scholarly journals Phacoemulsification under Topical Anesthesia in a Tertiary Care Hospital

2021 ◽  
Vol 8 (11) ◽  
pp. 378-382
Author(s):  
Sheikh Sajjad ◽  
Hina Kounsar ◽  
Suhail Raheem Rather
Keyword(s):  
Cataract Surgery ◽  
Tertiary Care ◽  
Cost Effective ◽  
Topical Anesthesia ◽  
Intraocular Lenses ◽  
Patient Comfort ◽  
Ocular Motility ◽  
Care Hospital ◽  
Topical Anaesthesia ◽  
Intraoperative Movement

Introduction: The use of topical anaesthesia for cataract surgery dates back to 1884 when Knapp used 5% cocaine to anaesthetize cornea. The advancement in cataract surgery techniques like small stepped, self-sealing corneal incisions, phacoemulsification and advanced intraocular lenses has allowed the use of topical anaesthesia thus reducing surgical time and need of akinesia. Materials and Methods: Prospective non-comparative evaluation of patients’ and surgeon’s satisfaction under topical anaesthesia. All patients received topical anesthesia with proparacaine 0.5%. A 10-point visual analogue scale was given to patients to rate the level of pain felt during the operation. Also, the level of patient satisfaction, the need for supplemental anaesthesia, level of ocular motility, surgical complications and postoperative visual acuity were recorded. Results: Total number of cases were 156 out of which 86 (55.1%) were males and 70 (44.9%) were females. Nuclear sclerosis was most common type of cataract followed by mixed opacities. Majority of patients had no intraoperative movement and 30.8% of patients had some movement. Surgeon was dissatisfied in only 12.2% cases who had disturbing movements during surgery. Although majority of patients felt no pain (68%) or mild pain (23.7%) during surgery 8.3% cases had moderate to severe pain which required supplemental intracameral lidocaine. Conclusion: Topical anaesthesia is cost effective, provides high patient comfort during surgery, is less stressful for the patient, saves considerable time and complications compared to regional anaesthesia. Keywords: topical anaesthesia, phacoemulsification, pain assessment, surgeon`s satisfaction.

scholarly journals Intraoperative visual experience and preoperative counselling during phacoemulsification under topical anaesthesia

2016 ◽  
Vol 4 (2) ◽  
pp. 45-49
Author(s):  
Kiran Shakya ◽  
Suprada Pokhrel Pandey ◽  
Ram Prasad Pokhrel ◽  
Om Krishna Pokhrel
Keyword(s):  
Cataract Surgery ◽  
Visual Experience ◽  
Tertiary Care ◽  
Topical Anesthesia ◽  
Eye Drops ◽  
Care Hospital ◽  
Light Perception ◽  
Medical College ◽  
Preoperative Counseling ◽  
Structured Questionnaire

Background: Phacoemulsification surgery using topical anesthesia makes patient experience a multitude of visual sensations. However, it makes cataract surgery safe with the quickest visual recovery.Objective: To find the effect of preoperative counseling about potential intraoperative visual experience during phacoemulsification under topical anesthesia to alleviate fear in patients having cataract surgery.Methods: This non- randomized and non comparative study was carried out in a tertiary care hospital from February 2015 to April 2015. Forty five adult patients underwent cataract surgery (phacoemulsification with foldable intraocular lens implantation) under topical anesthesia using Proparacaine hydrochloride 0.5 % eye drops by a single surgeon. All patients received counseling on the potential intraoperative visual experience during phacoemulsification. A structured questionnaire was used to collect data on socio-demographics, pain, intraoperative visual experiences and their fear. Participants were asked if they experienced visual sensations such as light perception, gush of water and movements during surgery.Results: Nineteen (42.2%) of them were men and 26 (57.8%) were women. Sixty nine percent of the patients were above 60 years. All of them reported having experienced visual sensations during surgery, the most common being light perception (100%), movements of instruments or surgeon’s hands (91.1%) and gush of water (62.2%). One case (4.4%) felt tolerable pain associated with fear (P=0.000) due to these visual experience.Conclusion: Preoperative counseling about the potential intraoperative visual experience during phacoemulsifiaction under topical anesthesia alleviates the visual experience fear in patients having cataract surgery.Journal of Kathmandu Medical College, Vol. 4, No. 2, Issue 12, Apr.-Jun., 2015,Page: 45-49 

Telemedicine During A Crisis: Challenges, Opportunities & Way Forward At A Tertiary Care Hospital (Preprint)

2021 ◽  
Author(s):  
Sadia Masood ◽  
Zanaib Samad ◽  
Sarah Nadeem ◽  
Unzela Ghulam
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cost Effective ◽  
Successful Implementation ◽  
Care Hospital ◽  
Quality Health Care ◽  
Cross Sectional ◽  
Innovative Strategy

BACKGROUND Telemedicine is utilized to deliver health care services remotely. Recently, it is well established due to pandemics because it can help the patients get required supportive care while minimizing their hospital exposure. In the future, it will continue to be used as a convenient, cost-effective patient care modality. OBJECTIVE The objectives were to identify physicians' challenges during teleconsultations and recognize the opportunities and strengths of this modality during the pandemic in a lower-income country. METHODS This cross-sectional study was conducted in a tertiary care hospital. The self-made questionnaire was filled through an online medium and responses were recorded on a five-point Likert scale. RESULTS A total of 83 participants were enrolled in this study. Most of them were Associate professors (29.8%), Assistant professors (26.2%), the ratio of the females was (52.4%) greater than males (,47.6%). 46 (54.8%) have laid between the age group 30-40 years. Pediatricians and senior instructors faced more difficulty in using telemedicine. The ones having clinical experience of fewer than 15 years or categorized in the age of 50-60 years faced challenges while using this modality. CONCLUSIONS During the current pandemic, situation telemedicine is the only glimmer of light to provide better quality health care. Telemedicine is an innovative strategy and it is important to understand the perception of physicians about it. Incomplete and inadequate infrastructure and attitude of the physicians is the main obstacle toward successful implementation of telemedicine. Successful installation and deployment of this technology require a complete grasp of the process among physicians.

scholarly journals Frequency of Complications Following Cataract Surgery in Diabetic Patients at Tertiary Care Hospital

2022 ◽  
Vol 9 (1) ◽  
pp. 75-81
Author(s):  
Muhammad Bilal ◽  
Shafqat Ali Shah ◽  
Marina Murad ◽  
Saad Ali ◽  
Ammad Ali ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Tertiary Care ◽  
Case Series ◽  
Female Gender ◽  
Posterior Capsule Opacification ◽  
Posterior Capsule ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Case Series Study

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.

scholarly journals Adverse events following immunization with pentavalent vaccine in a tertiary care hospital

2017 ◽  
Vol 5 (1) ◽  
pp. 82
Author(s):  
Sharad Bansal
Keyword(s):  
Adverse Events ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cost Effective ◽  
Care Hospital ◽  
Immunization Programs ◽  
Global Alliance ◽  
Immunization Program ◽  
Pentavalent Vaccine ◽  
Mild Fever

Background: Immunizations currently save 3 million lives per year throughout the world and is one of the most cost-effective health interventions. The Global Alliance for Vaccines and Immunizations (GAVI) and WHO recommended the use of pentavalent to replace the DPT vaccine in developing countries. Vaccines related most side effects are mild and non-serious. Surveillance of adverse events following immunization will enable us to monitor the safety of immunization programs and thereby contribute to validating the immunization program. The main aim of this study is to analyze all suspected adverse events in children reported for pentavalent vaccination.Methods:A prospective, observational epidemiological study was conducted in the department of Paediatrics OPD at tertiary care teaching institute during October 2016 to December 2016. The study was conducted amongst 190 children attending the department of Paediatrics OPD for the second or third dose of pentavalent vaccine.Results: The study shows the following adverse effects after pentavalent injection  127 (66.8%) children had pain at the site of injection, 103(54.2%) mild fever, Swelling at injection site 84(44.2%) and 55(28.9%) children held their leg back due to pain. In majority 85 (44.7%) of children antipyretic and in 65 (34.2%) children analgesic was given was given to relieve the symptoms. The parents were very positive for completing their children’s immunization schedule even though they have faced few symptoms.Conclusions:It can be concluded that all the adverse events reported were mild and could be managed easily without any complications. 

scholarly journals Supervision and monitoring to assess quality of outreach immunization sessions in a rural area using a checklist

2020 ◽  
Vol 7 (5) ◽  
pp. 1950
Author(s):  
Ambika R. Bhaskar ◽  
Mridula Solanki
Keyword(s):  
Tertiary Care ◽  
Immunization Coverage ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Effective Interventions ◽  
Immunization Services ◽  
Timely Fashion ◽  
Assess Quality

Background: Immunization is one of the most cost-effective interventions to prevent the suffering that comes from avoidable sickness, disability and death. Outreach immunization services ensure that immunization is available to children who are unable to access a general practice in a timely fashion for their immunization events. Effective supervision and monitoring will help in improving quality and coverage of immunization.Methods: This was an observational cross-sectional study conducted in the rural field practice area of a tertiary care hospital. 50 outreach sessions held in various outdoor places including Anganwadi were supervised and monitored using checklist. 110 mothers and 20 stakeholders were interviewed. Immunization records were assessed.Results: Outreach immunization sessions were found to be of good quality. 89% children were fully immunized. ANMs and ASHAs were of the opinion that outreach session has significantly raised immunization coverage. 75.4% mothers had knowledge about services provided by outreach sessions.Conclusions: There was increase in immunization coverage due to outreach sessions. There is need for adequate supervision on safety injection practices and regular timely incentive to ASHA.

scholarly journals Assessment of Factors Associated with Dropout for Pentavalent Vaccine in Tertiary Care Hospital of Kathmandu, Nepal

2020 ◽  
Vol 22 (3) ◽  
pp. 106-110
Author(s):  
Supri Raj Shrestha ◽  
B Shakya ◽  
R Oli
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
College Teaching ◽  
Sampling Technique ◽  
Cost Effective ◽  
Dropout Rate ◽  
Care Hospital ◽  
Vaccine Preventable Diseases ◽  
Factors Associated ◽  
Pentavalent Vaccine

Immunization is one of the most cost-effective public health measures as it has helped in huge reduction of disease, disability and death from different infectious diseases in children by protecting them from vaccine preventable diseases. The current study aimed to study factors associated with dropout for pentavalent vaccine in tertiary care hospital of Kathmandu. A longitudinal observational study using purposive sampling technique was conducted among 196 infants. The information was obtained using self-constructed structured questionnaire from parents visiting Community Medicine OPD of Nepal Medical College Teaching Hospital. The information regarding socioeconomic characteristics of mother, gender of the infant, place of delivery of child, birth order and reasons for dropout of pentavalent third dose were taken. The dropout of third dose pentavalent vaccine was mainly seen in infant of parents living in rented house and according to gender wise, dropout was high among male infants. The different reasons for dropout of vaccine were busy parents, forgotten date, visit to other immunization centres and sick infants. Among these, the main reason for dropout of vaccine was due to infants getting sick during the time of immunization. The dropout rates between first and third dose of pentavalent vaccine were 26.3% and 30.4% respectively for two consecutive months and the overall dropout rate was 28.35%. Also, literacy level of the mother was directly associated with the immunization visit of the infant as, maximum number of infants of illiterate mother were absent for third dose of pentavalent vaccine as opposed to no absentee among master degree holding mothers. Thus, the present study provides valuable information regarding the factors associated with dropout for pentavalent vaccine.

scholarly journals Study of clinical profile of cervical cancer patients: a hospital based study

2017 ◽  
Vol 6 (11) ◽  
pp. 4873
Author(s):  
Preeti Umate ◽  
Dhuldev S. Thengal ◽  
Dhundiraj Kurdukar
Keyword(s):  
Early Stage ◽  
Past History ◽  
Clinical Stage ◽  
Tertiary Care ◽  
Cost Effective ◽  
Educational Status ◽  
Clinical Staging ◽  
Common Symptom ◽  
Care Hospital ◽  
Quality Cancer Care

Background: As a consequence of growing and ageing populations, developing countries are disproportionately affected by the increasing number of cancers. Though the situation in India is gradually improving there still exists a disparity between the availability of quality cancer care. With this view, the present study was planned to undertake in this tertiary care institute to find out symptoms, clinical staging, complications and management of cases of carcinoma of cervix.Methods: This was a prospective observational study of carcinoma of cervix carried out at a tertiary care hospital catering services to the people of Maharashtra and neighbouring states. A thorough history including presenting complaints, demographic details, educational status and occupational details, details of menstrual and obstetric history along with any significant past history were recorded on a standard proforma.Results: Most common symptom was per vaginal bleeding which was found in 29 (69.04%). In the present study almost two third of cases i.e. 28 (66.6%) had advanced stage (IIB, III, IV) at the time of admission while the number of cases diagnosed at early stage were only 14 (33.3%). For Wertheim’s hysterectomy, most commonly used approach was transperitoneal 08 (61.53%) while 05 (38.46%) were operated by extraperitoneal approach. Pelvic lymph nodes were positive in 03 (23.07%).Conclusions: A high proportion of patients presented in stages III and IV. This emphasizes the need for early detection of Gynecological cancers in our population. Accordingly, the importance of detection of the pre-clinical stage of the diseases by considering the possibility of initiating cost-effective screening measures needs to be emphasized. 

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