Short term results of pterygium surgery with adjunctive amniotic membrane graft.

OBJECTIVE: The objective of this study is to present the 3 months results of pterygium excision with adjunctive amniotic membrane graft. MATERIALS AND METHODS: In a non-comparative case series study, the medical records of all patients who had pterygium excision with adjunctive amniotic membrane transplant on bare sclera from December 2009 to August 2010 were reviewed. All the patients were followed up for 3 months. The data collected were sex, age, occupation, type of pterygium (primary or recurrent), extent of pterygium, post-operative complications and recurrent pterygium growth. RESULTS: Thirty eyes of 30 consecutive patients were operated on. There were 14 males and 16 females (M:F =1:1); age range 25 to 70 years (mean: 48.3 SD + 12.01). Twenty-six eyes had primary and 4 recurrent pterygia. Stage 3 pterygium accounted for most of the cases (53.3%) followed by stage 2 (36.7%) and stage 4 (10%). Nineteen patients (63.3%) had occupations with considerable exposure to actinic damage. Of these, manual laborers accounted for the highest number contributing 13 (43.3%) out of the 19 cases. Of the 30 patients 2 had a reoccurrence giving a recurrence rate of 6%. One patient developed dellen 1 week post-operatively with complete resolution following conservative large soft contact lens application. CONCLUSION: Short term results suggests that adjunctive amniotic membrane transplant with pterygium excision is effective and safe. A larger randomized clinical trial with a longer follow-up period is however recommended.

Identification and synthesis of potential impurities of rabeprazole sodium.

Rabeprazole sodium (1, Achiphex) is a gastric proton pump inhibitor. It causes dose-dependent inhibition of acid secretion and is useful as an anti-ulcer agent. In the process for the preparation of 1, two potential unknown impurities were identified in HPLC at levels ranging from 0.05-0.8%. Based on mass spectral data vide LC-MS, the two impurities were characterized as 2-{[(4-chloro-3-methyl-2-pyridinyl) methyl] sulfinyl}-1H-bezimidazole (2, chloro analogue of rabeprazole) and 2-[{(4-methoxy-3-methyl-2-pyridinyl)methyl}sulfinyl]-1H-benzimidazole (3, methoxy analogue of rabeprazole). The structures were unambiguously established by independently synthesizing them and co-injecting in HPLC. To our knowledge, the compounds 2 and 3 have not been reported as process impurities elsewhere.