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Aim of the study To study the cross-sectional area, the maximum thickness of the nerve fascicle and the thickness/width ratio of the sural nerve in patients with diabetes mellitus and non-diabetic subjects using high-resolution ultrasonography and to correlate the results with nerve conduction studies. Material and methods This prospective study was conducted among 60 patients divided into two groups: A and B. Group A consisted of 30 patients >18 years of age with a history of type 2 diabetes mellitus, and Group B consisted of 30 non-diabetic patients >18 years of age. High-resolution ultrasonography was performed using a linear transducer with the frequency of 5–18 MHz in all the patients in the prone position with the transducer placed in a transverse position at the junction of the middle and lower thirds of the calf. Nerve conduction studies were performed using Aleron 201 (RMS) in all the patients. Results As compared to the control group, the sural nerve in the diabetic group showed increased cross-sectional area, maximum thickness of the nerve fascicle and thickness/width ratio ( p <0.05). Nerve conduction studies showed decreased amplitude, increased latency and decreased velocity in the cases as compared to controls ( p <0.05). The cross-sectional area, maximum thickness of the nerve fascicle and thickness/width ratio showed statistical significance when compared with amplitude, latency and velocity in the cases as well as controls ( p <0.001). Conclusion This study suggests that high-frequency ultrasound of the sural nerve is a useful tool for evaluating changes typical of peripheral neuropathy in patients with diabetes mellitus.

The cost of technology is high in ophthalmology but given the increasingly competitive environment and the social demand, there is a pressure to progressively lower the costs to the consumer. To keep costs down there is a tendency to do as many surgeries as possible in an assembly line fashion both in hospitals as well as in the charitable camps. This article provides ophthalmologists an insight into the legal pitfalls in practice of ophthalmology in India and the dangers of the constant lowering of costs of surgery as well as of free service. This lowering of costs would have been ideal in a Utopian world, but times have now changed and there is cost to be paid even for providing free service. In India the prevalent tradition of providing free service, has also resulted in a lowering of guard by the eye surgeons. These mass eye surgery assembly popularly called “free eye camps” has seen millions of people benefited. But recently there is an increase in number of cases where exorbitant penalty has been imposed by the courts, on these philanthropic surgeons for any deficiency in service, and this has destroyed the careers of many ophthalmologists. Time has now come to introspect and to factor the cost of litigation and compensations into the cost of surgeries so that we not only benefit the patients but also safeguard the ophthalmologists and help them fulfill their responsibilities towards their own dependents.

Ocular exposure to chemical explosions constitute true emergency that can be associated with injuries leading to significant visual morbidities. Herein, we report a case of bilateral eye injury in a 54 year old male farmer due to a chemical explosion while preparing a Gandhak Potash mixture. He presented with multiple charred wounds around his face and embedded particulate matter over the eyelids, conjunctiva and cornea. He underwent superficial debridement of the particulate matter along with conservative management using topical antibiotics, cycloplegics and steroids with good visual outcome. Gandhak potash explosions can be potentially visually devastating. Ophthalmologists, especially those working in agricultural surroundings, should be aware of this mode of injury. Good visual outcome is possible with urgent, appropriate medical intervention.

Acts of violence against health care professionals (especially doctors) as well as facilities are a growing global problem. In our country, it has taken an unfortunate dramatic turn of the involvement of a mob—a ragtag group of persons who organize and perpetrate the crime based on community, caste, religion, or political affiliations. This crucial factor is the fundamental difference in what we face as compared with the so-called Yi Nao phenomenon of China. In India, the mob gathers and indulges in acts of violence, intimidation, and blackmail at the behest of its “leader,” often having no direct relationship with the deceased patient. It is premeditated and systematic vandalism. Often it is also associated with financial gain to the perpetrators through extortion and blackmail, adding to the woes of the health care professionals and hospital facility. We discuss what is the primary goal and what is a byproduct in this cycles of violence against the people who are doing their best to save the lives of patients. Unless the governments and the courts take this matter seriously as well as follow-up with corrective measures, the future looks bleak for all stakeholders.