scholarly journals Use of Simultaneous Bilateral Cataract Surgery (SBCS) to Optimize Parameters Affecting the Subjective Perception of the Procedure

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
P. Studený ◽  
J. Vránová ◽  
L. Nováček

Introduction. Simultaneous Bilateral Cataract Surgery (SBCS) is still a relatively controversial procedure. The main objection is the risk of bilateral endophthalmitis or bilateral refractive error. However, SBCS has also some advantages (faster visual rehabilitation, lower risk of nosocomial infection, and lower cost). Performing surgery on both eyes in one session has one additional advantage which has not yet been described in the literature (according to the information available to authors). It allows surgeons to distinguish the effect of minor differences in the surgical protocol on the subjective perception of the procedure more accurately, which is a more suitable method than comparing two independent groups of patients. Purpose. To compare the effect of minor changes in the surgical protocol during SBCS on intraindividual subjective perception of surgery (pain, pressure, glare, and perception of the duration of the surgery). Methods. During the surgery of the right and left eyes of one patient, we randomly changed one surgical parameter (use of intracameral anesthesia, light intensity of the operating microscope, type of eyelid speculum, creation of the posterior circular capsulorhexis, and communication with the patient during surgery). Patients immediately after both surgeries subjectively evaluated the perception of pain (on the scale 0–10), pressure, and glare (on the scale 0–5) and estimated the duration of the surgery, separately for each eye. Each change was evaluated in a group of 50 patients. Results. In the control group with no parameters changed, we noted no difference in subjective perception of the first and second surgery. In subgroups, where we changed the protocol, we detected only minor differences in subjective perception of pain, pressure, glare, and duration of the surgery. Only one statistically significant difference in subjective pain perception was in the subgroup where we used eye intracameral anesthesia (0.34 eyes with intracameral anesthesia, 0.44 eyes with only topical anesthesia). We did not note any statistically significant differences in the perception of the time of surgery. Conclusion. SBCS can be used to optimize the parameters of cataract surgery. In our study, we noted a positive effect of intracameral anesthesia on subjective perception of surgery.


2021 ◽  
pp. 1-8
Author(s):  
Sevde Aksu ◽  
Pelin Palas Karaca

<b><i>Aim:</i></b> The research was conducted as a randomized controlled pilot study to evaluate the effects of reflexology on lactation in mothers who delivered by cesarean section (CS). <b><i>Methods:</i></b> A single-blind randomized controlled experimental study was conducted with a total of 60 postpartum women in the reflexology application (<i>n</i> = 30) and control groups (<i>n</i> = 30). After the CS, the mothers in the control group were given approximately 3-h routine nursing care after recovering from the effects of anesthesia; the introductory information form was applied, and the Breastfeeding Charting System and Documentation Tool (LATCH) and visual analog scale (VAS) for the signs of the onset of lactation were implemented on the first and second days. Reflexology was applied to the women in the intervention group after an average of 3 h following the mother’s condition had become stable and she had recovered from the effects of anesthesia. Reflexology was applied a total of 20 min – 10 min for the right foot, 10 min for the left foot – twice a day with 8-h intervals on the first and second days after CS. After the last reflexology application, the LATCH and VAS for the signs of the onset of lactation were applied. <b><i>Results:</i></b> Of the women, 70% breastfed their babies within 60 min after delivery; 46.7% of the mothers received breastfeeding training and 81.7% needed support for breastfeeding after the CS. The LATCH breastfeeding scores of the women in the intervention group on both days were significantly higher compared to those of the women in the control group (<i>p</i> &#x3c; 0.001). On the first day after the CS, apart from breast pain, there was no significant difference between the two groups in terms of breast heat and breast tension (<i>p</i> &#x3e; 0.05). On the second day after the CS, apart from breast tension, there was no significant difference between the groups in terms of breast heat and breast pain (<i>p</i> &#x3c; 0.05). In the study, women in the intervention group were found to have higher scores in terms of all three symptoms compared to the control group (<i>p</i> &#x3c; 0.05). <b><i>Conclusions:</i></b> In the study, it was determined that LATCH scores and signs of the onset of breastfeeding increased in the mothers who received reflexology after CS.



Author(s):  
Graziela Maria Martins-Moreira ◽  
Alessandra Spada Durante

Abstract Introduction Good hearing in pilots, including central auditory skills, is critical for flight safety and the prevention of aircraft accidents. Pure tone audiometry alone may not be enough to assess hearing in the members of this population who, in addition to high noise levels, routinely face speech recognition tasks in non-ideal conditions. Objective To characterize the frequency-following response (FFR) of a group of military pilots compared with a control group. Methods Twenty military pilots in the Study Group and 20 non-pilot military personnel, not exposed to noise in their work, in the Control Group, all with normal hearing, aged between 30 and 40 years old, completed a questionnaire to assess their hearing habits, and their FFRs were measured with a /da/ syllable (duration 40 milliseconds, speed 10.9/s), at 80 dB NA in the right ear. All procedures were approved by the ethical committee of the institution. Statistical analysis was performed using the t-Student or Mann-Whitney tests for quantitative variables, and the Fisher or chi-squared tests for qualitative variables, and a value of p < 0.05 was considered to be statistically significant. Results There was no significant difference between the groups regarding auditory habits. In the FFR, wave amplitudes A (p = 0.01) and C (p = 0.04) were significantly lower in the Study Group. Conclusion Working as a military pilot can be a crucial factor in determining an individual's typical FFR pattern, demonstrated in the present study by statistically significant reductions in the amplitudes of the A and C waves.



2017 ◽  
Vol 45 (06) ◽  
pp. 343-349 ◽  
Author(s):  
Nicole Wente ◽  
Jan-Hendrik Paduch ◽  
Doris Klocke ◽  
Elisabeth Mansion-de Vries ◽  
Martina Hoedemaker ◽  
...  

SummaryObjective: The aim of the study was to investigate the use of somatic cell count (SCC) and aerobic bacterial counts as possible tools to choose animals for selective dry cow treatment (DCT) on cow level. Blanket antibiotic DCT is an approved and common method in Germany aimed at increasing the cure rate of existing intramammary infections (IMI) at the time of drying off and decreasing the risk of new infections during the dry period. However, not all animals benefit equally from an antibiotic DCT. Moreover, dairies, consumers and politicians demand a reduction in the use of antibiotics in farm animals. Several criteria for identifying animals which would benefit from antibiotic DCT have been described in the literature. Material and methods: Animals chosen for this investigation were divided into three study groups: Aerobic Count Petrifilm® group A (153 cows), SCC group S (160 cows) and control group C (169 cows). All quarters were treated with an internal teat sealant (ITS) no matter which group the cows belonged to. Results: Group C, in which all cows received an antibiotic DCT, achieved the best results referred to udder health, particularly regarding bacteriological dry period cure. However, the results of the two study groups A and S, in which the animals were dried off selectively, were only marginally worse. A significant difference regarding bacterial dry period cure was revealed between group S and group C (p = 0.039), whereas no significant difference concerning new IMI risk could be detected between the three study groups. Compared to a blanket antibiotic DCT of all cows in the corresponding study group, a reduction of the usage of antibiotics of 23.5 % (A) and 55 % (S) was noticed, respectively. Furthermore, it could be shown that the lactation number as well as the microorganisms present at the time of drying off influence udder health. Conclusion: Selective DCT is an alternative method to the widespread blanket antibiotic DCT. However, it has to be mentioned that selective DCT involves the described marginal decline in udder health and the additional amount of time, which might arise from the procedure of choosing the right animals and performing the applied rapid test methods.



Author(s):  
Talaat A. Hassan ◽  
Shaima Fattouh Elkholy ◽  
Bahaa Eldin Mahmoud ◽  
Mona ElSherbiny

Abstract Background Multiple sclerosis is one of the commonest causes of neurological disability in middle-aged and young adults. Depression in MS patients can compromise cognitive functions, lead to suicide attempts, impair relationships and reduce compliance with disease-modifying treatments. The aim of this study was to investigate and compare the microstructural changes in the white matter tracts of the limbic system in MS patients with and those without depressive manifestations using a diffusion tensor imaging (DTI) technique. Methods This study included 40 patients who were divided into three groups. Group 1 comprised of 20 patients with relapsing-remitting MS with depressive symptoms and group 2 comprised 10 MS patients without symptoms of depression. The third group is a control group that included 10 age-matched healthy individuals. All patients underwent conventional MRI examinations and DTI to compare the fractional anisotropy (FA) values in the white matter tracts of the limbic system. Results We compared the DTI findings in MS patients with and those without depressive symptoms. It was found that patients with depression and MS exhibited a significant reduction in the FA values of the cingulum (P < 0.0111 on the right and P < 0.0142 on the left), uncinate fasciculus (P < 0.0001 on the right and P < 0.0076 on the left) and the fornix (P < 0.0001 on both sides). No significant difference was found between the FA values of the anterior thalamic radiations in both groups. Conclusion Patients with depression and MS showed more pronounced microstructural damage in the major white matter connections of the limbic pathway, namely, the uncinate fasciculus, cingulum and fornix. These changes can be detected by DTI as decreased FA values in depressed MS patients compared to those in non-depressed patients.



2018 ◽  
Vol 16 (3) ◽  
Author(s):  
Jhenifer Karvat ◽  
Camila Mayumi Martin Kakihata ◽  
Lizyana Vieira ◽  
José Luis da Conceição Silva ◽  
Lucinéia de Fátima Chasko Ribeiro ◽  
...  

ABSTRACT Objective: To evaluate the effects of right sciatic nerve compression and cryotherapy on muscle tissue. Methods: We used 42 male Wistar rats, subdivided in the following Groups Control, Injury 3, Injury 8 and Injury 15 submitted to nerve compression and euthanized in the 3rd, 8th and 15th day after surgery. The Cryotherapy Injury 3 was entailed treatment with cryotherapy by immersion of the animal in recipient for 20 minutes during 1 day, then animals were euthanized at the 3rd day after surgery, and the Cryotherapy Injury 8 and the Cryotherapy Injury 15 was treated for 6 days, and euthanized at the 8th and 15th day after surgery. Functional evaluation was performed by the grasping strength of the right pelvic limb. The right tibialis anterior muscles were evaluated for mass, smaller diameter and cross-sectional area. In the Cryotherapy Injury 8 and the Cryotherapy Injury 15 groups, the hydroxyproline was dosed in the right soles. Results: In the compression there was a significant difference in the Injury Groups compared with the Control Group (p<0.05). In the smaller diameter, the compression in Control Group was higher than Injury 8 (p=0.0094), Injury 15 (p=0.002) and Cryotherapy Injury 15 (p<0.001) groups. The comparison between groups with euthanasia in the same post-operative period, a significant difference (p=0.0363) was seen in day 8th after surgery, and this result in Cryotherapy Injury Group was greater than Injury Group. In the fiber area, Control Group was also higher than the Injury 8 (p=0.0018), the Injury 15 (p<0.001) and the Cryotherapy Injury 15 (p<0.001). In hydroxyproline, no significant difference was seen between groups. Conclusion: Nerve damage resulted in decreased muscle strength and trophism, the cryotherapy delayed hypotrophy, but this effect did not persist after cessation of treatment.



Author(s):  
Gannaram Laxmiprasad ◽  
Chhaya Shori ◽  
Rakesh Shori ◽  
Ashalatha Alli

Background: Recent reports indicate that both manual small incision cataract surgery and extra capsular cataract excision surgery with posterior chamber intraocular lens implantation are safe and effective for treatment of cataract surgery, however, manual small incision cataract surgery gives better uncorrected vision. Objectives of the study were to compare intraoperative and postoperative complications, to compare induced astigmatism and to compare the visual rehabilitation.Methods: This is a prospective study of 100 consecutive patients assigned to undergo conventional extra capsular cataract excision surgery (50 cases) and manual small incision cataract surgery (50 cases). Study was done for a period of two years at a tertiary care referral hospital. Institutional Ethics Committee permission was taken. Also the informed consent was obtained from each patient.Results: In conventional ECCE, the most common surgically induced astigmatism was WTR in 73.4% of cases with mean of 2.79 D±1.3 on first day. 70% of cases with mean 2.1 D±1.28 and 64% of cases with mean of 1.86 D±1.14 at six weeks. ATR was common in MSICS group, 83.67% of cases with mean of 1.5 D±0.72 on first day, 86% of cases with mean of 1.03 D±0.6 at one week and 88% of cases with mean of 1.27 D±0.81 at six weeks. The induced astigmatism was less in MSICS group compared to ECCE group at first day but after six weeks there was no much significant difference found. Early visual recovery was better in MSICS groupConclusions: MSICS has definitive advantages over conventional ECCE in terms of early visual rehabilitation, minimal surgically induced astigmatism; no suture related complications and reduced surgical time.



2019 ◽  
Vol 31 (4) ◽  
Author(s):  
Nawar Bahjet Kamil ◽  
Nada M. Al-Ghaban

Aim of the study: Is to evaluate the effect of myrrh oil local application on the healing process of skin wounds histologically , histomorphometrically and , histochemically. Materials and methods:Twenty male white New Zealand rabbits were used in this study. An incisional wounds with full thickness depth and of 2 cm length were done on both sides of the cheek skin of each rabbit. The left sided incisions (the control group) were irrigated with distilled water (10µL). The right sided incisions (the experimental groups) were treated with myrrh oil (10µL). Each group was subdivided into 4 subgroups according to the healing interval into 1,3,7 and 14 days(5 rabbits for each group). Results: Histological findings of our current study showed a highly significant difference between the experimental and the control groups in count of the inflammatory cells which showed that mean values increased with time for the control and the experimental groups. The histomorphometrical findings had shown that the thickness of the epithelium was nearly completed at about 7 days for the experimental groups and at about 14 days for the control. The blood vessels count was recorded to have a highly significant difference between the groups at days 1 and 3 only. The histochemical findings had shown that the collagen fibers remodeling had recorded a highly significant difference between the control and the experimental groups at days 7 and 14. Conclusion: The current study had revealed that myrrh oil accelerates wounds healing in rabbits. Key word:Wound healing , Myrrh oil, Masson’s Trichrome staining.



2020 ◽  
Vol 63 (6) ◽  
pp. 541-549
Author(s):  
Tomoya Nishida ◽  
Takashi Kojima ◽  
Takahiro Kataoka ◽  
Naoki Isogai ◽  
Yoko Yoshida ◽  
...  

<b><i>Introduction:</i></b> Although biomechanically corrected intraocular pressure (bIOP) is available, the effectiveness of intraocular pressure (IOP) correction in keratoconus and forme fruste keratoconus (FFK) eyes has not been investigated. <b><i>Objective:</i></b> Evaluation of bIOP measurements in eyes with keratoconus and FFK. <b><i>Methods:</i></b> Forty-two eyes in 21 patients with keratoconus in one eye and FFK in the fellow eye were examined (KC/FFK group; mean age 24.62 ± 8.6 years; 16 males and 5 females). The control group consisted of 62 eyes in 31 unaffected subjects (mean age 26.26 ± 3.64 years; 15 males and 16 females). The bIOP was determined using a Scheimpflug-based tonometer (Corvis Scheimpflug Technology [Corvis ST®]) after measuring the IOP with a conventional non-contact tonometer (NIOP). The agreement between NIOP and bIOP values was examined using the Bland-Altman plot. The difference between NIOP and bIOP (bIOP correction amount) was compared between keratoconus and FFK eyes. <b><i>Results:</i></b> In the control group, there were no significant differences between right and left eyes in both NIOP and bIOP values (<i>p</i> = 0.975 and <i>p</i> = 0.224, respectively). In the KC/FFK group, NIOP values were significantly lower in the keratoconus eyes (9.93 ± 1.96 mm Hg) than in the FFK eyes (12.23 ± 3.03 mm Hg; <i>p</i> = 0.0003). There was no significant difference in bIOP values between the right and left eyes of the KC/FFK group (<i>p</i> = 0.168). The bIOP correction amount was significantly increased in keratoconus eyes (3.58 ± 2.12 mm Hg) compared to in FFK eyes (1.80 ± 3.32 mm Hg; <i>p</i> = 0.011). <b><i>Conclusions:</i></b> For eyes with keratoconus and FFK, the bIOP method is effective to adjust IOP measurements based on corneal biomechanical properties.



Dose-Response ◽  
2019 ◽  
Vol 17 (2) ◽  
pp. 155932581984083
Author(s):  
Alba Parras-Moltó ◽  
Juan Ribas-Serna

Our aim was to test the effects of Andullation therapy on pain threshold, pain perception, feeling of well-being, arterial pressure, and leg volume in healthy and unhealthy patients. We used a multidirectional vibration (frequency range: 5–40 Hz; peak-to-peak amplitude: 2–8 mm; acceleration: 0.4–2 m/s2) in an undulatory way through the surface of the body when the patient was in contact with a mattress (“andullation”). The vibes traveled from the heel to the head in a random fashion while the participants (N = 50) were lying on the mattress. We measured the pain threshold using an algometer; pain perception and well-being through a visual analog scale (VAS); arterial pressure with an electronic sphygmomanometer; and leg volume with Kuhnke’s technique. Measurements were made just before the first andullation session and after the fifth andullation session. Every participant received andullation sessions of 30 min a day for 5 consecutive days. The patients’ pain threshold significantly ( P < .001) increased by 34.48% and 25.79% in the lumbar and trapezius zones, respectively, after 5 sessions of therapy. The subjective perception of pain decreased by 52.3% and the feeling of well-being increased by 45.1%. The systolic and diastolic pressures significantly ( P < .001) decreased by 6.44 and 4.68 mm Hg on average, respectively. Leg volume significantly decreased ( P < .01) by 64.39 mL after the fifth andullation session. Despite not including a control group in our study, the andullation intervention showed an improvement in pain, well-being, arterial pressure, and lower limb volume in the studied population.



Author(s):  
Maryam Keramati, MD ◽  
Mohammad Sadegh Sargolzaei, MSc ◽  
Ali Moghadasi ◽  
Mohammad Hasan Basirinezhad, MSc ◽  
Reza Mohammadpourhodki

Background: The patients under cataract sur-gery often experience anxiety not only during the surgery, but also prior to the surgery.Purpose: We sought to determine the effects of slow-stroke back massage on anxiety in patients undergoing cataract surgery. Setting: The study was conducted in the Amiral-momenin Hospital of Zabol city, south-east of Iran.Participants: A total of 60 candidates of cataract surgery participated in the study.Research Design: The participants were ran-domly allocated to either control or intervention groups. The intervention group received slow-stroke back massages, while patients in control group received routine interventions.Intervention: The slow-stroke back massage was performed on the patients assigned to the interven-tion group. The intervention was performed in the morning of the surgery day at 30 minutes before the surgery. The researcher performed each mas-sage session in a sitting position. The duration of each massage session was 15 minutes. Main Outcome Measures: Anxiety was assessed in the both groups in the morning of the surgery, before and immediately after the intervention. In-dependent samples Student’s t test, paired samples Student’s t test, and chi-squared test were used to analyze the data.Results: Anxiety was not significantly different between the two groups before and after the mas-sage (p = .816). On the other hand, paired samples Student’s t test showed a significant difference comparing the anxiety scores before (49.7±5.43) and after (45.16±3.89) the massage in the interven-tion group (p < .001). Conclusions: Based on our results, slow-stroke back massage, which is a low-cost and safe method, reduced anxiety in patients who were candidates for cataract surgery.



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