Background: The vagina contains dozens of microbiological species in variable quantities and is, therefore, considered a complex environment. Among the microorganisms, bacteria have important repercussions on women’s health. The present study was conducted to elucidate this type of vaginal isolates and their sensitivity towards currently used antibiotics. Methods: This was a retrospective study conducted at the Department of Obstetrics and Gynaecology, Sapthagiri Hospital, Bangalore, India from January 2012 to December 2013. All symptomatic women who had a high vaginal swab taken for culture and sensitivity testing were included in this study. Antibiotic susceptibility was tested using disc diffusion method (modified Kirby-Bauer’s method). The antibiotic sensitivity patterns of isolated microorganisms were studied. Results: Out of 200 patients, 95% had positive vaginal cultures. Fifteen types of microorganisms were isolated. The highest frequency of infection was seen at the age of 20-30 years, followed by 41-50 years and 31-40 years, and a low frequency of infection was observed above 50 years of age. The most prevalent pathogen was Escherichia coli, followed by Streptococcus agalactiae and diphtheroids with equal incidence. Among the antibiotics tested, isolated pathogens were completely resistant to nalidixic acid and highly sensitive to meropenem and imepenem. Conclusion: The high prevalence of gynaecological infections demands that patients with symptoms undergo thorough investigation with cultures and sensitivity essays. Changes in treatment protocols are required to treat vaginal infections effectively.

Background: SLC25A46, mitochondrial protein shown to be involved in mitochondrial dynamics. Mutation in this protein has been associated with neurological disease. Case Description: We describe a 19year male presented with decreased vision in both eyes at the age of 5-7years associated with clumpsiness in doing things with upper limb with involuntary movements during rest and tremors. He had low visual acuity for both distant and near, abnormal color vision in both eyes. Features of bilateral optic atrophy and absent P100 waves on VEP. Deranged lipid profile and Raised TSH and TPO antibodies were seen. Muscle biopsy showed neurogenic atrophy and loss of myelination. Lumbar lardosis was noted and Whole exome sequence analysis homozygous pathogenic mutation in SLC25A46 (C.1018>T/P. Arg 340cys). Conclusion: It's important to be aware of genetic inheritance and phenotype variants of these mitochondrial disorders. We present a novel variant (p.Arg340Cys) of SLC25A46 deficiency and unusual association with hashimoto's thyroiditis.

Oguchi disease also called congenital stationary night blindness is an autosomal recessive genetic condition first identified in Japan with a few cases reported in other countries like Europe, America, India and Pakistan. We report one such case exhibiting the Mizuo-Nakamura phenomenon with a reduced amplitude on the b-wave of the rod electroretinogram advocating this diagnosis. Case Report: A 40-year-old man presented with complaints of non-progressive decrease in vision as the day progressed for 6 months with normal vision during the day in both eyes. There was no history of trauma or any other ocular or systemic disease. His parents had a second-degree consanguineous marriage and his father experienced similar symptoms. Visual acuity for distance was 6/6 and N6 for near in both eyes. His anterior segment and posterior segments were normal. When the patient was put to dark adaptation for 3 hours, there was a change in his fundus background colour from grey to red (Mizuo-Nakamura phenomenon). The b-wave amplitude was decreased on the rod electroretinogram. The cone electroretinogram on the other hand was normal. All this was confirmed by his genetic study which favoured this diagnosis. Conclusion: This disease presents with features similar to retinitis pigmentosa in terms of mutations in the SAG gene. This highlights the importance of the Mizou-Nakamura phenomenon in formulating a confirmatory diagnosis and treatment protocol.

To compare the outcome following external dacrocystorhinostomy with silicon tube intubation with endoscopic endonasal dacrocystorhinostomy in patients with nasolacrimal duct obstruction. A prospective randomized comparative study conducted for 4years 6months in a teaching hospital with 26 cases of external dacrocystorhinostomy with silicon tube intubation and 15cases of endonasal dacrocystorhinostomy with a regular follow-up over 3years.Data regarding outcome and complications were analyzed and compared using chi-square test. Total of 41 patients was included in the study, 22 were females and 19 were males. The mean age for external dacrocystorhinostomy with silicon tube intubation and endoscopic dacrocystorhinostomy was 36.69 years and 39.33years respectively. Epiphora was the commonest presenting symptom (92.3%). Lid edema in postoperative period (3.8%) was the most common complication noted in external dacrocystorhinostomy with silicon tube intubation and bleeding, synechiae formation in endoscopic dacrocystorhinostomy (4.9%).The primary success rate was 100% with external dacrocystorhinostomy with silicon tube intubation, although 5.6% of patients had complications which were treatable and comparable to endoscopic dacrocystorhinostomy which was 90% (P value 0.0477 respectively) with two patients requiring revision procedure with successful outcome over follow-up. The outcome of both external dacryocystorhinostomy with silicon tube intubation and endonasal dacrocystorhinostomy were comparable, although complications were high in endonasal dacrocystorhinostomy (46.8%) with two requiring revision procedure due to failure and results were statistically significant. Therefore external dacrocystorhinostomy with silicon tube intubation can be considered as a primary procedure in patients with epiphora for better success rates and improvement in quality of life in pediatric case.

Dacryops, is a clinical entity of unknown aetiology. Here we present the clinical features and radiological presentation of a bilateral dacryops as a unique case. Case Description: A 36year old woman presented with unilateral lid swelling, since 7years non-perceptible but obvious on reflex tear secretion. However, she had no complaints of pain, redness, discharge. On examination, vision was normal and lacrimal ducts were patent. Mass in the left eye was noted on reflex tear secretion such as exposure to air/chewing. No signs of inflammation present. Tear film tests were normal. Fundus, routine blood parameters and serum ACE was negative. Ultrasonography of the orbits showed well defined hypoechoiec cystic lesion along lateral aspect of left globe and CT showed bilateral predominantly cystic lesion more prominent on left compared to right. Bilateral Dacryops, is unusual. Thus it becomes essential that clinicians are aware of this condition and consider it as one of the differential diagnosis of the lacrimal gland masses. Results: A case of bilateral dacryops detected incidentally, was investigated and followed up. Conclusion: Dacryops, or a lacrimal gland ductal cyst, is a rare clinical entity, whose bilateral presentation is unusual. It is essential that we as clinician's are aware of this condition and consider it as a differential diagnosis of the lacrimal gland masses.