Outcomes of refractive surgery

Thesis (M.A.)--Boston UniversityProcedures to reshape the cornea to correct refractive errors have been a longstanding and fast-evolving area of interest for centuries. As recent advances in excimer laser technology allow keratorefractive treatments to deliver precise treatments with fewer associated risks and complications, the popularity of modern refractive procedures continues to grow at unprecedented rates. For this reason, it is imperative to continue correlating patient characteristics to outcomes so that refractive surgeons can more accurately foresee the results of the selected procedure. This study examined the outcomes of refractive surgeries at a full-scope ophthalmology clinic from January 2011 to November 2011. The main objectives of th is study were to determine the differences between the outcomes of LASIK vs. LASEK, Custom vs. Traditional treatment plans, myopic vs. hyperopic patients and MMC exposure vs. no MMC exposure (LASEK only). More importantly, the data was scrutinized to determine whether or not any of these treatments and/or patient characteristics correlated with poor visual outcomes or the need for an enhancement. Of the 590 myopic eyes treated with Custom LASIK, 90.85% (n=536 eyes) had UDVA of 20/20 or better, 96.10% (n=567 eyes) had UDVA of 20/25 or better and 99.32% (n=586 eyes) had UDVA of 20/40 or better. Of the 170 myopic eyes treated with Custom LASEK, 70.59% (n=120 eyes) had a UDVA of 20/20 or better, 82.94% (n=141 eyes) had a UDVA of 20/25 or better and 96.47% (n=164 eyes) had a UDVA of 20/40 or better. Of the 45 hyperopic eyes that were treated with Traditional LASIK, 44.44% (n=20 eyes) had postoperative UDVA of 20/20 or better, 62.22% (n=28 eyes) had postoperative UDVA of 20/25 or better and 82.22% (n=37 eyes) had postoperative UDVA of 20/40 or better. Of the 536 eyes receiving LASIK, 91.42% (n=490 eyes) had an UDVA of 20/20 or better, 96.46% (n=517 eyes) had an UDVA of 20/25 or better and 99.44% (n=533 eyes) had an UDVA of 20/40 or better. Of the 146 low or moderately myopic eyes receiving Custom LASEK, 74.65% (n=106 eyes) had an UDVA of 20/20 or better, 86.62% (n=123 eyes) had an UDVA of 20/25 or better and 96.48% (n=137 eyes) had an UDVA of 20/40 or better. Of the 54 highly myopic eyes treated with Custom LASIK, 85.19% (n=46 eyes) had an UDVA of 20/20 or better, 92.59% (n=50 eyes) had an UDVA of 20/25 or better, and 98.15% (n=53 eyes) had an UDVA of 20/40 or better. Of the 28 highly myopic eyes treated with Custom LASEK, 53.57% (n=15 eyes) had an UDVA of 20/20 or better, 64.29% (n=18 eyes) had an UDVA of 20/25 or better, and 96.43% (n=27 eyes) had an UDVA of 20/40 or better. An analysis of these data yields significantly greater percentages of myopic (low, moderate and high) eyes achieving 20/20 or better after treatment by Custom LASIK versus Custom LASEK. The data suggested no correlations between poor visual outcomes and/or the need for an enhancement treatment and intraoperative complications, magnitude of ametropia, pupil size, age, treatment type, and treatment plan. All of the LASEK patients who underwent an enhancement treatment were exposed to MMC during their original procedure. Hyperopic patients displayed significantly reduced visual outcomes than comparable myopic treatments. Future studies should investigate similar preoperative characteristics and attempt to correlate them to results to improve predictability and, thus, visual outcomes

Stereotypes of Saudi Women among Saudi College Students

This study investigated the nature of stereotypes regarding Saudi women in contemporary Saudi Arabia. Despite the extremely high levels of inequality between men and women that The Global Gender Gap has documented in Saudi Arabia (American Association of University Women, 2014), little is known about the actual perception of women within Saudi society. Several factors in Saudi Arabia’s history—including its pastoral herding economy, tendency toward frequent warfare, and polygamous family structure (Wagemakers et al., 2012)—link Saudi society with a tendency to encourage the formation of restrictive gender stereotypes that may be particularly harmful to women (Alesina et al., 2013; Nisbett & Cohen, 1996). Nevertheless, there is a dearth of research regarding gender stereotypes within Saudi Arabia and consequently there is limited data available about the specific stereotypes held by Saudi men and women about Saudi women. This study aimed to contribute new research to fill the gap in the literature regarding gender stereotypes about women within Saudi society. Using the social psychological framework provided by social role theory, social identity theory, and self-categorization theory, this study first attempted to identify some of the central stereotypes faced by Saudi women and then to elucidate ways in which gender impacts how men’s stereotypes of women differ from Saudi women’s self-stereotypes. This study employed a cross-sectional, between-groups, quantitative design to test two hypotheses using a dataset that was collected from 841 Saudi undergraduate participants via survey questionnaire, the Saudi Women Stereotypes Scale (SWSS), in October 2014. The SWSS was a new scale, and as such the study also served to test the reliability and validity of the scale itself. To test the existence of the proposed stereotypes, items on the SWSS were subjected to Exploratory Factor Analysis (EFA) with varimax rotation (Gorsuch, 1983) to determine the optimum number of variables (stereotype dimensions). Multivariate Analysis of Variance (MANOVA) was employed to test overall gender difference as well as similarities across stereotypes and differences across stereotypes. The study’s first hypothesis was supported, as that there are stereotype categories associated with Saudi women: virtuous, submissive, isolated, less competent, and source of shame. The second hypothesis was partly supported, revealing a multivariate effect of gender on stereotype endorsement such that men and women differed in their overall endorsement of female stereotypes. Men showed stronger endorsement of the stereotype that Saudi women are less competent, submissive, while women reported stronger support for the stereotype that Saudi women are, virtuous, and isolated. These findings provide some of the first evidence about the type and strength of stereotypes about Saudi women. It can be concluded that the type of stereotypes about Saudi women endorsed by participants in this study reflect the nature of social relations in Saudi society and appear to maintain a system that segregates women and gives men a higher status, yet also regards women as virtuous

Stereotype Threat and STEM Self-Perceptions of Saudi College Women

Research shows that women’s educational progress in scientific (STEM) fields is limited by negative stereotypes about their abilities in such fields. These negative stereotypes may be internalized by women and adversely affect their academic self-concept and progress in STEM fields. In the case of women in higher education who study in STEM fields, their knowledge that they are stereotyped as having less ability than men in those fields may result in a stereotype threat that reduces their performance in cognitive tests and reduces their academic self-perception in regard to STEM domains. Most research on the negative female stereotype and stereotype threat in STEM fields has been conducted in Western countries. Little research has been conducted on women studying in STEM fields in universities in Saudi Arabia. It is important that such research be conducted because of Saudi Arabia’s unique cultural limitations on women and the strength of the country’s female stereotypes. Due to these circumstances, Western research results may not be applicable to Saudi women. Western results may also not be applicable to Saudi women because women higher education in Saudi Arabia occurs mostly in women-only institutions, unlike in the West. This study aimed to contribute new research to fill the gap in the literature regarding gender stereotypes about women in science majors in academia within Saudi society by examining how exposure to types of stereotype about women’s science ability (stereotype threat vs. positive stereotype) impact academic performance (in terms of math test results) and self-perceptions in science (in terms of science identity, science self-efficacy, belief about science, and overall academic science self-perception) for women STEM/medical students in different types of gender classrooms (classes only for women vs. mixed gender classes) at university in Saudi Arabia. In addition, the study investigated the interaction between the types of gender classrooms and the types of stereotype about women’s academic science ability on math performance and self-perceptions in science. These questions were tested by using the data that were collected from 634 Saudi women college students. The results found that students who were exposed to stereotype threat had lower math test scores and lower academic self-perception than women who were exposed to a positive statement about their STEM abilities. The study also found that women in mixed-gender classes had higher math test scores and academic self-perception than women in women-only classes. In addition, the results showed that in stereotype threat experiment condition women scored equally low in the math test regardless the type of gender classrooms. However, in the positive stereotype experiment condition, women in mixed-gender classrooms scored significantly higher in math test score compared to the women in single-gender classrooms. For the academic science self-perceptions, the results also showed a significant interaction effect of gender classroom type and stereotype about women’s academic science ability; indicating the effect of stereotype depended on the type of the classroom. In the threat experiment condition, women were significantly lower in academic self-perceptions both types of gender classrooms. However, women who were exposed to positive stereotypes in mixed classrooms scored significantly higher in academic self-perceptions compared to women who were exposed to positive stereotypes in single gender classrooms. These findings provide evidence that female Saudi students in STEM fields were above the midpoint of the scales on science self-perception (averaging on the positive ends of the scale), which may indicated to good level of academic self-perception in science. More specifically, when they are in mixed gender classrooms, the positive message support them to buffer themselves against negatives stereotypes to define their capabilities, and thy see themselves as being very capable in STEM subjects

Outcome of Deep Brain Stimulation (DBS) for the Treatment of Parkinson’s Disease in Terms of Improvement in MDS-UPDRS Scale Over 5 Years

Background & Objective:  Parkinson’s disease (PD) is the second most common Neurodegenerative disorder after Alzheimer’s disease. There are several surgical procedures for advanced PD, but amongst all deep brain stimulation has proven to be safest and effective. The objective of this study was to see the outcome of DBS for the treatment of PD in terms of improvement in MDS UPDRS over 5 years. Material and Methods:  44 patients were included in study from Oct 2014 to Sep 2019. History, examination was carried out, and preoperative MDS-UPDRS (Movement Disorder Society Unified Parkinson’s Disease Rating Scale) was recorded. Postoperative improvement in MDS-UPDRS score was assessed at first Programming, 2nd week, and 6th week and at 3rd month. Results:  At baseline the mean, the MDS – UPDRS (Part-I) score was 14.20 ± 0.61 and at the end of 3rd month, the mean score was 11.18 ± 0.47 respectively. At baseline the mean, the MDS – UPDRS (part-II) score was 18.99 ± 0.70 and at the end of 3rd month, the mean score was 13.01 ± 0.57, respectively. At baseline the mean, the MDS – UPDRS (part-III) score was 45.19 ± 0.90 and at the end of 3rd month, the mean score was 25.15 ± 1.20 respectively. At baseline the mean, the MDS – UPDRS (part-IV) score was 10.18 ± 0.87 and at the end of 3rd month, the mean score was 3.85 ± 1.03, respectively.  Conclusion:  The Deep Brain Stimulation (DBS) is safe and effective in the management of PD

CAUSES OF DELAY IN THE EXECUTION PHASE OF CONSTRUCTION PROJECTS IN KHYBER PUKHTOONKHWA PAKISTAN

Construction phase is the big problem in large construction business in the Islamic Republic of Pakistan. The construction of large industry plays important role for economy growth, development and evolution in the Islamic Republic of Pakistan. Delay causes a wide range of negative impact on construction projects. Current research focuses on the main flaws which impart delay in projects in sight of various industrial stakeholders which are clients, consultants and contractors. Current study is intended to identify and evaluate the factors causing delay and effects of delays in construction projects of Khyber Pukhtoonkhwa, Pakistan. The survey was conducted through validated questionnaire from structured interview and pilot survey to collect the responses on the causes of delay and delay effects. Client, consultants, and contractors were asked by questionnaire on the causes and effects of the delays. To analyze the data, statistical formula used to calculate the importance of the causes and effects of the delay through Relative important index (RII). After the outcome of the research fifteen (15) factors to cause delays and nine (9) factors of the effects of delays are examined. The top ranked of the reasons for the delays is the lack of Fund to finance the project to completion. While the top ranked of the effects of the delays is time overrun. By adding weight to these factors of trust in the people of the province will be restored to the correct way of mega-projects. Also provide these crucial attention factors, projects can be abstained from more than budgeting and will be useful to gain time and work area.Â

The Surgical Results in Pure Endoscopic Endonasal Trans-sphenoidal Surgeries in 403 Pituitary Adenomas: An 8-Years of Experience from a Single Neurosurgical Unit

Objective:  To review and report the results in pure endoscopic endonasal trans-sphenoidal surgery done at our unit for pituitary adenomas (PAs) in last 8 years. Material and Methods:  We reviewed 403 consecutive patients who underwent pure endoscopic endonasal trans-sphenoidal surgery for newly diagnosed pituitary adenomas between August 2012 and July 2020 at our neurosurgical unit. Endocrinological, demographic features and outcomes, their complications, and duration of stay in hospital were assessed in these patients who were operated in our neurosurgical Unit. The Mean Follow-up on average was 3.5 months. Results:  403 consecutive cases were reviewed. Majority of cases were in the 4th decade of life at presentation. 227 (56%) were non-functioning pituitary tumors and 176 (44%) were hormone secreting pituitary adenomas. Thirty-one (7.7%) complications were observed in 28 post-operative patients. The most frequently observed complication was diabetes insipidus (temporary in 19 (5%) and permanent in 3 (0.7%) cases), cerebrospinal fluids leaks (5 cases) (5.7%), Syndrome of inappropriate antidiuretic hormone (1 case) (0.2%), internal carotid injury (1 case) (0.2%), Empty Sella syndrome (1) (0.2%) and post-operative cardiac complication (1 case) (0.2%). The Follow-up on average was 3.5 months. Conclusions:  The pure endoscopic endonasal trans-sphenoidal surgery of pituitary adenomas provides acceptable and reasonable results representing a safe alternative procedure to the traditional Trans-sphenoidal microscopic approach

DETERMINATION OF MIXING HEIGHT IN RIYADH, SAUDI ARABIA

Twice-daily mixing heights, one morning and one afternoon were calculated by using the computational program MIXHTS. MIXHTS utilizes the meteorological data collected from the King Khalid International Airport (KKIA) surface and upper air stations in Riyadh city during the year 2002. Climatic data shows that the city of Riyadh has in general, a hot and dry weather in summer and cold and dry in wintertime, whereas strong insolation is dominant all over the year. Monthly average afternoon mixing heights are ranged from 1629 m to 3971 m, whereas the morning mixing heights are ranged from as low as 935 m to 2920 m. Estimation of mixing heights obtained by this work were found in a good agreement with the daily maximum value obtained from the dry adiabatic temperature method

Lack of sleep and its association with academic progress of undergraduate students of foundation university medical college, islamabad, Pakistan

The objective of the study,isto compare the relationship between lack of sleep and the academic performance of the undergraduate students of a medical college of Pakistan. METHODS AND MATERIALS: A cross-sectional study was conducted in a medical college of Pakistanin April 2016. Subjects were recruited by non-probability convenient sampling. A total of 140 subjectswereasked questions about sleep by a properly designed questionnaire from 2nd to 5th Year MBBS. Students having a prior diagnosis of sleep disorder were excluded from study.Data was analyzed using SPSS version 18. RESULTS: A total of 101 females and 39 males participated in the study. Duringnon-exam days, 41.14% of the students slept less than seven hours. The figure approached 80% in exam days. Cross tabulation failed to reveal a correlation between hours of sleep and academic performanceSpearman correlation showed a negative academic performance with less sleep in fourth and fifth year students. CONCLUSION: Students sacrifice their sleep during exams particularly girls. However, the association of sleep hours and academic performance was not established in this study. In fact, there was a negative association between academic performance and decrease sleep in fourth and fifth year students

Outcome of Minimally Invasive Percutaneous Plate Osteosynthesis Technique for Management of Extra Articular Distal Tibial Fractures

Objective: To assess the outcome of the minimally invasive percutaneous plate osteosynthesis (MIPPO) method applied for the management of extra-articular distal tibial fractures.Materials and Methods: This quasi-experimental study was conducted at the Department of Orthopaedic Surgery, Benazir Bhutto Hospital, Rawalpindi, Pakistan. Total 57 patients have included extra-articular type A distal tibial fracture, duration of injury <1 week, and competent neurological and vascular status of the fractured site. All the patients were treated with MIPPO Technique by using the distal tibial medial locking plate and the outcome of all patients was assessed radiologically in terms of union and functionally by using the Ovadia-Beals clinical scoring system. Data were analysed by using SPSS v. 21. Results: As per sample size calculation, 57 patients were included with a mean age of 37.19 ± 9.22 years. There were 45 (78.94%) male patients and 12 (21.05%) female patients. According to AO classification; the most common type was 43A1 with 31 patients (54.38%) whereas 18 (31.57%) were in Type 43A2 and 8 (14.03%) in Type 43A3. In our study, fracture union was achieved in a mean duration of 19.6 ± 3.45 weeks. When the functional outcome was analyzed, 41 (71.92%) patients had excellent outcome, 8 (14.03%) had good results, 5 (8.77%) had fair and 3 (5.26%) had poor outcome based on the subjective result and 44 (77.19%) patients had excellent, 7 (12.28%) had good, 3 (5.26%) had fair and 3 (5.26%) had poor result based on an objective result of Ovadia-Beals clinical scoring system. Conclusion: Thus MIPPO can be highly successful in achieving good to excellent outcomes in the maximum number of patients presented with a distal tibia fracture. So in the future, we can rely on this technique for such types of fractures. &nbsp