To compare central visual field progression using mean deviation and pointwise linear regression analysis

Purpose: To compare central visual field progression using mean deviation and pointwise linear regression (PLR) analysis. Methods: We analyzed the 10?2 Humphrey visual field (HVF) tests for moderate and advanced primary glaucoma who had undergone at least five reliable 10?2 visual field tests with a minimum follow?up of at least two years and best?corrected visual acuity better than 6/12. Regression slope less than ?1 dB/year at P < 0.01 at a point was defined as an individual threshold point progression. Results: Ninety?six eyes of 74 patients were included. The median follow?up duration was of 4 years (±1.97). Median 10?2 mean deviation (MD) at inclusion was ?19.01 dB (interquartile range [IQR] ?13.2, ?24.14) and ?21.90 (IQR ? 13.4, ?27.8) on 24?2 HVF. The median rate of MD change was ?0.13 dB/year (IQR ? 0.46, 0.08) for 10?2. The median rate for visual field index (VFI) change was 0.9% per year (IQR ? 1.5, 0.4). Twenty?eight percent of eyes (27 eyes) showed progression. Twelve percent (12 eyes) showed progression of two or more points in the same hemifield on pointwise linear regression (PLR) analysis, and 16% of eyes (15 eyes) showed progression of one point. The median rate of MD change was significantly more in progressing eyes based on PLR analysis than eyes with no progression (?0.5 vs. ?0.06 dB/year P < 0.001). One patient had likely and the second had possible progression on 24?2. In 24 eyes, event analysis did not show any change; the rest mean deviation was out of range. Conclusion: Central visual field PLR analysis is useful in detecting progression in advanced glaucomatous damage.

The dose time relationship in the radiotherapy of carcinoma of the cervix--application of CRE formalism.

A retrospective analysis of 291 patients with cancer of the uterine cervix treated with a combination of external and intracavitary radiotherapy was carried out. Patients were either treated with 45 Gy in 20 fractions by five fractions per week or with 42 Gy in 14 fractions by three fractions per week or with 42 Gy in 14 fractions by three fraction per week schedule by external radiotherapy. For brachytherapy the total dose was 24 to 32 Gy at a dose rate of 1.4 to 2.2 Gy per hour. Complication were correlated with total CRE values for point A (CRE TA) and for rectum CRE TR. Correlations of CRE TA with overall complication rate (p value < 0.05) and rectal complication rate (p value < 0.01) were excellent. Lack of correlation was observed between CRETR and overall complication rate (p value > 0.1) as well as rectal complication rate (p value > 0.1). In order to limit Grade II and III rectal and bladder complications to acceptable level, in combined external and intracavitary treatments, CRETA value of less than 2500 reu is suggested.

Prevalence of spontaneous bacterial peritonitis.

To assess the prevalence of spontaneous bacterial peritonitis (SBP), ascitic fluid cell count, and ascitic fluid culture by conventional method and by bedside inoculation in blood culture bottles were performed in 31 consecutive patients of liver cirrhosis. Seven (22.58%) patients had ascitic fluid polymorphonuclear count (PMN) more than 500/mm. Ascitic fluid culture by conventional method was negative in all the patients, while in 4 patients culture was positive by bedside inoculation method. Six of 7 patients with SBP or its variant were in Child class C. Clinical features in these patients were abdominal pain (5 patients), fever (4) and encephalopathy (2); serum bilirubin level was 6.8 +/- 5.5 mg/dl, serum albumin 1.98 +/- 0.2 g/dl, prothrombin index 59.8 +/- 12.2%, ascitic fluid protein 0.78 +/- 0.24 g/dl. Three of 7 patients with SBP or its variant expired during hospital stay; the other 4 patients recovered after appropriate antibiotic therapy. We conclude that SBP is a serious complication in patients of liver cirrhosis with ascites. Ascitic fluid PMN count and bedside inoculation of blood culture bottles with ascitic fluid are sensitive indicators of SBP. Hence they should be performed routinely for early detection of SBP.