Purpose:In this study, we intend to analyze ropivacaine and bupivacaine in various parameters during phacoemulsification under deep topical fornix nerve block (DTFNB), a known form of nerve block for phacoemulsification.Methods:This prospective randomized study was conducted on 100 patients undergoing elective cataract surgery by phacoemulsification under DTFNB. Patients were divided into two equal groups of fifty patients each, Groups B (bupivacaine) and Group R (ropivacaine). Two sponges, approximately 2 mm × 3 mm dimensions, saturated with either 0.5% bupivacaine or 0.75% ropivacaine were placed deep in the conjunctival fornices to perform the deep topical block. Both groups were evaluated for magnitude of pain and discomfort at various stages of phacoemulsification using a simple pain scoring system. The level of surgeon satisfaction, requirement for supplementary anesthesia, and surgical complications were also evaluated. Quantitative variables between the two groups were compared using unpaired t-test. Qualitative variables were correlated using Chi-square test.Results:Overall demographic parameters of patients were similar in both groups. Similar mean pain scores were found in the ropivacaine and bupivacaine groups, with no statistical significance. Surgical satisfaction and the need for supplemental anesthesia were also statistically insignificant.Conclusion:Ropivacaine is a good alternative for deep topical anesthesia as it has a better safety margin and lesser toxic effect than other comparable local anesthetic agents.

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Introduction: Retinopathy is one of major micro vascular complication in long standing diabetes, but diabetic keratopathy has potential to decompensate following stress. The central corneal thickness is a sensitive indicator of health of cornea and may influence outcome in cataract, refractory surgeries and may lead to fallacy in Intraocular pressure measurement. Present study was cross sectional observational study, undertaken to determine the correlation between central corneal thickness (CCT), and diabetes control and duration in hilly north Indian patient.Material and Methods: This is a cross-sectional study conducted in the department of ophthalmology of a tertiary care centre in Kumaon region. 400 subjects from age group 40 to 80 years were studied. An ultrasound pachymeter was used to measure CCT. The subjects were divided into two groups, 200 of them were non-diabetic subjects, and 200 were diabetic patients. The collected data was transformed into variables, coded and entered in Microsoft Excel. Data was analysed and statistically evaluated using SPSS-PC-17 version. Results:The average central corneal thickness in diabetic patients was 527.01± 25.57 microns. The average central corneal thickness found in non-diabetic patients was 513.38 ± 27.01 microns. The statistically significant (p<0.001) increase in central corneal thickness found in diabetic patients compared to non-diabetic patients.CCT tends to increase significantly (p value<0.05) in uncontrolled diabetes (HbA1C level > 7%) and longer duration of diabetes.Conclusion: Diabetic patients had an increased central corneal thickness when compared with non-diabetic patients. And this is more in patient with longer duration of uncontrolled diabetes.Key Messages: Diabetic patients exhibit a greater statistically significant average CCT than non diabetic patients. There was also a positive correlation of thicker cornea with longer duration of diabetes and poorly controlled diabetes signifying that thicker cornea are more likely to be found in advanced stage. Diabetic keratopathy may lead to fallacy in IOP measurement and may decompensate following stress in refractory surgery.

BACKGROUND India has the largest blind population, more than any other country in the world. Among the total disability population of India, disability in seeing accounts for 18.8%. A total population of 5 million people have disability in seeing, of which 1.1 million are between the age group 5-19 years. Eye diseases in this group of population are important cause of medical consultation and require prompt attention because of their impact on education, future work and quality of life. In the state of Uttarakhand, blindness has been reported in 29,107 cases, of which 5,371 cases are from age group 5-19 years. [1] MATERIALS AND METHODS The present study was done to determine the pattern of eye diseases and the socio-demographic factors responsible for the ocular morbidity among the patients aged 5 to 16 years from Kumaon region, who presented to the Department of Ophthalmology, Government Medical College, Haldwani, Uttarakhand, between October 2014 and October 2016. A sample size of 400 was taken and a complete enumeration method was applied. A pre-designed proforma was used to document the patient particulars, history, examination and the diagnosis. Multiple ocular diseases were diagnosed by using different diagnostic test and criteria for individual diseases. Once the diagnosis was made by the attending ophthalmologist, the patient data and frequency of different ocular morbidities were documented. Socio-demographic factors responsible for ocular morbidity were studied by determining frequency of each morbidity in different age groups, gender and socioeconomic class. RESULTS In the present study, overall the disorders of ocular muscles, binocular movement, accommodation and refraction was the most common (37.25%) cause of ocular morbidity followed by Disorders of conjunctiva (25.75%), Congenital malformations of eye (7%), Disorders of eyelid, Lacrimal system and orbit (6.50%), Injury of eye and orbit (3%), Superficial injury of eye (1.50%), Disorders of sclera, cornea, iris and ciliary body (1%), Disorders of choroid and retina (0.75%) and Presence of functional implant (IOL) (0.5%). CONCLUSION Most causes of ocular morbidity among the study group in this survey were avoidable, refractive error being the leading cause. Stable intervention programs targeting refractive errors, allergic conjunctivitis, infections of lid and adnexa and trauma may significantly decrease the burden of ocular morbidity in this region.

Diabetes is one of the important public health problem. There are currently 415 million people affected worldwide and number is increasing day by day to an epidemic proportion. Diabetes is a lifestyle related metabolic disorder; besides genetic factor other risk factors are also involved in causation. Gravity of situation is compounded by the fact that fifty percent cases of diabetes remain undiagnosed until complication appear. A change in lifestyle, weight reduction, activity and improved awareness about diabetes can delay diabetic related complication. METHODSA cross-sectional questionnaire based interview of 450 patients was carried out in diabetic OPD of Dr. Susheela Tiwari Memorial Hospital associated with Government Medical College, Haldwani, Nainital, Uttarakhand. The question regarding patient's demographic characteristic and awareness of various aspect of diabetes including general knowledge, cause, complication and prevention were asked. RESULTIn present study, 302 (67.1%) knew what diabetes is. Most of the patients, i.e. 383 (85.1%) patients in present study were not aware about symptoms of diabetes. Among studied patients, 249 (55.3%) did not know that diabetes can cause ocular complication. Nearly half (48.8%) patients were not aware about the cause of diabetes; 168 (37.3%) patients were not aware about specific organ involvement in diabetes. The main source of awareness about diabetes was family members and friends, i.e. 201 (44.7%). A large number of patients (n=215, 47.7%) were not aware about preventive measure of diabetes. CONCLUSIONThis study clearly indicates that despite a good literacy rate, patient's knowledge about preventive measures is still low. There is a need to improve awareness regarding diabetes and its different aspect in the community. KEYWORDSAwareness, Diabetes Mellitus, Systemic and Ocular Complication, Questionnaire-Based Survey, Kumaon.HOW TO CITE THIS ARTICLE: Satyawali V, Pandey S, Sharma V, et al. Assessment of level of awareness for diabetes mellitus, its systemic and ocular complications: a questionnaire-based survey at tertiary care centre of Kumaon region.