Background: The relationship between lag time and outcomes in retinoblastoma (RB) is unclear. In this study, we aimed to study the effect of lag time between onset of symptoms and diagnosis of retinoblastoma (RB) in countries based on their national-income and analyse its effect on the outcomes. Methods: We performed a prospective study of 692 patients from 11 RB centres in 10 countries from 1 January 2019 to 31 December 2019. Results: The following factors were significantly different among different countries based on national-income level: age at diagnosis of RB (p = 0.001), distance from home to nearest primary healthcare centre (p = 0.03) and mean lag time between detection of first symptom to visit to RB treatment centre (p = 0.0007). After adjusting for country income, increased lag time between onset of symptoms and diagnosis of RB was associated with higher chances of an advanced tumour at presentation (p < 0.001), higher chances of high-risk histopathology features (p = 0.003), regional lymph node metastasis (p < 0.001), systemic metastasis (p < 0.001) and death (p < 0.001). Conclusions: There is a significant difference in the lag time between onset of signs and symptoms and referral to an RB treatment centre among countries based on national income resulting in significant differences in the presenting features and clinical outcomes.

Objective: The aim of the study was to describe the clinical presentation, management strategies, and outcomes in a case series of primary lacrimal sac tumors. Methods: This retrospective study was conducted in Sheikh Fajilatunnessa Mujib Eye Hospital and Training Institute, Bangladesh, from July 1 to December 31, 2020, and included all patients who were evaluated, treated, and followed up for at least 6 months from January 2013 to October 2020. One patient developed a recurrence of the adenocarcinoma of the lacrimal sac after 1 year of primary treatment. Patients’ demographic data were analyzed and reviewed from published articles on lacrimal sac tumors. We assessed patients clinically, followed by radiological evaluation. We also analyzed the biopsy technique, treatment modality, and recurrence. An oncologist reviewed all patients to prepare a plan for adjuvant treatment. Results: Ten patients with lacrimal sac tumors were included in this study. Swelling in the medial canthal region was the most common presenting feature (100%), followed by epiphora (60%) and pain (30%). Open biopsy was preferred over fine-needle aspiration biopsy. Incisional biopsy or complete excisional biopsy was performed for all suspected malignancies. Malignant tumors were found in 7 (70%) cases, and benign tumors in 3 (30%) cases. Non-Hodgkin’s lymphoma (NHL) (40%) was the most common malignant lacrimal sac tumor. Mucosa-associated lymphoid tissue lymphoma was 75%, and diffuse large B-cell lymphoma was 25% among the cases of NHL. Patients with epithelial malignancy were treated with external beam radiation therapy, while NHL patients were treated with chemotherapy (CHOP regimen). Recurrence was noted in 1 case (10%) of epithelial malignancy after 1 year of treatment. Conclusion: Successful management of lacrimal sac tumors requires a high index of suspicion, as these are fatal tumors, often misdiagnosed as dacryocystitis. Nonepithelial malignancies are more predominant than epithelial malignancies, and hematolymphoid tumors are most frequent.

The protective effects of breastfeeding on various childhood malignancies have been established but an association has not yet been determined for retinoblastoma (RB). We aimed to further investigate the role of breastfeeding in the severity of nonhereditary RB development, assessing relationship to (1) age at diagnosis, (2) ocular prognosis, measured by International Intraocular RB Classification (IIRC) or Intraocular Classification of RB (ICRB) group and success of eye salvage, and (3) extraocular involvement. Analyses were performed on a global dataset subgroup of 344 RB patients whose legal guardian(s) consented to answer a neonatal questionnaire. Patients with undetermined or mixed feeding history, family history of RB, or sporadic bilateral RB were excluded. There was no statistically significant difference between breastfed and formula-fed groups in (1) age at diagnosis (p = 0.20), (2) ocular prognosis measures of IIRC/ICRB group (p = 0.62) and success of eye salvage (p = 0.16), or (3) extraocular involvement shown by International Retinoblastoma Staging System (IRSS) at presentation (p = 0.74), lymph node involvement (p = 0.20), and distant metastases (p = 0.37). This study suggests that breastfeeding neither impacts the sporadic development nor is associated with a decrease in the severity of nonhereditary RB as measured by age at diagnosis, stage of disease, ocular prognosis, and extraocular spread. A further exploration into the impact of diet on children who develop RB is warranted.

Objectives: Glomerular Filtration Rate (GFR) is an important parameter of kidney function. Many methods are used to measure GFR namely: inulin clearance, double plasma sample method (DPSM), Gates’ method, and equation based method. DPSM has become the gold standard in clinical research. Gates’ method is routinely practiced at National Institute of Nuclear Medicine and Allied Sciences. Chronic kidney disease epidemiology collaboration (CKD-EPI ) equation is encouraged as it is simple and reliable. The aim of the study was assesment of agreement between Gates’ method and CKD-EPI equation with plasma sample method for estimation of GFR. Patients and methods: This cross sectional observational study was carried out at NINMAS, during July 2017 to June 2018. A total of 70 subjects referred for 99mTC-DTPA renography along with GFR estimation, were included in this study. Result: The mean GFR value evaluated by DPSM, Gates’ and CKD-EPI equation were, 81.86 ± 22.42, 86.13 ± 26.70 and 78.48 ± 23.87 mL/min/1.73 m2 respectively. A strong positive correlation (r = 0.922) was found between DPSM and Gates’ method and also between DPSM and CKD-EPI equation (r= 0.930). The Gates’ and CKD-EPI equation also showed strong positive correlation (r = 0.872). The mean difference between DPSM and Gates’, between DPSM and CKD-EPI equation, between Gates’ and CKD-EPI equation were 4.26 ± 10.45, 3.38 ± 8.78 and 7.64 ± 13.09 mL/min/1.73 m2 respectively. Conclusion: Strong positive correlation and excellent agreement were observed between DPSM and Gates’ and also between DPSM and CKD-EPI equation. Strong correlation was also found in between Gates’ and CKD-EPI equation. So, DPSM, Gates’ method and CKD-EPI equation can reflect GFR almost equally and used interchangeably. Bangladesh J. Nuclear Med. 22(1): 36-40, Jan 2019

: to address common lid margin sequalae presented in steven Johnson syndrome and to assess the outcome of posterior lamellar replacement with oral mucous membrane graft. : This single center longitudinal study was conducted in Ispahani Islamia Eye Institute and Hospital. 56 diagnosed cases of Steven Johnson syndrome with lid margin sequalae during the period of July 2020 to June 2023 were included in the study. Patients with ocular cicatrizing pemphigoid and chemical burn were excluded from the study. Demographic profile, presenting lid margin sequalae, outcome of surgery and complication after intervention and its management were properly evaluated and recorded. : A total of 98 eyelids (upper and lower) in 56 patients were evaluated. The Mean age was 38.33 ± 15.22 years (range 6 – 70 years). 21 patients were male and 35 were female (male: female=1:1.66). 14 patients had unilateral defect and 42 patients have bilateral defect. Most common lid margin sequalae was lid margin keratinization (85.71%), distichiasis (62.5%), trichiasis (21.42%) and entropion (8.92%). All lid margin defect were successfully corrected by posterior lamellar replacement with oral mucous membrane graft. During 6 months post-operative follow up, significant symptomatic relief from epiphora, foreign body sensation, pain and photophobia were achieved in all patients. There was remarkable reduction of conjunctival inflammation (88.63%) and persistent corneal epithelial defect (71.42%). Mean visual acuity was significantly improved. Common complications of the surgery were misdirected lashes (7.14%), dislodgement of graft (2.04%%), and recurrent entropion (2.04%). All complication was successfully managed through appropriate second procedure.Posterior lamellar resection with an oral mucous membrane graft for modifying lid margin defects in Steven-Johnson syndrome shows promising results.