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

Comparison of the long-term and short-term fluctuations of frequency-doubling technology perimetry between peripheral and paracentral zones of visual field

Objective: To compare the long- and short-term fluctuations of frequency doubling technology perimetry between peripheral and paracentral zone and determine the relationship between threshold sensitivity and long- and short-term fluctuation within peripheral and paracentral zone of visual field

Study Design: Descriptive study

Place and Duration of Study: Eye Department, United Nations, Pakistan Field Hospital Level-3 Darfur, Sudan, from February to July 2015

Methodology: Normal eyes of 30 volunteers were recruited. Frequency doubling technology perimetry, program N-30, full threshold was employed. Each subject was tested at weekly intervals, once in the 1st, 3rd and 4th sessions and three times in the 2nd session. Visual field was divided into paracentral, superior, and inferior zones. Short-term and long-term fluctuation as well as threshold sensitivity were calculated for each patient as the mean fluctuation and mean sensitivity value. Mann-Whitney U-test was used to compare each zone in terms of their short- and long-term fluctuations and Spearman's rho correlation test for determining the relationship of threshold sensitivity with short- and long-term fluctuations

Results: Long-term fluctuation values differences were insignificant between superior and paracentral zones. Short-term fluctuation values were statistically insignificant between all three zones. Short-term fluctuation and threshold sensitivity in each zone did not correlate. Long-term fluctuation and threshold sensitivity had a very weak negative, statistically insignificant correlation in superior and paracentral zones

Conclusion: Frequency doubling perimetry exhibits uniform short- and long-term fluctuations in peripheral and paracentral zones of visual field in normal subjects. Threshold sensitivity and long- and short-term fluctuations are independent of each other in peripheral and paracentral zones of visual field

Efficacy of 2.5% and 1.25% povidone-iodine solution for prophylaxis of ophthalmia neonatorum

Objective: To determine the efficacy of 2.5% and 1.25% Povidone-Iodine solution for Ophthalmia neonatorum prophylaxis

Study Design: Interventional study

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

Methodology: A total of 200 eyes of 100 newborn babies were enrolled and divided into two groups of 100 right eyes and 100 left eyes. A conjunctival swab for bacterial culture was taken within 30 minutes after delivery. A single drop of 2.5% Povidone-Iodine was then placed in the right eye while in the left eye a single drop of 1.25% Povidone-Iodine was placed. Thirty minutes after placing Povidone-Iodine, a conjunctival swab was again taken. A bacterial suspension was prepared from each swab in determining bacterial counts. The bacterial suspension was inoculated on yeast extract agar and the number of colony forming units were counted. At each culture, the number of colony forming units before and after instillation of 2.5% Povidone-Iodine and 1.25% Povidone-Iodine were compared. Wilcoxon's signed rank test was used for statistical analysis

Results: The 2.5% Povidone-Iodine solution caused a statistically significant decrease in the number of colony forming units [p=0.001]. Similarly, the 1.25% Povidone-Iodine solution also reduced the number of colony forming units to a statistically significant level [p=0.001]

Conclusion: The 1.25% concentration of Povidone-Iodine is as effective as the 2.5% concentration of Povidone-Iodine in reducing the number of colony forming units in healthy conjunctivae of newborns

clinical significance of perilimbal conjunctival pigmentation in vernal conjunctivitis

To compare the extent of perilimbal conjunctival pigmentation and limbal palisadal pigmentation in patients with vernal conjunctivitis and controls and correlate it with the duration of disease. Case control study. Eye Department, Combined Military Hospital, Abbottabad, from May 2009 to March 2010. One hundred subjects including 50 patients with vernal conjunctivitis and 50 controls were studied. Demographic data, family and personal history, disease duration, symptoms, signs, complications and extent of perilimbal and palisadal conjunctival pigmentation were recorded among patients and controls. Mann Whitney-U test and Spearman's rho test were used for statistical analysis. The extent of perilimbal conjunctival pigmentation in patients with vernal conjunctivitis was more than controls [p < 0.0001]. Similarly, limbal palisadal pigmentation was also more extensive than controls [p = 0.004]. There was no correlation between the duration of disease and severity of conjunctival pigmentation [r = 0.24] [p = 0.086]. The presence of increased perilimbal and limbal palisadal conjunctival pigmentation among patients with vernal conjunctivitis is a specific sign of vernal conjunctivitis

Grading complication following radical cystectomy and ileal conduit for bladder cancer using clavien grading system

To determine the 30-day complication rate of radical cystectomy and urinary diversion using a validated system. An analytical descriptive study. The Aga Khan University Hospital, Karachi, from 1990 to 2010. Patients who had undergone ileal conduit [IC] formation, following radical cystectomy [RC] for muscle invasive transitional cell carcinoma, were studied, using a prospectively maintained data base. Basic details were determined, complications were noted and graded according to the modified Clavien grading system [CG]. Results were presented using descriptive statistics. Of all the RC performed at this hospital 89 patients received IC. Of them 75 were male and 14 female. Mean age was 60 years. Mean duration of hospital stay was 14 days. Ten patients each received pre-operative chemotherapy and radiotherapy, respectively. Mean duration of surgery was 8.2 hours, with mean estimated blood loss of 1334 ml. Preoperative radiotherapy was associated with more complications. No other factor like ASA, co-morbidities, blood loss or duration of stay influenced the complications. Fifty patients [56.2%] did not have any complications. Most common complication of wound infection was seen in 7 patients [CG-2], followed by uretero-ileal leakage in 5, requiring percutaneous intervention under local anaesthesia [GC-3a]. Mortality rate was 4.5%, classified as CG-V. Radical cystectomy with Ileal conduit is a major procedure with a good safety profile at this institute. Longterm follow up is still needed to evaluate delayed complications and quality of life