Comparison of Intravitreal Dexamethasone Implant and Ranibizumab in Vitrectomized Eyes with Diabetic Macular Edema

Purpose. This retrospective study aimed to compare the efficacy of intravitreal ranibizumab (IVR) and intravitreal dexamethasone implant (IDI) for pseudophakic vitrectomized eyes with diabetic macular edema (DME) in a single institution. Methods. Pseudophakic vitrectomized eyes with treatment-naïve center-involved DME were enrolled, with one eye in each patient. They were divided into two groups: one group receiving IDI every 3 to 4 months and another group receiving IVR using 3 monthly plus treat-and-extend injections, all with monthly follow-up for 6 months. Switch of intravitreal drugs or deferred macular laser was not allowed. Primary outcome measures included change in central foveal thickness (CFT) in 1 mm by spectral-domain optical coherence tomography and best-corrected visual acuity (BCVA) at Month 6. Results. Twenty-two eyes were included in the IDI group and 26 eyes in the IVR group. The baseline demographics, glycosylated hemoglobin level, intraocular pressure (IOP), BCVA, and CFT did not significantly differ ( p > 0.05 ). Compared to baseline data, CFT decreased and BCVA improved significantly after either IDI or IVR at Month 6 ( p < 0.05 ). Significantly better mean final BCVA (0.38 logMAR vs. 0.62 logMAR, p = 0.04 ), more mean visual gain (−0.30 logMAR vs. −0.15 logMAR, p = 0.02 ), lower mean final CFT (310.9 μm vs. 384.2 μm, p = 0.04 ), and larger mean CFT decrease (−150.0 μm vs. −60.1 μm, p = 0.03 ) were found in the IDI group compared to those in the IVR group. A smaller mean treatment number (2.6 vs. 5.6, p < 0.001 ) and higher rate of postinjection ocular hypertension requiring topical hypotensive agent therapy (27.3% vs. 0%, p = 0.0002 ) were demonstrated in the IDI group than those in the IVR group. Conclusion. We concluded that IDI and IVR can both effectively treat vitrectomized eyes with DME. Dexamethasone implants had significantly better visual/anatomical improvement, smaller treatment number, and higher rate of elevated IOP after injection than IVR in pseudophakic vitrectomized eyes with DME in a 6-month period.

Management of Bhagandar (Fistula in ano) by Ksharasutra – A Review

Bhagandara is a single or multiple opening around guda Pradesh associated with different types of discharge along with pain. Acharya sushruta has described bhagandara on its consequences under astamahagada. The disorder has reached a height due to an unhealthy lifestyle. It can be correlated with fistula in ano. Fistula in ano is an abnormal hollow tract or cavity lined with granulation tissue. It is a nasty condition for the patient and often creates issue which leads to unease. It affects their daily lifestyle. For the treatment number of the surgical method are available.In Ayurveda, Acharya Sushruta has described various types of treatment like Chedana karma, Ksharasutra therapy. In modern science fistulectomy, fistulotomy, seton, and so on. But due to reoccurrence, damage of the anal ring, incontinence, and complication, Ksharasutra stands as a major para surgical procedure to cure bhaganadara. Ksharasutra is a unique medicated thread that helps in cutting as well as drainage of the fistulous tract. It works as cutting and healing of fistulous tract simultaneously. Hence the possibility of damage to the anorectal sphincter muscle is less and chances of incontinence are null. It is safe minimal, cheap, and easy to use. It works effectively on various stages.

The Impact of Extracorporeal Shockwave Therapy on the Reported Pain Levels of Chronic Patients in a Clinical Setting

BackgroundA review of literature for in-office, low to medium energy (.04mj/mm2 to .4mj/mm2) Extracorporeal Shockwave Therapy (ESWT) shows a substantial body of evidence suggesting strong efficacy and safety for the use of this form of Acoustic Compression Therapy. Much of this evidence is focused on the treatment of a specific region of the body, such as lateral epicondylitis, plantar fasciitis, and shoulder tendinopathies. This evaluation is designed to address the clinical utility of low to medium energy ESWT in an outpatient health care office setting, including delivery to multiple regions of the body, and for patients considered good candidates based on the failure of at least six months of prior conservative care.MethodsOrdinary least squares (OLS) models with errors clustered at the patient level estimate the association between shockwave treatments and patient-reported pain levels. Additional models utilizing polynomial treatment indicators test for a non-linear relationship between treatment number and reported pain level.ResultsFor the sixty-one patients represented in this analysis, the mean reduction in pain was 2.3 points on a 10 point scale, representing a 47% reduction in average reported pain levels. Results suggest that each treatment is associated with a 0.33 point reduction in reported pain levels (on a 10 point scale), controlling for patient demographics and treatment intensity. Additional models utilizing polynomial treatment indicators suggest a non-linear relationship between treatment number and reported pain level, indicating that the initial benefit of treatment is a 0.67 point reduction in pain for the first treatment, and falling slightly with each subsequent treatment. A subset of patients responded to follow up requests to ascertain reported pain levels at least three months after the final treatment. All patients were contacted, out of which 24 responded, reporting average pain levels of 2.9 out of 10, a substantial improvement from initial reported pain levels following final treatment (4.0), representing a decrease of 28%.ConclusionThe results suggest the use of Acoustic Compression at these doses on properly selected cases can improve clinical outcomes for conservatively treated patients who may otherwise end up requiring more aggressive measures in the absence of ESWT. Evidence reviewed suggests that continued healing time leads to further improvement.

COEFFICIENT OF VARIATION: A NEW APPROACH FOR THE STUDY IN MAIZE EXPERIMENTS

The magnitude of the variation coefficient (CV) is insufficient to validate the quality of the experiment, regardless of the number of treatments, repetitions and effect of treatments. The objective was to develop a new approach to the study of coefficient of variation, as well as evaluations of these nuances with applicability in new scientific research. The study was conducted via computer simulation. The replicates (r) ranged from 2, 3, 4, 5, 10 to 20. The treatment number (t) ranged from t 5, 10, 15, 20, 25 and 30. In each of these combined scenarios we have the variation of 25 different CVs, ranging from 1, 3, 5, 7, ..., 49 to 51 %. It was imposed the variation of 11-1 treatment effects 0, 240, 480, 720, ..., 2000, 2400 kg ha-1, totaling 9,900.00 scenarios. The type I error is statistically invariant in the scenarios studied. With high treatment effect the CV has no implications on the power of the test (1-β). The results obtained in this research reveal that experiments with a high percentage of CV are sufficient to obtain high probabilities of the power of the F test, which do not compromise the complementary analyzes.

Awareness and attitude of Saudi parents towards pulp therapy of the primary teeth: survey based study

Background: Some parents believe that it’s not worth to treat and spend money on this tooth because they will shed after all. Many of them are not aware that primary dentition should be maintained in the dental arch in a healthy state for the overall health of the child.Methods: The survey included questions related to demographics, such as gender and educational level. Further investigative questions included the need of pulp therapy in primary teeth, knowledge about pulp treatment, importance of pulp treatment, number of dental visits, reason of dental visit, filling of carious tooth and preference of pulp therapy.Results: The total number of questionnaires filled by participants was n=736. Out of which, 104 (14%) were males and 632 (86%) females. As far as the educational levels were concerned, 81 (11%) had completed primary school, 110 (15%) had completed high school and 545 (74%) were graduates from university.Conclusions: Overall there was no statistically significant difference between the subgroups of gender and educational level.

PEMANFAATAN BOKASHI FESES SAPI TERHADAP PRODUKTIVITAS RATUN SORGUM VARIETAS KAWALI

UTILIZATION OF BOKASHI FESES COW ON PRODUCTIVITY RATOON OF KAWALI SORGHUM VARIETY. This study aims to determine the effect of bokashi cow feces on the productivity of ratoon sorghum variety of kawali. This research was implemented in Wusa village at districts Talawaan. The design used was completely randomized design (CRD), which consists of 4 treatments and 5 replications to obtain 20 units of trial. The treatment consists of P0= without fertilization, P1= 4 kg of fertilization, P2= 8 kg of fertilization, P3= 12 kg of fertilization. The measured variables are number of tillers, plant height, and panicle weight. Result of the analysis showed that treatment with 12 kg/plot provides highly significant effect (P <0.01) of the number of tillers, plant height, and panicle weight compared with other treatments, ie 8 and 4 kg/plot. The HSD test indicated that treatment number of tillers showed that between treatment P3, P0, P1, and P2 showed highly significant. In the treatments of advanced test HSD indicated also that plant height between P3, P0, P1, and P2 showed highly significant. In the treatment of panicle weight of advanced test of HSD showed that between treatment P3 and P0, treatment of P3 and P1 is very different, but the treatment of P3 and P2 showed no significant difference. Based on this research it can be concluded that cattle feces bokashi as the organic fertilizer up to 12 kg produced the best effect on number of tillers, plant height, and panicle weight. Keywords: Bokashi, productivity, ratoon, sorghum, kawali