ABSTRACT
Objective: To study the role of retinopathy of prematurity [ROP] coordinator in improving compliance of patients with ROP screening examination visits
Study Design: Prospective observational cross sectional study
Place and Duration of Study: Lahore General Hospital from, 1[st] Jan 2015 to 31[st] Dec 2015
Material and Methods: This prospective observational cross-sectional study was conducted at Lahore General Hospital over duration of one year, from 1st January, 2015 to 31st December, 2015. It included 326 preterm infants discharged from the Neonatal Intensive Care Unit [NICU] of the same hospital. Parents were provided scheduled ROP screening examination appointments at the time of discharge. These preterm infants were divided into 2 groups. Group-I included 163 infants discharged from NICU in the first 6 months [Jan 2015 to June 2015]. Group-II included 163 infants discharged from NICU over the following 6 months [July 2015 to Dec 2015]. Patients in group-II had the advantages of telephonic reminders provided by ROP coordinator before every follow-up visit, along with targeted education regarding ROP. They were also generously helped during every examination visit. Compliance in the two groups was compared and studied. Non-compliant parents of the infants of both groups-I and II were contacted using telephonic calls to inquire about patients' reasons for missing follow-up visits
Results: Significant difference was observed with respect to compliance of parents among group-I who were not reminded about follow-up visits through telephone versus parents of infants enrolled in group-II who were contacted by the ROP coordinator through telephonic conversation [p-value=0.001]
Conclusion: ROP coordinator can play a vital role in improving compliance and decreasing refusal without reason in ROP screening through telephone reminders
ABSTRACT
Objective: To estimate the reliability of Objective Structured Assessment of Cataract Surgical Skill [OSACSS] Study Design: Co-relational reliability. Place and Duration of Study: Department of Ophthalmology, Lahore General Hospital [LGH] 1[st] Nov 2015 to 30[th] Jan 2016
Material and Methods: Eleven operations performed by trainees and surgeons were recorded. Three raters/ observers [including one very experienced, one having comparatively less experience and one novice] observed the recordings and rated on the Objective Structured Assessment of Cataract Surgical Skill [OSACSS] checklist. The same checklist was filled three weeks later by each observer. Inter and intra rater reliability was assessed
Results: Inter rater reliability [Cronbach's Alpha] was 0.681 [Questionable] in the first test and 0.878 [Good] in the retest. Intrarater reliability [Cronbach's Alpha] was 0.918 [Excellent] for the rater A, 0.844 [Good] for rater B and 0.662 [Questionable] for rater C
Conclusion: Objective Structured Assessment of Cataract Surgical Skill [OSACSS] had excellent intra rater reliability in experienced hands and intra rater reliability decreases as the experience of the observer/rater decreases. Inter rater reliability increased in the retest indicating more experience of the observers/raters would make the instrument more reliable
ABSTRACT
Objective: To evaluate the students' experiences about One Minute Preceptor [OMP] as an instructional tool
Study Design: Case study
Place and Duration of Study: Riphah International University, Islamic International Medical College Trust, Pakistan Railway Hospital, Rawalpindi from January 2013 to March, 2014
Material and Methods: Non-probability convenience sampling of 75 final year medical students who had experienced OMP during their rotation in gynecology department was done. A survey questionnaire having 12 closed ended statements and 3 open ended questions regarding OMP was designed. The students were asked to fill in the forms at the end of their rotation using a 7 point agreement Lickert scale after taking informed consent. The survey form was filled in anonymously to protect the identity of the students. The questions included the efficacy of OMP in making concepts, time utilization, skills learnt, understanding the clinical diagnosis and management. Data analysis was done using IBM SPSS version 17 to calculate frequency analysis of the survey. Content analysis was done using NVIVO 10 by text query analysis to produce word frequency table, cluster analysis and word cloud
Results: Quantitative analysis of our study show that OMP is a useful instructional tool for improving presentation skills [78.2%], providing feedback [72%], formulation of an assessment plan [75.9%] and encouragement to read more about the disease [77%]. Qualitative analysis shows that it is a student friendly tool which provides instruction in a short period of time. Time was the most commonly used word in all the 7 themes including clinical skills, case presentation, decision making, problem solving, time management, organization and resources
Conclusion: OMP is perceived as a good tool to improve presentation skills, clinical evaluation of the patient, making a plan of action and providing feedback in a short clinical encounter with the patient
ABSTRACT
The purpose of this study was to evaluate the different clinical presentations, morphology and management of dermoid cysts involving the eye and orbit. This is an interventional case series. All cases of ocular and periocular dermoid cysts operated between January 2000 and July 2005 were included in the study. Inclusion criteria were all peri-ocular swellings which had a histological diagnosis of dermoid cyst and were seen on the globe and near the orbital rim. Patients with medial and orbital dermoids underwent CT scan to rule out intracranial extension. Patients were followed up for 1 to 3 months to observed any recurrence. There were 36 cases of dermoid cysts out of which 7 were limbal, 11 medial orbital, 15 lateral orbital and 4 deep orbital. Two limbal dermoids were associated with pre-auricular skin tags. Most of the growths presented with slowly advancing lesions. Proptosis and displacement of the globe was produced by orbital and large medial dermoid. All cysts were removed completely and sent for histopathology. The cysts were lined with stratified squamous epithelium, underlying dermis and skin appendages. There was keratin, sebaceous material and hair inside the cavity. The orbital dermoids that to be drained before excision of the posterior wall. There was rupture of 2 medial dermoids while dissecting them from the periosteum. There were 3 referred cases of recurrent dermoid cysts out of which 2 were lateral and one orbital, which were removed successfully. Follow up was done from 1 to 3 months. There was late infection in one of the orbital dermoids which responded well to intravenous antibiotics. One patient with recurrent orbital dermoid had a frozen orbit on presentation which improved after surgery but she needed ptosis repair later. There was severe visual loss in one case of deep orbital dermoid. Inconclusion orbital dermoids should be removed carefully and completely to prevent recurrence and scarring of orbital contents