RESUMO
The aim of the study is to introduce a newer technique of conjunctival incision called ‘Limbus Sparing Limbal Incision (LSLI)’ for horizontal rectus muscle strabismus surgeries. Methods: 20 patients were randomly divided into two groups of 10 each. In group 1, the conventional limbal incision was given in the conjunctiva and in group 2, a modified limbal incision, Limbus Sparing Limbal Incision (LSLI) was given. Each patient was followed post operatively on 1st, 7th and end of six weeks. Symptoms like pain, discharge, FB sensation, conjunctival congestion, excessive watering and lid swelling were noted. A record was also made of the conjunctival hyperaemia/chemosis, gaping in conjunctival incision, conjunctival retraction/coiling, thickened conjunctival flap, suture granuloma, corneal abrasion, dellen formation, other signs of ocular surface disorders, need for suture removal and need for resuturing. Results: The mean pain score in group 1 was 1.30 ± 0.68 and 2.10 ± 0.57 in group 2 (p=0.010). Mean foreign body sensation score in group 1 was 1.10 ± 0.32, and 2.30 ± 0.68 in group 2 (p<0.001). In 20% of patients in group 2, re-suturing of the wound had to be done. Dellen formation was seen in 10% of patients in group 1 and none in group 2 (p=1.0). Conclusion: Though, the new modified conj incision spares the damage to perilimbal tissue and stem cells, the post op discomfort and delayed healing limited its use. However, large scale studies are needed which can compare the two techniques in terms of outcomes, complication rates, and patient satisfaction.
RESUMO
Background Simple and mucopurulent chronic bronchitis (SMCB) is characterized by recurrent mucoid or mucopurulent expectoration in absence of localized suppurative disease. This observational open label study was undertaken to evaluate the effects of homeopathic medicine in SMCB. Methods 1902 patients were screened from 07 centres out of which 1305 were excluded. 597 patients were enrolled as per the inclusion and exclusion criteria. A total of 14 pre-defined homeopathic medicines were shortlisted for prescription after repertorizing the pathological symptoms of SMCB. Outcomes were assessed through chronic bronchitis symptom scale (CBSS) and FEV1/ FVC ratio with spirometry for over a period of two years. Appearance of any change (relief/ worse)/ status quo was immediately followed by placebo/ change in dilution/ change in remedy. Statistical analysis was done using SPSS version 20. Results: 532 patients were analyzed based on the intention to treat principle using last observation carry forward method. Mean CBS score reduced from 29.86±4.5 at baseline to 12.33±7.6 at completion of 2 years. Repeated measures ANOVA, at time points 0 (baseline), 3, 6, 9, 12 ,15, 18, 21 and 24 months, showed significant reduction in CBS scores [Wilk's Lambda 0.104, F=564, df 524; p=00001]. The FEV1 and FEV1/FVC was maintained within normal limits. 86% prescriptions included Lycopodium, Arsenicum album, Pulsatilla, Phosphorus, Stannum metallicum, Calcarea carbonica, Silicea, Bryonia alba. Conclusion: The result suggests effectiveness of homeopathic treatment in early years of SCMB patients. Controlled trials are warranted. (AU)