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

Corporate Social Responsibility (CSR) practices of financial institution in Bangladesh: the case of United Commercial Bank

Purpose: The main purpose of the research is to understand the CSR practices of financial institutions in Bangladesh better. Research methodology: Corporate Social Responsibility (CSR) is concerned with businesses’ interactions with society as a whole. Such CSR operations cover an organisation’s fiscal, legal, ethical, and philanthropic obligations. United Commercial Bank Limited (UCB) has been chosen as the study’s subject. This study is a qualitative research project that used an exploratory research design. For data collection, both main and secondary data sources were used. The in-depth interview approach with an open-ended questionnaire was used to gather primary data on CSR practices from 70 UCB employees. Results: According to the findings of the study, UCB is deeply performing its fiscal, legal, ethical, and philanthropic responsibilities, but it has not expanded its philanthropic activities on a voluntary basis. Furthermore, the representation of UCB employees in CSR management is inadequate, with the exception of top-level executives. Limitations: Any methodological issues were addressed, such as sampling challenges because financial institutions do not encourage third parties to obtain their secrets because competition occurs everywhere. Contribution: This study makes several suggestions, such as improved and more systematic communication of CSR strategies to employees, increased investments in CSR programs, and specially targeted CSR preparation, which could assist UCB in encouraging a more successful application of its CSR strategies

Craniocerebral injuries in war against terrorism --- A contemporary series from Pakistan

Objective: Terrorism-related bomb attacks on civilian population have increased dramatically over the last decade. Craniocerebral injuries secondary to improvised explosive devices have not been widely reported in the context of unarmored civilians. This series intends to report the spectrum of these injuries secondary to suicidal and implanted bombs as encountered at the Aga Khan University Hospital, Pakistan (AKUH). Further, a few pertinent management guidelines have also been discussed.Methods: The hospital database and clinical coding during a 5-year period were examined for head injuries secondary to terrorism-associated blasts. In addition to patient demographics, data analysis for our series included initial Glasgow Coma Scale, presenting neurological complaints, associated non-neurological injuries, management (conservative or operative) to associated complications, and discharge neurological status.Results: A total of 16 patients were included in this series. Among them 9 were victims of suicidal blasts while 7 were exposed to implanted devices. The patients presented with diverse patterns of injury secondary to a variety of shrapnel. A follow-up record was available for 12 of the 16 patients (mean follow-up: 7.8 months), with most patients having no active complaints.Conclusion: The results of this series show that civilian victims of suicidal and improvised bombings present with a wide range of neurological symptoms and injury patterns, which often differ from the neurological injuries incurred by military personnel in similar situations, and thereby often require individualized care

Automatic Diagnosis of Diabetic Retinopathy Using Morphological Operations

Diabetic retinopathy is diabetic eye disease or a sight threatening complication (one of the major cause of blindness) for the person suffering from diabetes which causes progressive loss to the retina, in which retina of the eye is affected because the capillaries of the retina are damaged. Diabetic Retinopathy is unpredictable at early stage, it is only predictable in advanced stage when diabetic patient suffers from loss of vision due to leakage of lipid, blood vessels bursts and there is formation of new fragile blood vessels which blocks the blood supply to retina. Diabetic Retinopathy include Microaneurysm, hemorrhage and exudates. However, early detection and treatment is most important that can reduce the chances of occurrences of blindness about 95%. To analyze Microaneurysm and hemorrhage as early stages of DR is a challenging task for Ophthalmologists to prevent vision loss. Automatic analysis of Diabetic Retinopathy helps in preventing vision loss. Our proposed method is based on automatic detection of hemorrhage using colorful fundus images. In proposed work we have used supervised learning to classify the data as hemorrhage and without hemorrhage with SVM classifier. To find hemorrhage and its severity, we have extracted statistical features (including standard deviation, energy, entropy and contrast of an image), used classification approach and then segmentation methods. After feature detection, Morphological Operations are applied to detect blood vessels and hemorrhage detection with help of segmentation technique. Here the threshold optimization, Grey Wolf Optimization (GWO) techniques are used in our proposed work for getting maximum accuracy, sensitivity and specificity performance metrics

Promising fortitude of vegetables worth in Dhaka city: A supply chain analysis

Vegetables trading require some vital support of integrated supply chain system and also depend on function of intermediaries, where transport facilities are most important The objective of paper is to analyze the role of vegetables supply chain in Bangladesh. The paper is exploring determination of vegetables price in Dhaka city which is ever-increasing fast with respect to rural market price in Bangladesh. Data were collected from different areas of Dhaka city and others districts for present study on vegetables price from rural to urban market where prices are very much discrimination. Analyzing the collected data it has been found that vegetables market and exploring the analysis of supply chain on the vegetables price is important. Study has further found that there have many barriers in vegetables market

Workers’ remittances impact on the economic growth: Evidence from capital inflows in Bangladesh

This paper examines the macroeconomic determinants of workers’ remittances in Bangladesh. Multiple regressions find that the macroeconomic variables such as real gross domestic product (RGDP), workers’ remittances (WREMI), foreign direct investment (FDI), official development assistant (ODA), inflation rates (INFRAT) of Bangladesh have significant impact on RGDP. The study focused on the importance of WREMI inflow and its implication for economic growth in Bangladesh. Using time series data over a 35 year period, by using estimated multiple regressions approach, we analyze the impact of WREMI inflow on economic growth in Bangladesh for the period 1976-2010. WREMI income increased from low $24 million in 1976 to over$11.1 billion in 2010 (WDI, 2011). WREMI is one of the major sources of foreign exchange earnings and it exceeded FDI and ODA inflows to the developing countries (World Bank, 2006) and we found that growth in WREMI does lead to economic growth in Bangladesh. The paper also discusses economic growth issues arising from the results of the analysis in relation to WREMI in association with macroeconomic determinants. This determinant is statistically significant, supporting a mediating effect of investment between WREMI and economic growth and shows that WREMI effect on growth of RGDP positively and significant impact on foreign reserves in both the short run and long run

<em>In Situ</em> and <em>Ex Situ</em> Agricultural Waste Management System

The transformation of agricultural wastes, either in situ or ex situ manner can help to ensure nutrient recycling, energy generation, preparation of animal feed, medicines, packaging material, substrate for mushroom cultivation, biofuel production and product formulations. The in situ methods of waste management are prioritized as the problems of collection and transportation from the source can be avoided. The in situ methods are slow and require land and labour. The conversion of agricultural waste into fuel and useful value-added products is gaining traction and demands utilization of appropriate technology. In this context, the technological dependence on ex situ methods is higher than in situ methods. The selection of the particular method depends on the type of waste, process employed and final product required. The remedial measures can lead towards a sustainable future in terms of Safeguarding of human health, protection of soil, conservation of aquatic ecosystem and beneficial soil microbes and pave the way towards a cleaner, healthier and eco-friendly environment and ambience

Development of an Arduino Based Device for Early Detection of Gas Leakage in Hospitals & Industries

Leakage of gases in a system makes infrastructures and users vulnerable, it can occur due to its environmental conditions or old groundwork. Hospitals and industries where many types of gases are used like nitrogen, mono oxide, due to small amount of concentration in air can cause toxicity whereas detection of small amount of gas at its initial stage is very difficult task. Many systems have been developed which were failed in past to give accuracy in its implementation. In this research a portable detection system for the small leakage of gases has been developed, gas sensor (MQ-2) is used to find leakage when it is at its initial phase. The sensor and transmitting module senses the change in level of gas by using a sensing circuit. When a concentration of gas reach at a specified threshold level it will activate an alarm and sends a text massage to receiving module. The proposed system works well in hospitals, home, and industries