Effect on Corneal Dioptric power in patients undergoing 23G Suture less plana vitrectomy

Objective: To determine the effect of 23-gauge pars plana vitrectomy on corneal dioptric power through a comparison of difference in pre- and post- surgery keratometry

Study Design: Prospective non-comparative interventional type

Place and Duration of Study: The study was conducted at the Armed Forces Institute of Ophthalmology [AFIO] Rawalpindi from Dec 2016 to Jul 2017

Material and Methods: We studied 33 patients [33 eyes] who underwent 23-gauge vitrectomy with mean age of 46.4 +/- 12.8 years. Among them 13 were females and 20 were males. These patients were divided in four groups on the basis of pre-surgical diagnosis. 18 [55%] patients had rhegmatogenous retinal detachment, 9 [27%] had macular holes 3 [9%] with Vitreous hemorrhage and last 3 [9%] had dislocation of intraocular lens. Total vitrectomy was performed in all patients by standard 23G pars plana vitrectomy [PPV] procedure as used with three scleratomies and tunnel shaped incision. Keratometry readings before the surgery and at the end of 1st, 6th and 12th post procedural weeks were recorded in horizontal [K1] and vertical meridian [K2] by utilizing topcon auto kerato-refractometer

Results: The pre-operative dioptric power of cornea in horizontal and vertical meridian [K1 and K2 respectively] was statistically compared with post- operative dioptric power of cornea at the end of 1st, 6th and 12th postoperative weeks. At the end of first post- operative week there was significant difference between pre and post-operative corneal dioptric power with horizontal p-value<0.05 and vertical <0.04; leading to astigmatism. However, at the end of 6th and 12th post procedural weeks there was no significant difference between pre and post-operative corneal dioptric power which is evident with insignificant p-values. The p-value at the end of 6[th] post-operative week was 0.521 and 0.57 for K1 and K2 respectively. At the end of 12th post-procedural week these values are 0.854 and 0.941 for K1 and K2 respectively. Clinically these patients did not have any sign or symptoms of astigmatism

Conclusion: 23G was found safe procedure in vitreoretinal surgery with no insignificant change in corneal dioptric power except in cases in which silicone oil was used. However, due to small study group and short follow up further studies with longer follow-ups are required to establish the long-term changes in corneal dioptric power after 23G suture less vitrectomy

Gastric emptying scintigraphy in postprandial distress syndrome

Objective: To find out the pattern of gastric emptying scintigraphy [GES] in patients with post prandial distress syndrome [PDS]

Methods: This study was carried out from January 2015 to July 2016 at Combined Military Hospital [CMH] Kharian and Nuclear Medical Centre [NMC] of Armed Forces Institute of Pathology [AFIP] Rawalpindi. Patient's inclusion criteria were dyspepsia of post prandial distress type for more than six months duration. Patients with dyspepsia due to epigastric pain syndrome and other organic disorder were excluded. Upper gastrointestinal endoscopy was performed in all patients to rules out organic causes. Four-hour Gastric emptying scintigraphy was carried out at NMC, AFIP. Results were compiled and statistical assessment was done by utilizing SPSS IBM 22 version

Results: Thirty-eight patients were included in the study with age range from 15-72 years with mean age of 37.05 +/- 13.5 years. Males were 28[73.7%] and 10[26.7%] were female. Mean gastric retention with SD at one, two, three and four hours were 63 +/- 19.04, 37 +/- 20.62, 19 +/- 16.66 and 10 +/- 12.73 percent respectively. Early gastric emptying was in 3[7.89%] and delayed gastric emptying at two and four hours was seen in 4[10.52%] and 12[32%] respectively. Seventeen [44%] of the patients had normal gastric emptying despite the classical symptoms of PDS

Conclusion: Gastric dysmotility in GES seen in half of the patients points some additional mechanism as well like gastric accommodation or visceral hypersensitivity in the patients with PDS

Cholescintigraphy of children with prolonged neonatal jaundice

To find the cause of neonatal jaundice in patients of up to 1 year of age, referred to Nuclear Medical Centre, AFIP Rawalpindi. Patients of jaundice up to 1 year of age referred by paediatricians from Military Hospitals were subjected to radionuclide cholescintigraphy at Nuclear Medical Centre, AFIP, Rawalpindi. The pattern noted was that 41% cases were scintigraphically positive for biliary atresia, 37% cases were found to be negative for it. Sixteen percent of the cases showed scintigraphic evidence of parenchymal liver disease and the possibility of biliary atresia could not be completely ruled out in these patients. Interestingly 6% of the cases were noted to be inconclusive though they were suffering from jaundice. The female to male ratio were 1:1.5, 1:6, and 1:1.6 for biliary atresia, negative for biliary atresia and parenchymal liver disease respectively. The cause of neonatal jaundice in most cases was biliary atresia and the frequency in males was higher as compared to female patients

Interactions between sparfloxacin and antacids-dissolution and adsorption studies

Sparfloxacin is a broad-spectrum oral fluoroquinolone antimicrobial agent with a long elimination half-life, extensively used against both Gram-positive as well as Gram-negative microorganism. Concurrent administration of antacids and sparfloxacin decreases the gastrointestinal absorption of sparfloxacin and therapeutic failure may result. The present study was designed to evaluate the influence of some antacids on the availability of sparfloxacin. The release of sparfloxacin from tablets in the presence of antacids like sodium bicarbonate, calcium hydroxide, calcium carbonate, aluminum hydroxide, magnesium hydroxide, magnesium carbonate, magnesium trisilicate and magaldrate has been studied on BP 2003 dissolution test apparatus. These studies were carried out in simulated gastric and intestinal juices for three hours at 37oC. The results confirmed that the dissolution rate of tablets was markedly retarded in the presence all of antacids studied, whereas magaldrate and calcium carbonate exhibited relatively higher adsorption capacities in simulated gastric juice and magnesium trisilicate and calcium hydroxide in simulated intestinal juice

Fabrication of nanoparticles within polymeric pores for controlled release of drug

Nanotechnology, a multidisciplinary scientific undertaking, involves creation and utilization of materials, devices or systems on the nanometer scale. The field has enabled the development of an amazing variety of methods for fabricating nanoparticles in recent years. The technology is expected to create innovations and play a critical role in the field of biopharmaceuticals especially in controlled release of drug delivery. Sol-gel technique is one of the most widely used techniques to fabricate porous nanoparticles within the polymer. Such nanoparticles have also applications in vascular drug delivery and release, site-specific targeting [passive as well as active targeting], as well as transfusion medicine. This article concentrates mainly on fabrication of porous nanoparticles, its characterisation and its use for controlled release of drug. It also encompasses the strategies that have been used to translate and fabricate a wide range of particulate carriers e.g., nanospheres, liposomes, micelles, oil-in-water emulsions, with prolonged circulation and/or target specificity. With regard to the targeting issues, attention is particularly focused on the importance of physiological barriers. we have also critically reviewed and assessed the fate and activity of biodegradable/bioerodable polymeric drug delivery vehicles because the uniformity in degradation of these polymers is questionable

Degradation studies of azithromycin and spectorphotometric determination in pharmaceutical dosage forms

A simple, accurate and rapid spectrophotometric method for the estimation of azithromycin has been developed by the acidic hydrolysis of the drug with sulfuric acid and monitoring the absorbance at 482nm. All variables affecting the reaction conditions such as sulfuric acid concentration, heating time, temperature and dilution solvents were carefully studied. Analytical parameters such as stability, selectivity, accuracy and precision have been established for the method and evaluated statistically to assess the application of the method. The method was applied successfully for the assay of azithromycin dihydrate in pure and pharmaceutical dosage forms as tablets, capsules and suspensions. The method was found to have the advantages for simplicity, stability, sensitivity, reproducibility and accuracy for using as an alternate to the existing non-spectrophotometric methods for the routine analysis of the drug in pharmaceutical formulations and also in pharmaceutical investigations involving azithromycin dihydrate

Spectrophotometric method for quantitative determination of iron III from iron polymaltose complex in pharmaceutical formulations

A visible spectrophotometric method has been developed for the quantification of iron [III] from iron polymaltose complex in pure and in pharmaceutical preparations. The method is based on hydrolysis of iron polymaltose complex under acidic conditions and the formation of red colored chromogen with ammonium thiocyanate, which showed absorption peak at 471 nm. This absorption wavelength can be used for the determination of iron [III] from iron polymaltose complex. The limit of detection of iron polymaltose complex at 476 nm was 6.207 ng mL-1. The calibration was linear in the range of 19.8'22.2 micro g mL-1. Analytical parameters such as stability, selectivity, accuracy and precision have been established for the method in HAEMOTYL [R] syrup and evaluated statistically to assess the application of the method. The method was validated under the ICH and USP guidelines and found to comprise the advantages for simplicity, stability, sensitivity, reproducibility and accuracy for using as a method for the routine analysis of the drug in pharmaceutical formulations and in pharmaceutical investigations involving iron polymaltose complex

Comparison between hartmann's Paul-Mikulicz and primary resection and anastomosis in sigmoid volvulus

To compare the results of three procedures used in the management of gangrenous sigmoid volvulus [Paul-Mikulicz procedure, Hartmann's procedure and resection and primary anastomosis]. This study was conducted at Nishtar Hospital, Multan. Study included 30 patients with gangrenous sigmoid volvulus, admitted through the emergency department. The details of history, physical examination, investigations and surgical procedures done was noted in the collection form. In present study 20 [66.7%] patients were between 40-65 years, 10 [33.3%] patients were between 35-40 year. Mean age was 48 years. Out of 30 patients, 22 [73.3%] patients were male and 8 [26.7%] patients were females. As regards predisposing factors, 15 [50%] patients used high fiber diet, 5 [16.7%] patients had history of chronic constipation, 3 [10%] patients were hospitalized, 2 [6.7%] patients had long mesentery of sigmoid. Abdominal distension with delayed abdominal pain, indicting large bowel obstruction presented in 66.7% patients 60% had generalized abdominal pain and 83.3% had absolute constipation. While 16.7% patients had frank peritonitis and 23.3% patients had fever. Preoperatively diagnosed cases of gangrenous sigmoid volvulus were 66.7% and patients diagnosed on laparotomy were 33.3%. gangrenous sigmoid is an important cause of intestinal obstruction. More cases occur in males. In upto 80% cases diagnosis is based on the findings of an AP plain film. Hartmann's operation had least morbidity and mortality