Prospective Observational Cross Research Articles

Prevelance of Hearing Loss and Factors Association in Chronic Kidney Disease Patients.

Aim: Chronic kidney disease (CKD) is becoming a great concern, especially in developing countries and SNHL among patients with CKD is considerably higher than general population. So, current study aims evaluation and assessment of degree of hearing loss in chronic kidney disease patients using pure tone audiogram and correlation of hearing loss with its contributing factors. Materials and methods:70 patients with CKD were included in this prospective observational cross sectional study performed in tertiary care hospital. A detailed history; general physical, otological examination, blood investigation was done.CKD staging was done using KDIGO guidelines and hearing assessment using pure tone audiometry. Hearing loss association with CKD and contributing factors were studied. Result: Out of 70 participants, SNHL was seen in twenty one participants. Hearing loss was present in 3 out of 22 participants of CKD-3; 6 out of 12 participants of CKD-4 and 12 out of 15 participants of stage CKD-5. A statistically significant association of hearing loss was found with CKD stage, albuminuria, hemodialysis, hypertension and other factors. Discussion: Since hearing impairment may well have a negative impact on the social function of an affected individual, the use of pure tone audiogram to monitor CKD patients should be considered as a routine procedure. Patients with CKD would benefit from early detection of hearing loss which will allow for early rehabilitative measures to be taken.

A Study on Contraceptive Practice and Associated Factors among Women Garments Worker

Introduction: The garment industry is a crucial contributor to the economy of Bangladesh and employs a large number of women of reproductive age. However, contraceptive use among these women is low, which can lead to unintended pregnancies and adverse health outcomes. The present study aimed to assess the contraceptive practices and associated factors among female garment workers in Bangladesh. Methods: This prospective observational cross- sectional study was conducted at Islami Bank Hospital, Mirpur, Dhaka, Bangladesh. The study duration was 1 year, from November 2021 to October 2022. During this period, a total of 300 garment workers were enrolled in the study following the inclusion and exclusion criteria from those employed at any of the various garments of Mirpur region, Dhaka, Bangladesh. Result: The study found that a majority of participants were aged 21-25 years (44.33%), Muslim (77.67%), had a primary level of education (44.33%), and had 1-2 children (69.33%). Almost half of the participants had good knowledge of contraception (48.33%), 66.67% had a positive attitude and 66.00% reported using contraception regularly. The most commonly used method of contraception was oral contraceptive pills (43.04%), followed by condoms (29.13%), and injections (22.17%). A considerable number of participants (14.35%) reported an unknown source of contraception. Among the 70 participants who did not use contraceptives, the most commonly reported reasons were an expectation that the patient will not get pregnant (45.71%) and partner refusal (41.43%). Only 25.33% of participants had access to family planning services. The accessibility of family planning services was significantly associated with the knowledge of contraception, the attitude toward contraception, and the use of contraception. The use of contraception was higher among participants who reported access to family planning services (84.93%) compared to those who did not have access (59.91%). Conclusion: The study highlights the low prevalence of contraceptive use among female garment workers in Bangladesh and the need for increased access to family planning services. Partner involvement and education on contraceptive methods and their side effects may also contribute to increased contraceptive use.

Effect of Haemodialysis on Serum Magnesium Level in Patients with Chronic Renal Failure: A Cross-sectional Study

Introduction: The dialysate Magnesium (Mg) concentration is the primary determinant of serum Mg levels in individuals on maintenance haemodialysis. A stable dialysate Mg content of 0.5 mmol/L is currently recommended. An alteration in this concentration can lead to altered serum magnesium levels. Few studies indicate that dialysate Mg concentration needs to be altered for maintenance of stable serum magnesium level. Aim: To compare pre and postdialysis serum magnesium levels in patients with chronic renal failure and the effect of drug intake and duration of dialysis on serum magnesium levels. Materials and Methods: This prospective observational cross- sectional study was conducted in a tertiary care hospital of Coimbatore, Tamil Nadu, India, for a period of three months, from June 2021 to August 2021. The predialysis and postdialysis serum magnesium levels of 100 chronic renal failure patients undergoing maintenance haemodialysis were measured. Parameters such as dialysis period, predialysis weight, predialysis routine blood chemistry variables (estimated glomerular filtration rate, serum urea, serum creatinine, serum sodium, serum potassium and serum calcium, serum phosphate measurements) history of diabetes, history of hypertension and history of medications, were assessed for all the patients. Statistical analysis of the data were done using Analysis Of Variance (ANOVA), Students’ t-test and Pearson’s correlation coefficient. Results: Total 71% of the study population were males and 29% were females. The mean age of the study population was found to be 51.34 years. The mean predialysis serum magnesium levels was 2.28±0.48 mg/dL. The mean postdialysis serum magnesium level was 1.69±0.52 mg/dL. Total 2% of the chronic renal failure patients had hypomagnesemia before dialysis, while 27% of the patients developed hypomagnesemia after dialysis. There was significant difference between pre and postdialysis Mg levels, p<0.001. There was no significant correlation between pre and postdialysis magnesium levels and drug intake. Patients undergoing dialysis for more than 300 days had a significantly decreased serum magnesium levels than those undergoing dialysis for less than 90 days. Conclusion: The risk of hypomagnesemia is definite in patients undergoing dialysis. Uniformity of dialysis fluids for all patients may not be advisable. Dialysate should be titrated in individual patients according to the predialysis serum magnesium levels.

Prediction of Acute Renal Failure in Dengue Fever Patients

Background: Dengue virus (DENV) infection is caused by an arboviral strain and is transmitted by the mosquito Aedes aegypti which is found in Sudan especially Red Sea and Kassala states in the east. The disease is known to cause renal disturbances and a thorough understanding of that will potentially help in the prediction, diagnosis and treatment of the disease. Methods: This study is a prospective observational cross sectional study conducted in the Eastern Sudan College of Medical Science and Technology and Port Sudan Teaching Hospital. 200 confirmed Dengue virus infected patients along with 200 healthy appearing adults (control) were enrolled for the study. Statistical analysis was carried out after the collection of patients’ demographic, clinical, and investigational data including serum urea and creatinine values. Ethical approval was obtained from the ministry of health, Red Sea state and informed written consent was obtained from each participant. Results: The highest incidence of DENV infection was observed in individuals of the middle age group (29%). Elevated blood urea levels were detected in 10 (5%) patients while elevated creatinine levels were seen in 17 (8.5%) patients. Although fallen within reference ranges found in the literature, mean blood urea and creatinine values differed significantly between patients and controls and between different categories of the disease. Mean blood urea concentration showed a statistically significant difference between the control (22.3 mg/dl) and the test (28.4 mg/dl) (P value < 0.001). Similarly, mean serum creatinine in the control (0.70 mg/dl) differed significantly (P value < 0.001) from test (0.94 mg/dl). Clinically, fever was present in 97.5% of patients, headache in 95.5%, joints pain in 71%, lethargy in 67%, vomiting in 49%, skin rash in 40%, abdominal pain in 24% and bleeding in 17.5%. Conclusion: We strongly conclude that renal involvement is not uncommon in Dengue fever and that blood urea and creatinine evaluation should be considered in the counseling of DENV infection patients. Patients need to be subjected to necessary laboratory investigations associated with acute kidney injury to decrease the rate of morbidity and mortality associated with the disease.

Study of prevalence of asymptomatic bacteriuria and its associated risk factors in rural elderly female patients

Background: Urinary tract infection is one of the most frequent bacterial infections in the elderly population occurring both in the community and in the long term care settings. Asymptomatic bacteriuria is common among the same elderly population which should be differentiated from obvious urinary tract infections. Objectives: To identify the prevalence of asymptomatic bacteriuria (ASB) in elderly females from rural background and to examine associated risk factors Methods: In this prospective observational cross sectional study a total of 100 elderly female patients aged 60 years and above from rural background in whom routine urine examination revealed bacteria or pus cells without symptoms of urinary tract infection are studied.Results: Out of the 100 elderly female patients, 68 patients were found to have Asymptomatic Bacteriuria (ASB). Risk factors associated with asymptomatic bacteriuria are Diabetes mellitus, catheterisation, urinary incontinence and structural urinary tract abnormalities. E.coli was the most common organism isolated in asymptomatic bacteriuria patients.Conclusion: The prevalence of Asymptomatic bacteriuria was significantly high in rural elderly female patients and it should be correlated with the clinical features of CUE findings of pus cells or bacteriuria and also the risk factors associated with UTI, so that patient with Asymptomatic bacteriuria are segregated from patients with UTI who require antimicrobial therapy.

Evaluation of Acute Cannabis Intoxication in Pre- School Children Admitted to Poison Control Center –Ain Shams University Hospitals

Background: In Egypt, cannabis is on the top list of the substances abused according to statistics of Fund for Drug Control and Treatment of Addiction. Its widespread use translates to greater access for children. Cannabis intoxication in young children can cause encephalopathy and coma. Aim: to evaluate the prevalence of acute cannabis intoxication in pre-school children (less than 6yrs) in Egypt; analysis of different factors related to the problem, clinical picture, management, assessment of severity and outcome of the problem by poison severity score (PSS). Method: prospective observational cross sectional study carried on all pre-school children (less than 6yrs) of both sex who admitted to PCC-ASUH, during the period from first of March 2019 to the end of December 2019, with history of acute cannabis intoxication and confirmed by cannabis positive screen. Results: The prevalence of acute cannabis intoxicated pre-school children (less than 6yrs) was 89.9%.The mean age was (17.38 month ±8.75). Fifty four percentages were males. As regard PSS, the majority of patients (55.1%) were of group II, while (31.4%) were of group I & (13.5%) were of group III. Regarding clinical manifestations; tachycardia observed in (5.8%), hypertension in (13.5%), tachypnea (18%), drowsiness (31.4%), muscle rigidity (21.5%), extra-pyramidal manifestations presented in (21.5%), coma grade I in (67.7%), coma grade II in (0.9%), respiratory distress in (1.8%), vomiting in (17.9%), mydriasis in (13%), miosis in (18.8%), flushed skin (12.1%) and respiratory acidosis (26.5%) of patients .ICU admission occurred in (68,7%) of patients and the majority were admitted ≥24 hours (65.9%). Conclusions: The prevalence of acute cannabis toxicity in pre-school children (less than 6yrs) has dramatically increased. Severity of acute cannabis intoxication in pre-school children(less than 6yrs) can be evaluated simply by using PSS. Recommendation: Public education is very necessary to decrease the problem. Early arterial blood gas analysis with careful neurological examination could help in identifying patients at risk.

CROSS SECTIONAL STUDY OF CAUSES AND DETERMINANTS OF STILLBIRTHS AT TERTIARY CARE TEACHING HOSPITAL

Introduction- Stillbirth rates are unacceptably high in developing countries. It reects the suboptimum quality of maternal and child health services. Material And Methods- Prospective observational cross sectional study, carried out for one year duration at tertiary care referral hospital in central India. Results-There were 9165 deliveries and 9318 babies born in the hospital.There were 318 stillbirths of which 245(77%) were antepartum stillbirths and 73(23%) were intra-partum stillbirths. The stillbirth rate in the present study was 34/1000 births. Ante-partum haemorrhage (36%) and pregnancy induced hypertension (21%) were most common causes of ante-partum stillbirths where as extreme prematurity with very low birth weight (41%), birth asphyxia, meconium aspiration (21%) and intra-partum haemorrhage (15%) were common causes of intra-partum stillbirths. Conclusion- There is high rate of stillbirths in the present study. Health education, improvement of maternal nutrition, regular antenatal check-ups, high risk pregnancy identication and timely referral and institutional deliveries will help in preventing large number of stillbirths.

Cerebroplacental ratio in gestational hypertension and its impact on neonatal weight

Background: Pregnancy a physiological process that involves changes in vascular system responsiveness that affects the placental development in direct and indirect methods by hormonal and other signals that are critical in normal blood flow rates within the fetal system. Predicting fetal outcome using sonographic indices is considered a noninvasive valuable protocol to manage cases with hypertensive disorders with pregnancy. Fetal weight is one of the critical issues faced by obstetricians and perinatologists Aim of the study: to determine the value of cerebro placental ratio in predictability of neonatal weight in cases of gestational hypertension. Patients and Methods: A prospective observational cross sectional study that included 100 pregnant women, 50 ladies had gestational hypertension and 50 women as normal control group attending the antenatal care clinic of Algezeera hospital. Ultrasonographic assessment was carried out with evaluation of routine fetal biometry in addition to Middle cerebral artery (MCA), Umbilical artery (UA) Doppler indices. Results: UA PI, MCA PI, CPR, Fetal weight and birth weight were statistically significantly higher among the control research group in comparison to the hypertension with pregnancy research group (p values&lt;0.001). Conclusion: Cerebroplacental ratio is a promising ultrasonographic marker for fetal and neonatal weight that could aid in prediction of neonatal wellbeing and clinical prognosis of hypertensive cases in pregnancy.

Study use of Antiepileptic Drugs in Pediatric Ward at GMERS Hospital, Gandhinagar, India

Abstract: Introduction: Epilepsy, a common neurological disorder characterised by a transient paroxysm of neuronal discharge and the condition seizure disorder is reported majorly among pediatric population. Around 4-10 % of children suffer atleast 1 seizure in their first 16 years of life. It includes febrile convulsion (typical or atypical), epilepsy or any neurological disorder. Anti-epileptic drugs are the primary therapeutic measure to control seizure and manage epilepsy. To determine rationality of therapy, it is necessary to have knowledge on how drugs are prescribed and used to treat a particular disease or a group of diseases in the clinical setting and so due to paucity of data on anti-epleptic drugs usage amongst pediatric population in India, drug use study was conducted. Objectives: The study aims to determine the utilization pattern of anti-epleptic drugs in in-patient admission in pediatric wards of GMERS Hospital, Gandhinagar. Materials and Methods: The study was a prospective observational cross sectional study which was conducted for a period of 4 months. Data of 132 pediatric patients prescribed with anti-epleptic drugs by were enrolled and the resource used to collect data included subjects case notes which was recorded on a pre-structured data collection form. Utilization pattern of anti-epleptic drugs was assessed based on socio-demographic variables, clinical profile, therapy and newer and conventional drugs. Results: Total 1687 patients were admitted, out of which 132 were prescribed with anti-epleptic drugs. Majority of anti-epleptic drugs were prescribed in 2-12 years age group (59%) and in boys (56%). Febrile convulsion (40%) being the most commonly diagnosed condition followed by epilepsy (29%) amongst the study population. Midazolam were administered to 113 patients (41%), being the most frequently prescribed benzodiazepine the frequently used dual therapy was midazolam+phenytoin followed by midazolam+clobazam. The most used triple therapy was midazolam+phenytoin+sodium valproate. Conclusion: Phenytoin was the most used anti-epleptic drugs and midazolam was the most used benzodiazepens Midazolam monotherapy was used as a first line drug for management of seizure attack. If seizure was not controlled with midazolam then phenytoin was added. Conventional anti-epleptic drugs were used more as compared to newer AEDs. Keywords: Epilepsy, Drug utilization, Seizures, Anti-epileptics, Paediatrics.

Pregnancy Outcome in Impaired Liver Function in Pre-eclampsia

Pre-eclampsia induced liver disease is a disorder unique to pregnancy and is frequently seen in third trimester. Severe pre-eclampsia is defined by extreme elevation in systemic blood pressure and evidence of organ compromise. HELLP syndrome is a unique liver related disorder of pregnancy that was first described by Weinstein in1982 as a constellation of clinical and laboratory abnormalities in pregnant women in their third trimester. This disorder was termed HELLP syndrome with (H) for haemolysis, (EL) for elevated liver enzymes and (LP) for low platelet counts. This is a severe variant of pre-eclampsia. Objective of this study was to determine the alteration of liver function in preeclampsia and its correlation with the clinical severity as well as the perinatal outcome. This was a one-year prospective observational cross sectional study included 100 patients with pre-eclampsia. Severity of the pre-eclampsia clarified clinically. Pre-eclampsia patients having history of hepatitis, cirrhosis of liver, gallbladder diseases and other pre-existing medical disorders that altered liver function were excluded from this study. The mean age of the patients was 25.3+4.9 years ranging from 18 to 37 years. One third of the patients (33.3%) were in the age group 28 to 32 years. Out of 100 patients, 58% belongs to poor income group. Among the studied samples 17% had epigastric pain and discomfort, 13% had complaints of vomiting and 43% develop severe pre-eclampsia. Among the Patients with altered hepatic enzyme level, 8.33% had complaints of epigastric pain, 6.66% complains vomiting. Maximum patients (66.6%) with elevated liver enzyme had no major complications whereas 33.4% of patients developed major complications. Patients with severe pre-eclampsia have elevated liver enzyme whereas patients of mild symptoms had normal liver enzymes level. Cases with raised serum biochemical markers had strong association with complications of severe pre-eclampsia. Pregnancy outcome in severe pre-eclampsia with hepatic involvement is grievous. Graves sequlae of pre-eclampsia can be prevented and minimized by timely institutional intervention. Post-partum followup would help to find out other parameters of pregnancy outcome. Bangladesh Med J. 2020 May; 49(2) : 9-13

Prevalence of Glaucoma among High Myopia

Abstract Background Glaucoma is an optic neuropathy that is characterized by the selective loss of retinal ganglion cells and their axons, which manifests as the loss of the retinal nerve fiber layer (RNFL). Numerous studies have shown that the extent of RNFL damage correlates with the severity of functional deficit in the visual field (VF), and that RNFL measurement by optical coherence tomography (OCT) has good sensitivity for the detection of glaucoma. Purpose To assess the prevalence of glaucoma among high myopic patients and the association between them using standard automated perimetry (SAP) and optical coherence tomography (OCT). Patients and Methods A prospective observational randomized cross sectional study included a total of 80 eyes with high myopia, in the period from November 2017 to April 2018. This cross sectional study included 44 subjects with 80 eyes regarding high myopia using the outpatient services of the Qlawoon Hospital, Cairo, who satisfied the inclusion and exclusion criteria between November 2017 and April 2018 aiming to determine the prevalence of glaucoma in high myopic patients. Results In our study, we depended on the following highly significant parameters in detection of prevalence of glaucoma among high myopic patients: Spherical equivalent median is -12, Vertical cup/disc ratio mean is 0.55, MD median of visual field is – 5.38, PSD mean of visual field is 3.53, GHT is 64.7% outside normal limits, 17.6% border line and 17.6% general reduction of sensitivity and RNFL thickness mean is; for average thickness is 86.37, for superior thickness is 90.06 and for inferior thickness is 82.68 a highly significant P-value. Conclusion Prevalence of glaucoma among our study group is 42.5% depending on Spherical equivalent median, Vertical cup/disc ratio mean, MD median of visual field, PSD mean of visual field, GHT and RNFL thickness.

Analysis of Ocular Cyclotorsion in Lying Position after Peribulbar Block

Abstract Background: Cyclotorsions are movements of cyclotorsion of the eyes. The cyclotorsion of the human eye occurs with movement of the head and body, changing the original position of the corneal axis. A significant different range of cyclotorsion between a lie and a supine position was previously reported as varying from 2 to 7 degrees. Aim of Study: The aim of this prospective study is to determine the amount of ocular cyclotorsion in supine position after peribulbar block, to avoid misalignment of the toric IOL which negates the desired effect of correcting astigmatism. Patients and Methods: A prospective observational rand-omized cross sectional study included a total of 50 eyes of 50 patients undergoing cataract surgery under peribulbar anaesthesia in El-Durrah Specialized Eye Centre, in the period from March 2018 to September 2018. Results: In this prospective series of 50 consecutive cases we observed that: The mean of cyclotorsion in the study after peribulbar block: Was (5.20±1.85 degrees), which was statis-tically significant greater than 0 degrees. Incyclotorsion appeared in 31 eyes (62%) and the mean of rotation was 5.77 degrees. Excyclotorsion ocurred in 16 eyes (32%) and the mean was 5.06 degrees. There were no cyclotorsion in 3 eyes. Cyclotorsion (1-5) degrees occurred in 27 eyes (48%). Cyclo-torsion more than 5 degrees occurred in 23 eyes (46%). Conclusion: Cyclotorsion represents another potential source of residual refractive errors that subsequently will lead to a reduced visual quality post-operatively. Therefore should be carefully taken into account in the pre-operative analyses.

IMPACT OF OBESITY ON SUSTAINED VIROLOGIC RESPONSE TO SOFOSBUVIR BASED REGIMENS IN THE EGYPTIAN CHRONIC HEPATITIS C PATIENTS

Hepatitis C virus is one of the flaviviruses that can cause both acute and chronic hepatitis. Chronic HCV infection often follows a progressive course over years that could result in cirrhosis, hepatocellular carcinoma, and possible liver transplantation. Identifying modifiable risk factors that add to progression of the disease in HCV patients aids in choosing treatment approaches and overall disease management. Hepatic fibrosis may occur as a result of obesity, host, virus-mediated factors and hepatic steatosis. Nonetheless, the role of overweight and obesity on hepatitis C progression remains debatable. Nowadays, Direct Acting Antiviral therapy is the cornerstone of treatment of chronic hepatitis C virus infection aiming to eradicate HCV RNA, which is predicted by reaching sustained virologic response (SVR). This prospective observational cross sectional study assessed the impact of obesity on the SVR to Sofosbuvir based therapy in patients with chronic HCV infection. The study included 188 chronic hepatitis C patients eligible for antiviral therapy according to the Egyptian guidelines issued by the National Committee for Control of Viral Hepatitis. G1: 93 obese patientswith BMI ≥30 kg/m2 & G2: 95 non obese patients with BMI < 30kg/m2. Each group was subdivided into 3 subgroups; GA received Sofosbuvir & Daclatasvir, GB received Sofosbuvir & Simeprevir while GC received Sofosbuvir & Ledipasvir.The results showed that overall SVR was 96.7% in G1 and 95.7% in G2. There was no association found between stage of fibrosis and SVR, and no significant association reached between obesity and sustained virologic response (SVR) to Sofosbuvir based regimens.

A clinical study of prevalence of metabolic syndrome in psoriasis patients: a prospective cross-sectional observational study at a tertiary care centre in South India

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Metabolic syndrome (MS) is a constellation of risk factors like central obesity, atherogenic dyslipidemia, hypertension and glucose intolerance.Psoriasis is associated with MS and this may be contributed by various inflammatory mediators like interleukin 6 and tumor necrosis factor α which are increased in psoriasis. Aim of the study is to assess the prevalence and risk factors associated with metabolic syndrome in psoriasis patients and to find association between metabolic syndrome and severity of psoriasis using PASI score.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A hospital based prospective observational cross sectional study was conducted in Vinayaka Missions Medical College and Hospital, Salem over a period of one year (June 2017 – June 2018) involving 100 psoriasis patients, included based on the inclusion and exclusion criteria. Patients were analyzed based on a standard proforma and metabolic syndrome was diagnosed with the South Asian Modified National Cholesterol Education Program Adult Panel III (SAM- NCEP ATP III).&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; In the present study, prevalence of metabolic syndrome was 54%. The risk factors noted were female gender (p=0.015), nail involvement (p=0.249), joint involvement (p=0.007) and increasing PASI score (p=0.194).There was no significant association between type of psoriasis and metabolic syndrome. Among the different components of metabolic syndrome, majority of psoriasis patients were having raised fasting blood sugar.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The occurrence of metabolic syndrome is high in Indian population. Therefore apart from getting treated for psoriasis, patients should be screened for components of MS and should be followed up regularly for onset of components of MS.&lt;/p&gt;

Effect of Anatomical Variations of Osteomeatal Complex on Chronic Rhinosinusitis: A Propective Study.

This is a prospective observational cross sectional study comprising of 57 patients who were having symptoms of chronic rhinosinusitis which were evaluated with the help of computed tomography scan (Coronal and axial sections) to identify various anatomical variants of osteomeatal complex and to find their percentage and to find the pattern of sinus involvement in chronic rhinosinusitis patients. The most common anatomical variation was agger nasi which was present in 52 (91.23%) patients followed by abnormal uncinate process in 43 (75.44%) patients and maxillary sinus was the most commonally involved sinus in CRS.

Changes in Maxillary Sinus Volume and It's Walls Thickness Due to Chronic Rhinosinusitis: A Prospective Study.

This is a prospective observational cross sectional study comprising of 57 patients who were having symptoms of chronic rhinosinusitis which were evaluated with the help of computed tomography scan (coronal and axial sections) to measure the thickness of all walls of maxillary sinus and it's volume. Computed tomographic imaging of sinonasal region has become the gold standard in the evaluation of patients with chronic sinusitis. The maxillary sinus is pyramidal in shape with lateral wall of nose forming its base and its apex is directed towards zygomatic process. All three dimensions of the maxillary sinus were measured and the volume of each maxillary sinus was also calculated. Hyperostosis of maxillary sinus tended to increase maxillary sinus walls thickness which ultimately results into decrease in maxillary sinus volume in chronic rhinosinusitis patients.

Prevalence of Glaucoma among High Myopia

Background: Glaucoma is an optic neuropathy that is characterized by the selective loss of retinal ganglion cells and their axons, which manifests as the loss of the retinal nerve fiber layer (RNFL). Numerous studies have shown that the extent of RNFL damage correlates with the severity of functional deficit in the visual field (VF), and that RNFL measurement by optical coherence tomography (OCT) has good sensitivity for the detection of glaucoma. Purpose: To assess the prevalence of glaucoma among high myopic patients and the association between them using standard automated perimetry (SAP) and optical coherence tomography (OCT). Patients and Methods: A prospective observational randomized cross sectional study included a total of 80 eyes with high myopia, in the period from November 2017 to April 2018. Results: This cross sectional study included 44 subjects with 80 eyes regarding high myopia using the outpatient services of the Qlawoon Hospital, Cairo, who satisfied the inclusion and exclusion criteria between November 2017 and April 2018 aiming to determine the prevalence of glaucoma in high myopic patients. Conclusion: RNFL thickness mean is; for average thickness is 86.37, for superior thickness is 90.06 and for inferior thickness is 82.68 a highly significant P-value.

Is Partial Coherence Interferometry More Accurate Than a Scan Ultrasonography in the Estimation of Anterior Chamber Depth ?

Purpose: To assess the degree of agreement of anterior chamber depth (ACD) measurements by optical device (NIDEK AL-scan biometer) and contact ultrasound A-scan (Mentor [R] - Advent [TM] A/B system US biometry). Setting: Department of Ophthalmology at ALAZHAR University, Cairo, Egypt. Methods: This prospective observational cross sectional comparative study of 50 normal healthy eyes were included in this study, ACD estimation was done by 2 methods partial coherence interferometry (PCI), and contact ultrasound A-scan. The measurements were performed by the same observer. The difference in measurements between the two methods was assessed using the t-test. Results: The mean ACD (±SD) by the two methods were (2.8 mm) and (3.5 mm), respectively. There was a statistically significant difference between measurements recorded by the 2 methods (P<0.01). Conclusion: there was a statistically different between the two methods the PCI values were significantly higher (by 0.7 mm) than the U/S values with no correlation between the two sets of values. So, PCI is more accurate but we still need U/S measurements in some situations (e.g., tear film abnormalities, corneal pathologies).

POTASSIUM MONITORING IN HEART FAILURE PATIENTS RECEIVING COMBINED THERAPY OF CAPTOPRIL AND FUROSEMIDE

In the treatment of heart failure is recommended the use of a combination of ACEI (captopril) with diuretics (furosemide), ACEI has the side effect of hyperkalemia 10-38% in hospitalized patients and 10% in outpatients, is increased in patients with renal failure and diabetes mellitus, the use diuretics occur hypokalemia 5-20% in outpatients. Hyperkalemia and hypokalemia both should be avoided in heart failure patients, because it can cause cardiac conduction disorders such as cardiac arrhythmias This study aims to monitor levels of potassium in the use of combination therapy with furosemide captopril in heart failure patients. The study was conducted using the method Prospective Observational Cross Sectional Analysis, conducted in January-May 2015 in heart failure patients male and female NYHA II-III receiving combination therapy with furosemide Captopril met the inclusion criteria were treated in the department CVCU Dr. Wahidin Sudirohusodo Makassar. Potassium levels were measured pre and post administration of the combination therapy. A total of 37 patients met the inclusion and exclusion criteria in this study, 31 male patients (83.8%) and 6 female patients (16.2%) aged between 35-80 years, during this study after administration of the combination therapy, 5 patients (13.5%) had hypokalemia (&lt;3.5 mmol/L) and 2 patients (5.4%) experienced hyperkalemia (&gt; 5 mmol/L) and 30 patients (81.1%) of normal potassium levels (3,5 to 5.0 mmol/L). The test results paired t test p = 0.432 (p&gt; α;α = 0.05) showed no significant differences between potassium levels pre and post potassium levels. In conclusion, the use of a combination of captopril and furosemide therapy, the risk of hyperkalemia and hypokalemia not significant but need to be monitored levels of potassium and ECG patient.

Study on analysis of the causes for the failure of Antiepileptic treatment in children with seizure disorders in a tertiary centre.

Objective: To study and analyze the causes for the failure of Anti epileptic treatment in children with seizure disorder in relation to age, sex, type of seizure and possible etiology. Design: Prospective observational cross sectional descriptive study. Setting: Children between 1-14 years who are suffering with recurrent seizures who are taking AEDs were taken for the study for a period of 6months (from Jan 2011 to June 2011) who were admitted in emergency and pediatric wards of Institute of Child and Women Health, Niloufer Hospital, Osmania Medical College, Hyderabad. Participants: Over a period of 6 months, 120 children between 1 14years were admitted in the hospital, were included and 3 were excluded because they are lost to follow up. Methods: All children with recurrence of seizures who are admitted pediatric wards and in emergency were constitute the study sample. The factors causing the recurrence of seizures were studied in the preset proforma. A thorough clinical examination of the study sample is done and including the relevant investigations. The data was analyzed statistically by using ODDS Ratio, and Relative Risk ratios, Chi-square test. For all children with seizures EEG and CECT were done. Age below1 year, above 14 years, any episode without antiepileptic treatment and Myoclonic seizures, Cerebral plasy with more than 1 Anti epileptic drug, Neurocutaneous syndrome, Lenox Gestaut syndrome, West syndrome were excluded from the study. Results: This study is comprised of 120 children (76 were male and 44were female) out of which 80(66.67%) children suffered with GTCS, 33(27.5%) suffered with complex partial seizures and remaining 7(5.83%) with atypical febrile seizures. Noncompliance is more common in more than 6 years children than less than 6 years. The p value is 6 years and the odds ratio is 1.69.GTCS type of seizures is more common recurrence in the age of above 6 yrs than below 6 yrs age group. The RR is 1.29in above 6 years. Conclusions: Male children were more commonly get recurrence of seizures (63%). Phenytoin drug users were more likely to get the recurrence of seizures.