Platelet derived growth factor inhibitors: a potential therapeutic approach for ocular neovascularization

Retinochoroidal vascular diseases are the leading causes of blindness in the developed world. They include diabetic retinopathy [DR], retinal vein occlusion, retinopathy of prematurity, age-related macular degeneration [AMD], and pathological myopia, among many others. Several different therapies are currently under consideration for the aforementioned disorders. In the following section, agents targeting platelet-derived growth factor [PDGF] are discussed as a potential therapeutic option for retinochoroidal vascular diseases. PDGF plays an important role in the angiogenesis cascade that is activated in retinochoroidal vascular diseases. The mechanism of action, side effects, efficacy, and the potential synergistic role of these agents in combination with other treatment options is discussed. The future of treatment of retinochoroidal vascular diseases, particularly AMD, has become more exciting due to agents such as PDGF antagonists

Comparison of different treatment modalities in advanced laryngeal hypopharyngeal squamous cell carcinoma

To compare outcome of patients with advanced laryngeal hypopharyngeal squamous cell carcinoma treated surgically or with chemotherapy and/or radiotherapy. Observational study. The Aga Khan University Hospital, Karachi, from January 2000 to December 2005. Medical records of already treated stage-Ill and IV squamous cell carcinoma of larynx/hypopharynx patients were reviewed. Group-A comprised of patients treated with surgery +/- adjuvant therapy whereas non-surgically managed patients were labeled as group-B. One hundred and nineteen out of 275 met the inclusion criteria. Kaplan Meier technique was used to estimate mean recurrence time with standard errors. Cox proportional hazard regression was used to estimate the hazard ratio with 95 percent confidence interval for gender, age and tumour location. Sixty two percent of group-A and 49% patients of group-B were stage-Ill. In group-A, 40% patients received postoperative adjuvant therapy while in group-B, 45% received concomitant chemoradiation. Mean follow-up duration was 18.3 months. Mean recurrence time was 1369 +/- 193 days. In group-A, mean recurrence time was 2097 +/- 277 days. It was 399 +/- 68 days for group-B patients [p <0.001]. The hazard ratio of recurrence in hypopharyngeal tumours was 1.5 times [95% CI 0.68, 3.30] as compared to tumours of larynx. The hazard ratio of recurrence was 1.98 times [95% CI 0.99, 3.95] when both larynx and hypopharynx were involved as compared to when tumour was localized to larynx only. No residual disease was noted at the completion of treatment in surgical group-A while 62% patients of the group-B had residual disease at the completion of treatment. Larynx was retained in only 25% patients in group-B. Statistically significant difference was noted in disease free outcome when stage-Ill and IV larynx hypopharynx cancer was managed surgically as compared to non-surgical management. Chances of retaining larynx are only 25% when managed non-surgically

Prevalence of Depression, Anxiety and their associated factors among medical students in Karachi, Pakistan

To estimate the prevalence of anxiety, depression and their associated risk factors among students of a public medical college in Karachi, Pakistan, A cross sectional study was done on the students of a public sector, who had spent more than six months in the medical college and had no physical or mental illness other than anxiety and depression. A self administered questionnaire was given out to students who were randomly selected from the list of names obtained from the college administration. Primary outcome was anxiety and depression which was defined as a cut of score 19 or above on AKUADS. Multivariable models were built and logistic regression analysis was performed to determine the factors independently associated with the primary. The mean [SD] age of the students was 21.3 [1.88] years. Majority of the students were females. A very high prevalence of anxiety and depression [70%] was found among students. Students using substance abuse, having family history of depression and anxiety and those who had lost a relative in last 1 year were 2.66, 2.35, 3.4 times more likely to be depressed and suffered from anxiety, respectively. This study suggests that there are certain risk factors other than academic stressors which predispose a medical student to psychological morbidity such as anxiety and depression