Purpose:The aim of this study is to elucidate the causes and level of visual impairment (VI) in patients with different pathologies of diabetic retinopathy (DR) who presented to a low vision care (LVC) clinic, to analyze the type of distant and near devices prescribed to them and the visual benefits thereof.Methods:A retrospective chart review was done for 100 consecutive patients with DR who were referred to the LVC clinic from June 2015 to June 2016. The reason for referral was assessed from the electronic medical records and available fundus photographs, fundus fluorescein angiograms, and optical coherence tomography images by a retina specialist. The details of low-vision devices and subsequent improvements were noted.Results:Of the 100 patients, 52% had moderate VI, 19% mild VI, 16% severe VI, and 13% had profound VI or blindness. The most commonly prescribed low vision device was half-eye spectacles (38.4%). The pathologies which had statistically significant improvement (P < 0.05) in distance vision with low vision devices were DR with disc pallor (4.4% improvement), ischemic maculopathy (11.9% improvement), and plaque of hard exudate (10.1% improvement). However, in all pathologies, there was statistically significant improvement (P < 0.05) in near vision.Conclusion:Usually, the patients with DR presented to the LVC clinic with moderate VI. The use of low vision devices can help these patients in cases where medical and surgical treatment have no or a limited role in restoring useful vision.
ContextElderly people are at a high risk of malnutrition leading to poor outcomes and quality of life.
AimsWe aimed to find an association between the nutritional and functional status of hospitalized elderly patients and the three-month all-cause mortality among them.
Settings and designA cross-sectional study was carried out at a tertiary care hospital in North India from July 2018 to December 2019.
Methods and materialA total of 177 patients were recruited for the study, and their demographic and clinical data were collected on a preformed questionnaire. Comorbidity, nutritional status, functional status, and depression were calculated using the Charlson Comorbidity Index (CCI), Mini Nutritional Assessment (MNA) form, Katz Index of Independence in Activities of Daily Living (Katz ADL), and Geriatric Depression Scale (GDS), respectively.
Statistical analysisA Chi-square test was used to find the association between different qualitative variables. A regression model was used to find out the odds for mortality. Statistical significance was set at p<0.05.
ResultsAccording to the MNA score, 49.7% (88) were at risk of malnutrition, and 22.6%(40) were malnourished. Malnutrition, Charlson Comorbidity Index, and the functional status of the patients were found to be associated with three-month mortality, with a p value of 0.005, 0.017, and 0.021, respectively. On regression analysis, malnutrition (odds ratio (OR): 3.796; 95% confidence interval (CI): 1.178-12.234; p=0.025) and the functional status (OR: 3.160; 95% CI: 1.256-7.952; p=0.015) of the study participants were found to have higher odds for three-month all-cause mortality.
ConclusionsNutritional status and ADL assessed at the time of discharge are good prognostic markers of health outcomes in the elderly population.
Key messageADL and nutritional assessment at admission and discharge should be routinely incorporated in the geriatric assessment of hospitalized patients to triage and prognosticate.
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