Intraoperative and early postoperative complications of manual sutureless cataract extraction.

OBJECTIVE: To determine the intraoperative and early postoperative complications of manual sutureless cataract extraction. STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: Redo Eye Hospital, Rawalpindi, Pakistan, from January 2009 to December 2010. METHODOLOGY: Three hundred patients of cataract through purposive non-probability sampling were selected. The patients underwent manual sutureless cataract surgery (MSCS) by single experienced surgeon and intraoperative complications were documented. The surgical technique was modified to deal with any intraoperative complications accordingly. Patients were examined on the first postoperative day and on the first postoperative week for any postoperative complications. The data was entered in Statistical Package for Social Sciences (SPSS) version 13.0 and the results were calculated in frequencies. RESULTS: Among the 300 cases, 81.3% surgeries went uneventful whereas 18.6% had some complication. The common intraoperative complications were superior button-hole formation in 5%; posterior capsular rent in 5% and premature entry with iris prolapse in 3% cases. Postoperatively, the commonly encountered complications were striate keratopathy in 9.6% and hyphema 9%. At first week follow-up, 4% had striate keratopathy and 0.6% had hyphema. Striate keratopathy resolved with topical medication on subsequent follow-up. A total of 9 cases (3%) underwent second surgery: 2 cases for lens matter wash, 2 cases for hyphema and 5 cases needed suturing of wound for shallow anterior chamber due to wound leak. CONCLUSION: Superior button-hole formation, posterior capsular rent and premature entry were the common intraoperative complications of MSCS whereas the common early postoperative complications were striate keratopathy and hyphema.

Medical students' perspective about factors motivating participation in small group discussions.

OBJECTIVE: To assess perceptions of medical students about the factors that may enhance motivation for learning through small group discussions. METHODS: The qualitative descriptive study was conducted in May, 2013, at Riphah International University, Islamabad, and comprised undergraduate medical students from the first to the fourth year who were given a questionnaire that sought their opinion about group characteristics, composition, expectations from the teachers, environment, additional tools and optimum time duration. The effects of granting extra marks for active participation, feedback and weightage of attendance in enhancing motivation in small group discussions were also explored. Common themes from within the responses were highlighted. RESULTS: Initially, 400 students were given the questionnaire, but complete responses were received from 290(72.5%). About the effective group size, 221(76.2%) suggested 12 or less students, while 153(52.75%) thought groups should be divided into subgroups according to the task, and 148(51.03%) were in favour of mixed gender composition of a group. A comfortable and air-conditioned environment was suggested as a motivating factor by 156(53.79%) students. Use of models, laptops and internet during the discussion was suggested by 97(33.44%) students, and 232(80%) suggested an hour or less as sufficient time. Grant of extra marks 209(72.06%), feedback 220(75.86%) and weightage of attendance 193(66.55%) were all considered positive motivating factors. Finally, 250(86.20%) were in favour of continuation of small group discussion as a learning tool. CONCLUSION: Most students thought a smaller size makes a small group discussion more effective, and that it should continue to be used as one of the learning modalities.