RESUMO
INTRODUCTION: During tetralogy of Fallot repair, leaving or even create an interatrial communication may facilitate post-operative course particularly with right ventricle restrictive physiology. The aim of our study is to assess the influence of atrial communication on post-operative course of tetralogy of Fallot repair. METHODS: Retrospectively, we studied all children who had tetralogy of Fallot repair (2003-2018). We divided them into two groups: tetralogy of Fallot repair with interatrial communication (TOFASD) group and tetralogy of Fallot repair with intact atrial septum (TOFIAS) group. We performed propensity match score for specific pre- or intra-operative variables and compared groups for post-operative outcome variables. Secondarily, we looked for right ventricle restrictive physiology incidence and influence of early repair performed before 3 months of age on post-operative course. RESULTS: One hundred and sixty children underwent tetralogy of Fallot repair including (93) cases of TOFIAS (58%) and (67) cases of TOFASD (42%). With propensity matching score, 52 patients from each group were compared. Post-operative course was indifferent in term of positive pressure ventilation time, vasoactive inotropic score, creatinine and lactic acid levels, duration and amount of chest drainage and length of intensive care unit and hospital stay. Right ventricle restrictive physiology occurred in 38% of patients with no effects on outcome. 12/104 patients (12%) with early repair needed longer pressure ventilation time (p = 0.003) and intensive care unit stay (p = 0.02). CONCLUSION: Leaving interatrial communication in tetralogy of Fallot repair did not affect post-operative course. As well, right ventricle restrictive physiology did not affect post-operative course. Infants undergoing early tetralogy of Fallot repair may require longer duration of positive pressure ventilation time and intensive care unit stay.
RESUMO
PURPOSE: We present the magnitude and determinants of refractive status of Indian school children in Riyadh, Saudi Arabia. METHODS: This cross-sectional study was conducted in 2017-18 at a preparatory and secondary Indian school in Riyadh. A "Spot Screener" was used to determine if the child passed or failed a refraction test. Data were collected on refractive status in each eye, amblyopia, and strabismus. The type of refractive error (RE) was estimated and association to the gender, age group, and higher education was analyzed. RESULTS: We examined 770 students. The prevalence of RE in Indian school children was 50.3% (95% confidence interval [CI]: 51.3; 58.3). There were 51.1% of boys and 49.3% of girls. The prevalence of RE in preparatory and secondary grade students was 47.9% and 56.8%, respectively. The proportion of myopia and hyperopia among children with RE was 48% and 5%, respectively. Family history of RE was positively associated to RE in school children (odds ratio: 1.5 [95% CI: 1.1; 2.0]). The existing refractive services provided 47.4% coverage for children with RE. The current screening initiative could identify 22 (2.9%) new cases of RE who required visual aids and 38 (4.9%) students who needed a new prescription for RE. The compliance rate for using visual aid among students with RE was 78.9%. The prevalence of amblyopia and strabismus was 1.2% and 11%, respectively. CONCLUSION: A high proportion of Indian school students in Riyadh have RE. Periodic ocular assessment and refractive services are recommended for this group of school children.