scholarly journals Intravitreal Injections of Bevacizumab: The Impact of Needle Size in Intraocular Pressure and Pain

2017 ◽  
Vol 11 (2) ◽  
pp. 38-41 ◽  
Author(s):  
Mónica Loureiro ◽  
Rita Matos ◽  
Paula Sepulveda ◽  
Dália Meira

ABSTRACT Aim To compare the effect of 30-gauge vs 27-gauge needle size on intraocular pressure (IOP) rise and patients’ pain experience after intravitreal injection (IVI) of bevacizumab. Materials and methods Cross-sectional, randomized, double-armed study. Patients were randomized to IVI with 30-gauge or 27-gauge needle. The IOP was measured pre and post IVI. Patients’ pain was graded using the visual analog scale (VAS). Results A total of 54 eyes were included. The IVI caused a significant IOP rise in both groups (p < 0.001). In the 30-gauge group, the mean pre- and postinjection IOP was 16.3 ± 3.6 mm Hg and 24.1 ± 9.0 mm Hg. The corresponding figures in the 27-gauge group were 18.0 ± 2.54 (p = 0.26) and 23.1 ± 7.5 mm Hg (p = 0.66). In the 30-gauge group, the mean VAS pain score was 3.2 ± 2.6 compared to 3.0 ± 2.5 in the 27-gauge group (p = 0.78). Conclusion The IVI caused a significant rise in IOP after the injection, independently of the needle size used. The 27-gauge needle coursed with lower postinjection IOP without prejudice of the patient comfort. Clinical significance The IVI with 27-gauge may be considered for glaucomatous eyes (higher risk eyes), for which IOP spikes are not recommended. How to cite this article Loureiro M, Matos R, Sepulveda P, Meira D. Intravitreal Injections of Bevacizumab: The Impact of Needle Size in Intraocular Pressure and Pain. J Curr Glaucoma Pract 2017;11(2):38-41.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Clare Shakespeare ◽  
Handsome Dube ◽  
Sikhangezile Moyo ◽  
Solwayo Ngwenya

Abstract Background On the 27th of March 2020 the Zimbabwean government declared the Covid-19 pandemic a ‘national disaster’. Travel restrictions and emergency regulations have had significant impacts on maternity services, including resource stock-outs, and closure of antenatal clinics during the lockdown period. Estimates of the indirect impact of Covid-19 on maternal and perinatal mortality was expected it to be considerable, but little data was yet available. This study aimed to examine the impact of Covid-19 and lockdown control measures on non-Covid outcomes in a government tertiary level maternity unit in Bulawayo, Zimbabwe, by comparing maternal and perinatal morbidity and mortality before, and after the lockdown was implemented. Methods This was a retrospective, observational study, using a cross-sectional design to compare routine monthly maternal and perinatal statistics three months before and after Covid-19 emergency measures were implemented at Mpilo Central Hospital. Results Between January-March and April-June 2020, the mean monthly deliveries reduced from 747.3 (SD ± 61.3) in the first quarter of 2020 to 681.0 (SD ± 17.6) during lockdown, but this was not statistically significant, p = 0.20. The Caesarean section rates fell from a mean of 29.8% (SD ± 1.7) versus 28.0% (SD ± 1.7), which was also not statistically significant, p = 0.18. During lockdown, the percentage of women delivering at Mpilo Central Hospital who were booked at the hospital fell from a mean of 41.6% (SD ± 1.1) to 35.8% (SD ± 4.3) which was statistically significant, p = 0.03. There was no significant change, however, in maternal mortality or severe maternal morbidity (such as post-partum haemorrhage (PPH), uterine rupture, and severe preeclampsia/eclampsia), stillbirth rate or special care baby unit admission. There was an increase in the mean total number of early neonatal deaths (ENND) (mean 18.7 (SD ± 2.9) versus 24.0 (SD ± 4.6), but this was not statistically significant, p = 0.32. Conclusions Overall, maternity services at Mpilo showed resilience during the lockdown period, with no significant change in maternal and perinatal adverse outcomes, with the same number of man-hours worked before and during the lockdown Maternal and perinatal outcomes should continue to be monitored to assess the impact of Covid-19 and the lockdown measures as the pandemic in Zimbabwe unfolds. Further studies would be beneficial to explore women’s experiences and understand how bookings and deliveries at local clinics changed during this time.


Retina ◽  
2015 ◽  
Vol 35 (7) ◽  
pp. 1401-1406 ◽  
Author(s):  
Claudine E. Pang ◽  
Sarah Mrejen ◽  
Quan V. Hoang ◽  
John A. Sorenson ◽  
K. Bailey Freund

2020 ◽  
pp. 019459982096963
Author(s):  
Vanessa F. Torrecillas ◽  
Kaden Neuberger ◽  
Alexander Ramirez ◽  
Paul Krakovitz ◽  
Jeremy D. Meier

Objective Third-party payers advocate for prior authorization (PA) to reduce overutilization of health care resources. The impact of PA in elective surgery is understudied, especially in cases where evidence-based clinical practice guidelines define operative candidacy. The objective of this study is to investigate the impact of PA on the incidence of pediatric tonsillectomy. Study Design Cross-sectional study. Setting Health claims database from a third-party payer. Methods Any pediatric patient who had evaluation for tonsillectomy from 2016 to 2019 was eligible for inclusion. A time series analysis was used to evaluate the change in incidence of tonsillectomy before and after PA. Lag time from consultation to surgery before and after PA was compared with segmented regression. Results A total of 10,047 tonsillectomy claims met inclusion and exclusion criteria. Female patients made up 51% of claims, and the mean age was 7.9 years. Just 1.5% of claims were denied after PA implementation. There was no change in the incidence of tonsillectomy for all plan types ( P = .1). Increased lag time from consultation to surgery was noted immediately after PA implementation by 2.38 days (95% CI, 0.23-4.54; P = .030); otherwise, there was no significant change over time ( P = .98). Conclusion A modest number of tonsillectomy claims were denied approval after implementation of PA. The value of PA for pediatric tonsillectomy is questionable, as it did not result in decreased incidence of tonsillectomy in this cohort.


2021 ◽  
pp. 1-6
Author(s):  
Shivani Saini ◽  
◽  
Agarwal Shail ◽  
Jain Manish ◽  
Yadav Devendra ◽  
...  

Background: Dermatophytosis is a common fungal infection affecting 20-25% of the world population. Aims: Our study was aimed to assess its impact on health-related quality of life(QoL), mental health, and various variables. Materials and Methods: A cross-sectional study was done from April 2019 to September 2019 on 174 patients of dermatophytosis of aged more than 16 years with their informed consent. The impact of infection on the quality of life was assessed by using the Dermatology life quality index questionnaire and General health questionnaire-12 was used to assess psychological impact. A visual analogue scale was used to assess the severity of pruritus. Appropriate statistical tests were applied. Results: Males to females ratio was 1.4:1. The age group of 21-30 was having the highest number of patients with the mean age of 27.8±9.97. Most patients had BSA under 10%. The mean value of DLQI and GHQ-12 were found 15.989±7.407 and 2.8563±2.8964, respectively. We found that dermatophytosis had a very large effect on the quality of life as the maximum number of patients(39%) were within this category. The “work and school” part in the questionnaire gained maximum importance(52.8%). The mean VAS score was 6±2.733 with most patients(32.7%) had moderate itching. We found a positive correlation between VAS and DLQI, VAS and GHQ-12, DLQI, and GHQ-12 with the statistical significance. Conclusion: In our study dermatophytosis affected the quality of life as well as the psychological health of patients. Therefore proper treatment of superficial dermatophtytosis is essential to prevent it from further complications


2019 ◽  
Vol 25 (5-6) ◽  
pp. 107-11
Author(s):  
Helena Siregar ◽  
Azwin Lubis ◽  
M. Arif Nasution ◽  
Indra Kesuma Nasution ◽  
Thamrin Tanjung

A cross sectional study about the relationships between family size and marital age and the impact of educatimt, occupation and family planning programme was conducted in the region of South Tapanuli North Sumatera. The study was performed on 246 married couples by simple random sampling of households in the villages Pakantea, Tamiang, Muarasoro and Sumuran, during the period of September 25 up to October 3, 1982. The eariiest age of marriage for women was 14 years, ancl the latest 20 years. Most of the women (68%) married at 15-20 year. The main education of responders were primary school (67%). The occupational status was mostly (90%) farmer. The mean family size under 20 years old was 6.3 and over 20 years, 5.3. Fertility rate under 20 years was still high. Family Planning was not yet widely accepted in this area.


2003 ◽  
Vol 23 (6) ◽  
pp. 550-556 ◽  
Author(s):  
Mark Wright ◽  
Graham Woodrow ◽  
Siobahn O'Brien ◽  
Neil King ◽  
Louise Dye ◽  
...  

Objective Malnutrition is common among peritoneal dialysis (PD) patients. Reduced nutrient intake contributes to this. It has long been assumed that this reflects disturbed appetite. We set out to define the appetite profiles of a group of PD patients using a novel technique. Design Prospective, cross-sectional comparison of PD patients versus controls. Setting Teaching hospital dialysis unit. Patients 39 PD patients and 42 healthy controls. Intervention Visual analog ratings were recorded at hourly intervals to generate daily profiles for hunger and fullness. Summary statistics were generated to compare the groups. Food intake was measured using 3-day dietary records. Main Outcome Measures Hunger and fullness profiles. Derived hunger and fullness scores. Results Controls demonstrated peaks of hunger before mealtimes, with fullness scores peaking after meals. The PD profiles had much reduced premeal hunger peaks. A postmeal reduction in hunger was evident, but the rest of the trace was flat. The PD fullness profile was also flatter than in the controls. Mean scores were similar despite the marked discrepancy in the profiles. The PD group had lower peak hunger and less diurnal variability in their hunger scores. They also demonstrated much less change in fullness rating around mealtimes, while the mean and peak fullness scores were little different. The reported nutrient intake was significantly lower for PD. Conclusion The data suggest that PD patients normalize their mean appetite perception at a lower level of nutrient intake than controls, suggesting that patient-reported appetite may be misleading in clinical practice. There is a loss of the usual daily variation for the PD group, which may contribute to their reduced food intake. The technique described here could be used to assess the impact of interventions upon the abnormal PD appetite profile.


2018 ◽  
Vol 7 ◽  
Author(s):  
Julius T. Kamwesiga ◽  
Lena K. Von Kock ◽  
Gunilla M. Eriksson ◽  
Susanne G.E. Guidetti

Background: Knowledge about perceived impact of stroke on everyday life as well as rehabilitation needs after stroke in Uganda is necessary to identify and develop rehabilitation interventions.Objectives: To explore and describe clinical characteristics and functioning during the acute or subacute phase and chronic phase, as well as the impact of stroke on everyday life during the chronic phase in stroke survivors in central Uganda.Method: A cross-sectional observational study was conducted on a consecutively included acute or subacute (n = 58) sample and a chronic (n = 62) sample. Face-to-face interviews were conducted to collect demographic information and clinical characteristics. The Scandinavian Stroke Scale (SSS) was used to collect clinical characteristics, assess neurological impairment and define stroke severity. The Barthel Index was used to assess the level of dependence in activities of daily living. In addition, the Stroke Impact Scale (SIS) 3.0 Uganda version was used to assess the impact of stroke in everyday life as perceived by the individuals in the chronic sample receiving rehabilitation.Results: The mean age of the acute/subacute sample was 49 years and 81% had moderate or severe stroke. The mean age of the chronic rehabilitation group was 53 years and 58% had mild stroke. Time since onset in the acute sample was between 2 days and 3 weeks, and time since onset for the chronic sample varied between 3 months and 3 years. Strength, hand function and participation were the most impacted SIS domains in the chronic sample.Conclusion: People with severe and moderate stroke were more likely to be admitted to Mulago Hospital. The mean age in the study sample was lower than that in high-income countries. Further knowledge is needed regarding the impact of stroke to develop guidelines for stroke rehabilitation interventions feasible in the Ugandan healthcare context in both rural and urban areas.


2020 ◽  
pp. bjophthalmol-2019-315445
Author(s):  
Alexei N Kulikov ◽  
Dmitrii S Maltsev ◽  
Alina A Kazak ◽  
Maria A Burnasheva

PurposeTo study the correlation between intraocular pressure (IOP) reduction and the number of hyper-reflective particles appearing in the anterior chamber following selective laser trabeculoplasty (SLT).Material and methodsIn this prospective interventional study, we included primary open-angle glaucoma patients. All participants received a standardised SLT session, which consisted of 100 pulses of 0.9 mJ over 360°. Anterior segment optical coherence tomography (4×4 mm volume scan, 101 horizontal cross-sectional scans) and applanation tonometry were performed before SLT and 15 min, 1 day, 1 week, 1 month and 3 months after. Particles were counted on cross-sectional scans using a standardised algorithm.ResultsIn this study, we included 25 patients (25 eyes), 14 males and 11 females, with a mean age of 68.9±10.5 and baseline IOP of 21.4±4.5 mm Hg. IOP at month 1 and month 3 after SLT was 18.0±4.0 and 17.4±3.3 mm Hg, respectively. The mean number of anterior chamber particles before and 15 min after SLT was 0.62±0.2 and 7.1±2.0 particles/mm2, respectively (p=0.036). There was a statistically significant correlation between the mean number of anterior chamber particles 15 min after SLT and IOP reduction at 1 month (r=0.62, p=0.03) and 3 months (r=0.71, p=0.01).ConclusionThe number of the anterior chamber particles graded using anterior segment optical coherence tomography after the procedure correlates with the IOP-lowering effect of SLT.


2010 ◽  
Vol 13 (11) ◽  
pp. 1818-1825 ◽  
Author(s):  
Tove Nystad ◽  
Marita Melhus ◽  
Magritt Brustad ◽  
Eiliv Lund

AbstractObjectiveTo assess coffee consumption in the Sami and Norwegian populations and to investigate the impact of unfiltered boiled coffee consumption on serum cholesterol concentrations.DesignA cross-sectional study. Information was collected by self-administrated questionnaires and total serum cholesterol was analysed. Participants were divided into three ethnic groups: Sami I (Sami used as home language in the last three generations), Sami II (at least one Sami identity marker) and Norwegian.SettingIn an area with Sami, Kven/Finnish and Norwegian populations, the SAMINOR study, 2003–2004.SubjectsA total of 5647 men and 6347 women aged 36–79 years.ResultsMore than 90 % of the study populations were coffee drinkers. Only 22 % were unfiltered coffee consumers. Sami I had the highest proportion of participants who consumed nine or more cups of unfiltered coffee per day, although the number of participants was limited. Total coffee consumption was associated with increased total cholesterol for men (P < 0·01) and women (P < 0·0001). For those who drank only unfiltered coffee, a significant association was found only in Norwegian men, adjusted for physical activity in leisure time, BMI and smoking habits (P < 0·001). From the lowest (less than five cups) to the highest (nine or more cups) unfiltered coffee consumption category, the mean total cholesterol levels increased by 0·29 mmol/l in Norwegian men.ConclusionsUnfiltered coffee consumption was lower in the present study compared to previous reports. In general, total coffee consumption was positively associated with total cholesterol levels. However, for unfiltered coffee consumption, an association was found only in Norwegian men.


2018 ◽  
Vol 28 (4) ◽  
pp. 393-397 ◽  
Author(s):  
Francisco W Rodrigues ◽  
Camilla de MN Silva ◽  
Déborah C Modesto ◽  
Antônio WS de Oliveira ◽  
Rodrigo Egidio da Silva

Objective: To evaluate the intraocular pressure variation before and after phacoemulsification through pneumatic tonometry in addition to correlating it with the age, gender, and preoperative intraocular pressure of the patients evaluated. Methods: This is a cross-sectional observational study. Inclusion criteria were older than 18 years, deep anterior chamber visualized by the slit lamp and estimation of open angle using the Van Herick technique, intraocular pressure less than 21 mmHg, without surgical complications, and without any ocular disease. The intraocular pressure was measured by the pneumatic tonometer. The intraocular pressure assessment was performed at the last consultation before phacoemulsification surgery and 30 days after. Results: A sample of 182 eyes was used. The mean age was 68.41 ± 10.84 years. Of the patient, 65% were females and 35% were males. The mean intraocular pressure in the preoperative period was 16.0 mmHg (±3.3 mmHg) and the mean intraocular pressure in the postoperative period was 13.44 mmHg (±3.31 mmHg). There was no correlation between intraocular pressure variations in both eyes (age-matched open angle) and age. There was a statistically significant correlation between the preoperative intraocular pressure value and the intraocular pressure changes in the postoperative period. In the comparison of the intraocular pressure variation between the genders, the female gender presented a statistically significant negative variation. Conclusion: We conclude that the cataract surgery is related to the reduction of intraocular pressure in the postoperative period and this reduction is more influenced by its preoperative value. Other studies of high epidemiological impact are needed, which may corroborate that the cataract surgery could directly influence intraocular pressure variation.


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