Objectives-Optimum Revascularization strategy in very elderly population with Acute Coronary Syndrome (ACS) is currently unclear. There is reluctance on the part of physicians to recommend Percutaneous Coronary Interventions (PCI) in India because of financial constrains and fear of the complications. In this retrospective analysis we aimed to identify the demographic profile and acute outcomes of very elderly patients who have undergone percutaneous coronary intervention as compared to those treated conservatively. Material and Methods -Out of total cohort of 198 patients more than 80 years of age, data of 45 patients (23%) who underwent percutaneous coronary intervention were retrospectively analyzed for demographic profile, treatment strategy and short term outcomes compared with 153 conservatively treated patients. Results- Over a period of 3.5 year, 198 patients in the very elderly group were admitted with ACS. PCI was performed in 23% of them. Patients treated with PCI were younger (84 vs 87 year), had less number of diseased vessels (1.8 vs 2.4), better LV function at admission (EF 51.3% vs 43.0%) and had less co- morbidities. In-hospital and 1 month post discharge mortality was lower in patients treated with PCI (8.8% vs 22.2% and 11.1% vs 26.1%). They also had lower re-hospitalization rate for heart failure than those treated conservatively (8.9% vs 23.5%). Conclusion- PCI may yield better results than conservative treatment strategy in carefully selected octogenarians with one or two vessel disease with preserved ejection fraction and minimal co-morbidities who are not at a very high risk of acute contrast induced kidney injury.

Introduction: Dry eye syndrome is one of the most frequently encountered ocular condition and is a common cause of discomfort especially in the elderly population. It has a multifactorial etiology, which, in most cases, is always chronic and progressive. Material and Methods: This study was conducted from January 2015 to December 2015 and total 108 patients of more than 50 years age group were enrolled. It was a non randomized observational study in which all patients attending outdoor of department of Ophthalmology at MDM Hospital, Jodhpur with features of dry eyes syndrome were enrolled after receiving informed written consent. Results: Dry eye was more common in females (63.89%) in comparison to males (36.11%). Seventy eight percent of patients suffering from dry eye were above 60 years of age. 67.59% of dry eye patients were from rural areas. Most frequent complaint in patients suffering from dry eye was feeling of grittiness and soreness in eyes (80.56%). Next most frequent complaint was redness of eyes in 68.52% of cases followed by burning sensation in eyes (66.67%). Dry climatic condition was present for 100 percent of patients. Evidences suggestive of meibomian gland dysfunction were present in 63.89% of patients. History of cataract surgery by phacoemulsification and diabetes were present in 49.07% and 44.44% of patients respectively. Among symptomatic females, 34.26% patients were postmenopausal. Conclusions: Dry eye disorders are more common in elderly females. Most frequent complaint in patients suffering from dry eye was feeling of grittiness, redness and burning sensation in eyes. Dry climatic conditions, meibomian gland dysfunction, previous eye surgery, diabetes mellitus, long term antihistaminics and topical anti glaucoma drugs were most important risk factors for causing dry eyes in our study.

Significant scientific research has lead to greater understanding in areas of neurobiology, genetics, classification and treatment in bipolar disorder. However late onset Bipolar disorder, regarding "organic" risk factors and in areas of treatment, remains a less researched area. Whether late onset bipolar disorder is a distinct entity or an artificial boundary exists from bipolar disorder of adult onset is not clear yet. Vascular risk factors have been well studied and have attained etiological status for depressive disorders; the role of risk factors and possible etiological role for manic episodes and bipolar disorder remain unclear. A case of first episode mania at 85 years is presented in the background of vascular risk factors.

Frailty is an ageing phenomenon and it becomes essential to understand frailty, its causes and consequences as well as the risk factors that will enable us to plan appropriate interventions to target elderly who are at risk and thus preventing them from developing frailty. Frailty is linked with multiple morbidities and it adds on to the burden of the disease on the elderly making them dependent for their basic activities of daily living further deteriorating their overall quality of life. Limited studies have been done to determine association of frailty with nutritional status in the western countries, but in developing countries like India, where the elderly population is increasing at a faster pace; there is a dearth of information regarding the prevalence rates and the associated risk factors. This article attempts to provide an overview of frailty in elderly which may help create awareness among the older age groups and in focusing the attention of the healthcare providers in preventing this phenomenon to reduce the health care costs in our country.