ABSTRACT
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
ABSTRACT
Objective: To determine the etiology and severity of various forms of ocular war injuries in patients presenting at an Army Hospital in Pakistan
Methods: This cross sectional study was conducted at the Department of Ophthalmology, Combined Military Hospital, Peshawar over four years period from June 2012 through March 2016, Two hundred ten consecutive soldiers who presented with ocular war injuries were included for analysis after taking written informed consent. A predesigned proforma was used to record patient's demographic details along with the cause, side, type and severity of injury, ocular trauma score was also recorded at presentation
Results: The mean age of the patients was 29.34 +/- 5.35 years. All of them were males. Left side was more frequently involved [n=126, 60.0%] and the most frequent underlying cause was IED blast injury [n=114, 54.3%]. Closed globe injuries were more frequent and were recorded in 120 [57.1%] patients. Upon assigning Ocular Trauma Score, Grade-V [28.6%] injuries were the most frequent followed by Grade-I [25.7%], Grade III [25.7%], Grade II [11.4%] and Grade IV [8.6%]. When stratified for the type of injury, OTS Grade I injuries were highest [60.0%] among patients with open globe injuries, hence poorer prognosis, while OTS Grade V injuries were highest [50.0%] among patients with closed globe injuries [p=0.000]
Conclusion: IED blast injuries are most frequently encountered ocular war injuries often involving soldiers in the age group 20-30 years. These open globe injuries had worst clinical presentation to begin with and poorer prognosis than closed globe injuries
ABSTRACT
To determine the frequency of different causes of left vocal cord paralysis in patients reporting in a tertiary care set up. Descriptive cross sectional study. This study was conducted at Combined Military Hospital Rawalpindi from Jan 2008 till Jan 2013. A total of 74 diagnosed cases of left vocal cord paralysis who consented to participate and fulfilling the inclusion criteria were included in this study. All patients were diagnosed by indirect laryngoscopy supplemented by flexible nasopharyngosopy whenever required. After detailed history and physical examination every patient was investigated in a sequence till confirmation of any pathology or exclusion of any underlying factor. Sequence of investigations were X-ray chest PA view, Barium swallow, Ultrasound neck, CT scan with contrast from base of skull to diaphragm, FNAC whenever required, panendoscopy under general anesthesia and biopsy. The commonest cause identified was malignancy in 20 cases [27%], followed by iatrogenic trauma 18 cases [24.3%], idiopathic 14 [18.9%], non surgical trauma 13 [17.5%] and miscellaneous causes that accounted for 9 cases [12.1%]. Left vocal cord paralysis is a common entity in ENT practice with multiple etiologies. An extensive protocol for investigation is required. Protocol should include USG, CT scan from base of skull to diaphragm because malignancy is still the most frequent cause of left vocal cord paralysis