Silicone oil flowability rates through a standard 23g vitrectomy system

To compare the viscosity of silicone oils made by different manufacturers by comparing the flow rates through a standard 23G millennium vitrectomy system. Quasi experimental study. Department of Ophthalmology, Lahore General Hospital Lahore, Pakistan during 2012. Viscosities of silicone oils of l000cs and 5000cs, manufactured by multinational / national manufacturers in Pakistan, were compared. Oils of 1000cs/500cs were placed in 20 ml syringes, marked randomly and placed in water-VVbaths at 25°C, to standardize the control environment. Each syringe was then attached to 23G millennium vitrectomy system and time taken to empty 9 ml of oils at pressures of 40 mrrtHg and 70 mmHg was noted. Oils of same centistokes manufactured by different manufacturers behaved differently in terms of their flowability and rates of emptying. The emptying times for l000cs oils ranged from 112.1 seconds to 144.4 seconds at 40 mmHg and 60.2 to 70.3 seconds at 70 mmHg, whereas corresponding figures for 5000cs were between 335.7 seconds and 802.0 seconds at 40 mmHg and between 169.6 seconds and 348.7 seconds at 70 mmHg. The differences at all levels were statistically significant [p< 0.001]. Silicone oils of similar centistokes behaved differently in terms of their rates of flow through a standard 23G vitrectomy system under standard conditions indicating better standardization of the viscosity of silicone oils available in the market

Axial myopia and its influence on diabetic retinopathy

To evaluate the correlation between axial myopia and diabetic retinopathy. Cross-sectional study. Eye Department of Postgraduate Medical Institute, Lahore General Hospital, from August 2012 to February 2013. A total of 258 participants suffering from type-2 diabetic retinopathy were included. Axial length was measured by two optometrists using contact type ultrasound biometer. Colored retinal photographs, red free retinal photographs and Fundus Fluorescein Angiography [FFA] were performed on all patients using standard fundus camera. All fundus photographs and angiograms were independently reviewed and graded by two qualified vitreoretinal fellows. Out of 258 patients, 163 were males [63.2%] and 95 [36.8%] were females. Average age of patients was 56.30 +/- 7.57 years. Average axial length of right and left eyes were 23.16 mm and 23.15 mm respectively. There was statistically significant negative correlation between axial length and severity of diabetic retinopathy in the right eye, [Spearman correlation = -0.511, p = 0.0001] as well as the left eye [Spearman correlation = -0.522, p = 0.0001]. There is a protective influence of longer axial length of globe on the stage and severity of diabetic retinopathy. This study may help in modifying the screening protocol for diabetic retinopathy amongst patients of differing axial lengths

Breast self examination - awareness and practices among lady health workers

To find out the awareness and practices regarding breast self examination [BSE] among the lady health workers of Tehsil Arifwala, district Pakpatan, Punjab. This cross sectional study was conducted in July 2011. 300 LHW's fulfilling the inclusion criteria were selected through consecutive sampling technique. Information was collected regarding awareness and practices of BSE through interviews on questionnaire covering all variables. The BSE practices of LHW's were determined on the basis of two criteria: 1. Number of BSE steps performed [categorized as 'average' for performing >2 steps and 'below average' for performing one or two steps]. 2. Interval of BSE [categorized as 'correct' for regular monthly interval and 'incorrect' for >1 month interval]. Data was entered and cleaned using Epi Data 3.1 and analyzed using Epi Info 3.5.1 Mean age of participants was 32.06 +/- 7.8 years. Majority were married [79%], rural dwellers [64.3%], had job experience up to 5 years [55.3%] and were educated above middle [53.7%]. Majority 280 [93.3%] were aware of breast self examination but only 80 [28.5%] were practicing it. Out of 80 who were performing BSE, 34 [12.1%] were practicing BSE at correct interval and only 46 [16.4%] were practicing average steps. Significant relationship was found between the age and awareness while higher levels of job experience had a significant relationship with BSE practice. The awareness level of LHW's regarding BSE was relatively high as compared to their practices of BSE. As a LHW has direct link with the community, there is a need to organize training courses for LHW's regarding correct BSE practices. Special emphasis should be paid to timeliness and steps of the procedure so that she can provide proper information to community for early detection of breast cancer.

Clostridium difficile postantibiotic diarrhoea diagnosis

To study the frequency of Clostridium difficile in postantibiotic diarrhoea in patients admitted to the medical ward of a secondary care hospital. Observational study. Sindh Government Hospital, Liaquatabad, Karachi, from June 2002 to May 2009. Adults of either gender who received antibiotics after admission and subsequently had watery stools at least 2 days after admission were selected. The exclusion criteria were past history of inflammatory bowel disease or any type of malabsorption state and those who did not show WBCs in stools. All variables of these patients along with clinical findings, type of antibiotic received, and number of stool motions per day were recorded. Three samples of the stools were sent for detailed reports to analyze the number of leukocytes per high field and culture, on cycloserine - cefoxitin - fructose agar [CCFA]. All findings were entered into and analyzed by SPSS 16 for statistical analysis. Out of the 473 patients who received antibiotics for any reasons, 191 [40.38%] developed diarrhoea. The mean age was 45.6 +/- 17.73 years and male to female ratio was 1.85:1. The average number of stools passed per day was 4.84 +/- 1.24 and all patients showed leukocytes in stool samples with a mean count of 6.67 +/- 0.89/HPF. The stool culture on CCFA was positive for 57 patients [29.18%], while 134 patients [70.15%] were stool culture negative as well as negative for evidence of any parasites; these samples were labelled benign antibiotic associated diarrhoea [BAAD]. Ampicillin and amoxicillin with clavulanate were the most implicated antibiotics in this study. Clostridium difficile is the main putative agent in postantibiotic diarrhoea. In settings with limited resources, use of specific culture media such as CCFA proves to be highly cost effective, and sensitive for this diagnosis. Macrolides and quinolones are the safest agents to prescribe in this context

Are tremors in old age, really senile? a hospital based study

To study the frequency and severity of tremors in otherwise healthy elderly adults at Sind Government Hospital Liaqatabad, Karachi. This cross-sectional study, was conducted at the Sindh government hospital, Liaquatabad, Karachi from October, 2007-2009. Five hundred otherwise healthy adults of both genders of more than 60 years were selected. After thorough clinical examination, classification and the severity of tremors were assessed by tasks given to the patients by principal investigator which he designed himself. All variables were put in proper register. Data entry and analysis was performed by single researcher on SPSS 16 for biostatistics. The inclusion criteria were adults of more than 60 years of either gender with no history of any systematic or neurological illness and presently not on drugs. The exclusion criteria were disputed age groups and those who cannot sign or write their names because they cannot be assessed by tasks. The mean age was 68.75 years +/- 6.74 with male female ratio of 1.95:1. Out of 500 subjects 84 [16.8%] showed no tremors, 307 [64.4%] had mild tremors only evident on special movements i.e. enhanced physiological tremors [physiological senile tremors] and 109 [21.8%] had moderate to severe tremors evident on movements i.e. kinetic, essential tremors [pathological senile tremors], with family history of 50.45%. Tremors in old age are not part of life. Most of them had enhanced physiological tremors while few were of essential type with strong family history. If these are detected, they should be evaluated and classified and can be managed to make elderly population more useful to their family and the society

Dropped nucleus during phacoemulsification; outcomes

The increasing popularity of phacoemulsificalion in restoring good visual acuity has also led to an increase in the incidence of its complications like nucleus drop during the procedure. Proper management of such patients not only reduces intravitreal lens fragments related complications but also significantly improves the visual acuity. To evaluate the clinical features of the eye with retained Intravitreal lens fragments after the phacoemulsification surgery. We also aimed to investigate the incidence of cystoid macular edema, retinal detachment, suprachoridal hemorrhage and any other complication in patients after pars plana vitrectomy for retained intravitreal lens fragments. This study was carried out at the department of ophthalmology, Lahore General Hospital, Lahore. The duration of study was one year 17-05-2004 to 28-04-2005. Descriptive prospective. The reported frequency of dislocated lens material at 0.3% is quiet low. Despite LGH being a referral center for retinal diseases, dropped nuclei and nuclear fragments constitute a very small fraction of the referred cases. Therefore the study was limited to 15 cases only so that it could be completed within specified period. 15 eyes having retained lens matter after phacoemulsification surgery were included. Aphakia was present in 10[66.75%] patients. 5 [33.4%] patients were pseudophakic. Raised intraocular pressure was found in 11 [73.4%] patients, cornea edema in 7 [46.7%], uveitis in 6 [40%] patients. Two [13.4%] patients had retinal detachment at presentation. The range of visual acuity way perception and projection of light to counting fingers in 9 eyes [60%], 2/60-6/60 in 5 eyes [33.4%]. 6/24 in 1 [6.64%] eye preoperatively. After vitrectomy, range of visual acuity was 6/9 to 6/18 in 9 patients [60%] and 6/24-6/60 in 6 patients [40%]. The comparison of pre-operative visual acuity and that of last follow-up showed p<0.01 [statistically highly significant]. Intraocular pressure was raised in only 2 patients [13.3%]. No patient developed retinal detachment. Cystoid macular edema was found in only 2 patients [13.4%].No patient developed significant intraocular inflammation after vitrectomy. Patients having retained intravitreal lens fragments presented with raised intraocular pressure, reduced visual acuity, uveitis and retinal detachment. In such patients combined pars plana vitrectomy and secondary intraocular lens implantation reduced the risk of postoperative complications including secondary glaucoma, uveilis and helped in restoration of useful visual acuity

Tremors; myths and misconceptions; a 7-year clinical survey 2002-2009

To determine the myths and misconceptions about [Tremors] among those who developed this disorder and their health seeking behavior, and also among those who never had tremors, at the psycho-neurology and medical OPD of Sindh Govt. Hospital, Liaqatabad no. 10, Karachi. A single centre based cross-sectional survey, conducted from year 2002 to 2009 at Sindh Govt. Hospital [SGH] Liaqatabad no.10, Karachi. 403 adult patients of either sex with tremors were selected from medical and psycho-neurology OPD's. For comparison 100 healthy individuals from general population, who never had tremors, of the same area were also included. Questionnaires regarding different myths and misconceptions about tremors were filled by the patients/normal healthy people after obtaining the consent. Out of 403 selected patients [61.53% males and 38.47% females] majority belonged to the urban areas. Out of hundred normal healthy people 73 [73%] were males and 27 [27%] were females. Only 8% of the patients considered tremor was a neurological illness, while 33% of the patients and 41% of the general population related it to magic or witchcraft. Overall, females were more inclined to choose alternative medicine and spiritual therapy than males. Myths and Misconceptions about tremors are present in our society because of strong belief and observations. Provision of primary education, health education and using electronic media can play a key role in abolishing these misconceptions