Iqra Mushtaq

Abstract

Introduction: Cataract surgery now, is not just rehabilitative surgery but therapeutic also, as patient wants to be ridden off glasses. Surgically induced astigmatism (SIA) is the cause of poor post-operative vision even af ter uneventful cataract surgery. Aims and Methodology: The aim of study was to compare the astigmatic outcomes and incision integrity in 5.5mm temporal clear corneal incision (TCCI) and superior scleral incision (SSI) in phacoemulsification surgery. A total of 200 eyes were included. Cases were randomly divided in two groups. Group A underwent phacoemulsification with TCCI and Group B with SSI, of 5.5mm length. Patients were followed up on post operative day (POD)1,8,40,90,180 Postoperative astigmatism was recorded by keratometry, SIA was analyzed by SIA Software and incision integrity observed by slit lamp examination. Results: Mean Post-operative astigmatism in TCCI group was 0.90, 0.87, 0.79, 0.75, 0.73D on POD 1, 8, 40, 90, 180 respectively, and that in SSI group was 1.43, 1.37, 1.28, 1.24, 1.24D. It was low in TCCI group and statistically significant. Mean SIA in group A was 1.13(0.59), 1.15(0.5), 0.99(0.42), 0.92(0.44), 0.90(0.46) on POD1, 8, 40, 90 and180. The change from POD1 to 40 was significant and there was no further significant change in SIA upto 6months. In group B, SIA was 0.9 2(0.48), 0.92(0.39), 0.80(0.34), 0.75(0.30) and 0.76(0.36) on POD1, 8, 40, 90 and 180. The change from 1st to 40th day was significant and there was mild decrease in SIA on POD 90 and POD 180 but not significant compared to POD 40. Conclusion: Though SIA was high and statistically significant in TCCI group but postoperative astigmatism was less and statistically significant. There was significant WTR shift in postoperative astigmatism in TCCI group and ATR in SSI group. Large incision size of upto 5.5mm clear corneal incision can have self-sealing properties hence dismissing the use of suture. Keywords: Astigmatic outcomes Incision integrity, Postoperative astigmatism surgically induced astigmatism.

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Introduction: Lymphadenopathy is one of the commonest clinical presentations in children and a common scenario for pediatrician. Unexplained lymphadenopathy often poses a great deal of anxiety and concern in parents. Fine needle aspiration cytology (FNAC) is a minimally invasive, cost effective and a well established technique as a high diagnostic efficacy tool. FNAC especially in benign inflammatory condition has aided in clinical practice by avoiding unnecessary excision biopsies also limiting its complications and psychological trauma to patient. The present study was conducted to evaluate FNAC as a diagnostic tool in pediatric lymphadenopathy and study spectrum of various cytomorphological patterns in paediatric age group. Materials and Methods: The present study was undertaken in the Department of Pathology, in a tertiary care hospital in Maharashtra. Reports of 312 pediatric FNAC (<16years) of various lymph nodes were studied from July 2014 to November 2017 retrospectively. Results: Maximum number of aspirates were found in 12-16 years (38.78%) i.e older age group and were of benign nature i.e. 96.80% with remaining (3.20%) malignant in nature. Anterior cervical lymph nodes predominate over other lymph nodes (41.02%) followed by posterior cervical lymph nodes (31.40%) when FNAC anatomical site subdivision was done. Maximum number of aspirates were found to be reactive lymphadenitis (61.53%) followed by tuberculous lymphadenitis (8.65 %). Conclusion: To conclude fine needle aspiration cytology has emerged as a reliable initial screening tool in all the lymphadenopathy cases in pediatric age group due to its cost-effectiveness and high diagnostic accuracy. A spectrum of different lesions can be evaluated by using FNAC. Pediatrician plays a very important role by taking initiative in referring all the pediatric patients for FNAC, in a resource limited settings like India. Keywords: Fine needle aspiration cytology, Lymphadenopathy, Lymphadenitis.

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Abstract

Introduction: Haemoglobinopathy is a major genetic public health problems in India, responsible for significant morbidity and mortality. Individuals with trait (carriers) are healthy and unaware of their carrier status unless specifically screened. If a couple carry a clinically significant haemoglobinopathy trait there is a 1 in 4 chance with each pregnancy that their child will inherit a major haemoglobinopathy. The most effective approach to reduce the burden of the society is to reduce the incidence by implementation of a carrier screening programme. Material and Methods: The present study was carried out in a tertiary care hospital for a period of 2 years. 500 Antenatal patients attending Obstetric-out patient department for routine check-up were included in the study. Screening of patient was done by Solubility test, Sickling test and Alkali denaturation test. Finally a very standardized method to detect HbA2 and HbF was done by using an automated High Performance Liquid Chromatography. Results: Out of a total of 500 pregnant women 4% were having haemoglobinopathies, whereas 96% had normal haemoglobin. Out of 20 cases, maximum number of cases i.e. 2.2% was of ? –Thalassemia trait, followed by Sickle cell trait cases i.e. 1.2%. Other haemoglobinopathies are also found i.e. sickle cell disease 0.2% ?? Thalassemia case 1.2% and double heterozygous 0.2%.Out of a total of 20 positive pregnant women only partners of 8 women were screened and out of them 37.5% were found positive. Conclusion: Detection of carrier status using HPLC during pregnancy along with couple screening provides prospective parents with the option of testing the fetus for hemoglobinopathy. Keywords: Antenatal, Double heterozygous, Haemoglobinopathies, High Performance Liquid Chromatography, ? –Thalassemia trait.  

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