Effectiveness of the addition of citicoline to patching in the treatment of amblyopia around visual maturity: A randomized controlled trial.

Aim: To study the effectiveness of the addition of citicoline to patching in the treatment of amblyopia in the age group of 4‑13 years. Materials and Methods: A randomized controlled trial, which included patients who were randomly divided into two groups. Both the groups received patching therapy till plateau was achieved in phase 1 of the study. Then in phase 2, group I received citicoline plus patching and group II continued to receive only patching. Outcome Measures: Outcome was measured by the visual acuity in logMAR every month in phase 1 till plateau was achieved and then for 12 months in phase 2. Results: No significant difference was found in the mean visual acuities in these two groups in phase 1 till plateau was reached. In phase 2, for the initial four months, there was no significant difference in the visual acuities in these two groups, at the respective intervals. However, five months onward, up to 12 months, there was a significant difference in the visual acuities in these groups.The result was the same in younger patients (< seven years of age) as well as in older patients (> seven years of age). In phase 2, the mean proportional improvement in group I was significantly more than that in group II, at two months and onward, at the respective intervals. Conclusion: The improvement in visual acuity with citicoline plus patching was significantly more than that with patching alone, in one year of treatment.

Maternal Risk Factors Associated with Term Low Birth Weight Neonates: A Matched-Pair Case Control Study.

Objective: To study maternal risk factors associated with full term low birth weight (LBW) neonates. Design: Matched pair case control study. Setting: Multicenter study including 2 medical colleges and 1 civil hospital, between July 2009 to December 2009. Patients: Of 2382 neonates screened, 274 full term LBW babies (of 638) and 274 pair matched controls (of 1744) were included in the study. 364 LBW babies were excluded because of premature delivery/gestational age not known (314), unavailability of suitable matched controls (18), and insufficient data (32). Methods: Maternal factors including birth spacing, height, pre-delivery weight and pregnancy weight gain, age, parity, educational and economic status, type of family, antenatal care (ANC), maternal exposure to tobacco, hypertension and anemia were studied. Results: Birth spacing <36 months, maternal height 145 cm, pre-delivery weight 55 kg, pregnancy weight gain 6 kg, exposure to tobacco, inadequate antenatal care, maternal hypertension, low socio-economic status, maternal anemia and less maternal education were associated with delivery of a low birth weight infants. Conditional logistic regression analysis showed that significant risk factors associated with low birth weight were inadequate ANC (OR-4.98, 95% CI-2.64 to 9.39), maternal weight before delivery 55 kg (OR-4.81, 95% CI-2.53 to 9.15) and height 145 cm (OR-4.13, 95% CI- 2.04 to 8.37). Conclusion: Maternal malnutrition, inadequate antenatal care and poor weight gain during pregnancy are significant predictors for delivery of a low birth weight neonate.