DiagnosticI accuracy of contrast enhanced computed Tomography in staging of colorectal Carcinoma

Objectives: To determine the diagnostic accuracy of CT scan in staging of colorectal carcinoma among biopsy proven patients of colorectal carcinoma by taking histopathological finding as gold standard

Study Design: Cross-sectional validation study

Place and Duration of Study: Combined Military Hospital Rawalpindi, Six months, from Jul 2015 to Dec 2015

Material and Methods: A total of 176 cases of 15-70 years of age, diagnosed of colorectal carcinoma oncolonoscopic biopsy, were included in the study. Patients with previous malignancies other than colorectal carcinoma, allergy to the contrast agent and pregnant patients were excluded from the study. All the patients then underwent CT scan for detection of the stage of cancer. After surgery, histopathology of the resected specimen was compared with the findings on CT scan

Results: Mean age was 50.27 +/- 14.50 years. Out of these 176 patients, 113 [64.20 percent] were male and 63 [35.80 percent] were females with ratio of 1.8:1. Among CT positive, 80 were true positive while 11 were false positive. Among, CT negative patients, 12 were false negative while 73 were true negative. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of CT in staging colorectal carcinoma taking histopathology as gold standard was 87.91 percent, 85.88 percent, 86.96 percent, 86.90 percent and 86.93 percent respectively

Conclusion: This study concluded that CT scan is a highly sensitive and accurate modality for pre-operative detection of stage of colorectal carcinoma

Correlation of intraocular pressure with ocular axial length after intravitreal injection of bevacizumab in diabetic macular edema

Objective: To determine the effect of Intravitreal injection of Bevacizumab on IOP in eyes of different axial lengths. Study Design: Cross sectional study. Place and Duration of Study: This study was conducted at AFIO Rawalpindi, from Sep 2013 to Jan 2014

Material and Methods: In this study 55 patients scheduled for intravitreal injection of bevacizumab for the treatment of diabetic macular edema were enrolled. An informed written consent was taken from all the patients. All patients underwent clinical ophthalmic examination including uncorrected distance visual acuity, corrected distance visual acuity, slit lamp bio-microscopy and fundus examination with 90 diopter lens. Axial length was measured before IVB using IOL master. Intra Ocular Pressure [IOP] was measured before and after 1 minute of administration of Intravitreal Bevacizumab [IVB] using Tono-Pen

Result: The mean age of patients was 54.51 +/- 7.53 years with minimum age of 43 years and maximum age of 70 years. There were 26 [47.3%] male and 29 [52.7%] female patients. The mean axial length of the examined eyes was 21.12 +/- 1.80 with range of 6 mm. Mean IOP before IVB was 13.09 +/- 1.62 mmHg. After 1 minute of IVB, mean IOP was 32.8 +/- 6.19 mmHg. A good correlation was observed between the axial length and intraocular pressure rise after 1 min i.e. Pearson correlation [r.] = -0.914 [p-value <0.001] with R2 = 0.835

Conclusion: There is significant rise in IOP after intravitreal injection of bevacizumab in patients with short axial length as compared to long axial length

Comparison of corneal endothelial cell density in patients of pseudoexfoliation syndrome with normal population

Objective: To compare the corneal endothelial cell density in patients of Pseudoexfoliation syndrome [PXS] with normal healthy controls. Study Design: Cross sectional comparative. Place and Duration of Study: This study was carried out at Armed Forces Institute of Ophthalmology, Rawalpindi from Mar 2016 to Jan 2017

Patients and Methods: Patients of PXS and healthy subjects of both genders between ages of 40 and 50 years, with best corrected visual acuity of 6/6 on snellen visual acuity chart were included in the study. All the participants including controls and PXS patients were subjected to ophthalmic clinical examination including corrected distance visual acuity, slit lamp examination by the single trainee researcher to exclude bias. Participants in both groups were evaluated for corneal endothelial cell density [ECD] by using non-contact, TOPCON SP 3000P Specular microscope. Sampling bias was eliminated by analyzing 100 cells in the center of each specular microscope photograph and mean of three readings was analyzed

Results: Both the groups were similar with respect to gender and age. In our study sample there were 29 [58%] males in PXS group and 24 [48%] males in control group with no statistical significant [p-value > 0.05] difference between gender distributions of both groups. The mean age of the PXS group was 46.34 +/- 2.932 years, and in control group was 45.54 +/- 2.887 years [p-value >0.05]. The mean value of ECD was found to be 2021.548 +/- 528.142 cells/mm2 in PXS patients and the mean value of ECD in healthy subjects was noted to be 2772.692 +/- 383.395 cells/mm2, showing significantly lower ECD in PXS cases. Similarly, significantly higher number of cases 22 [44%] had CED <2000 in PXS as compared to normal healthy subjects

Conclusion: Corneal endothelial cell density decreases in patients of pseudoexfoliation syndrome and this must be considered while planning any intraocular surgery including cataract extraction

Causes associated with frozen shoulder

The purpose of this study is to analyze the causes in the detection and measurement of frozen shoulder in our population. Seventy five [75] patients were investigates to know the causes associated with frozen shoulder, by asking them a set of question. The result shows that female were more affected than males belonging to different walk of life. Patients with hypertension are more at risk for developing a frozen shoulder. Mobilization techniques performed by physical therapists were used to increases mobility in such patients. Frozen shoulder occurs in about 4% of the general population. Mostly among the people between the ages of 40 and 60