scholarly journals A Mitomycin C-Sparing Novel Technique for Subscleral Trabeculectomy in Primary Congenital Glaucoma

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Ashraf Bor’i ◽  
Salah M. Al-Mosallamy ◽  
Tamer G. Elsayed ◽  
Wael M. El-Haig
Keyword(s):  
Intraocular Pressure ◽  
Mitomycin C ◽  
Congenital Glaucoma ◽  
Surgical Interventions ◽  
Primary Congenital Glaucoma ◽  
Group I ◽  
Significant Difference ◽  
The Mean ◽  
Group Ii ◽  
Contralateral Eye

Purpose. To evaluate the safety and efficacy of a novel modified subscleral trabeculectomy technique in management of primary congenital glaucoma. Methods. This study included 25 infants diagnosed of having bilateral primary congenital glaucoma. For each patient, one eye was assigned to undergo subscleral trabeculectomy with trimming of the edges of the scleral bed (group I), while the contralateral eye underwent subscleral trabeculectomy with application of mitomycin C (0.4 mg/ml for 3 min) (group II). All the patients were followed up for a period of 14 ± 3 months (range 13–22 months). Results. 25 eyes were included in each group. Patients’ mean age was 2.5 ± 0.5 months (range 1.8–6.5 months). The mean preoperative intraocular pressure was 31 ± 4.9 mmHg and 32.1 ± 4.0 mmHg in group I and II, respectively. The mean postoperative intraocular pressure was 9.0 ± 1.0, 11.0 ± 3.2, 12.5 ± 0.9, 13.0 ± 2.9, and 15.5 ± 1.5 mm Hg in group I and was 10.3 ± 1.2, 12.0 ± 2.5, 13.5 ± 1.7, 15.0 ± 1.5, and 17.1 ± 2.8 mm Hg in group II at the first week and 1, 3, 6, and 12 months, respectively. There was no statistically significant difference between the mean intraocular pressure values recorded at both groups preoperatively and at each follow-up visit. Failure necessitating further surgical interventions was recorded in 4 eyes (16%) in group I as compared to 3 eyes (12%) in group II (P>0.05). Postoperative complications included mild hyphema, which occurred in one eye (4%) in group I and 2 eyes (8%) in group II, and shallow anterior chamber in 3 eyes (12%) in group I and in 2 eyes (8%) in group II. One eye (4%) in group I developed drawn-up pupil. Choroidal effusion developed in one eye (4%) at each group. Conclusion. Trimming the edges of the scleral bed adjacent to the sclera flap is a safe and effective surgical step which can be added to the subscleral trabeculectomy procedure to effectively control the intraocular pressure in patients with primary congenital glaucoma, sparing them the hazards associated with mitomycin C application.

scholarly journals Mean Change in Intra-Ocular Pressure in patients undergoing Trabeculectomy with Mitomycin C

2021 ◽  
Vol 15 (5) ◽  
pp. 1044-1046
Author(s):  
Munib Ur Rehman ◽  
Shahid Mahmood Dayal ◽  
Ali Zain Ul Abidin
Keyword(s):  
Intraocular Pressure ◽  
Mitomycin C ◽  
Congenital Glaucoma ◽  
P Value ◽  
Cross Sectional ◽  
Primary Congenital Glaucoma ◽  
Intra Ocular Pressure ◽  
Department Of Ophthalmology ◽  
Significant Difference ◽  
Ocular Pressure

Aim: To examine the outcomes of trabeculectomy followed by mitomycin C in term of mean change in intra-ocular pressure in patients presented with primary congenital glaucoma. Study design: Cross-sectional/observational Place and duration of study: Department of Ophthalmology, Khawaja Muhammad Safdar Medical College, Allama Iqbal Memorial Teaching Hospital, Sialkot from 7th July 2020 to 6thJanuary 2021. Methods: Fortypatients of both genders with ages up to 5 years presented with primary congenital glaucoma were enrolled in this study. Patients demographics were recorded after taking written consent from parents/guardians. All the patients were receivedtrabeculectomy with 0.4mg/ml Mitomycin C was applied below the flap for 2 to 3 minutes. Intraocular pressure was examined preoperatively and at 12th day after surgery. Results:Twenty-four (60%) were males while 16 (40%) were females. 30 (75%) patients were ages <2yearsand 10 (25%) patients had ages >2 years. A significant difference was observed regarding mean change in intra-ocular pressure (pre-operatively 30.48±3.62 versus post-operatively 16.35±2.86) with p-value <0.001. Conclusion: Trabeculectomy with Mitomycin C is very effective for reducing intraocular pressure. A significant decrease in intra-ocular pressure was observed post-operatively. Keywords: Primary congenital glaucoma, Intra-ocular pressure, Trabeculectomy, Mitomycin C

scholarly journals PRIMARY CONGENITAL GLAUCOMA;

2017 ◽  
Vol 24 (09) ◽  
pp. 1415-1419
Author(s):  
Iftikhar Ahmad ◽  
Nida Nadeem ◽  
Nahdia Ashraf ◽  
Muhammad Ahsen ◽  
Zubair Ahmad
Keyword(s):  
Intraocular Pressure ◽  
Successful Treatment ◽  
Tertiary Care ◽  
Congenital Glaucoma ◽  
Outcome Variable ◽  
Care Hospital ◽  
Female Ratio ◽  
Primary Congenital Glaucoma ◽  
Significant Difference ◽  
The Mean

Objectives: To determine the outcome of trabeculotomy in patients presentingwith primary congenital glaucoma at a tertiary care hospital in Pakistan. Design: It wasa descriptive case series. Place and Duration of Study: This study was conducted at theDepartment of Ophthalmology, Allied Hospital Faisalabad over 3 years from January 2014to December 2016. Material and Methods: 45 consecutive children presenting with primarycongenital glaucoma were included after written informed consent. These children underwenttrabeculotomy. Outcome variable was frequency of successful treatment which was definedas persistent intraocular pressure below 20 mmHg without medication for at least six monthsand reduction or stabilization of cupping of the optic disc. A predesigned proforma was usedto record patient’s demographic details along with outcome variables. Results: The mean ageof the patients was 17.47±5.77 months. There were 28 (62.2%) male and 17 (37.8%) femalechildren with a male to female ratio of 1.6:1. It was bilateral in 37 (82.2%) patients. There wassignificant improvement in the mean intraocular pressure (12.69±2.12 vs. 25.09±4.52 mmHg;p<0.00001), horizontal corneal diameter (11.96±1.49 vs. 14.87±2.03mm; p<0.00001),axial length (20.16±2.51 vs. 20.69±2.37mm; p=0.0002) and cup-disc ratio (0.30±0.15 vs.0.51±0.19; p<0.00001) from baseline at 6 months follow-up after trabeculotomy. Treatmentwas successful in 39 (86.7%) patients. There was no significant difference in the frequencyof successful treatment across age and gender groups. Conclusion: Trabeculotomy is aneasy to perform procedure with high success rate of 86.7% in children with primary congenitalglaucoma. The complications observed in the present series were related to surgical skill andtechnique and were successfully managed.

scholarly journals Combined trabeculotomy-trabeculectomy with antimetabolite and releasable suture: outcome with primary congenital glaucoma in a north Indian population

2015 ◽  
Vol 7 (1) ◽  
pp. 16-25 ◽  
Author(s):  
S Dubey ◽  
A Agrawal ◽  
L Chauhan ◽  
S Mukherjee ◽  
G Douglas
Keyword(s):  
Intraocular Pressure ◽  
Mitomycin C ◽  
Indian Population ◽  
Case Series ◽  
Congenital Glaucoma ◽  
North Indian Population ◽  
Success Rates ◽  
Primary Congenital Glaucoma ◽  
The Mean

Objective: To determine the surgical outcomes of combined trabeculotomy- trabeculectomy with mitomycin-C and releasable suture in children with primary congenital glaucoma (PCG) in a North Indian population. Design: Retrospective, interventional, consecutive, non-comparative case series. Materials and methods: The medical records of 137 eyes of 77 patients who underwent combined trabeculotomy- trabeculectomy with 0.2 mg/ml mitomycin C (MMC) either bilaterally (49 patients) or unilaterally (28 patients) between January 2004 and March 2012 were reviewed retrospectively. The main outcome measures were postoperative intraocular pressures, corneal clarity and diameter, duration of follow-up, success rate and complications. Results: The mean preoperative intraocular pressure reduced from 34 ± 7 mm Hg (range 15- 54 mm Hg) to 17 ± 7 mm Hg (range 5 - 32 mm Hg) with a mean reduction of 44 % (P < 0.001). The mean follow-up period was 24.4 ± 10.3 months (range 6 – 48 months). Complete success defined as intraocular pressure < 21 mm Hg without any medication and clinically stable glaucoma at last follow-up was achieved in 113 eyes (83 %) while a ‘quali¿ed success’ of intraocular pressure < 21 mm Hg with one medication was achieved in ten eyes (7 %). The Kaplan-Meier survival analysis revealed success rates (at ‘n’ months) of 90 % (6), 85 % (12), 82 % (24), 80 % (36) and 77 % (48). There were no signi¿cant intraoperative or postoperative complications.Conclusion: Primary combined trabeculotomy-trabeculectomy with mitomycin-C and releasable suture offers a viable surgical option in Northern Indian infants with primary congenital glaucoma. The use of 0.2 mg/ml mitomycin C for 2 minutes improves the overall success while the releasable suture decreases the risk of postoperative complications especially associated with the use of antimetabolites.

Immersive and Non-Immersive Virtual Reality Distraction on Pain Perception to Intraoral Injections

2021 ◽  
Vol 45 (6) ◽  
pp. 389-394
Author(s):  
Supriya Kumari ◽  
Rachana Bahuguna ◽  
Nishita Garg ◽  
Ramakrishna Yeluri
Keyword(s):  
Virtual Reality ◽  
Pain Perception ◽  
Dental Treatment ◽  
Immersive Virtual Reality ◽  
Dental Procedures ◽  
Group I ◽  
Significant Difference ◽  
The Mean ◽  
Group Ii ◽  
Chi Square Analysis

Objective: To evaluate the efficacy of immersive VR (IVR) and non-immersive VR (NIVR) distraction on perceived pain during intraoral injections in children undergoing dental procedures. The objective was to introduce 3-dimensional nature of virtual reality during the provoking phase of dental treatment as a means of distraction in children. Study design: A total of 200 children were selected for the study, 100 for IVR group and 100 for NIVR group. After randomization, children were introduced to Oculus Go Standalone equipment; MCDAS (f), VAS, WBFRS and the treatment procedure using tell show do technique. Group I children were introduced to oculus go standalone headset with hand held controller to play temple run or roller coaster game while in group II, children watched cartoon movies of their choice. Pre-operative & post-operative MCDAS scores were obtained using MCDAS (f) questionnaire in local language. Post-operatively, VAS and WBFRS scores were also obtained. The data was analyzed using independent t-test and chi-square analysis. Results: Pre-operatively, the mean MCDAS scores were similar in both the groups viz. Group–I (29.20 ± 3.197) and Group–II (29.09 ± 3.803) and is statistically not significant. Post-operatively, the mean MCDAS scores were higher in non-immersive group (20.72 ± 2.822) as compared to immersive group (10.99 ± 2.227). VAS score was higher in non-immersive group (2.72 ± 0.99) as compared to immersive group (0.75 ± 0.88). WBFRS scores were higher in non-immersive group (2.78 ± 1.097) as compared to immersive group (0.82 ± 1.104). Conclusion: Three-dimensional virtual reality was found to be an effective means of distraction in children undergoing dental procedures and especially during the provoking phase. The significant difference obtained clearly indicates irrespective of immersiveness of virtual reality, anxiety had been decreased and on comparison the pain perception to intraoral injection is less in immersive virtual reality environment. Immersive VR distraction technique can serve as an adjunct to traditional behavior management strategies already available to the pediatric dentist.

scholarly journals Comparitive evaluation of different concentrations of alcohol in ultrasound guided coeliac plexus neurolysis for pain relief in upper abdominal malignancies

2021 ◽  
Vol 8 (4) ◽  
pp. 492-500
Author(s):  
Manish Kumar Singh ◽  
Pragya Verma ◽  
Sarita Singh ◽  
Gyan P Singh ◽  
Hemlata Verma
Keyword(s):  
Quality Of Life ◽  
Morphine Consumption ◽  
Rescue Analgesia ◽  
Vas Score ◽  
Group I ◽  
Significant Difference ◽  
The Mean ◽  
Group Ii ◽  
Upper Abdominal

Patients suffering from advanced upper abdominal malignancies have pain as predominant symptom affects their quality of life and survival. USG guided coeliac plexus neurolysis become benevolence in these patients on part of their pain management and quality of life improvement. To compare the efficacy of USG guided coeliac plexus neurolysis for pain relief in upper abdominal malignancies by using different concentration of alcohol (50% vs 75%).This Prospective, comparative, randomised double blinded study was conducted during Sep 2019 – Aug 2020 at our tertiary care centre. Total 60 cases were taken as per following inclusion and exclusion criteria and randomly divided into 2 groups i.e. 30 each group, we compare Visual Analogue Scale (VAS) score, quality of life (QOL) and need of rescue analgesia profile between the groups to know the efficacy of USG guided coeliac plexus block. In our study, we observed that the baseline mean VAS score in group I was 8.26±0.78 while in group II was 8.03±0.76. No significant difference was found in mean VAS score at this time between the groups (p=0.24). The baseline mean QOL score in group-I was 77.46±3.40 while for the cases of group II the mean QOL score was 77.36±3.33. No significant difference was found in mean QOL score at baseline between the groups (p=0.90). The baseline mean morphine consumption in group-I was 113.33±39.24 mg while for the cases of group-II the mean morphine consumption was 120.33±38.37mg. No significant difference was found in mean morphine consumption at this time between the groups (p=0.48).Both groups having 50% alcohol and 75% alcohol decreases the VAS score from baseline in patients having upper abdominal malignancies along with QOL and dosages of rescue analgesia whereas no significant difference in VAS score in patients of both groups.

scholarly journals TO STUDY THE ONSET AND PROGRESSION OF AIRWAY ABNORMALITY IN TERMS OF ALTERATION IN PFT IN ASYMPTOMATIC SMOKERS.

2019 ◽  
Vol 3 (11) ◽  
Author(s):  
Dr. Hitesh Kumar Solanki ◽  
Dr. Omnath P Yadav ◽  
Dr. Anita J Gojiya
Keyword(s):  
Lung Function ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Medical College ◽  
Group I ◽  
Significant Difference ◽  
History Of ◽  
Young Smokers ◽  
The Mean ◽  
Group Ii

The study was conducted in department of physiology, B J Medical College, Ahmedabad from Mar. 2012 to Feb. 2013. This was a cross-sectional study to evaluate the effect of smoking on lung   function and serum lipids in asymptomatic smokers   and comparable non   smokers. The mean of the various spirometric parameters were calculated of the subjects for both the groups. The mean FVC in group I and group II was 2.60 ± 0.62 L and 4.10 ± 0.64L respectively. The mean FEV1 in group I was 1.91 ± 0.57L and     3.19 ± 0.77L in group II Group I had mean FEF25% - 75% and PEFR of 1.98 ± 0.67L/sec and 4.50 ± 1.57L/sec respectively. Group II had mean FEF25 – 75% of 4.22 ± 1.23L/sec and a mean PEFR of 7.22 ± 1.42L/sec. In young smokers and asymptomatic, still the spirometric values were significantly deranged as compared to controls. Even smokers with history of less pack years of smoking also had significant abnormalities of lung function. All he spirometric values in the two groups had statistically highly significant difference and were higher in non-smokers as compared to smokers. The spirometric values were reduced in smokers with history of smoking for as low as two pack years. Keywords: Progression, PFT, Asymptomatic & Smokers

scholarly journals A clinical comparison of high dose and low dose of Suxamethonium

2014 ◽  
Vol 9 (2) ◽  
pp. 1-8
Author(s):  
RK Yadav ◽  
PC Majhi ◽  
D Tiwari
Keyword(s):  
Intraocular Pressure ◽  
Dose Group ◽  
Low Dose ◽  
Cardiovascular Responses ◽  
High Dose ◽  
Clinical Effects ◽  
Duration Of Action ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Background: Suxamethonium having its rapid onset and short duration of action makes this drug unique amongst the neuromuscular blocking drugs described so far. However, use of suxamethonium is associated with a large number of undesirable side effects. Objective: To evaluate clinical effects of high and low dose of suxamethonium and to determine whether lower dose of suxamethonium can be used for any beneficial effects in terms of its various adverse effects e.g. cardiovascular responses, post-operative muscle pains and intraocular pressure. Methods: A total of 100 patients were included in this prospective study. All these patients on preoperative clinical evaluation were assessed to have adequate airway. All the patients were divided in two groups, low dose group (group I) and High dose group (group II) with 50 patients in each at random. A standard anesthetic technique was adhered to all the patients and following parameters were observed on comparative basis: a. Fasciculation and post operative myalgia. b. Cardiovascular effects, c. Intraocular pressure. Observation: The incidence of post Suxamethonium pain was significantly greater in group II. Increase in heart rate from baseline was significant in both groups. There was no significant difference between the two groups in the diastolic pressure but rise in systolic blood pressure was significant at all assessment times in both groups. This rise from control was statistically significant. Conclusion: Suxamethonium can be used in lower doses (0.5 mg/kg) in elective cases without airway compromise. It gives benefits of reduced muscle pains, cardiovascular responses and intraocular hypertension. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-2, 1-8 DOI: http://dx.doi.org/10.3126/jcmsn.v9i2.9677

Interleukin-1-beta concentration and neutrophil-lymphocyte ratio as possible predicting biomarkers of response to therapy with checkpoint inhibitors.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 3024-3024
Author(s):  
Rashida Orlova ◽  
Natalia V. Zhukova ◽  
Anna Malkova ◽  
Ekaterina Kaledina ◽  
Anna Gubal ◽  
...  
Keyword(s):  
Checkpoint Inhibitors ◽  
Immune Therapy ◽  
Interleukin 1 ◽  
Anticancer Therapy ◽  
Response To Therapy ◽  
Interleukin 1 Beta ◽  
Group I ◽  
Significant Difference ◽  
The Mean ◽  
Group Ii

3024 Background: One of the discussed predictive markers of the immune therapy efficacy is the index of neutrophils to lymphocytes ratio in peripheral blood (NLr), which reflects the activity of adaptive immunity and correlates with the level of tumor-infiltrating lymphocytes (TILs). High NLr and low TILs are associated with disease progression. Interleukin-1-beta (IL-1β) is one of the main cytokines produced by the tumor microenvironment (TMO). Overexpression of the cytokine leads to a local immunosuppression. For some tumors, elevated serum IL-1β levels have been associated with a poor prognosis. The aim of this work is to analyze the serum IL-1β level as a marker of TMO activity and the NLr as a marker of adaptive immunity activity in relation to the response to therapy with checkpoint inhibitors in patients with various solid tumors. Methods: The study involved 63 patients with various solid tumors who were treated at the City Oncological Dispensary and were prescribed checkpoint inhibitors (nivolumab (n = 33), pembrolizumab (n = 23), ipilimumab + nivolumab (n = 7)). The determination of the level of IL-1β was performed using the ELISA method ("Interleukin-1-beta, ELISA-best", Novosibirsk), a clinical blood test was performed in a dispensary. The response to treatment was assessed 3-6 months after the start of therapy. Statistical analysis was carried out in GraphPad Prism. Results: Among the examined patients 49.21% (31/63) achieved partial regression or stabilization of the process (group I), and 50.79% (32/63) progressed (group II). The mean concentration of IL-1β before treatment in group I was 2.21±0.3 pg/ml, in group II - 0.98±0.2 pg/ml. NLr was increased in 7 patients from group I and in 9 patients from group II, with the mean index level being 2.9±0.39 and 3.2±0.5, respectively. There was no statistically significant difference in the concentration of IL-1β and the NLr between the studied groups. In group II, the number of patients undergoing systemic anticancer therapy before immune therapy (n = 18) was statistically significantly higher than in group I (n = 8), p = 0.033. There was no statistically significant difference in IL-1β concentration and NLr relative to previous treatment. Conclusions: Our study showed that the level of IL-1β corresponds to that of healthy donors and its isolated determination has no prognostic value. The NLr in most patients from the progression group was higher than normal, in contrast to group I, which is confirmed in the literature. The presence of previous systemic anticancer therapy was found to be associated with disease progression. The described feature can be explained by the fact that patients who received therapy before, already have a longer period of illness, a more severe clinical condition. The presence of systemic anticancer therapy does not affect the level of IL-1β and NLr.

scholarly journals Diode laser trabeculoplasty in open angle glaucoma: 50μ vs. 100μ spot size

2011 ◽  
Vol 64 (3-4) ◽  
pp. 211-214
Author(s):  
Veljko Andreic ◽  
Aleksandar Miljkovic ◽  
Nikola Babic
Keyword(s):  
Intraocular Pressure ◽  
Diode Laser ◽  
Open Angle Glaucoma ◽  
Spot Size ◽  
Laser Spot ◽  
Open Angle ◽  
Pressure Decrease ◽  
Group I ◽  
The Mean ◽  
Group Ii

The study was aimed at evaluating the efficacy of diode laser trabeculoplsaty in lowering intraocular pressure in patients with both primary open-angle glaucoma and exfoliation glaucoma by using different size of laser spot. This six-month, unmasked, controlled, prospective study included sixty-two patients with the same number of eyes, who were divided into two groups. Trabeculoplasty was performed with 50 ? and 100 ? laser spot size in the group I and group II, respectively. Other laser parameters were the same for both groups: the wave length of 532 nm, 0.1 second single emission with the power of 600-1200 mW was applied on the 180 degrees of the trabeculum. The mean intraocular pressure decrease in the 50 ? group (group I) on day 7 was 24% from the baseline and after six-month follow-up period the intraocular pressure decrease was 29.8% (p<0.001). In the 100? group (group II), the mean intraocular pressure decrease on day 7 was 26.5% and after six months it was 39% (p<0.001).

The Role of sFas in the Immune Escape Mechanism and Progression of Cancer Larynx

2009 ◽  
Vol 2 ◽  
pp. CMENT.S2565
Author(s):  
Amr A El Badry ◽  
Ismail Elmofty ◽  
Amira Helmy
Keyword(s):  
Serum Level ◽  
Buffy Coat ◽  
Control Group ◽  
Group Iii ◽  
Soluble Fas ◽  
Group I ◽  
Significant Difference ◽  
Cancer Larynx ◽  
The Mean ◽  
Group Ii

This work assess serum levels of soluble Fas form (sFas) in patients with different stages of laryngeal squamous cell carcinoma(LSCC) to investigate its prognostic significance. We correlate its levels with the morphological changes of peripheral blood cells via buffy coat examinatin. The study population included 70 patients clinically diagnosed and pathohistologically confirmed LSCC in addition to 20 healthy controls. According to TNM classification 33(47.1%) patients were in stage I (group I) and 24(34.3%) in stage II (group II), 13(18.5%) in stage III (group III). The results revealed that the mean serum level of sFas (pg/ml) in the control group was 51.2, in group I was 66.33, in group II was 81.33 and in group III was 112.45. Statistical analysis of the mean of sFas by ELISA test in the patients' groups in comparison to the control revealed a significant increase of both group II and III in comparison to the control group (P < 0.01) but there was no significant difference (P > 0.05) between group I in comparison to either the control or group II. There was a significant difference (P < 0.05) between group I in comparison to group III. LM examination revealed massive extent of the apoptotic cells in group III when compared to both group I and group II. EM examination of the buffy coat revealed apoptotic changes, mainly in the peripheral blood mononuclear cells (PBMNCs), represented by surface membrane ruffles and blebs with clumped nuclear chromatin and vacuolated cytoplasm. In conclusion, this study may help us to better understand one of the escape mechanisms in cancer larynx. This mechanism is represented by the significant increase in both the serum level of sFas and the morphological apoptotic changes that detected in PBMNCs. Soluble Fas may contribute to the progression of laryngeal cancer. It can be used as an attractive target for anticancer therapy and may be considered as a marker of disease progression and poor prognosis in laryngeal cancer.

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