BACKGROUND Secondary glaucoma is an anatomically identifiable abnormality which in turn is an underlying cause of the events that lead to aqueous outflow obstruction and rise in the intraocular pressure. This prospective study mainly highlights the secondary glaucoma with special reference to its proportion, causes and its risk factors in a tertiary care hospital. METHODS This study was a cross sectional study. Patients, who attended the Department of Ophthalmology after fulfilling the inclusion and exclusion criteria diagnosed with secondary glaucoma, were included in the study. The study period was from February 2018 to June 2020. A standard form was filled up for each patient documenting parameters and findings of various examinations and was evaluated as per protocol. RESULTS Secondary glaucoma was seen in 0.2 % patients who visited during the study period. Out of 106 patients, males were 50, females were 56, with a male: female ratio of 1:1.1. The most common cause of secondary glaucoma was lens induced glaucoma seen in 44.34 % followed by uveitic glaucoma in 20.8 % cases, traumatic 17.9 %, neovascular 10.4 %, pseudoexfoliation glaucoma 2.8 %, pigmentary glaucoma 1.9 %, silicon oil induced 0.9 %, and uveitis-glaucomahyphema syndrome in 0.9 % cases. Around thirty five percent (34.9 %) cases presented with sudden onset of painful diminution of vision with nausea and vomiting. CONCLUSIONS Secondary glaucoma is still one of the prevalent diseases in this part of country. Lens induced glaucoma is still the most common cause of secondary glaucoma. Hypermature cataract, uveitis, trauma and neovascularisation are the different risk factors. KEYWORDS Secondary Glaucoma, Lens Induced Glaucoma, Phacomorphic Glaucoma, Uveitic Glaucoma

OBJECTIVE:To study the prevalence of diabetic retinopathy and its relationship with the various risks factors in type 2 diabetes mellitus patients. PATIENTS AND METHODS: One hundred type 2 diabetes mellitus patients attending the departments of Medicine and Ophthalmology of TMC &Dr. BRAM Teaching Hospital comprised the material of this study. Detailed history, clinical examination and thorough ophthalmological examination including fundus photography of all the diabetic patients under study were done. The glycaemic control was evaluated for all the subjects by estimation of blood glucose and HbA1c, presence of microalbuminuria and lipid profiles. RESULTS: There were 61 (61%) females and 39 (39%) males in the study of which 42 (42%) patients, 15(35.7%) males and 27(64.3%) females had diabetic retinopathy. Among 42 retinopathy patients NPDR, PDR and ADR were 15(35.7%), 17 (40.48%) and 10 (23.81%) respectively. Duration of diabetes was found the most significant contributory factor in the causation of DR (Chi-square -43.66; p<0.01& F-78.037, p=0.00). Other factors which were significantly associated with diabetic retinopathy are age (p=0.00), glycaemic control as assessed by HbA1c (p=0.00), blood glucose-fasting (p=0. 00) & postprandial (p=0.00) and MAU (p=0.00). Factors like blood pressure-Systolic (p=0.655) & diastolic (p=0.964), hypercholesterolemia (p=0.140), and BMI (p=0.513) did not show any significant correlation. KEY WORDS: Diabetic retinopathy, type 2 diabetes mellitus INTRODUCTION: Diabetic retinopathy (DR) is a sight threatening, chronic microvascular complication of diabetes mellitus that eventually afflicts most patients with DM despite the availability of various modalities of treatment. Upto two percent of type-2 diabetes have retinopathy at the time of first diagnosis and more than 60% of them have some degree of retinopathy by twenty years of diagnosis. 1 DR is a major global cause of total blindness according to the global update of available data on visual impairment in the year 2002. 2 Its prevalence was estimated to be as high as 4.8% of the total of blindness. It is the leading cause of new-onset blindness among American adults aged 20-74 years 3 with an estimated 24, 000 people losing vision each year as a consequence. The risk factors identified to be related to the progression of DR are duration of DM, glycemic control, blood pressure and microalbuminuria. Data on other factors including BMI, male sex, serum lipids and smoking have demonstrated varying results. 4 We aim to study the prevalence of DR in Tripura and its correlation with age, obesity, glycemic control, hypertension and dyslipidemia as there is no data regarding the DR in Tripura so far.

BACKGROUNDHeadache is one of the causes of discomfort to a human being and can be classified as primary or secondary headache. CT scan has proved to be useful when the neurological physical examination is abnormal. The aim of the study is to-1. Determine the causes of headache of patients presenting with nontraumatic headache by CT scan at Tripura Medical College and Dr. B.R. Ambedkar Memorial Teaching Hospital, Hapania, Agartala, West Tripura. 2. Correlate the clinical diagnosis and the CT scan findings of patients with nontraumatic headache. MATERIALS AND METHODSA total of 157 patients presented with nontraumatic headache underwent CT scan examination in the Radiodiagnosis Department of Tripura Medical College and Dr. B.R. Ambedkar Memorial Teaching Hospital, Hapania, Agartala, West Tripura and scans were viewed for the presence of any secondary cause of headache and findings were expressed as frequency and percentage. Statistical Analysis-The data were entered in spreadsheet and analysed using SPSS 21 statistical software. Results were expressed as frequency and percentage. RESULTSIn our study, female patients (50.96%) were slightly more than the male (49.04%) patients and majority of the patients were in the age group of >20 to ≤40 years (54.14%) followed by >40 to ≤60 years (25.47%).Primary headache (73.89%) was found to be more common than secondary headache (26.11%). Sinusitis (73.17%) was the commonest cause of secondary headache. Prevalence of positive CT scans of patients presenting with headache was 26.11%. Most of the clinical diagnosis did not correlate (61.78%) with the CT scan finding. Patients with clinical diagnosis of migraine correlates mostly with the CT scan finding (69.44%), which is one of commonest cause of primary headache where we got negative findings in CT scan followed by sinusitis (38.77%), CVA/ICH (cerebrovascular accident and intracerebral haemorrhage) 32.25% and brain SOL (25%). CONCLUSIONCT scan has a role in determining the cause of headache. Primary headache is more common than secondary headache. CT scan has a significant role in detecting intracranial pathology in patient presenting with headache associated with abnormal neurological function.

ABSTRACT:Complications of sinusitis are rare nowadays because of higher and broad spectrum antibiotics. Preseptal abscess may rarely present as a complication of sinusitis. Our patient presented with a preseptal abscess with underlying ethmoidal sinusitis. The patient was treated with antibiotics; Incision and drainage of the preseptal abscess were done and infection in the ethmoidal sinuses was eradicated by endoscopic sinus surgery.

AIM: Evaluation of the benefits of suture less and glue free conjunctivo-limbal autograft for primary pterygium management. MATERIALS AND METHODS: This was clinical outcome study of 50 consecutive eyes with primary nasal pterygium requiring surgical excision. Autologous conjunctival graft taken at the superotemporal limbus was used to cover the sclera after pterygium excision. Sutureless and glue free conjunctivo-limbal autograft was performed in all the patients followed by bandaging for 24 hours. The patients were followed up post operatively on 2nd day, 1 week, 4weeks, 3 months, 6 months and 12 months. They were examined for subconjunctival hemorrhage, granuloma formation, graft dehiscence, graft rejection, graft retraction, chemosis, recurrence or any other complication. RESULTS: The study included 28 females and 17 males (mean age 39.3 years). Recurrence was seen in one eye (2.2%) of a patient at one year. Graft retraction on conjunctival side occurred in 5 eyes (11.1%). Partial Inferior flaps dehiscence in 2 patients (4.4%) and one conjunctival granuloma (2.2%) were noticed during 1 st week follow up. No any major postoperative complications occurred. CONCLUSION: The described technique is fast, safe, and effective and as well as economical while giving results without any increased chances of complications for the management of primary pterygium.