RESUMEN
Iridogoniodysgenesis is a rare autosomal dominant disorder affecting anterior segment of the eye. Fifty percent cases of iridogoniodysgenesis have glaucoma, which is particularly difficult to manage. We report here a case of 40 years old man with this rare disorder, presenting to our glaucoma department. It was characterised by iris hypoplasia and juvenile glaucoma. To stop fluctuation in his intraocular pressure [IOP] and to save his vision from glaucomatous damage, our team had to do three different surgical procedures, i.e. trabeculectomy with F5U, diode laser cycloablation and aqueous shunt procedure, over a period of 10 months. This case report discusses management of glaucoma in this particular patient and challenges faced during the treatment. Regular follow-up and timely intervention can save such patients from complete blindness. To authors' knowledge, this is the first reported case of iridogoniodysgenesis in Pakistan
RESUMEN
Newborn mortality is one of the most neglected health problems in the developing world. In Pakistan it also remains very high. Most of these deaths could be prevented through cost-effective interventions. A large proportion of births continue to occur at homes. The study was undertaken to describe newborn care practices in the hospital and at homes, as an initiative to focus this alarming problem. This comparative cross-sectional study was carried out during the months of June and July 2005 in District Mardan, Pakistan. Data was collected and compared in hospital-based and community based deliveries. Gynae labour suite in District Headquarter Hospital Mardan was chosen as hospital-based facility. Irum colony in Mardan city was taken as community-based population. Information from 30 delivery cases was gathered; half the cases were hospital-based and half at homes. Sampling method was convenient. Descriptive statistical analysis was performed. The result of this study showed that among hospital deliveries 80% were conducted by nurses, 20% by skilled dais and none by doctor. Among these cleanliness was kept in 33%, cord care 100%, thermal protection 83.3%, breast feeding initiation within an hour was noted in 66.6%, spontaneous breathing was 100%. All of the home based deliveries were conducted by unskilled birth attendants. Among these; cleanliness 16.6%, cord care 80%, thermal protection 100%, breast feeding within an hour 14%, spontaneous breathing 100%. In both of these groups eye care was 0%, and immunization was 100%. This small scale study highlighted the deficiencies in the newborn care. Both hospital practices and traditional ones neglected the basic principles of newborn cleanliness, early breast feeding, eye care and cord care. A community based essential newborn care strategy is recommended