IntroductionWe wanted to assess the efficacy, predictability, and stability of topography-guided, laser-assisted in situ keratomileusis (TGL) on normal untreated eyes with a preoperative best corrected visual acuity (BCVA) of 20/20.MethodsThis was a retrospective, non-randomized, and single arm study evaluating the outcomes of TGL in eyes with a preoperative BCVA of 20/20. We included 50 eyes of 50 patients who presented to the Hashmanis Hospital, Pakistan and were followed for six months postoperatively. All eyes underwent treatment using the Alcon Wavelight Allegro Topolyzer (Alcon Laboratories, Inc., TX, USA).ResultsThe mean preoperative sphere, cylinder, and spherical equivalent (SE) values were -4.3 ± 1.6 dioptres (D), -1.0 ± 0.8 D, and -4.8 ± 1.8 D. On day one these values were 0.2 ± 0.8 D, -0.5 ± 0.3, and 0.3 ± 0.8, respectively, and on month six they were -0.1 ± 0.6, -0.5 ± 0.3, and -0.4 ± 0.6 D, respectively. On postoperative day one and month six, 86% and 94% of eyes had a UCVA of 20/20 or better, respectively. Two eyes (4%) had an SE change of greater than 0.5 D from three to six months.ConclusionOur study demonstrates good efficacy, predictability, and stability of eyes undergoing TGL with a follow-up of six months.
Background: The goal of this study is to evaluate the extent to which caffeine consumption, cigarette smoking, technology use, and academics are associated with the sleeping habits of university students. Methods: 643 undergraduate students aged 18 to 23 from five universities of Karachi completed a cross-sectional survey about sleep patterns and lifestyle habits between December 2014 and November 2015. Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality. Data was entered and analyzed using SPSS version 22. Pearson Chi-square test was applied to determine relationship between sleep patterns and factors affecting sleep. Threshold of significance was set at <0.05. Results: Majority of the participants (60.5%) reported poor sleep quality (PSQI score >5), with an average PSQI score of 6.5 (±3.033). Sleep duration was less than 7 hours for 71.8% (N=462) of the participants. Also, most participants went to bed between 9pm to 12am, with 52.5% of males (N=136) sleeping after 12am compared to 46.1% (N=177) of the females. Other than energy drinks, no stimulant beverage showed significant relation with sleep quality. However, coffee, tea and energy drinks had a negative impact on sleep onset latency. Smoking too showed an association with poor sleep quality (p-value <0.009) and delayed sleep onset (p-value <0.009). Mobile phone was by far the most frequently used technological device. Conclusions: Poor sleep quality is prevalent among college students of Karachi. Behavioral habits like consumption of caffeinated drinks, smoking, and technology use are associated with increased odds of poor sleep quality.
Objective: To determine the effectiveness of digital health technologies in the management of chronic pain. Methods: The systematic review comprised search for randomised controlled trials and controlled clinical trials involving patients with chronic pain published between 2010 and 2020. The search was conducted on PubMed, Google Scholar, MEDLINE, National Centre for Biotechnology Information, and National Library of Medicine databases. Risk bias tool was used to evaluate the biasness in the studies and Pedro scale was used to assess the quality of the included articles. Results: Of the 33 articles fully assessed, 14(42.42%) were analysed. All the studies analysed were randomised controlled trials and scored 6-10 on the Pedro scale which showed high quality of methodology. The studies typically reported statistically significant benefits of digital health technologies in the management of chronic pain. One of the main benefits was enhanced pain coping skills of the patients. Additionally, majority of the studies included increased adherence to exercise as an essential advantage. Conclusion: All the studies analysed reported favourable conclusions regarding the use of digital intervention for chronic pain management. Key Words: Chronic pain, Digital intervention, Health technologies, Pain management, Randomised controlled trial.
Background: Patient and clinician relationship plays a pivotal role in the progress of treatment. Evidence based practice is the key methodology which integrates the best research evidence, clinical expertise and patient need for a better outcome. To evaluate the factors that influence the application of evidence based physiotherapy in public and private sectors of Karachi, Pakistan. Methodology: A cross-sectional survey was conducted from July to December 2017 in major physiotherapy clinics and rehabilitation centers of Karachi covering major government, semi-government and private sectors. Data was collected from 75 practicing physiotherapists through convenience sampling technique and were asked to fill self-administered close-ended questionnaire. Data entry and analysis was done using SPSS Version 16 and chi-square test applied. Results: Lack of availability of resources to access information was noted to be the biggest practitioner barrier while disinterest in evidence based practice (EBP) was considered as the least important. Among various organizational barriers, lack of time provided by management and lack of support among physiotherapists were stated to be the biggest barriers. Perception of evidence based physiotherapy was noted to be generally positive among the physiotherapists. Graduates with experience of 1-5 years were found to be keener to refine their EBP skills and were more likely to agree that EBP integration with practical knowledge improved prognosis. Almost 70% well experienced (10 years +) physiotherapists were reported to have access to research publications whereas 80.4% fresh experienced said they were confident of their capability to search relevant research.Conclusion: Individuals and organizations should work to rectify the identified barriers from this study and express learning in a way that helps them in applying research findings to ordinary patients in ordinary clinical settings.
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