scholarly journals To Study the Safety of Multi-dose Topical Anaesthetic Eye Drops One Month after Opening

2019 ◽  
Vol 35 (3) ◽  
Author(s):  
Mehr-un-Nisa Irfan Qayyum Malik Muhammad Wasif Irshad

Purpose: To determine the risk of ocular infections due to topical multi-dose anaesthetic eye drops in patients one month after opening the bottle. Study Design: Quasi experimental study. Place and duration of study: Department of Ophthalmology DHQ Teaching Hospital, Gujranwala from 22nd May 2018 to 22nd June 2018. Materials and Methods: In this study topical anaesthetic eye drops containing proparacaine hydrochloride 0.5% as main ingredient and benzalkonium choride as preservative (Alcaine�) were tested daily to see if any bacterial/fungal growth occurs in the bottle containing eye drops or not. Same bottle was used in patients presenting in outdoor and indoor departments. Samples taken from the bottle contents were cultured on different media to see growth of fungi or bacteria. Patients who already had keratitis, conjunctivitis, corneal opacities, thin corneas and having dry eyes which were prone to get infected were excluded from this study. Results: There were 60 patients included in our study and they were divided in two groups. Group A included those who presented in the outdoor department and group B comprised of those admitted for various operative procedures. There were 30 patients in each group. All patients were adults (18-60 years). After 1 month of daily culturing on agar plates, no micro-organism growth was seen in both groups. Conclusion: Topical anaesthetic eye drops can be used safely for 1 month in different patients after opening the bottle without any risk of causing infectious keratitis, conjunctivitis or endophthalmitis. Keywords: Proparacaine, Culture medium, Endophthalmitis.

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Sairam Ahmed ◽  
Iqra Ghazanfar ◽  
Fuad Ahmad Khan Niazi ◽  
Ali Raza

Purpose:  To compare 0.1% Nepafenac ophthalmic solution with placebo in terms of decreasing mean intraoperative miosis in patients undergoing cataract surgery. Study Design:  Quasi experimental study. Place and Duration of Study:  Department of Ophthalmology, Holy-Family Hospital Rawalpindi from September 2017 to March 2018. Methods:  A total of 150 eyes with senile cataract of patients between 40-80 years of age and of both genders, undergoing uneventful cataract surgery and fulfilling the inclusion criteria were included. Patients were divided into 2 equal groups. Group A received Nepafenac eye drops and group B received placebo drops (Preservative free artificial tears). The diameter of pupil as viewed through the operating microscope was measured with Castroviejo Caliper at following steps; immediately before the start of surgery (baseline), after complete nucleus removal and at the end of surgery. Results:  Mean decrease in pupil size from the start of surgery to the end of phacoemulsification in Group A (nepafenac group) was 0.48 ± 0.26 mm while in Group B (placebo group) it was 1.40 ± 0.49 mm (P = 0.0001). Mean decrease in pupil size from start to end in Group A (Nepafenac group) was 0.75 ± 0.32 mm while in Group B (placebo group) was 2.02 ± 0.62 mm (P = 0.0001). Conclusion:  Intraoperative miosis in terms of mean decrease in pupils size (both from start of surgery till phacoemulsification and also from start of surgery till end of surgery) was lower in 0.1% Nepafenac group as compared to placebo group. Key Words:  Phacoemulsification, Miosis, Nepafenac.


2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Abdul Rafe ◽  
Saquib Naeem ◽  
Tariq Munawar

Purpose:  To compare the outcomes of conjunctival autograft fixation using autologous serum vs fibrin glue to cover the bare sclera in pterygium excision surgery. Study Design:  Quasi experimental study. Place and Duration of Study:  The study was conducted in Ophthalmology Department of CMH Kharian from April 2018 to November 2018. Material and Methods:  Forty patients with primary pterygium were selected by convenient sampling technique. Patients with recurrent Pterygia and moderate to severe dry eyes, keratitis or secondary to trauma were excluded. The patients were divided into two groups, group A treated with fibrin glue and group B treated with autologous serum technique. All patients underwent pterygium excision under topical anaesthesia. The conjunctival autograft was removed from superior temporal bulbar conjunctiva to cover the scleral bed produced by pterygium excision. Post operatively the patients were followed-up for three months to assess the fixation or otherwise. Data was noted and analysed by using SPSS version 23. Results:  The graft was taken-up nicely in most of the cases. The patients were followed up for three months after surgery. The frequency of graft lost in Group A and Group B was noted as n = 8 (40%) and n = 1 (5%), respectively (p = 0.008). The only other complication was recurrence of pterygium which was n = 5 (25%) and n = 3 (15%), in Group A and Group B, respectively (p = 0.429). No case of infection was noted. Conclusion:  Fixation of conjunctival autograft with autologous serum is a safe and effective method and potential alternative of fibrin glue technique.


2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Abdul Rafe ◽  
Muhammad Tariq Munawar

Purpose:  To compare the effect of topical steroid with cyclosporine eye drops in recurrence of sub-epithelial corneal infiltrates in epidemic keratoconjunctivitis. Study Design:  Quasi Experimental study. Place and Duration of Study:  CMH Kharian from Jan 2017 to June 2018. Methods:  Eighty eight patients with epidemic keratoconjunctivitis were divided into two groups. Group A included patients who received topical steroid drops and group B received topical Cyclosporine eye drops. The inclusion criteria comprised of fresh cases of SEIs, between the ages of 20 to 50 years, having a vision of 6/6 before the illness. The exclusion criteria included patients suffering from allergic conjunctivitis, ocular surface disease like Sjogren syndrome, corneal ulcer, blepharitis, old corneal opacity, glaucoma and those who had been using steroids in the past e.g. uveitis. The patients were followed up at 2, 4, 8 and 12 weeks. On resolution of sub-epithelial infiltrates (SEIs), both regimen were tapered off in next two weeks. The patients were advised to continue monthly follow up for two months to see any recurrence. Results:  SEIs resolved in both the groups by week 12, however the resolution was slightly quicker in group A. SEIs resolved in 84.1% of cases in group A and in 70.4% cases in group B at the end of 4 weeks. Recurrence was higher in group A (11.3%) while it was 4.5% in group B. Conclusion:  Cyclosporine eye drops are a safe and equally effective treatment of epidemic keratoconjunctivitis related SEIs, with an added advantage of reduced recurrence rate. Key Words:  Epidemic, Keratoconjunctivitis (EKC), Cornea, Subepithelial Infiltrates, Cyclosporine.


2019 ◽  
Vol 35 (3) ◽  
Author(s):  
Dr. Mehr-un-Nisa Abid ◽  
Dr. Irfan Qayyum Malik ◽  
Dr. Irfan Qayyum Malik ◽  
Dr. Muhammad Wasif Irshad

AbstractPurpose: To find out if we can use topical anesthetic eye drops among different patients for one month after opening the bottle without any risk of causing corneal or conjunctival infections and endophthalmitis.Study Design: Experimental studyPlace and duration of study: Department of Ophthalmology DHQ Teaching Hospital, Gujranwala from 22nd May 2018 to 22nd June 2018.Materials and Methods: This was an experimental study in which topical anesthetic eye drops containing proparacaine hydrochloride 0.5% were tested daily to see if any bacterial/fungal growth occurs in the bottle containing eye drops or not. Same bottle was used in patients presenting in outdoor and indoor departments. Samples taken from the bottle contents were cultured on different media to see growth of fungi or bacteria if any.Results: After 1 month of daily culturing on agar plates, no micro-organism growth was seen.Conclusion: Topical anesthetic eye drops containing proparacaine hydrochloride as the main ingredient and benzalkonium chloride as the preservative (Alcaine®) can be used safely for 1 month after opening in different patients without any risk of causing infectious keratitis, conjunctivitis or endophthalmitis.Keywords: Topical anesthetic, Culture medium, Risk factor, Endophthalmitis


2021 ◽  
Vol 1 (3) ◽  
pp. 20-24
Author(s):  
Faruq Bashir ◽  
Farouque Ahmed Haolader

The purpose of this research was to conduct a comparative study to find out which setting performs better between students in the Co-educational Instruction setting and Students in the Single-gender Instruction set. In this research process, the researchers compared the performance of students who receive instruction in a single-gender classroom with the performance of other students who receive instruction in a co-educational classroom. The study population was 756 students of single and mixed-gender streams, classified into two groups (A & B). Out of this, one single-gender male class of 268 students (group A) and one COED class of 488 students (group B) were sampled from the Islamic University of Technology (IUT) in Bangladesh. The research adopted a quasi-experimental research design. The instruments used for data collection were the summative assessment of both groups' first and second-semester results that serve as test instruments. Frequency counts and the Arithmetic means were used for descriptive analysis. The independent sample t-test was used to test the hypotheses. Social learning theory emphasizes the importance of biological, social, and cultural impacts on human behavioral development and learning, especially on gender and genders specific traits and roles. Based on the analyses and interpretation of the data, the researcher found that male students perform better academically in single-gender classes, contrary to their academic performance when mixed with females in the same classes. Thus, single-gender instruction could be a more favorable environment for male students than a co-educational instruction environment.


2020 ◽  
Vol 17 (1) ◽  
pp. 128-131
Author(s):  
Keith Ong ◽  
Leonard Ong

Purpose: Subconjunctival fibrosis is one of the main causes of failure of glaucoma filtration surgery. It can result in absence of a filtration bleb, a small scarred bleb, or a cystic bleb. 5-Fluorouracil (5-FU), mitomycin C (MMC), and topical steroids have been used to suppress subconjunctival fibrosis. Method: A study was done analyzing the number of postoperative subconjunctival 5-FU injections for trabeculectomy on pseudophakic eyes prior to and following the change to a BAK-free regimen. The cohort consisted of 16 consecutive cases undergoing primary trabeculectomy without intraoperative MMC or 5-FU. The trabeculectomy surgery included a groove sclerectomy procedure. Group A were 8 eyes of patients who had the author’s standard Chlorsig, Maxidex, and Prednefrin Forte eye drops tds. Group B were 8 eyes who had Chlorsig-dexamethasone and Optive-dexamethasone tds eye drops postoperatively. Results: Group B (BAK-free) patients required fewer postoperative 5-FU subconjunctival injections (average: 2.9, range: 1-5 injections) compared to Group A (BAK) patients (average: 7.3, range: 4-18 injections). This difference was statistically significant (P = 0.02, unpaired t-test). All patients had functioning blebs and did not require glaucoma medications to maintain target intraocular pressure. The Group B (BAK-free) patients had more diffuse blebs than the Group A (BAK) patients. Conclusion: The results demonstrated that when BAK was eliminated from postoperative eye drops in trabeculectomy, the number of postoperative 5-FU injections was reduced.


2019 ◽  
Vol 6 (6) ◽  
pp. 1931
Author(s):  
Nimesh B. Thakkar ◽  
Pranav Patel ◽  
Gautam Sonagra

Background: The present study of evaluation of the use of electrocautery to incise the skin has been done to evaluate and assess basically. The advantages and disadvantages of the electrocautery to incise the skin when compared with that of scalpel. The results of the use of electrocautery on skin wound are then assessed to formulate the criteria for proper case selection for this procedure.Methods: A total of 100 patients were taken for this study. 50 patients underwent electrocautry monopolar mode incision (group A) who were compared with 50 scalpel incision patients (group B). Study was done from 01 January 2016 to 30 September 2017. Variables used in this study were complication like pain, lack of apposition and skin infection at the site of incision, pain, sinus formation and induration. This method was also evaluated with respect to following parameters: days of hospitalization, cosmetic result, rate of infection, wound apposition and requirement of secondary suturing.Results: As per our study, results are in favour of electrocautry by means of hemostasis. But we found that infection rate and complications are more with it. Moreover number of dressings required and hospital stay was also more with patient undergoing skin incision with electrocautry.Conclusions: For locally overlying healthy skin with no compromise of vascularity or any oedema and there is less fat, electrocautery use for skin incision can still be recommended for better cosmetic result and shorter healing time with less complication and rapid surgery.


2020 ◽  
Vol 24 (1) ◽  
pp. 50-53
Author(s):  
Ali Kashif ◽  
Rizwana Bashir Kiani ◽  
Syed Muhammad Asad Shabbir ◽  
Tariq Mahmood ◽  
Ghulam Sabir ◽  
...  

Aim: To compare the frequency of epigastric pain and uterotonic effect of an equivalent dose of oxytocin administered as an intravenous bolus versus intravenous infusion during elective LSCS under spinal anesthesia. Methodology: We recruited 98 parturients undergoing elective LSCS under spinal anesthesia for this prospective quasi experimental study and divided them into two groups. Group-A received 5 IU of oxytocin as bolus intravenous (IV) injection in 5 sec (bolus group, n= 48), and Group-B (infusion group, n= 50) received 5 IU of oxytocin as an infusion over 5 min. Any complaint of epigastric pain by the patients was noted and its frequency was compared between the two groups. The uterine tone was assessed as adequate or inadequate by an obstetrician. The data were entered into SPSS version 22. Patient demographic data were analyzed with independent samples T-test and the study data were analyzed with Chi‑square test and presented as n (%). p < 0.05 was considered statistically significant. Results: Epigastric pain was noted in 25 (52.03%) out of 48 parturients in Group-A and 15 (30%) out of 50 in Group-B (p = 0.026). There was no significant difference in the uterotonic effect of oxytocin between the two groups (p = 0.736). Conclusion:  We conclude that oxytocin infusion is associated with lower frequency of epigastric pain in elective LSCS when compared to intravenous bolus of an equivalent dose of oxytocin, However, the effect on uterine contractions was adequate with both methods. Citation: Kashif A, Kiani RB, Shabbir SMA, Mahmood T, Sabir G, Fatima NE, Khan WA. Epigastric pain after intravenous administration of oxytocin in patients undergoing lower segment cesarean section: A quasi experimental study comparing intravenous bolus with infusion technique. Anaesth pain intensive care 2020;24(1):_ DOI: https://doi.org/10.35975/apic.v2i1. Received – 20 February 2019; Reviewed – 4, 16 March, 25 June, 9 September, 2, 25 November, 10 December 2019, 7 January 2020; Revised – 19 June, 10 August, 29 September, 1 November 2019, 6 January 2020; Accepted – 10 January 2020;


2018 ◽  
Vol 25 (08) ◽  
pp. 1143-1146
Author(s):  
Ammrah Tahir ◽  
Muhammad Sajid Hameed Ansari ◽  
Abdul Waheed Khan

Objectives: To compare the continuous and interrupted closure in term offrequency of wound dehiscence in emergency midline laparotomy incision. Study Design:Randomized controlled trial. Setting: Surgical Unit-I, Allied Hospital Faisalabad. Period: From15th March 2014 to 15th November 2014. Material and Methods: Two hundred patients werediagnosed clinically by taking thorough history and examinations were included. Fascial layerof wound of the patients sampled for group A was closed with interrupted mass closure withprolene no.1 whereas in group B was closed by continuous mass closure with prolene no1. All included patients were kept nothing by mouth. Resuscitation was done with, ringerslactate and blood transfusion if needed until adequate urine output (0.5 ml/kg/hr). Base lineinvestigations were done. After resuscitation and giving preoperative antibiotics, patients wereexplored through mid-line incision. Obvious source of contamination was dealt with accordingly.Variables wound were examined daily for any sign of dehiscence. Temperature pulse wasmeasured daily along with surgical site examination for any kind of discharge, stitches cutthrough and gut visibility through wound. In case of no complication patient was discharged ontenth postoperative day, which was the end point of study. Results: There were 61 (61%) malesand 39 (39%) females in group A, while in group B, 63 (63%) males and 37 (37%) females withmean ages of patients were 39.77+10.16 and 38.61+9.75 respectively. The wound dehiscencewere found 7 (7%) in Group-A and 18(18%) in Group-B while remaining 93 (93%) in Group-Aand 82 (82%) in Group-B had no morbidity statistically (p<0.01). Conclusion: It is concludedthat wound dehiscence is significantly higher in continuous closure as compare to interruptedclosure for emergency midline laparotomy incision for generalized peritonitis.


1996 ◽  
Vol 3 (3) ◽  
pp. 176-180
Author(s):  
RC Balkissoon ◽  
L Clelland ◽  
L Whitehead ◽  
MT Newhouse

OBJECTIVE:To compare the safety and efficacy of a new spacer-oral nasal mask device with those of the standard needle nozzle spray method for the delivery of aerosolized lidocaine to the upper airway for pre-bronchoscopic anaesthesia in a tertiary care hospital.DESIGN:Single-blind randomized control trial.SETTING:University affiliated tertiary care hospital, ambulatory care bronchoscopy unit.SUBJECTS:Thirty consecutive consenting patients referred for fibreoptic bronchoscopy for various indications.INTERVENTION:Thirty randomized subjects received 150 mg of topical 1% aerosolized lidocaine via standard long needle nosed applicator (group A) or via a new oral/ nasal mask with spacer device (group B). Bronchoscopists, blinded as to the preprocedure topical anaesthetic method used, gave additional topical lidocaine at their discretion.MEASUREMENTS:The study nurse recorded the total dose of lidocaine (mg), timing of the procedure (s), cough frequency expressed as coughs per minute (c/min), vital signs, time for return of gag reflex and patients' subjective comments.RESULTS:Fifteen patients were randomized to each group. The lidocaine dose required for insertion through the vocal cords (mean ± SD) was 282.6±66.3 mg in group A and 203.3±70.6 mg in group B (PÃ0.005). Total lidocaine dose required for the procedure was 330.6±70.2 mg in group A and 256.6±75 mg in group B (PÃ0.01). The mean time for passage of the bronchoscope from mouth entry to through the vocal cords was 82.7±54.5 s in group A and 110.5±64.4 s in group B (P>0.1). The mean total time for the procedure was 699.7±377.5 s in group A and 697.2±409.1 s in group B (not significant). The mean cough frequency was 8.2±6.1 c/min in group A and 7.0±5.7 c/min in group B (not significant). There were no statistically significant differences in heart rate, in return of gag reflex time or in complication rate between the two groups.CONCLUSIONS:A statistically significant reduction in the dose of lidocaine is required to achieve equivalent topical anaesthetic for bronchoscopy with a new mask and spacer device compared with a more conventional method. Since no other variables related to the procedure showed a significant difference, the new method appears to be superior to the previous method.


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