Comparison of visual outcome between superior scleral tunnel and temporal scleral tunnel approaches in Manual Small-Incision cataract surgery

To compare the postoperative visual acuity, per-operative and post-operative complications and the magnitude of the post-operative astigmatism in [Manual Small Incision cataract surgery [MSICS]] in superior and temporal scleral tunnel approach. A comparative interventional study. The study was conducted at LRBT Secondary Eye Hospital Lar, Multan from Jan 2008 to September 2008. 250 patients, aged from 45 to 90 years, were enrolled and divided into two groups, group A [N=125] and group B [N=125]. Group A underwent MSICS by superior while group B underwent MSICS by temporal scleral tunnel incision approach. The patients were followed up at 1st and 3rd post-operative days and 2nd, 4th and 6th postoperative weeks. 107 patients in group A and 119 patients in group B completed their 6 week follow up. The intraoperative complications, post-operative complications, postoperative visual acuity and magnitude of postoperative astigmatism were recorded at 6 week follow up and compared between two groups. At 6th week postoperatively, 46 of 107 [42.9%] of group A and 79 of 119 [66.1%] of group B had uncorrected visual acuity of 6/18 or better. 98 of 107 [91.3%] of group A and 110 of 119 [92.2%] of group B had best corrected visual acuity of 6/18 or better. There was no significant difference between the two groups for intra-operative and post-operative complications. Minimum and safe stigmatism is present in temporal approach. Both superior and temporal scleral tunnel approaches are safe and effective for MSICS but the temporal approach gives better un-corrected visual acuity and minimum and safe astigmatism

Myocardial preservation with intermittent aortic cross-clamping technique during coronary artery bypass grafting

To evaluate the safety and efficacy of intermittent aortic cross-clamping technique for myocardial preservation during coronary artery bypass grafting and to compare the results with other published series using the same technique. Design: An institution-based analytical study. Place and Duration of Study: Study was carried out from July 1995 to December 1997 at Punjab Institute of Cardiology, Lahore. Patients and The data of 100 consecutive patients were analyzed who had coronary artery bypass grafting without cardioplegia using intermittent aortic cross-clamping. All the patients who had emergency or concomitant major surgery, reoperations, and aortic disease with calcification were excluded from this study. Despite minor complications there was no mortality, no rhythm disturbance or perioperative infarction. Inotropic support was needed in 8% of patients. Our results compared favourably with other published series using the same technique. These results provide re-assurance that intermittent aortic cross-clamping provides excellent myocardial protection and operative conditions for primary coronary artery bypass. It also provides a simple and safe option for myocardial protection during coronary artery bypass grafting

Fluoxetine and it's good sexual side effects

Fluoxetine- a selective serotonin re-uptake inhipitor has been used extensively like other SSRI for the treatment of depression. Four case reports of good sexual side effects of this drug are reported as these noted sexual side effects are interesting and need further investigation to use these as one of the methods of treatment of erectile importance