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Objective: To determine the pattern of proton pump inhibitors (PPIs) use in medical wards. Study Design: Prospective observational study. Place and Duration of Study: Department of medical post graduate medical institute, study for 24 weeks, from 01 Nov 2014. Material and Methods: One thousand eight hundred consecutive patients admitted in medical wards and emergency department were enrolled and followed during hospital stay and their discharge slips were analyzed without intervention in the management protocol of different primary consultants. Results: Results were analyzed on SPSS version 20. Out of 1800 patients, 53.3% (n=960) were males and 46.7% (n=840) females, 72.6% (n=1306) had been prescribed PPIs. Major indications for the use of PPI were stress ulcer prophylaxis (32.5%), upper G.I bleeding (20.0%), acid peptic disease (12.5%), patients of GERD (8.1%) and NSAID use (7.5%). In 19.3% patients, indication of PPI use was not mentioned. Out of the admitted patients 57.7% patients were prescribed inject-able and 42.3% were given oral PPIs. There were 77.9% (n=1018) patients prescribed PPIs on discharge slips while duration of treatment and indication for their use were not mentioned on discharge slips for 66.3% (n=866) and 72.3% (n=944) patients, respectively. Conclusion: PPIs are over used without clear indications in hospitalized and discharged patients. [ABSTRACT FROM AUTHOR]

Objective: To compare the viscosity of silicone oils made by different manufacturers by comparing the flow rates through a standard 23G millennium vitrectomy system. Study Design: Quasi experimental study. Place and Duration of Study: Department of Ophthalmology, Lahore General Hospital Lahore, Pakistan during 2012. Patients and Methods: Viscosities of silicone oils of 1000cs and 5000cs, manufactured by multinational / national manufacturers in Pakistan, were compared. Oils of 1000cs/500cs were placed in 20 ml syringes, marked randomly and placed in water-VVbaths at 25°C, to standardize the control environment. Each syringe was then attached to 23G millennium vitrectomy system and time taken to empty 9 ml of oils at pressures of 40 mmHg & 70 mmHg was noted. Results: Oils of same centistokes manufactured by different manufacturers behaved differently in terms of their flowability and rates of emptying. The emptying times for 1000cs oils ranged from 112.1 seconds to 144.4 seconds at 40 mmHg and 60.2 to 70.3 seconds at 70 mmHg, whereas corresponding figures for 5000cs were between 335.7 seconds and 802.0 seconds at 40 mmHg and between 169.6 seconds and 348.7 seconds at 70 mmHg. The differences at all levels were statistically significant (p< 0.001) Conclusion: Silicone oils of similar centistokes behaved differently in terms of their rates of flow through a standard 23G vitrectomy system under standard conditions indicating better standardization of the viscosity of silicone oils available in the market. [ABSTRACT FROM AUTHOR]

The burden of intravitreal injections has increased tremendously over the past few years. Since traditionally the operation theatre setup is currently used for this procedure, it is increasingly becoming difficult to manage such a patient load in the theatres. To overcome this challenge, office-based setup for intravitreal injection was started. This study was planned to determine the incidence of endophthalmitis after office-based intravitreal bevacizumab injection and to compare it with previously reported incidence of endophthalmitis after operation theatre-based intravitreal injections. The study was conducted at Al-Ehsan Eye Hospital, Lahore, Pakistan, from July 2015 to June 2016, and comprised patients who received intravitreal injections of bevacizumab (Avastin) for different ocular indications. A total of 1,047 intravitreal injections were given in an office-based set-up. Of them, 2(0.19%) cases of clinically suspected endophthalmitis were identified. Office-based set-up for intravitreal bevacizumab injection was found to have comparable safety profile with traditional operation theatre-based set-up.