Complications of cataract surgery can occur before, during, or after the procedure. Preoperative complications include anxiety and eye irritation. Intraoperative complications involve injuries to the iris, lens, or capsules. Early postoperative issues comprise hyphaema, uveitis, and endophthalmitis. Late complications involve cystoid macular edema, retinal detachment, and secondary cataracts. Intraocular lens implantation can lead to malpositions, uveitis, glaucoma, or toxic reactions.
Ectropion
It is an outward turning of the eyelid margin . This more frequently affects the lower eyelid.Upper eyelid ectropion is uncommon.Classified in 5 types
1)Congenital 2) Involutional 3) Paralytic 4) Cicatricial 5) Mechanical
Involutional ectropion is more common.Congenital ectropion is very rare.
Symptoms Epiphora :- excessive tearing.Excessive dryness.
Foreign body sensation Irritation.Burning.Redness.Chronic conjunctivitis KeratinizationCorneal exposure
Grading
Lid margin is out rolled and depending on out rolling ectropion can be classified as under:
Grade I –only punctum is everted
Grade II –lid margin is everted and palpebral conjunctiva is visible
Grade III –fornix is also visible
Etiological factors
Horizontal lid laxity:-can be demonstrated by pulling the central part of the lid 8 mm or more from the globe, with a failure to snap back to its normal position on release without the patient first blinking.
Medial canthal tendon laxity
demonstrated by pulling the lower lid laterally and observing the position of the inferior punctum If the lid is normal the punctum should not be displaced more than 1–2 mm
Lateral canthal tendon laxity
characterized by a rounded appearance of the lateral canthus and the ability to pull the lower lid medially more than 2 mm.
>Normally, the displacement should only be 0-2 mm.
Treatment
1 medical therapy
2 surgical therapy
Ectropion
It is an outward turning of the eyelid margin . This more frequently affects the lower eyelid.Upper eyelid ectropion is uncommon.Classified in 5 types
1)Congenital 2) Involutional 3) Paralytic 4) Cicatricial 5) Mechanical
Involutional ectropion is more common.Congenital ectropion is very rare.
Symptoms Epiphora :- excessive tearing.Excessive dryness.
Foreign body sensation Irritation.Burning.Redness.Chronic conjunctivitis KeratinizationCorneal exposure
Grading
Lid margin is out rolled and depending on out rolling ectropion can be classified as under:
Grade I –only punctum is everted
Grade II –lid margin is everted and palpebral conjunctiva is visible
Grade III –fornix is also visible
Etiological factors
Horizontal lid laxity:-can be demonstrated by pulling the central part of the lid 8 mm or more from the globe, with a failure to snap back to its normal position on release without the patient first blinking.
Medial canthal tendon laxity
demonstrated by pulling the lower lid laterally and observing the position of the inferior punctum If the lid is normal the punctum should not be displaced more than 1–2 mm
Lateral canthal tendon laxity
characterized by a rounded appearance of the lateral canthus and the ability to pull the lower lid medially more than 2 mm.
>Normally, the displacement should only be 0-2 mm.
Treatment
1 medical therapy
2 surgical therapy
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
DISSERTATION on NEW DRUG DISCOVERY AND DEVELOPMENT STAGES OF DRUG DISCOVERYNEHA GUPTA
The process of drug discovery and development is a complex and multi-step endeavor aimed at bringing new pharmaceutical drugs to market. It begins with identifying and validating a biological target, such as a protein, gene, or RNA, that is associated with a disease. This step involves understanding the target's role in the disease and confirming that modulating it can have therapeutic effects. The next stage, hit identification, employs high-throughput screening (HTS) and other methods to find compounds that interact with the target. Computational techniques may also be used to identify potential hits from large compound libraries.
Following hit identification, the hits are optimized to improve their efficacy, selectivity, and pharmacokinetic properties, resulting in lead compounds. These leads undergo further refinement to enhance their potency, reduce toxicity, and improve drug-like characteristics, creating drug candidates suitable for preclinical testing. In the preclinical development phase, drug candidates are tested in vitro (in cell cultures) and in vivo (in animal models) to evaluate their safety, efficacy, pharmacokinetics, and pharmacodynamics. Toxicology studies are conducted to assess potential risks.
Before clinical trials can begin, an Investigational New Drug (IND) application must be submitted to regulatory authorities. This application includes data from preclinical studies and plans for clinical trials. Clinical development involves human trials in three phases: Phase I tests the drug's safety and dosage in a small group of healthy volunteers, Phase II assesses the drug's efficacy and side effects in a larger group of patients with the target disease, and Phase III confirms the drug's efficacy and monitors adverse reactions in a large population, often compared to existing treatments.
After successful clinical trials, a New Drug Application (NDA) is submitted to regulatory authorities for approval, including all data from preclinical and clinical studies, as well as proposed labeling and manufacturing information. Regulatory authorities then review the NDA to ensure the drug is safe, effective, and of high quality, potentially requiring additional studies. Finally, after a drug is approved and marketed, it undergoes post-marketing surveillance, which includes continuous monitoring for long-term safety and effectiveness, pharmacovigilance, and reporting of any adverse effects.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
2. Complications
PREOPERATIVE COMPLICATIONS
INTRAOPERATIVE COMPLICATIONS
EARLY POSTOPERATIVE COMPLICATIONS
DELAYED(LATE) POSTOPERATIVE COMPLICATIONS
IOL- related COMPLICATIONS
3. PREOPERATIVE COMPLICATIONS
Anxiety
Nausea and Gastritis
Irritative or Allergic conjunctivitis
Corneal abrasion
Complications during local anesthesia
1. Retrobulbar Hemorrhage
2. Oculocardiac Reflex
3. Perforation of globe
4. Subconjunctival hemorrhage
5. Spontaneous dislocation of lens
4. OPERATIVE COMPLICATIONS
1. Superior rectus muscle laceration
2. Excessive bleeding
3. Incision related complications
In manual SICS and phacoemulsification:
----Button holing of anterior wall of tunnel
----Premature entry into anterior chamber
----Scleral disinsertion
5. 4. Injury to the Cornea, Iris and Lens
5. Iris injury and Iridodialysis(tear of iris from root)
6. Complications related to anterior capsulorhexis
Escaping capsulorhexis
Small capsulorhexis
Very large capsulorhexis
Eccentric capsulorhexis
6. 7. Posterior capsular rupture
During forceful hydrodissection
By direct injury with some instrument like Sinkey hook, chopper
or phacotip
During cortex aspiration
8. Zonular dehiscence
7. 8. Vitreous loss-adequate measures should be taken to prevent this like:
To decrease vitreous volume
To decrease aqueous volume
To decrease orbital volume
Better ocular akinesia and anaesthesia
Minimising external pressure on the eye
Use of flieringa ring to prevent collapse of sclera
8. 10. Nucleus drop into the vitreous cavity
11. Posterior loss of lens fragment
12. Expulsive choroidal hemorrhage
9. [C] Early postoperative
complications
1. Hyphaema.
Treatment. Most hyphaemas absorb spontaneously and need
no treatment.
hyphaema may be large and associated with rise in IOP.
In such cases, IOP should be lowered by acetazolamide and
hyperosmotic agents.
10. 2. Iris prolapse. It is
usually caused by
inadequate suturing
of the incision
3. Striate keratopathy.
corneal oedema with
Descemet’s folds
due to endothelial
damage during
surgery.
11. 4. Flat (shallow or
nonformed) anterior
chamber. wound leak,
ciliochoroidal detachment or
pupil block
5. Postoperative anterior
uveitis can be induced by
instrumental trauma, undue
handling of uveal tissue,
reaction to residual cortex or
chemical reaction induced by
viscoelastics, pilocarpine etc.
12. 6. Bacterial endophthalmitis. This is one of the most dreaded
complications with an incidence of 0.2 to 0.5 percent.
The principal sources of infection are contaminated solutions,
instruments, surgeon'shands, patient's own flora from conjunctiva,
eyelids and air-borne bacteria.
13. Ocular pain, diminished vision, lid
oedema, conjunctival chemosis
and marked circumciliary
congestion, corneal oedema,
exudates in pupillary area,
hypopyon and diminished or
absent red pupillary glow.
14. [D] Late postoperative complications
These complications may occur after
weeks, months
or years of cataract surgery.
1. Cystoid macular oedema (CME).
Collection of
fluid in the form of cystic loculi in the
Henle’s layer of
macula is a frequent complication of
cataract surgery.
15. 2. Delayed chronic postoperative endophthalmitis
is caused when an organism of low virulence (Propionibacterium acne)
becomes trapped within the capsular bag.
3. Pseudophakic bullous keratopathy (PBK) is
usually a continuation of postoperative corneal
oedema produced by surgical or chemical insult to a
healthy or compromised corneal endothelium.
16. 4. Retinal detachment (RD). Incidence of retinal detachment is higher in
aphakic patients as compared to phakics. It has been noted that retinal
detachment is more common after ICCE than after ECCE. Other risk factors
for aphakic retinal detachment include vitreous loss during operation,
associated myopia and lattice degeneration of the retina.
5. Epithelial ingrowth.
6. Fibrous downgrowth into the anterior chamber
17. 7.After cataract. It is also known as ‘secondary cataract’. It
is the opacity which persists or develops after
extracapsular lens extraction.
Causes.
(i) Residual opaque lens matter may persist as after cataract
when it is imprisoned between the remains of the
anterior and posterior capsule,
(ii) Proliferative type of after cataract may develop from the
left-out anterior epithelial cells.
18. Clinical type
Soemmering’s ring
Elschnig’s pearls
Dense membranous
Treatment is as follows :
i. YAG-laser capsulotomy
ii. ii. Dense membranous after cataract needs surgical membranectomy.
7. Glaucoma-in-aphakia and pseudophakia
19. [E] IOL-related complications
1. Complications like
cystoid macular oedema, corneal endothelial damage, uveitis and secondary
glaucoma are seen more frequently with IOL implantation.
UGH syndrome refers to concurrent occurrence of uveitis, glaucoma and
hyphaema.
20. 2. Malpositions of IOL
. decentration, subluxation and
dislocation.
Sun-set syndrome (Inferior subluxation
of IOL).
Sun-rise syndrome (Superior
subluxation of IOL).
Lost lens syndrome refers to complete
dislocation of an IOL into the
vitreous cavity.
Windshield wiper syndrome. It results
when a very small IOL is placed
vertically in the sulcus. In it the
superior loop moves to the left and
right with movements of the head.
21. 3. Pupillary capture of the IOL may occur following
postoperative iritis or proliferation of the remains of lens
fibres.
4. Toxic lens syndrome. It is the uveal inflammation excited
by either the ethylene gas used for sterilising IOLs (in
early cases) or by the lens material (in late cases).