Pattern and risk factors of retinopathy of prematurity in tertiary care centre

Retinopathy of prematurity is one of the commonest cause of blindness in sick neonates exposed to excessive oxygen following NICU admissions. The present study was thus conducted to assess the pattern and risk factors associated with incidence of retinopathy of prematurity.A retrospective record based study was conducted at tertiary care centre between 1st July 2017 to 30thMay 2020 were screened for ROP. Baseline characteristics and risk factors for ROP were assessed. The zone and stage of ROP were categorized as per the International classification of ROP along with iris neovascularisation and plus disease as per the revised international classification of retinopathy of prematurity (ICROP) preplus disease criteria. Data was entered in excel sheet and analysed using SPSS software version 20.Majority of neonates belonged to gestational age of 28 to 31 weeks (58.8%) and 51.2% neonates had birthweight of 1.5 to 2 kg. Male preponderance was observed with male: female ratio of 1.75:1. Amongst the various risk factors, the occurrence of ROP was highly significantly associated with gestational age and birthweight (p<0.01). Subgroup analysis revealed that aggressive posterior ROP (APROP) contributed significantly to Type I ROP in 11.1% (3) cases. And the observed difference in gestational age and birthweight between APROP and other cases of ROP were statistically highly significant (p<0.01).Early and timely screening of ROP for all high risk neonates especially low birth weight and neonates with small gestational age should be mandatory as these are the most significant risk factors associated with ROP in present study.

Content Comparison of Long-Term Care Instruments Based On The International Classification of Functioning, Disability And Health (ICF)

Background: Aging crisis is proposing a huge challenge to the whole Chinese social welfare system, however a national Long-term Care (LTC) Instrument has not established yet. The objective of this study was to analyze and compare the content of six selected LTCs based on the linkage of the International Classification of Functioning, Disability and Health (ICF), so as to provide insights for the development of Chinese national LTC instrument in the future. Methods: Two trained health professionals performed the linkage according to the refined ICF linking rules. The main concepts included in the items of three international LTC instruments, namely Minimum Data Set 3.0 (MDS 3.0), Initial Assessment Instrument(IAI), and New Assessment Tool for Determining Dependency on Nursing Care (NBA), as well as three Chinese instruments, namely Disability Assessment of Long-Term Care (DA-LTC), Specification for Elderly Care Unified Need Assessment in Shanghai Version 2.0 (SEC-UNA 2.0), and pictorial-based Longshi Scale (LS) were selected and linked to the ICF categories. The six selected LTC instruments were analyzed and compared at the levels of ICF components, chapters, and categories. Results: The main concepts of 340 valid items of the six LTC instruments were linked to 112 different ICF categories. Within the ICF framework, the “Activities and Participation” component was most frequently addressed in the LTC instruments followed by the “Body functions” component, and the percentages were 0.52 and 0.38, respectively. At the ICF chapters level, “b1 mental functions,” “d4 mobility,” and “d5 self-care” were the core of the LTC instruments. In addition, the contents of the six selected LTC instruments differed greatly. Conclusions: The ICF provides a useful external reference for the analysis and comparison of different LTC instruments. The findings suggest that key elements to determine eligibility for LTC in China need to be further identified. It is anticipated that this study will provide new insights for the development of Chinese national LTC instruments.

Trends in the Prevalence and Progression of Diabetic Retinopathy Associated with Hyperglycemic Disorders during Pregnancy in Japan

The aim of this study was to determine the prevalence and progression of diabetic retinopathy (DR) with hyperglycemic disorders during pregnancy (HDPs) in Japan between 2013 and 2018 using two cohorts. The patients with HDPs were classified as those with pre-existing DM (pexD), gestational DM (GDM), and overt DM (ODM). Cohort 1 was obtained from the health claims database whose diseases were classified by the International Classification of Diseases-10. Cohort 2 was derived from a retrospective, multicenter analysis of the medical records of 225 patients from 10 ophthalmological institutions. In Cohort 1, there were 5268 patients with an HDP prevalence of 8.4%. Among them, 73 of 1139 patients had pexD (6.4%) and 61 of 4129 patients with GDM (1.5%) had DR; the overall prevalence of DR was 2.5%. In Cohort 2, 36 of 225 patients (16.0%) had DR, and 149 patients were followed at the early and late stages of pregnancy. Moreover, 10 of the 102 patients with pexD (9.8%) and two of five patients with ODM (40.0%) had a progression of DR. In conclusion, the prevalence and progression of DR in patients with pexD is lower than previously reported. More attention should be given to pexD and ODM.

Application of the International Classification of Functioning, Disabilities and Health in the Rehabilitation Process

With the development of high technologies in medicine, the diagnostic process is improving, the methods of treating patients are refining, the percentage of patients who survived after serious injuries, diseases and/or conditions is increasing. The issue of the patients` quality of life that received primary medical, specialized, including high-tech medical care is becoming a priority for health care. Rehabilitation is defined as one of the critical interventions “enabling people with disabilities to achieve and maintain maximum independence, full physical, mental, social and professional ability and full inclusion and participation in all aspects of life”. The problems and prospects of rehabilitation medicine for the future arise due to critical changes in demographics, life expectancy, a variation in approaches to assessing disability, an increase in the prevalence of long-term health disorders, especially in connection with the new coronavirus infection, technological progress, as well as changes in health care costs and changes in society’s requirements for well-being and quality of life, including health. The object of the study is the process of organizing medical rehabilitation of patients with cerebral stroke at the second phase of rehabilitation process in a 24-hour inpatient medical rehabilitation department for patients with impaired function, structures, limited activity and participation due to damage to the central nervous system based on the application of the International Classification of Functioning, Disabilities and Health (ICF) for the rehabilitation diagnosis description (the degree of disturbance of structure, function, limitation of activity and participation, the degree of influence of environmental factors) and the formation of the medical rehabilitation program on its basis.