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

Вплив екологічних факторів навколишнього середовища на мінеральний профіль дітей та імунну відповідь до цитомегаловірусної інфекції

Мета - визначити вплив мінерального дисбалансу в дітей, які мешкають у різних за екологічними характеристиками районах великого міста, на імунну відповідь до цитомегаловірусної інфекції (ЦМВІ). Матеріали та методи. Обстежено 128 дітей, хворих на ЦМВІ, поділених залежно від екологічних умов району проживання та активності захворювання: I група - 66 дітей, які мешкали в умовно чистому районі (УЧР): І-а - 40 дітей із латентною ЦМВІ (лЦМВІ), І-б група - 26 дітей з активною ЦМВІ (аЦМВІ); II група - 62 дитини з умовно брудного району (УБР): ІІ-а - 34 дитини з лЦМВІ, ІІ-б група - 28 дітей з аЦМВІ. Показники мінерального профілю дітей визначено у волоссі методами рентгенофлуоресцентної спектрометрії та γ-активаційного аналізу. Стан клітинної та гуморальної ланок імунітету, рівні інтерлейкінів досліджено в сироватці крові. Отримані дані оброблено за допомогою програми «StatSoft Statistica 6.1». Результати. У дітей із лЦМВІ, які мешкають в УБР, визначено достовірне підвищення рівнів стронцію, хрому, свинцю, нікелю, цинку, зменшення міді і заліза в зразках волосся та достовірно вищі показники IL-1β та ФНП-α порівняно з показниками дітей, які мешкають в УЧР. Встановлено пряму кореляцію між вмістом свинцю, нікелю, стронцію, хрому в зразках волосся та підвищенням рівня протизапальних інтерлейкінів. Висновки. Проживання дітей в УБР великого міста є фактором ризику формування макро- та мікроелементного дисбалансу з накопиченням умовно токсичних елементів. Доведено, що дисбаланс мінерального профілю негативно впливає на імунну відповідь у дітей із лЦМВІ. Дослідження виконано відповідно до принципів Гельсінської декларації. Протокол дослідження погоджено Локальним етичним комітетом для всіх, хто брав участь. На участь дітей у дослідженні отримано інформовану згоду батьків. Автори заявляють про відсутність конфлікту інтересів

Influenceof the FeedingTypeon theMacro-andMicroelementalProfileof Infants

Аналіз мікроелементного профілю дітей першого року життя показав, що, незалежно від виду вигодовування, рівні стронцію, нікелю, брому та хлору знаходяться у референтних значеннях. У дітей, які знаходились на штучному та частково грудному вгодовуванні відмічається достовірне підвищення сірки та фосфору, відзначався дисбаланс Mg/Ca/P обміну.In the work are given the results of screening of the mineral status of conventionally healthy infants that constantly live in Kharkov city and are on the different types of feeding. Aim: to determine the macro and microelemental (ME) profile of children on the different types of feeding. Methods: There were examined 50 children 5 month old who are on the different feeding types. Children were complexly examined by the narrow specialists and divided into groups: breast-feeding (BF), partially breast feeding (PBF), artificial feeding (AF). The evaluation of mineral profile was carried out on the base of determination of ME content in hair by the method of mass-spectrometry on «ElvaХ» apparatus (2008 year of issue). Results: Analysis of the results demonstrated that the strontium, nickel, bromine and chlorine level in children on the different feeding types has not any reliable differences that can be considered as the norm variant and does not need correction. Profile of children on the other ME who receive the mixture in ration partially of completely was compared with profile of children on BF. In children on AF was noted the decrease of magnesium level (0,029%), increase of iron (0,884%), chromium (0,714%), sulfur (0,943%) and phosphorus (0,036%) indices р≤0,05; was noted the imbalance of К/Са ratio 0,487 – 1,945%. In children on PBF was registered the decrease of sodium level (0,019%) р˂0,05. Was noted the increase of Zn (0,905%), chromium (0,72%), sulfur (0,901%) and phosphorus (0,039%) р≤0,05. Potassium-calcium imbalance is less abrupt comparing with the group of children on artificial feeding - 0,367-1,266%. There was observed the increase of chromium level in 40% of children on BF. Conclusions: There was established that children on partially breast and artificial feeding do not have the adequate macro/microelement balance and are in the risk group of formation of pathologies of the cardio-vascular and osteo-muscular systems, allergic diseases that needs the certain correction at the stage of preclinical manifestations

Socioeconomic deprivation worsens the outcomes of Italian women with hormone receptor-positive breast cancer and decreases the possibility of receiving standard care.

BACKGROUND: Socioeconomic factors influence access to cancer care and survival. This study investigated the role of socioeconomic status on the risk of breast cancer recurrence and on the delivery of appropriate cancer care (sentinel lymph node biopsy and breast-conserving surgery plus radiotherapy), by patients' age and hormone receptor status. METHODS: 3,462 breast cancer cases diagnosed in 2003-2005 were selected from 7 Italian cancer registries and assigned to a socioeconomic tertile on the basis of the deprivation index of their census tract. Multivariable models were applied to assess the delivery of sentinel lymph node biopsy and of breast-conserving surgery plus radiotherapy within socioeconomic tertiles. RESULTS: In the 1,893 women younger than 65 years, the 5-year risk of recurrence was higher in the most deprived group than in the least deprived, but this difference was not significant (16.4% vs. 12.9%, log-rank p=0.08); no difference was seen in women ≥65 years. Among the 2,024 women with hormone receptor-positive cancer, the 5-year risk was significantly higher in the most deprived group than in the least deprived one (13.0% vs. 8.9%, p=0.04); no difference was seen in cases of hormone receptor-negative cancer. The most deprived women were less likely than the least deprived women to receive sentinel lymph node biopsy (adjusted odds ratio (ORa), 0.69; 95% CI, 0.56-0.86) and to undergo breast-conserving surgery plus radiotherapy (ORa=0.66; 95% CI, 0.51-0.86). Conclusions: Socioeconomic inequalities affect the risk of recurrence, among patients with hormone receptor-positive cancer, and the opportunity to receive standard care

Linking Medical Treatment and Physiotherapy in Stroke Recovery: A Meta-Analytical Statistical Synthesis

Stroke remains a leading cause of long-term disability worldwide, necessitating integrated approaches to rehabilitation. This meta-analytical study synthesized data from previously published peer-reviewed articles to assess the combined impact of physiotherapy and medical treatment on stroke recovery. To investigate motor and cognitive outcomes, independence in recovery time to (ADLs) and quality of life, data from studies that contained information from over 10,000 patients were analyzed. The meta-analysis covered 18 studies (2010–2023) from PubMed, Scopus, Web of Science, Cochrane, and Google Scholar. Studies were selected based on predefined inclusion and exclusion criteria focusing on adult stroke patients and quantitative outcome reporting. Statistical analysis utilized independent t-tests, ANOVA, and multiple linear regression. Key findings revealed a significant improvement in motor function in the combined treatment group (M = 71, SD = 9.4) compared to the medical-only group (M = 58, SD = 10.1), t (9988) = 35.2, p < 0.001, Cohen’s d = 1.32. Cognitive scores were also significantly higher in the combined group (M = 83.4, SD = 8.2) versus medical-only (M = 70.3, SD = 9.1), t (9988) = 30.1, p < 0.001, Cohen’s d = 1.25. Regression analysis indicated that treatment type and age were significant predictors of recovery outcomes (R² = 0.67, F (4, 9945) = 506.3, p < 0.001). Demographic subgroup analysis highlighted better outcomes in younger female patients and those with hemorrhagic stroke. The study underscores the importance of early, structured physiotherapy within multidisciplinary care models and provides statistically grounded insights to inform stroke rehabilitation protocols

The Role of Neighborhood Environment in Promoting Risk Factors of Cardiovascular Disease among Young Adults: Data from Middle to High Income Population in an Asian Megacity

Background: Modifiable risk factors of cardiovascular diseases (CVD) have their triggers in the neighborhood environments of communities. Studying the environmental triggers for CVD risk factors is important to understand the situation in a broader perspective. Young adults are influenced the most by the environment profile around them hence it is important to study this subset of the population.Methods: This was a descriptive study conducted using the EPOCH research tool designed by the authors of the PURE study. The study population consisted of young adults aged 18-25 in two areas of Karachi. The study setting was busy shopping malls frequented by young adults in the particular community being studied.Results: Our total sample size was 120 individuals, who consented to be interviewed by our interviewers. Less than 50% of the population recognized some form of restriction regarding smoking in their communities. The largest contributor to tobacco advertising was actors smoking in movies and TV shows with 89% responses from both communities. Only 11.9% of the individuals disapproved of smoking cigarettes among men with wide acceptance of \u27sheesha\u27 across all age groups. Advertising for smoking and junk food was more frequent as compared to smoking cessation, healthy diet and exercise in both the areas. Unhealthy food items were more easily available in contrast to healthier options. The cost of healthy snack food options including vegetables and fruits was higher than sugary drinks and foods.CONCLUSION: This assessment showed that both communities were exposed to environments that promote risk factors for cardiovascular diseases