Learning Curve of a Trainee Ophthalmologist in Manual Small Incision Cataract Surgery: A Self-Appraisal
Emmanuel Olu Megbelayin,
Ashok Rangarajan,
Sreedhar Pindikura
Issue:
Volume 1, Issue 5, December 2013
Pages:
63-69
Received:
13 November 2013
Published:
10 December 2013
Abstract: Purpose: To appraise the learning pattern in Manual Small Incision Cataract Surgery (MSICS) of a trainee ophthalmologist. Setting: Sankara Eye Hospital, Pammal, Chennai, India. Design: Retrospective study. Methods: Case files of patients who underwent MSICS during the training were reviewed. Surgical complications, nucleus density, extent of supervisors’ intervention in surgeries and visual acuity were either tabulated or graphically presented. Two-way ANOVA and multiple regressions were used to compare dependent variables. Results: There were 123 eyes of 123 patients {males 49 (39.8%), females 74 (60.2%)}. The mean age was 63.19 + 6.6 years with a range of 40-80 years. The worst post-operative visual acuity (VA) was in the first month of training. With an overall complication rate of 30.9%, posterior capsular rent (PCR) was most prevalent in eyes operated in the first month of training (3 of 18 eyes, 16.7%). Supervisors’ intervention in surgeries was highest in the first month of training and declined as training progressed. Fischer’s Exact test for intraoperative complications and extents of supervision showed a statistically significant (P = 0.012). Multiple logistic regression analysis showed that density of nucleus was statistically significant (P = 0.02). Conclusions: Three months appear sufficient for learning the surgical rudiments of MSICS for a trainee with a modest competence in Extra-capsular Cataract Extraction (ECCE), especially if surgeries are performed on a continuous basis during the period.
Abstract: Purpose: To appraise the learning pattern in Manual Small Incision Cataract Surgery (MSICS) of a trainee ophthalmologist. Setting: Sankara Eye Hospital, Pammal, Chennai, India. Design: Retrospective study. Methods: Case files of patients who underwent MSICS during the training were reviewed. Surgical complications, nucleus density, extent of superv...
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Diaphragmatic Hernia Revealed by Post-Partum Respiratory Distress
Alexandre Descloux,
Ulrich Schneider,
Thomas Kocher
Issue:
Volume 1, Issue 5, December 2013
Pages:
70-72
Received:
18 November 2013
Published:
20 December 2013
Abstract: Introduction: Diaphragmatic hernias occurring during pregnancy or during labor are very rare. This kind of injury or complication is mostly diagnosed with delay. Case report: A 30-year-old, primigravida woman presented an acute respiratory distress three weeks after childbirth by emergency caesarian section. The past history was uneventful till a car crash three years ago with whiplash injury without blunt abdominal trauma. The diagnostic of the dyspnea was assured by thorax CT scan. Symptoms of gastrointestinal obstruction were not recorded. An emergency thoracotomy was performed. The incarcerated gastric fundus had to be resected. The central diaphragmatic hernia could be closed by sutures. An abdominal approach was not necessary. The postoperative follow-up was uncomplicated. Discussion and Conclusion: Incarceration of abdominal viscera by diaphragmatic hernia is an uncommon cause of pleural empyema. Her happening during pregnancy or during the peri-partum period is increasingly rarely and represents a life-threatening event for the pregnant woman and her fetus. Early diagnosis and surgery in an emergency setting are required. Diagnose and treatment of diaphragmatic hernias in women in child-bearing age should happen before pregnancy in matter to avoid potential lethal complications for the expectant mother as well as for the fetus.
Abstract: Introduction: Diaphragmatic hernias occurring during pregnancy or during labor are very rare. This kind of injury or complication is mostly diagnosed with delay. Case report: A 30-year-old, primigravida woman presented an acute respiratory distress three weeks after childbirth by emergency caesarian section. The past history was uneventful till a c...
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Aetiology and Outcome of Combined Closed Trauma of the Abdomen According to the Date of Samarkand Hospital
Mustafakulov I. B.,
Machmudov F. Ch.,
Norov M. Ch.,
Shakirov B. M.
Issue:
Volume 1, Issue 5, December 2013
Pages:
73-76
Received:
28 August 2013
Published:
20 December 2013
Abstract: General principles of aetiology and outcome of combined abdominal closed traumas have been resumed and unified. Between 2000 and 2010, 1.758 patients with combined abdominal traumas were admitted to Samarkand branch of RSCUMA, Samarkand, Uzbekistan. Of them 305 (17, 3%) patients with combined closed traumas of the abdominal organs were operated on. Peculiarities of the clinical history and proved surgical treatment tactics of combined abdominal closed traumas have been presented. The final outcome of combined closed traumas depends performing an adequate firs aid in good time, correct surgical management of such types of patients.
Abstract: General principles of aetiology and outcome of combined abdominal closed traumas have been resumed and unified. Between 2000 and 2010, 1.758 patients with combined abdominal traumas were admitted to Samarkand branch of RSCUMA, Samarkand, Uzbekistan. Of them 305 (17, 3%) patients with combined closed traumas of the abdominal organs were operated on....
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