scholarly journals Training of Resident Ophthalmologists in Cataract Surgery: A Comparative Study of Two Approaches

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Argyrios Tzamalis ◽  
Lampros Lamprogiannis ◽  
Nikolaos Chalvatzis ◽  
Chrysanthos Symeonidis ◽  
Stavros Dimitrakos ◽  
...  

Purpose.To evaluate and compare the efficacy of two different training methods in resident-performed phacoemulsification surgery.Methods.502 eyes of 467 patients who underwent resident-performed phacoemulsification were included in the study by reviewing their medical records. Residents were allocated into two groups according to the method applied during their training in cataract surgery; Group A included residents that were trained with the “step-by-step” method and Group B those trained with the “one-step” method. Primary outcome was the incidence of main complications, defined as posterior capsular ruptures and/or zonular dehiscence with vitreous loss.Results.Each resident performed a median of 63 phacoemulsification surgeries. A statistically significant difference (p=0.0032) was noted in the main complications rate between the two groups, yielding a mean of 17.3% in Group A and 7.25% in Group B. Other intraoperative complications were not shown to differ statistically significantly between study groups (p>0.05). Among the first 40 surgeries of each resident, main complications rate differed also statistically significantly (p=0.0048) between Group A (21.67%) and Group B (8.5%), while a better surgical performance-yielding statistical significance in Group A (p=0.017) was indicated in both groups between the 20th and the 30th procedure.Conclusions.Training in cataract surgery using the “one-step” method may lead to an improvement in surgical competency, when measured by complications rates and, therefore, to significantly better quality of training for resident ophthalmologists.

2017 ◽  
Vol 10 (3) ◽  
pp. 140
Author(s):  
Sultana Parveen ◽  
Mozammal Hossain ◽  
Md. Mujibur Rahman Howlader ◽  
Md. Abdul Hannan Sheikh ◽  
Md. Shamsul Alam ◽  
...  

<p>The purpose of the present study was to assess the giomer retention following application of one step self etch adhesive and one-step self-etch adhesive plus an extra hydrophobic adhesive layer in non-carious cervical lesion. Twenty four participants having bilateral cervical lesion at the maxillary premolars teeth were selected. Following cleaning of the cervical lesions, 24 left premolar teeth were restored with giomer by using the one-step self-etch system (Group A) and 24 right premolar teeth were restored with giomer by using one-step self-etching plus extra hydrophobic adhesive layer (Group B). Participants were recalled at 6 and 15 months for evaluating the clinical outcome. The results showed that at 15 months, 18 giomer restorations in Group A and 21 in Group B were intact inside the cavity and no significant difference was found between the two groups. It can be concluded that giomer restoration used with one-step self- etching plus additional adhesive layer slightly improved the retention of the material.</p>


2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Mayank Bhandari ◽  
Sabyasachi Chowdhary ◽  
Milind Rao ◽  
Gopinath Bussa ◽  
Julie Holm

Abstract Background Roux en Y gastric bypass (RYGB) surgery for morbid obesity is considered as gold standard, but there can be a difference in the length of alimentary and biliopancreatic limb to achieve optimum weight loss. Till now there is no agreed consensus on the ideal limb lengths and their effect on the weight loss. We would like to evaluate the change in the alimentary limb length on the weight loss after the gastric bypass surgery,  as a short to medium term single center study. Methods A retrospective analysis from prospectively maintained   database of 523 patients who underwent RYGB from  2012 till 2018 was done. Patient who had at least a follow up of 2 years(n = 388) were included.  At our center we use alimentary limb of 120 +/- 10 cm for Body Mass Index (BMI) &lt; 40 kg/m2 (group A)  and 150+/-10 cm for the BMI &gt;40 kg/m2  (Group B). The biliopancreatic limb length varies from 50 to 70 cm and this does not change with BMI.  The percentage excess weight(EWL) loss was measured and analyzed  at 1st  and 2nd year post operatively. We used paired t test to check for statistical significance. Results There were 172 patients in Group A and 216 in Group B. The number of females were 330 and  males were 58.   The average age was 44 years .  The mean  preoperative  BMI for the 120 cm limb group was  37.1 kg/m2 and  that for  150 cm limb was 45.3kg/m2. The EWL for the group A at 1 year and 2 year post op was a  Mean and standard deviation  of 79.3% +/- 39.4% and 78.3% +/- 35.2% respectively and for group B was 58.8% +/- 26.6% and 58.6% +/- 23.2% respectively. The difference was statistically significant (p &lt; 0.001) . The analysis and interpretation for metabolic syndrome is yet to be determined.   Conclusions In our study, Increasing the alimentary limb length for higher BMI reduced  EWL. This is consistent with few other publications regarding the same. This has resulted in a  change in our practice namely keeping the length of alimentary limb constant and varying the BP limb length. We will be analyzing  and presenting this data in future.


2020 ◽  
Vol 12 ◽  
pp. 251584142092430
Author(s):  
Carlo Cagini ◽  
Adriana Pellegrino ◽  
Alessia Iannone ◽  
Alessio Cerquaglia ◽  
Antonella Modugno ◽  
...  

Aim: The aim of this study is to compare the efficacy of different dexamethasone eye drops formulations in controlling postoperative inflammation. Methods: Cataract surgery was carried out in 72 patients (35 males) divided into two groups: group A (36 patients, mean age = 78.0 ± 5.6) received four times daily for 2 weeks a suspension containing tobramycin 0.3% mg/ml + dexamethasone 0.1% mg/ml, and group B (36 patients, mean age = 76.2 ± 6.8) a solution containing tobramycin 0.3% mg/ml + dexamethasone 0.1% mg/ml. Both groups received ofloxacin 0.5% four times daily for 7 days, and nepafenac 0.1% three times daily for 3 weeks. Best-corrected visual acuity, intraocular pressure, corneal thickness, endothelial cells count, aqueous flare and macular thickness were evaluated preoperatively and at 1 day, 15 days, 1 and 2 months. Results: In group A, intraocular pressure, corneal thickness and aqueous humour flare values preoperatively and at the end of follow-up were 14.3 ± 1.8 and 13.2 ± 1.8 mmHg, 546.4 ± 34.6 and 539.6 ± 36.1 µm, 11.84 ± 4.44 and 13.52 ± 5.54 ph/ms, respectively, with no statistically significant difference. In group B, intraocular pressure, corneal thickness and aqueous humour flare values preoperatively and at the end of follow-up were 14.3 ± 1.5 and 13.1 ± 1.7 mmHg, 552.9 ± 37.4 and 548.1 ± 39.3 µm, 11.45 ± 4.06 and 13.73 ± 4.99 ph/ms, respectively, with no statistically significant difference. No difference was detected in the macular thickness values in the parafoveal area preoperatively and at 2 months follow-up in group A (332.18 ± 16.19 and 337.71 ± 16.33 µm) and group B (329.11 ± 18.28 and 334.37 ± 20.86 µm), respectively. Conclusion: The two different formulations of dexamethasone eye drops reached the same anti-inflammatory effects.


2010 ◽  
Vol 25 (2) ◽  
pp. 66-71 ◽  
Author(s):  
B Akbulut

Objectives Chronic venous insufficiency (CVI) is an important cause of discomfort and inability to work. Hydroxyethylrutosides (Venoruton®; 0-[beta-hydroxyethyl]-rutosides) has been used for decades for the treatment of CVI. Studies have reported symptomatic relief and a decreased capillary filtration after the administration of the oral preparations. Calcium dobesilate is a synthetic venoactive drug acting on several levels. It inhibits capillary permeability; it has antioxidant properties; and it inhibits the synthesis of prostaglandins and thromboxanes, reducing platelet and erythrocyte aggregation, as well as blood viscosity. The aim of this study is to determine whether the combination of both drugs is more effective in decreasing patients' complaints. Methods One hundred and fifty patients with primary venous insufficiency were randomized into three groups: Group A receiving calcium dobesilate only, Group B receiving oxerutin only and Group C receiving both calcium dobesilate and oxerutin. Patients were evaluated with a questionnaire before and four weeks after treatment regarding following parameters: itching, fatigue, heaviness, numbness, cramp, swelling and sensitiveness. Patients rated their symptoms from 0 to 4 (0: absent; 1: mild; 2: moderate; 3: severe; 4: very severe). Results Complaints, which were scored by patients before and after treatment, decreased. Among the single-drug groups, itching score decreased more in Group B, whereas scores of fatigue, heaviness, numbness, cramp and swelling decreased more in Group A. But the difference was not significant, statistically. But all complaints decreased significantly in Group C. Difference of scores after treatment revealed no statistical significance in Group A and B, but scores of Group C produced a significant difference when compared with Group A and B. Conclusion Results demonstrate that a combination of calcium dobesilate and oxerutin shows a better improvement of complaints. These observations have to be confirmed in larger series with objective tests. Changes of quality of life after a combination therapy might also be of interest.


2018 ◽  
Vol 11 (2) ◽  
pp. 118-123
Author(s):  
Sanjay Rastogi ◽  
Tousif Ahmed ◽  
Kolli Giri ◽  
Ramakant Dandriyal ◽  
Indra B. Niranjana Prasad ◽  
...  

The aim of this prospective study was to appraise the role of embrasure wiring in the treatment of mandibular fractures over the arch bar as adjunctive techniques of maxillomandibular fixation (MMF). This study was conducted on 40 patients who were surgically treated for mandibular fractures with accessory use of MMF (embrasure: group A vs. arch bars: group B). All patients were evaluated for demographic data, etiology, and location of fracture. Characteristically, the complications, including wire injury, infection, and malocclusion, were recorded. The data were analyzed using Student's t-test and chi-square test as appropriate. Statistical significance was set at p < 0.05). In this study, data from 40 patients were included. In group A (embrasure wiring), time required for placement of MMF was significantly less than (7.85 ± 0.81 minutes) that in group B, and also there was less incidence of wire prick to the operator in group A than in group B ( p < 0.05). However, in terms of wire prick and malocclusion, no statistically significant difference was noted in groups A and B ( p > 0.05). Patient treated with embrasure wiring intermaxillary fixation had better outcomes especially in terms of time of placement and less incidence of wire prick injury when compared with arch bar.


2019 ◽  
Vol 3 (2) ◽  

Objective: Aim of the study is to Compare the astigmatism induced by a reduced temporal sclerocorneal tunnel incision manual small incision cataract surgery with an extended temporal clear corneal Phacoemulsification of similar width . Methods: A Prospective, randomised controlled study was carried out in 224 selected patients who were again divided into two groups - Group A (112 patients) and Group B (112 patients). Group A patients underwent temporal manual small incision cataract surgery with a 5.5 mm sclerocorneal incision and Group B underwent phacoemulsification by a 2.8 mm clear corneal temporal incision which was extended to 5.5 mm before IOL implantation. In both groups, a 5.25 mm rigid PMMA IOL was implanted in the bag. UCVA and BCVA of both group of patients was quantified and analyzed at 1 week and at 6 weeks Observation: It was seen that the mean surgically Induced astigmatism in group A (N=112) was 0.5625D , which was slightly lesser than that in Group B (N=112) which was 0.65D, although the p-value of 0.26 indicated that there was statistically no significant difference in visual outcomes between the two groups of patients. Here, a p-value of < 0.05 was considered statistically significant. Conclusion: In Skilled and Safe hands, refractive outcomes following performing a 5.5mm temporal sclerocorneal frown-incision manual small incision cataract surgery and a phacoemulsification procedure by a 2.8mm temporal clear corneal incision extended to 5.5mm for implanting a 5.25mm rigid PMMA IOL , are comparable.


2019 ◽  
Vol 35 (6) ◽  
Author(s):  
Uzma Bashir ◽  
Moizza Tahir ◽  
Muhammad Irfan Anwar ◽  
Faisal Manzoor

Background & Objective: Cutaneous leishmaniasis (CL) is endemic in developing countries like Pakistan. Pentavalent antimonials are still drug of choice, despite being toxic and intolerable for patients. Second line treatments have been extensively studied but the results of their efficacy are conflicting. This, to our knowledge, will be the first study in this regard. Our objective was to  determine if combination of oral itraconazole with intralesional (IL) meglumine antimoniate (MA) reduces the duration of treatment for cutaneous leishmaniasis, as compared to intralesional MA alone. Methods: A randomized controlled trial (single blinded) was carried out from August 2017 till December 2017 on 69 patients who fulfilled inclusion criteria. They were assigned to Group-A or B by lottery method. Group-A patients received IL MA once a week while Group-B received oral itraconazole 200mg, once daily, for six weeks along with similar regimen of IL MA as Group-A. The patients were assessed every three weeks by the blinded assessor till clinical cure was achieved. A follow up visit, two months after clinical cure was done to look for relapse of the disease. Results: Thirty patients in Group-A and 35 patients in Group-B completed the study. At 3, 6, 9 and 12 weeks the patients were assessed for: no, partial or complete response and results of the two groups were compared for statistical significance. The p-values of 0.20, 0.57 and 0.11 at 3, 6 and 9 weeks, respectively, depict that there was no significant difference at any step of assessment between the two groups in terms of healing. The p values of each t test was >0.05 refuting the hypothesis. Conclusion: Combination of oral itraconazole with intralesional MA offered no benefit over intralesional MA alone in the management of cutaneous leishmaniasis in terms of duration of therapy.  Abbreviations Used: IL = Intralesional,  MA = Meglumine Antimoniate, LD = Leishmania Donovan, CL = Cutaneous leishmaniasis, CMH = Combined Military Hospital. doi: https://doi.org/10.12669/pjms.35.6.363 How to cite this:Bashir U, Tahir M, Anwar MI, Manzoor F. Comparison of Intralesional Meglumine Antimonite along with oral Itraconazole to Intralesional Meglumine Antimonite in the treatment of Cutaneous Leishmaniasis. Pak J Med Sci. 2019;35(6):1669-1673.   doi: https://doi.org/10.12669/pjms.35.6.363 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S501-S501
Author(s):  
Mary Katherine. Theoktisto ◽  
Delvina Ford ◽  
Omar Khan ◽  
Kelly R Reveles ◽  
Jose Cadena

Abstract Background Tuberculosis (TB) remains a significant public health concern, and exposure in healthcare settings is prevalent. Current guidelines recommend testing for TB by acid-fast bacilli (AFB) smear microscopy with 3 sputum samples and/or using nucleic acid amplification test (NAAT), and mycobacterium culture. The purpose of this project is to compare how different TB diagnostic tests affect the duration of stay in respiratory isolation. Methods This study was conducted at the Veteran Affairs South Texas hospital, which includes a total of 437 beds. Data were collected retrospectively from medical records. Eligibility included patients admitted to the hospital and placed in airborne isolation for TB screening and diagnosis, had 3 sputum samples collected 8 hours apart and/or had 2 PCR MTB/RIF. Patients were excluded if they had TB or were not undergoing evaluation for TB. Three time periods analyzed included, 3 AFB sputum samples analyzed in-house from December 2012 to January 2014 (Group A), 3 AFB sputum samples analyzed at outside facility during 2013 to 2014 as well as 2 months in 2012 (Group B), and 2 MTB PCR/RIF in house during 2017 and 2018 (Group C). Duration of isolation was compared between groups using the Kruskal–Wallis test. A total number of 815 patients were screened, leaving 105 patients for analysis after exclusion. There were 49 patients analyzed from Group A, 28 from Group B, and 28 from Group C. Results Crude analysis of the data showed numerical differences in the total number of days and hours in isolation between the 3 groups. The average (mean) days in isolation were 4.2 for Group A, 7.4 for Group B, and 5.5 for Group C. There was no statistically significant difference in either days or hours of airborne precautions by “rule out” method. Days of isolation in airborne precautions (median IQR) was 4 for all groups (P = 0.3313). Likewise, hours of airborne precautions had a median IQR of 96 for all groups P = 0.4347. Conclusion Although there was no statistical significance between the groups, crude analysis did show a numerical difference in the mean total airborne days and hours. Lack of statistical difference may be due to low number of patients, timing of order placement for in-house PCR, and longer than expected stay in airborne precautions. Disclosures All authors: No reported disclosures.


2017 ◽  
Vol 11 (3-4) ◽  
pp. 134 ◽  
Author(s):  
Michael E. Chua ◽  
Megan A. Saunders ◽  
Paul R. Bowlin ◽  
Jessica M. Ming ◽  
Roberto Iglesias Lopes ◽  
...  

Introduction: Advances in communication technology are shaping our medical practice. To date, there is no clear evidence that this mode of communication will have any effect on unnecessary postoperativeemergency room (ER) visits. We aim to evaluate the effect of email and media communication with application of smartphone digital photography on post-hypospadias repair ER visit rates.Methods: This prospective cohort study included all patients who underwent hypospadias repair performed by a single surgeon from October 2014 to November 2015. Patients were categorized intotwo groups: Group A consented for smartphone photography and email communication and Group B declined. Reason for ER visits within 30 days postoperatively was assessed by another physician, who was blinded of patient group assignment. The reasons were categorized as: unnecessary ER visit, indicated ER visit, or visit unrelated to hypospadias surgery. Chi-square test and T-test were used for statistical analysis. Relative risk (RR) and corresponding 95% confidence interval (CI) were also calculated. Statistical significance was set at p<0.05.Results: Over a 14-month period, 96 patients underwent hypospadias repair (81 in Group A, 15 in Group B 5). No significant difference was noted between groups for overall ER return rate (RR 0.46, 95% CI 0.21, 1.0). However, the number of ER visits for wound check not requiring intervention was significantly lower in Group A than in Group B (RR 0.14, 95% CI 0.035, 0.56); likewise, a higher number of ER visits requiring intervention was noted in Group A compared with Group B, although statistically this was not significant (RR 1.67, 95% CI 0.23, 12.21).Conclusions: Email communication with the use of smartphone digital photography significantly reduced the number of unnecessary ER visits for post-hypospadias wound checks.


Author(s):  
Edith Umasi Ramos ◽  
Luan Pier Benetti ◽  
Júlio César Silva Oliveira ◽  
Ana Paula Farnezi Bassi

Abstract Objective We examined if the association of ibuprofen with arginine has a better anti-inflammatory effect on pain, edema, and trismus after surgery of the impacted mandibular third molar than ibuprofen alone. Materials and Methods The study included 21 patients, 18 to 30 years of age, each with an impacted, and bilateral and symmetric third molar (total n = 21) that required transalveolar extraction. Patients were randomly assigned numbers from 1 to 21. Group A received ibuprofen-arginine as preoperative medication, while Group B received only ibuprofen. Both groups received the same postoperative medications: amoxicillin + acetaminophen. All patients were evaluated for pain at 6, 12, and 24 hours. They were evaluated for edema and trismus before surgery; immediately after surgery; and at 24, 48, and 72 hours postoperatively. Postoperative pain scores used the visual analog scale (BS-11). For facial edema and trismus, linear measurements used the method modified by Gabka and Matsumura. Statistical Analysis For the evaluation of data between Group A and Group B, we used the statistical software SPSS version 22. The Shapiro-Wilk, analysis of variance, the Bonferroni comparisons, and the Wilcoxon test were used. All tests were based on a significance level of 0.05. Results The study results reveal that the facial edema scores of Group A and Group B presented statistically significant differences (p < 0.05), while for postoperative trismus, there was no statistically significant difference (p > 0.05) between the scores of Group A and Group B. Conclusion As a conclusion, we can state that the use of ibuprofen-arginine allows for significantly better control of pain and edema, and shows a tendency toward better recovery from trismus, although without statistical significance. Based on this, we can assert that arginine improves the anti-inflammatory power of ibuprofen, thus generating better tissue healing after surgery of the impacted third molar.


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