RESUMEN
Purpose: Outcome of topography?guided excimer laser ablation in conjunction with accelerated, high?fluence cross?linking in corneal ecstatic disease using the NIDEK CXIII equipped with CATz algorithm from the FinalFit software棓Bharat Protocol.� Methods: Retrospective case record review of 30 eyes of 17 patients of stage 1?3 keratoconus who underwent the procedure was performed. Data collected were for visual acuity, distortion?induced eye pain, and keratometry. Pachymetry, lower order and higher order aberrations, spherical aberrations, and topographic cylinder were documented from by Scheimpflug imaging (Pentacam 70700: Oculus, Wetzlar, Germany). Results: At a minimum follow?up of 6 months (range 6.2� months), there was significant improvement in UCVA (P < 0.00001), BCVA (P = 0.0061), decrease in Kmax (P = 0.0349), Ksteep (P < 0.0411), Kflat (P = 0.0099), and pachymetry (P = 0.0001). Significant improvement was also seen in distortion?induced eye pain (27/30 to 2/30; P < 0.00001). A more than two?line improvement in UCVA and BCVA was seen in 23/30 and 17/30 cases, respectively. Ectasia was stabilized in all cases at the last follow?up, and no complications were seen. Conclusions: The 揃harat� Protocol to arrest keratectasia progression and improve corneal regularity is a safe and efficacious alternative as a keratoconus management option. This is the first such study on Nidek Platform for the same.
RESUMEN
COPD is a leading cause of death and disability worldwide as well as in India. It is a multisystem disorder among which cardiac manifestations are common. Echocardiography provides a rapid, non-invasive, portable, and accurate method to evaluate such changes. We wanted to assess the cardiac changes due to COPD by echocardiography, evaluate the correlation between echocardiographic findings and severity of COPD using GOLD guidelines (2011 updates).METHODSThis study was a hospital based cross sectional study conducted in M.L.B. Medical College, Jhansi (U.P.). The study included admitted COPD patients in Internal Medicine Department and T.B. Chest Department. The study was conducted after obtaining permission from the Institutional Ethics Committee and identity of the patients has not been revealed.RESULTSOut of 200 admitted patients, 98 patients had cor pulmonale and were further classified by using GOLD guidelines 2017. Upon comparing FEV1 with mPAP in each group we observed p value of 0.001 which is statistically significant. A positive correlation was also found between duration from onset of the disease and mPAP.CONCLUSIONSBy estimating PAP early in the disease process, even in those patients who are not able to perform lung function test correctly due to other co-morbidities, we can determine the progression of the disease and can achieve a better outcome by planning a more appropriate and intense line of management.
RESUMEN
It has only been a quarter of a century since the discovery of adult stem cells at the human corneo-scleral limbus. These limbal stem cells are responsible for generating a constant and unending supply of corneal epithelial cells throughout life, thus maintaining a stable and uniformly refractive corneal surface. Establishing this hitherto unknown association between ocular surface disease and limbal dysfunction helped usher in therapeutic approaches that successfully addressed blinding conditions such as ocular burns, which were previously considered incurable. Subsequent advances in ocular surface biology through basic science research have translated into innovations that have made the surgical technique of limbal stem cell transplantation simpler and more predictable. This review recapitulates the basic biology of the limbus and the rationale and principles of limbal stem cell transplantation in ocular surface disease. An evidence-based algorithm is presented, which is tailored to clinical considerations such as laterality of affl iction, severity of limbal damage and concurrent need for other procedures. Additionally, novel fi ndings in the form of factors infl uencing the survival and function of limbal stem cells aft er transplantation and the possibility of substituting limbal cells with epithelial stem cells of other lineages is also discussed. Finally this review focuses on the future directions in which both basic science and clinical research in this fi eld is headed.