Although the increased dose of gatifloxacin elevated plasma concentration, it failed to raise vitreous levels significantly higher than the 400-mg dose at the 4-hour time-point. Orally administered gatifloxacin achieves therapeutic levels in both inflamed and non-inflamed human eyes with a spectrum covering the bacterial species most frequently involved in the various causes of endophthalmitis. However, the levels achieved were below the MIC(90) for Pseudomonas aureginosa and Enterococcus.
    Acta ophthalmologica 12/2008; 87(6):648-52. · 2.44 Impact Factor
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    ABSTRACT: Human cysticercosis and tuberculosis are endemic diseases in developing countries. Both these diseases have certain common factors of origin. We would like to present the co-existence of these infections in a 20-year-old female. She was a known case of pulmonary and ocular tuberculosis and she acquired cysticercosis of the eye and brain.
    Infection 07/2006; 34(3):169-72. · 2.44 Impact Factor
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    ABSTRACT: This prospective study reveals the epidemiological profile of ocular trauma referred to a tertiary eyecentre over one year. All consecutive patients referred to Vitreo-retina service during 1 year periodwere examined.Out of total 523 eyes registered large proportion was <25years of age (67%), males(88%) and literate (77%). Forty-four percent belonged to rural area and 38% were students. Mostof the open globe injuries were Zone 1(50.8%). 75% presented >1 week after injury. The incidenceof intraocular foreign body and retinal detachment was 17.4, and 11.3% respectively. Diagnosis ofpost traumatic endophthalmitis was made in 20.5% of open globe injuries. Development ofendophthalmitis correlated with younger age, rural setting, illiteracy, presence of foreign body andlens disruption. Ocular trauma requiring tertiary care commonly affects young students, labourersand factory workers. Younger, rural and illiterate patients are more likely to develop infection especiallyif they have lens injury or intraocular foreign body.
    JK Science : Journal of Medical Education & Research. 01/2005;
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    ABSTRACT: To compare modified needle drainage (MND) with conventional drainage (CD) of subretinal fluid (SRF) as described by Schepens in surgery for primary rhegmatogenous retinal detachment. Prospective randomised clinical trial of 80 patients undergoing scleral buckling with subretinal fluid drainage for primary rhegmatogenous retinal detachment. In 40 patients modified needle drainage of subretinal fluid (SRF) was done using a perpendicular trans-scleral entry with a 26-gauge needle and the appearance of SRF in the hub of needle as end point. In 40 patients conventional drainage was done as described by Schepens using a diathermy needle. Adequacy of SRF drainage, intraoperative complications, anatomical and functional outcome were noted. 100% adequate drainage was achieved in all cases. The complication rate was 32.5% (n=13) in the CD group and 15% (n=6) in the MND group. In the CD group, 17.5% (n=7) patients had subretinal haemorrhage and in 2 eyes it was clinically significant. In the MND group 15% (n=6) of cases had subretinal haemorrhage and in one patient it was clinically significant. In the CD group, more serious SRF drainage complications were observed; these were absent in the MND group. Modified needle drainage is a safe and effective procedure for SRF drainage. In comparison with CD, MND is technically easy, less cumbersome and requires no special equipment.
    Indian Journal of Ophthalmology 10/2004; 52(3):211-4. · 1.02 Impact Factor
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    ABSTRACT: Results of core vitrectomy in post-traumatic endophthalmitis are poor. Our initial results of complete vitrectomy with primary silicone oil endotamponade were promising. A comparative study of this procedure with conventional core vitrectomy was therefore carried out. A prospective randomized controlled study of 24 consecutive cases of post-traumatic endophthalmitis was conducted. Patients were randomized into two groups in the absence of clinical improvement after primary tap and treatment with intravitreal vancomycin and amikacin: group 1 consisted of patients who underwent core vitrectomy alone, group 2 of patients who underwent complete vitrectomy with silicone oil endotamponade. All patients included in the study received intravenous antibiotics and underwent lensectomy. Patients were followed up 1, 2, 4 and 12 weeks postoperatively. In all patients of group 2, silicone oil was removed 6 weeks after primary surgery. The mean duration of follow-up was 112+/-55 days. Vision of 20/400 or better was obtained in 58.33% of cases (14/24). Visual acuity of only one patient in group 1 was >or=20/200, compared with that of 58.3% of patients (7/12) in group 2 ( P=0.02). Intra-operative retinal breaks were found in 50% (6/12) of the patients belonging to group 1, but did not affect the final visual outcome. In group 1, 33.33% (4/12) developed rhegmatogenous retinal detachment in the immediate post-operative period. Only one of these patients had useful final visual outcome after resurgery. Complete vitrectomy with primary silicone oil endotamponade is a useful treatment modality which improves the anatomical and functional results in post-traumatic endophthalmitis.
    Albrecht von Graæes Archiv für Ophthalmologie 07/2003; 241(6):478-83. · 1.93 Impact Factor
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    ABSTRACT: To evaluate penetration of oral ciprofloxacin in the retro-silicone oil space fluid (RSOF) in silicone oil (SO)-filled eyes. One dose of 750 mg ciprofloxacin was given to two groups of five patients with vitrectomized eyes with SO endotamponade, 4 hours (group I) and 8 hours (group II) before SO removal. In 10 vitrectomized eyes with SO endotamponade (group III) and another 10 patients scheduled for vitrectomy for the first time (group IV), two 750-mg doses every 12 hours, with the last dose 12 hours before surgery, were given. Blood samples were taken at the time of collection of RSOF samples in groups I, II, and III and of the vitreous in group IV. All samples were assayed for ciprofloxacin by high-performance liquid chromatography. The mean drug concentration in the RSOF was 0.34 +/- 0.09, 0.37 +/- 0.04, 0.84 +/- 0.29, and 0.44 +/- 0.11 micro g/mL in groups I, II, III, and IV respectively. The mean serum concentration was 1.29 +/- 0.63, 1.08 +/- 0.14, 1.93 +/- 0.84, and 1.34 +/- 0.55 micro g/mL in groups I, II, III, and IV respectively with no statistically significant difference between groups III and IV (P = 0.081). Antibiotic levels in the RSOF in SO-filled eyes after oral administration of ciprofloxacin in two 750-mg doses exceeded the minimal inhibitory concentration for 90% of isolates (MIC(90)) for most bacterial species and was higher than levels reached in the vitreous in nonvitrectomized eyes (P = 0.001).
    Investigative Ophthalmology &amp Visual Science 03/2003; 44(2):505-9. · 3.44 Impact Factor
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    ABSTRACT: A small amount of fluid is usually present in the space between the posterior surface of the silicone oil bubble and the retinal surface in silicone oil-filled eyes. A new technique is described for sampling this fluid using a 27-gauge cannula mounted on an empty tuberculin syringe that is connected to a 10-mL syringe through tubing.
    Ophthalmic Surgery Lasers and Imaging 01/2003; 34(2):149-50. · 1.46 Impact Factor