RESUMO
Upper extremity arterial thrombosis is less common than that in the lower extremity. Upper extremity arterial thrombosis, when present, is more likely to occur on the ulnar side of the circulation. Severe ischemia resulting from radial artery thrombosis is rare, but iatrogenic cannulation is the most common etiology when it occurs. The risk factors underlying this dreadful presentation are numerous and still under investigation. Pregnancy and the immediate postpartum period are physiological hypercoagulable states. Here we present unusual cases of acute limb ischemia post iatrogenic cannulation in two patients within six weeks postpartum. At four weeks postpartum, a 26-year-old para-1 live-1 female presented to the emergency department with swelling in her right upper limb for four weeks and its blackish discoloration for one week. A 24-year-old primigravida female who had a termination of a blighted ovum 12 days ago presented to the emergency department with gangrenous changes in her right hand and forearm. Both patients reported recent antecubital fossa cannulation within six weeks postpartum, triggering gangrenous hand changes. Both patients had to undergo amputation of the digits and hand ultimately. Thus we postulate the need for extra care and education of healthcare workers in the cannulation of pregnant and post-pregnancy patients to prevent limb-threatening complications.
RESUMO
Aim: Digital device usage, especially during the pandemic, has catapulted into a new age problem, the computer vision syndrome. This study aimed to quantify the prevalence and determinants of digital eye strain (DES). Subject and Methods: A total of 345 university students in India were surveyed in June-July 2022, by a validated tool, the Computer Vision Syndrome Questionnaire (CVS-Q) © in this cross-sectional study. According to American Optometric Association, digital eye strain and computer vision syndrome are synonyms. Non-parametric tests of medians were used to compare the median DES scores, Chi square test to compare categorical variables, and binary logistic regression to find the determinants of DES. Results: The average age of the study participants was 21.0 ± 2.2 years, ranging between 18-26 years with 52.8% females and 47.2% males. The prevalence of DES was 45.5% (CI 95% = 40.2%-50.8%). Any existing eye disease (p-value = 0.000, OR = 0.41, 95% CI = 0.26-0.65), average daily screen time (p-value = 0.001, OR = 1.61, 95% CI = 1.22-2.13) and using gadgets in the dark (p-value = 0.000, OR = 0.37, 95% CI = 0.23-0.61) were significant determinants of the same. Conclusion: Framing guidelines limiting the hours allotted for online classes for university students are imperative, with promotion of ergonomic practices for digital device usage such as blue light filters and night mode on devices.