Psychometric analysis of Anatomy MCQs in Modular examination

Objective: To analyze the psychometric indices of Anatomy question items in modular system assessment

Methods: A quantitative study was done to determine the quality of MCQs and to analyze the performance of 1[st] year 100 MBBS students. Each module covers different subjects of MBBS curriculum but psychometric analysis was done on the subject of Anatomy only. The assessment results of 3 modules were taken and checked by item analysis to see the mean differences between the modules using ANOVA. Post hoc analysis was determined by using Tukey HSD test

Results: A total of 140 one best [OB] Anatomy MCQ. items were calculated for difficulty index, discriminatory index and reliability. Difficulty index was found to be higher in module I when compared with module II and III. Discriminatory index comparatively showed higher results in module II whereas reliability of module III was significantly higher than the other modules. Results were considered to be significant with p-value <0.05

Conclusions: The psychometric analysis of Anatomy MCQs showed average difficulty, good discrimination and reliability

Predicting severity of pancreatitis and its mortality-comparison of BISAP and Ranson scoring systems

Objective: to find out the prognostic significance of BISAP scoring system and its accuracy in predicting the severity of acute pancreatitis in comparison with Ranson criteria

Study design: cross-sectional study

Place and Duration of study: Department of General Surgery ward 26 Jinnah Postgraduate Medical Centre [JPMC] Karachi, from January 2013 to December 2014

Methodology: Patients of either gender more the 14 year of age with acute pancreatitis admitted through emergency department were included. All the patients were scored according to the Ranson criteria [at time of admission and at first 48 hours post admission] and BISAP score [in first 24 hours of admission]. Patients were categorized having mild or severe acute pancreatitis on the basis of organ failure for more than 48 hours and these patients were treated in HDU/ICU according to the standard protocol

Results: a total of 50 patients diagnosed as acute pancreatitis were admitted during the study period. The mean age of the patients was 43.48 +/- 15.75 year with the age range from 15 year to 75 year. There were 30 [60%] females and 20 [40%] males with F:M ratio of 1.5: 1. The duration of hospital stay was 2-50 days with mean of 12.15 +/- 5.85 days. Nine [18%] patients developed persistent organ failure for more than 48 hours and were classified as having severe acute pancreatitis. These patients underwent contrast CT- scan abdomen on day 3 of admission. Three of them had necrotizing pancreatitis. The frequency of severe form of acute pancreatitis stratified by the BISAP and Ranson score were both statistically significant [p < 0.001]. Three [6%] patients died during their hospital stay [mortality rate 6%]. All the three patients who died had Ranson score > 3 and BISAP score = 3 respectively

Conclusion: in predicting the frequency of severity and mortality in patients with acute pancreatitis the BISAP scoring system is equally effective as Ranson scoring system

Open lichtenstein repair versus laparoscopic transabdominal preperitoneal repair for inguinal hernia

To compare open Lichtenstein with laparoscopic transabdominal preperitoneal [TAPP] inguinal hernia repair. Randomized controlled trial. Surgical Ward Jinnah Postgraduate Medical Center Karachi, from October 2012 to March 2013. This study was carried out on eighty patients, divided into 2 equal groups of 40 patients each. Group I, was offered Lichtenstein hernia repair and in group II, laparoscopic transabdominal preperitoneal approach was performed. Mean operative time, duration of hospital stay, pain score and infection rate were compared between two groups. All the patients included in this study were males. The mean age of the patients was 44.9 +/- 18.02 year in group I and 38.9 +/- 18.21 year in group II. Operative time and hospital stay were statistically insignificant but pain and wound infection had significant differences. The mean VAS score was found higher in group I than group II [p value 0.0048]. It was 6 +/- 1.89 in group I and 3.6 +/- 1.35 in group II. There were three cases [7.5%] of wound infection in group I whereas in group II there were no case of wound infection [p=0.0405]. The laparoscopic hernia repair is a preferable procedure. It has less postoperative pain and less wound infection

Asphyxial deaths: a four year retrospective study in Peshawar

The study provides epidemiological analysis of autopsy record on asphyxial deaths and different methods used to carry it out. It was a retrospective [descriptive] study done at the Department of Forensic Medicine and Toxicology, Khyber Medical College Peshawar. Analysis of autopsy record was done and cases of asphyxial deaths and the cause of asphyxia was noted. The data covers a period from January 2009 to June 2012. A total of 3,265 [males n=2839, Females n= 426] cases were presented for autopsy to Forensic Medicine and Toxicology Department of Khyber medical college Peshawar and 130 deaths were due to asphyxia compared with 2370 deaths due to firearm. Homicide was the most common manner of death. 89 cases were males and 41 were females. Approximate ages of the autopsies conducted were 0-19 years n= [18.2%], 20-40 years n= [64.5%], 41-60 years n= [13%] and 61 or above n=4 [3.0%]. Strangulation was found to be the most common method used. Asphyxial deaths are not as common as firearm deaths in Peshawar. Homicide is the most common method of death. The findings may be helpful for the security agencies in investigation of asphyxial deaths

MRI brain findings in patients with high serum prolactin levels

The purpose of the study was to find MRI findings in patients with Prolactin levels above1000mIU/L. Methodology: This Retrospective study was conducted in Radiology Department, Rehman Medical Institute,Peshawar, from December 2009 to October 2012. A total of 86 patients, aged 16-48 years with high Prolactinlevels, were screened with MRI for pituitary gland abnormalities. Only new undiagnosed patientswere considered for the study. Children and patients with known causes for hyperprolactinaemia wereexcluded.The most common abnormality on MRI was microadenoma [n=34, 39.5%] followed by macroadenoma[n=14, 16.3%]. 12[7%] cases of complete/partial empty sella syndrome were seen. Macroadenomawas more common in males [n=6 out of 14, 42.3%] while microadenoma was more common in females[n=32 out of 72, 44.4%]. Majority of Patients had an abnormal MRI finding, showing that MRI screening should berecommended for Prolactin levels above 1000mIU/L. Microadenoma was the most common abnormality,having higher incidence in female patients

Analysis of autopsy record of unnatural deaths in Peshawar district

This study was undertaken to describe the unnatural deaths and their causes in Peshawar and its suburbs. This descriptive study was conducted at the Department of Forensic Medicine and Toxicology, Khyber Medical College, Peshawar. Autopsy data from January 2009 to April 2012 was analyzed and only those cases were selected for the study where the cause of death was unnatural i.e., homicide, suicide, accidental or undetermined. Of a total of 3,265 autopsies due to unnatural causes during 40 months period, 2,839 [87%] were males and 426 [13%] were females. There were 2,856 cases of homicide - 2,475 [87%] were males and 381[13%] were females, 317 were accidental deaths - 281 [89%] males and 36 females [11%], 66 were suicide cases - 61 [92%] males and 5 females [8%] and 26 were undetermined deaths - 22 males [85%] and 4 [15%] females. Most victims were aged 20-40 years. Most common cause of death was firearm - 2370 cases, blunt trauma 279 cases and bomb blast/explosives 167 cases. The rate of unnatural deaths in Peshawar is very high. Autopsies done during the study period were a lot more than previous years. Homicide is the most common manner of death with firearms being the most common weapon used. Strict laws should be implemented to limit illegal weapons. Surveillance must be increased in all parts of the city to reduce the loss of precious human lives

Resistance and sensitivity pattern of Staphylococcus aureus; a study in lady reading hospital Peshawar

This study was done to determine the sensitivity and resistance pattern to the most common antibiotics in use. The data for this retrospective study was obtained and analysed from October 2010 to October 2011 in Lady Reading Hospital, Peshawar. Purposive sampling and univariate analysis was done. 2058 samples were cultured for sensitivity using Kirby Bauer's Diffusion technique and in a period of one year, growth of Staphylococcus aureus was obtained in 723 samples. These 723 growths were obtained from clinical isolates of pus [699], blood [16] and urine [8]. Fourteen drugs from five different classes of antibiotics were tested for sensitivity against Staphylococcus aureus. Most of the growth was obtained from pus [96.7%]. Resistance was high to all groups of antibiotics except glycopeptides. There was no case of Vancomycin Resistant Staphylococcus aureus [VRSA]. Out of 723 samples, 228 [31.5%] were Methicillin Resistant Staphylococcus aureus [MRSA]. The resistance to a representative antibiotic of each group is as follows: Ciprofloxacin [Fluor quinolone] 51.7%, Cephradine [Cephalosporin] 46.2%, Amoxicillin+Clavulanic Acid [Penicillin group] 45.6%,Imipenem+Cilastatin Sodium [Carbapenem] 42.0% and Teicoplanin [Glycopeptide] 19.8%.Resistance of Staphylococcus aureus to Teicoplanin and most of the antibiotics is high and strict guidelines are required to control unnecessary prescriptions and over the counter sale of antibiotics

Comparison of female reproductive organs morphology between fertile and infertile women with polycystic ovaries

To compare the morphology of pelvic reproductive organs between fertile and infertile women with polycystic ovaries. This cross sectional comparative study was performed at Rahat Hospital, Karsaz Karachi from January 2008 to December 2008. In which 100 women diagnosed with polycystic ovaries identified by ultrasound were inducted for the study; 50 were fertile and 50 were infertile [20-40 years]. Trans abdominal scan [TAS] was performed to rule out abnormalities other than PCO. Ovarian volume [OV] in cm[3], follicle count [FC] and size [FS] in mm, uterine area [UA] in cm[2], endometrial thickness [Endo] in mm were measured and noted by transvaginal scanning [TVS] ; Basal Metabolic Rate [BMI] was calculated and correlated with endometrial thickness. Unpaired t-test and Pearson correlation were used for analysis. In the total fertile and infertile women with PCO the following result was obtained OV-TAS 7.33 +/- 3.17 vs. 10.87 +/- 2.49 [0.001], OV-TVS 8.79 +/- 2.19 vs. 12.44 +/- 2.36 [0.001], FC 14.41 +/- 2.18 vs. 14.75 +/- 2.80 [0.245], FS 3.26 +/- 0.22 vs. 8.99 +/- 0.45 [0.001], BMI 25.6 +/- 4.7vs. 27.6 +/- 5.7 [0.04], UA 86.9 +/- 25.7 vs. 117.2 +/- 29.0 [0.001] and Endo 4.5 +/- 1.4 vs. 5.8 +/- 1.9 [0.052]. BMI and endometrial thickness showed a positive correlation with 'r' value of 0.06[0.05] in the infertile women and a negative correlation with 'r' value of - 0.40[0.05] in fertile women. The OV, FS, BMI, UA and Endo show a significant increase in the infertile women who are suffering from PCO. However the FC showed no significant difference between the two groups. The BMI and endometrial thickness has shown a positive correlation with infertility

Coverage and causes of non immunization in national immunization days for polio; a consumer and provider perspective study in Peshawar

Polio is a viral disease that may cause paralysis and infant death. Despite ongoing efforts, polio has not been eradicated from Pakistan. The purpose of this survey is to estimate the coverage of polio vaccine during National Immunization Days and to determine the factors associated with lack of immunization. A Cross-sectional survey was conducted in Peshawar, Pakistan, from 1[st] June to 9[th] June 2010. Confidence level of 95% and confidence interval of 4 was used to derive the sample size [for a population more than 20,000]. Parents of 600 children under 5 years were asked about immunization during NIDs of January - May 2010 [5 NIDs]. Questions regarding demographics, income, education, occupation, accessibility to health centers and frequency of visits from health workers was inquired. Knowledge and views on immunization were also asked. 40 health personnel involved in immunization were also interviewed and they were asked about hurdles faced in immunization. 83.7% children were vaccinated in all National Immunization Days, while 94.7% had at least, taken polio vaccine once. 5.3% had not taken polio vaccine during National immunization Days of 2010. Main reasons for not vaccinating were; Vaccinator absent/not visiting home/vaccine not available [63.36%], no awareness [17.4%], Child ill [5.8%], family problem/mother busy [3.3%] and wrong ideas/sterility [3.3%]. Many health personnel [32.5%] considered lack of awareness among people and low accessibility to vaccine as the main hurdles in immunization, besides the poor salaries and incentives. Polio vaccination during National Immunization Days 2010 was a partial success because some pockets of poor children and afghan refugees were poorly vaccinated. In order to eradicate polio, they must be vaccinated

Comparative analysis of vitamin B 12 levels and effects of its deficiency in selected adult population diagnosed with various clinical conditions

Back ground: vitamin B12 deficiency has been associated with various clinical conditions and co-morbidities however none of the individual symptom, or group of symptoms could be ascertaining directly to its declined status. Mostly older population is affected and documented causes of deficiency are hematologic or neurological, followed by gastrointestinal and a possible altered vascular symptoms

Aim: the present prospective observational study was initiated to compare analytical levels of vitamin B12 and evaluation of underlying clinical condition and symptoms associated with possible vitamin B12 deficiencies. Materials and Methods: The study was prospective observational and carried out for the assessment period of 1st January 2000 till 30th Dec 2010. After two years of assessment, 290 patients [males, n = 156 and females, n = 134] were inducted in the study and finalized during the period 1st January 2002 to 30th December 2009. Age ranges were from 16 to 70 years, and categorized in two groups as > 60 yrs. and < 60 years. Several blood parameters [serum folate, B12, CBC, LDH, creatinine, Hb] were analyzed by standardized methods on automated analyzers

Results and Conclusion: vitamin B12 deficiency was found to be more prevalent in females and when compared with other groups the percentage increased up to 58.20% in individuals with vitamin B12 <150 pg/ml. The most common condition was malnourishment followed by anemia [n = 75; 46.01 %] and weakness [n = 55, 33. 74%] as the more frequent clinical findings. Other clinical conditions were neuropsychiatric, whereas less frequent findings were paresthesia and gastrointestinal symptoms. Moreover, hypertension was more prevalent in vitamin B12 deficient individuals followed by diabetes, dementia, stroke, ischemic heart disease and Parkinson's disease

Short title: vitamin B12 deficiency in clinical conditions

Coverage and causes of missed Haemophilus influenzae type B vaccination in urban and rural areas of Peshawar

Haemophilus influenza type b [Hib] is a major cause of morbidity and mortality in Pakistan. Hib vaccine was introduced in 2009 in EPI programme. The purpose of this study was to find out the coverage and factors associated with non-immunization of Hib in urban and rural areas of Peshawar. Data was collected through random sampling in Peshawar University, Peshawar Saddar, Hashtnagri, Naway Kalay and Pawaka from 9th to 19th of June 2010. A questionnaire was used to interview parents of 600 children aged 1 year and below about demographics, Hib vaccination status, reasons for missed vaccination and views on immunization. Pearson's Chi-square test was used for statistical testing, and p<0.05 was considered significant. Completely vaccinated children were 64.2%, 25% not vaccinated at all, and 11% were incompletely vaccinated. The reasons for not vaccinating were lack of awareness [26%], family problem/mother busy [18%], centre too far [16.9%], wrong ideas [12.2%], fear of reaction [5.4%], child illness [8.1%] and miscellaneous causes [13.7%]. Low Hib vaccination coverage in Peshawar is mainly due to low awareness among people, poor economic conditions and illiteracy

Retinoblastoma presenting as metastasis

The purpose of this study was to evaluate the frequency of metastatic retinoblastoma on initial presentation. Prospective study. Supra Regional Centre for Retinoblastoma, Department of Ophthalmology, Khyber Teaching Hospital Peshawar Pakistan from 1[st] July 1999 to 31[st] January 2003. Data was collected from 80 registered Retinoblastoma patients admitted and examined under anaesthesia for tumours assessment. Diagnosis was supported with the help of CT scan and confirmed by histopathology of the enucleated specimen for evidence of optic nerve invasion by the tumour. Twenty [25%] patients were presenting as Metastasis on initial presentation. Mean age was 3.5 years, range was 7 months to 12 years. Out of these 20 patients with metastasis, 10 were male and 10 were female. Eighteen [90%] of them were from lower socio-economic group. Failure in early diagnosis of retinoblastoma, advance age and unilateral disease are associated with extraocular spread; this tragic scenario can be prevented best be early detection and prompt treatment plan implementation

Serum and aqueous lactate dehydrogenase ratio in the diagnosis of retinoblastoma

Leakage of lactate dehydrogenase hormone from malignant tumors cells has been described. To measure the serum and aqueous lactate dehydrogenase ratio as diagnostic indicator for retinoblastoma. Prospective analytical study, carried out at Khyber Teaching Hospital Peshawar between 1[st] July 1999 and 31[st] December, 2003. Hundred newly diagnosed patients with retinoblastoma were registered for treatment. The aqueous lactate dehydrogenase was determined in fourteen randomly selected retinoblastoma patients, classified as advanced stage VB group [Rees-Ellsworth classification]. Samples from aqueous of these patients were analyzed for lactate dehydrogenase level using automatic scanner [Selectra XL, vital scientific Netherlands]. The Aquous lactate dehydrogenase was determined in 14 patients, who had a mean age of 36 months [range 2 months - 7.5 years]. There was equal number of unilateral and bilateral cases. Mean serum lactate dehydrogenase level was 730 i.u/litre and aqueous lactate dehydrogenase was 27,042 i.u/litre. Serum: aqueous lactate dehydrogenase ratio was 27:1 against normal ratio of 1 to 1. Aqueous lactate dehydrogenase levels were proved to be sensitive biochemical test for supporting the diagnosis of retinoblastoma

Retinoblastoma in NWFP, Pakistan

Retinoblastoma is a malignant intraocular tumour of childhood, if not detected early, it results in loss of eye as well as life. The Objective was to study the pattern of presentation of Retinoblastoma in order to detect the disease at an earlier stage. It was conducted at Supra Regional Referral Centre for Retinoblastoma, Department of Ophthalmology, Khyber Teaching Hospital, Peshawar, Pakistan from 1st July 1999 to 30th September 2002. Seventy patients were registered and admitted for diagnostic evaluation. After initial interview a proforma was filled about history of disease. Examination under anaesthesia included indirect ophthalmoscopy with indentation. B-scan of the eye and CT scan of the Orbit was done when required. Forty [57.14%] patients presented with Leukocoria; other presentation included hyphaema, strabismus, proptosis, 56.48% patients presented in stage VB [Rees Elsworth classification]. Early detection through better understanding of presenting features of the disease and application of diagnostic skills can reduce the advanced stage of Retinoblastoma

Perforation operation interval as a prognostic factor in typhoid ileal perforation

To find out significance of perforation-operation interval [POI] in relation to early prognosis in patients with peritonitis due to typhoid Heal perforation [TIP]. Case series. Department of General Surgery, Jinnah Postgraduate Medical Centre [JPMC] Karachi, from October, 2004 to March, 2007. The study included 92 patients with generalized peritonitis diagnosed as typhoid Heal perforation Methods fulfilling the inclusion criteria. All non typhoidal and traumatic perforations were excluded from the study. Data was collected in the proforma designed for the study. The diagnosis of typhoid Heal perforation was established on the basis of history, clinical examination, radiology, isolation of Salmonella Typhi, and a positive Widal test. Histopathological confirmation of the diagnosis was also made. Out of 92 patients, 75 were males [81.5%] and 17 [18.5%] females, with male to female ratio of 4.4:1. The ages ranged between 15 to 50 years. The most common symptoms were fever [100%], abdominal pain [100%], constipation [81.5%], vomiting [76%] and distension of abdomen [69.5%]. The most common signs elicited on abdominal examination were tenderness [100%], guarding [72.8%] and absent gut sounds [65.2%] Out of 92 patients 12 patients [13%] presented within 24 hours of onset of severe abdominal pain [Group A]. Among late presenters, My nine [64.1%] patients presented 25-72 hours after severe abdominal pain [Group B] and twenty one patients [23%] presented after 72 hours [Group C]. Mortality was highest among group C patients [8/21 ;38%], while the mortality among the late presenters [Group B] was 10.2% [6/59]. There r was no mortality in the early presenters [Group A]. Overall mortality was 15.2% [14/92]. The average perforation operation interval in survivors was 44.2 hours as compared to average of non-survivors- 63.9 hours [p <0.01]. Prolonged presentation time leads to a high mortality rate. Once intestinal perforation occurs, early recognition, early referral and aggressive management could decrease the high mortality

Tuberculous tenosynovitis: a cause of carpal tunnel syndrome

To highlight the presentation of tuberculous tenosynovitis as Carpal Tunnel Syndrome [CTS]. A descriptive study conducted with purposive sampling on the patients presenting between April 2004 to January 2005 to the department of Plastic Surgery, CMH Rawalpindi, with the clinical picture of CTS. Symptoms and signs were recorded. The carpal tunnels were explored under nerve blocks. Where tenosynovitis was observed per-operatively, specimen of excised synovium were sent for histo-pathological examination, acid fast stains and bacterial cultures, to ascertain or rule out the presence of tuberculosis. A total of 53 patients predominantly males were included in the study. The median age was 43 years and average duration of symptoms was 9 months. Tenosynovitis was observed in three patients [6%] per-operatively, with histopathology suggestive of Tuberculous tenosynovitis. Point Prevalence of tuberculous tenosynovitis as a cause of CTS was 6%. These patients reported clinical improvement with anti-tuberculosis treatment. NCS/EMG co-related well with clinical relief. Tuberculous tenosynovitis is an uncommon cause of median nerve compression at the wrist. As symptoms are usually typical of CTS, diagnosis is frequently missed. Consideration of the possibility, examination of the opened canal at surgery and proper treatment can result in a successful outcome

Skin sparing mastectomy and immediate breast reconstruction

To evaluate skin sparing mastectomy[SSM] and immediate breast reconstruction[IBR] in terms of the survival, chances of recurrence, aesthetic restoration and prevention of psychosocial problems. An interventional study. The Department of Plastic and Reconstructive Surgery, CMH, Rawalpindi from November 1998 to November 2003. Twenty-eight patients of breast cancer, included in the study, were discussed in a Multidisciplinary Breast Clinic. Detailed metastatic work-up was performed. In all patients SSM with en-bloc level II axillary clearance and IBR was done. The patients' age ranged between 25-46 years. Two patients [7%] were nullipara. Tumor size was T1 in 10 [36%] and T2 in 18 patients [64%]. In all the patients a circum-areolar incision was used. A contralateral uni-pedicled TRAM flap was used in 24 [86%] and latissimus dorsi flap in 4 patients [14%]. All the flaps survived completely. There was marginal necrosis of native skin flaps in 03 [10.5%], infection in 03 [10.5%], axillary seroma in 03 [10.5%] and abdominal seroma in 01 patient [3.5%]. As late complication 5 patients [19%] developed fat necrosis. Adjuvant chemotherapy was given in 6 [21%] and adjuvant radiotherapy in 4 patients [14%]. No recurrence encountered in maximum follow-up. We found an excellent aesthetic restoration in 23 [82%], good in 1 [3.5%] and fair in 4 patients [14%]. SSM for patients with early breast cancer is an oncologically safe procedure. IBR can greatly reduce the psychological trauma associated with breast loss including diminished feelings of feminity, decreased libido, social behavior, sense of mutilation and depression

Evisceration, enucleation, and exentration: painful but life saving surgical procedures

To determine the indications for Evisceration, Enucleation and Exentration in patients operated at the eye department. It was a prospective study done at Khyber Teaching Hospital, Peshawar, from May 2001 to October 2003. A total of 110 cases comprising of 50 enucleations, 34 evisceration, and 26 exentration were seen. Ocular malignancy was the commonest cause for eneucleation while postoperative panophthalmitis and trauma were the reasons for evisceration and for exentration the indication was squamous cell carcinoma involving lid and conjunctiva followed by basal cell carcinoma. Only a minority of cases of eye globe surgery are preventable and/or treatable, while rest are due to malignancy. Early diagnosis in these cases is likely to make surgery easy with promising postoperative cure

Acute amphotericin-B induced nephrotoxicity in albino rats

Nephrotoxicity is one of the major problems encountered during treatment with amphotericin B which is a potent broad spectrum antifungal drug used in systemic and deep fungal infections. The present study was undertaken to investigate the acute effect on the morphology of renal parenchyma when drug is administered in nephrotoxic doses in albino rats. A total of 20 albino rats of either sex were taken and divided into two groups. Group A as control and Group B received a single dose [10 mg/Kg] of intraperitoneal amphotericin B. The animals were sacrificed and their kidneys were subjected to detailed histological examination. The morphological features observed in the kidney of these two groups were analyzed and compared. The animals receiving 10 mg/Kg amphotericin B as a single dose showed flattering of the tubular epithelial cells with loss of proximal tubular brush borders and accumulation of lymphocytes in the cortical interstitium as compared to control group. The number of the proximal tubules as well as the tubular cell nuclear count was also decreased significally. It is suggested that, amphotericin B induced damage to renal cortical tissues is due to free radical injury which later caused direct cytotoxicity to renal epithelium

Pterygium and dry eye - a clinical study

This study was done to evaluate the status of tear film in patient having pterygium and to find any correlation between pterygium and dry eyes. A prospective study on the correlation of pterygium and dry eyes was done in the Department of Ophthalmology, D.H.Q Teaching Hospital, D.I. Khan, from 1st Aug 2001 to 31st July 2002. Ach patient had a complete ophthalmological examination and all information were recorded in a specially designed proforma. Status of the precorneal tear film, marginal tear film meniscus, tear film break up time [BUT] were noted. Schirmer test was also performed. We examined 120 patients, having 170 pterygia. 95 [79.16%] were males and 25 [20.84%] were females. Male to female ratio was 3.8-1. 63 [52.5%] were having normal marginal tear film meniscus, 45 [37.5%] were having decreased marginal tear film meniscus and 12 [10%] were having severe tear film abnormalities with a concave marginal tear film meniscus. Tear film break up time was also decreased with a mean of 6 seconds and a range of 3 - 14 seconds. Schirmer test was also performed, and it was also decreased with a mean of 5.70 mm and Patients with decreased teary production are more prone to the damaging effects of U-V rays in the sun light. There is a positive correlation between dry eyes and pterygium. Patients with pterygium are having decreased tear production, decreased Tear film break up time and decreased Schirmer test value