Fungal diseases kill more than 1.5 million and affect over a billion people. However, they are still a neglected topic by public health authorities even though most deaths from fungal diseases are avoidable. Serious fungal infections occur as a consequence of other health problems including asthma, AIDS, cancer, organ transplantation and corticosteroid therapies. Early accurate diagnosis allows prompt antifungal therapy; however this is often delayed or unavailable leading to death, serious chronic illness or blindness. Recent global estimates have found 3,000,000 cases of chronic pulmonary aspergillosis, ~223,100 cases of cryptococcal meningitis complicating HIV/AIDS, ~700,000 cases of invasive candidiasis, ~500,000 cases of Pneumocystis jirovecii pneumonia, ~250,000 cases of invasive aspergillosis, ~100,000 cases of disseminated histoplasmosis, over 10,000,000 cases of fungal asthma and ~1,000,000 cases of fungal keratitis occur annually. Since 2013, the Leading International Fungal Education (LIFE) portal has facilitated the estimation of the burden of serious fungal infections country by country for over 5.7 billion people (>80% of the world’s population). These studies have shown differences in the global burden between countries, within regions of the same country and between at risk populations. Here we interrogate the accuracy of these fungal infection burden estimates in the 43 published papers within the LIFE initiative.

https://www.mdpi.com/2309-608X/3/4/57/pdf/1

Global and Multi-National Prevalence of Fungal Diseases—Estimate Precision

Pterygium and ultraviolet radiation. A positive correlation

Fungal keratitis is a severe corneal infection that often results in blindness and eye loss. The disease is most prevalent in tropical and subtropical climates, and infected individuals are frequently young agricultural workers of low socioeconomic status. Early diagnosis and treatment can preserve vision. Here, we discuss the fungal keratitis diagnostic literature and estimate the global burden through a complete systematic literature review from January, 1946 to July, 2019. An adapted GRADE score was used to evaluate incidence papers-116 studies provided the incidence of fungal keratitis as a proportion of microbial keratitis and 18 provided the incidence in a defined population. We calculated a minimum annual incidence estimate of 1 051 787 cases (736 251-1 367 323), with the highest rates in Asia and Africa. If all culture-negative cases are assumed to be fungal, the annual incidence would be 1 480 916 cases (1 036 641-1 925 191). In three case series, 8-11% of patients had to have the eye removed, which represents an annual loss of 84 143-115 697 eyes. As fungal keratitis probably affects over a million people annually, an inexpensive, simple diagnostic method and affordable treatment are needed in every country.

The global incidence and diagnosis of fungal keratitis.

The Montreal Protocol has limited increases in the UV-B (280-315 nm) radiation reaching the Earth's surface as a result of depletion of stratospheric ozone. Nevertheless, the incidence of skin cancers continues to increase in most light-skinned populations, probably due mainly to risky sun exposure behaviour. In locations with strong sun protection programs of long duration, incidence is now reducing in younger age groups. Changes in the epidemiology of UV-induced eye diseases are less clear, due to a lack of data. Exposure to UV radiation plays a role in the development of cataracts, pterygium and possibly age-related macular degeneration; these are major causes of visual impairment world-wide. Photodermatoses and phototoxic reactions to drugs are not uncommon; management of the latter includes recognition of the risks by the prescribing physician. Exposure to UV radiation has benefits for health through the production of vitamin D in the skin and modulation of immune function. The latter has benefits for skin diseases such as psoriasis and possibly for systemic autoimmune diseases such as multiple sclerosis. The health risks of sun exposure can be mitigated through appropriate sun protection, such as clothing with both good UV-blocking characteristics and adequate skin coverage, sunglasses, shade, and sunscreen. New sunscreen preparations provide protection against a broader spectrum of solar radiation, but it is not clear that this has benefits for health. Gaps in knowledge make it difficult to derive evidence-based sun protection advice that balances the risks and benefits of sun exposure.

/pdf/human-health-in-relation-to-exposure-to-solar-ultraviolet-17qp1qde8e.pdf

Human health in relation to exposure to solar ultraviolet radiation under changing stratospheric ozone and climate

Curcumin, the major curcuminoid of the turmeric, has been extensively used in many countries since ancient time for preventing and/or treating a multitude of diseases. This review is to illustrate the researches on the properties of curcumin and its potential therapeutic efficacy in major anterior segment eye diseases. The bio-medical potential of curcumin is restricted because of its low solubility and digestive bioavailability. This review will discuss promising research in improving curcumin bioavailability through structural modification. In vitro and in vivo research made progress in studying the beneficial effects of curcumin on major anterior segment eye diseases, including anti-angiogenesis effect in corneal diseases; anti-inflammation or anti-allergy effects in dry eye disease, conjunctivitis, anterior uveitis; anti-proliferation and pro-apoptosis effects in pterygium; anti-oxidative stress, anti-osmotic stress, anti-lipid peroxidation, pro-apoptosis, regulating calcium homeostasis, sequestrating free radicals, protein modification and degradation effects in cataracts; neuroprotective effects in glaucoma. Curcumin exhibited to be a potent therapeutic candidate for treating those anterior segment eye diseases.

/pdf/curcumin-a-potential-therapeutic-candidate-for-anterior-dlhae1wp24.pdf

Curcumin, A Potential Therapeutic Candidate for Anterior Segment Eye Diseases: A Review.

Objective To study the post-treatment visual outcome of fungal keratitis. Methods This prospective study was carried out at Chandka Medical College and Hospital, Larkana, Pakistan, from March 2005 to March 2016. Patients with clinical features of fungal keratitis, with positive corneal scrapings for fungi, and those who followed up for a minimum period of three months after recovery from infection were included.Other causes of infectious keratitis were excluded. The clinical diagnosis of fungal keratitis was based on risk factor identification and characteristic non-specific and specific corneal features. Treatment included antifungal preparations, topical and if necessary systemic, in addition to symptomatic measures. SPSS 20 was used for data analysis. Results Of the 1,130 patients, 750(66.37%) were males and 380(33.63%) were females. The overall mean age was 39.44±12.46 years (range:16-74 years). After the completion of treatment, 590(52.21%) of the eyes just retained visual acuity of not more than counting fingers and 126(11.15%) patients lost their globe. Patients with remaining corneal opacity needed keratoplasty. Conclusions Most of the eyes just retained visual acuity of counting fingers while some patients lost their globe.

Visual outcome in patients of keratomycosis, at a tertiary care centre in Larkana, Pakistan.

Purpose
The purpose of this study was to determine the factors associated with Pterygium, utilizing history and examination.

Factors associated with pterygium based on history and clinical examination of patients in Pakistan.

Material and Methods: This study was conducted in the department of ophthalmology, Chandka Medical College Larkana, from Oct. 2003 to Sept. 2005 and included patients with history of first time ocular trauma in association of secondary opaque ocular media were included in this study. The exclusion criteria included known anterior / posterior segment pathology and previous ocular surgery or trauma. (group A)

Usefulness of B-Scan Ultrasonography in Ocular Trauma

Material and Methods: The study was conducted from July 2003 to December 2005. Forty eyes of 40 patients were selected for secondary intraocular lens implantation. Twenty two patients (55%) were male while 18 patients (45%) were female. Age range was between 5 years to 62 years with mean age of 33.5 years. Anterior chamber implantation was performed in 20 patients with ruptured posterior capsule (Group I) while posterior chamber implantation was done in 20 patients with intact posterior capsule (Group II). All patients were followed for six months after surgery.

Secondary Intraocular Lens Implantation

Material and Methods: This prospective case series study was conducted from September 1999 to September 2014 at ophthalmology department Chandka medical college and Syed eye clinic, Larkana, Pakistan. Patients identified clinically as cases of hypovitaminosis A on the basis of presence of “Imtiaz’s sign” were included in the study. Patients with Retinitis pigmentosa, glaucoma, chronic liver disease and malabsorption syndrome were excluded from the study. Imtiaz's sign of vitamin A deficiency and nyctalopia were noted and relevant laboratory investigations available were also done on selected patients. Patients were given therapeutic doses of vitamin A and improvement was observed to see resolution of Imtiaz’s sign of vitamin A deficiency and remission of nyctalopia.

Partab Rai

Papers

Visual outcome in patients of keratomycosis, at a tertiary care centre in Larkana, Pakistan.

Factors associated with pterygium based on history and clinical examination of patients in Pakistan.

Usefulness of B-Scan Ultrasonography in Ocular Trauma

Secondary Intraocular Lens Implantation

Assessment of "Imtiaz's Sign" for Early Detection of Hypovitaminosis A