Netarsudil monotherapy as the initial treatment for open-angle glaucoma and ocular hypertension in Indian patients: A real-world evaluation of efficacy and safety

Purpose: Glaucoma is the second leading cause of blindness worldwide, affecting more than 64 million people aged 40–80. The best way to manage primary open?angle glaucoma (POAG) is by lowering the intraocular pressure (IOP). Netarsudil is a Rho kinase inhibitor, the only class of antiglaucoma medications that reorganizes the extracellular matrix to improve the aqueous outflow through the trabecular pathway. Methods: An open?label, real?world, multicentric, observation?based 3?month study was performed for assessing the safety and ocular hypotensive efficacy of netarsudil ophthalmic solution (0.02% w/v) in patients with elevated IOP. Patients were given netarsudil ophthalmic solution (0.02% w/v) as a first?line therapy. Diurnal IOP measurements, best?corrected visual acuity, and adverse event assessments were recorded at each of the five visits (Day?1: screening day and first dosing day; subsequent observations were taken at 2 weeks, 4 weeks, 6 weeks, and 3 months). Results: Four hundred and sixty?nine patients from 39 centers throughout India completed the study. The mean IOP at baseline of the affected eyes was 24.84 ± 6.39 mmHg (mean ± standard deviation). After the first dose, the IOP was measured after 2, 4, and 6 weeks, with the final measurement taken at 3 months. The percentage reduction in IOP in glaucoma patients after 3 months of once?daily netarsudil 0.02% w/v solution use was 33.34%. The adverse effects experienced by patients were not severe in the majority of cases. Some adverse effects observed were redness, irritation, itching, and others, but only a small number of patients experienced severe reactions, as reported in a decreasing order: redness > irritation > watering > itching > stinging > blurring. Conclusion: We found that netarsudil 0.02% w/v solution monotherapy when used as the first?line treatment in primary open?angle glaucoma and ocular hypertension was both safe and effective.

Analgesic effect of continuous adductor canal block versus continuous femoral nerve block for knee arthroscopic surgery: a randomized trial

Abstract Background and objectives Anterior cruciate ligament reconstruction (ACLR) is one of the most frequently performed orthopedic procedures. The ability to perform ACLR on an outpatient basis is largely dependent on an effective analgesic regimen. The aim of the study was to compare the analgesic effect between continuous adductor canal block (cACB) and femoral nerve block (cFNB) during arthroscopy guided ACLR. Method In this prospective, randomized, controlled clinical trial, 60 ASA I/II patients for arthroscopic ACLR were recruited. Patients in Group I received cACB and those in Group II cFNB. A bolus dose of 20 cc 0.5% levobupivacaine followed by 0.125% 5 mL.h-1 was started for 24 hours. Rescue analgesia in the form of paracetamol 1 g intravenous (IV) was given. Parameters assessed were time of first rescue analgesia, total analgesic requirement in 24 hours, and painless range of motion of the knee (15 degrees of flexion to further painless flexion). Results The time-to-first postoperative analgesic request (hours) was earlier in Group II (14.40 ± 4.32) than Group I (16.90 ± 3.37) and this difference was statistically significant (p< 0.05). The cumulative 24-h analgesic consumption (paracetamol in g) was 0.70 ± 0.47 in Group I and 1.70 ± 0.65 in Group II (p< 0.001). The painless range of motion (degree) was 55.67 ± 10.40 in Group I and 40.00 ± 11.37 in Group II (p< 0.001). Conclusion The findings of this study suggest that continuous adductor canal block provides superior analgesia in patients undergoing arthroscopic ACLR when compared to continuous femoral nerve block.

A Study of Cardiac Dysfunction in Patients of Hypothyroidism

Introduction: Thyroid disorders are probably the mostcommon endocrinal disorders affecting the populationworldwide. Hypothyroidism is associated with obesity,dyslipidemia and increased atherosclerotic cardiovasculardisease. Hypothyroidism are associated with increasedcardiovascular morbidity and mortality. The present study wasplanned to study the cardiac dysfunction in hypothyroidismcases by using non-invasive method ECG and 2 D ECHO.Material and methods: A total of 100 patients withhypothyroidism were enrolled in the study.They were clinicallyevaluated and underwent relevant investigations,includingthyroid profile, ECG and 2D ECHO for cardiac abnormalities.Results: Mean age of patients was 40.45±13.03 years.Majority of patients were females (71%). There were only29% males. Male to female ratio of study population was0.41:1. Among 100 patients,on ECG abnormal findings wereseen in 57% cases. Bradycardia alone was the most commonECG abnormality affecting 27% of patients. 25% patientsshowed low voltage complexs. A total of 5% patients showedboth bradycardia and low voltage complex. On 2D ECHO,62% patients had normal findings. Abnormal findings wereseen in 38%. Among abnormal findings, the most commonwas mild pericardial effusion (18%) followed by LVDDGrade 1 (16%), LVDD Grade 1 with mild pericardial effusion(2%) and LVDD Grade 2 respectively.Conclusion: Cardiac dysfunction was found in hypothyroidpatients.

Quantification of Sexual Behaviour Traits in Presence of Teaser Male in Relation to Libido and Semen Quality in Buffalo Bull

Screening and selecting bulls for desirable reproductive traits and high libido is known to improve the reproductive performance of the herd. Evaluation of sexual behaviour and semiogram is very useful in demarcating the high fertility bulls. Therefore, the purpose of the present study was to quantify the sexual behaviour in presence of male teaser in relation to semen quality in buffalo bulls. Bulls were categorized into two groups (high and low libido) on the basis of reaction time. The average duration of first licking of prepucial area was significantly (p<0.05) lower in high libido bulls as compared to low libido bulls. The average frequency and overall duration of licking of prepucial area until ejaculation in high libido buffalo bulls was significantly (p<0.05) lower as compared to low libido bulls. The average time lag to show flehmen response following sniffing and licking the prepucial area and urine of teaser male was similar (p>0.05) in high and low libido buffalo bulls. The average chin resting time were similar (p>0.05) in high and low libido buffalo bulls. Individual sperm motility (%) and viability (%) was found to be significantly higher (P<0.05) in high than the low libido bulls. Sperm abnormality (%) was significantly higher (P<0.05) in low libido bulls. Therefore, it can be concluded that breeding buffalo bulls can be demarcated for high libido based on quantification of sexual behaviour traits in relation to semen picture

experience of disseminated intravascular coagulation [DIC] at periphery of Karachi

The purpose of this study is to describe the common causes and clinical presentations of Disseminated Intravascular Coagulation at periphery of Karachi. It was a descriptive study conducted by the department of Medicine at Jinnah Medical and Dental College Hospital, Korangi, from January 08 to December 08. Jinnah Medical and Dental College Hospital, provides health care facilities to the rural areas of Karachi including Sharafi, Chashma, Rehri Goths etc. We studied mode of presentation, laboratory investigation, treatment options and mortality. All the findings were recorded on a pre-designed Proforma. Sixty patients with Disseminated Intravascular Coagulation [DIC] were studied as protocol. Out of sixty cases 36 [60%] were male and 24 [40%] were female. Patients were 13-65 years of age mean 37.33%. Out of sixty patients 50 [83.3%] presented with bleeding and hemorrhage from various sites and only 10 [16.6%] presented with signs of hypercoagubility. Bacterial infection was found to be most common underline illness. The mortality rate was 43.3% in this study the mortality rate was higher in patients in which underlying illness was not easily curable. Disseminated Intravascular Coagulation [DIC] has various modes of presentation with very high mortality all over the world. In our study the majority of patients presented with bleeding from various sites, and the main causative agent was infective illness, so it is advisable if patient presented with bleeding and has history of infective illness than Disseminated Intravascular Coagulation [DIC] should be included in differential diagnosis

Treatment compliance and associated demographic factors in newly diagnosed tuberculous patients on directly observed therapy - short course [DOTS]

To asses the treatment compliance and effectiveness of DOTS program at a secondary health facility level. A Hospital based Cross Sectional study. Patients attending TB clinic at Taluka Hospital SajawaL District Thatta Sindh. a secondary health facility during 2003-2004. A total of 240 Patients were enrolled for the study irrespective of gender, ethnicity and religion. Present study showed population compliance of 82.19%, success rate of 75% and disease specific death rate [case fatality rate] of 7.5% on DOTS therapy. DOTS [directly observed treatment short-course] strategy for tuberculosis [TB] control as recommended by the World Health Organization has proved to be a is a very effective program for decreasing morbidity and mortality in tuberculous patients provided it is practiced properly