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Purpose of reviewThis study is to highlight the incidence of corneal pseudomicrocysts in FDA-approved antibody-drug conjugates (ADCs), and success of preventive therapies for pseudomicrocysts and related ocular surface adverse events (AEs).Recent findingsADCs are an emerging class of selective cancer therapies that consist of a potent cytotoxin connected to a monoclonal antibody (mAb) that targets antigens expressed on malignant cells. Currently, there are 11 FDA-approved ADCs with over 164 in clinical trials. Various AEs have been attributed to ADCs, including ocular surface AEs (keratitis/keratopathy, dry eye, conjunctivitis, blurred vision, corneal pseudomicrocysts). While the severity and prevalence of ADC-induced ocular surface AEs are well reported, the reporting of corneal pseudomicrocysts is limited, complicating the development of therapies to prevent or treat ADC-related ocular surface toxicity.SummaryThree of 11 FDA-approved ADCs have been implicated with corneal pseudomicrocysts, with incidence ranging from 41 to 100% of patients. Of the six ADCs that reported ocular surface AEs, only three had ocular substudies to investigate the benefit of preventive therapies including topical steroids, vasoconstrictors, and preservative-free lubricants. Current preventive therapies demonstrate limited efficacy at mitigating pseudomicrocysts and other ocular surface AEs.

Antibody-drug conjugates (ADCs) are a fast-growing class of cancer drugs designed to selectively deliver cytotoxic payloads through antibody binding to cancer cells with high expression of the target antigen, thus reducing systemic exposure and minimizing off-target effects. However, ADCs are associated with various ocular adverse events (AEs) that may impact treatment administration and patient outcomes. In this review, we provide a summary of ocular AEs associated with approved and investigational ADCs, recommendations for the mitigation and management of ocular AEs, current guidelines and expert opinions, and recommendations for clinical practice. A literature search was performed, using PubMed and Google Scholar, for English-language articles published between January 1985 and January 2023 to identify studies reporting ocular AEs associated with ADC use. Search terms included generic and investigational names of all identified ADCs, and further searches were performed to identify strategies for managing ADC-associated ocular AEs. ADC-associated ocular AEs include symptoms such as blurred vision and foreign-body sensation and signs such as corneal fluorescein staining, corneal pseudomicrocysts, and conjunctivitis. Reported management strategies include ADC dose modification (eg, dose delay or reduction), cool compresses, artificial tears, topical vasoconstrictors, and topical steroids. Although ADC dose modification appears to be beneficial, the preventive and/or therapeutic benefits of the remaining interventions are unclear. Although the exact mechanisms are not fully understood, most ADC-associated ocular AEs are reversible with dose delay or dose reduction. Management of ocular AEs requires a multidisciplinary approach to minimize treatment discontinuation and optimize clinical outcomes. [ABSTRACT FROM AUTHOR]

To describe a case series of patients with unilateral, posterior interstitial keratitis presumed to be caused by herpes simplex virus.Retrospective case series.Five patients were found to have unilateral, posterior interstitial keratitis. Three of the involved eyes had decreased corneal sensation, and 2 eyes had corneal stromal neovascularization. All patients were treated with topical steroids and an oral antiviral, and among those with long-term follow-up, clinical improvement required treatment over an extended duration. A review of the literature revealed 1 reported case with a similar clinical appearance, although that case was attributed to Lyme disease.The clinical presentation of unilateral, posterior interstitial keratitis may be a rare manifestation of herpes simplex virus keratitis.

Objective: To determine the frequency of various causes of upper gastrointestinal bleeding on the basis of endoscopic findings. Study Design: A descriptive observational study. Place and Duration of Study: Study was done from 1 , January, 2015 to 31st December, 2017 at Pakistan Railway General Hospital Rawalpindi. Material and Methods: The study was carried out in the Department of Medicine at Railway Hospital. The record of patients admitted with upper GI bleed through indoor/outdoor was retrieved from the Endoscopy Unit. 100 Patients fulfilling inclusion criteria were selected in the study. The relevant data and endoscopic findings were documented on Performa. The data was analyzed retrospectively. Results: Out of 100 patients selected, 58(58%) were males and 42(42%) females. The mean age of 52.20 years ± SD 15.88.The most common cause was esophageal varices (47.90%), followed by gastritis/esophagitis 23%, peptic ulcer 14.58%. The malignant condition contributed 1.58 %. While in 9(9%) of patients, no cause of bleeding was identified. Conclusion: Variceal hemorrhage is the most frequent cause of upper gastrointestinal bleeding in our population.

Geospatial technology has an enormous capacity to analyze large and diversified datasets for evaluating the hidden spatial relationship which provides a better comprehension of the subject and helps significantly in policymaking and planning future strategies.

Road transport is the dominant mode of transport in Pakistan carrying 91% of the country's passenger traffic and 96% of freight traffic. National highways, being 3.7% of the entire road network, carry 80% of commercial traffic. Due to the high number of road traffic crashes and resulting fatalities, a random parameters logit model was estimated to determine the risk factors that influence the severity of injuries caused by motor vehicle crashes on national highways. The effects of driver characteristics, crash characteristics, highway characteristics, temporal characteristics, and environmental characteristics were considered for the analysis. From the results, it was revealed that many factors such as overspeeding, driver dozing, driver carelessness, driver age, Author(s): Hanif Ullah (corresponding author) [1]; Asim Farooq [1]; Akhtar Ali Shah [2] 1. Introduction Globally, around 1.35 million human lives are lost due to road traffic crashes (RTCs) every [...]