Browsing by Author "Panthee, Pradeep"
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Publication Causes and Outcome of Neurogenic Vision Loss(Nepal Health Research Council, 2024) Ghimire, Pukar; Karn, Ragesh; Gajurel, Bikram Prasad; Ojha, Rajeev; Rajbhandari, Reema; Shahi, Sumit; Panthee, Pradeep; Bhandari, Pragya; Lamichhane, JayaramBackground: Neurogenic vision loss is often a medical emergency. Early evaluation and urgent treatment of the causes is the key to better visual prognosis. Methods: This was a retrospective cross-sectional study based on hospital records of patients admitted to the Neurology department of Tribhuvan University Teaching Hospital with complain of diminution of vision from April 2023 to March 2024. The visual outcome of the patients was recorded based on telephone interviews with the patients or their family members. Results: A total of 64 patients were identified of which 62 were interviewed for visual outcome. The median age was 38 years of which 62.5% were female. Bilateral eye involvement was reported in 59.4% of the cohort and half of the patients had normal optic disc. The distribution of visual acuity at presentation was 39.1% for 6/60 or better, 9.4% for 3/60 to less than 6/60, 32.8% for 3/60 and 18.8% having no perception of light. The commonest diagnosis in decreasing order of frequency was idiopathic intracranial hypertension, neuromyelitis optica spectrum disorder, idiopathic optic neuritis and myelin oligodendrocyte glycoprotein antibody disease with the frequency being 17.2%, 15.6%, 10.9% and 9.4% respectively. Of 62 patients interviewed, 67.7% reported a complete recovery of vision, 14.5% reported a partial recovery and 17.8% reported no visual recovery. Severity of visual loss at presentation was associated with poor visual outcome (p=0.021) whereas age, gender, number of eyes affected and duration of visual symptoms had no significant relation to visual recovery. Conclusions: Idiopathic intracranial hypertension, neuromyelitis optica spectrum disorder, Idiopathic optic neuritis, myelin oligodendrocyte glycoprotein antibody disease were the commonest causes of neurogenic visual loss. The severity of visual loss at onset is a prognostic marker of the visual recovery in these patients. Keywords: Blindness; Vision Disorders; Optic Nerve Diseases; Neural Optical LesionPublication Clinical Profile and Outcome of Guillain Barré Syndrome in a TertiaryCare Hospital: A Retrospective study(Nepal APF Hospital, 2026) Lamichhane, Jayaram; Gajurel, Bikram Prasad; Karn, Ragesh; Rajbhandari, Reema; Gautam, Niraj; Ghimire, Pukar; Panthee, Pradeep; Bhandari, Pragya; Khanal, KapilAbstract: Background: Guillain-Barré syndrome (GBS) is an acute autoimmune polyradiculopathy characterized by a highly variable long-term prognosis. There isn't much data from resource limited settings like Nepal. The objective of this study was to assess the clinical characteristics and disability outcomes one year later in GBS patients at a tertiary care center. Methods: This retrospective study encompassed adult patients diagnosed with Guillain-Barré Syndrome (according to Brighton criteria) at Tribhuvan University Teaching Hospital from May 2023 to May 2024. We gathered information about the patients' clinical, electrophysiological, and treatment history. The Hughes GBS Disability Scale (GBS-DS) was employed to evaluate the severity of disability. One-year outcomes were classified as favorable (GBS-DS 0–2) or unfavorable (GBS-DS 3–6). Statistical analysis was employed to ascertain prognostic factors. Results: The study included 62 patients, with a mean age of 40.18 ± 17.52 years, of whom 74.2% were male. The most common types were typical GBS (88.7%) and acute inflammatory demyelinating polyneuropathy (AIDP, 37.5%). Almost half of the patients (49%) only got treatment for their symptoms. 31.4% got intravenous immunoglobulin (IVIG), and 19.6% got plasma exchange. A year later, 51 patients were checked on again. 92.2% of them had a good outcome, and 7.8% of them had a bad outcome. Conclusion: The majority of GBS patients exhibited significant recovery one year later. Future larger prospective studies are necessary to elucidate the prognostic factors for GBS in resource-constrained regions.