ABSTRACT
To evaluate visual outcome and complications in intraocular foreign bodies. Descriptive case series. This prospective study was carried out in the department of Ophthalmology, Services Hospital Lahore, over a period of one year from July 2008 to July 2009. Eighteen patients having magnetic or non-magnetic intraocular foreign bodies [IOFBs] were included. The location of foreign body was determined with the help of slit lamp, direct and indirect ophthalmoscope, orbital radiogram, B-scan and CT scan. Patients with open entry wound underwent primary repair. Vitrectomy for intraocular foreign body was performed within to weeks of primary repair. Eighteen eyes of 18 patients were analyzed. There were 17 [94.44%] males and 1 [5.66%] female. Pre-operative visual acuity was perception of light in 9 [50%], hand movement in 5 [27.77%], finger counting in 2 [11.11%] and 6/60 in 2 [11.11%] patients. Post operative visual acuity was 6/18 or better in 6 [33.33%] and 6/60 in 4 [22.22%], hand movements in 6[33.33%], perception of light in 2 [11.11%] patients. Lens touch occurred in 1 [5.55%] patient and endophthalmitis developed in 1 [5.55%] patient. Giant retinal tear and total retinal detachment [RD] in 1 [5.55%] and phthisis bulbi in 1 [5.55%] patient. Intra ocular foreign bodies contribute a significant component of ocular morbidity associated with open globe injury. However with prompt treatment a useful vision can be restored
Subject(s)
Humans , Male , Female , Visual Acuity , Prospective Studies , VitrectomyABSTRACT
Objective: to detect and assess posterior segment pathology in cases of vitreous hemorrhage by ultrasound examination in patients presenting to ophthalmology department of Services Institute of Medical Sciences, Lahore
Material and Methads: this study included 179 patients [200 eyes] with vitreous hemorrhage who underwent A and B scan ultrasound by one examiner at Eye unit I in Services Hospital, affiliated to Services Institute of Medical Sciences, Lahore, for the duration of four years from January 2003 to January 2007. 114 were male and 65 were females. All patients had dense vitreous hemorrhage prevented visualization of the retina. Age range was between 10 to 67 years. Before ultrasound, all the patients were completely examined in OPD including a comprehensive history, record of visual acuity and intraocular pressure, Detailed fundus examination was carried out after dilatation of pupils with mydriacyl [tropicamide] eye drops with 78 D lens and Indirect ophthalmoscope
Results: unilateral cases were 60 and bilateral cases 70. Proliferative diabetic retinopathy with vitreous hemorrhage was observed in 90 eyes, [tractional retinal detachment was present in 38 eyes, both tent like and table top configuration were observed on B scan white vitreous hemorrhage with proliferative diabetic retinopathy was observed in 52 eyes]. Rhegmatogenous retinal detachment was observed in 10 eyes. Vitreous: hemorrhage due to penetrating injuries occurred in 55 eyes and out of these 55, rnetallic intra-ocular foreign body was present in 05 eyes. Eales disease with vitreous hemorrhage was present in 25 eyes. Posterior vitreous detachment was noted in 20 eyes with vitreous haemorrhage
Conclusion: ultra-sound surgeons A-and B-ultrasound the most important examination tool. It should be typically performed early and frequently after presentation of patient with vitreous hemorrhage
ABSTRACT
Objective: to determine long term effects on final visual outcome, macular fluorescein leakage and intraocular pressure after intravitreal injection of triamcinolone for treating refractory diabetic clinically significant macular oedema [CSMO]
Material and Methods: patients with CSMO of more than 12 months duration, diagnosed according to ETDRS criteria were recruited. All patients had at least two or more macular grid laser treatment with the more recent laser at least 3 months prior to the injection. Patients with CSMO and active proliferative disease, vein occlusions and macular ischemia were excluded. Patients with pre-existing significant cataract or glaucoma were also not considered. Triamcinolone, 4mg was injected through the pars-plana, infrotemporally using a 27 guage needle. The response to the treatment was monitored at 1 month, 3 months and 6 months. Visual acuity was assessed by Log MAR units, Fluorescein leakage by measuring the area of late phase of digital fluorescein angiogram and intraocular pressure by Goldman's applanation tonometry
Results: fourteen eyes of 13 patients were included in the study. The mean age was 68 years. All patients had an average of 2.4 previous sessions of grid laser treatment for CSMO. The mean visual acuity improved from 0.54 Log MAR units prior to the injection to 0.43, 0.40 and 0.37 Log MAR units at 1, 3 and 6 months post-injection. This showed statistically significant p-values of 0.042, 0.013 and 0.002 respectively. The mean intraocular pressure [IOP] increased from a pre-injection value of 16.57 to 19.42, 22.07 and 21.50 at 1, 3 and 6 months post injection respectively. The p-value for this rise in IOP was also statistically significant at 0.035, 0.005 and 0.000 respectively. Evaluated subjectively in a masked fashion, macular post injection fluorescein angiograms of all 14 eyes [100%] were graded to show less leakage than on the pre-injection angiograms in at 1, 3 and 6 months visits. No injection site related complications were noted. No patient had a repeat injection
Conclusion: intravitreal triamcinolone has shown visually and anatomically encouraging results for the treatment of diabetic macular oedema that fails to respond to conventional laser photocoagulation. Raised intraocular pressure is a concern but longer follow up is needed to assess the efficacy and safety as well as need for re-treatment
ABSTRACT
Objective: to assess the anatomical and functional results in macular hole surgery
Material and Methods: this study was conducted in the department of ophthalmology, SIMS/ Services Hospital Lahore over a period of one year between July 2008 to July 2009. Eighteen eyes of eighteen patients were included in this study. Pars plana vitrectomy was done in all cases. Internal limiting membrane [ILM] staining with trypan blue or brilliant Perfluoropropane [C3F8] 14% was used in 17 cases and silicone oil was used in one case for internal tamponade. Patients were advised to posture in face down position for one week. All patients were followed-up for at least six months
Results: 18 eyes of 18 patients were operated. 15 [83.33%] patients had idiopathic while 3 [16.66%] had secondary macular holes. There were 17 [94.44%] phakic and 1 [5.55%] pseudophackic patients. In 5 [27.77%] ILM staining was done with brilliant peel while in 13 [72.22%] patients Trypan blue was used. For internal tamponade C3F8 was used in 17[94.44%] patients and in 1 [5.55%] silicone oil was used. Postoperatively, 100% macular hole closure was achieved in all cases with at least 6 month follow-up
Conclusion: pars plana vitrectomy with ILM peeling is a very effective technique for the surgical closure of full thickness macular holes. This technique should be combined with post-operative head posturing for at least one week to expedite hole closure
ABSTRACT
Background: Argyrophilic nucleolar organizer region [AgNOR] size and distribution are related to malignant potential in a tissue or cell. Typing of AgNOR has been attempted in cytological specimens and found useful in grading dysplasia from mild to severe in oral lesions. This study was conducted in an attempt to find any difference between smokers and non-smokers oral mucosal cells as regards AgNOR size and distribution
Methods: The cytological smears of buccal mucosa in 75 smokers and 75 nonsmokers were stained for AgNORs. Ag NOR typing based on size and distribution was performed in both smokers and nonsmokers using Ahsan's criteria
Results: No statistically significant difference was found between smokers and nonsmokers. AgNORs were round and had clustered distribution in both groups
Conclusion: It is not possible on the basis of AgNOR typing to differentiate between smoker's buccal mucosal cells and that of nonsmoker's. This study also indicates that AgNOR technique is simple, inexpensive and easily reproducible. Moreover Ahsan's criteria for AgNOR typing is simplest and don't depend on the availability of expensive precision instruments
ABSTRACT
Background: Folate deficiency is an important cause of megaloblastic anaemia in renal failure. Red cell folate is better indicator of body folate status. This study was carried out to find out the serum and red cell folate levels of diagnosed patient of End Stage Renal Disease [ESRD]
Methods: Sixty subjects were selected. These included 30 normal healthy subjects as control and 30 patients with ESRD. Absolute values and Hb were done by haematology auto analyzer and serum and red cell folate were done by commercially availabIe kits using competitive immunoassay
Results: These were analyzed by using Student's [t] test and level of significance was determined. A significant decrease in serum and red cell folate in end stage renal disease patients as compared to control was observed
Conclusion: Patients of end stage renal disease are deficient in folate levels so they need folate supplement to prevent megaloblastic anemia and minimize the risk of transfusion
ABSTRACT
Ninety subjects were included in the present study and were divided into three groups. Group A included 30 pregnant females with normal pregnancy as control from 20 weeks of gestation onward. Group B included 30 pregnant females with intrauterine fetal death < 20 weeks duration and Group C included 30 pregnant females with IUFD > 2 weeks duration. FDPs and D-dimers were performed by commercially available kits. Results were analysed by using chi-square [x2] test and level of significance was done. FDPs and D-dimers were significantly increased in females of IUFD in groups B and Crecommend it as a curative and palliative procedure for benign and malignant diseases of esophagus
ABSTRACT
The present study was carried out to detect the serum anticardiolipin antibodies [ACA] in recurrent abortion. Fifty women with history of recurrent abortions [Group A] were selected with twenty normal women of childbearing age as controls [Group B]. Routine haematological investigations like haemoglobin, TLC and Platelets were done by haematology autoanalyzer. PT, APTT and serum anti-cardiolipin antibodies [IgG and IgM] were done by commercially available kits. Serum anticardiolipin antibodies were raised in patients with recurrent abortion when comparing with controls. PT was prolonged in one patient and APTT was prolonged in four cases
ABSTRACT
Sixty subjects were selected and were divided into two groups. Group A included 30 patients of end stage renal disease on regular dialysis and group B included 30 normal healthy subjects as control. Absolute values and Hb were done by hematology auto analyzer and serum and red cell folate were done by commercially available kits. Results were analyzed by using Student`s `t` test and level of significance was done. A significant decreased in serum and red cell folate in end stage renal disease patients with regular dialysis as compared to control
ABSTRACT
A total of 80 full term pregnant women were selected and were divided into two groups on the basis of hemoglobin level. Group A included 40 pregnant women having Hb level more than 11.0 g/dl. Group A, included neonates born to group A mothers. Group B included 40 pregnant women having Hb < 11.0 g/dl and B, included their respective neonates. Serum iron, serum TIBC and serum ferritin were done by commercially available kits. Results obtained were analyzed by using students `t` test and level of significance was done. Serum iron and serum ferritin w as reduced in mothers of group B and their respective neonates while serum TIBC was higher in mothers and neonates of group B
ABSTRACT
Seventy Five subjects were selected. Fifty subjects were breast cancer patients and 25 healthy control subjects were included. FDPs and D-dimers were performed by using commercially available kits. Results obtained were analyzed by using chi-square [X2] test and level of significance was done. A significant increase in the levels of FDPs and D-dimers were found in patients with breast cancer
ABSTRACT
Assessment of Staphylococcus aureus [S. aureus] and MRSA nasal carriage in our general population. Cross-sectional analytical study. A private Pathology Laboratory in Lahore city from January 2002 to December 2003. Nasal swabs were obtained from the apparently healthy persons accompanying the patients attending the laboratory. These swabs were inoculated on blood and mannitol salt agar plates and incubated at 37°C. The isolate[s] were identified as S. aureus on the basis of colony morphology, Gram staining, catalase and coagulase tests. Sensitivity to Oxacillin was determined using standard Kirby Bauer technique. Nasal swabs from 1660 subjects from the community were studied. Out of these samples, a total of 246 [14.82%] samples were positive for growth of S. aureus [nasal carriers of S. aureus]. Out of 246 S. aureus isolates, 48 [19.51%] isolates were methicillin resistant S. aureus [MRSA]. Nasal carriage was higher in males [15.47%] as compared to females [13.26%], in urban areas [16.99%] as compared to rural areas [11.32%] and in the year 2002 [16.02%] as compared to year 2003 [13.08%]. However, the difference was significant only for the urban vs. rural comparison [p<0.05]. MRSA isolates were also significantly higher among S. aureus isolates from the nasal cavities of urban subjects [22.98%] as compared to rural ones [11.11%]. Maximum nasal carriage was present in the age group upto 9 years [20.23%] with decrease in the age groups 10-19, 20-29 and 30-39 years followed by small rise in the older subjects. The nasal S. aureus carriage as well as methicillin resistance among these isolates are more common in urban community
Subject(s)
Humans , Male , Female , Staphylococcal Infections/epidemiology , Nose Diseases/epidemiology , Methicillin Resistance , Carrier State , Rural Population , Urban PopulationABSTRACT
Qualitative assessment of bacteriological quality and chlorination status of drinking water in Lahore. Design: Descriptive study. Place and Duration of Study: Lahore city from October 2000 to September 2001. Materials and A total of 2160 water samples from distribution system were tested from nine different localities of Lahore. These localities represented areas with different socioeconomic conditions [SEC]. Twenty water samples were tested from each locality from the same taps each month. All the water samples were subjected to H2S strip test for determination of bacteriological contamination as well as orthotolidine test for detection of chlorine. Four hundred and forty-six [20.64%] samples were positive for bacterial contamination. It was observed that contamination was the maximum in low SEC areas [32.22%], followed by intermediate SEC areas [18.47%] and high SEC areas [11.25%]. The difference was found to be statistically significant [p<0.01] among different areas. Only 27.73% samples were chlorinated. Positivity of samples for chlorine was the lowest in areas with low SEC[20.69%] and highest [32.77%] in areas with high SEC, the difference being statistically significant. Maximum contamination was present in samples tested during summer months[June-August] of the year [31.11%], followed by autumn months [September-November] of the year [20.9%], spring months [March-May] of the year [18.7%] and winter months [December-February] of the year [11.85%]. Samples tested during summer months showed the highest positivity [77.96%] for chlorine [p<0.001] as compared with other months of year. Among chlorinated samples 12.32% showed bacterial contamination. However, contamination was significantly higher [p<0.001] among non-chlorinated samples. Bacterial contamination of piped water is a significant problem in Lahore. Regular chlorination and monitoring of water supplies can improve it