Spectral domain optical coherence tomography for early detection of retinal alterations in patients using hydroxychloroquine

Objective: To determine whether early toxic effects from hydroxychloroquine (HCQ) could be detected by spectral-domain optical coherence tomography (SD-OCT) before symtomatic visual loss occured. Materials and Methods: Fifteen subjects with a history of the chronic use of hydroxychloroquine monotherapy for less than five years without fundus changes (group 1) and 15 visually normal healthy subjects (group 2) were enrolled in this study. All participants underwent systemic and ocular examination, visual field testing, and macular scan imaging using SD-OCT. Results: There were no significant differences in sex and ages between the groups (P > 0.05). Mean duration of HCQ usage in group 1 was 2.5 ± 1.34 (range:1-5) years. Visual field testing with central 10-2 threshold program was normal in all subjects. Inner retinal thickness in parafoveal and perifoveal area were found to be significantly lower in group 1 compared to group 2 (P < 0.01 for perifoveal, P < 0.05 for parafoveal retinal measurements). However, significant thinning was demonstrated only in full retinal thickness of perifoveal area in group 1 compared to group 2 (P: 0.013). Parafoveal and perifoveal inner retinal thickness measurements of inferior quadrants were significantly reduced in group 1 compared to group 2 (P < 0.01). Conclusion: Significant thinning of inner retinal layer especially in parafoveal and perifoveal areas in the absence of clinical fundus changes was observed in our study. We consider that SD-OCT may determine when inner retinal thinning starts in these patients and may contribute a quantitative approach to the early diagnosis and progression of retinal changes

Determination of knowledge and behaviour of nurses about pain management

WOS: 000431943800003Objective: This study was conducted with the aim of determining knowledge and behavior of nurses about pain management. Material and Method: The study was designed as a cross-sectional study. The study was performed on 560 nurses between February and April 2014. Data were collected by using Nursing Information Form and The Survey Regarding Nurses' Knowledge and Behavior Regarding Pain. Data were evaluated by using descriptive statistical methods, Student's t-test, One-way ANOVA and Kruskal-Wallis tests. Results: Out of total 560 nurses, 45.2% were in the age group of 29-38 years, 88.6% were female, 66.1% had a graduation degree, 69.8% were working in internal diseases units and 91.6% were working as a bedside nurse, 39.5% of nurses had an experience less than 5-year, 56.2% of nurses had no in-service training regarding pain, and 76.6% did not follow the literature about pain. One-third of nurses (35.2%) were not using scales for pain often. In the survey, nurses scored 4.95 +/- 2.16 points in knowledge and behavior about pain. The average knowledge and behavior in pain scores of nurses with post graduate degrees (6.31 +/- 2.19, p=0.002), of nurses who followed nursing publications (5.30 +/- 2.25, p=0.03) and of nurses those always used the pain scales (5.26 +/- 2.38, p=0.02) were significantly high. Longer the working times, lower the average knowledge and behavior scores of the nurses (p>0.05). The average knowledge and behavior score of nurses working in internal diseases units were higher than the scores of ones working in surgical units (p>0.05). The nurses who had in-service training in pain had higher average scores (p>0.05). Conclusions: The study indicates that nurses do not have sufficient knowledge about diagnosis and management of pai