Background: When hospital staff leave their positions, it may be difficult to satisfy patients' demands and maintain a good standard of care, which in turn can put more pressure on the remaining staff. The outcome may be a dramatic shift in how nurses conduct in their employment, with repercussions including decreased job satisfaction, decreased productivity, and even employee turnover. Objective: The goal of this research was to identify the causes of staff turnover in tertiary care hospitals. Methods: shaheed mohtarma benazir Bhutto institute of trauma a tertiary care hospitals in karachi,participants were included in a cross-sectional study, from 01/05/2022 to 31/10/2022. Participants had to be registered staff with at least a year of experience working in a clinical environment at either hospital. Quota sampling was used to pick staff from hospitals, stratified by shift, with signed informed permission from each participant. Information was gathered by a self-administered questionnaire with four parts (Brooks' assessment of QNWL, Anticipated Turnover Scale (ATS), free-form questions, and demographic details). Results: A total 80 participants were recruited to carry out the present study. According to the cutoff for willingness to depart as determined by the ATS (> 3.5), 61% of people are interested in finding another employment. Hospital employees were more likely to be dissatisfied with their quality of life on the job if the QNWL cutoff satisfaction level (≤4.2) was lower. There was an equal gap in discontentment between men and women on the quality of their work lives. There is a considerable increase in work dissatisfaction among participants between the ages of 31-40 (19%) (P0.000). Nonetheless, those between the ages of 41- 50 accounted for the largest percentage of respondents (21%) who were interested in leaving their current place of employment. Conclusion: Because of the implications and effects on patient care, the QNWL and nurse turnover pose serious difficulties for healthcare organizations. Keywords: staff turnover, survey-base, quality of life, Tertiary hospital

Background: Atopic dermatitis (AD) is a chronic pruritic inflammatory skin disorder of childhood with a broad spectrum of ocular manifestations, including keratoconjunctivitis, keratoconus, cataract, and rhegmatogenous retinal detachment (RRD). This study was aimed at reporting the visual outcomes in patients with bilateral cataract and RRD in the context of AD. Methods: This was a retrospective, observational case series. A thorough history, clinical features, and surgical management of seven consecutive patients who presented to the Birmingham and Midland Eye Centre with bilateral cataract and RRD secondary to severe AD were investigated. Results: Fourteen eyes of seven patients with AD were analyzed. Twelve of the 14 eyes had cataract (85.7%). Seven patients had anterior or posterior subcapsular cataract (58.3%); 13 of the 14 eyes had RRD (92.8%). Most cases were bilateral or simultaneous (85.7% and 71.4%, respectively). Eight eyes had involvement of the temporal quadrant (61.5%): three eyes had giant retinal tears (23%) and five eyes with proliferative vitreoretinopathy (38.5%). Three eyes underwent scleral buckle surgery with or without cryotherapy (21.4%), and eight eyes had PPV (57.1%) combined with other procedures. Two eyes (15.4%) had persistent RRD postoperatively. The latest recorded postoperative best-corrected distance visual acuity was 6/36 or better in 10 (71.4%) eyes. Conclusions: Temporal RRD was commonly observed in retinal detachment secondary to AD. Surgical repair was often challenging because of proliferative vitreoretinopathy and significant cataract. A further multidisciplinary study involving dermatologists would be helpful in identifying a larger high-risk population for AD and earlier detection of asymptomatic retinal tears or holes, which would allow preventive treatment and limit sight-threatening complications.