Comparison of effect of Olanzapine and Resperidone on Serum Prolactin levels in patients with first episode Psychosis

Objective: To compare frequency of Hyperprolactinemia with Risperidone and Olanzapine in patients with first episode psychosis

Study Design: Randomized controlled trial

Place and Duration of Study: Combined Military Hospital [CMH] Lahore, over a period of six months from Sep 2015 to Feb 2016

Subjects and Methods: Total 60 patients who had psychosis as accompanying feature in any of the various psychiatric illnesses according to ICD-10 diagnostic criteria were enrolled in this Randomized controlled Trial. Fasting venous blood samples for serum prolactin were collected between 0800 hrs and 1000 hrs at baseline [first visit]. The patients were then randomly assigned to receive risperidone or olanzapine by lottery method. Serum prolactin levels were then collected at 3 months follow-up visit. All samples were tested in labortary of Pathology department, CMH Lahore for measurement of serum prolactin levels and results were verified by a classified pathologist. Confounding variables were identified and excluded by exclusion criteria

Result: A total of 35 patients [58.33 percent] developed hyperprolactinemia. The olanzapine group showed 13 out of 30 patients [43.33 percent] and risperidone group showed 22 out of 30 patients [73.33 percent] with raised prolactin levels with p-value of 0.018 indicating that the difference was statistically significant

Conclusion: Frequency of hyperprolactinemia is high with risperidone than with olanzapine in first episode psychosis

Posterior capsulotomy; complication after ND YAG laser in our setup

To study the complications of ND: YAG laser capsulotomy. Clinical trial. Department of Ophthalmology KHYBER Medical University Institute of Medical Sciences Teaching Hospital Kohat Development Authority [KDA] Kohat. Jan 2007 to June 2008. A total number of 250 patients with posterior capsular opacification were studied and look for complications after ND: YAG Laser application. One hundred and thirty five [54%] were male and one hundred fifteen[46%] patients were female. 63% of patients had right eye involvement while 37% had left eye were involved. Patients were thoroughly examined before and after the procedure. All patients were followed for minimum six months after the procedure. Data was analyzed by SPSS version 16. Chi square test was calculated for the significance of analysis. After Nd YAG laser capsulotomy there was significant improvement in visual acuity of my patients. There was transient rise of IOP in 25 [10%] of patients. Mild anterior uveitis in 20 [8.0%] of patients. Intra-ocular Lens pitting or cracks in 30 [12%] of cases. Macular edema in 20 [8.0%] of cases. Retinal detachment in 5 [2.0%] of cases. Nd YAG laser is safe, effective and non-invasive procedure outdoor procedure by which we can get better visual outcome. Which had also some serious complication for that we have to avoid and educate the patient about the complications of procedure

Prognostic significance of serum bilirubin in stroke

Background: Oxidative injury is an important cause of the neurologic lesion in stroke. Serum bilirubin is considered a natural antioxidant that may affect the prognosis of stroke. The purpose of this study was to evaluate the prognostic significance of bilirubin in stroke patients. Methods: A prospective cross-sectional study was conducted in Medical Units of Khyber Teaching Hospital, Peshawar. Inpatients admitted with acute attack of stroke were included in this study. Data regarding serum bilirubin and concurrent cerebrovascular risk factors were collected. National Institutes of Health Stroke Scale [NIHSS] and modified Rankin Scale [mRS] were used to analyse stroke's severity and functional outcomes, respectively. Results: Hypertension, diabetes mellitus and heart diseases were the most common risk factors. Patients were divided into 3 groups on the basis of serum bilirubin, i.e., =0.6 mg/dl [Group-1], 0.7–0.9 mg/dl [Group-2], and =1.0 mg/dl [Group-3]. The mean pre-hospitalisation NIHSS score for Groups 1, 2 and 3 was 5.62, 11.66 and 25.33, respectively; and post-hospitalisation score was 0.875, 3.76 and 16.26, respectively. The pre hospitalisation mRS score was 4 for Group-1, 4.52 for Group-2 and 4.93 for Group-3; while post-hospitalisation Mrs Score was 1.50, 2.38 and 4.26, respectively. Average serum bilirubin level was significantly higher in patients with poor outcomes as compared with good outcomes [p<0.01]. Conclusions: This study suggests that higher serum bilirubin levels were associated with increased stroke severity, longer hospitalisation and poor prognosis. Keywords: Stroke severity, stroke outcome, stroke prognosis, serum bilirubin, National Institutes of Health Stroke Scale [NIHSS], modified Rankin Scale [mRS]