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28 May 2018
A very low-carbohydrate diet intervention appears to be beneficial to patients with type 1 diabetes mellitus, providing exceptional glycaemic control but without increasing the risk of adverse events, a study reports.

Video diversion boosts fundoscopy success rate in young children

14 Jun 2018
The screen dilemma: when babies or toddlers only eat with a screen in front of them

Playing a video as a diversion during fundoscopy appears to increase the success rate of the operation in young children, according to a recent study.

Researchers performed a prospective, multi-practitioner, multi-clinic, randomized controlled trial involving 101 young children (mean age 2.8 years) who were randomized to fundoscopy with or without video diversion assistance. Success was defined as being able to visualize the fundus within 60 seconds.

In a total of 202 fundi examined, the absolute success rate was significantly higher in operations with vs without video diversion assistance (84 percent vs 64 percent; p<0.001).

Subgroup analysis showed that such effect was driven mostly by improvements in the very young patients who did vs did not have video assistance (1–2 years; 79 percent vs 55 percent; p=0.004). No significant improvements were observed in the 3–4-year age group (92 percent vs 79 percent; p=0.104).

In terms of secondary outcomes, the mean time required to visualize the optic disc was significantly shorter in the video vs nonvideo group (14.6 vs 19.9 s; p<0.01), with the effect being more pronounced in the 1–2-year-old subgroup (21.7 vs 23.6 s; p<0.01). Improvements in time to view were not observed in the 3–4-year-old subgroup (16.7 vs 15.6 s; p=0.14).

The perceived difficulty, measured by the 10-point Likert scale, likewise significantly improved in fundoscopy performed with video assistance, as assessed by practitioners (33-percent improvement) and caregivers (42-percent improvement).

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