Browsing by Author "Thapa, Raba"
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Publication Assessment of Skin Carotenoids among School Children(Nepal Health Research Council, 2024) Thapa, Raba; Ruit, Sanduk; Bernstein, Paul SBackground: This study aimed to assess skin carotenoid measurement among children in the Hill region of Nepal. Methods: School children between 3 to 7 years old from six schools were enrolled in the study. Skin carotenoid levels were assessed using the Veggie Meter® (Longevity Link Corporation, Salt Lake City, Utah, USA). Detailed eye evaluations were conducted in subjects with low skin carotenoid scores (<150 Reflectance Units(RU)) and/or those with a history of night blindness. Results: A total of 324 school children were enrolled in the study with mean age of 5.12±1.33 years. The mean skin carotenoid score was 163±71 RU, ranging from 1 to 363 RU. The skin carotenoid level was <150 RU in 46.9% of children and between 150 and 200 RU in 23.5% of children. Low skin carotenoid scores (<150 RU) were found in 17% of 3 year olds, 28.3% each of 4 and 5 year olds, 20.4% of 6 year olds, and 11.2% of 7 year olds. In multivariate analysis, age was significantly associated with low skin carotenoid scores (p=0.003; OR; 2.02; 95% CI: 1.28- 3.19). Odds of having <150 RU was 2.02 times more among the children up to five years old as compared to those over five years of age. Conclusions: Nearly half of the school children had low skin carotenoid scores. Skin carotenoid score was significantly lower among the lower age group. These findings emphasize the need to enhance awareness to consume plenty of green leafy vegetables and fruits in the diet. Keywords: Children; Nepal; skin carotenoid; veggie meter; vitamin A.Publication Clinical Characteristics of Proliferative Diabetic Retinopathy and Outcome of Pars Plana Vitrectomy in Proliferative Diabetic Retinopathy(Nepal Health Research Council, 2024) Thapa, Raba; Sharma, Sanjita; Pradhan, Eli; Duwal, Sushma; Paudyal, GovindaBackground: Proliferative diabetic retinopathy is a leading cause of blindness among people with diabetes. The study aimed to assess the clinical characteristics of proliferative diabetic retinopathy and outcome of pars plana vitrectomy in Proliferative diabetic retinopathy. Methods: A prospective study was conducted from September 2019 to December 2021 among consecutive cases of proliferative diabetic retinopathy who underwent pars plana vitrectomy at a tertiary eye care center. Study was conducted after ethical approval from Institutional Review Committee. Detailed systemic and ocular history, visual acuity, ocular findings under mydriasis, surgical procedures, and outcome following pars plana vitrectomy were recorded. Cases were followed up regularly until one year after the pars plana vitrectomy. Results: Total of 83 cases (89 eyes) of proliferative diabetic retinopathy were enrolled in the study. The mean age was 53 years ±9.7 SD, ranging from 26 years to 72 years. Males comprised of 62.7% cases. Type two diabetes comprised of 94% of cases. Indications for pars plana vitrectomy were; mixed vitreous hemorrhage and tractional retinal detachment (38.2%), non-clearing vitreous hemorrhage (38.1%), and tractional retinal detachment only (24.7%). Pre-operative intra-vitreal anti-vascular endothelial growth factor was given in 78.65% eyes and pan retinal photocoagulation in 58.42% eyes. The anatomical success was achieved in 95.5% eyes, visual improvement in 68.54%, static in 14.6% and worsened in 16.86% of eyes. About 15.7% of eyes had some form of post- operative complications. Conclusions: Vitreous hemorrhage with tractional retinal detachment, persistent vitreous hemorrhage and tractional retinal detachment involving macula were the common indication of pars plana vitrectomy among cases of Proliferative diabetic retinopathy. Anatomical success and visual acuity improvement can be achieved in majority of the eyes following PPV in Proliferative diabetic retinopathy. Keywords: Anatomical outcome; pars plana vitrectomy; proliferative diabetic retinopathy; visual outcome.Publication Outcomes Of Microincision Pars Plana Vitrectomy In Rhegmatogenous Retinal Detachment(Nepal Health Research Council, 2022) Subedi, Santosh; Thapa, Raba; Pradhan, Eli; Bajiyama, Sanyam; Sharma, Sanjita; Duwal, Sushma; Poudel, Manish; Poudyal, GovindaAbstract Background: With the technological advances, microincision pars plana vitrectomy is commonly used method for primary treatment of eyes with rhegmatogenous retinal detachment. Objective of this study is to evaluate anatomical and visual outcomes of microincision pars plana vitrectomy in eyes with rhegmatogenous retinal detachment. Methods: This was a hospital based prospective observational study done in Tilganga Institute of Ophthalmology, Kathmandu, Nepal. All consecutive cases of rhegmatogenous retinal detachment who underwent primary microincision pars plana vitrectomy from October 2020 to March 2021 were included in the study. Patients were evaluated at baseline, postoperative day 1, 1 week, 6 weeks and 3 months. Outcome measures evaluated were anatomical results, visual outcomes and complications of the surgery. Results: Forty-nine eyes with rhegmatogenous retinal detachment treated with primary microincision pars plana vitrectomy with minimum follow up of at least 3 months were evaluated. Anatomical success was achieved in 91.8% of cases (45/49). Baseline mean best corrected visual acuity was logMAR 1.63±0.88 and median best corrected visual acuity was 2.00 (range 0.00 to 2.70) while at 3 months follow up mean best corrected visual acuity was logMAR 1.22±0.66 and median BCVA was 1.00 ( range 0.00 to 2.70). There was significant improvement in median BCVA ( p= 0.005). There were no cases of postoperative hypotony and endophthalmitis. Other complications were also minimal such as silicon oil in anterior chamber in 1 eye, epiretinal membrane in 3 eyes and macular hole in 2 eyes. Conclusions: Microincision pars plana vitrectomy is an effective surgical method of primary treatment for rhegmatogenous retinal detachment with good anatomical and visual outcomes with minimal complications. Keywords: PPV; RRD; visual outcome