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Background: Single spinal anesthetic has been shown to be ineffective in preventing obturator nerve activation and adductor muscle contraction, which can lead to problems such as bladder perforation during transurethral resection of lateral wall bladder tumor (TURBT) under SA. To counteract this, numerous additional approaches are still being investigated, with the inguinal approach lately gaining traction. The aim of the study was to observe the incidence of jerk/ muscle spasm after obturator nerve block by Inguinal Approach in TURBT of lateral wall urinary bladder tumor under SA. Material & Methods: This retrospective observational study was conducted at the Department of Anesthesiology & ICU of National Institute of Kidney Diseases & Urology, Dhaka, Bangladesh. The study duration was 6 months, from January 2022 to July 2022. During this period, a total of 20 cases of transurethral resection of lateral wall bladder tumor (TURBT) had been included as the study population, following inclusion and exclusion criteria. Results: Among the participants, 45% had been from the age group of 60-69 years, 30% had been from the age group of 50-59 years, 15% had been between the ages of 70-79, and 10% had been of 80 years or older. Hypertension was the most common comorbidity, observed in 70% of the participants. 45% had diabetes, 15% had chronic kidney disease, another 15% had chronic obstructive pulmonary disease, 10% had heart disease, and 15% had benign enlargement of prostate. During TURBT, majority of the patients had no jerk, while only 10% had minimal jerk and 1 patient had maximum jerk. During the 24-hour follow-up, 20% of patients regarded their outcome condition as excellent, while 60% had regraded their outcome as good. Only 1 patient regarded their outcome as poor, while follow-up data was unavailable for 15% of patients. Conclusion: The study observed very few incidence of muscle spasm or jerk during TURBT after using the inguinal approach. The study also found positive short-term outcome in most of the patients.
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Background: Osteoarthritis (OA) is the most common type of rheumatic disease and a leading cause of disability. Current treatments aim at alleviating these symptoms by several different methods: non-pharmacological and pharmacological treatments and invasive interventions. Among the regenerative methods, hyaluronic acid (HA) is popular now-a-days where differences exist in concentration, molecular weight, dosage, expected duration of effects and added formulations. Based on HA molecular weight, these products are classified in two groups (high and low). Due to cost effectiveness, low molecular weight HA is commonly used. To find out the outcome of single intra-articular injection of high-molecular- weight HA in patients with knee osteoarthritis.Material & Methods:This was a randomized clinical trial conducted among purposively selected 55 patients suffering from Knee OA attending at the Physical Medicine and Rehabilitation outpatient department, DMCH during July 2020 to June 2021. Patients were randomly allocated into two groups; group A received single dose of high molecular weight HA and designed exercise program and group B received same exercise program only. Pre-treatment and 3 weekly post treatment assessment were done up to 12 weeks in each group. In each follow up visit, pain, and functional status were measured in Visual Analog Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) respectively and compared between group A and group B where was considered as significant (p value <0.050.Results:The mean age of the participants in group A and group B were 56.8 (±9.8) and 53.3 (±7.4) years respectively where majority of the patients in both groups were female patients with overweight. In group A, VAS and WOMAC significantly decreased from base line to each follow up till 12th weeks after treatment with high-molecular-weight HA (P<0.001). In group B, VAS and WOMAC significantly decreased from base line to each follow up till 12th weeks after treatment with conservative management (P<0.001). After 6 weeks of intervention, the mean VAS scores of the patients became 4.9 ±1.1 and 6.0±1.0 in group A and group B respectively which showed significant statistical difference (P<0.001). At the end of 12 weeks, the VAS score was significantly decreased in group A (2.8±1.3) than group B (4.9±1.7) (P<0.001). After 3 weeks of intervention, the mean WOMAC scores of the patients became 71.2±6.6 and 75.0 ±4.9 in group A and group B respectively which showed significant statistical difference (P<0.001). At the end of 12 weeks, the WOMAC score was significantly decreased in group A (61.9±6.6) than group B (68.1±4.6) (P<0.001). Conclusion:Single intra-articular injection of high-molecular-weight Hyaluronic Acid is effective in patients with knee osteoarthritis in reducing pain and improving functional impairment. Long term and large scale research studies are needed to establish the effectiveness and safety of this procedure in patients with knee osteoarthritis.
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Background: Prolapsed lumbar intervertebral disc is one of the most common problems encountered in medical practice. In orthopaedic practice patients having lesions of lumbosacral region causing low back pain with sciatica are not uncommon since the begdatainning of recorded history. To evaluate the fenestration and discectomy for prolapsed lumbar intervertebral disc by minimally invasive procedure.Material & Methods:This prospective observational study was conducted at National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh during July 2015 to June 2017. A total of 31 patients with prolapsed lumbar intervertebral disc were included for the study. A 3cm incision was made in midline on back centering the desired space of the spine. The analysis was done according to the standard statistical analysis system. Prior to commencement of this study, the research protocol was approved by the Institutional Review Board of ethics of National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR).Results:Mean age was (35.98 ± 8.50) years with the range from 17 to 50 years. Out of 31 patients, 26 (83.87%) patients were male and 05(16.12%) were female. Out of 31 patients 01(03.22 %) had prolapse at the level of L3-L4, 23(74.19%) had at the level of L4-L5 and 07(22.58%) had at the level of L5-S1. In this series the most common causes of muscle weakness in EHL. Out of 31 patients, 22 (70.96 %) patients had weakness in EHL. 08 (25.80%) cases had weakness in FHL and both muscle weakness in 01 (3.22%). Out of 31 patients, 30 (96.78%) patients had preoperative sensory deficit and 03(09.67%) patients had postoperative sensory deficit, which is statistically significant. In preoperative period, moderate pain in 27(83.87%) patients, severe pain in 04(12.90%) patients. In postoperative period had no pain in 22(70.96%) patients, mild pain was noted in 08(25.08%) patients, moderate pain in 01(03.22%) patient. 20(64.51%) patients had para spinal muscle spasm in the preoperative period. Postoperative mean SLR was 81.94 ± 4.774 degree and range was 70?-90?, which was significantly improved. 29 (93.54%) patients had normal spine movement and 02 (06.45%) patients had restricted movement after 3 months of follow up. The minimum period of duration for follow up was 3 months and maximum duration of follow up was 12 months..Conclusions:By considering all aspects fenestration and discectomy is a better technique in the context of our country with the advantage of less tissue injury, good spinal function, smooth patient recovery, improve working status with early rehabilitation and maintain clinical efficacy.
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Background: Different phenotypic detection method for theMethicillin Resistant Staphylococcus aureus is available.Objective: The aim of this present study was to evaluate theoxacillin disk diffusion test for the detection of methicillinresistant Staphylococcus aureus isolated from clinicalspecimens.Methodology: This cross-sectional study was planned to carryout in the Department of Microbiology and Immunology atBangabandhu Sheikh Mujib Medical University, Dhaka fromJanuary, 2010 to December, 2010 for a period of one (01)year. Different clinical specimens were collected from thepatients presented with infections at anybody sites. Isolationand identification of Staphylococcus aureus (S. aureus) wasperformed by staining, culture and biochemical tests. Oxacillindisk diffusion test was performed to detect the methicillinresistant Staphylococcus aureus. PCR was performed fordetection of the mecA gene for MRSA.Results: Out of the 22 suspected MRSA isolates 19 weremecA positive by PCR. The sensitivity and specificity ofoxacillin disc diffusion method for the detection of MRSA was84.2% (95 CI 60.4 to 96.6%) and 66.2% (95% CI 9.4 to99.2%) respectively. The positive predictive value and negativepredictive value of oxacillin disc diffusion method were 94.1%(95% CI 76.1 to 98.8%) and 40.0% (95% CI 15.2 to 71.2%)respectively. The accuracy was 81.8% (95% CI 66.7 to 95.3%).Conclusion: Oxacillin disk diffusion test shows high sensitivitywith moderate specificity for the detection of MRSA fromclinical specimens.
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Diabetes mellitus is a world-widely public health issue associated with premature mortality, decreased quality of life and increased health-care expenditures. The aim of the review was to elevate the effect of apple cider vinegar on glycemic control, hyperlipidemia and obesity control in type 2 diabetes patients. Many clinical trials showed the hypoglycemic, hypolipidemic and anti-obesity effect of vinegar. Proposed mechanisms action of vinegar for the hypoglycemic, hypolipidemic effect are including slow gastric emptying, it promotes uptake of skeleton muscles glucose in the body and acetic acid may inhibit disaccharides activity in the small intestine blocking the complete digestion of starch molecules, suppression of hepatic glucose production and increased glucose utilization. Results of previous studies showed that apple cider vinegar has the potential of anti-diabetic, antihyperlipidemic and antiobesity effects in diabetes mellitus patients. Objective of review: The objective of the current review study was to investigate the effect of apple cider vinegar on glycemic control, hyperlipidemia and control on body weight in type 2 diabetes patients and other therapeutic and commercial effect of apple cider vinegar. Data sources: To collect data for relevant literature PubMed, Google Scholar, science direct and Cochrane sources were used.
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Aim: The aim of the trial was to measure the effect of apple cider vinegar on glycemic control and biochemical parameters in type 2 diabetes mellitus (DM) patients with poor glycemic control. Methods: A single-blind, randomized, placebo-controlled trial was conducted on 110 eligible types 2 DM patients who were selected and allocated into 2 groups. The interventional group was given 15 ml apple cider vinegar in 200 ml water during dinner for 3 months while the other group was placebo. Before and after HbA1C (glycosylated hemoglobin), fasting lipid profile, fasting blood sugar, anthropometrics, and dietary changes were assessed and analyzed using IBM SPSS version 20, through statistical tests. Formal ethical approval was obtained from the local institutional review board. Results: Significant mean change was found in interventional group in HbA1c (p<0.001), blood sugar fasting (p<0.001), total cholesterol (p=0.002), triglyceride (p=0.002) and hip-waist ratio (p=0.002). No significant change was observed in the mean of these statistics in the placebo group. No significant change was observed in height, weight, mid-upper arm ratio, and low density lipoprotein, high density lipoprotein and food frequency in intervention and placebo groups before and after. Conclusion: Apple cider vinegar if used regularly is effective in controlling diabetes, lowering hypercholesterolemia and hypertriglyceridemia in DM type 2 patients.
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Nuclear medicine has been offering diagnostic and therapeutic solution since the introduction of radioactive iodine for thyroid diseases since decades. However, the concept of theranostics has given a new found impetus to the use of pairs of radiopharmaceuticals for diagnosis and treatment. Presented here is a perspective on theranostics from Pakistan.
Subject(s)
Diagnosis , Iodine , Nuclear Medicine , Pakistan , Radiopharmaceuticals , Theranostic Nanomedicine , Thyroid DiseasesABSTRACT
Objective: To evaluate key corneal tomography parameters for screening refractive surgery patients in Pakistani population
Study Design: Cross-sectional, observation study
Place and Duration of Study: Armed Forces Institute of Ophthalmology AFIO, National University of Medical Sciences, Rawalpindi, Pakistan, from August 2013 to December 2016
Methodology: Myopic patients were evaluated by two separate observers on Allegro OculyzerII [Wavelight] for normal ocular examination. A total of 20 tomographic parameters, used for pre-refractive surgical evaluation, were included. Normality of data was evaluated using Kolmogorov-Smirnov test. Results for outliers were displayed as 2.5%, 5%, 95% and 97.5% percentiles
Results: The sample of 451 patients [895 eyes], comprised of 61% [n=277] females and 39% [n=174] males [39%]. The mean age was 26 +6.4 years [range of 18-62 years, M=F]. Normal mean anterior segment values included; flat simulated keratometry [K1] 42.9 +/-1.44 diopters [D], steep K2 43.9 +/-1.52 D, K mean 43.4 +/-1.43 D, K maximum 44.6 +/-1.56 D, astigmatism -0.96 +/-0.97 D, anterior chamber depth [ACD] 3.19 +/-0.28 mm, front elevation at the thinnest point 4.11 +/-2.44 um, and that at the back was 7.56 +/-4.52 um progression index [PI] maximum 1.14 +/-0.17, Ambrosio relational thickness maximum [ART max] 487.5 +/-89.0 and pachymetry at thinnest point 542.2 +/- 31.1 um
Conclusion: The study demonstrates key corneal tomography parameters, which can be useful for screening refractive surgery patients in Pakistani population
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Nuclear medicine has been offering diagnostic and therapeutic solution since the introduction of radioactive iodine for thyroid diseases since decades. However, the concept of theranostics has given a new found impetus to the use of pairs of radiopharmaceuticals for diagnosis and treatment. Presented here is a perspective on theranostics from Pakistan.
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Background: The emergence and re-emergence of viral haemorrhagic fevers [VHFs] is a growing concern worldwide. They are associated with major epidemics with an estimated 51101 million cases each year, of which around 67 000 are fatal. In 2007, 13 countries in the Eastern Mediterranean Region reported VHF cases.
Aims: The main purpose of the study was to review the epidemiological situation in the Region vis-à-vis VHFs to obtain baseline epidemiological information for the establishment of the Emerging Dangerous Pathogen Laboratory Network [EDPLN].
Methods: A literature search was performed using PubMed, ProMED-Mail and GIDEON databases. Reported data included disease burden [reported cases and deaths], human prevalence [general population, highrisk groups], vectors and reservoirs. A scoring method was employed to divide countries into 4 groups [very highly, highly, medium and low affected countries].
Results: Very highly affected countries were Afghanistan, Egypt, Islamic Republic of Iran, Saudi Arabia and Sudan. Highly affected countries were Djibouti, Morocco, Oman, Pakistan, Tunisia and Yemen. Medium affected countries were Iraq, Somalia and United Arab Emirates. Low affected countries were Bahrain, Jordan, Lebanon, Libya, Palestine, Qatar and Syrian Arab Republic.
Conclusions: This study contributes in prioritizing countries to be part of EDPLN and in addressing specific needs related to outbreak investigations, surveillance and research
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The current study was designed to evaluate mucoadhesive buccal tablet containing metronidazole [MTZ] for local action aided by Hydroxypropylmethylcellulose K4M [HPMC] and Carbopol 940® [CP] as mucoadhesive polymers with other ingredients like sodium starch glycolate [SSG], polyvinyl pyrollidone K30 [PVP] as disintegrant and binders respectively. Formulations [F1-F8] were prepared by direct compression method and characterized for different physicochemical parameters. Results showed that the average weight and friability were within USP limits. Maximum mucoadhesive time was observed for F2 [14 hr] containing moderate amount of HPMC and CP used in the study. Up most mucoadhesive strength value was observed with F3 containing highest amount of HPMC used. Results indicated that high amount of HPMC was linked with the moderate to higher mucoadhesive strength and time. Maximum swelling index was observed in F7 [191.3%]. Only F1-F3 showed complete in vitro MTZ release within 3 hr. Formulations containing PVP released MTZ incompletely over time while SSG released earlier. Formulation F1 was considered best in terms of MTZ release [100.5%] with diffusion based Korsmeyer-Peppas release kinetics. Therefore, MTZ exhibiting best physicochemical characters in mucoadhesive buccal tablet was found in F1 containing HPMC and CP in amounts of 37.5 mg and 25 mg, respectively, for local action
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Objectives: To get information regarding the most preferred contraceptive method used by married women of rural area of Basic health unit [BHU] 96/GB of Faisalabad
Method: The cross-sectional study was conducted on 300 married women of rural areas with different socio-demographic factors, age groups, and family backgrounds. A structured questionnaire consisting of open ended and close ended questions was made, and pre-tested. Face to face interviews of those willing women were done at their residence with the help of a trained Lady Health Workers [LHWs] and the 100% response rate achieved. Non-probability sampling[convenient] was adopted to include willing married female. Statistical Package for the Social Sciencesp-19 was used for analysis and descriptive statistics were calculated
Results: Out of 300 participants majority of women 129[43%] are using Combined Oral Contraceptive Pills [OCP] followed by condoms 65[21.6%] and natural method [exclusive breast feeding] 40[13.6%]. Majority of women 125[41.6%] have been taking contraception for 1-2 years. Most participants 217[90.3%] were of age 27-36 years along with majority of participants were having gravidity and parity of 4-6 each. Opinion of better family well-being was given by 110[36.6%] women after taking contraception for family planning. Major side effect of nausea and vomiting noticed among 35[11.6%] user of oral contraceptive methods
Conclusion: Oral contraceptive pills are the most commonly used contraceptive method among married women. The reason of this preference is availability of combined oral contraceptive pills at basic health units. These OCP delivered through lady health workers increased the number of women taking contraception for family planning. It is also related with increased awareness about family wellbeing and health of mother
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Background: Anemia is one of the most widely recognized nutritional deficiencies for the duration of pregnancy in underdeveloped countries. It is a risk factor for preterm delivery and consequent low birth weight new born, and subsequent ill effects on neonate and infant health. Further research and sufficient data in different setting is required for determining the extent to which maternal anemia might contribute to maternal morbidity, mortality and impact on pregnancy outcomes
Objective: To assess the effects of iron supplements on pregnancy outcomes
Study Design: Cross-sectional study in which women delivered in hospital were questioned for history of intake of iron supplements during ante-natal period and new born was examined for any adverse effects of iron deficiency anemia
Setting: Hilal-E-Ahmar Maternity Hospital Faisalabad
Results and Discussion: 400 respondents were included in study that was regular in attending ante-natal clinic in the hospital during different gestational period. No significant adverse effects/outcomes were seen in women and newborn irrespective of frequency of iron supplementation already taken during these gestational periods
Conclusion: Majority of the newborn delivered full term and without any complication of pregnancy in this study as well as most of them had normal birth weight. This finding is linked with intake of iron supplements taken by majority of pregnant women during antenatal care. Incidence of low birth weight new born, abortion [spontaneous and therapeutic] and fetal deaths were almost negligible
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The present study was aimed to evaluate the effect of educational intervention provided to the patients of hypertension through pharmacist with the goal to improve knowledge about hypertension, adherence to prescribed medicines, blood pressure control and HRQoL [Health Related Quality of Life]. A total of 384 patients were assigned randomly into 2 groups including intervention and control groups each having 192 patients. Urdu versions of knowledge questionnaire regarding hypertension, medication adherence scale [MMAS-U] by Morisky and EuroQol scale [EQ-5D] were utilized. Each patient's blood pressure was measured. After educational intervention, an increase was found in mean knowledge score about hypertension [18.18 +/- 4.00], adherence score [5.89 +/- 1.90], HRQoL score [0.73 +/- 0.12] and Visual Analogue Scale [VAS] score [69.39 +/- 5.90] among the IG. The blood pressure control also improved and lower systolic [131.81 +/- 10.98 mmHg] and diastolic blood pressures [83.75 +/- 6.21 mmHg] were observed among the patients of IG. This study showed that educational programs are useful for patients in increasing patient's levels of knowledge about hypertension, improving adherence to prescribed medication and enhancing blood pressure control. This increase is in turn accountable to improve HRQoL
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Objective: To explore effect of format change in house job training and other factors, hindering or promoting junior doctors' training/learning in their transition to practical life
Study Design: Mixed Method Sequential
Place and Duration of Study: Sir Ganga Ram hospital Lahore, from Nov 2011 to Oct 2012
Material and Methods: Four hundred and ninety two doctors completed the modified PHEEM survey after completion of their house job from November 2011 till October 2012 after institutional ethical review Board's approval. Second phase comprised semi-structured FGD to triangulate findings of the survey with FGD results, to find out, in detail, about doctors' expectations from their house job training and suggestions for future after ensuring confidentiality and anonymity to study participants
Results: The mean overall score for clinical learning environment was 77.67, implying 57.0 percent satisfaction. Themean total scores for autonomy; teaching and social support was 25.6, 31.9 and 20.0 respectively. Satisfaction with regard to autonomy, teaching and social support was 25.6/48 [53.3 percent], 31.9/52 [61.3 percent] and 20.0/36 [55.5 percent] respectively. Patterns emerged from FGD were lack of standardization, nonexistence of formative assessment, opportunistic learning, poor quality feedback and inappropriate teaching by medical officers. Skill learning under supervision, confidence in patient management and part of clinical team were motivating factors while poor accommodation, sanitation, catering facilities and short duration of rotation were hindering factors for learning
Conclusion: Evidence generated has shown that internship year was very challenging. Dissatisfaction was expressed with unstructured opportunistic nature of training. Unstructured training program, role ambiguity, substandard physical environment and short duration of rotations were perceived to negatively influence learning. A valued member of clinical team, confidence in patient management, opportunity to acquire procedural skills under supervision and being supported were the factors perceived to enhance learning
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Objective: To evaluate the role of sub anesthetic dose of ketamine when given 5 minutes prior to Propofol injection in alleviating pain of injection during cesarean section surgery
Study Design: Randomized controlled trial
Place and Duration of Study: Department of anesthesia and critical care, Nishtar Hospital Multan, from Aug 2016 to Feb 2017
Material and MethodsA total number of 130 [100 percent] patients were included in the study. Data was analyzed using SPSS [v 23.2], mean and SD calculated for continuous data [age, BMI] and in continuous data was presented as frequency and percentages [ASA status, pain of propofol injection]. Effect modification seen by applying chi square test and p-value
Results: A total number of 100 percent [n=130] patients were included in this study, all were females. The main outcome variable of this study was pain of propofol injection. It was observed that, in control group, 87.7 percent [n=57] patients complaints about pain after propofol injection and 12.13 percent [n=8] remain normal. But, in ketamine group only 16.9 percent [n=11] patients complaint about pain of propofol injection and 83.1 percent [n=54] were remained pain free
Conclusion: Administration of ketamine 0.25Ug/kg five minutes before propofol injection is a safe and effective method in preventing propofol injection pain
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Objectives: To describe the spectrum of complications of Diabetic Ketoacidosis [DKA] observed in children admitted with severe DKA
Methods: Retrospective review of the medical records of all children admitted with the diagnosis of severe DKA in Pediatric Intensive Care Unit [PICU] of the Aga Khan University Hospital, from January 2010 to December 2015 was done. Data was collected on a structured proforma and descriptive statistics were applied
Results: Total 37 children were admitted with complicated DKA [1.9% of total PICU admission with 1.8% in 2010 and 3.4% in 2015]. Mean age of study population was 8.1 +/- 4.6 years and 70% were females [26/37]. Mean Prism III score was 9.4 +/- 6, mean GCS on presentation was 11 +/- 3.8 and mean lowest pH was 7.00 +/- 0.15. Complications observed included hyperchloremia [35.94%], hypokalemia [30.81%], hyponatremia [26.70%], cerebral edema [16.43%], shock [13.35%], acute kidney injury [10.27%], arrhythmias [3.8%], and thrombotic thrombocytopenic purpura [5.4%], while one patient had myocarditis and ARDS each. 13/37 children [35%] needed inotropic support, 11/37 [30%] required mechanical ventilation while only one patient required renal replacement therapy. Two patients [5.4%] died during their PICU stay
Conclusion: Hyperchloremia and other electrolyte abnormalities, cerebral edema and AKI are the most common complications of severe DKA
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Intensive Care Units, Pediatric , Diabetes Mellitus , Child , Diabetes Complications , Retrospective StudiesABSTRACT
Objective To evaluate the effect of methanolic extract of Syzygium cumini (L.) Skeels (S. cumini) seeds on the major organs in an animal model of diabetes through biochemical and histopathological studies. Methods The methanolic extracts of S. cumini seeds (100 and 200 mg/kg body weight) were administered to alloxan-induced diabetic rats daily, with fasting blood glucose levels being measured by glucometry at one-day interval for a duration of two weeks. Biochemical assays to evaluate changes in the functions of the heart, liver, pancreas and kidney were carried out. Histopathological changes in the diabetic rat organs (pancreas, liver, heart, kidney and spleen) were also observed after the 14 days of treatment with the extracts. Results Oral administration of methanolic extracts of S. cumini seeds (100 and 200 mg/kg body weight), with gliclazide as a positive control (25 mg/kg), showed beneficial effects including lowering blood glucose levels (P < 0.001), improved heart and liver functions, and hyperlipidemia due to diabetes. At 200 mg/kg, the extracts reversed cardiac and liver damage caused by alloxan. Conclusions In addition to the anti-hyperglycemic activity of methanolic extracts of S. cumini seeds, the extracts demonstrates potential to minimize cardiac and hepatic complications.
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Classic Raymond syndrome presents with abducens nerve palsy on the ipsilateral side with contralateral hemiparesis and facial nerve paralysis. A 60-year gentleman presented with deviation of left angle of mouth and right sided weakness. Examination showed that he had left sided abducens nerve palsy, with contralateral central facial paralysis and paresis. MRI of brain confirmed left pontine infarct. These findings were consistent with classic Raymond syndrome. Till now, only a few cases have been reported worldwide, this being the first case reported in South Asia. This case confirms that classic Raymond syndrome is different from the common type of Raymond syndrome in terms of sparing of coritcofacial fibers in the latter type
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Objective: To determine the Efficacy of Corneal Crosslinkage [CXL], using Corneal Topography, in eyes with progressive Keratoconus
Methods: This randomized control trial was conducted at Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan from October 2013 to April 2014. A total of 60 eyes of 30 patients were included who presented with bilateral progressive Keratoconus. Each eye of the patient was randomized either to a treatment group [Group-A] or control untreated group [GroupB] of 30 eyes each. A written informed consent was obtained from each patient, following which corneal crosslinkage [CXL] with topical riboflavin eye drops was performed. Follow up visit was done at three months post operatively, Corneal topography was repeated and recorded
Results: The mean age of the patients was 23.13+/-7.62 years [range 13 to 39 years]. There were 26 males and 34 females patients. The mean simK value at the start of study was 50.94+/-4.84 diopters in Group-A and 49.73+/-5.24 diopters in Group-B. At three months follow-up, the mean simK value was significantly lower in Group-A [48.28+/-4.47] as compared to Group-B [51.11+/-4.85]. Keratoconus improved/ remained stable in 34 [56.7%] eyes while progressive disease was noted in 26 [43.3%] eyes. When compared between the groups, the frequency of efficacy was significantly higher in Group-A [86.7% vs. 26.7%; p=.000] as compared to Group-B
Conclusion: Corneal Crosslinking was found effective in causing regression or halting the progression of disease in patients with progressive Keratoconus at three months follow-up, however, the efficacy of corneal crosslinking was unaffected by patient's age and gender