Objective: This study was undertaken to study physiological and behavioral pain responses of neonates and to assess the analgesic effect of orally administered sucrose as assessed by the behavioral pain rating scale [DAN (Douleur Aiguë du Nouveau-né) score] during venepuncture in neonates. Method: In 50 healthy neonates requiring bilirubin estimation, blood sugar was randomly assigned to receive 2ml of 30% sucrose two minutes before the venepuncture (intervention) in comparison to a group not receiving sucrose (control). During the procedure, pain was assessed by behavioral pain rating scale [Douleur Aiguë Nouveau-né (DAN) scale]. The heart rate, oxygen saturation before, during and after procedure as well as crying time was noted. Results: There was significantly lower pain (DAN) score in the intervention group compared to control group. Median (interquartile) DAN score in the group receiving sucrose was 3 (1.5-5.5) compared to 7 (5-9.5) in control group. The difference in median DAN score between two groups was statistically significant (p = 0.0001). There was a significant increase in heart rate in the control group whereas in group receiving sucrose, no significant change in heart rate was observed. Similarly, oxygen saturation was also significantly reduced in control group when compared to intervention group. Conclusion: The analgesic effect of 30% sucrose was large enough to be clinically significant and can thus be detected by behavioral rating scale for acute pain (DAN). Sucrose reduces the physiological alteration occurring during venipuncture.

Background Dry eye is a common disorder of the tear film that results from decreased tear production, excessive tear evaporation, or abnormality in mucin or lipid components of the tear film associated with symptoms of ocular discomfort. Objective To determine the prevalence of dry eye among patients above 40 years attending out-patient department in a Tertiary Care Hospital of Nepal. Method This was a prospective hospital-based study done at the Department of Ophthalmology in Dhulikhel Hospital, Kathmandu University Hospital for a period of six months from September 2016 to February 2017. All the patients above 40 years of age, attending out patients department were screened by ophthalmologist using the Ocular Surface Disease Index (OSDI). Those patients who were diagnosed of dry eye by OSDI were further evaluated by Schirmer’s test and Tear film breakup time (TBUT). Result Out of 4470 patients attending Ophthalmology outpatient department 1599 patients were of age above 40 years. The overall prevalence of dry eye according to OSDI questionnaire was 25% (400). The mean age of patient with dry eye was 54 yrs. 169 were males (42.2%) and 231 were females (57.7%). Among them Schirmer’s test was positive in 16.7% (67) and TBUT was positive in 85.7% (343) of the patients with dry eye. Conclusion Dry eye is a common condition among patients attending ophthalmology outpatient department in tertiary care center and is leading cause of ocular discomfort. The prevalence of dry eye was higher among indoor workers than in outdoor workers. Further studies are needed to establish association and risk factor of dry eye.