ADHD presenting as recurrent epistaxis: a case report

Epistaxis is an important otorhinolaryngological emergency, which usually has an apparent etiology, frequently local trauma in children. Here we present a case report wherein the epistaxis was recalcitrant, and proved to have a psychiatric disorder as an underlying basis. The child was diagnosed with Attention Deficit/Hyperactivity Disorder, hyperactive type, which led to trauma to nasal mucosa due to frequent and uncontrolled nose picking. Treatment with atomoxetine controlled the patient's symptoms and led to a remission of epistaxis

Prevalence of pseudoexfoliation syndrome in patients scheduled for cataract surgery in eye camps in Kashmir

Aims: To study the prevalence of pseudoexfoliation syndrome (PEX) in patients scheduled for cataract surgery in eye camps in Kashmir. Materials and Methods: This was a prospective study conducted by the Mobile Ophthalmic Unit holding eye camps in rural areas of Kashmir from December 2010 to July 2011. Total of 1117 patients from 11 areas with age-related cataract scheduled for surgery underwent complete clinical examination. The PEX was diagnosed by the presence of gray flakes on the anterior lens capsule or at the pupillary margin or both. A Chi square test was used for statistical analysis. Results: The prevalence of PEX was 26.32%. The prevalence from the different areas varied from 4 to 36.36%. Males comprised 64.62% of the patients with PEX ranging in age from 49 years to 89 years. Increasing age was associated with increase in prevalence of PEX (P value < 0.001). Prevalence of PEX was higher in patients involved with outdoor activities (P value < 0.001). Most common type of cataract seen in patients with PEX was nuclear sclerosis. Patients with PEX had visual acuity (VA) significantly lower than patients without PEX (P value = 0.0013). Conclusion: The prevalence of PEX in Kashmir is relatively high. This is important from the perspective of mobile eye camps considering the increased frequency of cataract and the surgical complications associated with PEX, and thus the surgery mandates a thorough preoperative clinical examination to ensure good surgical outcome

Outcome of Phacoemulsification in patients with and without Pseudoexfoliation syndrome in Kashmir

<p>Abstract</p> <p>Background</p> <p>The aim of the study is to compare the outcome of phacoemulsification in patients with and without pseudoexfoliation syndrome in Kashmir.</p> <p>Methods</p> <p>200 patients were prospectively evaluated and divided into 2 groups. Group 1 comprised 100 cases with pseudoexfoliation and Group 2 (control) 100 cases without pseudoexfoliation. Phacoemulsification with posterior chamber intraocular lens implantation was performed by 3 surgeons. Intraoperative and postoperative observations were made in both the groups at regular intervals upto 6 months. A chi square test was used for statistical analysis.</p> <p>Results</p> <p>Patients with pseudoexfoliation were significantly older (P = 0.000), had harder cataract(P = 0.030) and smaller mean pupil diameter(P = 0.000) than the control group. Intraoperative complications were comparable between the 2 groups except the occurrence of zonular dehiscence which was seen in 7% patients of Group 1 compared to 0% in Group 2. Higher postoperative inflammatory response was seen in Group 1(P = 0.000). Decrease in intraocular pressure (IOP) at all postoperative measurements was more in Group 1(P = 0.000). The visual acuity was better in the control group in the early postoperative period (P = 0.029), however the final visual acuity at 6 months was comparable between the 2 groups.</p> <p>Conclusions</p> <p>Phacoemulsification in presence of pseudoexfoliation necessitates appropriate surgical technique to avoid intraoperative complications. Pseudoexfoliation is associated with higher inflammatory response, significant postoperative IOP drop and satisfactory visual outcome.</p