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@#AIM: To investigate the effect of perioperative synoptophore scintillation training on postoperative restoration of binocular visual function in patients with constant exotropia.<p>METHODS: We retrospectively reviewed 68(136 eyes)patients with constant exotropia, who successfully underwent surgical ophthalmological treatment from January 2017 to March 2021. Patients were divided into group A(n=35 cases, 70 eyes)and group B(n=33 cases, 66 eyes)according to whether or not they received perioperative synoptophore scintillation training. Group A included 19 males(38 eyes)and 16 females(32 eyes)(mean age: 29.34±12.72 years). Group B included 13 males(26 eyes)and 20 females(40 eyes)(mean age: 30.12±8.75 years). One month postoperatively, the patients were examined with a synoptophore, and the restoration of simultaneous vision, fusion function, and stereoscopic function were compared between the two groups.<p>RESULTS: There were no significant differences in age, sex, and preoperative far and near deviations between the two groups(P>0.05). Postoperatively, the restoration rates of simultaneous vision, fusion function, and stereoacuity were 54%, 54%, and 43% in group A, respectively. And 27%, 27%, and 15% in group B, respectively. Statistically, there were respectively significant differences between the two groups(χ2=5.117, 5.117, 6.280; all P<0.05).<p>CONCLUSION: Perioperative synoptophore scintillation training can effectively improve the binocular vision function of adult patients and older children(>12 years)with constant exotropia without binocular vision function and enhance the therapeutic effect of surgery.
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2-6 % of full term newborn children manifest symptoms of congenital nasolacrimal duct obstruction. The most frequent presentation is tearing associated with mattering of the eyelashes and recurrent infection. We designed a study to compare the success rate of nasolacrimal duct probing for congenital nasolacrimal duct obstruction in younger and older children seen at our western regional institute of ophthalmology. Probing under general anaesthesia was done in a cohort of children presenting with congenital nasolacrimal duct obstruction . The demography ,clinical presentation, management and outcome of the cases were documented. Factors associated with success of the procedure were documented. Aim: The aim of the study was to document the clinical outcome and factors predictive of success of nasolacrimal duct probing for congenital nasolacrimal duct obstruction in younger and older children seen at our Western Regional Institute of Ophthalmology in India. Methods: The study was carried out at our Western Regional Institute of Ophthalmology. The study period was July 2018 to May 2019 . The study was a prospective interventional outcome study in an institutional cohort. Probing was reserved for patients with recurrent infection or acute dacryocystitis in children between 6 months to 9 months of age . Initial probing was the treatment of choice for children between one year and three years as well as older children above three years upto twelve years. Probing was performed under general anaesthesia. Patients were followed at 1 week, 3 weeks, 3 months and 6 months after the procedure. Outcome was defined as resolution of symptoms and signs of nasolacrimal duct obstruction as observed by the ophthalmologist as well as reported by the parents within 3 weeks of the procedure and continued remission for 6 months post procedure. Probing was done twice before the procedure was declared a failure. Statistical Analysis: Student t test and chi square test was used for statistical analysis . p<0.05 was taken as significant. The Fischer exact test was used to calculate the chi square value. Results: 25 eyes of 18 children with congenital nasolacrimal duct obstruction were subjected to probing during the time of the study. The age range was six months to eleven years. The overall success rate was 16/25(64%). The success rate for children less than or equal to three years was 8/9 (89%).The success rate in the age group three years to less than or equal to seven years was 7/12 (58.3%) . The success rate dropped to 25% (1/4) for children more than seven years of age. The success rate of nasolacrimal duct probing was observed to reduce with increasing age of the child. Persistent dacryocystitis, firm obstruction on nasolacrimal duct probing and repeat probing were statistically significantly associated with the outcome of probing. The children with any of the above factors had a lower success rate of nasolacrimal duct probing. Conclusion: The results of our study are comparable to other studies reporting outcome and predictive factors of nasolacrimal duct probing in younger and older children with congenital nasolacrimal duct obstruction. Children less than or equal to three years of age with congenital nasolacrimal duct obstruction could be successfully managed with nasolacrimal duct probing with great outcomes. Older children too had a reasonable outcome and age did not appear to be a significant factor affecting outcome. A firm obstruction on probing, persistent dacryocystitis and repeat procedure are significantly associated with the outcome of nasolacrimal duct probing. Conclusion: Children less than or equal to three years of age with congenital nasolacrimal duct obstruction can be successfully managed with nasolacrimal duct probing with great outcomes. Older children too had a reasonable outcome and age did not appear to be a significant factor affecting outcome. Thus in the light of the fact that probing is a safe and effective procedure , it appears logical to give a trial of initial nasolacrimal duct probing even to children older than three years. A firm obstruction on probing, persistent dacryocystitis and repeat procedure are significantly associated with the outcome of nasolacrimal duct probing.
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An Analysis of a Survey Questionnaire on health care workers’ knowledge and practices regarding of infection control and complains them to apply universal precautions. Health care workers are at substantial risk of acquiring blood borne pathogen infections through exposure to blood or other products of patients. To assess of infection control among health care workers in Sana'a healthcare centers, Yemen. A cross-sectional study was conducted in the health center to assess knowledge and practices regarding of infection control among 237 health workers in Sana,a city. A structured self-administered questionnaires were used and data was analyzed using SPSS version 20 and the associations were tested with chi-square, with p-value of < 0.05. The health care workers in public centers ware (51.1%) and (48.9%) of them works in private centers. One hundred and seventeen (49.4%) respondents had poor infection control knowledge, 113 (43.5%) had fair knowledge, and 17 (7.2%) had good knowledge. The knowledge was significantly associated with type of center (P < 0.018), such that the public center had the highest proportion with poor knowledge. And nurses and midwife having the highest proportion with fair knowledge of infection control. Eight (3.4%) respondents had a poor practice of universal precautions, 93 (39.2%) had fair practice, and 136 (57.4%) good practice. The practice was significantly associated with the profession, level of education and work experience (P < 0.001), (P < 0.006), (P < 0.001) respectively, and nurses and midwives as the profession with the highest proportion with good practice. We conclude that the practices and knowledge of universal precautions were low and that's need for intensive programmes to educate health care workers on various aspects of standard precautions and infection control programmes and policies.
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Objective To study the application effect of different internal fixation scheme in older children with proximal hu-merus fractures .Methods The clinical data of 102 cases of elder children with proximal humerus fracture from March 2009 to Feb-ruary 2014 in the hospital were retrospectively analyzed according to different internal fixation methods ,they were divided randomly into A ,B ,C group ,34 cases in group A ,using elastic intramedullary retrograde intramedullary internal operation ;32 cases in group B ,using open reduction and Kirschner wire internal fixation operation ;27 cases in group C ,using open reduction and plate internal fixation operation .Compared and study the operation treatment effect on children in three groups .Results The operation time ,hos-pitalization time ,fracture healing time ,the excellent and good rate of postoperative shoulder joint Neer score ,complication rate of patients among the three groups had no statistical significance (P > 0 .05) .Compared with group B and group C ,the amount of bleeding was significantly decreased and incision length was significantly shortened in group A(P< 0 .05) .Conclusion Elastic intr-amedullary retrograte internal fixation ,kirschner wire interal fixation ,open reduction internal fixation ,all can fix proximal humeral fractures in older children safely and effectively ,and the clinical effect of elastic intramedullary retrograte internal fixation is better than other two fixation .
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[Objective]To evaluate the outcome of the Pemberton osteotomy for the treatment of developmental dysplasia of the hip (DDH) in older children. [Method]There were 21 children (24 hips) older than 7 years in our study , who received the Pemberton osteotomy, and combined with femoral shortening, derotational or varus osteotomies according to the level of dislocation, anteversion and neck-shalf angle of the femur. The average age at operation were 9 years and 7 months (range: 7~13.5 years).[Result]The mean follow-up were 5 years and 5 months. Eighteen hips achieved the excellent or good clinical results according to the McKay's clinical criteria. All of the hips got improvements of the Acetabular Index, Sharp Acetabular Angle, Center-Edge Angle and Acetabular Head Index. The average results were in the normal range. Eighteen hips got ⅠorⅡclass of the Severin’s radiographic classification.However, 9 hips were limited in the range of movement. Four hips got subluxation.Six hips developed avascular necrosis of the femoral head. Three hips got improved osteoarthritis.[Conclusion]The Pemberton osteotomy for the treatment of developmental dysplasia of the hip in older children can mostly achieve well-used, contained or concentric reduction hips, meanwhile need to reduce the complications.