Central corneal thickness and its relationship to intra-ocular and epidmiological determinants

Objective: To measure central corneal thickness in Pakistani population and determine its relationship to intra-ocular pressure, age, gender and ethnicity

Study Design: Cross-sectional observation study

Place and Duration of Study: Pakistan Institute of Medical Sciences, Islamabad, Pakistan, between December 2013 and February 2015

Methodology: The right eyes of 1000 cases [496 males and 504 females] were recruited for this study. Inclusion criteria were Pashtun or Punjabi ethnicity, intra-ocular pressure < 22 mmHg, gonioscopically open angles, cup-disk-ratio < 0.5, and age matched normal visual fields. Cases with prior ocular surgery, contact lens use, corneal pathologies, myopia or hypermetropia > +/- 3.0 diopters, astigmatism of > +/- 1.0 diopters were excluded. Central corneal thickness was measured using a TopCon non-contact specular microscope. Intra-ocular pressure was measured using Goldmann applanation tonometer. Frequency distribution, test of significance, and regression analysis was carried out using Statistical Package for Social Sciences version 20.0

Results: Mean age was 47.31 +/- 11.78 years. Ethnic composition was 51.6% [n=516] Pashtun and 48.4% [n=484] Punjabi. The mean central corneal thickness was 503.96 [ +/- 12.47] urn, while the mean intra-ocular pressure was 15.61[ +/- 2.68] mmHg. Regression analysis showed a significant association between central corneal thickness and intra-ocular pressure [p=0.00] and age [p=0.00]. A +/- 100 u change in central corneal thickness was associated with change in IOP of +/- 3.30 mmHg, whereas central corneal thickness decreased by 0.12 urn per year. No significant association could be established between central corneal thickness and ethnicity [p=0.19]

Conclusion: Central corneal thickness of the studied races was comparable to non-Caucasians which affects intra-ocular pressure measurements, and decreases with increasing age. No relationship was observed between central corneal thickness and ethnicity or gender

Convergence of technologies: the print, web and multimedia united to deliver an integrated basic medical sciences course in a resource limited setting

This mixed methodology study was conducted at Shifa College of Medicine to see if study guide, module website and multimedia compact disk can be used to deliver an integrated basic sciences course while introducing the concepts of evidence based medicine and how it translates in students' performance. The study guide focused on the management of learning, activities and provision of information. The website was used to introduce evidence based medicine while the multimedia disc provided pictures, videos and animations for organs of special senses. Feedback questionnaire and end of module result were used to evaluate the module and its learning tools. The students agreed that the study guide, module website and multimedia compact disc facilitated their learning experience

Lingual tuberculosis

Tuberculosis is a common disease in developing countries like Pakistan. Although it can involve almost any region of the body, some presentations are still very rare. This is a case report of a 36 years old male with tuberculous lesion on the tongue presenting as a lump. Patient also had disseminated disease. There are very few cases reported of this rare presentation across the globe