Partnership with private sector only way to tackle waiting lists properly
Government plans for five to ten years ahead tend to be affected by deep discounting and great uncertainty about future funding. Even a prime ministerial assurance may not be worth much against the global market place. Long term plans have their place, but should be thought of as a process with a series of steps. The key question is about the first phase: can we get momentum going in making a real difference to the problem?
Consuming health care
Another year winds itself up like a scroll. As the final few days stretch out before the festive season, managers throughout the country will be hoping that the seasonal flu remains as it is at present: mainly of the least virulent strain. The prayer must be that, if not ‘the season to be jolly’, this winter will not be the cause of misery for patients and for all the team of staff throughout the health service.
CASE REPORT: EXCISION, AMNIOTIC MEMBRANE GRAFT, CRYOTHERAPY AND INTRALESIONAL MITOMYCIN C INJECTION FOR THE TREATMENT OF A LIMBAL MELANOMA IN A DOG
A four-year-old, female neutered, Shih-Tzu dog was presented with a one-year history of limbal masses on both eyes (OU, oculi utrque). The masses arose from the corneoscleral limbus with marked corneal involvement. An en bloc excision of the involved meridians with human amniotic membrane grafting was performed at the left eye (OS, oculus sinister) limbal masses. A double freeze-thaw cycles of cryotherapy and intralesional mitomycin-C (MMC) injection was performed on both eyes two weeks later. Histopathology provided the definitive diagnosis of limbal melanoma. After 6 months of follow-up, OU limbal masses recurred without intraocular invasion, and 2 cycles of cryotherapy and intralesional MMC injection was then performed on recurrent sites. Despite that both cryotherapy and intralesional injection were applied the lesions recurred at an interval of 4–6 months for 18 months. At the end only a small corneal scar was present on OS, and there was no recurrence for 3 years until now. The cryotherapy combined with intralesional MMC injection was able to control the recurrence of limbal melanoma after tumor excision while maintaining the ocular surface integrity.