ABSTRACT
Marijuana is the most widely abused "recreational" substance in the United States, with highest prevalence in young adults. It is reported to cause ischemic strokes, hepatitis, anxiety, and psychosis. Although it is associated with dose dependent tachycardia and can lead to coronary vasospasm, it has not been directly related to acute myocardial infarction (AMI). Marijuana induced coronary vasospasm can result in endothelial denudation at the site of a vulnerable atherosclerotic plaque in response to hemodynamic stressors, potentially causing an AMI. Spice refers to herbal mixture with composition and effects similar to that of marijuana and therefore is referred to as "synthetic marijuana." Herein, we report 3 cases of spice induced ST-segment elevation myocardial infarction. All patients were relatively young and had few or absolutely no risk factors for cardiovascular disease. All patients underwent emergent coronary angiography, with two needing stent placement and the third requiring only aspiration thrombectomy. Our case series emphasizes the importance of suspecting and investigating synthetic marijuana use in low risk young adults presenting with AMI.
ABSTRACT
BACKGROUND: 28-43% of the patients develop posterior capsular thickening after extra capsular cataract surgery. Nd-YAG laser capsulatomy is a method of choice to treat this complication. METHOD: We conducted a prospective clinical, randomized comparative study to evaluate the post YAG laser IOP rise in 54 patients at Ayub Teaching Hospital Complex. RESULT: There were 43% male and 57% female patients with a mean age of 63.6 years. The mean time for capsular opacification was 14.6 months. Postoperative visual improvement was 6/24 to 6/6. All patients showed post laser IOP rise that was controlled by Topical Beta-blockers and steroids effectively.
