Role of Topical Nepafenac and Topical Dexamethasone in Postoperative Inflammation after Cataract Surgery: A Comparative Study.

Background: To study the role of nonsteroidal anti-inflammatory Nepafenac 0.1% topically in comparison to topical steroid for controlling postoperative inflammation after cataract surgery. Methods: Prospective randomized controlled trials were given and double blind study was done. In both groups, similar baseline parameters were taken into consideration. Postoperative inflammation, intraocular pressure and visual acuity following routine small incision cataract surgery were assessed in both groups in first 21 days. Parameters were graded according to severity. Results: There was not much difference statistically in two groups in the treatment of any of the signs, including ciliary congestion, aqueous cells, flare, descemet’s folds, visual acuity and intraocular pressure (p 0.001) however, there was apparent improvement with corticosteroids when aqueous flare was considered but with Nepafenac there was no side effect and was well tolerated. Conclusion: Nepafenac is equally effective as topical steroid and can safely be used in routine postoperative inflammation after uncomplicated cataract surgery.

Electrocardiographic prediction of left anterior descending coronary artery occlusion site in acute anterior myocardial infarction.

The complications, therapy and prognosis are significantly determined by the exact location of occlusion site in left anterior descending (LAD) coronary artery in anterior acute myocardial infarction (AMI). This study assessed the role of Electrocardiogram (ECG) as a predictor of coronary artery occlusion site in anterior AMI. Sixty two patients of anterior AMI were divided into two groups according to the occlusion site in relation to first septal and first diagonal branches, proximal--group A and distal--group B. Their initial ECG were analyzed and interpreted. The number of patients having ST elevation in leads aVR and aVL (> or = 0.5 mm) were significantly higher in proximal group compared to distal ones (42.3% vs 2.8% and 73.1% vs 22.2%; p < 0.001). Similarly the number of patients having ST depression in inferior leads, II (> or = 1 mm), III (> or = 1 mm) and aVF (> or = 1 mm) were also significantly higher in proximal group (84.6% vs 22.2%, 88.5% vs 33.3% and 84.6% vs 22.2%; p < 0.001). The sensitivity of ST depression in inferior leads II (> or = 1 mm), III (> or = 1 mm) and aVF (> or = 1 mm) to predict the proximal lesion were 85.0%, 88.0% and 85.0% respectively, whereas specificity were 78.0%, 67.0% and 78.0% respectively. The ST elevation in a VR had 42.0% sensitivity and 97.0% specificity to predict proximal lesion. Similarly ST elevation in aVL (> or = 0.5 mm) had 73% sensitivity and 78% specificity. In anterior AMI, ST elevation in aVR, aVL and ST depression in inferior leads can predict the occlusion site in LAD proximal to first diagonal and first septal branch.

Birth-weight status of newborns and its relationship with other anthropometric parameters in a public maternity hospital in Dhaka, Bangladesh.

According to the World Health Organization, birth-weight of less than 2,500 g is considered low birth-weight since below this value birth-specific infant mortality begins to rise rapidly. In Bangladesh, the prevalence of low birth-weight is unacceptably high. To screen low-birth-weight babies, simple anthropometric parameters can be used in rural areas where 80-90% of deliveries take place. A sample of 316 newborn singleton babies were studied in a government maternity hospital in Dhaka city to examine the birth-weight status of newborns and to identity the relationship between birth-weight and other anthropometric parameters of newborns. The mean birth-weight was 2,889 +/- 468 g, and 15.18% were low-birth-weight (<2,500 g) babies. All key anthropometric parameters of the newborns significantly correlated with one another (p<0.001). The best cut-offs for detecting low-birth-weight and normal-weight babies were <10 cm (odds ratio=17.4), <30.5 cm (odds ratio=25.0) and <33 cm (odds ratio=19.4), respectively, for mid-upper arm circumference (MUAC), chest circumference, and head circumference. The sensitivity and specificity were best for chest circumference (83.3% and 83.6% respectively). At lower cut-off points of <9 cm, <29.5 cm, and <32 cm, respectively, for MUAC, chest circumference, and head circumference, high-risk babies could be identified with a minimum number of false-positive cases. Chest circumference was the best detector of birth-weight with a correlation-coefficient of just above 0.84, followed by MUAC with a correlation-coefficient of just below 0.84. Based on the findings of the study, it is recommended to use <29.5 and 29.5 to <30.5 cm for chest circumference to identify 'high-risk' and 'at high-risk' newborns respectively.