OBJECTIVE: Microbial keratitis is a sight-threatening condition with a higher incidence in agrarian populations. In countries with a high indigent population, due to financial and other constraints, patients prefer to seek therapy locally rather than travel to advanced centres. The aim of this study is to describe the epidemiology, clinical characteristics, and outcomes of 60 consecutive patients with microbial keratitis managed at a rural centre.
METHODS: Descriptive case series. All patients clinically diagnosed with infectious keratitis were included. Corneal scrapings were obtained and microbiological identification was done by Gram stain. Anti-microbial therapy was commenced based on smear findings and the patients were followed up till disease resolution.
RESULTS: Sixty eyes of 60 patients were diagnosed with microbial keratitis in the study period. The mean age was 47.43 ± 18.69 years. Male:female ratio was 47:53. Risk factors included ocular trauma in the majority of patients (46/60; 76.7%). Microorganisms were identified on 75.6% of smears, with fungal filaments (65.4%) being the most common. Ulcers were central in over half (32/60; 53.3%), and > 3 mm in diameter in over three-fourths (81.6%) of patients. Forty-four patients (73.3%) achieved treatment success whereas 16/60 (26.6%) required referral to our tertiary-eye care facility for management. The median time to resolution was 14 days (IQR 10-26 days).
CONCLUSIONS: Our series demonstrates the feasibility of microbiology-guided therapy in microbial keratitis by ophthalmologists at the secondary rural eye-care level. Two-thirds of the patients could be successfully managed at the rural centre and only severe cases needed a referral to tertiary centres.

UNASSIGNED: We have designed a study, whose aim was to confirm the feasibility and safety of the zero fluoroscopy approach in the treatment of supraventricular tachycardias (SVT) and premature ventricular contractions (PVCs) originating in the right ventricle in a secondary centre located in the south of Belgium.
UNASSIGNED: We included in our retrospective analysis patients with a clinical history and/or electrocardiographic documentation of SVT or frequent symptomatic monomorphic PVCs referred to our centre from November 2019 to March 2020 for catheter ablation.
UNASSIGNED: A total of 49 patients were considered eligible for potential enrolment in the study, 3 were excluded because of presence of a manifest left sided atrio-ventricular accessory pathway, 5 because of left ventricular PVCs and 4 because of left atrial tachycardia. 4 patients were instead excluded because of need of utilisation of fluoroscopy during the procedure. A total of 33 patients were therefore included in the analysis. Right atrial flutters and typical AVNRT were the most common arrhythmia treated, corresponding together to the 81% of the total. Right femoral access was obtained in 86% of cases with left femoral access used in the remaining when right femoral access was not successful after the third attempt. Coronary sinus cannulation was efficacious within 10 min in 76% of cases. There were four minor complications overall.
UNASSIGNED: The main finding of our study is that non-complex ablations can be performed on zero-fluoroscopy safely and with a good clinical outcome also in a secondary centre.