Indian Journal of Public Health Research & Development

Kunal Sharma ¹, P.K. Manjhi ², M.L. Pandey ³, Neha ⁴, Vineet Gupta ⁵, Roopam Chauhan ⁶, Kritika Singla ⁶

Affiliations
1 Post-graduate Resident, Dept. of Ophthalmology, MMIMSR, Maharishi Markandeshwar (Deemed to be University), IN
2 Professor & Head, Dept. of Ophthalmology, MMIMSR, Maharishi Markandeshwar (Deemed to be University), IN
3 Professor, Dept. of Ophthalmology, MMIMSR, Maharishi Markandeshwar (Deemed to be University), IN
4 P.G. Resident, Dept. of Ophthalmology, MMIMSR, Maharishi Markandeshwar (Deemed to be University), IN
5 Assistant Professor, Dept. of Ophthalmology, MMIMSR, Maharishi Markandeshwar (Deemed to be University), IN
6 Senior Resident, Dept. of Ophthalmology, MMIMSR, Maharishi Markandeshwar (Deemed to be University), IN

Abstract

Background: Suturing of conjunctival graft is a traditional technique for pterygium excision surgery. Owing to its many disadvantages & complications many newer techniques like autologous fibrin glue have been introduced & accepted as an alternative method of graft adhesion. Methodology: The present study was conducted at the Department of Ophthalmology, MMIMSR, Mullana (Maharishi Markandeshwar Deemed to be University) in the time period extending between December 2017 and January 2019. 100 eyes of patients of either sex with primary pterygium were selected and divided into 2 groups of 50 each in Group 1- patient underwent conjunctival auto graft with 10-0 ethilon sutures while in Group 2 suture less conjunctival auto graft was done with patient’s own blood fibrin. Results: Parameters such as mean operating time, presenting complaints like pain, watering, burning and foreign body sensation, complications & recurrence were compared between the two groups on postoperative Day 1, Day 7, 2 weeks, 1 month, 2 month, 3 month & 6th month. Statistical significant difference (p<0.01) was found between the suture and sutureless surgery for pterygium in relation to post-operative discomfort grading. There was a significant difference (t = 22.149, p = 0.001) in the duration of surgery for GROUP I surgery. Conclusion: Conjunctival auto graft with autologous serum is a safe and fast method. It is equally effective as conventional sutured autograft technique. Post operative discomfort is significantly less in this method. It also prevents suture related complications.

Keywords

Pterygium, sutures, sutureless, duration of surgery postoperative discomfort, complications, recurrence.

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Vineet Gupta ¹, Kunal Sharma ², Neha ²

Affiliations
1 Assistant Professor, M.M.I.M.S.R., (Maharishi Markandeshwar Deemed to be University), IN
2 2IIIrd Year Resident (Deptt. of Ophthalmology), M.M.I.M.S.R., (Maharishi Markandeshwar Deemed to be University), IN

Abstract

Aim: To study postoperative outcome & related complications of Glue free and suture free conjunctival autograft in pterygium excision in Haryana-A North Indian state. Materials and Method: The present study was conducted at the Department of Ophthalmology, MMIMSR, Mullana (Maharishi Markandeshwar Deemed to be University) in the time period extending between December 2017 and January 2019. 50 eyes of patients of either sex with primary pterygium were selected and pterygium was excised & sutureless & glue free conjunctival autograft was done with patient’s own blood fibrin. Parameters such as mean operating time, presenting complaints, grade, complications & recurrence were observed on postoperative Day 1, Day7, 2 weeks, 1 month, 2 month, 3 month & 6th month. Results: The mean age of the study population was 48.82 + 11.13 years... Out of 50 eyes only 1 (2%) had conjunctival cyst, 2 (4%) graft edema and 3 (6%) had graft displacement, 1(2%) had graft lost, 1(2%) had graft rejection & 1(2%) had recurrence at 6 month follow up. The mean operation time was 24.88 minutes. Regarding type of the pterygium, out of 50 patients 9(18%) were grade 1, 26(52%) were grade 2, 11(22%) were grade 3 and 4(8%) were grade 4. Conclusion: Conjunctival autograt using patients own blood technique is a safe, cheaper, effective, with less surgical time & has minimal postoperative discomfort.

Keywords

Complications, pterygium, recurrence, suture free, glue free conjunctival autograft.

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Pankaj Saini ¹, Varsha A. Singh ², Kunal Sharma ³, Gunjeet Singh ³, Abhishek Chauhan ⁴, Shailja Sharma ⁵

Affiliations
1 Junior Resident, Department of Microbiology, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
2 Professor, Department of Microbiology, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
3 Junior Resident, Department of Pharmacology, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
4 Junior Resident, Department of Respiratory Medicine, M.M.I.M.S.R., Maharishi Markandeshwar (Deemed to be University), MMDU, Mullana, Ambala, Haryana, IN
5 General Physician, Baghpat, Uttar Pradesh, IN

Abstract

Non-tuberculous mycobacterium (NTM) has been identified in human pulmonary and extra pulmonary diseases and is of great concern for clinicians and microbiologists because of their increasing global incidence. They are now increasingly recognized as important pathogens in both immunocompromised and immunocompetent population. They should be identified rapidly and should be carefully differentiated as contamination, colonization ordisease. Cultures were made on conventional LJ and LJ with PNB media. Growth was confirmed as AFB (acid fast bacilli) by ZN staining. NTM were identified by growth on LJ with PNB media, colony morphology, rate of growth, pigmentation, catalase activity and confirmed by MPT 64 antigen rapid test (using SD Bioline TB Ag MPT 64 test kit) . Data was analysed statistically using SPSS software. Out of total 500 processed samples (250 pulmonary & 250 extrapulmonary), 12(21.05%) and 7(21.8%) NTM were isolated from pulmonary and extrapulmonary samples respectively. Maximum pulmonary NTM (41.7%) were isolated from > 60 years age of patients in contrast to extrapulmonary NTM isolates which were more in 20-40 years of age group. There was 16.7% previously treated patients in pulmonary while 100% were newly diagnosed patients in extrapulmonary TB cases. This study highlights the importance of early diagnosis and differentiation among Mycobacterium tuberculosisand NTM so that these NTM are not underestimated in routine diagnostic procedures merely as environmental or laboratory contaminants.

Keywords

Non-tuberculous mycobacterium, p-nitrobenzoic acid, Pulmonary TB, extrapulmonary TB, MPT64 antigen.

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Kunal Sharma ¹, Neha ¹, M.L. Pandey ², Vineet Gupta ³, Pankaj Saini ¹

Affiliations
1 Resident, Department of Ophthalmology, M.M.I.M.S.R. (Maharishi Markandeshwar Deemed to be University), Ambala, Haryana, IN
2 Professor, M.M. Institute of Medical Science and Research, M.M.I.M.S.R. (Maharishi Markandeshwar Deemed to be University), Ambala, Haryana, IN
3 Assistant Professor, Department of Ophthalmology, M.M.I.M.S.R. (Maharishi Markandeshwar Deemed to be University), Ambala, Haryana, IN

Abstract

Purpose: Axenfeld-Rieger syndrome is an ocular anterior segment dysgenesis, autosomal dominantly inherited, commonly associated with glaucoma and systemic anomalies. This study presents various clinical manifestations of Axenfeld-Rieger syndrome within one family. Material and Method: Three members of the family: patient 1--father (54 years old), patient 2--son (12 years old) and patient 3--daughter (8 years old), underwent complete ophthalmic examination, including standard glaucoma diagnostics. It was impossible to perform complete eye examination in one case (patient 1) because of severity of ocular changes. Results: All family members described had iris abnormalities (hypoplastic iris stroma) and advanced glaucoma, however severity of symptoms were different in each case. The most advanced disease was recognized in patient 1. Other findings included: posterior embryotoxon (patients 2 and 3), iridocorneal angle abnormalities (patients 2 and 3), stretch holes and extraocular features (patient 2): dental anomalies (microdontia and hypodontia), maxillary hypoplasia and periumbilical skin fold. All of these symptoms supported the diagnosis of Axenfeld-Rieger syndrome. In addition, we also diagnosed high myopia & strabismus (patient 2) and corneal scar in (patient 1). Conclusion: Reported cases of Axenfeld-Rieger syndrome demonstrate phenotypic variability of the disease among family members, which is characteristic for this disorder and can cause diagnostic problem.

Keywords

Axenfirldreiger syndrome, Glaucoma, Corectopia, Iris Stretch holes, Maxillary hypoplasia, dental abnormalitiies.

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