A glued technique of external dacryocystorhinostomy

Purpose: Fibrin glue was used for anastomosis of lacrimal sac and nasal mucosal flaps and was compared with the conventional suture technique in external dacryocystorhinostomy. Methods: A prospective interventional randomized control study in which 50 consecutive patients of primary acquired nasolacrimal duct obstruction (PANDO) were equally allocated into two groups. The case group underwent glued technique of external dacryocystorhinostomy (Ext DCR) in which fibrin glue was used for the apposition of the anterior lacrimal sac and nasal mucosal flaps. In the control group, conventional technique of Ext DCR was used to suture the flaps. Functional success was assessed by improvement in epiphora and fluorescein dye disappearance test (FDDT), whereas anatomical success was assessed by lacrimal irrigation and endoscopic view of the osteotomy site. Results: The anatomical success in both the groups was 92%, whereas the functional success was 92% in the case group and 88% in the control group. The difference in the success rates between the two groups was statistically non?significant. Conclusion: Glued technique of Ext DCR is a simple and easy alternative to suturing of the flaps. Though the final outcome was comparable in both the groups, glue can be especially useful in uncooperative cases, in cases of excessive bleeding, or in situations where the flaps are very thin or have become friable

Identification of genetic variants the CCKAR gene and based on body measurement and carcass quality characteristics in Qinchuan beef cattle (Bos taurus)

BACKGROUND: This study aimed to explore genetic polymorphisms of the CCKAR gene and their relationship with the growth and development of Qinchuan cattle which could be used as molecular markers for the improvement of the breeding of Qinchuan cattle. RESULTS: Here, we have identified seven single nucleotide polymorphisms (SNPs) at loci g. 1463 C>G; g. 1532 T>A; g. 1570 G>A; g. 1594 C>A; g. 1640 T>C; g. 1677 G>C; and g. 1735 C>T in the coding region of the bovine CCKAR gene. The frequencies identified on allelic and genotypic characteristics have shown that all seven SNPs diverged from the Hardy-Weinberg-Equilibrium. The SNP2, SNP3, SNP6 and SNP7 had the lowest polymorphism information content values, and remaining SNPs were found to be moderate (0.25 < PIC < 0.50). The genotype CG in SNP1 at loci g.1463 C>G had the greatest association with WH, HW, CD and CCF, while the genotype TA at the very same loci was associated with BFT, ULA and IMF content in Qinchuan cattle. The CCKAR gene expression level in adipose tissue, small intestine, liver and skeleton muscle was found to be higher, whereas, the expression level of mRNA in organs of other digestive system including reticulum, abomasum and omasum was moderate. Some expression of CCKAR mRNA was found in the large intestine, kidney and rumen. CONCLUSIONS: In summary, our finding suggested that the CCKAR gene could be used as a potential candidate for the improvement of carcass quality and body measurements of Qinchuan cattle.

Insomnia among medical students: a cross-sectional study

Background: Insomnia, the most common sleep disorder, is the perception or complaint of inadequate or poor-quality sleep because of one or more of the following conditions: difficulty in falling asleep, frequent waking up during the night with difficulty for returning to sleep, waking up too early in the morning, or unrefreshing sleep. It is the most common sleep related complaint reported in the primary care setting. Medical students are specially at risk of developing insomnia and its consequences. This study evaluates the prevalence and severity of insomnia in medical students in relation to certain socio-demographic factors like age, sex and class of education.Methods: A questionnaire based study was done on 135 medical students of Nishtar Medical University, Multan chosen on basis of random sampling to test the prevalence of insomnia using Athens Insomnia Scale (AIS). Out of these students 75 were males and 60 were females. Students were interviewed to obtain information about age, sex and academic year of education.Results: According to Athens insomniac scale scoring, 55 (40.74%) students were found insomniac while 80 (59.25%) were non-insomniac. Out of 55 insomniac students, 23 (41.81%) were males while 32 (58.18%) were females. Likewise, out of 80 non-insomniac students, 52 (65%) were males while 28 (35%) were females. The prevalence of insomnia in medical students was found to be increased with the increasing age. It was found that the females have more insomnia prevalence as well as more severe signs and symptoms of insomnia. Moreover, final year students tend to show more prevalence and severity of insomnia than their juniors.Conclusions: According to this study, 2 out of every 5 students were insomniac. Demographic comparison showed that the prevalence and severity of insomnia was more in females and final year students. Also, it was increasing side by side with increasing age.

Efficacy of Nasobiliary Tubes and Biliary Stents in Management of Patients with Bile Leak after Liver Transplantation: A Systematic Review

BACKGROUND/AIMS: Bile leak is one of the most common complications of liver transplantation. The treatment options for bile leaks include conservative management, surgical re-intervention, percutaneous drainage and endoscopic drainage. We aimed to perform a systematic review to identify the efficacy of endoscopic treatment in the resolution of post-transplant bile leaks. METHODS: Two independent reviewers performed systematic literature search in PubMed, ISI Web of Science, grey literature and relevant references in May 2017. Human studies in English with documented post-liver transplant bile leaks were included. RESULTS: Thirty-four studies were included in the final analysis. The pooled efficacy of biliary stents for the resolution of post-transplant bile leaks was 82.43% compared with 87.15% efficacy of nasobiliary tubes. The efficacy of biliary stents was lower for anastomotic leaks (69.23%) compared to T-tube (90.9%) or cut-surface/ cystic duct stump related leaks (92.8%). Similarly, the efficacy of nasobiliary tube was also lower for anastomotic leaks (58.33%) compared to T-tube or cut-surface related leaks (100%). CONCLUSIONS: In this systematic review, the overall efficacy was 82.43% in biliary stent group, and 87.15% in nasobiliary tube group. Both biliary stent and nasobiliary tube were more effective in managing non-anastomotic leaks compared to anastomotic leaks.

Statins everyday versus alternate days: Is there a difference in myalgia rates?

Objective Statins are widely used drugs, known to cause myalgia, leading to high discontinuation rates. The objective of our study was to determine the frequency of myalgia in patients on everyday-dose (EDD) regimen with those on alternate-day dose (ADD) regimen. Methods This cross sectional study was conducted in a tertiary care hospital of Pakistan. A sample size of 400 patients between the age of 40–70 years, taking simvastatin 40 mg for at least 6 months or more were selected. Patients with prior musculoskeletal or neuromuscular complains, and family history of muscular disorders were excluded. Subjects were evaluated for myalgia via a self-administered questionnaire, and those complaining of myalgia were then evaluated for serum vitamin D levels. Data was analyzed through SPSS 16.0 and compared using chi square test. Results The overall prevalence of myalgia was 7% (28/400). Frequency of myalgia in patients taking simvastatin everyday (n = 20, 10%) was significantly higher compared to those taking it every alternate day (n = 8, 4%) (p = 0.02). There was no significant difference between the time of onset, nature, severity, type, or location of myalgia between the 2 groups. The most common cited triggering factor for pain was physical exercise. Of the patients experiencing myalgia, 13 (6.5%) from the EDD group and 6 (3%) from the ADD group had low levels of vitamin D. Conclusions ADD regime was better tolerated by the patients than EDD regime. Alternate day therapy, with or without vitamin D supplementation, may be used by the physicians for troublesome muscular complains.

Efficacy of serum blood urea nitrogen, creatinine and electrolytes in the diagnosis and mortality risk assessment of patients with acute coronary syndrome

Background Although blood urea nitrogen (BUN), creatinine (Cr) and electrolytes are not the mainstay of diagnosis in acute coronary syndrome (ACS) patients but they may have a role in providing a more detailed view of the complications and mortality rates. The aim of this study was to determine the efficacy of these parameters in the diagnosis and mortality risk-assessment of patients with ACS. Methodology A total of 200 patients with ACS were recruited in this prospective study. The relationship of serum BUN, Cr and electrolytes with cardiac enzymes, Global Registry of Acute Coronary Events (GRACE) and mortality was assessed during a 6-months follow-up. Statistical test like multivariate linear regression and binary logistic regression analysis were applied. Results On multivariate linear regression analysis, serum potassium (K) (Unstandardized Coefficient B = −3.77; p = 0.04) showed significant negative association with Creatine Kinease and serum BUN (Unstandardized Coefficient B = 0.52; p = 0.001) showed significant positive association with Troponin I. The patients with GRACE > 105 had significantly higher levels of serum BUN and Cr. Receiver operating characteristic curves showed that area under curve (AUC) of BUN (0.7) was higher than AUC of Cr (0.5). Multiple adjusted model showed that patients with BUN > 32.5 mg/dl were almost 20 times more likely to be associated with mortality as compared to reference group. Conclusion In addition to cardiac enzymes, K along with BUN and Cr may serve as important aid in diagnosis of ACS. BUN and Cr may also serve as important tools in mortality-risk assessment of ACS patients.

Panretinal photocoagulation plus intravitreal bevacizumab versuspanretinal photocoagulation alone for proliferative diabetic retinopathy

Objective: to compare panretinal photocoagulation [PRP] plus intravitreal bevacizumab [IVB] against PRP alone in the treatment of proliferative diabetic retinopathy [PDR] in terms of mean change in best corrected visual acuity [BCVA], neovessels on disc [NVD] and neovessels elsewhere [NVE]

Study Design: experimental study

Place and Duration of Study: department of Ophthalmology, Benazir Bhutto Hospital, Rawalpindi, from December 2014 to July 2015

Methodology: sixty eyes were randomized into two groups with 30 eyes in each. In group A, IVB was given 15 days prior to PRP but in group B only PRP was given. In both groups, BCVA and neovessels status at disc and elsewhere was assessed before and at day 30. NVDs were judged as per percentage of NVD occupying surface of the disc [DD%]. NVE were also judged as per reference to diameter of disc surface

Results: the mean age of the study patients was 52.27 +/- 6.7 years. Mean BCVA [logMAR] in the PRP plus IVB group improved considerably from mean 0.64 +/- 0.17 to mean 0.49 +/- 0.21 at 30th day. However, in PRP group, there was no significant change in BCVA 0.64 +/- 0.16 at baseline to 0.63 +/- 0.18 at day 30. There were extremely significant changes between the two groups at 4th week [p<0.001]. Mean NVE at baseline in PRP plus group was 3.30 +/- 0.95% at baseline that changes to 1.50 +/- 1.06% at day 30. While in only PRP group, mean NVE was 3.33 +/- 0.7% at baseline and 3.17 +/- 0.7% at one month of follow-up. In PRP plus group, NVD changes from mean 31.27 +/- 9.8% at baseline to 11.40 +/- 5.5% at one month of follow-up. In only PRP group, NVD changes from mean 31.13 +/- 10.23% at baseline to 29.53 +/- 11.04% at 1 month of follow-up. There were extremely significant changes between two groups at day 30 [p<0.001]

Conclusion: intravitreal bevacizumab in short duration is effective as adjunctive treatment to PRP with early and greater rate of regression of retinal neovessel than PRP alone in PDR patients

Role of zinc supplementation in acute diarrhea in pre-school children

Objective: To monitor the therapeutic impact of zinc supplementation on clinical course of acute diarrhea i.e. frequency of stool, on stool amount and duration of acute diarrhea

Study Design: Randomized controlled trial

Place and Duration of Study: Family medicine department, PAF Hospital, Islamabad Pakistan from Jul to Dec 2009

Material and Methods: One hundred and twenty eight children aged6 months to 60 months in an Outpatient pediatric department of PAF Hospital, E-9 Sector Islamabad with acute diarrhea of less than 14 days were included in this randomized controlled trial. They were further divided into two groups zinc supplemented group [n=65] and non-zinc supplemented group [n=65]

Results: Baseline characteristics were similar in both the groups. Mean age in zinc supplemented group was 33.67 +/- 16.45 months and in non-zinc supplemented group 33.63 +/- 16.44 months. Reduction in stool frequency per day was found 62% in zinc supplemented group and 26% reduction was found in non-zinc supplemented group with obvious difference of 36% between these two groups from day 3 to day 5, which was found statistically significant [p=0.01]. Similarly, significant difference [p=0.01] was observed for reduction in amount of stool per day from day 3 and day 5 with obvious difference of 45% between the study groups

Conclusions: Oral zinc administration in acute diarrhea reduces the frequency of diarrhea, output of stool and decreases total duration of diarrhea

Seroprevalence of transfusion transmitted infections among different blood group donors at blood bank LUMHS, Hyderabad

Objectives: To study the prevalence of HBsAg, Anti-HCV, HIV, Syphilis and Malaria in blood donors

Methods: This is a cross sectional descriptive study, conducted at Blood bank and Transfusion center at Liaquat University of Medical and Health Sciences [LUMHS] Hyderabad, during the period from January, 2014 to June, 2015.A total of 4683 blood donors were screened for HBsAg, Anti-HCV and HIV on Architect 20001 [manufactured by Abbott], employing chemiluminescent microparticle immunoassay [CMIA]. For Syphilis, VDRL ICT kits were used and Malaria parasite was screen through MP slides. Blood grouping was performed by both forward and reverse methods

Results: This study showed a high frequency of HBsAg, VDRL and malaria positivity among the O-ve blood group donors, i.e. 3.70%, 9.25% and 0.61% respectively. Blood group B-ve individuals were commonly infected with HCV [12.5%] as compared with all other blood group donors. HIV is more commonly reported in A+ve blood group individuals. Blood group O+ve is more prevalent [37.41 %]

Conclusion: High frequency of HCV infection in blood donors advocates implementation of strict screening policy for donors and public awareness campaigns about preventive measures to reduce the spread of this infection as well as other transfusion transmissible infections

Correlation of back pain with obesity and posture among teenagers

Low back pain [LBP] rises rapidly during adolescence, reaching adult levels at the ageof 18. It has been suggested that adolescent LBP has least effect. Back pain usually effects females more than males and athletes are more effected by it. Sciatica and Scoliosis are the main causes of back pain. Sciatica might due to sensory deficit while, scoliosis is the abnormal curvature of spine. Disc herniation, degenerative changes, compression are the causes for sciatica while vertebral anomalies, neuromuscularfactors caused scoliosis. As sciatica is not a disease, so diagnosed with nonspecific low back pain which can be treated with acupuncture treatment or spinal infiltration. Lumbar corpectomy, disc replacement and screw usage are the ways of treatment for scoliosis

Prolonged Systole in a Patient with Hypothermia

No abstract available.

Bilateral congenital infantile hemangioma of upper eyelids.

A newborn female baby presented to us with horizontally oval swelling involving posterior lamella of both upper eyelids and is limited by lid margin. The swelling was bright red, nontender, firm in consistency, nonreducible, blanches on pressure, and fixed to underlying structures with no rise in temperature. The size of the swelling was 2.8 cm × 1.1 cm × 1 cm in the right upper eyelid and 2.8 cm × 1.3 cm × 1 cm in the left upper eyelid. There was total occlusion of the visual axis [Fig. 1]. Magnetic resonance imaging of both orbit shows diffusely bulky and heterogeneous altered signal intensity lesions involving the posterior lamella of upper eyelid on both sides [Fig. 2]. The patient was prescribed oral propranolol 2 mg/kg in two divided doses under the supervision of a pediatrician and responded well to the treatment within a week of the initiation of the treatment [Fig. 3] and reduce further in size within 12 weeks of the treatment with the clearing of the visual axis [Fig. 4]. Discussion Infantile hemangioma, a benign tumor of vascular endothelial cells, is the most common type of childhood tumor.[1] Infantile hemangiomas are more common in premature or low‑birth‑weight infants.[2] It usually presents at birth or is evident by 6–8 months of age. The lesion typically manifests within the first few weeks of life, grows rapidly in the 1st year during the proliferative phase then invariably and slowly regresses over the following 4–5 years during the involutional phase.[3] For the management, the long‑term use of topical 0.5% timolol maleate solution is safe and effective in treating superficial infantile hemangiomas.[4] As compared to corticosteroids, oral propranolol also represents an effective therapy for periorbital infantile hemangioma.[5]

unusual case of crimean congo hemorrhagic fever: prolonged bleeding with successful recovery

Crimean Congo Hemorrhagic Fever [CCHF] is a tick-borne viral disease with a major reservoir in both domestic and wild animals. In Pakistan, it is endemic largely in rural areas and most cases occur in spring and autumn. Recently, cases are being reported throughout the year, including winter months, with some even from urban areas. Death from CCHF is most likely to occur during the hemorrhagic phase. We report a case presenting from an urban locality in December. Clinical presentation was characterized by a prolonged hemorrhagic phase and a delayed normalization of platelet counts

Efficacy of intravenous tramadol in reduction of propofol induced pain

Objectives: Propofol is one of the mainly used intravenous anaesthetic used around the globe.However, it is commonly associated with intravascular pain at the time of administration. In this study, we wanted to determine the effectiveness of Tramadol in comparison to Lignocaine in reducing Propofol induced pain

Study Design: Randomized clinical trial

Study Setting: It was performed in Main Operation Theatre, AK CMH Rawalakot; over a period of seven Months from 27-09-2013 to 27-04-2014

Subjects and Methods: 100 patients, having ASA I and ASA II who had presented for elective surgery, were included in the study. Patients with psychiatric disorder or hypersensitivity to lignocaine, propofol or tramadol were excluded. They were divided into two groups of 50 each. Group A received 50 mg intravenous Tramadol, followed by 25 % of dose calculated for Propofol [2 mg/kg]. Drugs were injected into most prominent vein of hand, using 20 G cannula, at rate of 1 ml/sec. Group B received 2 ml of 2 % lignocaine, followed by Propofol in same manner. IBM SPSS version 20 was used for statistical analysis. Independent sample T-test was used for find out p value for age. Chi square was used to find out p value for gender and pain. Pain was assessed by anesthetist as per patient's facial response or complaint of pain

Results: Mean age was 31.94 +/- 17.59 and 29.86 +/- 13.58 in group- A and B respectively [P value=0.07]. Group A comprised of 33 female and 17 males, whereas Group B comprised of 30 females and 20 males [P value =0.534]. Pain was present in 7 [14%] patients in group A as compared to 11 [22%] patients in group B [P value=0.298]. Statistically the difference in regards to gender or pain was insignificant

Conclusion: The study concludes that there is no significant difference between pretreatment with tramadol or lignocaine, in relieving pain caused by propofol?

Efficacy of prophylactic intravenous administration of ondansetron for prevention of spinal anesthesia induced hypotension in elderly patients

Objective: Hypotension is the commonest side effect associated with spinal anesthesia. Multiple modalities have been tested to find adequate preventive measure. Main objective of this study is to find out the effectiveness of prophylactic administration of inj. ondansetron for prevention of spinal anesthesia induced hypotension in elderly patients

Study design: Double blind, randomized controlled trial

Place and duration of study: This study was conducted in our anesthesiology department from 01 July 2014 to 31 December 2014

Methodology: 100 patients were selected for the study using non-probability sampling technique, and divided into two groups of 50 each using random numbers table. Each patient was preloaded with ringer's lactate solution in a dose of 10 ml/kg Patients of Group A received 8 mg of ondansetron IV five minutes prior to administration of spinal anesthesia; whereas patients of Group B were injected normal saline IV. Data were collected and analyzed using IBM SPSS version 20. Chi square test was used to compare hypotension between two groups. A p-value < 0.05 was taken as significant

Results: Mean age of Group A was 64.16 +/- 8.47 years, whereas that of Group B was 62.58 +/- 8.99 [p value= 0.39]. Mean weight of Group A was 72.64 + 5.82 kg, whereas that of Group B was 70.66 + 5.96 kg [p = value p- 0.295]. Hypotension was present in 23 [46%] patients in Group A, where as it was present in 34 [68%] patients in Group B [p value= 0.026]. Bradycardia was recorded in 3[06%] vs. 11 [22%] patients in Group A and B respectively [p=0.021]

Conclusion: We conclude that intravenous administration of 8 mg of ondansetron, 5 minutes prior to subarachnoid block, is effective in decreasing frequency of hypotension and bradycardia in elderly patients

Use of neostigmine in black mamba snake bite: a case report

Snake bite is quite common in most of the countries of the world, especially tropics and subtropical areas. The snake venom is usually one of the two types; neurotoxins and hemotoxins or hemolysins. The management of snake bite consists of supportive treatment and anti-snake venom serum. The patients suffering from respiratory problems due to muscular paralysis will require mechanical ventilatory support. We present a case of a victim of black mamba bite, which is one of the most dreaded snakes in Africa. His recovery was slow and marred with coagulation profile derangement. Finally we started neostigmine and atropine and witnessed a dramatic improvement in his muscle power. He rapidly improved and was discharged with complete recovery

Importance of immature platelet fraction as predictor of immune thrombocytopenic purpura

Background and Objective: Immune thrombocytopenic purpura [ITP] is a clinical syndrome in which a decreased number of circulating platelets [thrombocytopenia] manifests as a bleeding tendency, easy bruising [purpura] or extravasation of blood from capillaries into skin and mucous membranes [petechiae]. The diagnosis of ITP can be made clinically on the basis of symptoms, we need to see if ITP can be confirmed in patients by quantification of residual RNA containing immature platelets [megakaryocytic mass] or immature platelets fraction [IPF] using automated hematology analyzers [Sysmex XE-2100]

Methods: In order to check the efficacy of IPF% parameter of Sysmex XE-2100 a total of 231 patients of thrombocytopenia were included in this study. Complete blood count [CBC] was estimated. The data was statistically analyzed by SPSS version 17

Results: About 62 patients were diagnosed as ITP and 169 patients were diagnosed as non ITP on the basis of clinical history. The mean IPF % value of ITP patients was 16.39% and the IPF % value of Non ITP patients was 7.69% respectively. There was no significant difference in IPF% values with respect to time between sampling and acquisition of complete blood count. The diagnostic sensitivity of IPF% as biomarker for ITP and non-ITP was 85.71% [95% CI: 84.04% to 85.96%] and 41.76% [95% CI: 39.87% to 43.65%]

Conclusion: The mean IPF % value by Sysmex XE-2100 can be used to predict ITP

VATS without general anesthesia: initial experience of 18 cases

Background: General anesthesia and selective ventilation has long been the traditional anesthetic approach for video-assisted thoracoscopic surgery [VATS]. However it may not always be necessary or feasible in a certain variety of patients. VATS under locoregional anesthesia and sedation has proved to be a safer and more efficacious alternative to general anesthesia, especially in cases deemed unfit for the latter

Methodology: We retrospectively reviewed medical records of patients who underwent VATS under regional anesthesia/nerve blocks with sedation in three private hospitals from April 2014 to November 2015. VATS are conducted in these hospitals by the same anesthesia team and operated by a single surgeon. Eighteen patients included in the case-series were either considered high-risk for general anesthesia or required minor to intermediate surgery. None of the patients required endotracheal intubation or conversion to thoracotomy during the procedure

Results: Eighteen patients underwent successful VATS under locoregional anesthesia with sedation at our set-up from April 2014 to November 2015. The procedures included pleural biopsies, pleurodesis, empyema drainage, biopsies for mediastinal masses, lung tumors and apical infiltrates, all performed under video-assistance. There was no perioperative mortality or unanticipated ICU admission

Conclusion: VATS under locoregional anesthesia and sedation is a valuable, efficacious and safe alternative to general anesthesia that needs to be incorporated more frequently in the modern anesthesia practice

Role of prophylactic ondansetron for prevention of spinal anaesthesia induced hypotension in lower segment caesarean section

Objective: To determine the efficacy of prophylactic administration of intravenous Ondansetron for prevention of spinal anaesthesia induced hypotension in lower segment caesarean section

Study Design: Double blinded randomized controlled trial

Place and Duration of Study: It was conducted in Anesthesiology department, CMH Rawalakot; from 3 Mar to 4 Jun 2014

Material and Methods: One hundred patients were selected for this study, and randomly divided in two groups of 50 each, using random numbers table. Both groups were preloaded with Ringer's lactate at dose of 10ml/kg. Group A received 04 mg of IV ondansetron 5 min prior to spinal anaesthesia, whereas Group B received normal saline 05 minutes before administration of Spinal Anaesthesia

Results: Average age of Group A was 28.62 +/- 4.64 years, whereas that of Group B was 27.88 +/- 3.98 [p-value= 0.394]. Average weight of Group A was 70.30 +/- 6.25 kg, whereas that of Group B was 70.74 +/- 6.17 kg [p-value= 0.724]. Hypotension was noted in 21 patients in group A [42%], whereas it was observed in 34 Patients in Group B [68%] [p-value= 0.009]. Bradycardia was noted in 9 patients in Group A [18%] and 19 patients in Group B [p=0.026]

Conclusion: Intravenous administration of 04 mg of intravenous ondansetron, 05 minutes prior to subarachnoid block, is effective in decreasing frequency of hypotension

Cost‑effectiveness analysis should continually assess competing health care options especially in high volume environments like cataract surgery.

Context: Cost‑effectiveness analysis should continually assess competing health care options especially in high volume environments like cataract surgery. Aims: To compare the cost effectiveness of phacoemulsification (PE) versus manual small‑incision cataract surgery (MSICS). Settings and Design: Prospective randomized controlled trial. Tertiary care hospital setting. Subjects and Methods: A total of 52 consenting patients with age‑related cataracts, were prospectively recruited, and block randomized to PE or MSICS group. Preoperative and postoperative LogMAR visual acuity (VA), visual function‑14 (VF‑14) score and their quality‑adjusted life years (QALYs) were obtained, and the change in their values calculated. These were divided by the total cost incurred in the surgery to calculate and compare the cost effectiveness and cost utility. Surgery duration was also compared. Statistical Analysis Used: Two group comparison with Student’s t‑test. Significance set at P < 0.05; 95% confidence interval (CI) quoted where appropriate. Results: Both the MSICS and PE groups achieved comparative outcomes in terms of change (difference in mean [95% CI]) in LogMAR VA (0.03 [−0.05−0.11]), VF‑14 score (7.92 [−1.03−16.86]) and QALYs (1.14 [−0.89−3.16]). However, with significantly lower costs (INR 3228 [2700–3756]), MSICS was more cost effective, with superior cost utility value. MSICS was also significantly quicker (10.58 min [6.85–14.30]) than PE. Conclusions: MSICS provides comparable visual and QALY improvement, yet takes less time, and is significantly more cost‑effective, compared with PE. Greater push and penetration of MSICS, by the government, is justifiably warranted in our country.