scholarly journals LASIK-induced Corneal Changes after Correction of Hyperopia with and without Application of Mitomycin-C

2019 ◽  
Author(s):  
Ehab M. Moawad ◽  
Ahmed A. Abd Elghany ◽  
Amr A. Gab-Alla ◽  
Osama M. Elbassiouny ◽  
Mohsen S. Badawy

Abstract Background The study aimed to assess the role of intraoperative mitomycin-C (MMC) application during hyperopic LASIK correction (+1.00 D to +6.00 D) by examining topographic corneal changes and incidence of regression over a one-year follow-up period. Methods This comparative randomized control study included 136 eyes of 68 hyperopic patients divided into two groups; Group A included 68 eyes of 34 patients that had LASIK with the application of 0.02% MMC for 10 seconds on the stromal bed after excimer laser treatment, and group B included 68 eyes of 34 patients that had LASIK without MMC application. Uncorrected distance visual acuity (UDVA), refraction, keratometry and topography were recorded at 1st week and 1st, 3rd, 6th, and 12th months postoperation. Predictability and treatment efficacy were also recorded at the end of the follow-up period. Results Better predictability was noted in group A than in group B at the 6 month and 12 month follow-up visits, with a mean cycloplegic refraction SE of +0.5 ± 0.31 D in group A and +0.67 ± 0.39 D in group B at the 6 month visit, and +0.63 ± 0.37 D in group A and +0.89 ± 0.48 D in group B at the 12 month visit. The efficacy of the treatment at the end of the follow up period was better in group A than in group B. Group A showed fewer topographic corneal changes than group B. Conclusions Intraoperative MMC application during hyperopic LASIK achieves better predictability and efficacy and induces fewer topographic changes and lower regression rate of hyperopia during the first postoperative year. Trial registration: the Pan African Clinical Trial Registry PACTR201901543722087, on 29 January 2019.

2019 ◽  
Author(s):  
Ehab M. Moawad ◽  
Ahmed A. Abd Elghany ◽  
Amr A. Gab-Alla ◽  
Osama M. Elbassiouny ◽  
Mohsen S. Badawy

Abstract Background The study aimed to assess the role of intraoperative mitomycin-C (MMC) application during hyperopic LASIK correction (+1.00 D to +6.00 D) by examining topographic corneal changes and incidence of regression over a one-year follow-up period. Methods This comparative randomized control study included 136 eyes of 68 hyperopic patients divided into two groups; Group A included 68 eyes of 34 patients that had LASIK with the application of 0.02% MMC for 10 seconds on the stromal bed after excimer laser treatment, and group B included 68 eyes of 34 patients that had LASIK without MMC application. Uncorrected distance visual acuity (UDVA), refraction, keratometry and topography were recorded at 1st week and 1st, 3rd, 6th, and 12th months postoperation. Predictability and treatment efficacy were also recorded at the end of the follow-up period. Results Better predictability was noted in group A than in group B at the 6 month and 12 month follow-up visits, with a mean cycloplegic refraction SE of +0.5 ± 0.31 D in group A and +0.67 ± 0.39 D in group B at the 6 month visit, and +0.63 ± 0.37 D in group A and +0.89 ± 0.48 D in group B at the 12 month visit. The efficacy of the treatment at the end of the follow up period was better in group A than in group B. Group A showed fewer topographic corneal changes than group B. Conclusions Intraoperative MMC application during hyperopic LASIK achieves better predictability and efficacy and induces fewer topographic changes and lower regression rate of hyperopia during the first postoperative year. Trial registration: the Pan African Clinical Trial Registry PACTR201901543722087, on 29 January 2019.


2019 ◽  
Author(s):  
Ehab M. Moawad ◽  
Ahmed A. Abd Elghany ◽  
Amr A. Gab-Alla ◽  
Osama M. Elbassiouny ◽  
Mohsen S. Badawy

Abstract Background The study aimed to assess the role of intraoperative mitomycin-C (MMC) application during hyperopic LASIK correction (+1.00 D to +6.00 D) by examining topographic corneal changes and incidence of regression over a one-year follow-up period. Methods This comparative randomized control study included 136 eyes of 68 hyperopic patients divided into two groups; Group A included 68 eyes of 34 patients that had LASIK with the application of 0.02% MMC for 10 seconds on the stromal bed after excimer laser treatment, and group B included 68 eyes of 34 patients that had LASIK without MMC application. Uncorrected distance visual acuity (UDVA), refraction, keratometry and topography were recorded at 1st week and 1st, 3rd, 6th, and 12th months postoperation. Predictability and treatment efficacy were also recorded at the end of the follow-up period. Results Better predictability was noted in group A than in group B at the 6 month and 12 month follow-up visits, with a mean cycloplegic refraction SE of +0.5 ± 0.31 D in group A and +0.67 ± 0.39 D in group B at the 6 month visit, and +0.63 ± 0.37 D in group A and +0.89 ± 0.48 D in group B at the 12 month visit. The efficacy of the treatment at the end of the follow up period was better in group A than in group B. Group A showed fewer topographic corneal changes than group B. Conclusions Intraoperative MMC application during hyperopic LASIK achieves better predictability and efficacy and induces fewer topographic changes and lower regression rate of hyperopia during the first postoperative year. Trial registration: the Pan African Clinical Trial Registry PACTR201901543722087, on 29 January 2019.


Author(s):  
Prachi Shukla ◽  
Suman Bhartiya

Introduction: Recurrence is the most common problem with pterygium excision. Various adjunctive methods have been described to decrease the recurrence rate of pterygium. Mitomycin C (MMC) and limbal Conjunctival Autograft (CAG) are most commonly used methods to reduce its recurrence. Aim: To compare the recurrence rate of pterygium and the complications with MMC eyedrops after bare sclera pterygium excision versus sutureless and glue free CAG. Materials and Methods: Total 104 eyes were divided into two groups (A and B) of 52 eyes each. Group A patients underwent bare sclera excision of pterygium followed by 0.01% MMC eye drops BD (twice a day) for five days and Group B patients had sutureless and glue free CAG using oozing blood as tissue adhesive after pterygium excision. The patients were followed-up postoperatively on day 1, day 3, day 7, one month, three months, six months and one year. All the patients were examined for recurrence and complications. Statistical analysis was done by using Statistical Package for the Social Sciences (SPSS) version 16 and student’s t-test was applied for comparison. Results: A total of 104 eyes of 92 patients were divided into two groups (A and B) of 52 each. The mean age of Group A was around 45 year and group B was around 43 years and the difference was statistically insignificant (p>0.05). Total three patients had recurrence in one year of follow-up in group A, out of which first case appeared before the end of 1st month, second before the completion of 3rd month and the third case at the last follow-up. In group B only one case presented with recurrence at 6th month follow-up. The difference between the recurrences in both the groups was statistically insignificant (p>0.05). Short term complications were observed in five patients in group A. One patient had corneal thinning; one had scleral thinning, two patients presented with avascular sclera and one patient with granuloma. In group B, 18 patients with graft retraction, eight with graft oedema, five with sub-conjunctival graft haemorrhage and one with granuloma were observed. All these complications resolved by the time. Long term complications were not observed in any patient of both the groups. Conclusion: This study concluded that the use of MMC eye drops (0.01%) BD or glue free and sutureless CAG after pterygium excision is safe and effective treatment modalities for pterygium.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
N Iwahashi ◽  
J Kirigaya ◽  
M Horii ◽  
T Abe ◽  
E Akiyama ◽  
...  

Abstract Background The early transmitral flow velocity (E) divided by the early diastolic velocity of the mitral valve annulus (e') is referred to as the “E/e' ratio,” is useful even for ST elevation acute myocardial infarction (STEMI). However, the role of late diastolic velocity (a') which reveals the atrial function for STEMI is still unclear. Objectives We evaluated the clinical usefulness of tissue Doppler including atrial function for a first-time STEMI by long time follow up. Furthermore, we evaluated the meaning of each parameters by performing immediately after PCI or 2 weeks later. Methods We treated consecutive 571 first-time STEMI patients by immediate PCI within 12 hours after onset, and we examined 270 patients at immediately after PCI (GroupA, 65 years, 250 male) and 301 patients at 2 weeks after onset (GroupB, 64 years, 243 male). We examined trans mitral flow and TDI, then defined E/e' as LV filling pressure and A/a' as left atrial function. We followed them for a long time (>5 years). The primary end point (PE) was cardiac death or re-admission for heart failure (HF). Results We followed the patients in Group A for 10 years, Group B for 5 years. PE occurred in 64 patients in GroupA during 10 years, and 45 patients in GroupB during 5 years. We analyzed the univariate and multivariate Cox hazard analyses and we compared e' and a', E/e' and A/a' (Table). In GroupA, a' and A/a' were the independent predictors, on the other hand neither a' nor A/a' were the predictors in GroupB. E/e' was an independent predictor both in GroupA and B. Conclusion TDI parameters have different meanings by the timing of echocardiography after onset of a first-time STEMI. These results demonstrated that atrial dysfunction immediately after onset of STEMI suggests the poor prognosis after STEMI. Cox Hazard Proportional Analysis Funding Acknowledgement Type of funding source: None


Author(s):  
Akshaya Patil

Lifestyle disorders like unhealthy dietary habits, physical habits, disturbed sleep and rest patterns are the principal factors that cause many digestion related disease. Irritable bowel syndrome (IBS) is also one such disease which occurs due to the ingestion of unwholesome diet causing disturbances in Agni. According to Ayurvedic science, this disease can be considered as a Grahani roga. So we may consider IBS as Grahani roga. Various herbal medications and panchakarma (biopurification) procedures are described in the treatment of Grahani roga though there is no reliable medical treatment for IBS in modern medicine; various efforts have been made to overcome this problem by the virtue of Ayurvedic therapy. The present study was done to assess the efficacy of Panchmooladya choorna with Takra(buttermilk) as anupan in Group A(10Patients) and Group B(10Patients)with luke warm water as anupan in management of Grahani roga in total of 20patients.The results of therapy were assessed by various parameters after 1month with follow up of 15days.The result concluded that Panchmooladya choorna with Takra as anupan reduced the symptoms of Grahani rog as compared to Group B.


2019 ◽  
Vol 5 (1) ◽  
pp. 64-68
Author(s):  
Ali Imam Ahsan ◽  
Nasimul Jamal ◽  
Ashfaq Ahmad ◽  
Syed Farhan Ali ◽  
Momenul Haque

Background: Treatment of granular myringitis (GM) is diverse with no definitive management. Objective: The aim of the present study was to see the effectiveness of different interventions for treating granular myringitis. Methodology: This was a single centred, parallel, randomized control trial. This study was done at the Specialized ENT Hospital of SAHIC, Dhaka from July 2010 to June 2012. Patients presenting with granular myringitis of 18 years of age or more with both sexes were included. All patients were divided into two groups by simple random sampling method of which patients of group A were treated by surgical treatment and that of group B were treated by medical treatment. Medical treatment was given in the form of topical ear drops and surgical treatment was performed by surgical debridement of granulation tissue followed by chemical cauterization. Repeated follow up was performed up to 6 months in both groups of treated patients. The primary outcome was the resolution of granulation tissue. During follow-up the secondary outcome variables were recurrence, perforation of the TM and any other complications or complain from the patients. Results: A total number of 60 patients were studied of which 30 patients were treated medically and 30 patients were treated surgically. The cure rate was higher in surgical treatment (80%) than conservative (16.7%) (p=0.011). The recurrence rate (17.24%) is also less in surgical group compared to medical treatment group (77.27%) (p=0.001). Conclusion: Surgical treatment is a more successful treatment modality for granular myringitis. Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 64-68


Vascular ◽  
2019 ◽  
Vol 27 (5) ◽  
pp. 518-523 ◽  
Author(s):  
Gergana T Taneva ◽  
Marco V Usai ◽  
Georgios A Pitoulias ◽  
Giovanni Torsello ◽  
Martin Austermann ◽  
...  

Aim To evaluate the performance of two different flexible devices, the balloon-expandable BeGraft stent as on-label chEVAR use with the Endurant (Medtronic, Santa Rosa, USA) stent graft compared to the self-expandable off-label employment of Viabahn (Gore Flagstaff, Arizona, USA). Methods All patients treated for pararenal aortic pathologies between 2008 and 2017 using Endurant II (Medtronic, Santa Rosa, CA, USA) abdominal endograft in combination with Viabahn (Gore, Flagstaff, AZ, USA) or BeGraft (Bentley, Hechingen, Germany) at our institution were retrospectively analyzed. Patients were divided into two groups according to the employed chimney graft, namely Viabahn (group A) and BeGraft (group B). The primary endpoint was the incidence of type IA endoleak at one month and last follow-up. Secondary endpoints included reintervention rates, primary patency of the chimney graft, and need for additional placement of bare metal stents also known as relining. Results A total of 27 patients (mean age: 76 years) were treated with overall 47 chimney grafts. In particular, 11 patients received 21 Viabahn and 16 patients underwent placement of 26 BeGraft stents. Mean follow-up was 14.3 ± 9.0 months for group A and 13.0 ± 13.7 for group B, p = .451. The mean chimney graft length was 85.1 ± 38.9 mm for group A and 34.9 ± 9.8mm for group B ( p < .001). The oversizing rate at the proximal sealing zone was significantly higher in group B (Group A: 23.1 ± 16.5% vs. Group B: 33.6 ± 7.6%, p = .007). The primary patency rates were similar between groups ( p = .250). The subgroup analysis showed a significantly higher early (9–42.9% vs. 2–7.7%, p = .005) and at last CT follow-up (5–23.8% vs. 0–0.0%, p = .011) type IA endoleak, higher primary relining (14–66.7% vs. 5–19.2%, p = .001) and reintervention rates (5–23.8% vs. 0–0.0%; p = .011) for group A chimney stent grafts. Conclusions Both chEVAR combinations displayed similar patency rate, showing the BeGraft-Endurant composition less need for relining and fewer one-year type IA endoleak and reintervention rates in the subgroup analysis.


Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 825-825
Author(s):  
Dmitriy Zamarin ◽  
Manisha Bhutani ◽  
Danielle Chimento ◽  
Sergio Giralt ◽  
Nikoletta Lendvai ◽  
...  

Abstract Abstract 825 BACKGROUND: Autologous stem cell transplantation (ASCT) is a widely used therapeutic option in first line treatment of multiple myeloma (MM). However, many patients eventually relapse. While precise knowledge of relapse and progression (R/PD) patterns would be important to generate evidence based surveillance recommendations after ASCT, such data is limited in the literature, especially in the era following the introduction of the free light chain assay. The purpose of this study is to examine the patterns of post-ASCT relapse and to derive evidence based recommendations for optimal surveillance of patients. METHODS: We performed a retrospective analysis on 258 patients with MM who underwent ASCT within one year of diagnosis at MSKCC between 2000 and 2010, as part of first line therapy. We used the IMWG standard criteria for serologic and clinical R/PD. We first determined for all patients the date of serologic R/PD. Patients identified as having serologic R/PD were further examined to determine whether clinical (anemia, renal failure, hypercalcemia, development of soft tissue lesions), radiologic (skeletal survey) or urinary R/PD had anteceded serologic R/PD. Several groups of patients were derived and further analyzed in terms of relapse patterns and adequacy of follow up. RESULTS: Among 258 patients, 173 were determined to have serologic R/PD at a median of 19.2 months post-transplant. Among these patients, on the dates of their serologic R/PD, 17 (9.8%) had concurrent overt symptomatic evidence of clinical/radiologic R/PD (Group A symptomatic R/PD), while 156 (90.2%) were found to have isolated asymptomatic serologic R/PD without apparent evidence of concomitant clinical/radiologic R/PD (Group B asymptomatic R/PD). Group A included patients with distinct and sometimes coinciding clinical characteristics (poor risk cytogenetics with aggressive disease (n=3), leptomeningeal relapse (n=1), soft tissue relapse (n=4) and acute severe anemia at relapse (n=3)); patients with IgA gammopathy (n=5); and patients considered to have inadequate serologic follow up intervals (range of follow up interval between date of serologic R/PD and prior serologic testing 149 to 245 days) (n=6). Upon further examination of group B, 44 patients had radiologic imaging at the time of serologic R/PD (within 4 weeks following the date of serologic R/PD). Fourteen among them (32%) had evidence of new bone lesions. Among all 173 patients with serologic R/PD, 83 patients had a skeletal survey within one year prior to the date of serologic R/PD. Only 3 (3.6%) had evidence of radiologic R/PD anteceding serologic R/PD. All 3 patients were considered to have had inadequate serologic follow up interval (Range 208 to 252 days). Abnormal urine immunofixation (UIF) anteceded serologic R/PD in 5 out of 41 (12%) patients tested who had achieved CR post transplant. In these patients the abnormal UIF anteceded the serologic R/PD by a mean of 2.4 months. Abnormal UPEP anteceded serologic R/PD by 1.9 months in only 1 out of 40 (2.5%) patients tested who had achieved less than CR post transplant. CONCLUSIONS: Based on the results of this analysis, several conclusions can be drawn: 1) The vast majority of R/PD in patients with MM are asymptomatic R/PD detected first by serologic studies. A small percentage of patients (those with aggressive cytogenetics, specific relapse types including soft tissue, severe cytopenia, and IgA gammopathy) will have symptomatic R/PD with overt concomitant evidence of clinical and/or radiologic R/PD at the time of serologic R/PD; 2) Among patients who have apparent asymptomatic R/PD, a significant percentage will have evidence of skeletal lesions and therefore imaging should be recommended in these patients; 3) In the absence of serological R/PD, routine surveillance screening with yearly skeletal surveys cannot be recommended based on this analysis since this test was not useful in any of the analyzable patients in whom it was obtained; 4) Aside from few patients in CR whose relapse may be detected earlier by UIF (with probably no clinical benefit), all patients with multiple myeloma whose disease progresses will have serologic R/PD at the time of progression and follow up limited to serologic testing may well be sufficient for monitoring patients with MM post transplant. Disclosures: No relevant conflicts of interest to declare.


Author(s):  
Pragya Verma ◽  
Dolly Chawla ◽  
Rashmi Khatri ◽  
Preeti Verma

Background: Despite of wide spread use of prophylactic antibiotics and various antiseptic measures, post-operative infection remains one of the significant and serious complication of caesarean delivery contributing to high maternal morbidity and mortality. Objective was to study the incidence of post-operative infectious morbidities in patients with/without povidone iodine vaginal cleansing done prior to caesarean section.Methods: A prospective randomized control study was done in the department of obstetrics and gynecology of Dr. Baba Saheb Ambedkar Medical College and Hospital, New Delhi.Results: Mean age of participants in group A is 26.22±2.47 years and in group B is 26.48±2.3 years. Majority women (84.0%) underwent emergency lower segment caesarean section (LSCS). (6.4%) women developed post-operative endometritis, out of which maximum (4.6%) belong to no vaginal cleansing group (B) compared to 1.8% in povidone iodine vaginal cleansing group(A), which is statistically significant (p=0.01). Over all (13%) women had post-operative fever, with significant difference among the two groups i.e. (8.6%) were in group B versus (4.4%) in group A (p=0.005).Conclusions: Povidone iodine vaginal cleansing prior to caesarean section is significantly effective in reducing post-operative infectious morbidities.


2016 ◽  
Vol 23 (03) ◽  
pp. 246-250
Author(s):  
Yousaf Jan ◽  
Waqas Ahmad ◽  
Shaukat Hussain ◽  
Muhammad Shah ◽  
Ahmad Din

Objectives: To evaluate and compare the effect of aspiration plus methylprednisone injection versus surgical excision of the dorsal wrist ganglions in terms of resolution,complications and recurrence. Study Design: Prospective study. Setting: Surgical wardHayatabad Medical Complex, Peshawar. Period: June 2009 to December 2011. Methodology:After taking permission from ethical and research committee. Included patients were all adult ofboth gender with dorsal wrist ganglion. Patients with cancer, bleeding disorders and diabeteswere excluded from the study. The patients were divided in two groups: Group A includedpatients for aspiration and injection treatment, while Group B included patients underwentsurgical excision. All the patients were followed for complete resolution of ganglion, anycomplications of treatment and recurrence within one year. Follow up arranged at 7th day, 1,3, 6 and 12 months. Results: Total of 80 patients was included in the study. Out of 80, 65%(n=52) were females while 35% (n=28) were males. The mean age was 26.37±5.62 years.Group A and group B patients had overall success rates of 75% and 95%, with recurrence of25% and 5% in group A and group B respectively. In methylprednisolone group, mild pain wasreported by 70% (n=28), while in the surgical excision group, all the patients experienced mildto moderate pain postoperatively which necessitated oral analgesics for few days. Conclusion:Surgical excision is superior to injection-aspiration method for dorsal wrist ganglion treatmentbecause of high success and low recurrence rate. As injection-aspiration treatment


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