Quality of eyeglass prescriptions from a low-cost wavefront autorefractor evaluated in rural India: results of a 708-participant field study

ObjectiveTo assess the quality of eyeglass prescriptions provided by an affordable wavefront autorefractor operated by a minimally trained technician in a low-resource setting.Methods and Analysis708 participants were recruited from consecutive patients registered for routine eye examinations at Aravind Eye Hospital in Madurai, India, or an affiliated rural satellite vision centre. Visual acuity (VA) and patient preference were compared between trial lenses set to two eyeglass prescriptions from (1) a novel wavefront autorefractor and (2) subjective refraction by an experienced refractionist.ResultsThe mean±SD VA was 0.30±0.37, –0.02±0.14 and −0.04±0.11 logarithm of the minimum angle of resolution units before correction, with autorefractor correction and with subjective refraction correction, respectively (all differences p<0.01). Overall, 25% of participants had no preference, 33% preferred eyeglass prescriptions from autorefraction, and 42% preferred eyeglass prescriptions from subjective refraction (p<0.01). Of the 438 patients 40 years old and younger, 96 had no preference and the remainder had no statistically significant difference in preference for subjective refraction prescriptions (51%) versus autorefractor prescriptions (49%) (p=0.52).ConclusionAverage VAs from autorefractor-prescribed eyeglasses were one letter worse than those from subjective refraction. More than half of all participants either had no preference or preferred eyeglasses prescribed by the autorefractor. This marginal difference in quality may warrant autorefractor-based prescriptions, given the portable form factor, short measurement time, low cost and minimal training required to use the autorefractor evaluated here.

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Quality of eyeglass prescriptions from a low-cost wavefront autorefractor evaluated in rural India: results of a 708-participant field study

10.1101/390625 ◽

2018 ◽

Author(s):

Nicholas J. Durr ◽

Shivang R. Dave ◽

Daryl Lim ◽

Sanil Joseph ◽

Thulasiraj D Ravilla ◽

...

Keyword(s):

Visual Acuity ◽

Form Factor ◽

Standard Deviation ◽

Low Cost ◽

Rural India ◽

Low Resource ◽

Resource Setting ◽

Low Resource Setting ◽

Significant Difference

ABSTACTAimTo assess the quality of eyeglass prescriptions provided by an affordable wavefront autorefractor operated by a minimally-trained technician in a low-resource setting.Methods708 participants were recruited from consecutive patients registered for routine eye examinations at Aravind Eye Hospital in Madurai, India, or an affiliated rural satellite vision centre. Visual acuity (VA) and patient preference were compared for eyeglasses prescribed from a novel wavefront autorefractor versus eyeglasses prescribed from subjective refraction by an experienced refractionist.ResultsMean ± standard deviation VA was 0.30 ± 0.37, −0.02 ± 0.14, and −0.04 ± 0.11 LogMAR units before correction, with autorefractor correction, and with subjective refraction correction, respectively (all differences P < 0.01). Overall, 25% of participants had no preference, 33% preferred eyeglasses from autorefractor prescriptions, and 42% preferred eyeglasses from subjective refraction prescriptions (P < 0.01). Of the 438 patients 40 years old and younger, 96 had no preference and the remainder had no statistically-significant difference in preference for subjective refraction prescriptions (51%) versus autorefractor prescriptions (49%) (P = 0.52).ConclusionsAverage VAs from autorefractor-prescribed eyeglasses were one letter worse than those from subjective refraction. More than half of all participants either had no preference or preferred eyeglasses prescribed by the autorefractor. This marginal difference in quality may warrant autorefractor-based prescriptions, given the portable form-factor, short measurement time, low-cost, and minimal training required to use the autorefractor evaluated here.SYNOPSISEyeglass prescriptions can be accurately measured by a minimally-trained technician using a low-cost wavefront autorefractor in rural India. Objective refraction may be a feasible approach to increasing eyeglass accessibility in low-resource settings.

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Comparisons of Four Methods for Thinning Eucalyptus Hybrid Coppice Shoots in Brazil

Journal of Experimental Agriculture International ◽

10.9734/jeai/2019/v41i630434 ◽

2019 ◽

pp. 1-7

Author(s):

Nilton Cesar Fiedler ◽

Ricardo Pinheiro Cabral ◽

Adriano Ribeiro de Mendonça ◽

Weslen Pintor Canzian ◽

Antonio Henrique Cordeiro Ramalho ◽

...

Keyword(s):

Low Cost ◽

Eucalyptus Grandis ◽

Mechanical Damage ◽

Operation Time ◽

Significance Level ◽

Homogeneity Of Variances ◽

Randomized Design ◽

Significant Difference ◽

The Mean

Both manual and semi-mechanized systems are used for operations involved in coppice remodeling. Thus, there is a paradigm about the higher yield of semi-mechanized operations compared to manual operations. However, the small volume of research on this subject does not present data which is capable of confirming this hypothesis. Thus, the present study aimed to perform a technical analysis of costs, quality and productivity of different methods for conducting regrowth in Eucalyptus grandis x Eucalyptus urophylla hybrid plantations under coppice regeneration in areas of forest fostering. The experiment was conducted under a completely randomized design with four treatments (sprouting methods) and four replications in plots of 360m² each. The methods used were: brushcutter, sickle, machete and hand digger. An F-test (p <0.05) was performed to verify the differentiation between treatments for a given characteristic after verifying the normal distribution of data and homogeneity of variances. The means were compared by analysis of variance at the 5% significance level to analyze if there was significant difference between the operating times in the analyzed methods. An estimate of the costs per hectare was subsequently obtained in each offspring method and the quality of the operation was evaluated by observing the frequency of damage to the remaining trunk. The mean operation time of the methods did not differ significantly (p> 0.05). The brushcutter presented the highest cost per hectare (US$ 40,06/ha-1) and the excavator presented the lowest (US$ 18,65/ha-1). Spreading with the brushcutter presented the lowest percentage of mechanical damage (6.88%) and the sickle obtained the highest (20.63%). It was concluded that the operation with brushcutter was the method that provided the highest productivity, but has the highest operational cost, making the method with brushcutter, advantageous for its low cost, associated with a satisfactory productivity.

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Quality of life of obstetrics fistula patients before and after surgical repair in the Jimma University Medical Center, Southwest Ethiopia

BMC Women s Health ◽

10.1186/s12905-021-01360-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tilahun Fufa Debela ◽

Zerihun Asefa Hordofa ◽

Aster Berhe Aregawi ◽

Demisew Amenu Sori

Keyword(s):

Quality Of Life ◽

Surgical Repair ◽

Obstetric Fistula ◽

Medical Center ◽

Mean Value ◽

Significant Difference ◽

Before And After ◽

The Mean ◽

Jimma University

Abstract Background The consequences of obstetric fistula on affected women are more than the medical condition. It has extensive physical, psychological, social, and economic consequences on them. Obstetric fistula affects the entire health and entire life of women. Women suffering from obstetric fistula are often abandoned by her partner, relatives, and the community. This study aimed to determine the quality of life of obstetrics fistula patients before and after surgical repair. Methods Institutional-based prospective, before and after study design was conducted in the Jimma University Medical Center from November 1, 2019–October 30, 2020. A face-to-face interview was conducted with fistula patients who visited Jimma University Medical center, fistula clinic during the study period. All fistula patients were included in the study. Accordingly, 78 women who underwent surgical repair were interviewed. The means and the standard deviation were computed using conventional statistics formulas. The unpaired t-test was used to compare two independent means, and one-way analysis of variance (ANOVA) was used to compare the quality of life before repair and after a successful repair. Linear regression analysis was done for identifying determinants of quality of life. A P value of 0.05 will be considered statistical significance. Result The overall quality of life of women was 58.17 ± 7.2 before the surgical repair and 71.20 ± 10.79 after surgical repair. The result indicates there is a significant difference in the mean value of pre and post-operative (P < 0.001). The overall satisfaction of women with their health status before the surgical repair was 22.5 ± 1.30and it has increased to 53.0 ± .90after surgical repair. The physical health dimension score was 16.51 ± 5.27 before the surgical repair while it has increased to 21.77 ± 5.38 after the surgical repair. The score of the social domain before the surgical repair was 5.19 ± 1.34 and it has increased to 7.13 ± 3.67 after the surgical repair. The score of the environmental health domain was 17.41 ± 2.89 before the surgery while it also increased to 21.65 ± 4.04 after the surgical repair. The results have shown there was a significant difference in the mean values of pre and post-operatives in both social and environmental scores (P < 0.001). The score of the psychological health domain before the surgery was 19.06 ± 1.46 and it was increased to 19.84 ± 3.21 after the surgical repair. The result showed there is a significant difference in mean value pre and post-operative (P = 0.048), though it is a slight improvement compared to other domains. Conclusion The overall quality of life of the patient with fistula was improved after successful surgical repair. Although all domains of quality of life had shown significant improvement after successful surgical repair, the psychological domain showed slight improvement.

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MO822POLYPHARMACY NEGATIVELY AFFECTS HEALTH-RELATED QUALITY OF LIFE IN DIALYSIS PATIENTS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab098.0014 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Julia Colombijn ◽

Anna Bonenkamp ◽

Anita Van Eck van der Sluijs ◽

Alferso C Abrahams ◽

Joost Bijlsma ◽

...

Keyword(s):

Quality Of Life ◽

Health Related Quality ◽

Dialysis Patients ◽

Self Rated Health ◽

Therapeutic Benefits ◽

Significant Difference ◽

Related Quality ◽

Health Related ◽

The Mean

Abstract Background and Aims Dialysis patients are often prescribed a large number of medications to improve metabolic control and manage co-existing comorbidities. However, several studies suggest that a large number of medications can also detrimentally affect their health-related quality of life (HRQoL). Therefore, this study aims to provide insight in the association between the number of medications and various aspects of HRQoL in dialysis patients. Method A multicentre study was conducted among dialysis patients from Dutch dialysis centres three months after initiation of dialysis as part of the ongoing prospective DOMESTICO study. The number of medications, defined as the number of concomitantly prescribed types of drugs, was obtained from electronic patient records. Primary outcome was HRQoL measured with the Physical Component Summary (PCS) score and Mental Component Summary (MCS) score (range 0-100) of the Short Form 12. Secondary outcomes were number of symptoms (range 0-30) measured with the Dialysis Symptoms Index and self-rated health (range 0-100) measured with the visual analogue scale of the EuroQol-5D-5L. Data were analysed using linear regression and adjusted for possible confounders, including age, sex, dialysis modality, and comorbidity. Analyses for MCS and number of symptoms were performed after categorising patients in tertiles according to their number of medications because assumptions of linearity were violated for these outcomes. Results A total of 162 patients were included. Mean age of patients was 58 ± 17 years, 35% were female, and 80% underwent haemodialysis. The mean number of medications was 12.2 ± 4.5. Mean PCS and MCS were 36.6 ± 10.2 and 46.8 ± 10.0, respectively. The mean number of symptoms was 12.3 ± 6.9 and mean self-rated health 60.1 ± 20.6. In adjusted analyses, PCS was 0.6 point lower for each additional medication (95%CI -0.9 – -0.2; p=0.002). MCS was 4.9 point lower (95%CI -8.8 – -1.0; p=0.01) and 1.0 point lower (95%CI -5.1 – 3.1; p=0.63) for the highest and middle tertiles of medications, respectively, compared to the lowest tertile. Patients in the highest tertile of medications reported 4.1 more symptoms compared to the lowest tertile (95%CI 1.5 – 6.6; p=0.002) but no significant difference in the number of symptoms was observed between the middle and lowest tertile. Self-rated health was 1.5 point lower for each medication (95%CI -2.2 – -0.7; p<0.001). Conclusion After adjustment for comorbidity and other confounders, a higher number of medications was associated with a lower PCS, MCS, and self-rated health in dialysis patients and with more symptoms. This suggests that it may be relevant to weigh expected therapeutic benefits of medication against their possible harmful effects on HRQoL. An unfavourable balance between expected benefits and impact on HRQoL might be ground to deviate from clinical guidelines, especially for patients with a limited life-expectancy and for whom a kidney transplant is unattainable.

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Effect of Ranibizumab Treatment in Cases of Choroidal Neovascular Membranes Secondary to Pathological Myopia versus Age-Related Macular Degeneration

QJM ◽

10.1093/qjmed/hcaa058.011 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

M S Abdaltawab ◽

Z F Ismail ◽

W M A Ebeid ◽

S M Fawzy

Keyword(s):

Visual Acuity ◽

Macular Degeneration ◽

Age Related Macular Degeneration ◽

Intravitreal Injections ◽

P Value ◽

Newly Diagnosed ◽

Pathological Myopia ◽

Age Related ◽

Significant Difference ◽

The Mean

Abstract Aim of the Work The aim of this work is to compare the response of treatment with ranibizumab in terms of visual acuity in cases of CNV secondary to pathological myopia versus CNV secondary to age-related macular degeneration. Methods This prospective, comparative study included ten eyes newly diagnosed as having CNV secondary to pathological myopia, and 10 eyes newly diagnosed as having subfoveal active CNV secondary to AMD. All patients had 3 monthly intravitreal Injections of 0.50 mg (in 0.05 ml of solution) ranibizumab with monthly evaluation of best corrected visual acuity (BCVA) by Landolt C chart, and also calculated in Logarithm of Minimum Angle of Resolution (Log MAR). Results pretreatment there was no significant difference between the two groups as the mean VA (Log Mar) was 1.31 ± 0.2 in AMD group and 1.17 ± 0.3 in MCNV group of P value = 0.431 and also post three IVI of ranibizumab showed no significant difference between the two groups as the mean VA (Log Mar) was 1.22 ± 0.2 for AMD and 1.22 ± 0.5 for MCNV of P value = 0.635. Conclusion there was no significant difference in BCVA between AMD and MCNV groups after three intravitreal injections of ranibizumab.

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Comparison of Quality and Lifestyle in Women with and Without Uterine Leiomyoma Referred to Gynecology Clinics of Shiraz University of Medical Sciences in 2018

Shiraz E-Medical Journal ◽

10.5812/semj.100815 ◽

2020 ◽

Vol In Press (In Press) ◽

Author(s):

Mahnaz Zarshenas ◽

Mozhgan Sorkhenezhad ◽

Marzieh Akbarzadeh

Keyword(s):

Quality Of Life ◽

Uterine Leiomyoma ◽

Healthy Lifestyle ◽

World Health ◽

Medical Sciences ◽

Cross Sectional ◽

World Health Organization Quality ◽

Significant Difference ◽

The Mean

Background: Uterine leiomyomas are considered as a major source of complications and the most common cause of hysterectomy. Objectives: The aim of this study was to compare the quality of life in women with and without uterine leiomyoma referred to gynecology clinics of Shiraz University of Medical Sciences in 2018. Methods: In this cross-sectional study, a total of 126 patients who referred to the clinics of Shiraz University of Medical Sciences were selected and divided into equal groups according to uterine leiomyoma, 1 - 7 cm uterine leiomyoma group and non-uterine leiomyoma group by convenience sampling. The World Health Organization Quality of Life and Healthy Lifestyle questionnaires were used for data collection. Independent t-test was used to analyze the data. Results: The mean quality of life of women with uterine leiomyoma was 47.20 ± 12.41 and women without uterine leiomyoma had a significant difference (51.11 ± 11.23, t = 3.93, P = 0.041). The mean lifestyle of women with uterine leiomyoma was 114.18 ± 25.48 and women without uterine leiomyoma had 149.11 ± 23.81 (t = 4.01, P = 0.029). Conclusions: The mean score of quality of life and lifestyle were significantly different in women with and without uterine leiomyoma. Therefore, it is necessary to improve the quality of life of women by improving their lifestyle and providing psychological counseling.

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Comparitive evaluation of different concentrations of alcohol in ultrasound guided coeliac plexus neurolysis for pain relief in upper abdominal malignancies

Indian Journal of Clinical Anaesthesia ◽

10.18231/j.ijca.2021.109 ◽

2021 ◽

Vol 8 (4) ◽

pp. 492-500

Author(s):

Manish Kumar Singh ◽

Pragya Verma ◽

Sarita Singh ◽

Gyan P Singh ◽

Hemlata Verma

Keyword(s):

Quality Of Life ◽

Morphine Consumption ◽

Rescue Analgesia ◽

Vas Score ◽

Group I ◽

Significant Difference ◽

The Mean ◽

Group Ii ◽

Upper Abdominal

Patients suffering from advanced upper abdominal malignancies have pain as predominant symptom affects their quality of life and survival. USG guided coeliac plexus neurolysis become benevolence in these patients on part of their pain management and quality of life improvement. To compare the efficacy of USG guided coeliac plexus neurolysis for pain relief in upper abdominal malignancies by using different concentration of alcohol (50% vs 75%).This Prospective, comparative, randomised double blinded study was conducted during Sep 2019 – Aug 2020 at our tertiary care centre. Total 60 cases were taken as per following inclusion and exclusion criteria and randomly divided into 2 groups i.e. 30 each group, we compare Visual Analogue Scale (VAS) score, quality of life (QOL) and need of rescue analgesia profile between the groups to know the efficacy of USG guided coeliac plexus block. In our study, we observed that the baseline mean VAS score in group I was 8.26±0.78 while in group II was 8.03±0.76. No significant difference was found in mean VAS score at this time between the groups (p=0.24). The baseline mean QOL score in group-I was 77.46±3.40 while for the cases of group II the mean QOL score was 77.36±3.33. No significant difference was found in mean QOL score at baseline between the groups (p=0.90). The baseline mean morphine consumption in group-I was 113.33±39.24 mg while for the cases of group-II the mean morphine consumption was 120.33±38.37mg. No significant difference was found in mean morphine consumption at this time between the groups (p=0.48).Both groups having 50% alcohol and 75% alcohol decreases the VAS score from baseline in patients having upper abdominal malignancies along with QOL and dosages of rescue analgesia whereas no significant difference in VAS score in patients of both groups.

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Anatomical and Visual Effects of Implantable Phakic Contact Lens on Correction of Myopia

10.21203/rs.3.rs-1245764/v1 ◽

2022 ◽

Author(s):

Mahmoud Ekram ◽

Ahmed Mohamed Kamal Elshafei ◽

Asmaa Anwar Mohamed ◽

Mohamed Farouk Sayed Othman Abdelkader

Keyword(s):

Visual Acuity ◽

Anterior Chamber ◽

Contact Lens ◽

Anterior Segment ◽

Anterior Chamber Depth ◽

Case Series ◽

Care Group ◽

Case Series Study ◽

Significant Difference ◽

The Mean

Abstract Purpose: To evaluate the anatomical effects of implantable phakic contact lens (IPCL) (Care Group, India) on anterior segment and its visual outcomes .Patients and methods: In a prospective interventional case series study, 60 highly myopic eyes of 32 patients were subjected to IPCL implantation in the Ophthalmology Department of Minia University Hospital, Egypt from January 2019 to June 2021. All patients had complete ophthalmic examination and were followed up for 1 year. Pentacam was used for preoperative and postoperative estimation of anterior chamber depth (ACD), anterior chamber angle (ACA), anterior chamber volume (ACV) and IPCL vault in the 1st, 3rd, and 12th months. Assessment of corneal endothelium was done using specular microscope preoperatively and after 12 months. Preoperative and postoperative refraction and visual acuity were measured. Results: There was a statistically significant decrease in ACD, ACA, and ACV. There was no significant difference between preoperative and postoperative mean intraocular pressure (IOP) by the 12th month (P=0.163). The mean preoperative endothelial cell count (ECD) was significantly reduced from 2929.3±248 cells/mm2 to 2737.9±303 cells/mm2 at the 12th month (P<0.001). with a statistically highly significant improvement of mean Log Mar uncorrected visual acuity (UCVA) from 1.48±0.19 preoperatively to 0.46±0.11 by the end of follow up (P<0.001) with insignificant difference between preoperative best corrected visual acuity (BCVA) and postoperative UCVA (P=0.209). In the 12th month, the mean vault was 240±540 μm. No sight threatening complications occurred.Conclusion: Although IPCL induced anatomical changes, it was safe and effective for correction of high myopia.

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Performance of colposcopic scoring by modified International Federation of Cervical Pathology and Colposcopy terminology for diagnosing cervical intraepithelial neoplasia in a low-resource setting

South Asian Journal of Cancer ◽

10.4103/sajc.sajc_302_18 ◽

2019 ◽

Vol 08 (04) ◽

pp. 218-220 ◽

Cited By ~ 3

Author(s):

Prabhakaran Nair Rema ◽

Aleyamma Mathew ◽

Shaji Thomas

Keyword(s):

Cervical Intraepithelial Neoplasia ◽

Scoring Systems ◽

Intraepithelial Neoplasia ◽

International Federation ◽

Screening Tests ◽

Substantial Agreement ◽

Low Resource ◽

Resource Setting ◽

Low Resource Setting

Abstract Introduction: Colposcopy is a tool to evaluate women with cervical pre-cancer and cancer. To interpret the colposcopic findings, various scoring systems are used but with inter observer variations. To improve the quality of colposcopy, International Federation of Cervical Pathology and Colposcopy (IFCPC) has introduced a colposcopic nomenclature in 2011. Colposcopic scoring helps to select patients who need treatment for cervical intraepithelial neoplasia. Aim of the Study: The study aimed to evaluate the agreement between colposcopic diagnosis with the modified IFCPC terminology and cervical pathology in patients with abnormal screening tests and to assess the utility of this colposcopic scoring system in low resource settings. Methodology: Patients with abnormal screening tests who underwent colposcopic assessment in the department of Gynaecological oncology were included in the study. Colposcopic scoring was done by the modified IFCPC nomenclature. The results were compared with cytology and the final histopathology. Results: 56 patients were included in the study. The colposcopic scoring when compared to histopathology showed agreement in 65.7% which indicated the agreement was substantial and was statistically significant (P = 0.0001). With cytology the colposcopic score showed agreement in 35.6% indicating a fair agreement and this was also statistically significant (P = 0.001). Conclusion: Colposcopic scoring by modified IFCPC 2011 criteria showed substantial agreement with cervical histopathology. Compared to traditional methods, 2011 international terminology of colposcopy could improve colposcopic accuracy.

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Effects of spectacles and telescopes on visual function in students with oculocutaneous albinism

African Health Sciences ◽

10.4314/ahs.v20i2.28 ◽

2020 ◽

Vol 20 (2) ◽

pp. 758-767

Author(s):

Siddeeqa Jhetam ◽

Khathutshelo P Mashige

Keyword(s):

Visual Acuity ◽

Contrast Sensitivity ◽

Reading Rate ◽

Oculocutaneous Albinism ◽

Eye Care ◽

Significant Difference ◽

Observational Study Design ◽

The Mean ◽

Better Than ◽

Spectacle Correction

Purpose: To investigate the effects of spectacle and telescope corrections on visual acuity (VA), contrast sensitivity (CS) and reading rates (RR) in students with oculocutaneous albinism (OCA). Methods: An observational study design was conducted on 81 students with OCA. Distance and near VA, CS and RR were measured without correction, with spectacle correction and with a combination of spectacle correction and telescopes. Results: The mean distance and near VA values with a combination of spectacle correction and telescopes were significantly better than those without correction and with spectacle correction alone (p = 0.01). Mean CS values achieved with spectacles alone were significantly better than those obtained with a combination of spectacles and telescopes (p = 0.01). There was no significant difference between logCS values obtained without correction compared to those obtained with a combination of spectacle correction and telescopes. There were no significant differences between RR values obtained with a combination of spectacles and telescopes and those without and with spectacle correction alone (all p > 0.05). Conclusion: This article provides valuable information to eye care practitioners on the effects of spectacles and telescopes on visual acuity, contrast sensitivity and reading rate in students with OCA. Keywords: Oculocutaneous albinism; visual acuity; telescope; contrast sensitivity; reading rate.

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