Efficacy and safety of intacs SK in moderate to severe keratoconus

To examine the safety and efficacy of Intacs SK for moderate to severe keratoconus [KGC] using femtosecond technology. This prospective, non-comparative study included 37 contact lens intolerant keratoconic eyes [stage II-III] of 24 patients who underwent femtosecond-assisted Intacs SK implantation. Inclusion criteria were mean K readings <56.00 D, corneal thickness >400 micro at the incision site, mesopic pupil <6.50 mm. Evaluation included manifest refraction, slitlamp examination, corneal topography, uncorrected distance visual acuity [UDVA] and corrected distance visual acuity [CDVA]. P< 0.05 was statistically significant. Thirty-one [83.8%]eyes were classified as Amsler-Krumeich's stage II and 6 [16.2%] were stage III. Mean central pachymetry was 490.3 +/- 37.4 microm. UDVA at 6 months post-operatively was significantly better than pre-operatively [0.90 log MAR +/- 0.52 standard deviation [SD] versus 0.32 +/- 0.27 logMAR; respectively, P < 0.000l], as was the spherical equivalent [SEq] [-3.64 +/- 2.52 D vs. -1.84 +/- 2.2 D; P< 0.000l]. The mean CDVA and manifest cylinder improved compared with pre-operatively [P = 0.319 and P= 0.078, respectively]. Average keratometry decreased significantly from 48.50 +/- 3.08 D to 44.40 +/- 3.03 D [P< 0.000l]. Implantation of Intacs SK using femtosecond laser in moderate to severe KG is safe and effective

Diagnostic utility of sonar guided biopsy in tuberculous effusion

Tuberculous pleural effusion remains the commonest cause of exuda tive effusions in areas with a high prevalence of tuberculosis and histological examination of pleural tissue is the gold standard for its diagnosis. This study was to assess the diagnostic utility of sonar guided biopsy in tuberculous pleural effusion. 50 patients [34 men] of mean +/- SD age 38.7 +/- 16.7 years with pleural effusions and a clinical suspicion of tuberculosis were enrolled in the study. Transthoracic ultrasound was performed on all patients, who were then randomly assigned to undergo 4 Abrams needle biopsies followed by 4 Tru-Cut needle biopsies or vice versa. Pleural tuberculosis was diagnosed in 31 patients, alternative diagnoses were established in 16 patients and 3 remained undiagnosed. Pleural biopsy specimens obtained with Abrams needles contained pleural tissue in 29 patients [92.0%] and were diagnostic for tuberculosis in 26 patients [sensitivity 82%], whereas Tru-Cut needle biopsy specimens only contained pleural tissue in 21 patients [78%] and were diagnostic in 21 patients [sensitivity 64%] Ultrasound-assisted pleural biopsies performed with an Abrams needle are more likely to contain pleural tissue and have a significantly higher diagnostic sensitivity for pleural tuberculosis

Short-term visual outcomes of Boston keratoprosthesis type I in Saudi Arabia

To evaluate the visual outcomes, complications and retention of threadless type I Boston keratoprosthesis [KPro] in Saudi Arabia. Retrospective analysis of four eyes of four patients [one female and three males; age range: 48 to 72 years] who underwent Boston type I threadless KPro implantation between January and December 2009. In the median follow-up of 11 months [range 6 to 14 months], visual outcomes were satisfactory. Preoperative diagnosis included two patients of post-trachoma dense vascularized corneal scarring, one patient of corneal alkali burn and one patient of repeated failed corneal grafts. All patients demonstrated significant improvement in vision; with pre-operative visual acuity of hand movements [HM], counting fingers and HM improved to best corrected visual acuity [BCVA] of 20/200, 20/60, 20/50 and 20/30 on their last follow-up visits respectively. None of the patients developed glaucoma as a result of the procedure. No retro-prosthetic membrane developed till the last follow-up visit. One of the four patients had a corneal melt [due to severe dryness associated with trachoma] 6 months after the KPro implantation and underwent a successful KPro revision. Despite the relatively poor prognosis expected in alkali burn eye, the patient attained the maximum BCVA [20/30] of the four eye series on the last follow-up visit at six months. In consistent with the earlier reports from other parts of the world, all the 4 eyes had a significant increase in vision after Boston type I KPro implantation. However, patients require close lifelong follow-up to manage any complications

level of bronchoalveolar lavage fluid prostaglandine E2; is it diagnostic of bronchogenic carcinoma?

Lung cancer is the leading cause of cancer-related mortality in the United States. Cigarette smoking is the number one risk factor for lung cancer. It causes about 90% of lung cancers [14]. Evaluation of bronchoalveolar lavage level of PGE2 in patients with primary bronchogenic carcinoma. The study was conducted on forty subjects; including twenty patients with bronchogenic carcinoma, ten patients with non-malignant lesions, and ten healthy control subjects. All subjects were submitted to fiberoptic bronchoscopy with bronchoalveolar lavage was done and examined for prostaglandin E2. The PGE2 level was significantly higher in BALF of group III [malignant group] compared to group I and II, with no significant difference between group I and group II. The cut- off value of PGE2 was 45.63 pg/ml with minimal overlap between malignant and benign lesions. Bronchoalveolar lavage level of PGE2 was significantly increased in patients with bronchogenic carcinoma