No abstract

Background: Recent advancements in cataract surgery and local anaesthesia administration has led to the majority of cataract surgeries been performed under local anaesthesia. This has further intensified the search for the ideal anaesthesia. The use of topical anaesthetic agents in cataract surgeries has brought us closer to finding that ideal anaesthesia. Objective: The objective of this study is to determine the viability of topical anaesthesia as a comparable mode of anaesthesia to subtenon anaesthesia in cataract surgery. Methods: This is a randomized double-blinded placebocontrolled clinical trial. 118 subjects undergoing small incision cataract surgery were allocated to either a topical anaesthesia group (topical anaesthesia with placebo subtenon's injection of balanced salt solution, n=40) or subtenon's group (sub-tenon's anaesthesia with placebo topical balanced salt solution, n=78). Pain experienced during and after the operation was assessed using the numerical rating scale, aided with a visual analogue graphic pain score chart. Results: There was no significant difference in mean pain score between the two groups during anaesthesia administration (P=0.48), during cataract surgery (P=0.37), immediately after surgery (P=0.77) and 30 minutes after surgery (P=0.17). Conclusion: Topical anaesthesia is comparable to subtenon's anaesthesia in patients undergoing cataract surgery.

Background: This study investigates the health-related quality of life (HRQOL) of female patients with congenital adrenal hyperplasia (CAH) in Malaysia. The objectives were to attain socio-demographic and medical data on these Malaysian females with CAH and establish their health-related quality of life (HRQOL) in comparison to age matched diabetic controls. Methods: A cross-sectional study was conducted over 6 months in the two main tertiary centres for CAH patients in Malaysia. Participants including 59 female-raised CAH patients (mean age ± SD = 16.3 ± 4.2 years, range 10-28 years) compared to 57 age-matched female diabetic patients (mean age ± SD = 16.5 ± 3.4 years, range 10-26 years). Socio-demographic and medical profiles was obtained through semi-structured interviews. HRQOL of participants were evaluated utilising validated, Malay translated questionnaires which were age appropriate: Pediatric Quality of Life Inventory (PedsQL v4.0) scales for Child (8-12) and Adolescent (13-18) and Medical Outcome Survey 36-item Short Form version. These were then compared to the diabetic controls. Results: The CAH participants consisted of children (ages 10-12 years, n = 12), adolescents (ages 13-17 years, n = 29) and adults (≥ 18 years, n = 18). The majority were Malays (64.4%) and had salt-wasting CAH (67.8%). There were no significant differences between the total mean score of the HRQOL of the combined children and adolescents CAH group (total mean score ± SD = 81.6 ± 17.9, 95% CI = 75.6-87.6) when compared to age-matched diabetic patients (total mean score ± SD = 80.8 ± 11.0, 95% CI = 77.0-84.5, P = 0.81, effect size = 0.05); no significant difference between the adult CAH and diabetic controls in the physical [median score (IQR) CAH vs diabetics; 49.3 (11.4) vs. 50.2 (6.1), P = 0.60, effect size = 0.09] and the mental composite scores [median score (IQR) CAH vs. diabetics; 47.8 (14.1) vs. 50.0 (10.8), P = 0.93, effect size = 0.01]. Conclusions:The HRQOL of the Malaysian CAH cohort were comparable to the diabetic controls.