Purpose:To establish the practicality of the survey scale in estimating baseline severity at the time of diagnosis and resolution of the vernal keratoconjunctivitis (VKC) symptoms after topical medication Study Design:Longitudinal survey design Place and Duration of Study: Ophthalmology department of Nishtar Medical Hospital, Multan.from June 2021 to November 2021 Methods: A total of 267 VKC (vernal keratoconjunctivitis) patients' data was filled in on preformed Google forms. Improvement in symptoms after follow-ups was recorded on it. Chi-squared test an Kruskal-Wallis test were employed to determine the statistical significance of the variables. Results:There were 52.4% females and mean age of the patients was 29.52+18.39 years. There was preponderance of patients falling under 20 years of age. At baseline, 63.3% patients were on topical steroids, while 5.6% of patients were using steroids at the second follow-up visit. The mean interval between patients’ visits to the hospital was 7.64 ± 2.086 weeks. Nonparametric Kruskal-Wallis test was used to calculate the difference in means of radial point scale scores at the baseline examination (4.47 ± 2.321) and second follow-up (1.31 ± 1.615) visits. Z-score value was 15.266 with a significance of 0.001. For patient satisfaction and resolution of symptoms at the second follow-up visit, Chi-square values were 164.75 and 119.55, respectively, with a significance of 0.001 in each case. Conclusion: The survey scale aided in quantifying disease symptoms, which can be useful in prescribing and adjusting the medications’ dosage easier.

Purpose/Objective(s): Various adjuvant approaches are utilized in the management of endometrial cancer based on surgical pathology and institutional preference. The radiosensitivity index (RSI) is a previously validated multi-gene expression index that estimates tumor radiosensitivity. In this study, we evaluate RSI as a genomic predictor for pelvic failure (PF) in patients treated with adjuvant radiotherapy. Materials/Methods: A total of 204 consecutively treated patients with endometrial cancer were identified from our IRB-approved institutional tissue biorepository. All patients underwent hysterectomy with bilateral salpingo-oophorectomy with the majority undergoing lymph node dissection (nZ181; 88%) between 01/99 and 04/11 and followed until 01/ 19. Gene expression was from Affymetrix Hu-RSTA-2a520709 (Affymetrix; Santa Clara, CA). The RSI 10-gene signature was calculated for each sample using the previously published algorithm. Radiophenotype was determined by dichotomization of RSI at the previously identified cutpoint of 0.375; 0.375 Z radioresistant (RR) and <0.375 Z radiosensitive (RS). Time to event analysis was performed with Kaplan-Meier estimates and the log-rank test. Associations between radiophenotype and outcomes were explored with univariable (UVA) and multivariable (MVA) Cox regression. The threshold for statistical significance in all tests was set at p<0.05. Results: Median follow-up was 38.5 months (range: 0.2-216). The median RSI was 0.42 (range: 0.11-0.70). There were no significant differences in RS and RR patients in age (pZ0.99), serosa and/or adnexa involvement (pZ0.37), vaginal and/or parametrial involvement (pZ0.48), cervical stromal invasion (pZ0.59), receipt of adjuvant chemotherapy (pZ0.12), and node involvement (pZ0.78). A total of 83 (41%) patients were treated with adjuvant radiotherapy with vaginal brachytherapy (nZ19; 23%), pelvic radiotherapy (nZ26; 31%), or both (nZ38; 46%). In patients treated with radiation, RR patients were more likely to undergo PF (3 year pelvic control 84% vs 100%; pZ0.02) with worse PF free survival (PFFS) (3 year PFFS 65% vs. 89%; pZ0.04). However, since RSI is a radiation specific signature it did not predict PF (pZ0.86) or PFFS (pZ0.57) in patients not treated with radiation. Factors found to predict PF on UVA included grade 3/1-2 (HR 3.8; 95% CI 1.2-14.8, pZ0.03), serosa and/or adnexa involvement (5.9; 95% CI 1.6-20.2, pZ0.008), lymph node involvement (4.9; 95% CI 1.5-18.8, 0.009), and RR/RS (7.7; 95% CI 1.5-140.9, 0.01). On MVA, factors that continued to predict for PF included RR/RS (10.7; 95% CI 1.9-202.4, pZ0.004), lymph node involvement (4.1; 95% CI 1.2-16.3, pZ0.03), and serosa and/or adnexa involvement (4.3; 95% CI 1.2-16.4, pZ0.03). Conclusion: RSI was found to be a significant predictor of PF in patients treated with adjuvant radiotherapy on MVA. We propose RSI may be a method to predict which patients are most likely to fail in the pelvis and candidates for treatment escalation in the adjuvant setting.

Background: Refractive errors are the most common cause of avoidable visual impairment in children worldwide. Importance of school screening of refractive errors is one of the most important initiatives outlined in WHO Vision 2025 targets. Corrected refractive errors visually rehabilitate the school going children. But the benefit depends on the compliance of the spectacle wear by children. Purpose: To study the compliance of spectacle wear and to highlight the reasons of non compliance in school going children of Multan. Study Design: Cross-sectional descriptive study. Setting: Ophthalmology Department, Nishtar Medical University Multan, Pakistan. Period: Jan 2009 to Oct 2012. Materials and Methods: 631 students. Among them 187 males and 175 female students were prescribed spectacles for constant wear during school screening program. Each student was given a pro forma indicating name, age, gender, prescription and column of reasons of non compliance. After six months, we conducted a follow-up visit where these students were accessed about spectacle compliance and reasons of non compliance on the given feedback pro forma from teachers. The data was collected and analyzed by SPSS version 20. Results: The overall non-compliance rate of spectacle wear in primary school children was 35.91%. A significantly higher proportion of boys 119 (57.14%) were not wearing their spectacles compared to girls 175 (54.86%). Themain reasons for non compliance in primary school boys and girls were casual in wearing their spectacles, does not like to wear spectacles, break their spectacles frequently and some children feel spectacles are not needed or cause headache. Conclusions: Poor compliance of using spectacles was noted in our study among children with refractive errors with main reason for not using these spectacles was that they did not like to wear them. So there is need to adopt aggressive awareness campaign among teachers and parents to enhance their knowledge for better outcomes and visual improvement of the children. Screening of primary school children with refractive error was difficult task in Multan. Limited information was available on the magnitude of the compliance for spectacle wear and their reasons of noncompliance. This information is crucial for establishing a program and will strengthen the efforts for a better eye care in school children.