Knowledge of patients\u27 visual experience during cataract surgery: a survey of eye doctors in Karachi, Pakistan

Abstract BACKGROUND: Several recent studies have recommended that ophthalmologists must be aware of the visual sensations (and their associated anxiety/fear) experienced by patients undergoing cataract surgery. We assessed the knowledge of a group of eye doctors in Pakistan regarding these phenomena. METHODS: This was a cross-sectional survey. Eye doctors (ophthalmologists, residents and medical officers) attending the Ophthalmological Society of Pakistan Annual Conference 2011, in Karachi were invited to participate in the study. A self-administered structured questionnaire was used to examine their knowledge of visual sensations and their associated anxiety/fear experienced by patients during cataract surgery. Simple frequencies and proportions were calculated to describe the data. RESULTS: A total of 150 ophthalmologists, residents and medical officers were invited to participate in the study. Of these, 68 (45.3%) responded. The mean age (±SD) of the participants was 42.9 (13.2) years. The proportion of participants who thought that patients could experience visual sensations during cataract surgery under regional anaesthesia was 89.7% and that under topical anaesthesia was 73.5%. The most frequently cited sensations included: light perception, changes in light brightness, movements, instruments and surgeon\u27s hands or fingers.The eye doctors estimated that 38.9% and 64.3% patients would see at least something during cataractsurgery under regional anaesthesia and topical anaesthesia, respectively. They also believed that 24.2%-36.9% of patients may experience anxiety/fear as a result of visual sensations during such surgery. Approximately half of the eye doctors did not think that retained vision was a source of fear or anxiety for the patients. While most of them acknowledged the importance of preoperative counselling in helping to alleviate such fear/anxiety, the majority of them did not regularly counsel their patients on what to expect during the surgery. CONCLUSION: Our study reveals that a significant proportion of eye doctors do not have adequate knowledge of the visual phenomenon and their associated anxiety or fear, that patients can experience during cataract surgery. Targeted educational interventions are needed to increase awareness of this phenomenon among eye care professionals

Patients’ visual experience during phacoemulsification cataract surgery and associated fear

Abstract Background: Data from several published studies indicate that patients undergoing phacoemulsification cataract surgery can experience a variety of visual sensations which can result in fear. This phenomenon has not been studied in Pakistan to-date. We examined the visual experience and its associated fear among patients undergoing phacoemulsification cataract surgery under topical anaesthesia. Methods: This cross-sectional study was carried out in Aga Khan University Hospital, a tertiary care hospital, in Karachi, Pakistan from August 2010 to July 2011. Adults \u3e18 years of age scheduled to undergo cataract surgery (phacoemulsification with intraocular lens implantation) under topical anaesthesia by a single surgeon were included. A structured questionnaire was used to collect data on socio-demographics, intraoperative visual experiences and subsequent reaction to these sensations. Participants were asked if they experienced visual sensations such as colours, shapes and movements during surgery. Moreover, they were asked if they developed fear due to these sensations. Results: Fifty three patients (mean age: 60.4 ± 12.4 years) were enrolled. Thirty (56.6%) of them were men and 23 (43.4%) were women. All of them reported having experienced visual sensations during surgery, the most common being light perception (100%), different colours (77.4%), movements of instruments or surgeon’s hands (37.7%) and different shapes (7.5%) such as circles, clouds and patches. The most common colours perceived included white (46.2%), blue (35.8%), red (30.2%) and yellow (30.2%). One out of every four (26.4%) participants reported having developed fear due to these visual sensations. Only 4 (7.5%) reported having received preoperative counselling regarding such sensations. Conclusion: Patients in our study experienced a variety of visual sensations during cataract surgery under topical anaesthesia. The prevalence of frightening visual sensations is higher than that reported in all previous published studies on the subject and needs to be addressed through targeted interventions

Pakistan and the Question of Recognising Israel: Historical Issues and Future Prospects

Historically speaking Pakistan and Israel are not directly engaged in any hostility or clash with each other. Pakistan did not recognise Israel since its inception because of her consistent support to Palestine issue and its apprehension that India Israel connections are against her security, ultimately shattering sub-continental balance of power. During General Musharraf regime, the debate to recognise Israel was on high side. It had been debated at academic, official as well as public levels. It was believed at that time that if Pakistan accord recognition to sate of Israel, the sensitivities associated with the issue might change. The cost and advantage quotient of recognition were kept in mind and discussed openly. During Musharraf regime and onwards, the moot point in Pakistan has been the cost benefit analysis of recognition. The existing world scenario has changed the ground realities and placed Pakistan in a difficult situation that how it can move closer to Israel without abandoning historical stand on Palestinian cause. It is also believed that if the transformation and change in Pakistan’s policy is not hasty, only then it might be more productive and successful. The eventuality of recognising Israel might spur the sentiments of public and it may take some time to have popular placement in our society By analysing different and conflicting view points, this paper will investigate primarily the debate held during Musharraf era in the light of historical background and shall see what course Pakistan should take on in this regard after assessing pros and cons of recognition. After going through different approaches on the subject, this will also contribute whether Pakistan should shift her stance about Israel or otherwise

Modeling induction and routing to monitor hospitalized patients in multi-hop mobility-aware body area sensor networks

In wireless body area sensor networks (WBASNs), energy efficiency is an area of extreme significance. At first, we present a mathematical model for a non-invasive inductive link which is used to recharge the battery of an implanted biomedical device (pacemaker). Afterwards, we propose a distance-aware relaying energy-efficient (DARE) and mutual information-based DARE (MI-DARE) routing protocols for multihop mobility-aware body area sensor networks (MM-BASNs). Both the routing protocols and the non-invasive inductive link model are tested with the consideration of eight patients in a hospital unit under different topologies, where the vital signs of each patient are monitored through seven on-body sensors and an implanted pacemaker. To reduce energy consumption of the network, the sensors communicate with a sink via an on-body relay which is fixed on the chest of each patient. The behavior (static/mobile) and position of the sink are changed in each topology, and the impact of mobility due to postural changes of the patient(s) arms, legs, and head is also investigated. The MI-DARE protocol further prolongs the network lifetime by minimizing the number of transmissions. Simulation results show that the proposed techniques outperform contemporary schemes in terms of the selected performance metrics. © 2016, Javaid et al

Inspirational leadership and innovative communication in sustainable organizations: a mediating role of mutual trust

The possibility of accomplishing sustainable objectives is largely connected to the management and flourishing of an organizational system which keeps human capital engaged and committed. Our study investigated the association of inspirational leadership and innovative communication with employee engagement and commitment under the lens of leader member exchange theory. Specifically, we emphasized the mediating role of mutual trust in connection to social sustainability facets. A survey of data from employees in the manufacturing sector of Yunnan, China was utilized to test the hypothesized model. The study findings reported a significant association and came to the conclusion that a leader’s inspirational behavior coupled with innovative communication is a significant predictor of engagement and commitment in socially sustainable organizations. Moreover, mutual trust significantly mediated the relationship of innovative communication and inspirational leadership with employee engagement and commitment reaching the social perspective of sustainability. The current study added to the literature of sustainable organization by pointing out the social dimensions of sustainability

Radiation-grafted membranes based on polyethylene for direct methanol fuel cells

Styrenewas grafted onto ultrahigh molecularweight polyethylene powder (UHMWPE) by gammairradiation using a 60Co source. Compression moulded films of selected pre-irradiated styrene-grafted ultrahigh molecular weight polyethylene (UHMWPE-g-PS) were post-sulfonated to the sulfonic acid derivative (UHMWPE-g-PSSA) for use as proton exchange membranes (PEMs). The sulfonation was confirmed by Xray photoelectron spectroscopy (XPS). The melting and flow properties of UHMWPE and UHMWPE-g-PS are conducive to forming homogeneous pore-free membranes. Both the ion conductivity and methanol permeability coefficient increased with degree of grafting, but the grafted membranes showed comparable or higher ion conductivity and lower methanol permeability than Nafion\uae 117 membrane. One UHMWPE-g-PS membrane was fabricated into a membrane\u2013electrode assembly (MEA) and tested as a single cell direct methanol fuel cell (DMFC). Low membrane cost and acceptable fuel cell performance indicate that UHMWPE-g-PSSA membranes could offer an alternative approach to perfluorosulfonic acidtype membranes for DMFC.Peer reviewed: YesNRC publication: Ye

Visual Speaker Identification Using Lip and Body Movements

Speaker identification has been studied in many fields such as image processing, audio processing, artificial intelligence and speech recognition. Two of these areas are integrated together in order to identify the speaker. This research will focus on two main approaches which are lip movements and body movements. We will work on the two approaches to achieve the speaker identification. The expected outcome of this study will be to identify the speaker in different scenarios, if there is a single speaker or if there is multiple speakers in the video or if the speaker’s lips are not in view

Ultrawideband Cross-Polarization Converter Using Anisotropic Reflective Metasurface

Broadband metasurface-based devices are essential and indispensable in modern wireless communication systems. This paper presents an ultra−wideband and wide incident angle reflective cross−polarization converter metasurface. The unit cell of the proposed structure is a 45° rotated anisotropic meta−sheet developed by cutting the rhombus−shaped patch from the central part of the square patch. The unit cell’s top structure and ground blocking sheet are made of copper, whereas a dielectric substrate (FR−4) is used as an intermediate spacer between them. The unit cell thickness is minimal compared to the operating wavelength (1/14λ∘, where λ∘ is the wavelength of the starting frequency of 13 GHz of the operating band). The proposed structure efficiently converts linearly polarized waves into their orthogonal component, with a polarization conversion ratio of (PCR > 90%) over a broad frequency spectrum of 13 GHz to 26 GHz. The physical origin of polarization conversion is also depicted using surface current distribution plots. An ultra−wideband and highly efficient polarization conversion (above 90%) is achieved with the help of strong electromagnetic resonance coupling between the upper and lower layer of the metasurface. This kind of ultra−wideband polarization conversion metasurface can be employed in satellite communication, radar cross−section reduction, and navigation systems

An Efficient and Simplified Model for Forecasting using SRM

Learning form continuous financial systems play a vital role in enterprise operations. One of the most sophisticated non-parametric supervised learning classifiers, SVM (Support Vector Machines), provides robust and accurate results, however it may require intense computation and other resources. The heart of SLT (Statistical Learning Theory), SRM (Structural Risk Minimization )Principle can also be used for model selection. In this paper, we focus on comparing the performance of model estimation using SRM with SVR (Support Vector Regression) for forecasting the retail sales of consumer products. The potential benefits of an accurate sales forecasting technique in businesses are immense. Retail sales forecasting is an integral part of strategic business planning in areas such as sales planning, marketing research, pricing, production planning and scheduling. Performance comparison of support vector regression with model selection using SRM shows comparable results to SVR but in a computationally efficient manner. This research targeted the real life data to conclude the results after investigating the computer generated datasets for different types of model buildin

Knowledge of patients’ visual experience during cataract surgery: a survey of eye doctors in Karachi, Pakistan

Abstract Background Several recent studies have recommended that ophthalmologists must be aware of the visual sensations (and their associated anxiety/fear) experienced by patients undergoing cataract surgery. We assessed the knowledge of a group of eye doctors in Pakistan regarding these phenomena. Methods This was a cross-sectional survey. Eye doctors (ophthalmologists, residents and medical officers) attending the Ophthalmological Society of Pakistan Annual Conference 2011, in Karachi were invited to participate in the study. A self-administered structured questionnaire was used to examine their knowledge of visual sensations and their associated anxiety/fear experienced by patients during cataract surgery. Simple frequencies and proportions were calculated to describe the data. Results A total of 150 ophthalmologists, residents and medical officers were invited to participate in the study. Of these, 68 (45.3%) responded. The mean age (±SD) of the participants was 42.9 (13.2) years. The proportion of participants who thought that patients could experience visual sensations during cataract surgery under regional anaesthesia was 89.7% and that under topical anaesthesia was 73.5%. The most frequently cited sensations included: light perception, changes in light brightness, movements, instruments and surgeon’s hands or fingers. The eye doctors estimated that 38.9% and 64.3% patients would see at least something during cataract surgery under regional anaesthesia and topical anaesthesia, respectively. They also believed that 24.2%-36.9% of patients may experience anxiety/fear as a result of visual sensations during such surgery. Approximately half of the eye doctors did not think that retained vision was a source of fear or anxiety for the patients. While most of them acknowledged the importance of preoperative counselling in helping to alleviate such fear/anxiety, the majority of them did not regularly counsel their patients on what to expect during the surgery. Conclusion Our study reveals that a significant proportion of eye doctors do not have adequate knowledge of the visual phenomenon and their associated anxiety or fear, that patients can experience during cataract surgery. Targeted educational interventions are needed to increase awareness of this phenomenon among eye care professionals.</p