We recommend that all referrals for cataract should confirm a detrimental effect on lifestyle and the patient's willingness for surgery, in addition to confirming cataract as the main cause of visual loss.

Funding Acknowledgements Type of funding sources: None. Introduction International guidelines recommend effective cardiac rehabilitation programs to decrease mortality and morbidity and improve health-related quality of life. However, cardiac rehabilitation remains underutilized with low referral rates. Data on referral rates and factors affecting referral are lacking in our setting. Purpose We evaluated the utilization of inpatient cardiac rehabilitation in our general hospital in terms of referral rates of patients with Class I indications for cardiac rehabilitation, time to referral, treadmill exercise test (TET) participation rate, and characteristics of patients referred and not referred. Methods We conducted this retrospective descriptive cross-sectional study by reviewing the medical records of eligible patients admitted between January 1 to December 31,2018. Patient characteristics, indications for cardiac rehabilitation, referral rates, time to referral, and TET participation rates were determined. Results We included 759 patients with a mean age of 57.5 years; majority were male (59.9%), married (66.8%), hypertensive (58.4%) and diabetic (32%). The overall referral rate is 17.7%. The highest indication-specific referral rates were for CABG(70%), STEMI(32%), PCI(32%), and PAD(32%). The lowest referral rates were seen in patients with NSTEMI(18%) and HF (16%). The mean time to referral was 6 days. The TET participation rate was 1.3%. Conclusion Cardiac rehabilitation remains underutilized despite evidence-based recommendations. Intensified efforts are needed to enroll all patients with Class I indications for inpatient cardiac rehabilitation, increase referral rates, improve the existing program, and optimize the management of our cardiovascular patients.

reported with extensive pericardial calcification associated P. acnes infection. It also highlights the potential for this organism to cause invasive infections. The extensive calcification seen in this case may be due to the indolent course of infections caused by P. acnes. P.acnes has been associated with Sarcoidosis, we hypothesise that the extensive calcification seen in this case may be via a similar mechanism to the classic "eggshell" calcification seen in Sarcoidosis.

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