BACKGROUND Context-We have chosen 216 patients presenting with a chief complaint of haemoptysis attending our tertiary care unit both mild, moderate and severe in our prospective study from 2013 to 2016. Aim-To study patients of haemoptysis including their age, sex distribution, background disease, severity of haemoptysis, smoking status, active disease existing and method of treatment. Settings and Design-We have taken up patients with the complaint of haemoptysis analysed history and did thorough Physical examination. MATERIALS AND METHODS A total of 216 patients presented with haemoptysis above 20 years of age were included in our study. Investigated these patients with chest x-ray and sputum for AFB. CT scan chest, bronchoscopy were done in selective patients. Smoking history was taken from all the patients, both male and female after taking consent from the Ethical Committee. Majority of the patients were subjected to conservative management. Glue therapy and Bronchial artery embolisation were required for 6 patients. RESULTS Among 216 patients admitted in the prospective study, maximum number of patients were seen in 30-49 years' group. Males outnumbered females in our study. Pulmonary tuberculosis both acute and old inactive tuberculous residual lesions are responsible for haemoptysis in nearly 60% of patients; 9.2% cases had bronchiectasis. Nearly 10% of patients came for streaky haemoptysis secondary to acute pharyngitis. Iatrogenic haemoptysis secondary to pulmonary procedures occurred in 3.24%. Post bronchoscopy procedures are an important cause of significant haemoptysis in 6.10%. Post procedural haemoptysis was always self-limiting and never life-threatening in our study. Among TB patients, active tuberculosis is responsible for haemoptysis in 25.92% among new cases of TB, followed by old inactive TB (19.9%), Defaulters (9.72%), Relapse after successful treatment (3.24%) and MDR TB (0.92%). Haemoptysis in our study group was mild in a majority (< 100 mL/day), moderate (100-300 mL/day) in only 9 patients and severe (> 300 mL/day) in only 4 patients. Most of the patients were managed only conservatively. Only six patients required intervention in the form of cyanoacrylate glue bronchoscopically and only three patients were subjected to bronchial artery embolism. CONCLUSION Haemoptysis is an alarming symptom both to the patient and the physician. Tuberculosis old and active is an important cause of haemoptysis in India. URTI, acute pharyngitis, bronchiectasis, chronic bronchitis and lung tumours and cancer are important causes of haemoptysis. Haemoptysis is mild in a large number of patients. Glue therapy and bronchial artery embolisation were required for 6 patients. Majority of the patients were managed conservatively; 10% required ICU admission.
Pterygium excision by bare sclera technique was first described by Ombrain. However it is associated with recurrence rate of 9 to 75%. Conjunctival autografting is safe and cost effective method in preventing recurrence. In this study 100 cases of primary pterygium are evaluated. Mean age group was 47 years. 55% were male and 45% were females. Literature documents more incidence of pterygium in outdoor workers. This correlated with our study findings where in 66% of the patients were exposed to heat dust and sunlight while working outdoors. 89% had nasal pterygium. Most Patients (87%) had with the rule astigmatism. The average with the rule astigmatism was 2 diaptors preoperatively which decreased to 0. 67D postoperatively. In our study of 100 cases 50 underwent pterygium excision by bare sclera technique. Rest 50 underwent pterygium excision with conjunctival autografting. All cases were followed up for 6 months. In the bare sclera technique 6 (12%) cases had recurrence and none in conjunctival autograft technique (p-value < 0.05). Two cases had sclera thinning following pterygium excision which resolved after tapering steroid dosage. 2 cases had graft edema and three had loose sutures. 4 cases had granuloma formation in the bare sclera group and one had corneal scarring.
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