Pattern of ocular injuries in stone pelters in Kashmir valley

To describe the pattern and types of ocular injuries in stone pelters in Kashmir valley during recent turmoil. Cross sectional study. Sixty patients with different types of eye injuries were assessed between June-September 2010 and initial visual acuity was recorded. The injuries were classified according to Systems for Classifying Ocular Injuries [OTCS] and Ocular Trauma Score [OTS] was calculated in order to estimate the probability of follow-up visual acuity range. Most of the victims [75%] were young boys between 16-26 years with a mean age of 20.95, 95% of cases were males. The main cause of injury was stones [48.3%] and pellets [30%] besides rubber bullets, sling shots and tear gas shells. Most of the open-globe injuries due to stones were of Type B and A, Grade E, Zone II and III with Afferent Pupillary Defect [APD] in 30% of the cases. Closed-globe injuries were mostly of Type A, Grade C and D and Zone II and III. Most of the open-globe injuries due to pellets were of Type D, Grade D, Zone II and APD in 33.3%. Pellets Intra Ocular Foreign Body [IOFB] was in 41.6%. Most of the closed-globe injuries were of Type A, Grade D and E and of Zone III. Overall OTS of 1 was calculated in 16.6% and 3 in 53.3% of the cases. In stone pelting demonstrations eye injuries can result in visually significant trauma. Injuries due to pellets are mostly perforating and pellet IOFB, and both tend to have a very poor prognosis. OTS can be used to estimate visual prognosis

Central venous catheter practice in an adult intensive care setting in the eastern province of Saudi Arabia

To study the standard central venous catheter [CVC] practice in an adult intensive care unit [ICU] for potential improvement. This is a prospective descriptive study conducted in an adult ICU of the 300-bedded King Abdul- Aziz Hospital, Al Ahsa, Saudi Arabia. All consecutive patients admitted over 18 months [April 2007 to September 2008] were included. Details of CVCs, indications, complications, and patients' demographic information were recorded daily until CVCs were removed. Overall, 379 patients had 474 CVCs, which accounted for 3024 catheter-days, with a mean duration of 6.35 +/- 4.7 days [95% confidence intervals: 5.92-6.78]. The most common site of insertion was the internal jugular vein [230 [48.5%]]; 192 [40.5%] subclavian catheters, and 52 [11%] femoral. The CVC utilization ratio was 0.64. The catheter related local infection [CRLI] rate was 4.6 per 1000 catheter-day [the highest in the femoral site] and the catheter-related bloodstream infection [CRBSI] rate was 1.98 per 1000 catheter-day [the highest for the jugular route]. There were only a few mechanical complications including 2 pneumothoraces, 5 arterial cannulations, and a single significant catheter dislodgement causing respiratory failure. Our results suggest that the current CVC practice enabled us to keep the rate of complications low, which is comparable to international standards