Browsing by Author "Paudyal, G"
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Publication Age-Related Macular Degeneration in Nepal(Kathmandu university, 2011) Thapa, R; Paudyal, G; Shrestha, MK; Gurung, R; Ruit, SABSTRACT Background The Age–related Macular Degeneration (AMD) is a common cause of visual impairment and blindness worldwide in elderly. Objective This study aimed to explore the demographic characteristics, pattern and risk factors for AMD at a tertiary referral eye centre in Nepal. Methods This is a hospital-based prospective study, conducted at Tilganga Institute of Ophthalmology, Nepal from September 2008 to May 2009. All the consecutive cases of AMD diagnosed at the institute were included. Results A total of 141 patients (266 eyes) with AMD recruited for the study. The mean age was 69.5 years (9.1SD) with three fifth males (58.9%). Housewives and occupations like agriculture comprised of 38.3% and 42.5% respectively. Three fourth (75.6%) of the patients were illiterate. The proportion of dry and wet AMD were found in 62.4% and 37.6% respectively. Bilateral involvement was seen in 88.7% of the subjects. Three fourth (71.4%) of the AMD eyes had presenting visual acuity less than 6/18. History of smoking was found in 69.9% of patients. Hypertension was the predominant systemic problem (45.4%) followed by diabetes mellitus (12.8%). Conclusion AMD is correlated with ageing in our study as well. Dry AMD is more in age groups 45-64 years and wet AMD at 65 years and older. Bilateral involvement with one eye dry and fellow eye wet AMD is more predominant (44%). Smoking and occupations like agriculture and housewife are significant risk factors for AMD. Likewise male sex, illiteracy and hypertension are other risk factors for AMD in hospital settings. KEYWORDS agriculture, dry macular degeneration, hypertension, illiterate, smoking, wet macular degenerationPublication Epidemiology of Critically Ill Patients in Intensive Care Units in Dhulikhel Hospital, Nepal: a retrospective observational study(Kathmandu University, 2025) Kharbuja, K; Ranjit, S; Aryal, D; Sapkota, P; Paudyal, G; Bajracharya, A; Pasachhen, S; Bhusal, SABSTRACT Background Critical care involves the management of acutely ill patients at risk of organ failure. The burden of critical illness is a major public health concerns, particularly in low and middle income countries like Nepal where access to intensive care services is limited. Objective To identify the clinical profile of patients admitted to the Level III Intensive Care Unit at Dhulikhel Hospital. Method Data over a period of six months were collected from the ICU registry. Severity and mortality risks were assessed using APACHE II and eTropics scoring systems. Clinical profiles and outcomes were analyzed using SPSS version 25. An independent samples t test was used to compare continuous variables between two independent groups. A p value < 0.05 was considered statistically significant. Result A total of 486 patients were included in the study, of whom 57% were male . The median age was 55 years (IQR: 41-69). Most patients were admitted from the emergency room (52.7%). Patients with medical conditions had a higher ICU admission compared to surgical patients. The majority of patients (63.6%) were transferred to the ward followed by discharge to home (16.2%). Non routine discharges included treatment withdrawal in 89 (18.3%) and patient leaving against medical advice 53 patients (11%). The overall mortality rate was 11.3%. Conclusion This study shows that most admissions were male, with median age of 55 years and medical cases were more prevalent than surgical cases. The observed mortality rate may underestimate mortality due to high rate of treatment withdrawal discharges. KEY WORDS Critically ill patient, Epidemiology, Intensive care unit, OutcomePublication Outcome of pneumatic retinopexy at a tertiary eye care centre in Nepal(Kathmandu University, 2008) Thapa, R; Shrestha, MK; Gurung, R; Ruit, S; Paudyal, GAbstract Background: Rhegmatogenous retinal detachment is one of the commonly encountered retinal problems where timely treatment could prevent irreversible vision loss. Pneumatic retinopexy (PR) is a simple and minimally invasive procedure for retinal reattachment. Aim: This study aimed to assess the outcome of pneumatic retinopexy in primary rhegmatogenous retinal detachment at our facility. Study design: This was a retrospective- prospective, interventional case series. Materials and methods: All subjects with rhegmatogenous retinal detachment who underwent pneumatic retinopexy at Tilganga Eye Centre of Nepal from January 2002 to June 2007 were included in this study. Results: A total of 32 cases were included in the study. The mean age of patients was 55.2 year (SD=11.0). The majority of cases (62.5%) presented within two weeks of symptoms with blurring of vision in 90% of cases. Pre-operatively, 56.3% (18) patients had a best corrected distance visual acuity of <6/60. Retinal detachment involving less than two quadrants consisted of 37.5% (12). A single retinal break was present in 78.1% (25) of cases and 87.5% (28) of the retinal breaks were located in the superotemporal quadrant. The macula was attached in 37.5% (12) of the cases. Sulfurhexa uoride and Per uoropropane were used in 68.8% (22) and 31.3% (10) respectively. The average follow up period was 1.02 years (range one month to four years). The retina was completely attached in 81.3% (26) of cases at the last follow up. The best corrected distance visual acuity of 6/18-6/60 was found in 40.6% (13) of subjects in the last follow up. There was a transient rise in intraocular pressure in 6.3% (2) of subjects after the procedure. Conclusion: The anatomical success rate following pneumatic retinopexy is quite high (81.3%) with good visual recovery and less morbidity translating to higher productivity for the patient. This procedure, being quicker than the alternatives, will also save surgeon’s time making PR a good choice for managing primary rhegmatogenous retinal detachment in countries like Nepal where resources are scarce. Key words: Rhegmatogenous retinal detachment, retinal break, pneumatic retinopexy, Nepal