Browsing by Author "Sakya, S"
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Publication Increase use of contact lenses for optical correction(Institute of Medicine, 2006) Poudel, P; Khadka, J; Sakya, S; Shrestha, JK; Shah, DNAbstract Introduction: Contact lenses (CL) are considered as a widely accepted modality of refractive correction in the last few decades, though their history is nearly about 100 years old. Millions of people are wearing contact lenses all over the world. Every year the number of CL wearers has increased significantly. No definite statistics are available regarding the number of people wearing contact lenses in Nepal. Contact lenses are not used only for refractive correction but also for therapeutic and cosmetic use. Methods: The main purpose of the study was to find the popularity of contact lenses irrespective to other optical correction. A hospital based retrospective study was conducted evaluating the medical records of 848 CL patients attended in CL clinic at B. P. Koirala Lions Centre for Ophthalmic Studies. Results: In this study, the number of CL wearers was found to increase significantly every year. The number of contact lens wearers in the year 2002-2003 was 158 where as in the later years the number reached up to 326 and 364 respectively. Similarly, the numbers of RGP wearers and bandage CL wearers also increased significantly in comparison to previous years. Almost 90 percent wearers were using soft contact lens. It was found to be more popular among the age group of 21yrs to 30 yrs. The number of female wearers was predominant than the male wearers. The contact lens wear ocular complications were found to be very rare. Conclusion: In Nepal, contact lenses are being considered as suitable alternatives for optical correction due to better cosmesis than the conventional mode of optical correction.Publication Sepsis: a private hospital experience in Nepal(Institute of Medicine, 2006) Lakhey, S; Karki, B; Sakya, S; Pandey, SBAbstract Introduction: Sepsis, severe sepsis and septic shock are associated with high mortality. Data about patient profile and outcome of sepsis in ICU of Nepal is lacking. This study was conducted to investigate the source of infection leading to sepsis, its complications and eventual outcome. Material and Methods: It is a prospective study carried out from August 2004 to July 2005 in the ICU of B & B Hospital. The patients admitted in the ICU with the diagnosis of sepsis in accordance to the criteria laid down by American College of chest physician and Society of Critical Care Medicine were analysed and followed up. Age, sex, source of infection, duration of stay in the ICU, Co-morbidities (Mc Cabe’s score), associated severe sepsis, septic shock, acute respiratory distress syndrome (ARDS), multiple organ dysfunction syndrome (MODS), disseminated intravascular coagulation (DIC) and the eventual outcome of sepsis were taken into account. The cause of death was also studied. Infection was diagnosed on the basis of clinical, radiological and microbiological parameters. Results: Of the 28 patients included in the study, 53.6% were male and 46.4% were female, the youngest was 15 years old and the oldest was 93 years old. More than half of the patients were more than 60 years old (53.6%)the average stay in the ICU was 6 days and the main source of infection was lung/respiratory tract (57.14%). 10.7% had sepsis, 89.3% had severe sepsis, 82% had septic shock, 42.9% had MODS, 32.1% hadARDS and 7.1% had DIC. The overall mortality was 39.3%. In elderly the mortality rate was higher (46.7%). The mortality rate was highest in patients with MODS. The mortality rate of sepsis, severe sepsis and septic shock increased progressively from 0%, 39.3% and 47.8% respectively. The mortality rate in patients with ARDS was 55.6%. The most commonly failing organ was circulatory system (82.1%). The mortality was 100% in patients with 3 or more organ failure. Conclusion: Sepsis with its complications has high mortality in our hospital that is similar to the recent findings in Brazil, Norway and USA. Awareness of sepsis and its appropriate treatment as per Surviving Sepsis Campaign Guidelines has become mandatory to reduce its mortality.