scholarly journals Usefulness of the Non-Contact Tonometry in Out-Patient Screening

2016 ◽  
Vol 15 (2) ◽  
Author(s):  
Satheesh Solomon T Selvin ◽  
Chris Elsa Samson Jacob ◽  
Thomas Kuriakose
Keyword(s):  
Central Corneal Thickness ◽  
Care Center ◽  
Corneal Thickness ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Applanation Tonometry ◽  
Cross Sectional ◽  
Significant Difference ◽  
Iop Measurement ◽  
The Mean

Purpose: Goldmann applanation tonometry (GAT) is considered the gold standard for Intraocular Pressure (IOP) measurement. It has the disadvantages of being a contact device, need for a slit-lamp, non-portability and need of a skilled examiner. Many hospitals are using a Non Contact Tonometry (NCT) as a screening device to save clinician time, however the usefulness is not proved in terms of reliability. This study was aimed to determine the usefulness of the Air-puff tonometer (TONOREF NIDEK II, NIDEK CO., LTD., JAPAN) over a GAT in a tertiary care center. Design: Cross-sectional Study Methods: This was a cross-sectional, non interventional observational study conducted on 224 eyes (right eye) from 224 patients. All patients underwent the IOP measurement with both methods and a central corneal thickness (CCT) measured. The data was analyzed using SPSS 20.0 software. Results: The mean age of the patients was 40.3±11.29 years. There was a statistically significant difference (p<0.001) between the mean NCT and GAT readings which persisted even after correction for central corneal thickness. The correlation between NCT and GAT using Pearson’s correlation coefficient was strong irrespective of the corrections for their corneal thickness (r = 0.751 and 0.718 for uncorrected and corrected values respectively). The correlation of the individual clinicians for the readings varied from moderate to strong. The ROC curve showed the best sensitivity and specificity to occur at around 13 to 14 mmHg. Conclusion: NCT seems to overestimate the IOP at low ranges as compared to the GAT and underestimate at higher ranges. The crossover of the values is seen between 12 to 13 mmHg.  The clinician should do an individualized analysis of his/her GAT measurements to the readings of the NCT machine at the clinic to obtain clinician specific nomogram. 

scholarly journals The pattern of central corneal thickness in patients attending a Tertiary Hospital in Dar-Es-Salaam

2021 ◽  
Vol 9 (2) ◽  
pp. 127-133
Author(s):  
Annamary Stanislaus ◽  
Ntsilane Susan Mosenene ◽  
Celina Mhina ◽  
John Stanslaus Kisimbi ◽  
Frederick Robert Burgess ◽  
...  
Keyword(s):  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Dar Es Salaam ◽  
Applanation Tonometry ◽  
P Value ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Cross Sectional ◽  
Significant Difference ◽  
The Mean

Background: Central Corneal Thickness (CCT) is an indicator of corneal health status as well as being an essential tool in assessment and management of corneal diseases. It is an important factor in the diagnosis and management of glaucoma as it affects the measurement of intraocular pressure. However, the pattern of central corneal thickness in our population is not known. Our study aimed to describe the CCT measurements and their variation with age and sex among patients attending the eye clinic at Muhimbili National Hospital (MNH), in Dar es Salaam, Tanzania. Methodology: A hospital-based descriptive, cross-sectional study used convenient sampling to recruit adult patients aged 18 years and above, presenting to the MNH between August 2016 and January 2017.Visual acuity assessment, Goldman applanation tonometry and CCT assessment using an ultrasound pachymeter were performed. Patients with previous intraocular surgery were excluded. Results: A total of 398 patients (208 males and 190 females) were recruited. The mean CCT was 526.64±38.30 µm; being 523.99±38.20 µm for males and 529.7±38.3 µm for females. 226 (56.85%) had CCT of less than 520 µm.There was no statistically significant difference in CCT between gender. The proportion of patients with thinner CCT increased with increasing age from 25.8% in those < 30 years to 75% in those aged 71years and above. The mean CCT decreased with increasing age with P-value<0.001. Conclusion: The average CCT in patients attending Muhimbili National Hospital is 526.64 µm (SD 38.30) which is generally thin, inversely proportion to age and similar that of other Africans and African-Americans. This finding has implications for the management of glaucoma in this population.

Ocular Response Analyzer versus Goldmann Applanation Tonometer for Measurement of Intra-Ocular Pressure

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Rim Raafat Fayez ◽  
Mohamed Adel Abdelshafik ◽  
Ahmed Ibrahim Aboulenain ◽  
Momen Mahmoud Hamdi
Keyword(s):  
Corneal Thickness ◽  
Cross Sectional Study ◽  
Applanation Tonometry ◽  
Ocular Response Analyzer ◽  
Cross Sectional ◽  
Goldmann Applanation Tonometer ◽  
Applanation Tonometer ◽  
Iop Measurement ◽  
The Mean ◽  
Method Of Evaluation

Abstract Background Goldmann applanation tonometry (GAT) has been the gold standard for intraocular pressure(IOP) measurement ,since its appearance in clinical practice around 50 years ago.(1) In spite of being almost unchallenged, the last few years have become a sustained search for a new standard method for IOP measurement,. One such recently marketed instrument is the Ocular Response Analyzer (ORA), which able to detect the corneal biomechanics. Aim of the Work is to compare the IOP measurement estimated by Goldmann applanation tonometer to that of ORA and detect the effect of state of refraction, corneal topography and central corneal thickness (CCT) on these measurements. Patients and Methods This cross-sectional study was done from March 2018 to October 2018 on 65 eyes of patients visiting the outpatient clinic. Results The mean GAT IOP was 15.938 ± 6.041 while the mean ORA (IOPcc) and (IOPg) were 19.711 ± 7.59 and 17.242 ± 7.35 mm Hg respectively. There is a strong positive relationship between GAT IOP & ORA IOPg measurement (r = 0.880 – p = &lt;0.001*). Also finding a weak yet significant correlation between IOPg and CCT (r = 0.385, p = 0.001). None of the pressure measurements was affected by refraction or corneal curvature significantly. Conclusion In conclusion, our results suggest that mean IOPs obtained by ORA were significantly higher than that of GAT with different influencing factors that are not completely understood. caution has to be sought when using the ORA, the values obtained ought not to be used interchangeably with the values obtained by 1 GAT, despite the presence of a positive correlation between these values. This underlines the importance of using one and only method of evaluation of the IOP for every patient in successive follow-up visits.

Prehospital Intubations Are Associated with Elevated Endotracheal Tube Cuff Pressures: A Cross-Sectional Study Characterizing ETT Cuff Pressures at a Tertiary Care Emergency Department

2021 ◽  
pp. 1-4
Author(s):  
Ruo S. Chen ◽  
Laurel O’Connor ◽  
Matthew R. Rebesco ◽  
Kara L. LaBarge ◽  
Edgar J. Remotti ◽  
...  
Keyword(s):  
Endotracheal Tube ◽  
Cuff Pressure ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Endotracheal Tube Cuff ◽  
Cross Sectional ◽  
Tube Cuff ◽  
Respiratory Therapists ◽  
Significant Difference

Abstract Introduction: Emergency Medical Services (EMS) providers are trained to place endotracheal tubes (ETTs) in the prehospital setting when indicated. Endotracheal tube cuffs are traditionally inflated with 10cc of air to provide adequate seal against the tracheal lumen. There is literature suggesting that many ETTs are inflated well beyond the accepted safe pressures of 20-30cmH2O, leading to potential complications including ischemia, necrosis, scarring, and stenosis of the tracheal wall. Currently, EMS providers do not routinely check ETT cuff pressures. It was hypothesized that the average ETT cuff pressure of patients arriving at the study site who were intubated by EMS exceeds the safe pressure range of 20-30cmH2O. Objectives: While ETT cuff inflation is necessary to close the respiratory system, thus preventing air leaks and aspiration, there is evidence to suggest that over-inflated ETT cuffs can cause long-term complications. The purpose of this study is to characterize the cuff pressures of ETTs placed by EMS providers. Methods: This project was a single center, prospective observational study. Endotracheal tube cuff pressures were measured and recorded for adult patients intubated by EMS providers prior to arrival at a large, urban, tertiary care center over a nine-month period. All data were collected by respiratory therapists utilizing a cuff pressure measurement device which had a detectable range of 0-100cmH2O and was designed as a syringe. Results including basic patient demographics, cuff pressure, tube size, and EMS service were recorded. Results: In total, 45 measurements from six EMS services were included with ETT sizes ranging from 6.5-8.0mm. Mean patient age was 52.2 years (67.7% male). Mean cuff pressure was 81.8cmH2O with a range of 15 to 100 and a median of 100. The mode was 100cmH2O; 40 out of 45 (88.9%) cuff pressures were above 30cmH2O. Linear regression showed no correlation between age and ETT cuff pressure or between ETT size and cuff pressure. Two-tailed T tests did not show a significant difference in the mean cuff pressure between female versus male patients. Conclusion: An overwhelming majority of prehospital intubations are associated with elevated cuff pressures, and cuff pressure monitoring education is indicated to address this phenomenon.

scholarly journals Reference values of the central corneal thickness with different refractive errors for the adult Egyptian population

2020 ◽  
Author(s):  
Amr A. Gab-Alla
Keyword(s):  
Reference Values ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Cross Sectional Study ◽  
Refractive Errors ◽  
Spherical Equivalent ◽  
Sectional Study ◽  
Cross Sectional ◽  
Egyptian Population ◽  
The Mean

Abstract Background: To generate reference values of the central corneal thickness (CCT) with different refractive errors for the adult Egyptian population. Methods: A retrospective, observational, and cross-sectional study of 2200 eyes in 1166 subjects scheduled for LASIK, who came to private refractive eye center, Ismailia, Egypt. The study period was from January 2018 to January 2020. The subjects were divided into a broad range of myopia with spherical equivalent (SE) <-0.5D and hyperopia SE> +0.5D. Then, the myopic eyes divided into low (SE>-3.0D), moderate (SE-3.0D to >-6.0D), and high (SE<-6.0D). Similarly, the hyperopic eyes were divided into low (SE<+3.0 D) and moderate (SE+3.0D to <+6.0D) and high >+6.0D. The refractive error was measured by an auto-refractometer (Topcon, Tokyo Optical Co., Ltd., Japan), and CCT was measured using Sirius (CSO, Florence, Italy). Results: The data of 1100 myopic eyes in 556 subjects (30.5% males and 69.5% females) and 1100 hyperopic eyes in 610 subjects (33.6% males and 66.4% females). The mean+SD of CCT for the total myopic subjects was 531.98+32.92μm, range (406 to 636μm). The mean+SD of SE was -4.1±2.5D, range (-0.5 to -12.0D). The mean+SD of CCT for the total hyperopic subjects was 529±38.8μm, range (448 to 619 μm). The mean+SD of SE was +3.65+1.97D, range (+0.5 to +8.5D).Conclusion: In this study, the mean of CCT of the Egyptian population was 531.9 μm for myopic and 529μm for hyperopic subjects respectively. The myopic and hyperopic subjects show a reduction in CCT with age. Females have a thinner cornea than males, 23.6% of the myopic eyes, and 16.5% of the hyperopic eyes have CCT less than 500μm.

scholarly journals Study of Delirium on Psychiatric Referrals at Helping Hands Community Hospital, Kathmandu, Nepal

2018 ◽  
Vol 5 (2) ◽  
pp. 19-26
Author(s):  
Praveen Bhattarai ◽  
Devavrat Joshi
Keyword(s):  
Risk Factors ◽  
Alcohol Intoxication ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Liaison Psychiatry ◽  
Chi Square ◽  
Cross Sectional ◽  
Significant Difference ◽  
Associated Risk Factors

Background and Objectives: Delirium is one of the most important neuro-psychiatric disorders in Consultation liaison psychiatry. There is a dearth of studies in this subject in Nepalese context. The objective of this study was to find out the demographic profile, source of referral, reason for referral and possible risk factors for delirium and association between risk factors and subtypes of delirium.Material and Methods: This is a descriptive cross-sectional study carried out in a tertiary care center over a period of six months. Delirium was diagnosed by psychiatrist based on International Classification of Disease, 10th revision, Diagnostic Criteria for Research (ICD-10 DCR) and was classified into subtypes using the Liptzin and Levkoff criteria. Data analysis was done using SPSS version 16 and chi- square test was applied to find the association between risk factors and subtypes of delirium.Results: A total of 52 cases of delirium were included in the study. Majority of cases were aged 65 years and above with male preponderance. The most common cause for referral was disturbed behavior and disorientation. Hyperactive delirium was the most common subtype of delirium. Most of the referred cases of delirium were from Medical ward and Intensive Care Unit/Critical Care Unit (ICU/CCU). Infection / Inflammation, Drug/alcohol intoxication or withdrawal and those with multiple etiologies were the most common possible causes of delirium. There was no significant difference in terms of associated risk factors between the clinical subtype (p = 0.8023).Conclusion: The presence of delirium warrants prompt intervention to identify and treat the underlying causes and consultation liaison psychiatric services should be enhanced to achieve this goal.Janaki Medical College Journal of Medical Sciences (2017) Vol. 5(2): 19-26

scholarly journals Study of incidence and severity of menopausal symptoms in women of sub Himalayan region, using the Greene Climacteric Scale

2021 ◽  
Vol 10 (3) ◽  
pp. 1102
Author(s):  
Geetika Syal ◽  
Neha Mohindroo ◽  
Anshul Rana ◽  
Rita Mittal
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Lower Abdominal Pain ◽  
Cross Sectional Study ◽  
Menopausal Symptoms ◽  
Hot Flushes ◽  
Cross Sectional ◽  
Northern India ◽  
Menopausal Women ◽  
The Mean

Background: Identifying and measuring menopausal symptoms using Greene Climacteric Scale and calculating the mean age at menopause to find out the frequency of the menopausal symptoms so that can be used for better perimenapausal and menopausal care to females.Methods: A cross-sectional study was conducted in a tertiary care center in northern India. All menopausal women in gynaecology outpatient department were enrolled in study, over six months from May 2019 to October 2019. A total of 206 women fulfilled the inclusion criteria and were interviewed using the 21 points Greene Climateric Scale (GCS) Questionnaire. Analysis was done using SPSS 20 Windows software. Descriptive statistics included computation of percentages, means and standard deviations. Level of significance was set at P≤0.05.Results: The mean age of menopause was 47.9±3.42 years. About 90.3% of the menopausal women studied belonged to the rural population. The most frequently perceived symptoms by females were muscle joint pain (100%), vaginal dryness and pruritus vulvae (84%), lower abdominal pain (79.6%), hot flushes (50.5%).The most frequently reported symptoms as per the GCS were muscle and joint pains, loss of interest in sex, headaches, feeling tired or lacking in energy, difficulty in concentrating, attacks of anxiety, difficulty in sleeping and hot flushes. The mean total score was 17.61.Conclusions: Menopausal symptoms were common in this study group but women seeking help for the same was less. Therefore menopause clinics and care programmes need to be developed and strengthened to promote better health and higher quality of life in menopausal women.

scholarly journals Overweight is more prevalent in patients with Parkinson's disease

2012 ◽  
Vol 70 (11) ◽  
pp. 843-846 ◽  
Author(s):  
Hugo Morales-Briceño ◽  
Amin Cervantes-Arriaga ◽  
Mayela Rodríguez-Violante ◽  
Juan Calleja-Castillo ◽  
Teresa Corona
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Normal Weight ◽  
Sectional Study ◽  
Normal Range ◽  
Cross Sectional ◽  
Significant Difference

Underweight and malnutrition are well documented in Parkinson's disease (PD), while overweight has been less reported. We carried out a cross-sectional study including 177 healthy controls and 177 PD patients attending a tertiary care center. We recorded weight and height for all participants. A statistically significant difference was found in body mass index (BMI) between controls and PD patients (29.1±5.4 versus 27.2±4.7, p<0.001). In the PD Group, two patients were underweight, 32.7% were within normal range, 46.9% had overweight, and 19.2% were obese. Overweight and normal weight were more prevalent in the PD Group (p=<0.01 and <0.001, respectively) when compared to controls. In conclusion, overweight/obesity are common among patients with PD, while underweight is almost negligible.

scholarly journals Comparability of three intraocular pressure measurement: iCare pro rebound, non-contact and Goldmann applanation tonometry in different IOP group

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Min Chen ◽  
Lina Zhang ◽  
Jia Xu ◽  
Xinyi Chen ◽  
Yuxiang Gu ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Pearson Correlation ◽  
Linear Regression Analysis ◽  
Corneal Thickness ◽  
Intraclass Correlation ◽  
Cross Sectional Study ◽  
Applanation Tonometry ◽  
Cross Sectional ◽  
Wide Range ◽  
Iop Measurement

Abstract Background Measurement of intraocular pressure (IOP) is essential for glaucoma patients. Many factors such as central corneal thickness (CCT) can affect the accuracy of IOP measurement. The purpose of this study was to evaluate the agreement of IOP measured by non-contact tonometer (NCT), iCare pro rebound tonometer (iCare), and Goldmann applanation tonometer (GAT) in different IOP group. Methods This was a Hospital-based cross-sectional study. Two hundred subjects were enrolled in this study. All subjects underwent IOP measurement using an NCT–iCare–GAT sequence. Bland-Altman, Pearson correlation and intraclass correlation analysis were performed using SPSS 17.0 software. The influence of CCT on each IOP measurement methods was evaluated by linear regression analysis. Results The mean difference (Δ) of NCT–GAT did not differ from (Δ) iCare–GAT in IOP < 10 and 10–21 mmHg group. However, (Δ) NCT–GAT was significantly higher than (Δ) iCare–GAT in IOP 22–30 and > 30 mmHg group (P < 0.05). Bland–Altman analysis showed significant agreement between the three devices (P < 0.01). IOP measurements of the three methods were significantly correlated with CCT (P < 0.01). Conclusions ICare pro shows a higher agreement with GAT over a wide range of IOP compared with NCT. The consistency between the three tonometers was similar in a low and normal IOP range. However, NCT shows a greater overestimate of IOP in moderate and higher IOP group. The variability of IOP measurement affected by CCT is NCT > iCare pro > GAT.

scholarly journals Gender differences in awareness of diabetes mellitus among the rural population

2017 ◽  
Vol 8 (2) ◽  
pp. 44-49
Author(s):  
Iyshwarya Udaya Kumar ◽  
Jaya Prakash Murthy ◽  
Ujwal Upadya ◽  
Mahesh Venkatesh
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Public Awareness ◽  
Care Center ◽  
Tertiary Care ◽  
Education Programme ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Significant Difference ◽  
Males And Females

Background: Diabetes Mellitus is a chronic disorder, which is becoming rapidly epidemic in India.There are many complications occur due to uncontrolled diabetes mellitus.The outcome of diabetes depends mainly on the patient’s self-management like health-related behavior, which is based on his or her knowledge. Awareness on diabetes mellitus is still a lacunae among the Indian population.Aims and Objective: To determine the knowledge regarding awareness of diabetes like the risk factors, symptoms, complications and the management among the males and females in rural population.Materials and Methods: It is a cross sectional study conducted at the tertiary care center in rural Bangalore. A structured questionnaire was used and 300 adults were assessed on their knowledge regarding the awareness of diabetes.Result: Out of 300 adults, 159 adults (53%) had a history of diabetes. There was no gender difference observed regarding the awareness, nor the education played a role. There was significant difference observed in knowledge of diabetes Mellitus among the diabetics with respect to renal complications (p <0.013), symptoms like blurring of vision (p < 0.043) and burning feet (p < 0.009).Conclusion: Both the diabetic and non-diabetic groups had very low awareness regarding diabetes and associated risk factors. Both Males and females awareness levels were poor. Proper Diabetic education programme will help in raising public awareness of the disease.Asian Journal of Medical Sciences Vol.8(2) 2017 44-49

scholarly journals Relation of Parents Economical, Educational and Awareness on Immunization Status of Children

2021 ◽  
Vol 15 (5) ◽  
pp. 965-967
Author(s):  
Lubna Riaz ◽  
Waqas Ali Khan ◽  
Shamayal Mandokhel ◽  
Asfand Tariq ◽  
Neelam Faryad ◽  
...  
Keyword(s):  
Low Income ◽  
Care Center ◽  
Tertiary Care ◽  
Income Level ◽  
Cross Sectional Study ◽  
High Income ◽  
Exclusion Criteria ◽  
Cross Sectional ◽  
Immunization Status ◽  
The Mean

Aim: To determine the immunization status of children 0 to 2 years and factors leading to low vaccination status in children visiting tertiary care center. Study design: Cross-sectional study Place and duration of study: Department of Paediatrics Shaikh Zayed Hospital Lahore from 1st November 2019 to 31st April 2020. Methodology: Five hundred children age between 0-2 years were enrolled after fulfilling inclusion and exclusion criteria. Results: The mean age was 9.9±6.1 months, with mean weight of 7.4±3.4 kg and 200 (40%) were male and 300 (60%) were female patients. Sixty (12%) were not vaccinated, 145 (29%) partially vaccinated and 295 (59%) fully vaccinated. In the distribution by income level 255 (51%),180 (36%) and 65 (13%) parents were having low, middle and high income respectively; By education level,155 (31%) with no education, 140 (28%) some education and 205 (41%) with high education, regarding knowledge of immunization, 50 (10%) had no knowledge, 215 (43% )had wrong perception of immunization and 235 (47%) were fully aware.295 (59%) had up-to-date immunization Conclusion: More than half of the study populations were upto date about immunization status. It is also concluded that majority of parents of low-income level and uneducated were unknown about immunization status and majority of middle and high-income level and educated people were partial known or up-to-date about immunization status Keywords: Economical level, Educational level, Awareness level, Immunization status

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