scholarly journals EFFICACY AND SAFETY OF LOW DOSE ATROPINE 0.01% IN SLOWING OF PROGRESSION OF MYOPIA

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Shalini Gupta ◽  
Poonam Gupta ◽  
Rashi Verma ◽  
Basudeb Gosh ◽  
Rakesh Bhardwaj
Keyword(s):  
Low Dose ◽  
Eye Drops ◽  
Efficacy And Safety ◽  
Visual Disability ◽  
Myopia Progression ◽  
Rapid Progressors ◽  
Significant Difference ◽  
Progressive Myopia

Background: Myopia, commonly referred to as short sightedness is a form of refractive error and is a very common cause of visual disability throughout the world. Methods: Hospital based prospective study conducted on 100 patients of Myopia attending to Department of Opthalmolgy. Results: There was no significant difference in the age, gender distribution, baseline myopia progression or follow-up duration between patients who used night application compared with daytime atropine. Effectiveness was better with daytime application. Conclusion: 1% atropine eye drops were well tolerated and efficacious for the retardation of progressive myopia in Indian eyes. Effectiveness was better with daytime application. Further studies are necessary to assess the role of 1% atropine in the rapid progressors and patients poorly responding to low-dose atropine. Keywords: Myopia, Atropine, low dose.

scholarly journals Myopia: Efficacy of 1% Atropine in Retarding Progression

2020 ◽  
Vol 3 (4) ◽  
pp. 114-118
Author(s):  
Mashhood-uz-Zafar Farooq ◽  
◽  
Shama Mashhood ◽  
Sana Adeeba Islam ◽  
Raffat Rasool ◽  
...  
Keyword(s):  
Treatment Group ◽  
Demographic Data ◽  
Health Clinic ◽  
Control Group ◽  
P Value ◽  
Eye Drops ◽  
Myopia Progression ◽  
Total Period ◽  
Significant Difference

Purpose: To determine the efficacy of 1% atropine eye drops in control of myopia progression. Methods: This was a Case control study, conducted at the Mohsin Family Health Clinic, Block-16, Federal B Area, Karachi, during January 2018 to December 2019. A total of 194 (97 cases and 97 controls) cases were included in the study by the calculation of online software openepi.com. The Treatment Group was given 1% atropine eye drops while Control Group received no treatment. The follow-up of all the cases was carried out according to the follow-up schedule for a total period of one year. All the demographic data, clinical findings and the follow-up results were recorded on a proforma designed for the study, and the results were tabulated. Results: A total of 194 children age 6-15 with best corrected visual acuity 6/6 were recruited in this study. Half of the children were included in treatment group who received once a day application of 1% atropine eye drops at bedtime. The other half received no treatment and were taken as control group. Mean spherical equivalent refraction (SER) at baseline was 2.93±0.69 of Treatment Group and 2.98±0.61 of control group with insignificant P-value of 0.461. After 1-year treatment statistically significant difference with P-value 0.001, was observed with SER 3.37±0.91 in Treatment Group and 3.69±0.94 in control group. Conclusion: Atropine 1% eye drops is well tolerated and is found efficacious in controlling myopia progression.

scholarly journals A prospective comparative study to evaluate the efficacy and safety of olopatadine eye drops and bepotastine eye drops in subjects of vernal kerato conjunctivitis

2020 ◽  
Vol 9 (5) ◽  
pp. 706 ◽  
Author(s):  
Amatur R. Malahat ◽  
Sudhakar Kodudula ◽  
Vijaya L. Gali
Keyword(s):  
Comparative Study ◽  
Symptomatic Relief ◽  
Vernal Keratoconjunctivitis ◽  
Eye Drops ◽  
Efficacy And Safety ◽  
Conjunctival Hyperaemia ◽  
Parallel Group ◽  
Significant Difference ◽  
Ocular Discomfort

Background: Vernal keratoconjunctivitis (VKC) is an allergic eye disease that especially affects young boys. Both olopatadine and bepotestine are dual acting drugs that provide rapid symptomatic relief coupled with the long-term disease-modifying benefit. The present study is conducted to compare the efficacy and safety of olopatadine eye drops and bepotastine eye drops in patients of vernal keratoconjunctivitis.Methods: A prospective, randomized, parallel-group, comparative study is conducted over a period of 4 weeks on paediatric patients with VKC. 50 patients are recruited and randomized into two treatment groups. They received the assigned drugs for 4 weeks and are called for follow up at the end of 1st week, 4th week and 12th week. At each follow-up, patients are examined and the clinical parameters are graded.Results: This study shows that both olopatadine and bepotastine are equally efficacious. Bepotastine provided quicker relief to symptoms of watering, ocular discomfort and conjunctival hyperaemia. Number of responders are also more in the bepotastine group. Absolute eosinophilic count improved with both the drugs but there is no statistically significant difference between them. Both drugs showed good safety profile. However, 24% patients reported aversion to bitter taste with bepotastine. There is no treatment related severe adverse effects in both the groups.Conclusions: Both olopatadine and bepotastine are effective in treating vernal keratoconjunctivitis. However, bepotastine performed better in reducing tearing, ocular discomfort and conjunctival hyperaemia.

scholarly journals The role of high-dose steroid therapy in Covid-19 pneumonia

2021 ◽  
Author(s):  
Ayperi Ozturk ◽  
Figen Ozturk Ergur ◽  
Suna Kavurgacı ◽  
Melahat Uzel Şener ◽  
Murat Yıldız
Keyword(s):  
Mortality Rate ◽  
Low Dose ◽  
High Dose ◽  
Efficacy And Safety ◽  
Short Term ◽  
High Dose Steroid ◽  
Younger Age ◽  
Observation Period

Introduction: Today, whereas hypoxemia and respiratory failure is the major challenging problem in the course of severe COVID-19 pneumonia, to control the disease at a mild-moderate stage or to stop the inflammation by recognizing the cytokine storm early should be the most prominent goal. We aimed to reveal the clinical efficacy and safety of short-term high-dose corticosteroids in severe COVID-19. Material and Methods: This retrospective observational study consisted of 54 patients who were given high-dose steroid (HDS (>250 mg/day methylprednisolone, 3 days.). Low-dose steroid (LDS) therapy (dexamethasone 8 mg ) was applied to all patients. HDS group was reviewed in terms of decreasing hospital mortality and preventing fibrosis development in follow-up. Results: During the observation period, out of 317 severe COVID-19 pneumonia hospitalized, HDS and LDS were administered to 54 and 216 patients, respectively. Higher body mass index, younger age, more oxygen need of patients at admission, and more need for advanced oxygen therapy during hospitalization were found in the HDS group (p<0.001). Furthermore, 18.5% of patients in the HDS group had need transfer to the intensive care unit whereas it was 3.8% in LDS (p<0.001). Additionally, the mortality rate was determined higher in the HDS group (25. 9% vs 9.9%, p<0.001). The HDS group had lower saturated O2 [IQR, 85% (76-89), p <0.001], and higher ferritin at admission. It was found that HDS was given simultaneously with the increased ferritin with deepening lymphopenia on the third and fifth days. There was no difference in fibrosis development between HDS patients receive and not (15.4% vs 26.2%, p=0.11) Conclusion: The use of HDS in hospitalized COVID-19 patients remains unclear. Along with this, our study demonstrated the use of high-dose corticosteroids might not be associated with a lower mortality rate among hospitalized severe COVID-19 patients.

SUBLINGUAL VITAMIN D3 DRUG THERAPY IN VITAMIN D DEFICIENCY PATIENTS AT PRAVARA RURAL HOSPITAL

2019 ◽  
pp. 18-20
Author(s):  
Sanjeeva Kumar Goud T ◽  
Rahul Kunkulol
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Vitamin D3 ◽  
Serum Vitamin ◽  
Cross Sectional ◽  
Serum Vitamin D ◽  
Significant Difference ◽  
Before And After

The present study was aimed to study the effect of Sublingual Vitamin D3 on Serum Vitamin D level in Vitamin D deficiency patients. This was a cross-sectional and interventional study. All the Vitamin D deficiency patients of age 18-60years and either gender, willing to participate in the study were included. Patients who had greater than 20 ng/ml were excluded from the study. The total number of participants in our study was 200, out of these 111 males and 89 females, the mean age in our study was 51.07 ± 7.39Yrs. All volunteers were given sublingual vitamin D3 (60,000IU) in six doses every fifteen days of follow up for 3 months. The subject’s serum 25(OH)D levels were estimated before and after the treatment of sublingual vitamin D3. There was a statistically significant difference in serum vitamin D3 level before 16.61±6.71 ng/ml and after 35.80±7.80 ng/ml after treatment with Sublingual Vitamin D3. Six doses of 60,000IU of Vitamin D3 sublingual route having improved the role of serum 25(OH)D levels in the treatment of Vitamin D3 deficiency patients.Keywords: Vitamin D3; Sublingual route

Restaging of patients with lymphoma

2008 ◽  
Vol 47 (01) ◽  
pp. 37-42 ◽  
Author(s):  
T. Pfluger ◽  
V. Schneider ◽  
M. Hacker ◽  
N. Bröckel ◽  
D. Morhard ◽  
...  
Keyword(s):  
Low Dose ◽  
Non Hodgkin Lymphoma ◽  
Contrast Enhanced ◽  
Pet Ct ◽  
Significant Difference ◽  
18F Fdg ◽  
Sensitivity Specificity ◽  
Fdg Pet Ct

SummaryAim: Assessment of the clinical benefit of i.v. contrast enhanced diagnostic CT (CE-CT) compared to low dose CT with 20 mAs (LD-CT) without contrast medium in combined [18F]-FDG PET/CT examinations in restaging of patients with lymphoma. Patients, methods: 45 patients with non-Hodgkin lymphoma (n = 35) and Hodgkin's disease (n = 10) were included into this study. PET, LD-CT and CECT were analyzed separately as well as side-by-side. Lymphoma involvement was evaluated separately for seven regions. Indeterminate diagnoses were accepted whenever there was a discrepancy between PET and CT findings. Results for combined reading were calculated by rating indeterminate diagnoses according the suggestions of either CT or PET. Each patient had a clinical follow-up evaluation for >6 months. Results: Region-based evaluation suggested a sensitivity/specificity of 66/93% for LD-CT, 87%/91% for CE-CT, 95%/96% for PET, 94%/99% for PET/LD-CT and 96%/99% for PET/CE-CT. The data for PET/CT were obtained by rating indeterminate results according to the suggestions of PET, which turned out to be superior to CT. Lymphoma staging was changed in two patients using PET/ CE-CT as compared to PET/LD-CT. Conclusion: Overall, there was no significant difference between PET/LD-CT and PET/CE-CT. However, PET/CE-CT yielded a more precise lesion delineation than PET/LD-CT. This was due to the improved image quality of CE-CT and might lead to a more accurate investigation of lymphoma.

scholarly journals The Effect of Long-Term Low-Dose Atropine on Refractive Progression in Myopic Australian School Children

2021 ◽  
Vol 10 (7) ◽  
pp. 1444
Author(s):  
William Myles ◽  
Catherine Dunlop ◽  
Sally A. McFadden
Keyword(s):  
Low Dose ◽  
High Dose ◽  
Eye Drops ◽  
Myopia Progression ◽  
At Risk Children ◽  
Slow Group ◽  
Blue Eyes ◽  
Global Population ◽  
Axial Growth

Myopia will affect half the global population by 2050 and is a leading cause of vision impairment. High-dose atropine slows myopia progression but with undesirable side-effects. Low-dose atropine is an alternative. We report the effects of 0.01% or 0.005% atropine eye drops on myopia progression in 13 Australian children aged between 2 and 18 years and observed for 2 years without and up to 5 years (mean 2.8 years) with treatment. Prior to treatment, myopia progression was either ‘slow’ (more positive than −0.5D/year; mean −0.19D/year) or ‘fast’ (more negative than −0.5D/year; mean −1.01D/year). Atropine reduced myopic progression rates (slow: −0.07D/year, fast: −0.25D/year, combined: before: −0.74, during: −0.18D/year, p = 0.03). Rebound occurred in 3/4 eyes that ceased atropine. Atropine halved axial growth in the ‘Slow’ group relative to an age-matched model of untreated myopes (0.098 vs. 0.196mm/year, p < 0.001) but was double that in emmetropes (0.051mm/year, p < 0.01). Atropine did not slow axial growth in ‘fast’ progressors compared to the age-matched untreated myope model (0.265 vs. 0.245mm/year, p = 0.754, Power = 0.8). Adverse effects (69% of patients) included dilated pupils (6/13) more common in children with blue eyes (5/7, p = 0.04). Low-dose atropine could not remove initial myopia offsets suggesting treatment should commence in at-risk children as young as possible.

scholarly journals THU0517 THE ROLE OF ULTRASOUND-DEFINED SYNOVITIS GRADE I IN PATIENTS PRESENTING WITH INFLAMMATORY ARTHRALGIA, A RETROSPECTIVE STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 497.2-497
Author(s):  
J. Arroyo Palomo ◽  
M. Arce Benavente ◽  
C. Pijoan Moratalla ◽  
B. A. Blanco Cáceres ◽  
A. Rodriguez
Keyword(s):  
Rheumatoid Arthritis ◽  
Inflammatory Arthritis ◽  
Statistical Tests ◽  
Median Number ◽  
Painful Joint ◽  
Significant Difference ◽  
The Mean ◽  
Specialized Unit

Background:Musculoeskeletal ultrasound (MSUS) is frequently used in several rheumatology units to detect subclinical inflammation in patients with joint symptoms suspected for progression to inflammatory arthritis (IA). Synovitis grade I (EULAR-OMERACT combined score) is known to be a casual finding in healthy individuals, but studies headed to unravel its possible role on rheumatic diseases are sparse.Objectives:To investigate the correlation between synovitis grade I, and the diagnosis of IA made after a year follow-up period since MSUS findings, in patients of an MSUS-specialized unit of a Rheumatology Department.Methods:We conducted a descriptive, retrospective and unicentric study. 30 patients were selected from the MSUS-specialized unit of our Rheumatology Department from July-18 to January-19. Patients presenting synovitis grade 0 (exclusively), 2 and/or 3 on combined score were excluded. Data collection at baseline included age, sex, immunological profile and previous physical examination to the MSUS findings, as well as the diagnosis made by the rheumatologist in 1-year visit follow-up: dividing the patient sample into two groups: those who were diagnosed with IA and those not. Non-parametric statistical tests for comparing means were used.Results:The mean age was 51,6 years and 70% were females. 6 (20%) patients were diagnosed with inflammatory arthritis after a year follow-up: 2 (4,8%) psoriatic arthritis, 1 (3,3%) undifferentiated arthritis, 1 (3,3%) rheumatoid arthritis, 1 (3,3%) Sjögren’s syndrome. Non-inflammatory arthropathies were also found 24 (80%), of which, 12 (40%) were non-specific arthralgias and 8 (19%) osteoarthritis.In the group of patients who did not developed an IA the mean C-reactive protein (CPR) value was 3,12 mg/L and erythrocyte sedimentation rate (ESR) was 8,2 mm; all of them were rheumatoid factor (RF) positive and ACPA-negative except one patient. 5 (31,3%) patients presented low antinuclear antibodies (ANAs) levels. In those who HLA B-27 and Cw6 were tested (4,25%); both were negative except for one that was HLA B-27 positive. The median number of swollen and painful joint count was 0, and the mean of joints with MSUS involvement was 3,5; the mean involved metacarpophalangeal (MCP) joints was 1,83; proximal interphalangeal (PIP) joints was 1,48 and distal interphalangeal (DIP) joints 0,21.Among the group of patients that developed an IA the mean of CPR and ESR was 9,27 mg/L and 14,17 mm respectively; 2 (33%) patients were RF- positive, and 1 ACPA-positive. ANAs were positive in 3 cases (50%). The median of swollen joint count was 2 and for painful joint count was 0, the median of joints with MSUS involvement was 4,5. The mean of MSUS involvement was for MCP, PIP and DIP joints: 1,67, 2 and 0. Comparing the means of CPR values in the two groups with Student’s t-test we obtained a statistically significant difference (p=0,023). No other significant differences were found.Conclusion:Despite the limitations and possible statistical bias, the presence of MSUS-defined synovitis grade I and elevated CRP levels could be related to further diagnoses of inflammatory arthropathy. Besides, the absence of synovitis in DIP joints might have a diagnostic role. Normal physical exploration and normal levels of CRP might suggest low MSUS value. However, further research is needed to clarify the role of MSUS-defined synovitis grade I.References:[1]D’Agostino MA et al. Scoring ultrasound synovitis in rheumatoid arthritis: a EULAR-OMERACT ultrasound taskforce-Part 1: definition and development of a standardized, consensus-based scoring system. RMD Open. 2017;3(1):e000428.[2]Van den Berg R et al. What is the value of musculoskeletal ultrasound in patients presenting with arthralgia to predict inflammatory arthritis development? A systematic literature review. Arthritis Research & Therapy (2018) 20:228.Disclosure of Interests:None declared

Comparative Analysis on Low- and Standard-Dose Regimes of Alteplase Thrombolytic Therapy for Acute Ischemic Stroke: Efficacy and Safety

2017 ◽  
Vol 79 (1-2) ◽  
pp. 68-73 ◽  
Author(s):  
Guangjian Zhao ◽  
Tingfen Huang ◽  
Mei Zheng ◽  
Yansen Cui ◽  
Yunyong Liu ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Acute Ischemic Stroke ◽  
Dose Group ◽  
Low Dose ◽  
Standard Dose ◽  
Efficacy And Safety ◽  
Significant Difference ◽  
Symptomatic Intracranial Hemorrhage ◽  
Intravenous Alteplase

Objective: This study analyzed the efficacy and safety of low-dose and standard-dose alteplase intravenous thrombolytic therapy for acute ischemic stroke (AIS). Methods: Patients with AIS who underwent intravenous alteplase thrombolysis from July 2012 to December 2016 were retrospectively analyzed and correspondingly divided into low-dose (0.6–0.89 mg/kg) group and standard-dose group (0.9 mg/kg) according to alteplase dosage. The clinical outcome was evaluated by modified Rankin Scale (mRS) at 90 days after onset. The safety index was the mortality at 90 days after onset and the incidence of symptomatic intracranial hemorrhage (SICH) within 7 days. Results: A total of 1,486 patients were included (1,115 cases in low-dose group and 371 cases in standard-dose group). There were no significant differences in baseline data between the 2 groups. As mRS, good outcome rate as well as mortality rate in both groups had no significant difference (36.1 vs. 37.6%; χ2 = 10.882, p = 0.890; 5.5 vs. 7.3%; χ2 = 2.163, p = 0.076), but the incidence of SICH in low-dose group was significantly lower than that of the standard-dose group (2.2 vs. 5.9%; χ2 = 3.157, p = 0.001). Conclusion: The efficacy of low-dose alteplase intravenous thrombolytic therapy for AIS was equivalent to the standard-dose regimen but with higher safety.

A two different chemoprophylaxis approaches after phacoemulsification surgery in one thousand patients in Iraq

2020 ◽  
Vol 1 (3) ◽  
pp. 154-159
Author(s):  
Suzan Amana Rattan ◽  
◽  
Mahir Kadhim Mutashar ◽  
Keyword(s):  
Treated Group ◽  
The Other ◽  
Eye Drops ◽  
Topical Medication ◽  
Group Methods ◽  
Significant Difference ◽  
Infection And Inflammation ◽  
Group 2 ◽  
Age Range

AIM: To evaluate the effectivity of the combination of intracameral moxifloxacin 0.1% with subconjunctival triamcinolone acetonide 4 mg as prophylaxis of infection and inflammation after phacoemulsification in comparison with topical medication treated group. METHODS: A total one thousand patients with age range from 38 to 70 years old who scheduled for phacoemulsification were divided into 2 groups of no statistically significant differences in age, preoperative intraocular pressure (IOP) and central macular thickness (CMT), P=0.6, 0.9 and 0.8 respectively. The surgeries were done by 2 surgeons each one planned to use one method of prophylaxis at Eye Speciality Private hospital, Baghdad, Iraq. For the 1st group of patients (500) a topical moxifloxacin hydrochloride 0.5% and dexamethasone 0.1% eye drops were prescribed four times a day for 1mo postoperatively. For the 2nd group intracameral (IC) diluted moxifloxacin at 0.1% with subconjunctival (SC) triamcinolone 4mg in 0.4 cc were administered at the conclusion of the surgery. Follow up visits were on the first postoperative day, 1wk, 1mo, and 3mo postoperatively. Anterior chamber (AC) reaction was examined during the 4 visits while IOP was measured during the last 3 and CMT was measured only in the last one. RESULTS: The current clinical trial study compared 2 samples with 2 different prophylaxis methods. No endophthalmitis case reported in both group. By a 2-Sample t-test, the IC-treated group (group 2) had statistically significant lower AC cells at the 1st day postoperative visit than the other group while there were no statistically significant differences at 1wk, 1 mo and 3mo visits between the 2 groups. There was no statistically significant difference at 3mo visits in IOP and CMT between the two groups. A breakthrough inflammation rate with the topical medication was (9.6%) while in the other group (IC treated ) was 4.0%. A significant IOP elevation ≥10 mm Hg at 1mo in 2.4% within the topical medication group which was higher than the rate in the other group (0.8%). CONCLUSION: In addition to the safety and effectivity of the combination of intracameral moxifloxacin and subconjunctival triamcinolone in preventing infection and inflammation after cataract surgery. The majority (480) of our included patients didn’t require any topical postoperative medication that is cost saving for the patient, helped patients who were unable to administer topical medication, and decreased chance of complication related to patient poor adherence to postoperative medication.

Role of Diffusion Weighted Imaging in Differentiating Benign from Pathological Vertebral Compression

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Faten Mohammed Mahmoud Kamel ◽  
Hazem Ibrahim Abdel Rahman ◽  
Amany Sayed Khaleel Ahmed Elkhayat
Keyword(s):  
Vertebral Fractures ◽  
Diffusion Weighted Imaging ◽  
Laboratory Evaluation ◽  
Vertebral Collapse ◽  
Adc Value ◽  
Conventional Mri ◽  
Diffusion Weighted ◽  
Significant Difference

Abstract Background Vertebral collapse is a common problem due to benign conditions (trauma, infection, osteoporosis) or malignant process. And although the spine is the most common site of bone metastases (39% of bony metastases in patients with primary neoplasms) benign vertebral fractures due to osteopenia occur in one third of cancer patients, making it essential to determine whether the cause of vertebral collapse is benign or malignant. Aim of the Work To establish the role of DWI in differentiating benign from pathologic vertebral fractures using ADC values in comparison with histopathology report /laboratory evaluation and clinical follow-up. Patients and Methods A cross sectional study is approved by the ethics review board of Ain Shams University Hospital (Al Demerdash). All patients provided informed consent for the MR imaging examinations and for inclusion of their data in this analysis. From April 2020 to october 2020, 25 cases with previous imaging with vertebral compression underwent conventional MRI study on the affected region. Diffusion weighted imaging and ADC was added. Results We performed DWI using maximum b-values 600, and quantitative analysis, named apparent diffusion coefficient (ADC). We correlated the ADC number to histopathology, laboratory finding and clinical follow up. In our study there was significant difference (p &lt; 0.04) between DWI of the benign and malignant groups. Also the ADC value showed significant difference &lt;0.001. The mean ADCs of benign VCFs were higher significantly than those of pathological fractures. Conclusion DWI with ADC value was helpful when added to conventional MRI to differentiate benign from pathological (malignant) vertebral compression. It should be a routine sequence in patients with vertebral compression fractures for accurate diagnosis and successful management also can decrease no of biopsies.

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