#Laser eye surgery in Srinagar

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Rare and Interesting Case of Eye Choriodal Melanoma Presenting as a Congestive Glaucoma in a 55 Years Male Patient-Juniper Publishers

Abstract

55 years male patient presented as a case of a glaucoma in 2011 at ER ophthalmological dept of medical hospital Srinagar Kashmir, he presented with severe pain marked redness of left eye and marked loss of vision on exam he had sever ciliary congestin corneal odema very shallow a chamber and dilated pupil no clear view of fundus and IOP of more than 550mm Hg. He was put on emergency medication of a c glaucoma in form of topical LUPITISS eye drops one drop l eye od 2 britiblu eye drops i drop L eye bd 3 osmotic diuretic 20 percent mannitol 250cc IV 4 500mf of injection diamox I we even with this medication pt dod not respond even after more than 12 hours of this medication he was advised admission which he refused however no a aor B-scan ultrasound was done pt after couple of days sought second ophthalmic consultation this time the con ophthalmologist performed B-scan ultrasound and picked up a solid retinal detachment of l eye to confirm melanoma.ch he was referred for MRI scan of orbits and brain unfortunately for patient and treating ophthalmologist the report of scan was very unsatisfactory the radiologist gave a very unsatisfactory report that pt has pan ophthalmitis l eye however ophthalmologist requested him that this is a case of CD melonoma [1], and it has to be confirmed by MRI in this process p both pt and got confused and patient left the treatment he was unfortunately going from one oph to other as a painful blind eye for two years key words melanoma.ch is the commonest tumor it can be benign or malignant LUPITISS t is prostaglandin analogue and t stands for temilola beta blocker beta blocker 3 britiblu is brimolol 3 mannitol is osmotic duretic 4 diamox is carbonic anhydrase inhibitor od means one dop once a day 5bd is one drop twice a day glaucoma is a v=condition where i o gets raised in eye pathogenesis of IOP aqueous is produced by ciliary process of ciary epethelium im post chamber where [2], the aqueous nourishes lens then through pupil it comes in ant chamber and aqua nourishes cornea and then it is dained though angle of filtration through canal of schlem and finally aqueous comes in aqua veins so any condition which causes obstruction in drainage of aqueous will result in rise of IOP which is called glaucoma classification of glaucoma cong glaucoma occurs during intra uterine life 2 infantile glaucoma if from birth to 3 years 3 juvenile off 3 years to 17 years 2 primary glaucoma open and closed angle 3 sec glaucoma which occurs sec to any intraocular disease 4 ocular hypertension sec to systematic tension dx of cong glaucoma also called buphthalmos big eye ball a large cornea we do under anesthesia in these neonates and measure [3], IOP and measure corneal diameter treatment modalities which r surgical have been

I. Goniotomy

II. Goniopexy

III.Trabeculotomy

IV.Sinostomy

    Case Report

In open angle glaucoma there is no pain moderate rise of IOP causes headache there are 3 features

a. Fundus changes

b. Changes in visual fields

Fundus causing glaucomatous cupping and even optic atrophy most the times pts of open angle glaucoma are diagnosed late due to lack of pain and pt may come when pt already [4], had glaucomatous cupping and optic atrophy that's why we are doing glaucoma screening after 40 years of age where we do routine measuring of IOP refraction and fundus examination in this screening we are able t pick up cases of open angle glaucoma treatment is medical and surgical first [5], we put it on medical therapy and if it doesn't not respond to it or it not coming for regular ophthalmic evaluation or pt belongs to fat of place lack of ophthalmic advice one should do surgery the surgical modalities are 1 trabeculectomy advantages of this procedure

1. It is cosmetically better

2. It can be repeated

3. It is a physiologically better operation

4. It communicates the ant c with canal of schlem by splitting the trabecular mesh work

Nowadays, we have better options of lased and operation of laser choice is an argon laser trabeculoplasty closed angle glaucoma comes very early due [6], to severe pain redness and marked loss of vision in most of the these case they respond to anti glaucoma medication after the eye settled down we do laser iridotomy even in normal eye of these pts we do polylectic laser iridotomy then we have ocular hypertension due to systemic hypertension key is control of b p ten we have a miscellaneous group of glaucoma 1 neo vascularisation glaucoma due to c are c occlusion it is said to subside in 3 months last l by least we have absolute glaucoma pt has painful blind eye treatment modalities.

a) Cyclodiathermy

b) Cyclo croprexy

Sometimes due to severe pain we may inject retrobulbar injection of xylocaine or alcohal to revealve pain sometimes one may have to enuck leation if all measures fail introduction ch melanoma is the most common primary malignan intraocular tumor and the second most common type of primary malignant melanoma in the body it most often whites of northern European descent essential update early treatment may prevent metastatic deaths in patients with melanoma.ch in a prospective cohort study of 3072 patients with melanoma. ch researchers we found for some pts early treatment rather than watching and waiting might better prevent metastatic deaths signs and symptoms melanoma.ch remain asymptomatic for prolonged period of time may be found incidentally during ophthalmoscope in general the more the their origin the longer the delay of any symptoms melanoma.ch present with following symptoms:

a. Blured vision

b. Paracentral scotoma

c. Progressive and painless visual loss

d. Floaters

e. Sever ocular pain

f. Weight loss marked fatigue cough or change in bowel or bladder suggests primary non ocular malignancy with melanoma.

ophthalmological examination may reveal following

A. Small melanoma.ch typically takes the form of a nodular dome shaped and well circumscribed mass under the retinal pigment epethelium

B. Melanoma.ch grow they adopt more irregular configurations

C. Diffuse melanoma.ch characterized by growth throughout the choroid with minimal elevation are more difficult to diagnose and often cause significant exudative redetachment

D. Melanoma.ch may have variable coloration some are more pigmented and others are less

E. If tumor is light colored its abnormal vascularisation usually can be seen ohthalmoscopicaly

F. Overlying melanoma. ch

There are usualy tet pig epethelial changes eg drusen dx 1 liver enzyme are indicated in any pt with uveal melanoma is the most common site of melanoma.ch metastases so one has to do

a. Alkaline phosphates

b. Glutamic oxaloacetic trans aminase

c. Lactase dehyrogenase

Gamma glutamyl transpeptidase a scan and B-scan ultrasound MRI scan ct scan f f angoigraphy can help point toits dx 2 small ch melanomas may show floresene angigrahkic changes similar to choriodal nevi 3 large melanomas may show patchy pattern of early hypoflourence and hyper flourescence followed by late intense staining simultaneous flourescence of retinal [7-8], and ch circulation within is fiarly distintive of melanomas.ch management

I. Observation may be acceptable for post uveal tumors not well established in particular tumors of less than

II. To 2.5mm and 10mm in diameter can be observer until growth is documented

III. Plaque brachy therapy is a widely accepted alternative to enucleation medium sised post uveal melanomas less than 10mm

IV. External beam irradiation with protons and helium ions

V. Pp vasectomy

VI. Block excision

VII. Laser photocoagulation

VIII. Orbital exenteration in extreme cases.

    Introduction

The above mentioned pt b was seen by me in 2013 his all investigations l f t c bc k f t lipid profile f b s were within normal limits ultrasound abdomen normal no evidence of any metastases i requested for MRI scan of orbits and brain it was very satisfactory showing that optic nerve optic tract Chiasm a basal ganglia pit gland thalmoid brain ventricles and cerebral hemispheres all were normal discussion we have aired mentioned that scleral cavity can be

1. Antto lens so it will cause visual impairment

2. Involve vitrous causind floaters

3. Involve angle of filtration and present and a c glaucoma as was seen in our case.

    Discussion

So after all above mentioned investigations under gowhar ahamed I removed whole cornea lens vitrous choriod and retina [9-11], so we were left with intact intra scleral cavity optic nerve and all ocular muscles i stitched ant and pst lips of sclera with 6 zero vicryl kept a drain in intra scleral cavity which was removed after 24 hours later i put a confirmer to give shape to orbit for 15 days after removal of confirmer i fitted a well matching and fitting prosthesis the removed tissues were sent for histopathological examination did not show any evidence of malignancy 3 years [12-15], have passed all repeat tests od blood ultra sonography b abdomen are normal.

    Conclusion

So any pt f ac c glaucoma if does not respond to treatment please do a or b scan ultrasound to pick up solid ret det and rule out m melanoma.ch by MRI review of literature 1 vertex varies can present as Uveal melanoma however it is a benign condition and temporary 2 in dept of ophthalmology manchester a pt came with a c glaucoma vision in normal eye unaided was 6,18 have did not respond to treatment MRI showed melanoma.ch so Enucleation was done 2 in Saudi medical lornal and cairio institute of ophthalmology and nophthalmology one pt came with BSEC glaucoma with imp of 56mmhg pt did not respond to treatment MRI was done it revealed melanoma.ch so Enucleation was done.

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LASIK LASER EYE SURGERY IN SRINAGAR

So, you finally decided to undergo Lasik laser eye surgery in Srinagar and now the actual process of exploration starts, exploring what exactly is Lasik surgery, its technical aspects, various procedures developed and available, cost of each procedure and discounts available, if any. Here the most prominent questions are which Lasik surgery can be suitable for your refractive error, cost of that procedure along with the discount possible.

Cost of Lasik Laser Eye Surgery in Srinagar

Most of the potential Lasik patients, who wish to get rid of eye glasses, look for the primary information about Lasik, such as the suitable Lasik procedure, cost of the Lasik Laser Eye Surgery in Srinagar and discounts available if any available. When cost of the Lasik is considered, it is totally variable component, as it keeps changing with various factors and important factor is the kind of technology or procedure, one undergoes.

Choose the Best Lasik Clinic and Lasik Surgeon in Srinagar

Centre for Lasik experts in India have gained more than 20 years of experience and performed over thousands of Lasik laser surgery treatment for vision correction and so are considered to be the finest and best surgeons in the World. If you genuinely look for getting rid of the eye glasses, yes, Centre for Lasik has the right solution for it and we help you to connect to your nearest Lasik centre and help you to guide to book direct appointment, get reasonable rates for Lasik, in Srinagar.

For more information call us + 91 – 9667770453 visit https://www.laser.fyi/srinagar/

#LASIK LASER EYE SURGERY IN SRINAGAR

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Gaudium IVF Janakpuri at Elawoman

Gaudium IVF Janakpuri Solutions is currently located in Janak Puri, Delhi. The offerings furnished through the centre are Surgical Sperm Extraction - Testicular Sperm Aspiration (TESA), Percutaneous Sperm Aspiration (PESA), Microsurgical Epididymal Sperm Aspiration (MESA), High-Risk Pregnancy Care and Management, Donor IntraUterine Insemination (IUI), IntraCytoplasmic Sperm Injection (ICSI), In-Vitro Fertilization (IVF), Andrology Clinic, Assisted Reproductive Technology Services and Counseling Sessions for Pregnancy and Infertility. The Surrogacy & IVF Center caters to the wishes of women and men who're having infertility and cannot turn out to be mother and father through the herbal method. They have efficiently brought greater than 10000 babies for the reason that its status quo. With a feat of global patients from USA, Canada, UK, Australia, New Zealand, South Africa, Bangladesh, Nepal and plenty of other locations, the humans are happy with the work of the docs and the devoted body of workers. It became set up in 2008 and within India, they have 9 centers across four major cities. Gaudium IVF and Gynae Solutions is registered under Indian Council of Medical Research (ICMR) and has given a brand new hope to women who've failed within the preceding IVF cycle.

Dr. Shiveta Kaul ranks on the top as the first-rate infertility specialist in Delhi. With many years of experience, she has received many awards and is exceptionally identified in the scientific enterprise. She finished her MBBS and MD from Government Medical College, Srinagar in 2011 and 2016, respectively. IVF, IUI, ICSI, embryo switch, infertility evaluation, gynecological problems, and excessive-chance pregnancy care being some of her specializations. She is also a member of the Indian Academy of Paediatrics (IAP).

Dr. Shiveta Kaul is famous in Delhi for imparting complete treatment offerings at an affordable package. Patients from all over the u . S . Come to go to Dr. Shiveta Kaul for infertility Treatment. He adopts cutting-edge treatment methods to make sure exquisite Treatment service. Her understanding in superior clinical and surgical Treatment has helped hundreds of hundreds of patients to obtain their parenthood with minimal complications.

She is working towards as a Gynecology consultant and infertility expert at Gaudium IVF Center, Delhi. Gaudium IVF Center is renowned globally for its specialised worldwide popular of affected person care and excessive fulfillment charge in ART treatments. Due to this very motive affected person from all across the globe go to Gaudium IVF for his or her treatments. The reducing facet therapeutic and healing device integrated at the sanatorium has helped several thousand patients to accomplish their parenthood via world-class treatment at an affordable fee. Gaudium IVF is famous all over India for its high standards and outstanding patient care. Besides the basic facilities, the sanatorium additionally has OT’s with LAMINAR Airflow & Laminar shields, Fully Equipped Advanced IVF lab, Deluxe Recovery Rooms, and Meals & Catering Services.

Dr. Meetu Bhushan is a Gynecologist, Obstetrician and Infertility Specialist in Kamla Nagar, Delhi and has an enjoy of nine years in those fields. Dr. Meetu Bhushan practices at Mayors Eye, Gynaecology and Fertility Centre in Kamla Nagar, Delhi and also visits at Gaudium IVF Center in Janakpuri, Delhi. She completed her graduation with MBBS from Himalayan Institute of Medical Sciences in 2004 and submit-graduation in MS - Obstetrics & Gynaecology from Sri Ramachandra University, Chennai in 2008 and Fellowship in Reproductive Medicine from Chettinad Hospital & Research Institute in 2009.

Dr. Meetu Bhushan has a club of  Indian Society for Assisted Reproduction (ISAR) and Fertility Preservation Society of India. She is expertized within the fields of Infertility and Gynecology are CU-T Insertion, Normal Vaginal Delivery (NVD), Caesarean Section (C Section), Natural Cycle IVF and Intrauterine Insemination (IUI), and so on. 

Dr. Meetu Bhushan treats her patients following superior techniques for precision and care. Most of the patients visit her as she is a professional in Infertility Evaluation/Treatment, Diseases in Pregnancy and Gynae Problems. She is a certified physician as she has completed wonderful educational success. She is a medical doctor with a superb attitude and ensures that the sufferers journeying her at the fertility middle get hold of the pleasant best care and professional help with appreciate their condition. Due to her contribution in gynecology and infertility Treatment, she is presented by diverse institutions throughout the nation.

Dr. Manika Khanna is an award-prevailing Infertility Specialist and Laparoscopic Surgeon based in Delhi. She is a professional in Infertility Evaluation / Treatment, High-Risk Pregnancy Care, Laser Surgeries, Intracytoplasmic Sperm Injection (ICSI), Embryo Freezing, Egg Freezing, Egg Donation, Donor Insemination Surrogacy, IVF and IUI treatments. She has been facilitated with several honors and awards for her exemplary achievements in the area of Assisted Reproduction.

Dr. Manika is a Gold Medallist in MBBS from Baroda Medical College, Gujarat. After finishing her commencement in 1996, she went to do MD in 1999. She then completed schooling in Advanced Gynecology Endoscopic Surgery (D.A.G.E) from Kiel, Germany in 2004. Dr. Manika Khanna is also a member of the European Society of Human Reproduction and Embryology (ESHRE) that is broadly acclaimed inside the medical enterprise.

She is also well-known for her compassion and dedication to her field, she has been facilitated with numerous honors and awards. Recognized because the youngest achiever in infertility and IVF care, Dr. Manika Khanna is a incredibly-valued call in the medical fraternity. Dr. Manika has helped ladies and childless couples from over 30 countries and has executed over 10,000 successful IVF treatments. In 2014, she efficaciously handled an affected person with 15 previously failed IVF cycles, which has been a first rate achievements inside the history of IVF treatment in India.

Dr. Manika served as a Consultant Physician at Deen Dayal Upadhyay Hospital, New Delhi and later as Senior Consultant and Head of Department, Gynaecology, and Obstetrics at Sri Balaji Action Medical Institute, New Delhi for numerous years.

Adiva Hospital is one of the first-class multi-area of expertise tertiary care hospitals. Located at C 1/C, Green Park Extension, Landmark: Beside Green Park Metro Station, Green Park, Delhi that's a top business vicinity and is hooked up with a wide network of roads. It caters to all age agencies as well as home & worldwide patients. The medical institution changed into set-up in 2012 with the imaginative and prescient to offer excessive- cease scientific care offerings at an inexpensive price. It has been setting requirements in turning in fantastic clinical health care services. Adiva has gained its reputation as a high IVF and Gynecology/Obstetrics healing center presenting services like In-Vitro Fertilization (IVF), Intrauterine Insemination (IUI), and IntraCytoplasmic Sperm Injection (ICSI). They have a sole goal to make certain a longer in addition to better nice existence for their patients.

Dr. Meenakshi T Sahu is an experienced Gynecologist and Infertility Specialist currently practising at Adiva Hospital. Dr. Meenakshi T Sahu has been in clinical practice for more than a decade and has done masses of successful infertility treatment. She has wealthy revel in in dealing with obstetric emergencies, and regularly operates on patients in which surgically method is needed.

Sarthak Medical Centre is one of the Top Gynecology Hospital in Malviya Nagar, New Delhi. Sarthak Medical Centre is positioned within the city of Gurgaon and effortlessly available. Sarthak Medical Centre is known for its various offerings covering Prenatal Care, Normal Vaginal Delivery, Painless Delivery, Cesarean Section, Postnatal Care, Maternal Fetal Medicine, Menopause Advice and Hysteroscopy, Cervical issues, Endometriosis, Fibroids, Gynecological Oncology, Abnormal uterine bleeding and Menopause management, Ovarian Cysts, Obstetrics Problems and Gynae Problems .

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Sports For All: JKSSC holds meeting with coordinators

SRINAGAR: J&Ok Nation Sports activities Council (JKSSC) Saturday convened a meeting of Sports coordinators of Sports activities for All, a declaration from the branch said.The meeting, the declaration said, become called in a bid to take Sports to grass-root level and infuse Sports activities lifestyle a few of the youth.

      Secretary J&Okay SSC Waheed Ur Rehman Para chaired the assembly with officers from the council, diverse heads of Sports clubs and Sports for All district coordinators of numerous Sports activities disciplines in attendance.

Inside the meeting, the coordinators were requested to furnish a detailed undertaking document duly supported with the revenue model for the general advertising of diverse Sports activities disciplines Inside the Kingdom, so that such proposals may be taken as much as facilitate the running of such golf equipment/academies or stadiums.

In line with the declaration, tips were also sought from the Sports activities coordinators for making Sports council reach at grass-root ranges. It’s far pertinent to say here that 1, 20,000 games, in recent months played at block/district ranges in various disciplines for which the registrations have been sought in advance.

“The heads of the diverse Sports golf equipment/academies who have registered their golf equipment with the Sports council stated that the reaction of the JK Sports Council is modern and innovative,” study the declaration

diverse Sports membership heads and sportspersons were of the opinion that stadiums need to be built on present day lines, Sports activities equipment ought to receive to players, groups and golf equipment.

“Sports activities players, clubs, teams have to receive group kits, Sports equipment and the work on stadiums ought to be fastened, in order that we the sportspersons ought to compete at higher stages,” stated Salman, the coordinator from Pampore.

“Sports activities infrastructure must be developed at all the block ranges so that the centers are supplied to the aspiring sportspersons of the rural vicinity,” said Sofi Arafat, who hails from Pahalgam.

Parra said that in Sports Council’s bid to convey transparency and duty Inside the machine, the branch changed into streamlining the player management device, which tracks the performance of each registered player at various levels at some stage in his affiliation with the council.

“Registrations of clubs, groups, and gamers will join all of the applicable stakeholders in an effort to help in figuring out the talent at diverse stages below various matrices and as a consequence deliver council’s intervention for nurturing of identified expertise.”

The Worksite Wellness Program Coordinator Job Series – You’ve Got The Job. Now What? (Let’s Go!)

Congratulations! You are the new worksite wellness coordinator. Whether you volunteered for the job or were assigned the role, your first question is probably, now what?

The first thing to remember is that you are not alone in this alone. There are many worksite wellness program coordinators just like you. The coordinator community is also very supportive and giving. Just reach out and ask for help. Also keep reading this series to learn how to become successful and feel less overwhelmed by your new role.

The Worksite Wellness Program Coordinator Role

What does the job entail? In a nutshell, the job entails two things:

• Helping to create healthy employees

• Helping to create a healthy organization

Recognize right away you will often have to fulfill your role with little or no budget and often without a lot of leadership and management support. You may also hear yourself being called the wellness police, so develop a “thick skin.”

Where Do I Start?

First and foremost, learn about wellness as a concept and construct. Wellness is a holistic, multi-dimensional concept related to the quality of one’s life. Wellness is about more than just the physical health of the employee or their health related risks. Wellness and wellbeing are nearly synonymous terms.

Since wellness is as much about the business as it is the employee, learn as much as you can about the organization you working for and the industry your organization is in. These two areas can provide significant context for the wellness program you will eventually roll out. Keep your eyes and ears open for issues and trends unique to each.

Third, learn about the basics of worksite wellness program development and implementation. The Wellness Council of America’s (WELCOA) 7 Benchmarks program model and the National Healthy Worksite Program model are both good models to become familiar with.

Keep in mind that while you should follow a recommended evidence based program model, your particular programming and interventions will be determined by the uniqueness of your organization’s culture and the identified gaps between existing resources and your identified program purpose and program goals. In addition to following the recommended program model, your program should also address:

• Increased employee awareness

• Increased employee knowledge and skills

• Employee lifestyle management

• Organizational change

• Program evaluation for continuous quality improvement

Why we your new role may seem daunting to you now, as you learn more about the field of worksite wellness and worksite wellness program development, you will come to see how easily managed a program can become and how the program can be of significant benefit to both the employees and the organization.

You Can Be Successful and Effective

You too can become proficient at implementing and coordinating a successful and effective worksite wellness program. I specialize in mentoring worksite program coordinators and creating Done With Y

Business Meeting Thank You Note Samples

    After just about any meeting, successful or note, it never hurts to follow up with a thank you note. It shows you respect your client’s time and even if your product wasn’t a good fit this time, your client knows you’re a courteous, professional colleague he’d like to do business with again.

  It was a pleasure to finally get a chance to meet you today. Your research project sounds very interesting and offers a compelling value proposition to to the mobile phone carriers. As discussed, my team has done extensive work in the type of data collection that your research requires.

Please let me know if I can provide you with more details about how we would work on the project.

Look forward to speaking with you soon.

Thank you for your time today. Jack and I very much appreciated your input on our new business development strategy. I know that you have a number of demands on your schedule right now so the fact that you took as much time as you did to guide us is even more welcome.

We will be sure to circle back with you when the plan is finalized in order for you to provide your stamp of approval as well as any final

Everything About Visiting a Sports Medicine Chiropractor

    Chiropractic care and healing has helped millions of people around the world. Patients mostly visit chiropractors for pain and chronic back issues, but chiropractic extends beyond general pain management. For decades, chiropractors have been exclusively working with athletes and sports teams for enhancing physical fitness. Most top professional athletes and fitness enthusiasts have credited their respective coaches and chiropractors for their performance. If you play a sport or are actively into physical activities, seeing a chiropractor is highly recommended. Here are some of the things you need to know.

The Benefits

Most sports and related activities can impact your spine and muscles. Regular overtraining and intense practice sessions can leave you tired, bruised and fatigued. With a sports medicine chiropractor, you can enhance your overall fitness levels. In addition to helping you heal, chiropractic can help you recover from common sports injuries. In case you already have an injury, chiropractic treatment can reduce your dependency on drugs and surgeries. Depending on the condition of the athlete, chiropractors may use other forms of non-invasive and drug-free alternative treatments, such as cold laser therapy or spinal decompression, to accelerate the healing process. Chiropractic sessions are particularly beneficial for treating foot injuries, shoulder pain, headaches, and hand pain.

What to Expect?

You must recognize that a sports chiropractor has extensive knowledge of sports related injuries, the mechanism of injury, the anatomy that’s typically involved with your injury while considering your past history and fitness goals. If you