Corneal Collagen Cross Linking [CXL] in treatment of Pseudophakic Bullous Keratopathy

Objective: To determine mean change in visual acuity, central corneal thickness and symptoms in patients with pseudophakic bullous keratopathy after treatment with corneal collagen crosslinking

Methods: This quasi experimental study was conducted at Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan from April 2015 to Nov 2015. A total of 24 eyes of 24 patients were included in the study. Visual symptoms were graded in five grades [Grade 1-5], Grade-1 being very mild with decreased vision only while patients with all five symptoms [decreased vision, foreign body sensations, pain, watering and photophobia] were graded as Grade-5. Corneal collagen cross linking using topical isotonic riboflavin followed by UVA radiations [3mW/cm[2] for 10 minutes] was performed in all the patients

Visual acuity [VA], visual symptoms and central corneal thickness [CCT] were recorded before and 04 weeks after the treatment

Results: A total of 24 eyes of 24 patients [18 male and 6 females] underwent surgery

Age of the patients ranged from 55 to 75 years with mean age 65.83 + 3.89 years. Mean visual acuity was 2.09 + 0.23 before treatment while after treatment it was 2.13 + 0.22. Mean CCT as measured by optical pachymetry [Galilae G6] was 753.96 + 55.16 and 641+ 29.25 before and after surgery respectively. Improvement of clinical symptoms was seen in all the patients

Conclusion: Corneal collagen cross linking is a temporary but effective symptomatic treatment of pseudophakic bullous keratopathy

Welding associated ocular injuries

To determine the types of eye injuries during welding and to suggest measures for its prevention. This study was carried out at CMH Sialkot from October 2005 to March 2007. An observational study was conducted at [18 months]. Welders included in this study were from military setups i.e. Electrical and Mechanical Engineering [EME] workshops, battalion workshops, Military Engineering Services [MES] and civil workshops. They attended eye OPD for their ocular injuries, sustained during welding and grinding. Their knowledge of welding induced ocular injuries and level of safety measures awareness was assessed. Patients were thoroughly examined with special emphasis on anterior segment. Orbital x-ray and B-scan ultrasound were carried out where intraocular foreign body [IOFB] was suspected. Total 110 patients were studied during a period of 18 months. The commonest ocular injury that we encountered was metallic foreign body followed by photokeratitis and conjunctivitis. Majority workers were between 25 and 35 years of age. Their knowledge of safety measures was satisfactory but few were aware of ocular hazards of welding. Eye injuries due to welding are preventable. Workers performing welding tasks or working nearby welders must be trained, to reco gnize the potential hazards of welding and in proper use of safety equipments to prevent ocular damage

Metabolic syndrome in patients with ischemic heart disease

To determine the frequency of metabolic syndrome in patients with Ischemic Heart Disease [IHD]. Cross-sectional, descriptive study. Cardiology Department of Punjab Institute of Cardiology, Lahore, from June 2006 to June 2007. A total of 100 subjects with ischemic heart disease, fulfilling the inclusion criteria, were enrolled in the study. Demographic data [age and gender] and the 5 component conditions of the metabolic syndrome were noted. Subjects were physically assessed for the abdominal obesity, based on waist circumference. Fasting blood samples for glucose and lipid profile in first 24 hours after acute coronary insult were drawn and tested in central laboratory. Variables were processed for descriptive statistics. In this study population, 68% were male and 32% were female with mean age of 52 +/- 13.6 years in men and 56 +/- 12.5 years in women. Frequency of metabolic syndrome was 32% in men and 28% in women. It increased with age. The highest rate of metabolic syndrome was in men diagnosed as STEMI [odds ratio: 3.39, 95% Cl=1.36-8.41]. Frequency of metabolic syndrome was high among the patients with IHD. It supports the potential for preventive efforts in persons with high-risk of IHD

Incidence of atypical presentation of myocardial infarction

Chest pain is widely considered a key symptom in the diagnosis of myocardial infarction, although not all patients with MI present with chest pain. To determine the frequency with which MI patients present without chest pain and finding elements in the history of atypically presenting patients that may be helpful to the clinician in identifying atypical MI. Descriptive type of study. The study was conducted for the duration of 3.5 months [16-07-07 to 30-10-07] in the CCU of a large Tertiary Care hospital i.e. Holy Family Hospital of Rawalpindi Disgrict, attached with Rawalpindi Medical College. We made a Performa and filled it by direct interview, reading the remarks of the consultant about the patient written on the file, using the hospital lab results and by discussing the patient's file remarks with the medical officer on duty. We included the patients of MI admitted in the CCU that fulfilled our diagnostic criteria. Of all 125 patients diagnosed as having MI, 20.8% did not have chest pain on presentation to the hospital. Atypical presentation of MI was mostly among elderly and diabetic patients. Maximum number of MI patients presenting atypically were of age greater than 74 years [33.33%], with a higher proportion of men [69.23% vs 30.77%]. Associated symptoms were more manifested in atypically presenting MI patients. Our results suggest that patients without chest pain represent a substantial segment of the MI population. Patients with pain lasting for more than 1 hour, which is continuous, fullness sensation or pressure sensation or constricting in character located in epigastric, interscapular region or in jaw and neck should be 1st explored for an atypically presenting MI