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Background:Corneal endothelial cells are susceptible to mechanical trauma from ultrasound energy during phacoemulsification. Several studies have reported various results of phacoemulsification effect on corneal endothelial cells between diabetic and non-diabetic patients due to stressful events. Present study was aimed to evaluate corneal endothelial density, hexagonality and Central Corneal Thickness (CCT) changes between diabetic and non-diabetic patients at early postoperative period and 1 month after phacoemulsification.Material And Methods:Specular microscopy examinations prior to phacoemulsification and at early postoperative period and 1 months after phacoemulsification were performed on diabetic and non-diabetic groups in grade 2 and grade 3 nuclear sclerosis. Laterthe changes in endothelial density, the percentage of hexagonality, and Central corneal thickness were evaluated.Result:Mean age of 120 study sample was 58.45 years (standard deviation –8.498 years), with the highest 74 years and lowest 43 years. Therewere 53 (44%) females and 67 (56%) males in the study. 42 (35%) samples were from 51-60 years age group followed by 37 (30.83%) subjects in 61-70 years age group. Mean corneal endothelial cell density decreases after cataract surgery in comparison with pre-operative density among study samples. Mean pre-operative corneal endothelial cell density was lower in diabetics in comparison with non-diabetics, and the difference was statistically significant. Cell density count decreases after cataract surgery inboth groups with significant difference between two groups. Mean corneal endothelial cell morphology (hexagonal cell percentage) decreases after cataract surgery in comparison with pre-operative density among study sample s. Central corneal thickness increases in early postoperative period followed by normalisation at day 30.Conclusion:Diabetic group showed greater hexagonality decrease compared to non-diabetic group at 1 month after phacoemulsification. It is suggested that diabetic corneal endothelium requires additional care and protective measures during cataract surgery to minimize surgical trauma. There were no statistically significant differences in the endothelial loss and Central corneal thickness changes between the diabetic and non-diabetic group at 1 month follow up after phacoemulsification.
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Background:Surgically induced astigmatism (SIA) is astigmatism that is created by incisions in cataract surgery; change in both the power and to a lesser degree, orientation of the principal meridians following a corneal incision. Prese nt study was aimed to study change in vision and astigmatic refractive error postoperativelyin patientsundergoing clear corneal phacoemulsificationsurgerywithfoldableintraocularlens.Material And Methods:Present study was hospital based, prospective, observational study, conducted in patients posted for phacoemulsification cataract surgery with foldable IOL with clear cornea and regular astigmatism on keratometry, with preoperative astigmatism more than or equal to 0.5D on keratometry, willing to participate in study.Result:In present study,44 eyes of 44 patients were considered for study. Mean age of the patient is 56.98 ± 5.98 years. There were 29 males and 15 females. Right eye surgery was done in 18 eyes and left eye surgery was done in 26 eyes. Refractive acceptance preoperatively was 0.50 D to 2.0 D. Mean IOL power was 22.7 ± 0.801. Preoperatively mainly eyes had best visual activity between 6/24 to 6/18 while visual activity range from 6/60 to 6/12. Improved vision postoperatively day 90th where vision was 6/6 unaided in 24 eyes out of44 eyes and 6/9 in 14 eyes respectively. Majority of patients had Preop Keratometric Difference (K1-K2) of 1.5 D, all required LRI Incisions length of 4 cloc k hours (60°). On postoperative 90th day, improved dioptric difference by automated keratometry ascompared to preoperative values. LRI was slightly more effective in patients above 50 years as compared to in patients below 50 years.Conclusion:In patientsundergoing clearcornealphacoemulsification surgery with foldable intra-ocular lens, postoperatively improved vision and reduced astigmatic refractive error is noted.
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Background:Aim&Objective:To study the epidemiology of vitreous hemorrhage in patients presenting without retinal detachment. To study various etiology of vitreous hemorrhage. To study visual outcome in patients with non resolving vitreous hemorrhage required vitrectomy surgery. To study prognostic factors (age, sex,andvitreous hemorrhage in diabetic patients, hypertensivepatients, ARMD, Ealesdiseases) affecting visual outcome in vitreous hemorrhage. Material And Methods:Study included34patients out of which 13 have diabetes, 6 have hypertension, 7have both diabetes and hypertension, 6have past history of tuberculosis and 2 have no systemic illne ss. Examination includedpreoperative and postoperative best corrected visual acuity, slit lamp examination, intraocular pressure, ultrasound B scan and dilated funduswith indirect ophthalmoscope. Result:Majority patients (38. 2%) were in the age group of 51-60 years with the mean age 51. 35 years. Males [73. 5%] had higher incidence of vitreous hemorrhage than females and Incidence of vitreous hemorrhage was higher in lower socio-economic group. Diabetes Mellitus andHypertension werethe most common co-morbidities with Proliferative diabetic retinopathy,Eales diseases and Branch Retinal vein occlusion are the important Risk factors for vitreous hemorrhage. Most common presenting symptom of vitreous hemorrhage is sudden loss of vision [52. 9%] followed by gradual loss of vision and blurring loss of vision. Patients who received pan retinal photocoagulation and Anti-vegf have better visual outcome post-operativel. Pan retinal photocoagulation, Epiretinal membrane, traction band,macular edema,andchoroidalneovascular membrane are the intraoperative findings noted intra-operatively. Preoperatively most of the cases of vitreous hemorrhage had visual acquity in the group of Perception of light and finger counting close to face. Post-operatively 15 patients have visual acuity in group of 6/18-6/9. Among them 8 were PDR,4 cases of Eales disease and 3 were BRVO cases. Visual acuity of 8 cases belongs to group of 6/60 –6/24 which include 5 PDR , 2 BRVO and 1 Ealesdisease. Post-operatively 7 patients developed complications. Raised IOP seen in 3 cases which includes 2 PDR cases and 1 Eales disease. Cataractous lens noticed in 2 PDR cases. Retinal detachment developed in 1 PDR case. Revitreous hemorrhage occurred in 1 Eales disease. 2 cases underwent re-surgery. Revitrectomy done in 1 case of Eales disease for re-vitreous hemorrhage. Re-vitrectomy with silicone oil insertion done in 1 PDR case for retinal detachment. Conclusion:Visual impairment due to Vitreous hemorrhagemay be prevented by early detection of cause by appropriate investigations and treatment.
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Background:In current maternal mortality situation in India, it is pertinent to determine the relationship between booking status of mother and maternal and fetal outcomes. Material And Methods:In present study 1500 patients were studiedfrom July 2019 to June 2021 in department of Obstetrics and Gynaecology Smt. S.C.L general hospital, Ahmedabad. Amongst these 1000 were booked (>= 3 antenatal visits) and 500 were emergency (unbooke d) cases (<3 antenatal visits). Result:Majority of patients was between 21 to 30 year age group, lower socioeconomic class and from urban area. In booked patients incidence of Antepartum, Intrapartum, Postpartum complications, medical complications, blood transfusion requirement, rate of caesarean section, incidence of Preterm babies, low birth weight babies, NICU admission, perinatal mortality and maternal mortality was less. Conclusion:In booked cases fetomaternal outcome was good. Hence targeted, integrated, patient friendly, affordable, accessible health services need to be delivered in an equitable manner and through routine screening, monitoring and follow up complications, mortality and morbidity can be reduced.
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Pneumocephalus, characterized by the presence of air in the cranium is frequently caused by trauma and surgery. Meningitis is a very rare cause of pneumocephalus. Here we report a patient who had meningitis as a cause for his pneumocephalus. This patient was diagnosed to have pneumocephalus on CT scan study and was treated with antibiotics to which he responded well, and the repeat CT scan done after two weeks showed normal study.