Nasogastric tube insertion is a common clinical procedure carried out both by doctors and other paramedical personnel. Misplacement of the nasogastric tube into the tracheobronchial tree is not uncommon. It can easily be detected in awake patients with intact cough reflex. Insertion of the nasogastric tube under general endotracheal anaesthesia can be difficult and when the misplacement is not promptly detected can result in unusual and disastrous complications. Laryngospasm is not uncommon in anaesthetic practice; however, reports of recurrent laryngospasm are very sparse. We report a case of misplaced nasogastric tube causing recurrent laryngospasm.
Aim:
To compare visual acuity using the LEA symbol chart with Snellen E test chart in preschool children of age 3-5 years.
Patients and methods
:
Inclusion criteria:
50 emmetropic children aged 3 to 5 years.
Exclusion criteria:
Strabismus, amblyopia, ametropia, and any organic eye disease. A pseudo randomized protocol was used to test visual acuity (VA) in each subject monocularly on both eyes using Snellen E chart and LEA symbol chart. Visual acuity for both charts was scored as smallest optotype size which the child correctly identified 3 of maximum 4 optotypes. The strength of agreement on VA between two charts was tested using Interclass correlation coefficient (ICC). A Mann-Whitney U test was applied to compare both the groups.
Results:
Boys: Girls = 26:24 with a mean age and standard deviation of 4.12 + 0.79 years. ICC between Snellen’s and LEA symbol chart was 0.256 and 0.213 for right and left eye respectively. Analysis of the two samples using Mann-Whitney test showed a significant difference between the two charts (p value <0.000).
Conclusion:
LEA symbol test showed only a fair agreement with Snellen E charts for visual acuity measurements. Visual acuity measurement with LEA symbol chart showed significantly higher scores as compared to Snellen’s chart.
We report the final outcomes, based on final visual acuity, of patients who underwent cataract surgery at an outreach rural ophthalmology unit and document the details of the ophthalmic examination, type of surgery, intra- and postoperative complications and the final visual acuity. Of 208 eyes (198 patients), 81.3% had small incision cataract surgery and 18.7% had phacoemulsification. We believe that, with good planning and the proper utilization of available resources, it is possible to achieve a good visual outcome in the great majority of cases.
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