Primary effects of intravitreal bevacizumab in patients with diabetic macular edema

To evaluate the efficacy of primary intra vitreal bevacizumab [IVB] injection on macular edema in diabetic patients with improvement in best corrected visual acuity [BCVA] and central macular thickness [CMT] on optical coherence tomography [OCT]. This prospective interventional case series study was conducted at Retina Clinic, Al-Ibrahim Eye Hospital, and Isra Postgraduate Institute of Ophthalmology Karachi. Between December 2010 to June 2012. BCVA measurement with Early Treatment in Diabetic Retinopathy Study [ETDRS] charts and ophthalmic examination, including Slit-lamp bio microscopy, indirect ophthalmoscopy, Fundus fluorescein angiography [FFA] and OCT were done at the base line examination. At monthly interval all patients were treated with 3 injections of 0.05 ml intra vitreal injection containing 1.25 mg bevacizumab. Patients were followed up for 6 months and BCVA and OCT were taken at the final visit at 6 month. The mean BCVA at base line was 0.42 +/- 0.14 Log Mar units. This improved to 0.34 +/- 0.13, 0.25 +/- 0.12, 0.17 +/- 0.12 and 0.16 +/- 0.14 Log Mar units at 1 month after 1[st], 2[nd] 3[rd] injections and at final visit at 6 months respectively, a difference that was statistically significant [P > 0.0001] from base line. The mean 1mm CMT measurement was 452.9 +/- 143.1 microm at base line, improving to 279.8 +/- 65.2 microm [P < 0.0001] on final visit. No serious complications were observed. Primary IVB at a dose of 1.25 mg on monthly interval seems to provide stability and improvement in BCVA and CMT in patient with DME

Anthropometric Variables and Nutritional Status of Adolescent School Girls in a Food Insecure Rural Area of Bangladesh

This study estimated the anthropometric variables and nutritional status of rural adolescent school girls of food insecure Bera subdistrict of Pabna district in Bangladesh. The cross sectional study was carried out in rural adolescent school girls of 21 governments approved high schools of Bera sudistrict of Pabna district, Bangladesh. Anthropometric and socio-demographic information from 2,196 adolescent girls were collected during 2011-2012 academic session. Height and weight were measured using standard procedure and the body mass index (BMI) was calculated. BMI was compared to the 2007 WHO growth reference. Height- for-age (HAZ), weight-for-age (WAZ) and BMI-for-age (BMIZ) were used to evaluate stunting, underweight and thinness respectively, based on the National Centre of Heath Statistics (NCHS) < - 2 Z score values. Classification of severity of malnutrition was done based on WHO recommendation. Mean BMI-for-age were less than those of 2007 WHO growth reference for girls at all ages. The overall rate of stunting, underweight and thinness was 33.13%, 28.06% and 17.92% respectively. Based on WHO classification of severity of malnutrition, the overall prevalence of stunting was high (30-39%), whereas those of underweight 20-29% was high. This study concludes that poor anthropometric variables and nutritional status among the adolescents indicated a major public health problem in food insecure rural areas of Bangladesh. An intensive and comprehensive approach is required to improve the nutritional status of rural adolescent girls of Bangladesh.

Outcome of pars plana vitrectomy with silicon oil versus scleral buckling in primary retinal reattachment surgery

To evaluate the outcome of primary pars plana vitrectomy with silicon oil tamponade versus scleral buckling procedureas a treatment for rhegmatogenous retinal detachment. This prospective, comparative, interventional study was conducted from July 2008 to June 2009. Patients were selected and divided into two groups. Pars plana vitrectomy [group I] or scleral buckling [group II] was performed as primary procedure. Patients were followed for 06 months after surgery. Anatomical outcome in pars plana vitrectomy procedure was 96.2% as compared to scleral buckling procedure 87.0%. Functional outcome in pars planavitrectomy, best corrected visual acuity of 6/6 - 6/18 was attained in 34.6%, in sclera buckling procedure 65.2% at 06 months. Anatomical outcome in pars plana vitrectomy is better as compared to sclera buckling. Visual outcome and visual rehabilitation is earlier and better in scleral buckling as compared to pars plana vitrectomy

Dacryocystorhinostomy without intubation with intraoperative mitomycin C

To evaluate the success rate and complications of intraoperative Mitomycin-C in dacryocystorhinostomy [DCR] surgery. Quasi-experimental study. Isra postgraduate institute of Ophthalmology, Al-Ibrahim Eye Hospital, Malir, Karachi, from January 2003 to December 2004. This study included total 90 eyes of 90 patients fulfilling the inclusion criteria.The surgical procedure of external DCR done with intraoperative Mitomycin-C with a neurosurgical cottonoid soaked with 0.2mg/ml. Mitomycin C was applied to the anastomosed flaps and osteotomy site for 10 minutes, without Silicon tube intubation. Surgery was done under local as well as general anesthesia. Patients were followed for 6 months. Out of 90 patients included in this study, only 2 patients complained of persistent epiphora after 6 months follow-up and were labeled as failed DCR. Remaining 88 had either no tearing or significant improvement of tearing after 6 months follow up and patent lacrimal system by syringing without pressure. Success rate in this procedure was 97.77% [p-value< 0.001]. This study showed very high rate of success. Only complication noted was excessive nasal bleeding which was easily controlled. Intraoperative Mitomycin-C application in external DCR is safe, effective, cheap adjunct that helps to achieve good results of DCR surgery