Résumé
Purpose: The purpose of the study is to investigate the effects of combined 0.8% tropicamide and 5% phenylephrine on the corneal parameters using Pentacam. Methods: The study was performed on 200 eyes of 100 adult patients visiting the ophthalmology clinic for evaluation of refractive errors or cataract screening. Mydriatic drops (Tropifirin; Java, India) containing tropicamide 0.8%, phenylephrine hydrochloride 5%, and chlorbutol 0.5% (as a preservative) were instilled into the eyes of the patients three times every 10 minutes. The Pentacam was repeated after 30 minutes. The measurement data of various corneal parameters from different Pentacam displays (keratometry, pachymetry, densitometry, and Zernike analysis) was manually compiled on an Excel spreadsheet and analyzed using Statistical Package for the Social Sciences (SPSS) 20 software. Results: Analysis of Pentacam refractive maps revealed a statistically significant increase (P < 0.05) in the values of radius peripheral (cornea front), pupil center Pachymetry, pachymetry apex, thinnest location Pachymetry, and cornea volume. However, pupil dilation did not affect the Q?value (asphericity). Analysis of the densitometry values revealed significant increase in all zones. Aberrations maps revealed statistically significant increase in the value of spherical aberration after the induction of mydriasis, but the values of Trefoil 0º, Trefoil 30º, Koma 90º, and Koma 0º were not affected significantly. We did not observe any untoward effect of the drug, except transient blurring of vision. Conclusion: The current study showed that routine mydriasis in the eye clinics leads to a significant increase in various corneal parameters including corneal pachymetry, cornea densitometry, and spherical aberration as measured by Pentacam, which can influence the decision?making in the management of various corneal diseases. The ophthalmologists should be aware of these issues and make adjustments in their surgical planning accordingly
Résumé
ABSTRACT BACKGROUND: The aim here was to study acute effects of hemodialysis among end-stage renal disease (ESRD) patients. DESIGN AND SETTING: Prospective study in tertiary-level care center. METHODS: Fifty ESRD patients undergoing hemodialysis were studied. Spirometric pulmonary function tests were performed before and after four-hour hemodialysis sessions. RESULTS: The patients' average age was 45.8 ± 10.0 years; 64% were males and 64% had normal body mass index. Anemia (94%) and hypoalbuminemia (72%) were common. Diabetes mellitus (68%), hypertension (34%) and coronary artery disease (18%) were major comorbidities. Forty-five patients (90%) had been on hemodialysis for six months to three years. The patients' pre-dialysis mean forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) were below normal: 45.8 ± 24.9% and 43.5 ± 25.9% of predicted, respectively. After hemodialysis, these increased significantly, to 51.1 ± 23.4% and 49.3 ± 25.5% of predicted, respectively (P < 0.01). The increase in mean FEV1/FVC, from 97.8 ± 20.8% to 99.3 ± 20.1% of predicted, was not significant (P > 0.05). The pre-dialysis mean forced expiratory flow 25-75% was 50.1 ± 31% and increased significantly, to 56.3 ± 31.6% of predicted (P < 0.05). The mean peak expiratory flow was below normal (43.8 ± 30.7%) and increased significantly, to 49.1 ± 29.9% of predicted (P < 0.05). Males and females showed similar directions of change after hemodialysis. CONCLUSIONS: Pulmonary function abnormalities are common among ESRD patients. Comparison of pre and post-hemodialysis parameters showed significant improvements, but normal predicted values were still not achieved.