scholarly journals Comparative Assessment of Pain in Sequential Cataract Surgery with Topical Phacoemulsification - A Prospective Observational Study from a Tertiary Care Hospital in Uttar Pradesh

2021 ◽  
Vol 8 (23) ◽  
pp. 1937-1942
Author(s):  
Ziya Siddiqui ◽  
Sunny Bhatia ◽  
Ahmad Abdullah ◽  
Yasir Alvi

BACKGROUND With the advancement in anaesthetic measures, a safe and effective alternative to peribulbar and retrobulbar anaesthesia for phacoemulsification is provided by topical anaesthesia.1 (Fichman, 1996). Studies highlighting varied pain experiences have been published with some reporting higher pain in second eye surgery,2,3 (Ursea et al. 2011; Tan et al. 2011) while others did not.4,5 (Bardocci, 2011; HariKovacs, 2012). So, we conducted this study to assess and compare pain experienced by patients subjectively as well as objectively in first and subsequent eye following topical phacoemulsification cataract surgery. METHODS A prospective observational clinical study was done for a duration of two years at Institute of Ophthalmology, Jawaharlal Nehru Medical College, AMU Aligarh. Study groups consisted of patients having bilateral cataract, to be operated in both eyes undergoing topical phacoemulsification and placement of an intraocular lens within one-year interval. Subjective as well as objective assessment of postoperative pain was done in the recovery room. RESULTS A total of 60 patients were included in the study with 51 (85 %) patients having higher pain score for second eye surgery as compared to first eye surgery, which was also significant while comparing their mean pain score (0.73  0.86 vs 2.17  0.91). Systolic and diastolic blood pressure as well as mean arterial pressure (MAP) were higher in first eye surgery as compared to second eye surgery. CONCLUSIONS In our comparative study, we observed higher pain in second eye surgery. As this subjective assessment of higher pain was not supplemented by objective assessment, we concluded that it may be due to more apprehension and uneasiness because of previous surgery. Patients going for second eye surgery should be prior consulted as well as managed properly. KEYWORDS Cataract, Pain, Topical Phacoemulsification

ABSTRACT Blindness is one of the significant social problems in India with 7 million of the total 45 million blind people in the world residing in our country. Major barriers to cataract surgery are poverty, no transportation, need not felt, and sex related. The low literacy rate among females and poor accessibility of the surgical sites were identified as important barriers in rural areas. There was also association found between socioeconomic status and cataract among cataract patients. In this study, a total of 208 participants who attended the ophthalmology outpatient department were studied for the observation on perception of cataract patient regarding cataract surgery. Data were analyzed and results were compared with other global studies. How to cite this article Kumar P, Joshi HS, Katyal R, Ranjan P. An Epidemiological Study on Perception of the Cataract Patients regarding Cataract Surgery in Tertiary Care Hospital, Bareilly District, Uttar Pradesh. Int J Adv Integ Med Sci 2016;1(4):148-150.


2016 ◽  
Vol 1 (1) ◽  
Author(s):  
S. K. Sharma ◽  
V. P. Shrotriya ◽  
D. Imtiaz ◽  
S. B. Gupta

<bold>Introduction:</bold> Perceived Health is a subjective assessment of the physical as well as mental health and includes so many aspects as mentioned in SF-36 form that are difficult to capture clinically such as incipient disease, physiological, psychological reserves and social functions. To assess the impact of Diabetes Mellitus, Hypertension and other socio-demographic factors on the Social Functioning component of mental health of the patients attending a tertiary care hospital in Bareilly. <bold>Material and Methods:</bold> Perceived health status of the patients was assessed by the Social Functioning dimension of the Mental Component Summary (MCS) using the SF-36 form. <bold>Results:</bold> The presence of both Diabetes Mellitus and Hypertension was associated with lower Social Functioning scores compared to those with diabetes (p = 0.013) and hypertension alone. Age was negatively related with Social Functioning scores (p<0.001) but male gender (p>0.000) and higher income (p<0.424) were all associated with higher Social Functioning scores. Rural subjects were found to have better SF score compared to urban. <bold>Conclusion:</bold> Age, gender and morbidity was found to have profound influence on Social Functioning scoring of the subjects. However, the results should be interpreted in terms of the study’s limitations.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Feng Zhang ◽  
Jin-Hua Wang ◽  
Mei-Sheng Zhao

Abstract Background The purpose of the study was to investigate whether dynamic monocyte chemoattractant protein-1 (MCP-1) level might be as predictors of perceived pain during the first and second phacoemulsification eye surgeries in patients with bilateral cataract. Methods Consecutive bilateral cataract patients undergoing bilateral sequential phacoemulsification were retrospectively enrolled. Patients’ preoperative anxiety score and intraoperative pain score were registered. Aqueous humor samples were obtained during surgery. MCP-1 level in the aqueous humor was measured by enzyme linked immunosorbent assay (Elisa). Patients were assigned to seven subgroups based on the interval between first-eye and second-eye cataract surgery. Comparisons were performed for a subjective sensation and MCP-1 levels among different subgroups. Results pain score during second-eye surgery was significantly higher than during first-eye surgery. Whereas there was no statistical difference in anxiety score between both surgeries. Result from subgroups comparison showed that the visual analog scale (VAS) pain score was statistically greater in 1-group and 6-group during the second eye surgery. Anxiety score did not statistically differ in subgroups. Additionally, the second-eye MCP-1 level was significantly higher at week 1and 6 intervals. Preoperative MCP-1 level was positively correlated with perceiving pain score during both surgeries. Conclusions MCP-1 level in aqueous humor significantly correlated with perceived pain during cataract surgery. Dynamic MCP-1 level could function as predictors of perceived pain during the first and second phacoemulsification eye surgeries in patients with bilateral cataract, which might support clinicians in treatment optimization and clinical decision-making.


2021 ◽  
Vol 8 (41) ◽  
pp. 3541-3546
Author(s):  
Jayaprakash Subramani ◽  
Rajesh Prabhu ◽  
Jagadeesapandian Palpandi

BACKGROUND Acute pancreatitis is not uncommon in surgical practice with variable clinical presentation. Because of its potential notable catastrophic complications, it is mandatory to assess the severity at the earliest. In recent times, the decision making in the management is quite difficult due to its complications and outcome. So, an objective assessment of severity based on clinical and laboratory scoring verses computed tomography (CT) severity is still debate, hence the need for study. The purpose of this study was to compare the efficiency of CT severity index verses APACHE II and Ranson criteria in predicting the severity of acute pancreatitis. METHODS A total number of 36 consecutive cases of acute pancreatitis who were admitted between January 2013 and December 2014 in Apollo Specialty Hospitals – Madurai were included in the study. Written informed consent was obtained from all study participants. RESULTS In our study, out of 36 patients, 30 (83.33 %) were males and 6 (16.66 %) were females. The sex distribution shows a clear male predominance. Most of the patients in the present study belonged to the middle age group. Alcohol was the most common cause accounting for 41.7 % of the cases followed by the billiary pathology. CT severity index was the superior tool for prediction of the prognosis and early complications. CONCLUSIONS When using contrast enhanced computed tomography, it was found that there was a significant correlation between the development of organ failure and severity of pancreatitis. The specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of Ranson and acute physiology and chronic health evaluation – II (APACHE II) at 48 hours of admission with acute pancreatitis does not correlate in determining the severity of acute pancreatitis. KEYWORDS Acute Pancreatitis, Severity Markers, CT Severity Index


2022 ◽  
Vol 9 (1) ◽  
pp. 75-81
Author(s):  
Muhammad Bilal ◽  
Shafqat Ali Shah ◽  
Marina Murad ◽  
Saad Ali ◽  
Ammad Ali ◽  
...  

OBJECTIVES: To determine the frequency of complications following cataract surgery in diabetic patients admitted in the ophthalmology unit. METHODOLOGY: A prospective descriptive interventional case series study was conducted after approval of the ethical committee, from June 2017-June 2020 at the Ophthalmology department MTI-MMC. A total of 129 patients from either gender were enrolled in study. All the study patients went through detailed history and complete ocular examination. After necessary investigations, surgical procedure was carried out. Results were analyzed through the SPSS-24 version. RESULTS: Out of the total 129 eyes of the diabetic patients, fifty-nine (45.7%) were males and seventy (54.3%) were females with a ratio of 1:1.2. Uveitis leads the chart in complications found in twenty (15.50%) eyes while PODR being the least common found in only ten (7.75%) eyes. Worse visual acuity was observed in fourteen (10.85%) eyes. Striate keratopathy and posterior capsule opacification were found in sixteen (12.40%) and fifteen (11.62%) eyes respectively. Among the patients, 15.7% were having more than one complication during follow-up visits and eighty-eight (68.2%) eyes were found to have none complication. The age group 51-60 years observed frequent complications as compared to other groups. Similarly female gender (38.57%) has frequent complications as compared to males (2.7%). CONCLUSION: The study concludes Uveitis as the most common complication observed in 15.50% 0f the eyes while worse visual acuity (10.85%) and progression of diabetic retinopathy (7.75%) being the least common. Striate keratopathy was found in 12.40% while posterior capsule opacification in 11.62% of the eyes.


Author(s):  
Ankur Kumar ◽  
Vandana Upadhyay ◽  
Amresh K. Singh ◽  
Jayesh Pandey

Background and Purpose: Superficial mycosis is more prevalent in tropical and subtropical countries, such as India. Regarding this, the present study was conducted to determine the epidemiology of superficial mycosis and identify the most common dermatophytic species in this region. Materials and Methods: For the purpose of the study, a total of 220 skin scraping, nail, and hair root specimens were collected. Direct microscopic examination was performed using potassium hydroxide mount. Additionally, the samples were inoculated onto Sabouraud dextrose agar (SDA) and dermatophyte test medium (DTM). The fungal colony of each isolates was stained with lactophenol cotton blue mount, and observed under microscope for species identification. Results: Out of 220 isolates, 172 samples, obtained from 108 males 64 females, were positive for skin fungal infections by either KOH mount or culture. Furthermore, 113 isolates were identified as dermatophytes, while 59 samples were found to be non-dermatophytes. Among the dermatophytes isolated from different clinical samples, Trichophyton verrucosum (42/113, 38%) was the most common species, and Tinea corporis was the most common infection (36.2%). Conclusion: As the findings indicated, dermatophytes had an isolation rate of 78%, which is higher than normal. This can be due to the fact that the majority of the patients were from a rural background (71.7%) with a low socioeconomic status and poor personal hygiene who were exposed to climatic changes.


Author(s):  
Bikram K. Gupta ◽  
Shubham Tomar ◽  
Anukul Karn ◽  
Jassimran Singh ◽  
Aditi Agrawal ◽  
...  

Background: Every medical student in India have to undergo a compulsory rotatory internship for completion of their course where they encounter various medical emergencies and apply their medical knowledge. An early encounter to a basic life support course and training will increase the efficacy of cardiopulmonary resuscitation and thus the outcome of the patient. This study was designed to test knowledge of MBBS students in a tertiary care hospital.Methods: This observational study was conducted in a tertiary care hospital in Uttar Pradesh and used a preformed validated questionnaire to test awareness and knowledge of basic life support and cardiopulmonary resuscitation in a sample of 500 MBBS students. Descriptive analysis was performed on the questionnaire responses. All data obtained from the questionnaire was evaluated and statistically analysed using software IBM SPSS Statistics software version 24 (IBM Corp., Armonk, NY, USA) for MS windows.Results: With a response rate of 47% among 500 MBBS students, the mean score obtained was 2.34±1.066 out of a maximum score of five. A maximum score of 2.804±1.055 obtained by 5th-year students. Surprisingly, first-year students achieved an average score of 2.66±0.97, which was higher than that of 2nd, 3rd, and 4th year students. 87% of students were like-minded to participate in the cardiopulmonary resuscitation (CPR) awareness program. Only 45% of students correctly answered the order of CPR as C-A-B (chest compression-airway-breathing).Conclusions: The study showed that though the awareness and importance of basic life support (BLS) are high among the medical students, the accurate knowledge required in performing BLS is inadequate. This study also showed that the National medical commission has taken a positive step in the incorporation of BLS in the curriculum.


2021 ◽  
pp. 63-65
Author(s):  
Neena Gupta ◽  
Uruj Jahan ◽  
Subhashini Singh

BACKGROUND: Maternal health is an important aspect for the development of any country in terms of increasing equity and reducing poverty. For reduction of maternal mortality and morbidity Government of India launched National health mission (NHM). Some of the major initiatives under NHM are– ASHA (Accredited Social Health Activist), JSY/JSSK (Janani Suraksha Yojana / Janani Shishu Suraksha Karyakaram), National mobile medical units, National ambulance services. METHODS: A retrospective observational study was performed in department of Obstetrics and Gynaecology, G.S.V.M Medical College, Kanpur, Uttar Pradesh which is a low performing state, during the period of 2018 to 2019. A total of 5134 obstetric patients including 1032 low general condition patients were included over duration of 20 months since January 2018 to august 2019. This observational study collected information regarding number of deliveries in different years in this tertiary care hospital, effect on availability of health facilities and antenatal care to the antenatal women after introduction of JSY, ASHA and ambulance services. CONCLUSIONS: After JSY there is major difference in OPD admission and institutional delivery rate. Ambulance services had major contributory role in reducing maternal mortality and morbidity. There is need to improve performance of ASHA by proper supervision and monitoring.


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