The effectiveness of sub-Tenon's infiltration of local anaesthesia for cataract surgery

Purpose: To determine if adequate anaesthesia and akinesia could be obtained using an inferonasal quadrant sub-Tenons anaesthesia for cataract surgery.
Methods: The sub-Tenons method of local anaesthesia was used in 50 patients undergoing extracapsular cataract extraction and lens implantation. The technique followed was that described by JD Stevens in his study of 50 patients. Posterior sub-Tenons space was approached through a conjunctival incision in the inferonasal quadrant and the anaesthetic solution delivered by an irrigating cannula. The patients were assessed for residual ocular movements just before surgery. Effectiveness of anaesthesia was assessed during surgery using a verbal pain rating score. Scoring was based on the concept of a visual analogue pain score chart.
Results: Total akinesia was obtained in 20% patients and total anaesthesia in 24% patients. The remainder of the patients had adequate akinesia and anaesthesia to proceed with and complete the surgery.
Conclusion: This method provides satisfactory anaesthesia for cataract surgery.     

Hypertension and vascular disease in India and migrant Indian populations in the world

The association of hypertension, diabetes mellitus and abnormal lipoprotein patterns suggests that this combination has a lethal effect with regard to vascular disease. It is therefore necessary to do something about the known lifestyle factors such as cigarette smoking, obesity and possibly a low fibre diet. The high incidence of ischaemic heart disease among emigrant Indians in South Africa and Trinidad, and the low incidence in blacks of South Africa and the West Indies, suggests that there may be different thresholds for susceptibility to disease in various ethnic groups, beyond which the risk factors begin to operate.     

REM SLEEP BEHAVIOUR DISORDER: AN OVERVIEW

REM sleep behaviour disorder (RSBD) is a recently described parasomnia characterised by a history of excessive nocturnal motor activity and absence of muscle atonia during REM sleep. Only limited literature is available on this condition. The exact prevalence is unclear, but recent studies suggest it might not be an uncommon condition. The elderly are more often affected and there is a male preponderance. While transient RSBD can be seen after taking certain drugs or during drug withdrawal, the chronic type is usually idiopathic or associated with an underlying degenerative neurological condition. It can result in considerable distress and/or serious injury to the patients or their bed partners. Differential diagnoses include sleep-walking, night terrors, nightmares, nocturnal seizures, obstructive sleep apnoea, post-traumatic stress disorder, dissociative states and nocturnal confusional states. The dramatic response to clonazepam highlights the importance of recognition and appropriate treatment of this sleep disorder.     

Risk indicators and psychopathology in traumatised children and adolescents with a history of sexual abuse

PURPOSE: Childhood sexual abuse (CSA) is widespread amongst South African (SA) children, yet data on risk factors and psychiatric consequences are limited and mixed. METHODS: Traumatised children and adolescents referred to our Youth Stress Clinic were interviewed to obtain demographic, sexual abuse, lifetime trauma and psychiatric histories. RESULTS: Data for 94 participants (59 female, 35 male; mean age 14.25 [8.25-19] years) exposed to at least one lifetime trauma were analysed. Sexual abuse was reported in 53% of participants (42.56% females, 10.63% males) with 64% of violations committed by perpetrators known to them. Multinomial logistic regression analysis revealed female gender (P=0.002) and single-parent families (P=0.01) to be significant predictors of CSA (62.5%). CSA did not predict exposure to other traumas. Sexually abused children had significantly higher physical and emotional abuse subscale scores and total CTQ scores than non-abused children. Depression (33%, X(2)=10.89, P=0.001) and PTSD (63.8%, X(2)=4.79, P=0.034) were the most prevalent psychological consequences of trauma and both were significantly associated with CSA. CONCLUSIONS: High rates of CSA predicted high rates of PTSD in this traumatised sample. Associations we found appear consistent with international studies of CSA and, should be used to focus future social awareness, prevention and treatment strategies in developing countries.     

Community participation in a low-income neighborhood: The salience of sociodemographic characteristics,perceptions and experience of violence,and neighborhood attachment

While community participation may serve as a vehicle to improve health and socioeconomic outcomes for residents in poor communities, little research exists on the individual factors that influence community participation, particularly in contexts where violence is exceptionally high. This study examined the relationship between sociodemographic characteristics, perceptions, and experiences of violence, neighborhood attachment, and community participation in a low-income, under-resourced neighborhood in Johannesburg South Africa. The study used baseline data from 300 randomly selected households and multiple linear regression to assess the relationship between individual factors and community participation. The results suggest a high level of community participation, with religious organizational membership the most common. Being female, employed, and fear of violent crime were positively associated with community participation. Future research should include mixed methods and transdisciplinary research approaches for building our understandings of social justice and transformation-oriented community participation.