Role of anticoagulation with apixaban in left‑sided atrial tachycardias

Background@#Atrial tachycardia poses challenges in patient management due to the associated risks of stroke and systemic embolism. While anticoagulation is recommended in atrial fibrillation (AF), its role in atrial tachycardia remains less defined. This prospective study aimed to evaluate the efficacy and safety of apixaban, a direct oral anticoagulant, in individuals diagnosed with left-sided atrial tachycardias. @*Methods@#Patients diagnosed with left-sided atrial tachycardia (n = 439) were observed over 3 years. Baseline characteristics, medication regimens, and clinical outcomes were assessed. Apixaban-treated individuals (n = 213) received standard or reduced dosages, while the control group (n = 226) received standard care. Primary outcomes included stroke, systemic embolism, bleeding, and mortality rates. @*Results@#Baseline characteristics were comparable between groups. The apixaban cohort showed a lower incidence of stroke (7.0% vs. 9.3%, p = 0.027) and decreased all-cause mortality (11.7% vs. 12.8%, p = 0.012) compared to controls.No significant differences were found in major bleeding or systemic embolization between groups. @*Conclusion@#Apixaban demonstrated a potential benefit in reducing stroke and mortality rates in patients with leftsided atrial tachycardia. While requiring further validation, these findings suggest a potential role for apixaban in anticoagulation strategies for atrial tachycardia management.

Glaucoma capsulare; [role of filtration surgery]

To emphasize the role of filtration surgery in the treatment of glaucoma capsulare. Moreover the study also highlights the importance of thorough ocular examination and diagnosis as the condition is likely to be missed. This study was conducted to find out the results of filtration surgery [trabeculectomy] in such cases. Forty cases with pseudoexfoliation glaucoma presenting in the Dept of Ophthalmology PAF Hospital Mushaf Sargodha were included. These patients were initially treated with topical medications for three months. Thirty cases that showed poor response to drugs were operated upon and a trabeculectomy was performed. Postoperative pressure readings were recorded twice weekly for the first two months and then once monthly for four months. After a follow-up of six months, twenty five cases [83.33%] were effectively controlled without any added medications whereas five cases [16.67%] required addition of a single drug to achieve the desired effect. The response to medical treatment is generally not satisfactory and surgery has to be undertaken as a final resort. Trabeculectomy is the safe and effective operation in glaucoma capsulare [pseudoexfoliation glaucoma]

Posterior capsule opacification following cataract surgery

To find out the incidence of posterior capsule opacification [PCO] following cataract surgery and means for its management. Design: An interventional study. Place and Duration of Study: The study was conducted at Eye Department, Military Hospital Rawalpindi from June, 1993 to June, 1997. Subjects and Two hundred patients operated for cataract which included 100 patients of simple cataract extraction, while remaining patients were implanted with posterior chamber intra-ocular lens. Those who reported visual deterioration due to PCO were thoroughly investigated and YAG laser capsulotomy was performed in all such patients. The study revealed a higher incidence of PCO in younger age group, 26[13%] patients developed PCO, pearl type was the most common, 6[23.07%] patients had ruptured anterior vitreous face, 4[15.38%] patients showed rise in intra-ocular pressure while one [03.84%] patient showed evidence of cystoid macular edema. The patients were treated with Neodymium- yttrium-Aluminium, Garnet [Nd-YAG] laser. Conclusions: The PCO is the most common complication responsible for visual deterioration following cataract surgery that can be reduced by thorough removal of lens epithelial cells and cortical remnants. Nd-YAG laser capsulotomy is non-invasive and most favoured treatment