Vignetting and negative dysphotopsia using intraocular lens inside far peripheral vision

Happiness is an essential part of human health. The purpose of health care, including diabetes care, is to achieve happiness, or euthymia. Happiness, can also be viewed as a means to achieving good health, as well as a technique to overcome challenges, encourage team work and ensure better adherence to therapy. This opinion piece shares simple ways of achieving happiness in the diabetes care clinic. It lists best practices related to environment communication style, communication content, and inter-consultation contact. If integrated into daily practice, these will help create a happy health care ecosystem, which in turn will enhance patient satisfaction.Cardiovascular disease (CVD) is a major cause of morbidity and mortality across the globe. Prevention and management of the CVD pandemic calls for concerted action on part of all health care professionals, as well as other concerned stakeholders. We call for cardiovigilance in healthcare and define it as "the action or state of keeping careful watch, to prevent, screen, diagnose and manage cardiovascular disease (CVD) in a timely and appropriate manner". We expand upon the concept of cardiovigilance, describe its utility, and suggest various taxonomic rubrics to simplify its practice.This study aims to share the results of haemorrhoidal artery ligation under direct vision in the management of symptomatic haemorrhoids. We conducted a case series of 70 patients at Combined Military Hospital Rawalpindi & Quetta, from January 2015 to October 2017. All patients underwent Haemorrhoidal Artery Ligation (HAL) and Recto Anal Repair (RAR). Ligation of superior haemorrhoidal artery was done under direct vision following manual palpation. Patients were followed up postoperatively at 1, 3 and 6 months. At 1 month follow up, all 70 (100%) patients were pain free. Post operative bleeding was observed in 7 (10%) patients but did not require surgical intervention. Sixty two (89%) patients were able to return to their daily activities 1 week after surgery and 57 (81%) resumed military duties or joined their work place at 2 weeks. 70 (100%) patients were asymptomatic and 45 (64%) highly satisfied with their surgery at 3 months. This increased to 53 (75%) at 6 months. 48 (69%) said that they would recommend this procedure to someone else. Prolapse recurrence was observed in 1(1.42%) patient 6 months post operatively which was dealt by band ligation. GSK343 nmr All patients completed follow-up at 1, 3 and 6 months. HAL is a simple yet safe technique with few complications, acceptable patient satisfaction and early return to work.Right recurrent laryngeal nerve can take a "Non-Recurrent" course and can present as a Non Recurrent Laryngeal nerve which is a rare entity. Such anomalies can lead to difficulty in locating the laryngeal nerve during thyroid surgeries and there are higher chances of it being injured. Therefore, surgeons should be mindful of this entity. We report the case of a 53-year-old lady who underwent thyroid surgery and a right Non Recurrent Laryngeal Nerve was identified intra-operatively.We report peri- and post-operative management of haemostasis in a 11-year old girl with Glanzmann Thrombasthenia (GT) who had feminizing genitoplasty for genital ambiguity due to Congenital Adrenal Hyperplasia (CAH-21 Hydroxylase deficiency). A blend of Glanzmann Thrombasthenia (GT) and DSD 46XX due to CAH is not reported in literature. Surgery particularly genitourinary reconstruction in patients with GT is challenging due to risk of intra and post-operative bleeding. Haemostasis can successfully be achieved with platelet transfusions, antifibrinolytic (Tranexamic acid) and judicious use of recombinant factor VIIa (rFVIIa) even in a resource limited setting.Paediatric calcified tendinitis is a rare entity. Although trauma is a triggering factor, the aetiology is unknown. Conservative management is the treatment of choice with most patients experiencing symptom resolution within six weeks. We describe the case of a six-year-old male child with persistent wrist pain despite conservative treatment. Exploration revealed involvement of the extensor carpi radialis brevis, and complete recovery after surgical excision of the lesion identified on X-ray.We report a case of Eggerthella lenta bacteraemia. An elderly lady with metastasised endometrial adenocarcinoma presented with complaints of fever nausea vomiting and abdominal pain. CT scan of the abdomen showed enlarged liver with multiple metastatic lesions raising suspicion of small-bowel obstruction. Due to multiple comorbid conditions, surgery was contraindicated and she was treated empirically with meropenem and vancomycin. Blood culture received on admission grew Eggerthela lenta.The study is aimed to analyze female emergency physician domestic support, social activity, occupational satisfaction level, and subjective happiness scale results. An electronically designed questionnaire form was e-mailed to 380 female emergency physicians working in our country. Happiness level of the participants was rated using the Subjective Happiness Scale. Among 380 female emergency physicians working in Turkey, 100 completed questionnaire. We did not detect any significant differences between the happiness scale scores of the participants with respect to their age, duration of working as a physician, academic title, monthly income, institution, monthly number of night duties, and the daily number of patients visiting emergency department.Beta cell function Type-2 diabetes mellitus (T2DM) has always been considered a heterogeneous and broad-spectrum disease with many associated complications and variations. Worthwhile in this regard were the findings that different individuals with T2DM label had slightly different set of clinical features and end-organ damage. Evidence is also there that pharmacotherapy related response also varies between individuals for the same category "T2DM". This report uses the existing molecular evidence to provide a suggested sub-classification for T2DM by using newly available molecular evidences from literature. The study broadly categorizes these T2DM with patients having primarily beta cell dysfunction or insulin resistance. While common features exists between T2DM subjects like hyperglycaemia and various organ damages, still the literature search highlight the subtle difference between the aforementioned two categories. Patients with insulin resistance can be clustered into obese, lipid/liver type and lipodystrophy associated features.