Effectiveness of preoperative subconjunctival injection of mitomycin-C in primary pterygium surgery

Objective: To compare the effectiveness of preoperative subconjunctival injection of Mitomycin-C at 24-hour and at one month before primary pterygium excision

Study Design: Randomised controlled trial

Place and Duration of Study: Eye Department, Combined Military Hospital, Sargodha, from January to December 2014

Methodology: Eyes of 60 patients were randomly allocated into two equal groups [A and B] of 30 each. In group A Mitomycin-C was injected into the pterygium one month before, and in group B Mitomycin-C was injected 24 hours before excision. All pterygia received 0.1 ml of Mitomycin-C in a concentration of 0.15 mg/ml. Primary pterygia greater or equal to 2.5 mm were selected and excised as a bare sclera technique. Postoperatively, all patients were followed-up for 06 months. The recurrence and corneoscleral complications were recorded. Pearson chi-square test was used to compare the recurrence between group A and group B

Results: The recurrence of pterygium in group A was 3.3%; and in group B, it was 6.7%. Comparison of the recurrences between both the groups was statistically insignificant, [p=0.554].Postoperatively, no serious corneoscleral complications occurred in either group

Conclusion: The preoperative subconjunctival injection of Mitomycin-C in a dose of 0.15 mg/ml given 24 hours prior to excision is as effective as 01 month preoperative injection for primary pterygium surgery with bare sclera technique

Non-dermatophyte moulds and yeasts as causative agents in onychomycosis

Although dermatophytes are the most common pathogens of onychomycosis, yeasts and non-dermatophyte moulds can also be found as causative agents. To find out relative frequency of non-dermatophyte moulds and yeasts as causative agents in onychomycosis. Forty patients of all age groups and either sex suffering from onychomycosis were subjected to fungal cultures. Demographic and clinical features of the patients were recorded. Nail scrapings were inoculated on fungal culture media and growth pattern studied. Out of 40 patients, eight [16%] were positive for fungal culture. Amongst culture positive cases 4 [50%] were dermatophytes, all of them belonging to genus trichophyton, whereas 2 [25%] were positive for Candida spp. and 2 [25%] were positive for non-dermatophyte moulds belonging to Scopulariopsis spp. and Aspergillus spp. each. Dermatophytes remain the most common cause, but the role of yeasts and nondermatophye moulds should receive due consideration in a case of onychomycosis

Role of inferior vena cava filter implantation in preventing pulmonary embolism

A retrospective review of all patients undergoing IVC filter implantation at Shifa International Hospital, Islamabad, from June 2004 to June 2006 was conducted to study the indications of inferior vena cava [IVC] filter use and impact on short-term morbidity/mortality. A total of 17 patients received IVC filters. Five patients were excluded due to data loss. One month clinical follow-up was available for 12 patients and 6 months follow-up was also available for 4 of 12 patients. The underlying disease was deep venous thrombosis [DVT] with pulmonary embolism [PE] in 6 [50%], DVT without PE in 4 [33.3%] and PE with negative duplex scan for DVT in 2 [16.6%] patients, respectively. Indications for IVC filter implantation were DVT and/or PE with contraindication to anticoagulation in 8 [66.7%] and DVT and/or PE with complications of anticoagulation in 4 [33.3%] patients. No procedure-related complications were noted in all 17 patients. Three patients [25%] died of non-PE related causes during the 1st month. There were no PE related mortalities at 6 months. This data set indicates that IVC filter implantation is a safe procedure with no short-term morbidity/mortality and potential long-term mortality benefit

Predictors pf ischemic versus hemorrhagic strokes in hypertensive patients

To identify the factors that predispose to ischemic versus hemorrhagic stroke in hypertensive patients. Cohort study. The study was conducted at the Aga Khan University Hospital [AKUH], Karachi, from August 1999 to May 2001. All the hypertensive patients, who were registered in AKUH acute stroke outcome data base, over a period of 22 months, were identified and from this cohort the patients with first ever stroke were selected. The data regarding demographics, stroke type [ischemic vs. hemorrhagic], pre-existing medical problems, laboratory and radiological investigations was recorded and analyzed. Five hundred and nineteen patients with either ischemic stroke or parenchymal hemorrhage were registered over a period of 22 months. Three hundred and forty-eight patients [67%] had hypertension and of these, 250 had first ever stroke at the time of admission. Presence of diabetes mellitus [OR: 3.76; CI: 1.67-8.46] and ischemic heart disease [OR: 6.97; CI: 1.57-30.98] were found to be independent predictors of ischemic strokes. Presence of diabetes mellitus and ischemic heart disease predict ischemic stroke in a patient with hypertension