Significance of stress induced myocardial ischemia in young hypertensive Egyptians

Normal ECG does not exclude significant coronary artery disease or left ventricular hypertrophy. Silent ischemia is common in hypertensive patients. Nowadays there is increase in the prevalence of essential hypertension in young adults. Is to test the significance of exercise ECG in detection of CAD, and its prevalence in young hypertensive patients. This study included 100 patients with age range between 16-35 year. A control group of 20 healthy adult volunteers of the same age range. All patients were subjected to thorough History taking, Clinical assessment, Laboratory investigations [FBS, Lipid profile], Baseline ECG, Echocardiographic study, Exercise stress testing. The resting systolic blood pressure, mean maximum systolic blood pressure and The recovery heart rate were significantly correlated with LV mass in hypertensive patients. There was a significant dyslipidemia and impaired diastolic function in hypertensive patients, and this dyslipidemia correlated with LV mass. LV mass, dyslipidemia, and diastolic dysfunction were the most determine, related to abnormal exercise response in hypertensive patients. Patients with ST-segment depression showed a sign of increased LV mass, increased recovery heart rate and dyslipidemia

Phacoemulsification in eyes with previously functioning filtering blebs

Purpose: To evaluate the effect of clear corneal phacoemulsification on glaucomatous eyes that has had previously successful filtering surgery

Methods: This study was undertaken in 21 eyes with glaucoma that had phacoemulsification after successful trabeculectomy. The interval between trabeculectomy and phacoemulsification ranged between 15 to 26 months. Only those cases who had IOP <21 mmHg over the preceding 6 months without any medical treatment following trabeculectomy were included in this study. All patients underwent phacoemulsification through a superior clear corneal, three-stepped, 1.5 mm long tunneled incision and in-the-bag PMMA intraocular lens implantation. Surgical difficulties, complications, postoperative intraocular pressure and best corrected visual acuity were studied and analyzed over a follow up of 6 months

Results: Complications seen during the surgery were corneal edema in 5 eyes [23.8%], iris trauma in two eyes [9.5%], tear in the rhexis in two eyes [9.52%], vitreous loss in one eye [4.76%] and early increase in IOP in one eye [4.76%]. Postoperatively, visual acuity improved in all cases. Mean IOP increased after phaco-emulsification by about 1.23 mmHg [preoperatively 14.84+/-2. 73 mm Hg], 6 months postoperatively [16.26+/-1.2 mmHg]. Difference in IOP at all patients during follow up period was found to be statistically insignificant [p>0.05]

Conclusion: Clear corneal phacoemulsification in previously filtered glaucomatous eyes is feasible although difficult. However, with slight modification in the technique, it can be accomplished without sight-threatening complications. In addition, it does not adversely affect the functioning of the bleb

Corneal topographic and pachymetric changes following trabeculectomy

Purpose: to evaluate the corneal topographic and pachymetric changes before and after sub scleral trabeculectomy

Methods: twenty eyes of twenty patients were subjected in this study that were scheduled to undergo standard sub scleral trabeculectomy operation

Results: as regard astigmatic changes measured with Orb scan Corneal Topography system [OCXS]; one patient developed no astigmatic change. Three patients developed decrease in astigmatism. The other 16 patients developed increase in astigmatism The central corneal thickness increased by the first week postoperatively then decreased in the first month and continued to decrease in the second month postoperatively. There was a positive correlation between the central corneal thickness and the intraocular pressure [IOP]

Conclusion: trabeculectomy operation has a benign effect on the re-active condition of the patient, as it is a mild and transient effect. The pachymetic changes showed rise in the first week postoperatively due to the events of surgery followed by a decrease more than the preoperative level due to significant reduction in IOP

Effect of myopic laser in situ keratomileusis on corneal sensitivity

Purpose: to study changes in the corneal sensitivity following laser in situ keratomileusis [LASI. for the correction of myopia to determine the time required for recovery of this parameter

Methods: corneal sensation was measured with Cochet-Bonnet esthesiorneter in 28 patients who had LASIK for correction of their myopic errors. Esethiometry was performed before, 1 day, 1 week, 1 month and 3 months after correction

Results: after LASIK, corneal sensitivity was significantly decreased after 1 day, 1 week and 1 month it recovered slightly at 3 months, although it remained sign9cantly less than preoperatively

Conclusion: a significant reduction in corneal sensitivity immediately following surgery occurred and was evident for at least 3 months after surgery

Safety of trypan blue 0.1% and gentian violet 0.001% staining of the anterior capsule for capsulorhexis in eyes with white cataract

Purpose: to compare the safety and efficacy of trypan blue 0.1 % and gentian violet 0.001% for anterior capsule staining in cases of white cataract

Methods: thirty eyes with age-related white cataract had anterior capsule staining with trypan blue 0.1% [15 eyes], and gentian violet 0.001% [15 eyes], under an air bubble followed by phacoemulsification with posterior chamber intraocular lens [PC IOL] implantation. The ease of creating a continuous curvilinear capsulorhexis [CCC] and intraoperative complications were noted. Postoperative examinations at 1day, 1week and 1month included visual acuity, anterior chamber reaction, and intraocular pressure [IOP] were documented. The mean phaco power and time were also recorded

Results: complete CCC was achieved in 24 eyes [80%], 6 eyes [20%] had extension of the capsulorehexis, thus the surgery was converted to conventional ECCE. All patients had a BCVA worse than 6/60 before surgery. One week after surgery, Twenty-three [76.7%] had a BCVA of 6/9 or better. Five eyes [16.7%] had a BCVA worse than 6/60 postoperatively. Examination of those eyes revealed preexisting posterior segment pathology. Two eyes [6.7%] had increased IOP, with the highest measured at 26mmHg postoperatively. Their BCVA were 6/24. These 2 eyes responded well to medication, and the IOP returned to normal by the second postoperative week. Almost all eyes achieved a BCVA of 6/9 from the first week postoperatively to the last follow-up. The side port and corneal tunnel were stained most intensely with gentian violet than trypan blue groups. All eyes had clear corneas and a quiet anterior chamber 1 month after surgery. The mean phaco power and time were not significantly different between the 2 groups [P=0.367 and P=0.12, respectively]

Conclusion: both trypan blue 0.1% and gentian violet 0.001% are safe and effective for staining and visualization of the anterior capsule during phacoemulsification of white cataract