ABSTRACT
Background: It is necessity to work more on non-invasive markers like right liver lobe size/albumin concentration ratio for predicting esophageal varices. We aimed to see the right liver lobe/albumin ratio in identifying esophageal varices among patients with cirrhosis caused by hepatitis B and C
Methods: A cross-sectional study was conducted among all indoor patients admitted to the Department of Internal Medicine, Pakistan Atomic Energy Commission, General Hospital, Sector H-11/4 Islamabad, Pakistan, during May-December 2016. A non-probability purposive sampling technique was used for data collection. Diagnosed cases of cirrhosis caused by hepatitis B and C virus infection aged 25 years or more were included. A pre-designed questionnaire was used for data collection. Statistical analysis was done using SPSS software version 20
Results: A total number of 160 patients were included. Mean +/- SD age was 56.04 +/- 10.22 years, while 96 [60%] were men. Child-Turcotte-Pugh grades showed 41.88% of the patients with grade A, followed by grade B [38.12%], and grade C [20%]. Esophageal varices were observed in 76.25% of the patients. The sensitivity was 86.89%, while specificity was 78.95%. The positive predictive value was 92.98% [95% confidence interval [CI] = 86.64% - 96.91%] and negative predictive value was 65.22% [CI = 49.75% - 78.64%] with a diagnostic accuracy of 85%
Conclusion: The use of the studied non-invasive markers of portal hypertension particularly the right liver lobe size/albumin concentration ratio, can help physicians to restrict the use of endoscopic screening only to patients presenting a high probability of esophageal varices
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Diabetes is a condition where the fasting blood glucose level elevated above the normal range [80-120mg/dL]. This increase in blood glucose level may be due to the insulin deficiency i.e. insulin dependent diabetes mellitus [IDDM or type I] or due to insulin resistance i.e. non-insulin dependent diabetes mellitus [NIDDM or type II]. Diabetes leads to severe complications in the body even life treating complications e.g. nephropathy, retinopathy, neuropathy increased vascular permeability and delayed wound healing if left untreated. Different drugs are used for the treatment of diabetes mellitus, but synthetic drugs are costly and possess severe side effects. So, more emphasis is being placed on the use of traditional medicines because these sources have fewer side effects than the synthetics drugs and are economical. So the white skinned sweet potato [Ipomoea batatas L.] peel-off was selected for its anti-diabetic effect as well as to see its effects on biochemical parameters. Both young [3-4 months] and old [up to 1 year] Wistar rats were selected for current study. It was found that the aqueous extract of WSSP peel-off had shown beneficial effects. In addition to the decrease in blood glucose level it also decreased protein glycation level total cholesterol, triglycerides, and LDL-cholesterol. Increase in HDL-cholesterol was also observed after treating the rats with aqueous extract of Ipomoea batatas. Additionally, WSSP peel-off had also shown positive results on total protein concentration, albumin, globulin, and plasma enzymes [SGOT and SGPT]. Further research would be needed in order to purify the anti-diabetic components and it should be available in compact dose form for all diabetic patients
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Lovastatin is a natural competitive inhibitor of 3-hydroxy-3-methyl glutaryl coenzyme-A [HMG-CoA] reductase and inhibits specifically rate limiting step in cholesterol biosynthesis. Further, lovastatin in comparison with synthetic drugs has no well-reported side effects. Four pure isolated filamentous fungal strains including Aspergillus niger IBL, Aspergillus terreus FFCBP-1053, Aspergillus flavus PML and Aspergillus nidulans FFCBP-014 have been cultured by solid state fermentation [SSF] using rice straw as substrate for the synthesis of lovastatin. After selecting Aspergillus terreus FFCBP-1053 as the best producer of lovastatin, various selected physical parameters including pH, temperature, inoculums size and moisture content were optimized through response surface methodology [RSM] under center composite design [CCD] for lovastatin hyper production. Maximum lovastatin production of 2070+/-91.5 was predicted by the quadratic model in the medium having moisture content 70% and pH 4.5 at 35 degree C which was verified experimentally to be 2140+/-93.25Mug/g DW of FM [microgram/gram dry weight of fermentation medium], significantly [P<0.05] high as compared to un-optimized conditions while it was noted that lovastatin production is independent on inoculum size [P>0.05] measured by spectrophotometer at 245 nm against standard. It was determined that optimized conditions for the hyper-production of lovastatin from fungal sources have a significant effect
ABSTRACT
In diabetic patients, electrolyte disorders frequently occur with the characteristic changes in minerals like calcium and magnesium etc. Several medicines are used to manage diabetes mellitus but they exert adverse effects. Plants are a valuable alternative to synthetic medicines because they are easily available, economical and have fewer side effects. Ipomoea batatas L is a well-known antidiabetic plant [sweet potato] but its effects on calcium and magnesium concentration have not studied. The prime focus of this study is to estimate the potential of Ipomoea batatas L peel-off on magnesium and calcium level in Alloxan-induced diabetic rats. Alloxan monohydrate was mixed in 0.9% NaCl solution and administrated [150 mg/kg [S/C]] to male Wistar rats to induce diabetes. After three days blood samples were collected and blood glucose level was recorded. Wistar rats having a blood glucose level of 200 mg/dl and above were selected for the study. Methanol and water extract of Ipomoea batatas L peeloff was given orally with a dose rate of 4g/day. Calcium and magnesium estimation was done using an atomic absorption spectrophotometer. Our results revealed an increase in both the calcium and magnesium level in heart, brain, liver, hind limb, and forelimb after Ipomoea batatas extract treatment. In kidneys decreased calcium level was noted as they excrete calcium. Mineral [Calcium, magnesium] level was increased in all organs except kidney after both extracts treatment. Ipomoea batatas being anti-diabetic in nature also maintain the homeostasis of calcium and magnesium in diabetes. Therefore, we propose the long-term use of such agents might help in the prevention of diabetes-associated complications. However, the validation of these results to human population needs further extensive study
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Ivy leaf is used for the treatment of respiratory diseases with the intensive mucus formation, respiratory infections, and irritating cough coming from the common cold. Conferring to clinical trials, the efficacy, and tolerability of ivy leaf is good. The main compounds accountable for biological activity are triterpene and saponins. Ivy leaves show convulsive/antispasmodic, anti-inflammatory, antimicrobial, analgesic, anthelmintic and anti-thrombin activity. Not only ivy but also marshmallow and mustard seeds are used for these indications. This study was conducted to evaluate the efficacy and safety of Cough [EMA; European Medicines Agency] granules used for upper respiratory disorders. This clinical trial was conducted on 150 patients, out of which 75 received the Cough [EMA] granules and 75 received the placebo. The age range of patients was 3 years to above 15 years. The sample paired t-test was applied to evaluate the significant level. Cough [EMA] granules were found effective in the treatment of cough, cold, and flu symptoms. The new treatment Cough [EMA] granules were safe and well tolerated in patient at given specific age group. The study recommends that Cough [EMA] granules can be used effectively in the treatment of upper respiratory tract infection
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The potent phytotherapeutic modalities against the hepatotoxicity have motivated us to explore numerous plants and polyherbal preparations because conventional drug discovery is more expensive and tedious. So, this study was conducted to evaluate the hepatoprotective potential of a polyherbal formulation [PHF], comprising of Solanum nigrum, Silybum marianum, Atrmesia absinthium, Achillea millifolium and Cichorium intybus against carbon tetrachloride [CCl4] induced hepatotoxicity in experimental rats. CCl4 intoxication induced vacuole formation and fast degeneration so selective liver enzymes including alanine aminotransferase [ALT] and aspartate aminotransferase [AST], alkaline phosphatase [ALP] and total bilirubin in rat's plasma, as well as liver histological architecture, were used to evaluate the effect of herbal treatments with different doses [ranging 100-500 mg/kg] for two weeks. Statistical analysis showed that PHF significantly [P<0.05] improved the level of liver enzymes as well as improved the liver architecture comparative to control groups. It could be concluded from current findings that PHF prepared from Solanum nigrum, Silybum marianum, Atrmesia absinthium, Achillea millifiloium and Cichorium intybus have some hepatoprotective activities
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Left-sided acute appendicitis is a diagnostic dilemma. Because the appendix is located in an abnormal position there are two different anatomic anomalies attributed to a left-sided appendix: situs inversus and malrotation of the midgut loop. In case of abnormal anatomical site of appendix as in situs inversus or gut malrotation, atypical presentation begins with epigastric pain radiating to left lower quadrant of abdomen along with tenderness confusing with diverticulitis. There has been an increasing use of imaging modalities, such as USG and CT, in the diagnosis of acute appendicitis. Diagnostic laparoscopy is the gold standard in cases with complicated differential diagnosis. Clinical assessment/judgment has no match in diagnosis and avoiding serious complications. This is a case report of 25 years old young male who presented initially with pain epigastrium and vomiting with diagnosis of acute gastritis. Later on pain localized to lower abdomen more on left side than right lower side. It was initially treated conservatively, later on due to persistence of pain abdomen and increase in intensity clinical diagnosis of acute appendicitis was made and appendicectomy was planned via traditional incision. Per-operatively, left-sided acutely inflammed appendix along with caecum and ascending colon were found in left lower abdomen, operation was completed via lower midline abdominal incision. The main aim was to stress on clinical assessment/judgment where highly sophisticated diagnostic facilities are not available
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Drug-drug interactions are most commonly occurring phenomenon in clinical practice. Many physicians are afraid of being involved in an allegation of malpractices due to the occurrence of any severe interaction. These interactions not only occur between drugs but also between any kind of food, tobacco smoke, caffeine and alcohol etc. Therefore, the present study was directed to inspect the effect of caffeine on the anticoagulation activity of warfarin in healthy adult male albino rabbits. Blank blood samples were collected from each rabbit. Rabbits were given warfarin [0.5mg kg-1] orally via stomach tube and blood samples were collected in PT/INR vials at various intervals. After a washout period of 14 days, warfarin was orally administrated at same dose rate along with caffeine [5 mg kg-1 every twelve hours for three days] and same sampling schedule was repeated. Prothrombin time [PT] and the international normalized ratio [INR] of blood samples were determined to estimate changes in the anticoagulation activity of warfarin after its concurrent administration with caffeine. The PT data revealed that Rmax and AUC increased significantly [P
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Glutathione is an essential antioxidant of living organism that provides a primary protection against metals toxicity. A significant amount of glutathione is present in blood erythrocytes, plasma and liver hepatocytes to protect them from oxidative damage from both external and internal oxidants. Metalo-element palladium has numerous pharmacological, clinical and toxicological compensations, like palladium is used as anti-viral, anti-bacterial, neuroprotective and anti-tumor agent. However studies have also indicated some mild to serious toxic effects of palladium metallo-elements. In the presence study the interaction of palladium inorganic salt and organic complex with glutathione [GSH] content of liver homogenate was examined spectro-photometrically. 20% [w/v] liver homogenate was prepared of the collected liver of rabbit in 5% TCA [tri-chloro-acetic acid] solution and 1mm EDTA, using a potter-eveljhem homogenizer with motor driven Teflon pestle. The GSH content quantification was carried out by Elman's method. Our finding showed that there was a depletion of GSH content by both palladium inorganic salts and organic complexes, concentrations wise as well as with time elapse as level of GSH content decrease from [43.6% to 72.62%] with Palladium Nitrate and from [24.09 to 59.5%] with Bis-benzonitrile Palladium II Chloride as compared to control, and further dropped with time incubation from 0-90 minutes from [49.7 to 87.1%], with Palladium Nitrate and from [29.3% to 67.6%] respectively. The result showed that the effect of both inorganic salt of palladium was more enhanced as compare to its organic complex. It was suggested from our finding that the depletion in the glutathione content of liver homogenate may be due to oxidation of glutathione or due to glutathione metal abduct formation by both inorganic salt and organic complex of palladium. This study in situ is a model of in vivo
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The objective of study was to find out major correlates of neonatal mortality. The main focus was in determining the impact of different demographic and health related characteristics of neonates and their mothers. A planned questionnaire was prepared in order to collect the information from mothers of newborns. The data were collected from different public and private hospitals of Faisalabad district. Discharge condition of neonate [dead or alive] was taken as response. Binary logistic regression was applied in order to unveil the impact of different contributory factors on the chances of neonatal mortality. Marriage age of mother, age of mother at baby birth, number of pregnancies, time since last birth, antenatal care, delivery mode, gender of baby, baby weight, baby disease and its nature, domestic violence, baby nutrition and residence were found to be significant factors affecting neonatal mortality. Odds ratio was used as a measure of association. From the results, it can be summed up that marriages at optimal ages, lesser frequency of pregnancies, early initiation of mother feeding, increased care during pregnancy to avoid low birth weight and birth time diseases, and increased facilities of antenatal care in rural areas can effectively reduce the neonatal mortality rates
ABSTRACT
Background: Pre eclampsia is the commonest obstetrical complication in pregnant women. The etiology of pre eclampsia has yet not been clearly understood. It has a worldwide prevalence of 2-10% of pregnancies and one of the major causes of increase in maternal and perinatal morbidity and mortality. Zinc plays an important role in the course and eventual outcome of human pregnancy and is essential for normal embryogenesis and fetal growth. Zinc deficiency in pregnancy is thought to be associated with pre-eclampsia
Objective: The aim of this study was to investigate the serum zinc level in pre-eclampsia
Patients and Methods: This Hospital based study conducted at Gynecology Department of Indus Medical Collage, Tando Muhammad Khan, Sindh from October 2015 to March 2016 with the Permission of Head of the Department and Principal of Institute. The study groups consist of 40 consecutive diagnosed cases of pre eclampsia and 40 women with normal pregnancies. The serum zinc level of the subjects under this study was determined using Atomic Absorption Spectrophotometer
Results: The results of our study showed that serum Zinc level among the pre-eclamptic and was statistically significantly low as compared to normotensive pregnant women
Conclusion: The findings of current work are statistically significant to establish that concentration of serum zinc among preeclamptic subjects is lower than in the normotensive women during pregnancy
ABSTRACT
Stone formation occurs most commonly in acute and chronic renal failure. A kidney stone is a solid lump made up of crystals that separate from the urine and build up on the inner surfaces of the kidney. The current study was conducted to investigate the clinical efficacy of Unani medicine Renax in comparison with allopathic medicine [Spironolactone + Furosemide] to treat urolithiasis. The study was conducted in District Dera Ghazi Khan, South Punjab region. This was case control, randomized, double blind clinical study. All patients were examined by the Physician and given either herbal or allopathic medicine for Urolithiasis. The patients were divided "into two groups" a control group and test groups. A Total of 24 patients were completely cured out of 50 by use of Renax while a total of 9 patients was cured out of 50 with allopathic medicine [Spironolactone + Furosemide]. This study validated the claim of traditional healer for use of Unani medicine in the treatment of urolithiasis
ABSTRACT
Aim of present study was to investigate the pharmacokinetic behavior of Montelukast in the healthy male volunteers under indigenous conditions. One tablet of montelukast 10 mg was administered in each subject and blood at different time intervals. Concentration of montelukast in plasma samples was analyzed by high performance liquid chromatography method to calculate pharmacokinetic parameters. The plasma concentration of montelukast was in the range of 1.31-1.76 micro g/mL at 0.5-12 hours with C[max] value of 1.59+/-0.16 micro g/mL at 3.71+/-0.64 hours. These values of plasma drug concentrations were above the minimum effective concentration of montelukast during the entire study hours. Absorption and elimination half-lives of the montelukast were evaluated as 2.52+/-0.54 hours and 2.63+/-0.35 hours, respectively. The volume of distribution and total body clearance of montelukast were investigated as 0.34+/-0.01 L/kg and 0.01+/-0.00 L/hr/kg, respectively. The pharmacokinetic parameters i.e. Cmax, AUC, t1/2, Vd and ClB of montelukast calculated in present study were found different as compared to that of the previous literature values which was due to genetic and environmental variation
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The antipyretic effect of the aqueous extract of herbal coded formulation containing equal amount of Salix alba, Emblica officinalis, Glycyrrhiza glabra, Adhatoda vasica, Viola odorata, Thea sinensis, Veleriana officinalis, Foeniculum vulgare, Sisymbrium irrio and Achillea millefolium was investigated using the yeast induced pyrexia model in rabbits. Paracetamol was used as a control group. Rectal temperatures of all rabbits were recorded immediately before the administration of the extract or paracetamol and again at 1 hour, after this, temperature was noted at 1 hrs interval for 5 hrs using digital thermometer. At 240 mg/kg dose the extract showed significant reduction in yeast-induced elevated temperature as compared with that of standard drug paracetamol [150 mg/kg]. It is concluded that herbal coded medicine at a dose of 240 mg/kg has marked antipyretic activity in animal models and this strongly supports the ethno pharmacological uses of medicinal plants of this formulation
Subject(s)
Animals, Laboratory , Antipyretics/pharmacology , Acetaminophen/pharmacology , Body Temperature Regulation/drug effects , Phytotherapy , Plants, Medicinal , RabbitsABSTRACT
Traditional herbal healers "Hakims" use various plants of the Cholistan desert, Pakistan for treating a number of infectious and non-infectious diseases. However, there has never been a scientific validation of these plant-based therapeutics. We compared the antipyretic effect of Echinops echinatus, Alhagi maurorum, Fagonia cretica, Cymbopogon jwarancusa and Panicum turgidum in animal model. These plants were used to reduce E.coli lysate induced pyrexia in rabbits. There were five groups of rabbits having five rabbits in each group. Among these five groups, three received various doses of experimental treatment, paracetamol was given to fourth group known as positive control. The fifth group of animals served as negative control and received no treatment. Ethanol extracts of Fagonia cretica [500mg/kg], Panicum turgidum [500mg/kg and 750mg/kg], Alhagi maurorum [500 and 750mg/kg], Cymbopogon jwarancusa [250mg/kg] and Echinops echinatus [750mg/kg] showed significant antipyretic effects when compared with controls and experimental counterparts. These results revealed that ethanol extracts of the plants evaluated in this study have dose dependent antipyretic activity. Further detailed screening of these plant species is recommended
Subject(s)
Animals , Antipyretics , Rabbits , Plant Extracts , Escherichia coliABSTRACT
The aim of the current study was to formulate and evaluate glipizide controlled release matrix tablets by means of different grades of polymer Ethoceland different co-excipients in order to evaluate their effect on drug release profiles during in vitro dissolution studies. Type II diabetes mellitus is usually treated with Glipizide. Glipizide belongs to sulfonylurea group. Gastric disturbance and severe hypoglycemia has been observed after taking glipizide orally. To overcome these problems, controlled release matrices were developed using different grades of ethyl cellulose polymer with a drug-polymer ratio of 1: 3by the direct compression method. The effect on drug release of partial replacement of lactose by different co-excipients, HPMC K100M, starch and CMC, were also studied. Diameter, thickness, hardness, friability, weight variations, drug contents of formulations were tested, these properties were within prescribed limits. Co-excipients and polymer containing formulations were compared to the without co-excipients and polymer containing formulations with respect to their release profile. After a 24-hour release study, ethyl cellulose polymer containing formulation exhibited prolonged release for 5-16 hours; however the polymer Ethocel standard FP 7 Premium without co-excipient containing formulation exhibited controlled release for 24 hours. Incompatibility was investigated between drugs, co-excipient DSC and polymer study was performed and any type of interaction was not found. Different kinetic models were used to study the release mechanism. An enhanced release rate was observed in case of excipients containing formulations
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HIV or AIDS is a major threat for humanity in the world especially in developing countries. The causative factor of the syndrome is HIV, which infects and destroys one of the cellular components of the immune system, the T cells, causing deficiency in the immunological surveillance and ultimately leading to AIDS. According to WHO, around 35 million people were living with HIV in 2013 and since the start of epidemic 39 million people have died due to AIDS. Center for disease control and prevention estimated in 2014 that 1,201,100 people aged 13 and above were suffering from HIV infection Worldwide. The most effective approach is the highly active antiretroviral therapy [HAART] containing the combined use of drugs having different mechanisms of action. However, complete eradication of HIV from the body does not occur by HAART, but it lead to long term toxicity occurs and emerges as drug resistant. Despite the recent development of various new antiretroviral compounds, there is still a need to develop need to search for new alternatives which are equally efficient and less expensive as compared to the contemporary treatment available. This review provides an overview and a summary of herbal medicines for HIV infection and summarized the efficacy and medicinal use of different plants used in the treatment of HIV infection. The objective of this review is to enlighten the recent advances in the exploration of medicinal plants used for treatment of HIV/AIDS
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The objective of present study was to evaluate the antiurease and anti-oxidant activity of Vaccinium macrocarpon fruit. The parent extract was ethanolic extract while its sub fractions were prepared in n-hexane, chloroform and n-butanol. The method based on scavenging activity and reduction capability of 1, 1-diphenyl-2- picrylhydrazyl radical [DPPH]. N-butanol fraction was the most effective antioxidant with 87.0 +/- 1.15 activity but the activity was less than ascorbic acid i.e. 93.74 +/- 0.12. Highly significant urease inhibition was shown by crude ethanolic extract [71.00 +/- 0.2a] with IC[50] [392.66 +/- 2.1] followed by aqueous fraction [68.00 +/- 0.5e] with IC[50] [159.83 +/- 2.8]. The results of crude ethanolic extract and aqueous extracts were highly significant [p<0.05] than standard Thiourea. Present study showed that Vaccinium macrocarpon exhibits potent antiurease and antioxidant activities
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Objective: To study the association between psychological predictors of depression i.e. social support and quality of life in diabetic patients
Study design, settings and duration: Cross-sectional study conducted in clinics of different hospitals of Gujranwala, Abbottabad and Islamabad from January 2013 to January 2014
Patients and Methods: Fifty nine adult type II diabetic patients of both genders who came to hospital's diabetic clinic for diabetic treatment were selected for the study. The data was collected using multidimensional scale of perceived social support WHO quality of life scale and depression scale, All these scales had already been validated in the local population. Data was analyzed using SPSS Version 20
Results: Social support and quality of life were negatively related to depression. Within gender, it was found that male were significantly higher on social support, quality of life, friends support, physical quality of life and social quality of life as compared to female
Conclusion: If diabetic patient's social support and quality of life is improved, their levels of depression decrease. Depression associated with diabetes was more common in females
Policy message: Diabetes patients need better social support and better quality of life to cope up with diabetes related depression
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Diabetes Mellitus , Quality of Life , Cross-Sectional Studies , Social Support , Diabetes Mellitus, Type 2ABSTRACT
Objective: To find out outcomes of pterygium excision with sutureless, glue free conjunctival auto graft
Study Design: Observational / descriptive study
Place and Duration of Study: This study was conducted at the Ophthalmology Department Unit-I, Dow University of Health Sciences, Civil Hospital Karachi from June 2011 to May 2015
Materials and Methods: Either gender patients above 25 years of age enrolled for primary pterygium excisionfollowed by limbal to limbal orientation of conjunctival auto graft without suture or adhesive glue. Recurrent pterygia, pseudo pterygia, ocular surface disorders, vascularized cornea, dry eye and patients already on topical anti metabolites were not included. Follow up was scheduled on 1[st] day, 1[st] week, 1[st], 3[rd], and finally 6[th] months. Chi square test was applied to check significance of recurrence with age, gender, occupation and graft size or graft application time
Results: Out of 382 participants, 303 [79.3%] were males. Majority of patients [77.7%] were young between 25 to 45 years of age. Mean time required for graft application was 16.89 +/- 2.58 [std] minutes. Recurrence of pterygium was found in 32 [8.4%] cases. No significant relationship of recurrence of pterygium was found with other variables like gender, age, occupation, graft size or graft application time
Conclusion: Natural healing tendency of vascularized conjunctiva allow graft to adhere underlying scleral bed while well aligned autograft margins and limbal to limbal orientation do not allow overgrowth of fibrovascular conjunctival tissue thereby prevent recurrence of pterygium