Introduction: Sleep-disordered breathing comprises of obstructive sleep apnea, central sleep apnea, and periodic breathing. There is a link between obesity diabetes and sleep apnea with its ...association with retinopathy. Therefore this study was done to find out the association of sleep-disordered breathing in uncontrolled diabetes mellitus and association with retinopathy.Materials and Methods: This study was done from 2015 September to 2018 September in Sleep center, Nepal. Patients diagnosed with Type 2 diabetes mellitus were included. Diabetes mellitus was diagnosed as blood sugar fasting ≥ 126mg/dl, or blood sugar postprandial ≥200mg/dl and glycosylated hemoglobin above 6.5%. Obstructive sleep apnea risk was determined using the STOP-BANG questionnaire. Relationships between the risk of Obstructive sleep apnea and clinical variables along with its association with diabetic retinopathy were evaluated using bivariate analyses and covariate-adjusted logistic regression models.Results: A total of 150 diabetic patients were analyzed. Among them 30 (20.0%) patients had mild Obstructive sleep apnea, 14 (9.3%) patients had moderate Obstructive sleep apnea and 15 (10.0%) patients had severe sleep apnea. Among patients with diabetes mellitus on multivariate regression analysis Obstructive sleep apnea was associated with diabetes mellitus OR 2.05, 95% CI (1.69- 8.83) and diabetic retinopathy OR 1.20 (0.67-5.89).Conclusions: This study concludes that those individuals having diabetes may be suffering from obstructive sleep apnea and association with retinopathy these individuals can be considered for the screening of sleep-disordered breathing by polysomnography.
Introduction: High altitude has various effects on human beings. Altitude-related illnesses are a frequent cause of morbidity and occasional mortality in travelers to high altitudes throughout ...the world. Altitude has potential undesired ophthalmological effects too. Most of these problems are primarily preventable with an adequate level of information before and during travel. In this article, ophthalmological effects like altitude retinopathy and other ocular presentations of high altitude, likely to be encountered by mountaineers, are reviewed.Materials and methods: This is a hospital-based cross-sectional study from March 2016 to March 2017 done in Swacon International Hospital and Sleep Care Center, Kathmandu, Nepal. All the patients diagnosed as acute mountain sickness in the hospital during the study period were included. All the patients were evaluated by a physician and an ophthalmologist. All the findings were recorded in the proforma.Results: A total of 167 patients were admitted. Among them, 98 patients were diagnosed with acute mountain sickness; 20 patients had High altitude cerebral edema and 40 had High altitude pulmonary edema. Ocular findings, among patients who presented to our centre, were a high altitude retinopathy (28.48%) corneal abrasions (5.6%), snow blindness (8.86%), acetazolamide induced myopia (2.53%), conjunctivitis(8.22%), corneal ulcer (1.26%) and retinal detachment(0.63%).Conclusions: Mountaineers are at risk of developing high-altitude-related illnesses. Many other tissues in the eyes are also affected by high-altitude hypoxia, and effects can be observed on the conjunctiva, cornea, intraocular pressure, lens, uvea apart from the retina and the optic nerve.
Introduction: Computers and other visual display terminals are now an essential part of our daily life. In the present era, use of computer has increased many folds, and its use has been associated ...with increased health risks, especially eyes.Materials and Methods: This hospital-based prospective, observational, descriptive study. “Specific Computer Users Questionnaire’’regarding the visual symptoms was put used. Schirmer’s test –I, and Tear film break up time were evaluated in all students.Results: Among 100 medical students 74% of the medical students sampled who used to spend 2 hours or more on their digital screens on a daily basis were complaining of one or more of CVS manifestation. Eye strain, burning eyes, neck, shoulder, or back pain, dryness, irritation and redness of eyes, headaches during or after working on computer and overall body fatigue were recorded in 89%,87%,78%,77%,71%and 68% respectively. Dry eye was associated with CVS in 58 % in right eye and 55% in left eye according to-Tear film break up time measurement whereas 59 % students have dry eye in right eye and 57% students have dry eye in left eye according to Schirmer’s test – I measurement.Conclusions: Symptoms of CVS increase with increased duration of working on digital screens for 2 hours or more. The factors associated with the severity of CVS were hours of digital screens use per day and dry eye..Nepalese Medical Journal, vol.1, No. 1, 2018, Page: 29-31
Introduction: Dry eye is a disorder of the tear film which occurs due to tear deficiency or excessive tear evaporation. It causes damage to the interpalpebral ocular surface and is associated with a ...variety of symptoms reflecting ocular discomfort.Materials and Methods: This was a hospital-based retrospective descriptive study conducted to study the demography of dry eye patients and associated attributable risk factors for the disease. Every patient presenting with symptoms suggestive of dry eye was given a questionnaire, as per Salisbury Eye Evaluation Study and thorough ocular examination was done along with two tests for dry eye i.e Schirmer test I measuring less than 10mm and Tear film break up time measuring less than 10 sec. Final data analysis was done using statistical tool SPSS.Results: Demographic profile revealed a female preponderance in the patients with a ratio of 1.9:1. Amongst them, prevalence of premenopausal age was 53%. Dry eye was found to be more common in age group between 30 to 40 years (29%). The modifiable attributable risk factors were urban residence (67%), exposure to air condition and computer user (52%), indoor workers (59%), and environmental pollutants (60%).Conclusions: This study revealed the patients who presented with dry eye were mostly female of premenopausal age group, and exposed to modifiable risk factors which included residing at urban areas, indoor work, and exposure to environmental pollutants. Nepalese Medical Journal. vol.1, No. 1, 2018, page: 9-11
Background: Diabetes is one of the most common leading causes of blindness in 20–74 year old persons. Recently, problems involving the ocular surface, dry eyes in particular, have been reported in ...diabetic patients. This study was performed to assess the prevalence of dry eyes syndrome and diabetic retinopathy and its association with HbA1c in diabetic patients.Materials and Methods: All the diabetic patients referred to Eye OPD were consecutively selected during the study period of three years. All the subjects were assessed by developed questionnaire; complete eye examination and Tear Film break up time (TBUT) test and Schirmer’s test. HbA1c was performed in all patients as advised by the physician and was entered in our records.Results: Of 304 subjects, 165 patients (54.3%) suffered from dry eyes syndrome. Although dry eyes syndrome was more common in female patients, this association was not significant. Diabetic Retinopathy was found in 154 patients (50.65%). Dry eyes syndrome was more frequent in diabetic patients with diabetic retinopathy. (P = 0.02). Compared with patients without diabetic retinopathy, those with diabetic retinopathy were more likely to have higher HbA1c (p<0.001). Conclusion: Diabetic retinopathy and dry eyes appear to have a common association like ageing. Examination for dry eyes should be an integral part of the assessment of diabetic eye disease. In addition, high HbA1c level was an important factor associated with prevalence of Diabetic Retinopathy.
Refractive Errors Among Medical Students Karki, Poojyashree; Sijapati, Milesh J; Basnet, Pragya ...
Nepalese medical journal (Online),
06/2018, Volume:
1, Issue:
1
Journal Article
Peer reviewed
Open access
Introduction: Refractive errors are becoming a problem in many societies, with prevalence rates of myopia in many Asian urban countries reaching epidemic proportions. This study aims to determine the ...prevalence rates of various refractive errors among medical students of Kist Medical College Teaching Hospital, Nepal.Materials and Methods: Medical students were included in the study. Demographic data was obtained via questionnaires filled in by the students after taking informed verbal consent. Refractive error measurements were determined by dry retinoscopy and additional cycloplegic refraction as and when needed.Results: The prevalence rate of simple myopia was 64.81% and 3.7% had high myopia. Hyperopia (Hypermetropia) was present in 1.8% of the participants while overall astigmatism prevalence rate was 29.6% among medical students. Conclusion: Prevalence rates of myopia in medical students are found to be quite high.Conclusions: Prevalence rates of myopia in medical students are found to be quite high.Nepalese Medical Journal, vol.1, No. 1, 2018, page: 21-23
Introduction: Sleep-disordered breathing is one of the greatest health problems. It comprises of obstructive sleep apnea, central sleep apnea, periodic breathing, and upper airway resistance ...syndrome. There are several studies reporting association of uncontrolled blood pressurewith individuals having sleep disordered breathing. Data regarding this were sparse in developing countries. Therefore this study was performed to find out the sleep-disordered breathing among uncontrolled hypertensive patients.Materials and Methods: Study was performed from January, 2014 to January, 2017 in sleep center in Kathmandu, Nepal. Patient with uncontrolled BP were included. Uncontrolled BP was defined as blood pressure>130/80mmHg not on intensive antihypertensive regimen and resistant elevated BP was defined as blood pressure >130/80 mmHg despite intensive antihypertensive regimen. These patients were subjected for polysomnography.Results: Three hundred patients were selected out of which 250 patients with uncontrolled blood pressure were included. They were subjected for overnight polysomnography. Among them, 70patients (28%)were found to have mild obstructive sleep apnea, 20 patients had moderate obstructive sleep apnea (8%)&15 had severe obstructive sleep apnea (6%).Conclusions: This study concludes that those individuals having uncontrolled blood pressure has obstructive sleep apnea and these individuals have to undergo polysomnography.Nepalese Medical Journal, vol.1, No. 1, 2018, page: 36-38
Background: Chronic obstructive pulmonary disease is most common disease entity and third leading cause of mortality worldwide. The presence of bronchiectasis in severe chronic obstructive pulmonary ...disease patients had led to frequent exacerbation requiring hospitalizations. The purpose of this study was to identify the factors associated with bronchiectasis, using routine data collected during medical visits from patients diagnosed with chronic obstructive pulmonary disease.Materials and Methods: This is hospital based cross sectional study conducted on 120 chronic obstructive pulmonary disease patients. All patients were subjected through history, examination, pulmonary function test, sputum samples and imaging of chest.Results: Out of 120 patients among them 67 patients (55.8%) were chronic obstructive pulmonary disease without bronchiectasis while 53 patients (44.1%) had chronic obstructive pulmonary disease with bronchiectasis. Thirty patients (56.6%) having chronic obstructive pulmonary disease with bronchiectasis and 18 patient (26.8%) having chronic obstructive pulmonary disease without bronchiectasis had exacerbation in one year requiring hospitalisation. Most common organisms isolated were Pseudomonas Aeruginosa in 20 patients (55.5%), Klebsillae Pneumoniae in 6 patients (16.6%) among chronic obstructive pulmonary disease with bronchiectasis group.Conclusion: Chronic obstructive pulmonary disease patient with severe airflow limitation, with frequent exacerbation and colonisation with isolation of organisms resulting in bronchiectasis requiring frequent hospitalisation.
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