Emotional and psychological factors in patients prior to cataract surgery

Background: Cataract constitutes as the leading cause of blindness. Lack of information about the surgical procedure and results of surgery in cataract patients tend to show high levels of anxiety. Preoperative educational intervention planning is necessary to prepare patients for cataract surgery. The aim of present study was to identify emotional factors related to daily difficulties among patients having cataract.Methods: The present cross-sectional study was conducted over a period of 10months by means of a preformed pilot tested questionnaire on patients who had been screened for cataract in various eye camps and admitted for cataract surgery in the upgraded Department of Ophthalmology, Government Medical College, Jammu. All the questions were explained to participants in their local language for better understanding and those who were willing to participate, were requested to fill the semi-structure pilot tested questionnaire form with informed consent.Results: Around 75% of participants reported daily difficulties due to the ocular conditions, of which walking (79.6%) followed by doing housework (77.8%) were the most frequently reported difficulties. About 75% of the participants reported fearing the surgical procedure. Regarding the level of acceptance of cataract surgery 13.9% reported being very much afraid. With respect to the surgical procedure, doubt as to the outcome was reported by 22.2%. When cataract surgery was compared to other kinds of surgery, 31.9% thought it was better to undergo eye surgery whereas 48.6% had not given any opinion on the matter.Conclusions: Preoperative orientation is necessary in order to ease the suffering caused by surgery and render satisfaction with the treatment. Thus, patient should be prepared for the procedure, information regarding common outcomes and risks of surgery reduces anxiety and improves patient satisfaction following cataract surgery

Sociodemographic profile of pterygium patients attending Government Medical College, Jammu, Jammu and Kashmir- a study from North India

Background: Pterygium is a fibrovascular wing or triangular shaped tissue that develops from the conjunctiva and encroaches on to the cornea.Methods: This prospective observational study was conducted at postgraduate department of Ophthalmology of GMC Jammu, Jammu and Kashmir, India. A total of 90 pterygium patients were selected to analyze various sociodemographic factors especially age, sex, residence, occupation, position etc. on the occurrence of this problem.Results: In the present study, out of 90 pterygium patients, 40% were in the age of 31-40 years followed by 24.44% in 41-50years, 60% were males whereas 66.67% belong to rural areas. The incidence was found to be maximum among farmers 35.56% followed by labourers 20%. The right eye was involved in 55.56% cases while majority 97.78% cases of pterygium were nasal. Progressive pterygium was found in 80% while 20% reported with atrophic pterygium.Conclusions: People who work outdoors are subjected to involuntary U.V. B exposure, dust. Workers must be aware of this and they must take appropriate precautions like wearing protective photochromatic glasses, caps etc

A 5 year retrospective study on epidemiological pattern of ocular trauma

Background: One of the delicate structure in the human body is eye and trauma to the eye is essentially a very grave matter. Major cause of preventable monocular blindness and visual impairment in the world is ocular trauma. So any injury to the eye must be deemed to be an ocular emergency and should be handled with utmost care. Despite its public health importance, there is relatively less population based data on the magnitude and risk factors for ocular trauma specially from developing countries. The objective of the study was to find out the epidemiological pattern of ocular trauma.Methods: The present study was 5 year retrospective study of all the patients who reported directly with ocular injury or referred from the casualty to the department of ophthalmology from January 2013 to January 2018. Various parameters like age, sex, mode of injury, type of injury etc. of all patients seen during this period were analyzed.Results: Total of 4192 ocular trauma patients were seen during study period. Maximum number of ocular trauma patients i.e. 1146 were seen in age group of 21-30 years. Males i.e. 3490 outnumbered females in the present study. Road traffic accidents were the most common cause of ocular trauma and accounts for 1760 cases. Most common reported ocular trauma was periorbital oedema/ecchymosis followed by laceration. Surgical intervention was done in 1660 cases whereas 2532 were managed medically.Conclusions: From present study, we may conclude that the maximum number of ocular trauma patients were seen in the age group of 21-30 years with more preponderance in males. Road traffic accidents were the most common cause of ocular trauma. The fact that the lifetime prevalence of ocular trauma is higher than that of eye diseases, which can be decreased by implementing the traffic rules with strict force and imposing heavy fine and license cancellation for drunken driving

Microvascular complications and their prevalence in newly diagnosed type-2 diabetes mellitus

Background: A group of metabolic diseases is ‘diabetes’ which has become a major global concern is characterized by high blood sugar. In the world about 347 million people have diabetes. Untreated long standing hyperglycemia leads to microvascular complications in newly diagnosed DM. The objective of the study was to find out prevalence of microvascular complications in newly diagnosed Type-2 diabetes mellitus.Methods: The present cross-sectional study was conducted over a period of 6 months involved 200 patients who were diagnosed with T2DM having ≤6 months duration was conducted in the out-patient department of medicine and ophthalmology at a tertiary care hospital. Informed consent was taken from all the participants who were willing to participate. Detailed history, clinical examination and relevant investigations were done to diagnose microvascular complications.Results: Maximum number of studied subjects i.e. 54% were seen in age group of 41-50 yrs. Males were 56% whereas females comprised 44%. Total of 52% of subjects were from rural background. Nephropathy was the most common microvascular complication present in 54% patients followed by neuropathy in 30% and retinopathy in 8% (NPDR in 7% and PDR in 1%) of patients.Conclusions: From the present study it has been concluded that nephropathy is the most common microvascular complication in newly diagnosed T2DM followed by neuropathy and retinopathy. Authors recommend that education of high-risk group regarding diabetes and its complications by electronic and print media is required so that they seek medical consultation at the earliest. Screening for diabetes at a younger age in view of lower average age at presentation and high prevalence of microvascular complications

Comparison of level of awareness regarding eye donation among medical, engineering and law students in Jammu, India

Background: Blindness due to cornea is a major public health issue, especially in developing countries like India. Corneal transplantation is the treatment for restoring vision in corneal blind patients. The aim of present study was to compare the level of awareness regarding eye donation among medical, engineering and law students.Methods: The present cross sectional, comparative study involved students following their respective courses (1st final year) from October 2017 to December 2017. Out of 168 students, 60 were medical, 56 were engineering and 52 were law students. The study started with initial clarification of questions and those who were willing to participate, were requested to fill the semi-structure pilot tested questionnaire form on eye donation with informed consent.Results: All the students were aware of eye donation, but medical students were much aware on various parameters. The most powerful information tool to reach out all the students was television whereas among medical ophthalmology is one of subject they study in their respective course which provide them maximum knowledge regarding eye donation.Conclusions: Level of awareness and knowledge regarding eye donation is much better among medical students (MBBS) in comparison with engineering and law students. Thus, professionals (medical doctors, engineers and lawyers) should be actively involved in creating awareness regarding eye donation and hence play vital role to reach out people for optimum benefit

Clinical correlation between dry eye and pterygium: a study done at government medical college Jammu, Jammu and Kashmir, North India

Background: To study the prevalence of dry eye among the patients of pterygium and to find the clinical correlation between dry eye and pterygium.Methods: The study was conducted at postgraduate department of Ophthalmology of GMC Jammu over a period of one year. 90 pterygium patients and 180 age and sex matched controls presenting to the eye OPD of GMC Jammu were included in the study. The TBUT, Schirmer’s test, basal tear secretion and Rose Bengal staining score were estimated in all patients. A TBUT of less than 10 seconds, a Schirmer’s test of less than 10mm, basal tear secretion of less than 10mm, Rose Bengal staining score of more than 3 were considered abnormal.Results: Redness 57 (63.33%) was the most frequently occurring symptom in pterygium patients followed by cosmosis 49 (54.44%). The mean TBUT, mean Schirmer’s, mean basal secretion and mean Rose Bengal staining score values were 9.88±3.39 seconds, 13.17±4.57mm, 10.11±4.81mm and 3.27±1.85 in pterygium patients and 14.22±3.99 seconds, 16.40±5.21mm, 12.19±5.05mm and 2.49±1.86 in the control group respectively. There was a statistically significant difference in the dry eye results between the pterygium patients and control groups (p<0.001). The odd’s ratio between dry eye and pterygium was 3.83, dry eye was present in 53 pterygium patients.Conclusions: The prevalence of dry eye in pterygium patients was 58.89% which suggests that there is a strong positive clinical correlation between dry eye and pterygium

Responding to Independent Juror Research in the Internet Age: Positive Rules, Negative Rules, and Outside Mechanisms

Independent juror research is an old problem for jury trials. It invites potentially prejudicial, irrelevant, and inaccurate information to guide jury decisionmaking. At the same time, independent juror research compromises our adversarial system by preventing parties from responding to all the evidence under consideration and obfuscating the record on which the jury’s decision is made. These threats have only increased in the internet age, where inappropriate sources of information are ubiquitous and where improper access is hard to detect. Nevertheless, courts and parties continue to engage in the same inhibitory measures they have employed for decades. This Note argues for change by providing a new conceptual framework for thinking about and categorizing responses to the problem: positive rules (court rules that channel independent juror research and the impulses that govern it into something productive within our adversarial system), negative rules (court rules designed to eliminate independent juror research and its effects by blocking and punishing access to independent sources of information), and outside mechanisms (the parties’ attempts to similarly stamp out this conduct and its effects). After first analyzing the problem of juror research, this Note argues that the old-fashioned system of negative rules and outside mechanisms is an inadequate response to the growing problem. Although this Note offers insight about specific negative rules and outside mechanisms that may continue to be useful in tackling the challenges of independent juror research—-for example, by arguing that trials should be prerecorded and videotaped—-it ultimately contends that the traditional framework must be supplemented by positive rules, which will promote a more active jury. This Note concludes by endorsing two specific positive rules: allowing the jury to ask questions (of the judge, witnesses, and parties) and providing the jury with an electronic record