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Purpose: To evaluate age-related changes in macular vessels and their perfusion densities using optical coherence tomography angiography (OCTA). Methods: A total of 108 eyes of 54 healthy subjects between the age group of 11 to 60 years having unaided visual acuity of 20/20 were studied on spectral domain OCTS using 3 * 3 mm macula protocol. These subjects were divided into 5 groups; Group 1: 11–20 years, Group 2: 21–30 years, Group 3: 31–40 years, Group 4: 41–50 years, and Group 5: 51–60 years. An early treatment diabetic retinopathy study (ETDRS) grid overlay at the macula was used to calculate changes in different quadrants of the superficial retinal plexus. Results: A total of 98 eyes of 49 patients were considered for the final analysis. The vessel density values decreased from the second to the sixth decade in all four quadrants (except the third decade, where a slight increase was noted). The total vessel density decreased from 168 ± 78 mm-1 (group 1) to 131.47 ± 18.32 mm-1 (group 5). A similar reduction pattern in perfusion density was seen in each quadrant from the second to the sixth decade. The total perfusion density reduced from 309 ± 15.63% (group 1) to 283.05 ± 45.23% (group 5). The foveal avascular zone area was 0.18 ± 0.09 mm2 in group 1, 0.33 ± 0.13 mm2 in group 2, 0.30 ± 0.10 mm2 in group 3, 0.38 ± 0.05 mm2 in group 4, and 0.46 ± 0.06 mm2 in group 5. Conclusion: In our population, macular vessel density appears to decrease noticeably from the fourth decade onwards but a statistically significant decrease was observed only from the fifth decade onwards. However, it was not uniform along with all the quadrants. Similarly, the percentage of perfusion density dropped from the fourth decade but these values also varied among the different quadrants.
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Retinal dialysis is mostly associated with blunt trauma or at times spontaneous. A patient presented to us with fresh rhegmatogenous retinal detachment with no telltale history or signs of trauma. The causative break was retinal dialysis noted on the superonasal periphery. A characteristic peripheral chorioretinal degeneration simulating a coastline almost extending six clock hours was seen in both the eyes. We have discussed this rare presentation and the possibilities of the association between this newly identified lesion and spontaneous retinal dialysis in the following case report.
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A patient, being a moderate myope with an axial length of 24.71 mm, presented to us with a fresh rhegmatogenous retinal detachment and marked peripheral chorioretinal degeneration. Difficulty in maneuvering with the standard 23 gauge vitrectomy cutter, inability to identify the break due to poor peripheral contrast, inadequate laser uptake, and an unusual large silicon oil fill (7.3 ml) were a few findings raising suspicion. Postoperative ocular ultrasonography showed an oblate eyeball with a relatively longer oblique axis (26.1 mm) as compared to the axial length confirming our suspicion. Oblateness should be suspected when the chorioretinal degenerations are more marked in the periphery as compared to the posterior pole. Intraoperative difficulties should be kept in mind while operating such cases.
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Purpose: To compare clinical outcomes of patients undergoing macular hole surgery with heads-up three-dimensional (3D) viewing system and conventional microscope. Methods: In all, 50 eyes of 50 patients with stage 3 or 4 macular hole were randomized and macular hole surgery [inverted internal limiting membrane (ILM) flap technique] was performed in 25 eyes using 3D viewing system and 25 eyes using conventional microscope. All surgeries were performed by a single surgeon. Patients were followed up for a period of 3 months. Logarithm of the minimum angle of resolution (logMAR) visual acuity, macular hole index, intraoperative parameters such as total surgical time, total ILM peel time, number of flap initiations, duration of Brilliant Blue G dye exposure, illumination intensity, postoperative logMAR visual acuity, and macular hole closure rates were recorded and compared between the two groups. Results: The mean age was 67.92 ± 7.95 and 67.96 ± 4.78 years in both groups, respectively (P = 0.98). Gender (P = 0.38) and right versus left eye (P = 0.39) were also comparable. Preoperative and postoperative best-corrected visual acuity (P = 0.86, 0.92), macular hole index (P = 0.96), total surgical time (P = 0.56), total ILM peel time (P = 0.49), number of flap initiations (P = 0.11), and macular hole closure rates (P = 0.61) were not statistically significant when compared between the two groups. Illumination intensity of microscope (100% vs 45%) and endoillumination (40% vs 13%) were significantly less in the 3D viewing system. Conclusion: The clinical outcomes of macular hole surgery using 3D viewing system are not inferior to that of conventional microscopes, and it has the added advantages of better ergonomics, reduced phototoxicity, peripheral visualization, magnification, and less asthenopia, and it serves as a good educational tool.
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Background: Understanding the future career interests of medical graduates is important, as they are the future workforce of the healthcare profession. Aim: The aim of this study was to determine the career choices and the factors that influence undergraduate medical students to choose a particular medical specialty. Materials and methods: A cross sectional observational study was conducted among ‘300’ undergraduate medical students of Sardar Patel Medical College, Bikaner, Rajasthan between January to March 2014. A self-administered questionnaire was used to collect data and the association between different variables was tested using Chi-square test. Results: Out of total ‘300’ respondents, 84% (n=252) considered post-graduation very important for future career and majority of them (99%) wanted to pursue the same in clinical subject. The most preferred specialty expressed by male students was Medicine, followed by Surgery and Orthopedic, while the female students were more interested in Radiology, Paediatrics and Obstetrics and Gynecology. Little interest was shown in other specialities. Personal interest was found to be the most common factor that influenced the choice of specialization. Conclusion: A variety of factors appeared to inspire medical graduates to opt for a particular specialty. All the substantial factors that influence the medical graduates’ decision should be equally justified and addressed, so that the quantitative and qualitative inequality of specialists can be nullified.
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Background and Objective: Fractures and dislocations are a signifi cant public health and economic burden for any country, but current knowledge on the basic epidemiology of fractures in Saudi Arabia is very limited. This retrospective analysis was performed to determine the patterns of incidence of traumatic fractures and dislocations in the urban population of the Eastern Province of Saudi Arabia
Materials and Methods: Data were collected on all fractures and dislocations admitted to the orthopaedic wards between January 1, 2004 and December 31, 2009. The inclusion criteria were all patients admitted after trauma. The data collected included was the type of accident, fracture and dislocations sustained, surgery undertaken either emergency or elective, implants used, associated injuries, complications, status of the union of the fracture at the time of the final review and complications
Results: There were 1428 patients with 2056 fractures and dislocations. Five-hundred and eighty-four [40.89%] of the injuries were sustained in road traffic and motorcycle accidents. Lower extremity fractures were 830, upper extremity fractures were 555 and spinal fractures were 323. Of these, 202 [14.4%] patients had dislocations, a majority of which were hip joint dislocations. The overall complication rate was 166 [11.69%] and infections formed the majority. Delayed union occurred in 32, nonunion in 24 and malunion requiring surgery occurred in 17. Twenty-seven [1.31%] of fractures were missed
Conclusions: This analysis shows that road traffi c accidents are still a major cause of trauma in an urban population and lower extremities form the common site of fractures. Fractures and dislocations due to trauma are steadily increasing and the young are the most affected. We believe that injury prevention programs should be made mandatory to limit muskuloskeletal injuries resulting from trauma. In the coming years, the number of these injuries will rise considerably with the increase in population
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The study was done to see the changes of placental diameter, thickness and number of cotyledons in eclapmsia. A total 45 placenta, 25 from eclamptic mother and 20 from normal pregnant mother were collected from Gynaecology and Obstetric department of Mymensingh Medical College and Hospital (MMCH). Study was done in Anatomy department of Mymensingh Medical College (MMC). Macroscopic study of the formol saline fixed placentas revealed that, compared to the controls there was trend of less placental diameter in eclamptic group(p=0.0004). Cotyledon number was found to be significantly less in eclampsia (p=0.0001). However there was no significant difference in placental thickness in eclamptic placenta than that of normal group. Statistical significance of difference between two groups was calculated by using Students "t" test. A difference between the two groups was considered to be significant when p<0.005. The morphological changes in placenta are possibly due to reduced uteroplacental blood flow in eclampsia.
Subject(s)
Case-Control Studies , Eclampsia/pathology , Female , Humans , Placenta/pathology , PregnancyABSTRACT
The study was done to see the relationship of recurrent laryngeal nerves with corresponding inferior thyroid artery with the aim to increase the knowledge regarding variational anatomy in our population. Sixty samples were collected as block dissection of thyroid gland along with the surrounding structures containing the supplying vessels and adjacent nerves from 48 male and 12 female cadavers of different age groups and fixed in 10% formol-saline solution. Fine dissections were carried out to study the toporgaphic relationship of recurrent laryngeal nerves with corresponding inferior thyroid artery. The findings were compared between different age groups and also with the findings of western researchers. In this study, in majority of the cases the recurrent laryngeal nerves were found in their usual location that is posterior to the terminal branches of inferior thyroid artery on the left side and anterior to that artery on the right side. It was important to note that, on both sides recurrent laryngeal nerves were also frequently found to pass in between the terminal branches of inferior thyroid artery.
Subject(s)
Adolescent , Adult , Aged , Bangladesh , Cadaver , Child , Female , Humans , Male , Middle Aged , Recurrent Laryngeal Nerve/anatomy & histology , Thyroid Gland/blood supplyABSTRACT
The study was done to see the gross morphologic changes of placenta in human normal pregnancy and eclapmsia, with the aim that it would be able to increase the general body of knowledge regarding the gross morphology of normal placenta and the changes that occur in eclampsia in our population. Total of 45 (n=45) placenta, 25 (n=25) from eclampsia and 20 (n=20) from normal pregnant cases were collected from Gynaecology and Obstetric Department of Mymensingh Medical College & Hospital (MMCH). Study was done in Anatomy Department of Mymensingh Medical College (MMC). Macroscopic study of the formol saline fixed placentas revealed that, compared to the controls there was trends of lower weights and volumes of placentas in eclamptic group. Statistical significance of difference between two groups was calculated by using Students "t" test. A difference between the two groups was considered to be significant when p<0.005.