Browsing by Author "Dahal, Polina"
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Publication CKD or is it a Fabry Disease: a case report(Madhesh Institute of Health Sciences (MIHS), 2025) Dahal, Polina; Mishra, Surendra; Suvedi, Anil; Acharya, NikitaABSTRACT: Fabry disease is a rare X-linked lysosomal storage disorder caused by mutations in the GLA gene, leading to deficient activity of the enzyme alpha-galactosidase A. This case report presents a rare instance of Fab- ry disease in a 37-year-old female patient, highlighting the unique clinical presentation with multisystem involvement. The patient presented with a complex array of symptoms, including loss of appetite, general- ized body weakness and significant blurring of vision accompanied by a history of hypertension and chronic kidney disease (CKD). Laboratory investigations revealed deranged complete blood count, elevated renal function parameters, and significant proteinuria. Ophthalmic evaluation showed decreased visual acuity in right eye with normal visual acuity in left eye, typical whorl like deposits in both corneas, tortuous con- junctival vessels and tortuous retinal vessels in both retinas with venous beading and flame shaped hemor- rhages prominent in left eye whereas right macula had significant macular edema. On further screening on her offspring, her male child also had similar whorl like deposits in both corneas. This case is a rare and unique example of Fabry disease in a female patient, with symptoms affecting multiple organ systems, includ- ing the renal, cardiovascular system and eye. It underscores the importance of maintaining a high index of suspicion for Fabry disease, even in female patients, and the need for a comprehensive diagnostic approach to ensure timely diagnosis and appropriate management. Early recognition of this rare condition in females is crucial for the implementation of targeted therapies to prevent the progression of multi-organ damage.Publication Diabetic Retinopathy among Diabetic Patients at a Tertiary Care Hospital: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Bastola, Pradeep; Khatiwada, Saurav; Khadka, Mandira; Dahal, Polina; Bastola, SheekshaAbstract Introduction: The alarming rise in the prevalence of diabetes mellitus is a global public health and economic problem. Diabetic retinopathy is the most common ocular morbidity in the diabetic population and is the leading cause of blindness among the working-age group. This study was aimed to find out the prevalence of diabetic retinopathy in diabetic patients attending to the department of ophthalmology of a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted in the Department of Ophthalmology of a tertiary care hospital from 15th August to 30th November 2021. Ethical clearance was taken from the Institutional Review Committee (Reference number: CMC-IRC/078/079-021). Convenience sampling was done. Basic demographic data, risk factors, clinical characteristics, and prevalence of diabetic retinopathy were noted. Data entry was done using Statistical Package for the Social Sciences version 26.0. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: Among 540 participants, 146 (27.04%) (23.29-30.79 at 95% Confidence Interval) study subjects had diabetic retinopathy changes in at least one eye. Smoking in 88 (60.27%), type 2 diabetes mellitus in 139 (95.21%), hypertension in 85 (58.22%), raised glycated hemoglobin levels in 120 (82.19%) were the major factors observed in the study subjects. Conclusions: The prevalence of diabetic retinopathy was higher in our study when compared to national studies.Publication Ocular Morbidity among Patients Visiting the Department of Ophthalmology during the Coronavirus Disease 2021 Pandemic at a Tertiary Care Hospital: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Bastola, Pradeep; Dahal, PolinaAbstract: Introduction: Due to the ongoing coronavirus disease 2021 pandemic and lockdown, eye care services have been compromised globally. The magnitude of ocular diseases across all populations in Nepal are few and far between and rare during this pandemic. This study was aimed to find out the prevalence of ocular morbidity among patients visiting the department of Ophthalmology of a tertiary care hospital during the pandemic. Methods: A descriptive cross-sectional study was conducted among the patients visiting the department of Ophthalmology of a tertiary care hospital from 18 August 2021 to 30 September 2021. Ethical clearance was taken from the Institutional Review Committee (Reference: 078/079-023). Convenience sampling was done. Basic demographic data, clinical characteristics, visual status and prevalence of ocular morbidities were noted. Data entry was done using Statistical Package for the Social Sciences version 26. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: Out of 650 study subjects examined, 454 (69.8%) (66-73.0 at 95% Confidence Interval) study subjects had at least one ocular morbidity in at least one eye. Refractive error 153 (33.7%) was the commonest ocular morbidity followed by headache 52 (11.5%), dry eyes 50 (11%), non-communicable diseases related ocular morbidity 41 (9%), and age related cataract 37 (8.1%). Conclusions: The prevalence of ocular morbidity in our study was higher than findings from other similar studies done at national and international levels, though the causes of ocular morbidity was similar.