ABSTRACT
Background: One of the most widely performed surgical procedures nowadays is cataract surgery combined with monofocal intraocular lens implantation (IOL). Monofocal IOLs can compensate for the spherical refractive error but not astigmatism. Thus, patients with astigmatism are unable to see well after surgery without spectacles. A new generation of IOLs called toric IOLs, improve uncorrected visual acuity in eyes with high astigmatism due to a specific lens design. This study aimed to present a practical method of toric intraocular lens (IOL) implantation based on a refractive power analyzer system and slit-lamp observation.Material & Methods:This prospective study comprised 30 patients who underwent toric IOL implantation with cataract extraction at the Department of Ophthalmology, National Institute of Ophthalmology, Dhaka, Bangladesh. This study was conducted from Jan 2021 to Dec 2021. Approval from the local ethical committee was obtained.Results:The study included 45 eyes of 30 patients. The sex distribution of the study patients where the male was 18(60%) and the female was 12(40%). In the age distribution of the study, 5(16.67%) patients were from the 60-69 range, 10(33.33%) patients were from the 70-79 range, and 15(50.00%) patients were from the 80-89 range. The patients’ demographic variables consequently. Changes in visual acuity and refraction are shown in table-4 thorough preoperative and postoperative. Postoperative IOL alignment methods are shown in table-5, the mean±SD of the slit-lamp target was 2.55±2.76 and in the range, of 0.0 to 12.0, the mean±SD of the corneal analyzer target was 2.55±1.98 and range was 0.0 to 11.0, and the mean±SD of the slit-lamp corneal analyzer was 3.27±2.98 and range was 0.0 to 16.0.Conclusions:We studied 2 methods of assessing toric IOL alignment postoperatively and found no significant difference between them. Both were reliable and predictable. In addition, we found that the simple preoperative marking technique we used yielded toric IOL alignment that was as accurate as that obtained with other commonly used techniques and that was within a clinically acceptable level.
ABSTRACT
Aims: To make approaches to data collection and analysis for reviewing the impact of malnourishment upon the high incidence of infections and infestations among children in slum. Study Design: This prospective study was carried out among the total of 110 slum children and incidence of infections and infestations among them was observed. Data were collected by survey of dwelling condition, face to face interviews with the mother and examination of physical condition of children aged less than 12 years. To calculate the incidence rate for infections and infestation among the malnourished children and their association with aspects of demographic, socioeconomic, health and community factors Gomez's original classification and Waterlow classification was used and statistical analysis was done. Place and Duration of Study: The study was conducted from July 2011 to June 2012 in Kushtia Districts of Bangladesh. Methodology: The survey form was prepared in two sections. The first part was conducted in order to assess the nutritional status by taking anthropometric measurement and dietary history of the child and the second part was prepared for examining presence of any disease. Children were eligible for inclusion in the study if they were less than 12 years of age. For all dwellings with at least one eligible child data on socioeconomic and demographic variables were collected through structured face-to-face interviews. Where the main householder or career or mother was not available the interview was conducted with a secondary householder or career. Results: Of the total 110 slum children 67.27% were found moderately malnourished, 12.72% were severely malnourished and 11.81% were mild malnourished. It also found that a greater part of the children were wasted (52.72%) and 15.45% of the children were both wasted and stunted. In this study 45 children (40.9%) out of 110 were found to be infected with one or more of the infections. Among these infections the most prevalent are - cough (17.27%), skin abscess (14.54%), diarrhea (13.63%), tonsillitis (8.18%) and respiratory distress (15.45%) are also very common. Among the malnourished boys 43.24% were infected and the infestation rate among the malnourished boys was 45.94%. Among the malnourished girls the infection and infestation rate was 45.31% and 37.5% respectively. By sexes combined 44.5% malnourished children were infected and 40.6% were infested. Conclusion: The analysis proved that the factors which predispose the host to malnutrition also predispose to infection, thus establishing the vicious circle of infectionmalnutrition- infection. The analysis also revealed that intestinal parasitic infestations contribute significantly to poor growth and malnutrition in children.
ABSTRACT
Total hip replacement is a reconstructive procedure that has improved the management of those diseases of the hip joint that have responded poorly to conventional medical therapy. Conventional, primary total hip replacement is a durable operation in the majority of patients. A hip replacement is a mechanical device with parts that are assembled before and during the operation. But the possible complications of total hip arthroplasty, and its clinical performance over time, is a challenging occasion to the surgeons, and such a challenge we faced with our presenting patient. A 68 year old lady with history of cemented bipolar hemiarthroplasty done in a tertiary care hospital, due to fracture neck of the left femur having the history of diabetes, chronic kidney disease, heart disease, anaemia, and mental disorders presented with loosened prosthesis, thinning of medial proximal cortex of the femur which had broken within few months after surgery. She complained of painful walking at left hip joint. There was also evidence of chronic infective and degenerative arthritis of acetabular component of the affected hip joint. Cemented revision total hip replacement surgery was performed with expert multidisciplinary involvement. On 2nd postoperative day the patient was allowed to walk on operated limb with the aid of walker. On 12th postoperative day all the stitches were removed and wound was found healthy.