Background and Aims:Assessment of patient satisfaction is an important tool for monitoring the quality of care in hospitals. The aim of this survey was to develop a reliable tool to assess patient satisfaction with acute pain management service (APMS) and identify variables affecting this so that care can be improved.Methods:A questionnaire was developed and administered to patients after being discharged from APMS care by an unbiased person. Data collected from record included patient demographics, surgical procedure, analgesic modality, co-analgesics and dynamic and static pain scores. Questions included pain expected and pain experienced, APMS response time, quality of pain relief with treatment, professionalism of APMS team, overall experience of pain relief and choosing/suggesting same modality for themselves/family/friends again. Five-point Likert scale was used for most of the options. Statistical analysis was done using SPSS 19.Results:Frequency and percentages were computed for qualitative observation and presented on pie chart and histogram. Seventy-one per cent patients expected severe pain while 43% actually experienced it. About 79.4% would choose same analgesia modality in future for self/family/friends. Ninety-nine per cent found APMS staff courteous and professional. About 89% rated their experience of pain management as excellent to very good.Conclusion:The survey of patients’ satisfaction to monitor the quality of care provided by APMS provided positive inputs on its role. This also helps to identify areas requiring improvement in care and as a tool to gauge the quality of care.

Background: Worldwide, some one million people pass the sixty year old threshold every month (Ageing, WHO). Between 2010 and 2050, the number of older people in less developed countries is projected to increase. Methods: Cross-sectional study conducted in Outpatient clinics (OPD) of two hospitals in Karachi from April to May 2013. Elderly (> 60 years of age) visiting the clinics were consecutively recruited. 477 elderly were approached and a pretested, structured questionnaire was used to obtain information. Data was analyzed using SPSS version 19 and Pearson chi-square test was used to identify the factors related to choosing of "Old Age Homes". Results: A total of 400 participants were selected. Fifty-five percent of the elderly were in between 60 to 65 years of age and majority was males 54.8 percent. Elderly were aware of the presence of "Old Age Homes" in Pakistan, however only 7 percent choose to live in there. The main reason was found to be that the elderly did not want to go away from their families and loved ones. Conclusion: In conclusion, majority of the participants felt insecure to live in a home with strangers. However, "Old Age Homes" were preferred choice for those with chronic diseases or those living alone. Media should initiate public education programs to reduce social stigmas in seeking alternate long-term care services outside of the family.

An atypical case of carotid cavernous fistula (CCF) is presented which was challenging to diagnose even with investigations. A 50-year old female, presented with complaints of increasing chemosis, diplopia and proptosis of her right eye following a fall from stairs. Her IOP was 32 mm Hg in right and 18 in left eye. Absence of other classic clinical signs like bruit/thrill of carotid cavernous fistula led to difficulty in diagnosing. There was absence of radiological evidence like enlargement of superior ophthalmic vein on MRI, MRV and MRA. We started symptomatic treatment for increased IOP and exposure keratopathy. Right sided CCF diagnosis was confirmed on CT angiogram and Digital Subtraction Angiography. Coil embolization was done which resulted in symptomatic and clinical relief. Carotid cavernous fistula with absence of typical signs is sometimes challenging to diagnose and treat. Importance of Digital Subtraction Study and CT Angiogram is highlighted.

Purpose:  To find out the pattern and magnitude of ocular trauma in road traffic accidents (RTA). Study Design:  Descriptive cross sectional study. Place and Duration of Study:  Shaheed Mohtarma Benazir Bhutto Trauma Centre, from September 2021 to December 2021. Methodology:  Patients meeting the inclusion criteria had history and detailed examination. Data included age, gender, duration of presentation, eye involved, vehicle and type of eye trauma. Frequencies and percentages were computed for all categorical variables and mean and standard deviation was calculated for age. Effect modifiers like age, gender and vehicle were addressed through stratification. Effect of reporting time of injury, age, gender and type of vehicle involved in the pattern of injury was addressed. Post stratification chi-square was applied. P-value less than or equal to 0.05 was considered as significant. Results:  Out of 117 patients, 81.1% were males and 18.9% were females. Average age was 29.88 ± 13.9 years. Maximum number of patients was in the age range of 10 – 20 years (35%). Two wheelers were 65.8%. Sixty five percent reported within 24hours of accident. Closed globe trauma accounted for 78.6% and contusion was found in 51 patients (43.6%). Among all, 66.7% had 6/6 – 6/9 visual acuity. No significant association of age and gender was found with pattern of ocular trauma. Reporting time and type of wheeler had association with type of ocular trauma and pattern of ocular trauma (p values less than 0.05). Conclusion:  Ocular trauma is more common in young males and patients who report early have better visual acuity.