Obstetric Emergencies requiring Rapid response team activation: A retrospective cohort study in a high-risk tertiary care centre

Author(s):  
Jillian Taras ◽  
Gita Raghavan ◽  
Kristi Downey ◽  
Mrinalini Balki
Author(s):  
Manoj Prathapan ◽  
Namrata Pambavasan ◽  
Smrithi Sony Thampi ◽  
Smriti Nair ◽  
Leyanna Susan George ◽  
...  

Introduction: Cataract is the leading cause of preventable blindness worldwide. It is caused by the degeneration and opacification of the lens fibres. Phacoemulsification is the current treatment modality available for cataract. However, there is a possibility of an increase in the anterior chamber depth after phacoemulsification. This occurs as a result of the removal of the bulky lens matter and implantation of a thin intraocular lens, thereby reducing the intraocular pressure. Aim: To compare the preoperative and postoperative Intraocular Pressure (IOP) changes and the factors associated with intraocular pressure changes among patients who underwent phacoemulsification in a Tertiary Care Centre in Kerala. Materials and Methods: A retrospective cohort study was carried out among 610 patients, who underwent phacoemulsification surgery from January 1st, 2017 to December 31st, 2017. Using a checklist, the following data such as age, sex, Date of Surgery, Last recorded preoperative intraocular pressure of both eyes, First recorded Postoperative intraocular pressure of both eyes any time after 3 months, Axial length, Grade of cataract and comorbidities like diabetes, hypertension, dyslipidaemia, glaucoma and Coronary Artery Disease (CAD) was obtained from the hospital Information System. Data collected was entered into an MS Excel and was analysed using SPSS version 20. Frequency and percentages were calculated and association assessed using Chi-square test. Paired t-test was applied to find the mean changes in the IOP levels and p-value was ≤0.05, thus significant. Results: It was observed that there was a mean reduction of 7.907 mmHg in ocular hypertensives when compared to ocular normotensives following phacoemulsification. This finding was found to be statistically significant (p-value <0.001). There was association between grade of cataract and change in IOP which was significant with a p-value of 0.031. Conclusion: Phacoemulsification is the treatment of choice in patients with cataract. In the study, it was found that ocular hypertensives who underwent phacoemulsification had a significant drop in intraocular pressure post-surgery. Phacoemulsification can be employed in patients who have both ocular hypertension and cataract. This procedure can improve vision and in addition to having a positive effect on IOP reduction.


2017 ◽  
Vol 17 (1) ◽  
pp. e92
Author(s):  
Raajit Chanana ◽  
Manju Sengar ◽  
Hasmukh Jain ◽  
Navin Khattry ◽  
Bhausaheb Bagal ◽  
...  

2015 ◽  
Vol 30 (4) ◽  
pp. 692-697 ◽  
Author(s):  
Roger J. Smith ◽  
John D. Santamaria ◽  
Espedito E. Faraone ◽  
Jennifer A. Holmes ◽  
David A. Reid ◽  
...  

2015 ◽  
Vol 29 (4) ◽  
pp. 302-309 ◽  
Author(s):  
Merlina Sulistio ◽  
Michael Franco ◽  
Amanda Vo ◽  
Peter Poon ◽  
Leeroy William

Background: Approximately one-third of rapid response team consultations involve issues of end-of-life care. We postulate a greater occurrence in patients with a life-limiting illness, in whom the opportunity for advance care planning and palliative care involvement should be offered. Aims: We aim to review the characteristics and compare outcomes of rapid response team consultations on patients with and without a life-limiting illness. Design/Setting: A 3-month retrospective cohort study of all rapid response team consultations was conducted. The sample population included all adult inpatients in a major teaching hospital network. Results: We identified 351 patients – including 139 with a life-limiting illness – receiving a total of 456 rapid response team consultations. The median time from admission to the first rapid response team consultation was 3 days. Patients with a life-limiting illness had a significantly higher mortality rate (41.7% vs 13.2%), were older (72.6 vs 63.5 years), more likely to come from a residential aged-care facility (29.5% vs 4.1%) and had a shorter hospital stay (10 vs 13 days). Rapid response team consultations resulted in a change to more palliative goals of care in 28.5% of patients, of whom two-thirds had a life-limiting illness. Conclusion: Patients with a life-limiting illness had worse outcomes post–rapid response team consultation. Our findings suggest that a routine clarification of goals of care for this cohort, within 3 days of hospital admission, may be advantageous. These discussions may provide clarity of purpose to treating teams, reduce the burden of unnecessary interventions and promote patient-centred care agreed upon in advance of any deterioration.


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