Corneal Complications And Visual Impairment In Vernal Keratoconjunctivitis Patients.

BACKGROUND: Vernal kerato-conjunctivitis (VKC) is an infrequent but serious form of allergic conjunctivitis common in warm and humid areas where air is rich in allergens. It affects both eyes asymmetrically. Although VKC is a self-limiting disease but visions affecting corneal complications influence the quality of life in school children. The aim of this study was to list the corneal complications due to this condition and to find out the extent of visual impairment among VKC patients. METHODS: This cross-sectional study was conducted in the department of Ophthalmology, Benazir Bhutto Shaheed Hospital on 290 eyes of diagnosed cases of VKC. The diagnosis of VKC was made on the basis of history and examination. Visual acuity was recorded using Snellen's notation and visual impairment was classified according to World Health Organization classification for visual disabilities. RESULTS: The mean age of presentation was 10.83±6.13 years. There were 207 (71.4%) males and 83 (28.6%) females. Corneal scarring was observed in 59 (20.3%) eyes. Keratoconus was found to be in 17 (5.9%) eyes. Shield ulcer was detected in 09 (3.1%) eyes while 07 (2.4%) eyes had corneal neovascularization. Majority of the patients with visual loss had corneal scarring and the complication that led to severe visual loss in most of the eyes was Keratoconus. CONCLUSIONS: Vernal kerato-conjunctivitis in the presence of corneal complications is a sight threatening disease and can lead to severe visual impairment.

EVALUATION OF THERAPEUTIC POTENTIAL OF PICRURHIZA KURROA GLYCOSIDAL EXTRACT AGAINST NIMESULIDE NEPHROTOXICITY: A PILOT STUDY.

BACKGROUND: Picrorhiza kurroa (Pk) is a traditional Ayurvedic herb famous as a potent bepatoprotective agent, only few studies are available on the nephroprotective activity of this herb. The objective of this pilot study was to determine the therapeutic effectiveness of Pk against nimesulide induced toxicity. METHODS: This laboratory based experimental study was conducted on mice at National Institute of Health, Islamabad from Dec 2012 to Jan 2013. The mice were divided in to 4 groups. One group was given only PK while the other three groups were given nimesulide in a dosage of 750 mg/kg body weight for 3 days to induce nephrotoxicity and protective effect of Pk was noted by giving 250 mg/kg and 500 mg/kg pk for 14 days to the two of the nimesulide induced nephrotoxicity groups. Biochemical assessment of kidney was done by measuring serum urea & creatinine. Also histology was done to confirm the findings of biochemical assessment. RESULTS: In our pilot study out of 20 mice, 19 mice survived. Only 1 mouse of nimesulide group died. Mean serum urea of nimesulide group was 60 mg/dl and was decreased to 23 mg/dI and 25 mg/dl by two doses of Pk. Mean creatinine in group 2 was 0.55 mg/dl and was decreased to 0.21 and 0.19 mg/dl by two doses of Pk. CONCLUSION: Our study shows that nimesulide is a potential nephrotoxic drug and its toxic effects on kidney can be minimized by using glycosidal extract of Pk.

Scoring Of Pain Perception During Phacoemulsification Under Topical Anaesthesia.

BACKGROUND: Topical anaesthesia is safe and inexpensive type of anaesthesia used during phacoemulsification as compared to local anaesthesia. The trend of conducting surgeries under topical anaesthesia is increasing globally. The objective of this study was to determine the perception of severity of pain during phacoemulsification using topical anaesthesia. METHODS: This descriptive cross-sectional study was conducted at Jinnah International Hospital Abbottabad for a period of one year and included 196 patients of posterior subcapsular cataracts. Data was collected on a pretested structured questionnaire and analysed by SPSS version 20. Chi square test was used to find association between variables and p-value of equal or less than 0.05 was considered significant. RESULTS: The mean age of the patients was 60.43±14.63 years. Out of 196 patients, 110 (56.1%) were males and 86 (43.9%) were females. During surgery pain score was 0 (no pain) in 149 (76%), 1 (mild) in 14 (7.1%), 2 (moderate) in 15 (7.7%) and 3 (severe) in 18 (9.2%) patients. Pain score was found to be significantly associated with gender (p=0.003) and age group (p=0.008). CONCLUSIONS: Phacoemulsification can be safely performed under topical anaesthesia in patients with posterior subcapsular cataracts with minimum intraoperative pain perception by the patients.

Mechanism Of Nephroprotection By Picrorhiza Kurroa.

BACKGROUND: Humans are exposed either deliberately or unintentionally to a variety of diverse chemicals that harm the kidney. To reduce the alarming high incidence of nephrotoxicity, some chemical as well as herbal alternatives are needed. Nimesulide belongs to a group of antiinflammatory drugs that are in common use in our society. Like all non-steroidal antiinflammatory drugs, it carries a potential threat of nephrotoxicity especially when other risk factors are present in user. The objective of this study was to find herbal alternative with antiinflammatory and nephroprotective qualities and to bring into light its mechanism of nephroprotection. METHODS: This experimental study was conducted on mice at National Institute of Health, Islamabad from Feb 2013 to March 2014. Nimesulide was given in a dosage of 750 mg/kg body weight for 3 days to induce nephrotoxicity and protective effect of Picrorhiza kurroa was noted in two doses of 250 mg/kg and 500 mg/kg for 14 days. Renal function tests were done and urinary PGE2 was measured to assess the effect of nimesulide and Pk on kidneys. RESULTS: In our study, significant improvement was seen in serum urea and creatinine levels in mice receiving low and high dose Picrorhiza kurroa. However, no significant improvement was noted in urinary PGE2 showing that the mechanism of nephroprotection is not by vasodilatory effect of Pk. CONCLUSIONS: This study showed nimesulide nephrotoxic potential and Pk is a good herbal antiinflammatory and nephroprotective alternative for nimesulide but its mechanism of nephroprotection is not by PGE2.

Perspective About Mental Illnesses: A Survey Of Health Care Providers Of Abbottabad.

BACKGROUND: Mental Health problems are widespread globally and are the leading causes of disability. The lives of people living with mental illnesses are often drastically altered by the symptoms of the illness and made worse by the society's reaction. Stigmatizing attitude among general population is prevalent. Relatively less research has been done to explore the attitude of health care providers towards mental illness especially so in Pakistan. This study aims to investigate views of healthcare providers of Abbottabad regarding mental illnesses. METHODS: A cross-sectional study was conducted in major hospitals and medical institutes of Abbottabad wherein 640 selfadministered questionnaires based on Opening Minds Scale for Healthcare Providers (OMS-HC) were distributed among healthcare providers selected through non-probability convenience sampling; 553 (86.41%) were returned. Data was collected from June to September 2016 and analyzed using SPSS-16.0. RESULTS: The mean age of the participants is 26.12 years±7.612. Majority 346 (62%) were medical students, 60 (10.8%) were teachers, 50 (9%) were house officers, 70 (12.7%) were trainee medical officers, 27 (4.9%) were consultants. There were 313 (56.6%) females. The highest degree of stigma was observed among the 'Attitudes' of the people while it was relatively lower in Disclosure and Help Seeking domain and least in the factor of Social Distance. CONCLUSIONS: Stigma associated with mental illness is prevalent among healthcare providers..