Role of dexamethasone in brachial plexus block

To evaluate the effect of dexamethasone added to [lignocaine] on the onset and duration of axillary brachial plexus block. Randomized controlled trial. Combined Military Hospital Rawalpindi, from September 2009 to March 2010. Patients and Methods: A total of 100 patients, who were scheduled for elective hand and forearm surgery under axillary brachial plexus block, were randomly allocated to group A in which patients received 40 ml 1.5% lidocaine with 2 ml of isotonic saline [0.9%] and group B in which patients received 40 ml 1.5% lidocaine with 2 ml of dexamethasone [8 mg]. Nerve stimulator with insulated needle for multiple stimulations technique was used to locate the brachial plexus nerves. After the injection onset of action and duration of sensory blockade of brachial plexus were recorded at 5 minutes and 15 minutes interval. Group A showed the onset of action of 21.64 +/- 2.30 min and in group B it was 15.42 +/- 1.44 min [p < 0.001]. Duration of nerve block was 115.08 +/- 10.92 min in group A and 265.42 +/- 16.56 min in group B [p < 0.001]. The addition of dexamethasone to 1.5% lignocaine solution in axillary brachial plexus block prolongs the duration of sensory blockade significantly

Comparison of retinal nerve fiber layer thickness in patients of primary open angle glaucoma and healthy adults

Objective: To compare the mean retinal nerve fiber layer [RNFL] thickness in Primary open angle glaucoma [POAG] patients and healthy age matched adults

Study Design: Case control study

Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi from 12[th] December 2011 to 17[th] October 2012

Material and Methods: Sixty subjects were included in the study, 30 cases and 30 controls, by non-probability consecutive sampling. In group A, patients of POAG were included and in group B, healthy adults having normal intraocular pressure were included. Mean retinal nerve fiber layer thickness [RNFL] measurements and mean of three intraocular pressure [IOP] readings of 30 patients of POAG were taken. RNFL thickness was obtained by spectral domain optical coherence tomography. IOP readings were taken with calibrated Goldman applanation tonometer

Results: Mean RNFL thickness of 66.19 +/- 14.83 microns in group A eyes was significantly lower than mean RNFL thickness of 96.46 +/- 14.76 microns in normal adults [p<0.001]

Conclusion: The overall thinner mean retinal nerve fiber layer thickness in POAG patients as compared with normal age matched individuals highlights the importance of early diagnosis and prompt intervention in such patients to reduce the morbidity related to potentially blinding but treatable disease like glaucoma